Big toes and tumours

Hubby, aka ‘Mr Magoo’, has another infection in the big toe on his right foot. This means that the Avastin treatment has to be delayed even further whilst the foot heals. Not an easy ask when the circulation in his legs is so impeded thanks to other NF2 tumours and previous surgeries that he can’t feel very much, and the right foot is always ice cold, whatever the weather.

We’re disappointed that despite a wait of four months now, and foot problems being one of many in his notes, that no one told us he’d have to ensure that he was toe infection free before the chemo could start; or that he’s still not been referred to a foot care specialist for long term care. So we’re taking matters into our own hands, and getting that much more assertive. This is an easy task for me – I got assertive years back! Less so for hubby who’s always worried about offending or upsetting others, more than ensuring that he receives the best possible care.

We have another appointment with our GP tomorrow to arrange a referral to a local foot care clinic, and won’t be leaving until that letter has at least been started, and his foot dressed properly. The neurologist and NF2 nurses that we saw yesterday at the John Radcliffe Hospital were appalled that hubby had been allowed to leave the doctor’s surgery that morning without a dressing, or the all important referral. We’ve gotten used to patching him up ourselves, but enough is enough.

They seemed sad too that despite hubby having had access to world class surgeons for tumour removal up in Manchester, that his all round care has been somewhat neglected. Until now, we’ve been the only ones considering the bigger picture, so for someone else to start asking questions has come as a welcome relief. Having the time and space to look at the latest scan results, and talk about how the NF2 is affecting him generally, made us feel more a part of our own lives, if that makes sense.

There were a few surprises of course – par for the course with NF2. No one had told us previously about the large tumour at the top of his lung, or that the one in his abdomen is the size of a honeydew melon. The growth in the largest brain and spinal tumours has also been more significant than we were led to belief.

On a more positive note, they mentioned possibly being able to help him with his eye problems – he can’t close his eyes properly because of nerve damage, and has to use drops almost constantly to keep them moist. They also provided us with all of their contact details and strict instructions to contact them at any time with any query. So we’ve feeling the love a lot more, and less like we’re out on a limb.

These last few months have been difficult because there are so few support networks for those with NF2 and their families. Both hubby and I are guilty of sometimes keeping our feelings hidden away, but when so few people understand NF2 it’s almost impossible to do anything else, and it’s often less stressful to pretend that everything is ok. It’s meant that I’ve sobbed at a reflexology session, and had to retreat into a side street  to cry in private because the sadness hits at inopportune times, but at least the tears come, and I think I’d worry more if we stopped being able to cry about it all. We’re not sad people. Far from it. But sometimes we need hugs, and lots of them, to help make us that much stronger in the baddy places.

His and hers coping strategies

Whilst hubby and I are similar in many ways, we have very different approaches to shining a light on the darker times such as now, what with his brain tumour, chemo, and Norwich City‘s performance.

How hubby makes himself feel better:

How I make myself feel better:

  • Meditation
  • Pilates
  • Qigong
  • Reflexology
  • Bowen Therapy

Fortunately, what with hubby being deaf and having to rely on subtitles n’all, the volume is turned down when the telly is on and he’s watching what I affectionately refer to as “all that shite”.

In all seriousness though, whilst even he admits that it’s trash telly, we both realise that watching something a little bit mindless and silly, is exactly what he needs after a hard day at work, and to take his mind off what’s going on in his body. If I ask him what he’s thinking when he’s watching these programmes, the response is always “I’m not”. And that’s EXACTLY what meditation should be about. Whilst I have to consciously sit down and meditate, hubby has mastered the art of shutting out unwanted thoughts and focusing on the present. He’s a Zen master, without even realising it.

Fortunately he also likes being outside and staying active, and our trekking trips and holidays balance out any time spent in his man chair. This way we still get out to see the real world; stay as fit as we possibly can despite both having medical quirks; and broaden our horizons.

Avastin

We received some good news on Friday. The funding for hubby’s round of Avastin therapy has been granted, and preparations are under way for the baseline tests. We’re now waiting for an appointment with the oncologist, and a new MRI scan date. As hubby has an ABI – Auditory Brainstem Implant, he can only have an MRI where his head is wrapped very tightly. This way there’s less of a risk that the magnet in his skull will flip over during the scan. Whenever he emerges from the scan room I can’t help but notice the looks of terror on the faces of other patients in the waiting room. With his head covered in bandages, and sometimes a little bit of blood from the anesthetic needle, he’s quite a sight!

As May is NF (Neurofibromatosis) Awareness Week, I thought I’d take this opportunity to talk a little more about Avastin and NF2. Huge thanks here must go to my wonderful friend Kate – medical librarian extraordinaire, who knows full well that we like to read all the science bits, and went out of her way to track down research papers. We loves you Kate.

You may have heard of Avastin as the ‘postcode lottery’ cancer treatment drug. I won’t go into the ethics of patients being denied treatment because the companies that make the drugs charge so much for them, but needless to say I think it’s abhorrent. Sort it out drug companies. You can still make a profit without forcing doctors to make heart wrenching decisions over who gets to live a little longer. Your CEO’s will just have to lose a yacht. Or two.

Avastin is the brand name for a drug known as Bevacizumab. In NF2 it’s used to try and stop growth or even shrink the benign nerve tumours. Whereas conventional chemotherapy drugs kill dividing cells, even healthy ones, Avastin only targets one particular protein on the surface of a tumour producing cell. This protein is called vascular endothelial growth factor (VEGF). In very simple terms, whilst conventional chemo has a more toxic effect, ‘targeted therapy’ drugs such as Avastin stick to the VEGF protein, and persuade the body’s immune system to attack only the tumour cells. By preventing the tumour from developing new blood vessels, Avastin effectively starves it, meaning that it can’t grow any bigger, and may even shrink. The drug is administered by drip once every two weeks, and whilst this will make every second Friday interesting for a little while, it will at least mean that we get to see mum-and-dad-in-law oop north more often.

We’re not the sort of people to get too hung up on reading about side effects, but these could include nausea, tiredness, weakness, loss of appetite, diarrhoea, high blood pressure, blood clots, and changes in the way the heart and kidneys work. Hubby’s favourite though, is that as Avastin can affect fertility, he’ll be asked if he wants to store some of his sperm. I’ve lost count of the number of times he’s made crude jokes about not needing magazines to help him do the deed, when there are women in nurse’s uniform wandering around! I despair, I really do.

Long term – well who knows. We’ve never really planned more than 6 months ahead. Ill health has that effect. It makes sure that you live in the present. For us it’s all about travel, and the first thing we did this weekend was book a trip to celebrate the funding, and to help us keep our spirits up. It’ll fit in nicely between hubby’s dosings, and won’t be so exhausting that we knacker him even more. It will however allow us to have a little adventure, and it’s these adventures that give us the strength to carry on.

Lipseaking for the paramedic

Hubby had a seizure in the early hours last Saturday. We were spending the weekend with mum-and-dad-in-law at a holiday cottage in Monmouthshire, Wales and had arrived the previous afternoon. By 1am I was on the phone to the ambulance service, trying to direct them to a building in the middle of nowhere when I didn’t have the full address, or clear headedness to think about giving them a grid reference. Fortunately they were able to find us from the information I was able to provide, whilst the lovely man on the end of the phone looked at holiday cottage websites for the map and postcode.

I knew there was something wrong instantly. Hubby had had a seizure 20 months ago and whilst we were hoping it was a one off, I’ll never forget the noises he made. Because of damage to his throat and tongue made during and as a result of previous surgeries, he tends to snore quite badly. He also has difficulty swallowing, especially when he’s tired, and has to drink so much water to get the food down that he tends to fill up on this rather than actual solids. During the first seizure he’d made noises that sounded like he was desperately trying to draw breath, and amplified by the plastic valve in his throat this created a sound that’s extremely difficult to describe, but not forget.

Waking to this sound again, at least I knew what to expect when I turned on the light. Seeing someone you love so physically vulnerable and exposed is never easy though, no matter how many times you experience it. Fortunately mum-in-law is a retired nurse and on both occasions we’ve been lucky enough to be staying with her, so she didn’t panic when I roused her. After we put him in the recovery position she stood guard whilst I phoned for the ambulance and had to keep running up and down the stairs to give the paramedic a status update, whilst making sure I was there to greet him with a torch on the remote country road.

I felt a slight relief when those blue flashing lights appeared, and guilty that I never asked the paramedic his name. But we’ll never forget him. Faced with a deaf man in the post-ictal phase of a seizure, he didn’t bat an eyelid about having to use me and mum-in-law to speak to hubby. Hubby is normally a brilliant lip reader, but in a confused state and despite having a wife with a strong South Welsh accent, there was no way he was going to be able to understand lovely paramedic man, at least not today.

My heart sank a little when hubby wasn’t able to say where he was and what month we were in, but then relaxed when the paramedic asked me for details such as his birthday. Given that I could only respond “it’s the week after mine, if that helps,” I realised that under stress it was no surprise that hubby was finding it difficult to remember certain things. Thankfully mum-in-law saved the day and prevented me having to locate my own driving licence.

Satisfied that hubby was stable, especially when he started grabbing the paramedic’s wrist to see what the time was, and asking about the ambulance car, we unanimously agreed not to force him to go to the local hospital. After the last seizure he’d had to stay in a different hospital for 5 days because they had little experience of NF2. At one stage he’d threatened to escape, so to avoid a repeat we decided that we’d follow up with his medical team back up north. We don’t know what caused the seizure. It could be a case of several triggers coming together, it could be the brain tumour, it could be a combination of all these things, or it could be something else all together. We may never know.

What we do know is that I’ll be watching him like a hawk again for a little while. He’ll no doubt get fed up of me reminding him not to drink too much, to go to bed earlier, to wear a hat and sunscreen and drink lots of water in the sun, to eat regularly and to rest when he needs to. But that’s a small price to pay, and he assures me that he married me partly because he likes assertive women.

Sleep has gone out of the window again for me as I’m up and alert at the slightest change in his breathing pattern or usual snore. As I work for myself I can sleep during the day though, and we’re getting into a routine whereby he knows that he has to get to sleep by a certain time, and I feel relaxed come 5am and he’s ok. Cat napping works wonders, and I’ve always been able to get by on very little sleep. I may be cranky as hell mind, and eventually collapse, but I can function better than most.

More than anything, hubby is gutted that he won’t be able to drive again for a wee while. Driving and rallying is a passion of his. It gives him an independence which is highly valued when some might consider him disabled. Thanks to a disorganised DVLA it took him several months longer to get his licence back the first time, so now he’s dreading having to go through the same. Fortunately we’d changed the car a short while back and ‘Skyra’ – our little 4×4, runs like a dream. So I’m happy to chauffeur hubby, and put the car through her paces, whilst hubby clings on for dear life and wiggles his finger at the speedometer.

The day after the seizure, not surprisingly hubby did feel low. When he started talking about “giving up” I had to go elsewhere and have a little cry, because if he gives up, I give up. He is my world, and I will be there every step of the way for him. I can deal with things like this happening. We’re both tough cookies. We both go into warrior mode very easily, and over the years I’ve certainly earned my nickname – ‘Dragon’.

Fortunately his low mood passed, and we’re dealing with the uncertainty and difficulty of living with such a rare and complex condition as NF2, by doing what we do best – planning lots, and lots of adventures. We now have a list that covers all bases. Different places that we can go to, and different things we can do, depending on how tired hubby is between chemo doses,  and if and when he needs brain surgery. In our eyes some of the plans seem quite calm compared to our usual adventures, but other people are still likely to see them as quite extreme, and it’s this pushing the envelope that helps keep us sane. No one knows what the future holds, but we do know that we can live fully in the present. When life gives us lemons, we make margarita’s.

 

The Green Spaces Project

Whilst we wait patiently for hubby’s chemo to start, sadly it means that we can’t organise any adventures too far afield. As always though, we have a plan. Neither of us are the sort to sit at home eating crappy food and wallowing in ‘why me-ness?’

Instead, we’re busy organising micro-adventures, mini-trips, and excursions to local green spaces.

We’ve always spent our weekends out and about, exploring the wilds on foot, so there’s not much change there. But we probably have become a bit blinkered to what’s right on our doorstep. Two excursions in and we’ve discovered a public park we never knew existed, complete with a wooden swing suspended from a willow tree; and this beauty:

By 'My Dog Sighs'

By ‘My Dog Sighs’

I’ve always been a fan of street art. Not the “So and so is a knob” sort, but the illustrations and messages that stop you in your track, and make you want to hunt down the artist and commission them to re-decorate the inside of your house. ‘My Dog Sighs’, the artist who created the painting, now has an international following, and it’s easy to see why. I’m in awe of his talent, as are so many others as the piece hasn’t been touched by anyone else yet, and that’s a mark of utmost respect.