Sunday, 27 May 2018

Touching the wounds of the past

The paradox of trauma is that it has both the power to transform and resurrect. - Peter A. Levine -
                 

This week as the preparation for my surgery moved on, I had an angiogram. I prepared for it, like a first day at school. Clothes laid out, bag packed, wee picnic, not quite sharpened pencils, but you get the drift. I was a bit nervous but also carried a little strange excitement; it’s a fine line between the two of course but if nothing else it was data for the blog (!) and a step towards the surgery. 
I arrived promptly at 9 and sat till 11 chatting with a fellow patient who was awaiting surgery that day. Our life experiences may have been different but we knew nerve pain and it’s impact. But unlike him I don’t need to return to a manual job, believing it’s the only thing I can do. As he marched off to theatre cheerily giving me a wave, I felt a jolt of concern for his future. 
Then I was gown on and off to theatre with the reassurance 'they are great team down there'. I had already met the senior registrar who was to do my spinal angiogram. He explained the process and the risks so I would sign my consent. Unknown to me one risk was of a spinal stroke (1:1000). I swallowed hard and signed. I was therefore slightly less calm as I went back to the bed that I was soon off to theatre in. The bed was so deeply comfortable it fooled me for the deeply uncomfortable process ahead. 
Now the angiogram itself was tolerable and carried out by compassionate and skilled staff. But lying flat is the very thing that triggers my nerve pain. I negotiated some pillows below my knees but frankly as time went on that wasn’t enough. I breathed through it, mindfully managing until close to the end when the spasms nearly took over. But I made it, returned to the ward and tried to deal with the trauma. Because it did feel traumatic as much of surgery and medicine is, especially when you consider cancer treatment which I’ve faced several times. 
I’m currently reading 'The Body Keeps the Score' by Bessel Van Der Kolk. It’s a fascinating journey through understanding more fully the impact of trauma and how to help as described here by Peter Levine
'So what we want to do is touch into the trauma as it’s held in the body today and at the same time find resources in the body that can heal the trauma as it’s being held'
I’ve especially been interested in this move to trauma-informed work from a public health point of view, with particular regard to adverse childhood events ( ACE’s). But as I read and reflected on the kind of trauma I have experienced, as a result of cancer diagnosis and treatment, I realise that it too has left its impact both emotionally and physically.  What struck me was that although we understand a little about the incidence of depression post cancer treatment and recognise that many will have the symptoms of PTSD ,I wonder how much attention is paid to that beyond antidepressants? Should we indeed be supporting people to release the trauma beyond a chemical suppression? I guess many find their own ways to recover, healthy and otherwise but what if we understood more about this and were able to help people more clearly and consistently through to wellbeing? Is it enough to understand that trauma especially in early life, increases risks of illness both physical and emotional and then simply accept that the treatments can themselves add further trauma?                                                   I realise approaching spinal surgery that a whole lot of trauma to my body awaits and this learning is helping me gain further clarity about what might help you recovery, alongside the medical treatment and rehabilitation. I’m hoping to continue to blog during this experience. I do plan however to avoid any oversharing as a result of morphine based pain relief! But the question about trauma and recovery will be one I will be holding as I work through it all. I would love to hear your thoughts too. 

What I do recognise along this journey is the power of kindness, from staff certainly but also from my friends ( who not only give time, warmth and friendship but these lovely flowers too) and of course my very special family. I'm so deeply grateful for the great people I have in my life. 





Sunday, 20 May 2018

the best laid schemes o' mice an' men, gang aft agley





And so it began, starting with my pre op assessment this week for my spinal surgery. I was all set, I even had a wee snack packed as advised as it could take some time. I was up early and organised. But this week we’ve had a sick family with both Andrew ( complication of man flu) and Cara the dog ( complication of dog bite) on antibiotics.


 So hot drinks and cheese disguised antibiotics were delivered ( only the dog got cheese to be honest ). Much reassurance given that I could drive there myself. So blue badge in hand I set off to my car in the hope of a parking space near the door of the clinic. The car didn’t start. OK we’re a two car family and no one was well enough to be going out so back in the house, swapped car keys, tried car number two, all good except blue badge was the other car and time was slipping away. Much cursing ensued and back for the other keys.....Amazingly i arrived on time. 
First off I saw the nurse who asked loads of questions and told me things I don’t remember much about if I’m honest. But I do remember she said we plan for the very best outcome here and you’ve the team who can deliver that. That was a magical moment that flipped my pessimism and helped me focus on a good outcome. Happy day. The anaesthetist was another star. She lifted my bag ( I’m unable to travel light!) and then I saw her profile and noted her advanced pregnancy. It won’t be me for your surgery but we will look after you well she pronounced as she took me through what to expect. It was incredibly reassuring. She told me she had seven shifts left before maternity leave and I wished her well. And returned home to my own patients.
Fortunately the week ended with a sun filled trip to the East Neuk of Fife with my friend. She is the very spirit of kindness and caring and we can laugh and cry together, what more can you want in a friend. I even managed to explore the local towns in my mobility scooter! It was a special couple of days to help me prepare for the next stage.
This week I have an angiogram under local anaesthetic as a day patient. I have all the instructions. But of course just when you think everything is under control nature takes over and you get a virus. It wasn’t simply man flu after all, it seems. So now I’m a wheezy mess. Fingers crossed it doesn’t delay anything...

Sunday, 13 May 2018

" No one talks about it, till it happens"




I cried for someone I hadn’t heard of before, and certainly never met, on Friday. I expect some of you did too. Frightened Rabbit are not on my playlist but when the story unfolded of Scott Hutchison my heart ached. I’ve seen people post some painfully raw tweets today around times when they too have felt suicidal. The moment passed and they are still here and grateful for that.
And honestly I too know that place. When I first had breast cancer I went into fight mode as the language used around cancer urges us to do; you’ve got to fight it, you must battle with it, you should keep going and so you deny the impact of treatment and smile over the deepening cracks. I got through it and then came to the end of treatment, celebrated and planned a holiday a few months later. The thought of that holiday kept me going. Paris, spring...wonderful. No Gallery was left unturned but my favourite was the Musée de Rodin, I knew I could have sat in that garden forever. I returned to work and crashed. I was overwhelmed, exhausted, stressed and couldn’t see an end in sight. I was driving my car soon after returning home and felt drawn to drive it off the road. It lasted several minutes but somehow I managed to keep going on the road and when I stopped I realised I needed to get help.
 I did get help and was signed off work to give me time to recover. I spoke to a therapist and my GP but never admitted suicidal thoughts. I felt ashamed to have fought a life threatening condition, only to consider ending my life. But really I just wanted to end how I was feeling, not to die. And I imagine many people who do die by suicide felt similarly. Something stopped me, maybe it was that competing drive to live and to be there for my children. I’m fortunate, the people i turned to listened and acted on it. That made all the difference and I learned from that time. I am much better at meeting my needs now and better at asking for help. My best advice now to anyone living through cancer treatment is, carve your best path through it all with compassion for yourself. 
 I’ve recently been involved with work on Suicide Prevention and this report is our recommendations from the perspective of lived experience. The forthcoming action plan needs to be ambitious for change. A recent campaign by the Samaritans encourages all of us to reach out when we see someone we feel concern for. Just that moment of compassion can save a life. 
My dog Cara was bitten this week and has needed stitches and -especially stressfull for her- she has had to wear a cone.

We’ve had several neighbours come to ask after her, even the postie stopped to enquire and deliver dog biscuits with the mail. The compassion in our special community shown has been so very moving. The words to console dogs and their owners come more readily to us, don’t they? But what about when we fear for someone’s life? I’ve had both counselling and coaching training and even I might stumble over what to say and do. But just asking are you ok, can I help is really enough isn’t it? 
My tears this week for Scott were heartfelt, I ache for his family and friends and all those affected by his situation. May he be at peace now and I do hope he knows how much he was loved.
Perhaps his loss will encourage all of us to do what we can to notice, reach out, listen and respond when we see someone in pain. Because none of us are immune. 

The Samaritans are available for free 24/7 on 116123 and by email jo@samaritans.org