Oscopy....shmoscopy.

Oscopy....shmoscopy..... I know an imminent medical indignity when I see one.

Just before Christmas I returned from a (very emotional) night out at the Birmingham Town Hall with some friends. We had been to a reading of  'A Christmas Carol' and were informed that Dickens himself had given the first public reading of his, now-famous, novel in the very same place more than 150 years earlier.

While at my friends' house I made a discovery when visiting 'the bathroom' - a pinkish hue to my pee - clinicians would term it haematuria.

After (only a little) procrastination this resulted in an email to my specialist nurse at the Queen Elizabeth Hospital, even though there was and has been, no recurrence. Time went by and I thought/hoped my email had disappeared into the cybervoid of the seasonal period.

Then a few days ago a letter arrived informing me that an appointment had been made for me to attend the urology clinic for an endoscopy in mid-February. Endoscopy, cystoscopy - let's be clear - this is all about pushing a lens into and up a particularly sensitive part of my anatomy. It's not that I'm against these 'invasive' procedures, it's just that I think they should be reserved for other people.

I've written to the specialist nurse making a generous offer. If she has other, more urgent, patients waiting for an appointment then I am willing to give up my place in the queue.

Well, it's worth a try.

Another letter arrived today. This was the copy of the radiologist's report from my last CT scan. As I promised to share the detail the following is a lightly-edited extract.
Previously documented lung nodules have either resolved or reduced in size: a 3mm nodule in the apical segment of the right lower lobe close to the mediastinum on the previous study is barely apparent; a nodule in the right middle lobe measuring 4mm now measures 2mm.

A nodule in the right lower lobe measures 5mm and has reduced from 8mm previously. More posteriorly in the right lower lobe the nodule has reduced from 13mm to 6mm. Other smaller nodules are no longer apparent, no new focal abnormality is seen in the lungs or mediastinum.

So, although there are one or two queries relating to a 'collection' outside the lungs and other matters, I'm sure you'll agree that this amounts to good news. It was puzzling to read in the conclusion that 'appearances are stable' when the body of the text suggests that it is so much better than that - but I guess this may fall within the range of what some have unfairly termed, my tendency to pedantry. 

Next appointment (do try to stay awake!) is with the consultant at the Royal Orthopaedic Hospital next week. Forget what I wrote earlier, the continuing discomfort is such that I'm going to ask him to insert a steel rod into the scoliotic lumbar region of my spine and attach my poor degenerating vertebrae to it.

Honey, I shrank (sic) the nodules.

We have just returned from the Queen Elizabeth Hospital and our consultation with the oncologist following the recent CT scan. The news is good. The scan gives evidence that the nodules - not sure of the precise number but about 5 or 6 - have shrunk. I have asked for a copy of the radiologist's report but it would appear that shrinkage is of the order of 30 - 60%. This puts me in the 40% bracket of those who have shrinkage, rather than the 40% who have no growth and the 20% for whom nodule growth continues.

So, I'm in the right group and will go forward to the next drug cycle that starts tomorrow. I'm pleased even though it probably will mean repeating the experience of plantar fasciitis - inflammation of the soles of the feet which makes walking (and standing) very painful after a short period. The approach however is to treat the side effect rather than reduce the dosage while there are evident clinical benefits to taking the drugs. If I can tolerate something like 6 cycles then I think they look to reduce the dosage.

The treatment for plantar fasciitis includes the use of Udderlysmooth - a cream developed for the inflamed udders and teats of dairy herds. Apparently, one of the constituents is urea - though I'm not sure who or what animal makes that particular contribution. I've just ordered some so I'll let you know as and when it is revealed.

If my mood is less than euphoric it is partly because the 'good news' was delivered in a 'tone' that was flat and inconsistent with the content, partly because of apprehension about the drug side effects but mostly because the consultant revisited the bald, stark and scary statistics about my condition.

For some reason he thought that we were a partnership that had opted not-to-know about the prognoses. When we assured him that this was not the case he furnished us with some dispiriting 'median survival periods' for those on Sunitinib.

But hey, I'm not the median man! I'm the guy with shrunken nodules and that's something joyous I could never have predicted saying, just one short year ago!!

I'm back - again.

It has been a long time I know - but I'm back and I'll try to explain..........


A part of the explanation has to do with the events of mid-December. I wrote a blog about it at the time entitled, 'Dark days, 'crab years.'' and posted it shortly thereafter. I decided to take it down a day or so later having reconsidered the  appropriateness of some of the material. I am re-posting a part of it (see below) and you may well be able to imagine something of that which I have excised.


Some of you will know that the 'crab years' began for us not with the diagnosis of my condition last May, but nearly five years earlier when Diana was told that she had breast cancer. So, a few days ago, after her 'final' follow-up mammogram of the week before, she attended her 'signing-off' consultation at the Women's Hospital. Every check-up since her mastectomy has resulted in an 'all clear'; this one did not. She was told that the mammogram had revealed a possible DCSI ( Ductal Carcinoma In Situ). This means she may have a cancerous condition which might also require a lumpectomy with radiotherapy follow-up. So there will be another biopsy and given previous experience, the prospect of further treatment.

There are times when I, when we, ask, 'Why us?' Everyone in our or a similar position must ask the same question. There are science-based answers concerning factors with which particular cancers are linked. An obvious one is smoking and lung cancer but the linkage is much less clear with other conditions. Anyway, I'm not sure that the 'science answer' is what I and perhaps others, are ultimately seeking. The question is more of a desperate, confused and uncomprehending plea for someone to make sense out of the chaos. Even a consultant surgeon can't offer the answer to that. In the absence of a belief in God we must find our own sense - though I know that we are not alone in this.

A part of the answer has sometimes been 'Why not us?' We are no more 'special' or 'insulated' from personal crisis than anyone else. Another part has to do with the learning that comes from confronting circumstances such as these, that there is something precious in discovering the uncertainty, the fragility, the transient nature of being alive.

I try to keep such thoughts in mind.


The date for the follow-up consultation after the biopsies (not biopsy, as it transpired) was the 28th December. This meant that we had to contain our anxiety through a good portion of the seasonal events. It helped of course that we had grandchildren-sized distractions but Diana had, nether the less, plenty of time to prepare herself for the worst. 


We went to the Women's Hospital together and sat in the very same places, in the same room that we had sat in five years earlier when the consultant had begun with the words, 'Unfortunately, it's not good news...........'. I lost the rest of what he had to say in a miasma of slow-motion shock and confusion. This time, as before, another consultant came straight to the point. I can't recall the words, I was too busy preparing myself for listening, for the portentous moment. Through the fog, I became aware of the smile in Diana's words and the delight in the squeeze she was transmitting through her hand to my hand. She was clear. The biopsies revealed nothing more than 'normal calcification' occurring in a proportion of women over the age of 50.


Most of you know all this by now - but not all. It was a great end to a difficult year.


A day later we were back at the QEH for my end-of-3rd-cycle CT scan. This was the scan that should tell the oncologist what impact the 'chemo-type' drugs have been having. The final few days of the 3rd drug cycle had been difficult because of the onset of 'sore feet syndrome'. This had made walking, for anything but a short distance, too painful. 


The results of the scan are due in a couple of days. I'm hoping for good news and know that a lot of people are with me - including, I'm sure, the un-named person, who called me on the phone the other day to enquire after my health.


"Rod," he said. "How are you?"
"I'm ok," I replied before adding, "but I have been better."
"Look," he advised "you've got to stay positive. Things could be worse...."
"I'm sure you're right.'
"Of course things could be worse - look, for a start - it could have been me!"


That triggered the best, full-throated laugh that I have enjoyed for a very long time! You would have to know the person.......