Tumour Diary, Day 3 - Thu 10th Feb 2011

7:25am Observations. BP - no idea. Trying to get back to sleep
7:30am Registrar arrives. Says he will discuss situation with Consultant and return in an hour. Guess I should make a list of questions so I don't forget (no breakfast to distract me, of course):

* Please show me my scans and explain them
* When will the operation be? If today, at what time?
* Please describe in detail what you plan to do
* How long will the operation take?
* Are there risks? Complications?
* How long will the recovery period be? What are the things I will need to recover from?
* How long before I can go home? Any special care needs I will have?
* After care/follow-up?

8:30 Nurse brings me my steroid tablets (to help with any brain swelling). Allowed the tiniest sip of water to take them
9:25am No sign of the Registrar. Still waiting. Bill "the Brain" just popped in. He shares my concern about the apparent lack of planning/transparency. Says this isn't the kind of operation you just "fit in", and if I haven't heard anything in an hour I am to call him.
10:45am No news. Called Bill. He's on the case.
11:25am Bill rings back. He has appointed someone to find out "yea or nay" for definite for today, thinks his gut feel is probably "nay". Will call him in half an hour - would be good to be able to have lunch!
12:15pm Shower. Ditch the fetid stockings - hooray!
12:45pm Wow. Gone from news blackout to information overload! Consultant has finally been to see me and talked me through the scans. First thing is there will be no op today (food!). It's a four-hour procedure so they will know by tonight if there's a slot tomorrow. If not Friday they will release me over the weekend. They will definitely do it within the next week i.e. Thursday latest.
Key points (not for the squeamish):
I have a cystic haemangioblastoma in the lower brain stem/upper cervical spinal cord (c1).
There is a birthmark/lesion on the rear left surface of the spinal column behind the c1 vertebra. Blood leaking from it inside the spinal column has formed a large cyst slap bang in the middle of the cord.
To see the cyst on the scans, it looks big, to the extent that I was amazed that my symptoms aren't much more serious. The doctors share this view, which is why they rushed me in here as soon as they saw it.
The thing itself is benign, but given the size of it, its location and the fact that it is growing, it has to be dealt with swiftly.
Usually the primary approach with one of these cysts is to insert a catheter to drain it, then seal off the blood supply with glue.
The location in this case makes this method impossible. Surgery is the only option.
The approach will be to open a window in the neck and cut away the c1 vertebra at the back and go through the sheath around the spinal column to gain access to the site.
The cyst will then be drained and plugged with glue. The "birthmark" will be removed also.
Obviously care has to be taken not to damage the nerves any further and not to disrupt the blood supply to the spinal cord. Then it's just a question of closing everything up. The vertebra will not be replaced - apparently lots of people have this removed, both children and adults, with no ill effects. The neck muscles provide adequate protection.
So, doesn't sound too bad, does it? What makes it serious is the size and position of the cyst right in the middle of the spinal cord, plus the high vascularity of the area (lots of blood vessels).
Chances of the procedure being a success are 95%. What this means is that I would expect to be much the same as I am now. Existing nerve damage, consisting of stretching caused by the cyst, will not be repaired. They will not rule out an improvement, but they do not expect it. The main benefit will be no worsening of the condition.
A worst-case scenario is that a disaster occurs resulting in loss of blood supply to the spinal column and nerve death. I would be paralysed from the neck down and on a ventilator for the rest of my days. They estimate the chances of this as remote, at 1 in 500 or less.
So, lots to think about there.
Bill "the Brain" is coming to see me later for a chat. All visits gratefully received.
2pm They want to monitor my Oxygen saturation levels, not sure why. Have to have a little machine clamped onto my index finger all the time
3pm No visitors yet. Must be time for the tea trolley soon...
3:15pm My neighbour Carol arrives for a nice surprise visit.
3:55pm Carol departs, Caroline arrives. She's a rather lovely choir friend. Brings me posh coffee, funny reading material and her delightful conversation. We talk gory brain stuff for ages
4:30pm Another one of my lovely neighbours arrives - Kirsty. Brief but welcome surprise. I'm doing very well today
5:30pm Member of the surgical team arrives to inform me that there will be no possibility of surgery until Monday - hopefully can get a weekend pass to go and visit my folks
6pm Louise arrives bearing generous gifts. She made the mistake of asking me what I wanted, and then proceeded to actually try and get it for me, when I wasn't being 100% serious. So I got green grapes (as requested) and Duchy Originals organic toffee x 2 (I asked for Thorton's Original Special Toffee partly as a joke) plus some special chocolate brownies. Must remember in future that when Louise asks what you want, she will actually try and get it for you. Feel bad now...
7pm Fran and Kate arrive, followed shortly by Caroline M with a nice card.
I think the hospital staff are a little bemused by all the attention I'm getting. No complaints here...
9:15pm Visitors are away. Time to catch up on some correspondence.
Hopefully in the morning can get away home...
11pm Corrected the nursing staff on their misapprehension that I need to be Nil By Mouth again from midnight
11:05pm Apparently it's not oxygen saturation they want to measure overnight, but pulse oximetry, whatever that is [actually the same thing - Ed]. Anyway someone forgot to order the right piece of kit before the relevant department closed, so no monitoring of that will be happening tonight. In the morning they'd better not even for a second entertain the idea that I can stay here another night for them to monitor it. Apparently it's a portable jobby anyway, so I could just take it with me...

Tumour Diary, Day 2 - Wed 9th Feb 2011

6:34am About 3 hours' sleep. Woken by Registrar to get me to stick my tongue out at him for 10 seconds. "You can go back to sleep now". Thanks mate. Try to get back to sleep
7am Nurse in for observations. Good news - BP is normal. Try to get back to sleep
7:30am "Stranglish" nurse is back. Must take steroids before breakfast. Try to get back to sleep
8am Up and decent, ready for food!
8:15am No sign yet...
8:30am Consultant rings. Explains that the tumour is a cyst that has grown up around a birthmark. Benign. Not in a good place, but removable. Both tumour and birthmark must go.
They want to do an angiogram today to get some more info. All good news, except...Nil By Mouth. Noooooo!
10am Shower with "Surgical Scrub". Nice. In a surgical gown now, just need the stockings and the ensemble is complete
10:30am Young geeky doctor arrives and proceeds to do all the familiar poking and prodding. Yawn. I perk up when he suggests it might not be necessary for me to be NBM...
10:45am More blood taken. Only a handful this time
11:15am Another formful of questions, strangely familiar...
11:30am Observations. BP up again
11:35am Got my TED stockings on at last. Am made up
12:15pm Doesn't look like lunch will be forthcoming. Time for a nap instead
2pm No news. Bored
2:35pm Tessa arrives - my first visitor - hurrah! All-round fantastic person, and funny too. Perfect pick-me-up
3pm Porter arrives to take me for CT scan. Fortunately Tessa was about to go anyway.
3:40pm After much deferring to urgent stroke victims, finally get CT with contrast
4pm At last out of the hateful military-issue gown and back into civvies. Just in time for my brother John's arrival. Most welcome.
Also welcome is the lifting of the Food & Drink ASBO - Hurrah! Nurses scurry off to rustle up tea and toast. Where are those house-elves when you need them?
Consultant's Registrar arrives to confirm what we already know. Says he is off to review CT results and either he or the Consultant himself will return later.
4:20 Rachel arrives - with millionaire shortbread! Highly favoured lady. Hope all goes well with the birth of her second son, on Friday, if they induce...
4:45 Fran and Louise arrive - now we are 5. A proper party, except for the absence of gin.
They bring generous presents; Louise has loaded an ipod with an eclectic music selection and brings it complete with charger - how fab is that? Not to be outdone, at my request Fran has brought not one but two toothbrushes, plus some trashy chicklit novel she found abandoned on the train. I'm being unkind; she also brought some really great books too. Anyway what really matters is that they came. Special friends
5ish Rachel leaves and Declan arrives. Very pleased to see him (as always). We are all very well entertained by "the Special One". Generous lifting of spirits all round.
6pm John leaves, followed a bit later by the gels. Fortunately John notifies us that he has left his bag behind before the gels set off, so they take it and return it to him at Victoria. Result.
6:30pm Dinner arrives and Declan graciously bows out; he can no longer make himself heard over the loud troughing noises anyway.
6:33pm Dinner finished. 'Nuff said.
6:40pm Bill "the Brain" rings. He is concerned that no-one has come to see me with a plan of action yet.
7pm Observations. BP highish but I am getting a bit stressed not knowing what is going on.
Time for some Bookface before starting to phone back all the nice people who 'phoned and left messages.
8:15pm Still no word from the consultants. According to the nurses I am to be NBM after midnight and they will try and fit in surgery tomorrow.Concerned now that there doesn't seem to be a clearly-defined plan, or if there is, no-one has communicated it to me...
8:30pm Katharine & Daniel arrive for a welcome visit. Really appreciate all they are doing - amazing friends. Well, more like family really. Lovely cards made by godtwins Tom & Miriam (7). Seem to be having some trouble maintaining the stiff upper lip as I write this - must be a side-effect of the tumour
9:30pm Visitors depart. Must call back well-wishers.
11:50 Calls made and thanks expressed. Observations taken - BP highish but acceptable.
NBM in 10 mins. Hmm, now what can I scoff before bed?

Tumour Diary, Day 1 - Feb 8th 2011

Messages from the consultant on my answerphone when I got home from work. I'd had MRI scans 10 days ago on head and neck. They just got the results and summoned me in immediately. Tumour with cyst down where the head joins the neck. All they will say is - "not in a very good place".
7:10pm Start 'phoning family. Just get on with it as quickly as possible. Nightmare is not a strong enough word. Start packing a bag. Rang boss at work.
7:35pm Ring my good friends Katharine and Daniel. Immediately they insist on driving me to the hospital. (when Katharine insists, you don't refuse). God bless them!
9:10pm Arrive at King's College Hospital. As instructed, go to A&E because beds are in short supply. And this is the NHS BEFORE George Osborne takes an axe to it...
9:30pm Registered. Lots of kind messages coming in. Starting to sink in; get a tiny bit emotional for a second or two, but then get a grip.Waiting for my fantastic friend whom I shall call "Bill the Brain" to arrive. Bill's a Neurosurgeon at King's and has driven in from home specially to see me. Complete hero. Sees me safely into a treatment room and offers reassuring feedback about the problem and potential treatment.
10:30pm They've been pulling and prodding me, hitting me with hammers, even poking me in the eyes! Taken a load of blood (nearly an armful). Nurse sprayed some on the couch and my trousers for good measure. At least now I look like a proper A&E patient, covered in blood
11:00pm The long wait for a bed continues. Daniel still here keeping me company. Trooper!
12:45 Daniel off home. Observations taken again (3rd time). Blood Pressure, which was a bit high before, has gone down a bit.
1:00am Wheeled to one of the Neurosurgery wards where a bed has come free. Room to myself with ensuite. Luxury!
1:45am More observations. BP a bit better. MRSA swabs - fun. Not. Nice nurse brings most welcome tea and biscuits.
2:00am Now sporting ill-fitting fetching pale green NHS pyjamas. Different nurse asks me lots of questions from a form. His English pronunciation is slightly foreign to me so we have fun while I try and figure out what the hell he is on about, e.g.
"How many pills do you have?"
"Pills? None"
"No, pills when you sleep" (points at bed)
"Oh, pillows! 2 is fine, thank you" etc.
2:30am Typing up this diary while waiting for yet more blood to be taken - good job I still have quite a bit left. Some sleep would be nice.
2:45am It appears I misunderstood my English-strangling friend. No more blood-letting until the morning. To bed!

So - how much does an F1 Championship really cost?

So - how much does an F1 Championship really cost? £100 million? £300 million?

Or is it just a case of selling your soul to "the man"? A good person to ask right now ought to be Felipe Massa, having done exactly that yesterday at Hockenheim in the German Grand Prix when he pulled over to let his teammate Fernando Alonso past to win the race. Only Massa has repeatedly disappointed his interviewers by sticking to his story that it was his own decision.
There's no point in joining the argument (if there really is one) about whether or not this was "team orders" - this seems in no doubt, even though Massa, Alonso and everyone Ferrari sticks in front of a camera are swearing that black is white, up is down, and that Massa just decided all by himself to let Alonso through.
What has riled me enough to write this is the appalling farce put on by some media pundits - former drivers mostly - who are at great pains to justify the practice of team orders.
Martin Brundle (of whose commentary I am ordinarily a huge fan) reminds us that this is a team sport and that in F1 this kind of thing has always has gone on and always will. Since when does the repetition of an unethical practice make it right? How many times do you have to do it before it becomes acceptable? The answer - never. Unless your moral GPS is out of whack.
Then there is David Coulthard. His insight as an recent ex-driver is often, well, insightful (with the possible caveat that where the Red Bull team is concerned he is quite a long way up Christian Horner's exhaust pipe). On this issue, however, he shares Brundle's view; "this has always gone on", "without the team the driver would be nothing", "it's a team sport" and so on. He commends Felipe Massa as extremely "professional" for lying to the media about the incident. Let's not beat around the bush here - this isn't diplomacy or tact, we should call it what it is - lying: Massa is lying, his team prinicpal Stefano Domenicali is lying and after the race so was Massa's engineer Rob Smedley, who had the unfortunate job during the race of relaying the not-so-coded instruction to Massa. In my book, being professional includes being honest and upfront, not underhand and deceitful. Being faced with a situation where the easiest route (or the least difficult) is to lie does not make it commendable to do so. There is no doubt that Massa was surely under a lot of pressure to comply with the instruction, but that does not make his compliance correct or laudable. To then lie about it afterwards merely serves to compound the offence.
The rules of F1 are quite clear - no team orders are allowed. But far worse than breaking this rule in my opinion is the dismissive attitude which states that the contest doesn't matter, that open, fair and genuine racing is not important, that the fans can be summarily insulted and dismissed, and that "anything goes" in the pursuit of the title.
In what other sport is it acceptable to fix the result? None. In all other competitions this is surely the most heinous offence. This is about the essence of sport, of true sporting competition. It goes to the very root of the desire to compete. It seems that the corporate bigwigs in F1 are so busy chasing titles and sponsorship that they have forgotten these basic principles.
Messrs Brundle and Coulthard have pointed out repeatedly that Ferrari had no choice but to do this in order to have a chance of winning the Drivers' World Championship with Alonso. Surely, if the only way you can win a contest is to cheat, then you are simply not good enough and don't deserve to win it? Is there anything that is not acceptable in order to win? Or is anything permissible? Just what is the price of an F1 World Championship?

Posting footnote

Apologies to anyone who finds the format of these postings a bit weird - I certainly do, paragraphs all over the place and there doesn't seem to be anything I can do about it. Remind me to find a decent blogging tool at the first available opportunity...

The Monday Show

The Monday Show (with Alexander Armstrong) was a pilot made by Hat Trick Productions (Have I Got News For You, Armstrong And Miller, Father Ted, Drop the Dead Donkey). I went with five friends to see the recording at the London Studios. A busy weekend has meant that it is only now, 3 days later, that I sit down to pen this review...


First Impressions

    

An intriguing set. A cross between an office and a studio flat, not really giving away what the format of the show is going to be. In the first picture is Alexander's desk and chair ("Xander" to his friends). In the second shot can be seen the desk for his two comedian sidekicks (behind the desk in the foregound which is just for show). The final picture shows a lounge-like area with a sofa and coffee table. Oh yes and there's the autocue with Xander's opening words (let's call him AA from now - less pretentious).

What's it all about then?

This is what Hat Trick has to say about the show:

"A new comedy pilot for BBC1 starring Alexander Armstrong! He will be joined by three celebrity guests to look ahead at the events of the coming week in an upbeat entertaining mix of studio chat and location reports."

The show consisted a number of different elements. The theme is events about to occur in the week following the show. A number of features had been prepared in advance, including pre-taped segments, and AA navigated (or 'piloted' - geddit?)  his way through the material assisted by two comedians, in this case the ubiquitous Ed Byrne and slightly less well-known Jon Richardson.

Each week there is a special guest who is chatted to by AA, with contributions from the comedians. On this occasion the guest was Janet Street-Porter.

So, how did it go?

AA kicked off with some scripted material to camera. As is often the case with this kind of scripted material, it was a little hit-and-miss at times. This kind of delivery is something that I think AA does particularly well, although he did seem a little stiff to begin with. He soon settled in though, and for the most part these links worked well and were rather amusing. In fact, so smooth and natural was his delivery that during the guest chat section of the show it was a while before I realised that his questions to Ms S-P were also scripted.

Throughout the show the form is for the comedic talent to interject with wit, banter and general repartee. Ed Byrne seemed more than happy to chip in and was generally good value, although at times he dominated a little too much. Perhaps he was attempting to compensate for the initial quietness of his partner, Jon Richardson, who seemed a little shy at first. However, if he lacked Mr Byrne's verbosity, he certainly was not short of a keen wit and great timing. On several occasions he dissolved the audience with sharp, very funny remarks, and on the whole was the funnier of the two comics. Fewer words, but well-chosen.

The "chat" part of the show worked well, although Janet S-P is not everyone's cup of tea and lapsed pretty much entirely into her "Grumpy Old Women" routine. She was good in the sense that she could hold her own against the comics, though, and can take some stick (not enough was dished out in her direction, in my opinion!).

The pre-recorded segments were excellent. There were two main streams recurring at intervals throughout the show. The first was presented by the wonderful John Shuttleworth, supposedly on a grand tour of Britain. Classic stuff here, very good.

The second segment took the form of a vox pop, presented on the streets of London by Miranda Hart (Hyperdrive, Not Going Out). Entitled "Batman or Boris", the idea was to see if members of the public could tell which famous character had spoken certain quotes. Sounds easy, doesn't it? Well actually it proved quite difficult - the quotes were well-chosen and Miranda was very witty throughout. I would have liked to have seen more of this, with a larger number and greater variety of members of the public.

Miranda also presented a feature on National Customer Service Week (yes, really. Visit http://www.nationalcustomerserviceweek.com if you don't believe me). The spokesman from NCSW was unbelievably dull (it amazes me that such organisations don't wise-up to this) but fortunately that just provided perfect material for the excellent Ms Hart. Her competition to make an outfit out of everyday office items, held in a Customer Services department, was fantastic.

  

Ah, did I say the pre-recorded items were excellent? I was forgetting one. Each of the comedians were given a segment of their own, and Jon Richardson presented a VT segment on putting on a firework display to music. I'm not quite sure where the subject came from, and sadly the execution was weak - a damp squib, you might say. The only thing remotely amusing about it was the choice of music for the display - Lionel Ritchie's "Hello". All very ironic.

Ed Byrne was given a live segment to run with. This featured the Shetland Food Festival, also taking place this week. This was a promising idea, but didn't really work in the end. The participants (AA with Janet, Jon on his own) were presented with some ingredients and asked to guess what Shetland delicacy they might be made into. Then the real dishes were revealed and the lucky crew got to taste them. Needless to say the ingredients and dishes were obscure and revolting, seeming to consist mostly of fish heads! Unsurprisingly no-one was very keen on the tasting part, and on the whole, this segment bombed.

One segment which did work rather better involved the team decanting over to the sofa area on the right of the studio, where they reviewed a couple of books due out this week. This was excellent as it gave the comics something to get their teeth into, and they were very good value - Jon R particularly so. This was another section that I felt more time could have been devoted to.

And finally...

To conclude, then, I can see how you might think that the show was a bit disjointed, that perhaps it doesn't really know what it is. To be honest, this occurred to me at the time too, but perhaps with the benefit of editing the finished product might seem less so. Let's not forget that this is a pilot show - the format could well receive some tweaks if it gets the green light. On the whole, the standard of the writing was high and there were plenty of laughs to be enjoyed. High-calibre presenting talent meant that most of the show worked well, with a few exceptions.

As a footnote, I have exchanged a few tweets with Jimmy Mulville, co-founder of Hat Trick. He suggests that this show could be "a perfect bookend to the week with HIGNFY". Certainly I would welcome some decent entertainment during the week, especially right after going back to work on Monday. Who wants to wait until the weekend for a good laugh?

VERY much looking forward to the recording of the Monday Show with Alexander Armstrong tomorrow night! Naturally I'll be posting a review on my blog, so you can all watch the show when it airs and see how it compares...