My consultants medical secretary called me on Monday. At 8:08am. I was on the train to London, and had my phone switched off. She left a message asking if I could possibly attend my consultants morning surgery, that same day, around noon.
All I remember is standing on the platform at Waterloo station, listening to the message and thinking “this kind of short notice doesn’t sound good”. And a lot of swear words.
And of course, when I called her back, she didn’t know anything about what my consultant wanted to talk to me about – she’d just been asked to get me to the earliest possible surgery. So I booked myself into his Thursday evening surgery, and tried to get on with my day. As much as I could. It’s funny how your mind plays tricks with you; I remember feeling on top form on the train, and a few short minutes later leaving the platform with the weight of the world on my shoulders, with the whole day to get through. And in my mind was a little tape loop playing “It’s back, it’s back, it’s back” over and over again.
Fortunately when I got home I found a brief email from my consultant, which in (presumably) typical fashion didn’t mention cancer at all. Simply that he wanted to talk to me about my abscess. Which of course left me worrying why he hadn’t mentioned anything about the tests for cancer that they’d run over Christmas.
The observant will notice that Thursday has been and gone. And having seen my consultant, I can officially report that I am still (as far as they can tell) cancer-free. Which is jolly good news.
Unfortunately, the CT scan has not only been looking for cancer, but has also been peering at all the rest of my innards. And it seems that the abscess that formed as a result of the leak from the join in my bowel is now causing some problems. There is a excess of granulation/scar tissue forming in the abscess, and further inflammation in the tissues around the abscess, and this is now impacting some of the softer tissue structures close to it.
Specifically, it’s now pinching my left ureter, which if left untreated will start to lead to kidney problems. This is really not a good place to go, so my consultant is now very keen to resolve this. The initial suggestion is a ureteric stent, which will prevent the abscess from pinching off the ureter. Can’t say I like the sound of how they will fit that (even under a local!) but if it works, then I’ll grit my teeth and look the other way.
However, that isn’t a cure for the problem; only the symptoms. What we need to do is fix the abscess.
Normally my consultant would expect an abscess like mine to have started healing and shrinking down by now, but in my case I had adjunct radiotherapy before my tumour was removed to improve my chances of successfully getting rid of it all. As a result of that most of the tissues near to the abscess were irradiated too; good for killing the cancer, but it will have compromised their healing ability.
The thinking at the moment is that the small hole between my bowel and the abscess is preventing it from draining well enough, trapping infection inside the abscess where it continues to irritate my body, causing the reactions that are resulting in my problems.
The somewhat counter-intuitive solution is to open up the entrance to the abscess, making the hole in my bowel bigger, improving the abscess’ drainage, and hopefully giving me enough of a lead over the infection to allow it to start to properly heal over time.
Which sounds fine (I can’t believe I just wrote that!) except for the fact that we are deep into uncharted territory here. My consultant describes me as a “very rare case”. Which sounds quite flattering until you realise that this is a euphemism for “we’re making educated guesses as to what is the right treatment here”.
And at the moment I have a quality of life that I am fairly happy with. It’s not perfect, but it’s good enough. So I am very concerned that anything we do won’t result in a significant decline in that. But my consultant is equally concerned that he doesn’t let my desire for quality of life override good medical practice. At the moment he tells me that if we do resolve the abscess I should see a step improvement in my quality of life again. If we don’t resolve it then there is a fair chance that I will ultimately end up on a permanent “ostomy” of some type. Which is the last thing I want.
For now my consultant is pulling together a plan of attack. I’m expecting to hear more from him early next week.