Tag: tumour

Bobs Bowel 7 – Outpatients Anaesthetics


Thursday 13th February, and another appointment. Once again, at the Queen Alexandra Hospital. I’ll soon have my own allocated parking space if my visits carry on at this rate.

This time my appointment is with an anaesthetist in the Outpatients department.

My appointment was at 10:00, and right on the button, I was whisked away for some observations. I had my blood pressure, weight, and height measured, again. I was also given an ECG.  And then it was back to the waiting room where I had time to make friends, playing peek-a-boo with a toddler.

After a short while my name was called by the anaesthetist wearing an amazing pair of electric blue shoes.

After the usual pleasantries she revealed that we had met before. Ten years ago, when I went in for the brachytherapy treatment for my prostate. She was the anaesthetist who drew the short straw for my procedure. As a patient I was not very cooperative, not on purpose. With me sat on the table in theatre she attempted to give me an epidural. Three times!! My body just refused to play ball, would not give up my spinal fluid so no further attempts were made.

Once the procedure was underway it was time for me to misbehave again. I unconciously decided to vomit. She unfortunately had to deal with that, and call in Dynarod to suck out my tubes.

I apologised to her as in my head I was to blame, having had rather a lot of cheese as my last meal the night  before the procedure. Nobody told me that they tilted you head down to insert the nuclear seeds. She showed me the copious notes taken following that little episode but she was quite magnanimous. Noting my, as yet undiagnosed, type 2 diabetes which apparently can have the effect of slowing down your stomach process, causing “pooling” which in turn can cause regurgitation.

After reminiscing about old times we got down to the business in hand. We had the inevitable chat about my health in general and specifically focussing on weight, fitness and diet.

I was given a thorough but gentle arse kicking. Likening preparing for the operation to an athlete preparing for the olympics. Apparently the procedure will last about four hours and, although I will be unconcious laid out on the table, for my body it will be akin to running against Usain Bolt. So, as she put it, I need to be in the best possible shape to deal with the procedure but also the fitter I am the faster I will recover.

Exercise and weight loss are the order of the day, supplemented by plenty of practice with my spirometer. She wants me to up my daily walking. That shouldn’t be hard since it is negligible at the moment.

We also talked about diet with regard to my diabetes which can have a negative impact on my post op recovery. And right there is where I get into trouble.

In general the medics extol the benefits of a balanced diet, with plenty of fruit, vegetables, nuts, seeds and so forth. Quite often promoted as the mediterranean diet. Below is a typical chart promoting a balance diet. All stuff that I like.

Due to the location of my tumour which is partially blocking my bowel I have been advised to stay on a low residue diet which conflicts with the idea of a balanced diet. Which in turn also conflicts with a diabetic friendly diet.

What that means is that the only food that I can eat from the green zone is carrots which have been peeled and cooked until they are soft. I can have cucumber but I have to peel it and scoop out the seeds. From the yellow zone I cannot eat any of the wholegrain items. I can have potatoes cooked without their skins and not shown I can have white bread, rice and pasta.

Hang on a bit, actually, for my diabetes I should not be eating any quantity of carbohydrates as this gets turned into sugar, bad for diabetics. So between the diabetes and my tumour everything in the yellow zone is pretty much a no-no.

Things do get a little better when we look at that strange pink zone. I can eat the tinned tuna, chicken, fish, eggs, and mince. Although my tumour says no to fish skin and bones like you might get with sardines and pilchards. Meat is fine but no gristly bits, no bacon rind etc.

And on to the blue zone where I am allowed small amounts of cheese and milk.

And so, I am resigned to eating a mainly protein diet, not quite leaping into the full carnivor diet. Supplemented by squidgy overcooked root vegetables.

As if meal preparation wasn’t already difficult enough.

Ah well, as the anaesthetist says, it is only for a few weeks.

Sad to say, I still don’t have a date for my op.

Bobs Bowel 4 – NHS Healthcare


After years of paying National Insurance there is no doubt I am getting my moneys worth from the NHS. After playing the poo sticks game I have had a Colonoscopy, CT Colonography, a session with a colo-rectal consultant and have been booked in to Surgery School.

My home phone seems like it is a hot line to the QA (Queen Alexandra Hospital).

Following the consult I received a text message informing me that a call had been booked by the Care Coordinator !!! No explanation of why. Obviously I could make a pretty goood guess. But I still had to confirm back to them that a call before midday on the 31st was acceptible. I also took the opportunity to ask what the call was about. The response was almost instantaneous. Lisa, the Care Coordinator from my GP Surgery, having seen various letters between the hospital and my GP, was making a courtesy call to see how I was doing with the ongoing investigations.

So Friday 31st arrived and it turns out that Lisa had very little information. I have since seen the letters that my GP was sent. Not very enlightening. So I brought Lisa up to speed, giving my history so far, up to and including my consult on Tuesday.

She in turn told me about the services that were available to me leading up to the surgery and what support they can provide after I return home. This includes councelling, assistance with obtaining benefits etc. After a very pleasant chat we agreed that she would call me on 28th February to see how I was going. Hopefully I will be home recuperating after the operation.

As I said my phone has been very busy. On Friday morning I missed a call from Julie, one of the colo-rectal nurses. She left a message inviting me to call her back. I returned her call and retaliated by leaving her a message in her voicemail. After one round of answer phone tennis she called me.

She asked if I had heard from the anaesthetist, which I had not. She told me that they had spotted that I was borderline anaemic and that I needed to be scheduled in for an iron infusion/transfusion!

Two weeks ago, the doctor that did my colonoscopy had told me about this. I had forgotten but I am glad that the anaesthetist is on the ball. Julie told me that I should probably expect to be contacted early next week, and that if I didn’t hear from them by Wednesday, to call her.

Later that day I received one of those neutral NHS appointment invitations. Informing me that an appointment has been made for 10:00 on Thursday 13th of February. What is this for? Is it for my iron infusion, or just a face to face with the anaesthetist? There is no information about what if anything I need to take with me. Nurse Julie told me I should arrange a lift for when I have the infusion just in case I’m not fit to drive after. There is nothing in this invite to clarify so I will have to call them on Monday.

One thing I will say for the NHS, once you are in the system they do look after you. So far, I have nothing but praise for the staff that I have been involved with. With the one exception, the CT Colonography, they have ensured that my experience thus far has been reasonably pleasant.

Bobs Bowel 3 – The Consultant & More


Tuesday 28th January, and my first meeting with the consultant. It was quite intense and a bit of a good news, bad news scenario.

First up the bad news, the results of the biopsies taken during the colonoscopy  confirm that the tumour is cancerous. I guess I was expecting that and was already resigned to the fact that surgery was required. Confirming the cancer was just detail.

On to the good news. The results of the CTC show that the cancer seems to be contained within the colon and hasn’t spread elsewhere. Apparently, there are a couple of polyps but nothing to be concerned about at this time. Some time after the surgery, I will likely have a colonoscopy, and the polyps will be dealt with then.

I was told that I should get a surgery date within the next three weeks. The surgery itself will be of the keyhole variety. The consultant ran through some of the issues / risks. Obviously, all surgery comes with risks. It is invasive, and the body wasn’t designed for easy access. In my case, proximity to the spleen was of concern.

Given that my tumour is causing a partial blockage, surgery is the only option. It is what it is.

Prior to that, it seems they have a lot of fun activities planned for me, so I will be visiting the Queen Alexandra Hospital …. a lot.

I have already been booked into surgery school.  This two hour classroom session is on Monday, 3rd January, to be held at the Oasis Centre. The purpose of the class is to prepare the patient, me, for the surgery and after. To tell about the process, the time on the high dependency ward, and preparation for going home and what to expect in the time following the procedure.

Another treat will be a session with the stoma nurse. Although it isn’t planned, the surgeons won’t know until they go in and may decide that a stoma is necessary. This may be temporary to allow my bowel to heal or, worst case scenario, permanent if they can’t repair the bowel. Apparently, all bowel surgery patients are taken through this possibility and the ramifications.

Finally, there will be a consultation with the anaesthetist. If they can glean enough information from my notes, then it should be just a telephone consult. Otherwise, a further trip to the QA will be required.

Once I have had the operation, I can expect to be in the hospital for about a week or so. Escape will be dependent on my how fast my bowel starts to function. I was told that some patients have gone home after three days, but typically, it is a five day stay.

The things I’m prepared to do to get out of cooking and housework.

And then it’s on to recovery, i.e. back to normality. Again, everyone’s different, but they were talking three to six months.

I’m coming to realise that this is a big operation. Nobody has actually vocalised this fact, but I’m picking up on the odd words that were dropped by the consultant and one of the colo-rectal nurses.

I have no idea if there will be any after treatment, i.e., chemo or radio therapy. This was not mentioned, and I forgot to ask, but perhaps that is a discussion for after the operation, when they know what they are dealing with.

In the meantime, I have been having a lot of discussions with Gerry about preparing for my time in the hospital and immediately after. These are non medical in nature.

Gerrys mobility is OK around the house, but she can’t stand for long. So preparing meals for herself could be problematic. There are a number of companies that make and deliver ready meals so we are considering getting some to put in the freezer. Gerry should be able to manage those.

Of course, after I return home, my capabilities are a bit of an unknown quantity at this time. There are likely to be restrictions on lifting and carrying. Simple things like lifting a kettle to make a cuppa may not be allowed.

I won’t be allowed to drive for a while, and although Gerry still has her licence, she hasn’t driven for a couple of years. So we are going to have to rely on family to provide taxi services for any appointments etc..

Sadly, this bloody tumour is causing a lot of disruption, impacting others’ lives too.

At the back end of February we have tickets for two concerts. The first is for Uriah Heep, a band that I started following in the 70’s. This concert is part of a 50th Anniversary and farewell tour. Missing that will be a bit of a blow.

The other concert is for Brit Floyd, a Pink Floyd tribute band. We got tickets to this show as a Christmas present for Summer,  our great-granddaughter. She is always saying how she likes Pink Floyd, so we thought a tribute band was the nearest she would get to the real thing.

We are already trying to arrange for others to take the tickets

Two further events are possibly in jeopardy.  The Goodwood Members Meeting in April, which usually entails a whole day on my feet. And then there is an Andre Rieu concert at Wembley in May. We will just have to see how my recovery goes.

That’s it for now.

Bobs Bowel 2


Previous Posts On This Subject

The NHS Poo Sticks game, Colonoscopy, and Bobs Bowel.

I have become obsessed with bowel movements, or rather the lack of them.

After my CTC I restarted taking a laxative, Molaxole, but this was proving to be non productive. As well as the laxative I have also resumed eating normal foods, not the low residue diet, which is remeniscent of baby food.

The lack of bowel movements over the last few days, and the constant feeling that I just ate a full Christmas roast is troubling. The indications are that my tumour is severely restricting the flow in my digestive system.

And that is definitely not good news.

I have been consulting Dr Google, which is not always a good thing. But, in this case the concensus seems to be that, if my tubes are truly blocked, then continuing with the laxative can be counter productive.

Regardless of biopsy results I think it is imperative that the tumour is removed and tout de suite.

As I have been typing this post, and after several fruitless trips to the bathroom, I have finally had success. The fullness that I have been feeling is easing so I think I will carry on with the laxative for the time being. Based on my recent past experience, my bowel seems slow to react. So I have taken another dose of Molaxole and will drink plenty of fluids.

Tomorrow, I will contact the Colorectal Unit for some advice but regardless, I am seeing a consultant on Tuesday with whom there will be a full and frank discussion.

So, I am off now, to make a mug of Bovril.

Stay tuned….

Bobs Bowel


A few days ago, I posted about the NHS Poo Sticks game. There then followed a visit to the hospital for a Colonoscopy which led to my cancer diagnosis.

Apparently my tumour is positioned up at the top right corner in the diagram, where the transverse colon joins the descending colon.

Of course, that is not the end of the saga. We are only just getting started.

Shortly after the colonoscopy, at the meeting with the doctor along with the bad news I was given an appointment date for a meeting with the consultant. That is scheduled for 28th January.

After being discharged I headed home to find that the hospital had already been on the phone. I returned their call and was informed that they had an appoinment for me to attend the hospital again. This time for a CT colonography (CTC). Lucky me. I was scheduled in for Tuesday 21st at 08:30.

That was the good news. The bad news was that I had to go back on the low residue diet. OK, it was only for two days this time, starting on Sunday. On the Monday before the CTC, I was to start taking a liquid laxative. Two doses, one at 08:00 and the other at 18:00. No food after that time, just clear fluids until after the CTC.

The liquid laxative, Gastrografin, also contains a dye (contrast medium) that contains iodine and it helps to clearly show the colon on the scan.

Once again my imagination ran riot but reality was a lot simpler. I was expecting to spend the day on the loo, but after a brief eruption in the morning, I suffered nothing until the following morning. Even after the second dose.

Tuesday morning arrived soon enough and I took myself of to the hospital. No sooner had I arrived in the reception area than I was called through. Given a hospital gown to change into and told to take a seat in a waiting area.

I was then called through to have a cannula fitted. This was needed for the dye that they would inject during the scan. After a brief wait I was shown into the scanner room. I have had CT scans before so my anxiety levels were really low. And so it was up onto the scanning table where the unpleasantness started.

Firstly I was asked to lay on my side with my knees up towards my chin. Once in position a tube was inserted into my back passage. This was for the gas that they were going to use to inflate my colon.

As the gas flowed, so my discomfort increased. Initially there was the sensation of my abdomen bloating. This was soon accompanied by stomach cramps which grew in intensity. I was asked to lay on my back and I was threaded through the eye of the donut.

The discomfort was increasing.

They then injected the dye and we played thread the donut again. After a couple of passes I was asked to turn on my side.

Still the discomfort was building. So much so that I was muttering to myself. Something along the lines of “enough already”, “get me off this thing”, “please make it stop”. You get the picture.

After a couple more passes through the donut they came in to put me out of my misery. The gas pipe was extracted and I was led out of the scanning room, across the corridor and shown to a toilet.

It was there that the process of decompression began. It was also there that I got changed into my street clothes. I then went and sat in a waiting area but it wasn’t long before I headed back to the decompression chamber, and then back to the waiting area.

After a short wait I was invited into a small room where my cannula was removed, and then I was discharged.

Over the last few years I have undergone numerous procedures. But this was by far the worst. I have had CT scans before but the added gas takes them to a whole new level. Definitely an experience that I am not keen to repeat.

I am not Jumping Jack Flash and it definitely was not a Gas, Gas, Gas.

Now, I am eating a relatively normal diet but to ensure that my bowel doesn’t become completely blocked I have been prescribed a different laxative, Molaxole. This I have to drink twice a day. It doesn’t taste nasty but it isn’t pleasant. I have to add some orange squash to make it more palatable.

Yuukkk!

So, now I have to wait until Tuesday and the appointment with the consultant.

I’ll be in touch…..

Conundrum


I am currently languishing in the Perth suburbs, Western Australia.

Last October, my son-in-law Steve was diagnosed with a brain tumour (glioblastoma). Very quickly, following the diagnosis, he was whisked into hospital for brain surgery. At the time we didn’t know how much after care he would need but we offered to help out and so my wife and I travelled out to Oz to provide support.

After care wasn’t the issue. Steve really recovered well after the surgery with no real pain and none of the residual weakness that would have been present following an abdominal or chest operation.

No, the follow up treatment and schedule was the real issue.

The radiotherapy was daily, Monday to Friday, for six weeks. Whilst the chemotherapy was tablet form, taken daily Monday to Sunday during the same six weeks. Following the surgery Steve was forbidden to drive for the next six to twelve months. So, to enable my daughter to carry on working, my role was to act as chauffer. Daily trips to Fiona Stanley Hospital, Perth interspersed with trips to Sir Charles Gairdner Hospital, also in Perth. As well as various trips for blood tests and scans.

As the chemo built up in his system, the expected nausea and fatigue and exhaustion also built up. Alongside all this came the loss of appetite and corruption of taste buds.

And here is the conundrum.

What do you feed someone, who has all this going on ?

Even after the initial course of chemo and radio therapies has been completed, the dietary disruption continues.

After all, it is hard enough, under normal circumstances, to cater for the normal familial likes and dislikes of

  1. a granddaughter who doesn’t eat meat that isn’t chicken or ham (unless its a burger or a rissole, then almost anything goes) and has a limited set of veggie likes (eats broccoli and cauliflower but not green beans or pumpkin). By the way she loves fish but won’t eat salmon.
  2. a wife who loves fish especially salmon, has a short list of veggies (eats cauliflower but not broccoli and no sprouts or carrots) and doesn’t eat “spicy” food or creamy food i.e. white sauces are something of a minefield. Still waiting for the clear definition of what constitutes spicy.
  3. a daughter who also doesn’t like “spicy” food, likes fish that isn’t salmon or trout. Not sure about tuna ??? Eats most veggies (definitely no sprouts) and all non chicken meats have to be cooked to near charcoal point i.e. no pink

Before the tumour and chemo, Steve used to pretty much eat everything. Now he finds the flavour of most foods to be too strong, overpowering.

So, bland is the order of the day. Steamed fish or chicken predominates. Or the same but simply pan fried or baked. No sauces and definitely no herbs or spices. Some meals comprise just two tenderloin chicken pieces, total weight around 60g, steamed and maybe accompanied by a couple of carrot batons and/or a small broccoli floret.

So, how do I feed Steve without overpowering his hypersensitive taste-buds ? How do I coax him to eat a bit more as his energy levels are already depleted due to the chemo ? The lack of food does nothing to boost those already depleted levels. How do I introduce a bit of variety to his diet ?

Although he completed the initial concurrent chemo / radio therapies, my son-in-law has now started a new regime. He takes a five day course of tablet form chemotherapy, one week in four.

So, the disruption to taste, appetite, stamina and energy levels will be continuing for the next six months at least, maybe even for twelve.

Any suggestions ?