Cancer Blog - Episode 26 : The Enema Within

Five days of Radiotherapy was totally do-able. Leaving aside my dignity, which is currently in a hazardous waste bin somewhere in Eastbourne, I came away with a slightly pink left boob, a few days of fatigue, a new appreciation for radiologists and a stout body lotion. It was absolutely fine. Honestly.


The next round, however, is a bit more complex. Radiotherapy to the pelvic area is a bit more complex, as there are a lot more bodily bits (bowels and bladders and stuff) in the way that we don’t want to nuke. The solution, as I think I’ve hinted at before, is to make the bowel as flat as possible and to make the bladder as full as possible, so the two are as far away from the nuking site as they can be.


Planning

So as soon as a free day appears in my dairy, so arrives a recycled letter from the NHS inviting me along for another Radiotherapy Planning CT Scan. I had one of these before, for the breast treatment, and it’s the one where they measure you up on the CT machine, give you three tiny tattoo dots so you can be lined up again, and send you on your way, ready for the big day(s) to come. I’m so confident I barely even blink, and I pitch up to the appointment like an old hand. Radio Rita the Receptionist welcomes me like an old friend, I take my favourite seat by the window and wait to be called.


I’m usually in and out really quickly, but I have noticed that sometimes there are people still sat waiting when I’ve arrived, who are still there on the way out. Never really gave it much thought before, but maybe I’m just lucky. It would certainly make a change. Today there are three gentlemen sitting in the waiting area, plus me. The mood is softly chilled, with a citrus hint of crisp efficiency and a soft-bellied undertone of peachy vulnerability.


I’m called in.


Prep

The Radiologist (don’t know her name, I’m rubbish at names, let’s call her Sandra) talks me through the planning scan, and what radiotherapy is. We whizz through a few standard bits as I’m an old hand now. She explains about the bowel and bladder thing and how I’ll need to do some ‘prep’ before each of my appointments. The prep is to arrive with an empty bowel and full bladder, which isn’t as easy as it seems, especially for laydees, as the two evacuation processes usually happen at the same time, and it’s quite hard to hold one valve back when the other one is open, so to speak.


I’m lucky that we only live about 15 minutes away from the hospital - depending who’s driving, obviously. It’s 15 minutes if I’m at the wheel, and about 40 minutes if it’s Mr G, as he’ll try out a new ‘shortcut’ route to avoid the traffic, and inevitably and catastrophically deviate from ‘my’ route, which is, naturally, already the shortest and most efficient route, because I’ve thought about it in advance and am not a complete gibbering muppet who forgets that schools exist, that they are busy at certain times of day, and who doesn’t know where the temporary road works are and is unable to sit at traffic lights without doing a 3 point turn and heading off in the wrong direction. Anyway, where were we?


Timing

Yes. So. Timing is the key to efficient bodily fluid management it seems. Being 15 minutes away means I will be able to fill and evacuate my bladder and bowel in the privacy of my own home, rather than in the waiting room. I’m delighted, but also thinking about the actual chance for privacy in my home; I have two teenagers, so quiet bathroom time is hardly guaranteed. I’m already planning a “Do Not Disturb, Mum’s Doing An Enema” sign to go on the door, which should work, by all that’s good and holy, and if that doesn’t keep them away, very little else will.


I’m given a handy ready reckoner showing me the 60 minutes countdown to my appointment. At (insert appt time) -60 I need to administer (I was going to say ‘insert’ but I realise some of you may be eating) the daily mini enema, which should have taken effect by -45. At -40 I need to start to drink 4 cups of water, which needs to be completed by -30. At -25 I leave the house ready to pitch up at the Radiotherapy Dept 5-10 minutes before my time slot at 0 hours. It all sounds terribly efficient. Horrific, but efficient.


The Moment

Sandra opens a white cardboard box and starts to tell me about the mini enemas I’m going to need, but I’m one step ahead. I smugly tell her that my Oncologist already prescribed them and I have them at home, all ready for my first appointment. Sandra is absolutely delighted and asks if I have one with me, and suddenly there’s a moment. A moment where a single penny begins to fall, slowly and from a very great height, in a large, empty marble room with what will undoubtedly prove to be the very finest acoustics. The penny continues its slow motion freefall descent, spinning inexorably downwards towards the tympanic inevitability of the thunderous moment it will finally hit the unyielding receptor of the marble floor beneath it. And in those fleeting, muted precursory moments I realise that my first mini-enema experience won’t be in two weeks time, in the privacy of my own home. It will be here, now, or at least imminently.


And sure enough Sandra pulls a small white tube out of the box and passes it to me. Of course she does. Only a naive idiot like me would ever have failed to see this coming. You guys were already there, weren’t you? Knowing, sighing and waiting for me to realise that of course I need to be in the exact same state for a planning CT as I will be on the day itself. That’s the whole damn point of the planning scan. Sometimes I astonish myself with my own stupidity, I truly do.


Sandra passes me the tube and tells me what to do with it, as if I didn’t know. I have to then wait in the waiting room for it to take effect, then drink 4 cups of water, and she’ll come and check to see how I’m doing in a while.


The absolute fucking state of my life right now.


I’ll spare you the bathroom scene, but me and this little git had a moment, and then we shared another one, 15 minutes later.





Dawning

And as I’m sitting in the waiting room with the same 3 gentlemen who were there before, it also dawns on me why some people’s appointments take a lot longer than others. They too are, or will soon be, ‘prepping’. Oh my.


The man in the next chair starts talking to me, despite my very obviously closed body language. When you’re waiting for an enema to take effect, anything other than a closed body is extremely unwise. “First time?” he asks me. I take moment to ponder how the fuck he knows that this is my first ever enema, but thankfully (for him) I realise he’s talking about having a Radiotherapy appointment. I tell him no, I’ve had a few now, and he decides this is all the opener he needs to tell me his life story.


Bill and Ian

He’s called Bill, he’s 64, and he’s just been diagnosed with prostate cancer. He’s been here 40 minutes already and he hasn’t been seen yet. His wife’s waiting outside in the car park and she’ll be wondering. Bill supposes the NHS are busy though, so she’ll understand. Bill also has cataracts, and is going to be having surgery soon. He’s not sure how long this radiotherapy will last, and if it will clash with his cataract operation.


I smile and use a phrase I’ve become quite used to hearing over the last few weeks. “You’ve got a lot going on”, I say. And Bill nods, pleased that I acknowledge his woes.


Ian is called into the consulting room, from chair no 3, and I take a moment to inwardly wish Ian well.


Bill is texting his wife now so I update my cancer-bestie Darcey on the current shitty state of affairs (yes, I know, it was deliberate, thank you). A few minutes later Ian comes back out of the consulting room with a familiar looking white cardboard box and makes his way to the gents toilet. Et tu Ian, et tu.


Ian emerges again a few minutes later, eyes downcast and walking slightly gingerly. Ian sits back down again and wonders what to do with the large box of enemas he’s just been given (now one lighter). Poor Ian hasn’t bought a bag, so Ian has to leave his box of enemas on the table for everyone to see. Don’t be like Ian, always bring a bag.




Bill is called in and he delightedly jumps up and tells me perkily “Ooh, that’s me up”. I send up a little prayer to the gods, on Bill’s behalf, to go easy on him. He’s got a lot going on. But before I can send up another one for Bill’s wife, nature calls and I’m off to the little girls room myself. On the way back I grab myself 4 cups of water and line them up on the window sill. I’m sorry environment, but there's no way I’m doing the bladder walk of shame 4 times with Ian and Bill and Rita watching. Not now that we all know the score with the copious plastic cups and the extremely generous toilet to patient ratios.


I neck my 4 waters like I’m a student with a pint of snakebite and, not for the first time, I wonder what I did in a former life to deserve this. I must at least have been Mussolini.


Dazed and Confused

Bill comes back out and quietly walks to the toilet, clearly dazed, with his eyes straight ahead, like a bunny in the headlights. Poor old Bill. He’s got even more going on now. He’s back like a flash and he sits back down and picks his phone up and furiously starts to type. But at least Bills’ got a carrier bag to put his enema party bag in. Bill’s wife is clearly a good woman who’s done her research. Even if she hasn’t shared it with Bill. I can’t say I blame her, to be honest. He’s got a lot on, after all.


15 minutes later Sandra comes over and discreetly asks me if I’ve done my prep. I nod and she gives me the thumbs up. Ian is summoned into the CT room, so I’m guessing I’m up next.


Buddies

Darcey is, as ever, my constant companion and virtual cancer buddy and she’s very much enjoying today’s shenanigans. A little too much perhaps, so I don’t offer too much sympathy when she tells me her stitches are hurting from laughing so much. But to be honest I’m glad she’s laughing, we always manage to find something to laugh about in the hellish corner of the universe that we’ve been flung into together, but it’s been a tough time for her recently. She’s in the middle of a very punishing chemo regime and my heart goes out to her every day as she bravely battles exhaustion, parenting, hair loss and some pretty horrific side effects.


Darcey’s nearly half way through her treatment now, and I know that soon enough I’ll be joining her on the chemo train, and I also know, without question, that she’ll be there for me every step of the way, as I will for her. Cancer is the most horrific disease, it kills, maims, mutilates and destroys our physical bodies, but is also takes an enormous toll on your mental health. Not just during treatment, but for the rest of your life. Everything changes, everything you do from the day of diagnosis onwards, has cancer lurking somewhere in the background, threatening your plans, being ready to pounce again, changing your attitudes, your perceptions and your relationships.


Glimmers of Light

But cancer can also cause other things to grow and flourish; hidden strengths you never knew you had, new friendships, renewed passions, a new zest for life and adventure. The counterpart to cancer is the kindness, compassion and love that we receive for others that we never would have otherwise experienced. I have been inundated with support, love and light, ever since I first shared my diagnosis and I am truly humbled, honoured and nourished by every single kindness I have received. I may never have known or appreciated that kindness or that love unless cancer had entered my life. So whilst I’m not for one second suggesting that it has been a good thing (hell no, cancer is still an absolute fuckfestering knob-end of a sleaze bag of shitey scuzzbucketry) I can find ways to celebrate the wonderful things that have come about as a result of it. Darcey is one of those things, you lot are many, many of the others.


Wrapping Up

Gosh, that got soppy, I was having a moment there, sorry. Must be the effects of the enema. So let’s wrap this up before you all nod off. Once I’m called in for the planning scan everything is fine. The radiographers are fabulous, as they always are. I have 3 new tattoos on my hips and pelvis, and I will soon be able to audition as a Battleships board. The scan is quick and unlike the breast scan, I don’t have to position my arms like a sea anemone. Do sea anemones have arms? I dunno, like a wafty armed thing anyway. Nope, for this one all I have to do is lie flat on a slab and get nuked.


I can do that. I can absolutely do that. 28 times. In a row. With weekends off for good behaviour.


No problem.




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