Wisely manage exertion or you crash

What a sedentary year

Thinking of my main exercise, walking, I have noticed that this year, I have just barely breached 2,000,000 steps in what might, from one perspective, seem like my laziest year in the last five years.

Without making excuses, I understand that the advent of cancer and the treatment of the same limited my facility for exertion in ways I could not have anticipated. I started radiotherapy taking the advice that I could continue doing the routine things I used to do. Still, the experience taught me a lesson that my mind was way ahead of my body, for my body to attempt to catch up.

When I was actively walking, my smartwatch and health app would suggest after every session, the expected recovery time. A serious workout of 13.5 kilometres in about 2 hours called for almost an 18-hour recovery time for my age and abilities. That intensive brisk walking activity has for now sunk into the annals of memory.

What I cannot do now

For instance, yesterday, we went into Cape Town for brunch and decided to walk the seafront promenade from the public baths to the V&A Waterfront. That was about 4.7 km in the warmth of a hot summer. I was caught out, my desire strong, but my strength waning, by the time we reached our destination, I needed Brian for support, and I was totally exhausted.

As much as I tried to push myself, I could do little. On getting back home, I crashed out and my voice when I had to make some calls was closer to a wisping whisper, almost unrecognisable to people who knew me.

Recovery is the package

The moral of the story is that I am not as able as I think I am. For all the youthful zest I possess, I am somewhere in the grandpa category of having to take things easy, and for everything I do, I need adequate and extended recovery time. This is compounded by the fact that I am recuperating and so, I need considerably more time to recover my strength.

Staying in Muizenberg has many benefits. The beach is just 5 minutes away, and it is a good long walk in the breeze to the kiteboarding and surfboarding areas. It is tranquil, refreshing, exhilarating, and good for the soul. On good days, we make the most of the situation, and that is the tonic we need.

Photons on the Prostate - XIII

Many improvements in symptoms

Thinking of the process of recuperation after radiotherapy, I am getting better at least with the signs I have observed. There are fewer occasions of my voice sounding tired and waned from exhaustion, the weather might have contributed too as it is summertime in South Africa.

The symptoms with the waterworks persist and while it will not be defined as benign prostate enlargement the fundamentals of it still exist as the prostate was enlarged because of acinar adenocarcinoma of the prostate, the radiotherapy treatment of the cancer would have further inflamed the prostate and constricted the urinary tract, for which I have to take daily medication to ease water flow.

The image below best describes issues of an enlarged prostate, and links at the end of the blog give more context. The need to check your prostate health is important, I suggest you use the International Prostate Symptom Score (IPSS) Calculator as a starting point to buttress the case to your doctor for a Prostate Specific Antigen (PSA) test.

Courtesy of NHS Overview of Benign Prostate Enlargement

Other symptoms of concern

As pertains the waterworks, a polite reference to the bladder issues; there is lesser urgency or frequency, but the weak flow, straining, and nocturia are issues to manage as the prostate heals and hopefully returns to a normal size.

One other side effect that statistically affects others more but has been less of a concern for me is with bowel issues. They are manageable, but mishaps do occur. I reckon part of my original pain management medication has positively impacted expected diarrhoetic symptoms, but I must watch for irregular bowel movements.

What has not normalised is my sleep patterns, they are out of kilter. I suffer a lot from insomnia leading to tiredness during the day with the documented sleep record on my smartwatch showing barely 3 hours of night sleep and naps of about 60 to 90 minutes dotted around the day.

At the church service that I attended yesterday which started at 9:30 AM, I was wilting within an hour into the service. I hope this improves without having to resort to sleep inducement through medication. It might be something to discuss with my medical team.

Appreciating rest and recuperation

More importantly, it is the immediate support and care of my partner that has helped me. It was not easy facing a cancer diagnosis alone in Manchester, I had to rearrange some priorities for the uncertainties ahead. I received a confirmed diagnosis in mid-June but postponed any discussion about options for treatment for a month, while I took time to meet with my partner.

After I returned, the discussion about radical surgery and its side effects were not that encouraging, but I had to wait another fortnight to discuss radical radiotherapy and what confusion followed the different options in that area that we had a lot of back and forth. It was the second-hand experience of others that gave a better insight into what it entailed.

When the radiotherapy commenced in September, I worked through it, keeping up my routine as much as possible, though the fatigue set in, from the onset, at the first weekend, just after 2 treatments. Then, I tried to maintain productivity for another month after the treatments concluded as I realised radiotherapy did have a greater toll on my body than I anticipated.

Making the best of this rest period is critical even as I yearn to get back into professional activity. The art of restful relaxation is one I am yet to master even as I try to distinguish between holiday and recuperation, I should not make my recuperation seem like a holiday, just because I am away from home.

Blog - Men's things - Prostate Cancer blogs

Blog - Photons on the Prostate - XII

Other references

MedScape: International Prostate Symptom Score (IPSS) Calculator

Mayo Clinic: Benign prostatic hyperplasia (BPH)

Urology Care Foundation: Benign prostatic hyperplasia (BPH)

NHS: Prostate Specific Antigen (PSA) test

Prostate Cancer UK: The PSA blood test

Essential Snobbery 101: Between an escort and a chaperone

An industry getting worse

Much as I would hate to observe that recruitment agents have become lazier and more unprofessional, even with the benefits of AI they do not seem to care what they do. It is like they sling shit in every direction with the hope that something sticks somewhere and out of that comes the reward commission for placing a hapless recruit.

For instance, I have had more than a decade-long interaction with this major recruitment agency, they would at least have an old CV of mine that anyone would hope provides some background and history to inform of whether I should be contacted by anyone from the said agency about an opportunity.

That is if the recruitment agent concerned had done any research before using my email address for their scatter-gun activity. I am even surprised I was addressed by name; these emails are usually discourteously impersonal.

Subject: Escort Needed! Apply now [I was first shocked by the email header as the resolved email identity was unfamiliar, that was besides wondering why I would be contacted for any lewd activity as a sex worker which is work that I would hardly qualify for, at this age and not after my prostate gland had been zapped by radioactivity to rid it of cancer. On reading the detail of role, would chaperone have been a better word?]

The email I received yesterday afternoon

[The emphases in the email are as contained in the original with nowt taken out.]

Dear Akin,

Your new company

An exciting and challenging opportunity has become available to join HMP [His Majesty’s Prison nearby] as a contractor escort working as part of a third-party company. This company looks after all maintenance work within this prison.

Your new role

Your new role as a Contractor Escort at HMP [nearby] will consist of 39 hours working Monday – Friday and will involve escorting a variety of contractors and visitors around site, ensuring the strict policies in place are followed. You will be responsible for the protection of inmates, staff and visitors by ensuring these policies are adhered to. Other aspects of the job involve booking in contractor’s tools and supervising them once escorted to their designated working area. This is an ongoing temporary position.

What you'll need to succeed

In order to be successful in this role you will need to pass an enhanced background check conducted by the prison service. This is something we will facilitate upon registration. You will also need to be level-headed, well organised and hardworking person. A security background is beneficial but in not essential for the role.

What you'll get in return

For this job you will receive a competitive hourly rate of £13.68 with 33 days holiday a year. All uniform will be provided. There is a chance for permanent offer. [On the rate alone, I have resisted paying any attention to the derisory offer. The holidays seem generous for the role though.]

Kind regards,

[Recruitment agent name removed]

Recruitment expert in Construction & Property [Their expertise is questionable, at best.]

In all consideration

I could not get this out of my mind, the much I tried as I was both irritated and annoyed, it deserved some sort of response as I did not want my mailbox to be cluttered with such nonsense ever again.

I did consider a very curt reply with a clear rebuke expressing the depth of my indignation, but it probably would have been binned, and though I do not expect a response because such recruitment agents would never have been schooled in the kind of decorum that should make their communication a sign of their professionalism, I tried a different tack in my response, this morning.

With gratitude for the thought

Dear [Name withheld],

I am totally at a loss how any information you might have of me might have inspired my receipt of this job opportunity.

I have a 36-year career in IT, your explanation of how this role relates to my experience would be welcome and helpful.

Otherwise, it is better to first acquire some knowledge of a person's background before filling their mailboxes with irrelevant prospects. That would be the least professional course to take. 

However, thank you for having me in mind for this role, I regret it is unsuitable as I have no appreciation of how useful it is for me.

With kind regards,

[Signed]

The less said beyond this response, the better. However, if the agent does respond, I might update this blog.

That unwelcome discomfort from youth came visiting today

A familiar and rotten feeling

To date, I have never had a proper diagnosis, it is something I have suffered from juvenile times that I need to find a stop to. The stomach/abdominal pain that comes in waves with little in terms of relief can continue for up to a day. Usually starting early in the morning and continuing with moments of respite throughout the day.

Blog - I remember this tummy ache – (October 2007)

Blog - The pain is a long story – (September 2023)

It can be exhausting and the most I can do in terms of remedy is lie on my belly cushioned over a soft pillow and drink lots of sweet and milky tea. This might be accompanied by bowel movement or vomiting, which it was today, but it just adds to the discomfort of it all.

The thoughts that ran through my mind as I writhed with pain in my bedroom midmorning without the appetite for any ingestion even of pain relief, I would hate to consider again. I seem to have learnt to endure the pain with the hope it soon subsides.

The need for more rest

As I write this blog, even though I believe the worst of it is over, the muscles of my stomach seem to retain a memory of the suffering I endured with a foreboding that it might creep on me again. Thankfully, the pain associated with my waterworks post-radiotherapy has literally dissipated.

When I lay on the sofa in the living room, I passed the time away with old playbacks on YouTube of The Love Boat and Fantasy Island. Between the grimaces of pain and the comfort that interspersed today's main event, I did not even notice that we had some rain.

I think I’ll be fine for the rest of the day. There was no indicator as to why this ailment took hold today. I am glad it is over, and it is evident that for all the strength that I think I have regained in my first week of recuperation, I really do need as much rest as I can get, and I have not got nearly as much as I need, so far.

Feeling the warmth of a community church

Decisions for the good or the bad

We had a decision to make about where to attend a church service today without making the mistake of visiting a church with a self-absorbed worship team entertaining a congregation that was failed out of not being spiritually fed. At least that was our impression of the Hillsong Church in June.

We dared think of returning hoping that our first attendance was an off day, but we wrote to both the Cape Town campus and the mother church in Australia, and we received neither an acknowledgement nor a response. We had better go to a place where they are courteous and welcoming.

Blog - Between haughty Hillsong and bounty biltong

Planning without yawning

From Muizenberg to the St. George’s Cathedral, quite unlikely; when getting Brian out of bed on a Sunday morning is a herculean task at best, just perish the thought. So, I did a survey of churches in Muizenberg and two evangelical churches caught my interest, small, out-of-city, new, and growing. We set our minds on staying in Muizenberg.

It would have been a 45-minute walk or thereabouts, but we called an Uber taxicab to convey us to the Main Road of which there might be hundreds in South Africa, we had to be specific before I repeated the mistake of finding myself 33 kilometres from where I intended in Johannesburg, some 9 years ago.

Welcoming warmth and feeling

On arrival, we saw the church flagpole, but unsure of ourselves, we waited outside before someone came to the door. They were friendly and welcoming, and as she invited us inside, introductions followed. They all came to welcome and greet us.

Interest and engagement were evident in a small community church that espoused our Pentecostal beliefs. It was there that we learnt that a priest we knew at St. George’s Cathedral, the cousin of a congregant, had passed away last year.

As we were similarly attired, they wondered if we were band or choir members, we tend to turn heads on Sundays. I said we were partners, but they heard brothers even as I repeated myself. We eventually acquiesced to whatever they wanted to identify us as.

Simple yet impactful

It was low-key, intimate, and friendly. I was called forward to be prayed for, and the sermon was informal and easy-going with contributions from other members of the congregation. I began wilting later in the service but survived to the end before needing the use of the gents.

I took the offer of rooibos tea which I rarely have, sweetened without milk, it tasted good enough, I however do not intend to form a habit of it. We had a splendid time at church before walking back home. We will probably be returning next Sunday.

Companions in travel

Assistance is quite helpful

Those chance encounters with strangers and their stories. Too often we see people on the surface, with no inkling of who they are. Dare we strike up a conversation with them that leads to deep discoveries of similarities and differences between us?

For instance, I used customer assistance services for my trip to Cape Town. Someone to cater for getting me from the check-in counter to the aircraft and back through customs to the arrival terminal by wheelchair or a motorised buggy.

In Manchester, after the security check, I was left in a waiting area until my gate was shown. Soon, an elderly couple arrived, the husband needing a bit more help than his wife. She was amiable and friendly as he made for the gents.

Everyday interesting people

They had lived in Africa for more than 40 years, mainly in Namibia where he was an engineer, and she was in community development. They were going to Cape Town via Doha, arriving in Cape Town about 4 hours before I do.

As the conversation shifted to why we needed assistance, their son had made all the travel arrangements ensuring both his parents had the assisted service. Two years before she had open heart surgery and was put back together with 4 staples and glue.

She volunteered he had a non-cancerous enlarged prostate along with mobility issues and the onset of dementia. They were looking forward to their holidays, full of life and happiness. As we parted ways when I was picked up for the departure gate, we wistfully thought this might not be our last encounter.

I saw them later as they were being taken to their flight and we waved to each other. It might be a concert or wine estate where we'll drink a toast to good health.

The choices we make

Then sat beside me on my flight to Cape Town, I spoke to a lady, resident in Belgium but returning to South Africa to see her family. Alluding to my just completing treatment for cancer, she said she was going for surgery in a few weeks.

You would never have thought, but behind every facade is a world of stories with a touch of humanity. I used my experience to encourage her. She had made treatment choices to protect her quality of life. Every motivation is valid. I elected for radiotherapy over surgery to preserve urinary and sexual function.

With cancer, it is important to have all the useful information to make informed choices. The more pertinent thing: regardless of what people suffer, they go out and live their lives to the fullest.

From arrest to rest

A necessary situation

To think it was exactly two months ago that I walked into the Christie Hospital to begin 20 sessions of hypofractionated radiotherapy to treat malignant prostate cancer.

Until then, I felt nothing apart from what the blood work told us that further investigation revealed. I could have had a year totally oblivious of a growth in a delicate part of my anatomy that could be a cause of serious illness and death.

All through treatment that happened over 4 weeks of weekdays, I barely slowed down activity, though, as fatigue and other issues took hold, I made adjustments.

A betraying voice

This was brought home to me when I attended a conference having apologised for my low energy levels affecting the strength of my voice. Most listeners would have wondered why a sick man is pushing himself so hard. One sought out the management to raise their concerns.

I preferred to have some occupation rather than a distraction; I was accommodated even as others suggested I take time off.

The voice rarely improved; it bears the hallmarks of extreme exhaustion, yet, it is my voice, my tool of expression, slightly battered by resonant. Let me not suggest that it is indefatigable because fatigue has a role in moderating the sound.

Giving due consideration

Radiotherapy is painless and by that reckoning may seem harmless too. The havoc it has wreaked on my waterworks is one I hope to put behind me, along with the urgency that hits me when I need to map a route that offers immediate use of conveniences or sit at home.

The other consideration is finding the strength to do the simple things. It is five weeks since the end of treatment. The cancer is blasted but the body is far from a good state of recovery.

The decision to embark on a journey for the opportunity to access love and care was attacked from many quarters as much as others saw the need for it.

I made a determination after realising I needed to give myself both the time and the rest to recover, not sitting alone in cold Manchester but in the warmth of Cape Town with Brian.

Accepting my vulnerability

The discomfort of being carted around airports in a wheelchair in the knowledge that I truly am not fit enough to do the things I did without concern, before September is that independent streak denying my vulnerability.

However, I know how having a Radar key to access disabled toilets has prevented me from wetting myself the many times I have been out. This is all temporary.

I will get better, fully regain my strength and vigour, and then receive the all-clear assessment in April. What I need to tell myself is I need both the time and the rest to get well. Without that, I arrest my recovery.