Introduction
I had a small lump or cyst in the corner between my left eye and nose which was very slow growing and not causing me any pain or itching … it was just there for months & I knew I needed to take some action. When I was ready to deal with whatever the diagnosis of this thing I went to see my GP who knows me well
- GP referral Friday 2nd August 2024
- possible basal cell carcinoma
- may involve plastics
- referral to Dermatology at Clatterbridge hospital
Prep
Hearing the word cancer is obviously very worrying but equally I knew I could deal with whatever was coming my way step by step … I knew I needed support & clarity in order to cope with the oncoming anxiety & the inevitable bipolar mood swings
- I needed a mind map for clarity
- I needed a plan to settle me down
- I need help getting there & going into appointments = Helen ?
- Who needs to know what ?
- less is more = just Claire Helen & Jackie because oversharing wouldn’t work
- I need to do prep work on mindful deep breathing
- very important to stay as calm as I could
- not to overthink things or self diagnose re online google
My Mindful Mantras
Mindful deep breathing was going to be key and I started doing daily breathing exercises in order to try and stay as calm as I could. Also because I was going to be calling upon these techniques as I dealt with various appointments step by step
- Just breathe … just believe
- Be … here … now
- moment by moment
- step by step
- Observe my surroundings
- Be present
- Accept what is
- Still my mind
- Focus on my breath
- Ask … believe … receive
- Stay calm … stay confident
- hold on … just hold on
Mindful Quotes
Wherever you are, be there fully. Jon Kabat – Zinn
At the end of the day I can end up just totally wacky, because I’ve made mountains out of molehills. With meditation, I can keep them as molehills. Ringo Starr
If you feel anxiety or depression, you are not fully in the present. You are either anxiously projecting the future or depressed and stuck in the past. The only thing you have any control over is the present moment; simple breathing exercises can make us calm and present instantly. Tobe Hanson
Your mind can be like a runaway steam train if you let it. It can take you off to thoughts of the past, and then take you off to thoughts of the future by taking past bad events and projecting those into your future. Those out-of -control thoughts are creating too. When you are aware, you are in the present and you know what you are thinking. You have gained control of your thoughts & that is where all your power is. DAILY TEACHINGS
Dermatology at Clatterbridge Hospital
The 1st appointment was at Clatterbridge hospital. I knew I couldn’t just rock up on the day so Helen took me the week before to check out where the Dermatology department was plus car parking near by & we went into reception together to familiarise myself with where I would be waiting
- Tuesday 6th August = email & letter re Outpatient Appointment Confirmation
- Appointment = Tuesday 13th August at 10.00 a.m
- Seen by Dr Roopa Karumanchery
- Thursday 8th August = practice car run with Helen
The Dermatology Appointment
I was understandably nervous and anxious . I had written my questions in a notebook & Helen also had a notebook to make sure we got clarity. When I am stressed particularly with key appointments my head starts to whirl and i find it difficult to take in what is being said
- Tuesday 13th August
- Helen came in with me
- Dr Roopa examination
- confirmed suspected cancer
- Difficult to see clearly near to the eye
- referral to Eye Consultant at Arrowe Park Hospital
- Monday 9th September = practice car run with Helen
Eye Clinic at Arrowe Park Hospital = Examination
- Monday 16th September at 9.50 a.m
- Consultant Mr Peter Glasman
- eyesight tests / read charts / eye pressure = all ok
- photographs taken
- Mr Glasman & 2 helpers / examination / microscope how long has it been there ?
- Basal Cell Carcinoma in one spot = slow growing
- Need to do biopsy in 4-6 weeks
- Biopsy at Arrowe Park hospital SEAL Unit
- area to be removed = size of a 50p coin
- big scab and bruising after
- month after check up & diagnosis
- further procedures
- Helen take notes
Totally Unexpected
- Tuesday 17th = phone call from eye clinic re biopsy procedure tommorow at the SEAL unit !!
- Can Helen help get me there ???
- will be 1st on the list at 8.00 a.m
- Yes = 7.00 a.m pickup
- need to get out & do a weekly shop !
- received NHS letter online
- lots of mindful deep breathing !
- SEAL = Surgical Elective Admissions Lounge
- list of things to take especially = notebook & pen / iPhone / airpods & house key / water bottle
SEAL Unit at Arrowe Park Hospital = Biopsy
- Wednesday 18th September
- SEAL reception with Helen at 7.15 and first on the list again
- 8.00 admissions nurse pre-op various check & blood pressure surprisingly ok !
- Registrar = medication list & procedure explained
- Quiet room to wait away from full clinic seating area
- Dave support worker wheelchair = couldn’t find me at first !
- pre op room = Mr Peter Glasman explained what would happen re injections & would be an open wound after
Operating Theatre
- Dave wheeled me into room before theatre
- team & Mr Glasman greeted me
- felt wobbly getting out of wheelchair & onto bed
- hands were held either side
- lots of mindful deep breathing
- staff thought i did amazingly well
- very wobbly getting off the operating bed onto the wheelchair
- open wound was dressed with eye pad
Recovery room & waiting area
- single big eye pad
- cup of tea and biscuits
- nurse explained discharge letter
- Helen came in to collect me
- nurse explained discharge letter to Helen
- felt very wobbly getting into and out of the car
- felt very wobbly getting into the house
DischargeSummary Letter = Ophthalmology
- Wednesday 18th September
- Consultant = Mr Peter Glasman. Ophthalmology
- Diagnosis = Primary Squamous cell carcinoma (Rule Out) Laterality = Left
- Management = excision of SCC
- Primary Care Plan = pad on tonight
- For reconstruction 1/52
- Nursing comments (1) = keep dressings clean & dry / head upright don’t stoop or bend over
- (2) sleep with extra pillows at night to keep head elevated to reduce risk of swelling
- (3) if bleeding occurs apply pressure for 10-15 minutes & sit upright
- (4) If bleeding continues try a 2nd attempt of applying pressure
- (5) if after 2 attempts it continues to bleed then seek medical advice
- watch for any signs of infection = if so seek immediate advice from GP, Walk in centre or A&E
Aftercare
- Thursday 19th September
- remove eye pad
- gentle cleanse
- apply Chloramphenicol 1% eye ointment onto the wound (not the eye!) twice a day
- take regular paracetomol
- watch for bleeding / increased redness / increased pain / discharge / discharge / feeling unwell / got a temperature
- text Claire Helen & Jackie daily = starting to feel calmer & knew I was supported
- just a slight weep
- eyelid bruised
Claire PALS email
PALS = Patient Advice & Liaison Service. September 2024
This is not a complaint, this is very much a thankyou ! I am the neice of a patient, Kathryn Bromley, who had a biopsy procedure under Mr Glasman & his team last Wednesday 18th September at Arrowe Park hospital. My Aunt has bipolar disorder and finds changes to her routine particularly challenging. She has approached needing this biopsy ( and subsequent skin graft ) brilliantly & has managed the associated uncertainty and anxiety incredibly well. This is in no small part due to the wonderful care that she has received so far by the entire team working with Mr Glasman. She spoke of her difficulties to the pre-op nurse who was immediately accommodating and receptive to what my aunt needed in that moment to keep her calm, of the support worker who took her to the procedure with such cheerfulness & calm, and everyone in the operating theatre who took the time to be so supportive & clear in their explanations to her. As a doctor working in the NHS myself, I know how pressured the work is & how easy it is to feel too rushed to take that extra time needed. Without the exceptional care my aunt received from this team, it would have been harder for her to get through the procedure, and approach the next steps with calmness and positivity. Please do pass on my thanks to Mr Glasman’s team, including if it is possible to the pre-op team & the support worker , if it is possible to find out their names. Best wishes. Claire
PALS reply
Dear Claire. Thankyou so much for sharing Kathryn’s recent experience with the Opthalmology team. I have sent on your kind words to the management team to share with the wider team. Kind regards Lyndsey Hutchings. PALS. Patient Advice & Liaison Service assistant
SEAL Unit (2) at Arrowe Park Hospital = Reconstruction
- Wednesday 25th September helen help
- 7.00 a.m nurse quiet room
- 7.50 nurse sarah pre op checks
- 8.05 Mr Glasman = cancer all out Basal Cell Carcinoma / thank Claire for her kind email = shared with the team
- How have I been ?
- explained reconstruction procedure
- Dave support worker took me in wheelchair to op theatre area
Operating theatre
Sometimes all I can control is my breathing … but I knew I was in safe hands … just believe !
- Team ready and recognised familiar faces
- hands held throughout
- one and a half hours
- 75 soluble stitches delicate intricate work
- spent the time chatting re all sorts re golf / my website / neice Claire / psych team / my photography / football Bolton Liverpool & Tranmere / Geoff my tech guy & even my Canon Slade Grammar school in Bolton !
- all over by 10.20 a.m = phew ! Well done me !!!
- x2 big eye patches
- felt so very wobbly getting off bed onto wheelchair = they said it was the adrenaline
Recovery room & waiting area
- cup of tea & biscuit
- slight bleeding
- Helen left her cleaning job to come & collect me
Discharge letter
- Wednesday 25th September
- Consultant Mr Peter Glasman Ophthamology
- Diagnosis = Basal cell carcinoma of medial canthus Laterality = left
- Management = Reconstruction of medial camthus
- Primary Care Plan = eye pads on tonight
- Post Discharge Care = eye pads off tomorrow
- gentle cleaning with cooled boiled water & begin applying antibiotic ointment tomorrow
- the stitches are dissolvable
- after 2-3 weeks, when the wounds are no longer scabby, begin massage 2-3 times a day for a few minutes using firm pressure over the wounds and some vaseline / moisturiser
- Follow up Arrangements = follow up appointment to be arranged on due course
Aftercare
Started twice daily routine of cleaning wounds with cooled boiled water& applying antibiotic ointment. Pleased because I was ok overnight & no bleeding.
What helped to reduce the anxiety
- practising deep breathing throughout
- my Mindful Quotes ipad page
- Helen hospital car practice runs
- Helen being flexible to take me to key hospital appointments
- flagging up my bipolar and anxiety re stressful situations
- asking key questions
- needing explanations and getting clarity
- asking what the next steps are
- requesting & getting early morning appointment time
- possibility of appointment earlier in the week
- Jackie daily texts
- Claire daily iphone texts & sunday video calls
- Helen £ food shopping & offer of help if I needed in whatever way
- Claire PALS email & Arrowe Park hospital PALS email reply
Eye Clinic follow up
- Thursday 23rd January 2025
- Morning appointment Helen car help
- Nurse = vision check which was good
- Nurse = eye pressure check which was good
- Post op photos taken
Consultant with Mr Peter Glasman and his student
- How have I been ?
- How have I managed ?
- My feedback = no infection & no pain
- Consultant psychiatrist Dr Singh / my family & my friends all think I have done well & coped amazingly well
- Mr Glasman = yes you have … one of the calmest patients he has ever had !
- keep up x2 daily vaseline massage = put strong pressure onto bone areas
- ? my key questions = any sign of cancer / squidgy area / x2 firmer areas
- his feedback = no sign of cancer / you’ve coped really well /
- Re squidgy area = vision is good but can do a further reconstruction trim if it’s bothering me re my appearance
- Me said no cos I can live with it … its just part of my appearance
- reinforced to keep up further = daily firm vaseline massage down to the bone
- told him about my Playstation golf game
- told him that Dave support worker knows my good friends & neighbours Dawn & Mark
- told him about our family baby girl = congratulations hope it goes well
- am going to do a webpage called Cancer Courage & Care = is he ok about being in it ? 10k visitors so far & yes that’s fine with him
- yes so i will send him My World in Pictures card weblink in post
- am also going to do a personal thanks PALS email & he thanked me for that
- 6 months follow up check = July 2025 / he will contact me
My PALS email
Patient Advice & Liaison Service … helping people be the best they can be
I am a patient of Mr Glasman and wanted to express my thanks to him and his Ophthalmology team regarding the procedures and care that I have received since last September 2024. Throughout the whole process from the initial assessment, biopsy and subsequent reconstruction work I valued their grasp of my bipolar and anxiety issues, their calmness, clarity of explanations in addition to their patience, reassurance and his stitching skills. At no point was I in any pain and my mindful deep breathing kept me calm during all the various appointments and procedures. On behalf of myself, my family and friends and my Consultant Psychiatrist Dr Singh please pass on my thanks and appreciation to Mr Glasman and his top team. Regards. Kath Bromley
PALS Reply
Good morning. Thank you very much for your lovely email regarding your care under Mr Glasman & his Ophthalmology team. Please be assured that your thanks will be passed on to Mr Glasman to share with his team who were involved in your care. It is much appreciated by our staff when patients take the time to send in their thanks for care received. Once again thank you. Kind regards Julia. Patient Experience team
Thanks to GP Dr Clare Metcalfe
Thanks to Dr Roopa Karumanchery Dermatology at Clatterbridge hospital
Thanks to Mr Peter Glasman & all his top team at Arrowe Park Eye Clinic
Thanks to my Consultant Psychiatrist Dr Gandangeep Singh at The Stein Centre St Caths hospital
Thanks to my neice Claire, my helper Helen & good friend Jackie