Arm block, part 2...

Well i don't mind telling you, it's been a right couple of weeks! So much so I'm going to have to break it into two or three separate posts but believe me, even you will wet your pants this time! For now though I'll start where we finished, with the arm block.

When you're talking pain relief, where best to start than my angel Dr Ivan, the arm block guy.  As you know from the previous post the arm block worked like a charm and lasted two and a half blissful weeks.  Having no control over the arm was difficult at times but surprisingly enough you learn to adjust. One weird thing i did discover was that everywhere i went the toilet roll was always on the left hand side. Even in my own home! Girls will get this more than blokes but i first realised this in a public toilet. We women squat over the seat. This alone takes great skill. So there i am in position shall we say, flopsy is hanging by my side as usual, knickers down to my knees and i have to lean across myself to reach the toilet roll and of course i can't find the end. Typical! Usually there's miles of it on the floor but not today. With great skill and balance i did it though, without one inch of my skin touching that toilet seat. So now i pre-roll! Can't catch me out.

bruising caused by a combination
of trying to find the nerve space
and medication that makes me
bruise easily

As i was saying the arm block lasted two and a half weeks. The pain came back gradually up the hand and then within two days it was back full force. I could move my wrist, fingers and shoulder but not my elbow. So i was still completely floppy and now also in pain. Thank goodness my next appointment was Thursday, two days away. Instead of chewing on peanuts and gaining more weight, i just kept telling myself, two days, two days.

When we got to Dr Ivan on the Thursday the pain was starting to get me down. It seemed worse than before but I wasn't sure whether that was because I'd had a break from the pain or the fact that the tumours under the armpit were a lot bigger. So Dr Ivan went through the usual procedure. A little brandy (sedative) as he called it, although with the amount of medication i was on i don't think it made that much difference. Mum said i had a little slur. He put the local anaesthetic where he was going to insert the probe and off he went, but this time no twitching! My arm laid there as dead as a do-do! Dr Ivan explains that although he knows he's in the right place he cant put the 'blocker' in unless he's absolutely sure. In my head I'm thinking "twitch you bastard, twitch!" He tries again but still no twitching. I could tell by his face that he really didn't want to send me home in this much pain. That's why he's my angel because you can tell he really cares. It's as if he can feel the pain too. So the next thing I know hes getting an ultra sound machine sent down to the pain clinic to try to locate the right space.

When the ultra sound arrived Dr Ivan got started. My cousin Debbie had come along for the ride, so her and Connie Beachamp (my mum with too much Holby knowledge) were glued to the screen as Dr Ivan explained to them what each thing was and what he was looking for. He found the right space again but still no twitch even though he could see he was definitely in the right place. Again he decided it wasn't safe to inject the 'blocker'. I was absolutely gutted and so disappointed at the thought of having to put up with the pain again. However Dr Ivan hadn't given up. Apparently the procedure could be done under x-ray, so he made me an appointment for the following week.  



This bruising appeared after the
failed arm block for no reason at all.

The following Thursday could not have come any sooner. We turned up at the pain clinic all ready to be relieved of the pain because by this stage it was unbearable. I honestly was at the stage that i didn't know what to do with myself. I'm not a cryer, but found myself crying all the time because i was exhausted from lack of sleep due to the pain.  If i let the arm hang the pain in my shoulder was incredible, as if i had a 10kg weight hanging from it. Also because of the large tumours under the armpit, whenever the arm hung straight down it would compress the tumours against my ribs and hurt like hell. Imagine having two or three golf balls under your armpit then holding a bag of shopping with the same arm. Wearing a sling now to take the weight off the shoulder wasn't working either because my hand would begin to have an unbearable tingling sensation. A bit like when you've scraped the ice off your car without gloves and your fingers are so cold you cant feel them and then they hurt when they defrost. I couldn't win either way.  So knowing i was definitely getting the arm block today was such a relief.



This was the bruise that appeared by the
armpit. Apparently it was just part of the
nerve path but unexplained why it came
up like that. The 'easy bruise' medication
made it look worse than what it was.

Into the treatment room i go and what do i find? Dr Ivan in a leopard print lead suit. I couldn't stop smiling. Only him! He's got such a great sense of humour. He reminds me of Gino, that chef. When i took his photo i said to him

'can i take a photo of you in that suit for the blog?' and he said

'no....do i have to.... oh ok' this was all in one breath, then he struck the pose. He loves it really.

Anyway, back to the procedure. Dr Ivan decided to try it the original way first then move to the x-ray way. As usual i got my shot of brandy, then the local injection went in and then in with the probe. As Murphy's Law would predict the arm twitched like mad first time. I was so relieved it was gonna work. So in went the 'blocker' and i went back to the recovery area, where mum was, for a while where they monitor you, give you a cup of tea and see how it's worked.

At first i couldn't feel or move my hand but that only lasted 10 minutes or so. Before i knew it i had full function of my hand again except for my little and ring fingers. I couldn't move or feel them at all. Not even to touch the skin.

Dr Ivan was completely baffled as to what had happened and was going to consult with one of his colleagues that afternoon and ring me the next day with the next plan. The thought was that because i still didn't have full mobility that that somehow was effecting the block. What ever it was i was so dissappointed.  In the mean time though, Dr Ivan was very concerned about getting the pain under control. He had spoken to me weeks ago about Ketamine being excellent for nerve pain but in large doses it caused hallucinations. Aparently i didn't need to worry about that with the small dose i would be on. i knew the name Ketamine rang bells in my head but i couldn't think what for. So remembering that conversation and being desperate for something to alleviate the pain i agreed and he wrote me a prescription which had to be picked up from hospital pharmacy.



Fred Flintstone or Tarzan?
You decide, this is my Dr Angel.

When we got to the pharmacy it was a number system with only half a dozen people sitting there so at least this wouldn't take long. Yeah right!! Not today of course. Two bloody hours! I was five numbers off the number on the screen and it was going to take two bloody hours. I tell you, if the receptionist guy wasn't behind glass and i didn't have a floppy dead arm, i would have choked him.  We later learned that it's because they only keep four bottles of Ketamine on the premises at a time. At that stage i didn't know why.

As we walked back to the car, i was in so much pain and was so dissapointed about the arm block not working that i was holding back the tears but the minute we got into that car i let them out. We decided to fill in the two hours with McDonalds, perfect for depression, and some retail therapy at Hobby Craft. We got back to the pharmacy just as my number was being called. 

Part two of my Ketamine experience is soon to follow and it's a laugh from start to finish! You won't want to miss it.





One arm bandit...

One arm bandit, cool hand Luke or even quick draw magraw! Any of those nicknames would have done, but no! My arm has been nicknamed 'floppy penis arm'. To be honest, since the nerve block to my arm it does just hang there and i still can't move or feel it from my shoulder to my wrist. Aside from the pain free bliss I've been in for a week and a half, it has given me and my friends some hysterical moments of laughter and also a frustrating moment of embarrassment ( i was alone for that). But fortunately i am right handed and it truly is amazing how quickly we adapt to a situation and work with what we've got.



The pets seem to detect when i'm
out of sorts or in pain. This was taken
the night before the arm block. They wouldn't
leave my side for days.

Let's start with a normal morning. Say the shower. Now don't forget since i had the total node dissection to my groin (my left leg i might add), i still have to lift my leg to get it over the edge of the bath or in the car and so on. So imagine that act with one good arm lifting the leg and the other just hanging there (also my left arm) but don't worry, i did it safely...no broken bones and Mum was close by just in case. Now, wash your hair. Normally i would pour shampoo from the bottle with one hand into the other hand then place it on my head. Simple! But with flopsy i can't even turn my hand to catch the shampoo i'm pouring into it, so i had to pour the shampoo directly from the bottle onto my head. Obviously my quantity judgement was out because by the time i put the bottle back on the shelf the shampoo was pouring down my face like I'd been slimed and when i lathered it up i looked like I'd been in a foam party! I swear it took me twenty minutes to get the shampoo out and my hair was squeaky clean. Now I've got it sussed. i hold the bottle between my knees, squeeze tight and squirt the shampoo into my good hand that way. Genius!! I like to call it Kiwi ingenuity. Where there's a will there's a way.

Then there's simple things like putting deodarant on. You can't just lift your arm and spray. I have to pick my left arm up with my right, rest it on the dressing table, bend my knees to open the armpit area and spray. Think about it. Give it a try even. You'll be surprised how the smallest things become the most difficult.

One evening i even thougth i'd be extra clever and paint my nails. I am a Beauty Therapist afterall. How hard could it be? I'm right handed, flopsy only has to do five nails! Well i started off great guns, as you'd expect and then it came to flopsies turn to paint the right hand. Firstly i had to dunk the brush into the bottle with my right hand and place it between the fingers of my left...so far so good. I then figured because i couldn't move my left hand or grip the brush firmly to do the brush strokes i would pull my nail of the right hand along the brush instead. Easy-peasy! It only took five minutes to paint my right hand...but let me let you into a little secret. It also then took an hour to get the nail polish off my skin! But the satisfaction i get from not letting something like that beat me is well worth the time and effort.

Now lets move to the kitchen. Because the arm tends to ache at the shoulder because it's a dead weight, if i don't have a pocket i pick it up and place it on the bench. So this particular day, Mum was folding my washing for me and i was making us a cup of tea. You can do that with one hand! I was in the process of filling the water filter jug to pour into the kettle. I rested my dead arm on the handle of the jug as a weight so i could pull the lid off and because i have no feeling in my hand i forgot i had my hand in the handle of the jug. As I swung round to talk to mum, the jug was still in my hand but instead of just stopping i ended up in a process like a dog chasing its tail with my good hand trying to catch my dead hand and the jug. I was spinning round in circles saying to Mum 'help me catch it' but as i caught a glimpse of her she was standing there, legs crossed about to wet herself, laughing hysterically. Consequently, i now put the dead arm in a sling so i know exactly where it is.

Now for the embarrassing one. I don't know why I'm so honest with you all sometimes but with cancer you have your good days and your bad. Your funny times and your sad and i figure if you're going to read all about my journey you may as well know it all.

So this particular day it was decided that my G.P was going to ring me and we were going to discuss all the medication i was on. With being in so much pain before the arm block and having on call Doctors add new painkillers to the mix my Oncology team wanted to make sure i was taking the medication i needed to be taking. Also because my angel Dr Ramos (the arm block guy) wasn't sure how long it was going to last initially, the maximum doses were all left as they were. But as it was 4 days in and all was looking good, we decided to reduce some of the higher dose medications. As it turned out i was feeling really tired that day and decided to have a little afternoon kip. I didn't want to go upstairs because it would've been sods law that Dr Graham (my lovely G.P) would ring, so i decided to lay on the couch. Being blond and highly intelligent i had my head down by the phone so i could grab it with my good arm if he rang...not thinking my dead arm and dodgy leg were on the edge of the couch. It turned out i went into such a deep sleep and was there for over an hour. The phone didn't ring but when i woke up i was bursting to go to the toilet. Forgetting i had a dead arm, i leaned over to get up off the couch, my arm collapsed like spaghetti and i fell onto the floor. Well with my dodgy leg, if I'm on the floor it takes some mighty manoeuvring to get up anyway and that's with two fully functioning arms. So there i am on the floor, I've got a blanket tangled round me and like a walrus I'm trying to stand up! Don't worry, I do get up and unharmed and run to the loo with flopsy swinging by my side. Now is the embarrassing bit. Try pulling your top up out the way of your trousers and your trousers and knickers down with one hand at warp speed. Don't forget you can't just pull your trousers down on one side. You have to go all the way around your waist with that one hand. Try it next time you go to the toilet. Put one hand on your head and actually try it one day. Believe my it is a mission, let alone when your bursting. So needless to say i wet myself! I was mortified but more so relieved that Joe wasn't home to have seen his mum wet herself. Once i changed i sat there on the edge of my bed and had one of those feel sorry for myself moments. I thought, i can't have surgery...arm blocks are fantastic for pain but that leaves me with a completely useless arm...and I'm pinning all my hopes on a trial drug that may not work. So for all you lovely people out there that leave me such wonderful messages of how brave i am and how i inspire you all, please know i have bad days too. We all do. But you know what i did. I thought about how bloody funny i must have looked rolling round the floor like a walrus. I remembered how much pain i was in before the arm block and how quickly i have adapted to the use of one arm. I went out and bought some tena lady (at 41 years old) to prevent any further accidents and i reminded myself that i am still alive and i am positive that trial is going to work and shrink these tumors.