Disorientation

And so the sun sets on another week, and I find myself in a different continent.

sunset-porch-2

Under an African sky – in front of my eyes

I returned to Africa a week ago after an unexpected, and unwelcome reason for extension to my stay in Scotland. I should have returned two weeks earlier, after a short visit but things always take a surprise turn in that post diagnosis cancer world. I am fine, no nasty cancer surprises but I can attribute what happened directly to cancer.

So what happened, that warranted hospital admission and being unable to return for two whole weeks? A nosebleed, that’s what. Yes, a nosebleed. And one I blame unequivocally on cancer!

It started fairly innocently just before I had an optician’s appointment. One of a series of things to be done, while on home leave. The bleed would not stop, and reluctantly I had to cancel the optician. I pinched my nose, and waited patiently as the time for another appointment approached. The bleeding continued and worsened. I called the medical practice and was advised that I should go the Accident and Emergency Unit at the local hospital where they would be able to deal with the bleeding. The last thing I wanted to do, but with my history and being on blood thinners this was the correct and only course of action.

Treatment was not pleasant or nice, and for something as trivial-sounding as a nosebleed it was frightening to see how quickly a situation can become worrying. I was admitted to hospital and with the various procedures the bleeding was eventually staunched. I was allowed home the following day, with a strict set of instructions. No hot showers, no exertion, no flying or travel and the worst? NO TEA! That was a serious struggle. I have never craved tea so much in my life! But heat or exertion can re-start the bleeding and that is not a risk to be taken, so no tea and no immediate return to Africa.

How can I blame cancer? Quite easily in fact, the nose bone is quite clearly connected to the cancer bone in my case. Blood thinners were the cause of the nosebleed, and those blood thinners are a consequence of the Pulmonary Embolism I had, which was attributed to Tamoxifen. PE is a relatively rare but dangerous side effect of Tamoxifen. And of course,Tamoxifen is prescribed following hormone receptive cancer diagnosis. Thanks, cancer!

The sides and afters of cancer and its treatments continue to rumble on and we are reminded that even at times of NED (No Evidence of Disease) we exist with vulnerability and fragility.

I am enormously thankful that this medical hiccup has been dealt with relatively easily, but my confidence has again been damaged. I am approaching 7 years from diagnosis and am in pretty good health overall. Yet the fallout from cancer, while it might not be visible or evident apart from to me, is not to be underestimated. Life is fragile, precious and unpredictable. At the hospital, the ENT specialist advised me to be cautious and not to trust my body as it has let me down before. Interesting words from a doctor, validating anxieties and vigilance.

So I am pleased to have returned to my new life in Africa, though being in three continents in as many months has proved disorienting briefly. It is good to be able to look ahead with no immediate plans of long distance travel and to concentrate on my reorientation. My three word mantra for the year powerfully reminding me of my focus for the year. The time is right to seek to crystalize and settle now and I have a very clear reminder of my middle word – nurture – timely and so pertinent.

porch-sunset-1

I returned home yesterday late afternoon as the sun was sinking in the sky and I was treated to a spectacular sunset. And I was present in every sense to witness and appreciate it. With no thanks to cancer!

 

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The Great Escape Part 2

When I left Yangon with suspected pulmonary embolism, we all expected I would be back in a few days time.  My packing reflected that short timescale, as well as the expectation that I would be in hospital most of the time.  By the time I was eventually discharged from hospital (after a whole week) I had already worked my way through most of my clothes.  Most of my clothes comprising night clothes, a few tee shirts and 2 pairs of trousers.  And a swimsuit, just in case……..  that is a necessity.

The pain was mostly gone when I was discharged, but my blood levels had not reached the “therapeutic level” yet so I knew there would be a few more days in Bangkok before I could return.  I was told that it could take another 1 – 2 weeks for my bloods to not only reach the right levels, but they also had to remain stable within the” therapeutic range”.  As my strength slowly returned I was able to do some emergency shopping and get a few essentials to tide me over.

My first blood check was the day after my discharge from hospital.  I had already been back the previous evening for the dreaded injection into the stomach and as my appointment was not until 11 am I decided to nip over to the hospital early for my 8 am jab, get the blood draw and then return to the hotel for a relaxing breakfast.  My plan was sabotaged almost immediately as I learned that Dr W would actually be earlier and would see me as soon as the blood results were available in around one hour’s time.  With the blood draw done, I headed to the ward and had the second needle of the day, knowing I would miss the hotel breakfast unless my appointment with Dr W was extremely quick!

Of course I missed the breakfast!  It was not long after 9 when I was called in, but with the need to settle with the cashier afterwards, the hotel breakfast was clearly missed!  Happily though I did bump into a friend from Yangon and we had the chance to catch up.

Even more happily, and to my surprise, my bloods had just tipped over into the therapeutic range.  Dr W had looked subdued when I entered his consulting room, and with a kind of hang dog face, started with “I’m really sorry….”  My heart flipped over, expecting some kind of sinister news, and then he said “you will not be needing any more stomach injections after this evening!”  I was not sure whether to laugh, cry or squeal and probably did all three, as he leapt up from behind his desk and gave me a big hug!

I left the room with an appointment for the Tuesday, an adjustment in the Warfarin dosage, my blood results and a broad grin.  One more needle that day and then NO MORE NEEDLES for two whole days.  Two whole days without needles – just unimaginable bliss!

The following needle free days enabled me to begin that recuperating and rebuilding process as well as venturing slowly back into the scary outside world.  Those days passed incredibly quickly though, and I found myself again proferring my arm to the needle counter for the next blood draw.Another wait for results, with my eyes scanning over my book, reading and re-reading the same paragraphs and still retaining none of the words let alone any meaning.  Eventually, Dr W appeared and again I was summoned into his room.  No games this time, a big broad grin and he flamboyantly circled that day’s blood results.  A further nudge more comfortably into the therapeutic range.  He then prepared my report so that I could return home, pronouncing me fit to fly, providing me with 3 month’s supply of Warfarin, an instruction to adjust the dose again and to have regular draws in Yangon, and a return appointment for 3 month’s hence.  Which is also the time of my next oncology check, and the annual Big Check in October.

Finally I was able to  arrange my return travel and plan to get home to my non tilty bed, hubby, lush garden and super-cute puppy.  I had been away for two very long and scary weeks, longer than we all expected.  And that return home to Yangon was the long awaited Great Escape Part 2.

It does appear that this has been a “rare but dangerous” side effect of Tamoxifen and I have now been switched to Femara.  There were apparently several lobes of the lungs affected by embolism and it is no wonder that I was in such pain.  It was incredibly frightening.  I am very fortunate that cardio scans show no lasting effects or damage to the heart.  My confidence has been seriously knocked though and I think it will take a bit of time to rebuild emotionally as well as physically.  My 2012 pledge of resilience is incredibly pertinent and I am focusing intently on that.

From bed baths to bubble baths

Progress indeed!  Just over a week ago, I was still having bed baths and was accompanied even to the bathroom in case I had a bit of a turn.  Now I am in the Big Outside World and regaining strength, health and confidence. And a mark of that progress is seen in the transition from bed baths to bubble baths!  (Not quite as extravagent as this pic, but wonderfully healing and relaxing).

And today also saw my return to the hospital for another blood draw.  The good news is that my blood levels have remained within the therapeutic range for the second test in a row. I m very much hoping that this can see Part 2 of the Great Escape swing into action.

While I am waiting, the Norway post is finally about to be shared, after rather a long time in the brewing!