Two years post op and now in lockdown

Two years have now passed since I had my oesophagectomy.  I’ve been back at work for nearly 18 months and life was settling down to the point that in 2020, I planned to travel alot more. However, the corona virus pandemic has since put an end to that idea.

My drawing of a Coronavirus
Coronavirus

The UK has been in lockdown since mid-March and we are still not out of the woods. Although a remarkable time, it is not without stress or worry and not a time to be confident about health in any shape or form. However it has provided me with the opportunity to switch my attention from cancer-related art to drawings about my experience in lockdown. I have been posting my drawings on twitter and instagram and still have lots of ideas.

In terms of health, I can now eat larger portions and my weight has started to rise ever so slightly. I am in a bizarre situation where I need to rein in food portions. Regular meals are still needed as I still get reflux on an empty stomach but eating is no longer causing me any major issues. In fact I can now eat salads again, albeit small ones and still feel I am not losing out on calories.

My meals are more vegetarian and pescatarian now with meat once every couple of weeks or so. Since coffee outlets are closed, I kicked my daily take-out coffee habit and eating out has stopped for the time being. We now have a vegan in the house so we all drink oat milk instead of cow’s milk, which is actually very tasty and surprisingly versatile.

Exercise is also work in progress. I started to do yoga again and lockdown has provided an opportunity to walk most days. Walks are around 1-3 hours duration (3-8 miles) and I also do some High Intensity Interval Training. My pre-op fitness is returning albeit my upper body strength needs improvement.

I am still keeping an eye on my bloods but lockdown has prevented me from requesting these from the doctors. I have therefore used an online lab to do baseline bloods and this has worked well; so well that I will continue to use them to take a bit of pressure off the NHS. I used Thriva.co to test vitamin B12, D, iron, folate, cholesterol and HbA1c. Most values seem to be optimal but D has definitely dropped. Even before my operation, I did not absorb vitamin D well from food and had to rely on supplements and sunshine. This year I started supplementing vitamin D3 but the weather has been so good, I am hoping that 20 minutes a day has restored my levels to those of summer 2018.

Long term use of PPIs is well known for causing issues with bone density. I wondered if it interferes with vitamin D absorption which in term affects bone or acts directly on calcium absorption. Who knows but optimal vitamin D levels are definitely a good idea especially when supporting a healthy immune system for fighting covid-19. In fact there are one or two articles in the literature that hint that supplementing might be a good idea.

As for susceptibility to covid-19, I am not sure how I stand against the virus. As I have a permanent cough that kicks off with reflux and certain foods as well as previous chest surgery, I am concerned about my risk. I am also not sure how my immune system is after chemo. So I try really hard to look after myself and my family and have been extra careful when out, especially in the supermarket. I have also been working from home since before the whole country locked down and will remain doing so in the medium term.

I still get pain in my right shoulder but it hasn’t bothered me as much recently. Maybe because I am not sat at my desk for 7.5 hours a day. I find I move around more when working from home.

Dumping is very infrequent now and tends to occur after drinking something too fast, acting like Dyno-Rod on my system. Nice. Chocolate consumption did increase this year to the point that I was eating more than I should. The increased sugar intake not only created cravings, it also created bad shakes. Something I rarely suffered with. So I have reined in the sugar again and gone cold turkey with chocolate and I have not had a problem with dumping since.

In conclusion, I am doing well. The world in which we live is not quite the same as it was so I remain extremely cautious when it comes to monitoring my health but will continue to eat well and increase my range of exercise as and when I can.

 

 

Virtual art exhibition on twitter February 2020

February is oesophageal cancer (OC) awareness month. Throughout the month in 2020, I am tweeting an image a day (twitter name is @annorthernlass) #ocvirtualart.

I am rubbish at fundraising so this is my way of getting the message out and showcasing the amazing treatment our NHS has to offer to tackle this cancer.

There is currently no easily identifiable cause of OC – so essentially my message to you is as follows:-

  • be vigilant about heartburn and if you have it regularly, always get it checked out by your GP
  • do not rely on antacids and omeprazole without having regular checkups
  • if you have Barrett’s oesophagus or a hiatus hernia, ensure you are under the radar of a UGI specialist and are having regular endoscopies (have a camera down your throat).
  • Anyone with OC or Barrett’s in the family should also be vigilant especially if there are stomach related symptoms such as regular nausea, heartburn, reflux, a persistent cough especially when eating, hiccups or difficulty swallowing.

For more information – visit the links page.

Hats off to Ivor Lewis, born 27 October 1895

Ivor Lewis was an eminent surgeon who pioneered the right sided thoracic and abdominal approach to excision of carcinoma of the oesophagus. He presented this technique on 10 January 1946 as part of the Hunterian Lecture at the Royal College of Surgeons of England. Patients like me are thankful that Ivor Lewis had the foresight to develop this technique as all modern oesophagectomies have evolved from his original work.

Here is a very detailed account of his working and personal life from the Dictionary of Welsh Biography, an online listing of individuals who have made a significant contribution in Wales and beyond.

 

New publication – The Art of Oesophageal Cancer

Art of Oesophageal Cancer book coverThe Art of Oesophageal Cancer is a visual diary of the ups and downs of treatment and recovery. It is an A4 booklet containing over 20 drawings, 14 of these are part of an art exhibition of the same name.

The book may be of interest to oesophago-gastric cancer specialists and their patients. Books will be available free to delegates attending the conference for Association of Upper Gastrointestinal Surgeons (AUGIS) @augishealthon Thursday 26 September 2019.

Further copies are now available by contacting carotidbodypublishing@gmail.com or by using the contact form.

Confessions of a FLOT patient

FLOT stands for fluorouracil, leucovorin, oxaliplatin and taxotere (docetaxil) and is the standard neoadjuvant chemotherapy for oesophageal cancer.

After my FLOT treatment, I wrote a little booklet called Confessions of a FLOT patient to describe the experience. It is pretty much a ‘warts and all’ description of side effects and recovery. It also contains some tips on what to do before treatment starts. I hope it will help people to be aware of the type of symptoms to expect.