54 – Until Next Time…

8 April 2025

Written on behalf of Warren Garber by his son, Alex.

It’s been a few weeks since my last blog post, and to say it’s been eventful would be a huge understatement!

On Sunday 6^th of April, at around 5:00am, I took my final breath and came to rest peacefully in my sleep, surrounded by loved ones. When you’re up against cancer, you’re always the underdog. I managed to take it to extra time and penalties, but unfortunately I came up short (even I’m no Cantona).

It’s been an incredibly challenging 5 years – 1,834 days in fact since my very first post, to the one you are reading right now, but throughout this time I have experienced the most wonderful side of humanity and felt so much love and kindness, including from all of you following this blog. More on that later.

I mentioned in my last post that I was facing the reality of coming to the end of the road – and what a road it’s been by the way! I was very much in the ‘end of life’ phase of this illness, having just undergone a small dose of radiotherapy in an attempt to alleviate some of the excruciating pain in my ribs due to the tumour growth. In reality, this was just a sticking plaster and I was still dependent on morphine to supress the pain, making me very drowsy and not such great company (on the basis I fell asleep without warning!).

I was also heavily reliant on supplementary oxygen – I was regularly monitoring my blood oxygen levels and, while sat down and hooked up to my oxygen concentrator, I had reasonably good levels in the mid-to-high nineties range, however any physical exertion (using the bathroom, showering etc) would see those levels drop significantly causing me to feel faint.

On Sunday 23^rdof March, I took a bit of a turn for the worse and was rushed to A&E. As I had long suspected, it wasn’t necessarily the cancer that would kill me but rather a secondary illness/infection. I was diagnosed with pneumonia (at least it was a biggie!), rendering my condition, in the words of the A&E staff, as “not survivable”. Naturally this caused quite an emotional response between myself and Samros, and we recognised I was approaching the end of that road at greater speed than we would’ve liked. As per my RESPECT form, I left the hospital so that I could be at home for my final moments.

Family scrambled to Gloucester from London, Cheshire and Yorkshire upon hearing the news. The mood in the flat was sombre as each family member expressed their thoughts and prayers to me, as I lay there drifting in and out of consciousness, and to Samros and Nisa as well who have been with me every step of the way. Reluctantly, as the night went on, people left to check into their hastily-booked hotel rooms, expecting to wake up to the news no one wanted to hear…

…sorry to disappoint, but I’m not going down without a fight! The morning brought a stark contrast to the events from the night before. Through a combination of pain relief, supplemental oxygen, antibiotics, family support and sheer bloody-mindedness, I made it through this scare (and believe me, it WAS a scare) and felt reasonably okay, to the point where my brothers Mick and Gary were so satisfied with my condition they engaged in some much-needed TLC on the sofa.

Whilst I temporarily pulled through, this episode marked quite a significant milestone in the progress of my illness and unfortunately started the real decline in my health which, in just two weeks, would see me finally succumb to this disease.

It was at this stage I was properly introduced to the district nursing team. As I became less mobile and even more dependent on pain relief, a hospital bed was brought into the flat, a much more comfortable upgrade to the recliner sofa which I usually rested on. Additionally, a syringe driver was introduced to deliver subcutaneous pain relief at a controlled rate, over a rolling period of 24 hours, and a cannula was added to my arm for more acute doses of medication to be administered as and when they were needed.

I’ve always been partial to a cocktail or two, but I’m not too sure I’d recommend the ones I was taking. In the syringe driver, a hefty dose of morphine (120mg) mixed with a smaller amount of midazolam (30mg to start, later increasing to 50mg). Where morphine mostly addresses the pain, the midazolam helps as a relaxant. Together, they combine to help with my breathing and encourage me to take longer, deeper breaths. In the cannula, based on how agitated and uncomfortable I was, one of the kind nurses would administer a 10mg shot of morphine, and/or a 2.5mg midazolam chaser (later increasing to 7.5mg), sometimes even washed down with some glycopyrronium bromide to help with the secretions that were building up on my chest due in part to the pneumonia. On top of all this, during periods of consciousness, oramporh (liquid morphine) was encouraged to be taken as and when needed.

The healthcare team now entered a game of cat and mouse with my illness, constantly chasing the symptoms. There would be periods where the drug concoction was working, and I could go for 10+ hours without stirring. On the other hand, I might stir after only a couple of hours, requiring another visit from the nursing team to administer more injections as the pain/discomfort had started to outpace the relief I was getting from the syringe driver.

This brings me on to my decision to have my end of life care at home. Samros and I have been very clear with this wish, however there are a few lessons learned that I feel compelled to share. With this being a highly reactive phase of my illness, I hadn’t fully considered the reality of needing to call the district nursing team every time I had a flare up in pain or agitation. A call is made to the handler, who passes this on to the nursing team who then call back and arrange to visit. Unfortunately, this could take up to an hour, which felt like a lifetime for my family who where there witnessing my discomfort and watching the clock agonisingly tick by until one of the lovely nurses would come and administer some more relief.

While it would’ve been too taxing to move into a hospice at this stage, the family took the decision to engage the incredible staff at the Sue Ryder hospice. We utilised the hospice at home service, with 2-3 visits a day from nurses to help keep me comfortable but, more importantly, take some of the burden of care off my amazing wife Samros and the rest of the family.

The doses of medication were increasing over time and new drugs were introduced in an attempt to stay on top of the symptoms. Paracoxib and levomepromazine were trialled but at this stage the main priority was being comfortable, and the combination of morphine and midazolam seemed to be the most effective cocktail. Fortunately at Wozzer’s, every hour is happy hour!

Earlier in this post I talked about the wonderful side of humanity. The kindness and care shown by the district nursing team (Rachel, Katy, Jasmine and Beth deserve a special shoutout) and the Sue Ryder nurses (I’m convinced Cathy, Clare and Siobhan are angels) was absolutely incredible and as always I am left speechless by the compassion these wonderful people have in such a challenging job. Finally, I can’t leave out my palliative care nurse, Vicky Mills, who was so helpful in advising and guiding me and the family through one of the trickiest and most upsetting moments we’ll ever face.

I simply must also highlight my family and friends during these latter stages as well. Samros, my fantastic wife, and Nisa, our daughter, have arguably had the biggest burden in terms of looking after me and I will be eternally grateful to how they have helped spur me on over the past five years.

My daughter Verity camped out in our flat from April 1^st, and over the next few days the rest of my family scrambled once again to be at my side – Mum, my brothers and their wives, my children and their partners, one of my nephews and even my cousin and his wife. Every nurse that visited made a point of commenting at how many people there were by my side, and I felt incredibly lucky knowing that others in my situation were not so blessed to have such a loving family.

As you’ll be well aware, I’ve always enjoyed a “project” – and the end of my life was executed just I had planned. My final wishes were to be at home, and to go peacefully and calmly, surrounded by loved ones. I’m pleased to say that (despite the ups and downs of the past two weeks) this is exactly what happened. As an added bonus, I was even spared the boring 0-0 in the Manchester derby! And when in full planning mode, those that know me will know that Wozzer doesn’t just stop there – I managed to prepare a number of documents/ideas to help make the coming days/weeks more manageable and stress-free for my loved ones and to give them a head start on funeral arrangements, more on that to follow…

And with that, my battle with cancer has reached it’s conclusion. From my initial diagnosis in April 2020 to my oncologist describing me as “more art than science” as I continued to defy the odds, I couldn’t in my wildest dreams have imagined getting another five years to treasure with loved ones. Just shy of my 70^th birthday, yes it’s a life cut short, but I am blessed to say I have led a very rich and varied life, which is dominated by all the incredible people I have met on the way (friends all over the world – you know who you are). Thank you all for supporting me along this journey – this blog has been a great outlet and helped connect me to others in similar tragic positions. I’ve loved all of the comments and encourage you to post more anecdotes and memories of our interactions over the past years.

All my love (and until we meet again), Woz x