Thursday, January 12, 2012

Part 2 (the diagnosis): straight to the heart of the matter

(Continued from this post)

My trip to the Heart Hospital was like no other journey through London I’d ever had before. I was simply being transported from one hospital in North London to another in Central London – there was no urgency – but the ambulance driver put the siren on the whole way. It’s a weird feeling, being fully conscious, in a screaming ambulance, running every red light, speeding along as all the cars in front of you veer to the side, like Moses parting the Red Sea. “That’s the fastest trip to Central London I’ve ever had,” I told the ambulance driver as we took the elevator up to my ward at the Heart Hospital. “I just want to knock off and be home with my family,” the ambulance driver, who had been on call that night, replied with a laugh. Fair enough!
Going from North Middlesex Hospital in the northern suburbs to the Heart Hospital in Marylebone was like being upgraded from a seedy motel to the Hilton. I was delighted to see I had my own room, with my own ensuite, plenty of storage space, a much nicer outlook than my other hospital ward, and, from the looks of my dinner which was served on arrival – much better food.
I was feeling very ill and weak that day. I don’t know if it was the overexertion of my walk outside and ambulance transfer, or the North Middlesex hospital food, but I really wasn’t feeling well. I fell into a deep sleep, woken intermittedly for numerous tests, medications, surgery briefings, consultations etc.
The next morning, at 11am, they came to take me to theatre, much earlier than I expected. I wasn’t ready at all. “I need to put these on,” I said, holding up the horrendous-looking thrombosis tights to the porter, who tried to call a nurse, only to discover he was on his break. He was in quite a rush so we got set on trying to put the tights on ourselves, a tricky exercise. We were both giggling at the whole comedy of it all, both of us fumbling with the tights, in a mad rush to get me into surgery. “You’re too young to be having surgery,” the porter said as he wheeled me to the lift, and to the theatre.
As I entered the theatre, with its white walls, and blue-clothed people, reality suddenly hit me. They were about to cut me open. Nerves set in. I tried to put on a brave face. The nurses smiled warmly at me as they began to strap things to me. A man said he needed to put a needle into me, and I said, “Don’t worry, I’ve got enough holes in me. I’ll start leaking soon.”
Then the surgeon came to speak to me. “So, that’s a huge lump you’ve got there in your chest,” he said to me. “How did you find out it was there?” I was taken aback by his upfront nature but I instantly liked him – he was a larrikin and a character. The surgeon and I chatted briefly, then the anaesthetic was administered and I drifted off.
When I came to, my throat was dry and sore, I was coughing heavily and there was a deep pain in my left shoulder. The nurses all peered at me, and machines beeped at me. I suddenly felt really uncomfortable and scared, and I started to cry, in between coughing. “I don’t even know why I’m upset,” I said.
“Well, you just had surgery,” said one of the nurses. “You’re well within your right to feel upset. The anaesthetic can do funny things to you as well.”
Back in the ward, it was an excruciating wait for my mum to arrive. The hours ticked by, and I lay in bed, feeling much better, but not able to sleep because of the discomfort and anticipation. At about 3.30 she walked in, clutching Hippo Jo (a present from Sam, knitted by one of his 90-year-old patients. More about him later) and broke down into tears when she saw me. She came straight over and gave me a big hug, and even though it hurt slightly I didn’t care. Poor mum had been awake for 36 hours and probably wasn’t feeling much better than I was! We talked for a few hours. I was so happy to see her, her timing couldn’t have been more perfect. When I came out of that theatre all I had wanted is someone by my side.
Not long after, the surgeon came into see us. He said he was pretty sure it was a lymphoma and it was so big that it was squashing one of the air passages into my left lung. “You’re effectively operating on one lung at the moment,” he told me.
“It doesn’t feel like it,” I said, stunned.
“That’s because your body compensates,” he explained.
Then came the big question: if/when I could go back to Australia.
“Can you go back to Australia? The answer is no,” said the surgeon, and my heart fell. But he explained, because of the tumour’s placement around my lungs, I would find it very difficult to breathe on a 24-hour flight at that altitude. He said they were currently reducing the size of the tumour with steroids, but he wouldn’t feel comfortable about me getting on that plane until I’d at least had my first dose of treatment, which could keep me in London several weeks. The surgeon had said I should remain in hospital until I receive a diagnosis (which could take anything from five to 14 days).

Hippo Jo keeping me company in the Heart Hospital, post-biopsy

After that, it was an excruciating waiting game. I had put on such a brave face for so long but the long stay in hospital and the noticeable effect my illness was having on the people around me, especially my mum, was really getting me down. I missed normality and I longed to be back out there in the real world. Not living behind the walls and glass windows of the hospital, watching the world pass me by. I also learned that researching your likely condition on the internet was not a smart thing to do, either. All it did was frighten me and place a heavier burden on my mind. I cried myself to sleep a few times during those days. “Don’t be afraid of the bad days,” Matt told me and I knew he was right. I had to just let the bad days happen.
The next day, I was settling in for a long stay in hospital when the unexpected happened. The surgeon came marching in to my ward that afternoon, waving about a piece of paper. “We have it!” He said. “We have a diagnosis.” He sat down on the bed. “It’s non-Hodgkin’s lymphoma,” he said. This surprised me, as from day one all the doctors had assumed I had Hodgkin’s lymphoma, which was much more common in young people than NHL. He told us that he was going to arrange an appointment with an oncologist the following day and I could be discharged from the hospital tomorrow. So much to take on! I couldn’t believe it. He answered all the questions we fired at him and gave my mum a pat on the way out. “In a few months, she’ll be cured,” he said with confidence. And then he was gone. The surgeon was such a support to us, I can’t believe he worked so hard to get that diagnosis to us so quickly – he’d cut quite a few corners to get us the news quickly.
I couldn’t believe how stoic I was after hearing the diagnosis. I’d been as prepared as I could be. But it played on my mind that night. I didn’t sleep much.
The oncologist appointment the next day was the true reality check. I took my seat in the waiting room at the UCLH oncology clinic. Around me all I could see were sick people. People with cancer. It really hit me how much cancer there is in the world, and how it affects so many people. Sitting in that waiting room was depressing, but also eye-opening and in its strange way, comforting, though I still didn’t really feel like I belonged her yet. We sat there for almost an hour.
The oncologist who saw us was a registrar working under Professor Andrew Lynch, one of the world leaders in lymphoma. He looked young, possibly even younger than me. He was a rational man, but he appeared tired and seemed unsure of how to deal with my mum who was understandably quite emotional at this point. We found out later 70 patients had gone through that clinic that day.
At this stage they hadn’t confirmed what type of NHL I had – but it was between two different types. However, regardless of the outcome, I would be undergoing six months chemotherapy. I would be getting a bone marrow test and a PET scan which would establish the stage (how far it has spread across my body) of my disease. After consulting briefly with Prof Lynch, the registrar strongly recommended that I should stay in the UK for at least one cycle of treatment before I flew home.
There was a lot to take in that day. And the major setback was that I didn’t know when I would be going home, and it looked like I would be going home without mum. Mum was pretty upset about this. But at the time I was willing to follow doctor’s orders, if that was the best thing for me. Obviously I wanted to be home as soon as possible, but not at risk to my health. The lymphoma nurse, a gentle and kind lady, gave me a bunch of paperwork and her phone number which she told me we could call any time during business hours.
We caught a cab home. I was feeling overwhelmed and a little depressed. All I wanted to do was relax in a café and forget about everything for a little while. But we Skyped Sam when we got home, and suddenly the pressure of getting home and everything else heaped onto me. I was starting to realize what a hard, tough road I was facing.
That day was difficult; there were lots of tears. After talking to my mum, suddenly I could see the ultimate heartbreak a mother feels when she sees her child go through such unimaginable turmoil. Of course, a parent doesn't expect things to happen this way around. All mum wanted to do was fix me; and of course she knew she couldn’t do that, so the next best thing was to bring me safely home and care for me.
Friday was a new day. I spent the morning Skyping my friends in Australia, then I headed down the street for a haircut. I told the hairdresser to lop it all off, without letting her in on the fact that it would ultimately be a three or four-week haircut because my hair would all fall out in a few weeks. I wanted my £28 worth! I think she was quite taken aback by my nonchalance, as my hair was very long at this point.

Locks lopped! Liberating.
That evening my mum and I had the pleasure of meeting up with one of my sister’s friends, Glenn. Glenn and Jacqui had become friends in Brisbane several years ago and since then he had moved to London and built a life there. Around the time of my diagnosis Glenn had called me, to offer a listening ear and invited us both over to his house, which turned out to be virtually around the corner from mine! (Quite a coincidence, considering London is not a small place). Glenn was a lymphoma survivor, having undergone 10 months of chemotherapy for Hodgkin’s lymphoma more than 10 years ago.
Glenn came and picked us up with his adorable daughter Polly, and we headed to his place to meet his wife Justine. The last time I’d met them had been about 10 years ago in Brisbane. They put on an amazing dinner for us. It was great to talk to Glenn; he gave me some excellent tips and advice. It was also inspirational to see how the cancer experience had changed his life, and now he had ticked off all the things on his bucket list and was now living happily with his wife and daughter in London. It was a lovely night filled with stories, laughs, music and a wonderful dance performance from Polly. Mum and I went home all flushed by the loveliness of the evening and the unbelievable generosity of a family that were virtually strangers to us.

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