Biopsy

Each time I sit down to write a blog entry, I immediately get caught up in displacement activities. Check out South Georgia  - it's stopped snowing and the sun is rising and the snow covered peaks are turning a beautiful warm pinky colour. Read the papers. Play patience. Look out of the window, make yet more tea, comb a cat or two - anything rather than sit down and write something about me, and what I've been up to. Of course, it's true: I don't really want to be blogging at all, I don't think people are that interested in what I have to say. And I certainly don't want to be blogging about health problems, they are something that happen to other people, not me. My health has been so good for so long that I take it for granted, and get mildly affronted when I come down with a cold or something.

Which isn't even true, actually. I've had severe eczema for much of my adult life - the sort of thing where my dry skin cracks and bleeds and I can't wear pale colours in case it shows, or where you can always see where I been sitting because of the tell tale dusting of dandruff-like skin fragments around my chair. That went away, then a few years later I had some mental health problems. Then later, I had recurrent skin infections, then alopecia: when you stop and think about it, I'm a wreck.

But none of those things stopped me doing stuff, getting on with life. This, this tumour thing, is stopping me. I find I get really tired doing the least little thing, like making breakfast, or having a shower. I don't want to live in a world where emptying the dishwasher is something I have to recover from - Phew! I've just put away 8 mugs, 2 saucepans, and a selection of cutlery, now it's time for a break! I'm not even on chemo yet and I'm going on like this. I'm mystified as to why, and why so suddenly. I beat myself up that it's all psychosomatic, and actually I'm fine but taking the opportunity to be lazy - who can say?

Me in the UCH Cafe

Anyway, the biopsy.

We set the alarm for 5.30. I was awake at 4 and although I tried to sleep some more, it didn't take. So I got up at half past 4. Light breakfast and a shower, some recovery time, and we got a cab just before 7. Train and tube into UCH: we got there about 8.15 in time to have a cup of tea in "The Cafe" - my, how things have changed. I remember working at Barts in the 1980's when the only facility for patients and visitors was the grubby WRVS canteen in the bowels of the hospital round the back somewhere. It had a giant institutional tea pot full of not quite hot enough tea which was strong enough for depilation should you wish, and a choice of rolls in ham or cheese. An unchanging coffee cake under a plastic lid by the tills, made during rationing and last tasted in 1964. Opening hours: 11 - 11.30 and 2 - 2.15: plastic chairs and wobbly tables and a single lightbulb hanging over the till. By contrast, "The Cafe" at UCH was bright, spacious, and welcoming. It had a huge choice of things to eat and drink and you could watch the world go by while girding your loins for things to come. Well done UCH.

We got up to Imaging just after 9, and were led off to a treatment bay where I was asked the standard questions & got changed into the hospital gown. Then we were whisked down the corridor by a reassuringly breezy radiotherapist to the scanner room. The clinician who was to perform the procedure was Dr Taylor, a very pleasant lady who had a reassuring air of quiet competence. She gave us an absolutely clear and precise account what was to happen and possible side effects, then Godfrey went back to the waiting area and I got scanned. Except I didn't: first the machine broke down, and once they'd tried turning it off and turning it on again, they had to send me away and wait for a man with a hammer to come and fix it. 40 minutes later, we were ready to go.

Siemens Somatom Sensation 64 !

Just before the scanning started, Dr Taylor suddenly realised that poor Godfrey was unaware that there'd been a delay, and sent someone to tell him, so that he wasn't alarmed by my long absence. I was impressed, I was expecting more of an "it takes as long as it takes and you'll just have to wait" philosophy. Thumbs up to UCH, again.

Then all the lying down, sliding in an out of a giant polo mint. Repeated scanning. They scanned me first, to see the tumour and decide how to proceed. Then a guide tube was inserted under local anaesthetic, which was quite uncomfortable at times although not exactly painful. At each stage of the tube insertion, I was slid back into the scanner to check the placement. Then a clipping tool was put down the guide tube and pieces of the tumour were snipped off with a loud "Clip" noise.

Then it's all over, and off to the endoscopy recovery unit to recover. After a lung biopsy, there is a danger of creating a pneumothorax. So they do an X-ray after one hour, and then another 4 hours after the procedure. Then we were good to go. We left the hospital at about 4, and were home by just after 5.

I saw the CT image of the tumour, and Dr Taylor has kindly promised to send me a copy to put on here. But in advance of that, if you imagine your chest cavity as a kind of open figure 8, the tumour appeared to take up about half the space on one side. She said it was well defined, and pushing other vital organs aside rather than engulfing and absorbing them, which is good. The image I saw was only a slice, at one particular horizontal level in my chest. It could be bigger or smaller at another level. But I'm puzzled, because I glimpsed one of the X-rays as well, where it seemed to fill the lower portion of my right lung. In my head I can't square the two. All will be revealed on Monday when we're going back to OP and will, we hope, get a diagnosis.

CT Scan: The clipper is about 2cm beneath the guide tube you can see, and the void below is where the material was clipped from. This view is looking up from my feet: the tumour is in the right lung

We were both shattered when we got back, and I went to bed at about 9 and slept for 11 hours. But I'm still tired now. I'm starting to realise that this time, I have an illness which won't let me carry on as normal, which will force me to confront how much of my own self worth is defined by what I do rather than by who I am. Uncomfortable times ahead, I think.