Colour my ward

Cancer keeps moving, initially by stealth, often just a solitary mutative cell that multiplies to form a tumour or affect other cells.  Cancer might behave slyly for years but without treatment it will eventually mount a deadly attack.

 

Each year hundreds of thousands of people across the globe die from cancer.  Every organ in the body is susceptible.  The disease just never stops.

 

Once it is inside the body it is hard to get out.  If it wants it will spread from one organ to another or into the lymph glands.  Cancer does not discriminate.  It does not care who it affects and it is merciless.

 

Teresa (Terri) Windred was diagnosed with myeloma at 55 years of age.  Myeloma is cancer of the plasma cells in bone marrow.  In Australia, about 1200 people are diagnosed with the disease every year.  It generally affects the elderly and is more common among men than women.

 

The disease prevents normal production of blood cells and affects the creation of antibodies.  Abnormal plasma cells in bone marrow can expand and destroy the bone from within, leaving people with myeloma vulnerable to fractures or broken bones.

 

As abnormal plasma cells expand, the bone marrow is unable to produce normal blood cells, leading to low levels of red blood cells and platelets.  This leaves patients at risk of infection, commonly known as sepsis, due to decreased levels of white blood cells.

 

As the disease destroys the bones, increased levels of calcium are carried by the blood, which affects the kidneys.  Fifteen percent of patients experience kidney failure as a result of myeloma.  Some will die from kidney failure.

 

Almost fifteen percent of people with myeloma die within three months of diagnosis.  Patients who survive those initial three months must keep fighting, because myeloma has a subsequent death rate of fifteen percent annually.

 

Do the numbers.  That fifteen percent annual mortality rate keeps building.  Fifteen becomes thirty, which becomes forty-five.  Simply, the longer patients live with myeloma increases the chance that their next six months could be their last.

 

After Terri’s initial diagnosis in 2006 she raged at the injustice, trying to pinpoint the reasons why the disease chose her.  She was fit and healthy, running, swimming and taking part in low level triathlons on the Sunshine Coast.

 

‘We all smoked,’ she said of her younger years, but it’d been decades since she quit.  ‘And I drank too but I’d been fit all my life.’

 

Her first session of treatment in the oncology ward at Nambour General Hospital was intense.  Terri was frightened, disruptive and angry, why me, and she was difficult to deal with.

 

‘Before I was diagnosed I had no idea what myeloma was,’ she said.  ‘I didn’t know what oncology was and I was in shock the first few times I was here for treatment.’

 

Shock meant aggression and rudeness, traits she rarely exhibited in the course of her normal life.  She owned a hair salon, which demanded a vibrant personality all day, every day.  Following the diagnosis she worked in a daze, fashioning hair on instinct, overcome with mortality, unable to shake the thought that she had a disease that killed people. 

 

 ‘I was in a situation I had no clue about,’ Terri said.  ‘I felt my freedom was taken away and the staff bore the brunt of that.’

 

Her doctor, Jeremy Long, received the worst.

 

‘I kept telling him I’m not supposed to be here,’ Terri said.  ‘He kept telling me that I had to keep coming back for treatment.’

 

Treatment for myeloma includes chemotherapy, steroids and stem cell transplantation.  Drugs like thalidomide and bortezomib are also used to fight the cancer.

 

Bisphosphonates are used to treat bone degeneration and associated pain.  Patients who experience kidney problems are given erythropoietin to counter the effects of anaemia.

 

Myeloma is an uncommon disease with a swinging nature of symptoms.  No set course of treatment has proved successful.  Different things must be tried because drugs or procedures that work on one patient don’t always work on another.  Side-effects can cause major issues.

 

As Terri was undergoing treatment, she was also undergoing experiments, that drug didn’t work as we thought so we’ll try another one.  Those first few weeks were harrowing.  She went through the raft of normal emotions cancer patients feel, anger, hatred, bitterness and then the determination to fight. 

 

After the first few rounds of treatment she came to terms with the fight.  The surly, uncooperative attitude was dumped in favour of a positive approach.  She would approach life and treatment with a smile and an I’ll be alright temperament.

 

‘People think you get cancer and then you die, but it doesn’t mean your life ends when you get diagnosed,’ she said. 

 

Gradually Terri’s sparkling personality emerged.  She would kid around while receiving treatment, engaging with other patients, eking out a smile or a chat.  Afterwards she would return to work at the salon, determined to live life as she normally would. 

 

The staff in Nambour General Hospital’s oncology ward loved her for the energy and excitement she delivered.  Several became her clients, sharing painful moments with her inside and outside the ward.

 

Nambour General Hospital’s oncology ward is staffed by 53 people, team members they prefer to be called.  In the past year they have provided almost 7000 occasions of service, including 3528 rounds of chemotherapy.  They work hard.

‘Each time I come to the oncology ward I see how beautiful the staff are,’ Terri said.  ‘They are the best people and the work they do is vital.  The amount of people they treat here is amazing.  They just never stop during their shifts.’

 

In August, having been a patient of the oncology ward for almost six years Terri made a request before fronting for treatment.  She wanted the staff to dress colourfully, fancy dress was better. 

 

Nambour General Hospital’s oncology ward is like many wards in most hospitals.  Patients are under no illusions where they are.  The ward might not be drab and the staff are friendly and professional, but it remains an aid station filled with medicine, equipment and clinical staff.  It is foreboding and intimidating.

 

Colouring the ward, Terri suggested, would provide a welcome distraction from the agony of treatment and double as a fundraiser for the Leukaemia Foundation.  Clinical staff were happy to oblige, wearing all manner of garments to work, pink scarves, outrageous wigs, shockingly colourful shirts and flannelette pyjamas.

 

Terri entered the ward to whoops of delight, wearing an outfit inspired by Sarah Jessica Parker.  The skirt was white, decorated with orange and yellow patches.  A pink scarf around her neck matched her hair.  She wasn’t wearing a wig, having dyed her hair specially for the visit.  White pompoms in her hair provided the flair. 

 

Pushing her walker slowly in front, Terri shrieked with delight as she met people who’d dressed up for her.  The laughter continued as she moved through the ward posing for photos, hiking up her skirt in the best seductive pose she could create.

 

‘Without you guys I wouldn’t be here,’ she said to the staff that surrounded her.  ‘You are unbelievable, you’re like angels.’

 

There is no cure for myeloma.  Terri had fought the disease for six years and aside from those initial sessions, she cheered the ward during each visit. 

 

‘I’m much more fun to deal with now and I play up a bit,’ she said.  Playing up meant talking, cracking jokes about life and disease, moving around the ward.  Simply, she provided a welcome distraction.

 

Playing up caused her some grief during a stay in the Royal Brisbane Hospital.  Undergoing stem cell treatment, Terri was overcome with boredom and convinced another patient to flee the ward.  They went upstairs, somehow gaining access to the roof, gazing at the city and the suburbs.  When a helicopter flew into the hospital, Terri’s mischievous nature emerged again.

 

‘There was only one thing to do,’ she said.  As the chopper landed on the helipad, Terri and the other patient lifted their shirts and bared their boobs.  ‘We got into a bit of trouble for that,’ she said.  It was clear she didn’t regret it.

 

For the past six years Terri actively raised funds for the Leukaemia Foundation.  Educating the community about myeloma became her mission. 

 

‘Given what has happened to me, I wanted to spend the rest of my life raising money for myeloma and cancer research,’ she said.  ‘It is important to make the public aware of myeloma because it is a hideous disease.’

 

Few people in her circle of friends and clients had heard of myeloma.  Terri, without expecting sympathy, told people what the disease was capable of.

 

During August, Terri knew her fancy dress visit to the ward would be her last.  She’d hoped to remain strong enough to undergo another round of stem cell treatment in September, which may have prolonged her life for another five years.  Instead, she was aware of what was happening to her body.

 

Terri was dreadfully ill during that last visit.  Time was short.

 

Clinical staff surrounding her were aware of how advanced the disease was.  Despite the howls of laughter there was an undercurrent of sadness.  Terri knew she was going to die.  Everyone else did, too.

 

She was brave during that last visit to the oncology ward, behaving on instinct, ignoring the demands cancer made on her body.  It might’ve been a fundraising event, but it was also her last chance to say farewell and thank you to the clinical staff.

 

Terri didn’t undergo any treatment during that last visit.  Her long fight was over.  Cancer claimed another victim in late August.  When Terri died she was at home surrounded by family and friends. 

 

Acting Nurse Unit Manager Ann Kennedy said Terri’s memory would live on in the oncology ward.

 

‘Every time Terri came in for treatment she always brightened up the ward,’ Ms Kennedy said.  ‘All our patients are special but Terri had that ability to make our long term patients smile, which made their time here a little easier.’

 

The staff loved Terri.  Nurses came in on their day off to be there for her last visit.  It was also their chance to say goodbye to a woman who fought bravely for six years, a woman who changed attitudes, including her own, over that long, arduous fight.

 

‘Terry was an inspiration for everyone because she refused to take a backwards step,’ Ms Kennedy said.  ‘It was an honour to treat her and to be her friend.’

 

Despite Terri’s spunk and spark, she looked older than 61, stooped, gentle in step and needing a walking frame.  That is what cancer does.  It ravages the body, always moving, no matter how much the patient keeps fighting.

 

Terri fought hard.  She was a rascal, and that’s how she’ll be remembered, but the legacy she left extends beyond the risqué attitude and spicy behaviour.  She wanted to teach people about myeloma, perhaps inspire someone to make a small donation to the Leukaemia Foundation.

 

Terri had donated all the fight and vigour she had to Nambour General Hospital’s oncology ward.  Cancer was a struggle but life could still be fun. 

 

In the months before her death, Terri had a friend make a short film about her life and fight with cancer.  The film was to be a tribute to Terri and a documentary about a disease few people are aware of.

 

In those final days, as Terri slipped away, she remained hopeful her life and experience might help the next person diagnosed with blood cancer.

 

 

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