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Cancer and mental health

Once again, I’ve proven that consistency is not my strong point. I had planned to write another blog post some weeks back following my one year post-treatment appointment. However events took a bit of an unexpected turn…

The last few months have been really tough and the last few weeks have been hell. This appointment had been a long time coming; I had a blood test and a CT scan in preparation and was hoping to be given the news that one year on from completing treatment I was cancer free. Understandably, in the run up to this appointment I have been incredibly anxious, but my anxiety started to really get out of hand; I was vomiting most mornings, had a resting heart rate of over 90 consistently, high blood pressure, struggling to sleep, flashbacks, experiencing social anxiety and difficulty leaving the house, lack of motivation, intense food cravings and binge eating, constantly feeling overwhelmed, tired and on the brink of tears. All the while, I was studying, sitting an exam and going into placement full time and generally trying to convince the world and myself that I was fine.

Three weeks ago I had my appointment and instead of being told good news, I was told that my CT scan hadn’t been reviewed and that on examination, there was a red area on my cervix that wasn’t there previously which would require further investigation…holy fuck! After a brief meltdown (which mainly involved me ugly crying on my lovely Cancer Nurse Specialist’s shoulder) we discussed my anxiety. Basically, what I am experiencing is Post Traumatic Stress Disorder. It feels odd even saying that because of course, we usually relate PTSD to people who work in emergency services or the military – who witness awful things daily, or child or adult victims of violent or sexual attacks/abuse, not people who have/had cancer. However, the T in PTSD can actually refer to any traumatic event or experience; one persons PTSD is not necessarily the same as someone elses, and nobody should feel that their trauma is lesser or doesn’t entitle them to feel the way they do…it’s not a competition.

Following that news, I had an MRI and today I met with my previous surgical gynaeoncologist. We discussed why I was there and what the plan was, he said that he would examine me and that if a biopsy was needed it would need to be done under general anaesthetic, not in clinic. Yesterday was leg day at the gym; which was not the wisest choice the day before having to lie with my legs in stirrups for 15 minutes…fortunately though, it was worth it because the red looking area shows no indication of abnormal cells and both the CT and MRI scans look normal. Which means I can officially say I am 1 year cancer free!

Unfortuantely, my mental health is a little more complex and precarious. Just because I have good news now, doesn’t instantly erase the anxiety. I still face years of check ups, scans, blood tests (which involves dealing with my new phobia of being cannulated, following an incident where a nurse pushed a flush through a cannula that wasn’t in my vein) and worry about recurrence everytime my lower back aches or I get a chesty cough. I ended up cutting my placement short because it was just too emotionally exhausting to go in and care for other people during that time and thankfully my placement team were really supportive of that. I have joined a gym in an attempt to help me burn off some excess cortisol (stress hormone). I am also in the process of arranging counselling and cognitive behavioural therapy, because a) I don’t want to feel like this and b) I don’t want to start my nursing career with a lot of my own baggage, that has the potential to affect the care I give other people. Nursing is wonderful, but more stressful than most people can imagine; taking care of yourself is fundamental to being a good nurse.

Ultimately, I am very relieved and pleased that I can officially claim to be cancer free, but I am aware that the scars cancer has left me with are far greater than the visible ones on my belly and that recovery is long, complex and challenging.

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Nausea and syringe drivers

The last few days have been pretty rough as I have been really suffering with nausea. Had my chemo on Wednesday and felt ok, woke up on Thursday, chundered and felt so sick I couldn’t eat or drink anything.

I was expecting to have a review after my radiotherapy, but there was some mix up with it so I didn’t get my review and was sent to the Acute Oncology Service instead (kind of like A&E/AMU for people with cancer). The doctor I saw there was concerned that I was dehydrated and gave me some fluids. She also said she wanted me to have a syringe driver…I can’t help but relate a syringe driver with end of life care but the doctor explained that whilst I am being sick the absorption of oral medications is erratic and delivering it through a syringe driver offers more control. So after several hours, they sent me home with a syringe driver delivering ondansetron and metoclopramide. Went back yesterday to have it refilled and a district nurse is going to come and do it today and tomorrow. So I’m spending the hottest day of the year so far stuck in waiting for a nurse.

A syringe driver is exactly what it sounds like…the prescribed medication is drawn up into the syringe which is then put into a pump (or driver). The nurse sets the rate at which the medication will be administered and it is delivered through a small needle which sits just under your skin, so you are getting a continuous subcutaneous (under the skin) infusion. It is usually changed every 12-24 hours depending on the care setting and the medication.

I still feel pretty shitty, the drugs have relieved the symptoms slightly so that I am able to eat and drink a bit but I still feel sick constantly. I am still eating loads of ice lollies and also lots of sparkling water. I noramlly drink about 3 litres of water a day but I just can’t at the moment. Hopefully this will ease of the next couple of days and I really hope they can come up with a more permanent solution than the syringe driver. The nurse spent ages trying to find me a nice bag to put it in…I’m not sure the one she picked is exactly my style but I appreciate the effort! I definitely feel more self conscious with it, because up until now I haven’t had to deal with looking like a sick person (my treatment isn’t giving me any externally visible side effects), whereas with the syringe driver people can see the bag and tubing.

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1 week of chemo and radiotherapy treatment completed!

I have officially completed my first full week of treatment! So, 1 chemo and 5 radiotherapy sessions done, 1/20 to go!

So far my symptoms have been minimal, the only thing I am suffering from is nausea. The best way I can describe it is like having a permanent hangover…feeling kind of sick and pathetic and craving only crap food! Obviously isn’t the most fun thing in the world but it could be worse. I’m eating my own weight in ice lollies because they are the only thing that doesn’t make me feel sick…I’m probably going to need new teeth by the end of my treatment!

Tomorrow my second week of treatment starts with chemo and radiotherapy and then on Thursday I will have a review as well as my radiotherapy. This will give me the opportunity to speak to a doctor about how I’m getting on and hopefully they will review my anti-sickness medication. It’s really important to keep them in the loop about side effects/problems because the sooner they know about it, the easier it is to get on top of it.

The treatment itself is pretty straight forward, the radiotherapy takes 10-20 mins depending on whether they do scans at the same time (for my first 3 they did but as the images showed everything lined up perfectly they will just do these once per week from now on). The chemotherapy takes about 3 hours. The worst bit is the travelling…at the moment there are a LOT of roadworks so it’s a 3 hour round trip every day in which I insist on blasting the air con (because I feel sick) so my poor ma is sat there freezing!

Anyway, one week down, 4 to go!!!

Zoe Buckman photo of light cervix

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Fertility – ovarian tissue cryopreservation

So last Wednesday I had a unilateral laparoscopic oophrectomy for ovarian tissue cryopreservation…basically I had one of my ovaries whipped out and stuck in the freezer 😉

Just to be clear not everyone who has chemotherapy and radiotherapy becomes infertile but the chemo drug that I will be having and where the radiotherapy is targeting means that I definitely will have early menopause. So I was offered the opportunity to speak with the fertility specialist and I did even though I wasn’t sure I wanted to. The reality is that I don’t know if I want children ever, I certainly don’t right now. For the most part I find children quite annoying and whilst I think babies are cute, they certainly don’t make my heart or my uterus skip a beat. But, I didn’t think I would have to decide at 29 what I may or may not want to do at 39 (or whenever) and all of a sudden I’m just supposed to make all these huge fertility decisions about something I don’t even know I want!? Now, the harsh reality (as anyone who has ever gone through IVF will know) is that the success rate is pretty low for all fertility options but after speaking with the specialist I decided to go for the ovarian tissue preservation, whereby they remove and store the necessary tissue which can then be transplanted back in after being 5 years cancer free. This means that if it did work eggs could be harvested for IVF and that some or complete hormone function may return. I figured if I do nothing I WILL get the menopause so I may as well try something and if it doesn’t work then at least I gave it a shot! So incredibly lucky to be in a position to make such choices and to have the #nhs which means I get offered free healthcare which goes way beyond simply making me better but aims to improve my quality of life!

#forevergrateful #cancer #cancersucks #fertility #ovaries #ovariesbeforebrovaries #gynaecologicalcancer

Featured image courtesy of https://www.instagram.com/zoebuckman/

scan-xiety definition image

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PET-CT scans and scanxiety

Up until now I have had 2 CT scans, 2 MRI scans and 1 internal MRI scan (which was as horrendous as it sounds) but last Monday I had my first PET-CT scan. It wasn’t so dissimilar to having an MRI or CT in that they insert a cannula into your hand, but instead or giving you contrast medium (like in a CT) or buscopan (muscle relaxant like in an MRI) you are given a radioactive drug. You then have to lie completely still (not even reading or talking is allowed) for an hour before going into the scanner. The machine itself feels more like an MRI, in that you go right into it. However, it works more like a CT in that uses X-rays to take images. The radioactive drug works by showing up areas of the body where cells are more active than normal. This combined with the images gives a clearer picture of where any cancer cells are and/or if they have spread anywhere else.

Scans can feel quite claustrophobic especially when you are in it for a long time (a couple of mine have been about 45 mins long) and the process can be quite stressful making it difficult to stay still. When you move, the image quality is affected meaning they may have to do them again which means even longer in the scanner! So I have developed some coping mechanisms for all those hours in the scanners…I like to close my eyes (so I can’t see the confined space) and do some mindfulness exercises and yoga nidra; counting my inhalations and exhalations and bringing awareness to each part of my body in turn. This turns what could be quite a stressful situation into an opportunity for some relaxation and it definitely works for me!

#petct #scanxiety #cancer#cancersucks #cervicalcancer #cervicalcancerawareness #yoganidra #yogicsleep #mindfulness #copingmechanism

Featured image courtesy of www.cancer.net/blog

shit-o-meter

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First Post – Fuck I’ve got cancer!

Up until now I have been very quiet about my situation, only telling my family and a few friends because for the most part I am a pretty private person and because I don’t much like being the patient. However, as a health care professional I feel passionate about health promotion and disease prevention so I have decided to share my story…here goes… several months ago I was diagnosed with cervical cancer and after a long list of investigations, in January I had surgery to remove the tumour. This involved having my entire cervix removed along with 28 lymph nodes. Unfortunately, this is not the end of my journey because although the tumour was completely removed, cancer has spread to my lymph nodes, so I will be having chemoradiation to try and blitz any remaining cancer cells.

I have decide to speak out about my experience for a number of reasons, primarily because I think sharing stories in this way has the power to help and inform. I have been inspired to do so by friends and strangers who have chosen to speak frankly about their own experiences with mental illness, long term conditions and cancer. Cervical cancer is the most common type of cancer in women aged 35 and everyday 9 women in the UK are diagnosed with it, so I’m by no means alone but there is a relatively small social media presence (in comparison with other common cancers). Hopefully, I will be able to offer some useful information as well as personal experience and if that helps 1 person then it will be worth it.

I apologise if reading this has upset anyone and I appreciate that cancer is a very emotive topic for many so if anyone does not want to read about this I promise I won’t be in the slightest bit offended if you chose to unfollow me 😘

Finally, I have been inundated with flowers and cards which I am SO grateful for. However if anyone would like to do something for me from this point on can I request that you

  1. Attend your cervical screening appointment (or bowel, breast or prostate)
  2. Get any lumps, bumps or persistent symptoms checked out by your GP
  3. Give up smoking, or
  4. All of the above 😉

Thanks for reading! #cancer #cancersucks #cervicalcancer #cervicalcancerawareness