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.

Anne Tyler and insomnia

When I glance at Anne Tyler’s new novel Clock dance, I keep misreading the title as Clog dance. (The cover does have a beautiful backlit photo of a couple of girls dancing on a footpath.)

Do I keep thinking of the wrong title because of this photo? Is there some sly, ironic echo that she has set up here? Or is it just a mnemonic irrelevance, that keeps forcing its way to the surface because I am sleep deprived? For whichever reason, I find her to be a writer in whose seemingly modest domestic dramas, unexpected things happen.

I woke pretty early this morning with a kind of anxiety dream about this book. Actually, I felt more pleasure than anxiety: I could write about the way my dream fitted with the novel. I just had to go to the toilet first. Of course, when I had stealthily gotten up, made a cup of tea, and was sitting in the study with the cursor pulsing away at me on the laptop screen like a therapist possessed of implacable patience — after all this, there was no more dream, just a memory of a mood. No matter; I can just write about the book.

Well, once I got WordPress working, I could! The incestuous thing wasn’t saving drafts. I looked through the help procedures, but there wasn’t anything that related to “can’t save drafts” or similar. I saved my post as a Word file, then looked up “Contact us”, expecting to get an email address. I actually ended up in a chat session with a Happiness Engineer — I kid you not!

He did solve the problem — assuming it was a him — so kudos to him. After some to-ing and fro-ing about why they don’t have a procedure for solving this, I browbeat him into saying he will “see if we can get a document up” with the basic steps in it that he has suggested for me. By the time all this had occurred, I had absolutely had it, and went to sleep for about half an hour in the study.

So to the book. The plot covers the familiar Anne Tyler territory of eccentric extended families. Willa, a woman who was made a widow in her forties, has remarried. She has moved to Arizona with her second husband, Peter, who is eleven years older than her, and inclined to be patronizing. This situation is preceded by a sort of prelude in which she is shown as someone that things happen to; a typical Anne Tyler character, sleepwalking through her life.

A phone call changes everything. Her son’s former girlfriend, Denise, who lives in Baltimore, has been shot in the leg. There is no-one available to look after Cheryl, the daughter. Despite the fact that the child is not her son’s daughter, Willa decides to fly to Baltimore to take care of her. Peter decides to come with her because he doesn’t think Willa can manage without him. Time passes; Peter goes home, Willa stays in Baltimore.

This is a book with a lot of love for the characters, and a boundless appreciation for small things. There is a lot about food. Cheryl bakes, proficiently. Peter barbecues, elaborately. Willa goes grocery shopping and makes suppers for Cheryl and Denise. Willa’s life in Baltimore is almost studiedly mundane, but she finds herself staying longer than she needs to, because she feels needed there. Just as Willa is drawn into her temporary life, the reader is lulled by the rhythm and pacing of the novel, to the point where the idea of someone fetching up somewhere like that seems plausible. You can see why Nick Hornby called her the best line-and-length novelist in the world.

There are strange echoes of Portrait of a Lady. What would that book look like if Isabel Archer had travelled to Baltimore instead of Italy? If she had married Gilbert Osmond, left him, nearly gone back to him, but backed out of that at the last minute, to go where she could be loved? If she could take Pansy with her as well? Ralph Touchett and Lord Warburton are in this book as well. It is all quite playful and very subtle, and goes down like a big tub of the best ice cream. You can see I loved it. Give it a go.

How low can he go?

To anyone who read the earlier version of this post, the changes to this version are just minor tweaks. 

No, we’re not talking about The Donald, but about my PSA. As of yesterday, when I had my last blood test, it was 0.03. I said to Dr Parente “That’s very hopeful, ah, I mean, very positive”. He said “It’s both!”. (He is quite the most forthright specialist I have ever had dealings with.)

This morning’s was only a brief consult, but other matters that were covered included:

  • He wants and expects my PSA to get down to undetectable levels.
  • This achievement will mean I am in remission. (There is a good and very recent article about what remission means in The Conversation.)
  • I mentioned that I had read about some patients having repeated or continuing ADT (hormone) treatment. He said, yes, that was what he was planning to do with me.
  • He said he thought I looked better than when he saw me first, when he felt I had looked rather grey. (In a piece of l’esprit de l’escalier, I only thought, when driving home, that this improved appearance was possibly because I had had my iron tablet that morning! I generally see him in the afternoon. Regardless, I  feel fine.)

Generally I see Dr Parente on the same day as that on which I have the chemo. (The latter runs on a three week cycle.) Today was the exception, as he is going away for a fortnight, and this was the last date on which he could see me before he left. Next chemo session is next week. When I have this, I will book the following session directly with the day oncology centre. This will be co-ordinated with the next consult with Dr P. on 14 November.

It is very convenient to have the consult on the same day as the chemo, particularly as we can leave the car in the car park for Dr P’s practice and walk up the hill. That car park is usually full, however, requiring my beloved to sit in the car and wait for someone to leave. So today I left the car in the Whitehorse shopping centre car park, only seven minutes’ walk from the practice. Spots there are cheap and plentiful; for about an hour, this set me back $2.

This morning’s consult was the first with any specialist on which my beloved couldn’t be present. This was because we are having two new coolers installed, something that is happening even as I write. This booking had been made some time ago, when we thought we would be seeing Dr P the following week. Given that one of us had to be home for the air-conditioning guys, it was easier for me to go to see Dr P by myself, leaving Der Fisch to hold the fort. When I came home we did a Cox and Box arrangement, and she headed off to pursue her numerous tasks, leaving me in possession.

The new coolers (one evaporative and one split system) have been installed. There are now four guys crawling all over our modest abode, resizing vent covers, testing the electricals, putting in new controllers, etc. There was a slight issue in that two of the back parts of the vent covers (the bit that the ducting fits into) were the wrong size. The correctly sized ones will have to be fitted tomorrow. I will still be connecting the stereo back up when that is finished! We have a smaller TV in the study to look at before normal service is resumed in the living room.

Exclusive offer and new stuff

In my previous post about poncing around in the Benz, I gave the wrong information about subscribing to 3MBS-FM. I said $30; it is actually $85 for a Classic subscription. Didn’t check this — my bad. To make it up to you, though: if anyone following the blog wants to join 3MBS at the Classic rate, I will rebate them $55 from their first subscription. So you get it for $30 bucks as a one-off. This is a totes genuine offer to the first six to contact me. Expires at end of December. Check out the subscriber benefits and ask yourself – is this the best $30 I’ll ever spend? If you answer “yes”, just subscribe as normal and let me know. (My contact details are available from the sidebar.)

(Don’t live in Melbourne? You can listen to 3MBS via streaming radio on the internet, anywhere in the world. It hasn’t worked so far on VTuner in the stereo receiver, for some reason. It works just fine via my Google Home-enabled devices, though, which use TuneIn Radio. Or just use any laptop, phone or tablet. How will I send you your dough? I will use Paypal . All I will need is an email address or a mobile number. OK, if you don’t have a Paypal account, you will have to set one up, but this is free. Once the money has come through to your Paypal account from mine, it should take 3-5 days to transfer to your bank account.)

We have had a bit of turnover in some of our appliances. So I have some new gadgets to play with. The first was a pair of Pioneer bookshelf speakers. (These are for the living room stereo, which all fits inside a cabinet. This led to much neurotic measuring of the available space.) Anyway, after turning them upside down, toeing them in a few degrees, and sticking them down with Blu-tack (the audio nut’s friend), they sound a treat. Quite a bargain for around $250! (See description ; I didn’t buy them from this site, so this is not a plug for Kogan.)

Why turn them upside down? The tweeters are supposed to be about at ear level. The shelf on which they sit is maybe 8 cm above that, so if they are right way up, the tweeters are 15-20 cm too high. Could I move them onto the lower shelf? It would be quite a squeeze. Also, that would put them beside the TV, and they’re not magnetically shielded. We are having our new coolers installed soon; one (the split system) will have to go above the aforementioned cabinet. So everything in there will have to come out to allow the cabinet to be moved. When all is finally re-installed, I will see if I can bi-wire and/or move the passive subwoofer into a corner, to get a bit more out of that.

Another one is a new blu-ray recorder. Our old DVD recorder finally gave up the ghost last night, after about 10 years. (When we got it, we still had a big old CRT TV.) So after some more research, I headed out to Hardly Normal, as Harvey Norman is affectionately known hereabouts, for a Panasonic blu-ray recorder. When I pointed out that JB HiFi was selling this model at the same price, they threw in a 2 year extended warranty (on top of the 12 month factory warranty) and a $20 discount to the already-reduced price. Deal!

When installed, in the same cabinet as the stereo, it won’t yet connect to the network. I think I can fix this, but if I can’t, it is not a big deal; our Chromecast does all that. All the other setup went fine, ditto the main functions. What does it do? Record three programs at once – in high definition – record captions, set up series recording all in one go, and play blu-rays, DVDs, and CDs of all descriptions. All seems to work as expected; the interface is quite logical, and the picture, being HD, is notably sharper than the old one. There are cheaper ones with a smaller hard disc drive — this one has 2TB — but we watch time-shifted programs quite a lot. So getting the top model seemed a reasonable thing to put the extra money into. (We missed out on recording the first two episodes of War and Peace, but caught them from SBS Iview via the Chromecast. It is great!)

Things tend to come in threes, and the remaining novelty was a new kettle and toaster. (OK, this is four! Just seeing if you’re paying attention.) We had bought a new Kitchenaid kettle a few months previously. The lid latch became progressively more reluctant, until it finally didn’t open the lid at all. So we returned it to DJs and got a new Smeg kettle and matching four slice toaster. (The slots in two slot toasters are not long enough to take breadsticks or long slices.) The Smeg range is available in about six colours. We checked out the DJs web site and chose the powder blue; according to that site, Chadstone had stock of both. This being where we had purchased the Kitchenaid, I headed over there to effect the swap-over.

This was not as straightforward as expected. They accepted the old one back without cavil, and issued a refund. They didn’t have either of the Smegs to sell, however; the ones showing up on the web site may have been their floor stock. They did have this combo in store in polished chrome, almond green, pink, and cream. A rapid phone consultation ensued with my beloved, in which these colours were rejected in favour of the powder blue originally sought. DJs tracked down what we wanted at their The Glen store in Glen Waverley, only a short distance from Chadstone. After a fortifying coffee and almond croissant, I fired up Google Maps on my mobile phone, stuck it on the magnetic holder on the car dash, and embarked on the not-so-epic trip to Glen Waverley. All good — only took 2.5 hours for the round trip. Smashed avocado on toast for lunch!

Less is more

Chemo session #2 today; all seemed to go well. The infusion was, as usual, preceded by a consult with Dr Parente. He was encouraging, as usual, and today had something more to be encouraging about: the PSA is down to 0.18. (It had been 2.0 previously.) So the ADT has done what it was supposed to do. I am not really having persistent side effects. The worst — and it is not bad — is an itchy and rough patch on the back of my hands, over the knuckles. I am putting a medicated cream on those, which calms them down.

I asked Dr P a couple of questions:

  1. Question: does the fact that the new metastases are in different places mean that the radiation therapy was successful in treating the old mets? Answer: yes.
  2. Question: will the dosage and/or concentration of Docetaxel (the chemo medication) increase over the six sessions? Answer: no. I am scheduled to have the maximum dosage, and this will be the same each time. If I experience worse side effects, the dosage can be reduced. The Docetaxel itself passes out of the system in 12-24 hours. Its effects on the tumours, however, continue for about three weeks. (He put this particularly carefully, not saying “get rid of” or anything like that.)

We had a gap in between the consult and the chemo, the latter being at 12 noon, so were able to go to the cafe in Epworth Eastern (just up the road from Dr P’s practice). We both had a coffee, my beloved the rest of her breakfast, and I had a toasted sandwich. Ambrosial!

Upstairs in the day oncology unit, it seemed like a full house. I got a little more information today from the nurse driving the drip. The sensation of heat around the face I had experienced during the last cycle was due to the anti-nausea drug wearing off; this is a steroid medication.  The powers that be are also pushing exercise for cancer patients. (I had heard a lot about this during the Peter Mac information session a few months ago.)  Fatigue is one of the most widely experienced side effects of chemotherapy, and exercise can, paradoxically, help reduce this. I got a leaflet about a subsidised exercise program, designed specifically for cancer patients. This is doubly apposite for me, as I have my gym membership on hold while completing the chemo, so I will be investigating this.

I was pretty tired when I got home, so had a crash for an hour or so. Still feeling fine. There is enough of last night’s meal left over for dinner for my beloved tonight. I will have cheese on toast, or possibly a jaffle, with my two allowed standard drinks. You beauty! There is more excitement coming up during the rest of the month, with a heater service, installation of the new coolers, a memoir writing class, and a get-together with some other Melbourne ModPo folk. Like, in RL! I tell you, Melbourne in spring is not for the faint-hearted.

Alert readers, and this is both of you, will notice some minor changes in the blog. I have gotten off my duff and created some new categories, and applied them to some posts. The categories themselves have been shuffled up the batting order in the sidebar, so they now sit under the “Follow blog via email” link. You may still have to scroll down to see the categories, but they are there. More to follow. No, I’m not using Library of Congress Subject Headings. I may make an exception for “Anecdotes, facetiae, satire, etc.”. (I’m not making this up, you know! Technically, this was not a full heading, but a standard subdivision. It was replaced in recent years by the much more prim “Humor”: see example.) Will I be going back and applying categories retrospectively? What do you think I am, a librarian or something?