For Audrey, with love

It’s Cat here, Audrey’s daughter. It has taken me some time for me to sit down and write Audrey’s last blog, something I have said to my dad Andrew and brother Chris, that I’ve wanted to do since she passed away. We knew she would want to say a proper goodbye after she was taken so quickly last year. There was really no time for her to process and express what her quick progression of her cancer meant for her and her loved ones (of which there are too many to name). What is important for her after many (documented through this wonderful blog) years aboard her rollercoaster of health, was that she died peacefully with family at her side. We sang songs to her - thankfully she was good at telling us her favourites over the years – and held her hands when she passed away. In life and in death, she knew how much she was loved.

For all of you who were able to attend her funeral, and to those of you who joined online or sat in quiet reflection of Audrey and what she meant to you that day, thank you. Everyone’s generous giving to St Columbas Hospice, a charity so dear to her, in her memory will help so many others. It was a very special service, delivered by her dear friend Sheila. Andrew has watched the funeral online since the day and expressed what an amazing job Sheila did. We truly are eternally grateful. I wanted to share the music we played at her funeral, we think she would have approved, and I invite you to listen to these songs and think of her when the time is right for you. We welcomed Audrey to Joni Mitchell’s ‘Both Sides Now’. We watched photos celebrating Audrey’s life to Karine Polwart’s ‘Daisy’ and sang together in ‘Caledonia’. We paused in our grief to Leonard Cohen’s ‘Hey, that’s no way to say goodbye’, and left to King Creosote’s ‘Favourite Girl’. Audrey loved music, from happy to melancholic, and we hope she would have approved of these choices and how the words meant something to us. The 4th of February was Audrey’s birthday, her special day. She would have turned 69. Audrey loved birthdays, how they brought people together in love, celebration and the pop of the prosecco. While she wasn’t a lover of being in the centre of the limelight, particularly in her 60th year, she indulged in year-round celebration, and an in joke was every time we raised a glass that year, we’d say ‘Happy Birthday Audrey!’ - we still do this now. Andrew came up with a beautiful idea to mark Audrey’s passing and arranged a leaf for her on The Hope Tree at Edinburgh’s Botanic Gardens. It was up just in time for her birthday. As her leaf says, this place was her heaven. So special a place to her, this is where we held her celebration of life after the funeral, so now it is an even more special place to all who knew and loved her. You can see her leaf on the tree in the West Gate entrance, and it will be on display in remembrance forever. We hope this can be a place to visit and feel close to her. I am sure Audrey would say that Andy is a man of great ideas, and this was one of his finest. Audrey has left a wonderful legacy, and a lifetime ambition of hers was realised in 2024 when she self-published her book ‘A Journey to Better Times’. Quietly determined, she worked on this book, sharing her story, insights, fears and vulnerabilities. One of her books joined her on her coffin, we could not be prouder of this legacy she has left. Writing was a great comfort to Audrey, in her book, and in her poetry, and Sheila read her poem ‘Journey to now’, which opens her book, at the funeral. Following this poem, Chris gave tribute at her funeral, and we were blown away with how he did, she would have burst with pride. Audrey handed on a gift of a way with words, and speaking and writing to Chris, and we could not have been happier with the tribute he paid to her. I have read back on her blog in preparation for sharing final thoughts here and feel she wouldn’t forgive an opportunity to plug her legacy! Here’s a link to the book to buy and it’s also available on kindle Andrew was incredibly proud to hear from Audrey’s friends the Alliance (Health and Social Care Alliance Scotland) in the new year, a charity Audrey co-founded, and who hosted her book launch last year, seeking permission to rename an award at their annual award ceremony. The Alliance proposed a dedication to her by way of ‘The Audrey Birt Self Management Champion’ award. She would have been very moved, and humbled to be given this honour, and it is a beautiful way for her name to live on. Audrey gave her life’s work to nursing and improving health and social care for people in Scotland, and this is an honour very fitting to her and all she achieved.

In her book and blog, and social media, Audrey wrote about her pets, and their importance in her life. She shared that after Cara their beloved dog died, Koshka the cat became a lap cat, much to her amazement and utter joy every time (sometimes with the encouragement of her cheese) he jumped up on her lap for a cuddle! Well, I am pleased to share Koshka continues in this loving mood, choosing Andrew’s lap (and his electric blanket) over anywhere else to rest. Audrey would be so comforted to know this display of love and companionship lives on between them. For Audrey’s family and friends, we take comfort in each other’s company and remembering her in all we do. It is painful, and will always feel painful, that new milestones and experiences in life with come without her there. But her memory is alive and ever present in all the hearts she touched. Really, I wanted to use her platform to say a proper goodbye to her friends and readers, an opportunity that she sadly couldn’t have. I want to thank our family and friends for their enduring support as we collectively grieve her passing. She was the best wife, mum, sister, aunty, cousin, friend, colleague and super granny we all could have ever wished for. For one final message, I took her own words from the last blog she wrote, ‘Thank you, Andrew, with all my heart’. Rest in peace Audrey - 04/02/1956 – 06/08/2024

Rollercoasters and life with cancer

 

What goes up must come down.

I remember the chant from our favourite Disney ride in Florida. It’s beyond corny with chipmunk voices and puppets along the train route of Big Thunder Mountain. The ominous warning within the song as the wee train gradually climbs and then it comes-the drop-the cheesiest of roller coaster delivers the thrill. Wide smiles and pleas of can we do it again? Our kids were still young enough to enjoy the simple joys of Disney.

I was never particularly interested in going to Disney but after Andrew went on a business trip to Orlando, we decided that we should treat ourselves. It was the year after I had breast cancer for the first time and a year since my Dad had died. Our lives had been heavy and hard, with too few smiles and too many tears.

I’d love to tell you we planned it financially and budgeted wisely but no-it was way more impulsive. We blew a hole in a credit card and gave ourselves an early Christmas gift in October and had a blast! We laughed for two weeks and made memories. It was a different kind of therapy but therapy it was. And there were tears too as i realised my fatigue could not be pushed through and the 

tamoxifen caused a sleepiness a bit like that caused by pregnancy. I learned to create space for that and not to fight it. Finally it helped me accept this rather than rail against it. I don’t remember how long it took to pay off the holiday and don’t try this at home folks! It’s how credit cards make so much money but in a funny sort of way it saved us as a family. I’m not even sure what I mean by that but it was a significant stage in our lives and I’m grateful for that.

So why am I thinking of Big Thunder mountain? It’s because I recognise these last few months I’ve had a good spell, I’ve been happily enjoying that. Making plans, getting tickets for Edinburgh fringe, organising visits and pushing all concerns about secondary to one side. But these last few I’ve not done so well. Most noticeably my legs are swollen and won’t go down and I’m feeling queasy and the fatigue is back. My eyes close like the dolls we used to have when I was little, tip her slightly and she closed those eyes without effort at all!Thats me. I find myself saying please don’t take it personally. It’s not you, it’s me! 

Or more accurately I’m anaemic again….likely it’s caused by the oral chemo I’m on. The reduced dose means I’ve tolerated it for longer but it’s finally accumulating in my system and my quality of life has declined again and some of my plans look less certain or that my pacing needs to be tighter. Of course I knew logically this would happen but I’m heading back to a less certain time and if I can identify a feeling related to that it would be sadness. And an associated reminder to be grateful for all the special people I have in my life. 

And greatest thanks of all to Andrew because he enables me to do what I can and without him I’d be able to do a fraction of what I can. I don’t thank him enough I suspect. But please all of you who know him feel free to tell him how special he is. 

With our friends new puppy.

Thank you , Andrew, with all my heart ❤️. And right at this minute he’s making my favourite dish, cauliflower cheese. The smell is permeating the downstairs of the house. Making the favourite meal for someone who feels nauseous all the time is a real act of love. ❤️ 

Are your days special?

It’s been a quiet writing time. But for good reasons in the main. Last weekend we had a special time with friends. We weren’t far from home but it felt special with the sea close by, beautiful food and wonderful company. The day we came away I got my last scan results and they were really encouraging. The cancer in the liver was slightly reduced so the cancer is being controlled even with the reduced dose of olaparib. I feel so very fortunate. Instead of the potential to count my future in months that’s now opened up. No guarantees of course but hope opens up some possibilities. So at least summer comes with some optimism and I’m so grateful for that. 

I’ve had some opportunities to talk about my book and next month I’m doing a compassion salon. Compassion salon It’s a great concept when people explore compassion in the context of their work and life. My link is my life and the book. Element 10 is self compassion. But it’s a theme that traverses the whole of the main message of the book. Compassion is the backbone that builds the core of the ten elements. 

Promoting the book has helped boost my wellbeing because although I have stage 4 cancer and my future is uncertain, it reinforces that I still have a contribution to make and that makes this special time in my life and even more precious. I start my book saying my wish is when people read the book that they find hope and purpose from it. 

It’s certainly given me that…..thanks to all of you who have enabled me. 

I was so moved recently by the last message from Rob Burrows the rugby player who  died from MND. His spirit shines and his compassion for himself and all of us is evident from the twinkle in his eye and the wisdom of the message itself. Do have a look and as Rob says make each day special because from where I’m sitting, they truly are. Rob Burrows

Finding Hope and Purpose.

 

I’m hesitant to say the words but in the main I’ve had a settled time with my health. I’ve a million smaller complaints and I have tried to thole them. Just build them into my normal and accept that someone in my position will have many symptoms and that chasing all of them is the way madness lies. 

When Beverage planned the NHS he thought that if everyone had access to free healthcare at the point of need then the need for the NHS would decline. But instead he discovered the onion principle. That as you peel off one layer of illness the another emerges.

And that’s what I’m like, I get on top of managing one problem and symptoms from something else emerge. I’m almost embarrassed to talk about the long list that affects me. 

The truth is distraction helps at least initially. But the trouble is……..at night it’s so different. I’m less sheltered from my daily reality. And I’ve noticed that time seems to pause or stretch each minute. Sometimes I awaken around 11 having slept for just over an hour and fear encompasses me. Is this my night ahead? Checking the time and groaning in pain whenever I change position. My back has been so troublesome that at my last hospice appointment I asked for a massage from the therapist. What a good move that was and frankly it’s not been as bad since then. It’s always a plus to find a non drug solution.

I’ve also had the chance to talk about my book with a group of health and social care professionals. It’s such a buzz to hear what the book stimulates in others. I’m booked to speak to a book festival in the summer and a local compassion salon. It’s exactly what I hoped would emerge. I miss working, especially coaching and developing policy from those with lived experience so any chance still to do that is just wonderful. Here’s a link to the book to buy . https://www.ebay.co.uk/itm/394965421080 It’s also available on kindle https://www.amazon.co.uk/Journey-Better-Times-long-term-conditions-ebook/dp/B0CM82XJTS?dplnkId=9bd2d467-50e2-48a6-8431-414798dceaaa&nodl=1

And the final treat for me was the hospice newsletter covering my story and putting my photo on the front page! Thanks so much to that team for totally understanding what I’m trying to say in my book and giving me a platform for it. 

Because they know that although I have stage 4 cancer and my future is uncertain, I still have a contribution to make and that makes this special time in my life even more precious. I start my book saying I wish that people will read the book and find hope and purpose from it. 

It’s certainly given me that…..thanks to all of you who have enabled that. 

Is this the terminus?

In the recent  interview with the BBC they referred to me as terminal. That word triggered lots of people I know to be in contact me. It’s not a word I use. I’m not even sure it’s accurate. The world of secondary breast cancer is now a journey into the unknown. So far the only drug that’s worked for me is olaparib and it’s only available off license to me. No one knows how long it will work and right now I’m working on the basis I’m doing ok and hoping it will stay like this for a very long time. I set some dates in my head….if I can get to…..but don’t say them out loud for fear of tempting fate to have a different plan. I’m taking  wise advice on building up my nutrition and well being. And generally taking time to smell the roses……..or more accurately watch the blossom. It’s joyful catching the avenues of blossom around the city. 

We once visited Japan and more specifically, Kyoto during the blossom festival. The array of delicate flowers interspersed among the temples was so exquisite. So delicate  and precious it was impossible to capture in a photo or in text. Japan is an enigma to me. A land of contrast and I saw so little of it. I didn’t see Hiroshima or read more about the impact. And after that we went on to Vietnam to be tourists yes, but also to visit our son who was working there. Could a country be more of a contrast to the beautifully designed Japan? Vietnam or more specifically Hanoi at the start of our holiday, has a temple around any corner, a plethora of streets selling one type of clothing etc. There is for example a street of shoe shops, a street with all clothes, one with jewellery  and so it goes on. And then you see the French influence of croissants and baguettes for sale alongside the opportunity to breakfast on pho as the locals do. What was so apparent was that the warmth and friendliness of the Vietnamese is a contrast to the Japanese whose culture favours the inscrutable. It was a fabulous holiday, the type I can only dream of now, given my health and lack of mobility. 

So this summer the goal is to enjoy time with family and precious friends on closer shores but nonetheless beautiful. Scotland too has a treasured scene around many a corner and at this stage in my life that is more than enough. 

And back to that word, terminal. No I'm not there but I know it’s coming but till then I’m living…not dying. I started this poem and so far it’s only one verse…

 Terminal

Is it where the bus stops?

That cold spot in winter

when home beckons 

out of reach

a bleak spot.

Or so it seems from here,

so far from the terminal

and not far enough. 

The space between here and where?

 I am thinking about how to capture this space between life and death.  But Is it fair to call it that? After all in this space I’ve launched a book. I’ve planned webinars, I’ve been interviewed about assisted dying. In many ways it’s a fertile time, unfettered by work or demanding expectations. The photo below was taken when I was interviewed by the BBC about my thoughts on the issues with regard to the assisted dying bill in Scotland. A challenging issue for which there isn’t one answer. But it’s a good time to explore it. 

The greatest demands for us however come in the shape of a 15 year old tabby cat who has suddenly  become a lap cat from one who was aloof but friendly. We’ve tried to analyse him, perhaps he too was grieving our dog Cara who died exactly a year ago. 

Initially he shunned her bed, a bed he’d chosen to lie in daily during her life then walked away from when she finally succumbed to the growth that stole her later years. She was never aloof -more all embracing and verbose. This year that we’ve learned to live without her has found him emerge with a cheeky confidence; no longer last in line for the left over cheese. Now he spends some time each day curled up on our laps, snoring softly and ever alert for meal times. His transition is so welcome and I hope we are each meeting others needs equitably. He’s maybe just needing more comfort with the passing years, as we are too. Whatever the cause it’s so welcome. 

So this time in my life is about living not dying. But the limits of my energy reminds me daily that this is not a normal stage. On Friday we went to see Hamilton and I was wowed by it.But I could only get evening tickets and even as I was lifted by the music,the talent the whole experience the energy leaked out of me and affected my pleasure in it all. I want to watch it again and savour the experience it offers. In truth it’s not just Hamilton, I’m losing my evenings as I struggle to hold on to the life I have now and letting go of what’s no longer possible. I’m still learning the signals that say stop and unlearn the life long ones that pushed through tiredness and illness. 

Mmm it’s all news and part of me doesn’t want to let go of what was just yet.  

Scanxiety?

 

It’s not peculiar to cancer but waiting for results can be the worst time of all. Last week I had really quite bad scanxiety. Yes it’s so bad it’s got its very own word. I had a follow up scan after a few months on olaparib at a lower dose. The truth is I’d been tolerating the drug fairly well apart from anaemia. So I’d had a transfusion after feeling the effects of anaemia; from breathless, swollen ankles and being a sleepysaurus. It helped me and life has been a bit better. BUT was it stopping the cancer ? That was the question and so I approached the scan with some trepidation. 

The scan itself was simple but it’s the wait for result that starts to have an affect. The day before I was due to the clinic for the result the Secretary of the consultant called to ask if I could come at 1 pm rather than 12.10. It would save me waiting I was told. And that set the anxieties off. I imagined all sorts of reasons that on reflection seem so tenuous. But essentially I was being delayed because it was bad news. I was finally seen at 1.35. And by then I was truly scared. The door to the consultants office opened-How are you? he asked and I mentioned a couple of things then said but I’m really scared about this scan result and waited. 

Well it’s good, shows that the cancer is under control. I slowly breathed out. Not shrunk but stayed under control. I will take that I say. So a few more remarks and I was out the door, planning the summer and not looking back. 

Keep taking the tablets, look out for signs of anaemia and ask for a transfusion. I can do that. We then went away for a few days with good friends and enjoyed every moment. Happy days. We’ve even booked another trip together- life is good. 

But tomorrow I have an MRI to look for any issues with my pituitary which might have contributed to the adrenal insufficiency that has resulted in a very low cortisol. It should be fine. But when the machine plays its discordant symphony I defy the stress levels not to be affected. And then it’s waiting for the result. But I’m sure it will be fine…….won’t it?