Seven years ago to this month, my doctor in Zambia, after a random blood test, informed me my PSA numbers were up, but not to be too concerned. She also mentioned I had developed Type II diabetes, which she would prescribe medicine to control. By January, my PSA had doubled, so she, rather than stick a digit up my bum, sent me to be eco-scanned by an operator she had great faith in. His report showed no sign of cancer. I continued my work as usual, visiting both Mozambique and Ghana in that period, feeling relaxed due to what I was later to learn was my doctor's complacency rather than her confidence that I was cancer-free. By early February, my numbers had doubled again, so she sent me off to Johannesburg to see a urologist in the form of Doctor Bradley Wood. My physical inspection, yes, the intrepid finger, was enough to confirm I had prostate cancer. Further, he called the duty physician to check my health, who quickly ascertained I had been overprescribed medication for the diabetes and my blood sugar levels were verging on coma status. Due to blood thinners for my high blood pressure, they could not immediately perform a prostate biopsy. They could only do it in three weeks' time, further delays in treatment. Following the biopsy and due to my poor health status, they decided to control my cancer by brachytherapy and hormone treatment. It did initially appear that they had managed to control the cancer. They were concerned that my markers indicated possible further cancer, but all tests, including bone marrow tests, were unable to locate it.
That year, we left to live in Portugal, it being prior to Brexit, and by having paid my British National Health Insurance, I registered with the Portuguese Health Service. My PSAs were continuing to be monitored by Doctor Wood in South Africa, and we once again slowly saw them rising. He eventually suggested I go to a local urologist and proceed with a scan. I duly attended the consultation and was awaiting my scan date when events overtook themselves. I inevitably collapsed in October 2020 and, on admission to hospital, found it was due to having multiple heart failure, I thought it was panic attacks - no logical reason for that. They identified the cause of a very large tumour in my stomach, but fearful of the spreading cancer, did not do a biopsy, wishing to do a post-surgical intervention. First, they had to fix my heart, which was done by a great young doctor, Dr Luis Puga. In January 2021, Dr Monteiro operated on me, removing a 1.7-kilogram malignant tumour plus a good length of my intestines. Due to Covid-19 breaking out in the hospital ward, I was able to escape the hospital’s clutches within three days. The burden of nursing fell on Rozanne’s shoulders.
As my future was uncertain and while unable to do anything physical, including work on being diagnosed with this second cancer, I began this blog to keep me occupied and look back on my life and my philosophy to it. I never expected to still be around, never mind still writing it three years later. This part of my life most of you are aware of, but more recently some new followers have joined.
Early this year, on a review with Dr Montiero, he referred me to a urologist as my PSA numbers continued to rise. Rightly so, he had focused on prioritising the stomach cancer. Now was the time to revert back to concentrating on the prostate cancer. I was introduced to my to-be urologic oncologist, Dr Paulo Timido, who quickly informed me my prostate cancer had returned, but from the scans, he thought it was still confined to the prostate. The question was how to treat it. My case was complicated, having been treated once by radiation and more recently with serious open surgery of the stomach. By this time, my arrhythmic heartbeat had returned and was running at about 130 to 150 BPM. Dr Paulo Timido explained I had two options: further pinpoint radiation therapy or surgery. Both would have risks. He was very clear in outlining these and making me aware of the implications of radical prostate surgery. Following the success of the treatment of my stomach cancer, still in remission at this date, I said I would follow his recommendation. He said he would discuss the options of radiation or surgery with the radiation oncologists while I would send my records and reports to Dr Wood in South Africa for a second opinion. Dr Timido had no problem with this and welcomed it. Dr Wood thought my underlying health issues and radical prostate surgery carried high risks but said it could work. I gave his opinion to Dr Timido, and once again, we conferred going through each pro and con; he and the radiation oncologist concluded there was too much risk of internal bleeding and other complications using radiation therapy. Equally, it would not be such a simple surgery in comparison to the previous treatment. I said I was happy to go with his recommendation.
“If nothing else, you have to trust your surgeon or doctors capabilities. Your mental attitude in undergoing medical procedures does not require you, the patient, to hold any doubt in what you have agreed to do is the right decision nor doubt your specialist being the right person for the job.” - Peter MacSporran
For the remainder of this blog, I will recite, as in much of my quotes, my personal observations. Dr Timido duly agreed to find a theatre slot, and as he promised, two months later, on Tuesday, 3rd of October, I would be operated on at Centro Hospitalar e Universitário de Coimbra (CHUC) and would receive a telephone call on what time to check in on the designated day. Having some prior knowledge of the procedures in the said hospital, I went in fairly relaxed, although dreading the long nights filled with wailing caused by stress, pain and fear of other patients and, more importantly, the stress of the recovery room. I have more fear of the recovery room than the theatre.
“At night in hospital, that is when the sounds of fear and pain resonate around the surgical and trauma wards. Nothing like a long dark night to emphasise them while accompanied by the cacophony of monitors and alarms generally sending notice of the need for some scheduled medication or test. It does not matter; as a layman, they are to be feared as the bearers of possible bad tidings. Those cries of joy on leaving or having been treated successfully are subdued by comparison due to the daytime hustle and light of day.” - Peter MacSporran
For your information, wards would be more aptly called wings with normally about 12 rooms, each catering for up to three patients. The wing I was in was male only. The two elderly chaps, probably younger than me, could not speak English but through humour, we communicated. The younger of the two, I am not going to mention names, was an IT specialist who became close to fully paraplegic due to falling from an olive tree. The other had an artificial sphincter put in a year ago and, unfortunately, had developed an infection.
There is a bathroom with all the necessary equipment, the one unnecessary piece being the TV, which is usually switched on at about 7am and off around midnight, although you can always hear one blaring throughout the night. Sleep is difficult for many in hospital, it is easier to stare at a TV screen than a blank wall.
I was met by the junior surgeon on the team, Dr Joao Lorigo, who informed me there was no more food or water after 8 pm and I would receive an enema after a bowl of soup. I thought the enema would be in the form of irrigation; it was more of a depth charger shoved well up my nether regions. Blood samples and all vital indicators now monitored full-time, along with regular blood samples. No problem having been here before. Unfortunately, despite being October, Portugal these past ten days has been engulfed in a heat wave; therefore, intravenous drips are your only protection against dehydration.
The next morning, it was a shower and tights on to reduce the chance of thrombosis and then off to the operating theatres and through the abattoir steel doors into the pristine world of the operating theatres. Everyone has a job, they pretty well prepare you for anaesthetic and surgery in silence. The anaesthetist was agitated by my high pulse rate, which was now back to about 150 BPM. He kept asking if I was happy; he even asked me if I could climb a set of stairs. My fear was they would postpone the operation, I assured him I could climb six. I would not have believed me, I noted this statement was duly recorded in my discharge. For some reason, you are continually asked your full name and date of birth before and after the surgery. Coming round is always unpleasant, although the nurses are always within touching distance. Once again, my high pulse rate kept me there for an extended period returning to the ward after a twelve-hour absence. Pain, not as bad as the previous stomach surgery, may be a breeze even by comparison. I was informed the surgery went well, of course, we await the biopsy results.
The nurses, all young males and females with limited English, were happy to communicate as best they could with me. I received a lot of medication, and my BP, oxygen, sugars, haemoglobin, temperature and pulse were under continual observation. Things looked positive, other than not being allowed to eat or drink. Having had no food or drink, my nappies remained empty, unlike my roommates. The one with the artificial sphincter was on a diet of baked fruit, which seemed to have the ability to eject at the slightest attempt of a fart.
"When you are immersed in real pain, you try and survive a moment; a minute is the future, and a day is beyond comprehension." - Peter McSporran
By that evening, Wednesday, I was now in severe pain, my blood pressure dropped, and my blood sugars were low. Something was amiss. That night, I went delirious with pain. I convinced myself if I went to the toilet in the normal way, a bowel movement would relieve the pain. I just could not shit in the bed! The pain, along with the painkillers, had me hallucinating. Now I know why I avoided drugs, who would want to do that to oneself? I managed to climb out the bedside rails to be found in the toilet by two distraught nurses. My blood catheters were pulled out, and there was blood everywhere. The next day was hell as my vital signs crashed. Blood sugars below thirty, BP 60/50, heartbeat through the roof. My haemoglobin was below seven, and I, therefore, started to receive blood transfusions.
“Despite getting six units of Portuguese blood, my Portuguese has not improved” - Peter McSporran
The troop of doctors discussed the way forward. Rozanne became part of that conversation with the medical team and, from the content of that conversation, decided to call the children to come. How awful for them.
“I, at my age, I have little fear of death; my fear is the transition from life to death. Would it be painful? I was being convinced it sure was and would have been more than happy to give up if it was not for my family.” - Peter MacSporran
On Thursday, I had scans to identify where the blood was coming from, and that evening some high-tech machine cauterised all these points. Four hours lying awake as I felt the hot little darts, guided by expanded drawings reflecting the critical points. The young people working in the department looked more like young street kids than high-tech nerds. As I left, their leader said in passing, “You must not move for twelve hours.” How would I sustain that, considering my pain? That night I started hallucinating again. This time two male nurses rescued me in the toilet, and I finally shat in my nappy. The pain the next day had reduced, and on Saturday morning, I was wheeled back into theatre to be opened up again to remove all the blood and fluids and check the work done by the lasers. A very bad time in the dreaded recovery room. Rozanne called me and said the kids were on the way. Our surgeon was positive and sure enough pain started to subside while my high blood pressure returned. I thought I would not get out of hospital for ages and ages, but on Monday started to push, and to my surprise and perhaps more so the nurses, I was told I could go home. After all, Rozanne had an immaculate nursing record, although this time, she was scared.
I asked Rozanne to bring chocolates to the ward, which she did, a thirty-litre mix from the supermarket shelf, and she swapped that with the delighted staff for me.
Finally, I want to thank all of you who sent your love and messages of support. I am humbled.
“I have never felt so physically weak but mentally strong.” - Peter McSporran
Something for me to reflect on as I close this blog on Thursday night after watching South Africa smashing Australia at the cricket World Cup.
Disclaimer: Copyright Peter McSporran. The content in this blog represents my personal views and does not reflect corporate entities.
Comments