Wednesday, 18 November 2009

Running Late

Yesterday I posted a lot of advice about how to relax in a stressful situation.

Today I have a series of back-to-back appointments at the hospital.

First, I’m to see Mr Hadjiminas. Since helping to move Flossie’s bed, fluid has again started to collect in my back at the site of the surgery. Next I have a massage. Oh heaven. I’ve been looking forward to that since I booked in three weeks ago. Then I have an appointment to see Dr Coulter. I’m nervous about that because I intend to ask her lots of questions about side effects of radiotherapy and Tamoxifen. My final stop is for radiotherapy.

With such a schedule, I guess it’s unrealistic to expect zero hitches. Mr H’s clinic is running late. By the time Honoria calls my name it’s already time for my massage. Nick asks the receptionist to let them know that I may be 10 minutes late.

Mr Hadjiminas is full of smiles for me and handshakes for Nick. Once the niceties are complete, I disrobe behind the screen. Mr H prods a finger into the wobbly cushion of fluid on my back. “Ouch,” I say “Hmm,” he replies, “I think we will send you down to see Dr Butler, she can get a better look at it on ultrasound.” “What, now?” I gaze helplessly from him to Honoria. “Yes, now,” replies Mr H in a firm tone. “But I’ve got a massage booked,” I wail. Honoria promises to call the therapist to see what can be done. Mr H fills out an ultrasound form. Then it’s “goodbye” and “see you next year” to Mr H. Nick and I jump aboard the lift to the basement.

As we arrive the receptionist is on the phone. I hand her the form as she replaces the receiver. “Ah, Miss Lily,” she says. “They’ve just phoned to say that you should reschedule your massage for another day.” “Oh,” I squeak. I feel as though they cancelled Christmas. I keep my chin up and try not to pout as we take a seat in the tiny waiting room. But Nick can tell. “Breathe darling,” he says, “in... two... three... four... hold... two... out... two... three... four...”

A woman sitting opposite pipes up, “Hello again. How are you?” I look at her blankly. “I sat with you the last time I was here,” she says, in an encouraging tone. “I don’t think so,” I reply, without caring how churlish that sounds. I’m not doing very well here. Nick squeezes my hand. “Anyway, how are you going?” Nick asks the woman. She looks at him blankly. “Are you well? Are you having treatment for cancer?” he persists. “Oh,” she replies, “no, it’s my husband. He’s having the Cyberknife.” “The Cyberknife?!” Nick’s eyes light up. “What is it?”

The woman launches into an enthusiastic eulogy about the miracle of Cyberknife. How it can zap tumours in hard to get places that surgery cannot reach. How her husband can get up and go straight home after the procedure. She tells us that they have travelled from Newcastle to come here and that this is one of only a few Cyberknifes in the world. It seems that this lady’s husband has been suffering from liver cancer. Following surgery the cancer returned last year and they were told that nothing could be done. They decided to do their own research and learned about this new technology. At that time the nearest Cyberknife was in Turkey. Yes, that’s right. There is also one in India and one in Malaysia. As usual, the UK follows on the heels of the developing world when it comes to cutting-edge medicine.

So, they travelled to Istanbul only to be told that the treatment could not go ahead. They were not given a reason.

Then they heard that there was a Cyberknife in London, at the Harley Street Clinic. They argued the case with their health insurance company, who agreed to pay up. That was fortunate because it seems that a course of Cyberknife treatment costs in the region of £22,000. It’s sad to say, yet predictable, that Cyberknife is not available on the NHS.

Half an hour passes by with us deep in jolly chat about fantastic linear accelerators and the sorry state of the health system. I glance at Nick. “I’m due to see Dr Coulter in five minutes.” I gasp in a tone of rising anxiety.

Nick strides out to have a word and in the next moment a nurse calls my name. I’m ushered in to see Dr Butler, the ultrasound doctor. She runs her magic seeing eye over my back and pronounces that I have fluid build-up from under my arm right down to the small of my back. “But what is it?’ I ask. “Oh it’s just kind of... juice,” she pronounces. She inserts a needle to siphon it out. Breathe... two... three... four. It’s no good. My back goes into spasm. She withdraws the needle and we start all over again. As Dr Butler begins to draw off the fluid she looks over to the nurse. “Can you get me a bigger container?” she asks. Breathe... two... three... four... “This isn’t juice,” says Dr Butler, “it’s blood. You must have haemorrhaged into your back.” Breathe... two... three... four...

Eventually I dress and rejoin Nick in the waiting room. The nurse pops her head in. “Can you wait? Dr Butler wants you to take a sample of the blood to Dr Coulter in case she wants to have it tested.” “Oh Nick, I’m so late,” I wail. “Don’t worry, I will go up and tell them.” Once I’ve got the pot of blood tucked safely in my handbag I walk up to the main reception desk on the ground floor. Nick isn’t there. “He’s gone up to the second floor waiting room,” the receptionist informs me.

I insist on wearing my new down coat from Uniqlo at all times, even though the temperature in the Harley Street Clinic is usually about the same as it is in Dubai. By the time I’ve climbed upstairs from the basement to the second floor my spindly legs are buckling beneath me. I collapse into Nick’s arms and he brings me a plastic beaker of iced water. We wait. And wait. “Oh no, now I’m going to be late for radiotherapy,” I gasp. I’ve completely given up on the breathing by now. Nick leaps to his feet and heads to the desk. “There we go,” he says, “they’ve rescheduled your radiotherapy.” How I’m going to manage to make it to all these appointments alone I have no idea. At last my name is called.

Dr Coulter is no fool. Yet she has a very caring, almost maternal side to her nature. She can tell that I’m stressed and incoherent. She talks to me in a calm, soothing tone. First, I hand her the jar of blood. “I have no idea why they’ve sent me this. Your blood is perfectly healthy,” she pronounces. Smiling, she pops it in the bin. “Yes, well,” I reply, “I’m concerned about side effects. I’ve heard that Tamoxifen can cause other cancers.” “It is true,” Dr Coulter replies, still smiling, “that Tamoxifen doubles the risk of cancer of the uterus.” My face falls. “But the risk is very small to start off with. So, the general occurrence of cancer of the uterus is about a half in a thousand. With Tamoxifen that risk becomes one in a thousand.” “I went to a talk by this woman called T.S. Wiley who wrote a book about bio-identical hormones. Have you heard of those?” I ask. “I’m afraid I haven’t,” replies Dr Coulter. “Anyway, she said she wouldn’t take Tamoxifen.” “Oh? And why not?” asks the kindly doctor. “Well, I can’t remember. At least, she didn’t really say. But she said that you should get in touch with an oncologist called Dr Julie Taguchi who wrote the book with her.” I am surprised that Dr Coulter immediately acquiesces to that suggestion. “Of course. We can email her. This has to be your decision,” she says.