Wednesday 6 November 2024

Thought Picnic: Using time to recover

 

Ringing the 'End of treatment bell' on the 9th of October 2024

To ring that bell

It is four weeks since I rang the bell signalling the end of my radiotherapy treatment for malignant prostate cancer. From the moment I saw what the bell was meant for in the waiting area of the radiotherapy department at the Christie Hospital, I had every desire to make it toll.

For the 20 weekdays that I attended sessions for treatment, I only heard the bell ring thrice, the first two times was within ten minutes of each other, and then it was almost two weeks later that I heard it again. We all applauded at the celebration the ringing meant.

Yet, the distance in time from the said treatment has not resulted in the lessening of the effects of it, I have just soldiered on with the force of will and determination when I should have taken some time off. That would happen in earnest, and I am looking forward to it.

Perspective to recovery

Thinking back to almost 15 years ago; over five months, I endured 7 gruelling sessions of chemotherapy every three weeks that I was told, I would at the minimum need 6 months to recover. There were many things to recover from, weaning myself of opioid pain killers took three months after I felt no more cancer pain.

My return to work, just six weeks after chemotherapy was too much to manage that for the rest of the year from the end of March, I had Wednesdays off. My ambulatory performance had me lagging well behind people having a leisurely walk and the recovery of my sense of taste for different flavours took just about as long too.

Strangely, the seemingly lasting effect of chemotherapy was it shortened the time in which I was allergic to pollen from about 6 months to around 2 months. If anything, recovery from treatment for cancer takes time. We sometimes find ourselves too afraid to take all the time necessary to recover.


It is well with my soul

"My Help" - Brooklyn Tabernacle Choir, with lyrics

Knowing the Lord who keeps me

As I saw in the First of January this year from the fellowship of a small church in South Manchester, there is much I could not have planned for in 2024, except for having hope and expectations.

It has been quite an eventful year, and I am reminded of where to place my focus, not in men, not on events, or the vicissitudes of life that serve to both tempt and distract. I woke up one morning some time ago (that was literally four years ago), and I had to find the verse in the Bible that said, “The Lord who keeps me, neither slumbers nor sleeps.” Ps 121:4

Blog - He shall preserve my soul, even forevermore

It was in Psalm 121 of which a rather melodious song derived from the meaningful verses gives a sense that where all seems to go awry around us, there is a place to find all you need to know that when others are losing their heads in despair, despondency, dispute, disease, defeat, death or much worse, you will neither lose your way nor sway.

Beyond the human to the spiritual

I will be the first to say when I faced the prospect of malignant prostate cancer, I did not understand what was happening to me. Sometimes, a thought raced through my mind like I was facing the looming abyss of destruction, a sudden end over which I had become a victim of circumstances beyond my control.

I entered my closet, the confines of my humble abode. I began to playback messages of hope and encouragement, of life and living, of stories and testimonies, of triumph and victory. No, I was not hopeless, the advantages of medical science notwithstanding, the battle had to be won first in between my ears before I knew I could win elsewhere.

Trust in the Lord, always

I feel the same about today for there was another expectation in the human realm that had been dashed by some of the amazing mysteries of how humanity chooses the worse over the better. It is not a new thing. Most of the Israelites of the Bible in Exodus while quite desirous of being freed from Egyptian bondage ended up perishing in the desert because they focused on worsening circumstances over extraordinarily better assurances.

You learn with time that the earth is not on a trajectory to Paradise, it is coming to an end by nature and anthropomorphic abuse, we look to something new, something different, and more exciting than the natural mind can fathom. You are left with one thing to ponder, where is your faith, your assurance, your expectation, and your hope?

In that, I have the fullest confidence that this lies way beyond the reach of the travails of humanity, I meditate in the life-giving sustenance of words inspired by God to spew forth from the lips of men, on which to meditate and find calm in the storms of life, wherefore, I can say without dissimulation, I shall not be moved.

Read, recite, meditate

Psalms 121:1-8 KJV

(1) A Song of degrees. I will lift up mine eyes unto the hills, from whence cometh my help.

(2) My help cometh from the LORD, which made heaven and earth.

(3) He will not suffer thy foot to be moved: he that keepeth thee will not slumber.

(4) Behold, he that keepeth Israel shall neither slumber nor sleep.

(5) The LORD is thy keeper: the LORD is thy shade upon thy right hand.

(6) The sun shall not smite thee by day, nor the moon by night.

(7) The LORD shall preserve thee from all evil: he shall preserve thy soul.

(8) The LORD shall preserve thy going out and thy coming in from this time forth, and even for evermore.

Bible Hub: Psalm 121 (Parallel versions)

Sunday 3 November 2024

The gents are gentle on my mind

Sometimes, you just need the help

Yesterday afternoon, I braved the idea of going out for essential shopping for the simple reason that the kind of domestic help I require is unavailable.

Thinking to 15 years ago when I had my other encounter with cancer, I had the prospect of being discharged from the hospital early, but only after they had arranged for a nurse to visit me at my apartment every day.

Until that arrangement had been secured, I was not going to be let out of the sight of the ward nurses and staff until the logistics were sorted out. It happened that my on-off partner did come to stay with me for a few months, ensuring the very basic domestic issues were taken care of apart from the fundamental ability to cook.

The difficulties with getting good help

In this new dispensation, it has been a bit different, an old flame does visit to help with things, but we can agree that it is both sporadic and unreliable. Some have suggested I get a carer to manage things, without considering that would entail a specific set of instructions and particularities that it has taken a good while to even school into those who know me.

Imagine sending a stranger to specific shops for particular things without any consideration of substitution, I know what I need. I cannot have artificial sweeteners generally as they can worsen migraines, beyond that, they will aggravate issues with my waterworks. We can get cranberry juice from any shop, but they all have artificial sweeteners except for the brand bought in the large M&S supermarkets, the smaller M&S shops stock the artificially sweetened varieties.

My kind of shopping revolves around different supermarkets for choices based on brand, variety, quality, cost, and knowing what works for me. My sojourn into the city centre yesterday which was just over two hours visiting four shops included three toilet visits.

All the gents are gentle on my mind

The first, an urgency that presented before I had reached the tram stop, some 700 metres from home. I opted for the disabled toilet in the central library because access to the public toilet in the city council annexe which was nearer had been obstructed by police activity.

In the end, I used my Radar key thrice, to gain access to the disabled toilets and for once, all the three toilets had coat hooks for my coat and hat.

What is different is I used to walk to all these places with ease but between the strength to perform and the anxiety of toilet needs, each outing requires careful and deliberate planning apart from appreciating that the reliance on others can be a bit stressful. They have their own lives that you can only rely on what they offer rather than on what you need and demand.

Making the best choice for recuperation

Back to the issue of having the support and care for domestic arrangements, I have a partner, we are in a long-distance relationship, and this presents an opportunity for them where they have heretofore felt incapacitated to help from afar.

I continually reassure him that I still have his best support in the circumstances. How better to recover and recuperate than with a loved one; paying a stranger to attend to you might work where those you would typically rely on, willingly abdicate that responsibility and generously cater for the alternative, but you are left to the mercy of the stranger’s humanity being a bonus, if available.

I guess few would never be convinced of the validity of our relationship, but that is not my problem. I understand it would take travelling almost 10,000 kilometres to be in receipt of that support and care.

I think it would be more than worthwhile for me, for him, for my recovery, and our relationship. He knows me, he knows my needs, he understands me well, and we are coming to six years together.

I am glad for the fact that there are more people who understand the intrinsic value of people, setting, and relationships for recuperation, I intend to make the best of it.

Friday 1 November 2024

Photons on the Prostate - XII

Do not defy the prostate

Just over three weeks after radiotherapy treatment, if I am not already aware of what my prostate is, where it is, and what effects noticing it can have on you, I will have been in a parallel universe, but I am here in the full knowledge of this interesting piece of anatomy the size of a walnut.

Do not be deceived, its size is hardly indicative of what it portends; it was its growth in size and volume that suggested something untoward was at play.

Evidently, malignant prostate cancer after two PSA tests, a digital rectal examination, a multiparametric MRI scan with contrast that presented a PI-RAD score of 4, needing an ultrasound guided transperineal biopsy of the prostate.

Keep an eye on your prostate health

There are a whole range of issues that could be indicative of an enlarged prostate gland, usually referred to as benign prostatic hyperplasia (BPH) that would normally be non-cancerous but it is necessary to determine that is really the case, no assumptions should be made without a medical assessment.

The male reproductive system - Macmillan Cancer Support

A good check on your prostate health can be started with using the International Prostate Symptom Score (IPSS) Calculator as the site of the prostate gland below the bladder and surrounding the urinary tract as it exits the bladder can present issues with the ease of urination, a high IPSS score should alert you to proceed for the PSA test.

Dealing with a prostate cancer diagnosis

After the biopsy, the prostate was determined to have some cancerous cells and diagnosed as Stage 2 with a Gleason Score of 3 + 4 = 7, intermediate cancer and very amenable to treatment.

The urology department then referred me to a cancer specialist hospital for active treatment of cancer. While there were options for active surveillance, a radical prostatectomy, or radical radiotherapy.

After consultations, I elected for radical radiotherapy taking 20 courses of hypofractionated radiotherapy of the prostate for a total of 60 Gy on weekdays.

The side effects, various and different for each patient are for me concentrated on the waterworks, difficulty in urinating and burning sensation with the same, while presenting with urgency and frequency along with nocturia. Also, there is the fatigue that tends to show up with my voice sounding thin and weary.

Finding time to recuperate

One area my elective radiotherapy option might differ from others is I commenced treatment without neo adjuvant therapy which is hormone therapy to reduce testosterone, I later found out that my testosterone levels were quite low, which might well have been a blessing of sorts.

I was active throughout my radiotherapy treatment including for 75% of the appointments getting myself to and from the hospital as an outpatient. There were two or so days when after radiotherapy in the morning, I had to take the rest of the day off. In the main, I tolerated the treatment well and exercising will and mind over body at certain times.

However, radiotherapy while painless exerts quite a toll on the body, it was malignant cancer, and one needs to find the time to properly rest and recover to give the body the range and scope to return to full health and vigour. Despite the advancements in the science and engineering of radiotherapy, radiotherapy will touch healthy tissue as part of treating the cancer, which needs to heal too.

The outlook is incredibly good, now, get your checks done.

Blog - Men's things - Prostate Cancer blogs

Blog - Photons on the Prostate - XI

Tuesday 29 October 2024

Thought Picnic: Back on the treadmill of worthwhile relationships

Like a work of nature

Worthwhile relationships need to be cultivated; they are the product of complex dynamics in our humanity and interactions which I have learnt through experience might be difficult to understand.

This is not a zero-sum game, such that what you put into a relationship is what you get out, the transactional kind carries lofty expectations and extraordinarily little reward along with disappointment and disillusionment.

Cultivating relationships is like farming; you prepare the ground, sow the seeds, and let nature take its course; the sunshine for warmth, the rainwater for life, as the seed germinates, sprouts, grows, and thrives.

There is a concept of time and duration to it that matures relationships. We all need a personal experience and revelation of planting seeds and watching the wonder of nature, from seedtime to harvest.

The work is a cycle

Yet, it is not just about harvesting, it is a continuous cycle of life. Like a farmer, you work the land of relationships and experience the wonder of things you could never have imagined.

Certain emotions come to the fore quite unexpectedly, in how care, concern, and consideration for another create endearingly invisible and significant bonds.

These relationships can be familial, but we are all too aware that blood does not assure the best of relationships, it might be the start of something, but it goes beyond that.

It is in how we choose our partners and friends, and what we do to maintain relationships and maintain is such an inadequate word for it because it is not perfunctory.

Knowing the work that works

Yet, in the moment of vulnerability and adversity, you begin to see the quality and value of relationships, like who is still about watching out for you when there is nothing you can do for them except respond and engage.

Among those relationships that reach deep into the soul of whatever makes us human, you might have a hand and a half to count on.

I have many friends, but I only have a few friendships that are the substance of relationships to be cherished. You cannot account for how others feel about the people you choose to form these relationships with.

It is sometimes interesting to see the perspectives of others and realise how things are different. You should, however, be discerning about cultivating your relationships based on the viewpoints of others, for what is significant and valid for them might not be relevant to you.

And what works for me

As I end this rambling piece that I am not entirely sure makes all that sense, sometimes, we never really know how truly and fondly liked and loved we are by those with whom we have cultivated relationships in the main, and then others who for all sorts of reasons and issues in life might have failed to register until the point where we are sorely missed.

Just to check if I was still with it, before publishing this piece, I did a search on my blog for ‘Cultivating relationships’ and I had written one as recently as last month and then as far back as the year, 2007.

I am onto something. Then, there may be fences to mend and others to abandon, and then certain relationships are, unfortunately, not worth it. Yes, crops do fail. Such is life.

Saturday 26 October 2024

Nature calling with impatient urgency

The thought is already daunting

Going beyond my local corner shop was a daunting prospect, the thought of getting into town without the encumbrance of Saturday traffic and the elements of Halloween clawing away at everyone’s sensibilities.

This was my first determined foray from home, besides my almost forgotten hospital visits and my Sunday church attendance. I needed to do some shopping, and I wondered if I had the wherewithal to complete that activity.

I had to plan my journey, and I was already wearied at the thought of a 25-minute walk when I happened on the idea of using the tram to take about 18 minutes either way out of that strenuous workout. That is what it has become, even without the fatigue, it was just the strength to perform that was lacking.

Just Can’t Wait

Barely had I reached the tram stop and I was looking for a public convenience, an urgent call of nature creating a burning sensation from my bladder into my urinary tract. I had to choose between the public toilets in the library or the town hall annexe. I chose the latter because I won’t need to navigate stairs and doors, it was a bit further along too.

As I reached for my Radar key to access the disabled toilets, the attendant was at the ready, and he opened the door for me. What seemed like a relief was first painful, burning, and unpleasant, accompanied by straining to the point of getting herniated, and then a weak hot stream, but not with the comfort of completely emptying my bladder. A bit of massaging of intimate parts and rocking from foot to foot, then another slightly pleasant stream, with a feeling of being almost done.

Nature is a taskmaster

I was comfortable enough to continue my journey, returning to the tram stop, I boarded the tram to the city shopping centre and did the first part of my shopping at Aldi. Nature intervened before I could get to M&S, so, I was off to the public toilets again, having to wait for a disabled toilet to be vacated and the routine replayed itself like just 30 minutes before.

To think I was that long at M&S getting a few cartons of juice, a milkshake and some ready meals, I knew I was not going to make it home before the third toilet visit in just over an hour. I found the comforting enclosure of the disabled toilet at Selfridge’s before I began my return journey on the tram.

Within ten minutes of arriving home, we had to do it all again. It seems walking stimulates the bladder, which might become a concern about having accessible toilet facilities once one leaves home. You could be easily dissuaded even if you are equipped with the toilet map, a Radar key, and a Just Can’t Wait card. There is no time for embarrassment or shame, when nature calls, you answer.

Friday 25 October 2024

Thoughts in prose

Many dreams and brighter hopes

From a distance, he’s held my hand,
I have never felt too far from land,
To know one who can understand,
Quite very much a member of my band.

Whenever I have winced in pain,
As issues leave more than a stain,
Not once did his concern wane,
Nor from care and love abstain.

We have something built on trust,
That no situation can bring to rust,
Where everything else falls to dust,
This meets every test standing robust.

I had to write beyond my back on the ropes,
Even as things only seem like he just copes,
In the journeys of hills, troughs and slopes,
We harbour many dreams and brighter hopes.