The Finish Line

Yesterday, we went to the Tom Baker Cancer Centre for our penultimate meeting with the Radiation Oncologist. She reviewed Charl’s treatment, its effects, assessed how he was managing. Nodding: Good, good, she said. She explained that he would need one more PET/CT scan, and that she’d like to see him for a final appointment at the end of October. After that, we’d see our Haematologist every 6 months for routine check ups. Charl may experience mixed emotions now that his treatment is over, she explained. “This is entirely normal. It’s the end of a long and stressful process. Even though it will take you time to recover, we don’t need to see you anymore, you can still reach us if you need to.” She closed his file on her lap and pronounced Charl cured.


As though in a daze, we shook hands, thanked her, and arm in arm, walked out of the cancer centre. Tears incapable of expressing emotions streamed down my face. Chuckling, I asked Charl what was happening. He laughed and said he didn’t know either. The sun was shining, and a warm breeze rustled the leaves in the trees around us. Usually able to articulate my thoughts and feelings with ease, this scenario stumped me. Why was I crying? This is beautiful news! Was it sadness? No… Thankfulness, yes. Relief, indisputably. Surely we were thrilled!? But why did it feel so strange?

I thought of how to express what it’s like to experience walking out of that cancer centre with my husband now cured of cancer. Nothing suitable came to mind other than the experience of running a race; I likened it to the feeling of crossing the finish line of a long, hard race. An athlete sets a goal, sacrifices much, works very hard, and with stringent discipline focuses on that singular goal, endures the rigors of the race and triumphs over hardship.

Charl was thrown into running a race he didn’t sign up for; he had no time to prepare, no training, no coach, and the race had no bands playing or water stops along the way. He had to run several months before the finish line even came into sight. But what Charl did have was a God who gave him exactly what he needed to get to the finish line: the best medical care money can buy, loving and supportive family, friends and colleagues, a wonderful church community, more prayers than we will ever know, and faith that God would carry him through this trial.

It’s thrilling to witness someone reach their goal. We are thrilled to be done with the treatment; tired and relieved and partly sad to think of what we’ve come through; amazed at God’s provision, and so very thankful to every person who helped us along the way. To all of you who walked through this with us, read the blogs, prayed for us, sent cards, gifts, food, emails, and called us regularly to check in: You were like heavenly gifts to us during this time. Dare I sully my last blog with an old cliché – we couldn’t have done it without you.

I started the blog to keep those of you far from us in touch with how Charl was doing. I hope it served that purpose – I certainly enjoyed your comments. I also discovered that writing helped me cope with all that Charl and I went through.

I can now officially sign off with this, my last post. Tomorrow Charl will complete his last radiation treatment and cross the finish line victorious, my hero.

With love and grateful hearts,

C&C

So Close We Can Almost Taste It..

Man oh man, days like this are good ones..

• A contingent of Vernon Overends have come to visit and it's wonderful to have Andy and Mel and their three little ones here.
• The neighbours have been fantastic, lending us toys galore (obviously none of those around our house yet) including a huge pumped up jumping castle with water slide.
• The weather in Calgary has been lovely and sunny with the usual threat of thunderstorms rarely actually happening in our neighbourhood.
• I'm relieved to say that the Fish & Wildlife people came to deal with the black bear (whose three piles of bear scat we've seen in the trails adjacent to our home gave rise to suspicion of its snooping and pooping around) so I can once again run in full confidence of not getting eaten alive.
• And last but absolutely not least, Charl is still doing remarkably well. He finished his 17th radiation treatment this morning, and has the weekend break before he finishes the last 3.

Monday is our last visit with the Radiation Oncologist and the radiation will be over next Wednesday! So close... so CLOSE to getting a fully recovered and healthy husband back!! yipppppeeeeeeeeeeeeeee!!!

HALF WAY THERE (10 of 20)

Dr Trotter was optimistic yesterday at our Monday clinic. Each Monday, Charl is to meet with the doctor to check in, see how he is feeling, if he has any side effects he wishes to discuss, etc. Given the fact that he has no side-effects other than fatigue, she thought everything was going very well indeed. She also commented on his 'eternal optimism' (we had to smile at that). He was sent for routine blood tests this morning (they do this at the half way mark) just to make sure all is well.


Charl has been very good about getting out and doing his requisite exercise. (Dr Trotter told us that there is evidence that 30min exercise a day will decrease the likelihood of getting recurrent cancer, which obviously makes exercising a no-brainer. As you can see, Charl is more than willing, especially on hot summer days :)

Overall we are incredibly pleased that the radiation isn't causing Charl any pain or discomfort, and it is sooooo exciting to think that, God willing, we will be through this phase of our lives very, very soon. YAY!!!!!!!!

End of Second Week (8 of 20)

Just a quick update to inform you that we are almost halfway to the finish line. Yay!

The radiation makes Charl really tired, more so it seems than during chemo. But so far the fatigue and a bit of pressure in his chest are the only notable side-effects he is dealing with (totally normal as far as the doctor is concerned). The process takes just minutes each morning, and he usually has to nap for a few hours late in the morning or afternoon to regain some energy each day.

All in all, cancer cells are being killed, Charl is on the way to recovery and God has been very good to us indeed.

Vernon Cowgirl, Capetown Cowboy

Stampede to Calgary is like Mardi-gras to Rio de Janeiro. Not the crazy huge costume part, but how everyone seems to live the spirit of it for the duration of the fesitval (the cowboy costume part). Everyone gets into it, and everyone has cowboy boots here. Doesn't matter if you never step foot on a ranch or ever come within miles of a horse or a cow, you still own cowboy boots. (I can tell it will be hard not to get some, especially since they are, after all, boots).

It is not only common to see cowboys everywhere in Calgary during stampede, it would be an anomaly not to see cowboys during the week of stampede, and a big faux-pas to not dress the part when going to Stampede events. Kind of like showing up to a costume event wearing jeans and a tshirt. Y'all are just a dang damper on the parrty! 

Given the status quo we haven't gone to the grounds, or to any events, however we were invited to a private event during Stampede at a friends house last night. It was a mother-daughter chili cook-off, held in their back yard overlooking the city and mountains... a perfect reason to dust off the cowboy hats and get a glimpse of my husband dressing like a cowboy. Yeee haw!

The weather was fantastic and the chili was mighty fine (both Mom's and Daughter's). It was fun to mingle with friends and get into the Stampede spirit, even if for one night!

Radiation (4 of 20)

Charl just finished his first week of radiation. Tuesday was the first day, and we met with the techs and nurse to explain how the process will work; the dos and don’ts, what to expect, etc. In a room behind a very heavy door, Charl lies down on a gurney type bed which can be raised and lowered so that the light beams meet up with the small tattoos on his chest and sides (his head goes on the blue part). This is what it looks like:

Then the huge Star-Trek-esque machine rotates around him and they locate the precise points where they have to radiate. The techs read the screen on the machine, and also take readings from that PC monitor mounted near the ceiling. You can clearly read the monitor, but you can't read the monitor, if you know what I mean.

Now that he was in the correct position to administer radiation, for my safety, I was asked to leave the room. At that point I couldn't see the radiation being administered, but Charl said you see a projector like lens above you, kind of like an aperture focusing in a camera lens. It zaps him three times, for about 10 seconds on each of his tattoos. He doesn't feel anything at the time, but fatigue sets in a few hours after it is over. The nurse explained to us that while there isn't concrete evidence as to why all radiation patients feel so tired, they believe the fatigue is caused by the body working very hard to repair the intense "damage" done to the cells during radiation. That, to a body, is hard work and therefore exhausting.

Overall we are pleased with how it's going thus far. No negative side effects yet. 4 down, 16 to go...

Reflections on a Milestone Birthday

Charl totally outdid himself. He made my turning 40 about as good as it gets.
Apart from the lovely card, gifts and outdoor brunch at the VR Golf Club restaurant, I knew there was a surprise brewing for the evening. As adept and stealth as a secret service agent, he kept all the details hidden from me until the moment I walked into the restaurant for dinner, fully expecting Charl had planned to wine and dine just me. Alas, a big group of friends was there waiting for us. We shared a great meal at the Indian restaurant in Kensignton, finishing off the evening with my favourite choice of bday cakes, an ice cream cake from DQ, brought out by the wait staff! It was a great surprise, a lovely evening and a wonderful birthday. Thanks to everyone for all the cards and well-wishes, and thank you to the best husband in the world!

Ok here are some shots from the day (hope this link works)...
http://picasaweb.google.com/117460281625265439694/CarolS40th#

In the Meantime...

Since my last post, we have been occupying ourselves by becoming established in our new location and settling in (oh, and watching world cup!) while waiting to receive the start date for Charl's radiation. Although he still needs to rest during the day,  it is wonderful to report that he has been regaining energy steadily and able to do increasingly more each day. So much so in fact, that for the Canada day long weekend, we went camping with our friends Megan, Allyson and Dan Link in Johnston Canyon (about 20km north off the TransCanada between Banff and Lake Louise), and had an excellent time!

It is a spectacular location, nestled right in the Rocky Mountains with picturesque views from every direction.

We hiked, had camp-fire chats, had lots of laughs and spent two very cozy, warm and dry nights in our tent (even though it was only about 3C at night).

Spending a weekend camping felt so "normal"- not worrying about bloodcounts, or fevers or hospital visits - it was just great to be spending time in nature worry-free (well except that there was a grizzly in the campground the day we arrived and a black bear spotted in the area the next day - both of which caused me great duress, though for Charl it was a bonus and he couldn't wait to tackle whichever creature we came across). Charl still napped but had lots of energy to spare for all the activities of the weekend.

However, as I said that was in the meantime. We just found out that his radiation will start July 13 - each weekday for 20 days - which will take us to about the 11th of August. The radiation oncologist told us that he should expect little or no side effects for the first 2 weeks, but that we should expect difficulty in swallowing for the latter half, as his esophagus (the food tube) will be radiated to make sure they zap any cancer cells that may have decided to migrate north. Side effects are supposed to peak 7-10 days after the radiation is finished. As usual Charl is ready to take it on, get it over with, pray earnestly for total healing and move on from this episode.

It's astonishing to think of all Charl has gone through in the last 6 months since this all started. I look back at photos from just before he found out (Jan 19) and you'd never have known he was so critically ill. Here's one I love of Charl just before we got married, during a short hike with the family near Kal lake during last Thanksgiving weekend.

PS note the hair colour prior to chemo: BROWN. His hair is now growing back BLOND!!

All Tatt'ed Up

It's been a big week and Charl is tired, but we've mercifully gotten to the "one month after his last chemo treatment" stage, which is the time we anticipated it would take his bloodcounts to recover. Granted we were very careful of avoiding crowds etc, but he didn't get even so much as a sniffle during this time. This is rather remarkable given that his immune system has been beaten to a pulp over 6 chemo sessions, and he didn't have the benefit of the immune booster injection this last time. We are very grateful for no sickness, no fevers, no more ER visits. He is getting stronger, has more energy throughout the day and is able to do more which is celebrated by both of us!

In preparation for radiation, Charl had two tasks: get another CT scan, and get tattoos. The doctors take the CT scan results and "map" out where best to do the radiation. Knowing next to nothing on the topic, hearing just the little bit the radiologist explained to us sounds like it is a very complex and intricate process, and understandably one that is critically important to get right.

Once they know where the radiation will go, they insert dots of pigment onto Charl's chest, in the areas they will be radiating. They do this with indelible ink so it doesn't wash or rub off during the course of the 20 treatments, and also thereby avoid radiating the wrong body parts. The tattoos look very much like small black freckles, and they gave him three: one where the tumour is, and one on either side of his ribs, way around the sides. Don't have any further info on why they are on the sides, but we expect they do know what they are doing.

We haven't received a firm date yet for radiation start date, but we expect it to be within the next week.

Next Phase

In the professional, concise manner we’ve come to expect at the TBCC, Dr Trotter, the radiation oncologist, explained to us the results of the PET scan. To do this she showed us photocopied PET scan images of Charl's midsection from different angles: front view, side view, cross-section. The images were in black and white and varying shades of grey. His heart, bladder and other organs were shown as solid black. His lungs and spine were represented in solid grey. Other fleshy areas, say around his chest and arms, were very light grey.  What they are looking for is active cancer cells, which manifest on the PET scan as darker areas (to be clear, they know the abovementioned black or dark grey areas are not cancerous). The darker the area in or around the tumor, the more active the cells. So we knew when we looked at the results, the cancer was still present.

We had prayed, and hoped, for the best outcome, the outcome where the tumor would be miraculously dissolved by the chemo with not a cell of it left. But we also prayed for the ability to accept the results as they came, even if it was not what we wanted to hear. In fact the tumor hasn't shrunk since the last CT scan in April. You could still clearly see it in his chest. In medical terms, 'a rim of moderate hypermetabolic activity remains in the anterior mediastinal mass.. And the overall findings are consistent with residual active tumor.' The center of the tumor is dead (this is good) but the cells around it are not. It actually looks similar to a donut, from one angle anyway. They know for sure that some remaining cells have indeed been impacted by the chemotherapy and will in fact divide and die. But they can't be sure all of the remaining cells are of that type. If remaining active cancer cells are not of that type, they will eventually spread. And Charl will be facing a bone marrow transplant.


So how bad/good is this news?

After we both asked many questions and after receiving very thorough answers, we feel like we understand at least enough to know what risks Charl faces by not doing radiation, and what risks he faces by going through with the radiation treatment. Charl has two options: Option A, he could choose to wait, observe, and see if it comes back. If it does, he would have to undergo a bone marrow transplant, as it has already clearly been shown that not all his cancer cells responded to (died from) chemo. I don't know if any of you know someone who has gone through a bone marrow transplant but I would give my right arm to prevent Charl from having to go through that.  Option B, if he completes the scheduled combination therapy by undergoing 20 days of radiation now, there is a very good chance those remaining cancer cells will be killed. There are increased risks of other health problems down the road, of which I won't go into here, but he felt these were less of a risk than not attacking the cancer immediately with this present course of treatment. It wasn't a hard decision, but it was definitely one in which Charl was acutely aware of the both sides, their benefits and risks.

So what does this mean, really?

It means in order for Charl to get a 90+% chance of cure, he must endure some  unpleasant side effects of the radiation, plus a longer recovery until his life gets back to normal. For one thing, he is willing to do that, and for another, he promised me 60 yrs of marriage, so he has to go through radiation. (Yes we planned to live to 99 and 104 respectively, and we still do).

Waiting..

The PET scan came and went, a scan from his knees to his head, and in Charl's opinion, he's glad it's behind him. Now we wait until the 17th to hear the results: do they see active cancer cells (positive result) or not (negative result). If positive, he needs radiation. If negative, he doesn't.
Now we wait, and hope, for the best results.

PET scan

Since the discovery of Charl's Non-Hodgkins Lymphoma he's had many tests. The pinnacle of these tests is the PET scan. This is how petscaninfo.com describes it:

"PET is the most useful test that you can have when doctors are staging or re-staging lymphoma because it accurately shows the extent of the cancer.

How PET works:
In cancer, cells begin to grow at a much faster rate, feeding on sugars like glucose. PET works by using a small amount of a radioactive drug called a tracer in combination with a compound such as glucose. Once you are injected with the tracer and glucose, the tracer travels through your body. It emits signals as it travels and eventually collects in the organs targeted for examination. If an area in an organ is cancerous, the signals will be stronger since more glucose will be absorbed in those areas. 


In tissues or organs affected by lymphoma, more of the radioactive glucose will be taken up as compared to normal lymph nodes and tissues. This helps the doctors understand exactly where the lymphoma is. Proper staging of the location and extent of the tumor is the first step in appropriate treatment. Moreover, once treated, patients are often re-staged to determine the effectiveness of the treatment. In addition to providing basic staging information, the initial PET scan provides a baseline for subsequent evaluation of whether the therapy was effective or not. Whole Body PET may be particularly useful in detecting extra nodal sites of disease such as bone marrow, liver and spleen. 


The treatment of lymphoma has been one of the true cancer success stories of the last 20-30 years. Continued improvements in chemotherapy and radiotherapy have resulted in better survival rates. After first showing the doctors where the cancer cells are, PET can also see if the therapy has been effective at killing them."

We go in for what we hope is Charl's first and last PET scan on Friday June 4. We then have a consult with a new doctor, a Radiologist, who on June 17th will explain to us the results of that test; if the cancer is gone, or if he needs to undergo further treatment (radiation). We would appreciate any prayers for his total healing and full recovery. 

TGIF (Thank God It's Finished!)

The TBCC has become a familiar setting; a good place, a dreaded place. The chemo treatments friend and foe dressed in the same clothing. Often, the more you do, the sicker you feel. You dread the needles, the tests, the chemo, the endless pills - but you love how it kills the cancer. The chemicals that save practically kill you in the process. An ironic ally you love to hate.

Today was a momentous day as Charl underwent his last and final chemo treatment. In typical form, uncomplaining, he greeted the chatty nurses with a smile and a bared forearm, bracing himself for another injection of toxic chemicals (“poison sessions”, as Charl likes to call them) that frankly make him feel terrible.

It's what every cancer patient must do: suffer the ill-effects of treatment and focus on securing a positive outcome. It's the only way to go. But when someone has it worse than you, you see your circumstances in a different light. In fact, being a healthy person so close to this situation I feel that all patients are brave, no matter how they deal with it. The mere fact they wake up and walk through each day is bravery incarnate to me.

One of Charl's nurses told us of a man in his 30s who had to go through 13 rounds of chemo for his particular form of cancer. She told us that he got through all 12 rounds and didn't get nauseated until the 13th. The last one. We pondered how mentally strong he must have been, to withstand the onslaught of not only the physical trauma the body goes through ingesting all those toxic chemicals (in addition to the trials of the disease itself), but also the mental anguish of knowing you have so many more to go. 'Anticipatory nausea' they call it. The kind when you vomit just thinking about your upcoming treatment. Apparently he got to the parking lot of the TBCC for round #13, and up it came. A brave guy. Not because he didn't vomit until the last session, but brave to withstand the rigors of chemotherapy and the black pit of despair of facing an uncertain future - despite all efforts to manufacture a positive one.

Since then we have referred to that unnamed chemo patient on several occasions, comparing Charl's schedule of 6 treatments with his 13. That man became a tangible inspiration to us. His misery became our strength. We are both so thankful and glad to be done with this episode in our lives (Charl far more than me, I can assure you), but if Charl's story can be a tangible inspiration to someone carrying a heavy burden in their life, Amen to that.

Better!

Some good news to report: Charl took it easy yesterday and is back down to a normal temperature today. Had a good clinic this morning with the hematologist and we'll find out more about the radiation treatment once we are through chemo (last day tomorrow -yay!) and after we get the results of the PETscan on June 17.

Spoke too soon...

The deal is, if Charl runs a fever of 37.5C we have to phone the hematologist on call. If he runs a fever of 38C or more, we have to take him to Emergency. Last night he had a throbbing headache that wouldn't quit, and rapidly rising fever. We followed the instructions and headed to emergency at Foothills just after midnight.

Our doctor gave us a letter to take with us to emergency in case this ever happened. When you hand the triage nurse this letter, it's like you have a VIP status to get treated as quickly as possible. Not that they don't treat other patients as well, but we were astonished at how quickly Charl was admitted. We waited maybe 10 minutes for a bed, and within 20 minutes after that Charl was in the hospital bed, hooked up to an IV in one arm, oxygen tubes in his nose, a throat swab and Xrays were taken, and copious amounts of blood were being drawn from the other arm (6 small vials and 4 large ones that looked more like small bottles).

I can tell you that it was an unsettling sight to see my pale, shivering husband hooked up and helpless like that. We knew the staff was doing everything they could for Charl, but when a situation provides no comfort we turn to scripture and prayer for a comfort that can only come from God. I read Charl psalm 16 from my iTouch: "Keep me safe, O God, for in you I take refuge ...I have set the LORD always before me. Because he is at my right hand, I will not be shaken."
How complacent we become with a perceived improvement of health, and how frightening it is when the unexpected happens. You just never know when things will turn.

They take so much blood so they can run cultures to figure out what infection if any he has, and if there is an infection, which antibiotic to use to treat it. After several assessments from the emerg doctor, and hours of waiting, no obvious source of the infection was found. Fortunately, he was not neutropenic (where white blood cell count is too low) so by 5:00am they discharged him and told him to take it easy for the next 48 hours. If anything changes, or symptoms worsened, come back in right away.

Being positive has many advantages, the most obvious of which is not focusing on the worst aspects of the disease. But perhaps one disadvantage of being positive is assuming all is well and carrying on with life normally, while inadvertently pushing a bit too hard. Did we push it too hard? Or did he just pick up some random virus? We don’t know that, but what we do know is that he only had a fever of 38.5, but that was enough for the staff to treat his condition very seriously.

I thought to myself how different it would be if I went to emergency with a fever of 38.5. They'd point to the door and politely yet sternly tell me to get lost. As they should. In any event, we just hope he's well enough on Thursday to get through his last chemo.

LAST Filgrastim!

Tonight marked a major milestone in Charl's chemo treatment schedule. Before each chemo, his blood count goes way down and therefore has to inject himself with an immune system enhancer called Filgrastim. I have mentioned before how painful it is for him to take it, so finally they decided to lower his dosage to 1ml. This not only made his experience better every 3 weeks, but also morphed the pain into a mild overall stiffness that is easily manageable with Tylenol 3.
I'm always leery of this low blood count period because of the stories they (have to) tell you to warn you of what could possibly happen if a cancer patient gets an infection with no ability to physically fight it off. Once we reach the injection day, I know the artificial immune boost will keep his immunity up and give him more ability to deal with infections, common colds etc. It's like a get-out-of-jail-free card. You're automatically better off than you were before you had it.
That said, of course he could still get sick, but as tonight was his last injection, we have rounded a corner. We are on the homestretch to the LAST CHEMO.
We thank God for his continued, lasting health along the way.

Flora and Fauna

We took advantage of the high blood count week and took off for the warmth, sunny skies and beautiful spring scenery of the Okanagan.

It was stunning in the valley; the lakes reflecting perfect skies and greenery bursting with colourful flowers.

My favourite flower, the lilac, was in full bloom. White, lavender and deep purple colours with that glorious lilac scent seemed to be everywhere. We went for long walks near the farms up the east hill toward the BX.  I don't know what this tree was but it was stunningly beautiful.

Why is it you don't appreciate the beauty of your hometown until you move away?

We spent time at the cabin on Okanagan lake, and noticed more turtles and carp than ever before. In fact, apart from the usual suspects, we saw quite the number of creatures on this trip: a grizzly on the roadside near Lake Louise, mountain goats outside of Golden, deer and elk from the highway, marmots, turtles and loons at the cabin, an oriole, lots of quail... and even a black bear in a tree in Lakeview park (which is as unusual as seeing a bear in Kensington for Calgarians).

We canoed at the cabin, hung out with family, enjoyed the heat, and ate well - aka barbequed lots - all part of Charl's healthy recovery plan. Ultimately the change of scenery was good for both of us.

CT Scan results

There are two ways you can interpret results: as the old adage says, by looking at the glass half full or the glass half empty.

When we sat with a our pleasant oncology nurse this morning as she began to tell us the results, if there had been a camera in the room, you would have seen an almost imperceptible frown starting on both Charl's face and my own. This would have happened as she described, in centimeters, how large the remaining mass was.

In January, the mass was 15cm x 15cm x 8cm. The CT results from last week showed, she told us, 6.8cm x 6.5cm x 3.8cm. We knew the X-ray didn't show everything, but in all honesty we were expecting it to be smaller.

The nurse left the room and as we awaited the arrival of our hematologist Dr Savoie, we were thinking, ok, so just a touch over half way shrunk. Hmmm. Slightly disappointing. I mean good, but slightly disappointing. Glass half empty.

Just a few words about the doctor. Dr. Lynn Savoie comes across as a brilliant, young, friendly, approachable, direct, and even-keel kind of person. (And she has this amazing, big HAIR that I can not help but envy). Anyway, she came after hours on several occasions while Charl was still in hospital to discuss with him his diagnosis, and the realities of the chemo that would follow. She made every effort to make sure we were informed, and prepared for his treatment. She was so even-keel, in fact, that it was difficult to tell at the time if she thought his prognosis was good or bad. She just focused on the facts and remained neutral, with a bent on helping us fight the disease in any way possible. This description might be applicable of most doctors, but to us she was like a serious, capable, big haired angel, ready to lead the way to stratospheric recovery.

As she sat down to discuss the results with us she, again, was quite neutral (which before we questioned the results, didn't surprise us but also didn't inspire us either). Charl, in his genial way, joked that the chemo wasn't working very fast, and to this she retorted that we mustn’t focus on centimeters, we must look at the volume. Now we couldn't tell how much water there was in the glass...

Over lunch after our appointment, I pulled out a note pad for us to do the math and really work out the difference in sizes of the tumor. All of a sudden, the picture became so much clearer. Originally 1800cm3, it was now only 168cm3; it had gone from the size of a small football to less than a tennis ball. Volume. WOW. It had shrunk down 90% of its original size (in volume). OK so he still has a tumor the size of a tennis ball.. but glass half full!! The chemo is working!

Charl will still do the last 2 rounds of chemo, then a month recovery, then a month of radiation. They will do a PET scan (where they see if there are still active cancer cells in the mass) after the 6th round and a final CT scan after the radiation. We thank the Lord Charl is well on his way to recovery!!

Tomorrow

In the much-goings-on around here, tomorrow we will get the results from the CT scan, this time interpreted professionally and directly from the hematologist. We are both looking forward to hearing more positive results, and we hope to see the CT images as well. We'll let you know tomorrow afternoon.
C

Snowstorm? pshaw!

To make myself feel better in this raging almost-MAY snowstorm, I think about how great yesterday was. This is a crazy place - this city gets blanketed in snow in about an hour and if you try to walk in it your face gets ripped off by the wind and snowy/rainy pellets. Meaning no disrespect to any Calgarians.. I MISS VANCOUVER! But enough of my plight. Let's talk about how great yesterday was.

We are amazed at how many people shared in the joy of Charl's good news the other day. You people are amazing!! If you ever doubt that you can have an impact on someone else's life, by a small gesture like sending a quick email, or hugging someone, or lending a hand or sending cards etc.. please rest assured you doubt in vain. It is always an ecouragement to know that people are walking alongside us in this cancer journey, and for all the things, little and big, it means so much to us.

OK so back to yesterday.
Charl received a package of hand-made cards from the entire Swedish contingent of the Overend family. My brother, his wife and their three kids all made get-well cards for Charl, personalized to perfection. Isak's favourite was cutting and glueing portions of his card into little green pieces (he's 4). You can't start a day better than that - so sweet!!

South Africans all like this hard bread called Biskuit, or Rusk, dipped into their coffee or tea. It's similar to the Italian biscotti, only not as sweet and infinitely harder to find in Canada. Which is why they tend to bake their own. Hence Alida, our friend from the old country, decided I needed to know how to make this for my husband to keep him even happier than he already is at home. Happiness to a man is a full stomach (or something like that).

Armed with nothing but ground flax-seed and some sunflower seeds (from my trusty cancer cookbook I know that ground flaxseed has 3000x more healthy-ish somethingorother than other stuff that could possibly make up the familiar chunchy granularity of Charl's favourite coffee-soaked bread), I showed up at Alida's to start the learning process. Yup, that's me with the apron (alot of strange and wonderful things happen when you get married)

You'll see that this bowl of goo actually turns into delicious Canadian-made super healthy RUSKs, which I'm proud to say, tasted pretty darn sweet.

Upon returning home with the warmly baked goodness this fact was proven by Charl and I gorging ourselves silly on them.

How sweet of Alida to spend her afternoon sharing her million year old trandition with the likes of me??




Well to round the day off - as if the day wasn't already good enough - after we'd overindulged in the baking, we realized we didn't have anything prepared for dinner and were in that half-lazy fog of helplessness just before you capitulate and order take-out pizza. No word of a lie, the next minute, the phone rings and it's Barb from our bible study, saying she and her daughter had made us dinner and were bringing it over now and would that be ok?
ummm.. ya!

Totally kind mom and daughter taking care to make sure we had a home cooked meal.. Amazing grace!

Thanks everyone, for making our day soooo good, that even this freaky snow can't shake our good mood.

WOW

After having to drink 1.4 litres of medicinal-tasting water within a 2 hr period while waiting in the diagnostic area of the Peter Lougheed Hospital, Charl's name was called for his X-ray. A few minutes later, Charl bounced back into the waiting room, hurriedly suggested I leave my book there and follow him. The X-ray tech agreed to allow me to come in and take a look at the X-ray that had just been taken of Charl's chest.

We looked first at the screen that showed the X-ray that was taken back in January, when the tumor was first discovered. It was a big white mass on the screen. But when I looked over at today's chest X-ray, I immediately choked up. We have been praying for a miraculous result and we feel that is exactly what we got. The mass is virtually gone. Incredulous, we looked at each other with big teary smiles. Wow. Charl was going to be ok.

While we were so thankful for such a clear picture of the chemo working in Charl's body, we know that this is not the 'final' analysis of his cancer, and that a radiologist, and Charl’s hematologist, needs to inform us of what the CT scan results are. An X-ray is a one dimensional image; a CT can is not. It shows you multiple angles of the same image. We are well aware that there could be more to this story - i.e. more tumor left in his body - but the joy at seeing the chemo doing its job was undeniable. The CT scan results will be revealed to us next clinic, May 5.

We walked out of the hospital with a hope even more fierce, a feeling more exuberant and an outlook more positive than before. We are not out of the woods yet, but we will be soon. We thank God for the gift of modern medicine and the impact it has had in Charl's life, and we thank you for your prayers.

Birthdays

Some of us like birthdays, some of us don't. But is there anyone among us who doesn't like being remembered on their birthday? I think not. Yesterday was Charl's birthday. The day started with receiving a HUGE hand-made signed card and 4 (!) specialty cakes delivered to our door from his super thoughtful colleauges at work.
Here's a peak at the card:

Then he got a flower delivery from my mom (south african flowers), text messages, calls from friends and family... talk about everyone making his day! He was pleased as punch.

Then, given all that Charl has been through I thought I would do something a little different for his birthday, a change of scenery, so to speak.

So I secretly packed an overnight bag for him - which I will tell you is no easy task, given that Charl notices everything - made the requisite reservations, and told him I needed him for about an hour after lunch. It was a ruse ! Here is me kidnapping him and whisking him off...

 ... for the day and surprising him with a stay at a gorgeous hotel where we dined in the evening.




If you have ever been fine dining, which I'm sure more of you have than me, the more you pay, the less food you get. Our portions were laughably small but exquisitely delicious.

Take a look at this dish:

Have you ever seen a portion so tiny? But it was a divine taste experience! PS if you can guess what that food is, I'd be impressed.

They lavished us with flawless service, unexpected extras and even a special birthday treat for Charl (notice the edible white chocolate label):

We sat by a fireplace after dinner and let the beauty of the day sink in. It's so healthy to just get away and do something different. Except next time I steal my husband, I need to remember to take his toothbrush and medicine. Oops!
Dont' worry, he said it was worth it.

Progress Report

We heard from the Tom Baker Center that Charl is scheduled for an appointment for a CT scan. It is scheduled for Sunday April 25. He has to go get some liquid pumped into him an hour or so prior to the test, after which the test is at 11:00am.

This will be an important day for Charl; those results will determine whether he will stay on the planned course of treatment or deviate from it with more or different therapies. We are confident in the Lord's good providence, and we are not worried about a negative outcome. That said, we are hoping and praying that it is a good outcome and the tumour has shrunk down from the size of a football to the size of a ... pea (I just made that size up. Actually we hope it's totally gone!). We trust that when we see that CT scan, it will be a miraculous result.

Should the results be as expected (ie that the tumour has indeed shrunk), Charl will continue with two more rounds of chemo, and finish off with radiation therapy every day for a month. Once that is done, he will get one more test, a PET scan, to detect if there are any remaining active cancer cells left.

God is reverentially referred to in many ways: Yahweh, Lord, El Shaddai (Almighty God), Adonai (master). I've also heard him referred to as "the Great Physician". I like this title and especially like that Charl is in good hands!

We would love it if you would join us in praying for the best results possible this Sunday.

Sunny Recovery

One week ago today, Calgary was hit by a freak snow storm. While driving we were blinded by diagonal sheets of snowfall, and the city was white within an hour. We had no choice but to surrender to Winter - it was upon us in an instant. Today, however, it was summer in an instant. It was one of those perfect spring weather days: light breeze, azure skies and temps hovering near 20C.

We took advantage of Charl's prednizone-induced energy and went for a very easy walk by the Bow river, on the west side of Calgary. It was a thing of beauty to be back out in nature, feeling the warm touch of the sun on our skin, seeing tiny colourful specs resembling owners and their wildly sniffing dogs on the other side of the river, listening to birds chirping, watching a pair of Mallard ducks silently float downstream. I've missed this connection with nature, as Charl has, while being all too consumed by the torpor of illness.

We know that treatment plays an important role in recovery, as does rest and eating properly. But this fresh air walk - as mild and unstrenuous as it was - was ironically not what the doctor ordered, but was just what Charl needed. It was so lovely. Charl is tired but well pleased.

Chemo 4

Yay! Charl got through the 4th round today without a blip.

Charl got a bed in the 'corner suite' by the window where I read by his side most of the day. He napped on and off while his various IV bags went drip, drip, drip. I had the pleasure of receiving a call from some of my former colleauges in Vancouver -  catching up with them was a nice way to pass the time. Even though they haven't met Charl, they sent their warm regards. All these little bits of support are very encouraging when you are lying in a hospital bed on an otherwise beautiful sunny day.

April was our nurse and she was very chatty and friendly. Originally from Saskachewan, she thought Cape Town was in Eastern Canada somewhere, and commented, after Charl politely corrected her,  that she didn't think Canadians had strong accents like that.  (!)

We left the TBCC and returned home to another home cooked meal by Chef Overend, (formerly known as the chips and salsa girl with the empty cupboards ha ha).
:)

Clinic #4

Just a quick note to say that Charl's clinic went well today.  A few points on why :

a) Even though his white blood cell count was "in the boots" as the nurse practioner called it, she gave him the shot to boost his immune system (ie he didn't have to give it to himself, which is just not fun)

b) They gave him the thumbs up for taking Tylenol 3 for the pain associated with the injection (ie - Charl is in a happy place tonight, vs being in lots of pain)

c) We only had to wait 1hr 45 min to get in to be seen by the staff

d) Charl is still handling the chemo very well all things considered, and

e) The staff is great and the interaction with them is always pleasant.

We are hopeful again for a good day in Chemo #4 tomorrow - even though Charl doesn't look forward to it - and hopeful that these chemicals are doing an outstanding job of killing all remaining cancer cells in his body!!

Friendship

Friendships are interesting things. Some are lifelong, and are there because they've been there forever. They are dear and they fit like an old pair of jeans. Some friendships are new and fun and unencumbered by trial and unmarred by history. All have goodness in them. But some surprise you with special moments you won't ever forget.

We received an email from dear friends of mine - Mike and Mae Ward - from Vancouver. These were the first two people I was fortunate enough to call my first friends at church. We did so much together in the first days, before they had kids, before my job took me away from the city for long stretches, before I moved away. We'd shared many struggles, dreams, prayers and laughter over the years since we met. 

When Charl was diagnosed with cancer, they - among many others - prayed for him regularly, and let us know that we were in their thoughts and prayers.  Mike and Mae only met Charl the day of the wedding, but they considered him a brother and a friend all the same.

Today something out of the ordinary happened. Mike decided to really walk through this with Charl - a man he only met once, but for whom he cared deeply anyway. He decided to shave his head in solidarity for a friend going through cancer.

Words fail to express what this means to me and Charl. Or perhaps I just don't have skill to figure out which words to express it. Mike gave Charl an unexpected gift of friendship, solidarity and love. And it means so much.
Thanks Mike.

Brother and Sister

Life doesn't always allow for quality time spent together. But illness has a funny way of pushing aside hectic schedules and forcing us to make choices between our schedules and spending time with loved ones. I love being part of seeing Charl and his sister reunited at this time.  It has been such a blessing to have Elsje here, to spend time in meaningful conversation, cooking and tidying up together, going for walks, touring Calgary, watching videos, laughing, and hanging out. I suspect this is as much a restful rejuvenating time for her as is it for Charl. Makes me long to spend time with my brother who lives overseas.. 

In the meantime here are brother and sister together in steadfast South African tradition. The Afrikaans word Braai translated loosely means "BBQ" in English, but in fact the actual cultural and emotional translation is closer to it's in our lifeblood to bbq and if we don't we will die - or something like that. The men bbq in South Africa. That tradition has not died in the last 10 years Charl has lived in Canada. (This is a tradition I fully support)

Here they are braaing in what Charl thinks of as 'beautiful spring weather' and Elsje unapologetically calls 'freezing!' (note her wearing her brother's parka).

We will miss her dearly when she goes back tomorrow night but will cherish the memories of sweet time spent together.

Easter 2

One of the things I love about Easter is time spent with family.
Early on Sunday morning, around 1:00am, Charl's sister Elsje arrived in Calgary. She was on a trip to North America with her family, and on her way back to South Africa she detoured in for a visit. Charl and I are thrilled to have her here.

We have lots planned for the week, and we are going to treasure the time spent with his wonderful sister.
(I have to remind myself that this is now my family too, and not only does Charl have 'a new family', but so do I. So I'll enjoy this time with my sister too.)

We also invited Mike over for dinner and it was a great evening. Elsje brought us a lovely Sauvingnon Blanc from South Africa:

The main event at dinner :

and the hosts:

Easter

I love Easter. It's a time of lovely time of the year with birds chirping, warm(er) breezes, and green shoots starting to sprout. But it's a time to reflect upon and celebrate our risen Lord. This Easter we attended a good Friday service that included a one-man act depicting the life and character of Father Damien, the Belgian priest who gave his life to the people banished to the government sanctioned leper colony of Molokai (Hawaii).

The actor was from the Rosebud Theatre in Alberta, and he was able, through a simple monologue (and no props) to artfully insinuate the island's imagery and the resounding sense of isolation and drudgery those poor outcasts must have felt every day of their miserable lives. By moving there on his own - the only able bodied person on the island - he gave up his life so that they could better live theirs. A fitting play for Easter. Although less significant than Jesus's sacrifice, still a brave, loving soul. He eventually died of contracting the disease in 1889, and his martyrdom is still recognized in Hawaii, where they celebrate his life and death each April 15 (incidently my brother John's birthday).

Visits and Visitors

It's our tradition that each year my sister Aldyn and I take our mom somewherefor her birthday. I didn't want to venture too far from Charl this year, so they decided they would fly to Calgary and we'd go to Canmore for a couple of days. Unfortunately, she got sick and couldn't make it (aka was kind enough to forego joining us for fear of infecting Charl) so mom and I went for a night in Canmore on our own.

We went to the dinner theatre that we went to last summer, that fateful day when Charl and I were seated at the same table, the night we met. It felt strange to be there again, like he should have been there with us!
We saw the Andrew's Brothers (a parody musical based on the music of the Andrew's sisters) - where three guys played the three sisters. It was a fun night out.

Since then we've had lots of visitors, and kind wishes and we still can't thank everyone enough. Flowers from friends and emails and visits.. it's all good for the soul.

This weekend Charl's sister will be flying in from her whirlwind tour with her family, and we're excited to welcome her for a 6 day visit. It will be lovely celebrating Easter with her.

Hump day

It was with a relieved high-five we walked out of the Tom Baker Centre into the cool spring sunshine after the third round of chemotherapy was finished. As usual the staff were effecient and friendly, and during treatment Charl was comfortably resting his eyes in bed with the mildly noticeable din of conversation from patients around him. I read pretty much non-stop, other than to offer Charl encouraging glances, food we brought from home, or to fetch us nice hot lattes.

In clinic yesterday, the Dr informed us that Charl's neutrophil count was  back up to normal, as was his white blood cell count. This is good - we have that nasty injection to thank for that. They also told us that they would do a CT scan after the 4th round, to see how much the chemo has shrunken his tumour, and a PET scan after the 6th round to see if there is any cancer still lurking within any remnants of the mass. We are anxious for good news, solid results, percentage of improvement, key performance indicators, something concrete, to tell us that he is doing marvelously well, and this treatment is doing exactly what it should. But we have to wait for that, and rest in the knowledge that his improved lung capacity can only be an indication of the chemo working, otherwise he would still be coughing and out of breath at the least strenuous of tasks.

So today marks Hump Day - the official half way mark of Charl's journey through chemo. God willing, just three more to go..

On a lighter note..

Ok so now that I've stopped snivelling and pulled up my socks a bit here, it's time for a cute story.

A few days ago I asked my older brothers (one lives in Vernon, the other in Uppsala, Sweden) to ask their young children their thoughts on the best way to get better when one is sick. This is John's email back to me.

Here come some answers but I don't really think that they are the ones you're hoping for.
Those "out-of-the-mouths-of-babes" moments are difficult to order.

So here is how it transpired. I tried to talk to Olivia (6) alone but it didn't work so I decided to ask all three kids at once while we were eating dinner. Stina was working late so it was just the four of us.

When I asked 'what is the best way to get better', Max (9) knew right away why I was asking because he had been in and read your e-mail. So I explained to the other two why I was asking which was ok, but we were already far away from spontaneity. So Livy said "drink medicine" and Max said "eat lots of easy food — like apples and bananas." Isak (4) said "drink lots of water".

You see their reality is when you are really sick - you've got the stomach flu or a fever. Then Max said "well you should rest in peace". I think he picked up on the look on my face because he then went on to say that it wasn't that kind of rest in peace but to have peace and quite while resting.

After that the subject was simply exhausted and I could no longer extract anything more.


Hope that this helps in someway,
John

(And tell Charl to eat some easy food).

Super Store

They say you process bad news in waves. Today our reality hit me in a whole new way. Charl has cancer. He is going in for his third round of chemo on Thursday. My husband is critically ill.

I've been writing this blog to update people when events in his treatment warrant it, and to let everyone know that he is doing well - the happy, smiley stuff. But I don't write everything that could be written about what it's like to see someone you love so much suffer, what it's like for Charl to have this disease, to be justifiably frustrated, to be forced to withdraw from the normal activities enjoyed in life. Nor do I write about all the ways in which it affects our relationship and our plans, to live in a constant state of limbo, or what it's like when I'm scared or tired or feeling isolated. Well today I'm going to write about it.

It took me 3 hours to do my shopping at SuperStore today. I did not expect it to take that long, as buying groceries never does. I don't even know where the time went. Charl had to take his injection yesterday, and he dreaded its painful effects. When the drugs start working, they trick your bones into producing bone marrow so your white blood cell count will rise - which he needs to do in order for the nurses to be able to administer his next round of chemo. He has been in pain for the last 24 hours. This is not fun for him, and it is not fun for me to watch him go through it.

We were out of all the good foods he needs to eat, so I went out to do a routine weekly shop. Why it hit me at SuperStore I'll never know. 'My husband is at home, during a work day, laying in bed. In pain. This is not the way it's supposed to be. He should be at work, we both should be at work. We should be going out to a nice restaurant tonight. We should be buying the house we've always planned to buy together. We should be having babies. We should be planning the big summer vacation we've talked about for my birthday this summer...'  We should be. But we aren't.

In retrospect - on all those days I blogged when we were (mercifully) feeling 'up' - I was so glib about 'the new normal'. This is not to say I was purposely being disingenuous, or trying to present a false reality, but on the good days you can be glib. On the hard days, nothing about the 'new normal' is likeable.

Thank you mom and Patti for calling me today, and keeping me going while I was at superstore. Thanks to Liette from church who happened to also be there, and after a nice chat, though we hardly know each other, gave me a warm hug. God has given us everything we need to get through this time, about that I have no doubt. And we'll get through this. This, a Super Store day.

A Sabbath Rest

While my husband rests, I contemplate the meaning of rest as we know it today, versus the "original" rest declared by God
(Genesis 1:1-2:4)

The Bible Sabbath is a weekly day of rest and time of worship. On Wiki it explains it as being "observed differently in Judaism and Christianity and informs a similar occasion in several other faiths. Though many viewpoints and definitions have arisen over the millennia, most originate in the same textual tradition.
Sabbatarians believe that Sabbath-keeping is central to following Christ, and that he highly regarded Sabbath, while non-Sabbatarians believe that Christ has power to abrogate Sabbath, and that he reinterpreted it nonritually." Hmm. Ok so some people observe this day of rest as a God-sanctioned, non-optional day of rest and others see it as a non-legalistic, optional activity.

Can rest be optional? We can't live without resting. We are limited in our ability to feel energized, think clearly and operate effectively when we have even a moderate amount of tiredness. While rest and sleep are not the same thing, they are indisputably related. We need to sleep to survive, and we need to rest to live well. Charl needs rest right now to recover and rebuild depleted strength and energy reserves - the ones healthy people take for granted. For him, rest is certainly not an option. I'm pretty sure this applies to me too.

C.S. Lewis said that "a man can no more diminish God's glory by refusing to worship Him than a lunatic can put out the sun by scribbling the word, 'darkness' on the walls of his cell".  By the same logic, is it not fair to say that we can no more negate the command to rest by refusing to rest, than a child can rouse to life a stuffed toy by longing for it to be alive?

The 'Food vs Cancer' Battle

What do flaxseed, turmeric, seaweed, tomatoes, mushrooms and yogurt all have in common? They all play a critical role, along with just about every other food of plant origin, in protecting our bodies against cancer, say Drs Richard Beliveau and Denis Gingras. The Cancer Research Society funded their research, and one of the products of their work is a book called Cooking with Foods that Fight Cancer.

It is no exaggeration to say that this is the coolest cookbook I have ever read, perused or applied in my kitchen.  I'm serious about this book, and yes, while I'm admittedly biased and therefore enthusiastic about cooking healthy foods for Charl, I'm not in the slightest prone to fad remedies, or quick-fix solutions to health issues. So rest assured this book isn't saying it's got the cure for cancer. However cynical one can get about claims that fad diets can 'fix' serious, persistent health problems, the refreshing thing about their focus is that it's based on common sense: eating fruits and veggies is not only good for you, it's just plain smart living if you have cancer. And well, if you don't have cancer too.

Another benefit to this book is that it's more like a science text book than a book full of recipes and pictures of food (although it has plenty of that). That may sound odd that a science text would enhance a cookbook... but giving a very clear background in the research on which foods are doing what good to our bodies, and how they are doing it, is in my opinion giving a further understanding that can enhance an interest in cooking healthy foods, which in this case help Charl, and me, beat this thing, this "enemy" as they call it.
I am not being paid to market this book. But you should get a copy.

"The high incidence of [...] cancers typical in industrialized societies is an example that is as tragic as it is eloquent; it speaks to the major part played by diet in the development of cancer, and underscores the extent to which the modification of diet, through the addition of foods capable of protecting us against cancer, represents an incontrovertible objective of any strategy in the fight against this disease." (p17)


Happy cooking and happy eating. May your food choices win their battles against this insidious, annoying enemy called cancer.

PS thanks again Victor :)

The New Normal

Dear Bloggees,
We are surprised at the number of people who tell us they read this blog regularly and that they appreciate being able to follow Charl's progress. We are flattered and very glad that it's provided you with a way to journey alongside us through this process, however I regret to inform these dedicated readers there isn't always something particularly interesting to write about.
The truth is that for us, the reality of Charl's cancer has become relatively predictable; the anticipated perils of chemo have morphed into somewhat banal realities that we now accept as our new 'normal'. While Charl's normal is now a reduced ability to exert himself, an ability nonetheless exists to remain active in some form. He gets tired, as I've mentioned, and sometimes this necessitates staying in bed for sevearl hours during the day to regain his energy, sometimes not. Now walking, our only form of exercise, seems to be a metaphor for the our approach to getting through these next treatments. Slow and steady. You can't speed it up; you are forced to accept the schedule sanctioned by the system. Sometimes it's walking on glass shards, sometimes walking through green pastures on a sunny spring day. This, coupled with Charl's diminished ability to remain active, has generally just forced us to slow down to a pace to which neither one of us is accustomed. This is not a bad thing - we've spent many years busily working at building careers, managing homes, projects and blackberry addictions and leaving some of the more important aspects of life to the side. Now we have the ability to stop, reassess, shake off guilty feelings for not doing "more". Focus on what's important: regaining Charl's health and purposefully developing our marriage.  Exchange the rat-race for time to reflect, read, think, pray and listen. Love. Really take care of basic physical needs like eating well. (Historically not a strong tendency for either of us). Charl is meeting with friends and colleagues and fellow volunteers from church and is very much enjoying this perk as well.
Although the 'new normal' of cancer can have benefits, it dispassionately imposes a less than exciting life, inconvenient physical discomfort, and forces upon you constraints of ability otherwise unimaginable. We do however remain ever thankful to God for any positives there are, and for what we can learn through these slow times  - and Charl remains forcused on these.
(It just may be that slow times don't make for fascinating blog posts ;)

Realities of Chemo

Yesterday Charl completed Round 2 of chemotherapy. I've put some photos on the sidebar slideshow in Latest Pics that show the building, room and some photos of what it's like going through this process. He felt fine. We went for a nice walk in the sun after it was over to get some fresh air, and all seemed quite normal. After a pretty busy day today, however, he's not feeling so well. We had a few appointments and did the requisite walk (some form of exercise is highly recommended for overall health during chemo), but he says it's different from last time.. but has a hard time explaining what it's like. I imagine it is a mix between fatigue, mild nausea and being run over by a truck several times. But that's me. It's a good thing he's as strong as he is.

One of our appointments today was going to get Charl's head shaved. He was starting to lose hair at an alarming pace, which of course we expected, but anticipating and experiencing are two different animals. It's quite common to have some scalp sensitivity while losing your hair, so things we take for granted like lying on your pillow can become a nuisance as the hair can feel spiky on your scalp. So that, coupled with the amount Charl was losing (see here how much hair was coming out just by getting it wet in the shower) :

...we knew the time had come. We found a little hair place in the area and a nice Chilean woman did the deed. She was quite meticulous in trying to cut his hair as close to the scalp as possible. Apparently salons don't "shave" heads, only barbers do. So we had to settle for a 1mm hair length, as opposed to 0mm. So for $15 (including a hot water head massage) he's a new man. And a very handsome one at that!

Pretty cool eh??!

Low counts

Before the second chemo treatment can start, Charl has to do blood work to see how his blood cells are faring. You may remember that Charl came out of his 7-14 day period with (what we considered at the time) flying colours, because he hadn't gotten sick or picked up on an infection. But today we were shown his blood work results, and in fact his neutrophils and white blood cell counts didn't recover after that 14th day. They are both very low; the neutrophils barely above zero.

They say that a patient's physical response to the first treatment is generally indicative of their response for the proceeding treatments, and if so, we can expect Charl to do very well during the next 5 rounds. However, what we didn't expect was to have to be even more diligent about protecting him from infection beyond that 7-14 day window.

There are two ways a low blood count is managed: one is by waiting until his body naturally builds the count up again, but that would mean missing his scheduled chemo treatment. They did not advise this approach. The alternative, then, is to take a Filgrastim injection the day before chemo. Filgrastim stimulates the blood system (bone marrow) to make white blood cells, so that he has enough to be able to tolerate the harsh chemicals in chemo therapy.

Charl was prescribed three doses: one injection for today, and two preceeding round 3. These have to be injected at home, so it was up to me or Charl to play nurse. I immediately opted out given my pathetic intolerance to all things needle. So my brave husband stepped up to the plate, learned to fill his own syringe, do the 'mad doctor' tap-tap to remove air bubbles, clean and pinch a fat roll in his belly (sorry honey, I had to say that), and inject the magic potion. And voila! his blood count is on its way up for tomorrow's treatment.

We are now ready for round 2 tomorrow!