Apocalypse already?

Like most of the world, I have been watching and reading the coronavirus news with mounting alarm. Obviously, any new virus which is capable of causing fatalities is frightful. One to which there is as yet no vaccine (it being a new strain) is worse. And one which has the potential to initiate a global recession is worse still. All this is known. The cherry on top is the the uncertainty in figuring out just how bad things might get. Epidemiologists and other experts are either being properly cautious in their forecasts, or predicting that (as I saw over the weekend) coronavirus will be like the common cold; everyone will catch it at some point, but not everyone will be symptomatic, and only a few of those will progress to the full-blown disease. (There is a good article which I stumbled on, 12 myths about the coronavirus, that contains some good information in an accessible form.)

Like everyone, the unfolding news about the coronavirus affects me in a particular way. Before all this happened, my beloved was planning to going to Paris towards the end of March. I was to accompany her, and we would go somewhere in  Europe afterwards. But where? We were attracted by the idea of a cruise: just making one booking, and only unpacking once. None was available, though, it being just too early in the year. As time progressed, it became less likely that she would get to attend the meeting anyway: it was a long way to go for one-and-a-half days. The year was starting to look a bit crowded already, weirdly, with other things we had planned. So 2021 began to look like the earliest I could contemplate another overseas trip. Then the coronavirus news started trickling in, making what seemed only probable into a near certainty.

Given that (to put it bluntly) I may not get many more opportunities, an overseas trip is fairly high on the bucket list. So anything that defers it is unwelcome; the more so if the period of deferral is as indefinite as this. No-one seems to have the definitive formula for how people can minimise their chances of infection. For me, however, one precaution stands out: stay out of situations in which you are in forced proximity with a lot of people. An international flight and a cruise seem therefore like exactly the things to avoid.

Being a cancer patient by itself doesn’t mean you have to avoid all risk of infection. (An exception is people who are actually undergoing chemotherapy, who are encouraged to avoid opportunistic infections.) And I feel generally very well. Having had chemo and radiation treatment, though, does undermine one’s immune system. Consequently, I make sure to have a flu shot — all the more given the coronavirus infection peak may coincide with the flu season. So, while you can’t avoid risk altogether, you can sensibly minimise it. This means taking precautions that people who aren’t cancer patients may not bother to take.

My situation is fortunate in several ways. Being retired, I no longer have to undertake the daily commute on increasingly crowded trains or trams. Because my main income source is an indexed super pension, I am rendered fairly immune from the effects of an economic downturn. If I want to take a less risky trip, there are plenty of places to go in Australia with my beloved. (She is the one who will really need the holiday.) Many people would gladly swap their existential anxieties in the face of the coronavirus for my concerns. Saying this doesn’t make the latter go away — it just puts them in a context. 

On this note, some of you will have seen the article which fortuitously appeared in The Guardian this morning “Young and forever sick“. This piece gives an account of some young people’s experiences with a chronic (and acute) medical condition. The focus is on the concept of mortality salience — how a serious illness can change your view of the world. I have written about this before, so won’t repeat myself other than to say that I think this is an important discussion to have. Olivia Gee’s experience of serious illnesses in her twenties adds a layer to this already gnarly topic. Getting a life-changing diagnosis when you can reasonably expect to have most of your life in front of you would be tough indeed. (To say that it is tough at any life stage is not to negate her experience.) Medicos and mere mortals alike need to remember that their patients still have things that they want to achieve. This existential shopping list will be different for everyone.

Scoreless draw

My beloved and I went along for my final appointment with Dr Parente for the year. All was as if had been the other times — PSA undetectable — everything good. Of course, this is something we never get tired of hearing! Herself and I had a celebratory coffee in Hawthorn before went to my exercise class.

The week before each appointment, I have a blood test, leaving enough time for the lab work to be done and delivered to Dr P. Around then, I start getting testing anxiety; I am more irritable, although I try not to be, and my sleep is worse. On the morning of the appointment, I feel quite neutral — there is almost a relief that it is here.  On the morning of the appointment, we drive to Box Hill, hoping to get a spot in the practice’s car park. This is quite contested. To keep non-patients out, the practice has had to hand out passes each day to display on the top of their vehicle’s dashboard. If there is a spot, my beloved parks the car while I nick in to grab a pass. I bring this back to her and retrieve my backpack. Necessary things contained therein are my notebook, and a book to read. If I don’t have the notebook, I just don’t remember anything much of what is said in the appointment. I just sit and read my book until my name is called. 

We have found morning appointments are best; I am usually a bit more alert, and there is less chance of the good doctor running behind. Dr P goes through the results from the blood test. This is usually straightforward; everything is over in about five minutes.  It is strange how, after I get this news, I feel a bit scatty and distracted. I never expect the results to be the same as they were last time, even when they have been good all year, or remember how I feel from one time to the next. We have gone through this cycle eight times this year. In saying this, I am very conscious that everything is the best that it can be.

Every other time I see Dr P, all being well, I have another Zolodex. (This is the estrogen treatment that is keeping the cancer quiet. It is delivered in the form of an implant about the size of a grain of rice.) I just walk up the street from the practice to the Epworth Box Hill oncology ward. One of the nurses there checks the dose, and what side it went in on last time. Then they swab the other side of my tummy, and shove it in. This is one of the situations where being a bit rounded is actually quite a good thing! One of the nurses said that they have to hunt around on really lean patients to find enough fat into which to put the implant. Even with my moderate spare tyre, the injection still leaves a fair size bruise.

Dr P told me to keep up the exercise, which I intend to do. I am about half way through the three months of exercise classes I am doing for the university study; three classes a week for the next six weeks, with a break for Christmas. The classes are all supervised by PhD students in exercise physiology. They are lovely young folk, radiating fitness and endorphins, who implacably raise the bar on us old roosters. The aerobic session I do first has gotten longer, and now features high intensity interval training. (This is where you go flat out for a minute, then ease back to the original speed. I do this three or four times, then have a cool-down.) In the resistance training part, the weights have gotten heavier, and the number of sets has gone from two to three. I am feeling better for it all, and even putting on some muscle.  On Sunday, two days after my last class, I felt restless, and found it hard to concentrate. I think I am getting hooked on this exercise caper!

I have been pondering what to do around the end of January, after the study finishes.  I don’t think I will do three sessions a week on my own dime; two, however, is quite a possibility. Meanwhile, Christmas looms into view again. I had the end-of-year party for the Museum last week. This week there is the party for the physio practice I was going to before starting the university program. The same day there is a coffee morning for former RMIT people; everyone kindly rearranged this from its usual day to accommodate my exercise class. This week we will also be getting a visit from an air-conditioning installer, fortunately the day before a heatwave. We will have gone from fifteen to thirty-eight in the same week, an impressive range even for Melbourne. 

Nothing to see here …

The main news, and you will forgive me if I repeat myself, is the PSA is still undetectable.

Getting the all-clear from the good Dr P always gives me a bit of a boost. Before we saw him I had made an appointment for the following day (i.e. today) for an induction from the volunteer co-ordinator at the Melbourne Museum. (I will be working there on a project to make digital scans of archival scientific documents, and add metadata to records linked to those digital images.)  Being involved in this enterprise will be a good thing, because manageable. I will be there only a morning a week, breathing those cataloguing muscles back into life after five years of inactivity. I made notes on the train on my way in about how much I am really appreciating Melbourne this winter — the grey days, the European lanes in the CBD, the lovely gardens and Victorian buildings through and past which I walk on my way to the Museum. 

The morning went the deceptive way of days when everything seems to just fit in. I left the GT in a side street and walked back to the station. The train before mine stopped the traffic at the level crossing on Riversdale Road in nice time for me to cross, touch on with my Myki, and get the all-important coffee. I had allowed half an hour to get from Parliament station to the Museum, plenty of time to walk along Spring Street, past the Royal College of Surgeons, through the Carlton Gardens, and, with a slight detour, past the Exhibition Building. (In the course of my Museum induction, I learn that this huge structure, the best preserved of the Victorian era exhibition buildings, is technically part of its 15 million item collection.) 

Of course, when things seem to be going just right, some sand gets thrown in the gears. I had planned to do the food shopping on the way home. In my haste to leave early in order to get the coffee, I had forgotten to bring both the cool brick for the little esky in the car boot, and (disastrously) the shopping list. Rather than have to go home then go out again, I reconstructed the extensive list of comestibles as best I could on my homeward journey from the Museum. I decided to go to the supermarket, then the butcher, so that the meat wouldn’t be sitting in the esky sans cool brick. Of course I promptly forgot about this, arriving at the butcher first. Curses! Should I backtrack to the supermarket? No, I’ll just get the meat, then whiz through the grocery shopping so the meat doesn’t go off. (With ambient temperatures of about 12 degrees, this was never likely, but it is one of the things I am most neurotic about.) Of course, not having a proper list, many things remained annoyingly needing to be purchased in a second excursion tomorrow.

That day I am to have two cooks, the first to make a banana bread for morning tea. One of our neighbours is moving to the inner city; she and her daughter have been clearing the ancestral home. I offered to bring them around coffee and a snack to sustain them in this enterprise. Fortunately, they have no dietary issues for me to consider. (I wouldn’t mind if they did, it just makes things a tad more complex.) Unfortunately, I am not sure that I have enough sugar — this being one of the things left off my reconstructed list. If I don’t, I am going to have to improvise by making up the shortfall with a few spoons of jam. (I have done this once before — one just has to take a guess at quantities — but it worked surprisingly well.) The second cook is dinner for us and our niece. I have all the ingredients for the main course, but not the dessert. So I will have to head out after morning tea and get the things I left off the list. You’ll be sick of hearing about this list! I’m sick of thinking about it! My usual scattiness is being given a turbo boost by the stress of measurement anxiety — bringing me back to the start of this rather ratty blog post.

Still, compared to what they could be, the little niggles and irrits I am having a whinge about here are great problems to have. I do know this. Thank you, universe! You feel you can’t make things too easy for me — in case I get too complacent? Fair enough. You the man.