Stand at almost any intersection in downtown Toronto and you will typically see one or several of the following- a Tim Hortons, Shoppers Drug Mart, a pizza restaurant or convenience store. That is not the case if one stands at the corner of Gerrard Street and University. Towering over the street are four buildings that most people would prefer to avoid- Sick Kids, Toronto General, Mount Sinai and Princess Margaret Hospital (PMH).
It was there that I found myself late last December, nervously awaiting an appointment on the 18th floor of PMH. Entering into the building, I found myself in a beehive of activity as members of the public and medical staff swarmed down the hallways. Overhead signage indicated directions to various medical departments, all cancer related. The elevator ride to the 18th floor seemed to take forever as it stopped at almost every floor. Exiting onto the floor, the first sign to grab my attention was Ophthalmic Oncology.
Three hours and multiple tests later, I departed the building, my suspicions confirmed and an action plan in place for treatment. On the plus side, the medical team, while stressing some degree of urgency, felt that I should continue with my planned trip to Nicaragua.
First detected a little over two years ago in a routine eye exam the condition was initially identified as a nevus (a benign mole) on the rear inner surface of my left eye. After several tests, an ophthalmologist at the London Ivey Institute assured me that there was no cause for concern. Gut instinct told me otherwise. A diligent search of various professional ophthalmic web sites also told me otherwise. And yet, for various reasons, I failed to push for further tests or a second opinion until several months had passed.
A further optiscan in November showed a significant increase in the size of the tumour, thus initiating the trip to Princess Margaret Hospital where the condition was confirmed as choroidal melanoma.( Affecting 6 people in a million it seems to affect white blue eyed males at a disproportionate rate- just my luck!)
Wednesday March 2nd 2011
The whirring of my roommate’s humidifier is the only audible sound as I sit on my bed typing out this brief journal.
I arrived at the Princess Margaret Lodge shortly after 3pm today and will spend the night here before returning to the hospital for my surgery. I am not anticipating too much sleep- a) due to my apprehension about the upcoming procedure and b) due to the condition of my roommate Andy who has been undergoing chemo/radiation for a cancer on his neck. The treatment has essentially destroyed his salivary glands so he can’t eat and has issues with oral hygiene requiring him to rinse with various products on a frequent basis. As a result he is in and out of bed several times a night. Clearly he is in a great deal of discomfort with some very obvious radiation burns on his lower face and neck area.
The PM Lodge is a residence where out of town cancer patients (and room permitting, spouses) stay while undergoing surgery, chemotherapy or radiation treatments. Similar to a university dorm, each room has two single beds, a bathroom and a small fridge. Included in the nominal cost of a weeks stay ($75) are three meals served cafeteria style. Several lounges scattered throughout the building provide TV as well as an extensive library of used books, DVD and VHS movies as well as a considerable stack of old magazines. Nursing staff and security are on staff 24/7 to assist residents who need additional support
Friday March 4th 5pm
Thursday morning I woke around 6am, having managed 3 or 4 hours of sleep over the course of the night.
The temperature being a tolerable minus 2 degrees with no wind I chose to walk to the hospital rather than take a cab. The cool morning air and the relative quiet allowed me the chance to reflect upon the upcoming procedure and the days ahead.
Arriving just before 7am I found that they did not have a room available for me for my pre-op procedures. Consequently I spent an hour watching TV in the lounge. A little after 8am they made a room available where I was able to strip down to a gown and paper slippers. At 9am I was transferred to a gurney and rolled into an elevator for the trip to the 3rd floor operating room. As is typical, the room was well below normal temperature. One of the nurses in attendance quickly covered me in several pre-warmed blankets, while a resident practiced his IV insertion technique on me, supervised by the anaesthetist. After struggling to get proper IV flow they began adding antibiotics and a mix of analgesics and anaesthetics to the saline bag and then nothing…..
While I slept a small radioactive disk known as a plaque was slipped behind my eyeball over the area of the tumour. Over the next week it would emit sufficient radiation to destroy the tumour while, hopefully, causing little damage to the rest of the eye.
While I slept a small radioactive disk known as a plaque was slipped behind my eyeball over the area of the tumour. Over the next week it would emit sufficient radiation to destroy the tumour while, hopefully, causing little damage to the rest of the eye.
When I awoke, an hour and a half later, I found myself in the recovery room feeling very little discomfort and no nausea or other problems. After a light snack of crackers and cookies I drifted in and out of sleep for several hours.
In the next bed, an older gentleman from Brampton was recovering from the same procedure, except he was a week ahead and had just had his plaque removed.
The second surgery is apparently much simpler than the initial insertion and only takes a half hour to complete.
His tumour had been detected by chance during an eye exam in November, so his medical history was similar to mine, except his doctor acted on the situation immediately.
After remaining in the hospital overnight for observation, we were discharged back to the lodge armed with several eye pads; a couple of different eye drops and eye ointment.
Looking around the dining room at lunchtime, it was somewhat surprising to see that most of the residents looked healthy and not at all how one normally imagines a cancer patient, emaciated, skin discoloured, and in obvious discomfort. Thinking back to my Mother’s final days, it is clear that science has made some significant strides in the last 10 years.
As treatments are not typically carried out on weekends, most residents have gone home for a two day treatment holiday, leaving just a handful of people to fend for themselves since the kitchen is closed on Saturday and Sunday. Andy, after 7 weeks of therapy left today too. He was returning to Guelph and two months of recuperation at home before returning to work.
Monday 3am
Waking at 2 and unable to fall back to sleep, I continue…..
The weekend passed with relative speed and little excitement. Susanna came up on Saturday and we met at the Yorkdale Mall where we shopped for a lighter coat for me, my parka being a bit too heavy for the rainy weather. We had supper together at the Keg Restaurant adjacent to the lodge before she set out on what would be a snowy ride back to Listowel
Over the course of Saturday evening and Sunday, I chatted with a few of the residents who were staying at the lodge for the weekend. Some had been there for several months including one gentleman being treated for Lymphoma. He was undergoing a stem cell procedure and he and his wife had been there 5 months. Another resident, a lady in perhaps her mid fifties had been there for 7 weeks while another resident had been in the lodge with occasional returns home for close to two years.
So all in all it was apparent that my procedures and my one-week stay were a walk in the park compared to everyone else’s journey towards recovery.
Monday evening
The sun was shining yet there was a cool breeze as I walked to PMH for my 9:30 appointment with Dr Gonzalez. Removing my eye pad he viewed the eye under a microscope and seemed pleased with the progress. While he applied eye ointment and a new eyepad he answered a number of questions for me. The liver scan was negative for any sign of malignancy and with a negative liver scan there was no likelihood of spread to lungs or bone. Scans were suggested every six months for a year or so. The visual blurring that I was experiencing might be permanent and might actually get worse. It would take a couple of weeks following the second surgery for things to stabilize.
With the appointment concluded, I purchased a weekly Metro Pass then spent the morning wandering through the Eaton Centre just browsing music and video stores and bookshops. Before returning to the lodge I bought a toque (wool hat for any non Canadians who might be reading this!) at “Chinadian Tire” thus making the trip back to the Lodge a lot more comfortable than the earlier walk to the hospital.
Returning to the Eaton Centre later in the afternoon I met Caitlin, who was in town for a course and we had supper together at the Hot House Café.
By the time I returned to the Lodge the temperature was dropping to FYAO levels and I was glad to be back inside.
Friday March 11th
I spent Tuesday and Wednesday getting my moneys worth from my Metro Pass. Sadly the weather was not too co-operative so I found myself catching buses and streetcars on trips that I normally would have walked. I made visits to several music shops where I debated the possibility of buying a new guitar. With the exception of Steve’s Music and Long and McQuade most of the vendors had a “couldn’t give a shit” attitude to my presence as a potential customer. Maybe the patch over my eye was a bit of a deterrent or maybe business was so fantastic that they didn’t need to make another sale!!!! Doubtful, considering the current state of the economy.
Anyway, I decided that I could forgo a new toy, confining myself to a new set of strings and a better tuner for my old Ovation guitar, with its slightly cracked and warped top. I did get the sales rep at Steve’s to write down a couple of model numbers for a possible future purchase, assuming I get a decent income tax refund.
Thursday morning I returned to PMH at 8am for my pre-op sign in and preparation. The latter, as before consisted of eye drop instillation every 15 minutes for an hour pre-op. With surgery scheduled for 10:30 I was surprised to find them waiting to take me down to the OR at 10am. It seems that things were moving well ahead of schedule so I was prepped and on the table by about 10:20. Dr Simpson spent several minutes reviewing the upcoming procedure and chit chatting about the number of these surgeries he does [ 4 a week on average so that means he treats just about every patient in the country since there are approx.200 cases a year], keeping me occupied, while a line was painlessly inserted into my left hand. Not so painless was the flow of anaesthetic, which burned quite intensely for several seconds before I drifted off to sleep.
Other than the clock on the recovery room wall indicating 11:20, the only thing I noticed was a rather intense headache- something, like the burning, that I had not experienced during the first op. When I questioned Dr Gonzalez this morning, he assured me they had used the same mix of analgesics and anaesthetics as the first surgery- the difference in symptoms indicated otherwise- but at this point it matters little.
Returning to my room I found that my roommate had just undergone stage one of the procedure, so he spent much of the afternoon asking me questions. A 70-year-old resident of Hamilton, he had emigrated from Yorkshire in the mid sixties and made frequent trips back to England to visit family, so we spent much of our time swapping stories of the “old country”
This morning Dr Gonzalez arrived for rounds at 9am. When he removed the eye pad and tape, my vision was extremely blurred. That was in part due to the heavy ointment residue that was caked all over the lens. A saline cleanse improved the situation considerably and I was able to see that the double vision had cleared, as Dr Simpson had predicted. Clearly the distortion of the eyeball by the plaque was the root cause of the visual change.
Deciding that I would forgo a patch for the remainder of the day, he instilled a couple of tobradex drops into the eye, primarily to reduce the swelling. It also has antibiotic properties but he said there was little risk of infection, as the radiation would have killed off any bacteria.
I wasted no time in exiting the building and while in better weather I might have stopped to reflect on my good fortune at bidding PMH goodbye, I quickly entered the Queens Park Subway for my trip to the St Lawrence Market.
Twenty minutes later, I was sitting at a small table on the second floor, a peameal bacon and fried egg sandwich in front of me. After the tasteless trash that passed for food at PMH, this was heaven. Washed down with a perfect cup of coffee, it was the ultimate ending to my week in Toronto.
Sufficiently satisfied, I made a quick stop at one of the cheese vendors, choosing a selection of Edam, Gouda and Cheshire before heading for the bakeshop on the main floor where I picked up a loaf of Muesli and Raisin bread.
With the clock on my wall ticking its way towards 5pm, I only have a few more hours left in the big city. My train leaves at 10:55 tomorrow morning.
With only a few residents left in the building, supper will be a relatively quiet affair and once it is done, maybe I will be able to select something to watch on TV other than Coronation Street, Hockey and Curling since there will be few people to fight over the remote!
Having only spent a week at the PMH Lodge, my stay here is definitely one of the shorter ones. A number of people went home today after spending several weeks or even months here. Several are staying for who knows how long. Many of those leaving do so knowing that they may be fortunate enough never to return while some are aware this is just one stop in a journey that will take them along paths they would rather not travel.
As one of the lucky ones, I leave the Lodge cancer free and I hope that I remain that way. Liver scans every six months will be part of my routine for the next 3 to 4 years. More importantly, stopping to smell the flowers and savour the coffee will be a little higher on my list of priorities than seeing how many shifts I can fit into my semi-retired work schedule.
Thy name is my healing, O my God, and remembrance of Thee is my remedy. Nearness to Thee is my hope, and love for thee is my companion. Thy mercy to me is my healing and my succour in both this world and the world to come. Thou, verily, art the All-Bountiful, the All-Knowing, the All-Wise.
Bahá’u’lláh
Hopefully my next blog will be of a more touristic nature as I am planning a trip to Italy or Turkey in the Fall
Adios Amigos y Vaya con Dios
