What a Drag it is Getting Old, part II.

Alive!

Yes, alive! What could be better than that? I was greatly cheered up. When I rang my daughter to tell her I had cancer, she burst into tears and asked me why I was smiling. But the thing is, I was feeling happy at that point. Alive! The whole thing was nasty, but not fatal. I’d even gotten to the point where it was actually interesting. Perhaps I was trying to lessen the blow as well, but fundamentally, I was feeling so much better. The story made me smile. It had a happy ending already.

Calderdale, keeping up their rapid pace, booked me a visit to the see the consultant within the week . Let’s call him Mr C, a reassuringly calm man - you don’t want anyone excitable wielding sharp blades in the confined space of inside you. He explained that it was going to be keyhole surgery; that robotics would be involved ... in some way the surgeon with their clever hands controls tiny instruments tucked away among your insides. Has anyone old enough read the sci-fi story, Waldo? - such things always remind me of that. It also makes me think how good these guys must be at video games - I wonder how many of them were gamers when they were kids? Or still are now, for that matter.

I say I’d dropped the idea the idea that I might die from the cancer, but the idea of surgery itself was still scary. It might save your life, but it is, after all, a violent and potentially dangerous act upon your person that doesn’t always work out. When I was a boy, we at one point had next door neighbours, two sisters and two children, a boy and a girl. One of these sisters was called Margo - smart woman, always had good clothes and bright lipstick on, I remember. She amused me by teaching me this strange trick of speaking with her cheeks full of air - which I learned myself, and can do in her memory to this day.

Well, Margo had an operation of some sort - I’ve no idea what it was - and she died on the operating table due to some complication or reaction to the anaesthetic. A terrible tragedy; I remember her sister, Dot, who was a sister at the local hospital, weeping inconsolably. That was a long time ago - over sixty years gone - and surgical techniques and skills have come a long way since then. Still, at such times, we think of these things.

That thought apart, my biggest and most viable worry at at that point was - the bag. A stoma, as the medics call it. No one wants a bag, although I know of a few people who get by very well with one. More people than you might guess, I think. Like most things, the bag remains better than being dead, but questions remain. How do you do have sex with a bag? for instance. Do you keep it on? Do you take it off and plug yourself up? It could be tricky …

‘Whoops, sorry, it’s come off ...’

‘A stoma is not is not the intention,’ said Mr C. It sounds good, but in that word, ‘intention,’ there is a lot hidden. Things don’t always go to plan, do they? What are the odds? It’s unlikely, not part of the plan - but there was still the possibility that I might still wake up the morning after and find myself stomatasised, with a bag of my own poop hanging off my belly.

There was one clearly nasty surprise, though, which was the amount of bowel they were planning on taking out. I had a 30mm tumour, tucked away just round the corner in my descending bowel, but it turned out they were going to remove the whole of my ascending bowel, the whole of my transverse bowel, and then a short length of the descending bowel in the process.

‘It may seem like an awful lot to remove for one little tumour, but it’s because of the blood supply,’ Mr C explained. ‘It would be nice if the human body allowed us to take out just the area near to the tumour, but unfortunately, it’s not wired like that.’

It was difficult to understand, especially as the tumour was nowhere near the ascending bowel, all of which was going to go. Later on I had a look on-line at the blood supply to the bowel, but it was complicated and messy, as organic things often are, and I was none the wiser.

So they were going to leave me with about a third of the bowel I started out with. The large bowel is something like a meter long, so naturally I was curious to try to find out why evolution had given the whole meter when I was born; and exactly what having so much removed was going to mean.

Mr C admitted that the bowel absorbed water and some salts, which I partly knew. But do you really need a full meter for water and salts?

Apparently not. I might have to take water absorption pills to start with, but then the body would adapt.

So what’s it all for, then? Well, as far as I could gather, we have a full meter of bowel for storage purposes. Mostly, then, the large bowel is your shit warehouse facility.

‘If you went to toilet once a day, you’re likely to go twice. If you went twice a day, you’re likely to go three times,’ one of the nurses told me.

Which didn’t sound too bad - if it was true. The doctors seemed pretty straightforward to me, playing no games and telling me as it was. But even so ... two thirds of my bowel? Nearly 70 cm of it? For real? Nature usually knows what it’s doing. Did it really pack in all that bowel just to warehouse your poop?

I didn’t like the idea of that at all.

In that sense, the position of my dangerous little friend was bad luck, but there was some good luck, too. If it had been much further down the descending bowel, they’d had to remove all of that instead - including my rectum. That’s your pooping mechanism; and once they have to start mucking around with your poop mechanism, rather than your storage facility, that’s when you’re in bag territory. So I tried to count my lucky stars and not to worry about it.

The next hospital appointment - cancer is busy with hospital appointments - was to talk me through it again and give me my bowel preparation kit, which included once again those foul-tasting, strangely heavy, laxative drinks, and also some other stuff to drink just before the op, which I think was designed to line the bowel and prepare it for being chopped up.

So far, so good. The appointment after that was big one - the surgery itself. All in all, it was going to be under a month from diagnosis to surgery. Fast! I don’t really think you could ask for better than that. Calderdale health authority - congratulations!

They reckoned I’d probably be in hospital for five to seven days. Anita took three weeks off work to be around when I was hospitalised and to look after me when I came out - compassionate leave; one of the advantages of working for a big organisation like the BBC. I had been told I’d feel like I’d been hit by a bus when I came out, and we were expecting me to be walloped for a good chunk of that time. During the wait, we went to see my brother, who, as it happens, also had cancer - prostate in his case. We played, ‘Hands up who’s got cancer!’ Trevor and I always won. My younger brother Owen also had cancer - but he died from his, at age thirty, which really is a loss. That’s all three of us brothers who’ve had it, all in different places. Trevor, who has lived a life that can only be described as unbridled, is a smoker and drinker of limitless enthusiasm - he even belongs to clubs where people encourage each other to smoke - and is somewhat amazed that he’s still here. He described to us an interview he had with one of the nurses who asked him how much he drank.

‘I binge drink at the weekend,’ he told her.

‘Oh, everyone does that,’ said the nurse.

‘I just looked at her,’ Trevor told us, ‘ and I thought - you have no idea.’

I told various other people about it, close friends, mainly. The publicity director at my publisher of old, Andersen Press, got in touch to ask me to read a book for a quote, so I told him about it and asked him to let the editor and anyone else who was interested know. I didn’t spray it around though - not that I minded people knowing, but I wanted to be in control of it, I think. With cancer, despite all the diets and tricks and tips and tricks you see on-line, from the slightly useful to plain old batty, and often very dangerous conspiracy theories, it still seems that your best bet is to basically put your life into the hands of the doctors, and do as you’re told. Like many serious illnesses, it’s a very passive thing. Perhaps we like to hang on to what control we have.

I told a couple of people from the market hall - Paul Stansfield, the Butcher. I offered him some free gut for his sausages. Strange to say, he turned me down.

What else? I wrote a new will. I stopped drinking, more or less - you want to go into this sort of thing in the best nick you can manage, although I did have a number of treats of various kinds, on the grounds that treats were going to stop for a good while after the operation, when I could see eating and drinking being very much curtailed. Strangely, though, although I sit here thinking about those treats, I can’t remember what they were. The whole thing was a bit of dream. One thing I do remember; how healthy I was feeling at the time, which was odd since I actually had a life-threatening illness, the treatment of which was going to turn me into an invalid, for a while at least.

It’s a strange thing, cancer.

On the day, I had to be there very early doors. Anita drove me to the hospital, but you have to go into the surgery unit alone, so she drove off to sort some things out for the market stall while I went in. I had a bag with me - they suggested a wheelie bag to keep some clothes and other personal stuff in, the clothes because they wanted you to dress and not stay in your PJ’s the whole stay. As it happened, though, I didn’t see one patient dressed in their day clothes, unless they were actually leaving. None of the staff mentioned it either.

After a short wait, I got called through. First thing - identification. They ask you identification questions, even if it’s only your date of birth, every time you see someone, which mens over and over again. I guess there’s a deep dread of operating on the wrong person. One of the nurses did tell me a story of two people having the same name, who they managed to sort out just in the nick of time.

Then I undressed and got into my gown and those strange paper knickers.

There was quite a long wait then, punctuated by interviews with one or other of the surgery team, just checking that you knew what you were in for and getting you to sign papers giving them permission to cut you up. I’d actually already signed those, as not happened. but had to do it again - just in case. I guess you see so many different people on a journey through the NHS, they can never be sure if anything’s been missed.

I had my interview with a member of the surgical team, but a while after, I had another one. Someone had spotted that a slightly different course of surgical action might be possible. It seems that the colonoscopists can’t tell exactly whereabouts in the colon a tumour is - no doubt that’s why they tattooed it, to make sure there was no mistake. They can only tell more or less where it is, and it seemed that if it should happen to be just a cm or so lower, it might be possible to avoid taking out two thirds of my bowel, and just remove a corner of the transverse and descending colon instead. Good news! I had to sign another paper to give them permission to do that, too. The poor guys need permission to do anything at all, it seems. Some people jump at the chance to sue, or complain, even over such things as this. Amazing, really, how hard it is to do some people a favour.

Eventually the call came; it was my time. I put my dressing gown into my locker and went though to the prep room - a small ante chamber, surrounded by medical machinery, with four or five people there, including the anaesthetist. They got me to lie down on a trolly. At my feet was a set of ominous looked double doors, through which I was shortly going to be pushed. Doors, and not curtains but even so it reminded me strangely of a cremation. I imagined the surgeon standing on the other side, his gloved hands in the air, waiting ...

They took my blood pressure. I have high blood pressure and it was worrying me that it might be so high that they’d refuse to go ahead - after I’d had the colonoscopy it was up over 200. But on this occasion it was good. Then they got me to sit up and hunch my back so that they could inject liquid morphine into my spinal fluid. I wasn’t looking forward to that - is it an epidural? Something like that. I’d heard horror stories of such things. But after a local anaesthetic, I felt nothing, nothing at all. I lay back down and almost immediately the undersides of my thighs went numb.

They put a mask over my face.

‘This is just oxygen, Melvin.’

Nice.

‘Now it’s the anaesthetic.’

.......................................................................................................……………………………………………………………………………………………………………………………………………………………………………………………………………..

Anaesthetic - what’s that like? I have no idea. It’s just a total and utter blank, as near as you can get to death whilst still alive - so different from sleep, where you wake up and not much has happened. After surgery, your body knows something drastic has happened, something terrible, perhaps. But there’s no memory of it at all.

And waking up after an anaesthetic? what’s that like? Again, I have no idea. Apparently after I came round, Mr C had a word with me and told me what they’d done, but I have no memory of it. The first thing I really remember is Anita coming in to see me in the ward, and how pleased I was to see her. I have a very vague memory of her telling me that they’d managed to avoid removing two thirds of my colon and had just managed to take out that corner. Apparently Mr C had rung Anita up to let her know. Other memories ... this was a Friday, normally my day at the market stall, and Anna (hi, Anna!) had stepped in for me. I remember wondering how she’d got on. I asked that a few times, I’m told. And then I remember Anita leaving, and how disappointed I was when she left.

And that’s all I recall, apart from a few dream-like memories of the nursing staff hovering around.

All in all, then, it had all turned out better than we could have reasonably hoped. No one wants a cancer, as the colonoscopist had said; but the scan had showed no further tumours outside my bowel. I had woken up not only with no bag, but with most of my poop storage facility still intact. It can’t get much better than that really, but it did take a while before I began to appreciate it. At the time, in hospital, still woozy for a few days from the anaesthetic, I had other concerns.

Good news for Anita as well as me ... good news for us. Anita is fifteen years younger than I am, and we’re both very conscious of the fact that when I pop my clogs, as will happen to me first barring some terrible misfortune, she will be on her own. She has no children of her own, mine both live in distant lands, and her own family are either far away or more in need of help than able to give it. Old age could be a lonely time for her. She talks about making sure she has the money for a really good care home in the end. Old people seem to often do their best to avoid a care home, and are prepared instead to let their ageing children run themselves ragged looking after them. We live so long these days. I’d prefer the home myself, or even better, that bottle of good whiskey on the hill.

In a way, Anita’s plight to come is a hard thing for me to really worry about, since I won’t be here. But I do think about it a lot. Sometimes I wonder if it would be better if I went early, because then she’d have more time to find someone else and make a new life with a new love. In your fifties and sixties its easier to find someone than when you’re in your seventies and eighties - don’t you think? I know of some properly old people who found someone to love, but I don’t think it gets easier. In the end, though, it’s foolish to imagine I can plan anything to solve it for her. If I live too long, I’ll be a burden and maybe not even myself any more. If I go early - well, as she says herself, she’ll never forgive me.

To return to the hospital; I had four dressings on my abdomen - one big one where they’d sliced their way through my navel, and three smaller ones - two little holes and one small slit, which I think is where they drew out the offending length of colon with it’s uninvited passenger. Even though the wounds were very fresh I had very little pain that day, or the next day - that injection of morphine into the spine dealt with all that. That morphine was good stuff. Whenever I closed my eyes, interesting little animations started - little figures moving around. Very relaxing. Even so I had to be careful moving - it didn’t take much pressure to make those wounds hurt, not to mention the bruising inside. As I sit here, three weeks after the op, there are little brown-yellow marks on my skin where those bruises are still working their way out. It’s been a long time since they were sore, although I fancy I can still feel them from time to time.

The nurses came round every hour or so to check up on my blood pressure and so on - ‘Your numbers,’ as they call them. I didn’t need to get out of bed for any reason including the loo, as I’d been catheterised while I was unconscious.

Being catheterised is very handy. All I had to do was lie there - look! No hands! And of course my bowel had been emptied and it was going to take a while before that worked it’s way through. All I had to do is lie there. Anita had bought me a pair of good headphones, I had books, podcasts; but ... a fat tube up my willie. It’s all wrong. I didn’t even like looking at the poor thing. I was lying there cautiously, thinking that if I moved and pulled it it might come out; and the thought of that fat tube sliding in my urethra wasn’t something I fancied. So wrong! Penises are designed to go in, not to be penetrated themselves. I was very keen on getting it out, although the act of getting it out was in itself something I wasn’t looking forward to.

They let me lie there for ... I don’t know, one or two days, I’m not sure. I suggested getting it out myself, but the nurse on duty told me that there was a little balloon inflated inside my bladder, which would do damage if I tried to drag that out, so that was a no-go. A balloon in your bladder! Ye gods, whatever next. My mum always used to say that old age wasn’t for wimps. She was right. People talk about this sort of thing as if it’s an indignity. I didn’t feel that, but it is an odd experience being treated like so much piping and hoses ... Medical science is so … so practical.

Pipes and hoses. There you go. It’s what we are on one level.

I was de-catheterised in the end by an attractive young nurse, only in her early twenties I’d say. Very nice, very efficient, very attractive. I should add that there’s nothing even vaguely sexy about having a long, urine filled tube pulled out of your penis, no matter how attractive the nurse doing it might be. It wasn’t even very embarrassing. In a ward like the one I was in, there are no secrets. You lie there staring at the person opposite. You can draw your curtain, a thin blue shield around you; but although it hides you from sight, it leaves no noises to the imagination. Farts, groans, snoring, gurglings, vomiting, pitiful begging ... all are there for all to hear. Any pretence to the dignity of privacy has long gone. If anything there’s a kind of camaraderie of helplessness going on.

So my young nurse - let’s call her E - got prepared for the pull.

‘I’ll soon whip it out,’ she said.

‘No, no, don’t whip it out,’ I begged, imaging some grand, large movement, like a circus ringmaster with a bull whip. ‘Ease it out ... ease it out, E.’

She gave me a nudge with her elbow.

‘I don’t want to eat it out,’ she said.

‘No!’ - in a sudden panic of being accused of making a particularly hideous sexual reference to the poor thing - ‘I never said that’ I proclaimed loudly, in case anyone was eavesdropping. ‘Not eat - ease! Ease it out, E.’

E didn’t reply, and I’ve no idea if she was making a joke or genuinely mis-heard me. Given that most of us in that ward were going to need de-catheterising, she must have done it many times and I do wonder how often she gets remarks of that kind made to her. Some men, maybe, feel obliged to make a sexualised remark, even though, as I say, there is little in life less sexy than having tube stuffed up your willie. In the unsexy beats of life, it could really only come second to pulling tubes out of old men’s willies for young women, I’ve no doubt. Like so many other unpleasant things in this life, though, it makes for a good story. Some days later, when E was back on the ward, I wondered whether to remind her of our little misunderstanding, but since she never replied at the time, I decided to let it lie.

The actual deed wasn’t as bad as I thought. The first thing she had to do was deflate that little balloon full of water in my bladder; and that was the worst of it. She did it with a syringe, drawing the liquid out, and for some reason, that water getting sucked out of me felt dreadful. Not painful; more like some strangely fat wee, like passing thick, sticky, clinging syrup, perhaps. The actual tube going out I barely felt. Odd. I’ve no idea why.

So much for catheters. The next step on the path to wellness and going home was to have a wee myself, unaided. The nurses were regularly popping by to see if I’d passed water, and it soon became clear that if I didn’t, they were going to re-catheterise me.

Immediately, all I wanted out of life was to have that wee.

Hours went by. No wee. When I did start getting there, as soon as my body felt something moving in my urethra it immediately panicked and clenched. Stop that! - traumatised as it was by having a tube stuck up there shortly before. They went so far as to give me a bladder scan - an ultra sound, of the kind that pregnant women get, but this was looking for urine, not embryos. Very different kind of thing. I was amazed to discover that there were different amounts of urine in different parts of my bladder. I had thought it to be some kind of flexible balloon? - apparently not.

Colorectal surgery was opening up areas in which my knowledge was very patchy indeed.

Time went by; with each passing hour they were muttering more and more about putting the catheter back. It was tricky. You don’t want to push too hard with that wounded abdomen; but who wants to be catheterised when you’re awake? At last, through a heroic effort of concentration, gentle pushing and relaxation, I finally managed to squeeze out a few precious drops, before running back to the ward to let the nurses know I was a pee able man.

That was one landmark completed; there were a few to go.

On a surgical recovery ward, like the colorectal ward I was in, all anyone wants to do is to go home. Going home! It means that you’re getting better. The doctors don’t feel as though they need to keep an eye on you, you can take your pain killers and other meds and carry on healing up in the comfort of your own home. Hospital is for ill people, sick people - who wants to be one of them? That’s the biggie but there’s loads of other reasons. The food. The food’s not great, not as bad as I was expecting, but still, not your own. Then there’s sleep. A lot of people don’t sleep very much. There’s always something going on in a hospital ward, day and night. Someone’s getting treated, someone’s having their numbers done, someone’s being wheeled in or needs help or to go to the loo or they’re in pain. I managed to sleep fairly well, actually. Even so, like everyone else, all I wanted to do was go home - the final proof that all was well. But there was one big hurdle I needed to pass before I was allowed to do that. My numbers were good - better, strangely, than they were before I had the op; they still are, for that matter, which is something I don’t understand at all. But that one big trick ...

Reader, I needed to have a shit.