Dublin, London, Paris, New York.....Newcastle???

That last little bit of cancer needs to be fried, or melted, or poisoned, because it can't be cut out. 

To be honest, while I realise cutting out is the be-all and end-all when it comes to this kind of thing, I do find it is quite a nuisance when it comes to having a fully functioning body. It turns out that your body is pretty good at doing what it does, and when you start hacking pieces out of it, it doesn't react too well. Scar tissue, bowel shortage, liver regrowth - they all cause their own little bit of trouble. But, fair enough, quite a bit less trouble than flesh- and organ-eating cancer. All I'm saying is that a body diminished by surgery isn't as efficient as an intact one, in my experience. 

So the boyos cannot cut out this last bit, and that makes me just a little bit pleased. Only because they assure me that they can find another way to get rid of it. 

The options are stereotactic radiotherapy, electroporation, intra-arterial chemotherapy and possibly something else but I lost track a bit in the conversation at that point. 

What they didn't tell me is that the first one is also known as the Cyber-Knife, and the second one is the Nano-Knife. I don't know if the third one has a cool-sounding nickname, but since it won't have Knife in it, it would be hard to see how it could beat the other two. 

So, which is better? 

Cyber = techy, other-worldly, a bit mysterious

Nano = tiny, precise, possibly something to do with Mork and Mindy (or the Presentation Sisters. Either way, two impeccable pedigrees).

The other deciding factor is where I can get these done.

CyberKnife - fancy private hospitals in Dublin (which my insurance doesn't cover). Or Beaumont (not so fancy).

Intra-arterial chemo - New York or Paris (in Paris, they leave the pump hanging out of you, as a fashion accessory, obvs).

NanoKnife (my preferred option) - Newcastle. Upon Tyne like. Reet. Not exactly a top destination, but it does have that Brazilian knock-off statue thing. 

Of course, it's not really up to me (autonomy out the window again). My scans are being sent to Top Men all over the world (well, Newcastle mainly I think, because the chap there is the Toppest of Top Men) and they will do top-level chin-stroking, and get back to my own boyos who will let me know if it's Cyber, Nano or Pump. Another fun variation on the Rock/Paper/Scissors game. 

Now, where's my passport?

Hello Listeners

I know there are a lot of you out there, hanging on my every word, who won't be able to sleep properly until they know the latest update - will she live, will she die, who gets the jewellery etc.

Anyway, this is how it is - no change. 

This is marvellous news. 

Same little scabby calcified bit of ick stuck to my portal vein, like a toddler clinging to his mother's leg. 

Nothing else, nothing new. 

Job.

I'll fill you in on the exciting things we have in store for Junior when I have a minute. 

Now, back to Narcos.

In-Between Days

I had a couple of scans last week. Same old same old, didn't choose the music this time and ended up with Il Divo - crumbs that's easy money for them isn't it? I drank the gack manfully (womanfully). I did the banter. Grand.

I tend to enjoy the post-scan pre-results phase. I revel in the unknowing. But it's getting a bit old now. 

Everything is static until I find out what happens next. I write things on the calendar, accepting that none of it may happen because I will be in ICU/in chemo hell/in some new and as yet unfamiliar therapeutic misery. 

The anxiety builds and builds until it peaks, plateaus, dissipates. And then starts again. I often remind patients that a panic attack will always burn itself out, that your body and brain cannot sustain that level of autonomic overactivity forever. But I forget to tell them that as soon as it is gone it can start again.

There are plenty of things to do to distract me. Cleaning, sorting drawers, ignoring the psychological undertones of these obsessional activities. Dancing. Cooking. Shouting at children (again with the subconscious muscling its way into the everyday). 

I am acutely aware now that there are more people involved in this than I had previously considered. The Waiting Contingent include all those for whom my health, or lack of, is equally important. I feel like I am doing them a disservice by making them wait with me. 

As doctors we really have no idea what it might be like for the person on the receiving end of no news. I get results across my desk each morning. I quickly spot the serious ones, the ones with consequences, the ones I need to do something about. I skim over the normal ones, my brain filtering out the good news because it is not "urgent". Not to me it ain't, but oh so urgent to the man woman mother daughter waiting to hear if their world is about to end. Or not. 

It is probably true that no news is good news, because if I am phoning a patient about a result, it is because there is something up, not quite right, I'm sure it will be fine but we just need to do a few more tests. We use language that obscures our real fears and intuition, not out of badness but because sometimes our instincts, or our fancy diagnostic tests, are simply wrong. Not often, but enough to make it unwise to speak in absolutes. 

So the waiting is inevitable, and tough. 

But like the panic attack, it will always come to an end.

Then there is the next bit.