Prompt as you like, less than a week after seeing the Oncologist, I had a call from the hospital inviting me to an appointment at the Gastroenterology Department for the beginning of July. I predict that this will be yet another opportunity for my dignity to go wandering off out of the window. The Oncologist had used the word “suppositories” at one point. Bye-bye dignity, do come back and visit sometime soon.
It came to pass that on the very evening following the Oncology consultation, Cathy and I were loading up the caravan for a well-earned holiday in Scotland. Due to my minor incontinence issue, she had persuaded me to slip a panty liner twixt my bottom and my undies. The undies in question were boxers, and the trousers covering them were long shorts – just below the knee-length.
So there we were lifting and placing, grunting and groaning, and working up a warm-weather smidgeon of sweat. After a while I looked down at the ground by the caravan door and saw what looked like a panty liner by the step. I asked Cathy if she’d dropped one from all of the stuff we were loading in, and she in turn asked if it was maybe mine?
A quick grope around the nether regions established that it was, indeed, the one she had persuaded me to slip into my pants. That worked well then. Thank goodness we were at the caravan storage, and no-one was around to see it. Imagine if I had wandered into a shop, or worse – a football match – and it had dropped out? I fully understand her concerns, and why it might be a good idea to contain any seepage that way, but it seems we need to work on this a little before we venture into public.
It has to be said though, that the use of sanitary products has led to me changing my plea in regard to passing blood. Yes, there is a redness showing up now that I hadn’t been aware of before. I guess after all that the radiotherapy has caused damage to my bowel. Hopefully if the gastroenterologist is going to examine me to find the wound, it won’t be far from my prostate, and so the examination shouldn’t be any more intrusive than the examination I had for the cancer biopsy.
So to the first of July, and my Gastroenterology appointment. Being a Monday, and being acutely aware of the indignity I would endure in the afternoon, I did wonder how the doctors and nurses in the Gastroenterology department felt when they woke up on Monday mornings, with the prospect of another week of looking up people’s backsides in store for them. There are more attractive thoughts to wake up to.
They were surprisingly prompt, and a cheery young-ish doctor welcomed me to the consulting room. He had a “consultant” lanyard for his ID badge, just like my oncologist. But he shattered my illusions by telling me that all the doctors with a specialism get them, and my oncologist is not a “Miss”, but is in fact a “Doctor”.
He asked about my current anal situation. So I told him. Bits of blood were to be seen in the pads that I was now wearing. It was thin traces of blood, everything was thinned by the sweats I was regularly enduring (I keep telling myself that every sweat is a fraction off the PSA: believe in it, appreciate it). I also told him I was struggling to “close” my anus properly, as I thought my piles were playing me up. He said that there are three bands of muscle in the lower bowel, and he would check them out when he looked at it in a moment. It may be that if the muscles had been weakened he would refer me for physiotherapy. Apparently there are specialist physiotherapists whose expertise lies with the bowel. It never ceases to amaze me that there is such a range of jobs available in the medical profession.
He showed me into the endoscopy room, where two highly practiced and efficient nurses prepared the bed and the endoscope for me. Shorts (it was a warm day) and pants below the knees, lie down on your left side, you will feel a certain amount of discomfort. Reassuringly, they told me that in the USA they warm up the lubricating gel, but here it was soothingly cool on application. The endoscope is a tube that has a camera on the end of a sturdily flexible cable slipped through it. The camera was specially designed so that the blazing sunshine it encountered as it approached my arse didn’t inhibit the picture quality.
There was some discomfort, but actually it wasn’t as bad as I had prepared myself for.
The bleeding haemorrhoids I’ve been aware of lately aren’t haemorrhoids. It is a viral wart. The reason I can’t close my anus completely is that the viral wart is in the way. Further up, and there are a few miniscule polyps, but nothing that can’t wait for some other distant year; there are also piles, but they are tiny, and not an issue. Around the irradiated area there is some very slight damage, but not enough to be causing me the problem I’m experiencing, and certainly not needing any treatment. So far so good.
But back to the viral wart. It may be benign, or it may not. Afterwards, in the comfort of the consulting room, he showed me the photo of it, and to be completely honest to me it looked like my epiglottis when I check for a sore throat. It was impossible for me to get a sense of scale on the picture, but what I couldn’t see was any sign of an anus, so I guess it was quite big. Going back to the various body scans I had had, he said that they wouldn’t have necessarily picked up anything cancerous in that area of my body, tucked away as it is between pertly muscular buttocks, tree-trunk thighs, and six-pack stomach. Well, maybe he didn’t say that, maybe I made that particular bit up. But it is a well-hidden part of the body, with plenty going on around about to obscure it.
He is going to refer me on to a specialist, a “Mister” not a “Doctor”, who will further investigate. It will probably require surgery, but they need to be clear about what they are dealing with first. Obviously my oncologist will be advised of the development. The appointment will be fairly soon, and will of course give my dignity yet another opportunity to go sailing through the nearest window, always assuming I’ve managed to retrieve it by then.
My Google search history is getting more bizarre by the day. Viral warts are apparently the same thing as verrucas. I had warts on my hands when I was about thirteen, and I remember putting silver nitrate solution on them, which meant that I had black blobs on my hands and fingers for what seemed like a lifetime, but was probably only a few weeks. And with proprietary medicines like “Bazuka that Verruca” being advertised, you wonder at the need for surgery. But maybe being where it is (not on my feet), and being what it might be as well, discretion is the better part of gung-ho, especially as the Bazuka package includes an emery board!
Meanwhile my partner of thirty-four and a half years Cathy, being the nosy kind when it comes to all things grisly and revoltingly medical, has been enhancing the Google search history by looking up “anal warts” instead of viral ones. Of course the discoveries uncovered by her in-depth research means that it has now turned out to be a sexually transmitted infection. She gives me the hairiest of hairy eyeballs before delving deeper into Google to find out that the virus can remain dormant for many many years. This in turn means that rather like the teenage “rite of passage” herpes cold sore on the lip, a viral wart might well be one of those earlier early lifestyle gifts that just waits around for the opportunity to keep on giving. If this is indeed the case, then it has picked its moment well.
Then purely by chance I hear a science programme on Radio 4, and it turns out that we have all absorbed rather a lot of virus DNA over the past many millennia, which is now built in to us. They get triggered into action when something traumatic happens – and to me a maximum dose of radical radiotherapy sounds just like the sort of thing that would wake something nasty out of its dormancy.
So to the very short wait to find out what this is all about. Within days I am summoned to see the surgeon, and he has a cursory look (my dignity didn’t quite make it out of the window this time, but was headed that way) and told me the biopsy would have to be done under a general anaesthetic, as any other way would be far too painful. Meanwhile, he would set me up for a MRI scan and a CT scan, both focusing on the abdomen, to help him get a clearer idea of what he is dealing with.
Suddenly I have a week of appointments. Monday is the pre-op consultation with a nurse, who takes down my medical history and weighs and measures me. She also took my blood pressure, which for some reason (anxiety?) was way higher than usual. I did it again when I got home and the reading was more as it should be, if still a little raised.
Tuesday is the MRI and CT scans, which don’t go as well as hoped, because the MRI machine was playing up so I got delayed from my 08:30 scan time. This was a slight problem as the CT scan requires a tracer drink to be taken, about a litre of it, and of course they gave me that at 08:20. By the time I got into the MRI scanner it was 09:15 (which was my original scheduled CT scan time), and then the scanner man told me it would take half an hour. I felt comfortable, so not a problem.
Of course what started all this was prostate cancer. So it came to pass that my bladder is still not functioning at 100% efficiency. Twenty minutes in, and I press the emergency bulb in my hand. Nothing happens. I press it again and again, still nothing happens. Fortunately I can get my hand out of the scanner and wave at the staff. They release me from the machine and rush me to the loo where the bladder is happily, and lengthily, relieved. When I get back onto the machine they tell me there is 12 minutes left, which passes without stress.
If you have never had a MRI scan, I should warn you that they are very noisy. You get protective headphones, but it is still noisy. At times it is just a monotonous extended fart of a noise, other times it can be quite rhythmic, and even melodic. At one stage I was reminded of the mid-seventies albums by German synth band Tangerine Dream, especially when I found that by moving my jaw from side to side I could get a stereo phasing effect in the headphones. It kept me amused.
So at about 09:50 I was given another litre of tracer liquid to drink, as the original was past its use-by time. Which meant that I had to wait at least another 45 minutes to get that absorbed into my system. Finally I was laid on the scanner bed, and had a cannula inserted into my hand to put an iodine solution into my blood. I knew the iodine was circulating when a metallic taste appeared in my mouth. Three or four times the scanner pushed me into the doughnut shaped ring and then pulled me out after I had been instructed to breathe in and hold my breath.
Then I was told to take a ten minute recovery spell, which was followed by cannula removal, and “you’re free to go now.” Thence to the car park, where the cheery exit machine still says “Have a nice day” after it’s read your number plate.
I return on Friday 18th July, when I will be knocked unconscious and my “viral wart” will be sampled. The only definite outcome is that I won’t be allowed to drive for a minimum of 24 hours, ideally 48. I still don’t know what the treatment will be, either way. If it is cancerous, I guess I’ll be headed down the chemotherapy route; if is benign, then I don’t know if they will remove it surgically or chemically. All of those answers to follow in the next exciting chapter I suppose, which will conclude on 12th August when I’m scheduled to see my oncologist again.
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