Campaigns and awareness Case studies Mags: Bladder cancer led to a one-year ordeal It started with bladder cancer. Mags Turrell went to the loo and there was blood. She wasn’t in pain and there had been no previous symptoms but she wasted no time in visiting her GP. It was September 1, 2015. The doctor acted immediately to investigate the ‘single’ bleed and within two weeks she was given the diagnosis: the 66-year-old needed an urgent operation to remove two cancerous tumours from her bladder wall. This led to ‘a horrendous period’, culminating in almost a year in hospital and a year of intense medical care when Mags’ life hung in the balance. The initial operation to remove the tumours was successful but when the tumours were categorised, the consultants recommended that the bladder and all associated tissue be removed in an operation called Radical Cystectomy with Ileal Conduit. This led to the creation of a urostomy – stoma and bag. The procedure, however, created serious post-operative problems necessitating a third emergency operation which unfortunately raised as many problems as it had solved. A catalogue of complications ensued, along with unimaginable pain and distress. Finally, in January 2016, she was referred to the Queen’s Medical Centre (QMC) in Nottingham where, after four long months, the Turrell family began to see light at the end of what had seemed a very gloomy tunnel. The Senior Colorectal Consultant at QMC, John Abercrombie, and his team were brilliant, says Mags’ husband Philip. They administered TPN (Total Parenteral Nutrition) - intravenous feeding which delivers all the daily fluids and essential nutrition to patients who are unable to feed themselves by mouth. They are monitored by a team of dieticians. In common parlance, doctors needed to give Mags’ gut time to heal from the surgical procedures she had undergone so they isolated the entire digestive system and fed her intravenously for more than six months. The family stuck together throughout. Philip made the 100-mile round-trip from their home in Lincolnshire to Nottingham every day to visit. The medical team tried on one occasion to send Mags home in March 2016 for a break. “They gave us training, then everything we needed to change the bags ourselves but we only lasted three days – we simply couldn’t cope with the complexities of her three-bag maintenance regime,” said Philip. She was discharged from hospital in June 2016 when specialist TPN nurses attended to Mags twice a day at home for three more months. Her ileostomy was reversed in October 2016 - her bowel successfully reconnected and the TPN treatment complete. She can now eat normally and has adjusted to living with a stoma. Mags, a former ballet and aerobics teacher, now takes each day in her stride and is able to enjoy the company of her first grandchild, Oliver, who was born whilst she was in hospital. “There were times when we wondered when all this was going to end but we simply had to get on with it,” said Philip. One of the hardest things was that our friends, relations and colleagues all wanted to know how Mags was proceeding – presuming that she’d be getting better – so in the end I started to produce a regular email newsletter. Mags is alive due to developments in treatment. The family recognises that, had Mags been this ill ten years ago, she may not have survived and they therefore count their blessings. “You have to alter your life to accommodate for the way things pan out,” said Philip. “When we go abroad, we have to tell the airline that we need to take scissors in our hand luggage in case we need to change the stoma. This is backed up by the ‘Charter’ travel pack which explains to security why this is necessary and they’re fine about it. “Quite apart from the excellent – almost miraculous – skills of the QMC surgeons, we’d like to pay tribute to the fantastic NHS back-up services: the stoma nurses are absolute angels, offering 24/7 service and ‘Stoma Friends’ to help new stoma patients cope day to day; the ‘Calea’ nurses who deliver the home TPN service are all extremely competent and compassionate; Charter, who supply home deliveries of all of the stoma care products absolutely hassle free. Mags and I are absolute fans of the NHS and recognise the critical importance of continuing medical research.