Friday, December 12, 2008

The Upside is

That I get to go out tonight and tomorrow to two events I didn't think I'd make.

Tonight to a Led Zeppelin tribute band who are supported by another band I've seen before who are a Free and Bad Company Tribute band. It should be good and I have just noted that I can walk there in about 40 minutes so I get exercise too - well I'll need that exercise to burn off the beers at the Rugby Club where they are playing!!!!

Tomorrow I will get to go to a Lodge meeting in Gillingham. Again, I can get the train there and back and so can have a drink. last year I won a bottle of scotch in the raffle. The bottle was a one Gallon bottle and no I haven't finished it off yet...

So a bit of a bonus until I realised that we are going out on Sunday for a Christmas family meal and on Monday I have another office meal that I am going to.

I wonder why I put weight on at this time of year? Rhetorical question - sorry :-)

On being cancelled

My boss's boss said to me that it was disgusting about the Hospital cancelling. He reckoned that I would be resilient but felt most strongly for those who were older or more in need of surgery as it just added to their worries and more so given the time of year and perhaps other thoughts running through their head.

I like him a lot as he is insightful and intuitive about the needs and wants of people. I suppose being the head of a Charity you need to be seeing this as well as all the aspects of running what would be classified as an SME if it were a business. With about 40 staff we are a reasonable size.

It got me thinking this morning that my disappointment is that I wont know where I am so there is some uncertainty. Lets face it, I've been clear for some time now and a reversal would be a lower percentage option than a clear. A reversal would be devastating but controllable. This particular Cancer (the version I have) is slow growing and so a delay of perhaps a month or two is no real issue in terms of the long term outcome of my situation. Last May it could have been as the results would determine a further course of BCG treatment.

So, what about those who had tumours or other things more serious. The anxiety for them knowing that there was something growing inside them that they know to be dangerous (but may not have researched this thoroughly) can only be causing them more worry.

All of this because some Spreadsheet Manager decided to save costs and improve efficiency. In a way you wish the aforesaid Spreadsheet Manager would have been in the next bed waiting for a life saving operation and then seen what the news meant to them. The rest of us are a tick in a box for the moment but I know our Consultant will be going through the roof. I wouldn't want to argue with her - ever. She is brilliant but I wouldn't like to cross her or receive the benefit of her wit...

The cost not to operate means that in effect the Hospital will now have to pay twice for our procedures whereas if they had the beds they would have paid a one off cost. The National Health Service gives great care and whilst it occasionally screws up, you hear far more good things than bad. The trouble is and you can apply this to most large institutions is that you have managers who cannot manage and a bureauacy that would make your head spin, the litigious society (thanks US) that we now have over here and the utter nonsense that goes on under equal rights policies (the underlying stuff not the intent) plus constantly changing Government 'targets' are wreaking havoc and distracting top management downwards. If they could actually put together a vision, get everyone bought into it and execute it we would have the best health service in the world but not whilst some pencil pushing, spotty jerk with an NVQ in spreadsheet pie charting is controlling patients and health care professionals.

I think that is this morning's rant out of the way :-)

Thursday, December 11, 2008

Another Site and another view

This is an interesting site and a thing that I did know but thankfully it doesn't apply to me but, there but by the grace of God go I....

The Blog Site is here


What Urologists Faill to Tell Their Male Bladder Cancer Patients @ Yahoo! Video

Does my bum look big in this?

Theatre Gowns. Why?

Your arse ALWAYS hangs out the back of them no matter what you do. Invariably the cords to do the gown up with are broken or otherwise knotted. The cords are round the back making it impossible to do up anyway unless you do it up at the front and then try and get you arms in the holes! Those who can do them up are hideously deformed or are contortionists.

If you do manage to do them up there are always gaps where your arse hangs out.

It says all over the gown "For Hospital Use Only" For the life of me I have absolutely no idea what on this planet you could possibly do with one other than use it in Hospital, you wouldn't be seen dead in one and frankly and rightly the Style Police would arrest you and lock you away for life just for wearing one. Then there are the DVT Stockings - vitally necessary but again, no fashion statement there :-) The whole thing looks like some bizarre secret ritual and it is played out every day in Hospitals around the world. Not content with having to go through the psyching your self up for the process, the trauma of going into hospital etc, when you are there they ridicule you by making you dress up like a clown :-)

US - Canada - UK differences in TURBT / Cystoscopy

Steve sent me some details of the US and Canadian TURBT regime and I have reproduced these below. HK in Canada supplied the Canada details.

I've added Cystoscopy here as well because, in essence, that is what I have to have the biopsies taken but they use the same tool (I believe) in both because it cuts and cauterises the procedure is similar.

Here is the US:

In the US you go to the hospital as an "outpatient" and do not spend the night. After the surgery you get 1 hour of Chemo (no salt wash) and 3 hours of recovery, then you are sent home with a catheter. You take codeine (lortabs) for a couple of days, and on the morning of the third day, you remove the catheter yourself. By the fourth day you are back to mostly normal movement and should have bladder control with only minimal discomfort.

Here is the Canadian:

In Canada, you need to not eat after Midnight. Next day you need to go 3 hours before the Surgery, they put IV and Antibiotic through IV. Once the Surgery is done, 2 tubes are attached in Catheter ,one to clean your bladder with Sodium Chloride and the other to void through Catheter. Also IV is attached to. Doctor comes and checks in the morning (after 18 to 24 hours), and informs the nurse to remove IV and catheter.

Need to Void in the bottle to check how much urine comes out. Once it okay then you need to go home. If it is not enough then doctor decides either you have a Catheter go home or you stay in the Hospital. Sometimes doctor will come after couple of hours after surgery and he will give Chemo. ( doctors Decision). I hope this will help you .

Doctor will give you antibiotic once you are released from the Hospital.2 to 3 day is very painful. If you bleed a lot , need to go to Emergency that what doctor tells the patient. After 2 to 3 weeks result is given about the Tumour.

Here is the UK:

Typical no eating routine - if you go in for an afternoon operation then no food after 7:30, you can drink small quantities of water up to 11:00 and you go to the Hospital to arrive at 11:30. They take you to a pre-theatre area, get you kitted up into one of those gowns for operations, get your DVT Stockings to put on and you look a right Charlie! They do the usual tests and operations start at 2 pm. You can go any time from 2 to about 4 or 4:30.

You are wheeled to theatre - you would have signed consent forms and they go through a check list. You go to a prep room where they insert a cannula into the back of your hand and it depends whether or not you are awake or not whether they wire you up to the ECG and BP cuff etc. Sometimes it has been done before the cannula sometimes they must do it after they knock you out.

If a TURBT you wake up with a catheter inserted with a couple of large bags of washing out fluid and a bag for that to empty into. This is usually a frame based system to the side of the bed. Later you may get a leg bag to use. Often you will have a drip in the back of your hand and be on Oxygen for up to 30 minutes afterwards.

The Catheter stays in for about 36 hours. Certainly all the next day and the morning after that it is taken out before which they give you a jab of antibiotic. The nurse takes a sample from the catheter for analysis and then drains the bulb part holding the catheter in and she withdraws it - you give a few coughs to get it moving out past your prostate. The relief is short lived - see next para!

The first time you pass urine after this is perhaps the most painful thing and after that it gradually gets better. Passing blood for a short time then after two or three weeks the scabs will be ejected.

With a Cystoscopy for biopsies you go through the same routine as above except you do not have the catheter on waking and you maybe just have the drip. You need to pee in jugs to start with so they can monitor input and output (they do that in a TURBT as well). After the first pee which is every bit as painful as the first one noted above, they monitor you for a while. If they are happy you can - potentially - go home on the same day. Normally they monitor you overnight. In general terms with biopsies you don't pass much blood at all and after a few weeks the scabs come off and you pass them.

On both you wake up with a shaved leg - when I asked about that, it is where they ground the machine that cauterises the bladder as it cuts.

If you feel up to it - this short video shows the process of removing a tumour from the Bladder with the cauterising loop. Not for the feint hearted.



I'm not certain I like the idea of DIY catheter removal. I have not had any chemo with my treatments but I know they load you full of stuff at the time of the operation.

Pain relief is normally with Ibuprofen and Paracetamol tablets. They must give you something when you are under as well of course.

Generally results are 2 weeks - sometimes I have waited up to 4 weeks.

Celebrated like I was clear

One of the office parties. It was really good and I invited those who still stood to come over with me as I had negotiated time off to fulfill my commitments. I daren't even say what the bill at the wine bar came to but what a good evening. Thank goodness I woke up on the train at my home stop!!! I was well away :-)

I have agreed a short working month and to be able to review my e-mails and be in touch. Hopefully this will allow me to get all the planned stuff finished and to have a few days up in town with my work mates. If tonight is anything to go by, it should be most interesting!!!

Wednesday, December 10, 2008

Whoops

I bought some stuff for the staff from Harrods - chocolates, biscuits etc. It was because I wasn't going to be with them and a little thank you for everyone's hard work and friendship.

They arrived this morning which was a bit embarrassing - I had expected them to arrive sometime this week and as I wasn't going to be here....

It certainly was a surprise for them to see me but there you go. We are working out a plan that means I can work at home and come in on the odd day over the next two weeks or so.

I hadn't got a contingency plan for this at all! I should know better being a Project Manager for goodness sake! Mind you, life is a bit too short to plan for everything.

Tuesday, December 09, 2008

A little surprise for my work mates

I'll go in to work tomorrow which will be an interesting meeting with everyone. It is the day of the big United Grand Lodge meeting and so the place will be full of visitors. It is also the President's drinks party in the afternoon and so I may as well enjoy a drink with the staff - I wasn't going to be there of course and gave my apologies.

I will keep my ID bracelet on for a laugh. What a crazy thing, I have to now go and negotiate time off and sort out all of the things I was planning to do because I would have been sat at home at my office and spent the time doing it.

I will need to work out quite how I can fit everything in and spend the right amount of time on each. It's just one problem after another :-)

FUBB

So how come I am blogging when I am meant to be in Hospital recovering? No beds. All of us were sent home at 3 pm which was a real bummer. It has completely trashed my week and December for me. They have no idea when I will be asked to go back in, it could be anytime!!

I'm pretty upset as I wont know now for some time whether I'm clear or not, perhaps for some time to come, like January or February.

All the plans I had as well, to spend the down time doing useful stuff is now in deep trouble. I was fully expecting to spend next week doing this 75th History for my Lodge. That is obviously going to have to be reconsidered. On a better note - it does mean that going out on Saturday is going to be back on and perhaps the gig on Friday if there is a spare ticket. There are other things too, like my assignments and catching up on my Open University stuff - I can go to the tutorial on Thursday too now.

So - the Hospital is full of sick people :-) I did feel sorry for the chap opposite me who was to have his tumours cut out but he was reassured that they were low grade and he would be back very soon to have those sorted out.

After all the psyching up and worry and adrenaline expended, it was all for nothing. I walked home and had some soup and a sandwich and I am just settling back down and calming down - if I let it get to me I'd be very upset almost tearful it is just very annoying and just think of the costs of all those theatre staff and all the preparation work that was lost today. In trying to save money you can see how the NHS losses it when something like this happens.

What does Captain Jack Sparrow say at a time like this? "Oh Bugger!" :-) How very British!!

And off we go

Well not we, me. I used to have to go in accompanied but no longer. I don't mind taking myself in and I am OK as I just go into my shell and sit quietly listening to my music. Some people just chat and rattle on and I cannot stand the TV pumping out daytime TV (whoever thought up that needs shooting). So I sit just outside and am quite happy to sit on my own until I am called.

Right - must be off then, adieu.

Awake

That was a good few hours sleep, broken only by a numpty phoning me for something he already knew about!

So now showered and dressed and have an hour and a half to potter about the place and get myself ready, my bag packed, attend to last minute e-mails and then I can check batteries, run through my check list and take myself off to the Hospital.

I'm feeling calm and in control now, it is often the way. You just have to accept that this is it what it is going to be and make the best of it and whilst the worry precedes it, this time tomorrow it will all be over and in fact in less than 8 hours it will be over so it is just like a day at work - the one that seems to drag forever. Waiting at the Hospital can be a real pain as time just drags away. You are almost relieved when the blue coats come and get wheel you down to the Theatre.

So, apart from a slight stirring of my stomach (not sure that is nerves or the porridge earlier!) I'm sort of OK about it now.

That's Breakfast Sorted

That was it - a bowl of porridge and a cup of coffee - and my pills. Going back to bed to lie down for a while and let the chaos that is the morning with 2 teenagers and Mrs F all trying to get ready on time unfold outside and around me :-)

Once they are out of the way I can have the house to myself and then get ready. More later.

Things that cheer me up


There are some really funny Demotivating Posters here at Despair




Monday, December 08, 2008

Here we are again

Preparing for the morning, the early breakfast, the walk into the Hospital (I can walk there in about 20 minutes I suppose) and the other stuff. Waiting, preparing, wheeling, coming around, p*ssing razor blades :-)

I suppose I shouldn't have had a little shot of scotch with my coffee but hey, why not? It all helps to settle me down for the night. Tomorrow will be here soon enough and I'll have my music and breathing and self hypnosis to get me through the waiting.

The back of my hand is throbbing already - I wonder if they'll get the damn thing (cannula) out earlier this time? I wonder if they'll keep me in over night and at the end of the day, well, I suppose what will be will be.

It isn't any use worrying about these things but it does play on your mind. You know what is going to happen and you're back on the Roller Coaster my friend. You don't get off until they say you can. There is nothing worse than being out of control when you are a controller yourself!

Home from work early

I was sooo bored - I finished my work early on, got the check list finished and posted all my internal Christmas Cards. I decided enough was enough and the best course of action was to come home so did an hour early and I'm quite pleased I did. Had a chat and SMS message and a nice comment on previous blog entry and I'm sort of going to keep busy here so as to take my mind off tomorrow as much as I possibly can.

I think a number of people were startled that I wasn't going to come back to work before the New Year but hey, maybe if I feel good I will go back if I can face the long walks either end of the station. That really is the test of how it will be. There are some staff parties, not least of which on Wednesday which would have been great to attend but needs must and this is far more important to me than missing a party. There is another couple in a week and a half time. Maybe those ones?

We will see how I get on. It was sad to say goodbye to some of my colleagues - I don't think they knew I was going but I didn't broadcast it. Some people know. At least they'll get their cards soon and I have laid on a nice surprise from Harrods for them a little later in the week as a thank you for being great people to work with. I'd liked to have spent some time celebrating with them but again, that can wait. Who knows I might have some really good news to celebrate and wouldn't that be fun if I did. We could start 2009 off on a positive note. I really hope so.

Sunday, December 07, 2008

Dreams and schemes and things to do

I haven't mentioned the dreams for a while. They are still around and still as real as ever. It can be a bit difficult to distinguish what on earth is going on with these as they are very realistic and generally quite plausible. The bizarre thing is that I'm placed in a different setting most of the time but with people I know well.

As Tuesday approaches so I grow more anxious, I can feel it growing and it is controllable but I know I will be a bit less my normal self tomorrow. It is a dread feeling and who amongst us looks forward to actually going into Hospital? I can control much of the feelings and the fear and in many ways I can convince myself to go through with it and with the little self hypnosis stuff I have done before it will be OK. Of course there is still the nagging doubt at the back of your mind, a general anaesthetic, even if it is for a short while.
There are still things to do and I hope to have worked out how I am going to do them considering I wont be leaping about much or be driving the car for a week or a bit more. I have to complete sending out my cards and newsletters and to do a few mass e-mailings. This time of year is always so busy and I normally have a bit of time on my side but this year - it is all slipping away :-) I'm sure it will all get done somehow. If it doesn't - well tough I suppose. No one is going to die!
I'll just have to see how I feel after I come out I suppose. Oh well no use worrying too much about it for the moment, just get on and get ready I suppose. More later I'm sure...

Sword of Damocles or something else

This next stage is all a bit strange. If it is clear and you are being checked it is because unlike actually having the cancer cut out you have cured it and it has gone away. They check you with decreasing frequency as long as you are doing alright.

What it means is that this is with you all the time then. You are effectively clear and the cancer hasn't returned and the longer you are clear the less likely it is to recur. So the odds diminish but the thought of having to go through this lot again is a sobering thought.

We were out on Friday and they have, most unusually a Cigar bar - up on the roof of the restaurant, it has heaters, blankets and all sorts and I was really tempted to have a cigar but did very well I thought not to even have a puff. It is a powerful deterrent to remember that there was every possibility that smoking in the past may have contributed to my bladder cancer in the first place.

I am hoping that all is clear as it means turning over a new page, yet again, in this ongoing treatment and recovery process. Perhaps I can turn back to some long term goals and to shake off some of the baggage that goes along with it. Life has been put on to pause for 2 1/2 years so far and things really need to move along a bit. I wonder whether the worry of recurrence can be overcome. I suppose with time it can but I have a feeling that there will always be a nagging voice in the back of my head. At the moment any little ailment is cancer! That is just the way your head works.

Saturday, December 06, 2008

MP3 player locked and loaded

I've loaded up my tunes for the Hospital and they are ready to go. I put some of the original ones I had as CDs on here. By that I mean the ones I took in with me the very first time I went into Hospital.

I need to remind myself that things were a lot grimmer then than they are now and to get some balance into my way of looking at this. There are some other new ones on there too. I normally end up playing the whole lot in two sittings before and after the Op and at 1Gb of tunes - about 3 or 400 that takes some doing.

Need a laugh - this cheers me up EVERY time!

NOTE - This contains some "Adult Content" ie swearing so be warned...

Friday, December 05, 2008

Blimey

What a day - fantastic meal - toss pot of a waiter - "we are too busy to do this and so booked we can't do that". Bloody idiot - exactly who is the customer and pays your wages?

Don't start me on that. Had a great day - friend with arm break was there but nasty two place break - yuk. We had a lovely meal which could have been better had the head up arse waiter hadn't been quite so anally retentive. I almost asked him during the quiet periods ahead where he felt the custom might come from. The food was great, the company was brilliant and then I got the train which, half way home announced a body on the line which held us for a while, reversed us back up the track almost back to where we had come from and then after 30 minutes messing around to go the other way reported that said "body" had been removed and we recommenced our journey home wards. The strange thing is that the trains from this particular London terminus always seem to be filled with the loonies and left overs. Tonight was no exception. At least I got home in one piece.