Cancer treatment closer to home - Vicki Burns

Vicki Burns, chemotherapy outreach manager at The Christie

Vicki Burns

February has been a busy month for the outreach chemotherapy service. This month we have opened a new nurse led chemotherapy clinic at Tameside Hospital. The clinic will be held in the new ‘Tameside Macmillan Unit’. 

This new unit has been provided through a joint partnership between Tameside and Glossop Integrated Care NHS Foundation Trust and Macmillan. Initially, Christie chemotherapy nurses will host a treatment clinic from the unit twice weekly, increasing to three clinics a week in April. The new clinic will provide the opportunity for around 60 Tameside patients per week to receive their cancer treatment locally.

The Tameside clinic is just one of the many developments that my team and I have been involved with over the last few years.

I have worked as a nurse at The Christie since 2003 and have been in my current role as outreach chemotherapy manager since 2013. During this time, I have seen many changes to the chemotherapy service as it has evolved to cope with an ever increasing demand.

An important change in the last four years has been the focus on enabling patients to access their anti-cancer therapies closer to their homes.

Historically, The Christie has successfully worked in partnership with five other hospital trusts in Greater Manchester and Cheshire to provide local chemotherapy clinics to Christie patients. These clinics have enabled hundreds of patients per year to receive their treatment in their local hospital.

In 2012, we developed a new chemotherapy strategy to build on the success of the local hospital clinics and to ensure that the chemotherapy service would meet the demands placed on it over the following three years. The strategy mapped out a network of local provision that would benefit many of our patients living across Greater Manchester.

With patient experience at the forefront of everyone’s minds, the team set up two Christie chemotherapy clinics at health centres in Greater Manchester, run entirely by our chemotherapy nurses. The clinics located in Bury and Ashton proved very popular with our patients and enabled us to treat around 30 patients a week closer to home; these are patients who would otherwise need to make the journey to the main Withington site. Just months later, a third clinic was set up at Salford Royal Hospital, with Christie nurses treating a further 12 patients per week.

The next bold step for the team was to develop a mobile chemotherapy service. Through the amazing work of fundraisers and BBC Radio Manchester, The Christie charity was able to purchase a bespoke chemotherapy mobile unit. Launched in 2013, the unit visits five different locations throughout the week, treating patients in Rochdale, Trafford, Hyde, Chadderton and Bolton. Staffed by our own specialist chemotherapy nurses we are able to treat around 70 patients per week on this unit. The unit has proved extremely popular with our patients and has received excellent feedback. Patients have said that having their treatment locally has reduced anxiety, saved them time and money and made their treatment visit feel ‘less clinical’.

In 2014, we opened ‘The Christie at Wigan’ treatment unit. A joint venture between Wigan Wrightington and Leigh NHS Foundation Trust and The Christie, it offers the opportunity for around 70 patients per week from the Wigan area to receive their cancer treatment locally.

By the end of the three year chemotherapy strategy we had reached our objective with 80% of clinically suitable chemotherapy treatments being administered locally to our patients. The team’s hard work gained recognition from the Quality in Care programme and we won a prestigious award for the impact our service had made on patient experience. We were also thrilled to make the shortlist for two awards from the Nursing Times and Health Service Journal.

In 2015, new objectives were set and we knew we had much work ahead to ensure that the service could support future projected increases in chemotherapy treatments.

In the summer of 2015, we launched ‘Christie at Home’ which takes our chemotherapy nurses out into the community and into our patients’ homes. Over the past 12 months, the team has gone from strength to strength, developing the service to cover the whole of Greater Manchester and Cheshire.

The service currently provides treatments for breast cancer patients, but over the next six months we plan to expand further to be able to administer more treatments to patients with other cancer types.
2017 brings with it many more exciting plans for our chemotherapy outreach service, with additional clinics to be set up at health centres and local blood testing clinics; I know this year will be yet another important one for the service.

Thanks to the hard work and dedication of all the chemotherapy team, the service has come such a long way in the last few years. We are on track to provide in excess of 18,000 chemotherapy treatments through our local clinics this year. Seeing the difference the service makes to our patients will always keep us moving forward. The outreach chemotherapy team is passionate about what we do and we are all so very proud and privileged to be in a position to make such a difference to our patients.

If patients are interested in finding out more about Christie chemotherapy services in the community, please contact the satellite chemotherapy outreach team on 0161 918 7654.

I am so grateful that my oncologist and surgeon supported my decision to continue working - Geraldine Leydon

Geraldine Leydon, Christie Patient

Geraldine Leydon

I have just turned 50, feel very content and have so much to look forward to. My husband Tommy, our two girls and I are currently in New Zealand, part of a travelling fellowship from the Winston Churchill Memorial Trust to research international best practice in early years care and education.  

It seems a long, long time since the night in 2011 when my husband and I were given some difficult news that left us dazed, that I had cancer.

I had made a number of visits to my GP with what could in hindsight be described as atypical symptoms.  Eventually I happened upon Professor Gordon Carlson, who advised a precautionary colonoscopy. The colonoscopy helped to diagnose a very aggressive bowel cancer, more specifically a T4 N0 bowel cancer. 

It came as a huge shock at 45 years old, particularly as there was no previous history of cancer in my family.  

It was a trying circumstance for obvious reasons, which coincided with me changing jobs. 

In hindsight however, this proved to be a useful distraction from the ongoing treatment. My surgeon and oncologist were remarkably positive and motivating people, urging me to work as I wanted to and felt able. 

The new job, gave the family as a whole something else to focus on outside of the cancer bubble in which we felt encircled. Interestingly, I did not find that this was something that some people understood.   

Some people suggested that I might want to give up work. For me, I chose to work part-time, as that was right for my family and I at that point in our lives. 

I went to Salford Royal for my colorectal surgery under the care of Prof Carlson and the treatment was first rate. There were very structured and focused opportunities to prepare for what the treatment had in store for me. 

This was followed up with six months of chemotherapy at The Christie under the diligent care of Dr Mark Saunders. The Christie is an infamous institution and was known to me, as I am local to the hospital and passed it and its visitors regularly.  

Becoming one of ‘those people’ who needed to go there was one of the most unexpected and hardest feelings that I had to overcome.  However, those feelings passed remarkable quickly and my monthly visits became part of life’s routine.  

Now, five years on, I have gained a distinction in my Master’s in Education Degree and I have been accepted onto the Educational Doctorate. 

Most exciting of all is the travelling fellowship from the Winston Churchill Memorial Trust. I have travelled to Germany to observe a programme called Baby Watching and I am now in New Zealand visiting universities, the world famous Dunedin project and preschool settings working with the Te Whariki curriculum. 

Geraldine and family in New Zealand

I hope that cancer patients reading this will be inspired and that it will give them hope. I am so grateful that my oncologist and surgeon supported my decision to continue working. My work is my passion (family excluded) and I feel glad I did not give up work as that was the right decision for me.

And of course whilst I am in New Zealand and Australia with Tommy and my gorgeous girls we are having a little holiday!

Geraldine's blog is at http://eyfs.info/forums/topic/46559-travelling-fellowship-research-study-in-new-zealand-and-germany/

Being filmed helped me voice my personal opinions about cancer services - Bex Smalley

Bex Smalley, Christie patient and patient representative 

Bex Smalley

2015 was a big year for me as I celebrated 10 years in remission. This made me stop and think. I wanted to give back more than my annual fundraising events. So I started looking online for a more hands on approach. I wanted to help more. 

I started off by volunteering for Macmillan, leaving reviews on books and leaflets all based around cancer but I was looking for something much more hands on. Then I received an email about an organisation called Manchester Cancer and who were involved in something called a Vanguard. When I read more about this I found out that one of the aims of the Vanguard was to improve cancer care though early diagnosis and prevention around the Manchester area. I immediately knew it was something I wanted to get involved in. 

Since getting involved, I’ve had a busy time. I have been involved in lots of meetings and was asked to be in a video they were doing to show at a big eye opening event. 

The Greater Manchester Cancer Vanguard event was something that I felt very privileged to be a part of. It is very much centred on making positive changes to cancer care in Greater Manchester. To be in a room full of medical experts, chief executives and other patients who felt like me was daunting at first, but every person there made me feel welcome and an equal. They kept saying that patients are at the heart of these new services. 

Before this event I had no idea of the hard work that was going on to try to improve the system. Listening to the consultants and specialists speak with such passion for change made me very hopeful for the future. 

Being filmed helped me to voice my personal opinions about cancer services and to share my own cancer experience. 

When I was 17 years old I was diagnosed with Hodgkins Lymphoma. By the time I reached The Christie I was informed that it was a stage 4 cancer (the most serious). My left lung had collapsed and I had 4 tumours. 

One of them they classed as ‘bulk’ which they explained to me meant that it was larger than 13 centimetres (if my memory serves me correctly). 

This had all happened because I wasn’t taken seriously by my GP. I had visited several times over the course of around 2 years, but wasn’t referred to The Christie until the end of that period. I believe that this delay meant I needed to go through aggressive chemotherapy and radiotherapy treatment. 

I cannot fault the efforts of The Christie, nor the treatment given to me at the time. However, I have since found out that they no longer use the chemotherapy I was given as they have found a less invasive version. But this is just a sign of how treatment is improving. A lot of chemotherapy leaves people with side effects that they will suffer with for the rest of their lives. A common one being infertility, which is something I was warned about numerous times. However, in 2013, against all odds, I managed to welcome my daughter, Georgie into the world. 

Although I was incredibly lucky to have my daughter, the problems I faced were all due to my late diagnosis. This along with better patient aftercare is very close to my heart. 

Surprisingly, I found that after my treatment was when I needed help the most. I’m very pleased that these are some of the issues that Manchester Cancer and The Vanguard want to improve, especially early diagnosis, as this is so important in the most important thing - survival!

Being involved in such a large movement is more than I could have hoped for just a year ago and I feel very privileged to be a small part of the changes being made. It also gives me a chance to give back to the hospital, people and charities that helped save my life. 
If we can galvanise the system through experiences like my own, it almost makes my late diagnosis worth it. 

I had to try and find the very best cutting edge treatments that were being trialled - Diane Brooks

Diane Brooks - Christie Phase 1 Clinical Trials Patient

Diane Brooks

I became a patient at The Christie over 14 years ago when I was diagnosed with breast cancer at the age of 36. It wasn’t unexpected as I had a strong family history of the disease and soon after I discovered that it was a genetic fault and I was in fact a BRCA2 carrier.

Breast cancer was always part of my family and that’s why I was always interested in being a part of the research and learning aspect of my disease. I knew it could be a huge game-changer in my family’s future health.

Following surgery, chemotherapy and radiotherapy I remained cancer free until the summer of 2008 when it returned. It was a day I had always dreaded but somehow knew would come, as my cancer was aggressive and I knew from watching my mum struggle, it was going to try and beat me too.  

Once I had come to terms with the fact that I wasn’t going to be cured, I set about trying to ‘live’ with my particular type of disease. Always thinking about the lack of understanding and choices of treatment my mum was probably faced with, I had to try and find the very best cutting edge treatments that were being trialled. Thankfully being a Christie patient meant that I was in the right place.

I was lucky enough to be part of trials involving existing chemotherapy treatments that were being aimed at my particular type of disease, but it was in September 2010 that I embarked on my first Phase 1 Trial for an unlicensed drug. I thought it would be scary but in fact it was such a relief, despite the fact that I didn’t know how it was going to effect me, or whether in fact it was going to give me any quality of life. 

I recognised that I was very lucky to be accepted onto the trial and that it was available to me at The Christie. I had done as much homework as possible on my disease and just felt that this was the right treatment for me to try at this time. I was so lucky that it did in fact give me three years of being able to get on with my busy life with my husband, four children and my career. 

To know that you are contributing towards future cancer treatments that can have far reaching effects on others, gives me such a worthwhile feeling, and of course, I am also keen to invest in my family’s future, as they are all going to be affected by this hereditary disease in years to come. I want the doctors to learn as much as possible about our hereditary disease whilst I am alive, so I am always happy to put myself forward for appropriate drug trials in order for them to do their invaluable work.

Being a clinical trials patient has it’s ups and downs and can be intense at times, but the Phase 1 team is expert at guiding me through and helping me manage side effects, at the same time as gathering all their important data which will form part of future cancer treatments – it’s such a privilege to be part of something that is so much bigger than just me. I continue to marvel at how fast things are moving forward in research, and even though I am a small part of it by trying these new treatments, it gives me hope for the future.

I wouldn’t hesitate in recommending a patient to speak to their oncologist about clinical trials - “You don’t get if you don’t ask” is always my motto. However, you do have to fit certain criteria for each trial so it is never a done deal and you have to be realistic. It is important to follow strict guidelines with new drugs, but I have always felt in safe hands with the Phase 1 Team at The Christie, who will spend as much time as is needed to talk me through every step of the protocol attached to each trial.  We always refer to them as our “hospital family” and we have got to know them very well over the years. In fact it says a lot when I have been there longer than a lot of the staff – they must be doing something right!  

I will be celebrating my 51st birthday next month and yes, I am still a Phase 1 patient at The Christie, trying something new, with my husband, family and “hospital family” holding my hand and helping me through, but most of all I am still “living” with my inherited disease, and I continue to hope that many people in the future will benefit from the knowledge gained from research and clinical trials that I have been so very lucky to be a part of at The Christie.

The Christie’s NIHR Clinical Research Facility is a large, high quality, dedicated clinical research environment where our patients can participate in complex and early phase clinical trials. Around 400 clinical trials may be taking place at any one time. In 2016, the NIHR is celebrating ten years of funding and supporting clinical research in the NHS.  

Being a young person with cancer can make you feel isolated - Sophie Vohra

Sophie Vohra - Patient in our Teenage and Young Adult Unit

Sophie Vohra

At the age of 23, one of the last things you expect to hear is that you have cancer. In April I was diagnosed with a Ewing’s Sarcoma on my sacrum. I had been suffering increasingly from bad pains and numbness down my right leg since January, which became so unbearable during March that I finally decided to visit my GP. 

Initially, we both thought that the pains were due to sciatica and that I should try to reposition the slipped disc into place with NHS recommended exercises and using anti-inflammatories to help with any swelling. Over the next two weeks I was unable to sleep because of the pain when lying down, having visited the GP again for pain relief that didn’t have any effect. 

I finally accidentally aggravated it so much after I had been swimming that I went into retention and had to go into A&E as we thought it may in fact be Cauda Equina Syndrome, which would require immediate surgery. 

When I was transferred to Salford Royal, they scheduled me for an MRI, assuming they would see a  slipped disc. Sadly what we got back was worse. There was in fact a lump that was pressing onto my spinal cord and at that point they didn’t know what type of mass it was. I therefore had a biopsy and after having to wait around two weeks I was told it was malignant and by the end of the month I was told it was a Ewing’s Sarcoma that was pressing on my nerves. 

Each time I received another piece of the puzzle as to what it was I would get upset for a little while and then I would get my head round it all.  I knew I would get all the treatment I would need and that I would have the incredible support of all my friends and family throughout it.

I started my treatment at the end of April at The Christie, and everyone and everything from the minute I walked in was incredible. My family and I never felt like we weren’t getting all the information we needed and the organisation of my treatment from the beginning was so efficient. 

I had all the initial tests done, I was randomised onto a trial regarding the administration of the chemotherapy for Ewing’s Sarcomas, had a Hickman Line inserted, and began treatment in the space of a few days. 

The fourteen cycles of chemotherapy over the months were tough and my body certainly found its way around most of the side effects – sore mouth, achy body, no blood cells… the list goes on! My treatment cycles occurred every two weeks, whereas the standard treatment is every three weeks. This meant I had very little time to feel well enough to do anything because as soon as I had recovered from the chemotherapy I almost immediately started the next dose. 

Being around some of the nicest doctors, nurses and other staff you will ever meet was also really comforting when, for several months, you feel like you spend almost all of your life in hospital. 

I was also very lucky to be put forward for Proton Beam Therapy treatment in America, as my tumour cannot be operated on. This treatment means that, as opposed to standard radiotherapy, less damage has been inflicted on the area surrounding my tumour and hopefully I have less of a chance of secondary cancer which can be caused by treatment. Having all of this available to me has meant I have received all the best opportunities to try and beat this horrible disease.

The Christie also has teams in place to make sure that your social and mental needs are looked after. A cancer diagnosis means you are plucked out of normality for a while, which is a huge shock to the system. 

With having to spend long periods of time receiving treatment on the ward, one of the things I am incredibly grateful for is the amount of facilities and activities that were made available. 

Both the Palatine ward and the day unit are designed to allow younger patients, their families and friends to have as enjoyable a time as possible while going through some really difficult times. The hospital provides modern single-occupancy rooms, a social hub for when you want to spend at least a little time out of bed, access to games and DVDs from the games room and a gym space amongst many other amazing things. Many people who have visited me on the ward couldn’t believe how wonderful it was and questioned if it was in fact a hospital! 

These facilities are also available for anyone no longer receiving treatment, which means that former patients can come to events held on the ward for example. We have all manner of events organised for us within and outside the hospital. There are band rehearsals, art workshops, language lessons, cooking and baking, a pizza and film night every Wednesday, and seasonal events such as a Halloween party held on the ward just to name a few. 

The teams also get tickets for music and sporting events, organise meals and get-togethers, and generally encourage a lot of interaction between all former and current patients. These are advertised on their Facebook page so we can easily be kept in the know. 

Being a young person  with cancer can make you feel isolated because it is less likely that we have come across someone in our lives who is going through the same thing at the same age. So being able to relate to others who are, or have been, in the same position as you is very important in understanding and coming to terms with the experience you and those close to you are going through.

I have finally come to the end of my treatment, with only the post-treatment scans to happen now, and I know I couldn’t have got through it without the incredible support of every single person who works with Teenage and Young Adult  patients. 

No one should ever have to go through a life-threatening illness like cancer, but places like The Christie and the facilities they have for young patients mean that we can not only get through our treatment, but can also continue to live a fulfilling and happy life as we do. 

I can move on now with my life, having started my PhD last month at the University of York. 

But I also have a very important network of people who I am very glad I met out of such an awful experience, and I will stay in touch with this group of inspiring young people who have come together through The Christie and the incredible staff who have supported us.

I lost the sight in my right eye, my sense of smell and had a diminished taste - Graeme Heward

Graeme Heward - Christie patient and fundraiser

Graeme Heward

Five years ago, aged 50, I was going about my daily life, working as a physiotherapist, being father to two boys entering their last few years of school education, playing squash and generally enjoying life. It’s perhaps a stage in many people’s lives when they think of enjoying the fruits of their labour and taking life a little easier, however, my life was about to endure a twist.

The only thing that alerted me that an ‘Alien’ passenger had entered my life was a watering eye. The ‘Alien’ and me, plus a multitude of medical staff from The Christie and other hospitals in Manchester were about to commence a battle. I remember in those early days when my whole life was shaken into sudden turmoil, being so grateful that The Christie, with its wealth of expertise and facilities, was there to support me, my partner and family.

I had been diagnosed with a sinonasal adenocarcinoma following a scan and subsequent operation to remove the tumour, which at the time was thought to be benign. It’s a rare tumour affecting 1 in 100,000 people. Situated in my nasal lining, the tumour had expanded and grown to such an extent that it had fractured my delicately thin bony eye orbit.

As the ‘Alien’ took over, I lost the sight in my right eye, my sense of smell and had a diminished taste. 

Fifteen operations later, following muscle and skin grafts from thigh and abdomen, an autoimmune reaction, two episodes of radiotherapy and one course of chemotherapy; and having completed a gruelling charity fundraising bike ride I was ready to write a book – ‘Riding With The Alien’.

As a physiotherapist, I was in a unique position to see my care from both a patient and a medical perspective. I felt a responsibility, particularly with such a rare condition, to pass on my experience so that other patients and medical professionals could learn from it and see the whole patient picture.  

My book has been written entirely by me in easily understandable language and terminology. I hope it’s an enthralling story that draws you in with emotion and snippets of humour. 

Offering hope and inspiration to sufferers of any kind, it affords an opportunity for family and friends to gain a greater understanding of the patient’s perspective. For those who are sometimes guilty of taking life and good health for granted, it’s a fascinating ‘ride’.

The rollercoaster, with its ups and downs is a theme throughout my book. I explain in detail each operation and many of the consultations and procedures. I describe the effect it had on my health, relationships, finances, occupation and how it nearly forced me and my family out of our home. Through his time my family and I had to cope with incessant battles with the ‘Alien’ and rationalise the prospect of death.

Without the input of the fantastic medical staff, my friends and patients, I would certainly not be here today, nor would my two boys and myself have been able to undertake a challenging bike ride and climb that served not only to raise money for both The Christie and Macmillan, but also became a focus for my recovery.

I was encouraged to write this book by many people, my own patients and the doctors who have treated me, who, having read my internet blog, thought it worthy of a wider audience.  

Recently, I came through my first clear annual scan in four years. I’m going about my daily life now, working as a physiotherapist, being father to both sons who are now studying medicine at Manchester University, playing squash and cycling regularly. Life is a little more difficult now, especially with the loss of my eye, but it has also been enriched by meeting so many fabulous people. 

‘Riding With The Alien’ is available from Amazon in paperback (£7.99) or Kindle (£3.99). Profit from the book sales will go to The Christie.

How hypnotherapy can help our patients to overcome anxiety, claustrophobia, needle phobia, nausea and fear of pain - Peter Sandy

Peter Sandy - clinical hypnotherapist

Peter Sandy

Why is six scared of seven? Because seven, eight (ate) nine. This is my daughter’s favourite joke and you will find out why this is important when you read on. 

I’ve been a clinical hypnotherapist for eight years. For the last two and a half years I’ve been lucky enough to work in The Christie’s complementary therapies CALMs team with a talented group of experienced therapists supporting patients (and carers) to overcome a varied range of issues such as anxiety, claustrophobia, needle-phobia, nausea and fear of pain. 

I support patients undergoing a range of radiotherapy and chemotherapy treatments as well as MRI and CT scans. Radiotherapy patients are often most anxious during the mould making process prior to treatment and some of our patients need help with cannulation prior to having chemotherapy or other treatments and procedures.

Many people imagine hypnosis to be along the lines of the stage hypnotist in the TV programme Little Britain…“look into my eyes, not around my eyes” * click fingers * “you’re under!” 

Whilst the idea of a hypnotist having instant mind control may be entertaining (even a little scary), the reality is quite different. Nobody can tell you how to think, not even if you want them to. 

Hypnosis is an altered state of consciousness, a relaxing state of internal focus – a bit like daydreaming – where a person can feel calmer and become more in tune with their unconscious ideas, thoughts and beliefs. A skilled hypnotherapist will build rapport and have an understanding of how to use unconscious communication – verbal and non-verbal - to connect with, and then help discover new strategies, changes in emotional levels or alternative ways of thinking. 

We all have a vast collection of useful past experiences - some are easily remembered and some are buried deeper. These inner resources have been acquired over the years (like humour, stubbornness, intelligence, and a plethora of problem-solving skills), and the ability to imagine different ways of coping in the future. Hypnotherapeutic processes explore and utilise these pearls, and we are able to anchor and recall powerful resources using gestures, colours, words or aromas. 

There’s an old saying: “Give a man a fish and you feed him for a day, teach him to fish and he can feed himself for life”. The CALMs team can teach a variety of techniques and methods to help people become less anxious and feel calmer. This in turn can provide a long-term benefit, not only to the patient but also to everyone involved.  

If a patient is struggling with anxiety, we come alongside and invite them to try different self-soothing techniques to help them regain some control. Normally a patient who is panicking will be over-breathing so the first thing we might teach is a simple breathing technique, like breathing round a square shape to slow it down and keep it steady. We may ask them to close their eyes and vividly remember a special place and re-experience how they feel in that place (calm, relaxed, resilient, empowered) then use an aroma, object or even a hand gesture to retain and recall (anchor) the feeling. 

One of the things I really enjoy about working with patients is how often they teach us things.

I saw an 80-year-old man a few weeks back who was suffering from breathlessness. He was already halfway through radiotherapy on the lung and began the session looking out of sorts, slightly bent posture, struggling to breathe steadily. That was until we got onto the subject of Karate, of which he is an expert, and before I knew it, he was on his feet, chest out, showing me how to breathe in a way that allows you to take a punch to the stomach - which comes in handy when you have three kids! We swapped breathing techniques and this inspirational man quickly picked up how to do self-hypnosis so he can re-enter a useful relaxed state whenever he needs. 

Many of the radiotherapy patients we support will be receiving treatment focussed on the head and neck, lung or breast areas and they often have something in common – claustrophobia, the fear of confined spaces. 

Claustrophobia affects one in ten UK adults and, if severe, it can result in a full-blown panic attack. This type of phobia is awakened if the patient is required to wear a special mask that is closely moulded over their head, neck and shoulder areas and worn during each treatment to ensure they remain in exactly the same position for every session. Although this mask is an essential tool for the accuracy of treatment it is a very snug fit (and doesn’t look pretty either) so it’s not surprising that patients with high anxiety, pain, breathing issues or claustrophobia struggle to even have the mould made. 

Being able to help a patient get through the mould-making stage as smoothly as possible is important as it can reduce anxiety and make a significant difference to how that person feels about their future treatment. 

There are a number of ways we can help. I was asked to help a patient who suffered severe claustrophobia combined with neck pain issues from surgery who was shaking and hyperventilating in the waiting area outside the mould room. I recognised the signs of panic and quite naturally felt some of her anxiety rise in myself. As we spoke, I allowed my breathing rate to match hers so I could begin at her pace, and I invited her to take a sip of water and hold it in her mouth as research suggests that having a moist mouth tells the brain “you’re doing ok”. 

Next, I asked her to focus her attention on steadily clenching and then relaxing two squashy ‘stress-ball’ yellow stars in tune with her breathing, keeping in harmony with her as I slowed my own breathing and softened my voice. 

We agreed ways in which she could feel more comfortable and in control by establishing a clear stop signal. 

We discussed how she would like to feel in charge when we began to make the mould. We also spoke about things other people had found helpful, like slowly counting numbers down from 200 or focussing on rotating the yellow star and visiting places in her mind. We worked on releasing tension in her feet and legs by tensing and relaxing the large muscle areas involved in the fight-or-flight instinct.

Throughout the process, I continued to hold her hand and give her steady voice contact updating her on the mould process and directing her attention to all manner of other things. 

Having successfully completed her mould and the following CT scan, she thanked the radiologists and me and even laughed at my daughter’s favourite joke!