• Austin Birks

From The Top Of My Head To The Tips Of My Toes…Who Knows Where The Cancer Grows… Part 2

Following on from the first part of my journey exploring what the side effects of chemotherapy are and what they are actually like. I thought that I would move further south biologically, as it were. The first part explored exactly what has happened with my somewhat volcanic head, scalp, and face, as well as the other joys, and the effects on the eyes and mouth, and the delights of paraffin and other combustibles being part of a stable diet.


We now move on to the chest, back, and arms, which for some reason makes me think of a somewhat passive aerobics lesson, or even worse one of the those awful body hair removal rituals that some people seem to enjoy. I believe that they are known as back, crack, and sack. Now, I don’t know about you my dear chum, but quite frankly, I would happily choose the implications of unasked for chemotherapy, compared to people paying hard worked for cash to have their sensitive body hair ripped off them for the sake of fashion. No, no, no, let me tell you, although having said that one side effect of chemo has seen me lose all my body hair, including from my head. However, I am delighted to report that this happened all by itself and did not involve audience participation, and the sudden ripping of some sticky plaster monstrosity from ones private parts.


Anyway, as ever I digress. So lets start with the neck. Frankly, relatively unscathed to date except for the slight operation that required a cable being inserted under my skin, that was then attached to something called a port. This is not a receptacle for ships, but is essentially a plastic pin cushion which is where the chemotherapy is administered. To be fair, most people cannot tell where the cable is but it serves as a motorway for the drugs to be pumped through the blood stream. Of course, with chemo it cannot be filtered to the required affected parts so it goes everywhere along with the proverbial chemical kitchen sink.


Interestingly, critics of chemo claim that actually it does as much harm as good as it attacks all and sundry, hence the numerous side effects. My view is simple, I don’t care, I am still alive and am more than happy to take the side effects compared to not being here at all. The port looks like a circular disc and is where the nurses who administer the chemo stab the needle before hooking up the four different medical drips that are inserted every other week. They take on a average about two hours per concoction and until recently, I was enjoying 4 doses per visit, taking between 8 to 10 hours depending on how efficiently the pump was working. In addition, it also included an injection in the arm, which stings like a bee sting, but you soon get used to it, and the slower it is injected the less it hurts.


So, key side effects of the chemotherapy on the chest, back and arms has been the development of a rather unpleasant skin infection. This is the same skin disease that affected my face and then scalp. It manifested itself after excessive exposure to the sun, initially it was small spots that soon grew into large boil like things that then seemed to gang up to form reservoirs of disgustingness. They itch really badly but if you scratch them they burst, releasing a cross between good old-fashioned pus, and that sticky, gooey stuff that comes out when you burst a blister. To be fair, they started on my arms and then back and then chest and legs.


They soon became a major problem, so I had to be referred to the dermatology team at Warwick hospital. They were great. There were 5 doctors waiting for me, 2 junior doctors, 2 registrars and the head of department. All were ladies, and they were magnificent. I had to wear one of those smock things where you are in mortal danger of showing your bottom, due to the complexity of the tiny string things that you have to tie up into a bow. My main concern was that I would not subject the ladies to a full moon as it were. This was delicate, as I had to strip down and then don the smock then lie down on a bed while they extracted said pus from spots on my back to be sent for analysis.


They had me there for 4 hours and did all sorts before the big boss herself appeared. She was one of those commanding people who was no longer called Doctor but was Mrs Grand Fromage or whatever her name was. She breezed in, and told me that they were going to give me 5 prescriptions that required regularly rubbing into the skin, they were steroid based and were gel like in substance. Of course, I did as was asked and was from then on constantly smeared in this goo, I always felt slightly slippery due to its sticky like texture and my clothes were always initially damp as the chemicals made themselves at home under the skin. I was also taking my daily pills called doxycycline which are designed to help this condition.


Next on the anatomical roadmap is the effect of two rather large surgeries that I have endured. The first was in September 2018, when a rather nasty and large tumour was discovered on my abdomen wall. It had, sadly for me, burst before the surgery and had spread beyond the abdominal wall. This is potentially catastrophic as it means that the cancer cells are released to hitch rides on to other vital organs, which is usually fatal. The first operation resulted in 26 stitches. It also resulted in a rather nasty infection which was as a result of a trainee nurse who was asked to remove my metal stitches. She was very nervous and as a result she accidentally cut me as she plucked out the metal staples, as a result some turned septic. This meant me having to go to hospital every day to have the wounds dressed, darned nuisance quite frankly, but what can you do?


The second surgery was much bigger and resulted in 64 stitches after a 5 and a half hour operation conducted by two expert surgeons. Dr Hanni Yusef, and Dr Simon Radley, this as a result of the cancer having returned after I got the first all clear after the first operation and course of 12 chemo treatments. This was seriously heavy drama as the reality was that the cancer had spread to several parts of my stomach, including the rectal stump which sounds like a gay cricket match.


This was the really tough bit as I was told by Dr Peter that my prognosis was that I had a 25% chance of lasting another 2 years, this is never good being told that your life will be ending and you need to sort your affairs out. But, funny thing is I never really believed it, not because I felt arrogant or immune, but I just did not feel that it would happen to me.

So, fast forward to today and I have a large scar from the top of my abdomen to my groin, but still here, not out, as it were. The other lasting legacy is of course my stoma bag, which is effectively a plastic bag that is attached to a part of my bowel which then acts as a waste disposal unit. Obviously, this means that the actual bottom is in essence redundant. It has a P45 and now lives in an old people's home. The stoma bag requires respect, and careful management, it can be highly unpredictable and can misbehave itself, and when it does the results are horrific, without going into too much detail. When it does behave badly, it acts like a demented fire hydrant, except its not bursting out with water but with human waste. It has super human powers and can chuck it exceptional distances, and it can go on for a very long time. I have experienced this awfulness maybe less than 10 times, in our relationship. Bad experiences have been in hotels, driving in the car, and once famously in Morrisons when shopping in the freezer aisle. Lessons learned include: never take the stoma for granted and always ensure that you have the required kit to hand to replace and if needed clean the surrounding areas.


Early symptoms also included excessive tingling in the fingers and toes. This is quite uncomfortable but not really painful. Indeed, it always reminded me of the classic line from a Wet Wet Wet ditty “I feel it in my fingers, I feel it in my toes”. Although, in fairness, I no longer experience this sensation, it is very common when you start chemotherapy.


The final chapter concerns my fingers as one really annoying and very painful side effect is the deep cuts that appear normally next to your nails they are like paper cuts but very deep, you can combat them by applying a surgical glue that simply sticks the bits back together. I believe that it has something to do with a low immune system but I am not sure, but they are small in stature but big on pain and inconvenience. But, dear friends like everything else on this journey, you just need to keep one step ahead and take the medicine that is why it is given to you. Persistence and determination are without doubt essential and like a game of chess, you simply need to stay alert and keep ahead of cancers next move. Check mate!

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