"The first principle is that you must not fool yourself and you are the easiest person to fool." - Richard P. Feynman
After twelve full weeks of intentionally poisoning myself on a daily basis it’s time to see if there’s been any point to it all. I’m not convinced that there has been but my next CT scan will reveal what has truly been going on. The side effects may have become more tolerable after lowering my dosage but the tumour pain has not got any better. My assumption is therefore that the CT scan will not show any shrinkage in the cancer. Tori say’s I should be more positive, but considering all the pain I’ve been in, I really don’t want to build my hopes up. I’m having my scan at Southampton Hospital this time rather than Salisbury Hospital and when I arrive I notice that the procedure is slightly different. Once I’ve made the receptionists aware of my presence I am quickly presented with a jug of clear liquid to swig down before I can ride the big white doughnut. I’m offered a selection of fruit squashes to flavour the contrast and after taking a taster sip of the foul tasting liquid neat I immediately opt for a large dash of blackcurrant squash to try and mask the taste. The elderly lady in the chair next to me is clearly daunted by the sheer quantity of liquid she has been asked to consume and seems to take quite a bit of coaxing from her daughter and the nurse to drink some more. I opt for the technique of just downing a few glasses as quickly as possible and slamming the empty glass down on the table in the intention of just getting it over with.
It takes another hour until I’m finally called through to the scanner room, perhaps they expected me to to take my time and savour the contrast a little more? There is however one final chamber to pass through before I make it to the inner sanctum that houses the scanner. The purpose of this next room appears to be to cannulate me. The nurse surveys my inner arm, just below the elbow, wipes it off with an alcohol wipe and proceeds to stick a needle in it. Once the needle is inserted she tries to squirt a small amount of saline to flush it through. It is not however working and the needle has to be withdrawn. After a second attempt also fails she tries my other arm. Having failed to successfully attach the cannula to my other arm a more experienced nurse is summoned. She too has a go on each arm before giving up and going in search of a doctor. Whilst I have been sitting here waiting for for my cannula to be fitted, the elderly lady in the waiting room saunters in. She has either finally managed to complete her jug of filthy contrast, or her daughter has sneakily helped her out while the nurses weren’t looking. She is cannulated on the first attempt and slips into the scanner room ahead of me. The advantage gained by my hasty guzzling technique has now been lost. A new doctor appears and inspects both my arms and the back of my hands for the optimum location in which to stick the cannula. After studying the options available for some time he selects the back of my right hand and thankfully successfully inserts the cannula on his first attempt.
Contrast drunk and cannula inserted and I can finally enter the final room of the procedure. The scanner looks the same as the one at Salisbury hospital and I drop my trousers to my knees and mount the bed. The cannula is retested with a quick squirt of saline, all is still fine, and then connected to another pipe which I am told will inject the actual contrast during the scan. I am warned that I will feel the contrast as it is injected and whooshes around my body and that I may have the sensation that I have wet myself. The radiologist retreats to the safe monitoring station and I’m drawn into the scanner as it spins up and gives me my breathing instructions. There is a small beep and warm sensation seems flows through my body accompanied by a strange taste. The rotating scanner slowly comes to a halt, and the radiologists ventures out from her small protective control room to tell me it’s all good. Job done.
Next week and I’m back at the oncology centre for my results. You know the normal drill as well as I do now so I won’t take you through it again. After a bit of a wait I’m summoned into Dr. Wheater’s office. “Well?”, asks Dr. Wheater, “How have you been getting?”. Bugger that I think to myself, tell me the results of my scan. Dr. Wheater does not look like a man about to deliver bad news so I bide my time and answer the question first. “Not too bad.”, I tell him, “The side effects aren’t as bad since my dosage was lowered but it’s still pretty unpleasant and I get a lot of pain”. “Hmm”, muses Dr. Wheater as he brings my CT results up onto the computer screen, “Your scan shows that the tumours in your lung and liver have shrunk since the previous CT scan”. I breathe a huge sigh of relief as Dr. Wheater shows me the relative sizes of each tumour on the two separate scans. There is not a massive amount of shrinkage, the tumours haven’t halved in size or anything as dramatic as that but it is nonetheless a significant amount of shrinkage that confirms that the Pazopanib is working. I’ve put up with a lot these past twelve weeks, but if the drugs are working, perhaps it has been worth it after all. Dr. Wheater’s only slight concern is a slight inflammation of my pancreas which he suspects may be one of the more uncommon side effects of the Pazopanib. This might also explain some of my discomfort, a fresh blood test is requested to check my levels of amylase in the blood, and a letter will be written to get me an appointment with a gastroenterologist at Salisbury hospital, but otherwise the advice is to carry on with the chemotherapy and manage the pain with some co-codomol, of which Dr. Wheater kindly prescribes a large stack to keep me going.
Physically nothing has much changed between not knowing the results of my CT scan and getting the results today, nonetheless, it feels like everything has changed. The knowledge that the chemotherapy is doing its job and shrinking the cancer has a massive positive increase on how I am feeling. It’s also encouraged me to be a bit more active again and to try and get out of the house. At the start of the year we had set off on a trek with some friends to complete the Wayfarers walk. I had managed one more leg of the walk from New Alresford to Kilmeston before getting the news that my cancer had returned. Since then all wayfarers walking had been put on hold. After their summer break our friends had decided to resume the walk and completed the next leg last weekend. Determined that I am now capable of completing the walk again Tori and I decide to walk from Kilmeston to Droxford on our own so we can catch them up and rejoin our friends on next weekends walk without having missed any stages. The leg from Kilmeston to Droxford is just over seven miles and follows the South Downs Way in parts across farmland and small tracks. We spend a pleasant Wednesday afternoon ambling along at our own pace and discovering that it is not beyond my capabilities.
The following week we join our friends for shorter six-mile hike from Droxford to Denmead. This pleasant walks takes us from the Churchyard at Droxford and along to the river Meon. By the time we complete the ninth leg from Denmead to Bedhampton we finally approach the coast and the Solent comes into view, obscured only temporarily by the pub as we celebrate approaching the home straight.
The home straight the following, and final week, takes us from Bedhampton through meadows and alongside a stream until we reach Warblington churchyard and the final few miles along the shoreline to Emsworth and straight into a pub. The seventy one mile trail is not an especially daunting tasks once split into ten fairly leisurely legs, but given what I have been through this summer it feels like I hive climbed mount Everest as I relax in the pub in Emsworth catching my breath and enjoying my Sunday lunch.
This new found mobility means some more excursions too. Including a day out at in the New Forest at my friend’s Malcolm and Clio’s beautiful wedding and a day trip to visit some of my old haunts in Oxford. I also have a follow up appointment with my GP and I guess its now time to start thinking about going back to work again. A full five-day week still sounds a little daunting but my GP suggest writing me a fit note that will send me back to work for three days a week until Christmas with a view that if all is fine I can go back full time in the new year. This sounds like a pretty positive approach to me, and my ever helpful employers agree to it too. When my current sick note runs out in a few weeks I shall therefore return to work on a part-time basis.