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