Getting the hang of sitting in the shade or the sun.

As I type I am heading into the last few days of my holiday here in Dalyan, as always it has been a lovely time. The weather has been a bit odd for this time of year, more rain than expected and some days where it has been extremely hot and humid, again unexpected. Climate change has been mooted as the likely cause by local people. In between the unusual weather it has been typical early to mid June weather, low 30s with a breeze, so pretty perfect, not so hot it stops you being active, which I have been occasionally, not so much over the last week though.

This time last week I felt I was heading towards a bout of fatigue, turned out I was wrong it was a summer cold sneaking up on me, so after about a week I feel that I am over the worst of it, that being said the other day I thought I was, so I went for a walk to Caunos which was lovely and then suffered the next day from the cold and having no energy, which I put down to the fatigue. It feels like sometimes I am like a laptop with an old battery that works fine when giving out energy but takes forever to recharge because the charger mechanism is not working properly and needs the computer to have a factory reset to sort out.

Moving on from my terrible analogy, maybe my mitochondria are playing up since my cancer treatment. If I am feeling good I have plenty of energy and can do stuff, be it mentally or physically demanding, sometimes I can do this fine for several days, another time a few hours of activity and I am left feeling drained and unable to do much, everything is a struggle. This is leading to think I need to have a factory reset to sort this out. If anyone knows how you do a factory reset on a human let me know.

Of course being energy less is not such a trail here in Dalyan, I spend most of the days sitting on the terrace watching the world go round, snoozing, reading or browsing the net. I might take a few photos if the mood strikes me and have over the last few weeks got a few good shots of Caretta Caretta surfacing for a breath, which I am pleased with and few other good shots. When I have felt up to it I have gone out and about with the camera and got a few good shots too. But mostly this holiday it has been very terraced based enjoying the view of the river and watching the world go by.

I am at the stage in the holiday when the return is looming and you know you are much closer to leaving than arriving, but not yet at the stage, you are thinking about the mechanics of returning home. The return is still an abstract, something you know will happen but does not need to concern you because it is some time away. I know that it will soon become more real and move from abstract thoughts to thinking about the journey home and what I will be doing once I get back. So far I know I have a few things booked in over the next weeks and month, a few social events, my voluntary work, a physio appointment, Nordic Walking and a check-up is rapidly sneaking up on me. Besides this, I intend to get back on my bike and riding again. I had deliberately not ridden to see if this would help my shoulder and neck pain, I can conclusively say it hasn’t. I can also conclusively say that temperature does not seem to make much difference, I had wondered if that being cold made it worse, well it hasn’t and being warm doesn’t make it less painful either. Hopefully, the appointment with the specialist physio might give some clues about how to reduce or banish the pain.

Dalyan is filling up with Turkish tourists at the moment, this is for the end of Ramadan and the Byram Festival. I like being here in Dalyan when the majority of tourists are Turkish rather than Brits and Europeans, the feel of the place changes. Many of the local businesses have a love-hate with Turkish tourists, compared to Brits and Europeans they are much harder to please I am told. I guess Turks treat hospitality workers in much the same way many Brits do at home. Having worked in the hospitality trade I am aware of how hard they work. Sure sometimes they might be sat around, but they are still at work and have to be ready to serve a customer, cook a meal, clean etc. In the UK, I am often horrified at how rude some people are to serving staff, treating them poorly or rudely. Turkish tourists it appears can be the same. Yet Brits here in Dalyan are stereotypically thought of as easy going and easy to please customers and generally popular with businesses unless they become very drunk and leary. Dalyan doesn’t get much of that, people come here for a quieter holiday.

The other night I went with Ilker and his family to a Cay Garden where his oldest daughter worked. It was very busy with a mostly Turkish clientele from Dalyan and surrounding area. Walking back with them to the pansiyon through the area where there is a concentration of touristy bars I was struck by the difference. This area was noisy and did not have the chilled out feel of the cay garden. It was not raucous or rowdy, just full of competing music, lots of lights and people having fun in a different way than people were in the cay garden. People were drinking alcohol in the cay garden, so it was not just the alcohol that made the difference, it was more the way that people were having fun. Possibly like the difference between a quiet pub garden and a city centre pub, in both people are having a good time, both drinking yet the feel would normally be very different.

When I am in Dalyan, I rarely go into the bars, choosing to sit on the terrace and drink a beer, enjoying the peace or sometimes listening to live music from a restaurant about 70 metres upstream of the pansiyon, mostly though it is quiet here. The exception is on a Friday night when a restaurant does a Turkish night that I find pretty dire and does not for me reflect Turkish culture. It is obviously popular with many tourists but for me does not reflect Turkish Culture, I am not sure what it is about we Brits that we seem to like going to these sort of events that purport to be the genuine thing when in reality are no more real or representing the actuality than a toy teddy bear reflects a real brown bear. It is a shame because if you do see Turkish music played well it is fabulous and if you see or attend a Turkish wedding you get a very different experience that has little to do with the facsimile of the Turkish night. I can see why businesses do them because tourists flock into them, so maybe I am the one out of step here, not enjoying them because many clearly do.

So my time in Dalyan in nearing the end again, I have had a lovely time catching up with people, some were guests in the pansiyon who often stay when I am here, others are people I know in Dalyan. I have visited favourite restaurants, done some walking about, taken some photographs, probably put on several kilos of weight due to the excellent food here. Will I be back, well I hope to be back but a recurring thought at this time of a holiday is that this could be the last time. 4 years ago I was here in Dalyan for about 10 days, oblivious to the cancer inside me and thinking about my return later in the year and booking time off work and the flights pretty much as soon as I got back. Now I have to wait until after the next checkup before booking, well I don’t have to but I always do as it seems wiser to wait until I get the all clear.

Well, this is all for today, it is heading towards lunch time and I want to walk out into the countryside take a few photos before stopping at a favourite cafe for a larger than I need delicious snack.


Dalyan again and other stuff

It is a week or so into my holiday and I think I am getting into the swing of it. Weather has been warm but with a few showers, fortunately most has been in the evening or at night so have been able to do stuff in the day. Though to be honest I have not done a great deal yet, a few walks, catching up with a few friends, taking a few photos, revisiting favourite restaurants and cafes.

Some of my regular readers will remember me mentioning getting in touch with an old school friend via FB, we last saw each other around 40 years ago. Well, he is in the UK at the moment, arriving the same day as I left. Turns out the plane he arrived on was on the next but one stand to the plane I was leaving on, his plane arrived a few minutes before mine left. So we were about 50 metres from each other. I was on the left side of my plane and if he was on the right side of his we might have been able to glimpse each other through the windows. It is a shame we didn’t have a chance to catch up, something to look forward to when he next visits the UK.

As I write it is around eight in the morning, I have been sat by the river since around 6, enjoying the view or reading, taking a couple of photos, stroking a friendly feline as they wander past on their morning rounds. Being here I feel very fortunate. I first stayed in Onder Pansiyon in May 2013 having found it on the web via one of the usual sites, deciding on it by chance really. There were a few places on my shortlist, I wasn’t sure which to book and in the end decided on here more by chance than intent. Definitely a good choice I think, whilst I have stayed at other places in Dalyan, here is by far my favourite. It is not that there was anything wrong with the other places, more that here suits me more. I like Ilker and his family, I have made friends with other guests who have stayed when I am here and occasionally are stays overlap so we renew our friendships. I would post photos’ but for some reason I have never managed to work out how to post them here, I think it is because of the blog format I chose doesn’t allow photos, as most of you probably find these entriese via FB, you will have seen them so it is not that important.

When I started this entry I thought I had lots to write, yet as I type it has all flown out of mind, so I will end now, return to enjoying the view, listening to the wildlife and the sounds of Dalyan waking for another day.

Time flies by in a good way

Again I have left a big gap between entries, this is not intentional and not a reflection of a lack of desire to write them, more to do with being a bit busier recently I think. So what have I been doing, well not a great deal compared to someone who works full time but for me it has been busier. I have caught up with a few friends, visited a few of the open houses during the festival, once I went by myself and bumped into a few friends so did more chatting and catching up than visiting open houses, I think I managed to see 5 of the 10 I planned to visit. Was a nice afternoon catching up with people, some I hadn’t seen since my retirement party. The other time of open house visiting was with a friend and we chatted as we walked between houses so got more done. As ever in both trips around them, I was astounded at the talented people we have in Brighton and Hove who exhibit.

In between this, I have been busy doing a course for Macmillan, attending a few meetings and doing some work on the peer evaluation project. I also helped set up the Lost Cats Art Exhibition and went to the private view, a nice mix of helping out and socialising.

Unusually for England, we had lovely weather for the early May Bank Holiday and I spent a lovely afternoon at a BBQ, mostly meeting new people or getting to know them better. This new group of friends is a result of getting involved with the cats’ charity and meeting up with people from the local FB cats group. Whilst I was off sick with exhaustion and the first collarbone break I discovered the group and it opened up new social avenues and I have formed some good friendships as a result.

As the weather has been warmer and dryer recently I have been getting out and about, making a few trips out to National Trust places, sometimes with a friend and sometimes alone but always with my camera. For some reason, the solo trips often seem to be on a Monday, I mentioned this to a friend, who reminded me that he doesn’t work Monday so would happily come along now and again, so something to plan for. This week, I went to Sheffield Park Gardens in the morning and in the afternoon I went to Arlington Reservoir. While both are lovely scenic places there was an ulterior motive in that I hoped to find dragonflies to photograph, there were not many around, guess it is a bit early in the year for them. Did see other insects and photographed a few, some of the results were OK I think. Whilst wandering around the reservoir I bumped into someone I knew through work, he has also taken early retirement as a result of the cuts in public services and like me enjoying it.

At the moment I am nearing my next trip to Dalyan, fly out in about 5 days for a month. Haven’t really planned for this until suddenly this week I realised that I need to get my car MOT done before I go, discovered I need to get a leak on the boiler looked at and fit in a few appointments. So what I had thought was going to be a leisurely few days has suddenly become busier. Fortunately, I do have some nice social events as well so whilst busy it will have some fun times as well.

So this is my life at the moment, all very normal, a mix of the mundane with some good fun social bits. It feels good that it is like this, nothing major going on in my life as has been often the case over the last few years, no anniversaries of health issue events etc. Just life going on, with the normal ups and downs people experience, the normal stresses we manage, the simple and normal pleasures of friendship and family. To some my life might seem dull or boring, to me it is lovely to be in a period of calmness and none of the turbulence of the last few years, whether it be my health, retirement or the loss of friends and family to cancer or other illnesses. Something to savour and make the most of I think and being in Dalyan will help me make the most of it, with lots of good bits to notice and enjoy.

End of the month, where is spring?

It has been nearly 3 weeks since my last entry, in which time we have had some glorious hot weather, some wet and cold weather and everything in-between these extremes of April weather. Today, April is ending with the proverbial rain showers and it is cold too. January cold it being around 5C this morning. Weather is due to be warmer tomorrow and a yellow orb is promised to be floating across the sky by the Met Office which will be a welcome return to nice weather.

This time in 3 weeks I will be packing for my next trip to Dalyan, in between now and then I have some training to attend, this for the Macmillan Peer Evaluators Project which I am looking forward to. There are also a couple of meetings about planning the first evaluation. It is good to be engaged in an ongoing project and feel that I am using skills and experience gained through working for many years in the social care sector. The only slight downside is that the first day’s training is tomorrow and the weather is predicted to be sunny so I will miss most of it. Still, I have 4 weeks of good weather to look forward to in Dalyan and I will have a nice walk to and from the training venue in the sun.

I have now met up with other graduates of the Nordic Walking course and will be joining them for regular walks, which I am looking forward to. I have also undertaken a photoshoot for the Nordic Walking programme, whilst the photos are not perfect the client(s) seems happy and will be using them to publicise the programme. Still have not got back on my bike yet for a variety of reasons, mostly weather-related and if I am honest a bit of lack of motivation. I have been back for the follow-up physiotherapy appointment. As with everyone else involved with my collarbone and neck the cause of the continuing pain has not been identified. Mostly though, I got good news, having good mobility and strength in my shoulder and arm. Following consultation, with colleagues, my physiotherapist did a bit more assessment. Again the range of movement was thought to be good but there is a slight weakness of a few muscles so I have been given a range of exercises to do for 3 weeks until the next appointment. Whether the exercises will reduce the pain remains to be seen, what they will do though is get me closer to 100% function.

Readers in Brighton will know the Arts Festival starts this week. This evening I am planning to help set up a Charity Exhibition of Cat Art to raise funds for a cat charity and tomorrow we have the launch event/private view of this. Well, that is the plan. However, as I have a bit of a cold I might have to miss it so I can save energy for the training tomorrow, will decide later today. I haven’t booked to do anything but am looking forward to wandering around the Artists Open Houses over the next few weekends. This is always a lovely thing to do, you get to see some great art and you get to see inside many peoples houses, some of which are stunning and borrow some decoration ideas. If the weather is nice you can have a lovely wander around the streets of Brighton and Hove and most of the trails have a house doing refreshments so you can stop for a drink and snack midway round. Further ahead, once I get back from Turkey, there are likely to be many NGS open garden events around, which I also like doing if we get a nice or at least some dry days over summer when the gardens are open I will be happily wandering around these and taking photos.

Unexpectedly last week I got contacted by someone from Macmillan, this was after I commented on a thread on Facebook. They have asked me to consider being a case study for them. This means my story could be used in the press and other media, I might get interviewed as well. So far it is early days, I have just submitted a form which gives a brief summary of my journey. Pleased to have been approached even if it doesn’t go anywhere, and if it does, then maybe I can help people entering the cancer journey now and in the future cope with it better. I do think my determination to find the silver linings and notice good things around me as I was in treatment and post-treatment have helped me cope well or at least better with a difficult few years.

Last week, I had a catch-up appointment with my exercise adviser, we first met in October 2015. Whilst the review was more focused on how I have been over the last 6 months, we did discuss the changes over the last few years and how that this time I had managed to get from initial assessment to next assessment without breaking my collarbone. We spoke about the first meeting and my determination to be doing everything and more than I did before my cancer, my unrealistic expectations of myself. She observed that compared to then I look much healthier but more importantly I look much more relaxed and at ease with myself and life. Which on reflection is very true, then whilst I was postive and noticing the good bits, there was an element of being driven and forcing myself to do more. Now, I am taking it easier and not pushing myself so much, being kinder to myself and accepting my limitations more. Going back to work in June 15 was in some ways a mistake, I wasn’t ready, but conversely it was also essential as I wanted and needed to return to doing what I did in as I sought to get back to my normal.

Fortunately, though, it has all worked out well, despite becoming exhausted physically and mentally, breaking my collarbone in a silly accident because I was riding to close to the kerb, I have somehow ended up in a good place. Life is good, I am pretty healthy, have enough to live on, have a social life, have the voluntary work and many more good things going on and lots to look forward to. This is due to the care of all the professionals involved with my care, my friends, family and colleagues who all rallied round me when I needed it. Life is definitely good at the moment and even if it is a wet and grey Monday morning, like today, there are many good things going on for me to notice, be it a small thing like enjoying a coffee or a larger thing like having another holiday to look forward to.

3 steps forward etc

Over the last couple of days my energy levels have returned back to my normal following a few days of deep fatigue, I had been feeling slightly fatigued for a few days, well several to be honest. I thought I had been balancing being active and resting well so it would not turn into a deeper bout of fatigue. I got it wrong again and sunk into fatigue over the weekend. The silver lining to this was that the weather was pretty foul so I didn’t miss much by not venturing out plus there was stuff on TV I wanted to watch and I had a few bits recorded. I wish I could understand the triggers of the fatigue better but they do not appear to be consistent. Sometimes being busy does it, others I have a few busy days, have a quieter day and escape fatigue, another time I will not escape it. Another time I will be having a quiet and peaceful time, enjoying life and then bam another bout hits me. Still considering the alternative still being here 3 or so year after the treatment is a result.

Beyond the fatigue what have I been doing? Well I have taken a few photos of local cats as they wander around outside the house and posted them on FB, getting lots of positive response to the photographs. This spate of photography arose because I had been sorting out my gear and had a camera out when I was watering the plants and noticed a few cats outside so took some photos of them. I am looking forward to better weather so I can head out with my camera, find a peaceful spot watch the animal world go by and photograph it. I am also looking forward to being able to tramp around the countryside without getting covered in mud, it has been a very wet winter since Christmas here.

I haven’t been that social over the last week, some brief meetings with friends it about all, this changed yesterday when I caught up with an ex-colleague and went to a talk at Sussex Uni about Parental Anxiety’s effect on children delivered by an experienced clinician turned academic Dr Sam Cartwright-Hatton, she is an excellent public speaker. It was fascinating and supported the rationale of my old team in that working with parents alone sometimes was enough to reduce children’s anxiety. The colleague I went with is going to approach the Uni and hopefully meet with the academic and explore the use some of her ideas in future work. The social scientists at Sussex Uni and Brighton Uni for that matter in my experience have a real interest in spreading their work beyond the academic sphere and actively engage with others, be they community groups or professionals. I expect other Uni’s run similar open lectures and I would advise you look into them, I have been to a few over the years and have always learnt something and found them entertaining.

So what else has been going on in my world. Well, I have booked my next trip and head back to Dalyan towards the end of May for 4 weeks. I am looking forward to this but there is a slight downside, I am booked to fly out the day and old school friend arrives in the UK from Taiwan, where he now lives. We lost contact but reconnected when he found me on FB, not sure how he found me but I guess with all the stuff about FB in the news due to sharing data I guess there could be a connection. We haven’t seen each other for about 40 years after losing contact, which was much easier to do then. There is a lot of justifiable criticism about Facebook amongst others and the way they treat our data, sharing it and possibly misusing it. However, FB etc., have done a lot of good and helped people reconnect or maintain contact they move around. For me it will be a real shame not to meet up with him and it does like “sod’s law” is alive and well considering the closest we will get in several decades could be whilst in the air. Someone who will remain nameless suggested we could wave at each other as we flew past each other.

Over the next few weeks I have made arrangements to catch up with friends and ex-colleagues, so have that to look forward to. I am doing some training with Macmillan which I am looking forward to. I have put myself forward to be part of an advisory group for the Horizon centre, my interest is mostly focused on the plans for using the cafe as an exhibition space and hopefully, I can make a worthwhile contribution to this. I am also looking forward to dryer warmer weather so I can get out cycling again and keep up my Nordic Walking. I completed the course last week and now am able to walk independently, which I am looking forward to. I have also been asked to take some photos to help publicise the work the Macmillan, Brighter Outlook and the Nordic Walking organisation are doing to help people post-treatment or living with cancer. I offered to do this partly out of wanting to help but also because I want to see if I can find a way to combine Nordic Walking a photography so this will be a bit of an experiment to see if I can Nordic Walk with a camera bag on my back.

Whilst on fitness and health matters, I had a physiotherapy assessment yesterday. I was referred because of the ongoing pain rather than lack or movement etc. As per usual the clinician was struck by the complexity of my case due to the two collarbone breaks. In many ways I have done really well post surgeries etc, the movement is good, strength is good and it is only the pain that is a priority. Whilst he had a few ideas he was unsure whether physiotherapy would be the best approach and wanted to discuss my case with colleagues in the trust, so I go back in a couple of weeks to find out what happens next.

I guess some of you might be wondering about the title of this blog. Well, it refers to me sometimes feeling that with the fatigue I feel that I keep going backwards and forwards progress wise. On one level I am extremely happy with my post-treatment life, being here still is a massive piece of good fortune. I do at times though get frustrated with my fatigue and whilst it doesn’t get me depressed it does get me a bit down at times. When I do feel down I can almost always find a silver lining to the current cloud or notice something good going on around me. And on the rare times I find this harder, someone always seems to contact me and help me bounce back. I am not always sure if they are aware of the positive impact on me that their unexpected message can have. Whilst in some ways I could view my life as standing still if I step back and take an overview I can see that many changes are happening. It is around a year ago that I first felt that I had moved from being off sick into retirement. Then I set myself a soft deadline of the end of summer 2018 to have an idea of what next. Whilst I haven’t totally got a plan, I do seem to have moved into a different phase, my volunteering is part of this and my commitment to this will increase over the year.

I still have many things to think through but I am in the fortunate position that I don’t have to rush into any decisions and believe the answers to my questions about the next steps will reveal themselves when I am ready for them. So whilst I have taken 3 steps forward and it could be argued I have taken 2 or so back since the treatment a few times due to the collarbone issues and the fatigue I personally see that I am moving forward and am looking forward and expecting positive things to happen to or for me.

Update on the 3rd for the 4th year running.

For the last few days I have been thinking about writing another blog and for various reasons, it has not got beyond the thinking about it stage. Then this morning Facebook reminded me that I had made blog entries on this day since 2015, this prompted me to make a start. That and that it is due to rain mid-morning to lunchtime, so I will be indoors keeping dry.

Looking back at old blog entries is always fascinating, sometimes I am amazed at my progress and at others, I think, wow has that issue been going on for so long. My entry for 2015 talked about fatigue and how I was still suffering from it and how it was unpredictable which meant that planning things was difficult. People were also telling how well I looked, which I probably didn’t but compared to how I looked a couple of months before I did. Then two years ago I was recovering from the surgery from the first collarbone break and talking about managing one-handed, fatigue got an oblique mention. A year ago fatigue was the main theme of the blog entry and how I was not very good at rationing energy. I also mentioned the Snowcats photography, which was a great experience and I think helped me get back into doing things, thinking about and planning for a future post-cancer.

In 2014 around now I was talking with my colleague about his hopes for his throat cancer treatment and finding out how harsh it would be. Little did I expect in a few months I would be discovering a lump on my neck and embarking on the same journey. I have been more fortunate than him, in that I am still around whilst he died in August 2015. His diagnosis prompted me to think about what I wanted from life, think about the near to medium term future and think more about when to retire and the stuff you contemplate as you head towards 60. I expected for be working for several more years and was actively working to put my team in a good place to survive the austerity-led cuts, which worked as the team has grown even if it has been refocused slightly more than I anticipated but mostly it is where I hoped it would be.

Fatigue has been a constant theme and in the first entry on this day I was thinking about when I would be over it. I knew that fatigue could last a year or so and that this was fairly common for people who had my treatment regime. Being fit I thought I would breeze through it and be back to normal in a few months. I always judged myself and energy levels on good days, ignoring bad days. Now I am better at judging trends in energy levels but even so I do get caught out by fatigue still. I have had a couple of days of fatigue, it started with mild fatigue on Saturday and Sunday, which I ignored mostly. However, Sunday evening it hit and I suffered all day yesterday. This morning I feel back to normal energy levels. So I will be heading out for a bit later for a walk, being careful not to overdo it.

Reading the 3 blog entries really brought home how the last few years have been focused on health issues, partly due to cancer but also the 2 collarbone breaks and the other things that have gone on too. The latest one is more of an irritant than serious, being piles. These are a result of taking opiates for a long time according to my GP. I tried self-treatment but resorted going to the GP who has prescribed suppositories, lovely I imagine you are thinking. If the treatment doesn’t work I will be referred on to have them banded or injected, not something I am looking forward to. However, compared to my cancer treatment I am sure it will be a breeze. Does seem ironic in some ways that both ends of my alimentary canal have caused me issues, maybe it is a comment from it about life or just random chance, I favour the later.

The shoulder and collarbone pain continues and I now have a physiotherapy appointment to see if there are some exercise that could help reduce the pain. I don’t hold out much hope but I could be being less optimistic than I need to be. This time next week I will be there for my first appointment. Movement wise I do have some restrictions on my neck but shoulder movements are pretty good I think, I don’t really notice any restrictions. Most of the time the pain is just there and does not really impact on me, there are times though when it is much worse and impacts on me. There are rare moments when I notice there is no pain, but these don’t last long. I used to think they were when I am resting but I have noticed that sometimes they are when I am being active. Whilst some of the more intense pain can be connected to activities I do get times of moderate to severe pain when sat around reading or watching TV. I also get a range of different pains and in different parts of my neck and shoulder. This is making me think that there is more than one cause to the pain. Maybe as the weather warms up it will diminish? Time will tell.

Well, I guess it is time to end this fourth entry on the 3rd April. Despite the adventure of the last years I am still feeling fortunate and seeing all the positives in my life, which definitely outweigh the few negatives. Life is definitely good and I am sure it will continue to be so and could well improve.

More fatigue but worth it as 3 years clear

Somehow whilst being aware of this anniversary getting close it snuck up and caught me unawares. It wasn’t until Facebook reminds me that on the 11th 3 years ago I got my first all clear after the treatment ended. I can still remember the relief and elation that I felt once told, the apprehension I felt whilst in the cancer centre waiting for my appointment. My thoughts fluctuated between getting an all clear and needing more treatment to overcome my cancer, I never really entertained the idea that I could be told it was terminal. I remember walking out of the centre and starting to send messages to people and then realised I needed to get somewhere to sit down and then send the messages as I kept nearly bumping into people. So I walked most of the way home and sat by the pond in Queens Park, looking northwards and enjoying the view. After a bit of reflection and watching the ducks and geese in the pond that I started to send messages to people letting them know my news and getting messages back.

Once I got the good news I started to plan a holiday and around a month later was in Dalyan for the first time since my treatment, but I am jumping ahead. When I had the all clear I was still suffering a lot from pain, taking soluble medication of 60mgs Codeine and paracetamol 4 times a day because my throat was so sore I still couldn’t swallow tablets. I had stopped taking the morphine a few weeks before, probably earlier than I should have as I was still getting a fair amount of pain, but I didn’t like taking it so stopped it just before I went to La Palma. I phased out the Codeine over the next month or so and I think stopped it whilst in Dalyan the first time, just taking paracetamol regularly and eventually to now and again.

In the news over the last few days, there has been a lot of discussion about people in the UK becoming dependent on opiates and how difficult it is to come off them and how we are having an epidemic of opiate dependency that is similar to the well-publicised problems in the USA. Having been put on opiate-based medications 4 times over the last 3 years and stopping them 4 times I have a personal insight to this as well as professional experience of working with opiate-dependent people. The hardest time to reduce and stop them was in the gap between my surgery and the radiotherapy starting. It might have been because it was the first time causing the difficulty, I don’t think this is the case though. What made it difficult was that I was stressed about the upcoming treatment and outcome of it, even though I was certain it would work. I do remember sometimes noticing that as I was reducing the medication I was getting some anxiety, the symptoms of which would subside when I took more opiate based medication. I persevered, put up with the anxiety and was successful because I am a fairly determined person or bloody-minded according to some not so charitable people.

My view of this so-called opiate epidemic is that whilst people’s chronic pain has a part to play, much of the continuing use of opiates is down to people being unhappy or distressed about their lives. As a result, they are using the opiates to control anxiety or depressive symptoms, masking emotional distress alongside the pain control. Since my cancer surgery and radiotherapy I have had pain in my neck and shoulder, this has become worse since the two collarbone breaks and surgeries (btw the first surgery was 2 years ago yesterday). I tend to deal with the pain by living in the moment with it and not letting it interfere with my life as much as possible. In some ways I am very likely to be in the group to be dependent on opiates, what mitigates against this risk is my experience, training and knowledge of emotional wellbeing and mental health alongside my inherent optimism and belief that it will work out all right in the end. Whilst the media was trying to blame the drugs for the problem, a couple of doctors they interviewed shared my view that the opiate addiction is a symptom of people circumstances causing them distress or not allowing them to feel strong enough to face the ups and downs of life without the support of medication.

Part of the problem I believe is the stigma of admitting to having an emotional or mental health problem, it is easier for some people and probably their doctors to continue the opiate pain medication when they don’t really need it for pain control. Of course, some of them will need to have the pain medication because they have severe pain but many won’t. I do accept that I am oversimplifying this and that the psychological impact of chronic pain can be significant and lead to anxiety and or depression in people. However, I think people are being kept on opiates to treat this rather than given more appropriate medication because it is simpler and less contentious for GPs and patients who find it easier not to have difficult discussions about the mental health impacts of chronic pain and the other reasons that have led to them being emotionally fragile.

So alongside it being 3 years since I got the all clear, in the run-up to it, I got laid low by a bout of fatigue. In an online chat, I likened it to the old Duracell bunny advert, whereas most of you have an alkaline battery I have the less powerful zinc battery so run out of charge sooner than you. This bout started to hit on Friday night a week ago, as I was due out with friends on Saturday night I hoped a restful day would allow me to do this and it did. However, it have a cost energy wise and I ended up feeling wiped out for 3 or 4 days. The physical energy came back sooner than the mental energy, which came back fully a day later. Physically I felt OK Wednesday morning so went and did my Nordic Walking class, the hardest part was listening to instruction and working out how to implement them as I was still feeling not fully sharp mentally. As I gently exercised the sharpness seemed to return and Thursday morning when I awoke I felt a clarity and sharpness that hadn’t been there for several days and fortunately, it has remained and allowed me to contribute effectively in my voluntary work.

So this is my life at the moment, pretty good compared to most of the planet I would say. I have a fairly busy week ahead, something on every day from Monday to Saturday, but I also have periods where I can rest so I am hopeful that I will be able to survive it without a relapse into fatigue. And if I do, well I will have to cancel things again as I did last week and wait till my energy returns.