What a Drag it is Getting Old

Part 1 - Adventures up the bum

My cancer began with the squits - a rather odd case of the squits of a kind I’d never had before. I’ll spare you the details, let’s just say that it was a very early clue that something was wrong, but a clue that was masked by the fact that I’d recently had my meds changed for a totally unrelated issue, and I thought that was the cause. Thought I might as well wait a bit to see if things settled down - the body adapts, after all. I didn’t want to be complaining before time. And - well; we all know what a pain it is getting to talk to a GP these days. The long, long wait.

So I waited.

After a month or so it still hadn’t settled down, and I was thinking that now I needed to get those meds changed. A friend of mine, who really looks up all the meds he’s on, does the research properly, reads the books, checks the details, he told me that, yes, it was indeed the case that the meds in question will do that to you. So things drifted a little longer before I finally got the meds changed. And then of course, I had to wait a while longer for those to settle in ...

And just round about the point where I was still getting the squits and was finally realising that I really did need to get in touch with a GP - I got one of those poo testing kits through the post from the NHS bowel cancer screening programme.

For those of you not old enough to know about the turd-juggling exercise that the NHS asks you to do every few years once you get over about sixty ... you’ll find out soon enough. Let us draw another veil over that for now - just to say that they don’t require the whole thing, nicely wrapped in a box with a ribbon and put in the post. All they want is a mere smear. It’s getting that smear where we need to draw a discreet veil.

This was perhaps the third or forth time I’d been asked to perform the turd-jugging; and this time, the result came back positive. They needed to do further tests. Which didn’t necessarily mean cancer at that point - the colorectal people are at pains to point out that that will be the case only for one in ten lucky testees. There are all sorts of other possibilities. Piles. Polyps. Straining at stool. Who knows? But in my case, after that long dose of the squits, I thought the worst. The meds almost certainly hadn’t caused the diarrhoea which I’d had for some months now. The signs, reader, were not good. Could it be that I’d waited, literally, a fatally long time

The next step, then - colonoscopy. A camera up the bum.

Here in Calderdale you go to see a colorectal nurse first, who explains the procedure and the lead up to it, which involves drinking the GOAT of the foulest, but extremely effective laxatives and, among other thing, suggestions about protecting your nipsy from the effects of going to the toilet, ‘more times than you think is possible.’ For the procedure itself, which has to be performed while you’re conscious in case they need you to move around, they offer a sedative or gas and air, or nothing. A friend of mine (Hello, Martin) who had had one before - and when you get to my age, almost everyone you know has had a camera up their bum at least once - suggested that the gas and air was fun - so much fun, in fact, that they had to take it off him because he was using too much. So I thought I’d try that.

All things have a silver lining, even cancer. It is an opportunity to try some interesting drugs - although I’m also reminded of another friend who has the mantra - ‘the problem with doctors giving you drugs, is that it’s never enough, and it’s never strong enough.’

Calderdale, bless it, is really quick with this illness. They offered me my colonoscopy within a week, but I couldn’t take it because I had a trip lined up for Budapest. More delay! The fact is, that as part of my general, slow, ageing decline, I’d lost some teeth at the front, and I was planning on going to a dentist over there to get them fixed for under half the price to what you pay over here. The colorectal nurse pointed out that if I’d had surgery they might just decide they couldn’t give me the procedure, for some reason. Yet another delay! I suspect that was unlikely, but even so ... as I say, I now expected the worst. So when I got home I cancelled the trip. Arse before teeth, I thought. Let’s get our priorities right here. Or to put it another way - life before teeth. Perhaps.

My procedure was set for just over a week away.

So, colonoscopy. What does that involve? First off, the emptying of the bowel. A couple of days of a low-fibre diet, followed, the day before the procedure, by two drinks of that obnoxious tasting liquid, which bears so little resemblance to food or drink of any kind, that the mouth reacts as if you’re taking in a poison, which I suppose in a sense you are. The upper lip curls away involuntarily; the tongue shrinks back in the throat like a frightened child It’s clearly some kind of chemical, coming as it does in the form of a fine white powder that you have to dissolve in water. Mine was Mango flavour ... except it wasn’t. It tasted of toilet cleaner and citric acid, and was strangely heavy for a liquid - loaded, i suppose, with salts and sugar, along with it’s heavy dose of bowel emptier.

There are no convulsions, nothing of that sort, just a rapid liquefaction of everything you’ve eaten in the past few days. And boy, does it work! By the end of it you’re ejecting a streams of crystal clear water, down the loo, like the source of chalk stream. You could almost expect to find trout in the toilet bowel afterwards - except of course they’d be dead, poisoned and belly up in the pan.

So early doors to the hospital, where they gave me a hospital gown and a pair of strange paper knickers, which covered my modesty at the expense of making me look like a clown. The gown I found hard to fasten at the back, and almost as soon as I got into the procedure room, they undid it anyway. Flashing your arse at the medical staff is an experience that becomes normal almost as soon as it happens, strange to say. And there’s quite a team in there - I’d been warned about this; the colonoscopist himself, a polyp catcher, various nurses, students and various monitoring people. You lay down on your side, with the gas and air at hand; the colonoscopist - let’s call him Mr H - inserts a well greased, gloved and professional finger up your bum with one smooth, practised and (sorry) not entirely unpleasant movement. All very professional. Reassuring, I think is the word.

Then they insert the hardware. Or, to give it it’s proper name, CF-EZ-1500 DL 2303853.

It didn’t feel like much at the time, but there must have been quite a lot of it. A camera. A light. A hose for swooshing. A wire loop. A hot wire loop. (I’m not sure what ‘hot’ means in this context, by the way) and who knows what else. Apollo 13, probably. I suspect it all fits in some kind of conduit. The odd thing about it is, that the bowel has no feeling inside, no nerve endings of that kind, so as they explore your inner self with all these bits and pieces you feel nothing, except for your nipsy nibbling ineffectively at the conduit. From time to time, the colonoscopist was pushing something up there with quite large and vigorous arm movements, like a man pushing a wire along a drain - which in a way he was, I suppose. But throughout, I barely felt hardly a thing.

They whole thing is televised. There were two huge TV screen, one on either side, and as they work their way around, you can see it all. I know some people keep their eyes shut, but I found it fascinating. My bowel was arched and hooped and pink, coiled around with thin red veins, like a strange, moist pink cathedral - quite beautiful in its own way. Empty of course, apart from the water they squirted to open up the lovely folds and clear out any tiny flakes of remaining faecal matter floating about, like pale brown snow. All in all, an interesting experience.

In what seemed like a moment he got right the way up, across and down again to the end of my large bowel, where it joins the small bowel. They were a nice crowd, the colonoscopy team, quite chatty among themselves, and MR H gave me a commentary from time to time - pausing to show me where my large bowel ended and where my appendix was and so on. I thought it was all done by the time they got there, but in fact they had just begun. The real exploration happens on the way back.

Fascinating, as I say, and I was so entranced that I forgot about the gas and air, and just sneaked a quick breath every now and then, but I was put off as they asked me ... ‘Are you OK, Melvin,’ every time I had a gasp. In the end, I confessed ...

‘I’m fine. I’m only doing because it seems a waste not to,’ ... at which they all guffawed. They were equally amused by Paul’s dictum about doctors and drugs. Over all, the mood was professional, but jolly.

On the way back, they began to pick up polyps.

I’m a big fan of the natural world, and when I hear the word polyp, I think of coral reefs - fanciful crests, combs and castles of colourful sea life, with brightly coloured fish dancing about in the crystal clear waters. To my disappointment, bowel polyps aren’t anything like as glamorous - just small, misnamed, warty brown blimps among the pink arches.

This is where the wires come in, both hot and cold. The polyp catcher sits at the colonoscopist’s right hand, where he manoeuvres his wire loop around the polyp, and at a word from the lead man, snips it off. I was inclined to turn my head away for that bit, not wanting to see bits of myself pulled off me at close range. (Why?’ one of them asked.) But after the first time, realising I felt nothing at all, I watched. It was a strangely disconnected feeling, seeing all this magnified to the size of a minor pop star on the big TV screens, but feeling nothing. But strangely comforting as well, although I’m not at all sure why. I think, perhaps, because it was so relaxed and professional in there.

There were a fair few polyps, nipped off one after the other.

‘This won’t be your last colonoscopy, Melvin,’ said MR H. It’s these polyps that can turn cancerous if left to grow, so I had plenty of potential for cancers of the future to come after me.

My polyps were quite small to start with, and he reassured me that anything under 6 mill was innocuous. Then came the 6, 7, 8 and 9 mill ones.. For these, they employ the hot wire. As I say, I’m not sure what ‘hot’ means here. I didn’t see any sizzling going on. Maybe a quick flash to cauterise ...? No idea. But again he was reassuring, saying he had no concerns about them.

As we moved along the bowel, I was becoming hopeful that my fears were in vain. I knew that polyps can give you the squits as well as cancer itself - why not me? But by this time I had enough information, so that when the beast itself came into view, I knew at once what it was. No surprises here. There it was - pink as the bowel itself, squat, two lobed ... far bigger than anything else, clearly different. One glance at MR H’s face confirmed it; this was cancer.

They went to a bit of trouble with it. Took a biopsy with the wire (‘don’t worry about the blood, Melvin,’ - for which of course I did worry, but again it was painless.) They tattooed it and gave it a good swoosh before moving on. And fairly soon after that, it was all over.

‘Well, Melvin, it is a cancer, I can tell by the shape as much as anything. It had it’s own blood supply. It will have to be removed, but ... no one wants cancer but if you’re going to have it, the bowel isn’t a bad place to get it, as its designed to keep things in.’

All of which meant, your bowel keeps the shit inside, and therefore, with luck, the cancer too. So even though I was pretty unlucky to get it in the first place, I stood at least a chance of being lucky in my unluckiness, if you see what I mean.

Afterwards, dressed and waiting in a small room nearby, Anita joined me. She had driven me there and waited for me while all this was going on - not more than 45 minutes, I’d say. I told her what had happened and she looked bemused. We were soon joined by the nurse who had been monitoring the whole thing, making notes, too, I think, who told me that the biopsy would have to be sent off, but the C had loads of experience, and if he said it was cancer, it was cancer.

As I say, I wasn’t surprised. Anita, however, had decided it was the meds that had give me the squits for all that time, was surprised and promptly burst into tears. The poor nurse flushed - you can imagine how stressful it must be telling people they have a life threatening illness.

She ran through the next steps, which was a scan to see if it had spread, and if so, how far. After which, equipped with our new knowledge of my impending mortality, off we went on our way home. Stopped at a cafe in a garden centre to pause and adjust with coffee and cake. What can I say? It takes a little more than a slice of cake to get used to that.

This wasn’t the first time I’d had a life threatening condition. Some years before I went into the surgery for my annual check up and found I had a blood pressure of 240/120 - enough to blow your head off, you’d have thought, let along give you a stroke or heart attack or an embolism of some sort. That took me totally by surprise, but this one wasn’t so unexpected, as I say. The C had said it looked like an early cancer, and he should know - so I was in with a chance, despite my forebodings. Even so, no doubt about it - mortality beckons at moments such as this. The horizon gets nearer as you get older and you know that one day, sooner or later and perhaps sooner, you’ll be peering over the edge in the company of a dark stranger with a wide-brimmed hat and with just the one eye in his head, and you’ll know then that there’s only one direction left for you to go.

For my part, I’d already partly come to terms with it. I’m 71 now. ‘Three score years and ten,’ the bible says, ‘and every year thereafter a burden unto ye.’ It’s one of my favourite bits of the bible, even though it isn’t really true any more - if it ever was, much like the rest of that book. But I have had a life, a full life, with ups and downs, successes and failures, and if I went tomorrow ... well. I’d miss my old age, wouldn’t I? If you have to miss something, old age would be the one to pick. I’d done OK - unlike my brother Owen who died aged thirty, or my granny Burgess, who was 56, I think, when she went - of bowel cancer, scarily enough.

Bowel cancer, (I should think but I don’t know) is a shitty and fairly horrible death - although, as having the colonoscopy shows, it’s amazing how you get used to things. In these days of lives lived longer than they can be comfortably worn, I find myself thinking that I need an exit strategy. My own parents died at seventy-nine and eighty from smoking related diseases, but I know so many people whose parents had no bad habits, and lived not so much to ripe, but over-ripe or even rotten old age. Yet some people find their own way to the door, without having to wait. My mum, who had a dread of being a burden, turned her face to the wall, refusing medicines except pain killers, and died by her own volition, I think, of pneumonia. One way to do it - a very brave way. Drugs are perhaps the easiest, if you can get hold of them. Once I could have, easily enough, but not any more.

No one wants a violent death, I think. Hanging, jumping of a building? No thanks. Dorothy Parker had a point ...

Razors pain you;

Rivers are damp;

Acids stain you;

And drugs cause cramp.

Guns aren’t lawful;

Nooses give;

Gas smells awful;

You might as well live.

I do have an exit plan, as it happens, which involves a bottle of very nice whiskey and a trip up to the tops in winter. Up there the angle of sight into the valleys are so acute you can’t see them. Villages and even large towns just disappear into the ground. It’s like looking over an ancient tundra, flat and featureless as far as the eye can see. The wind is unimpeded and in the winter, when a cold shower in the valley below translates in a blizzard high up, you can wake up to a sculptures of ice and snow, carved by the high winds into dramatic and very beautiful curves. It must be easy to die up there, I think ...

It’s not perfect plan, though, by any means. For one thing, there’s getting there. Not easy if you’re weak and ill - getting the timing right is a tricky thing, however you decide to leave. And then, it has to be a good, cold winter’s day. I had cancer in the springtime. When would Odin stretch out his beckoning finger? What if it was spring again, or summer? All I’d get would be a horrendous hangover.

And finally, death, like life itself, isn’t all about oneself. Some poor bastard’s going to have to find you. By then, the foxes would have done their work with your soft tissues and you’d be transformed into an actual, real, dead horror.

Being found. It’s a thing. It’s one of the objections I have with hanging. The dead should be on the ground, below the living - not above, looking down on them. I’d be more than happy to feed the foxes, but I wouldn’t want to give any one bad dreams.

Such were my deliberations on my own mortality. I wasn’t all that scared - as I say, I’d been thinking about it for a while, so although I didn’t want to go, I was somewhat prepared. But all this was stopped short by the next part of my treatment - a scan. As I say, Calderdale are very quick off the mark with all this, and so it was with the scan. I had the colonoscopy on the Tuesday, and they offered me a scan on the Saturday, but then rang me up on the Thursday to offer me one on the Friday. Pretty good, eh? I was, and I remain, very impressed.

The scan went without incident, except that the poor guy operating the machine opened the door for the next patient while I was still doing up my trousers.

‘I made a mistake. I’m so sorry, I’m so sorry. Oh, I’m so sorry,’ he kept saying.

Bless.

‘Don’t worry,’ I told him. ‘Fortunately there weren’t any ladies there for me to frighten.’

But the results! Available almost at once ...

No further tumours.

No further tumours. Just the one. Despite several months of the squits, it hadn’t spread. So - an early cancer which hadn’t spread. Which meant - yes!

I was going to live.

Part II to follow. Alive!