Wednesday, 23 November 2016

The Cancer Jigsaw

This week, the similarity between jigsaws and getting treated for cancer has really struck me.

I’ve always loved jigsaws. 

They remind of Christmas, and roaring fires, and spending hours with my family, bent over a box trying to marry up subtle tonal shades and miniscule details against a cover image of dubious quality. They strain your mind…and your eyes, especially after a glass of festive fizz.

With a jigsaw, the first thing you always do is look for the corner pieces (or so I have always been taught!). These are the firm foundations from which to build up, out, and inwards.

In my case three corner pieces came my way very suddenly and unexpectedly, it’s almost like they leapt out the box. Emergency surgery, stoma, bowel cancer diagnosis. Three of the pillars of the puzzle complete. The fourth, I’ve still not come across yet. In my head it’s finally meeting the oncologist, the individual who will complete the quadrant and allow me to start pulling everything together. The oncologist, (who I am scheduled to meet next week), is the gatekeeper to accessing treatment, scheduling chemotherapy and (hopefully) putting me on the path to recovery. I feel he (or she) is my fourth corner.

In the meantime, whilst I wait to unearth my missing corner, (desperately hoping it has not been spirited away by my daughter into a dolly’s handbag, misplaced by the NHS, or swallowed by the dog (?)) I have also started working on my edges. The edges build up from the corners, they provide structure and stability and allow you to start connecting the dots and bridging the gaps. In puzzle world they start to make everything make sense.

Next to the stoma corner there are the expert colorectal and stoma nurses, the countless books on stoma+sport, stoma+kids, stoma+sex (?!?), the long-awaited prescription support pants which most definitely have no frills and no lace (Bridget Jones here I come)…and the cherry on the cake… the assorted selection of flanges (yep, technical stoma term for the bit of the bag that sticks on your tummy). Basically lots of support to help me move from complete incompetence to conscious competence and hopefully beyond.

Just along from the corner I’m calling ‘emergency surgery’ are the registrars, the anaesthetists, the CT scans, the high dependency unit, the consultants and of course the ward staff who have helped me recover from surgery. In four weeks I have stretched out a long way from the ‘surgery’ corner. A fantastic combination of amazing surgical glue, the extended medical team, the recovery support at home, the kind words and gifts from friends and family, my meals-on-wheels team…it’s probably the area that is most sorted. In puzzle terms it’s filling out nicely. This part of the puzzle is nearly complete. Extremely satisfying.

The bowel cancer corner is interesting and complex. I like to think of it as one of those challenging segments, like one of those jigsaws where dappled light filters through trees and leaves in every shade of green and brown. Totally infuriating to solve. You think you’ve connected something, only it doesn’t quite fit. Almost…maybe with a bit of brute force and pressure? But really it doesn’t fit.

As everyone knows, the internet is a minefield best avoided, but in a quest for reliable information I’ve read clinical trial papers, NICE protocols, Macmillan guides and, most importantly, I’ve had amazing advice from unspeakably courageous and positive individuals who have already trodden the path of bowel cancer as patients, clinicians or survivors and have kindly shared their time, insights and advice. Knowledge is always a powerful weapon however you come by it. Thank you to those who have helped me with this.

With the edges shaping up I have started working inwards towards the tricky middle bit of the puzzle. This is where things get messy during the jigsaw-solving process. You end up with the occasional set of three or four matching pieces floating like little irregular islands, a bit lost on the lake of the shiny coffee-table, constantly sliding around, desperate to connect to the mainland.

So it has been with this cancer malarkey. I have some mini oases of common sense – they relate to diet and nutrition, mindset, holistic therapies like reflexology and reiki. Individually potent strands of the bigger picture, but as yet I can’t pull everything together coherently.

Getting the full picture, the solution is going to take a long time. (As indeed do puzzles in my world). My puzzles often start with all-hands-on-deck on Christmas eve, everyone keen to help and support. But interest wanes, and only the tenacious and persistent remain involved, carefully analysing those subtle nuances of shape and shade on the box and on the jigsaw.

It would be wishful thinking to assume this is one of those 24-piece ‘first puzzles’ that my toddler is now working on. That would be naïve. I just sincerely hope it’s not one of those 3D puzzle monstrosities with an image of smarties or baked beans that makes no sense to anyone. Or by some extraordinary manufacturing fault this jigsaw actually transpires to have a piece missing. Right now, a standard 1000 piece jobby would be just fine.

As a final thought, there appears to be a consistent message that treatment for cancer is a team approach.

Chemotherapy on its own is not the answer. No corner piece or edge piece holds all the answers. Just as a puzzle needs corners and edges, so my journey from diagnosis to treatment and beyond need strong foundations AND a holistic approach. Friends, family, expert medical advice, diet, mental health, emotional strength, reiki, writing, exercise…the list could go on and on, but the message is very clear. Tempting as it is, don’t fixate on one piece of the puzzle. However big it may loom in your mind, the other pieces are just as important. Focus on the long term goal, the bigger picture and stay positive and tenacious…and finally, hopefully the solution will be reached.

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