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This post isn’t actually about french bread, but it does make for a much more photogenic image.

One of the features of Cancer we all hear a lot about is pain, not something I’m looking forward to but at least it’s more controllable than it used to be. There is a thing called the analgesic ladder that takes you from Paracetomol up (or down) to strong opioids like morphine. There are three rungs and so far I’ve spent most of the time on the first, or off the ladder entirely taking my favourite medicine (nothing at all), as I am at the moment. I’ll stick with ‘up is stronger’, call it the stairway to hell, appropriate if there should turn out to be an afterlife as that’s where I’d be headed. A little warm perhaps but at least I’ll see my friends again and a little harp music goes a long way.

I did have a bad week a month or so ago when I went to the second rung to handle some rather unpleasant stomach pains, particularly at night. I was prescribed the weakest drug at that level, Co-codamol which is a mixture of Paracetamol and Codeine. After one night I contacted the doctor again and moved on to a Codeine drug where one dose was twice as strong as two Co-codamol. Luckily that did the trick and, even better, after taking it for two nights I moved back down to Co-codamol for a few days, then Paracetomol and since then mainly nothing at all.

The journey was interesting, although not something I’m looking forward to repeating. As well as the physical pain it makes keeping cheerful and optimistic more challenging. In those dark hours of the early morning when I was lying awake asking the pain to please go away now, I couldn’t help fearing this was the start of a one way street. It also really brought home what people who live with chronic pain have to go through. It was always there for those few days, I took fewer pain killers during the day but it was less intense rather than absent. Concentrating was harder as it was always there, always reminding me of things I would rather not have to face every waking hour.

Once again the NHS were wonderful. I phoned the Christie helpline on a Thursday morning, was advised to phone my GP and let them know I needed prescription painkillers. The practice nurse rang me back, discussed my needs and prescribed Co-codamol. When I rang back the next day a GP spoke to me and moved me onto the Codeine, advising me to take only one pill at first rather than the two on the prescription due to its strength. Having the 24 hour Christie hotline is great, I always get through to someone who has access to my medical record and is clearly a medical person rather than a general call handler.

Right now I feel good, I completed a 21 km walk on New Years day at a quite respectable pace with only a few sore muscles to show for it. I’ve clearly lost a bit of fitness after a sequence of weekends when I wanted to get out but for one reason or another wasn’t able to, but I still feel good and have even managed to get my weight up to around 5kg over my norm. That added weight could be an important buffer if I do have a bad chemo reaction, but so far there hasn’t been a trace of a side effect, other than tighter fitting trousers from the extra weight.

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