Life can be capricious - and then it can be downright cruel

Last month I signed off a chapter in my life with a bit of a downbeat opening[1]. But, by the time I reached the story's conclusion I found myself being considerably
more upbeat: "So, I am fortunate to have had the last 14 years, and probably quite a few more, to gad about gathering new experiences."

And now I sit, a little over a month later, staring at an abyss. Two weeks ago I woke up with an excruciating pain in my lower abdomen. By the end of the day a rash of large red blisters had shown its ugly head. Luckily, in the interim, I had managed to obtain an appointment with one of Faringdon's GPs. Particularly luckily, she was able to see me later that afternoon and was sufficiently concerned to secure a hospital appointment for the next morning. I was to spend the majority of the day in the John Radcliffe Emergency Assessment Unit (EAU) being thoroughly tested for Diverticulitis, a fairly nasty condition, which can recur again and again once one's had it the first time. But, in the grand scheme of things, a condition tolerable enough for an old geezer whose main ambition was to spend most of his time with his 3-month old granddaughter.

​Then  the  Shit  Hit  the  Fan.

While the expert team was poking around in my vascular system to try to ensure they had the best quality blood to combat the Diverticulitis they discovered that any blood I needed to do anything was running out fast. Transfusions were called for and bags of platelets. Worse still, I was particularly deficient in white blood cells. A Haematologist was summoned from the Churchill, Oxford's specialist cancer hospital and he proceeded to drill into my hip in search of the vital leucocytes[2] within my bone marrow.

At the root of all this was something a lot more dangerous than Diverticulitis: Acute Myeloid Leukaemia (AML). AML is almost invariably inevitably fatal for someone of my age. 

​This probably requires an explanation of life expectancy for people of my age[3] who are suffering from AML: it is quite variable depending on the body circumstances of which there are too many to delve into here. The bottom line is, though, that, unless the diagnosis changes, I will be lucky to live much beyond the age of 75/76.

​Let's hope that with a brand-new grandchild, Niamh, it will be beyond the end of that zone so that there is a small chance she will remember her grandad into later years.

How did all this come about?

Well I'm sure many will deny this but I still suspect there is a drift in COVID that has reduced the population's resistance to the nasties out there in the atmosphere. In my own case, the slipping away from health has left me desperate to regain fitness after successive bouts of the dreaded disease. The last time I "had[4]" it I was in Portugal in October last year and felt very ill for intervals during the 10 days or so that I was poorly. I won't bore you with that because I covered it in the previous blog.

But I had felt I'd reached some sort of equilibrium for a while, 4 months and counting, maybe. My walking had stabilised at about 5 miles for an outing and I felt I should be content with that despite having been knocking out 50 miles on my bicycle when the whole slip and slide began at the beginning of 2020.

The diverticulitis came as a bit of a shock two weeks ago but still overcomeable until it was overtaken by the Leukaemia.

Now I'm just bloody scared and headed off to the haematologist yesterday morning to find out what the next steps might be ... I fear Chemo but what must be must be. I have to be a useful grandfather before the earth's jaws open.

Fortunately the haematologist at my first encounter agreed that a somewhat gentler therapy might actually be more effective at prolonging my life. She went as far as saying the Chemo might even kill me. We shall see over the next weeks, months and, hopefully, years.

Some positive takeaways from this shock are worth highlighting.
​
NHS Care

The staff in the John Radcliffe hospital in Oxford were all but exemplary.
From the polite and smiling cleaners to the most senior medical specialists and consultants.
A particular consultant on duty on the EAU took it upon himself to extract Shan's phone number from me  so that he could phone her to convey the worsening circumstances (i.e. that they were now dealing with Diverticulitis and Leukaemia and that I was more likely to be spending a week in hospital than a day). It was a hard blow to suffer but he ensured it was conveyed to her in the most sympathetic manner. Shan was touched.

I was transferred from the EAU in the middle of the night to the Complex Medical Unit (CMU) where I was given a private room because of my susceptibility to infection and where I was to remain for the next week.

Human interludes

With tears comes laughter: My friend Ready was determined that I wasn't going to spend the Sunday afternoon of a key 6-Nations rugby match on my Tod and without the essential accoutrements (necessarily toned down to 0% alcohol beer and pretzels for the great day). Unfortunately for Ready he had to overcome 3 obstacles to make it all happen: wear a bike helmet on the insistence of an insistent daughter and which left him with a big red patch on his forehead for the afternoon - he hadn't had one of his own and had to borrow his wife's; climb the only steep hill in Oxford on his bike; get the rugby coverage on my i-Pad working before the game started ... no mean feat as he'd assumed kick-off was at 14:15 when it was actually at 15:00.
"Do you want me to start the game on replay," he announced proudly when he'd finally tamed ITVx (it should have been on the BBC but apparently they don't like i-Pads). So we watched the entire match in real time and happily England won comfortably against Italy (but not quite as much as the beating they gave Ireland a week later!) 
​
I was feeling a bit maudlin a night or so later when I decided to listen to La Bohéme. No doubt trying to expurgate the feeling of deep sadness I had felt about depriving little Niamh of one of her grandfathers before an age she would actually remember. The closing Che Gelida Manina had the obvious effect, just as it had decades earlier when Ready and I, our wives, and a bunch of friends attended the Welsh National Opera Performance in Oxford. Even then there wasn't a dry eye amongst us, despite the strapping young couples we'd been.

And then there was the low-flying, record-breaking intervention Starry performed in his sleek black Alfa Romeo, bearing a delicious salad for my lunch and his usual naughty wit interspersed with intelligent philosophical observations. Friends eh! What would one do without them?

Shan​: Shan and I have been side by side through thick and thin for nigh on 45 years. Most of the caring traffic has been in one direction; you guessed it - from her to me and that at no time more than the past two weeks.

But, before that there was the vigil (along with Kate for some of the time) at the gargantuan University of Caen Hospital in Normandy, where I was trepanned to relieve the pressure of a pint of blood between my brain and my skull after a bicycle accident. There were also a few days in the London Clinic (also with Kate) while I had a radical prostatectomy to permanently delete my prostate cancer.

But these last two weeks were caring beyond the bounds. Parking at the JR is all but impossible in the mornings unless you are Shan, who left home at 5 am in order to get pole position and to be at the ward door when it opened at 6 am. Every morning like clockwork and she had the nursing staff eating out of her hands.

Neither of us was guilty of this but someone in the JR diaspora had suggested that Shan might be a retired GP. By the time we reached the Great Western a week later on the outskirts of Swindon, the consultant asked her the same question. Didn't do any harm but it certainly opened the conversation.


​More small anecdotes about this wonderful coterie of friends in blog episodes still to be written ...

[Endnotes]:

1. ​SO! About (Long) Covid: is it a real thing?
2. White blood cells are also called leukocytes. They protect you against illness and disease. Think of white blood cells as your immunity cells. In a sense, they are always at war. They flow through your bloodstream to fight viruses, bacteria, and other foreign invaders that threaten your health.
3. ​Source, Cancer Research UK: "For those aged between 70 and 79: around 5 out of 100 (around 5%) will survive their leukaemia for 5 years or more after diagnosis."
4. Completely unconfirmed because no-one really cares any more.