Michelle_Richer

A big thank you for everyones support, especially Kate_N and Jan McNulty, at least I can face this procedure with some optimisum. I have just returned home after seeing the Surgeon at Peterborough City Hospital and he has said my operation will be sometime in either May or June providing the Anaesthetist is happy. I will get an appointment so see the Anaesthetist in the next couple of weeks or so. I did mention to my surgeon that my Specialist Cardiologist from Boston is happy to urgently arrange a Dobutamine Stress Echocardiogram to help demonstrate the fitness of my heart to withstand the anaesthesia for the Right Hemicolectomy operation. The stress test exercises the heart whilst I am lying down, the dobutamine make the heart run faster and stronger than normal, whilst the echo cardiogram detects any abnormalities in the hearts response. However the surgeon declined and said it could be offered once I had seen the Anaesthetist. Time-line: My stay in Peterborough City Hospital 7 to 10days. Fitness to drive after discharge from hospital 2 weeks (providing I can steer and do an emergency stop properly). Athletic fitness for Ballet training 6 weeks. For the time being I’m off the low fibre diet, I will be given special instruction nearer the time, however I do know that I will not need to do the bowel cleansing as with the two previous procedures thank goodness. I must confess when I attended both Boston and Peterborough hospitals for these consultations, I really felt out of place as if I shouldn’t be there, I felt a bit of a fraud, most other patience looked really poorly, there need was much greater than mine. Back to pointe training this week Whoopee

A big thank you to everyone for your kind and supportive words. I guess the Colonoscopy today went reasonably well, in term I had it without any form of pain control or sedation. I ask the clinician that was carrying out the procedure to give me a commentary all the way through, bless him he was really good. When we got to the real problem area, he positioned me on my back so I had a screen to myself to see the growth inside my colon, which gave me a much better understanding of the issues. According to him he has no dought that it was cancer, although he did take a number of bioses from around that area. Because there is a high probability that the results are positive, they should get the results from the lab in 1 to 2 weeks rather than the usual 4 to 6weeks. Although I have an appointment booked with the surgeon on Monday, and I know from one of the multi-discipline team nurses that he is considering a Right Hemicolectomy, that is a major operation where they remove half of the colon, needles to say I'm not very comfortable with that, also I have seen it quoted in some medical stat that 1 in 20 patients loose their life under that procedure, not sure when it was dated. However according to my clinician today, I may not be fit enough for such an operation due to the condition of my heart and my iron deficiency anaemia (oxygen carrying capacity of the blood), thats why they have taken another blood sample today to check my Full Blood Count including my iron level since I’ve been on a high dose iron tablets, hopefully it may have risen substantially. I have also been doing a bit of research and there may be merit in colonic stents that work in a similar way to stents in arteries. The cancerous growth presents itself at the bend between the top of ascending colon (RHS) and the transverse colon (across the top of the abdomen), the folds appear very enlarged (swollen) and bleeding, and the hollow in the center for the poo to flow through, very restricted. As a result I have been asked to remain on a low fibre diet, otherwise I could easily become constipated and block that junction completely. I am to remain on that diet until the MDT team decide what action to take. The funny thing is the low fibre diet consists of a lot of unhealthy things I wouldn't normally choose to eat eg White bread, plain cake and plain biscuits, ice cream, jelly, custard, milk, eggs, potatoes, cheese, cream, plain yoghurt, butter, sugar, honey, clear jam, boiled sweets, plain /milk chocolate. I can and do normally eat these and these are on the list too: skinless chicken, grilled or poached fish, I guess Chicken could included duck or turkey too. As the future is uncertain until Monday, I think it pretty likely I will be back at ballet next week and possibly the week after, especially as I need to be home on the 24th for Adrian's Brothers funeral, then who knows and it really scary.

I have for the time being had to stop my ballet training for several things that have come together all at once. Firstly Adrian's brother has died, not only was it quite traumatic, especially when we and the family were asked about turning his life support off, I think we all had a little weep at his bedside, we are now left with disposing of his possessions, and applying for probate which we Adrian and I are half way through, as I have been there before. On top of that I have had a number of medical developments. Firstly the urgent 2 week appointment that was made for me for a colonoscopy, where the paperwork said “if I didn’t hear anything after the first week, to contact the hospital”, which of course I did and was told it had been cancelled as my GP had sent the wrong paperwork in, he had used the wrong pathway. After a lot of toing and froing, he made arrangements with a different hospital, Peterborough City Hospital. When I collected the paperwork from my GP’s surgery it didn’t state what the procedure was, I queried this with the admin team and said with my symptoms it should be for both upper and lower GI as per the British Gastroenterology Society guidelines, she said when they call you, you can discuss it with them then. No call, I simply received a pack of laxatives with instruction to prep for a CT Colonography (CTC) procedure, at the time I mentioned it to CTC clinicians and was told that is what the multi-discipline team recommended. After the procedure I was told I would be given an outpatients appointment by post to discuss the findings. Things then moved very quickly bypassing outpatients all together, with an urgent phone call. As a 3cm growth was identified the other day with the CT Colonography, I have been notified of an appointment for the next stage a Colonoscopy on Wednesday the 10th, they ask me to go in on Friday for a blood test as they didn’t have a recent eGFR result, while there I ask them for the Laxative and info pack as there wasn't much time before Tuesday when I have to take it. Unfortunately the eGFR figure determines which laxative to use. The gave me Moviprep but told me to phone in Saturday morning to get my eGFR result, if it was below 30 then I would need to go back into Peterborough City Hospital Endoscopy department and they would change the laxative to a different type, fortunately it was 49, so I didn’t have to go back in. Friday afternoon my phone was very busy with calls from the hospital, I was also notified I had another appointment on the 15th with a Mr Alexander Hardy, the surgeon that has been allocated to me, fortunately I was able to get from the nurse on the phone what the appointment was about, the procedure they are looking at for me is a Right Hemicolectomy. This is where they cut the colon in half and remove the grown and the affected colon area, then join the other two ends of the colon back up again. I mentioned I was worried that I was likely to end up with a stoma bag, but she reassured me that isn't usual with that procedure, but if something went wrong she couldn't guarantee it. I receive another call from the hospital from a lady on the multi-discipline team telling me about Wednesdays Colonoscopy and I queried why it was necessary as I already had a surgeon allocated to me, she was surprised that news had already got through to me before her. She explained that in the Colonoscopy they would be taking a biopsy and would tattoo the growth to identify it for the surgeon for when he operated. This may be wishful thinking, if the week of the 15th I have no other medical appointments / preps, I would at least like us to get my usual pointe and Pilates session in on Thursday the 18th April, but I have a feeling that the surgery will follow my appointment on the 15th almost immediately. Goodness knows when I will be restarting ballet, let alone fit enough to perform on stage.

Hi Janet I think it depends what meds you are on, this is shortened version of the NHS Guys and Saint Thomas's guidelines: 4 days before your colonoscopy Stop taking any medicines that contain iron, I take 300mg twice a day Continue to take all other medicines as usual. Eat and drink as normal. 3 days before your colonoscopy Stop taking any medicines that contain codeine phosphate (which is used to treat pain,a cough and diarrhoea). Stop taking any medicines that contain loperamide (which is used to treat diarrhoea). Im not sure but this may apply to Aspirin which I take as a blood thinner. 2 days before your colonoscopy It is important to drink plenty of fluids. Try to drink 2 litres (about 8 to 10 glasses) in aday. You need to start having smaller meals. The things that you can eat or drink are listedbelow. This helps the bowel preparation solution to work properly. Do not eat foods containing fibre. This is found in fruit, vegetables, pulses and grains,such as wholemeal bread and cereals. 1 day before your colonoscopy Medicines Take your regular morning medicines, unless you have been instructed otherwise. Try to take your usual morning medicines before 10am and your evening medicinesafter 9pm. Your body may not fully take in medicines between these times. This isbecause of the bowel preparation solution that you will have. Stop taking any bulk-forming laxatives (which create a heavy, more liquid-like poo thatis softer and easier to pass). These include: isphaghula husk (such as Fybogel®) methylcellulose (Celevac®) bran sterculia (Normacol®) Food and drink Have a light breakfast, such as boiled egg on toast (white bread), no later than 9am. After breakfast, do not eat any solid food until after your test. Drink clear fluids only today. Try to drink 2 litres (about 8 to 10 glasses) in total throughout the day (not includingthe bowel preparation solution). You can drink tea or coffee with a small splash of milk. Do not drink alcohol. Bowel preparation You need to start taking bowel preparation solution the day before your colonoscopy. Follow the instructions and timetable you are given for the solution that you are taking.Do not follow the instructions on the packet. The solutions taste better if they are served chilled. You may want to mix the solutionsin advance and keep them in the fridge. You need to use them within 24 hours ofbeing prepared. The day of your colonoscopy Food and drink Drink plenty of clear fluid. You can drink up to 3 hours before your colonoscopy. Do not eat anything. Bowel preparation It's important to take your bowel preparation solution at the right time. This dependson if you have your colonoscopy in the morning or the afternoon. If your colonoscopy is in the morning, take your bowel preparation solution at 6am. If your colonoscopy is in the afternoon, take your bowel preparation solution at 10am

I'm still hanging in there doing pointe work, even though I don’t seem to be progressing very much, I am at least holding my own. The new meds “isosorbide mononitrate”,with their slow release do seam to be helping as it extends to 10hours, yes I do notice the difference then and especially at bed time when the effect is really depleted. That said, although I still get the arm angina, the pain is somewhat less than it was but I still get the breathlessness with exertion. Also since I’ve been on the new meds, I’ve stopped taking the GTN spray and that is now reserved for real emergencies. I have finally got an appointment for my 3 month follow-up with my Cardiologist specialist at 5 months, even though the appointment letter has lots of false assumption in it, it clearly was constructed in a hurry, but alas that's been taken over by more recent events. My original stool test was rejected by the labs as I think the container leaked and I had a second FIT (Faecal Immunochemical Test) to do, the result from that was positive, that together with my iron deficiency I guess flagged up the possibility bleeding due to Cancer. Last Friday evening I got a phone call from my GP telling me of the result, and making it clear I was at risk of cancer. He ask me to call into the surgery Monday morning to pickup a 2 week urgent referral letter, and someone from the Hospital would be getting in touch with me by phone. I have no other brief than that. Oh poo, there is a conflict at the end week 2, Adrian and I will be in Liverpool. My referral letter has a phone number for me to ring, if no one has contacted me during week 1, I have to ring on Monday of week 2, however I tried today to try and get things in before Adrian and I go to Liverpool, but without success. As I have very little to go one as its virtually impossible to get a face to face with my GP, I have to do my own homework and try and make sensible assumptions. If a FIT test is positive and iron deficiency anaemia (IDA) The British Gastroenterology Society recommends that IDA should be investigated with both upper and lower GI endoscopy. The lower GI endoscopy otherwise known as Colonoscopy requires a 4 day prep before the procedure according to the NHS Guys and St Thomas's Guidelines, I'm really not sure how the NHS this end will handle this with the 2 week referral, especially if the documents are sent out by post. Lets just hope what they find is not down to the big “C”, but something that's more treatable, fingers crossed.

Hi Angela Thanks for your comment in your last paragraph, great minds think alike. Hi Linda As for joining the Silver Swans, bless them, they wont have me. In any case although I'm not making any real progress I have been doing a hour and a half pointe work session with Kim my ballet coach for most weeks as I suspended working on the La Bayadere Rep. You could probably add another 5 or 6 hours at least of steady pointe work in my own studio each week. So just doing your 10 to 15mins pointe at the barre isn't really practical. As you know my real passion is performing rep, rather than doing 45mintes at the barre or attending a Silver Swans type of ballet class. However about 3 or 4 weeks ago I was inspired by Giselle at Ballet in Cinema, particularly the first pas de deux, which appeared to be quite gentle in spite of a few soft grand jetes. Kim and I decided to see how feasible it would be for me to dance the most significant steps, our first session didn’t go too badly, this last week we danced it up to and just past the ballottes a couple of times before I was exhausted. Kim my teacher thought my stamina had improved from previous weeks but was still along way short of what I need to dance it from end to end. I really do think it has possibilities, although I know it will be a bit of a struggle at first. At least its captured my imagination out of the doldrum for the time being. To be fair I don’t think Adrian and I would have sufficient Giselle rep ready for our annual showcase this year, so we can take our time to develop it slowly as my body starts to mend, hopefully it may. After Thursday I thought thing were beginning to go really well. However Friday morning that feeling was soon dashed as I had one of my regular physio sessions, unfortunately it about 10mines walk from the town car park. I was reasonably ok walking there after a couple of stops to catch my breath, but the return journey wasn't as nice, I was seriously very breathless by the time I got back to the car, in-spite of using the GTN spray on the way, probably made worse with the very cold weather. Hi NeverTooOld Thank you for answering my questions, not an awful lot I can hang my hat on. However I find it quite interesting that your pulse rate managed to reach 120bpm, when my Rehab nurse advised 107 was the aiming point and especially as you are on Beta Blockers too. When Kim my pointe teacher and I was measuring responses against exercises I reached 120 doing Echappe en croix for a full music track, as we do for most pointe work exercises. New updates Whilst having a conversation with my Cariology consultant's secretary, I manage to get an email address so I could email in 4 pages of questions for my consultant. I managed to do that and got an acknowledgement from his secretary, but no reply from him to-date. However my GP received a request from my consultant from Cardiology to issue some new medication “isosorbide mononitrate”. Reading up one it, its slow release tablets for preventing angina rather than reacting too it. I haven't got any yet or instructions associated with it, but I’m presuming it may replace the GTN spray. The results of my latest blood test are showing things up since the op which needless to say I'm not happy about: 1) My glucose level is a couple of points too high indicating I may be at risk of developing type 2 diabetes. 2) My Serum ferritin level is very low, so I have been prescribe iron tablets twice a day. 3) There are 5 levels associated with my Full blood count that are low, according to a telephone conversation with my GP I could be loosing blood somewhere, consequently I have to submit a stool sample to see if there is any blood in my poo. So things are not going as well as I first thought.

Thank you all for your kind comments, as it is I haven't quite given up, I'm a bit in no man’s land as I really don’t know what the future holds or what to expect from those that could possibly help. About 3 weeks ago My GP said she would try and pull my 3 months follow-up appointment forward, I didn’t hear any thing from that. The three months is now passed, so last Monday I contacted my consultants office, they had no record of my follow-up, they advised me to contact the clerk at the Intensive cardiac unit at the hospital I had the Angioplasty at. I contacted them and clerk assured me that my consultants office had been notified, however she did say she would pass the info through again and someone would telephone me on Tuesday to arrange the follow-up appointment. You guessed it, it didn’t happen, Wednesday I called my consultants office again and my details still hadn't arrived, I said I would check the following Monday and if they still hadn't arrive, I would call a Lincoln hospital the following Thursday and walk them through the system myself. I received a phone call today from the secretary of my consultant, they now have the info but they cannot do the follow-up appointment until April and that is a long time to wait for answers to questions I have. Hi NeverTooOld That's fantastic that you already have experienced some of what I am going through, I guess the only difference is my rehab nurse said she couldn’t offer me the sort of exercise program that they normally offer as I was already doing more than enough( training 5 days a week). However I wonder if I can pick your brains, and ask if you don’t mind to share your experience of the following: How long did it take you before you started to see an improvement in stamina? Is there anything specifically that you have found that improves stamina? How long were you before you started to do grand allegro in class? Do you use GTN spray, if so how often do you use it? Do you use the GTN spray in anticipation of exertion in class? Do you only use it, if you get Angina chest pains? Do you know what the maximum pulse rate you have experienced during exertion in class or rehab exercises?. Many thanks x

As it been quite a while since I last posted, this is a bit of an update and so so sorry for its length. Firstly Adrian my partner had his second follow-up appointment at Moorfields eye Hospital just over a week ago, this was quite a worry for us, as the cancerous growth in his eye at the first follow-up had actually increased in size and the specialist weren't sure if the Proton beam therapy had been effective. The natural progression if the cancer continued to grow was removal of the eye, which would have been very traumatic for Adrian. Adrian and I had spoken about this before hand, and we agreed if the wort came to the worst we would push for a second session of proton beam therapy if it were humanly possible. On the day we had a phone call from Moorfields asking if we could come an half an hour earlier for our appointment, and of course we said yes. We arrived in time to grab a something to eat at the Hospital cafe and checked for the appointment about 15mins earlier than our new time. We even got to see our first clinician ahead of time, our second shortly after, the second did a scan so I was keen to ask him how it compared to his first follow-up, but he declined to answer and said we would have to wait and see the doctor. You can imagine what we thought, he also told us with an apology that there would be a 30minute wait before we would see the doctor. That 30 minutes turned out to be two and a half hours. Finally we see the doctor a very switch on young lady, first she carried out quite a detailed scan which clearly displayed the growth in green, the measurement thankfully showed shrinkage had finally started, she also followed it up with an ultra-scan which checks the depth of the grown. She was very happy with the progress so no more therapy, but the growth will be continued to be monitored at Moorfields every 4 months, with cancer guard monitoring of liver and kidneys at Addenbrooke's every six month as a precaution. Although we had to wait two and a half hours to see the doctor, for that news, it was worth it and my eyes couldn’t help but well up when the doctor gave us that news. Now Adrian truly is on his way to full recovery, its his turn to look after me. About 3 months ago I was in Hospital after a heart attack, if someone had said, when did you have a heart attach and what was it like, I really couldn’t answer that question. I guess to a large extend its probably been the way I have been living as if I’m indestructible. Thinks of note was during the summer we needed to replace our oil tank for our central heating system, I had arranged for 4 of us to do it as it weighed 136Kg. Various things happed where Adrian's prostrate op had been moved and he wouldn't be available, similar where my brother was no longer available. As this tank was sat on our drive strapped to a pallet, the thought crossed my mind “I wonder if I could move it”, you guess the rest, with scaffold boards across the lawn I could push it, scaffolding and pulley's I could lift it, with pipes underneath it as rollers, I could position it on its platform. Hey presto this ballerina did it all by her self, but I guess it did take its toll. Something probably more relevant was pruning our laurel hedge, as it had got well and truly out of hand as Adrian wasn't able. Most of it was no problem but the top was quite wide and difficult to get at, also it needed 4 to 5 feet removing from it. That took me the best part of 2 weeks during the summer break, perched on the top of a 12 foot set of steps with a long reach set set of pruners. I noticed I started to get a pain in my left arm, the arm that was extended and doing all the work with the pruners, it even still ached in bed at night. At first I thought is was a pulled or overused muscle, but it didn’t really go away. In the back of my mind I remember one of my brothers having a pain in his arm which turned out to be a heart problem which was many years ago but it wasn't at the forefront of my thought. Finally Adrian and I took a late holiday to Scotland in September as Adrian was about 5 weeks post of from his prostrate operation. One of the days we decided to do the rail journey from Oban to Glasgow, as I had never really explored the city before. As Adrian was still recovering and couldn’t walk very far, I found him a nice seat outside a cafe in one of the shopping centres and left him there while I did a quick rekkie round the City centre for future reference. As usual I was power walking very quickly to cover as much of the city centre as I could in 15 to 20min, then I started to get chest pains that I had never had before, it really worried me as I wasn't even sure I could get back to Adrian. I remember priming my phone with Adrian's number in case I needed to call him quickly and noting the street names as I went by them to return to him. Eventually I got back to him, then we returned back to the station very slowly with several stops on the way for me to get my breath. If I had a heart attach, I think that must have been where it was. Once home that incident seamed to be a bit of a blip, however I did phone my brother Pete and his advice was to go to see A and E right away, I declined and said I would see my GP instead. I remember it was a Friday and I contacted the GP’s surgery and ask if I could book an appointment to see my GP Monday morning, it was declined, they don't do it that way any more, I would have to phone my GP to book a call with him, he would phone back later and if he thought it necessary, invite me in for a consultation. Monday morning, it was barely after 8AM, I was 20th in the que, 45minutes later I managed to book the call. When I finally spoke to the GP he said he would put a blood test form out for me but couldn’t see me until the following Thursday, I told him to forget it and I would go to A and E. Adrian and I went to A and E in Boston, as it was possible heart problems we were placed fairly high on the priority list and went through triage quite quickly, eventually one of the nurses came back to us and said “we are going to have to admit you as there is an antigen in your blood test has revealed you have had a heart attach” From Boston I was transferred to the Cardiac at Lincoln and underwent an Angiogram, normal they would fits stents as part of that procedure, but not in my case. I was told I had multiple blockages and it would have to go before the Multi-discipline team to decide the way forward next Tuesday. In the meantime I was assigned a nurse as my representative on that team. Much of my discussion with her was about the options especially coronary artery bypass graft CABG surgery, unfortunately they didn’t do that at Lincoln and I would have to be moved to Nottingham where there was a 2 week wait for beds and a further week for the operation, also the recovery period was much longer. All I could see was, it would end my ballet forever, as the only milestone I had was Christmas 2022 when I had a problem with one of my toes and took a 3 week break from pointe work, which took me 5 weeks to catch up again. CABG surgery from what my nurse said looked realistically like a 6month break from ballet with pointe work. Tuesday came and Adrian was visiting me, the nurse came in and brought a doctor who too was a member of that team and needless to say I thought the worst. However they had decided to treat the two worst blockages with stents and the rest with drugs and blood thinners (Aspirin), the doctor said are you ok to have the procedure this afternoon, of course I said yes. That procedure was out of this world for me, as I arrived at the cath-lab everyone knew my name and were extremely nice, I had a really interesting chat with the professor in overall charge. The guy doing the actual procedure through a catheter up my right arm was asked to give me a commentary, which he did. A cannula was inserted in the left with a drip to protect my kidneys as this was my second Angiogram/ angioplasty. They discharged me the following day. The beginning of the second week back home I was back up on my pointe shoes, the second week back I was back at my pointe class, a week later I had intended to rejoin my regular ballet class at Stamford, but we didn’t make the minimum number of dancer (5) so it didn’t go ahead, since then to some extent my own condition had declined. At the moment I'm still doing one-to-one pointe work at Lincoln and Pilates a couple of times a week. Although I had intended to rejoin my on-line pointe class last December, our BT lines had accidentally been disconnected by the Outreach maintenance engineers from the 4th December until the 11th Jan, im in dispute with them at the mo on compensation, so I never managed to rejoin my online class. At the moment as pointework was a very hard hill to climb, there is no way I want to loose that and start again as I know I would never make it. As for normal ballet class, I very much dought I could handle even a beginners and grand allegro would really floor me. Two weeks ago Kim my Lincoln teacher and I decided to try and run through one of our Shades solos that we originally planned for this years showcase. As its some time since we last danced it, we decided to walk through the first shades solo from La Bayadere at 70% of its normal speed, when we got to the end diagonal, which is a sort of hopping arabesque alternating between flat foot and demi-pointe over something like 26hopps. Once I heard that music I had to give it a try, I must have missed the first 6 or so hops before I decided to go and managed to get through it. I remember before COVID dancing this pieces as part of the BBT performing group, several of our dancers complaining how difficult this was, although in those days I could dance through that section twice and think nothing of it. As Kim and I had this music on a loop, when the track restarted I tried to dance through it, I managed to get to where there is a little combination that has a grand jete, attitude turn, pas de buree and pirouette repeated 3 time, I managed twice and was totally breathless laid flat out on the floor. At the moment I almost having to treat my medical own condition as a scientific study, Although I have a rehab nurse allocated to me she contributes nothing other than politically correct statements that are more appropriate to an infirm geriatric old lady. Firstly there are some strange conflicting observations, If I go upstares to make our bed I get a really nastie ache in my left arm, at worst it extends to my thumb where I can feel the pulse in it. I have a bluetooth pulse rate detector which should be strapped around my abdoman just below my breasts and the results read of a smart phone, as the results were not as reliable as they might be , the strap was moved to above the bust which works well. I set a start point from being fully relaxed lain on a settee which give a pulse rate of 60bpm, walking up the stairs pulse rate rises to 80bpm and breathing rate increases too, by the time I get into the bedroom and start making the bed the pulse rate reaches around 95bpm, at that pointe the arm ache comes on, it remains on until the pulse rate drops too below 65bpm. Now the conflicts: I can go outside in the garden and start work, I feel really tired and short of breath to start with including the arm ache, after a while (about half an hour) those symptoms go away and breathing becomes more normal. I have had several instances of this, its quite repeatable. Kim and I have measured heart rate against various pointe work exercises and have set a heart rate of 80bpm to represent a resting warm-up rate for measurement between exercises. According to my rehab nurse I should be working toward and not exceed 107bpm, all but one exercise we well exceed it. The model I’m using to predict my heart rate is Fox and Brawner, specific for Coronery Artery Disease with Beta Blockers which I am now on. I'm also applying endurance banding according to the Karvonen method which this estimates ideal target heart rate in 10% intervals through range 50% to 100% maximum predicted heart rate for ones age. That fits in well with what we have measure. My theory of the left arm pain is in fact Angina with referred pain into the left arm from the left side of the heart due to the confusion at the nerve bundle where they both converge. A more common occurrence is left arm pain with chest pain from the heart in heart failure or Angina which I do not have. This is also accompanied with shortness of breath which is also consistent with Angina. One of the medication for treating Angina is GTN Spray, which is supplied to me on prescription, at first I didn’t take it as I had no chest pains. As the instruction provided with are inadequate for me I'm having to test it to find out the full dynamics behind it. First test: As there was a lot of walking involve travelling via underground from Kings Cross to Moorfield hospital I knew my arm would be aching and I would be short of breath by the time I got to Moorfields hospital and noted the following GTN spray instruction before an event : “To prevent an angina attack the usual dose is one or two sprays under the tongue immediately before you do the activity that is likely to bring on an angina attack, for example before doing exercise or going out in the cold.” It worked, however I noted an unpleasant event when I took it. I was on the train just past Stevenage and I took 2 puffs of the spray and it was a bright sun shiny day, I started to feel nauseous and the brightness started to close in, I thought I was going to faint, slowly it pass off by the time we got to Kings Cross. My thoughts behind that was, I really shouldn’t take that if im going to drive. Second test: I wanted to see if any of the desirable effects of the GTN spray remained when we left Moorfields, there wasn't, it had gone out of my system. Just before I got to the Oldstreet underground entrance my arm was hurting like hell and I was extremely short of breath and I really hadn't travelled very far. This time I took a single puff of spray and waiting at least 3 minutes for it to take effect, it should have been 5, by this time I had recovered, I had even got a spring in my step as I went into the underground. By the time I had got to Kings Cross I was well ahead of Adrian, and Adrian said “I thought you were going to take it easy”, we looked at the time, we only had 12minutes to catch our train and still quite a way to walk, so neither of us lost any time. By the time I sat down in the train I could just feel the presents of the arm ache starting, but it didn’t really develop. I liked the idea of the GTN spray as a precursor to exercise and decided to use it ahead of pointe practice in my own studio. As I wasn't driving I though I would go with 2 puffs so I could check its endurance. Firstly I felt the same effect that I had on the train which worried me, I know it supposed to expand the blood vessels and drop the blood pressure to a degree, so I measured it. The diastolic reading which normally sits around 80, for me about 75 because of the medication I'm on, was reading around 45, I took a second reading and it was 51, they are both extremely low and would explain the feeling of going to faint. As the effect wore off I tried some pointe work at the barre, my balance was rubbish it had never been that bad ever, it just wasn't normal for me. There is no way I will use GTN if I’m going to do pointe work. Almost every activity I do I scrutinise medically to try and understand my new body dynamics as they are so very different. The stamina I once had has completely gone and I cant walk very far without getting breathless. I had an extreme test of that this weekend as Adrian and I went to see Come Dancing on tour at the 02, the long walk and stairs at London bridge underground station was quite crippling, I had to stop many times to get my breath. When we got to the 02, the walk from the entrance to the H entrance was extremely long, but not only that, the seat Adrian had book was only one row from the very top, in this instance GTN spray didn’t help with the fatigue. Saturday was really challenging and said to me, it will be a really long time before I'm back performing on stage in London if ever. It really does feel like a completely new chapter of my life that I don’t know how to write it with ballet as its central core.

Will post an update on Sunday xx

Last week Adrian and I snatched almost a weeks holiday in Scotland, as the days were getting shorter and of course the summer temperatures were due to fall. We were also conscious of the serious flooding that had taken place the previous weekend and various road closures due to land slides and bridges washed away or damaged, but never the less we decided to go. We travelled up to just north of Glasgow on our first day to Dumbarton, needless to say it was dark when we arrived although we know the area well. We had pre booked an evening meal at a very pretty spot on the banks of Loch Lomond called Duck Bay, this was our first encounter of flooding. Although the Duck Bay Hotel and Restaurant is situated right next to Loch Lomond, the other side of the road has a large park of several tens of acres, all we could see in the headlights was water as if it was a huge lake. The overspill car park was also situated on the same side as our lake but fortunately only partially flooded, at least after we parked we didn’t get our feet wet getting to the restaurant. We called there the following morning for breakfast and could see the full extent of the remaining flood water. During the week we see lots of road / bridge repairs down to a single lane with traffic lights and also some major rock rebuilding out from the side of the road. I guess what was most memorable for me was the state of the stream and river beds that flowed under the roads, they were shiny grey, almost mirror like as if they had been highly polished with water and debris flowing down them. No trip to Scotland would be complete without Adrian and I visiting Gillian our Ballet Coach of many years and it was really nice to see her again. I did take my pointe shoes and resistance band up to Scotland with me, but our hotel room didn’t have anything high enough to utilise as a barre. While we were there we kept an eye on the weather, particularly the tracking of Storm Babet , not only for Scotland but for home too as we live next to a river. Although we had really beautiful weather from the weekend up to and including the Wednesday, it was clear the storm was going to hit where we was Thursday and Friday, so Adrian and I decided to travel home on Thursday morning. The night before we had seen amber warnings displayed on the road side. When we got up at the hotel it was clear the wind and rain had arrived, my worry was crossing the Clyde on the Erskine bridge, Adrian checked the predicted wind-speed on his phone and it predicted a fall around mid day. It was right , as we left the Oban area we had high winds, by the time we reached the backs of Loch Lomond they we considerably less. As we approached the bridge, there were sighs to say it was closed to high sided vehicles, but there were several cars crossing it which made us feel happier about crossing it, as we crossed over I noticed the trees on the south side, they were barely swaying. We continued to have fairly heavy rain until we reach the English / Scottish border junction M74/M6. Once we arrived home everything was bone dry, the storm had not arrived yet. First thing Friday morning it was still fine, there was just enough time to secure our two landing platform on our river, as they tend to float up on high flood water, at least if they are well secured to the bank they cant float way and simply settle down again once the water lowers. Similarly we had to make sure our boats are properly secured against fast flowing flood water too. Friday the storm hit, however the water authority had lowered the river level in anticipation, so far up to Sunday evening there is about a 3 foot rise and fall and a very fast flow, but no flooding as yet. However it takes about three days for the catchment area of our rive (River Glen) to flow thorough. After our short holiday , its back to Hospital follow-up appointments for Adrian, we have two this week, the first is on Monday at Addenbrooke's for an MRI scan, as something was detected in either an Ultrasound Scan or PET CT Scan both of which was done on separate days the week before our holiday. Unfortunately we have to be there by 7.40am Monday morning, which means getting up at 4am Grrrr. Our second follow-up this week is on Thursday at Moorfields Eye Hospital in London, Thursday is usually my busiest ballet day of 4 classes, needless to say I have had to re-arrange my 2 one-to-one classes to Tuesday, however I have very little prep time this week for them, but that's life. On the good side Adrian continues to make progress but I think that is going to be longer than we both first thought, especially while we were on holiday he does tire easily on long walk, but he is getting there bless him.

Hi Angela I'm not with a performing company right now, although Adrian and I do work on our own annual showcase each year with my one-to-one coach at Lincoln. I had a mail drop recruiting adult amateur dancers from the London Performance Company in Holloway road. LPC is run by Lisa Probert, she has been one of my teachers at London Amateur Ballet and also at ENB. When London Amateur Ballet closed, Lisa formed LPC from several of the Ex LAB dancers, I didn’t go there as I was already a dancer with The Alive Ballet Company and at one stage I did try dancing in two different ballets with both companies on the same day, even for me that was pushing things a bit too far. Initially I replied to Lisa to join the company for the Autumn term, then Adrian's operation was postponed for three week, and I said I would try and join at half term. However I didn’t anticipate the amount of hospital follow-up appointments Adrian would have covering both his issues, also I had expected the rail dispute to be over by now. So starting at half term is a non starter and I will review things for the new year. Slightly off topic, does anyone know where I can buy draw string for ballet slippers from, as Adrian lost the draw string from one of his black ballet slipper, fortunately we recovered one from an old slipper, but only after I had bought him a knew pair of ballet slippers.

Just a quick update, Adrian on Saturday was 4 weeks post-op and I'm glad to say is doing very well. At 2 weeks post-op each Sunday morning I started him off with some light Pilates exercises, a little PBT, some resistance band work and some light barre work and of course a little port de bras to finish, he has really enjoyed that. Each week as his strength and fitness has improved, I’ve either added a few more exercises or made the exercise slightly more challenging. I wont start Adrian's PDD training with me until after Christmas when he if fully fit and ready. On Saturday ( his week 4) we took the bikes out in a effort to strengthen his legs, that went like a dream for him, not quite so for me. We were cycling down some leafy lanes with a few miles from home, when a fly went into my eye Grrr. Naturally I stopped and tried to clear it with my finger and my bike toppled over with me underneath, we were resting on the side of this dyke, fortunately I didn’t slide in to it, luckily I didn’t hurt myself, not even a brews. The rest of the journey 5 or 6 miles was uneventful other that lots of flying bugs about and several coliding my face, I guess it was that time of year. It was really nice to be out and about with Adrian again, with a real sense of normality. Two more weeks to go and he can start to pick up some of the heavier work in the garden as there is plenty that needs doing and take the pressure off me a bit. On the downside Adrian still has a lot of follow-up hospital appointment coming up covering both his Prostatectomy and his eye cancer, so its unlikely I will be joining a Ballet performing group after half term. That's going to have to wait until after the Christmas break, I'm also hoping the rail travel dispute has been settled by then too. I have had one of my Friday classes close which has released some time for me, plus a few weeks ago I see a thread on this forum on Cecchetti, in that was a clip from the Cecchetti Diploma on pointe work, that gave me an injection of enthusiasm to pick up my Cecchetti Advanced 2 studies which now are extremely rusty. Certainly a least half a day of Fridays will be spent on my Cecchetti Advanced 2 syllabus, but at the same time where the differences aren't too great would like to incorporate the Cecchetti Diploma exercises too.

The last 3 days have been very traumatic with very little sleep, our first day for Adrian’s Prostatectomy operation, we were up at 4am, as we had to book in at Hinchingbrooke Hospital at 7.45am. After booking in Adrian disappeared to be prepped at around 8.30am when I asked one of the nurses “What time he was likely to be out and where could I wait for him”, I was told just after lunch time and assumed, just after mid day, and I could wait in the Surgical reception area where I was. It wasn't until 3.15pm that he arrived, then he had a knee bag fitted and the contents was a bright rich red indicating a high blood content. He showed me his release note which indicated that blood would appear in the urine for several day before it gradually diminished to nothing. When he got home I noticed he had 2 pieces of gauss knoted around the catheter very close to urethra exit point of the body, I guess to catch the blood that leaks out of the urethra on the external side of the catheter, it really didn’t look very nice as it was absolutely soaked in blood. I ask Adrian how long is he expected to keep it on, he was told until the next morning. As he was back to using a bag again, he decided he would have to sleep downstairs in the easy chair almost sat up as in the past it was the only way he could guarantee the bag would drain properly. I fitted a 3litre night bag as he was constantly drinking to flush his system out. Adrian ask me to stay down stair with him as he didn’t want to be alone, so I slept on the settee. When we turned in the colour of the fluid in his bag was beginning to lighted towards pink, obviously the water he was drinking was starting to have an effect. Just before 3am Adrian woke me very distressed, he complain he was feeling sick and very unwell, also the blood in the urine had gone back to more richer colour, he complained he should have never been discharged from the hospital and insisted I call an ambulance. I dialled 999 and spoke to the ambulance controller, we ran through a check list and the controller said he would arrange for the duty doctor to contact us but it may take up to 6 hours. It was a lot less and the duty doctor finally suggested it may have been a reaction to the antibiotics Adrian was given and suggested we contact his GP when they opened at 8am. As neither of us could sleep, around 6am I decided to clean him up and remove the awful soke ridden gauze around his catheter. There was no way I could release it with surgical gloves on, I tried sterilising some scissors but they wouldn't cut it either, in the end I found a new sealed pack of Stanley blades, so I took one out and sterilised it, whoopee it worked, then I could really get him clean, I think that was a boost to him too, we also noted the colour of the liquid was getting lighter too, I ask him about feeling sick, that was subsiding too . 8am came and I ask him about contacting his GP, he declined and said he was feeling much better, so I suggested he restart his antibiotics and see what happens, he now takes them with food and the effect is much less. Friday our last day to go to the hospital, here his catheter will be removed and we have to wonder around the hospital for 4 hour before they can scan him for retention of urine, the criteria set by his surgeon was no more than 300ml. The brief from the nurses was he must drink and pee, drink and pee and move around, they started him off with a large jug of water and a glass. We stayed around the Surgical reception area until he had drank the whole consents of the jug and then move on to the restaurant where he continued to drink and pee. Finally we arrived back at reception at the appointed time and Adrian was take away for his retention scan, when he appeared back he had a big smile on his face and gave me the thumbs up. To be fair from his anxious state of Wednesday, I was expecting the test to have failed, not only did he pass, it was an exceptional pass, he only retained 98ml. His brief now : he can take short walks from 1 week, he can start to cycle from 4 to 6 weeks, no heavy lifting or gardening until after 6 weeks. After week 2 I will commence some light barre work with him, mainly to for general fitness and staminer but more importantly to correct his posture as that has really gone in a very big way. I wont be starting any serious Pass de Deux work with him until the new year, however I'm pencilling in getting back to London to an amateur performing company around next half term (October) would be good. Hopefully we may get a chance to go on holiday to Scotland before then, but sadly we are not likely to make that for his Birthday holiday this month as originally planned. At least this nightmare is over for us both.

A very inspiring thread. I guess one piece that caught my eye was from the Video promoting the Enrico Cecchetti Diploma at 2.55, a gorgeous pointe work enchainment with beautiful music. Whilst I have that DVD , I have never noticed that piece. But then I only bought the DVD to give me some idea of the style and interpretation of the Advance 2 syllabus when we were only using the set book as no video were available for the old 2004 syllabus. Then for a single enchainment we would have to go through something like a dozen pages of descriptive text, it was awful and long and painful way to learn. Later I located a full set of Cecchetti Advanced 2 videos for download from Cecchetti Inc of Australia, but the UK wasn't on their country list, bless them they added it for me. Although there were some differences it was still hugely helpful. Unfortunately the release of the 2019 new syllabus was inevitably delayed by COVID as it came out in drips and drabs with DVD last. Whilst the new Syllabus is a bit bigger than the previous one, its a bit more challenging too, but I loved it. Sadly 2 years ago my Cecchetti teacher retired and soon after I let it fall by the wayside as I started to focus far more on Rep. I think this thread has given me a bit of a kick to make time and recommence my Cecchetti studies, be it without a teacher. Just to add to the Cecchetti resources, it worth looking at Julie Cronshaw’s websites: www.thececchetticonnection.com http://www.balletsecretcode.com and of course her documentary : https://youtu.be/ZGT4g7FHSvA

Just a quick update: We got a new date this morning, its the 6th of September, 3 weeks today, at least that has got the uncertainty out of waiting. The only downside is we only have a week of recovery before we had planned to go away on Adrian's Birthday holiday after the operation, as it is I certainly wont book anything until the day before we are due to go and then only if he is fit enough. In the meantime I'm on break from ballet with just enough maintenance mode practice to maintain my level pre-break.