My great climacteric

Tomorrow, 22nd May 2013,is a significant day for me; it is the occasion on which I enter my great climacteric. A climacteric is defined as 'a period in which some great change is due to take place in the constitution', though whether this be for good or ill is unclear. These periods are said to occur when we reach an age that is a multiple of seven and an odd number; 7x1, 7x3, 7x5, 7x7, 7x9 and some say, in these days of longevity, 7x11 and 7x13. The great climacteric however, is 7x9 = 63

I'm not sure how many further 'great changes' my body can take.

Mid-May also marks the second anniversary of my cancer diagnosis. I was told by the surgeon that the mean survival time for those in my position, with renal cell carcinoma that has metastasised to the lungs, was just in excess of two years.

Now, were I to conform to the mean - that would result in a significant change in my constitution.

However, I do know that the medics and the NHS haven't yet, given up on me.

The MRI scan and the cystoscopy (11/5/2013) have come - but not exactly, gone. The MRI turned out to be a doddle. Concerned as I was by the prospect of being 'entombed' in the tunnel, I took what precautions I could. I discovered that there are two scanners in the QEH Imaging department and one is more spacious than the other. I opted for the former and then requested backup sedation from my G.P. After a telephone consultation in which I asked for advice on the maximum, sub-lethal dosage, she prescribed diazepam. I duly took my tablet at the recommended time and - experienced no change.

For extra insurance, I opted to take my sister into the scanner room. She was to be directed to stand at the head of the scanner and repeatedly assure me of the proximity of my head to life-sustaining, open space.

Ok, so I took some trouble over this.................... but when I was admitted to the scanner room, my concerns evaporated. This bright, spherical , techno-miracle was so different to the elongated toilet roll of earlier experience. It still made a racket when in operation but at least I was unable to hear most of it - I fell asleep.

Now, I await the results as to the origins of my acute back pain. Though fine today, having just returned from a walk through a seasonal, shallow blue ocean in Austey woods near Wootton Wawen with Mary, Pete and Keith, I have been immobilised and bed-ridden on other days.

I see the physiotherapist on Friday and the oncologist, Thursday week. I'm hoping that between them and the radiologist's report, they can come up with a narrative to account for what exactly is going on with my spine - and better still, some advice on how to improve it.

As for the cystoscopy, the 'preamble' went well but the insertion of the 'box brownie' scope came to an abrupt halt when the doctors advised me that they could not continue. I had just settled back, both hands behind my head, in order to watch all the action on the overhead monitor, when they quickly decided they would have to terminate the procedure.


Apparently, I have a stricture, a narrowing, of the urethra and this would mean arranging a further appointment and another procedure. My urethra would be dilated in order to progress and examine the bladder. This will be carried out under general anaesthetic.

To be honest, I wasn't too upset to be told I was coming back for a G.A. (as we say in the business) - but you had probably already guessed as much. Please, don't be misled, I'm actually pretty tough. I once had a rose thorn removed from my finger without any pain relief, save that from my mother 'kissing it better'.

This was quickly ruled out as an option by the medical team last week.

Green and pleasant land, dark satanic mills

Where to start?

To answer my own question, perhaps with 'the now'.

I am sitting at my desk, early on a bright, but chilly, Saturday morning. I am worried. Within a couple of minutes of emerging, larva-like, from my bed, I could feel the return of acute pain deep in my left buttock at the base of my spine. It had started again yesterday, just before my re-referral appointment to the QEH physiotherapy department was due.

I won't bore you with the details but this pain first occurred after a lengthy workout on an upright bike at Moseley School's Health and Fitness Centre. For a while, until the paracetamol kicked in, the pain was excruciating and I could only move if bent double with my head down to the floor. I was relieved when after a few days on painkillers, I was able to walk as before; not exactly a model of agility and grace but no worse than I had been for what feels like half-a-lifetime ago, when all this began.

The physio was good. He explained that this new, acute pain was probably different to the chronic, neurological pain in my back and leg. The new pain he said was the result of trauma  (exercise) and was probably referred to the base of the spine from higher up in the lumbar region. All will hopefully become clearer after I have another full spinal MRI, scheduled for a few days hence.

After previous, claustrophobic, experiences, I am not looking forward to that. It has been ordered by the oncologist after hearing about the acute episode; I think he wants to check for further spinal metastases. For good measure, at the same consultation he ordered another cystoscopy.

'It was only a light pink', I whined after hearing his response to my telling him of a few occasions of blood in my urine (aka haematuria - it sounds more principled in the Graeco-Latin). 'It doesn't matter to him', I mused uncharitably. 'He just clicks a button'.

'And it only happened twice!'

'Three times', Diana added, treacherously.

So, I emerged with a double whammy - and now, this damn acute pain has returned to add another woe....

Enough. Time to change the record/cd/iPod playlist................

I was right about Geoff's funeral (21/4/13). It was emotional and it was special - attended by a sea of mourners. We said 'goodbye' at the crematorium and celebrated  his life at an amazing wake in the church hall on Billesley Lane. It was the kind of event with much music, food and drink, that Geoff would have organised - which, in a way, he had.

It has taken, it is taking, a long time to process the events and emotions of that day. Even now, I can feel my mood changing as I type - so I'm not sure that I can write about some of the darker 'stuff' that hung over me like a dense cloud last weekend. We were on Tees-side, a trip planned well before Geoff's death. It is an area of which I had no knowledge beyond the descriptions of an emigre, now honorary Brummie, Neil. He recommended RSPB Saltholme in the Tees estuary and a visit to the famous transporter bridge as well as hinting at other more pre-industrial delights.

We booked two nights in the Premier Inn on the Tees barrage and promised ourselves further nights at more picturesque accommodation as we wended our way home through North Yorkshire.

In one of Saltholme's bird hides, a knowledgeable and friendly RSPB volunteer explained that the original inter-tidal, estuarine, mudflats originally covered more than 14 square miles - but that was in pre-industrial times. Following extensive land reclamation, this very special habitat was now reduced to a few hundred acres.

Saltholme's scrapes and pools are not tidal but combined they elbow their way into a space between the industrial skyline of Middlesborough and the truly impressive chemical works to the south of Hartlepool. The backdrop for the many visitors to the reserve is a filigree pattern of poles, pylons and tall sky-piercing chimneys linked by horizontal pipes; the superstructure of the chemical works. It may sound strange, sacrilegious - even pretentious - but the vista brought to mind the ornate decoration of high-Gothic, rood screens in a mediaeval cathedral.

After the avian delights of Saltholme we moved a short distance up the road to the gleaming, muddy delights of Seal Sands and the Tees National Nature Reserve, remnants of that vast inter-tidal zone mentioned above. Thence to Hartlepool's historic highlights before the frustrating search for something to eat.

Meanwhile a dam of emotion threatened to burst at the most inappropriate moment; at breakfast the following day. I wanted to explain to Diana that I felt myself to be a fraud. There and then, I had to put the stopper back in the bottle; this was neither the time nor the place. Back in the hotel bedroom, I uncorked. Someone had recently said that I was 'inspirational' and others too, reading this blog, have used similar words. They - you - do not know the truth. I am at times a complete mess, hiding behind this jaunty veneer of amusing anecdotes. There is nothing admirable about my fears now made more real by Geoff's death.

But despite Diana's ministrations, I cannot escape the paradox - even this blogged confession has elements of the artful..................

We abandoned the ideas about North Yorkshire and drove home via Redcar, o'erlooked by the Tata steelworks, the Victorian resort of Saltburn and the beautiful Cleveland hills.