The Big C


Early Days


During the summer of 2002 I didn't ride a bike very much. Even though I built a rock garden at home, I didn't do much bending and playing with my children seemed to be less rough than usual. Of course, at the time you don't notice it much and if you stop doing things that cause you pain then it seems as though nothing is wrong. Looking back this was my period of coming to terms with what might be wrong. Physically, things had changed so slowly that I wasn't sure if anything had changed. It's said that if you put a frog into boiling water it will jump right back out but that if you put the frog into cold water and slowly heat it, the frog will eventually boil alive. I decided I didn't want to stay in the water.

On a pre-Christmas visit to England I decided to pay a visit to my doctor. After a straightforward physical examination he arranged for a urology scan at the local hospital. On Wednesday November 13th 2002 I attended the scan and the nurse, although very professional, was non-committal on the findings. She rightly told me that she could only perform the scan and that she was not responsible for interpreting the result. After the scan I decided to walk through the town and down to the St George church. I sat in the grounds and called my doctor to inform him that I had been for the scan and that I would call him for the results the following week. I was taken aback when his first words were "yes, I've just been speaking to them".

I flew back the following day with instructions to visit my own doctor in Prague. Again a physical examination resulted in a scan being arranged but, it would not be for two weeks. I explained that a scan had already been done and my doctor here requested that the scan report be sent to her as it may bring forward the Czech scan. A thoughtful weekend passed and as the UK doctor was away on Monday, I had to wait until Tuesday to get the report. It was faxed to me (the doctor's receptionist had never sent an international fax before and I had to agree to pay 3 for the service) around 1pm on Tuesday 19th November 2002. Not one to understand all the medical terms etc my attention was drawn to the last line "collectively, appearances are suggesting a serious underlying pathology". I faxed this to my doctor here at 1-30pm. At 4pm I got a phone call from the doctor to inform me that I could go to Motol Hospital in Prague anytime after 6pm that day for the scan.

A worried question from my girlfriend was answered with "I'll tell you what I know when I come back". People who know me know that I won't guess at the problem and that I'll wait until I understand it before taking the next step. A simple drive to the hospital was made more complicated by a police roadblock trying to stop protestors getting to the NATO meeting in central Prague. I arrived at MOTOL at 6-30pm.


Hard Truths

What you have to understand about the main hospital is that not all doctors speak English and that those who do often have a restricted vocabulary. Another scan was done and another doctor called. As I got changed and sat at the table the younger doctor was writing something on the paper when he looked up and with priceless simplicity announced "I'm afraid it is not good news". It got worse. 36 years old and I'm being told not just that I have testicular cancer but, that it was in an advanced stage. They could operate the next day if I wanted. I drove towards home and stopped at a restaurant for a large meal of steak and chips. I'd arranged to go back to the hospital the next day for the operation which meant that I could eat nothing after midnight. Most people have asked me how I even had an appetite after receiving such news. I always reply that I was not shocked at the news, rather I was relieved that what I suspected had been confirmed and that I could move on to the next stage.

The next stage was arriving home to tell my girlfriend the news and that she would have to take me to the hospital the next day. It was an emotional evening for us and our extended family.

So the next day Wednesday 20th November I arrived back at the hospital for an 11am operation which was delayed for 14 hours. I spent the day in a 3-bed room with two other guys who were both considerably older than me. Just after 1am on November 21st I was taken down to the operating theatre and answered for the hundredth time "no, I was not allergic to anything and had not had a general anaesthetic before". As I was being prepared I desperately pointed out that it was the left one with the problem i.e. please don't take the wrong one. I woke up in semi-darkness in more pain than I had ever known. I had no idea of the time but, outside it was snowing. Breakfast is early in hospital and I was on a special diet that reduced the requirement for me to go to the toilet. A bread roll had never tasted this good and I was to drink as much tea as possible.

That day and the next two followed the same pattern of being checked by doctors, gradually eating more and reading. I had to be able to walk by the first afternoon. This was no easy task as I began to realise quite how many muscles seem to be routed via my groin. Getting out of bed was an effort and having arrived at the toilet, I found that this was not going to be the usual straightforward visit that I was used to. Imagine trying to pee with somebody pressing a red hot nail against your skin. I never took it for granted ever again. It's a relatively simple procedure and after two nights and three days I could go home.


Recovery

I didn't have too much time to read until this happened but, the books started piling up on my side of the bed. For one week I had to stay in bed as much as possible. In the second week I started taking short walks. By the end of the fourth week I was walking to the end of the street and back. I was not allowed to pick up more than a bag of sugar. It was difficult not to be able to pick up my 2 year old son. As a reasonably fit 36 year old I felt that physical recovery would be quick and mental recovery might take a while. I consoled myself that I had been lucky in that the tumor had been found in time.


No News is Good News

On December 20th 2002, four days before the Czech Christmas celebrations, we were back at the hospital for the results of the testing of the tumor that had been removed. We sat quietly in the waiting room until called. There are two types of Cancer, benign means that only that tumor exists and it cannot spread. Malignant means that the tumor is capable of spreading. As luck would have it my tumor was malignant. I was drained. This I had not been ready for. The doctor explained that it was not the most aggressive cancer but, neither was it the least aggressive. On a scale of 1 to 10, I was hovering around 6 to 7 i.e. could be better and it could be worse. Malignant Cancer.


Winter 2002

About Christmas 2002 I have few memories. We had duck for dinner. I couldn't tell you who was there, when we arrived or when we left. I knew that all the adults at the table knew what was happening but that the children did not. Apparently I withdrew completely into myself during a period of thinking that lasted about 10 days. What goes through your mind I think is different for everybody. For me it brought tears to my eyes to look at my children. The question "why me?" didn't just pop into my head, it was there long before I found out for sure. The difference is that you look at others in a different way. It changes from "why me?" to "why me and not them?". You assess your whole life. What did I do that led to this? I took care of myself, didn't drink to excess, non-smoker, ate a reasonably healthy diet and played sport. What did I do wrong? You go through the mental mangle and when you come out the other side you face the cold truth. Chance. Your life is put on hold as you go through this stage. It's a real conversation stopper when you say you have cancer.
I had an appointment for two CT scans on January 13th/14th 2003. These scans would show if the cancer existed anywhere else. You take the magic pill and drink the special water not too fast but not too slow. You go into the tunnel, breathe in, hold it, OK breathe out. You watch the magnets spinning around. Unfortunately you are not fascinated by the technology. You are struggling to stay awake and you just want to be somewhere else.


Round 2

On January 20th 2003 we went to MOTOL hospital to get these results. Again we sat in the waiting room until we were called. We sat as the doctor finished some paperwork and then, taking a folder from a stack on the side he opens it and takes out a white envelope. Time stops. Your life is in that envelope. Not being a religious person I was not one for praying but, if anybody is controlling anything that goes on in life, I hoped that luck would be on my side that day. The results were negative. No other significant problems were found but, I was still in the woods so to speak as he suggested that I undergo an Lymphograph examination. This sounded a simple procedure. In practice it was akin to torture. When I had woken up after the operation, at least I knew that the worst was behind me. The Lymphograph was real time pain, cramp, more pain and sweat. Imagine that your legs are strapped to a table and the surgeon is in front of your feet. He puts a local anaesthetic on your insteps and then makes a one inch (2.5cm) incision in both feet. Tubes are then inserted into your feet and a blue dye begins to enter you blood system. As the dye enters your blood it is excrutiatingly cold and this works it's way up your legs causing cramps as you cannot move them. There's a TV screen above you which is pretty much an x-ray screen which is showing the blood vessel system slowly appearing as the dye works it's way in. The idea seems to be that if a tumor exists, the dye will show it. When the pictures are taken and incisions sewn up, the straps are removed and although free to move, you cannot as your legs are numb. It didn't end there as back in the recovery room I was not allowed to walk as the dye could clot and cause more problems. This time I had people on either side of me with "horseshoes", the scar left by operations on the head. Oh happy life!


Morning Sickness

As a result of the Lymphograph exam, I found myself visiting a special place in the MOTOL complex. In the first week of February I arrived as an out-patient in the Onkology department for a radio therapy course. I had been offered the chance to "save" my sperm as sometimes there was a danger of sterility. As I had two children already, I declined the offer. As the CT scans were negative, I was due a low level radiotherapy course but, "something" on the Lymphograph had caused concern and a higher dose would be required for one area of my back. Two hours later and I had my two red crosses and four blue lines on my chest and stomach which were to be the lining up markers for the radiation therapy machine. I have dry lips, not life threatening I know but why do I have dry lips? It's because I am short of the vitamin B6. No great shakes you say but, when receiving radiation treatment, the more B6 you have in you, the better you can resist the sickness. After the first dose I had to take extra medication to combat my lack of B6. For the next six weeks, twice a week I underwent the same procedure. Every time I sat in that waiting room I looked at my fellow patients thinking why am I the youngest person here. Everybody is at least thirty years older than me and I wonder where they get the energy to see this through. You start feeling a bit sorry for yourself and then a small child or baby gets wheeled through for chaemotherapy treatment. The look is always the same, skin with no colour, baseball cap, powdery eyes, smiling. Sort of brings you back to reality when you see what the kids are putting up with. Still, you could do without it.


Spring and shadows

On the first day of Spring 2003, four months to the day of the operation, my radiotherapy course was finished. The doctor explained the findings were negative. So, my life resumed and my 37th birthday was spent working in Hong Kong (again, no small job as Hong Kong had been in the grip of the SARS outbreak for the previous three months). I came back for my older son's birthday in early June and I also took the opportunity to go to the hospital to give some blood for testing. As the cancer was malignant, I must have this check every six months for the rest of my life. My wife says I have more grey hairs than I used to. I'll take the grey hairs and checks every six months given the alternative.