A little empathy

I’ve not posted on here for a while, mainly because I always worry about coming across as moany, but today I wanted to moan, so here goes.

We are currently experiencing a heatwave. Now as a gardener I know that plants need sunshine, and as a human I know that we need some exposure to sunlight, but unfortunately, not all humans can tolerate hot temperatures. I know that this might come as a shock to those who love the sun, worship and crave it, but unfortunately some people have medical conditions or are receiving medical treatments that mean that high temperatures can make them ill, sometimes very ill. For hubby, brain surgery for NF2 tumours has caused damage to his brain stem and hypathalamus. He’s also on chemo. All these things means that he can’t tolerate heat. For me, it’s the EDS and POTS which mean that I cannot regulate my body temperature when it’s above 24 degrees C.

When the thermostat rises, I have no choice but to make sure that I’m in a cool place, with access to a fan, ice packs and pillows, and when it gets close to 30 degrees C, an ice cold bath. Without exaggerating, I am constantly fighting heat exhaustion, and on too many occasions, have had to be brought back from the brink of heat stroke. For sun lovers, and those who’ve never seen anyone who experiences this, they seem to think that we’re moaning, that we’re just a bit hot and we should in the words of Peter Kay “just eat a Solero”. I wish. I really wish that eating an ice cream were all that it took. I hate not being able to travel to warm places, or to enjoy the sun here at home like many people do. I hate having no choice but to stay home after 11am so that I can ensure that I don’t get ill and collapse in public. I worry a lot that in the future, I won’t be able to find work that would accomodate me needing to keep cool – this is one of the reasons why I am fairly sure that I’ll go freelance once I have the PhD, so that I can manage my health without feeling as if I’m a liability, something which people with disabilities and chronic health conditions are often made to feel like. I worry too about people thinking that I’m being fussy, that I’m making it up. Sadly, empathy is often not forthcoming for invisible disabilities, even from those close to you.

Fortunately I now have sveral people in my life who don’t make me think as if it’s all in my head – (yep, I’ve had people say that in the past), and oftentimes this is through them having seen me when I’m not well. Strangers too have also stepped up to the plate. I recall a train journey last year where a man I had never met realised that I was in distress, and whilst everyone else ignored me (despite me not being able to stand up, and having spent the journey vomiting in the toilet) he helped me off the train and ensured that I was delivered into hubby’s capable hands. Other than those few people though, the ones who understand, I tend to make plans with as few people as possible during the Summer, so that I don’t have to cancel, and so that I’m not made to feel pathetic. I wear a false smile when people say “oh isn’t the weather lovely”, rather than being honest and then being seen as a grumpy old woman. I make sure that I don’t have to do anything too taxing intellectually, and that physically demanding jobs are done earlier in the year. Summer is very much something that I just have to get through. And it’s not just me who feels and experiences this. People with MS, other neurological conditions, anyone on chemo, they’ll all be suffering. So when it’s hot outside, spare a thought for those who will be debilitated by the heat.

Shrinking tumours

Before hubby started chemo in August 2014 for one of his NF2 tumours – the one in his brain, we spent many an hour researching the side effects and prognosis. The general medical consensus was that Avastin stood a good enough chance of shrinking and then stabilising the brain tumour (schwanomma), but was unlikely to have an effect on the one in hubby’ spine.

After an MRI scan last week – one of the special ones where his head is wrapped up like an Egyptian mummy’s to stop the ABI device exploding out of his skull and making a bit of a mess, yesterday we were told that the spinal tumour has also shrunk a little! The brain tumour has as expected now stabilised rather than shrinking any further, but in the NF2 world stability is good. No scrap that, it’s bloody brilliant, because the alternative is major surgery, and we want to delay that as long as possible.

Normally a very optimistic person, even hubby is suprised that both tumours have shrunk. He’d been expecting to see no change in the spinal tumour at best, and likelier still to have to start talking surgery. So to come away with such good news has left us a little shell shocked to be honest. Despite always appearing cool, calm and collected, with not a care in the world, hubby has faced four lots of brain surgery so far, one of which saw the surgical team fighting to save his life when he developed a bleed on his brain stem. I hadn’t met him by this point, but I cannot imagine what that must have been like for mum and dad-in-law. Or for hubby, waking up unable to speak or eat because he’d been fitted with a trachy and breathing tube. It’s only down to his sheer bloody mindedness, and that of his parents, that he’s now able to eat normally. Admittedly sometimes there’s a bit of spluttering when he gets tired, and I have to try not to start performing the Heimlich maneuver as soon as he starts choking, but otherwise we enjoy our food.

The previous surgery was unavoidable because sadly NF2 tumours can still lead to an untimely end, and yes accidents happen in surgery, but knowing that he doesn’t have to go under the knife again anytime soon is such a relief. He’ll have another chemo dose in two weeks, and then as far as we know he’ll move on to four weekly doses, and they’ll scan him again in May. So between now and May we’re going to get busy planning our summer adventure. Something that involves lots of walking, wild swimming, and me freaking hubby out with my driving on the ‘wrong’ side of the road.

Buying time

We found out yesterday that after 3 months of chemo hubby’s brain tumour has shrunk by 2mm. So far he’s had four doses of Avastin treatment, and was scanned after the 3rd, so this is very good news and means that treatment will continue for at least another 3 months. Three months where we don’t have to think about brain surgery, and where we can make the most of every waking moment.

We don’t yet know what’s happened to the largest spinal tumour, as the Avastin treatment is focusing on and being funded for the brain tumour only, but we’ll find out more in the new year after yet another fully body MRI scan. If the spinal tumour is still growing and the neurologist decides that it has to come out, hubby would have to stop chemo for a while to allow time for surgery and recovery, but we’ll cross that bridge when we come to it.

Hubby’s case has been described even by the NF2 team as complex. We don’t know why, but his seems to be an aggressive form of the condition. He has tumours in all of his limbs,  abdomen, face and scalp, as well as his brain and spine, and so has had to learn to live with pain and discomfort, as well as loss of function thanks to nerve damage and invasive surgery.

Whilst he tries to hide the pain, I know when it’s affecting him, and that makes me feel helpless. NF2 is not something you can take a pill for. There is no cure, and you don’t spontaneously recover from it.

We do know however that whilst it’s extremely rare, there are doctors who care passionately about helping those with the condition. They give NF2 sufferers hope, and we’re fortunate enough that in hubby’s case he’s had access to them from a young age. Sadly, some people are still being diagnosed in their forties and later, despite having presented symptoms for some time.

For now though, we feel as if we’ve bought some time. And as always, the first thing we talked about on getting home and sharing the news with loved ones was our next travel adventure. Travel insurance is ridiculously expensive if you are on chemo, but having wanted to explore Britain’s islands for a long time then this is not a big deal. If anything, it’s even more of an incentive for us to explore the UK’s nooks, crannies and wild places.

It’s probing time!

After being turned away from the second chemo dosing because hubby’s blood pressure was too high, we’d become model patients – sorting out meds for hypertension, and buying a fancy digital blood pressure monitor which we use daily. We’d had a blip last week when I’d had to call the triage emergency helpline because hubby had noticed about a teaspoon of blood on the tissue paper after going to the toilet, but they’d reassured us that given the severe constipation he’d had after the first dose, and that he’d had haemerrhoids earlier in the year, it was nothing major to worry about.

Knowing that his blood pressure had fallen to normal almost as soon as he’d started taking the pills, it was very frustrating to be sat in front of a temporary registrar oncologist before treatment number three, whilst he claimed that hubby’s blood pressure was still too high. Given that he’d just told him that he was going to perform a rectal examination to see if he could find any other causes for the previous bleed, no-one else was surprised that hubby’s blood pressure was elevated. Hubby later admitted that he’d had to stop himself laughing out loud at the oncologist’s announcement, because his first thought had been of the ‘probing time’ scene from the Simon Pegg and Nick Frost film about ‘Paul’ the alien. And yes, that’s one of his favourite films. ‘Under Siege’ and ‘The A-Team’ also top his list. Boy telly as I call it.

The oncologist seemed to be under the impression that a further delay in treatment wouldn’t matter, having obviously not read hubby’s file. We and the NF2 nurse however knew otherwise, and so I may have gone into what hubby now describes as ‘Scrappy Doo mode!’ Backed up by the NF2 nurse I demanded that the oncologist phone our GP and request the records that we’d submitted two weeks ago, all showing a much lower blood pressure; explained that hubby has a definite case of ‘white coat’ syndrome with his blood pressure; and that rectal examinations weren’t helping. Hubby just sat back thinking “I should have warned the poor bloke that she was Welsh!…”

Fortunately the examination confirmed that everything was ok down there, the oncologist decided to take our word for it with regards to blood pressure readings, and after helping hubby to calm down and breathe deeply, the final monitor reading fell within the required parameters. The oncologist assured us that he’d let hubby have treatment, and I almost cried with relief.

Once hooked up, we settled down for a gourmet picnic lunch, and got chatting to the lovely man and his wife in the next section. Unfortunately he was only diagnosed with NF2 two years ago in his early forties, and so it’s been one hell of a whirlwind for him and his family. Like hubby said, being bought up knowing what was coming made coping that much easier, and I knew what our future as a couple might hold from pretty much day one. To find out in your prime that you have a condition that will never get better, which may require lots of dangerous surgery, and may result in disabilities plural, is bloody hard.

That certainly doesn’t mean that we’ve found dealing with what’s happening to hubby easy – far from it, and it’s been a relief that support has come from often unexpected sources. NF2 is so rare that there just aren’t the support networks that there are for cancer and other conditions, so it can be quite a lonely place sometimes. Which is why we still make every effort to get out there and live the lives that we want to, to talk to people – often strangers, and to try and stay as optimistic as possible. Hugs however, are still always welcome 🙂

Losing my hair instead of my mind

After a two hour drive through not very nice traffic, car parking issues, seeing the oncologist, and settling down for chemo dosing number two, it was quite disheartening to then learn that it couldn’t go ahead. Hubby’s blood pressure was too high, and they couldn’t risk doing permanent damage to his organs. So we were packed off home, with me quietly seething that no-one had had the foresight to tell us that there are blood pressure parameters they have to work within, and that we should be monitoring hubby’s. Instead, we’ve now got three weeks to get it down to normal, or goodness knows what happens – we’re not ready to think about that.

Fortunately our local GP and Practice Nurse sped into action and this morning hubby was checked out, given a blood pressure monitor to bring home, prescribed medication to bring the pressure down to normal, and Movicol to help ease the chronic constipation which is unfortunately a very common side effect of Avastin treatment. As he has issues with swallowing and eating anyhow thanks to damage to his throat caused by previous surgery, not being able to go to the toilet has meant that his appetite has disappeared. Not good when he needs to be putting on weight.

We’ve been using alternative remedies such as good old fashioned prune juice, flaxseed and vitamin C, but with blockages like this (sorry to be so graphic!), only conventional drugs have the necessary oomph to flush it all out from the top down. Suppositories can work if waste is impacted in the lower bowel, but not in the top, and yes we’ve been using those too. So now you have the low down on hubby’s toilet habits.

As for me, well one of my lovely friends commented that she’d have had a breakdown if she had to deal with all of this. That’s not happening – simply because I won’t let it. Instead, I’ve started to lose my hair. There’s only one small bald patch at the moment, and it’s hidden, but if I lose any more then I will absolutely be buying a purple wig. Our diet is healthy and the doctor is pretty sure that it’s stress related, so I’ve been instructed to relax more (stop laughing), and to look after myself so that I’m as strong as I can be to look after hubby.

As some of you know already, losing my hair would not be as catastrophic for me as it might be for others, given that I’ve had a number two crop in the past, after an unfortunate incident involving half a bottle of wine and some hairdressing scissors. Having read that Sharon Stone used to cut her own hair in a room lined with mirrors, I though that I’d give it a go, using one of those tiny crappy mirrors attached to the front of my wardrobe. I basically managed to scalp myself. Fortunately my then hairdresser worked from home and was able to fit me in for an emergency appointment, but hearing my work colleagues scream when they saw me the following day was a bit disheartening. Hubby is being as supportive as ever, in his own words “don’t worry beau, it means that I can now start calling you cue ball…”