Saturday, 30 January 2010

An Update - Of Sorts

It has been a week since my last post and essentially nothing has moved on in terms of my diagnosis. I have received my appointment to see the Oncology specialist next Friday morning, that will be when I find out exactly what sort of badness was lurking in my left testicle and what we need to do about it, so come back next week to find out more.

In essence this week has been about recovering from my operation. I stopped taking the painkillers (not that they actually gave me any on discharge) early this week. From that point of view I seem to be recovering well, I've just been getting on with it. My interview was postponed by all of about 18 hours but that did mean the journey to London and on the tube was slightly less uncomfortable than if might have been. My suit trousers were the biggest challenge though - not fun going from roomy PJs to a waistband that sat precisely on my inguinal incision. The interview itself; well I guess it is impossible to say, it could have been better, could have been worse.

In other news, we have our fingers crossed that we may have found a new flat. It has its compromises in terms of size and furniture (in that it doesn't have any), but it does offer a small garden which will be nice and is cheaper than our current place. It is about 50 metres from where we currently live so will be easy to move over a week or two and should provide a stable base where we can get on with more important things rather than having to worry about being made homeless.

By the way, if anyone knows of any lovely Scottish hotels, I'd be grateful for your recommendations. With all this, and going abroad pretty much ruled out, I think a tour of Scotland on honeymoon might be an excellent way to start married bliss.

Sunday, 24 January 2010

Quite a Week

The news that I had testicular cancer barely had time to settle in last week. After finding out on Tuesday afternoon, things moved rather quickly. On Thursday I had a CT chest/abdo/pelvis and on Friday I was admitted for an operation to remove the offending testicle.

It is probably a cliché to say that all this will make me a better doctor but it was a very peculiar experience to be in a hospital gown on a bed. It was a long wait in the morning before I was called down to theatre but when it finally came everyone was great. The anaesthetic trainee who put me to sleep was fantastic, I didn't feel her whack a huge cannula in the back of my hand and the next thing I remember was waking up in recovery. I was given IV fentanyl for pain relief which was the most bizarre experience of my life and wheeled back up to the ward where missbliss was waiting for me.

By that evening although I could barely move I wanted to sleep in my own bed, the surgeon had been to debrief me and was happy for me to go home and eventually I convinced the ward sister that I could walk without falling over and she let me hobble into a taxi.

I have a lot of sympathy for any patient having an operation, it is fucking painful. I spent all Saturday in bed and have just about made it to the sofa on Sunday with significant pain relief. I can just about stand up and hobble around. Although it is still very early days it feels good to be rid of my left testicle which was apparently mostly cancer. I have been told the CT scan was clear but I'd like to see the report myself.

In the midst of all this, as well as moving house, getting the car fixed and getting married I've just been offered an interview in London next Wednesday. I'm going to give them a call on Monday to see if there is any leeway to rearrange otherwise it will be a rather painful train journey. With regards to the cancer, repeat blood tests await and a review from the specialist oncology centre to advise on further treatment when my histology is back.

Finally, a big thanks for all the good wishes on my last post.

Wednesday, 20 January 2010

Breaking Bad News

2010 has not exactly had the best start. Our landlords have just given us notice on our flat as they wish to return and I've been in a car crash which was the fault of some idiot who didn't even bother to stop to check I hadn't died. As they say, things come in threes and it was only a matter of time until something else happened...

Breaking bad news is never easy and is best done under controlled conditions by either a GP or a senior consultant ideally with the support of a specialist nurse. Sometimes it doesn't happen like this and it can be junior doctors who are put in a very awkward position but we're trained for that right? At medical school, a great deal of emphasis was put on communication skills, with particular emphasis on breaking bad news so it should be easy? I've had my own experience of breaking bad news to patients and relatives. Imagine breaking bad news to someone who is a doctor, would that be easier, harder, or perhaps just different?

Yesterday morning I had an ultrasound scan.

I can pinpoint the exact second I knew for sure I had it. It was 11:21 am and I was laid on the ultrasound couch chatting to the radiologist about my career aspirations as he probed my groin. The second he moved the probe up to look at my liver I knew, there could be no other explanation, he was looking to see if it had spread. He didn't say anything and nor did I, but he didn't have to. Although I remained calm, everything after that became a bit of a blur. When he'd finished I'm sure the radiologist already knew that I knew but he nevertheless confirmed my fear, I can't even remember how he broke the bad news but he almost didn't even need to. Before I knew it I'd had a chest x-ray too and was back to work on my ward. I sat there trying to to the simplest of jobs but 10 minutes later realised I hadn't actually done anything. At that point I knew I needed to go home, my consultant was great and I was soon back at home in desperate need of a cuddle or two.

So yeah, I've got testicular cancer, watch this space.