Another Day, Another Hospital Stay

The Progress of the Wound

I’ve spent so much time in hospitals over these past 12 months that I’m starting to consider myself somewhat an expert on them. Sure, the staff at a hospital spend much more time there than I ever could, but they aren’t then forced to sleep on the thin foam mattresses and eat the inexplicably disgusting food. When I go into the hospital, I really walk the walk. I throw up in the cardboard buckets, sulk in the side rooms and indulge in the various sizes of cannulas. Once, I had 3 separate cannulas in my two arms, yet the nurse still approached me and asked if she could put in another one. “What is wrong with the ones I already have in?” I asked. “They aren’t big enough for a blood transfusion,” she responded. I wondered how my veins were still managing to carry blood around my body at all. They were starting to resemble a Kerplunk tower.

My knowledge of hospitals is exactly what makes them so unappealing to me. The overbearing smell of the chemicals used to clean every surface. The solitude of the shared wards, where I am forever damned to being at least half the age of everyone else in the room. The excitement when a nurse or doctor shows up to talk to you about something, only for the conversation to last a mere 3 minutes; a momentary break in your daily routine of watching videos on Youtube, trying to sleep and staring at your own legs. A&E is even worse, though – a holding pen of drunk, miserable and desperate people, most willing to exaggerate, lie and even scream to get a 5-minute improvement in their overall wait time. Pair that with the average wait time being approximately 2 weeks and you get a pretty unappealing offering.

A&E is so unappealing in the UK right now that I spent 4 hours last Saturday night projectile vomiting and trying to withstand some of the worst abdominal pain I’ve ever felt just to avoid it. My theory was that it would all pass if I just waited another hour…

Another hour…

Just one more hour…

Eugh.

That theory never materialised and as I lay there on the sofa, keeled over in pain, I finally succumbed to the inevitable. At first, we tried to ring an ambulance to take me. The last time I required an ambulance was to be transferred from Leighton hospital to Manchester. During that journey, the ambulance crew encouraged me to ring an ambulance in future if I am in a lot of pain as they described my case as “more worthy than 99% of cases that we spend our lives attending to.” Encouraged by this advice, and in desperate need of some top-grade morphine, I called the ambulance service.

Unsurprisingly, they told me that I could wait, but it would be at least 4 hours. Who would have guessed that the ambulance service would be busy on a Saturday night? Perhaps I should have lied and told them that my chest and back were indeed hot, and that my stools were so black and tar-like that they turned the water in the toilet basin the colour of squid ink, but that isn’t the kind of person I am. I answered their list of questions as honestly and positively as possible, which got me exactly where it was always going to get me. Deprioritised. Rating your abdominal pain an 8 out of 10 and repeatedly projectile vomiting 2 months after major surgery is only worrying if your chest is also warm… You really do need to be on death’s door before they’ll take you seriously. My last ambulance crew told me that they spend their lives attending to low-priority calls about issues that barely require hospital attention, but maybe they were just liars.

My mum, Anna and I jumped into the car. Royal Stoke hospital is a 20-minute drive, so it isn’t too bad. It was the pain relief that I was so keen to get, and I knew that I wasn’t going to get it for hours if we walked into A&E. When you get an ambulance, you get it before you even make it to the hospital! It is a life of luxury in an ambulance – you’re given your own driver AND a separate paramedic who can prescribe you morphine; no wonder they’re so popular on Saturday nights. I crawled into the back of the car. My mum handed me a bucket, which was a good idea in hindsight, as 15 minutes into the journey I started throwing up again. The car stank for the last 5 minutes, but the bucket was then left in the back of the car, to my mother’s dismay as she returned to the car a few hours later. She then had to drive back to the house with the smell of stale sick lingering in the air.

Anna and I went straight into A&E whilst my mum negotiated the car park. One thing I will say about having a major operation and a history of pancreatic cancer is that you do get triaged very quickly. As the receptionist was handed my discharge notes from Manchester, which includes my original diagnosis of stage 3 pancreatic cancer, all of the gritty details of the operation, as well as the fact that I am now fully ‘insulin dependent’ (AKA Diabetic), she looked a little overwhelmed. We sat in the waiting room for no more than 10 minutes before I was called up. I was glad to be out of the waiting room – it was full of drunk, miserable people. I was also miserable, but the others were really miserable; there was wailing, shouting and some chaotic laughing coming from a man lying on a set of chairs who was occasionally shouting something at a man sitting across from him – I’m pretty sure he was being racist to the poor guy, but he could barely form a coherent word, so it was hard to really know.

The nurse took us into a bay and closed the curtain. As she asked me to explain what was happening, and I started making my way through the history of Dan’s cancer, I started to cry. At some point during my recital, a thought hit me like a freight train. I remembered watching an advert about cancer a few years ago where a woman described suddenly falling violently ill, projectile vomiting and not knowing why. A week later, she was diagnosed with cancer. I sat in the chair, bent forward and holding my abdomen. “It’s fucking spread, hasn’t it?” I said to Anna. Shortly after the nurse took us to a room and told me that I can’t be around the general population in case anyone passes something on to me. There we waited about 30 minutes for a bed and then we settled in. It was about 23:30.

It took around an hour or two for the nurse to put in a cannula, take bloods and give me a course of pain relief. Things slowed down after that. The nurse told us we were “going to be seen next” for a grand total of 5 hours. By the time a doctor finally came to speak to me, it was around 6:30 in the morning. After the pain relief had dampened my abdominal pain, I’d spent most of the time drifting in and out of sleep. Poor Anna and my mum were taking turns alternating between the two chairs in the room – one was actually a stall, so to sleep on it, they were having to lean their head forward and rest it on the bed. It didn’t look comfortable at all.

Luckily, when the doctor did eventually see me, she was extremely knowledgeable and diligent. She quickly went through my blood test results, telling me that my infection markers weren’t worryingly high but were raised. The plan was to do a CT scan at some point that morning. Unfortunately, the shift changeover was at 7:00am so after that brief interaction, we didn’t see her again. After a few more hours I was moved into another part of the hospital where I stayed for another few hours, before being admitted onto a ward. I really didn’t want to be admitted. In my experience, trying to get out of the hospital once you’ve been admitted is like trying to escape Alcatraz. The amount of procedures you have to fight through just to leave on the day you are discharged is crazy. You sit around waiting for the doctor to write the discharge notice, then you wait for the ward to process it, then you need a porter to ferry you to the discharge lounge where you have to wait for the Pharmacy to put together your medication, which has never taken less than 3 hours for me, then, finally, you’re allowed to leave. By this point, it is usually 20:00 in the evening and you’ve spent all day in purgatory, resisting eating any more hospital food because you know that soon you’ll be able to have real food from home, food that actually tastes of something.

So I went to a ward, then got moved to another ward and then went to do the CT scan. A few more scans were planned for Monday morning – the hospital needed to order some of the materials required to do the scan. The CT scan used a contrast dye which is pushed directly into your blood via the cannula which is connected to a line. The type which they couldn’t do was one where you drink a liquid before the scan, taking a cup of it every 15 minutes for an hour, and then you go into the scan. I believe the liquid you drink can be tracked as it makes its way through your body, allowing them to trace how things are moving through. Some of the details might be wrong there, but hopefully, you get the gist. The hospital didn’t have the liquid you need to drink prior to having the scan, so this is what we were waiting for.

The results of the CT scan showed that I had a blockage in my colon. One of the new joins in my digestive system had swelled up, I think, and it was causing my stomach to not empty properly. When my body realised it couldn’t digest food, it went into emergency mode and decided to fire it back out from where it came from. That seemed to explain why I’d had such a bad pain in my abdomen.

A downside to the next scan being Monday was that I wasn’t allowed to eat anything until after the scan. This wasn’t a problem Saturday night, with the taste of sick lingering in my nose and with me barely stomaching water alone. It was starting to become a problem by Sunday afternoon when I was actually feeling a lot better. My stomach was hurting but I was starting to get quite an appetite again. There was nothing to be done, though, so I settled into another night in a hospital.

A downside of being diabetic is that not eating can send your levels all over the place, especially if you’re ill. My body was not only fighting whatever was happening now, but it is also trying to recover from the surgery. The surgeon had warned me that this will likely be the case for 6 months and that my blood sugar levels will be difficult to control throughout this period. Between the illness, recovery from the operation and not eating, my blood sugars kept dropping to dangerously low levels.

For those of you who don’t know much about diabetes – the idea is to try and control your blood sugar levels in a similar way to how your body does when it is functioning properly. You inject insulin to stop your blood sugar from spiking when you eat and to bring it down, and if your blood sugar gets too low, you urgently take on sugar to bring it back into a safe tolerance. By ‘take on sugar’, I mean that you drink something sugary like fruit juice or Coke. You can also eat sweets that are all sugar, but anything that also has other nutritional content, like chocolate bars, which also contain fat, will take longer to digest. That means a slower increase in your blood sugar, which could be dangerous. Your blood sugars can be high without it being dangerous on a short-term basis, so it isn’t too concerning if they are slightly elevated. Low blood sugars can be very dangerous, though, and can result in an individual passing out, with the risk of falling into a coma.

Another downside of being diabetic and being an inpatient in a hospital is that nurses, in general, do not seem to know how to manage it at all. That night, the nurse came to take a reading from me. It stated that my blood sugar was at 2.7, which is low. The ideal range is between 4 and 7, but I consider anything up to 10 as Ok. The reason it had got so low is that my Continuous Glucose Monitor (CGM), the device which is attached to my arm and continuously sends readings to my phone, tends to record around 2 points higher than my blood sugar level when tested. It isn’t always that different, but when the blood sugar levels are changing frequently, as they were that night, it tends to be more inaccurate. That meant that I thought my blood sugar levels were around 4.7, which is fine, but in reality, they were lower than this. As I had recorded low blood sugar levels, the nurse had to put me on a sliding scale.

Now, I repeatedly told her that I’d rather manage it myself and that my body will be very susceptible to insulin when my levels are being so volatile, but that couldn’t supersede the ‘process’. If your blood sugars are recorded as low, the staff have to ‘take control’ the nurse told me. The problem is that most of the nursing staff don’t seem to understand how to control a diabetics levels. I heard the nurse repeatedly asking another nurse how a sliding scale works, what she should be doing with it etc. I wasn’t particularly happy that this person was in charge of it.

A sliding scale is a machine which is hooked up to the cannula and monitors your blood sugar levels. The nurse can tell it to give you a certain amount of insulin per hour, which is what this nurse did. The problem is that my level was randomly dropping without much warning, so why would I want to introduce more insulin into my body at this time? I said this to her, but she told me that they had it under control. Of course, that night, I had 3 hypos where I urgently had to eat glucose gel to get my levels raised again. Eventually, the nurse listened to my pleas to stop leaking insulin into my body and changed the amount of insulin being issued to 0. This was happening throughout the night as I was trying to sleep. I genuinely lay there terrified that these nurses were going to kill me if they didn’t listen to me and stop what they were doing. It is incredibly frustrating.

Going into the hospital as a diabetic is genuinely scary – you really see the lack of fundamental knowledge in the area. You are constantly given things like orange juice with your meals, there is no indication of how many carbohydrates are in a meal, which would help you inject the right amount of insulin for what you eat, and the nurses frequently seem bewildered by what to do with you as they routinely check your levels. I don’t blame the individuals, but something really isn’t working in this area of care. You’re far better off at home where you can eat healthier and be responsible for controlling your own blood sugar levels.

The next morning, the surgical team came and spoke to me. “You seem well,” the head surgeon said as he approached me. “Yeah, I feel fine now. I’m just starving,” I retorted. “Well let’s cancel the scans, let you eat and get you discharged then,” he said, to my surprise. He explained that these types of blockages usually clear themselves up and then the subject is fine. I was sceptical but I accepted what he said – he knows better than I do, and I was feeling much better now. That was that. A few hours later I was let out (I did not have to pick up any medication to be discharged with so I missed the pharmacy debacle, which was a relief).

My problem since leaving the hospital has been that some of the issues haven’t gone away. It isn’t comforting to be released from the hospital with nothing – no antibiotics, no advice on what to do next time, or what not to do to help prevent it from happening again, nothing. For the first few days at home, I did feel better, mostly. Since Wednesday, I’ve started getting this heavy feeling in my stomach and lower abdomen again. When I try to eat as much as I feel I want to in order to satisfy my hunger, I start feeling incredibly sick. The whole thing has left me feeling lost, and I’ve just reduced the amount I’m eating by a lot. I feel hungry all of the time, yet still a little bit sick. It is exhausting. As a result, my blood sugar levels are also all over the place. I seem to have at least 1 hypo every night, where my blood sugar drops too low and I have to have a glucose gel. Luckily, when my phone records a low reading, an alarm goes off. If I didn’t have this, I probably just wouldn’t be sleeping out of fear that I wouldn’t wake up.

All of this is worsened by the fact that my wedding is on Friday, so I am extremely nervous that I may have another episode around then, which would ruin the entire day. There are so many growing pains with everything going on – the diabetes, recovering from the surgery and, now, mentally preparing myself for the next bout of chemotherapy. Sometimes you wish life would just give you a break. I really need it right now.

Home Again With Little Lucy

An Update Post Surgery

The Road to Recovery

Where do I start? Do I talk about the operation and how a team of people tirelessly slaved away, working on my body for 13 hours, making sure that none of the tumour could remain? I wasn’t there for the surgery, so I can’t talk much of that experience, only the fallout afterwards. Do I talk about the stories I gathered as I was taken from room to room, doctor to doctor, fighting infections and numbing the different types of pain that were coming and going? Or do I talk about none of it at all, choosing to look forwards in my life for the first time since last November? “You will go and live your life now,” my surgeon said to me. Were the painkillers numbing my positive emotions too? I can’t even be happy about it; it just doesn’t feel real. My cancer hasn’t necessarily gone – I have to wait for the histology results to find out what comes next. I’m likely going to be back to chemotherapy soon.

It was hard to even think on it all too much for a few days, and I just burst into tears in the middle of the ward when I did. How has this actually happened? There was no version of events in my head where I actually survived this thing. I thought that my role in the world was to be that insignificant statistic who insignificantly died at the hands of a statistically significant cancer. You don’t boil yourself down to a statistic. Neither will your friends and family. Extend out a few more branches in the tree and you are in territory where you are a statistic, another name on a page. It’s how humans process information. It’s how we understand how good or bad something is. It’s how we make arguments about pancreatic cancer being one of the deadliest to have and how you have to be old to even be eligible for consideration. Yet, my surgeon sat and said to me in the most serious of ways, “We aren’t going to perform miracles, Dan. We can only do what we can with what is presented in front of us.” It seems that he has performed a miracle here, or has started the progression towards one.

So I haven’t been told I’m cured yet. Removing the entire pancreas is a good start, and I’ve only ever been told that I have cancer on my pancreas, so maybe it’s a really stupid thing to even suggest that I’m not. I’ve learnt not to assume anything with cancer, so I’m not going to assume anything. I’m almost certain there will be mop-up Chemotherapy, scans, and other bookmarks in the calendar that same carry a familiar type of anxiety. It sounds like the only objective is to get better for a good while though. Another surgeon who was looking after me for a while on the Sunday told me that the tumour would be cut apart the before performing some tests on it. That would help to indicate what the best next steps are in terms of treatment, as well as helping future research.

The headline really is that I don’t have a pancreas anymore. No more ripping on Dan Pan, Penny Pan Pan or Pan Can. This means that I am fully diabetic now and have been learning to interject insulin over the past few days. Alongside my pancreas being taken out, 3/5ths of my large bowel was also removed. Some major arteries were then reconstructed before I was finally put back together again.

I had a strange sensation on the Tuesday morning after the surgery. I’d been struggling to sleep and was overindulging in the pain relief button. It was about 4:30am. As I lay there; watching the nurses walk between their stations and the various beds, checking temperatures, replacing dressing and sitting on their computers reviewing data, I felt like I was in a game. They walked around with lights in their hands and shone them at exact spots for different reasons; because an alarm went off here, because they knew that they checked this this thing every 10 minutes. I started trying to learn their patterns and understand their movement, I was trying to figure out if I could fit in with them. Somewhere in the process, I alienated myself from them, and I sat there listening to the ‘moody’ playlist on Spotify and feeling lonely instead. My bed was in the corner and had a load of equipment next to it.

A few minutes later, the nurse surprise me and came over to get some equipment from the shelves next to me. I hadn’t predicted it. Damn it. “You do a lot for people you know,” I said to her as she filled up a box of various things from the drawers next to me. “We’re just here to take care of people, dear,” she replied with a smile. “It’s 4 o’clock. You need to sleep,” we were back to the games. I told her that I’d lost my headphones a few minutes prior after taking them out to talk to her. We found them together a few minutes later. It was a long night, why not waste a few minutes of her valuable time on my pointless games.

Stories are abundant in hospital, that’s for sure. My dad used to obsessively watch 24 Hours in A&E on tv here in England. It’s a show following the Accident and Emergency department of a hospital for 24 hours. It has everything that a compelling story might have – twists, tribulations, trauma. They don’t need to seek the stories out, only place the cameras in the buildings and wait. They knew that the stories would come from there. We haven’t been watching it so much these last few months. It isn’t so fun when your family is currently suffering from an ailment which affects you, very much centred around hospitals. My dad probably still does, but not when I’m around.

I don’t have enough energy to really speak at length about everything right now. Eventually, I’ll talk more about hospital and all of the challenges that came with it. For now, I wanted to think you all for the messages of support, and let you know that I’m doing well. I’m getting stronger every day and can walk outside the hospital when my family visit. I’m going stir-crazy on the ward and am hopeful that they will discharge me tomorrow so I can continue my recovery at home with my amazing family, fiancée and Lucy dog. The hospital want my insulin levels to balance before taking this final step, and we seem to have achieved this over the weekend.

I’m trying to do my best to remain grateful, but there is a lot of change on the horizon. It’s all very intimidating. I know that being diabetic will just be another thing that I’ll grow accustom too, but combined with the future threat of cancer, recovery from surgery and lack of any pancreatic enzymes in my body at all, it feels daunting. The next few weeks will be an interesting journey through these facets of the illness.

This is also the 100th post on the blog! What a momentous post to coincidentally fall into this milestone! Here’s to plenty more Ebb and Flowing (preferably without all the cancer, but we’ll see).

Last Thoughts Before Surgery

The Road to Recovery

‘You wanna move mountains, go ahead
I think I’ll suffocate instead
A change of scenery won’t tame
The endless earthquakes in my head

So I’ll suffer through
A means to an end, it’s all I can do’

This will be my final post before I go into surgery on Friday. I would imagine that it will be at least a week before I post again, if not longer. I’ve been told that I will be on a high-dependency ward for the first few days. Once I am cleared from that ward, I will be moved to a more routine one for around a week. Of course, it all depends on what is done during the procedure, how well I recover and whether there are any complications along the way. If a Whipple procedure is possible, the impact will be much greater on my body than the NanoKnife.

As the dietician told me, the Whipple involves the surgical team creating 3 new joins in the digestive system. Hearing the phrase ‘new joins’ in relation to your digestive system is a little unnerving; I can’t say that it is an attractive prospect of surgery. The fact that the Whipple would probably be my best chance at getting rid of the cancer however, makes the concept of having new joins in my digestive system a very attractive thing indeed. Join me up, doc… that felt a little weird to type.

Cancer is always pulling you in a million directions. Your standard of life changes so much that you find yourself feeling grateful to be eligible for major surgery, strangely looking forward to potentially having your digestive system rearranged like a hamster run. Of course, the alternative, to not have an operation and allow the cancer to grow inside your body unabated, is most definitely not better. Imagine telling myself a year ago, “Hey Dan, in 12 months you’ll be eight months into treatment for stage 3 pancreatic cancer and looking forward to an operation,” I’d probably have replied with a laugh and a “Who would look forward to major surgery?” I also thought I was immune to things like cancer 12 months ago because nobody in my family has had it. I thought I was invincible so long as I was either training for an ultra-marathon, or actually running one. Turns out that running ultra-marathons doesn’t actually make you immune to cancer. It probably makes your body a little bit better at fighting it, though, so it was still worth something. Hopefully. I enjoyed it anyway so it was worth every second.

I say that I’m looking forward to surgery. I’m not. That probably isn’t a surprise. It would be short-sighted to not acknowledge what a privileged position I am in to be offered this opportunity, though. There are people that read this blog regularly who are not in the position I am in, some who have been definitively told they are inoperable. My surgeon told me that to the majority of oncologists/surgeons, I may have been deemed to be inoperable given the circumstances, but luckily I am with a forward-thinking and optimistic team who do see opportunity here. I am grateful for that, and thus, am looking forward to being afforded such an opportunity. Am I looking forward to going through it, though? Hell no. Am I looking forward to putting my family through it? Hell no. It isn’t good for anyone involved, but it has the potential to change everything.

With a Whipple procedure unlikely to be a possibility, it’ll probably be NanoKnife. Although that carries a smaller recovery time, it still requires the surgeon to cut into my abdomen and play around with the organs there. Clamping this, cutting that; the scene doesn’t inspire a lot of enthusiasm in my brain. Then I remember that one of the things being cut is the tumour itself, and all of a sudden I get all evil and masochistic. “Do your worst, surgeon! Make him pay!” I feel like rubbing my hands together and snarling as I grin, staring at my own stomach. I’d only be cursing my own body, though, and I will eventually pay a price for whatever is done to the tumour. Whether that price is recovering from a successful removal, or recovering from electric pulses being applied to my pancreas, is yet to be seen. Either way, I’m sure it is going to suck at least a little bit in the days, weeks and possibly months afterwards.

I don’t like the war analogy when talking about cancer, but it can be hard to ignore. It’s hard not to liken yourself to someone fighting against an enemy force, even though you feel like a bystander in that war the majority of the time. You attend appointments, anticipate scan results and cower whenever the hospital calls you, but you don’t do a lot else to contribute to the process. Your war is usually with yourself – keeping your head up, finding a way through the painful days and doing your best to sleep well at night. It’s a war of attrition, but the cancer doesn’t have a brain to disadvantage it. Your brain will do everything in its power to attack you. Mine has been telling me that my neck is swollen, that it’s got in my lymph nodes and that my abdomen hurts more than usual. Sometimes, I wonder who’s side it’s really on.

It doesn’t help ignore the war analogy when you find yourself packing your bag the night before, knowing you have a critical period ahead of you. Last night, I was packing my bag and responding to all the lovely messages I’ve been sent. The war analogy felt real. Now, as I write this, I sit in the car on the way to hospital. It’s mostly silent… anticipation hangs in the air. I get the feeling that people feel more anxious than they’re letting on; you can sense it as we sit listening to the music playing from the speakers. Everyone is a sitting duck in their own head.

Anna has the password to the blog’s Twitter account, so that’s probably the best place to find an update soon on how things have gone. Thank you to everyone for the support. I will get back to all of the blog comments once I’m feeling well enough post-surgery! Thank you for continuing to read and I hope I’ll be coming back with some positive things to say next time I’m writing.

A Story About Surgery

The Road to Recovery

Dexter the Dog

I was meant to be in surgery last Friday but it was postponed by a week. Part of me wishes that I had not uploaded a post informing the audience of that fact, then uploaded a post in the middle of the day on Friday talking about being in surgery. That should have pulled in some views! I guess you can schedule posts on here, so if my audience knew about the WordPress functionality, they may deduce that it was all a ruse. Also, everyone that knows me personally already knew that it was postponed and they probably make up 50% of the audience of this blog, if not more. It would have surely fooled some people reading, though. Maybe I could have sat Tweeting as if I was in surgery throughout the Friday. ‘The surgeon is just clamping my stomach out of the way so he can access the pancreas. Still no eyes on the tiny twat of a tumour. Painkillers doing a good job but all the blood and organs are making me a little queasy #Hemophobic #ThatsSoSurgery’, the first Tweet could have read, to the dismay and disbelief of my followers.

All of a sudden it feels like I have cheated time. I got a similar sensation when I used to travel from the UK to America for work. It always felt like I had gained a few hours back for my travelling, with the time difference allowing my watch to jump back 5 hours upon landing. Of course, you lose that gained time when you make your way back to the UK, assuming that you ever go back. In a similar fashion with the surgery, I will lose another week further down the line recovering, where I would have felt better if I had been in surgery last Friday. That is probably worded a little confusingly, but hopefully you get my point. Now that I seem to have perfected the art of time travel, I may as well use some of my meaningless time to write another blog post, after a mini-hiatus.

I was shocked to read the news about Japan’s former Prime Minister, Shinzo Abe, being shot on Friday. Even more shocking was waking up to the news the following day that he had died. I spent a good 30 minutes in bed looking through articles from every news outlet I could find asking one simple question of them – why did it happen? Why did this man decide to shoot the prime minister dead during what seemed like a routine campaign speech? Further to this, why did he go to such lengths, creating his own firearm, just to carry out such a malice act? I couldn’t find anything provocative in the topic of speech, or even in the prime minister’s history in office. If anything, it seemed that he gained a lot of respect during his time in office, both domestically and on the international stage.

The answer to the question regarding why he created his own firearm seemed more straightforward – Japan has tight gun laws, so guns are hard to come by and gun crime is extremely low. Hence, if you want to shoot someone, you will struggle to get hold of a gun, so making one may be easier. Creating your own firearm requires a lot of planning, providing the potential perpetrator more time to get some perspective on what they are preparing to do. This person really wanted to kill this man, and no amount of time was convincing him otherwise. He followed through with the heinous act until the very end.

In the most human of ways, I was yearning for a concrete reason as to why this man decided to do this, as if everything is that simple. We humans like to organise the world into stories – they provide us with structure and allow us to better understand an event. In understanding the event, we can put it to bed in our minds, by providing an ending to the story and feeling that it was concluded. Sometimes we don’t find out the ending and it bugs us, but that also makes it an effective technique in storytelling – leaving it down to the interpretation of the audience, allowing them to create their own ending based on what they have learnt of the characters, events and mood of the piece. On other occasions, we may not like the ending of a story, and we find it jarring to accept what happened. By not agreeing with the ending of a story, we may discover more about ourselves and why we don’t accept the ending. Sometimes it may be obvious, like when our favourite character is killed. Other times it is less obvious, and we debate with friends over it, arguing that this or that should have happened differently.

I’ve been reading an interesting book recently called The Loop which talks a lot about human behaviour. One of the most interesting points that I have read is about how the brain processes information to ease the load on our cognitive functions. There are so many things occurring in the world around us that if we tried to perceive all of them at once, we would never get anything done. We would be overwhelmed by information, unable to make any meaningful decisions in response to it. To solve this problem, the book states that our brain takes all of the data from our senses and processes that information into a ‘story’ which we can process quickly. This allows us to make decisions quicker than we would otherwise be able to, which was critical to our survival when we were not organised into societies like we are now. If you are about to be attacked, you don’t have time to pay attention to the ambient bird song around you, or the storms approaching in the distance, you need to make a decision about the main threat as quickly as possible to better guarantee your survival. Will you run or will you fight? You’re usually already doing one before you have consciously made the decision.

I’m not sure how accurately I am describing these things, and whether they are mere theories, as opposed to things that are properly ‘proven’. To an extent, I think some of these theories are hard to conclusively prove as 100% correct, other than presenting evidence which seems to back them up. It makes sense to me, though. The fact that we seem so predisposed to enjoy stories and find predictable patterns in the world makes me believe it even more. Those things satisfy our brain because they make us feel safe, as if we understand that to be the natural order of the world. We like to think that things are predictable and follow a plot – it helps us drive our cars every day without worrying about the prospect of crashing, and it allows us to go about our lives without constantly worrying about having a heart attack at any random moment. We struggle to comprehend when a study is done, and the results tell us that our behaviour is irrational. Instead, we choose to believe that if we were in that study, we would have behaved differently, beating the odds and being one of the few that saw past the tricks. When we put a bet on a football team to win a game, they lose. When we decide to save the £5 we were going to bet on them winning, they do win. We curse the universe. Why does this always happen to me?

There are now theories about why the gunman carried out his heinous plan to kill the Japanese prime minister. Apparently, his motive centres around a political movement called the Family Federation for World Peace and Unification, or the Unification Church for short. The gunman claims that his mum made a huge donation to the Unification Church in the 90s shortly after she joined, which put a huge financial burden on his family. He claims that Shinzo Abe has ties to the Unification Church, due to him speaking at an event (or a few events, it isn’t very clear from the reading I have done) organised by the them. Police have said that upon searching his house, they found other handmade guns. The gunman apparently attended a few other events that the ex-prime minister had spoken at, indicating that he has had a fascination with the prime minister for a while. It is certainly unwinding to be an interesting story, one that almost sounds too unusual to be a feat of real life as opposed to fiction. Perhaps I am simply overindulging in the story.

I have been creating a few of my own stories these past few days; I wish I could say they were happy ones, but they aren’t. It has been much tougher this week compared to last. Last week, I felt good until I woke up on Wednesday. From that morning, I felt tense, stressed and worried about the upcoming operation. The call then came on Thursday morning informing me that the operation was having to be moved, and it took me another few hours to fully decompress. I did, though, and I spent the weekend enjoying the nice weather, seeing friends and family, watching the Wimbledon finals and generally enjoying the impromptu time which was afforded to me by the operation being moved. Sunday night brought an end to that luxury.

Things have been hard since. A few things stick out in my mind which demonstrate where my head has been the last couple of days. At some point on Sunday, it struck me that I should have been in a high dependency unit at that very moment, with a wound across my stomach and tubes going in and out of every part of my body. It then occurred to me that all of this will still be happening to me exactly a week from that moment. That thought didn’t sit well with me. I wanted it to just be here so I could get on with it and deal with it. No matter what I did, my mind went back to that place. It is still frequently going there. Last week it hadn’t bothered me as much – even in my tenseness, I was eager to get the operation done. It wasn’t due to me fantasising about what state I’d be in this time next week. Now, these thoughts are haunting me quite frequently.

Next, my mum’s dog Dexter has been hunting in the garden this week. He is a spaniel, so has strong instincts to sniff out and dispose of other smaller animals that he regards as inferior to him. Monday night he found a hedgehog and was running around the garden with it in his mouth. My sister eventually got him to drop it and put him back inside. The poor thing was curled up on the soil, blood speckled on its wood-brown spikes. It was breathing heavily. We weren’t sure if the blood was from Dexter’s mouth, wounds on the hedgehog, or both. We hoped it was from Dexter, but doubted it all was. After standing over it with a phone light for 10 minutes, we decided to go inside and return a little while later to see if it had left. 20 minutes later we returned and it had left, leaving only small blood stains on the strands of grass next to where it had been cowering. We couldn’t find it in the garden anywhere, and Dexter hasn’t run around with a hedgehog corpse since, which would have certainly happened if it was in the garden. I’ve convinced myself that the hedgehog is still alive somewhere as that ending makes me feel better. Unfortunately, I know that it is probably unlikely to be true, and the poor thing probably ran off to take refuge somewhere else away from the danger, only to suffer and die. That thought isn’t nice.

The next evening, last night, I was soundly asleep with all of the windows open. There is a heatwave in the UK at the minute and it is incredibly humid, especially during the night. I woke up to the sound of my dad shouting at Dexter. Earlier on in the day, we noticed a baby bird hopping around on the ground in the garden. My sister said that this is normal when they leave the nest as it takes them some time to learn to fly. We watched it hop around before it took refuge in a small corner of the garden. It was incredibly cute. Knowing where it was, we kept the dogs away from that spot. My sister had then let the dogs out in the front garden that night to go to the toilet before bed. She thought that the front garden would be safer than the back, as the back garden was where we had seen the baby bird and where the hedgehog had been the previous night. Dexter had apparently made some unusual sounds, and she had rushed over to find that he had the baby bird in his mouth and was shaking it. I’d been woken up by my dad shouting at him to drop it. He eventually did, and the bird was still alive, though my sister doubted it would be for much longer.

That happened at about 00:30. I lay awake for a while afterwards. In my head, I watched as the bird’s bones and feathers were compressed by the dog’s jaw. It bothered me that I lay there peacefully in bed, but outside there was a young creature probably calling out for its mother; the last gasps of helplessness before it succumbed to its injuries. All of a sudden, I felt a strong connection to it. I saw myself laying there during the operation. I felt the surgeon saying the words to the other specialists in the room – “It’s worse than we thought. What can we possibly do to save this young man’s life?” I felt the void open in my mind as I sat there in the hospital bed days later, listening to the news that they have tried what they can, but that the tumour is more established than they could have anticipated. At some point among this noise, I fell asleep, putting an end to the bleak safari that I was taking myself on.

It was short-lived, though. I woke up at 03:00 with a bad indigestion-type pain in my abdomen. That was familiar – it was the original symptom that I had tried to get diagnosed for over a year during the Covid lockdowns. The familiarity provided no comfort, quite the opposite. My body was mimicking my dark fantasies from a few hours ago. It was writing the story for me, telling me that something has changed, that things have gotten worse. I rolled over every few minutes. Each time I closed my eyes and told myself that I was being stupid, but that voice was quieter than the other one. “It’s spread,” it screamed. “You know that it’s spread!”

As I lay there, I started obsessively thinking about the tumour surrounding the artery. I thought about it strangling it, spewing the cancer throughout my bloodstream and forcing tumours throughout my body, wherever it cared to devise them. I felt like I could feel them. It’s the most sinister feeling I’ve ever had about the cancer. I’ve felt scared before, but I’ve never felt so inwardly disgusted by own my body. It felt like the enemy. My mind was wandering; I wasn’t viewing this story as one with a hung ending, providing the potential of different endings, some good and some bad… I was viewing it as a conclusive story – the cancer is spreading, the surgery will be unsuccessful, I won’t recover from this.

Today, as I drove back from an appointment at the hospital, I noticed a single raindrop land on the windscreen of the car. It felt pronounced, yet inconspicuous. I sat waiting for another rain drop to hit, but it didn’t come. “Did you just see that single raindrop?” I said to my mum. It fascinated me. Then, another single raindrop hit. A few seconds passed, and the storm came. A flood of thin rain dotted the windscreen. I smiled to myself. “That was so strange,” I announced to my mum, wondering if she knew what I was talking about, or was just entertaining me as a show of support for my deteriorating mental state.

For whatever reason, I seem to be finding a lot of stories in the world around me at the minute. A lot of those stories are not going in a good direction, probably influenced by the stresses of the looming surgery, and a return to that tense state that I found myself in last week. The raindrops on the screen left me in suspense – what was going to happen? Why did a single droplet reveal itself right in my line of sight? When the rain finally came, I felt a rush of adrenaline as the story concluded before my very eyes. I had been scanning my mirrors to see if the raindrop could have come from any trees by the road. There weren’t any. For a few seconds, it baffled me. Then, when the rain came, I felt relieved.

Maybe there was a chance that my story could end with a positive outcome. Maybe the tumour will be different to how it looked on the scan; maybe they will even be able to remove the whole thing in the surgery and carry out a full Whipple procedure. Even if they don’t, the NanoKnife could do a serious number on it. NanoKnife may even get rid of it, even if the surgeon was reluctant to emphasise this point, due to a lack of evidence of NanoKnife being used to treat pancreatic cancer. I just don’t know the end of the story yet and I need to stop trying to predict it based on my negative thoughts. I’m here for the ride either way so I need to focus on enjoying it… It just seems impossible, sometimes.

Dealing with Cancer: Support Groups

Dee, Robbie, Me, Anna: Having Lunch 04.07.22

Support groups are a common recommendation to cancer sufferers. I’ve heard various views from others about them and have a few of my own experiences now. My overall feeling is positive, but it has taken me a little bit of time to find some that felt right for me. Even now, where I feel that I am comfortable with my diagnosis and possible fate, I can find them tough. None of the ones I attend are regular meetings and I have not become part of a group so much. I’ve more found myself joining events, where we all come together and share our experiences in some way. There are a few charities that I am becoming more familiar with which I have found helpful for different reasons.

A few nights ago I participated in the Perkatory event for Elephants and Tea, a not-for-profit based in the United States who support Adolescents and Young Adults (AYA) suffering from cancer. Six of us were asked to read out our Dear Cancer letters on the call – we were all published in their most recent magazine edition, alongside a number of others. As the magazine’s organisers are American, it was scheduled for early evening EDT. That meant that it was at 19:00 for the majority of those on the call. Many of those who joined were audience members, so I’m not sure where they were all joining from, but everyone else who was reading were based in the united states. I was joining at midnight in the UK. I’m not very good at staying awake that late, so I was already forcing my eyes open when the call started and it lasted for an hour and a half. Luckily, the content was all very interesting and there were some fantastic pieces being read out. That made it easier to stay awake, but also harder to fall asleep once the time came. I’d fought through the tired period and was in the deliriously awake phase.

It took me a little while to hear about the AYA community. There are some good charities around that specifically target the group, such as Shine in the UK, and Elephants and Tea in the US. Before I realised that these charities existed, I tried to go to a support group at The Maggie Centre in Manchester. It wasn’t sold as a support group per se, as it was a creative writing course. Its function was to act as a support group, though, utilising creative writing as a means of seeking catharsis, and specifically utilising writing as a means of processing your feelings in front of a group, as it allows you to open up in a less direct way. Seeing as I had created the blog at this point and was starting to do a little bit of creative writing, I thought it would be a good opportunity to both seek support whilst improving a new skill. Unfortunately, it wasn’t quite what I thought it would be. Firstly, it wasn’t a ‘course’. Perhaps I should have realised that beforehand, but I didn’t. For some reason, I thought we would be learning skills and techniques for creative writing – how to develop characters, make our plots believable etc. I had built it up to be an actual training course in creative writing, but it wasn’t. That is my own fault for not looking into it enough.

The course was actually more for poetry, but it wasn’t about bettering your poetry necessarily. Our instructor would give us certain prompts and encourage us to talk about our experience through those prompts, but it was all very ‘free flow’. We’d have a few minutes to write about something based on a prompt. Some of it was extremely creative, including the methods used to diversify people’s prompts. For example, in the first game we were asked to choose a number between 1 and 100. Once we had all chosen, we were asked for our number one by one. The woman who ran the group would then refer to her magazine, which had a list of ‘100 Best Tips for Improving Your Life Without Trying’, or something to that effect. Once we had a list of the tips which adhered to the numbers we had chosen, we had 5 minutes to write something based on them. It was a cool idea. Inspiration didn’t rush to me, but I got a few lines together. That aspect of the session I really liked – it was fun to hear what others had written and how they used the prompts to pull out their experience. My main issue with the group slowly revealed itself, however, as I listened to what others had to say.

What I did not realise before the session was that the context of each person’s experience with cancer is extremely important in how useful it can be for you… or that is my opinion, anyway. This group was all people who were either bereaved, with a loved one passing away from cancer, or people in remission, with some even considered to be cured as they had been rid of their cancer for years. Although it was interesting to hear their perspectives, it did not feel particularly helpful to me in this context. At this point, I was a few weeks into chemotherapy and still rather terrified of my diagnosis. There is probably an argument that listening to someone in remission’s views on cancer could be encouraging, but I wasn’t in a place where I was ready to hear it. It was not the poems of the people in remission which troubled me, though, it was the poems from those who were bereaved.

I sat listening to a woman’s poem who had tragically lost her husband to cancer a few years prior. Her poem described the pain she experienced on a daily basis, even years after his passing. She described the emptiness that screamed out from the passenger seat in the car that they had bought together; the nights alone in bed. There was nowhere to hide – I was in a room of strangers, with one reciting to me the way that Anna will likely feel if I do die of cancer, or so I thought. I then started thinking about my family and friends – what would they feel? Her words were like glass shards pressing into my ears. I wanted to cover them and scream just to make it go away. All of my greatest fears were dancing around my head. It wasn’t enough to be scared of my own fate at the hands of my cancer, facing an unknown future containing boundless amounts of personal pain… I now had to imagine how that would impact my loved ones. I tried to tune out but it was impossible. After about 20 minutes of this, my GP called me to discuss a few issues I had been having. I was expecting the call, so had warned the woman leading the session that I’d need to excuse myself at some point. As I left the room to answer the call, I breathed a sigh of relief. “Thank God,” I said to myself as I shut the door behind me, “I can take my mind off my family’s grief and just talk about my stupid deadly cancer.”

The GP was calling me to discuss a recent episode that I had experienced. Just as I had fallen asleep the night before, I’d suddenly bolted awake. Straight away, my mind was in panic mode, but I had no idea why. Nothing I did would relieve it. I paced the room, telling a very tired Anna that I couldn’t settle. I downed water, made my way through a few yoga poses and tried to breath slowly, but none of it worked. Eventually, I grabbed my puppy Lucy and lay in bed hugging her. I woke up with her in my arms at 5am. I must have nodded off. I woke up feeling tired but better. The experience had shaken me and I’d left a voicemail with my GP that morning – this was her returning my call. Despite this being quite a traumatic event, it was a welcome distraction to what I was experiencing in the creative writing course.

The fact is this: the group that surrounds you is important. If you struggle to relate to the experience being beamed at you, it may in fact cause you more distress as opposed to relieving you of any. Hearing the perspective of someone who had been bereaved did not provide me with a useful perspective for where I was at in my journey. It gave me a direct line into one of my biggest fears – that the ones I love most, my family and closest friends, may struggle to get past my death for years, if it comes at the hand of my cancer. Such a perspective served no purpose in my life at that time.

Since then, I have found some use in hearing those words. I have decided that I need to support my family as much as possible whilst I am healthy enough to do so, so they do not reflect on my cancer as evil, immoral, or any other negative adjective. Whatever happens with my cancer happens. If I miraculously live until 70 or die next week, it shouldn’t matter. I’ve had a good life and everyone who cares for me should relish in that. Any sadness they experience is for a good reason, because we cared for each other dearly, made amazing memories together and changed each other’s lives for the better. If that isn’t something to celebrate, then I don’t know what is. It is easy for me to say these things now, and I would struggle to implement them if it was my friend or family going through this, but I’d like to think that I would find a way to over time. I really hope that they do if it comes to that.

Another problem with the group was more physical… they were all very different ages to me. All of them were over 60 years old. That is not always a problem per se, but it does contribute to you feeling that you cannot relate to all of the experiences that they speak of. The same thing can be applied the opposite way around – if a 65 year old attended a support group where all attendees were young cancer sufferers, they may struggle to relate with some of the specific issues being raised. Of course, some issues you can relate to each other over. I attended a few sessions with Pancreatic Cancer UK, and that common link (i.e. the fact that we all had pancreatic cancer) helped to bridge this divide. There were many people on that call who had a very similar experience to me, and it really helped to hear their perspectives. In this session, however, no one had the same cancer as me. The result is another wall forming between you and those around you. It makes you feel like you are in the wrong place and doing the wrong thing. That alienation does little to comfort you.

It doesn’t mean that I can relate to everyone just because they are within a certain number of years from me. In one of the sessions I attended, a man in his 40’s was making an argument that having Myeloma, a cancer of the blood, is hard compared to having a cancer where you have a physical tumour. He stated that not having a single place in the body that you feel you are fighting is difficult and leads to more mental stress. Although I understand his point, I sat feeling a little lost. I wasn’t going to start a debate on a support call, but it seemed an unusual place to raise such an issue, not that I think he shouldn’t raise it if he has it on his mind. I can’t see my tumour and have no physical concept of it really. The only difference is that I moan about my pancreas a lot, whereas I’d imagine he complains about his blood a lot. I actually complain about my blood a lot too, but that’s because nurses constantly want to pull it out of my veins with needles, and I’d rather they wouldn’t. I understood that this was something he clearly felt, though. It isn’t so different to my thinking, when I sit reading pancreatic cancer statistics and feeling like I’d rather have any other cancer in the world. That doesn’t mean that I actually believe those thoughts, though. Cancer may make us more humble in general, but we retain our own superiority complex. Our cancer is the worst, our diagnosis is the most scary, we’re the most lucky if we overcome it and everyone should listen to our story because it is the most interesting. You can’t get rid of a cancer of the ego! Besides, I am the strongest person to ever fight pancreatic cancer; I bet it regrets trying it on with me now.

AYA charities are so important because getting cancer at a younger age is more unusual, though. Since joining a call with Shine, and getting involved with Elephants and Tea, I have felt a much stronger connection to the community. As I sat listening to the other’s reading their Dear Cancer letters, I felt a sense of unity. Even the audience members, many of them faceless avatars sat on a call, were engaging through the chat function. It felt heartwarming and special. That feeling overpowers a lot of the difficulties that I had experienced when attending the session at The Maggie Centre. It isn’t that I related to every single thing that was said on the call, with none of the attendees having the same cancer as me, but the setup just felt more right. It was people in their 20’s, 30’s and 40’s giving their perspective on their cancer. Some were in remission, some still fighting, some were stable.

Perhaps age was more irrelevant than I thought. When I think about the times I’ve felt a benefit from these type of sessions, the biggest factor has been how much I feel that I can relate to the people and the things being said. On the Pancreatic Cancer UK call there were many different ages and I related to all of them. We had similar struggles – the Folforinox chemotherapy, dealing with scary survival statistics and getting our heads around the constant Creon usage. When I joined the Shine call, we spoke about the constant drag that comes with a cancer diagnosis, and how we are always fighting an uphill battle with it. Then on the call with Elephants and Tea, we were united through a common purpose – writing cancer a letter, and exposing ourselves in whatever ways it affected us personally.

My issues with The Maggie Centre group were probably varied. The group already knew each other, so it felt like I was an outsider from the start. If I’d have carried on attending, that would have changed, of course. What would I have to sacrifice to continue attending, though? Hours of listening to perspectives which disturbed me and kept me awake at night… It wouldn’t have been worth it.

The fundamental issue felt that too many people in the group were at a different stage of the journey to me, or didn’t have the right perspective for me. People who are grieving are going through their own hell, full of painful challenges which haunt them, probably in a similar way to how a cancer diagnosis haunts its victim…but that doesn’t mean the journey is comparable. Grieving forces one to be conscious of the finality of death – an unwanted conclusion to someone’s story for those left to contemplate it. In my experience, I have always managed to muster some hope with my cancer. Even when it has felt bleak, I’ve known that I can still beat the odds. One day I may have to deal with a more final warning from an oncologist – but even then, I can attend clinical trials, keep running, getting myself to the gym and spending time with my loved ones. There is still a life to live so long as I am capable of pulling air into my lungs and I open my eyes every morning. Death does not provide that same comfort, but it does provide a different sort of comfort… a reassurance that their pain is over and a subtle reminder that billions have suffered the same fate, and we will continue to do so.

Even with me finding some support group-type activities which work better for me, I still think that they take a lot out of me. I’m sure that this is another thing of personal preference, but my experience tells me that it is tiring to do these things too often. Having a shared experience, hearing others utter things you have thought and said, is a powerful thing, but it doesn’t relieve you of those feelings. That sense of community is amazing and has its place in my personal struggle. It is still hard to listen to other people’s trauma and pain. For me, I need space to try and live as normal a life as I can under the circumstances. That is the best therapy for me. Sitting around with friends laughing, getting to the gym and playing with my dog Lucy are all amazingly therapeutic for me. After all, I am not just Pancreatic Dan the Cancer Man, I am Dan the runner, Dan the sausage dog owner, Dan the brother etc. My life isn’t my cancer, no matter how much it dominates my time and energy. I know people who refuse to attend any kind of sessions about cancer, and others who have thrown themselves into things like group sessions. They certainly have a place in my life, and I like to dedicate my time to them, but I don’t like to throw myself into them weekly. I still haven’t established quite how often that I think they most benefit me, but I know that I need a little time to unwind after them, even if I leave them feeling positive and happy. The AYA charities are helping me find sessions which do benefit me in a unique way, and I can’t wait to attend more of them in the future… especially if I get to read out a piece I have written, like I did at the Elephants and Tea Perkatory event. Me me me me me!

Surgery Date

The Road to Recovery

You’ll have to excuse the constant posting about surgery, but it is a bit of a hot topic at the minute. The headline is that I have a surgery date – Friday, July 8th. I need to get to the hospital nice and early – for 7:15am that morning. Upon hearing the time, as the scheduler spoke to me on the phone, I briefly thought to myself, “I’m going to be shattered,” but then I realised that I am going to the hospital to be put asleep/knocked out for approximately ten hours during surgery, followed by days in intensive care recovering from whatever they manage to do to me to improve my cancer. I’m pretty sure I’ll find a way to not worry about how tired I may be after my 5:30am wakeup on that first day. That was a thought that certainly didn’t age well in the five seconds it existed in my head; I travelled from an innocent thought about being tired, to tyrannical thoughts about surgeons playing Operation on my real-life body. Come to think of it, the Whipple procedure may have been thought up as a surgeon was playing the board game Operation considering the aim of the game is to remove all of the organs out of a body; that doesn’t sound too far away from what the Whipple procedure aims to do to your digestive tract.

The surgeon told us in our first meeting with him that the best-case scenario will require about ten days in the hospital. The worst-case scenario that he has experienced with someone he has personally operated on was two months in hospital, where there were many complications. Luckily, he has never had anyone die on him, but he did say that a colleague in his team has. I think that was a veiled dig at his colleague; these surgeons are a competitive lot, even in the most serious of circumstances. I left the hospital thanking the universe that it was him performing the operation and not his colleague, even though I’m sure his colleague is a very skilled and diligent individual. I just don’t want to chance it, really. Although, given that it is such a long procedure, perhaps they work it by tagging in different members of the team like a wrestling tag match. Damnit. Don’t think of it, Dan. It won’t matter to you no matter what happens, you’ll be out like a light.

Specific complications that the surgeon called out included the pancreas leaking pancreatic fluid, the patient needing blood transfusions and I must have blocked out the rest of the list because I can’t remember any more examples. Leaking pancreatic fluid sounds pretty gross, I know that much. I remember him telling me that Nano-knife works by applying a small shot of electricity. The shock is supposed to be small enough so as not to produce too much additional heat, but I think he said that there is a risk that the heat could damage my organs. Maybe I’m remembering that wrong, I’m not sure. The meeting is a little hazy now, so trying to piece together the specific things that were said, and why they were said, is difficult. He definitely spoke about how the Nano-knife technique produces a small amount of heat and spoke about why they wanted to minimise this, but I think that I was high on adrenaline at this point and simply nodding my head and smiling, in a picture probably reminiscent of Christian Bale in American Psycho. For some reason, I always find myself being more upbeat in these meetings; I’ve probably creeped out every oncologist, doctor and surgeon that I’ve met who has been involved in the process. During my diagnosis, I actually started laughing when the doctor said “it’s bad news I’m afraid.” I couldn’t help but feel like I was in a drama on TV and couldn’t believe the news was actually being delivered like this. I was waiting for the Eastenders theme tune to start playing, but it didn’t.

There are a few questions that the surgery has raised, but the most important one is this: is five weeks enough time to recover and go on my stag do? We’re assuming so because otherwise a lot of plans have to be changed. What plans specifically, I’m not sure, as I wasn’t invited to the sleepover where they all drew up the sinister blueprints for the weekend. Luckily, I have literally centimetres of cancer in my pancreas (2.1cm to be exact), so they aren’t allowed to physically or emotionally traumatise me too much. That is how it works, right? Surely I’m not expected to join in with the Frosty Jacks boat races or anything. If Frosty Jacks boat races were not on the agenda already, I’m certain it will be after my best man Luke reads that sentence. He’ll kick himself for not putting it in the schedule already.

For those of you who don’t live in the UK, or who lived a much healthier teenage life than me and my friends, Frosty Jacks is a cheap cider which has an alcohol content of 7.5%. When we were younger, you could buy a 3-litre bottle of it for about £3.50, which is absolutely crazy. It has something like 22.5 units in a bottle and we drank them quite religiously from the age of 16 to about 18. If I tried to drink it now, it may actually kill me, both because it is almost certainly 99% chemicals, but also because the amount of alcohol in it could last me six months with my current drinking habits, or lack of. The thought of actually drinking a 3-litre bottle of Frosty Jacks over the course of six months is so sad, come to think of it… And for those of you who don’t know what a boat race is, it is where you split your group into two teams who compete against each other. The two teams face each other on either side of a table. Starting from the same side, both individuals start to down their drink. When they finish, the person next to them can start drinking. That means that everyone focuses on the one member of their team who is currently drinking, making it quite a high-pressure situation, especially when you’ve already had a few drinks and are getting competitive. The winning team is the one that finishes their drinks first. A truly remarkable game to be discussing in a cancer blog, I’m sure you’ll agree. I haven’t played it in years and have no desire to, but we have to keep the blog content fresh somehow – it can’t all be ‘cancer this’ and ‘cancer that’!

One thing that my best man has shared with me is that he has started baking bread over the weekend. That got me riled up, as I’ve been meaning to start baking bread for a while. So yesterday, I baked my first wholemeal loaf. It actually went pretty well. Today I did it again to test whether it was a fluke. Another success. It’s actually quite easy and makes eating it far more rewarding. Tomorrow, I’m going to try and bake a wholemeal spelt loaf. I know what you’re thinking, “that’s got an entire additional word in the name!” It’s a crazy thing to dare to do, but I’m going to do it. Replacing the wholemeal flour with the wholemeal spelt flour might just be the downfall of my entire bread baking career. If it goes well, though, it’ll mean that I have two types of wholemeal loaf to make in future. High risk, high reward!

Half way through making some banana bread this afternoon, I received a call from Macmillan at Manchester Royal Infirmary. After my meeting with the surgeon last week at the hospital, I had spoken to the nurse about how I was feeling about things. I mentioned the financial concerns I had, which have been ever-present for months now ever since my employer made it impossible for me to return to work, yet only paid me a month’s full salary. Very nice of them. I truly believe that their HR department could receive ‘Worst HR Department in the UK’, which would be nice for them; I’m sure it is the only way they’d ever win an award.

Anyway, bitterness aside, the nurse had told me that she will get one of the Macmillan representatives at the hospital to call me and chat to me. Every time I see an ‘0161’ number calling me, my heart stops a little bit as it is the area code for Manchester, where the hospital is located. I’m always assuming it’ll be someone telling me some new development about my cancer. It was a relief to hear that it was Macmillan. The representative I spoke to was incredibly helpful. She spoke to me about all of the things that concerned me, offered to speak to my mum to further support her and said that she would get the financial advice team to call me after I have been discharged from the hospital, after the operation.

There was something in particular that she said which has really stuck with me and has given me such a lovely perspective. She stated that surgeons won’t decide to do something unless they see value in it, and that they believe that the pros will likely outweigh the cons of doing it. After all, it isn’t only my life at risk, but their own reputation (and pride too, probably). These decisions are highly calculated and scrutinised by an entire team of extremely skilled individuals. Not only that, but this is an expensive procedure to perform, requiring a complex surgery with a lot of equipment, and a long period in hospital afterwards for aftercare. Going ahead with it must mean that they perceive it worthy of that cost, which could be used elsewhere, for another patient.

Although I had thought of it in many different ways to help me process the news, I really hadn’t considered this one. It made me reconsider so much of the conversation that the surgeon had with me. He is always going to focus on the risks, concerns and potential issues – all of this information is incredibly important. If a patient walks out of that office not understanding the full extent of the consequences of agreeing to such an operation, they could end up agreeing to something that they, in fact, do not consent to at all. It is, therefore, the intent of the surgeon to ensure that the severity of the situation is communicated in the clearest of terms – that there is little evidence of how successful Nano-knife may be, that the operation is a major surgery and carries a lot of risk, and that my general diagnosis is a damning one, especially statistically. He also pointed out that most people in my position wouldn’t get an operation at all, but I am getting one, so they must see something different in the situation. Whether it is my age, health or diagnosis that they see as ‘different’, or a combination of those things, I don’t know. I don’t care, of course. I’m grateful that they made the decision that they did and I need to remind myself of that when I am fearful or anxious about the surgery. Surgery is what I wanted, and it was not guaranteed at all. It does create a strange dichotomy between the excitement of achieving that goal, yet knowing that it means I will be having a big operation, but that’s ok. Life is full of situations which leave us emotionally confused, being pulled in multiple directions at the same time. We are complex beings; we cannot expect ourselves to always feel certain we understand how we feel about a situation, especially where it is complex.

There is one last thing which I saw today that I thought was worth talking about. As my Twitter account is for the blog, and the primary things I follow on there are cancer-related accounts, I get a lot of cancer posts in my feed. Today on my feed, I saw the below post by the actress Mindy Kaling, who was put on my radar by the series The US Office, but has had her own show since, and has been in various big-budget films.

I thought that I was glad she was posting about it to her 11.5M followers. It has to be good for pancreatic cancer, I’d think. Spreading awareness on such a big platform is a great thing. Being nosy, I went to the comments. That’s where I found an …interesting… take. The following comment had been posted:

“What you’re doing is great but children with multiple malignant brain tumors with so much treatment that they suffer a stroke and end up paralyzed and still tumors in the brain that cannot be removed to cured.

I’m honestly not sure what the central point even is here, it is so confusing how it is written. It seems to continue adding new ideas as the sentence drags on. What I do know is this – it may have been written with the best of intentions, but certainly doesn’t come across well to me at all. Why do people find a way to apply some form of elitism to every topic? What benefit is there to treating cancer like it is a new edition of Top Trumps? Mindy posting that she supports pancreatic cancer gaining funding from the government does not mean that she does not support more funding going towards children with cancer, or any form of brain cancer research. Why this person thought that this was a helpful or mindful thing to say, I do not know. The two things are not mutually exclusive. Perhaps they actually know more than I do, and the additional money would be allocated from brain tumour research, in which case it may make more sense. They have not said this, though. Sometimes I really wonder what people’s intent is – I’m sure this person came in with the best of intentions, but what help does it really provide? Is it really an appropriate place to raise such an argument?
So, I want to make this clear – when I say that I believe pancreatic cancer needs more funding, given it has the top mortality rate of any common cancer, it does not mean that I want money diverted away from any other cancers necessarily, or that I don’t value the struggle that other cancers bring. Having said that, pancreatic cancer seems to be low down on the priority list, due to an average diagnosis age of 72 and difficulty diagnosing it early enough to do anything about it (in most cases). Of course, the second issue is also probably that way due to a lack of funding, which I believe to be because it has been designated as an ‘old person’ cancer, which relates it back to point one. It is a vicious circle.

No one will say the words ‘it’s fine if old people die’ publically, but that is essentially what is happening in terms of pancreatic cancer, and I do believe that it hurts the attractiveness of the cancer in terms of research funding. I understand that having such an old average age of diagnosis is a genuine consideration when dealing with cancer and research grants, as it is much harder to save people who fall ill at this age, but it seems to be becoming unjustifiable. I regularly see pancreatic cancer charities sharing posts stating that the survival rate has not changed in over 50 years – how is that acceptable with how quickly our technology seems to move? I’m sure that the other common cancers have experienced at least some improvements in this period, if not significant ones.

The overall lesson is simple, though. Think about what you write online. It may feel like it only matters to you, as you sit alone on your phone and decide to voice your opinion on something, but by writing it, you are throwing it out into the online ether for anyone and everyone to consume at their will. I’m not sure if this comment was trying to imply that so long as children get brain tumours, no other cancer is worthy of consideration, but if it is, that isn’t fair. It isn’t fair to make people who care about pancreatic cancer feel bad for doing so, and it isn’t fair to take away from the message of Mindy’s post. No one would disagree that the things being described by them are horrific, and if that has happened to someone this person knows then I feel even more sympathy, but it is not the only consideration at play. It is also not the place to make such an argument. Would they be happier if Mindy took the post down, choosing to only post about brain tumours instead? Will she see your comment and repent, or simply ignore you? I believe the latter is more likely.

Rant over (until the next one). One day closer to surgery!

Father’s Day

Me, Mum, Dad at My Sister Josie’s Wedding, 2017

Last night I had a weird dream where I had hurt my knee. I was really worried about it as I sat in some kind of waiting room. I’m not sure if I knew how I’d hurt it in the dream, but I don’t remember that part if so. There are many blurry patches where I’ve forgotten what happened exactly, but I remembered the gist of it. The next thing that I remember is being in a doctor’s office and him feeling around my knee and asking if it hurts. All of a sudden he poked a spot which did hurt and I gasped in pain. It woke me up almost straight away. I was confused at first. I felt certain that it had really happened for a couple of seconds. Looking around me in the bedroom, I realised it was a dream. I suspiciously looked at my knee and felt a little uncertain about it. Was my dream predicting another problem with my knee? Or was my mind playing cruel tricks on me, reminding me what problems I used to consider life-altering in the past and laughing at the situation I find myself in now? If my mind is doing this, that means there is some part of my brain that is capable of doing such a thing. That would make me a bad person, wouldn’t it? It would certainly mean that part of my brain was plotting against me… although it probably was just a random memory dream.

This situation has happened to me before. I had an injury from overtraining in 2020. It happened a few months after lockdown started; I’m assuming because of the working from home and not moving around enough in the day, then running a lot in the evening. When I went to the physio at the hospital, I expected her to say that it was a knee injury – my knee hurt whenever I ran, so why would I expect anything else? As she made me do a series of exercises and activities, she smiled to herself. “I think I’ve figured it out,” she said, “it’s your hip.” Turns out that my left hip was very out of balance with my right one, meaning that my right one was much stronger than my left. It meant that my left hip was recovering slower from the runs, resulting in small changes in the way that I was stepping with my left leg whilst running. Those small changes were enough to start damaging my knee. Whilst investigating this issue, I had my first ever MRI scan. It felt a little intimidating at the time, but nothing came of it really. I just had to do strengthening exercises and have a break from running.

That winter I cycled a lot in place of running. It was during the first Covid lockdown and there wasn’t a lot of traffic around London. It was actually a lovely time to be cycling around the capital. I discovered all of the hills in the north of the city: Muswell Hill, Ally Pally and many around Hampstead. It was really fun. Then I started joining my cousin and a couple of his friends for ‘Tuesday Hills’ when the weather started to get warmer. Throughout summer, he and his friends would meet on Tuesdays to do 20 miles of tough hills around the Southeast of London, then go back to one of their houses for a BBQ and a few beers. That introduced me to the hills around Crystal Palace, Dulwich and Forest Hill, where Anna and I decided to purchase our flat in 2021. That summer had a large influence on me. I saw a lot of London that I hadn’t been to before. It influenced where Anna and I would buy our first flat ever flat, that I find myself writing this from and that we love so much.

For the first 6 months of living in the flat, I would regularly get out and train on those same hills. Despite it being the end of lockdown and the roads being busier again, it felt too convenient to not still get out on the hills around the flat. I haven’t been out since being diagnosed – I was thrown straight into treatment, and that’s been my life since really. I’m also worried about my hands as the neuropathy isn’t going from the chemotherapy. I don’t want to mess up using my breaks on the hills around London when there are cars everywhere, and there are always cars everywhere now. I’m not sure if it’s a mental block or a legitimate excuse, but I’m not ready to find out just yet.

My love of exercise comes from my dad. He’s always been obsessed with exercise and it defines a large part of his life, but not all of it. I’m going to list his passions below and then speak about them one at a time to provide some context to the best things about him on Father’s Day, here in the UK.

  1. Sweet Things
  2. Work
  3. Maintaining Bikes
  4. Exercising

1. Sweet Things

My dad has been a huge influence on me with his love of sweet things. He is the first person I witnessed putting chocolate in the freezer to stop it from melting when he eats it with his hands. I then witnessed him putting chocolate-covered digestive biscuits in the freezer, and now do that religiously too. To be honest, any snack with chocolate in/on/around goes straight into the freezer now, both in my house and in my parent’s house. It is a far superior way of eating chocolate. One area of sweet treats where my taste deviates from my dads is fruit cake. I cannot stand fruit cake. I’m not sure why, but it brings back memories of me being a kid and wanting something to eat, so eating some fruit cake from the kitchen side and feeling bitterly disappointed that it wasn’t chocolate cake. That disappointment sits on my shoulder and has never left; I now have a permanent grudge against fruit cake for not even attempting to be chocolate cake. It doesn’t even have chocolate chips in it – why would anyone bother? Nowadays I’m not too obsessed with chocolate cake, but I’m still mad at fruit cake for daring to not be chocolate cake.

I’ve witnessed my dad eat half a victoria sponge cake in a single morning before 9am. I came downstairs feeling a little hazy from the chemotherapy a few months ago. My mum had baked a cake the evening before for dad’s birthday, but it had been baked too late for anyone to eat any of it that evening. I thought I’d have a laugh and see how much he had eaten that morning as I waited for the kettle to boil, allowing me to make my coffee. To my dismay, half the cake had gone. The only people in the house were me, Anna and my mum. My mum was still in bed and Anna had been with me the whole time. There was no doubt who had eaten all that cake. Dad the cake mad lad. He has an unparalleled stamina for eating sweet, sugary things; he will forever be remembered for it by everyone that knows him.

2. Work

Part of the reason that my dad has such a stamina for eating sweet things is that they are quick and easy to consume. Why is that valuable to my dad? Because he only ever has 3 minutes maximum to spare between meetings. The man boasts about how many hours he works as if it is a badge of honour. He once told me a story about how he had not used hardly any of his annual leave one year. HR sent him an email telling him he needs to take more leave, reminding him that it is necessary to get a break to stay mentally sane (not their exact words). Dad’s rebuke to this was to suggest that he gifts his annual leave to his PA at the time; HR (obviously) disagreed and said that it was not even possible to do such a thing.

What HR probably didn’t realise was that work does seem to keep my dad mentally sane. Everyone thinks their parents have the answers to everything, I know this to be true, but I do think my dad could give a good answer to anything. He has a very analytical mind and enjoys solving problems. It is the reason he agonises over the cryptic crosswords in every newspaper, every week. Sometimes he likes to humiliate me by asking me one of the questions; inevitably, I tell him I don’t know, and he tells me how ‘easy’ it is before explaining the most insane, inexplicable pathway to get to the answer. The experience always leaves me more confused as to why anyone would ever enjoy doing them, and probably leaves him feeling even smugger about how much he genuinely does.

There is another thing that his work demonstrates – his commitment. Not only through the amount of hours he puts in, but also the amount of time he has spent working on the railway. It is a true passion of his and he knows the workings of railways through and through. I know that people say it is a generational thing, with my generation’s parents spending much longer in a job than we tend to, but I really believe he would do it all the same if he could go back. He loves it. His colleagues love him, and last year he was given an award for championing women in the company. My dad simply likes people who care; you don’t need to meet any specification outside of that. If you care, are willing to learn and are enthusiastic about what you do, he will ensure that he makes time for you and will do everything in his power to champion your success.

3. Maintaining Bikes

Linked to my dad’s love of work is his love of bikes. He’s a civil engineer by trade but has mostly switched the practical application of the trade from maintaining railways to maintaining bikes. Typical of him, he cannot half-arse it as a mere ‘hobby’. It is a lifestyle. You will regularly find him on a Saturday morning sat at his laptop, watching detailed videos on how to replace x part on a bike. He will then discuss at length with you the problem he is trying to solve, how he managed to get a critical tool to help solve the issue, and how he got that tool off eBay for 50% of the price. I’m not sure why he enjoys saving money when it comes to bikes as it is not something he enjoys in every other area of his life. He pays around £160 a month for Sky subscriptions, yet only watches approximately 5 programmes, 3 of which are on the same channel, which is available on Freeview anyway. Sky must wonder when he is going to sober up and start demanding his money back, but there doesn’t seem to be a risk of that any time soon.

My dad spent a few months working on a bike belonging to a colleague of his. After hearing her talk about her bike being broken, he offered to take a look at it. It was his project for months. He was incredibly excited about it, spending lots of his own money ordering new and better parts for it, and at least quadrupling its total value. When he handed it back, he mentioned nothing about the money, time or effort that had gone into it. It is a perfect representation of many of the things that make my dad great – his want to help people, his ability to grasp a problem with both hands and tackle it with ingenuity, and a genuine disregard for money (I assume this is what it is, as he never spends his money on himself, yet finds ways to spend it on everyone else, even his colleagues).

There’s another reason that maintaining bikes is so important to him: he loves to ride them.

4. Exercising

My dad has always been incredibly into exercise; he’s also always been very good at it. When he was younger, he boasts that he used to run over 100 miles a week on average. You’d be hard-pressed to find anyone who thinks that is a good idea anymore, but at the time “you tried to run as much as you could, as hard as you could,” according to him (the exact wording may be incorrect but the general message is spot on).

He told me a story about how he was involved in a run on a 400m track once. The race distance was 100km, which is a ridiculous distance to be running around a track. There were various houses which backed onto it, and one gentleman was apparently outside gardening, watching them run. After a while, he got confused about why they were still running. “Why are you running around the track for hours,” he shouted to my dad as he ran last. My dad had to do a full lap before he could answer. “We’re running 100kms on it,” he replied as he ran past again. Dad proceeded to do another lap before being in earshot of the man again. “Are you fucking mental?” The man shouted back as my dad made his way past again; that was his response even after having 400m worth of time to contemplate his response. I don’t blame him – it is totally fucking mental to run that distance on a 400m track.

As he got into his 30s, the hundreds of miles he was running a month started catching up with him and he developed various injuries. Cycling took over from there. He’s been on various trips to Europe to tackle some of the most notorious climbs, once taking my brother Greg with him. I was meant to go too, but was starting a new job and told I needed to join that week to join a training course; I wish I’d put my foot down and refused now – memories could have been made that would be far more valuable than any job. That job did teach me a lot, though, so it had its own value. I met many friends for life there as well as growing a lot as a person. Without it, I can’t confidently say that I’d be responding to this diagnosis in the way I am.

I know that things are hard at the minute for both of my parents. It must be surreal to have raised a son, investing so much time, energy and love into something for so many years, to watch it potentially end in front of their eyes. Feeling the excitement of every achievement with them, watching them become a teenager, young adult, going to university, getting their first job; hurting with them when things don’t work out, celebrating with them when it does. In Lord of the Rings, there is a quote which goes something like ‘No parent should bury their child’. No parent should have to bury their child; it isn’t right. The world doesn’t work by the parameters of our perceived morality, though. People have to bury their children all the time, sometimes in horrendous circumstances. Here, in London, there are always stabbings in the news. Just a week ago in Forest Hill, a helicopter had to land in the park next to our flat to transport a boy to the hospital who had been stabbed in the neck. Luckily, he survived. He is 17 years old. His loved ones would have got a call to inform them at some point – where is the morality in that situation? There isn’t any.

In March 2021, Sarah Everard was lured into a car by a man, convinced to do so by the sight of his police badge. Unfortunately, that off-duty police officer had sinister intentions for Sarah, who only realised so too late to try and save herself. Her body was found days later in Kent. It turned out that the off-duty police officer was Wayne Couzens. He had told her that she was being arrested for breaching lockdown restrictions, showing just how evil this man was. He was preying on the fear of the day and how could Sarah say no to a police badge as a law-abiding citizen? It’s absolutely despicable.

The advantage of having cancer is that I get a period of time where I know that I possess something that may kill me, and so do my family. If we look past the awful parts of it, that’s actually an amazing opportunity to be afforded. Whilst I’m still healthy and able, I want to enjoy my time with my family and friends.

I’ve said before in the blog that I used to have a crippling fear of watching my parents suffer. It kept me up at night when I was about 10 and the fear gripped me. Now I have an opportunity to show them that you don’t need to suffer through these situations; you can face them with relentless strength. I still cry, I still get scared, I still feel angry sometimes. I just try to let none of it consume me for longer than it needs to. My life is amazing no matter when it comes to an end; I’m not going to waste a second more than I have to on being sad, angry or depressed because of a situation that was totally out of my control. My dad has been positive throughout this process – seeing every next step as progress and unrelenting in his determination that the only outcome is recovery. Upon hearing the news of the surgery, he seemed different; there wasn’t a voice of positivity, an uplifting perspective that this surgery was necessary and amazing, in its own way. It may not be exactly what we wanted to hear, that the tumour was likely to be fully removed, but it’s something. There’s still a chance that this happens anyway. no matter how small. Even if that chance is 0.000001%, it’s still more worthy of our time and effort to believe that this will happen over a more bleak alternative.

So, this is me throwing the positivity back at you, dad, and telling you that this surgery is amazing no matter what happens. Whether it gives me a year, ten years or cures me entirely, it is amazing. Even if the worst case happens and I die in the surgery itself, it was the best opportunity we had to fight. Besides, I don’t want to be buried when I die, I want to be cremated, so there will be no parents burying any of their children in this process. There’s always a loophole if you look hard enough.

Thank you for everything, dad. We fight on.

Surgery and Yellow Mayonnaise

Taken 04.06.22 at a Music Festival

It has been a few days since the meeting with the surgeon. The response has been a bit varied among my family and friends. Surgery certainly makes everything more real. Knowing it is a major operation which carries so many risks brings an entirely different element of worry to the situation, I get that. If the situation with the tumour was more positive and the surgeon was more confident he could do a full removal, the decision to push on with surgery would bring a further level of comfort that it is the best decision. Seeing as this is not the case and that the tumour seems to be surrounding the artery still, it brings much more anxiety for all involved. For me, I will not be conscious for any of the surgery, or even most of the intensive aftercare. It is everyone else who will have to painstakingly sit for hours, waiting for the news of how the surgery has gone, what they managed to do, and if there were any ‘complications’. By the time I’ve found out these details, it’ll likely be days after the operation. I’ll be off in dreamland, so deep under the influence of drugs that I’ll probably be exploring Narnia from my vantage point, riding on a dragon’s back (I’ve never had a dream like this so I’m not sure why I would start now, but it’s nice to dream about the potential of your dreams).

There have been a lot more tears since Tuesday. Perhaps it is a combination of learning what my staging is and having it clearly communicated that a full removal is unlikely. It could still happen if the scan failed to be accurate in its portrayal of the tumour, but he seemed to doubt it would be so wrong. I did do another CT scan at the hospital, so I’m waiting for the surgeon to call me with the results of that. Perhaps he will be more confident of what will be done in surgery once he has reviewed it, assuming the scan is better quality than the last one and offers more insight. Nano-knife is the most likely outcome. A full removal is not out of the question eventually, I believe, but the surgeon didn’t seem willing to discuss such a scenario. I didn’t try, to be fair. He had an air of confidence about him which was tantalising. Every sentence was carefully thought out, every word scrutinised in his head before it left his mouth. These situations are tense; you could tell that he was experienced in dealing with them.

I’m unsure whether he will do some form of partial Whipple no matter what he decides is possible with the tumour. I need to ask him when he calls me about the scan results, but it’s one of those things that I’m unsure whether getting an answer is better for me. It seems easier to just wake up after surgery and face the music then. The outcomes sound so varied depending on what they see during the operation that I doubt I’d get a straight answer anyway. At least I trust this guy to tell me that the answer isn’t easy and I’d believe him if he said as such. The fact that there is a cyst on the other side of the pancreas to the tumour indicates that the surgeon will have to do more than just deal with the tumour. We did ask him if he would be removing the cyst despite what happened with the tumour, and he said that he would. It was funny – his reaction was almost like this was a total afterthought – an irrelevancy in the face of the cancer. “Oh yeah, there is a cyst there too, isn’t there? Yeah, we’ll get that out,” he casually said when the question was put to him by Anna. Surgeons are so casual. They must realise that their job terrifies the other 99.9% of people on planet earth. I’m sure that there’s a smugness that comes with that territory. I’d certainly be smug about it if I were one. He didn’t seem particularly smug at all. After arranging the CT scan on the phone with the radiology department, he said that he needs to get a nurse to put the cannula in. “I can do surgery on you but I can’t cannulate you,” he chuckled – I suspected this was that smugness coming in to play.

One of the things I have changed about my behaviour recently is my diet. Since learning a little about the immune system and how it is constantly fighting ‘bad’ cells being created in your body, I have been much more taken into the idea that your immune system plays a vital role in how your body battles cancer. Before, I thought whether you developed cancer or not was more a thing of luck, with a heavy dose of genetic makeup. The book I am reading seems to suggest that this is not the case. He references a study about fostered children. The study was conducted in New Zealand as apparently they have detailed records about births and biological parents. In the study, they measured the cancer rate among a group of people who were fostered from a young age. If the formation of cancer was more down to genetics, the numbers in people who suffered from cancer would be similar between the focus group and their biological parents, irrespective of whether they were raised by foster parents or not. If the formation of cancer was more down to behavioural patterns rather than genetics (e.g. diet, exercise habits etc), then there would be less significance between children and their biological parents, and more significance in the trends between the foster parents and the children they adopted. The study showed the latter, indicating that the formation of cancer was effected more by behaviour than genetics.

Now, I’m not suggesting this single study proves the point entirely, and more importantly, I have not looked into this study myself and do not plan to. It is enough to convince me that behaviour must be more important than I perhaps anticipated. As a result, I’m trying to avoid processed food as much as possible, based on some scrutiny of these types of foods. Turning over a food packet to look at the ingredients and seeing different types of sulphites listed is a little concerning to me, even with my limited knowledge of sulphites (and believe me, my knowledge is limited). A quick Google tells you that they are only dangerous for a small number of people who have problems with asthma. Does this mean that it is only an immediate risk to these people, though? I can’t imagine digesting a lot of additional sulphites is good for you, never mind the fact that they are added to foods to preserve them. Anything that makes it harder for the world to digest the food (i.e. through the process of bacteria breaking it down), sure means that it is harder for your body to break it down. The more unnatural the ingredient is that you are adding to preserve the food, the more dangerous it would be for your body, I would assume. It makes logical sense to me. The world isn’t always logical, though, so maybe I’m barking up the wrong tree here.

Yesterday morning, I decided to Google ‘should you avoid food preserved with sulfites’ to test my theory. I had seen ‘Sulphite Dioxide’ on the back of the packet for some dried apricots and it got me interested. Notice that I did not add ‘if I have cancer’ onto the end of the question; I’m not even getting into that with Google. Searching for anything specific to cancer with Google can lead you to all sorts of dark corners of the internet. It seems to be the most prolific hearsay topic on the planet.

The first article I clicked on was one titled 5 Food Additives You Should Avoid. According to this list, and after doing more reading around, it seems that sulphite dioxide has a low toxicity for humans in most cases, so is generally regarded as safe. As I stated previously, though, I’m sure it isn’t completely inconsequential eating it in a lot of your food, but anyway. The thing in the article which got my attention more was food additive number 1 in the list – Sodium nitrates. Want to know why? Because it states that they increase your risk of pancreatic or colorectal cancers. If there is one way to grab my attention, it is by throwing around the name of my beloved cancer. Pancreatic. Dancreatic. Dan’s Dancreas. Dan’s Dancreactic Dancer. Anyway…

Apparently, sodium nitrates are mainly added to meat to stop it from discolouring. That should make them extremely low risk for me, an individual who does not and has not eaten meat since 2016. Perhaps this is another cruel irony of the world, like when a non-smoker gets lung cancer. During the digestion process, toxic chemicals are released due to the sodium nitrates being broken down by stomach acid. It is them which pose a threat to humans according to the limited research I did on the web. Rather than always researching other people’s research, I thought I’d conduct my own. I headed down to the kitchen, opened the fridge and found a packet of bacon. It had come from Waitrose, one of the more expensive supermarkets here in the UK. I turned the packet over and read the ingredients. Just like that, I completed my study. Sodium Nitrate. Confirmed – it is indeed added to meat. Study complete. Science is so easy. You probably thought I was somehow going to confirm that the breaking down of sodium nitrates in the stomach releases deadly toxins didn’t you? I’m not that good – go speak to a real life scientist if you want real research.

It just feels like a minefield trying to investigate diet further. Information seems so inconsistent and you wonder how things get approved for use if they truly are so bad for you. What is true, apparently, is that cancer rates in the west are much higher than in the east, and it would make sense to me that the key difference between us is diet. We have been eating highly processed foods for longer in the West, with the quick growth of fast food since chains like McDonald’s grew in popularity. Now processed food is everywhere and considered very normal. We look at things like butter as being intrinsically bad, despite us being able to comprehend how butter is made. Look at the back of a margarine tub and try to figure out what on earth the ingredients are in it – half of them sound like they belong on the back of a toothpaste packet or something. Do we really feel better eating that just because it is lower in calories? Fats are very useful to us humans, we seem to forget that fact. My body struggles to process them now and I have to take supplements constantly to ensure they are being absorbed by my body. What I’m trying to say is that you should revel in the fact that your body can absorb fats naturally (if it can) and utilise it by eating full fat butter, damn it! I do it now more than ever and it is a beautiful luxury.

Sometimes I find myself pondering whether knowledge is power or not. Do I find myself feeling empowered by it or intimidated by it? The question never feels more applicable than when trying to research diet and cancer. My new thing is to mercilessly avoid food with preservatives in it, where possible. All of a sudden, I am not eating any crisps, baked goods from the shop or heavily processed chocolate bars; those of you who know me personally will understand what a huge deal that is for me. If I want something sweet, I try and bake something quickly. For example, I’ll bake apricot and walnut bars to have at breakfast, alongside fruit. I’ve started making my own mayonnaise instead of having it out of a bottle; the home-made stuff is much more yellow than white – it’s strange when you have only just started making it yourself. It really does taste lovely when fresh and you can mix up how much mustard you put in it, which is nice. The next step is to learn to make loafs of wholemeal bread but I’m building myself up to that. It’ll probably take me a morning to get into it as dough is not something I have worked with so far. Rivetting stuff, dear reader, I know. This blog is probably your guilty pleasure these days with such innane ramblings about diet and food, if you even try to have any pleasure from it. At least it isn’t all cancer cancer cancer; it also makes you feel guilty about enjoying the foods you’d normally mindlessly eat.

Yet, this obsession with avoiding preservates is probably just a new scheme to feel in control of the diagnosis. I’m not suggesting that it doesn’t assist in the fight against cancer too, but plenty of people have spent their entire life eating terribly, not having a care in the world about how many preservatives are in their bacon sandwich, yet don’t develop cancer. It is difficult to reconcile that, as I believe I’ve lived a fairly healthy life so far and still managed to get cancer. The fact that I likely ran 100km with the beginnings of cancer brewing in my pancreas is almost comical to me at this point. It was after I had originally got to the doctor’s complaining of stomach issues. The result of that was multiple scans at the hospital, but with no meaningful results. Their conclusion was that I had a strange form of constipation; it never convinced me. I guess when your tumour is 3.2cm at its largest, it is difficult to see with conventional scans. You have to step up to the expensive PET scan which they weren’t willing to do at the time. They don’t tend to assume that an otherwise healthy adult in their late 20’s would have pancreatic cancer; I know that from the first few weeks when trying to be diagnosed – “It’s probably pancreatitis but we can’t rule out cancer, although it’s very unlikely to be that.” I can’t remember how many times I heard words to that effect, but it was a lot.

So, here I am. Dan with the Dancreatic Dancer trying to research diet in an attempt to stop the Dancer getting the better of the Dan. Maybe the fight against preservatives will provide a useful distraction over the next few weeks, until the surgery day comes. Making everything from scratch is certainly time consuming. I’m getting used to the yellow coloured mayonnaise now, anyway.

Stage 3: The Surgeon’s Verdict

The Road to Recovery

Lucy, Anna, Matt and I At a Comedy Night – 10.06.22

Dealing with a cancer diagnosis is hard for many reasons. People frequently comment on how well I look and say that I’m dealing very well with it. These types of comments are nice and give me a lot of reassurance and strength. I believe I deal with it quite well given the gravity of the situation. Especially when I consider how quickly it changed everything about my life – I am far less able to be active now, work has not been a part of my life for the best part of 8 months and I’ve had to move back in with my parents. That is all a lot to process, never mind with the added ‘you might die in the next few years’ also playing on my mind. My biggest attribute in dealing with it all, I think, has been simply knowing myself well and knowing how I deal with things that bother me. It may sound generic and stupid, but I really do believe it to be true. I want to discuss it a bit before I go into what the surgeon at Manchester Royal Infirmary (MRI) said today.

The first time I tried yoga was when attending a beginner’s class in North London circa 2019. I went along with a woman that I had been dating at the time. It was a weird time in my life – I had been living and working out in America for about 8 months, working on a big project that we’d won. That project had wound down for a few months as it was between phases, so I was living back in London, but I wasn’t sure how long for. There was talk of my company drawing up an American contract for me, meaning I’d be permanently living out there, for a few years at least. There was also talk of them employing more people out there, though, to make it more cost-effective. I really enjoyed working in America and was pretty hopeful that the contract would work out and that I’d be moving back. At the same time, I loved London, I loved living with my sister and brother-in-law, who I’d been living with for two years, and I knew I’d miss regularly seeing my family and friends. Having said that, I really enjoyed living out in the states and was aware that I wouldn’t have to be there forever. The first phase of the project had gone well for me, so I thought it would be interesting to keep going until the end of the whole project, and wanted to see where it could take my career. One thing was certain, though – I was in two minds about it all. There was an obvious crossroad forming in front of me and I couldn’t decide which route I preferred.

On top of all of this, the situation with the woman I was attending the yoga class with was strange. We had dated before I left for America, but we had cut it off when I decided to move abroad. It was fair enough – we had been seeing each other on average once a week but nothing had really bloomed so to speak. Since getting back, we had seen each other once to clear the air a bit, and I wasn’t sure where we were at now. I agreed to go to the yoga class not really understanding where I stood with her. I also wasn’t sure what I wanted at the time, knowing that I could be going back to the US in the next few months. It didn’t feel like we were ever dating in reality – it never had, to be honest. There wasn’t much of a connection and we didn’t seem to know how to communicate properly; the lack of communication frequently caused problems for us and left me feeling quite self-conscious. I had never really understood what her intentions were in the situation.

Communication and confidence weren’t things I had ever really struggled with whilst dating up to this point. It was the first time I truly felt out of control of a situation with someone I was seeing. It felt weird to even say that we were dating as we weren’t really. We were just hanging out. We got on really well but only ever as friends – why did neither of us just say that, accept it and move on? I didn’t understand why I couldn’t admit that to myself and I didn’t understand why she wouldn’t say it to me either. Why was I investing time in this, when I could just clearly say to her “we’re just friends,” and be done with all of the weird aspects of our relationship? We’d regularly do things together around the city and it was fun. All the awkwardness came from the fact that we had never really identified what the motivation for us hanging out was – at first, I thought it was romantic, but that theory had long faded for both of us, I believe. It was starting to annoy me.

The yoga class was fun, despite me being terrible at it. Yoga is not a graceful thing to be a starter at. You are almost definitely going to look like a total clown during your first few sessions. It is much better to do some at home and learn the basics before going to a class, but I didn’t know that at the time. This class was specifically aimed at beginners, but beginner yoga is not the same as the beginner category in other things. I’ve been doing it for a few years now and I struggle to go up to the intermediate setting on DownDog, the app I use to do yoga classes, or when finding videos on Youtube. As soon as balances are thrown into the mix, it gets much more difficult. I’m better at them than I’ve ever been, but that isn’t saying much.

At the end of a yoga session, you finish in the Savasana position. This is where you lay on your back, with your arms and legs stretched out and separated, and completely relax. Your palms face upwards and your feet relax to the sides. The aim is to empty your mind, allowing yourself to be still. It’s extremely relaxing if you are used to it; if you manage to actually clear your mind of thoughts, it is also extremely therapeutic. I did not know about this position during this class. As we went into Savasana and the instructor told us to be still and try to dispose of our thoughts, my panic levels built. I never just sat and thought about things that were going on in my life necessarily; my primary intention in life was to not think about things as my mind quickly went to bad places and made me worry. I felt much better only tackling my worries when out running, which allowed me to feel productive in tackling those problems. Even running is a distraction, though, albeit a positive one.

All of a sudden, my mind was flooded with negative thoughts. My mind was screaming at me – “Why are you getting yourself back into this weird situation with this woman?” “What happens if you agree to go to America and everything goes wrong with your job?” “Will you miss your friends too much; will your relationships with them start to break down if you’re away for that long?” It was the longest five minutes of my life. I thought I was having a panic attack but I couldn’t stand up or leave as I felt pressured in a room of strangers. It was horrible.

I remember that feeling well. Some of the details about the day are a bit hazy, but I remember the panic I felt during that Savasana. It told me that I needed to do more to address things in my life that I was not happy with. Even if that only meant addressing them with myself to help me deal with them better. It did not necessarily mean I needed to go around shouting my mind about every little thing that annoys me, but I felt that I was uncomfortable with the way I clearly wasn’t being honest with myself about things that were annoying, worrying or upsetting me at the time. The running wasn’t doing enough to help me process these thoughts. When running, you work through things in quite an indirect way, whilst endorphins flood your mind, also making you feel better about those things. It is not addressing them in quite the same way that sitting and contemplating them with a clear mind does.

This is how I am linking my anecdote back to my main point. Through that uncomfortable situation, I bettered my life. I didn’t want to enter a state of panic if I just sat still, alone with my thoughts. My thoughts should be the last thing that scare me – they come from my own consciousness and reflect things I think and feel about the world around me. If I cannot address things with myself, how can I expect to address them with the external world? I had identified something that I considered a weakness in myself and improved it. A few months later, I could easily Savasana because I was taking time to work through my thoughts, not letting them intimidate me. It made me feel more in control of my life. I consider this a key strength of mine now, and one that has been critical in dealing with this journey through cancer.

So, fast-forward to today, with me, Anna and my mum sitting in the surgeon’s office. As is normal for me, I had felt incredibly stressed in the waiting room. The anticipation is a million percent worse than the news for me. Even if the news is incredibly bad, once I know it, I can deal with it. That alone provides relief to me. Waiting around in a hospital, listening to fraught conversations around me and watching the clock ticking is the definition of anxiety, in my opinion. It is hell. As soon as I am sitting in the office and a human is looking back at me, I feel better. It’s my time to know. I was ready.

The surgeon told me a lot of things about my cancer that I did not know, as well as going on to explain what his team’s intentions were from here. Probably the biggest thing that he expected me to know, but that I did not, was that my cancer is in stage 3. The tumour has completely surrounded a major artery. He said that the scan does not seem to indicate that the chemotherapy has managed to make the tumour recede enough that it can be fully removed. There was a big BUT here, though. The CT scan image represents a shadow of your internal body. As a result, it can be quite inaccurate compared to what is actually inside you. It was a key point that I needed to understand before discussing the next options.

It was interesting that my cancer is stage 3. Straight away in my head, I couldn’t help but think that this was the third stage of my treatment so far. I had the diagnosis stage, the chemotherapy stage, and I was moving into the surgery stage. For some reason that thought made it feel better. It didn’t actually matter to me anyway; staging is something that the medical professionals use to help describe something, but it doesn’t mean a lot to me. Us muggles assume that we understand far more than we do about staging, as an oncologist once pointed out to me. “You can have a good stage four and a bad stage one – it doesn’t mean very much on its own,” she had said to me during our first meeting. I’ve held onto that. Just because stage 3 is one away from stage 4 and one above stage 2, does not mean I understand it any more than the next person aimlessly walking around the hospital and attending appointments. Don’t cling onto something you don’t understand – the people who need to understand it are the ones giving you the information and that is all that matters. I’ve got good at saying mantras to myself. They help me sleep better at night.

The crux of the conversation was that they are going to get me in for surgery. He said I could do radiotherapy now if I wanted, but he did not recommend it. Apparently, radiotherapy can cause so much scarring that it can make surgery impossible. For this reason, he recommended doing the surgery first. That surgery did not have a clear plan, though. Until they open me up and look inside, he said, they would not know whether a full removal was possible, or if it would be Nano-knife that would be utilised. Full removal is the best scenario for me but if the scan is accurate, it won’t be possible. The next option, Nano-knife, is an experimental treatment which has not been used very much for pancreatic cancer. They electrify the tumour in an attempt to kill the cells. He told me that there is little documentation and research on its application for pancreatic cancer and that it has not been used very often in this instance in particular (i.e. stage 3, surrounding an artery etc). As a result, he really didn’t know how likely it was to offer good results, but he was willing to try if I was. He emphasised that it was more likely to be Nano-knife than a full removal. I understood. He sent out a few more warnings – may reduce my life expectancy, may not cure me, and he was satisfied that we were on the same page.

We were at MRI for a few hours after that as the surgeon asked me if I’d do another CT scan. The last one was unclear and he could not see the major artery that was surrounded by the tumour. He wasted little time in calling up a friend in the radiology department, requesting an urgent scan and pushing it through the booking system. It was amazing; his colleagues clearly have a lot of respect for him. My family researched him after the appointment and he is an internationally recognised surgeon, so that is very encouraging.

My mum and Anna were both upset, my mum especially. It is hard to hear things when they are put so bluntly, but also incredibly necessary. For the first time in a while, I felt that I left a meeting at a hospital understanding more about my cancer than I did when I went into the room. Now a few hours have passed, I still feel positive about the whole thing. No matter what happens, I’m getting a surgery, whatever that ends up being. The minority of people who are diagnosed with pancreatic cancer can say they managed to get a surgery. I feel well at the minute and I’m managing to run a little and cook a lot. Those things mean a lot to me. So long as I keep myself positive and enjoy these next few weeks before the surgery, that’s all I can do.

Whether I have one year, ten years, or a whole lifetime ahead of me, will only be revealed in time. For now, I have to live every second of my life with the knowledge that this unwelcome cancer is doing its best to destroy my body. All I can do is live with that knowledge and enjoy those seconds with even more vigour. I can’t cry away my disease and it’ll only make my life more unpalatable to try. I choose to spend it in a way which encourages happiness, hope and love, as any alternative to this is too bleak for me to fathom.

I want to thank my amazing family, fiancee, friends and everyone else for their ongoing support. It means so much to me. Dealing with this without you all would be impossible, no matter how established my ability is to address my own worries and concerns. It is a strange twist of fate that I met Anna when I did – without her, this entire journey would have been far bleaker; she is a constant beacon of light, always looking out for me and helping me through the endless curveballs, emotional breakdowns and detrimental diagnoses. Let’s see what comes in this next part of the journey and hope that it is more good than bad. Either way, what will happen will happen, and I’m going to have to deal with it. There’s a strange comfort in that.

“Death is certain, replacing both the siren-song of Paradise and the dread of Hell. Life on this earth, with all its mystery and beauty and pain, is then to be lived far more intensely: we stumble and get up, we are sad, confident, insecure, feel loneliness and joy and love. There is nothing more; but I want nothing more.”Christopher Hitchens

Note to Self (The First Meeting With the Surgeons)

The Road to Recovery

Anna and Lucy on a Dorset Beach

Elephants and Tea – Dear Cancer Letter

Elephants and Tea have posted my Dear Cancer story under the title Dear Cancer, Every Cloud Has a Silver Lining. You can find a link to the online post here. The full magazine can be found here. You can purchase physical copies of the magazine on their website which is a great way of supporting their work. It is free to view online.

They do amazing work, providing support for Adolescents and Young Adults (AYA) with cancer. Early on in my cancer journey, I sought out several support groups to help me feel less alone. Although some of them had amazing people in them, no one was under the age of 55. It did sometimes feel isolating, as if I was the only person this young actively seeking support. Finding Elephants and Tea was a huge relief to me, and their online resources really helped me out. I was incredibly happy when they accepted my submission.

In the June edition, you can find many other Dear Cancer letters, from all different kinds of perspectives. I’m still making my way through them but have thoroughly enjoyed the ones I have read. It is also the first time that I’ve seen something I have written in physical print – exciting!

You can follow them on Twitter and other platforms (I assume, I don’t have any others). They will appreciate all of the support, whether it is having a read of their posts, buying a physical copy of the magazine or just engaging with their social media accounts.


The next stage of treatment commences: I have my first appointment at Manchester Royal Infirmary with the team of surgeons. After the disappointment I felt at the final scan results post-chemotherapy, where I went into the meeting thinking I would be getting more information than I did, I’m trying to keep my expectations as low as possible. Maybe my life goal should be to become a blank slate with no hopes, dreams or inhibitions; that would make dealing with cancer much easier. It is tempting to convince myself that this will be the meeting where they will tell me I will be having this procedure on this day and everything is ready to go, but I feel I’m setting myself up to be disappointed by creating those expectations. Perhaps I need to go into the meeting having convinced myself that they are going to tell me absolutely nothing. “It’s an induction meeting,” I’ll repeat to myself over and over again until I truly believe it. That way, no matter what happens, it’ll feel like progress. Unfortunately, I’m not a machine and my stupid emotions won’t allow that to happen.

At this stage, I feel quite sorry for the medical professionals who are dealing with my case. I’m always extremely polite to their faces and truly do appreciate what they do for me, I want to make that clear. After we were told that it may take the surgeons a month to contact me, though, Anna and I left the meeting feeling surprised. An entire month to be contacted? Isn’t that far too long? Why the holdup? Surprise turned to righteous preaching as we spoke to friends and family about the meeting. “He even told us that if they do not contact us within a month, we should contact the surgeon’s secretary! How can they expect them to be so disorganised?” We were riling ourselves up. Righteous preaching turned to minor rage. Then, we realised that hearing nothing from them for a month meant a month of true freedom. No chemotherapy, no hospital appointments, nothing. We decided to do the things we haven’t been able to: go to London, visit Anna’s family in Dorset, enjoy ourselves. I’ve settled into the new life. It almost feels like I don’t have cancer anymore, other than how bad I feel every time I go running. For some reason that is only getting worse. Also the neuropathy. Also the abdominal pain. Ok fine, it doesn’t feel like I don’t have cancer. I’m even using double negatives now; everything is going wrong.

Wednesday evening, as I sat at my friend’s house in north London having dinner, I received an automated message from Manchester Roal Infirmary. ‘You have a new appointment letter. Click here to open it‘ it read. Here we go again – back on the appointment clock. The period of peaceful bliss only lasted about 12 days. Now I’m scorning the medical professionals for contacting me too quickly. I can’t even keep up with what I want from this process; I’d hate to be them on the receiving end of my negative energy (which I keep completely contained between me, my family and my friends, and which only ever lasts a couple of days before I see how unreasonable I was being). It is why I feel sorry for them, but I don’t actually criticise them. I realise that they are probably managing a lot of cases. You need to vent about things to your friends and family, it helps you process information that is difficult to comprehend.

The link that they had text me didn’t work at first. I called home and spoke to my dad to see if I had a physical copy of the letter but there wasn’t one. “Just move on,” I said to myself, trying to seize the day and just let it be. Ten minutes later I tried again; how can I seize the day when I might have a letter telling me that I am going to have my organs pulled apart by someone I have not yet met? This time the link worked and I was in the hospital mailbox. The letter didn’t contain the words ‘we are going to pull apart your organs’, which was a relief. They went for the standard template of time, place, person I would be meeting. A bit boring but understandable. Some may find ‘we’re going to pull apart your organs’ a little too direct.

As I left my friends house, I called my parents to tell them. Once I had hung up I think it all hit me properly. I sat on the train home, holding Lucy, thinking about what might come next. In my head, I bounced between telling myself that it was good and that I need to do this to survive, whatever this was going to be. Then I thought about potentially being under general anesthetic for half a day, about a knife cutting away at my organs, about waking up in a hospital bed and not being able to see anyone that I loved. It should have made the train journey go quickly, but it didn’t. As my mind played mental table-tennis with itself, my eyes evaluated the tube map over and over again, counting the stops before I got home. Lucy the puppy was sat on my lap. She was getting irritated as I wasn’t letting her on the floor. I could see her eyes surveying it for any crumbs that she could lick up. London has been a revelation for her. As you walk her down the street, you have to constantly look out for stray chicken bones and other food that has been carelessly discarded. It is everywhere and she loves it. I didn’t have the patience to deal with her at that time and it was another thing that was stressing me out.

By the time I finally got home, I felt stressed. It took me a few hours but I managed to get out of that headspace. It has come back a bit at times, though. Last night I lay awake in bed for an hour or two. I wasn’t focused on it the whole time, but it regularly seeped back into my mental. It never felt like I was struggling to get to sleep, to be fair. I’d watch something on my phone, listen to a bit of music, read a few articles. Anything to distract myself. Eventually I fell asleep but I don’t remember when. Anna was up at 4:30 this morning for work; I vaguely remember waking up and looking around as she got ready, but not really. Luckily I slept more and I’ve felt energised today.

I’ve spoken before about how quickly humans seem to adapt. We felt it during the Covid lockdowns and I’ve felt it throughout my journey with cancer. For six or seven months, the chemotherapy cycle was everything. None of it was enjoyable, but I made it work. I’d make plans with friends to take my mind of it, joke around with the staff whenever I was attending appointments at the hospital and I’d think of things to write in the blog. It all kept me busy; the time flew by. Post chemotherapy, it took about a week to start winding down from it. Not having these regular appointments anymore started off feeling very scary. As I resumed living a somewhat normal life, I realised that it was a blessing. I can be more independent again – there really is life after chemotherapy!That feeling stuck and it felt like I’d taken a big step towards beating the cancer.

Why did it feel like that, though? I’m barely through the first phase of a complex journey – ever changing and unpredictable. Perhaps it is a defence mechanism. Maybe it isn’t such a bad thing to feel like that; it did help me enjoy life much more while it lasted. Now I have appointments looming over me again and my expectations are building and building. What are they going to say? Will I finally get some concrete answers? Why can’t I just relax and let whatever it is, just happen? Doubt is back and the reassurance of familiarity is gone; no more appointments at The Christie hospital, no more nurses and doctors I recognise. It is all about Manchester Royal Infirmary now. I’ll have to make new connections, learn new processes. Who knows what I’m going to go through in those hospital buildings.

So, this blog post is more for me than anyone else, and it is to remind myself of a tough truth: YOU wanted this, Dan! You wanted them to contact you quickly, you want the surgery (or whatever other procedure you may need to get you to the surgery) and these days you have spent enjoying your life should be the motivation for getting back to normal life, cancer-free and rocking a badass scar. You can tell people that you were attacked by a shark or were involved in a skydiving accident. Or, you can tell people that you went through a major operation, after months of chemotherapy, and likely before months more of chemotherapy. Through the years of abdominal pain, the weeks spent jaundiced in hospital waiting rooms, the shifting diagnosis, the shared tears with your family and loved ones, the sleepless nights and the fear-filled days, you fought on. You did all of that. That should be enough. Sharks and skydiving aren’t necessary. It’s time to sink or swim, and although you hate swimming, you’d rather do it than sink.

‘Sink or Swim’ with Lucy