Level pegging

Updates to this post are minor, made only for clarity.

My beloved and I went to see Dr P on Wednesday, October 27th. The PSA is very slightly elevated — 1.01, up from 0.94 at the previous test. However, Dr P. said this is within the measurement error of the machine. So we weren’t to worry. He emphasised that he was still happy with where I was at. I am to see him next on 22 November, on which date I will also be having another Zolodex implant.

I am a bit late posting this because the consult came at mid-way of an extremely busy week. On Monday I parked the GT at the back of the IGA supermarket on Maling Road, Caterbury. I noticed a truck unloading in a right-of-way next to my parking space. I went to four places on Maling Road, at all of which I checked in, using the Service Victoria QR code reader and digital vax certificate. When I got back from the last stop (the IGA supermarket, as it happened), the truck had gone, but I noticed a bit of damage on the car bonnet and driver’s side guard. (There wasn’t a note on the car acknowledging responsibility.)

I whizzed back to the supermarket and asked if they had had a delivery that morning. (I’d chosen not to get a receipt for the items I’d bought, but, via the Service Victoria app, was able to show them that I had been in the store within the last half-hour.) They were very helpful and gave me a copy of the receipt that they had received from the delivery driver. The latter wasn’t an employee of IGA, but was working for a transport company. The invoice gave me his name and other useful information.

When I got home I wasn’t sure whether to call the transport company or my insurance company. I hadn’t seen how the damage occurred — I was only inferring that that it had been caused by the truck driver who’d made the delivery to IGA. So I rang my insurance company (Apia) and explained what had happened. They agreed that there was only circumstantial evidence that a third party was involved, charged me my excess (which I paid over the phone by credit card), and set an assessment and repair appointment in train.

After this I rang the transport company. They were unexpectedly sympathetic and said they would speak to the driver, and that someone would call me back. I didn’t have great hopes from this. However, I was pleasantly surprised to hear from the company the next day. They had indeed spoken to the driver, who said he hadn’t had any traffic accidents on his run. However, they had looked at footage from a video camera mounted on the back of the truck. This showed a pole, called a pogo stick, which the driver used in unloading the truck. The driver had leant the pogo stick against the truck, causing it to fall onto the bonnet of the GT as the truck reversed out of the right-of-way. So they acknowledged responsibility for the damage. (I thought this very decent of the company to put their hand up for this, and said so.)

To cut a long story short, after exchanging a few SMSs and emails, I received an indemnity form to fill in and send back. According to this the company said they would pay the amount of my insurance excess, if I, my heirs and descendants and so on, undertook to make no further claim on them in this matter. Rightio, I said, and filled it out and returned it to them forthwith. (What is this mysterious company’s name? I haven’t received the money yet, dear readers, so I am keeping schtum until I do. However, I expect the amount to be forthcoming.)

In the same week

  • I had two in-person exercise classes at the exercise physiology practice;
  • via Zoom, had a German lesson (for which I hadn’t done much hausaufgabe);
  • also by Zoom, had an appointment with my psychologist;
  • hooked up our barbecue (which had been sitting out in the garage for eighteen months or so after having been gifted to us by a former neighbour), in preparation for a Cup Day get-together with friends;
  • drove the GT out to Blackburn to the damage assessor/body shop place, where it resides until Friday (Apia shouted me an Uber back home); and
  • baked two sourdough loaves.

The loaves turned out well, the BBQ works fine (although I have to clean the grill plate soon), and I have been adapting well to only having one car between us. Actually, my beloved and I got by perfectly well with one car between us for twenty years. It is only in the last seven years that we have had a car each. As far as I am concerned, I would be happy to trade both the Toyotas in on an EV.

I can’t preview this post as I used to be able to, so I am just going to post it as is.

Down but not out

We went to see Dr P yesterday, and the news was good: the PSA was 0.94 at the last test. He said “I told you I’d get it down to zero”, and he has. As I understand it, anything under 1.0 is undetectable, so this is as close as makes no difference. (Or, as Dad would have said, 5/8 of SFA. That’s the expurgated version, anyway!) We walked away with a script for the next lot of Enzalutamide, a copy of the latest blood test results (“pristine”, according to the good Dr), a screed for the next blood test, and the receipt for the consult. After the Medicare rebate, this last was only a few dollars — 5/8 of you-know-what! Frequent illness points, or something.

I had been expecting the number to continue its downward progress, but still felt rather tired and drained afterwards. Had we been able to go out for a coffee we would have; as it was, we just had one at home, and watched “My Unorthodox Life” on Netflix. The show is about Julia Haart, who left an orthodox Jewish sect in New York and went on to make a major career for herself in the fashion industry. (There is a rather academic account of the show in The Conversation, which nevertheless covers most of the bases.) Whether you are into fashion or not, it is a lot of fun, and is beautifully shot in the Haart penthouse in Tribeca, her fashion company, and various other locations in Manhattan. In the last episode we watched, she, her husband and four kids also go to Paris for the fashion season. They hire a 13th century chateau as well (presumably close to Paris). You get the picture — they have plenty of dough — but this makes the show a great bit of escapism!

I had a small win also, closer to home. The study, where I spend a lot of time, had a picture which, for historical reasons, was situated oddly in the right hand corner of the rear wall. I wanted to move this picture to the middle of the wall, and hang my masters and long service award from RMIT on either side. The fact that all these are a different size — and that I didn’t have another hook the same as that which the picture was hanging on — made this a maƱana project. A catalyst that enabled me to Move Forward with it was reading an article in the New York Times about picture hanging. This article made a couple of helpful suggestion for hanging pictures of disparate size together:

  • give them a common top line, and
  • using painter’s tape (AKA masking tape) to show this line.

I had the further brainwave to use a blob of Blu-tak on the top of this line of masking tape to show the position of each hook. (Saves making pencil marks on the wall.) So the tape gives you the horizontal and the Blu-tak the vertical reference. Et voila!

Study

Of course I mucked it up slightly in the execution — measure once, cut twice, and all that. (Not saying where!) But eventually I think it was quite successful. Oddly, from this slight angle, there is a slight optical illusion that makes the large picture look a tad higher than the others. From where I am sitting it actually looks a bit lower. I can tell you they are the same distance apart, however they might look in the picture! Anyway, it is “rough enough for the bush”. More importantly, it has the elusive WAF (Wife Approval Factor). This is no small thing from someone I have been known to refer to affectionately as Der Fisch — as in, an eye like a dead fish! (This is meant to be complimentary: I can’t understand why it is not always so taken.)

Down, down

We went to see Dr P today, and the news continued to be good: the PSA is now 1.07, down from 3.2. The good doctor is confident he can get it below zero. I know I’m not supposed to be focusing too much on the PSA. But Dr P has led with it the last couple of consults. Maybe he does this because he knows we get concerned about it if it rises. Also, let’s face it, medicos, like everyone else, like to focus on good news — something with which to cheer the patients up. Whichever it is, I’ll take it anyway! So the Enzalutamide continues be successful, while at the same time not incurring any very objectionable side effects. (The exception to this is hot flushes, which are definitely on the increase. I don’t mind these, however, because I feel them to be a sign that the medication is doing what it’s supposed to do, i.e. starving the cancer of androgen.)

While I was just having the Zolodex, I used to see Dr P every six weeks. Now that I am having the Enzalutamide to my regimen, I need to see him every four weeks. This is to do with the Enza being dispensed in batches of 112 — a strange number, on the face of it. However, the logic is: I take four of these a day. Each lot of 112 therefore cunningly lasts me 28 days. (Trust me on this.) Dr P wants to see me after each batch, therefore every four weeks. I continue to have a Zolodex implant every 12 weeks. Each of these will now occur following every third consult with Dr P (instead of every second consult, as has been the case until now). Alles klar? I get most of the charge for each consult back from Medicare anyway, so having them more frequently is not a financial impost.

Coincidentally, today was also a Zolodex day. I was actually a bit early for this appointment. The nurse who was supposed to administer it was busy, so one of her colleagues took over. There was a slight confusion initially, on my part, over terminology. Zolodex had always been referred to previously as an implant; it is about the size of a grain of rice, and is placed just under the skin of the abdomen with a fair size syringe. This afternoon, though, the nurse asked something to the effect of “Which side would you like your injection on”? When I heard the word “injection” I automatically thought it would be something going into the vein at the wrist, so started rolling up my sleeve. Then I remembered it was an implant, and said this to the nurse. She said “Oh, I’ll go and get the box” (again, words to this effect), and went to fetch the relevant documentation.

At this point I should explain that each Zolodex implant goes into a different side of the abdomen to the previous one. Whichever side is used each time goes into the clinical record. Nursing staff avoid putting the implant into the same side twice in a row to reduce bruising, I think. However, I wasn’t worried about getting the wrong stuff — each dose is checked by another nurse before it is administered. (I know because, as always, they did this in front of me.) The patient is always asked their name and date of birth as well, to make sure the correct medication goes into the correct person. There was just a moment of being at cross purposes because the nurse said “injection”, not “implant”, sending me momentarily off down the wrong rabbit hole. We had a joke about how she was just seeing if I was paying attention (like Captain Mainwaring in Dad’s Army.) For chemo patients and those having CRT scans, an injection means a cannula in the wrist. (Yeah, OK, I suppose technically an implant is a type of injection. Please don’t correct me if I’m wrong about this! When I hear the word “culture” I reach for my Browning!)

Better news

We went along to see Dr P this afternoon to check how the Enzalutamide is going. He had some encouraging results from my last blood test. After two weeks the PSA has gone down from 7.2 to 3.2, a drop of 55% by my arithmetic. This has been accompanied by absolutely zero side effects. (I was supplied with a fancy little diary in which to record does times, dates, and side effects. After the first one, I had nothing to record.)

I will have my next Zolodex as scheduled on 1 September. Fingers crossed we can get away for a two-night break in a week or so (within Victoria, obvs). The arrangements are all made, but all of course is contingent on no more mystery cases, or people not being stupid. As I saw in an article somewhere or other — it is all down to the single males. (Apparently this is the the group most likely to party, not observe social distancing regulations, and thus be COVID spreaders.)

To be watchful of single males is also a maxim that everyone who learns German comes across early on. The masculine singular form of articles in the more exotic German cases (accusative, dative and genitive) do tend to be the most at variance with the plain old nominative forms. Crazily, this complexity is a reassuring thing into which to immerse myself. I’ve never been a crossword person — they just don’t grab me — but I imagine the feeling of finding the answers to a puzzle is similar.

Extra treatment

A week ago I had a CT and a bone scan, followed a couple of days later by the usual blood test. (I had to leave a gap between them because one of the scans involved being injected with a radioactive tracer dye. This dye can affect a blood test if the latter comes straight after.) This afternoon we saw Dr P to see what all these tests revealed.

The PSA has continued to creep up — only about 0.7 from the previous result, however. The scans revealed a few new spots, something of more consequence. Fortunately, however, these are all in bone, something that is greatly preferable to visceral metastases. (The phrase used in the findings of the scan was “mild progression of bony metastatic disease”.)

Dr P said he thought it was time for an additional treatment, enzalutamide. (The link points to a post in the Harvard Health blog which gives a bit of context about this type of drug.) I had heard of enzalutamide, and know a few guys who are on it. Dr P is confident I will tolerate this treatment well, and that he can get my PSA down to zero on it. (The last time he predicted this, it came about.)

Obviously having new spots isn’t ideal. However, Dr P emphasised that the new ones are minor, and that I’m not (as he put it) “lighting up like a Christmas tree” in the scans. We are both relieved to be moving to an additional treatment. I will continue with the Zolodex until further notice; the next implant for this will take place in 6 weeks. (I have actually been on Zolodex for almost three years, an unusually long time. Zolodex is an androgen deprivation treatment — see another link from the same source for more information.) I will see Dr P in a fortnight so he can see how I am going with the new drug. All going well, we will revert to our usual 6 weekly consult. Enzalutamide is on the PBS, so it should not cost much.

Pharmacists don’t tend to carry enzalutamide, so we had to order it, but it will be availabIe tomorrow. I will obviously just have to try it and see how I tolerate it.

Less good news

I have been procrastinating about writing this, so I am just going to get it over with. We saw Phillip P on Wednesday 9th (about 8 days after my appointment with Pat B). Unfortunately the “gains” that Pat reported, in terms of a reduction in PSA score, have entirely been lost. The score that we got from Phillip was 6.5, which is back to where it had been before the radiation treatment.

Phillip made several points about this. (Sorry, I have forgotten how to do numbered lists in this infuriating blog editor.) First, he found the increase “not upsetting”, and he hoped we were not perturbed by it. Second, he understood also that people made a fetish (my word) of the PSA score. However, the metric that he is focused on is the doubling rate, i.e. the time interval in which the PSA score doubles. A doubling rate of 6-8 weeks would cause him concern, but he feels I am a long way off that. Third, 90% of his consultation time is spent reassuring patients and their carers about PSA scores. So he gets that people find these increases worrying. (He was at pains not to ridicule or downplay our concern.) But he would like us to look, not just at the quantum of the score, but at its rate of progression. Fourth, he has many other treatments up his sleeve.

As to when it comes time for me to move to the next treatment, as he has said previously, Phillip wants to keep me on Zolodex for as long as possible. Let’s call the its successor “Treatment 2”. Say Treatment 2 has an estimated efficacy of a year. If I go onto it now, I will get a year out of it. If I go onto it in six months, I will get eighteen months out of it. So that is why he wants to defer Treatment 2, and its heirs and successors, for as long as possible. (Phillip has said to me before quite bluntly, that the fewer treatments I have, the better.) Treatment 2 will be deployed at a rapid rise in my PSA. But we ain’t there yet.

I was due for another Zolodex implant after the consult with Phillip, which I had without incident. I will go on having these every three months until I move to another treatment. I will continue seeing Phillip every 6 weeks, and having a CT whole body scan every three months. (The next one of these is booked in for 12 July.) So I remain under close surveillance.

It took us a while to digest this news. On hearing it, and the rest of that day, we both felt a bit stunned. What made me feel better, actually, was doing some German homework. Everyone deals with adversity in their own way, and this is mine. We both felt more positive the next day, having had some time to get a better grip on the situation.

It was obviously disappointing that the radiation treatment didn’t have more effect. However, Phillip has many arrows left in his quiver, and we are confident that he will deploy these as the situation dictates. I am still feeling fine, exercising, doing stuff on the home front, and all the other things I have been doing. So there are a lot of positives to focus on — take it from me, we are doing just that! To this end, I would also like to maintain the moratorium on questions. I say this for two reasons. One, I just don’t have any more information to add to what I have written above. Two, I don’t want to give the situation more mental space than it already occupies; we don’t want to delve into it further.

Marching on

I had my appointment with Dr P this morning. The PSA has gone up slightly again — to 4.8 from 3.7. However, the scans I had on Monday didn’t reveal any new activity. So I am still radiologically in remission. Dr P said there was a spot on my chest which was probably causing the increase in the PSA. (On the way home I checked the list of metastases, or “spots” in doctor-speak, that he gave me in February, 2019. This showed one on the sternum — this is probably the one he was referring to this morning.) Dr P referred me to a radiation oncologist for stereotactic treatment of that spot; I will be having this treatment starting on the 23rd.

(I had stereotactic radiation treatment a few years ago — after the operation and before the chemo/hormone treatment. So it is quite familiar. All these treatments are pretty refined, and fortunately don’t seem to cause me many side effects.)

Anyway, Dr P is not worried about the blood test and scan results — “not even close” were his exact words. I am certainly still feeling fine. The sleep continues to improve, and this always makes me feel better. I will continue with the exercise classes twice a week. (Ditto with the hormone treatment unless and until I need a different one.) I had another Zolodex implant after the appointment with Dr P. After that we had a coffee on Maling Road, and I went to the greengrocers.

The day went a bit pear-shaped after we got home, though. I should explain, for those who haven’t been to our place, we are in the rear unit of two. Another pair of units is directly to the north of us. As we approached our place, we saw a police car on the nature strip and a fire truck and an SES truck in the street. As we passed the units beside us, my beloved glanced up their driveway and exclaimed “Oh, my God!”. A car was sitting in their driveway at right angles to the boundary fence. When we got up to our driveway, the car belonging to the neighbour in the front unit was parked outside our garage. This was all highly unusual!

We asked one of the coppers what was going on. Apparently someone in one of the units to the north of us, while driving out of their garage, had lost control and gone through the boundary fence. This had flattened a section of the fence, and knocked a hole in the garage of the front unit on our side. (This was why the neighbour’s car was outside our garage.)

Our garage has a party wall with that of the front unit. The police and SES therefore asked to check inside our garage to see if it too was damaged. There was a small crack in our garage wall, but no other visible damage. As a precaution, though, the SES put a prop inside our garage to reinforce the roof where it joins our neighbour’s. The latter went to the trouble of tying up the prop to prevent it from falling onto our car, should the wall shift. (They were very concerned that they get this prop back — I assured them I would keep an eye on it. I reckon if the prop fell on the Camry, we would be up for a new car — they are hefty pieces of kit!) Our neighbour’s garage is quite badly damaged — one can see straight through the wall where the impact occurred. She will have to leave her car in the street for the time being. It was just lucky no-one was hurt.

Everyone was very calm and pleasant. One of the police helped me drag some stuff out of the garage to let the SES put the prop in. The police also helpfully supplied us with the contact details belonging to the driver of the car. Armed with this information we rang our insurance company and explained what had happened. They will be sending out someone to assess the damage to our wall in the next few days. No-one actually said “You can go on parking your car in the garage”, but we inferred that this was a fair thing to do while we are waiting for any remedial work that might be required. TBC!

Carry on in remission

We saw Dr P this morning. The news wasn’t great, on the face of it: the PSA is up from 2.3 to 3.7. However, Dr P continues to be happy with where I’m at. He referred to the scans I had had in December, which showed neither “clear evidence of bony metastatic disease”, nor indication of “local soft tissue recurrence”. He said while the PSA scores showed that there was something going on biologically, I was still in remission radiologically. He wants me to have scans now every three months, adding “I’m probably just being paranoid”. (He can be as paranoid as he likes as far as we’re concerned!) He doesn’t intend to change the treatment I’m on until something shows up on the scans.

As Dr P pointed out, we have been coming to see him for three years now, something that surprised us. During this period I have had adjunct chemotherapy and hormone treatment — the latter of which is continuing — and spent two years in remission, i.e. with an undetectable PSA score. It was welcome news to me also that I remained in any kind of remission — I thought this had finished when my PSA score started climbing. Being in remission doesn’t change anything, of course, it just makes me feel that bit better. Physically I still feel fine, thanks to the exercise classes and lots of walking.

The last lot of scans was bulk billed, so the only drawback of having more is the time required. There is a gap of an hour or two between the two scans. By the time you arrive, get prepped, have scan #1, then wait until you can have scan #2, the day has a fair sized hole in it. Last time I came home for lunch during the gap. Next time, however, I will just walk up to Whitehorse Road, buy a sandwich, and go and sit in the park across the road from the hospital. If it is a hot day I will renew my community membership in the RSL and have lunch there — the food is pretty good, and they even have a senior special menu!

Post for 23 November 2020

I am pretty tired after an eventful morning, so I am just going to write the basics.

I saw Phillip P, my oncologist, this morning. The PSA has gone up slightly, now 1.4. (The previous reading was 0.5.) He said it is still very low, he is happy with how I am travelling at present, and that I shouldn’t worry. He is focused less on the quantum of the PSA than on the trajectory of the rise. A steep increase would be concerning, but a gentle increase like this is not. Nevertheless, he wrote me a referral for a couple of scans (CT and bone) to be conducted before our next appointment. These will reveal if there is any spread of the disease.

(After I came home from a walk this afternoon, I got a call from the scanning centre at Epworth Eastern. The scans are booked for 17 December. It is a convenient location in Box Hill, being where I go for the Zolodex implants. Speaking of which, the next consult with Dr P, and the next Zolodex, are booked in for 23rd of December. This is a bit better than the original appointment, which was scheduled for the 30th of that month. There are lots of places at which I would prefer to celebrate my birthday than a day oncology centre!)

Dr P was running quite behind, and I had a consult booked also later that morning with my GP. I did make the latter on time. Unfortunately, it was a bit jarring. After having discussed a few alternatives for sleeping tablets, he wrote me a couple of prescriptions for some new ones. I quizzed him to make sure I understood how I was to take them — alternating one with the other, or both at once — the latter was the case.

He then said I had had my fifteen minutes and I couldn’t have any more time. If I had further things on my list (which I did), I should have outlined them at the start. I did get one more prescription out of him, for the blood pressure medication. Anyway, I will be changing GPs. I get that medicos are stressed. They need to manage that stress, though, in ways that don’t involve taking it out on their patients.

Positive points to the day included sitting down in a cafe for a coffee after the GP consult — I needed a lift by then! Another was going to the local library, picking up my hold, and taking out a few other books as well. These were both things I had missed doing for most of this year (cafes and libraries having been closed in Melbourne). Op shops have re-opened as well, so things are really getting back to normal.

Last night I took out a monthly subscription to Netflix. This will allow us to watch some more episodes of Emily in Paris, previously mentioned, and a favourite of my beloved. We will also be able to bring ourselves up to date with The Crown. The Netflix Android app works well with the Chromecast, and we were able to switch on the closed captioning without difficulty. One can just renew the subscription monthly. Entertainment is welcome at present, particularly in the leadup to The Festering Season (as I grumpily think of it).

Rest & recovery

When I started writing this post, I was trying to remember when I had had the hernia operation. According to an email message in my inbox, this took place on 9 October. I came home the following day. By now I am therefore well past the four week mark in my recovery. According to what the nurse told me, I have a couple of weeks to go.

The wound site was never really painful, and over the last few weeks has become gradually much less sensitive. It was always a bit worse in the evenings, when I generally felt more crummy. Now I am only conscious of the wound if I do something it doesn’t like. Yesterday was one of those days.

Sweeping the courtyard was one of the jobs I had been putting off. This procrastination isn’t unusual for me, but in this case I was conscious of all the bending down this job would involve. (Bending from the waist is better for me at the moment, as it puts less strain on the wound site.) By now, though, I thought that I could probably handle a little task like this. Sweeping the courtyard always makes it look neater and more inviting. Afterwards, I pictured myself sitting out there in the shade of the umbrella, enjoying my handiwork.

This was pretty much how it transpired. The sweeping, picking up all the debris into the big garden bag, putting some of that into the compost, and the rest into the green waste bin, all took about an hour. Along the way I re-fixed some shade cloth I have rigged up over the daphne in the front garden. I interspersed these with hanging out a couple of loads of washing, including the towels. (All these little tasks took me over my step target for the day, without having gone past the mailbox.)

I did notice the hernia wound after a while. It wasn’t painful exactly — just enough for me to think, okay, that’s about as much as I can manage right now. But I enjoyed being outside, getting things looking a bit better, and having a closer look at the garden.

The main problem I’ve had over the last few weeks has been my sleep. I think this has to do, at least in part, with my not being able to exercise as much as before the operation. (I did resume a modified exercise class just last week.) Consequently I have been getting, on average, an hour and ten minutes less sleep than I was having before the operation. I have also been waking several times a night, and getting up in search of something that will knock me out for a while. So the sleep has been both shorter and more fragmented.

The other reason is to do with my sleep medication (Stilnox), to which I have been gradually becoming habituated over the years. I really need a new one. Whatever I take, however, has to not interfere with the Zolodex — while I remain on that treatment. I will be seeing Dr P on Monday week to discuss all this, together with my most recent blood test.

I have had insomnia for about 25 years now. Over this time I tried most of the sleep treatments around. None delivered a cure, so I just learned to live with it. The last four weeks has been an extremely sustained patch of sleep deprivation, however, and I have been finding it pretty tough. I hope that gradually getting back to my full exercise program will help.

I am also going to investigate contactless shopping for groceries. In this scenario, I drive to the supermarket, open the boot of the GT, and send a text to the effect of “I’m here”. Someone will put the bags into the boot of my car, I drive home, and at this point my beloved will bring the bags inside. This way I will get a mini-outing, and she will have the chance to catch up on her work a tad. From each according to his ability, to each according to her need.

We did some old-style shopping over the weekend. Our dishwasher packed it in last week. (I think the noisy, thrashy thing is about 20 years old.) I read lots of reviews, and measured the recess in which it sits under the kitchen bench several times. Yesterday we headed to one of the nearby big box stores to kick some tyres. Did we want a two or a five year warranty? Would a cutlery drawer be a good thing, or would we make do with a basket? All the alternatives were worked through, and we chose a German make with which to replace the tired old Dishlex. The credit card was unfurled to good effect, and the new dishwasher — a Siemens — is being delivered on Friday.

In the meantime, my beloved and I have had some slightly nostalgic times handwashing our dishes, and drying them with a tea towel. I seem to remember Mum and Dad having sotto voce arguments while doing this. Like them, we have fallen into gender roles — my beloved washing, me drying up. We haven’t had any arguments so far, though, even when I queried her practice of putting the cutlery into the sink first. I will remain a cutlery-last man to the end of my days! (I hope this preference will soon revert to being a theoretical one.)