Original script of the story

ORIGINAL SCRIPT

This was the original account of my story I wrote about six months after my treatment.I wrote it for two reasons at the time. It had taken me up until then to have enough energy, beyond everyday convalescing, to begin to look for a task that would be a little bit taxing. I was bored and desperate to return to the real world again.

I also realized that over time I would forget some of the detail of what I had been through. I wanted to have my own record of my own disease. 

Writing down my story seemed to the perfect answer to both of these requirements.  Every day I could do as much, or as little, as I was able to do. There was no deadline. And in the end, I would have preserved the story for myself and I would have taken my first steps back towards being a normal person again.

There was no telling, at that point, how far that story could go from there.       

They say that life begins at 40 but Liam Ryan could not have anticipated the changes that he would experience in his life on reaching that milestone. Perfectly healthy on his fortieth birthday he was to undertake a journey that would take him through 3 life threatening illnesses in hospitals in three different countries before he reached 41 and a return to a city he thought he had left for good, Liverpool.

I am originally from Horseleap in Co. Westmeath and my own connections with Liverpool go back a long way. In 1982 I was accepted to study architecture in Liverpool John Moores University. After qualifying I remained on there to work with a local practice and did not return to Ireland until 1996, bringing home a little more than I arrived with, a wife and two children. My wife Pam is also an architect and two years later we set up our own practice in the twin towns of Ballina-Killaloe on the Tipperary Clare border. Everything was absolutely fine in our lives until my world was turned upside-down last May when out of the blue I was diagnosed with a massive cancer tumour behind my right cheek.

I was not an obvious candidate for cancer. At 40 I was still running regularly having 6 marathons, in decent times, under my belt and had never smoked. The last time I was inside the walls of a hospital was when I broke my arm at 17 in school and I was taken to Nenagh. My health ever since then had been very good. However I was now to learn that this disease does not conform to any preconceptions or patterns when it comes to seeking out victims. I had little awareness of hospital or the health industry but now that I have started my second life, post cancer, I realize that the people who daily inhabit the mini-city that every hospital is, perform the ultimate work of all and, in many ways put what the rest of us do to shame. It just doesn’t get any bigger than saving or improving people’s lives.

The first symptoms I experienced where intermittent but severe headaches in late April, 2002 and after attending both my GP and dentist I was admitted to the Regional hospital in Limerick with what we all thought was a sinus problem. I was taken to theatre for a sinus wash, where any infection I had would simply be washed out from the sinus. This was a routine procedure and by now I was the life and soul of the ward so I was almost beginning to enjoy my stay. When my consultant, John Fenton and the ward sister, Carmel O’Sullivan arrived at my bed the following morning I greeted them with my usual smile but only received serious faces in response. The curtain was drawn around the bed and Mr. Fenton didn’t have to say much more than his opening words “Liam, I’m afraid this is very serious”. In his investigation he had extracted what he described as a “cheese like” substance and his worst fears were confirmed the following day when a scan revealed that I had an enormous tumour.

It was the news that everybody dreads and most cancer sufferers will tell you that the worst day of all is the first time you get the news. You have no knowledge of, or preparation for, the world you are about to enter into and you go from 60 to 0 in seconds. For that single day alone, I was simply in pieces. It is cancer with the biggest possible “C” and it is very hard to see beyond the worst case scenario.
My condition was diagnosed as Squamecell Carcenoma but this is a broad description for a group of head and neck cancers that would also include skin cancers. In reality my condition was very rare, only about two in Ireland per year, and comprised a tumor in the maxillofacial area of the head. In my case it had grown to a stage four cancer, the most advanced possible (one consultant later told me that mine could have been called stage 44) and because of the size of the tumor, running from my cheek around my eye and right back to my brain, it looked as if that I was now beyond surgery. At that point it appeared that little could be done. John Fenton admitted to me that I was the second worst case he had ever seen and the worst case was dead in a month. At that instant he felt I was beyond treatment so things were not looking good.

My association and by now friendship with John Fenton had become crucial to my direction from this point. I asked him straight out that if he was in my shoes what would he do. As it turns out he had spent 3 years in Liverpool in what he regarded as the best head and neck cancer facility in Europe and because of my age and family circumstances his recommendation was that I should go there to establish if any treatment was possible. If I was to have any chance it would only be at a treatment center that had the best experience of my condition. At this stage, from our earlier conversations, he was also aware of my links to Liverpool and and knew that this would be a big advantage if I was referred to Merseyside for long term treatment. Pams family are still in Liverpool and I still have many friends there from my college and early working years so in many ways it was even a more appropriate referral for us than Dublin would be. We were delighted to be going somewhere we knew well and in a strange way it was almost as if Liverpool was calling me back again now that I was in trouble after having always sorted me out before.

On practically all of the days I had before going to England I ran at least four miles around the narrow roads of Ballina and Killaloe. I’m not sure why. I guess it was initially just to just get away and to start getting mentally prepared for what I was about to go through and to get fitter thinking that that was the best possible preparation I could make in order to help my case. As I hit the road the great community that I live amongst here fell on their knees and I was showered with hundreds of cards, Mass bouquets, relics and prayers. Now that I knew my disease however I realised that the bulk of the work was going to have to be done by myself. As I assessed my situation I knew that there would be only one escape door and the common denominator for all who beat cancer is a positive attitude and a will to live, no matter what. I knew that this was my end of the bargain. The medics would do their job but it was up to me to have my head sorted for the challenge and be the best possible patient I could. The rest would be in Gods hands.

My first visit to Liverpool was at the end of May to meet my two consultants, Simon Rodgers and Dave Husband. By now I could feel the tumour growing under my cheek and their assessment was that the surgery would be extremely high risk. They both agreed my chances of cure were only about 5%. Simon told me in later years that my chances were actually much less than 5% they gave me and they normally would not have recommended surgery for a case like mine but their decision is also based on how they feel the patient can cope with the ordeal they are about to embark on. Thankfully Pam and I had both impressed them that we were ready to take this on, no matter where it brought us and that I had the necessary single-minded determination to fight this all the way. My stark choices now were that I could risk a very complicated surgical procedure that I would possibly not recover from or I could just live out whatever I had left, which would be months rather than years. Having explained the procedure they moved to leave the room to give us time to decide but I told them there was no need to go. At 40 with 3 small children months were of little use to me so the decision was already made. I pressed the consultants to give me some idea of how realistic my chances were. They explained that the normal procedure for this operation would be to remove the tumour and a further centimeter clear all around. In my case this was not going to be possible as the tumour was so extensive it was backed up to my brain stem. I was therefore going to be relying on radiotherapy to kill off any of the tumour the surgery would miss to a much higher proportion than they liked. They both agreed my chances of cure, which I now know they were exaggerating to give me hope, were in figurative terms about 5%.

We left the hospital that evening with the very daunting figure of 5% ringing in our ears. I was later to speak to a friend of mine, Paddy Hynes from Athlone, who had beaten bowel cancer and he completely reversed my attitude towards this figure. 5% is fine he enthused, if it’s only one in a hundred then that one is you Liam, 1% is all you need. The 100 will include people who are frail, who smoke and who are un-fit but you are young, fit and not willing to let this beat you so if I had to pick one in a hundred, I would pick you. But its not even one in a 100 its 5 so now your job to make sure you get yourself inside that percentage. There is absolutely no reason why you can’t. You are the man! It was the best piece of advice I received during the entire ordeal and said with such single minded conviction that from then on I was almost bragging about my 5% chance. Paddy also said to me that I will simply be on a different road for the next 12 months or so and after that I’ll be busy getting on with the rest of my life. This was great stuff and I just focused single-mindedly on the chance that I had been given rather than the odds that were against me. Deep down I also knew that there would be time to prepare for the worst case scenario if every single escape route closed in on me but in order to give my fight the best possible chance I would not even contemplate that likelihood until all possible hope was completely exhausted.

After leaving the hospital we took advantage of the time given to us by our child minder and decided to go for a drink to reflect on what we had been told. As we passed through Williamson Square in Liverpool city center I just happened to glance into a dark corner and there I witnessed something that I had only ever seen before on films. I saw a man about my own age with his trousers down around his knees and he was injecting heroin into his thigh. I stopped to show Pam what I had seen and she was equally shocked. At that point in time I thought that like for like his chances were better than mine but if he goes to hospital nobody will really care. He won’t have any visitors, no cards no support group from Ballina Killaloe or old friends from Liverpool. Very few will really care whether he lives or dies. At that point I felt lucky I was me rather than him.
The date for the operation was fixed for July 8th. The surgery would involve cutting my face from just below my ear, across to my nose, breaking my jaw and then cutting down to my chin. My lower jaw would then simply be folded back and the surgical team would have to disconnect the many nerves running through the middle of my head from my brain to my eyes, ears, nose, mouth, etc. They would then begin the removal of the tumour as best they could, the removal of almost all of my cheekbone and my right eye and the removal of half of both the roof of my mouth and my top set of teeth. Replacement bone would then be taken from my hip to rebuild the cheek and lining would be removed from my stomach to hopefully reseal the roof of my mouth. Finally all of the nerves to my brain would then have to be re-connected, my jaw put back in place and everything stitched up.
The entire procedure took 12 hours and was undertaken by Simon Rodgers and his senior assistant David Vaughan who hails from Co. Cork. 12 hours is a long working day for anybody but these incredible people had been 12 hours in the middle of my head.
I came around in intensive care with Pam at my side. I knew that if things went badly wrong regaining consciousness after the surgery would have been at risk so I was very grateful to open my eyes. I was in good spirits and aware of my location if not fully of my condition which is apparently a normal state in intensive care. The morphine banishes the pain but thankfully not the awareness.
The great news was that although damaged, the surgical team had managed to save my right eye (although I was only to have a blurred image from it for a short while) and the flap to seal the roof of my mouth appeared to be a success. My fitness had also been a factor in my favour as the intensive care staff could not believe the strength of all my readings on the monitors.

For the next week I was unable to eat, drink, talk, walk or sleep as I was breathing through a tracheotomy and fed by a peg tube directly into my stomach. Two days after the operation Simon Rodgers came and sat on the end of my bed. He said that he felt it had gone well. They had removed all of the tumour that they could see and admitted that by the end they were very tired and were close to things they just didn’t want to be near, like brain and spine. He told me that my operation was just about as big as they come and was on a par with surgery for a major car accident. I almost felt embarrassed by what I do myself as he spoke and I started to appreciate the incredible work that surgeons do. At no point did they get to relax because even 11 hours later, when the main surgery was done, they still had to sensitively re-connect the many nerves they had to cut through and at that point I was still very much in danger of losing my sight, speech or hearing. I felt guilty that I had so little awareness of their work until now.

My first week after the surgery was probably the worst I’ve had in a long time. Although not in severe pain I was in what I would describe as 24 hour discomfort. In fact it has given me an insight into the condition of a patient to such an extent that I will now no longer trust a hospital if you phone up and are told that some is comfortable. You can take it from me that they may be stable but they are very much “uncomfortable”! I was awake for every second of the first two days with nothing to interrupt the timeless agony. I was unable to sleep because of the tracheotomy and unfortunately I was within view of the clock on the ward and this only helped to increase my frustration. Every five minutes passed as slowly as an hour and I literally spent these days just wishing a week away.
My running experience was a great source of strength to me at this time. When I was brought back to the ward I had about ten tubes coming out of me and on the following day when the first of these was removed, an anesthetic feed in my foot, I remember clenching my fist thinking one gone nine more to go. I could relate how I was feeling to the 20 mile stage in a marathon when with 6 miles still to go, you had nothing left but you dug and found something. In running when it is not going well I would often introduce a strategy of run what you see, literally get to the next bend or top of the next hill and then concentrate on the next stretch and so on. I applied the same tactic to these days of recovery and all I wanted was some progress for each day that came. This could be the removal of a tube or to sit up or get out of bed and eventually to talk, eat, drink and walk for the first time again.

I hated the tracheotomy. It was the worst part of all. Apart from the physical discomfort it had a psychological impact of tying you to the bed like a noose around your neck. I appreciate that with my mouth out of action it was keeping me alive but it was not pleasant. The worst thing it did was make me cough when I didn’t really want to cough. As it discharged air down my throat this air was moistened and the moisture would then collect on my chest. This would result in me coughing to clear my chest but each cough was extremely painful to my newly re-shaped hip and because the tracheotomy was lodged in the middle of my throat the coughing was ineffective anyway so I was caught in this vicious and very painful circle.

I felt as if I was stripped right down to basics that first week by not being able to eat, drink or talk. I would communicate to visitors with handwritten notes but would tire easily at this. However it was only now when I was denied these fundamental activities that I appreciated all of the simple things that we take for granted on a daily basis let alone something complicated like going for a run or driving a car. I found a positive channel for my thoughts to cherish all the wonderful things my body could do and I vowed that I would not let myself forget these feelings and become complacent ever again about the wonderful gifts we have all been given as human beings.

After a week the tracheotomy was taken out and by then I detested it so much that its removal gave me a huge lift in terms of progress. Within a few minutes I uttered my first words and was brought a glass of iced water. It is hard to find words that are strong enough to say how good it tasted but I suppose if you could imagine your favourite drink on the hottest day you’ve ever experienced, it would come close. I didn’t feel hungry when I was fed through the peg tube but I did feel quite thirsty. I kept getting flashes of a drink in my mind and after a day or two this grew to a billboard sized image of a long, tall, cold glass of Coca Cola. The more I tried to stop thinking about it the bigger it got. It was torture but again I promised I would appreciate every single drink I would ever have again rather than insisting on ice or lemon or that it isn’t cold enough or whatever.

My progress in the second week was almost miraculous. I was eating now and my physiotherapist (they nicknamed him the phsyioterrorist!) was amazed at how quickly and how well I was walking. I put this down to the strength in my legs from the running and again I adopted the same spirit for walking again as I would for the pain of getting through a marathon. I was definitely through the wall now and starting to cruise into the last mile or two knowing I was nearly home. Towards the end of that second week I looked as if I was going to break all kinds of records for recovery from major surgery and then disaster struck. I got meningitis.

I don’t remember very much about the first few days of meningitis. I was apparently drowsy for a day or so and whilst the nursing staff initially thought I was sleeping off the tiredness from the surgery, Pam, who was constantly at my side, knew something was wrong. When I came round two days later I was in the neuro wing of the hospital. I had been rushed there with suspected hydrocephalus but thankfully the water on the brain was only temporary and a lumbar puncture confirmed that I had meningitis. I had a very tricky 24 hours apparently but as I was asleep, the main commotion went on without me taking any part. When I awakened I was mainly concerned with how much I had regressed from the last time I was awake. There were those tubes again and I was confined to bed again after my walking had gone so well but the main drawback was that I felt absolutely exhausted. I was also slightly despondent to be confined to bed again and I spent the next week retracing steps that I had previously achieved, like eating, sitting out of bed, standing and eventually walking again.

The meningitis however was now under control and I made steady progress over the next two weeks. I was having regular visitors at this stage, many of whom were generously making the trip from Ireland. There was nothing like a new face to give me a lift on any given day. Then, once I had completed the antibiotics, I was stable on my feet and in great form so I was deemed fit enough to be discharged.
The consultants did not want my radiotherapy treatment to begin much later than 6 weeks after the surgery and thanks to the meningitis one month of this period had now been used up. It was now a case of getting as strong as I could and hopefully starting radiotherapy within 2 weeks. We moved in with my first cousin, Mary Naughton, originally from Clara, Co. Offaly and normal life began to creep back slowly into place for me. As my strength increased I was able to venture out to the odd pub or restaurant but then on August 20th another setback was waiting for me.
I woke up that morning and noticed my right calf was very swollen. I didn’t pass much remarks at first but by the following morning it was huge and I was rushed to the main hospital in Liverpool and diagnosed with deep vein thrombosis. Yet again I had been caught in time and I was released from hospital by the end of the day. The swelling started to go down the next day and although I was joking that most people with DVT’s have to take round the world flights to far-flung exotic locations to earn them, whereas all I had done was caught the Seacat from Dublin, I was a little despondent that here I was with yet another setback to overcome. The main impact of the thrombosis was that I was now dragging my right leg and my mobility was substantially curtailed. However it passed quickly as within a couple of days the swelling was gone and I was properly back on my feet again. It was critical that nothing else went wrong at this stage because my time limit for starting radiotherapy was now almost up.

It was confirmed that I would begin my radiotherapy on August 28th as Dave Husband claimed he could not postpone it any longer. I had still one more unexpected twist to face when I started to experience severe headaches the weekend before I was to start. We were very worried at that time because all we could think was that this was the tumour trying to re-establish itself after the longer than expected delay since the operation. I was taken for a scan and although the results weren’t fully clear Dave Husband felt that it showed enough to suggest that the tumour may well have been trying to re-form. He couldn’t afford to postpone the radiotherapy any further and now decided to introduce three chemotherapy treatments to directly attack the area where the tumour appeared to be visible. The first chemo session took place straight away and involved being hooked up to an interveinous drip for a full day and overnight stay in the hospital. I’m glad to say I did not experience any side effects from the chemotherapy sessions and thankfully didn’t have a headache after that.

My radiotherapy had now begun and in many ways this was my best period of the entire treatment. I was to attend on a daily basis for seven weeks with each treatment lasting no longer than about 15 minutes. A clear plastic full face mask was made from a plaster cast of my face and this was secured over my head for every treatment to ensure that the radioactive rays hit exactly the right spot every day. I was the man in the “plastic” mask. The facilities were like a scene out of Star Trek as whilst I lay on a moveable table, with my mask over my face, the radiotherapy device would hover over my head like a miniature spaceship and travel to three different positions to send out its invisible rays.

I was gaining in strength all the time at this stage and apart from my daily lunchtime treatment session the rest of my day was free. I started to live again. I had a lot of visitors coming from Ireland now and I had the energy to show them some of the sights in Liverpool that I knew well so we took in the two cathedrals, the Albert Dock, Speke Hall and tours of the Wirral on a regular basis. I was also able to attend matches at Merseyside’s 3 football league clubs, Liverpool, Everton and Tranmere Rovers and return to a lot of drinking haunts that I had not been in since I was a student.
The first couple of weeks of radiotherapy passed off without incident. One of the three angles of treatment was through my right eye, which had already been damaged by the surgery and the skin around this area began to show signs of stress on the 3rd and 4th weeks. The staff told me that this was normal and that it would probably escalate to a point where my mouth would swell and I would have to be re-admitted and fed through the tube again. Now that my life was back to some kind of normality again I would have regarded being re-admitted to hospital as the worst possible setback but there was little I could do as there was still 4 weeks of radiotherapy to go. Remarkably however my skin didn’t deteriorate over the next few weeks, there was no swelling of my mouth and I knew when I got to the second last week that I would make it. The radiotherapy staff told me that I must have had amazing skin to have held out over 7 weeks which was a lot longer than most of the other patients courses.

When you get cancer there is very much a feeling of joining a club. First of all you discover that there are an awful lot of people in the same boat that you never knew about before and then you realize you have a very strong bond with all your fellow sufferers. At lunchtime every day in Clatterbridge Hospital this club would transform into our own little group of patients brought together by our disease. The people in my group were mainly older women with breast cancer and every day we would support and entertain each other and get to know each others families. We had never met before and probably never will again but for these weeks we were all the sincerest of friends because we were united by the strongest bond of all, the will to live.

As the end of my radiotherapy approached and taking into account that I was in such good form I was getting desperate to return to Ireland. It had after all been 4 months since I was last home at this stage. I was to see Dave Husband on the Friday of my last radiotherapy session and I was braced for him to say he needed me for another week or two but ready to challenge him if he suggested that he needed me for longer. To my complete surprise he said that I had done so well through radiotherapy that he no longer needed me. I was free to go. I spent the rest of the weekend celebrating and thanking friends and family for their brilliant support and we loaded up and sailed on the Monday, October 14th. We were going home.

My situation now was that I had all the treatment that was possible. The surgery was so extensive and so complicated that it would not be repeated and because the tumor was so large I had been given all the radiotherapy I could possibly take. The hope therefore now was that this treatment would have effectively eradicated the tumor and there was nothing else that could be done if it came back. With head and neck cancers tumor invariably return quite quickly so it was considered that if I got 18 months clear I would be OK.
I had no problem accepting this as I appreciate that there is a certain amount of risk in everybody’s daily life and I hadn’t lost sight of the fact that, considering the odds, I was very lucky to still be alive anyway. There can be danger when you play sport or cross the road or drive a car and I was happy to include the possible return of the tumor with these as a normal part of my life from now on. Now that it was all over I was very grateful to the surgeons for their great work and to the great faith my family and friends had put into my recovery and of course, to God.

I returned home to an incredible welcome and learned something new again. After our hero’s in the world of sport, music, politics, arts and industry people who beat cancer are also up there in terms of achievement. The people of Ballina and Killaloe gave me the most amazing reception on return which was the culmination of all the support they had provided for me throughout my entire ordeal.
The next few weeks were spent taking things very easy and we then decided to book a sun holiday to give ourselves a break and re-group as a family after the summer we had.

We flew to Lanzarote on the 14th of November. At last my life was heading in the right direction again and we were going to see out the year on a high note with two weeks of warm weather and return home for the run-in to Christmas. The three boys were all excited and it was just what they and Pam needed after all they’d been through since May.
However the holiday spirit was not to last long as two days into the holiday, I began to feel unwell. Initially I was just in bad form but Pam had to call for a doctor when I became violently sick. We were very fearful at this stage that this was the return of the tumor and the doctor did little to ease our fears when she almost tearfully said to Pam “Well at least you have the children. They are beautiful”. I was taken to the tourist hospital on Lanzarote but my case was too serious for them to handle so I was taken by helicopter to the main hospital for the Canaries on Gran Canaria. I was never on a helicopter before and now when I got my big break I was unfortunately in such a condition that I wouldn’t be able to remember it.

In Gran Canaria another lumbar puncture confirmed meningitis again and this time it was two days before I was out of danger and yet again I had just been caught and treated with the antibiotics in time. My three sisters were summoned and flew out while I was in intensive care. I came around on the third day and realised that once again I had not been conscious while most of the action was going on. I was back again to where I had been before, hooked up to a drip to treat meningitis with the main danger having passed.
However I was to discover a new series of challenges.

From my performance in Liverpool after the surgery I was almost blasé about adopting a positive attitude towards recovery. Knowing that it gives you the best chance of beating any disease I couldn’t understand why everyone could not be positive about getting better. I was to learn in Gran Canaria that this approach is not as simple as I might have thought. I was not a happy patient for my first week in hospital over there. I was finding it difficult to come to terms with the landslide of emotion I was experiencing of having arrived on the islands for a holiday right down to now being on the flat of my back in a hospital. A lot of smaller details also combined to further fan the flames of my discontent. The food was awful, I was unable to converse with the other patients and had little communication with the doctors and nurses and I suddenly felt very vulnerable being so far from home in a strange land. I suddenly realized that sometimes it isn’t all that easy to be positive.

After a week I settled better. I realized that I had meningitis again and that the only way forward was to complete the medication and beat it once again. I had also given up on any hope of rescuing the holiday at this stage. I was on my feet now and able to eat in the cafeteria and had Pam and the kids and the girls in to see me daily. I was also starting to get literally hundreds of text messages through from Ireland. Hurray for modern technology.

On December 4th, after three weeks in hospital, I had completed the antibiotics and was passed fit to fly and return home. By now all I wanted to do was to just get out of 2002 but the following week the very final twist was to come when our youngest boy, Abe, was rushed to the Regional Hospital in Limerick with, unbelievably, meningitis. With the law of averages we just thought it couldn’t be possible. This was 3 cases of meningitis in the one house in 8 months. He was in for 5 days with Pam at his side and once again thankfully, it was a case of being caught in time. They came home on the Friday before Christmas and for the last few days of the year I was ready for the bubonic plague, scarlet fever and hailstones the size of footballs. Thankfully they didn’t come.
Midnight, December 31st 2002, happy New Year? – It sure was!

Now that I can look back on it all it was an incredible experience to go through and although very daunting and frightening at times it also had so much that was positive. I met so many incredible people that I just wouldn’t have come across any other way. I realized that I’ve got a fantastic wife and family and I live in an unbelievable community here in Ballina. I have a much greater appreciation for the great work all health workers do and I’m again enjoying so many things I can do as a human being that for years I took for granted. I’ve basically been re-invented as a person and I am just full of the joys of simply being alive.
You will often here from cancer sufferers that in a way it was the best thing that ever happened to them. Although extreme I can understand this sentiment as it can be the turning point that forces you to look at how you are actually living your life. It makes you see the real issues again and encourages you to make the necessary changes to ensure that these real issues are once again your priority. It forces you to think of life and death and where you stand in spiritual terms. It makes you look into yourself.
And finally when you beat it, it makes you proud that you took something on with the odds against you and won through. You live to fight another day.

ONE YEAR ON

A year later I wrote this short piece as a follow on to the original script.

I have a lot more dates in my diary this year. May 28th was the first anniversary of the day I was told I had cancer, July 8th was a year on from the date of my surgery and now mid October which was when my radiotherapy was completed and the point from which my remission clock started to tick. In many ways these have replaced all my old dates as the realization that I am getting a second chance at life is still very strong. I have two birthdays now, on one I was born, on the other I survived.

So here I am, one year on, and the miracle now is how well I’ve recovered. A little over this time last year I just wanted to be alive and would have accepted anything extra as a bonus. Now from a position where I can see the wood from the trees and fully realize how serious it all was I am quietly amazed to have come through all of this and be basically 95% of what I was before. In the thick of the fight last year I was only focused on surviving but the price of that survival could so easily have been to have lost my sight, my hearing and especially the ability to talk and eat because of all the bone that had to be removed from my cheek. I now realize that my recovery has become an even bigger story than my survival.
I remember one day in radiotherapy I sat beside a lovely woman who had a similar tumour to mine but hers was in her throat. Her surgery was successful but unfortunately it resulted in her never being able to eat or drink again and requiring a peg tube for life. So she looked at me and thought “well I’m glad I’m not him because as a woman I’m fussy about my looks and I wouldn’t fancy a dodgy eye”, and I looked at her and thought “well I’m glad I’m not her because when I go home I want to go down to Liam O’Riains for a pint and to the Cherry Tree for a steak”. But we were so strong at that time that if the situations were reversed we still would have preferred our own case. Now, twelve months on, I realize how much more difficult it would be to contend with not being able to eat or drink and I appreciate Liam’s pint and Harry’s steak all the more.
I can also walk, talk, sleep, drive and even work again just as I did before and the ability to do all of those, I now know, is miracle number two. I haven’t run again yet because my only complaint at this stage is still some tiredness but that too should be resolved in another month or two, so I expect to be back on the roads by the end of the year.

I said that physically I am 95% of what I was but in truth I am far better than that overall because cancer has changed my life completely. Because I came so close to losing my life, I now appreciate it so much more and my attitudes to everything as a result are now completely different. If I’m stuck in traffic or the shop hasn’t got what I came in to town for or I’m late for an appointment, it simply doesn’t matter anymore. It is not important compared to what was important to me over the last 18 months.
People frequently have asked me if I thought about dying in all that time. The immediate answer is yes, I would have been foolish not to. Just before the surgery I checked myself to see if I had any plan if, as looked likely, the worst case scenario were to materialize. As I looked at my life I appreciated that although short it had been very good. I had come from a great family, received a good education and gone to university, married a great woman, had my own family and lived and set up a business in the great community of Ballina. I realized I had been so much more fortunate than the people who didn’t get the same chances, the seventeen year old who comes off a motorbike or the three year old who is diagnosed with a terminal illness. I was then happy to put away those thoughts so that they wouldn’t dilute my positive fight in the knowledge that they were there if I needed them. This approach gave me great strength and knowing that I could deal with the very worst consequences was the foundation that I stood on to take on the disease itself. If you’re not afraid to die then nothing else can touch you.
Now, one year on, I am still taking great strength from that initial strategy. It is the basis from which I have a new attitude towards life and a new appreciation of everything that I do everyday.

I relish the future now because it is almost like an unexpected gift. We are just about to build a new house, the planning for which was a long drawn out process. Our practice is doing very well with a lot of good design work to be tackled and what were perceived as challenges previously are now opportunities to be enjoyed. However, apart from Pam and my family and friends, I now also have in my life some of the greatest people you could wish to meet. I will be forever indebted to John Fenton, Carmel O’Sullivan and my two Liverpool consultants, Simon Rodgers and Dave Husband for their dedication and great work. I am only half joking when I say I’m glad I got sick because I wouldn’t have met them otherwise.
The great community that I am part of in Ballina and Killaloe has also been extended to North Tipperary as I can no longer walk down the streets of Nenagh without somebody stopping me to tell me they’ve read my story and that it meant something to them. People are fantastic. But that is my role now, to encourage others and to show that the odds can be beaten. If I did it, there is no reason why you can’t too.
If I could offer anything in return for the tremendous support that I have had it would be to appreciate every day and the treasure the wonderful gifts we have all been given. Unfortunately it is generally not until they are taken away before we truly realize how lucky we really are.

A few close friends knew I had written these and asked to read them and then they began to get passed on to other cancer patients. All of the three local newspapers in my area, The Nenagh Guardian, The Clare Champion & The Limerick Leader then published them in full as well as The Westmeath Independent and from there all of the national newspapers in Ireland picked up the story. After Ireland it was picked up in Liverpool and the rest of England and then it started to go all over the world.

Had I not written this original account I probably would have never written the book and the book became an essential catalyst to this story reaching the global audience it has. So these lines were the very beginning of this wonderful story seeing the light of day!

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