Hello and welcome
Some of you by experience will have heard about a bone cancer called Osteosarcoma, a type of cancer that can affect any bone in your body, in
my case it was found in my left femur (Distal femur).
Here is my story.
It all started back in August of 2021, the family had been on a trip to west midlands safari park the previous day, I was complaining of leg pain all
the way round the walk through, I put it down to stopping and starting whilst on the safari itself. The following day I had been cleaning my car in
the afternoon, when finished, I headed into the house to see the grandkids playing. I stumbled on one of the toys, hit the floor like a brick and
heard a loud snapping noise, I knew at that very second I had broken my femur bone just above the knee. After what felt like an eternity,
medical staff arrived and knocked me straight out with ketamine, they then whisked me off to my local hospital. The Doctors there were baffled
how a fall in the living room could break a bone that commonly would take a major accident to do. They took a series of x-rays, I was in so much
pain and could barely bring myself to eat, I kept asking and asking the staff what’s going on? Why isn’t anything being done to fix my leg? Every
time the answer came back “ were still trying to work out the best possible approach”.
After several weeks of agony and frustration, a doctor came and informed me that I would be taken to the Royal Orthopaedic Hospital in
Birmingham (ROH from herein) for a biopsy, “for a biopsy of what” I asked, “of your Femur” he replied, the team had reviewed your X-rays and
think your bone was weakened with a cist, this is why it broke so easily, it would also rule out anything else that would have caused the break.
The next day I was shuttled to the ROH, the day after I went to surgery for the biopsy and shuttled back to the manor hospital (my local). I spent
the next few days asking questions and talking to other patients on the ward about their experiences, although I had a broken femur, I felt so
lucky looking and hearing the stories about other patients.7 days passed and finally the doctor came to give me the results, “Mr Birch” he’s said
softly, the results have come back and unfortunately they are inconclusive, as I understood what that meant I simply asked him what happens
now then? “well we have been in contact with Professor Abudu at the ROH” he said, he and his team think it’s a benign cist that weakened the
bone, because you have been laying in pain for 5 weeks he is going to operate, this would be a plate fixation to hold the two fractured bones
together, usually with around 12 screws. All I wanted at this point was for it to be dealt with, I had already lost over 2st in weight.
October 3rd 2021 came around and I was transported to the ROH, I met with the professor who was kind and compassionate to my case, the
operation would take place tomorrow 4th. Believe me I was so ready for this to be over. Nurses and a porter took me to theatre around 10.45 am
that morning, I woke up in recovery at 15.20pm, not being able to feel my leg or any pain, I took a quick glance under the blanket to see my leg
heavily bandaged, with wires and tubes coming out of it. Later that day Mr Abudu as promised came to my bedside and said “we have fixed your
femur with a plate and screws,” “we have also scraped out the bone and sent it for biopsy.” The team at this point think that indeed it does look
like a benign cist, “focus yourself on recovery and the pathology will call you to give you the results in around 14 days.” Taking on board what he
had said and that he must have seen this hundreds of times, i trusted his comment and did exactly that. The next day the dreaded Physio team
entered my room, “its time to sit out in your chair David” he said, “remember you are non weight bearing,” I managed to get out and sit in the
chair for about 30 minutes before the pain kicked in. Day 21 came (post op) along and it’s the dreaded removal of the staples, Trust me when I
say it was pretty darn uncomfortable to say the least. Doctors had suggested I could go home in a few days and sent occupational therapy to see
me, they asked me if I had arranged everything at home, a downstairs bed as I wouldn’t be climbing stairs for some time, a downstairs toilet, a
resting chair and somewhere to wash. My wife had arranged all this whilst I was in hospital, even though she has health problems of her own
she came good AGAIN! There had been a gofundme set up for me that really helped with the cost incurred doing all the above, the kindness of
others is overwhelming at times, and I can’t thank each and every donor enough for making my life so much easier, as you can imagine, my
savings had gone, and I had to sell my car to make ends meet, I had not planned to spend my savings on equipment, travel and other
necessities, but as you all well know life doesn’t always play out as we want it to.
The day arrived when I could go home, due to COVID rules I had not seen my family for 6 weeks, to say I was elated would be an underestimate.
Being home was great and seeing the Grandkids was wonderful, lots of questions I had to answer too, the weather had turned and it was getting
chilly outside. Waiting for the histology report was killing me inside, then I got the call from the oncology department at the ROH, expecting to
hear them say “the biopsy hadn’t shown anything sinister” I put the phone on loud speaker so my wife could hear. The lady on the phone
explained who she was, then read out the histology report, unfortunately cancer cells were present and the diagnosis was I had Osteosarcoma,
a rare type of bone cancer in people of my age. Everything went fuzzy and I felt sick in the pit of my stomach, Nicola (my wife) broke down in
tears on the settee, I asked what would happen next, and was told I would get an appointment within 2 weeks to see an oncologist at the Queen
Elizabeth Hospital Birmingham (QE here on in), obviously I had many questions that couldn’t be answered at this time, so I wrote them all down.
Appointment day came and myself and the wife visited the QE as scheduled, Dr Sherriff my Oncologist was very understanding and patient, it
was determined I had stage 3 Osteosarcoma in the left distal femur, I would be scheduled to have 3 cycles of chemotherapy then an operation,
at this stage it couldn’t be established whether I would lose my leg. Having to operate again so quickly would in itself be difficult. If there was
any good news to be taken away from this meeting, it was the fact treatment was with a view “to cure”. We went home waiting every day for
the phone to ring to say they had a bed, 16th November the call came in, a bed was ready and could I be there at 09.00 the next day to have my
PICC line fitted, this is the tube that chemo would be administered through. Packing my case, both myself and Nicola talked about how I would have to go through this on my own, due again to COVID regulations.
PICC line fitted I was transferred to the ward and booked in by a nurse, I introduced myself to the other patients and unpacked my case. The
ward doctor came to see me later that afternoon and told me what regime of chemo I had, also the type of chemo. I was having Doxorubicin
and Cisplatin, the former had earned the nickname “Red devil” due to its colour and side effects. Sounds pretty horrible doesn’t it. That
afternoon two nurses came to my bedside, one of which was a trained Chemo nurse, “it’s time to start your chemotherapy” she said. The two of
them cross checked specifics and hooked me up to the Bag of chemo, Red devil first over 30 mins, then a flush and Cisplatin for 1.5 hours,
followed by another flush for 4 hours. The same regime was repeated at day two. All was well for a few days later, then I felt like I had been hit
by a runaway train, I felt sick, couldn’t eat and was running a temperature, due to go home on Friday that week, the Dr informed me that I
wouldn’t be going until my symptoms calmed down somewhat. The following day I felt even worse so the doctor came and took some bloods to
send off to the lab, I really did feel unwell, I couldn’t face food and could just about manage to keep water down, because of this I was put on
intravenous fluids, each bag lasting 8 hours.
The guy in the next bed was incredibly kind (John), he kept me sane, we chatted all the time about different things, he really did keep my mind
busy, a man I will never forget. A few days later the Dr came and advised me that I had unfortunately contracted Neutropenic sepsis. This was
serious, but how on earth did I get an infection on the ward? The nurses explained that being in hospital, patients more at risk than if they were
to be at home, I got that to be perfectly honest. I just wanted to be home for Christmas, although there were people on ward to talk to I felt
lonely, my wife and I had always been at each others side, it was affecting her too, not being able to visit. Due to me not eating I had now lost an
incredible 3 stones in weight, Chemo tongue has kicked in overnight out of nowhere, a painful blistering of the tongue, a reaction to
Doxorubicin. 21st of December came and Dr’s told me my infection has cleared and I could go home, I was so looking forward to seeing my wife
and family.
Chapter2
Christmas held mixed emotions for me, on one hand I was able to spend time with my family, the other, I was still feeling pretty unwell even
though the infection had cleared. Watching the grandkids open their presents with the aroma of roasted turkey in the air was worth a million
quid. New year came and went far too quickly and it was time to think about Round 2 of Chemo, waiting by the phone yet again felt like I was
waiting to go to prison. 15th January came and I was back on the ward, I felt a little dejected knowing what I was about to endure.
17th January came “D-Day” in goes the Chemotherapy, I knew what was coming in a few days and oh boy did it come, I couldn’t stop throwing
up no matter how much anti-sickness they gave me, something felt wrong this time, my stomach felt really horrible. I had been telling the
nurses for hours before the inevitable happened, I needed the Commode and I needed it pretty quickly, I kept pressing for assistance then
eventually a Commode appeared, I hardly had chance to get on it when my bowels decided to dispose of its contents, that happened every 30
minutes for around 5 hours, i was absolutely knackered. The Dr came to see me the next day and advised that a sample had been sent off for
culture, it’s where the lab grow germs and find out if there is any infection. Just my luck the day later the Dr came and advised me I had
Gastroenteritis, yet another infection I had contracted whilst in hospital. Staff put me on a course of antibiotics and a drip to rehydrate, a few
days later I felt a little better and even managed some soup 🍲. The next few days I spent focusing on trying to eat more and get around the
ward in my wheelchair, I was lucky I had a side ward and a view onto the helipad, the football pitch was also visible to the side, others had no
view to speak of, they simply looked out at other wards facing. Home time came again and this time I was looking forwards to tasting my wife’s
Chilli Con carne, I know that sounds a little sad but I really was, I arrived home and before I even got in the door I could smell it! Yet again the
wife was there waiting, I had a mouthful of the chilli and oh boy, it burnt my mouth so bad, it would seem my taste buds had suffered at the
hands of Chemotherapy. Still I was not going to surrender to Cancer.
I spent quite a good period at home this time, being with the wife was simply amazing, she took care of me in every way, washing, cooking and
making me know how much she loved me. I had an appointment with the professor at the royal orthopaedic 16th February, this was to talk
about the next course of action he and my oncologist would be taking, the options were pretty obvious, amputation or prosthesis. I got called
back to the ROH on the 24th to see Mr Abudu, it was good news he could save my leg, the bad news was, the chemo had only contained the
tumour not shrunk it however, the operation could go ahead. More bad news was a part had to be made to measure and would take about 6
weeks to manufacture, in the meantime I would have another round of Chemotherapy just to contain any further development. He gave me a
preliminary date for the operation of first week in April, my sights were firmly set on this date, I had to be strong enough or it would not
happen. Mid March I was back in the QE Birmingham having my PICC line fitted for another round of chemotherapy, this time they struggled to
get the line in but persevered after about an hour. 2 hours later and the bleeding still hadn’t stopped. Finally after about 6 dressings the
bleeding stopped, and chemo could be administered, a nurse came in and advised me I was being moved to a side ward, I asked why but never
got an answer, once i had been moved to the side ward a nurse came and advised me i had tested positive for COVID yet again! A few days in
and I noticed my leg and foot had swollen (left), I mentioned this to the Dr who arranged for a doppler scan, the scan confirmed what I had
suspected myself, I had a DVT, what else can the world throw at me I thought. I sure hope this wouldn’t affect my operation first week in April,
Doctors reassured me that it wouldn’t affect my operation. With that in mind I just rode out the effects of chemo and started on blood thinners.
Dr Sherriff came to see me the day after and told me that Mr Abudu wanted me to have IVC filter fitted. IVC filter explained- An inferior vena
cava (IVC) filter is a small device that can stop blood clots from going up into the lungs. The inferior vena cava is a large vein in the middle of
your body. The device is put in during a short surgery. I was able to go home for a week before I was going to be admitted to the ROH for my
operation, again the wife was an angel, looking after my every need, at times I simply do not know what I would do without her by my side.
Chapter 3
April 5th 2022, I was back at the ROH in Birmingham, I will be taken to the QE Birmingham to have my procedure done (IVC filter), I didn’t realise
that the procedure was so technically challenging. A wire with the filter attached would be passed through a vein in my neck down to the
Inferior Vein down in my stomach, I had to remain still, very difficult when someone is baring pressure down on you neck! Prior to the operation
I was advised that if the filter didn’t sit right clots could get passed and cause an embolism, no pressure then huh! The procedure took around
40 minutes and was carried out successful by a team of around 7 people. I was allowed a cup of tea and transported back to the ROH the same
afternoon. 7th April and it was time for me to go under the knife of professor Abudu once more, he would be taking out the plate he previously
put in along with 80% of my femur bone, he will then replace it with an Endoprosthesis (EPR). This was another major operation and I was
indeed a little anxious, the team greeted me in the anaesthetics room and explained pretty much every step of the operation that was about to
begin. It’s a rather extensive surgery with many risks. I did however keep telling myself, the story could have been far more life changing if
amputation was the only option available.
I spent a few nights in ICU as I had been given 2 units of blood and my core temperature was a little low. The team there were absolutely
incredible, a dedicated nurse station at the end of each bed, monitoring everything as it happened. Back on the ward I was allocated a side
room, again with a pretty decent view of the garden area, squirrels and birds visited nearly all day. The following day a nurse came and told me
she was going to take off the packing and redress my wound, I was a little shocked at the length of the wound covering that was on my leg, it ran
from below my knee to just below my hip. By the time the nurse had finished dressing my wound the pain was intense, the nerve block had
been taken out prior. That night was very uncomfortable, having to lay on my back for the last 7 months was hard, I was able to get a pillow
behind my knee which did help. Physiotherapy came the next day with a leg brace, it was fitted and the flexion (bend) set at 10°, basically it
means when you stand the brace will stop the knee bending passed 10°, something that would be altered every week. Standing was really
painful but the best way forward, I really didn’t want my leg to be stuck straight with no bend, apparently the first 6 weeks are the most
important where flexion is concerned, if I could get to 90°, it was likely that anything beyond that would be a bonus.
Over the next few days I noticed a lump developing where the drain had been taken from, I mentioned this to the doctor who said it looked like
an haematoma, a clotting of blood under the skin, he said he would keep an eye on it over the next few days. Eventually it subsided and I felt a
little less anxious about it. The next week was made up of physiotherapy and trying to find an appetite, those of you who have spend longer
than 7 days in a hospital knows the menu repeats on day 8, you can mix it up but choices are limited, I do however understand that hospital
catering has to provide meals for hundreds of people, so having a fixed menu makes sense. The day came when it was time to have my staples
out, I wasn’t looking forward to it as I remembered last time! It went without any problems unlike previously when a few clips just wouldn’t
budge. New dressing on and a few hours off from wearing my leg brace, it felt really nice. Home time after nearly 4 weeks with a plan that
histology would ring with the results from the tissue they took from my leg during the operation.
Chapter 4
Getting home after such a long time was like being handed the winning lottery ticket, I know hospital staff and Doctors look after us when in
need, but there’s nothing like having family in close proximity. The Grandkids were pleased to see me and my wife stepped right back into carer
mode, she is an amazing woman and the backbone of our family, she too has health issues but never once complained about anything. It was
around 2nd week in may the hospital histology dept called and advised me that NO cancer cells were present after the last tissue was taken, a
massive weight lifted from my shoulders, we were all elated, we had been on edge for a few weeks wondering what was going to be said. I had
to attend the QE Birmingham on the 30th for a pre chemo check, bloods and COVID swab, a 28 mile round trip can be tricky on the M6 at the
best of times. With that complete I went home and was put on “bed watch” again, sitting by the phone waiting to see if that morning or the
next and so on, had a bed for me on the ward. 2nd of June I’ve got a bed, could I be there for 6pm same day. The wife and I had already packed a
bag so we were ready in that respect. I arrived on the ward and the nurse booked me in and said my PICC line would be fitted in around an hour,
I’d arrived at 5pm so the staff were also ready for me. After 2 attempts of pushing and pulling the specialist finally got the line in situ, I knew by
tomorrow my arm would be black and blue from all the stress. And oh boy did it bruise! But I was at least ready for what was coming, the next
morning in came the two chemo nurses checked off the chemo and started the IV. The first day went well without any complications, except for
the arm, it felt painful and heavy. Day 2 and the cycle starts again, 2hr fluids, 30 minutes Doxorubicin, 10 mins steroids, 30 mins flush, 4 hrs
Cisplatin, 2hrs fluids, 30 mins flush, 2hts fluids, Cycle 4 complete. So 10hrs and I’m done! Silly me, why did I say it was all going well? Day 3 it hit
me like a brick, sickness, fatigue and one hell of a fever kicked in, I hated this part of the cycle, for me it was a given factor of receiving
chemotherapy.
Knowing I still had 2 full cycles to go was on one hand good news but on the other, not something I would look forward to. I was really ill this
time and after several days of tests the Dr informed me that I had yet again got Neutropenic sepsis, commonly caused by bacterial infection with
Gram-positive pathogens such as Staphylococcus aureus, Enterococcus sp, Streptococcus pneumonia e and S. The next week I was in and out of
it, I can’t really remember the day it ended, but I did remember the care and support from all the staff at the QE Birmingham, I’m sure without
their intervention I would not be here today.
Chapter 5
July soon came and went, most of it spent trying to get back some mobility and recouping from another bout of Sepsis, again the family,
especially Nicola got me through some pretty dark days and I had found a bit of an appetite at last. I had noticed late in July that my leg had
started to lose a little flexion, very slowly but surely by mid August it had almost locked up, one morning I woke up early because I felt something trickle down my thigh, I looked down and my scar seemed to be oozing. The following morning I rang Professor Abudu’s secretary
and told them what was going on, within two days she rang me back and said the Professor wanted to see me urgently, could I make it to the
hospital tomorrow, I said I would and did. At the appointment Mr Abudu checked my leg over, looked at me and said “unfortunately David, this
is being caused by a deep infection” we need to book you in quickly for a debridement and washout of the prosthesis, it will I’m afraid mean
opening up your leg again (3) to access the problem. My wife and I embraced, we knew another long stretch in hospital was coming. I received a
call two days later, can I come in today early for a pre-op and then stay in, the operation would be the next day. Arriving at the hospital the ward
staff couldn’t believe it, what on earth are you back here for again David, they said to my wife, can’t you keep if just for a few months! I can only
imagine how Nicola felt, here one minute in hospital the next, that’s how it had been for nearly two years, since my first operation to correct a
broken femur.
The day of my operation came and the professor came to see me, he explained what was going to happen and that unfortunately it did mean
the full length of the previous incision would need to be opened up for access. When I came around from the anaesthetic I thought it was the
same day, it wasn’t however, I had been in ICU for 3 days, nurses told me that I had been very poorly after the operation, they had given me 2
units of blood and started me on very strong Antibiotics. Knock on the door, in comes Daniel the physiotherapist who had previously seen me on
my last visit, “I’ll be back tomorrow to start getting you mobile David” he said, get some rest until then. I tried to rest but was rather
uncomfortable from the pain, leg was heavily bandaged and a drain kept snagging on the bed rails. Physio was hard for the following week but I
managed to push myself through, Daniel had done all he could now it was down to me, I managed to get a stool by the sink so I could wash
myself down but had to rely on the carers to wash my left foot. One morning I looked down at my leg and noticed the oozing again, I was
frightened this time because I knew this was the exact reason I was admitted in the first place. The professor came in to see me the next
morning and asked the nurse to fit a vacuum pump to my leg, I had no idea what on earth he was talking about so I asked him, he politely told
me the vacuum pack helps to draw out the infection whilst healing the wound.
Here’s an explainer..
I had this in place for about 8 days, it was taken off and a smaller vacuum replaced it, OMG the alarm bell on it, due to loss of suction or
pressure was doing my head in, I asked the nurse if it was a necessity and she said “until the chamber was empty of fluid it had to stay on,” 4
days later it was removed much to my satisfaction. I had been in hospital 5 weeks at this point recovering from what seemed to me the hardest
and most mentally draining 5 weeks of my life. I’d been bombarded with fluids, antibiotics via IV, had two vacuum pumps fitted and subjected to
intense physiotherapy. My body was weak I was mentally drained and was missing my rock Nicola. I was allowed to go home the following week
and given a regime I must agree to, rest but keep the leg moving, the community staff would come out daily for the next 3 months to give me IV
antibiotics and check the wound, take bloods and blood pressure. Gradually whilst at home I started to get a good appetite and started putting
weight on, it sounds silly but it made me feel and look better for it, I was able to walk 10 feet and back using elbow crutches, most of all my
dignity got better having banished the Commode to the outhouse! Weeks then months passed and my first check up went well, all was moving
forwards albeit a little slowly.
Chapter 6
My follow up scan was clear too (3 monthly). This was the case for the next follow up too, on the 3rd scan (CT PET) two lymph nodes lit up,
oncology was concerned that this could be sinister but the professor at the ROH thought it was highly likely still enlarged from a recent skin rash
on my leg. He arranged for me to be seen again on the 20th October for another CT scan, I’m hoping all goes well.
I guess this journey has taught me to stay strong, even in your darkest moments reach out to loved ones for support, remember they are
suffering too, watching a loved one go through this ordeal is hard, I know because the woman looking after me, my rock, my wife Nicola has a
brain tumour debulked in 2013, it was and still remains one of the most mentally draining periods in my life. Now together we face yet another
period because it’s grown back, she has had 28 cycles (days) of radiotherapy, now we await the results, she has an MRI pencilled in for March
2024.
Never surrender to Cancer it will take you, fight and ask God for guidance, there is no shame in asking, believe and prayers can get answered.
Thank you for reading my story, may God bless you and give you strength to face whatever challenges come your way.