FRANK

Everything in life happens for a reason. I have never been one to believe in pure coincidence or dumb luck. That coupled with my religious beliefs, means that any and every good or evil that befalls me is all part of the life story of Mansur Saadu. That does not mean however that I do not have any control over my destiny. We are presented with choices in almost every waking moment of our lives, but the route I take on of my journey from A to B will be decided by the roads and paths I choose to take and mine alone. So you can imagine my surprise as I drove home, with my girlfriend at the time, to suddenly be gripped with a sharp tightness in my chest and sudden inability to breathe. I pulled over immediately, my girfriend panicking asking me a million and one questions. I couldn't speak, the pain had now risen from my chest and had a hold on my throat. I was looking franticly at my girlfriend, her eyes filling with tears with every passing second. She had managed to help me out of the car and sit me down on the curb. I spent the next 10 mins fighting for a breath, then just as suddenly as the pain came it went. Just like that. I looked up around me and saw my girlfriend crying holding my hands in hers. That was the first time Frank introduced himself to me. We spent the next two and a half years together, inseparable.

The rest of the weekend went by without any incident until Sunday night where I had another similar attack. This one however only lasted a painful 7 mins. Again my girlfriend was standing-by teary eyed holding onto my hands. Now by this point you would think I would have called an ambulance or atleast my parents who are both doctors. However my main concern, once the pain ceased, was to get home and spend the rest of the night with my girlfriend.

The next day at work was like any other. Four cups of coffee by midday, tedious meetings on cases needing to be worked by the end of the financial year and the constant watching of the clock until 5pm. Typical Monday morning. Tuesday at work was a similar affair, up until lunchtime. I start experiencing mild headaches and chest pains but nothing as severe as the previous weekend. I then made the executive decision to go home for the day, amidst jesting from my colleagues who were convinced I was skiving off. The first thing I did when I got home was tell my Mother I weren’t feeling too good and she suggested I book an emergency meeting with my GP straight away. At the time I thought she was overreacting, at worst I had a chest infection and at best I was coming down with a mild cold. But I played my role of the obedient child and called my GP and I was seen by a doctor later that afternoon. You will find throughout this story how incompetent and at times insensitive NHS doctors can be, but for now lets focus on the dull Doctor that diagnosed me with a chest infection, attributing it to sudden weight gain in the past couple months. Now for those that know me, I like to eat. You can tell that just by looking at my cheeks, and I’m not talking about the ones on my face, so I guess it wasn’t an absurd notion. However even I was sceptical on the doctors diagnosis, but I diligently took the prescribed medication and left the GP’s office. By the time I got home my dad had come back from work and I explained to him everything the GP had said. I then decided that this was the perfect time to explain that I was near deaths door the previous weekend. My dad then went on a rant for about 12 hours about how irresponsible I was for not mentioning anything to them. He then made his own executive decision and demanded that I follow him into work tomorrow and have a chest x-ray. It was then that I received my first formal introduction to Frank.

I walked in on the Wednesday morning with my Dad and headed straight to the x-ray imaging room. “Hello, Mr Saadu. We’ve been expecting you. Please remove your clothing, no metals can be left on your person and change into this gown. A nurse will come now and place a cannula in your arm”. Ohh well this is fancy isnt it? I was being treated like a VIP and within minutes I was ushered into the imaging room. The x-ray itself only took around 30 seconds. A big imaging plate was placed on the front of my chest and then the back. I was instructed to complete a few breathing exercises, holding my breathe, taking deep breathes etc. After the x-ray and as I was leaving the room, I asked the imagining nurse if there was anything she saw or could comment on. She immediately looked to her colleague dead faced, then turned back towards me and said “Your doctor will discuss with you any findings”. Well that was subtle. I then spent the rest of the time in the waiting room, patiently anticipating when the doctor will come and see me. About an hour later I saw my dad walking down with an Asian man alongside him. He shook my hand and introduced himself to me. I cant for the life of me remember his name. “Its a good thing your dad brought you in today, Mansur. From the x-ray we can see that your right hemi-diaphragm is raised. We need to have a look inside and see whats going on”. I then spent the next 3 days undergoing a series of tests. A CT scan, MRI scan and an Ultrasound. After all the results were in, I was back in my Dads hospital with the same Asian colleague. “Mansur..after going through the scan results. We have found that you have a tumor in your liver. It currently sits on top of your liver measuring 6 cm. We believe its pushing up against your lungs and causing your diaphragm to be raised. This is probably why you have been suffering from chest pains and difficulty in breathing. As of now we dont know if its cancerous but we will take some blood tests and we will know once they come back”. Great. I looked at my dad. He looked at me. I looked back at him. He just kept looking at me. I glared back like “say something nigga!”. He still looked back at me blankly.

I don’t really remember the 48hours that followed. All I could think of was that I wish the hapless GP had been right and my ailments was just because I’ve been eating too much pounded yam lately and not that I could potentially have cancer of the liver. So the day came when I would get my results and sat in the same office with the same Asian colleague who’s name continues to elude me. “We’ve received the tests and you have a benign liver tumor”. I looked back blankly at him. I’m guessing he understood that I had no idea what that meant because he then said, “that means you dont have cancer its just a series of blood vessels that have formed together into a lump”. Phew. “So i just take some meds and I’m good to go then” I said excitedly. “Urm no. We need to biopsy the liver and tumor to determine what type of benign tumor it is and you will also need to have your diaphragm, lungs and chest investigated. We are going to be sending you to you the Hammersmith Hospital which specialises in respiratory conditions”. “Fine” I sighed. The next year and a half turned out to be a nightmare. From October 2013 until September of 2015 I spent lengthy periods of time in hospital and was subjected to test after test. Within that time I got a new girl, received a promotion at work and had gone to the fabled land of Cancun during spring break. So it wasnt all bad.

The doctors had concluded that I had Focal Nodular Hyperplasia (FNH) aka Frank. They had explained on countless times and after a plethora of tests that these tumors don’t cause any symptoms and are usually discovered accidentally. They explained that they don’t develop into a cancer and after some time they usually resolve themselves and shrink. Now my original symptoms only previously consisted of chest pains and difficulty in breathing. So you can imagine my — shall I say annoyance, that by the time I had my first MRI scan I started developing severe abdominal pain. By the end of the first week of tests I was suffering from daily pain. I’ve lost count how many times I have been asked to describe the pain. The most irritable question I would be asked by medical personnel would be to rate my pain out of 10. Its too subjective a question. And the answer even more so. An 8 out of 10 could be a 12 to you or likewise a 3 to another. How do you measure ones own level of pain threshold. All I knew was that it was pain I have never experienced before in my life. The daily pain I imagined to a dull prodding pain. This I was able to withstand and ignore as long as I was distracted or asleep. Every few hours I would suffer sharp stabbing pains. These would last sometimes 15mins, at times hours and more often than I would have liked, for a whole day. Times like this would result in me having to take time off work until the pain settled. The worst pain, I wouldnt wish on my enemy. It would feel like my liver was being ripped out of my stomach. I imagine only child birth or being shot could compare in terms of the level of pain. Once the pain reached these levels I would usually spend a minimum of a week in hospital, in addition to a few days rest at home. This happened 7 times in the past two and a half years. You can imagine what my work absence record is like. I thank God everyday that I still have a job.

Although I would go on to experience pain on a daily basis, the intensity would range without a common denominator. Whether I was at home feet up watching Game of Thrones, out clubbing with friends, sitting at my desk at work or playing 5aside football at Power League. Irrespective of the food I ate, the position I slept at night or how much sleep I was getting. I had been prescribed a number of analgesia (painkillers). Within the first year I had taken different courses of Codeine, Amitriptyline, Tramadol and Diclofenac Sodium. I was taking 2 tablets a day, every 3 or four hours. Side effects were drowsiness, constipation and stomach erosion. I was then having to take mediation to protect my stomach lining from the medication. And if that wasn’t enough I was taking medication to ease my constipation and allow me to actually shit. Luckily I don’t have an addictive personality, which was a major concern for my parents and doctors especially whilst on Codeine, but this was put to the ultimate test when after my last hospital admission resulted in me being prescribed morphine. Oh the sweet joy of morphine. The only medication that erased my pain, albeit for only an hour or two. Those brief moments of relief alone were enough to get me hooked on the drug, even without the added bonus of feeling like your floating on rainbow coloured clouds. When life throws you a curve ball, you have to find the positives in your situation no matter how minute. Getting high on morphine was definitely one of those.

I’m not going to bore you with the emotional rollercoasters and times of doubt I had during this difficult time for me. I’ve always been a positive person, never one to complain. In fact I detest the notion that another human being has to sit there and listen to me wallow in self pity. As cliche as it sounds I truly feel that God only gives the the toughest challenges to his strongest warriors. And I’m mother-fucking Hercules. The outlook I always had was I would rather it was me going through this than any of my family or friends. The most difficult thing for me was actually witnessing others dealing with my condition. My parents, partner and friends would at varying times often get angry and frustrated with my situation and at the doctors who could just not resolve my symptoms. My own personal issue with this was that no-one else has the right to be angry at the situation or be irritable. I was the only one going through this, and if I’m able to go through life with a smile then so should they. I learned however that this was a selfish way of thinking…Reluctantly I might add. The one thing the doctors had stayed consistent with, was to explain that Frank doesn’t usually cause any symptoms and cannot be the reason for my pain and raised diaphragm . They were adamant that there must be something else wrong with me. They explained that they could remove the tumor however it is unlikely to resolve anything and they would have subjected me to a severe and risky surgery with a high possibility of no improvement. Hence I was subjected to being a human lab rat for over a year whilst the NHS strived to link my symptoms with another illness. To no avail. It was not until August of 2015 that I decided enough was enough. I’m sorry Frank but I think its time for you to go. I would like to say its been a pleasure…but...well..that would be lying wouldn’t it?

I sat in the hospital clinic room with my father and Prof. Davidson, the liver surgeon specialist I had been so graciously appointed, on 14th September 2015. I had now been off work since end of July. My employers had finally decided that they could not have an employee taking regular doses of morphine at work, regardless of the GP notes explaining that it was completely safe for me to do so in the workplace. I must say I’ve never enjoyed my time at work as I did for that week I was taking oramorph (liquid based morphine taken orally). Sitting in work meetings whilst high is an experience I encourage all to part take in if possible. I remember sitting, listening to my managers monotone voice harp on about targets and all I could focus on was how did the window cleaners manage to fly and why would they waste their awesome powers doing mundane manual labour. Surely a cat was stuck in a tree that desperately needed saving?

Back to the meeting. After Prof. Davidson explained that they are essentially giving up on my case, that they have done every test possible, have found no answer to symptoms, he rounded off by asking me what I wanted to do next. I purposely took a deep sigh and said “Prof, I cant go on like this. I’m at risk of losing my job at any moment. You have claimed for the past 2 years that the tumor is not causing my symptoms yet the only anomaly in my body is this lump in my liver. Which might I add from the last scans show is in fact 7.5cm. I cannot live the rest of my life on morphine or codeine or whatever drug you deem plausible. I want the tumor removed.” Another executive decision I made. I know I should run for prime minister right. Prof. then took his own noticeable sigh and replied;

“I understand, well we can definitely remove the tumor but I must explain the procedure and the potential risks. Firstly as there is no medical evidence that removing the tumor will resolve your problems, there is a very likely possibility that you may still be in the same position after surgery. Perhaps this is a condition you will need to learn to live with. The surgery itself has a mortality rate of 2–3%. But this is normal for any major surgery. There is however a 40–50% morbidity rate. Now this means there could be possible complications such as infection or in some cases liver failure. But as you are young and relatively fit this should be lower. The majority of patients we operate on are elderly and they come through just fine. Recovery is 6–8 weeks and we will need to cut out around 70% of your liver, which is the whole right lobe. We will also need to remove your gall bladder. Before we can go ahead we will need you to sign this consent form”. He then slid a yellow booklet across the table to me. He seemed awfully prepared for someone who only 5 minutes ago was adamant that surgery was not the way forward for me. “If you sign the consent form it doesn’t mean you have to go ahead with the surgery, you can just call us if you change your mind. But it saves you having to come in for another appointment to sign it.”

“Okay, I’m happy to go ahead with it and sign the consent form now. But I will need to go home and discuss it with family first”.

“Thats no problem. Once you have decided, give us a call and if your happy to go ahead we can go ahead and get you booked in”

I left the room, went straight home and slept. The next few days I went through a whole host of emotions. The thought of possibly dying from the surgery didn’t concern me that much, or even the relatively high morbidity rate. What I was battling with was the possibility that if this surgery didnt work, I would essentially have to live the rest of my life in excruciating pain. I would be on constant painkillers, my working life and career would cease to exist and my life in general would be severely limited. With every test and possible hypothesis doctors gave me for the past 2 years on what was causing my pain, had been slowly chipping away at me. Each test provided a glimmer of hope of finding out what was wrong with me, to then find out a week later that the results had come back negative. I was afraid that this was my last chance. If I built up my hopes again that I would finally be rid of Frank, to then be shot down for the 12th time made me fearful I wouldn’t recover mentally. Everything in life ultimately happens for a reason, and I made my choice to go ahead with the surgery. It was time for me to put my self proclaimed Herculean title to the test.

I lie awake in my house in the early hours of the morning writing, what I hope to be the final chapter of my story with Frank. I check the time and its 2.31am, Tuesday 9th December 2015. It has now been 7 weeks since my surgery date and the scars from the procedure are starting to take shape. The surgery itself took 8 hours and I spent the first 10 days at the Royal Free Hospital recovering. The surgery went well, with the only complication being a small infection in the wound where the surgeons made an ‘L’ shaped incision. The liver is truly a remarkable organ and mine is currently growing back to its full size, although it wont be in the same shape as before. But quite frankly (you see what I did there ;) neither am I as I look down at my swollen stomach — excess fluid still remaining from the surgery. Frank has now gone and finally measured a respectable 8.5cm which the surgeons describe as the size of a grapefruit. I made my peace with Frank and we left on quite amicable terms. I did however tell him under no uncertain terms that he was not welcome back but I wished him well on his journey nonetheless. I haven’t yet experienced the pain I was previously suffering from and I’m cautious that I still have a long way to go before I am fully recovered. But for now, I take comfort in the little things, like no longer needing to take painkillers and being able to shit as freely as I want.

God’s greatest warrior remember ☺