Back to the treadmill

Treatment is over ! Had final scans (all clear) and told to go out and enjoy life. So not much more coming from me about the treatment now - there will be follow up scans every 4 months for a year, every 6 months in the following year, and then annually for another 8 years. But these are merely precautionary, so it's time to get back to...

Health ! I was doing pretty well, pulling my weight down to around 17 stone before all of this started. And after the surgery (dropping to 14 stone) and the chemo (keeping my weight level as it burned up caloires) I've now got back to a healthy state but a less healthy size again (over 18 stone). On top of this, been getting an inflamed back, probably from the lack of exercise, and not assisted by my tummy muscles recovering from 2 bought with the surgical knife.

So back to weekend running, weekday cycling to work and yoga for me ! And the dreaded Monday weigh ins - you should see a little graph on the right hand side now, nothing like a bit of public shame to kick start a good habit. On top of which, I feel a little winter snowboarding might be in order this season - one trip booked so far on Feb (to St Anton in Austria), but I feel another trip either State-side or Euro, would top that off nicely ! Anyone interested ?

All is well Down Under

Last month, I had a colonoscopy to check all was well in the bowels. I got to see were the section of bowel was removed - there were still staples inside by bowels ! Otherwise everything looked good, except for a small polyp which they burnt of and removed. It was confirmed as non-threatening just as I was boarding my plan for holidays, which was good news to start on ! Alas I did not manage to fly with Mimi though - she is on a standby ticket which saves about 75% of a normal ticket price, but means she cannot get on any flight that is fully booked, which my flight was.

So the last two and a bit weeks have been spent in Australia, catching up with Mimi's family and our friends. As we were staying with Mimi's brother, we got to spend some good time with his 4 month old son, Luca a.k.a "Munchie", who I have taken to calling "Cheeks" on account of his gorgeous big cheeks. Photos to come soon ! He is a beautiful baby, is very cute when he tries to talk, generally a happy boy and needless to say, he loves beardy kisses from Uncle Ben.

We were also very grateful that Luca's christening was arranged for when we were in Australia, so got to experience a Greek Orthodox service, as well as engage in the whirl of wine, food and loud chatter that is the Greek feast afterwards.

After all that, we needed some time for "us", so I insisted on dragging Mimi away for a day and a night to a surprise hotel / spa package. We had luxury massages, champagne and then some of the best food I've ever eaten at Da Noi - a Sardinian restaurant, which was followed by some quality movie action. After spending the next morning lounging in bed with breakfast we then headed out for a nice walk around the botanical gardens, where I had booked a picnic hamper with good food - and more champagne !

Not wanting to let the moment (and large amounts of champagne) slip by, I then bought out one last surprise for my sweetie - I got down on one knee and asked her to marry me. Fortunately, after a small period of shock and surprise from her, she said yes ! So the last few days have been spent by both of us getting used to this idea, and slowly spreading the news to family, friends and facebook :)

Heading back home tonight - alas potentially alone again, as the flight is looking full which means Mimi may need to wait until Sunday for her departure. But first of all, a big send off BBQ with "just the close family" - 15 to 20 people - to say goodbye and announce our wonderful news to those who haven't heard yet. For those back in the UK - see you soooon !

The road to recovery

A year ago today, someone put a camera somewhere one never expects a camera to go, and I saw my tumour for the first (and last) time; a week after that it was gone.

Now I am going through the final steps of recovery - the spots are still hanging around, esp. on my neck, but they are simply a small nuisance now. I had my portacath removed, so have a sore shoulder for a couple of weeks while that heals over. And I'm still quite tired in general, but slowly building up my hours at work.

But one thing the medical world will not allow is to be hurried along ! I still have a few little thing, like having the stitches out for the portacath removal in a fortnight, then one more invasion of the camera to check everything is working correctly internally at the end of the month, and finally two scans (CT and MRI) at the end of September to check everything looks clear.

So in truth, it never truely feels 100% over - after that scan, there will be regular check ups throughout the years to come. But I do feel I am through almost all of it now, and hopefully by the time I return from my upcoming holiday to Australia, I hope to be at full energy levels and working full time again. It can be somewhat demoralizing to work part-time, you feel a lot less valuable and can often feel marginalised, and whilst I'll miss the 9-10 hours of sleep a night, I am looking forward to it.

Head down and out the other side

After spending a lot of time around the house healing from my liver operation, I finally resumed chemo for the last two cycles. I really couldn't stand being back on the drugs - same horrid steroids to counter the horrid Oxaliplatin, but still being lreft with constant horrid nausea. Problem now being my body knew what was coming, so I was getting nauseous before I'd even had the drugs, psychosomatic effects I suppose.

So I decided to shell up, just get through each day, which was probably not the most uplifting thing I could have done for myself, but I guess I was thinking now about that light at the end of it all. And so here I am, two of the longest cycles over, still tired with LOTS of Cetuximab rash all over my head, scalp and body, just waiting for it all to die away and feel like a real boy again.

But I do remember the day, last Thursday, when my Oncologist confirmed that all the cycles were over, there were no more drugs to take, and the next step was an initial scan to confirm that everything has worked. I knew this was the next step, but hadn't realised how shut off I'd been getting there, so it was good to find myself smiling all day, and maybe even a few tears of happiness too.

It's coming up to a year since my diagnosis, and I think by the time the side effects have mostly worn off it will be a full year. It has not been a year defined by cancer - I wanted to make sure of that and be lucky to have enough support to carry it through - but I am already looking back over it thinking "wow, how did I get through all that without freaking out". I guess the answer has always been "one day at a time", but without the love and support I've felt from friends, family, and the many wonderful people on this forum, I suspect each of those days would not have been half as bright.

Scars and Consolations

Last Tuesday, I checked into the specialist liver unit of the Basingstoke and North Hampshire hospital. They prepped me for the operation, warning me that they expected to remove around 60% of my liver, which would be survivable but might require months of careful eating and drinking as it regenerates.

Fortunately my surgeon, Mr Myrddin Rees, came around later in the evening, and confirmed that we were NOT expecting to remove so much liver. There were three lesions, one on the left of the liver and two smaller lesions on the right, and he expected to remove them all with wedge resections - literally removing a wedge shaped portion of liver to remove the nasty part.

The next morning I was taken down, operated on, then spent 24 - 30 hours in recovery - sleeping for short periods between having mad morphine dreams and trying to do deep breathing exercises. Finally I was taken back to a private ward room where I was told (now that I would actually remember things I was told !) that the operation was a success and only 10% of my liver had been removed. Recovery was swift - almost too swift, I felt great and ready to leave by Saturday, once all the tubes and drains into my belly were removed.

But I stayed one more night until Sunday - which was the most painful day of the recovery ! With the anaesthetic lines removed, the pains in my belly started up, reminding me more of my bowel operation when the pain control had not been as good. But I was ready to leave and go stay at my parents, where at least the pain was tempered with mothering and care from both Mimi and my folks. With the dressing removed, I could now see the scar on my belly - a large 1 foot scar starting from the top of my belly (where my bowel scar starts) and heading down and across to the side of my belly. Along with the bowel operation scar, I makes a large number 7 shape :)

Three days at home and things are getting better - slowly. Main pain comes from sleeping - it's hard to find a comfortable position and moving into or out of a lying position is quite a chore. But the days are getting better, I'm getting looked after, and paracetamol is a highly underrated pain relief drug - it really does take the sharp edge off !

The surgery has been cut

Took a long lazy day today just relaxing and getting my thoughts together. One of these thoughts, around 4pm, was that I'd left my phone in the other room, and when I went to fetch it I realised I had missed a call from my liver surgeon relating to yesterday's scan !

The message was that there was nothing distinctive on the CT scan to operate on - the lesions or "metastasis" on the liver were unclear which indicated the chemo was having a good effect on reducing them.

So it is the opinion of the surgeon that no operation should be attempted at this time, I should resume my treatment, and only if things reappear on a later scan should we attempt surgery. My thoughts are that this might mean I only delay a needed operation, potentially prolonging the time I am affect by this condition, but on a more positive note, it may be that no surgery will ever be required and the drugs can cure the liver metastasis all by themselves - which would be excellent.

I have had my month off chemotherapy, a break to allow myself some time to get my head together and be reminded what life is like outside of the drugs. I feel I am ready for another 3 months of treatment now, and hope future scans continue to offer the positive news that yesterday's scan did.

Cold Turkey before Xmas

So today I had my last injection, and tonight I am due to swallow the last of the Cepecitabine tablets. My right arm still hurts a little from a fortnight, my scalp is dry as heck and a couple of my fingers are starting to get quite painful around the nails... but I'm still in one piece !

This morning's MRI scan was delayed due to a broken MRI machine, so I am due to return to their other clinic tomorrow morning to get that done, after which I have an appointment on Thursday to discuss the next steps. Only then will I know 100% if we are going ahead with surgery, which would mean a break of Chemo over xmas, or if they have other things in mind. If they say otherwise, I will scream, but I'd rather do what's best advised rather than what suits me.

Got most of my xmas shopping done over the weekend too (much of it online) so looking forward to a pleasant and manageable run up to xmas holidays. Overall feeling quite confident that half of this is all behind me now, and with help, patience, experience and strength, the latter half will go even better.

More when I've spoken to the doctor on Thursday...

Bah, Humbug

So I had my (somewhat brief) meeting with the liver specialist. Was a little annoyed he had not seen my latest scans - so what were his current decisions based on ? - but was partially to blame as I had been advised to bring the copy I had along with me, and had forgotten to do so.

In any case, he said that as I was responding to the Chemotherapy, I should continue with it for a little longer to ensure the required surgery was as minimal and risk-free as possible, advising me to continue for SIX cycles. I had been hoping it was only to be four, as these last two cycles will fall across the Christmas holidays and my planned snowboarding weekend in January, all the way up to the 1st Feb - which means I'll get a nice present this year for my birthday anyway, as I would then come of Chemo for February in preparation for surgery in March.

No date was set in stone for the surgery though - More CT / MRI scans after the 6th cycle would determine what happened next. There is a small outside chance that the chemo might "clean up" the liver all on it's own, but this is quite rare.

In truth, right now, I'm gutted. I was looking forward to a "Chemo free Christmas", esp. as each cycle gets harder. I had put these dates and plans down as a mental crutch - waypoints to help me get through the long journey ahead, and in 10 mins with very little information provided, I've had it all messed around and shifted with what seemed to be a fairly uninformed decision. Probably not the wrong decision, and already I am mapping out what this new news means and finding solace with what it might offer : cheeky snowboard week in February anyone ? Might also be up for a mini-birthday celebartion now as well. And having my folks look after me over xmas week when I am struggling with the nastier part of it is surely not a bad thing.

All of which reminds me it's injection day on Monday. &^%k. With these extra cycles now planned, am I once again going to persue getting a "long line" or "port" fitted, that will allow the drugs to be adminsitered straight into my central blood stream, not via my poor arms. This should remove the pain in my arms which is one of the very worse side effects, after maybe the vulnerability to cold.

Overall : Bah, humbug.

A scanner lightly

Yesterday I had two scans taken - a CT and an MRI scan - the check the progress of the chemotherapy I have been taking now for almost 2 months.

The CT scan showed that there were no other "mystery spots" other than what was on my liver, pretty much as expected. The MRI scan then offered better imagery on the lesions on my liver and was compared to the previous scan I had the day before going in for surgery (just over 3 months ago now).

The MRI showed that the largest lesion on my liver had reduced in size a little, and a smaller cluster of lesions elsewhere on the liver was not as pronounced. Which in summary is great - it means the secondary cancers (which we must surely now presume these lesions to be) are shrinking under the chemotherapy drugs I am taking, and hopefully will be easy to remove.

I have a meeting with a liver specialist next week to talk about what exactly the new MRI scan shows, and what my choices are regarding removing them. It is expected we will book some surgery for this; surgery which needs to be at least 1 month after I stop chemo, and preferably not much more than a month. So it is my hope we will stop the chemo mid-Dec (which is after one more full cycle) and schedule the surgery mid-Jan, giving me xmas off. Which would work well for enjoying that time with my family, as well as the cheeky snowboarding weekend I've booked in the new year !

Cycle three start here

Fine - so it's cycle three.

Went to the clinic yesterday, go the Oxaliplatin in my arm - the second dose that has gone into the left arm. And f**k me it hurts - not just the usual deep pain in the vein, but most of the arm has gone numb and tingles, like a permanent pins and needles in the muscles. Really not a happy camper at all - had lots of trouble sleeping and pain-killers don't really do much.

Might need to discuss other ways of getting this horrid drug going forward - one option involves a line in your arm with runs a tube up to the heart - which means no localised pain in the arm, but does mean I get a cannula sticking out my arm for the treatment duration which might be even more depressing. Or a surgical operation can put in a central line in my chest - which sounds like the least painful option, except for the whole "going for surgery" part.

For now, everything just feels like hard work and I just want to lie down and wait for it to go away. But that's going to take days, so guess I need to fight through that, get some food, take all my daily drugs and keep up with life. Overall - Meh.

The only way is up

Today is a good day.

I picked up a winter cold at the weekend, and after a good couple of days rest, it's finally starting to shift, I feel. It also seems my face, covered in tiny yellow spots for the last couple of weeks, has now started to react to the Ocytetracycline a litte now, and most of the spots have retreated, just leaving some red dots (which blend slightly with the freckles :). Futhermore, I am near the end of my cycle, so free of most pains and tiredness caused by the drugs, and the extra dose of Cetuximab I had on Monday does not seem to have added to any of the less pleasent side-effects. Also my facial skin, which had gone very dry, is beginning to feel a little better after all the moisturising I;ve been doing - partly thanks to my sweetie for actually getting me some mosituriser and reminding me to do it when I forget !

So now just trying to make sure I get out and about and do some more outdoors things before the next injection on Monday, which I am dreading a little naturally. Not sure that any form of exercise is going to be a good thing - burning up energy stores seems crazy when you've got less energy than you're used to. Long walks and slow burning exercise could be the best idea - I feel a long walk around London Zoo might be in order - exercise AND monkeys, ideal for anyone's recovery.

Not much more to report, other than a larger stack of boardgames and a couple of Wii games, which I have been enticing people round mine to play in leiu of heading outside too much. Don't be shy people ! Also another scan is coming up later this month, hopefully then I'll know a little more about "what happens next".

Second cycle - all in all, I've just been hit by every brick in the wall

Well, 6 days into the new cycle, and I'm only really just finding the time and energy to blog about it. It's been a bit of a "ton of bricks" week - have been feeling really tired and low on energy - as well as combating the nausea and cold sensitive arm pain that comes with the first half of each cycle.

Fortunately, I did see this coming somewhat, and had arranged with work to NOT come in for the main chemo week. This left me free to rest in the house, having plenty to time to sort out my various pills and lotions to combat the side effects, and mainly to rest. Physical execution is one of the things that heightens the nausea, and being able to climb under the duvet when the proverbial ton of bricks smashes you around the head is a godsend.

This week has been harder than last cycle - perhaps I am feeling more dread and less curiosity going into it, knowing what to expect this time. Also the Monday itself was particularly hard work. I met my parents in town first of all, which was very nice, and they came to the clinic with me. I was due to start on a new drug called Cetuximab which is an antibody drug that helps block potential new cancer cells, as well as potentially helping the main chemotherapy drugs working. But this needed to be administered slowly for this first time, and they needed to check my blood first to be sure I would not react to it. All in all, this took about 2 hours to prepare for and another 2 hours to administer - after which I then had to go through my 2 hours of dreaded Oxalyplatin as well :(

I went in at 1pm, and didn't leave until just before 8pm, spending the last 2 hours in a fairly empty clinic feeling pretty sorry for myself; the Oxalyplatin felt cold, and I wrapped my jumper around my arm, but still it felt icy and painful. Outside, I realised I hadn't bought warm enough clothing, and held my arm to try and keep it as warm as possible whislt travelling home. Whilst the pain subsides after about 7 days, and is only really present when my arm gets a little cold or I use it in a certain way, I can still feel it's effects all the way through 3 weeks. Hence this Monday's injection went in the other arm - suspect we'll be swapping everytime.

As for which arm gets the Cetuximab in future, I don't know - this drug comes on a TWO weekly cycle, so I'll be heading back to the clinic a week from now for Cetux, two weeks for Oxy, three weeks for Cetux then in five weeks from now - both again. All in all, the 6 remaining trips to the clinic have become more like 12 more, which is depressing. That said, the Cetux infusions are probably not going to be as bad - they should only last around 1 hour in future, and the side effects are nowhere near as bad as Oxalyplatin so far. It has caused my face to redden, with a few spots starting to appear - I am on a monster load of Oxytetracyclene to try and stop me impersonating a 16-year old acne faced kid (again). It has also caused my eyelashes to grow, which was long overdue comic relief to this whole process !

Last cycle was probably a bit too "ah, it's fine", and might of given the impression that I'm going to soldier through this without anyone really noticing. The truth is, I am going to soldier through this, but it's going to get hard at times, and it's going to be a while until it's over. And I'm going to be a bit of a pain, demand extra attention, time and help where people can offer it, and probably keep talking about my horrid drugs, waving pill boxes in the air in anger and occasionally showing off my cool (and still very present) belly scar. And I thank everyone who listens, helps and has time for that, as it all helps me just do what I need to do, which is just keep going through this one day at a time. The hardest week of cycle #2 is over - in fact apart from the injection days, every day does get a bit easier than the last !

Next big date is 20th November, when I get some more scans done, and we see what the effect of all these drugs has been. Then we can start talking about how long the chemo will go on for and potential surgery options in the new year. Until then, I'll just keep taking the pills !

How does it make you feel?

Ok.
Just a little pinprick.
Therell be no more "aaaaaahhhhh!"
But you may feel a little sick.

Can you stand up?
I do believe its working. good.
Thatll keep you going for the show.
Come on its time to go.

[Pink Floyd - comfortably numb]

So I am coming to the end of my first 3 week cycle of chemotherapy (only 7 more to go !) Overall, I am relieved that the side effects did not overwhelm me, nor did I experience most of the more unpleasant or debilitating effects, such as vomiting, sore gums or numb hands / feet.

A lot of these are kept at bay somewhat by extra routines - I moisturise hands and feet daily now to combat drying out of the skin (as well as my scar, to try and reduce it) and use mouthwash at least twice a day (although they recommend four times). Not sure of the science here, but I think the chemo hits "newer" cells quite hard, so the front of the mouth has lots of saliva cells etc... that are quickly targetted and can become quite open to infection and ulcers.

The worst side effects peaked around 3-4 days into the treatment, and then subsided going into the second week. These were from the Oxyaliplatin, and consisted of this aversion to cold - which makes walking about outside in the cold quite unpleasant and draining unless rugged up really well. It also bought a horrible nausea, like having low-grade car or sea sickness in the background all day. The anti-nausea drugs probably kept this down a bit, and eating food made me feel somewhat better, although this tended to make me gobble down meals and then feel sick from that too. The advice of 5-6 smaller meals a day could be the one to follow here - I am trying to compile a list of snacky like food so the fridge and cupboard are well stocked for next week's new cycle - e-mails of recipie's for good snack meals are encouraged :)

I have also been working throughout the period, and possibly ended up working more hours than my body wanted to do (although the mind is still hungry for some challenges - think it's a bit bored of TV and computer games now !) The pills I take through much of each cycle cause fatigue, which is doubled in the earlier stages by the injection too. This often translates to a slower start to the day, sleeping in a lot more, and then even when I do go into work, I am hitting my wall around 3-4pm. So for next cycle I have proposed to take one day off a week - Wednesday would make sense - so that I don't overtire myself doing work and prevent myself having energy in the evenings to sort other things in life out - which with the ongoing tests and self-research into healthier living to help my recovery (more on this another post, I feel) are numerous indeed. I am also taking the week of the injection off as this quite physically tiring; after 3 days of work (~5-6 hours each day) I essentially slept through the whole weekend, which hinted I'd got the balance quite wrong. But it was also quite emotionally challenging, the constant nausea and very tender veins from the temporary damage this powerful drug does to them made me feel quite vulnerable and bought home what I had gone through and had yet to go through.

But like I say, overall this cycle has gone well, I've not missed a dose of drugs yet (hurrah to the Medi-memo !) and for next cycles I have some ideas set out:

* to keep fixed rest days from work to give myself some more energy outside of the office
* remove stress where necassary and relax more
* spend more time seeing friends - it's quite easy to become a hermit with lower physical energy levels, but time with friends is very emotionally lifting and just as important

All of which is nothing more than a subtle tack into a better bearing - I have been doing the above, but a little more of each should make the next cycle that bit more bearable still.

Pills 'n' Chills and Bellyaches

Every third Monday is now my treatment day, when I get to go receive another dose of Oxaliplatin, and pick up more pills for the coming weeks. Whilst comfortable in my fancy Kubrick-esque pseudo-2001 space odyssey environment (see previous post for photo), the actual injection leaves the vein quite tender, so with a somewhat tenuous nod to the the blog title, these days may not be "Happy Mondays". Although the tea and sandwiches are really quite nice, if I am to be totally honest, and the doctors are a smashingly nice bunch :)

My Pill regime following these appointments is set over 8 cycles, each of which is 3 weeks long. I get two anti-nausea drugs to take, as well as the core chemotherapy drug Capecitabine. In a fit of mathematics, I realised I need to take 4 of these chemotherapy pills every morning and night for the first 2 weeks of each of the 8 cycles - this is 896 pills in total ! To the left are the combined empty blister packs from just the first week's pill intake. A little over-dramatic, I'll grant you, but I quite liked the view of the aftermath from ejecting all these pills so wanted to share it with the general blog-o-sphere.

I've certainly never been a huge fan of chemicals in the body, and so taking all this medication has been quite a mental challenge for me. This purity of substance intake goes back to avoiding painkillers except when required by the worst headaches. And now it extends to working out which plastic bottles are killing me, as well as which of my favorite meat products cause Cancer too. There is a multitude of highly unhealthy food and drink products out there which are seen as perfectly normal, but seem to be a major contributor toward cancer, according to the experts.

But for now, I am obviously signed up for 6 months of Chemo's marvellous medicine, and with a new regime to adapt to, I suspect I will be reliant on a number of factors to help me along, not least of which are memory helping tools such as my new "Medi-memo", a box containing seven daily sections, each of which having dividers to spread pills across four different times of the day. Perfect for my current regime, I've even added a multi-vitamin onto each morning to bolster my iron levels (quite important I am told to avoid getting anaemic during the treatment), although I hope my diet is supplying much of my RDA for these things where possible. Certainly the large spinach curry for lunch today should have provided some good level of nutrition - it really is great that work have a "healthy eating" program in place at work, it makes getting nutritious lunches that much easier, giving me plenty of time to worry about all the other little things in life :)

Rested and starting the road to recovery

Ten days in Portugal amongst my family, including my two little nieces, was spent profitably reading some books, relaxing and eating seafood. After this, I feel much better and ready to begin my chemotherapy course. Some preliminary meetings and a PET scan later revealed little new information, other than to the best of medical knowledge right now, we must assume the liver spots are secondaries, even though they are not textbook examples. Some more information came back on the tumor as well, and it appears to be genetic in origin, more blood scans will confirm a little more going forward.

This began today, with a four hour long trip to the treatment suite at the London Oncology Clinic (LOC). This space age center has a dozen booths all decked out in white, and electrical adjusting big comfy chairs. During the hours, they injected a large dose of something called Oxyplatin, whilst explaining all the side effects I might feel (nausea, vomiting, tiredness, aching feet and hands plus a sensitivity to the cold). I also got a large stack of drugs to take over the next three weeks, including tablets of the 5FU-based main chemotheraphy drug, called capecitabin, who's side effects include nausea, vomiting, tiredness, aching hands and feet and hold on, it sounds just like the other one. They also bought me all the tea, coffee, water and sandwiches I wanted - awesome.

Actually, there are a few differences, and I was given a large number of other supporting durgs to help control any expected and not-as-expected side effects. The staff were very friendly, and I really felt I understood what was due to happen over the next few weeks. They discussed 8 "cycles" of three weeks each - which I realised meant the seventh cycle would begin on my birthday ! - but then again I think there is a solid probability of further liver surgery interupting things halfway through, once we have had more scans and seen what effect the chemotheraphy have had on the cancer secondaries on the liver.

Still coming at this from a positive viewpoint - I have no adverse reaction to the oxyplatin today other than a slight prickling from cold wind coming through my jumper and an odd reaction to eating cucumber from the fridge - packed full of slightly cold water, it was a little bit like my tounge being burnt - ouch. But I take it as more positive news that my body coped with the initial dose well. Other than that, I need to do some ongoing blood tests to monitor white blood cell counts, keep away from prolonged access to infectious people, and just listen to my body - rest when it's tired and report any side effects felt to the LOC team, who can tweak doses of the drugs to manage and reduce them as much as possible. I might even manage to fit a bit of work back into all of that - back into the office on Wednesday and seeing how things go.

Thanks to all who have offered best wishes and kind words during my reappearances in social society ! I really don't mind talking about it, even at "fun" situations, because for me talking about it and acknowledging everything that's happening is a superb way of avoiding falling into a "denial" situation, where I just try and put my head down and ignore everything, which as a long term strategy could be an emotional disaster. Equally don't feel obliged to hide any sad feelings from me - I don't have the monopoly on being upset about this - and sharing sadness is also another way this situation becomes more real and manageable. Naturally I am trying to keep positive, but some sadness and venting of emotions is an essential part of that.

Right, off to put all my new pills in my fancy new pill holder (yey ! Toys !) - look forward to seeing people soon, but you may just need to allow a couple more rainchecks here and there. I'll be sure to let you know though - don't withold any invites on MY account ;)

Scans and the liver

I saw my Oncologist (cancer specialist) today for an update on treatment going forward. So far no-one has been able to determine exactly what was on my liver, but the evidence points strongly towards cancer secondaries, and I expect my liver specialist / surgeon to confirm that in the next week. I am also down to have a PET scan to add to the MRI and CT scan and to confirm the spots on my liver are behaving like cancerous cells. The tumor had perforated the wall of the bowel, so I guess some cells may have spread that way. The 31 lymph nodes they removed with the section of the bowel all tested negative for spread however, which is good news - it means the tumor is graded as Stage II (or Dukes B).

In any case, I am due to start chemotherapy toward the end of the month, which will involve tablets and some intravenous drips. The exact composition of what they intend to give me will depend on some further tests of my genes (something called the K-ras gene, to be exact) and will be made much clearer in a few weeks. This should discourage any regrowth in the bowel, and hopefully help with whatever is going on with the liver too. Side-effects should NOT include hair loss, but might be some tiredness and sore hands / feet. Oh, and probably some of my old companion, diarrhoea, as well. All quite acceptable for the benefits it will bring me, I think.

Then, after 3 months, it will be time for more liver scans to check if there has been any change. At this stage, on the assumption that nothing has improved, I think there is a reasonable chance I may need to go for liver surgery to have the small sections removed. Liver surgery has come on leaps and bounds in the last 10 years, and the overall prognosis for this operation is not dissimilar to the bowel operation I had. Plus the liver is super-regenerative, so should heal easily. After a recovery period, I'd expect another 3 months chemotherapy.

So some quite tough roads ahead, but one step at a time and it should all be manageable. My key philosophies are that I am not my illness, and life is not getting put on hold for a year (or more) because of this - although it may come down a notch or two for a little while ! The specialist indicated some people do not return to work for the duration of this treatment, but I think that would stand against this main objective of getting back into life properly. There will still be frequent clinic appointments and tests going on in the background too, so whilst other plans should still go ahead, much of my time will very much be in the hands of doctors for the next year.

As always, armed with this information I am keeping a positive head on it all. It is all a bit scary, but I have had some good news with the lymph nodes being clean and the surgery so far has healed very well - only 2 weeks after the operation and I am up and about to a very favorable degree. I walked for almost 30 minutes today, cooked a big meal this evening, and my muscles don't hurt too much as a result. Still have a few back pains when the various muscles there are overworked (compensating for the weak tummy muscles) but hopefully that will improve in the coming weeks. Looking forward to heading out for some sun and relaxation at my folks place in Portugal in the next week. There both Mimi and I can relax a bit more, and get my head away from London for a while, and into a few good books.

My poor belly

This is mostly copied from mails sent out in recent days, to update blog readers on my recent health news.

Two weeks ago was examination time, and after 2 days fasting and drinking a special drink, I was truly empty and ready to see what be lurking within me, causing this discomfort. In a fit of bravery / stupidity, I refused the sedation offered for this examination (involving a tube, a camera, and a small level of embarrassment) so that I could see the camera. Seeing your internals on screen goes down as one of the more surreal experiences of my life, and aside from some mild discomfort at points, was not too bad. This "incredible journey" recalled some films of the 80's crossed with those medical documentaries on TV I try and avoid during mealtimes.

Finally we came face to face with what seemed to be the trouble. It looked large and angry, and I was a little concerned, but my doctor seemed quite calm. Unable to go any further (they should of equipped the camera with a laser gun), they took some sample (biopsies, to use the medical name) to work out what my lump was. One thing was for sure, this was not a simple inflammation as expected.

Friday came around, and I was told more about my lump, and that surgery was going to be required. This was sounding a bit more serious than I'd expected; I had still had hopes of taking a few pills until it goes away ! Fortunately I was already in some excellent hands and was being referred to some extremely well respected hands for this next step. Next step was scans to check the whole area for other potential bumps - don't want to miss anything ! And then on to see my surgeon to discuss options. It seemed that a bowel resection was required, which put simply is chopping out the section of bowel with the lump, and to connect up the two tubes. The area was surrounding my appendix, so it was removed as well (2 for 1 bargain).

But the reason I needed this treatment was quite a shock to someone my age, it seemed the lump was a tumor and I had bowel cancer.

With barely a day to take in the full extent of this news, they had me checked into a private wing of Saint Mary's hospital in London for the operation, which took place on Wednesday (20th August) at 7:30am. As you might have guessed, the operation was a success and the tumor has been removed. A short stay in hospital got me to the position where I could finally walk around slowly and eat again, and I have now been discharged and am back at home. Mimi has been working from home to help me out with cooking and other heavy chores that otherwise are quite tiring or hard for me to do. With most of my stomach muscles still weak from the surgical incision down my belly, moderate to heavy lifting is out, coughing, sneezing and sitting forward are hard and I have been advised to allow around 4 weeks to recover from the operation. That said, so far every day I have been feeling better and better, so hopefully the road to recovery will be relatively smooth.

After the 4 weeks it looks like I will begin some low-strength chemotherapy (nothing hair-losing, I have been told) to ensure nothing comes back. In addition, there are a few spots on my liver that are a little suspect and will need monitoring during the treatment to ensure they don't grow; and hopefully go away during the chemo. More information on the exact nature of the treatment will feed back to me as the removed section of my bowel is analysed, and the appropriate
authorities spoken.

So still some things going on, but with some very competent professionals who so far have been highly reactive, supportive and positive about coming through this illness. I am looking to maintain a positive outlook going forward, without wanting to just "put a brave face on" and thank everyone for the support and kind words so far.

In the meantime, it's back to the important things in life; resting, taking holidays and playing games.