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  • Writer's pictureAustin Birks

Reflections On Chemotherapy Dose 90, Small Scratch....

As my good friend Noah, the nurse, delicately uttered the magic words "slight scratch," he seamlessly inserted the needle into the vein, which was bulging due to the tight blue stretch band around my arm. It got me thinking that, in reality, this is the 90th time I have heard those famous two words, "slight scratch."


If you are not familiar with the NHS process, whenever you receive an injection, whether at a doctor's surgery or a hospital ward, the person about to administer the injection will always warn you just before the needle goes in that you might feel a "slight scratch." Now, when you think about it, it is actually quite clever reverse psychology because you are being reassured that all you will feel is a slight scratch, compared to the sharp pain many people fear from a needle being injected into a vein. I have had hundreds of injections, and the reality is that the more experienced the nurse, the less you feel, if anything.


It is the fear of fear itself that is the real demon, but there is one simple treatment that you can do yourself to teach you the skill of enduring a "slight scratch." That is to learn how to inject yourself in the stomach every day, sometimes twice a day. In truth, I do not recall ever saying to myself the immortal words before I injected myself. After all, I was both the giver and receiver.

Once you have overcome the first test, which is the toughest, and actually done the first injection, it does get easier, believe me. Yes, you cannot deny that it feels unnatural and goes against all your basic self-preservation instincts not to stab yourself with something sharp in the tummy. However, you need to consider the bigger picture, that these medications are there to save you and prolong the most precious gift you have: your life.


So, having said all that, what help or advice can I give someone who is about to start chemotherapy treatment for the first time and will no doubt be going through all the same fears and emotions that not only I, but also my family and friends, all experienced? First, obviously, is the fear of the unknown. Will it hurt? Will I be very sick? Will I be tired all the time? Completely understandable, and yes, been there and got the t-shirt. However, once the nurses sit down and explain the complete process, suddenly, it becomes clear, with a beginning, middle, and end, and is no longer a mystery.


So, let me, if I may, give you the Austin Birks guide to the three different ways that chemotherapy itself is administered. I am one of those rare individuals who have experienced all three, so I hope that I can speak with some conviction.


My first-ever treatment was the most basic one, where a bog-standard cannula or needle via a thin tube is inserted into a hand or an arm. The good thing about cannulas is that once they are complete, they remove it, stick a plaster on it, and that is it. Funnily enough, treatment number 90 was exactly the same as treatment number 1, so I have gone, as they say, full circle.

The second chemo insertion option is called a Picc line, maybe named after Dr. Picc; I have no idea. This is where they plant a cannula under your skin that stays there throughout the course of your treatment. When I had mine, it was covered up with a white bandage. Indeed, if you ever watch the video of my stand-up comedy gig at the Glee club in Birmingham in July 2019, you can see it in all its glory.


I once famously punched myself in the Picc line one night when I was teaching Karate, and it would not stop bleeding. I rang the hospital in Warwick, who told me to get there sharpish, which I did. The nurse was not impressed, "How on earth did you punch yourself? You must be a bit rubbish at this Karate malarkey." I declined to explain that back then I was a 5th dan and had been training/teaching for almost 50 years. As Kenny Rogers once famously said in the classic song "The Gambler," sometimes "you need to know when to fold them, and know when to hold them." In this case, I just smiled coyly and kept my big gob shut for once.

The Picc line insertion requires a day procedure, mine was done by super nurse Sarah, and I don't recall any pain as such, but it was an occasional annoyance. However, it did the job well enough. All that happens is that when it is time for your chemo, they just hook it up and start fuelling the tank with goodness knows what toxins you need to fight the cancer. Yvi once made me a rather wonderful ENSO Shotokan Karate club cover for it, which I loved, typical of her compassion.


The third and final option is what is called an implanted port, a small device that I describe as like a pin cushion. It is a permanent tube or catheter, mine was put in my chest by a very nice Polish lady doctor, and the whole thing took about 45 minutes, as I recall, painless.

However, when the same Polish lady removed the said pin cushion in December 2022, she told me that the anaesthetic might burn a bit. To be honest, it felt like I had been injected with molten lava. Not that I would know what that was like, but it burned like the fires of hell, not that I have experienced that yet either, and hope not too, let me tell you.


The reason why my port was removed, by the way, was because a blood clot had attached itself to the back of the port and had, as a result, kindly given me a mild heart attack. Eagle-eyed readers of this blog might recall that while I was in the ambulance being rushed to casualty, I managed to flog one of my books (My Journey by Me, available at Waterstones and Amazon) to a very nice paramedic called Mike, who asked me to dedicate the book to his wife Linda.


I was delighted to oblige; I even gave him an NHS discount, charging £20.00 instead of £25.00. Those who know me well know that my pint is always half full, and never half empty. So, as far as I was concerned, having a minor heart attack was actually an opportunity for good things to happen. Linda got a nice little stocking filler from Santa, and Mr. Birks got a nice crisp £20.00 note, or as the Cockney Sparrows like to call a twenty, a Bobby Moore, as it rhymes with score.

So, having paddled down the river of chemotherapy insertion methods, as road-tested by myself, what have I learned about myself? Well, my first and overriding feeling is relief that I am still here on this fine planet, defying the odds. I have never been one of those people who accept whatever the odds are, and there are reasons for that.

Secondly, I am grateful that I live in this great nation where the NHS, in its 75th year, has saved my life 90 times over, and it has not cost me a single penny. Sometimes we take for granted the liberties and help we receive in the UK, the generous benefits and medications to which we are entitled.


The journey has been tough, with difficult battles and dark times, and ugly side effects and pain. However, the pain is manageable, and you learn to live with it. But, I firmly believe that if you keep your spirits high and keep your body, mind, and soul as fit as you can, then you will prevail.

On Wednesday, after I finished chemo, I went straight to my gym. I did one hour on the Watt bike at level 5 out of 7 and burned 650 calories. I then did 4 sets of 250 sit-ups with other stomach exercises that I have amended accordingly because I have a stoma bag.


I then did 3 sets of 15 reps with 6 static weights to build my muscle mass. Why? The answer is very easy. Now that the cancer has spread to my right lung, I believe that if I make myself fitter and stronger physically, it makes me feel mentally and spiritually stronger.


Some might say that is utter rubbish, and it is all down to the chemotherapy, which is, of course, guided by my wonderful oncologist, Dr. Peter Correa. He has guided me through life-saving surgeries, as well as the different chemotherapy treatments I have had, some lasting 9 hours, some 6, some 4, but no matter what, he has always kept one step ahead, and I cannot thank him enough for that.


In conclusion, when I think about the toxic chemicals that have been injected into my 63-year-old body, it is a miracle that I am still here. But guess what? I am. And I will joyfully bring cakes and balloons when I reach chemotherapy treatment number 100. The cakes will be for the nurses and patients as we share our collective journey to live as long as possible. But that is only possible thanks to the angels in blue, and of course, the founder of the NHS, the visionary and brilliant Aneurin Bevan, or Nye, as he was called. Thank you, Nye.

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