Foetal Position

For six years I haven’t been able to sleep on my right side. I didn’t think it mattered that much. I have a whole left side and a back to lie on, so wanting a third option is just greedy, right? But now that I can, now that I have the choice again, I remember how important it is for me to be able to face the window, my intra-uterine muscle memory revelling in the curly cosy wonder of the perfect sleeping position. 

The reason for my restricted movements was my Portacath, the small firm hockey-puck device  which was implanted in the right side of my chest wall in December 2014. For three years or so, it allowed me to imbibe gallons of toxic and expensive drugs which shrivelled, shrank and shemozzled millions of cancer cells all over my body, for which I am eternally grateful. After it had done this tremendous work, it sat ready, like a ninja, waiting to facilitate the annihilation of any rogue cells who decided to make a new incursion. It waited, and waited, and waited. Over time, it became apparent that the rogue cells did not appear to be getting it together to launch much of an attack. It appeared, with every successive CT scan, that they were obediently staying in their quiet corners, possibly not even talking to each other, and maybe not even there at all.

How does the General know when to stand down the troops? When is the right time to withdraw from the conflict zone, disband the army, and decommission the tanks? What if the insurgents are simply lying in wait, lulling you into a false sense of security and waiting for the breach in your defences? 

[An aside: for a person who absolutely abhors the battle analogies which so often swirl around when the issue of cancer crops up, I seem to be flogging the backside out of them now.]

So for the past year or two, myself and my oncologist have been chatting periodically about whether the Port should stay or go. I had made up my mind last Christmas that I was happy to have it out, and then I chickened out and decided to wait for One More Scan. That scan was also NED (no evidence of disease) so I braced myself to accept the potential jinx effect and decided to pull the plug.

This meant going back to hospital again, back to the Old Ward, back to the sound of drip-stands being wheeled along bumpy marmoleum and infusion alarms chiming in futile symphonies. Identifying wrist bands strapped around the wrist, in case of a sudden incapacity to remember one’s own name. And the questions. Same questions, on a loop, over and over. Allergic to anything? Date of birth? Last meal? Allergic to anything? 

The question that irritates me the most, however, is the probing related to possible pregnancy. This tends to be approached in a number of different ways, giving you the feeling that they didn’t quite believe you the first time round and that they will catch you out with their cunning multi-faceted interrogation. Or that you, being female and all, might not be a “reliable historian” when it comes to knowing whether or not another human is growing inside you. So they ask “When was your last period?”, and I say “4 years ago”, and they write that down. Then they ask, “is there any chance you might be pregnant?” and I say “very little” (knowing from years of medical school that nothing is ever 0%). They scratch their heads, and wonder what they are going to write in the LMP box. I tell them I have two mirena coils. Their brains implode. I take the form from them and write NOT PREGNANT in the box, and sign it, and hand it back. Once they see the signature, they relax somewhat. They are no longer responsible for my womb or its contents. 

And then I move to the next room, and the next person with a form, and it starts all over again.

It is not unusual, when you present for any radiological procedure, to be asked about your pregnancy status at least 3 times. I get it. I understand the concerns. They are not in the business of foetus-frying. However, I do think that asking a woman once “are you pregnant?”, and then accepting her answer, is sufficient. Because, in general, women are not into foetus-frying either. If a woman is aware that xrays can harm babies, then they will be the first to call a halt to the process if they think they are pregnant. And I know that many pregnancies are undetected at an early stage, and I know some women can deliver full-term babies without having had an inkling they were pregnant, but to be honest the three-way interrogation in a day ward is actually unlikely to uncover those cases. For many women, being pregnant or not is a reasonably sensitive subject, even more so if they have undergone treatment for cancer. I think a one-off consent form that explains that the procedure would be bad for a foetus, and a Yes or No answer to “Could you be pregnant?” should suffice. And just ask once. 

Anyway, the Port came out, and I can now sleep like a baby. 

[This piece was first published in the Medical Independent]