Cancer & Me – Thirty Years On (Part 3 – Brachytherapy – the Radium Needle Implant)

My younger son spent as much of his Easter holidays with me as was possible and we travelled far and wide together, spending several days in London with friends who drove us all around the sights and we also saw Les Miserables from the cheapest seats up in the gods, looking down on the heads of the company, but nevertheless enjoying it (if that is the right word for we felt quite exhausted afterwards). We went up to Cumbria, to stay with another friend, visited Kielder Water, the Beamish Museum and attended a fund raising event hosted by Jonjo O’Neill, the jockey and trainer, himself a cancer survivor. The star of the show was Aldaniti the famous racehorse who had won the 1981 Grand National, ridden by Bob Champion, who had recovered from testicular cancer and the horse had even been nursed back from serious injuries. Bob’s story was made into the film Champions, starring John Hurt.

Aldaniti

_____________________________________________________________________________________________________

I was admitted to Christie Hospital (and Holt Radium Institute, as it was then) in April 1986. Dorothea came over to my folks to collect me the previous evening and I stayed the night with them. Not long after I got to Christies other ex-Zambian friends came over from Chester to visit.

Connie, Me, Jack and Stephen (Dorothea’s eldest)

I was introduced to the consultant in radiotherapy, Dr James and with him I had an immediate rapport. I was quick to notice a segment of one of his eyes was a different colour and I found it fascinating – even though I had seen this before on a friend at school. By some amazing stroke of luck, he had actually done three years at the University Teaching Hospital, in Zambia’s capital, Lusaka, so we already had a mutual connection. I felt safe with him and the staff.

Dr James examined me and explained I would be undergoing a series of tests, including rectal washes over a few days. I was to be given a radium needle implant, well, caesium to be precise. He showed me examples and I thought the word needle to be rather a misnomer, as the needles with their applicators resembled terrifyingly large nails! So, I would be moved to a bed in the corner, which had the radiation sign above it, to remind people I was radioactive. Ten needles would be surgically implanted around my anus, stitched into position and to be left in situ for nearly six days, with me remaining immobile for all that time and visitors only allowed for one hour and could come no closer that the foot of the bed. I’m sure the word brachytherapy wasn’t given to me at the time, but it is so hard to take everything in, that it may not have registered.

I would be on a special diet with no roughage and given medication to make me constipated and I would be catheterised. Each morning the nurses would bring me a bowl of water to wash in, bring me food and remove the tray after I had eaten. They would also bring a controlled drug to fight against infection, which needed two of them to sign for and administer. The needles would have silk threads attached to them, which would be the only visible sign after insertion and these would be taped to my legs and counted regularly just to make sure they remained in position. There would be no other contact from the nurses and I was to lie as still as possible.

Later that day I made a point of wandering down to the children’s ward for I knew that would be the leveller and help me get things into perspective. It certainly did that; children of all ages, bald headed, sunken pale faces, huge eyes, hooked up to all kinds of tubes or machinery – and great big smiles. The tears rolled down my face as I made my way back to Ward 1.

The procedure went ahead as planned and the nurses tried to make me as comfortable as possible. Visitors came and went (Dorothea or Pete most days) and a friend brought my parents in to see me, but I just couldn’t bear the pained expressions on their faces and it was really hard to cheer them up, as by this time the pain was becoming intense as I became quite badly burnt and when I moved the needles would criss-cross against each other. I was told I needn’t suffer, as I could ask for something for the pain at any time and not to worry about becoming addicted, as they would wean me off it gradually. I chose not to have any morphine, but one day I asked for some medication for a headache. And what a pleasant surprise to find the patients were offered a tot of brandy or sherry from the trolley, provided by the Friends of Christies. I looked forward to teatime each day!

Photos of the procedure are not for the faint-hearted so I tried to find diagrams that would explain better than I can verbally. I found several, but not pertaining to anal cancer, so these are the nearest and they are with regard to prostate cancer, so at least a similar area!

image from SeeDOS Ltd

Image from Wikipedia

If you really want to see a photo of anal brachytherapy, I managed to find one here: http://www.thejgo.org/article/viewFile/2694/html/17835

By the end of the six days I was quite badly burnt and the sickly sweet smell of burn flesh very noticeable. As the days wore on and the 132½ hours approached I became more and more sore and very scared of having the needles taken out. I have good healing skin and I knew it would be difficult removing them. Because the time had to be accurate they would be removed precisely at 10.30 at night and a sister had to do it, as staff nurses weren’t qualified to perform the procedure.

That night we didn’t have a sister on duty, so one from another ward had to be called, someone I had never met before instead of one of those I knew and trusted implicitly. By the time 10.30pm and the new sister approached I was in a state of panic, but without justification, because she was just as kind as the nurses who had been looking after me. Upon hearing my concerns she called a doctor, who came and administered an intravenous dose of Valium, which quickly sent me off to cloud cuckoo land! The sister was onto the 7th needle before I came back to earth. From then on it was painful, but far from horrendous.

The next hurdle was to get the old bowels open and I couldn’t leave hospital until then. From not being able to eat any roughage, I was suddenly stuffing myself with fruit, vegetables and anything else recommended. Everything failed! Everyone on the ward was most concerned about me. I would go off to the loo and when I emerged they would ask if I had been successful. Negative! Finally, in desperation I was given a castor oil enema. I had to lie in bed with the foot tilted upwards in order to help the caster oil do its work. When finally we had lift off it was excruciating – the back passage being so terribly burnt, but I felt it worthwhile as I had avoided a dreaded colostomy!

There was a well educated elderly lady in the bed next to me and when I told her the enema had worked she clapped her hands and exclaimed in her very refined voice, ‘oh, jolly hockey sticks!’ I thought that expression only existed in girls’ stories from a bygone time!

I’d been in hospital two weeks and back home at my parents I had daily visits from the District Nurse to ensure the burns didn’t become infected, but there wasn’t much she could do, finally deciding on honey dressings. The burns covered approximately a 4” diameter and by now were oozing pus. Going to the toilet remained a problem, but on the 21st April Charles and Diana were coming to open a sports centre in my town and despite the pain and discomfort I went along to see them, Mum and I were taken to the venue by Dorothea, as she wanted to see them too.

Mum and me waiting to see Charles and Diana (bit of a pained expression on my face!).

I was on a three-month air ticket and by the end of that time it was obvious that I wouldn’t be able to sit on an aircraft for several hours, so another friend pulled a few strings with the airline company and got my ticket extended by a month at no extra cost.

Being faced with your own mortality really spurs you on and even though I could hardly sit down even with the aid of a rubber ring (provided by Dorothea), I worked like a wild woman on commissions to try and make enough money to repay my airfare (I didn’t have time to die) and also did a painting for Ward 1, as they had very little on the walls. There was snow on the ground when I was admitted to Christies and the first daffodils were bravely pushing their heads through the snow. I saw that as a metaphor and so painted them and took the picture to the hospital when I went for my first check-up. The nurses got the maintenance man to hang it on the wall by my bed. In addition I framed two prints for them.

Looking back it’s hard to remember which paintings I did just after being discharged from hospital, but I think this is one from that period before I returned to Zambia:

Samantha

Some of the staff with the pics I took to Christies:

In the pictures above are Sister Kay, Staff Nurse May and Auxiliary Vera, apologies for not remembering the names of the other two sisters. I couldn’t have wished for better treatment from any of them. Next time it was to be on a surgical ward…