The last of the cheMohicans

I am becoming a bit blase about the chemo sessions, I fear. My dedicated followers will know the last one of the six occurred yesterday. I was just poking around in the kitchen a short time ago, looking at the calendar, which had it listed for Boxing Day. My trusty Raymond Weil automatic watch, obtained through the combined generosity of RMIT and my beloved about four years ago, told me it was the 28th today. Other sources contradicted this, telling me that today is the 27th: ergo, I had had the chemo yesterday. (The date window in the Raymond, for some reason, only adjusts forwards. Rather than advance a whole month, it is easier to not wear it for a day, and let the date run down to the correct one. September, April, June and November are all easy months, as all that is required is a single advance. February, of course, requires two, but I can just about cope with that.)

If I was having trouble remembering when I actually had the chemo, you can infer it went without incident. The worst thing was the coffee they sweetly made me in the oncology unit — they are so nice, I feel a bit mean to complain! (I just had another one at home.) The PSA continues to edge south, being now <0.01 — truly undetectable. I am not having any side effects yet, apart from a bit of fluid retention around the ankles. We got some lovely presents the day before, including a bottle of Mumm — my favourite! And my beloved gave me a super photo of our wedding day (the silver anniversary of which having ticked over a few days before).

Today it was hot — about 37 — so we went to see a morning session of Collette at the Balwyn Cinema. It was enjoyable, if rather resembling a BBC three-part costume drama stitched into a feature film. I would say “Get it on video”, but I am showing my age there! Still, anything with Keira Knightley is generally worth watching. Domenic West was good as Collette’s husband, the frightful (and appropriately-named) Willy. Lunch followed at a local Italian place, which was reliable as always. Then home to sit in the air conditioning and watch Day 2 of the Boxing Day test.  Hope everyone’s Christmas-New Year break is slipping similarly under the radar!

Advance future planning

Some people are just disgustingly organised. Yes, it’s around this time that the first shame-making batch of Christmas cards starts to appear in the mailbox. (Hand-addressed ones, I mean, from people you actually know, not those ones with the word-processed labels from real estate agents and other hopefuls.) Impressive as this is, some people of Olympian foresight are actually thinking about their new year’s resolutions. Fair crack of the whip! I’m still resting on my laurels from working out which bin to put out last Thursday.

For those who would like to take a mini-meerkat ramble, and peer over the parapet of the present (oh, when you’re hot, you’re hot), there is some pretty interesting stuff to ponder. The Guardian asked its readers for suggestions about how to live in a way that, while it didn’t involve throwing off the whole capitalist yoke, at least brought up some alternatives. The result was this article, From freecycling to Fairphones: 24 ways to lead an anti-capitalist life in a capitalist world . The suggestion that most tickled my fancy, not surprisingly, was the one about using libraries more.

(Strangely, I have just taken a not-a-new-year’s resolution to start using our local library less. This is to support a different NANYR, that is, to re-read In search of lost time. Having turned into a super slowpoke reader, I simply won’t get through this magnum opus in 2019 if I am forever putting books on hold. However, for anyone for whom their library service hasn’t been restructured, corporatised, and had its customer service outcomes optimised out of existence, I say — use it or lose it!)

My personal suggestion to do things differently in 2019? Shop in op shops. I had the most delightful conversation a few weeks ago with the co-owner of our local greengrocer, a Canadian, and a fellow op-shopper. I think I impressed her with my two op shop loyalty cards! (Not everyone would be.) I was able to fill her in about some local outlets, and admire her ability to score a wearable cardigan. Knitwear is definitely the Achilles heel, if I can put it that way, of the op shop. Most jumpers, or even sweat tops, are either stained down the front or worn thin. I have scored a couple of good jumpers, one of which I wear as I write, but the hit rate is definitely lower than for jackets, shirts, or pants. Op shops, though, are a great way to connect with your community, save stuff from landfill, and disconnect from the whole disposable fashion cycle. And obviously they are mega cheap. As the Mitsubishi ads used to say: please consider.

Sir’s undetectable

There was a line of wigs or hairpieces widely advertised in the media of the 1960s or 70s as “Sir’s Undetectable”. I am hoping that someone of my vintage, or thereabouts, can confirm (or otherwise) that I am spelling “Sir’s” correctly with the apostrophe after the “r”. These products were legendary in our family as “Sir’s detectable“!

Dr Google can only turn up a Yellow Pages advertisement for “Sir’s For Men Wigs & Hairpieces” in Baulkham Hills, Sydney, which assures us that this is “A Name You Have Relied On For Three Generations”. My curiosity being aroused, I turned to Trove, where I performed the following search . This only found results from advertising in the Canberra Times from 1980 onwards. These advertisers of this era were unsurprisingly unsure about whether to spell their product “Sir’s”, “Sirs” or even “Sirs’ “, resorting to all three spellings in the 19 ads retrieved. That apostrophe was indeed a pesky piece of punctuation! Is there a grammarian in the house?

There is indeed method behind all this tonsorial nostalgia. My last PSA result repeated the previous one, I think it was, as 0.01. Apparently this amounts to  being undetectable. (I had been hoping for the “bagel score” of 0.0, but I guess the .01 part is a courtesy amount, rather as people refer to retired military or politicians by a courtesy title.) Anyway, I remain happily in remission. The last chemotherapy session went well, as all the previous ones had. Only one to go, on Boxing Day! (I will be seeing the good Dr P on Christmas Eve to get the go-ahead for this final infusion.)

I am still enjoying punting the little Toyota around. The previous weekend I had the chance to stretch its legs a bit on a run down to Cranbourne. This was the first time I had had it on a freeway. It felt very stable and solid, and there was no problem keeping up with the other traffic. It isn’t the best car for an interstate cruiser, being a bit noisy on coarse-chip road surfaces. But it was definitely fun. I think what is enjoyable about it is not just the attributes of the car itself, but the fact that I bought such a wildly unsuitable and midlife-crisis advertising vehicle in so insouciant a fashion!

Still, I am trying to make it as practical as possible. I had the full size spare wheel fitted and the steering wheel re-covered at the dealer’s (these things having being folded into the purchase agreement). I also had a sunvisor and the reversing camera replaced, both under warranty. It remains a delightful car in being easy to manoeuvre around shopping centre carparks, small enough to fit in most car spaces, and very sporty in which to whip around corners. I am also getting the hang of various features like the ability to retract the side mirrors at the press of a button.

On one of these shopping expeditions, I left it in a brand-new supermarket carpark, and returned to find dark red fluid leaking from underneath its nose (or so I thought). On checking the service record, I found that the last service had occurred about nine months ago. This being, oddly, the service interval for this vehicle, I took it to my local garage for a workshop once-over. They replaced all the fluids, and declared that no leaks could be found. The previous owner having been pretty spotty with the servicing, I know it has been brought up to where it should be.

What’s been and what’s to come

Before the main part of the post, there is a small addition to the Resources page in the form of the NCI Dictionary of Cancer Terms .

We are now just a few weeks from Christmas. Those who know me will know this is my favourite time of year! (Not.) Still, it brings us to a sort-of review time for 2018.

The last twelve months has been one of numerous changes, and some milestones. I bought a new car, and we replaced some big-ticket things like the ducted cooling and the bed. The Blu-Ray recorder, and some electrical equipment, was also replaced. For the first time ever, my beloved moved to part-time employment. Most importantly, we are to celebrate our twenty-fifth wedding anniversary at the end of this year.

It has also been a huge twelve months or so health-wise. My treatment summary from November 2017 to now is the story of my cancer:

  • radical open prostatectomy
  • subsequent treatment with a physiologist specialising in continence
  • referred to a radiation oncologist, with whom I
    • had radiation therapy, with moderate success
  • then referred to a medical oncologist, with whom I
    • had androgen deprivation treatment and chemotherapy.

Of course the last of these is ongoing. However, being in remission is a great result for the treatments I have received under the care of Dr Parente and the staff of the oncology ward in Epworth Eastern. My GP has been terrific as well — someone I have been seeing for many years. Modern cancer treatment of course relies on adjunct modalities, and I feel my exercise physiologist (a recent referral) will become someone else I rely on.

My progress through these treatments has been one from specific to general, i.e. from treatments focusing on individual mets, to ones that are treating the whole body. This has been driven by the failure of the specific treatments to keep pace with the growth in the tumours.  I believe the progression in the treatments is also from ones with lower potential side effects to those with more potential side effects, but more efficacy. (Time, as ever, will tell.)

The chemotherapy  has been less of a big deal than I expected. I have dropped some social engagements in order to lessen the risk of opportunistic infection — something my immune system is less able to handle than usual. However, I haven’t wanted to become a recluse. So new year resolutions include doing a better job of keeping up with people, both individually and through groups like the local Cancer Survivors.

The chemotherapy is adjunct with androgen deprivation therapy. Their combination gives apparently an increase in efficacy of 10% in absolute terms, over either treatment singly. I started with the ADT some weeks before the beginning of the chemo, and I will continue with that as long as I remain in remission.

(On the subject of keeping up with people, we have been having a lovely time just recently having an old friend to stay for a couple of nights. She came down from Sydney for Die Meistersinger at the opera, which we all saw last night. Amazing! The second act was quite the most spectacular I have ever seen live. The orchestra played every bit as well as the Gewandhaus, whom we heard in the Leipzig Ring, and everyone acquitted themselves extremely well in the principal roles, especially Michael Kupfer-Radecky, the third singer to be engaged as Hans Sachs. And Warwick Fyfe as Beckmesser! Is there a better anywhere? Anyway, I hope that 2019 includes more Wagner as well as more socialising. Wagner’s beautiful libretto also gave me the latest candidate for my memoir title: How spring has to be.)

I need to do more to keep the remaining grey matter active next year, too. I think 2018 was the year of Karl Ove Knausgaard. (I have the final volume of his autobiographical novel sequence to finish off.) I feel that enrolling in a course would keep me at something better than if I were just doing it under my own steam. Some candidates include a couple of online masters programs in creative writing. Doing the internet course Modern Poetry over the last few weeks was great as well; it is very well-supported. Hearing the beautiful German in the Wagner last night, however, and even understanding bits of it, put this further up the batting order as something I could re-engage with.

I would also like to read through In Search of Lost Time again, with a group. Ever thought about it? Or even just wanted to see what the fuss is about? (For example, Maugham regarding it the greatest novel of the twentieth century.) I will do it via Skype, if required. So come on, all you wavering Proustians! Carpe the diem, grasp the literary nettle, and let’s get down to it. I can issue a portentous promise — your lives won’t be the same.

Remission man

I saw Dr Parente this morning, and had chemo #4. All went well. The good news from the consult:

  1. PSA is now 0.01 (down from 0.03); and
  2. I am now, according to Dr P, in remission.

I am still not quite sure if it has quite sunk in. Of course, to put it bluntly, “remission” doesn’t equate to “cure”. Still, I would rather have this result than others! Staying on the ADT should mean that the remission continues as long as possible.

Yesterday I saw an exercise physiologist. This was as a result of a leaflet given to me at the previous chemo session. There is a push to make exercise much more of a front line treatment for prostate and other cancers. (I wrote about this previously .) So I now have an exercise physio specialising in such matters. What is the difference between an exercise physio and a regular physio? In this context, the former has a qualification in working with particular patients; in my case, obviously, those with prostate cancer. They have the skills to devise and implement an exercise program that will both be tailored for my individual capabilities — any physio does this — and not aggravate the bone mets. The latter is the secret sauce!

What’s so good about exercise, anyway? Apart from all its usual benefits, you mean, like improving sleep (for most of us, anyway), lowering blood cholesterol, stress and risk of heart attack and stroke, and enhancing bone density, cognitive function and general well being? All with next to no side effects, at generally a modest cost. (How much does it cost to go for a walk?) Yes, OK, but what does it do for cancer patients? Well, the more active blood circulation increases the exposure of the tumours to the nasty stuff in the chemotherapy compounds. So they get more of what they don’t like. Why don’t more GPs prescribe exercise, then? Well, for one thing, not many exercise themselves. Some of the issues are canvassed in this recent MJA article [NB: pdf.] As ever, your mileage with your particular GP may vary.

Warning: eyeglazing detail to follow. One can get onto an exercise physiologist via a Chronic Disease Management Plan . This gives five subsidised consults with a physio (any type), chiropractor, nutritionist, or other allied healthcare professional. You can see more than one of these, but you still only get five consults per calendar year. Your GP decides whether such a thing would be appropriate for you, what practitioner/s you should consult, etc. (guided in practice by your input). It is a bit of a bureaucratic echo chamber, and a well-kept secret, but nevertheless a good idea for fairly crook people. Once you jump through all the hoops, the subsidy is much better than you would get for getting those services through your private health fund.

Mini-break

We just had a couple of days catching up with family in Ocean Grove and Barwon Heads. We stayed with one of the sisters in law, and caught up with all the other family members whom we hadn’t seen for a while. (Last Christmas I had not long had my operation, so we dipped out for that reason.) This was a very cruisy visit. The thought crossed both our minds to go down in the new TTM, a,k.a. Testosterone Machine. (The second “T” makes it scan better, don’t you think? Actually, what about Testosterone Transplant and Orgone Machine, a.k.a TTOM?)

We decided against this for several reasons. First, we are still waiting on the full size spare. (More on this later.) OK, there is an inflation kit, but I didn’t feel like getting to grips with that beside the Geelong Road on Cup Weekend. Second, I was very tired, and thought I might fall asleep at the wheel. My beloved can drive it, but is less familiar with it than I am. Third, although we have added it to our Linkt account, we have as yet no clip in which to attach the new e-tag. The tag itself is still sitting in the old clip behind the mirror of the Fairmont, whence I just have not had time to remove it. Fourth, in all the documents I had been given for the car, there was no phone number for the roadside assist service that comes with the extended warranty.

This was something I had to follow up. While going through the car manuals, receipts and so on, I had noticed that the roadside assist phone number was missing. I wanted to check on the full size spare as well, so called the dealer. The salesman from whom we had bought the car was away sick. I there fore explained it all to a fairly gormless sounding person, who coughed into the phone without saying “excuse me”. (He did say “Sorry about that” when I remonstrated with him.) He passed me over to a more senior salesman who had been present for the purchase of the car. Obviously no explanation had been given of the reason for my call, as I had to explain it all over again. Had we been given a little warranty booklet? We had been, but I had forgotten it in all the excitement, and no-one had mentioned it to me. This booklet contained the magic phone number.

We were going away on the Saturday. I was coincidentally picking up the Camry from a service the day before — not at the Toyota dealer, but nearby — so decided I would drop in to pick up this booklet while I was out. I saw the business manager, who searched on their database. No, I wasn’t on there. I began to wish I’d brought all the paperwork with me so he could get the details from there. He did eventually find the transaction. I got a copy of the booklet, into which he clipped a small printed notice with the roadside assist details. We agreed I would take the booklet home, he would raise a receipt which he would then scan and email me. I would print this receipt out at home; I would then stick it inside the booklet with the little piece of double-sided tape provided for that purpose. Clip the printed notice over the receipt, and I would be in business. All this he and I duly did. So now I have the phone number and the roadside assist dudes have verification that I am the authorised owner. (Note to self — remove previous car from RACV roadside assist.)

It is not all fiddly details and things falling through the cracks. Alert readers — I’m sure you’ve both had your coffee — will recall I purchased a two year warranty. There was an additional statutory warranty of three months. Rather than give us a combined warranty of two years and three months, the dealership gave us one for three years, at no extra cost. The reason? They can only provide warranty cover for two or three years, not 2.25 years. So rather than round us down to two years, they rounded us up to three.

The spare wheel? Thanks for asking. The senior salesman said “I’ll have to order that for you”. In other words, no-one had done anything about it. I just hope it will be available for Christmas, probably to be held down on the coast again, in about seven weeks. You’re welcome!

A crazy day

Crazy it might have been, but it was definitely fun. I have just bought a red sports car, same colour and shape as this one — although mine is about four years old.

A bit late for a mid-life crisis, I know. But not too late to do a bucket-list thing. It all started quite inoocently, going into Camberwell Toyota for some spare brake light globes for the faithful Camry. There was a white GT-86 in the used car lot; not the one I ended up with, obviously. (That one was a manual.) Anyway, I asked if they had any automatics. They had one; red, very low kilometres. That was pretty much game over.

When I took it out on its first test on Friday, the manager did inform me that someone was talking to finance about it. When I got back, it had been sold. I wasn’t bothered. This morning, a phone call from the sales rep. The deal had fallen through. So they are fairly popular cars. Was I being played? Possibly. But my beloved and I chipped enough off the ask to make it worthwhile for us to sign the contract. She was the bad cop in the negotiations, and played that magnificently. As soon as she said “We’ll have to go away and think about it”, it all got more business-like. Being near the end of the month helped as well, I think. Everyone wanted to get it done. I will miss the old Fairmont, just a little — it kept me on the go for five years — but I think I will enjoy driving a bit of testosterone on wheels!

I did some vaguely rational stuff like taking it to our local garage for them to give it the once over. (They found no evidence of prangs, or anything wrong.) I cast an eye over prices of the other automatic 86s for sale in Melbourne. I also bought a two year warranty with it, with roadside service. It is even going to come with a full size spare! (This would have been a deal breaker had it not been provided.) My beloved gave it a test drive also; it’s not much use if only one of us can punt it around. Yes, we can both get into and out of it. We will just need to be a bit selective about where we park it; it needs enough room to open those long doors. And, for a sports car, it makes sense. As the guy from the garage put it, a joint development of Toyota and Subaru has good genes. Like any modern car, I just have to keep it serviced properly (I have read about Soobies). But the $64 question is: is it fun to drive? Definitely!

What else happened today? We had our plumber install a towel rail in the ensuite; initially upside down. (He came back and put it in the right way up.) And we had a new bed delivered. This seems enormous, although it is the same size as the last one. However, it is at least 10 centimetres taller. Thank goodness the sheets fit it! A new bed tends to set off a frenzy of vacuuming; all the dust balls lurking under the old base are fairly unattractive. This delivery was no exception. However, the guys were very careful to only move it in the plastic, so no grubby handmarks on mattress or base. I gave them a couple of chocolate brownies in appreciation.

The chemo seems to be going OK. I get awfully tired if I overdo things. Apart from that, I feel fine. Looking forward to a less crazy day tomorrow; I might be able to get some cooking done, and even get out in the garden. The new wheels should be visiting Burwood later this week.