Chapter 32: Whitby Wheezing

“Breathless, we flung us on a windy hill, laughed in the sun, and kissed the lovely grass.”
Rupert Brooke

When I had my stag night in Whitby 30 years ago, I remember it being a relativly civilised affair. There was a certain amount of polite (but not excessive), imbibing going on, and Paul did bring a football for a bit of a kick about on the beach, but I absolutely do not recall any lewd or inappropriate behaviour. Things have changed.

It is a bit of a challenge getting in the door of the fish and chip shop due to the large number of drunken women sat on the door step and strewn across the pavement like the inevitable vomit they’ll leave behind. The unruly hen party seem to identify their fellow rabble raisers by a uniform of identical cowboy hats that they each sport. Colin is rather unfortunately wearing the exact same hat, but has since been too embarrassed to wear it due to association with the drunken women and their vulgar behaviour which I shan’t detail here. Whitby is not quite what it used to be, but thanks to the fact that it still has a damn good selection of second hand vinyl shops, I still love the place. Incidentally, if you’re interested, I got an original pressing of the 1975 Roy Harper classic, HQ, and a large haddock and chips.

It has been a great week in our beautiful cottage on the stunning North Yorkshire moors, and we’ve also been pleased to host several Northern friends who popped in for dinner during the week (John & Jane, Paul & Gillian and Morgan and Michelle and not forgetting, Betty – Colin’s mum who first took me on holiday to this area when I was just 16), all popped by for a most welcomed catch-up. My health is however not holding up as well as it did in Cornwall and Scotland. The pain is increasing again and I am having to up my doses of pain killers, but more importantly, I’m starting the get out of breath again. I know the climb from the bottom of Robin Hood’s Bay, up to the car park is a steep old hill, but I really should be able to manage it with a little less wheezing than this.

When we get back home to Wiltshire, my lung capacity has reduced further and it seems to be shrinking on a daily basis. As luck would have it though, I have a clinic with Dr. Wheater this week so I mention the problem to him. Dr. Wheater sends me off for a quick X-Ray that confirms my fears that the fluid is indeed building up again. The problem is however twofold, firstly there is the physical problem that the fluid will build right up again and cause me great discomfort, but it also suggests that the cancer is now out performing the pazopanib (in the lung area at least). Dr. Wheater does however have yet another cunning plan up his sleeve. First of all, he wants to sort my lung out. A simple drain like I had last time won’t work if the cancer is growing rapidly in the lungs again as the space will simply refill with fluid straight away. I have therefore been recommended for a more evasive procedure called a Pleurodesis, which will be performed under a general anaesthetic. Rather than allowing gravity to simply drain the fluid, the surgeon will have the ability to manoeuvre the drain into all of the nooks and crannies and suck out all of the offending fluid. Once clear, the surgeon will then use talcum powder to stick the inner and outer lung walls together and therefore remove the cavity in which the fluid was building up and thus ensure, (hopefully), no further build up of fluid.

Once Dr. Wheater has got my lung back under control he then plans to change my medication. In clinical trials the pazopanib is proved to be effective for an average of 11 months. I have been on the pazopanib for 11 months now and I was rather hoping to beat the average, nonetheless, it’s not a great surprise that it seems to be reaching the end of of its efficaciousness. Once my lung is sorted Dr. Wheater plans to move me to a new drug called nivolumab. Unlike the pazopanib, nivolumab is not actually a chemotherapy drug, but an immunotherapy drug that boosts the body’s immune system and makes it more aggressive towards the cancer cells. Dr. Wheater also mentioned another potential new drug that has only been approved by NICE today as a possible 3rd line treatment, should the nivolumab fail. I don’t need to remember the name of that drug yet though because I’m foolishly putting all my hopes into the nivolumab for now.

I come away from my clinic with Dr. Wheater feeling buoyed. The pazopanib may now be failing, but I’m going to get my lung fixed more permanently, and I’m moving on to an exciting new drug that could well extend my life greatly with very few side effects. With a bit of luck.

It turns out that I can’t just turn up for my my pleurodesis, I need a few checks first. I make my way back to Southampton hospital the following week to complete my pre-operation checks and meet my new surgeon. The pre-op checks seem pretty thorough. I have a full examination from the nurse and a lengthy chat with the anaesthetist to make sure I’m fit enough to go through the operation. I do my my best to look as healthy as possible, I’m realise my efforts wont get me in to Team GB 2020, but I managed to do just enough to convince him that I probably wouldn’t peg it on his operating table. After my anaesthetist I get to meet my surgeon, Dr, Alzantini. Dr. Alzantini takes me through the details of the operation once more and then asks me to sign a consent form detailing the possible risks of the operation. “There are a few low risks associated with this particular operation”, Dr. Alzantini explains, “The more serious one is death, but there’s only a 1-2% of chance”, reassures Dr. Alzantini. I’m presented with the consent form and happily sign-up to a 1-2% of chance, because that’s the way I roll these days.

Next we discuss a possible date for the operation. I have a week’s holiday in Lindisfarne at the end of the July, and thought it would be handy to fit the operation in the week before. Dr. Alzantini gives me a wry smile. “I don’t think that’s going to work” interrupts Dr. Alzantini, “You’re going to need at least 4 week’s recovery after the operation and you’re not going to be able to drive or fly”.

After the simplicity of my first lung drain, I had sort of assumed that within a few days I’d be back to normal. Dr Alzantini seems to be strongly hinting that it’s going to require a little more than that. I’m reluctant to cancel our holiday on Lindisfarne. I’ve booked the last available cottage on the island during the final week of our daughter’s archaeological dig, and I was looking forward to sticking my nose into proceedings. After a further chat however, Dr. Alzantini agree that the best solution will be to have the operation when I get back from Lindisfarne. Not the ideal solution as the fluid build up is getting very uncomfortable and I’m a little worried about leaving it that long. However, if things get too bad, Dr. Alzantini says he can get me in for another emergency temporary lung drain like the one I had before. Sorted, I’ll have the operation after Lindisfarne, and I’ll get an emergency lung drain if I become to breathless.

That should have been the end of my pre-operation visit but I still had one more specialist nurse too see. However, because they are short-staffed today I’m going to have to come back again next week to complete my pre-op checks.

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