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Death in different forms

5 years ago my Father died. He was 99, a ‘good’ age although his last year had been a deterioration mentally and physically, so was it really a ‘good age’? Would it have been kinder if his body had said ‘no more’ earlier?

5 years ago. It was in the time of Covid. Strict national guidelines on who, what, where and when but I had my own rules, and they were even more restrictive than those imposed by government. My husband had been diagnosed with Follicular Lymphoma and was on a journey with chemotherapy. His caregivers emphasised how vulnerable he was, no resistance to bugs. His consultant haematologist told him, in no uncertain terms, that he would DIE if he contracted coronavirus. We withdrew into our shells and interacted with family, friends and the world via electronic devices. The time we ventured out was to take walks together, exploring the beauty around us, whatever the weather.

My Father became ill, another stroke, he went to hospital and contracted Covid. Hubby and I were walking, a muddy, blow away the cobwebs escape to the country. My mobile rang, withheld number. It was a doctor from the hospital where my Dad was, the news was negative, my parent was not responding to treatment, can we discuss the End of Life care?

I didn’t wake husband. I didn’t want him to see me cry. To see how my sadness was not just due to losing my parent but also because I couldn’t have been there supporting my sister.

How odd, standing in a field chatting with an unknown doctor about how he would help ease my parent’s end of life experience. Just keep him well hydrated and pain free. This is going to seem harsh, uncaring, but I lost track after this. My sister, she divides her life between England and an antipodean country, she appeared and took control. I can’t remember time scale but one day it was obvious Dad was leaving us, he was dying. For me he had been dying for months. Due to covid, NHL and chemo I had not seen him for months. My focus had been 100% on my husband, on our own little lives. One night it became obvious my Father was on the last part of his journey. My sister and I spent much of the night on the phone to each other, she was alone with Dad, I was sitting alone. He died. I went to the window and a shooting star flashed across the sky. Bye Dad.

I cried. I didn’t wake my husband. I didn’t want to let him know how sad I was. How I was grieving my Father but also desperately sad that I couldn’t be there with my sister. That she had to do this all by herself. Then came the funeral. I couldn’t go. I phoned a well-known cancer charity for advice, for support, and was knocked back. I realised that this was all my problem, that I shouldn’t, couldn’t share with anyone else.

I have never really grieved my Father. I have locked my feelings away in my brain cupboard, the storage place for anything which causes me angst.

My Mother. Always a hard woman. We have never been close. Now is not the time to journey back over my childhood, my teenage years. Enough to say that I left home before I was 17. My Mother started preparing for her death from 40+. Every decade she joyously told us that she wouldn’t see her next. She lived on, studied for a degree, divorced my Father, remarried and is now in her mid-nineties. A few years ago she was put in a care-home by my sister. I agreed with the decision as Mum was showing minor signs of dementia and was really approaching the need for care. Mum was put into a care home, 20 minutes away from my sister’s UK home, an hour from my permanent home.

I find it easier to defer to my sister, so the home contact her when there are developments. Recently I received a message from my sister, currently overseas, to say that Mum was moving to the palliative care hub, could I pop in to see her. Off I went. Yes Mum has deteriorated, mentally more than physically. My Mother has gone. For years she hasn’t known me, but there would always be moments when we would connect. A prayer, a hymn a poem. Now there is nothing. She sits, toothless because she has lost so much weight they fall out, clapping and shouting wee wee. My Mother has gone. Why visit? She doesn’t acknowledge that anyone is there, she doesn’t care that anyone is there. I’m just ticking a box. Checking that the person with my Mother’s name is warm, clean and cared for. I spoke with my sister. Reassured her that although Mum has deteriorated mentally her physical state makes me feel that we will still have her in 2026. Sister has decided to come back in a couple of weeks to be with Mum on her journey to death. Perhaps this is where I go wrong. I don’t feel the need to be there, to witness life being extinguished. I’m already grieving my Mother.

Parish Council farce

Where are you Jackie Weaver when you’re needed?

If only we were still zooming, his gizzards would have been fried. Whose gizzards? The council bullyboy’s. You saw Handforth Parish Council and the loudmouthed, bullies? They are not the exception and, what’s more, you cannot get rid of them. Our Parish Council has it’s very own ‘I’m the chair. I have all the power’.

I’ll give a little outline. It’s May. It’s the annual meeting. Time to vote in the offices. Chair, vice-chair etc. We had a Chair who was a micro-manager and had to be ‘in’ on everything. Every project, every agenda item, he had the final say on. He was a worker though. The control freak wasn’t too good, neither was the misogynism, bullying or favouritism but on balance he was the best choice. He was voted back in unanimously, as was his vice-chair.

Annual meeting. Chair of Finance not present but Chair was happy to carry the responsibility. A few questions were asked, just process, nothing contentious. Then a topic that Chair had issues with, picnic benches. Council had agreed months ago to move forward with the project by going for tenders. All that needed to happen was agreement. The Chair wanted to put it off, again. No reason, just defer. Obvious unhappiness from ward councillors.

There was a slamming down of his glasses case, a shuffling of papers. Then he stood and shouted to the assembled councillors and the clerk that this was the shortest ever time of Chair, that he was resigning. Then he stated that 2 councillors present had done to him what they had done to a previous Chair and Vice-Chair. Made him resign. I shall not go into detail, except to say their resignations had been due to them not being aware the clerk was not up to being the Responsible Financial Officer, and that when they did realise they had attempted to hide it from council. That no one, or 2 councillors had been responsible for their resignations. Anyhow, following his outburst he left the meeting, reappearing 3 minutes later to state, ‘I’m not resigning as Ward Councillor though’. Then he went again. Silence, a shocked silence, reigned.

The man lost his temper. Behaved in an unprofessional manner, at a Parish Council meeting. A public meeting. Lied about 2 councillors to justify his behaviour.

Where do you think this leaves him?

Is he still a Parish Councillor?

Is he still Chairman?

Does his behaviour fulfil the Councillors Code of Conduct?

Transformation

Husband was in remission but his back was really causing him grief. His walking was becoming unco-ordinated, or that was how it appeared. His balance was off and sleeping, well, he, we, could forget that, the pain wouldn’t allow for that luxury. I was reassured by the fact he had a routine check-up with his haematologist, even though he was certain that the problem was his old back problems.

Before the meet with the consultant we needed to get some good analgesia on board, up until now he was on a diet of rogue painkillers that I had stashed (you never know when you’ll need them) under the stairs. Own GP, yes have these. Enough for 2 weeks. Repeat prescription request, half dosage prescribed. See locum GP. Now, she was more interested in telling us how ‘away with the fairies’ she was on half the dose of Gabapentin and how dangerous Cauda Equina is. She had suffered it. Had been unable to pass urine, or shit. She was obviously agreeing with husband that the symptoms he was displaying were spinal injury associated. Whatever. Prescribe him adequate pain relief. After another visit and an email we achieved the seemingly impossible, making his pain tolerable. Still horrendous, still incompatible with sleep but tolerable.

At last his consultant appointment arrived. His bloods were okay, as usual. Of note. Don not ever believe that NHL can be ruled out by ‘normal’ blood results. Throughout Husband’s results have been wonderful, reassuring. He told her about his back playing up again, in fact must have bored her rigid by detailing each and every episode of pain, incapacity, nerve damage and disc surgery. Before she nodded off I interrupted and told her that it was atypical, that he had never had difficulty peeing before, that he had never had groin numbness or great balls of fire before., and that all of this was left-sided, where his pelvic mass had been.

CT scan, urgent, requested. Just a little titbit here. I was due an MRI, non-urgent, both our appointments happened to be on the same day. Mine at the good old NHS resource, his at the yummy, private facility the NHS are utilising for their urgent work. 6 days later I had my scan results, 2 weeks later his ‘urgent’ results were still not available. In desperation the facility were requested to get someone, hopefully qualified, to look at the images. They looked and said there was something there, but that they weren’t worried. By now husband was very worried. He was still convincing himself that it was his back problem and he was worried that the nerve damage was more likely to be permanent due to the timescale.

Thankfully the Team were unhappy with the images so ordered a biopsy under CT of the ‘something’. Almost immediately an MRI appointment came through, and a repeat blood screen request.

We were invited for an appointment. Specialist nurse was there. Full results of anything were still not available but the preliminary conclusion was that the lymphoma had woken back up, the volcano was showing activity. Chemo was the way forward and it was booked to start the following Friday. Come in Wednesday to sign the consent form and have a covid swab.

Wednesday. Wednesday the 3rd August 2022. Was it my imagination that the receptionist on the unit seemed kinder than usual? That the staff who usually bustle past acknowledged us, said hello, smiled? Results are in. Large mass, bigger than before. Pressing on spinal cord, encompassing nerves and blood vessels. Its no longer Follicular Lymphoma, it’s transformed and is now Diffuse Large B-Cell Lymphoma, DLBCL. Time stood still. Ice flooded my system. I looked at husband and I could see the fear. ‘Fuck’ was what he said.

Volcano

Our journey goes on. The chemo finished in April 2021 and husband had a PET scan.

Now, this Non-Hodgkins Lymphoma is a tricky little bastard. A sufferer is never cured. What happens is remission. A person with NHL, who has achieved remission, is a dormant volcano. All their nodes, lumps and bumps are non-active, there are no active foci on Positron Emission Tomography scan. Excellent news, we had seen off the beast. Now there would be 2 years of maintenance treatment using one of the chemo drugs. A quick visit to the hospital every other month.

I’d love to report that life returned to normal. It didn’t, I’m not sure if it ever can. Covid is lurking, ready to pounce if we relax. Back in January he caught the dreaded Coronovirus. The NHS responded amazingly. Positive LFT, positive PCR and 24 hours later the local hospital phone and invite him in for a monoclonal antibody infusion. Husband has now had 5 vaccines, still we don’t feel ‘safe’. It really doesn’t help that to go on holiday we will have to pay £300 for single-trip insurance. What should be the time of our lives, the reward for a life of working, is turning out to be the worst time of our lives.

Can it get much worse? There is a global economic down-turn, Russia has invaded Ukraine and I have suspicions that the UK is being governed by a lunatic. Six weeks ago husband complained that his back was hurting. He has an impressive history of back issues, compressed disk, nerve damage, foot drop, loss of sensation. He diagnosed pain due to compression of the sciatic nerve. Oh yes, Dr Google has nothing on my beloved when he has his white coat nearby. I was delighted that he had an appointment up and coming with his consultant because me, the harbinger of doom, was suspicious that it was the pelvic mass on the move. That there was a shifting in the magma chamber.

Christmas looming and husbands birthday. Strangely I wasn’t feeling terribly festive approaching Christmas 2020. My close relationship with my family had been erased due to lock-downs and bubbles and my husband had been diagnosed with non-hodgkins lymphoma and had just started chemo.

Sometimes I think I may have manic tendencies. Having said that we wouldn’t be having a Christmas tree or decorations I decided we would amalgamate husband’s birthday and the Yuletide spirit, only I wouldn’t tell husband of my plan. Basically on his birthday the family and a couple of friends would be invited round, to stand in the front garden, and we would switch the decorative lights on and celebrate his birthday.

I ordered lights, stationary and flashing, coloured and white. Strings and shapes, 3-reindeer pulling a sledge. Not content with that I purchased a waterproof, bluetooth speaker and copied all our Christmas tunes to i-pod. I couldn’t help husband knowing I was putting up a miniature Blackpool illuminations but I kept the music, friends and family a secret. I did warn the neighbours though. Everything was on timers, at 7pm husband stepped through the front door, all the family, plus friends were standing waiting, if this was his last birthday it would be one for us to remember. The lights went on, the music played, we toasted Christmas, Birthday and Chemo.

Goodbye Dad

No photo description available.
My Dad

Two days after celebrating my husbands life, my 99 year old Father died. He had suffered a stroke 2 weeks before, gone to hospital, developed Covid-19, and been started on the end of life pathway. There is so much I could say, so much turmoil, distress, sorrow, regret.

On his final journey only one person could be with him, and that couldn’t, wouldn’t be me. Due to Covid-19 and a CEV husband who had started chemo I was advised I shouldn’t be there. I have a much younger sister. We had always supported each other, she had to face this alone. I could be at the other end of a phone, but not be with her. My relationship with my Father was dysfunctional. There were questions I had which he had never answered, now I would never know the answers. I could never say goodbye. The door would be firmly closed but the story not have a satisfactory ending. The worst thing though. Not being with my sister. His final hours were marked with my sister and I talking on the phone, her describing to me what he looked like, what his breathing was like. Then, he died. I had no idea what to think, what to do. I stood looking out of the window at a clear night sky. Suddenly a star moved across the sky. The logical part of my brain knew it was co-incidence, the emotional part believes it was a sign. It was my Dad leaving this world but allowing me to witness his final flourish. Goodbye Dad.

R-Benda

Should he enter the trial, should he just go on the traditional route? He read, we read. Hmm. The big thing, for both of us, was that traditionally, once in remission (more on that later) patients go on maintenance therapy. The research wants to decide if maintenance and or PET scans is the best way forward and to assist with this you go into a blind study. Basically this means that you may be given the maintenance, rituximab, or sterile water, you don’t know which, and then they see how many remain in remission and how many have a recurrance. The PETReA study was at a hospital 40 miles away. Husband decided that 1) He wanted to know he was having maintenance 2) The journey for his treatment would be easy. It was now November and he was worried about adverse weather affecting travel.

He opted out of the study.

Gosh. Haematology, oncology don’t hang about. He was given 2 days the following week when he would be starting chemo. The chemotherapy he would be on would be rituximab and bendamustine. Laiden down with information we walked out of the consultant’s office.

Would that life in 2020 were that simple. Coronavirus, COVID-19 was there. Lurking, ready to strike at anyone but especially if you were a grown-up, with pre-existing medical conditions and even more so if you are immuno-compromised. Husband looked to be the viruses favoured target.

Straight Talking

The doc may be small, but she doesn’t believe in small talk. The facts are itemised.

It is Non-Hodgkins lymphoma, follicular.

It is demanding treatment, no Watch and Wait for husband.

The pelvic lump is bulky, and there are signs of NHL above and below his diaphragm, and on opposite sides of his body it’s Stage 3, bulky.

Chemo.

Would that it was that simple though, there is a study. PETRea Do you want to take part? Here is the information. Read it and decide. We will see you in 2 weeks and proceed from there.

Oh yes. Don’t catch Covid, you will die. What? We had covid right at the start of the pandemic. We are immune, he is immune. Well, actually it turns out that he might not be as blood cancers can destroy your immune system. So what does this mean? It means that he must ‘shield’. That he must avoid people. Socially distance. Be Mr Very, Very Careful. That wasn’t the worst news though, I was included in the advice. The message being, you can’t die but you can kill him. You are also in social isolation. CEV. My husband is propogating acronyms. He has NHL and he is CEV, clinically extremely vulnerable.

‘Thank you’. Yes. That’s what we said, ‘thank you’.

We were summoned to see the haematologist, not an oncologist. Lymphoma is classified as a blood cancer. That made us feel it could just be masquerading as a malignancy. That it’s less serious, less of a cancer. Is this just the different ‘label’ or that the GP had planted in our psyche, that this NHL was a good cancer to have. Is it just that we are choosing to believe that this a fake cancer?

The day comes round to see the consultant. We are greeted at the hospital atrium by two people at a trestle table. Hand gel is promoted, masks are required and then the persons ask where we are going. We tell them and they decide I can’t accompany husband. We show them the letter which states I am expected to be there. They are adamant. Then my strong, unemotional husband grabs my hand and tells them he is not going anywhere without me. They make a phone call and I am ‘permitted’ to go up to the clinic with him, and we sit there, and sit there. No one else waiting, chairs all socially distanced. The whole hospital is like this. An environment which is usually busy and buzzing is virtually deserted. Areas which usually have a strange mixture of seating, all pushed up together, peopled with an assortment of humanity is now silent. The chairs solitary and only a couple of lonely attendees waiting, waiting for something, someone to acknowledge their existence. The usual sense of urgency has dissipated.

Just as we were giving thanks for the fact that parking charges were no longer in effect a small lady appeared before us and indicated that we should follow her. What is the protocol? We can’t get too close and we mustn’t pass too close to others. We mustn’t lose sight of her though. I felt as if I was participating in Alice in Wonderland and I was trying to keep up with the white rabbit, or was it the Queen of Hearts and she would suddenly shout ‘Off with his head’? Then we had manoeuvred into a room and were sitting staring at a pair of eyes. My headmistress, a nun, said to me that the eyes are the windows to the soul. I looked into this doctor’s eyes and I saw her soul, or I saw something that told me we were not about to discuss a fake cancer.

Recap. Painless lump. Transient, itchy rash. Breathless. Scan. Biopsy.

The escalator increased it’s speed and an appointment to see an haematologist flew in. A face-to-face appointment was issued and, despite Covid, I was invited to attend. Meanwhile I had sneaked a look at husbands medical record on the GP patient portal and there were the result of his Computerised tomography, CT, scan. Yep, there it was , the lump in his axilla. Hmm. The 9cm one in his abdomen, pressing against the major arteries supplying his lower limb came as a surprise to me, and an even bigger one to husband. He had been totally unaware of anything alien lurking in his abdomen, especially an intruder bigger than a grapefruit. It did explain the difference in leg colour though. There was a mention of the pancreas but all seemed not too bad really.

The waiting in the scheme of things was very short, but I have to say it seemed like an eternity. Information but no explanations, we had no idea where it was going. Our friend had Non-Hodgkins Lymphoma (NHL) 14 years ago and she had ‘Watch and Wait’ for a year. NHL is a weird old beasty. It can be several different types (see below) It can be quick or slow. The GP said that if you have to have cancer then it’s the one to have. Our friend had a round of chemotherapy and has been well ever since so it all seemed quite positive really. Husband was told by the GP that it was Follicular Lymphoma. That was the same version as friend had. All good.

We made the decision not to share any of this with the family, how can you share something which is still gradually revealing itself to you? We were finding it difficult to sit on our hands, not read too much, not anticipate and not get ourselves tied up in knots. Why inflict that on others?

Non-Hodgkin Lymphoma | Ask Hematologist | Understand Hematology

Back in March we both came down with Coronavirus. Recovery was slow but we just felt pleased that we were gradually feeling slightly more like ourselves. Yes, we were both breathless, husband more than me, but so what.

Life was returning to a new type of normal. We were socialising more, masks had become a fashion item, hand washing and sanitising part of ending every activity, of entering and leaving every shop. Everyone was walking, footpaths grew wider and wider. Farmers appealed with walkers to stick to footpaths. People would keep their distance. It was socially accepted that if you were walking down a pavement you would step into a driveway or into the road to ensure that social distancing was maintained. People would smile at each other, even say thank you, conversations would start up. The world, locally at least, became a far more friendly place.

August came and husband told me about the painless lump that he had discovered in his armpit. After 3 weeks it was still there, perhaps slightly bigger. He also developed this rash. Very itchy. He decided that it was a sweat rash. I wasn’t sure so gave him some Fucidin H to try. It helped. The H is hydrocortisone, a steroid. I noticed that his legs were different colours. One was paler than the other. I suggested he consult the GP. He wasn’t keen.

After a couple of weeks Husband must have been worried as he made an appointment to speak to the GP. The phone call, GPs don’t automatically see patients anymore as Covid has affected everything, led immediately to a face-to-face. The face-to-armpit led to a scan. The scan led to a biopsy. 3 weeks from phone call to biopsy.

Off we went to Cornwall to stay with our friends. On the 4th day we went to a beautiful little port, Portscatho. Standing, admiring the view over the bay, Husband’s phone rang and our lives took off on a different path. It was the GP, ‘It’s cancer’.

As I took this photo Husband was on the phone receiving the news that would decide our lives for at least the next 10 months
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