Consultant's Appointment

We wake around half past six, after the first night in our own beds since last Wednesday. When I let Norman out into the garden it is a beautiful spring morning this last day of April, a month that has been unusually cold. I make boiled eggs and rye toast for breakfast and in the absence of a full English breakfast Normy condescends to eat his Baker's again, but only because of the addition of a few spoonfuls of casserole from the slow cooker. Due to the roadworks en route to Castle Hill hospital, I will need to leave by nine o'clock, so I shower and dress before walking Norman round the village. Tickton Primary School starts at nine and there are parents and children arriving and leaving as we pass the gates, everyone seems cheered by the improvement in the weather, the strong, cold winds, seem to have died away and the effect has raised the temperature by a full ten degrees. I leave plenty of water for Normy and set off a few minutes after nine, the traffic around Beverley has died down after rush hour and the bypass to Cottingham is not too bad, so I arrive at the hospital at half past. I park in a space by entrance three, that I used when visiting Leslie and later Felicity, although this is a quarter mile away from outpatients, where parking is a nightmare and I do not need additional stress this morning. As I approach entrance two, I notice another car park across the road, the garden centre that owns the land has decided to offer it's parking spaces to hospital visitors, in a spirit of entrepreneurial endeavour. I shall use it next time. After booking myself in at the reception desk, I settle myself down to wait and read the book I have brought for just that purpose, it is Alexander Waugh's book about time. It's chapters are entitled, seconds, minutes, hours, days, months etc. etc. you get the idea. Patients are called to their specific clinics by their names appearing on a TV monitor, each new name accompanied by a gentle bong, as if from a temple gong. My appointment is for ten, but that time passes and I still haven't been call forward, I have finished the chapter on hours and am now onto days, and wondering whether there has been some confusion, when my name finally appears on the screen and I am told to make my way to clinic 3. A staff nurse apologises for the delay and tells me that Mr. Cooksey, my consultant, has a double case load as his registrar has phoned in ill. Graeme Cooksey is probably the best doctor I have ever met and I know that he will not rush patient appointments. People waiting for results that may indicate cancer, deserve time and care, so I settle in for the long haul. I finish the chapter on days and am well into months, before the nurse collects me again, in order to take my blood pressure, weigh me and persuade me to deliver a urine sample. All of which is accomplished fairly quickly, not surprisingly my blood pressure is ten per cent higher than normal 140/95, not really surprising considering the nature of my appointment and the long delay. Eventually, as I complete the chapter on months, I am called in to see Mr. Cooksey at half past eleven. He looks a little older than he did eight years ago, when he removed my prostate, with great skill. His hair is a little thinner and is now iron grey, but he has the same gentle smile and kindly intelligent eyes, I expect the passing years have taken the same toll on me, although grey hairs show less clearly in my blond hair. There is good news and bad news, both the bone scan and the MRI are clear, which means there is no immediate threat to my health from the cancer. The bad news is that he can't really be sure of the location of the tumour, as it is still too small to detect, despite its signature hormone steadily rising in my blood samples.
The probability, I am told, is that it lies in the bed from which the prostate was removed and can be treated successfully with radio therapy. The side effects of this are damage to the bladder and the rectum, which can result in a temporary loss of continence and significant discomfort. In fifty per cent of cases this achieves a complete cure, otherwise hormone therapy and other treatments are available as a rearguard action. We discuss my options, and agree, that at this time, it is best to adopt a watch and wait strategy, usually radiotherapy intervention is recommended when PSA levels reach 0.6 nano grams per millilitre of blood, my reading is currently 0.14 and at the current rate of progression, it may take several years before intervention is needed. In which time other therapeutic options may be available and the tumour detectable. It is agreed I will have a PSA test every three months and return in six, unless there is a material change in circumstances. I thank the doctor for his help and sympathise at his case load and then make my way to reception where I book my next appointment for the end of October. Outside the sun is shining brightly and it is a beautiful spring day, the results were just about as good as I could possibly have expected and so I should be around for a few more years yet. I drive back home and then Norman and I dine on our casserole, sat outside, in the garden, in the sun. It is warm enough to warrant wearing shorts, so after lunch I dash inside and dig out a pair and my sandals, then take off my shirt and work in the garden. After mowing the lawns, I trim the hedge and then weed all the flower beds, both back and front. It is pleasant work, sat on a folding stool in the warm sunshine, working my way round the garden just pulling up weeds and trimming the edges of the lawn. We break for dinner at five and finish the last of the casserole, which is slightly modified through the addition of some couscous, ten minutes before I dish it out. After cleaning both plates, old Norman lies on his side in the sun and sleeps, occasionally raising an eyelid to see what I am doing. We pack up at half past seven and retire indoors, where I wash my hands and then clear the dishes, before settling down with my book until bedtime.