When planning to walk Hadrian’s Wall in the north of England in 2014, I carried out a number of risk assessments (as all good Project Managers do!).  In true ‘Donald Rumsfeld style’, I considered all the ‘known unknowns’ and the ‘unknown unknowns’.  Anybody who doesn’t is either reckless or supremely confident (the latter can sometimes be the same as the former……).

This major undertaking was within 4 years of my diagnosis and within two years of 3 surgeries and I was borderline stable.  I wanted to get it done while I was able!

As a Cancer patient, there were some issues I had to consider which might not have made the list for most walkers covering this sort of distance and this type of terrain.  One of the issues I occasionally experience is stomach cramps, not that frequent but problematic and quite painful when they occur.  If you’ve had abdominal surgery, you might be having to deal with issue. Many Neuroendocrine Tumour (NET) patients also suffer these cramps, a side effect of the cancer or simply as a side effect of treatment.  Particularly with small intestine NETs or any other part of the bowel. 

For me, the main pre-diagnosis symptoms were flushing and occasional diarrhea, the former was helpful in working out my diagnosis. However, in hindsight some other issues might have been masked by routine/’run of the mill’ illnesses a couple of years prior to being diagnosed with Cancer.

I’m not particularly ‘syndromic’ following surgery and somatostatin analogues, however, I do occasionally have to deal with ‘stomach cramps’ (a term which tends to mean the whole abdominal area). Fortunately, they are not that frequent.  I might not have a stomach cramp for weeks and then suffer a couple of times in a single week. Consequently, after each attack, I study my activities, my medicine and my diet trying to figure out if there is anything I can avoid preventing this happening.  I now maintain a daily diary to assist.  Footnote from 2023, I don’t seem to have them anywhere as regular as I used to, but still painful when they turn up unannounced.  I guess your body heals slowly, you adjust all the time including what you eat. 

I think most people will have experienced stomach cramps at some point in their lives and those who have will agree it’s not nice. I’ve had some really painful episodes in the past; and as is usually the case, it’s helped by visiting the toilet/bathroom. Getting there can be painful as I sometimes find any movement exacerbates the pain with the worst attacks.  It’s worth noting there can be many reasons for “stomach cramps” many unrelated to NETs.  Read here 

You can now see why I listed this as a key risk in walking the 84 miles of Hadrian’s Wall! I ‘googled’ to check the availability of toilets along Hadrian’s Wall to find they are few and far between. You might be excused for thinking there shouldn’t be a problem with all that countryside available? Add the openness of the area; add the constant stream of walkers in both directions and the sum = not that much privacy!  As both an ex-soldier and a male, I’m used to using ‘outdoor’ toilets or at best temporary structures.  I use these skills to seek out private places to fill the need. I guess it’s more awkward for a female and I sympathise.  

I do have a special card which I keep in my wallet but it’s not much use out in the hills! I’ve actually never had to use this card ‘in anger’ but I came very close to using it on Day 5 of this 6 day walk.  I was suffering quite a lot of pain for a good mile or so on the outskirts of Carlisle which was semi-urban. I walked past a dozen houses but my pride would not let me use the card – silly boy!  There was no way I was going to do a ‘Paula Radcliffe’ (caught short during a marathon). Things were coming to a head as we approached a bridge with a small copse over a tributary of the River Eden.  At last, some cover! 

Since then, I occasionally waltz into the nearest café or hotel on the odd occasion when this happens, no-one has ever challenged me, and I have my special card ready just in case!

Read a short summary of abdominal pain and how to describe it to your doctor when you’re worried about something.