4. Cancer Has It's Own Rules

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Now I was freshly MRI'd and CT'd the next step would be to visit the cancer clinic.  Luckily this was the very next day and as I have explained before I now was required to have someone come in with me, cancer has it's own rules. Mind you if I was going to be informed that I had to get my affairs in order and don't buy anything online that might take a week or two to deliver then perhaps this was a good idea.

Helen and I were driven into town by my niece and dropped off at the Bristol Dental Hospital, yeah, weird, I know. Both you and I were expecting oncology but hey ho.

This is my actual first foray into the world of the cancer patient, let me tell you, there are bloody loads of us. The clinic was pretty much bursting at the seams with, mainly, portly men of a certain age. I fitted right in.

The aforementioned NHS efficiency was obviously taking a day off as we waited nearly an hour, which made me feel right at home, before a nurse called my name and we were summoned before the presence of a consultant who was still in short trousers and I'm fairly sure his voice hadn't broken yet.

Unlike Helen, I have been through the NHS diagnostic mill on numerous occasions, albeit for dodgy feet and ankles or exploding brain and it takes a while for them to find out exactly what is going on.  This is absolutely no reflection on their abilities or competence.  The human body is fucking complicated, even with the best of x-rays and scans it is very very difficult in most cases to determine causes of issues, well maybe not if you have an axe buried in your skull. Generally it's a case of careful elimination until you find a root cause. I was not expecting any great revelations.

And...as expected I didn't get any,  "I'm afraid the scan's are inconclusive" squeaked the teenage consultant.  Ok, ok, he was in his early thirties and quite annoyingly good looking, I'm just propping up my fragile masculinity.

"I'm afraid that this is how it nearly always goes" he said, "The good news is nothing massive showed up so we have to investigate further, I've requested a PET scan and a panendoscopy"

I nodded knowledgeablely, of course I had no fucking idea what he's talking about.  

"The PET scan involves a sugar solution and radiation and the panendoscopy is done while you are asleep".

Still no further forward but I guess we will find out, exciting isn't it?

Helen and I left the clinic pretty much as clueless as we had gone in, of course by the time we were outside waiting for the car I had come up with about a million questions that I should have asked, primary of which was which end do they stick the camera in and do they wash it between times.

Over the next few days I was bombarded with exciting texts, emails, letters and phone calls from, apparently, every single department of the NHS.

I was to attend South Bristol Community Hospital for an endoscopy, looked up 'endoscopy' and it's down the throat. Would I like sedation or the old fashioned method, quick spray of the back of the throat and down we go.  I have had approximately 50 relatives tell me about their endoscopies and the overwhelming advice is not only sedation, but ask for the good stuff. I will, don't worry. I was to attend Southmead Hospital for a PET scan, this missive came with entire library of prep that I had to read through and follow to the letter.

The day for the PET scan rolled round, the appointment wasn't until six fifteen in the evening and would apparently take several hours. I had nil by mouth for 6 hours as requested and refrained from sex and violent exercise, oh hang on, that's just my normal day to day refraining, but nil by mouth was important otherwise this wouldn't work.

We found the appropriate reception and before too long a very lovely nurse arrived to escort me away. So far I had been very lucky with my choice of cannula insertees, once I was confronted by a student who took five attempts and turned the back of my hand into a pin cushion and I promptly fainted.  This was many years ago and since then I have regular blood tests and have become a little more blase about needles, only a little mind you. 

Unfortunately,the very lovely nurse then fucked off and left me in the care of what would turn out to be, once again, the work experience nurse.  She obviously wasn't in a very good mood in the first place, I nervously explained that I had, in the past, fainted, she wasn't best pleased with this news and barked at me to "Get on the bed, that won't be happening whilst I am looking after you". 

She then proceeded to spend about half an hour looking for a vein, calling in a colleague to join the search and then sticking the fucking cannula straight into the muscle, oh no, my vision went a bit grey round the edges but I remained in the land of the living. It was moderately painful, she then had another go which was somewhat more than moderately painful, sharp scratch, my arse.  She did however find a vein, it was too late, the room started to recede and go fuzzy round the edges and she became quite upset and told me in no uncertain terms to breathe through my nose.  I can do this, to be honest, I've been doing it for years. I must have looked pretty green because she grumpily whipped out a kidney bowl and sharply told me "If you are going to be sick, do it in here"

The very lovely nurse from earlier reappeared and together they oversaw my return to full consciousness.  The radioactive isotopes in sugar were summarily sluiced into my system and I was told I had to wait on the bed for an hour, so I did. 

After this the PET scan itself was a piece of cake, albeit slightly uncomfortable as I had to keep my arms above my head and one of my shoulders is succumbing to old age and doesn't really approve of any movement above shoulder height. 20 minutes later the grumpy nurse offered me a biscuit, which I declined and we set off home. Me and Helen that is, not me and the grumpy nurse, that would have just been weird.

I've had diabetes for the last 14 years and I've learned a thing or two about sugar. Putting two and two together I have surmised how the PET scan works.  The nil by mouth is important because your body needs to be in a state where it will utilise any glucose immediately. The injection for the PET scan is a sugar solution with radioactive isotopes suspended within it.  They inject it, then wait for an hour to allow the fastest growing cells to immediately take up the sugar, cancer cells of course are very fast growing.  When you are scanned any radioactive areas will light up under the scan. The likelihood is that any cluster of cells that light up are cancerous. I've probably got this completely wrong so any of you of a medical bent feel free to tell me I'm an idiot.

It was, I can tell you, quite a long wait until the clinic the next week, but the fateful day eventually arrived and Helen and I toddled off to the Bristol Dental Hospital once more. This was an NHS on it's best form, we were whipped into the presence of the consultant in double quick time, he had a mate with him, uh oh, when they turn up mob handed you can be sure something nasty is in the wind.

"We've had the results of your PET scan and you have a tumour under the surface of your left tonsil, we are going to have to remove it"

"I should bloody well hope so" I replied with some asperity, in my head you understand. You can't go pissing off men wielding scalpels, it's never wise.

This sounded, cautiously, like good news. "I'm going to leave you with my colleague who will be doing the operation, he'll explain the next steps"

"I would like to get you in as soon as possible, would you be able to do Friday"

Urk, "Yes, of course" I stammered.

"Right OK, I need you to have a dental x-ray and see one of our dentists for a check-up"

Oh fuck, I might be slightly needle phobic but I hate dentists with an abiding passion, I can only have any dental work done under sedation and as previously averred I have the gag reflex from hell. I am, frankly, scared shitless of the dentist. I go to one who specialises in treating arrant cowards, he is a  very nice man and here I was in the fucking teaching hospital, this had all the hallmarks of something going very badly indeed.

I trudged off to meet my doom, I hate dental x-rays, the little shield always makes me gag extravagantly. Oddly, whilst I was sitting waiting to be called the woman opposite who was there with her teenage daughter asked Helen, "You're Jess's mum aren't you?" Helen cautiously agreed that she was. It turned out that this was one of Jess's mates and she had recognised Helen from her laugh no less. At this point I was called in by a rather stunningly attractive Finnish radiologist. Turns out I needn't have worried as this was a whole mouth x-ray, no little shield. It took approximately 30 seconds and I was scooted off to visit the dentist for a check-up.

Bristol Dental Hospital appears to be staffed only by the young and unfeasibly attractive, mind you that's probably because by the age of very nearly 60 my definition of attractive is much more flexible than it was when I was younger. 

I explained the dentist all about the gag reflex, yada, yada, yada...she said "Don't worry I won't be doing anything to make you gag this morning"

"That's what the last fucker said when he stuck a camera up my nose" I muttered to myself as the chair was swung into the supine position and we were off

"Upper 5, 3, 4 occlusal, missing, lower 6 missing, upper 8, lower left 9 partially erupted, missing, missing, missing, missing"

She finished her examination and said "Well the good news is that your teeth are all in good condition"

"I'm not fucking surprised, from the sound of things there isn't a single one left in my head", 

"However", oh lord I hate howevers, "Come over and have a look at this x-ray" 

I peered myopically at the x-ray, "See this tooth here, it's a partially erupted wisdom tooth, it can't come up any further because it is jammed under your jawbone, I'd like to remove this which will entail splitting the gum and shaving some bone off so that it can be pulled out. Also this wisdom tooth at the top on the other side"

I nearly fainted on the spot, then she said "We'll do this while you are under the general anaesthetic for the operation on the tumour"

Dentistry whilst completely unconscious sounds perfect so I readily agreed.  

"The reason for removing these two teeth is they are the most likely to get infected, there is nothing particularly wrong with them right now so normally we wouldn't bother, but if you have radiotherapy on your throat then that will inhibit blood flow and in turn that would mean that if these then became infected and had to be removed then they might not heal."

Jeez louise, the NHS can move quickly when they want to. I would be being operated on in three days time.