It’s close to midnight on June 20 of this year and I am lying in a bed in the Riverside ward of London’s Charing Cross Hospital.
The previous day a tumour had been removed from my colon in a six-and-a-half hour operation. My surgeon, Mr Paul Ziprin, the lead for colorectal cancer at the three large London hospitals that make up Imperial Healthcare, had reported that all had gone well. My boyfriend David had alerted this good news to waiting friends on a WhatsApp group.
Prematurely, as it turned out.
The next afternoon when a nurse tried to get me out of bed to sit in a chair, I nearly fainted. My oxygen levels were not as they should be, but all seemed well enough for first my son Sam, then David to leave my bedside and head home.
A few hours later my hospital bay had its curtains closed and began to fill with urgent-looking doctors and nurses — Mr Ziprin had been called and had ordered an X-ray and a CT scan.
Alexandra Shulman survived breast cancer three years ago, but has now been diagnosed with colon cancer
Alexandra in hospital, when she underwent a six-and-a-half hour operation to remove a tumour from her colon
It was then that a large pulmonary embolism (blood clot) was found in my lungs, something that can happen after surgery. As a result, my oxygen levels were getting increasingly worse and I had significant right-sided ventricular heart strain.
Strangely I didn’t feel at all ill, but the staff made me nervous by saying I could phone David and ask him to return at this late stage of the night.
‘But I’m not going to die tonight am I?’ I asked one of the doctors. His answer was not reassuring. It was long and convoluted and all I took in was that it wasn’t 100 per cent the case that I would stay alive.
Almost immediately the room was awash with whispering nurses who bundled me up and rushed me through the hospital corridors into intensive care.
I am someone who previously regarded myself as pretty healthy – closer to the invincible end of the sliding scale than the vulnerable. My mother is still thriving at 97. My father died at 90. Neither had ever had cancer.
However, three years ago I was diagnosed with a breast cancer, which was treated by a lumpectomy (leaving my breast intact), radiotherapy and hormone therapy. It was the first time I felt real fear about my health. But, nevertheless, I considered the odds of making relatively old bones were in my favour.
So it was with a casual attitude that I took the poo test sent out by the NHS bowel cancer screening programme to everyone over 54 and posted the envelope off.
After all why should I worry? I had none of the symptoms listed as potential warning bells – bleeding, bloating, stomach cramps.
When, a week later, I got a letter saying that further investigation was needed, I was concerned, but only slightly. It could be a polyp. Probably was a polyp. I’d had a colonoscopy ten years before and it had all been fine.
Whispering nurses rushed me into intensive care
However this time the colonoscopy, where a camera is inserted into the colon, was not fine.
As the doctor halted the investigation and asked a colleague to come over and put pressure on my abdomen, I remembered the moment my breast cancer was found during an ultrasound. I was pretty sure they had found something similarly unpleasant.
Was it cancer? ‘Yes,’ she said. ‘There is an obstruction here which I can’t get past. And it looks like a cancer.’
From that moment I was immersed in the sometimes seemingly impenetrable maze of waiting for biopsy results and hospital appointments that any cancer patient is familiar with.
‘The next weeks were a horrible wait. As someone used to being in control, I found it extremely difficult not having any say over one of the most serious events of my life’
When I met my surgeon, he explained it was a major operation, but he hoped he would be able to use the ‘da Vinci robot’ (such a heartening name) which enables the surgeon to operate through tiny keyholes rather than slicing open the whole area.
The next weeks were a horrible wait. As someone used to being in control, I found it extremely difficult not having any say over one of the most serious events of my life.
I tried to carry on as normal, but hanging over my days was the grim knowledge that I had colon cancer and I was going to have a major operation.
The first thing I thought of when I woke each morning was the operation. Everyone I spoke to said encouragingly that it was a simple little thing. They all knew someone who had had bits chopped out of their colon and were now right as rain.
My oldest friend said, with tremendous conviction, based on absolutely no knowledge, that nowadays it was just like having your tonsils out. Another said that, in the event I would need a stoma bag, I should remember the Queen Mother had had one. This piece of information was not entirely welcome.
It was difficult for friends and family to say the right thing. Either they seemed to downplay it or made me more frightened. I worried in some karmic way that, because I had been fortunate in how my breast cancer had turned out, I might not be so this time.
I grew increasingly nervous during the four-week wait. Any moment I wasn’t doing something I would just worry.
It was the only time throughout the whole thing I cried
One morning, feeling desperately sad, I visited the Maggie’s centre at Charing Cross Hospital, a place where anyone with cancer can go for support.
When I spoke to a counsellor there about how I was feeling, I realised what I really minded was being a person who needed to be in that building at all. Ludicrously I thought it wasn’t fair, as if fairness has anything to do with it.
It was the only time throughout the whole thing that I cried.
David tried to reassure me that I was catastrophising, that it was all going to be alright, however, a few days before the operation in a pre-op check-up my usually low blood pressure was so high that the man taking it told me I wouldn’t be able to be operated on unless I did something about it.
I asked him to take it again and again, trying my yoga breathing techniques, listening to soothing Joan Baez songs… no shift. So I booked an urgent appointment with my GP who immediately stepped up and gave me every anti-anxiety and blood pressure medication I could wish for. I choked them down by the handful.
By the time I was waiting to go into theatre I just wanted it to be over, eager for the blissful nothingness imparted by the general anaesthetic.
In all my worrying it had never once entered my head that 36 hours after the operation, I’d be in intensive care, battling a blood clot on my lungs.
Astonishingly, when I was made aware there was a possibility I might not survive the night, I don’t remember feeling frightened. Sad and surprised, definitely.
Alexandra in her garden at home. The former Vogue editor says that after leaving hospital she was ‘happy to be alive, happy to be in my wonderful home, so aware of the love of family and friends’
Perhaps it was the morphine pump attached to me (although I wasn’t using it) or the oxygen or possibly shock, but despite being of an anxious disposition, I didn’t experience any of the symptoms I am well acquainted with as a sufferer of panic attacks – icy terror that seeps through your body, a sickening dizziness, a sensation of a thread being pulled tight in the brain so that it might snap.
There was none of that. I felt only a kind of disbelief that this was happening. That this might be the end of things.
On one level being moved into the intensive care ward was reassuring with its ratio of one nurse to two patients. On another it was hard to avoid the thought that I was only in that place because this was serious.
I couldn’t see how many other patients were in the ward because everything I was wired into kept me prone, but I could hear their sometimes distressed shouts. It was a noisy place, filled with urgency.
About six o clock the next morning Mr Ziprin appeared, before heading off to another hospital for a day’s surgery.
He said he was sorry this pulmonary embolism had happened, but it can do. It was bad luck. He was in favour of keeping going with the blood thinners, but there would be a multi-disciplinary meeting including teams like respiratory and cardio which would also have an opinion.
A couple of hours later another doctor (there seemed to be millions) informed me that the clot was too large to leave in place.
‘It’s about as a big a mass as you can get,’ he told me both terrifyingly and, I felt, unnecessarily. The team had convinced my surgeon they should intervene with a procedure that involved threading a line into the vein from my groin to get rid of it. But – and I got very used to these ‘buts’ – this would carry a risk because I had so recently had a long surgical procedure under anaesthetic.
Ludicrously, that morning a nurse appeared with a fluffy dog of some description in her arms asking if I would like to cuddle it. ‘Some people find it reassuring,’ she said sweetly. Anyone who knows me would understand this was not the sedative I was after.
I wanted to cry. I thought that might help in some unidentifiable way, but at no point did a single tear appear, even faced with these two possibilities – a clot in my lung too big to leave, or an operation that post-surgery might be additionally life threatening.
I was appalled and miserable.
How lucky I was to have David and Sam with me throughout that day, both appearing so calm and encouraging.
I kept looking at my son’s huge brown eyes and thinking how unfair it was that he had to experience what must be so frightening for him, too. But he only smiled and spoke gently to distract me.
‘I probably won’t die,’ I said holding their hands. ‘But if I do, you have to know how much I love you and know you will be alright.’
Neither was foolish enough to tell me it was nonsense to talk like this.
By mid-afternoon two doctors came to check my heart. It was they informed us, in pretty good shape which was fantastic news because this persuaded the vast medical team that it wasn’t worth taking the risk of the procedure.
Two days later, I was moved into a regular four-bed ward for women only. From my bed by the window I spent hours watching the endless stream of planes coming in to land at Heathrow.
All day and night bells went off, usually because somebody’s drip had finished or their arm was in the wrong position.
Although my embolism was being managed by the blood thinners, my bowels were, as Mr Ziprin said, stubbornly ‘sleepy’. It was possible there was a kink and they might have to reoperate, although he hoped not. As did I!
He sent another senior member of his team in to check me who said – joy of joys – that he was all for ‘masterful inactivity’.
Every day I was taken to X-ray to see if the dye I had swallowed had progressed through my body and every day, there was no sign of it in my colon.
Unless this happened I would not be able to go to the toilet. They wouldn’t be able to leave things as they were for very much longer.
By Day six, as I lay on the X-ray table, I sang the Sinatra song Luck Be A Lady to myself, hoping this time my fortunes would change.
I was fed up with the tube down my nose sucking gruesome liquids out of my stomach. I loathed dragging a catheter around the wards as I tried to do some exercise to encourage my body to get its act together.
My luck changed. I was going to recover
I hated the long nights when I couldn’t sleep, and couldn’t move because of all the tubes and instead streamed box sets on my iPad, waiting till dawn when the ward would come alive with the tireless night-shift nurses doing their rounds before changeover.
And my luck did change that very afternoon or at least my colon decided to wake up, and slowly, very slowly, I was on the road to recovery, each day losing another wire or drip from my body.
Two weeks after the operation, I was out of the hospital gown and dressed in my clothes and David came to take me home.
What bliss it was to sink into my own bed and look out at the leafy green of the park opposite. What pleasure to wash in my bathroom with my favourite shower gels even though my stomach and arms were still covered in dressings.
Initially I was simply happy. Happy to be alive, happy to be in my wonderful home, so aware of the love of family and friends. And a few weeks later absolutely delighted that tests showed I needed no further cancer treatment, undoubtedly because of the early diagnosis.
There is still a blood clot in my lung, but I’ve been told it will dissipate with blood thinners.
However, this experience has changed how I feel about life.
I no longer feel I’m wrong to catastrophise — in the end the whole affair brought with it more horror than I expected.
For weeks I couldn’t sleep at night. My thoughts continually flashed back to the hospital ward and fears of another operation, no matter how hard I tried to distract myself.
I now know that however much friends and family might love and support you, there is nothing they can really do when you’re seriously ill. Endless concern, heart emojis, and bunches of flowers can only go so far.
And even now, as I go about the day, I see everything through the filter of this experience: I feel vulnerable and fragile and no longer so certain of living for decades more.
I think of practical things like money and realise there needs to be a plan A that covers me making a respectable old age and a plan B for that not being the case.
I feel more frail and fearful. I worry about tripping as I walk along the street and starting an unstaunchable bleed.
Every pain and ache makes me think something is going wrong again. And then I chide myself for being so melodramatic when so many people are much sicker than I have been.
After any kind of life-threatening event some people make radical changes to their lives, but I have realised how much I like mine how it is. I love my family and thoroughly enjoy my work. I know how fortunate I am.
Yet even so, there is a small part of me that is still waiting for an epiphany, something that would make me drastically reassess my life.
