The Unwelcome Guest

Those reading this blog who have prostate cancer and are on hormone therapy will know that the spring-loaded needle that drives the hormone implant into the luckless victim’s abdomen can sting a little. My last injection was administered by a doctor with the skill set of a porcupine in a hurry. In our house he’s now known as the South Lambeth Road Slasher (SLRS). For him it’s not so much an injection; more a drive-by shooting.

With my next injection due, I called the GP’s surgery to book an appointment with the nurse rather than a doctor and told them to make sure the Zoladex implant needle was in stock. Turning up two days later I tapped my details into the computer on the reception desk and guess who I was down to see? Yes of course, the Slasher himself.

I gently suggested to the lady on the desk that I didn’t want to waste the doctor’s time and would be very happy to see a nurse; only to be told that there was no nurse on duty. Finally, I had to admit that I didn’t have full confidence in the SLRS and asked if I could have an appointment with someone else on Monday or Tuesday. This didn’t prove possible at which point the lady on the desk volunteered to come in and hold my hand.

After agonising over the potential agony, I agreed to let the Slasher do his dirty work and waited for him to come and call me through. When he appeared, I gave a big wink to the ladies on the desk, all three were now in on it, and they burst into laughter. Hearing this the doctor said ‘I guess everyone’s so happy because it’s Friday’ which made everyone laugh some more.

This is where the story doesn’t build to a jabbing climax as It soon became apparent the pharmacy hadn’t delivered the hormone bazooka and I was able to escape unharmed from the clutches of the evil genius.

Unfortunately, I’ve just checked my voicemail and I’m now booked to see the Slasher on Tuesday. Will I escape unharmed, will I bottle out, will some kindly nurse come to my rescue and will this story ever get to the point? Stay tuned.

Slasher update

Pitching up at my GP’s surgery on Tuesday at 10.30, I tap my details into the reception desk computer and am rewarded with great news. The Slasher has been left on the bench and I’m seeing Nurse Angela for my hormone injection.

A shout of joy (mine) wakes up a couple of the older patients who are asleep in the waiting room’s heat. They look vaguely irritated, wonder what’s going on, but are soon back catching flies. So, it’s big news, the Slasher is side-lined.

Nurse Angela has been at the surgery for years and while she’s never skewered me with a Zoladex shot before, I’m mightily relieved it’s her doing the skewering and not you-know-who.

Because it’s a fairly serious procedure and being the professional she is, Angela wants a doctor in the room. A young medic enters, and I suppose out of professional courtesy she asks the doctor if he wants to give the injection. As you can imagine I’m having none of it and make it very clear if anyone’s going to ram a needle into Jim’s abdomen on the 15^th January 2019 then that rammer is Angela.

The doctor steps back and Angela asks me how long I think she’s been giving injections. I hazard a guess and say two weeks. She laughs and says actually it’s 45 years.

The needle is unleashed, explodes into my belly with almost no pain whatsoever. My next shot is 9^th April. I’ll be booking Angela early to avoid disappointment.

Practise Nurse

Having read the original article, Marnie, a practise nurse, got in touch. She has some interesting insights:

‘Although this injection (Zoladex) is fairly standard, originally nurses were not allowed to do it, only a doctor and back then they used to use a local anaesthetic. Over time nurses became deemed competent to do it, so that job is generally handed down. Research also shows that the local anaesthetic causes more problems than it solves so we stopped using it quite some time ago.

As with any task we do, we get better the more we do it, even in a very large surgery there may only be 2-3 patients on it at any one time so our skills can get a little ‘rusty’.

Because of this it is often left to one person only for these appointments, so they can keep their skills polished up. The drawback is, this treatment should not be delayed and if a (member of) staff is off sick, or (has) left, someone else should take over to make sure it is given on time. A new nurse or locum may not yet be trained to do it, so it is down to ‘slasher’ as a temporary solution.

I give my patients the choice of standing/sitting/laying down when they have it, sometimes a different position may help reduce the pain. I have even over the years had the odd patient who learned to do it themselves, rare but if you are brave enough!!’

This reminded me that the very first hormone injection I had was at Guy’s Cancer Centre where the nurse gave me a pain free shot standing up. I’ve suggested this to other nurses and doctors who’ve looked at me like I was mad.

Unfortunately, Marnie is also a cancer patient and is waiting on scans to see if her treatment has worked. Thanks for getting in touch Marnie and I sure hope it has.

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