Monday 7 January 2013

Post Number 16 - From the Patient's Perspective

Thank you for coming back and reading my next post.  This time it will be from a different perspective and a different writer; my husband Mark. My best friend and the man I would walk off the end of the edge of the world for.  He has been through so much, and still soldiering on, but he has decided to write a few words so that you can read about how his brain tumour has affected him and how he looks into the future...This is his story...

Guest Post: From the Patient’s Perspective

Hi, it’s Mark here.  I thought it might be useful for people to have some insight into how I have been going through all of this, and while it would be impossible to describe everything that has happened in the last three months, I will try to cover some of the main events.
Surgery and Recovery (Part 1)

Looking back on it all, the surgery part was probably the easiest part of the whole process. Sure, I was nervous beforehand, and every thought imaginable goes through your head, from wondering if you will make it through surgery, will I still be ‘me’ when I wake up, how much pain will I be in afterwards, but thankfully this all went well and there were no complications from surgery and I woke up still feeling like I was myself, knew where I was, who I was and actually felt surprisingly normal – the pain medication probably helped a lot too!!
It was only several days after the operation that I began to notice subtle things that were different. Trying to do some mental arithmetic or spell a word backwards would start with a feeling of complete ‘blankness’, and required a considerable amount of concentration to come up with an answer. And when I looked back later at the answers I had written down, I could see that some of them were wrong. On the positive side though, repeating similar tasks for a second and subsequent times got easier, more accurate and faster which gave me lots of hope that any deficits that I was currently noticing could be re-learned and that I could ‘work around’ any problems that I might currently be experiencing – the brain really is an amazing thing.

When I was out of hospital only a few days after surgery I had to adjust to a new way of life, very different from the normal working week that I was accustomed to. I had the idea that I would be able to return to work soon and life could get back to the way it used to be… but that was completely ruled out when I started working on a couple of personal programming projects that I have had on the go for some time. When I started looking at some of the code, I could recognise it without difficulty, but writing new code took a lot longer than I was expecting and was not up to the standard that I would normally expect of myself. But again, it got easier with practice and I started to feel reassured that I could return to the job that I enjoyed so much, and would be able to get back to the point I was at before surgery.
In fact there were even signs of improvements in things I had found difficult in the past – like touch-typing, something I had only very recently committed to teaching myself. I now found it a lot easier to find the right keys on the keyboard and type with much greater accuracy – bonus!

I was noticing though that my mood was pretty terrible and I would myself being very snappy with Irene and Seb over the smallest things. As someone who is normally very patient and the one who tries to bring calm and reason to problems, this worried me a lot and I didn’t like the person I was becoming – it’s like being a passenger in your own body, you are aware of what you are doing but at the same time being almost powerless to stop it. Looking back on it, I think a lot of this was due to the Dexamethasone, which is a powerful steroid used to reduce swelling (but you probably already know that from previous blog posts). Once I was able to stop taking it, my sleep started improving, and my mood along with it. I also felt like I was getting some strength back in my body and finally started having some energy to start helping out with a few things around the house again.
Being on Dex is like being on a caffeine-high, 24 hours a day, which makes you feel anxious, on-edge, and never able to really relax. I can feel so tired before going to bed but as soon as my head hits the pillow, I feel wide awake again and cannot shut off my brain. As a consequence I have had no need for caffeine from any other sources and have been trying to avoid it where possible.

Radiotherapy

I am now in the final week of radiotherapy, and I can’t wait for it to be over.  The actual treatment itself only takes a few minutes, but when you factor in travel time to and from the hospital, parking, waiting in the waiting room, then all of the preparation work in lining everything up, the whole process takes over an hour each day, and that’s 5-6 times per week.
It’s a painless process and you’re not really aware of much happening aside from a few noises from the machine and the main part of the machine moving around to target different parts of the brain (this is to minimise the radiation exposure to the healthy cells while maximising the dosage to any areas that may still have traces of the tumour remaining). It’s only a few hours later that I start to notice the effects, which is usually just like a wave of tiredness – a good excuse for an afternoon lay down!

There is nothing comforting about the thought of having X-rays aimed at your brain, and I have often worried about what long-term effects this may have on me. I can’t help but read things online relating to everything I am going through, and while I try to be very careful about not taking everything at face-value, Radiotherapy can cause long-term issues with memory and cognitive function. This is supposed to only affect a very small percentage of patients though, so I just have to accept this as a possibility and move on.
It doesn’t help that while going through Radiotherapy, it actually creates more swelling in the brain while the body tries to heal the damage done by the X-rays, which if not managed can cause more problems – in my case, briefly losing the ability to speak  or read fluently for a couple of minutes at a time. That was one of the most frightening experiences for me so far, and it’s at times like this you are left wondering ‘is this normal’, ‘should I be worried about this’, and it always seems to happen on a weekend when there isn’t a doctor available to speak to.

Long story short though, this has been OK since going back on the Dexamethasone, but as a result I am not getting a restful night’s sleep again, have to take Temazepam to help me sleep (which has its own problems when used long-term), and am back to feeling tired most of the time and not having much energy to do much at all – in fact, writing this blog entry is probably the longest I have sat in front of a computer for a few weeks now.
It’s a constant balancing act of finding dosages of medications that are required to get through this stage of treatment, but trying to minimise the side-effects in the process. I have heard it before that often you are on medication just to counteract the side-effects of another drug, and this is definitely what I am experiencing at the moment. I am really looking forward to being able to finish Radiotherapy, get myself off the Dex (again), and off the sleeping tablets, and hopefully be able to get back into a normal sleeping rhythm again.

Life from Here –Recovery (Part 2)

I’ve been told to expect to continue to feel tired for anywhere from 2 weeks to 3 months after Radiotherapy finishes, so even though my brain won’t be getting blasted with radiation, I will still be feeling the effects of it for some time yet. I have also been warned that at about week 4, a lot of people feel like the tumour is coming back again but this is the body’s final stage of healing, so I have to remember not to panic if and when this occurs!
This time though, my body should have a chance to recover fully and I will again have the strength to start doing more, learning more and just generally enjoying life more. Can’t wait!

Conclusion

Well, if you made it this far, well done!  It has been a lot to take in all that has happened in the last three months, and there is still a long road ahead of us.  For me, I think it has put into perspective how much we can take for granted in our lives, and just how quickly things can change from what you consider to be a normal life to something completely different.
The thought had crossed my mind in the past of how do other people cope when things like this happen to them, and how hard it must be on them and their family. I won’t sugar-coat it – it’s the most difficult experience I have ever had to go through in my life, but the thing I’ve realised is when you are forced into a situation like this, it’s surprising how capable we can be of adapting to the situation and finding that inner strength to keep moving on and to fight another day.

Probably the best advice I have for anyone going through any turmoil in their life is to try and live in the “now”. You can’t change what has happened in the past, and there’s no point worrying about what may or may not happen in the future – they are both out of your control, the only thing we have any control over is what we do right now. Easier said than done I know, but it has helped me a lot to calm the doubts and fears that go through my mind at times.
It’s not easy, some days you feel like giving up and saying “it’s all too hard”, but that’s not what life is about – you don’t get to quit, just like you don’t get to quit being a parent when you are sick or have a child that is misbehaving. I’m not angry about the diagnosis and the chaos that it has brought into our lives – if anything it has given me a chance to stop and reflect on what’s important in life and give me the opportunity to address some of the imbalances that were there in the past. It’s all too easy to get swept up in day-to-day life and lose track of the things that are really important to us, so for me I think this has been a wake-up call and a reminder to think about what really matters in my life.

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