my journey to health and well being via exotic destinations


in which I begin the long road to recovery

Me in the botanic gardens - just because I like the picture and it might be one of the last times in a summer frock!

Me in the botanic gardens – just because I like the picture and it might be one of the last times in a summer frock!

So here I am sipping champagne in BA Club Class. My leg is supported by two large blankets and I’m feeling pretty chilled.  Before I left for the airport I gave myself the second tummy jab – piece of cake! Decided that in the scheme of things why be scared of one tiny injection? Though trying to get the needle though my extremely tough epidermis is – literally – harder than I had anticipated, but pain there is none. I am a tough old boot, remember.

Ross cannot be with me today on the first part of my journey to recovery; he comes on Tuesday. Too much to do to at work before he leaves for a month or so. It’s hard saying goodbye to him, even for a few short days. But the thought of the other man in my life, son Tommy, waiting for me at the other end, is cheering.

The worst moment is going through security when, despite my wheel chair, everything is of course scanned. My syringe is nestled snugly next to the oxycontin, a controlled drug in Singapore, and my sleeping pills, aspirin and other emergency supplies. ‘Madam, we have to check your bag.’

Here we go…but the expressionless guard pulls out my jewellery bag and peruses it carefully. It is stuffed with Omani silver necklaces, beads from Bhutan and Somali gold…I surreptitiously take my handbag with its contraband onto my lap while she does this and we sail though. Phew!

On board the Singaporean steward has been charming and solicitous. I pop half a sleeping pill after a glass of champagne and sleep like a security guard, only to wake up 3 hours later. So off I toddle to the tiny cramped loo and prime my syringe for another jab, as prescribed by the doc, take the other half of the sleeper and fall asleep immediately.

I feel very strange the day I leave Singapore. I can’t help but ponder if and when I will be back. I know ‘If’ is not positive thinking, by my leg has been so painful the past 24 hours and seems to be trying to burst out of its stocking. As I give myself a mini pedicure, and slather on the Jo Malone lime and basil, I wonder if my left leg will ever receive such a treatment again.

The last picture of me with two perfect pins (Patrick Mavros eat your heart out)

The last picture of me with two perfect pins (Patrick Mavros eat your heart out)

I look around the flat for the last time, which we have made our own with favourite pictures: a Barns Graham, an Eileen Cooper, a pair of David Prices (chosen by Louise), a Margaret Hunter sculpture and our latest additions, a couple of Indian granite Buddha and Vishnu heads. We even have mementos of Mum – her favourite Arab Chest and a pair of fine Omani copper coffee pots. The words of the song pop in to my mind: ‘When will I see you again?’

As if in sympathy, two little sunbirds visit us today, male and female. We decide to change the blog header to reflect the symbol of hope and Louise that they represent. Then, in the middle of lunch, a massive storm breaks and it pours for 5 hours, so heavy our lift lobby is flooded.  ‘Singapore weeps at my departure,’ I tweet, ‘I may be some time but unlike Scott, I will be back’.

*                      *                      *

Now back in London, it’s 2 am and, despite taking a whole sleeping tablet, I can’t sleep: yesterday the mix of drugs, the long flight and general build up of stress left me feeling queasy and exhausted. I couldn’t even stay up to watch the Strictly dance-off, a treat I have anticipating in my sojourn abroad.

Dear Tommy drops in and stays all day, cooking a delicious late lunch of cod, crispy chorizo with pea and spinach puree. How spoiled! The only bad news today is watching Liverpool lose 1-3 to Hull in a lacklustre game, which has son throwing cushions around the sitting room (he’s 25!). His girlfriend has brought me a tiny bag containing Guatemalan Worry People. The Maya Indians put this woven sachet, containing 8-10 tiny figures, under their pillow at night so that the worries transfer to them. Despite the early hour I am feeling remarkably fresh and whole lot less anxious than last night, when I felt very tearful and afraid for what today has in store.

The other highlight of the day is an exchange of email with Prof Khong. He will be amused, I tell him, that I have managed to inject myself.

He replies: ‘I was very sure you would give the injections yourself given your determination and decisiveness. You remind me of Helen Mirren in Prime Suspect. If I may, I shall keep updated through your blog as well.’

So Prof Khong if you are reading this, you made my day!

*                      *                      *

Morning brings the darling Lewins at 9 am with chicken soup, guineafowl casserole, and chocolate cake! By 11.15 Dr Fi, now taking on Auntie role, has arrived and we sally forth to the Marsden in a cab, after greedily devouring the soup.

I have a really good night’s sleep with my little worry people under my pillow and feel refreshed, though still in great pain. Of course we arrive far too early so have a cup of much needed coffee opposite.


much-needed coffee while we wait anxiously

Checking in to the Private Out Patient wing of the Lister/Marsden in the Kings Road, I realise that, in order to avoid any confusion as to my identity I need to become Victoria Cattell as per my insurance. In Singapore, I was interrogated, Gestapo-style (You Unwin or Cattell? Need to change wrist-band and sign all documents again…) while on the trolley waiting to be wheeled into the operating theatre. I’m afraid I completely lost it!

Unfortunately this completely throws Professor Thomas and we spend the first 10 minutes of this precious appointment being administrative, changing my names and numbers. Whether it’s this or a bad morning in theatre, I am disappointed that he has not read the files and reports I had sent in advance. There are two terms, he says, I need to become familiar with: the ‘powerhouse plantar-flexor muscles’, which comprise the soleus and the gastrocnemius, and it appears the cancer is in all of them, putting large amounts of muscle tissue and movement at risk; and ‘clearance’: the amount of tissue they will have to cut out to prevent spread.

It is customary for surgeons to want to do their own path and histology, and this is going to cause further delays: I had hoped that we would get on with whatever almost immediately, but no, the first offer of an operation is over a week away. Slightly horrified by the thought of further hanging around, not least because of the pain, I ask myself what DI Helen Tennison would have done, and plump for sticking my neck out at the risk of unpopularity! Fi the while has decided not to let on she is a doctor, just my PA, scribbling frantically throughout the consultation. That’s what good friends are for! As I tweeted later, she was ‘a brick’ the whole day and I don’t know what I would have done without her comforting and wise presence.

Pointing out I had hotfooted it back specially, we manage to negotiate a date for this coming Friday 6 December, provided he can get the path completed. He kindly arranges an appointment with the radiologist at the Marsden for that afternoon to speed things up, and writes a prescription for more oxycontin and anti-coagulant injections.

The prognosis is good he says. ‘What prognosis, my leg or my life?’ He laughs, ‘Oh your life should be fine, and so should the leg…that’s what I’m here for’. Although as I later learn my leg will not look the same – withered and horrid to start with – and I will always walk funny. ‘No change there then, Mum,’ quips my lovely son.

Cheered by this yet dismayed by the thought of more time-killing, we stagger out to find a stiff G&T while we wait for the radiologist. We decide to try and get the prescription in the chemist opposite the pub (the same one we went to before my father’s memorial service at the Chelsea Arts Club, just last year). Oh no, they can’t dispense oxycontin as it’s a controlled drug and he’s written it on the wrong prescription! So they suggest we try the Marsden, where we have the same problem, even though the Prof is one of their consultants. Even worse than Singapore, where they insisted Prof Khong fill in my address himself on the prescription before they gave it to me! At least that didn’t take three hours!

Dr Aisha Miah is young and petite and absolutely charming. We click immediately, and we admit that Auntie Fi is in fact Dr Fi, and we therefore have a very grown-up discussion about my leg.  She answers all the questions we forgot to ask in all the shemozzle over my split identity. Like: how long with the wound be? Several inches so they have good access; how long will I be in hospital? 4-5 days; how long in between op and radiotherapy? At least 4 weeks (Yay, maybe I can go to Champery for Christmas and New Year!); how long will the radiotherapy last? 6.5 weeks, the first five being ‘conformal’ with the last week-and-a-half being intense. This to preserve the lymphatic drainage system and prevent lymphoedema later on; how quickly will I be on my feet? He gets you up straight away – be warned! Will I need chemo? No, even if tumours elsewhere are detected later on they will be treated as localised lesions.

She also gives us some statistics: 70-80% of tumours as dealt with successfully by surgery; a further 10% respond positively to radiotherapy, leaving about 10% with a bad prognosis rate. This is very good news. She also writes out a new prescription!

However, on examining my leg, she is concerned at the position of the tumour and re-visits the advantages of radiotherapy pre-op, which means 6.5 weeks of 5 times per week. Then the burns have to heal, another 4 weeks or so before the operation. This is mainly because of the proximity to the vascular and nerve bundles, but she and Prof Thomas need to sit down together and look at all the scans properly and will tell me on Wednesday evening which route they will take.

I had hoped for more clarity by this stage and am naturally a bit frustrated I don’t know which way this is going, although I realise its crucial to get it absolutely right.

I will therefore sit at home like the Queen of Sheba, being waited on hand and foot, catching up with all the Borgen and Homeland episodes I’ve missed, and await the final decision.  The most wretched thing is that the booze and the drugs don’t go together at all – feel queasy a lot of the time – so that solace is denied. I’m not giving up that easily though…

And, horror of horrors, when I open my new pack of tummy jabs, instead of the pencil type I was expecting, I discover a whole new set of long needles to torture myself with until Friday! WAH!

those needles! they joined me in my own mile-high club!

those needles! they joined me in my own mile-high club!


in which I get the low-down on my biopsy

I hope it doesn't get to this....thanks Annie for sending me your cartoon!

I hope it doesn’t get to this….thanks Annie for sending me your cartoon!

It’s been a tough couple of days since I received the biopsy report. The phrase that keeps on leaping out at me is ‘high grade’, scattered liberally amongst all sort of nasty-sounding long words  – hypochromatic, eosinophilic cytoplasm, karyorrhectic, even the cancer type, myxofibrosarcoma – which all mean absolutely nothing to me. As I am avoiding the internet, I will have to wait until I see Prof Khong again for enlightenment. But there’s a couple of days to kill…

My conversation with Prof Meirion Thomas (my surgeon from the Marsden) has left me feeling extremely anxious, not least the demand I hot-foot it back to London. Not to mention his cross examination of the Singaporean methodology…I tell myself that surgeons are well-known to be a bit gruff; later Prof Khong laughs when I tell him this.

Now come the questions: should I have gone back to London straight away? Would it have saved time? would it have stopped the cancer spreading to teh lungs and other soft issues (the biggest worry)? Deep breaths, Vic, calm down. I have to remind myself that it was not clear until AFTER the biopsy and PET scan that the tumour was malignant, so these thoughts are counter-productive. All the same, once JP has left and I am on my own, these anxieties niggle away and I envisage the little spindle cells  wriggling their way through my blood stream like a sperm seeking an egg.

 A couple of stiff drinks and some Nordic Noir are pretty successful distractions. However sleeping is becoming increasingly difficult and the pain-killers seem to do no good at all. The stocking seems to be growing increasingly tight as I  imagine the tumour growing within its confines.

In the meantime my phone rings constantly and emails ping around, lots of good advice and loving thoughts alleviate the underlying fears which, along with the pain, interrupt my sleep. No Ross to reach out for…he is in Korea.

So time for a bit of pampering: spend an hour topping up the tan by the pool, but as I can’t get my leg wet it’s too hot to stay for long! Then off to see a friend, who I have been helping with various articles on fans, so we escape into a world of Chinoiserie and the French court while we sip home-made barley water. Can’t do a pedicure as one foot is bandaged and they will only remove all varnish as soon as I step into hospital; anyway its too far to walk and too near for a cab. So as I settle for a cut and colour, I can’t help wondering if this is the last time I will have hair to indulge in such a way. I’m thinking of asking Louise’s friend Robyn Coles to design a special post-chemo hat for me; if she can make the princesses Beatrice and Eugenie look nice I’m sure she can sort me out.

‘Oh, what you done to your leg?’ asks Alvin the androgynous hairdresser. ‘Don’t ask,’ say I, ‘cancer but I don’t want to talk about it’.

‘OK, la, we talk about nice things…’. And utters not another word the whole two and a half hours. The word cancer has that effect on people.

Conversely taxi drivers here are delightful, full of concern and ‘God Bless’.

Which brings me on to the God question. I am delighted that so many people believe and are praying for me; even if I don’t share that belief I am sure that every positive thought helps me. Please keep all your prayers, positive vibes, messages, comments  and love flowing my way…

Finally we get to the debrief appointment. For the first time in my week of private medicine in Singapore we are running on time. As ever, Prof Khong is straightforward and honest, and explains everything to me in great depth.

To summarise: it is a high grade tumour and very fast growing. I don’t ask the stage number as I don’t want to scare myself and know that everyone is different so it is meaningless. More significant is the replication rate of the mitosis, which is ‘bad’ at 26. Anything over 10 is a cause for concern. He thinks it has not been there for very long, less than the 6 months he originally guessed.

I ask him what he would do if I was his patient. Operate immediately he says, and then do radiotherapy. These tumours – there are several ‘extremely rare’ present, one of which he has not seen before – do not normally respond to chemo, so he would not automatically do it since the tumour is contained. But other doctors may decide to zap any rogue cells on a ‘just in case ‘basis. He reassures me that it is possible that some cells might have already ‘spawned’ but they are so tiny that they wouldn’t show up for at least 3 months, the time it takes for them to reach 1mm when they can be picked up on a scan. ‘And in those early stages, its very treatable.’ The delays I have been angsting about are put into perspective.

He further explains that the big challenge facing the surgeons is the proximity of the tumour to the main vein, and how they remove it without damaging the main flow and losing it: there are three veins forming the vascular tree in the lower leg, can they damage one and survive on the other two is the question? He draws me a lovely diagram. Skilled stuff. In order to do this effectively he thinks that the English surgeons may want to do a CT Angiogram as it would help them be precise. They cannot rely on an MRI taken two weeks ago as the tumour is growing so fast.

I had taken the precaution of checking out my anticoagulation injection kit: imagine my horror when I remove the protective sheath to discover a needle one and a half inches long! The last ones I had were like an insulin pen. This is in fact my major concern today: it’s funny how anxiety can channel itself into something so seemingly irrelevant in the scheme of things. Hmm, they don’t do those in Singapore…so I am trying to work out if I have enough courage to jab myself inflight, as well as before and after… WAH! Am making contingency plans never fear…my bravery has its limits!

Now I have visions of being arrested and executed as a drug trafficker before I even get off the ground. I will be boarding the flight with a fully primed sharp and a load of the painkiller oxycontin, a highly addictive prescription drug which kills thousands of people each year in the US. Phof Khong is highly amused when I verbalise this fear. ‘You’ll be OK – no white powder,’ he reassures me.

After much hanging around (Singapore loses out to Switzerland on efficiency I’m afraid), I now have my MRI scan on disc and the biopsy slides, so I am all set for the next stage of my journey. There’s thunder and lightening outside,the oxy is kicking in and I feel mellow and relaxed as I write this…bring it on!

This darling sunbird, sometimes joined by its mate, comes to sing to me every morning on the balcony. Its yellowness reminds me of Louise...

This darling sunbird, sometimes joined by its mate, comes to sing to me every morning on the balcony. Its yellowness reminds me of Louise…