Paradox: a person or thing that combines seemingly contradictory properties.

Cancer has introduced a universe of paradoxes into my life. One of the most perplexing is the exercise vs. rest paradox. We are told that exercise is important, one of the few potentially preventive measures we can take to help avoid a reoccurrence. We are also told that it’s important to give the body time to recover because surgery and associated therapies take a hefty toll.

My surgeon was unwilling to do any further work last year because I’d already exceeded my quota of anaesthetics and treatments. I thought I was recovering reasonably well and had no qualms about more major surgery. She strongly advised against it so we agreed to pick up where we left off when we meet each other again later this year.  Last September I had yet to discover that chemo ages the blood by up to 15 years in a process that may well be irreversible. I anticipate this falls into the ‘unintended consequences’ category of chemo-related side-effects but it means my blood is now old enough to qualify for state pension! The rest of me falls some way short and will do for over two decades. Aged blood can, apparently, be problematic. The same is true of untreated cancer.

In spite of geriatric blood, the risks associated with more surgery and the unavoidable recovery period that accompanies it, my mind is made up. NHS permitting, the remaining work will be completed before the end of this year. I fully expect the chief executive of the health care trust to have to approve provision of more acellular dermal matrix even though he knows nothing about its essential role or my surgeon’s requirements. The approval is another bean counting exercise; a few inches of ACD significantly increases the cost of a surgery that is already well in excess of £5k. Cost vs. care – another cancer paradox.

The time between now and my date with a(nother) hospital stay offers an opportunity to build some fortifications. Being fit for surgery means being well prepared physically and mentally. I’ve noticed little attention seems to be paid to state of mind; often the focus is on physical attributes like BMI and blood pressure. These are important but I think it’s remiss to neglect the mind because it can affect the body, especially pain and recovery, and vice versa.

There’s no doubt that I get more physically and mentally tired these days than I ever did before the cancer chaos. What else can I expect when my blood is over 60 and still perniciously anaemic? There’s also no doubt the stubborn streak that saw me through treatment remains stubborn enough to make me finish important tasks at home and at work even if I’d rather collapse in a heap on the floor.

I am, however, better equipped to  listen to my body and to the frazzled walnut that rattles around inside my skull serving as a rudimentary brain. Pace is everything and that doesn’t mean doing everything like a sprinter! I was never good at short distance races even as a teenager so my chances of improving that now look very remote. Endurance was a better option so while I’m working to improve BMI, physical stamina and agility I’m also using the time to recharge mentally and emotionally.

I’m fairly resilient however I know returning to hospital for elective surgery will bring back memories I’d rather not dwell on. The corridors, smells and various sharp instruments act like the black and yellow stripes on an angry wasp. Instinctively I’d prefer to be nowhere near it and no matter how well prepared, I’ll never relish the thought of more surgical drains. All of these things are inevitable in order to do as much as I can to reduce the likelihood of another episode of unwelcome cancer. Needs must.

So I’m back walking the coast path photographing flora along the way as a means to create another reality, one that holds the strength, silence and serenity to carry me through what lies ahead. That’s going to be yet another paradox.