Final radiation treatment today

I had the tenth and final radiation treatment today.

To repeat a phrase I have no doubt over-used: so far, so good. The treatment itself seemed very refined, and I didn’t notice any side effects. Apparently these can occur within a few weeks of the last treatment. I have a nursing treatment plan, which basically says to go on applying the MooGoo lotion to the area on the chest where the radiation focused. I can call if I need further assistance, which I doubt I will. In six weeks or so I will have a blood test in which the PSA will be measured. This will be the proof of the pudding. A few days following this test, I have a follow-up appointment booked with the radiation oncologist. I will continue seeing Dr P (my medical oncologist) as usual. I will post the results of all these consults here.

The radiation oncologist (Dr B) advised me to have the COVID19 vaccine as soon as possible. This was different advice to that which I received from the radiographer. The basis of the advice to defer the vaccine was that any vaccine can have an effect on the immune system. And my immune system is a bit lowered by the radiation treatment. However, Dr B said that radiation treatment is not immuno-suppressive. Therefore there is no reason not to have the COVID vaccine.

It is a bit academic, of course, given that, for most folks, there is no vaccine to be had. I did ring a clinic that I found via the federal government vaccination finder web site. On getting through to a human, however, I found they are only offering these to existing patients (something not mentioned on the web site). It must be a damn nuisance for clinics to be bombarded by people wanting vaccinations, when they are not getting enough supply to give out these jabs. I am not that bothered about it, actually. I checked on my regular practice’s web site. When they get enough supply, they will contact patients under 70 who are in group 1B — my situation. When my number comes up, it comes up.

1st treatment down, 9 to go

I had the first of 10 radiation treatments this afternoon. It seemed to go well, without any noticeable side effect. I felt just maybe a bit out of it afterwards. But getting home on the tram was no problem. (Given that it goes right past the hospital, tram is really my preferred way of getting to these appointments. Thankfully, it is school holidays here. Otherwise, with a mid-afternoon return trip, I would be sharing the tram with boisterous school kids.) I will only post subsequent appointments if I experience anything side effects.

I saw a nurse afterwards who checked how I had found the treatment. I asked her whether I should have the COVID-19 vaccine while I was having the rest of the radiation treatment. She said I should defer that, should I be offered a jab. They think the vaccine has a temporary impact on people’s lungs (although they haven’t seen enough cases to be sure of this.) I am having radiation to the sternum, an area obviously close to the lungs. The radiation treatment can knock the immune system around a bit — although not as much as chemotherapy. She also suggested I defer the flu vaccine also until after the radiation treatment. However, the rollout of the COVID vaccine is so slow that I think I am unlikely to be offered a jab any time soon.

Sending this off as is without further checking or embellishment.

SNAFU wins the race

Well, as as a character says to another in The upside of anger, that was a mis-step. In the last post I attempted to convert the blog to private. The problem was, as a few intrepid followers found, that locked everything up tighter than a fish’s whatnot. Even I, as the blog founder, had difficulty logging back into WordPress to get things how I wanted them. The notification settings seemed mysterious. (I say “seemed” because I didn’t get to see the outgoing message that was sent to everyone I invited to become a viewer. This message obviously didn’t explain how viewers could be notified when I had posted new content to the blog.) Few people are going to come back and check in case I’ve updated the blog — something that’s become less frequent lately. (It’s possible to sign up for email updates, but I know some people haven’t been able to get this to work.)

Anyway, for those people who requested email updates, I will keep sending you those. I will post those also to the blog.

WordPress has no real half-way setting between “Open” (i.e. anyone can discover the blog) and “Private”. (The only one was something that “encourages” search engines to omit the blog from their search results. However, as WordPress pointed out, this depended on the search engines actually doing the right thing.) Oh well, just chalk it up to experience. Carry on irregardless, soz for that, and happy Easter!

Change to blog settings

From now, I have made this blog private. People who want to view and follow the site will not be able to do so unless I invite them. People I invite (and who accept) will need a free WordPress account to view the site. It will be necessary to log in to WordPress to view the site.

There don’t seem to be any people registered to follow the blog. (I know people have found this difficult to do.) However, I will invite people who I know used to follow it. If anyone is unsure about taking out a free WordPress account, my experience with them has been positive. WordPress has hosted the blog almost from the beginning, and I have very seldom been contacted by them. (Emails I have received have always been about changes to the blog editing software.) So, as far as I am concerned, they are a reputable company.

I will email family members with the content I am putting up on the blog (including this post) so they can follow it that way if that is their preference.

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!

Very nice what there was of it

Well, it has been quite some fortnight.

Not last Thursday but the one before, I had exercise class as usual at 11.30. My beloved came to lunch afterwards with a couple of the guys. After this I drove us to the first in-person meeting of our book group at 2.00 pm. The latter was a rather sombre affair in that we were all masked, and spread out around a large U-shaped table. Afternoon tea, which used to follow the meeting, was cancelled on health grounds. In spite of these rather no-fun aspects, and the fact that most people (including me) hated the most recent book, it was a really good discussion.

The real drawback was that the book kit for the March meeting was not waiting for us at the library as usual. Meetings of the book group take place at a community centre, which also houses a branch of the library service. Normally, at each meeting, someone picks up next month’s books before each meeting. These copies can then be distributed at the meeting. The fact that this arrangement had fallen through made the distribution of the March book much more of a hassle — see below.

The day or so after the meeting the book kit was sent to the branch, whence I collected it. I had hoped that group members could pick up their copy individually, but this wasn’t possible. Book group kits are only loaned out in one transaction to the authorised person, i.e. me. Rather than make everyone come to our place to pick up their copy, I undertook to distribute them all the following week. I notified everyone of the date and approximate time of the the drop-off. When the appointed day rolled around I entered everyone’s address in the satnav of the GT, and set off on a mini-trek around the eastern suburbs of Melbourne.

It was a hot day again — thankfully, the air conditioning was working fine. The satnav turned out to have a handy feature by which one could sort addresses by their distance from one’s current location. This made dropping the copies off considerably more efficient. Even so, with Melbourne’s traffic, it took a few hours to distribute eight copies. I did stop for a chocolate ice-cream at mid-morning. This turned out to be a very generously-filled single cone, and gave me quite a boost. All except one person was at home, and everyone was thankful for the delivery. (I should add that my beloved, and another group member, had gone through the same exercise a couple of times last year.) Everyone just hopes normal service resumes from the March meeting onwards.

The following Sunday was a 4.00 pm performance of Das Rheingold, at the Capitol Theatre in Melbourne. This was the first opera that had been staged in Melbourne since lockdown began last March or so. (I crossed my fingers when I booked the tickets for this late last year.) Good on Melbourne Opera for giving it a red-hot go! For anyone interested, they are planning to do the whole Ring cycle over the next four years. After the performance, one of my oldest buddies (a fellow Wagner tragic), my beloved and I repaired to Southgate for a Chinese feed. Like the opera, this repast had a strong finish, in the form of deep-fried ice-cream. I think I have eaten more ice-cream in the last seven days than I did during the whole of 2020!

The only downside of the outing was that, on our way home, the headlights of the faithful Camry seemed occasionally to go a bit dim. I dropped it off at the garage the following week for a checkup. This found a fault with the alternator, requiring a replacement unit to be fitted. Given that the car is 17 years old, one has to expect that things will need replacing from time to time. Fortunately, this operation will not be affected by the latest lockdown — garages are considered an essential service. I am just glad that these two excursions are all done and dusted before we are all confined to barracks again.

This morning I awoke a bit before seven — a real lie-in for me. We were running short of some essential supplies, so I grabbed a coffee and a piece of toast, and whizzed out to the supermarket. This turned out to be a good time to go — there were only a few cars in the car park when I arrived. Some shelves looked a bit depleted, but not many. Everyone knows the drill by now! Keep calm and go shopping — in whatever form this exercise is possible.

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!

A glimpse of eternity

To the Finnish composer Rautavaara, “music is great if, at some moment, the listener catches ‘a glimpse of eternity through the window of time’”. I heard this comment a short time ago on ABC Classic before they broadcast his Missa a capella, an extremely beautiful and tranquil work. This comment crystallised a few thoughts I have been having recently about music.

For many people, classical music means music that is calming and zones them out. Everyone will have their favourite pieces that do it for them. Works that come to mind for me are mostly slow movements: those of the “Emperor” concerto and the Seventh and Ninth Symphonies of Beethoven, the Piano Concerto no. 21, K.467, of Mozart, the piano concertos of Brahms, and so on. Piano concertos figure a lot in my list, but the experience can come from any type or genre of music. ABC Classic had a regular segment in its morning programs, which they named Swoon, for music of this kind.

Musical works that make time stand still like these have an obviously calming and slowing-down effect. There is something more subliminal that is going on as well. Moments like the examples I have listed are also moments of community: what used to be called togetherness. Like tapestries, music is made by groups. Whether you are an instrumentalist or a singer, your contribution is a strand in the fabric.

In times of anxiety and isolation, like the year we have all just had, music can remind us what cohesion is like. But to be part of the ensemble, you have to be able to play or sing your line. Making music can lift you a mile high. Wanting to be part of the magic, and being unable to do, so can leave you feeling lonely and ashamed.

This came to mind recently in a scene from the wonderful series Unorthodox (currently on Netflix). Esther (Etsy) has had a sheltered upbringing in an ultra-orthodox Jewish community in Williamsburg, New York. Her marriage to another member of this community doesn’t work out, and she travels to Berlin to track down her mother. Before she manages to contact her mother, she wanders into a conservatorium, where she is befriended by a group of students. Etsy learns that the conservatorium has scholarships for students from disadvantaged backgrounds, and applies for one to study piano. Before her audition, her new friends inveigle her into playing something for them. When she does, it clear that she is nowhere near the standard required to enter the conservatorium. She is so far behind, she will never catch up. One of the students tells her this, plainly. Life as a musician will obviously be impossible for Etsy. Worse, she will not be part of a group which accepts and likes her. Etsy is shattered, and flees to consider what options might remain to her.

Those who know me will know I learned the cello for about ten years. I decided to stop, for a range of reasons, a few years ago. The years I spent learning the cello gave me a taste of both the highs and lows of making music. Because I started so late, and for other reasons, the former experiences were much less frequent than the latter. Over the years of struggle, I fell out of love with the instrument. Deciding to stop was like realising that a marriage or relationship you were in was just not going to give you what you wanted — no matter how long you have persevered with it.

People I talked to about my struggles with the cello would say “Can’t you just enjoy your playing?”. But no-one can enjoy doing something badly, with no realistic prospect of doing it better. Like Etsy, I realised I would never catch up. A professional musician’s performance sits atop a mountain of grinding, repetitious, incessant practice. And once you reach this rarefied altitude, you need to practice to stay there. After I sold my cello, I used to console myself with Groucho Marx’s comment that he wouldn’t want to be a member of a club that would admit him.

Everything implies its opposite. There are no sweet harmonies without dissonant ones. The company of those we love is doubly delightful to one who has experienced loneliness and rejection. Without those times when the universe seems a bleak place, music would never open its window for us. For those in the cheap seats, their fingers twitching surreptitiously in time to the cascade of notes, eternity reserves a special place.

Best Xmas present yet!

I mentioned previously that I was scheduled to have a CT scan of the thorax, abdomen and pelvis and an isotope bone scan. These were done about a week ago. This morning we duly trooped off to Dr P to see what (if anything) these had revealed.

Basically, they found nothing new. To quote from the report, the bone scan found “[N]o clear evidence of bony metastatic disease”, and the CT scan found ” … no features at the level of the pelvis to suggest local soft tissue recurrence”. So, nothing to see here. The PSA has crawled up to 2.3, but Dr P wasn’t worried by that and said he was very happy with how I was going. I will continue on the Zolodex for the time being, depending on future tests. (I had another Zolodex as scheduled, after seeing Dr P.) Appointments were made to see the good doctor and for my Zolodex implant in March, 2021.

I will send this off now and rescue a load of washing from the machine! I hope everyone has a safe, unmemorable and uneventful Christmas.

Staying in touch

Yes, it’s Christmas again. As well as red bows around street trees, incessant carols in supermarkets, and gift catalogues, you know the season is under way when the first Christmas card appears in the letterbox.

In earlier decades, my intolerant, black-and-white younger self couldn’t see the point of sending a bunch of cards each year. Either you’re in touch with someone anyway, I thought, or you’re not. If you’re not, sending them a card every year isn’t much of a substitute.

It’s a mark of maturity (or selling out, whichever you prefer) that the annual ritual starts to make sense. Some people that you would like to be in more frequent contact with are just not close enough at hand for that to happen. As those people get older, as well, they acquire families and other appurtenances that push everyone else into second or third place. This is all inevitable and just the way things are. So getting a card each year provides that particle of reassurance that someone is thinking of you, even though you haven’t spoken to or laid eyes on that person for a while.

Australians move house, on average, every seven years. Our increasing mobility, new communications technologies, and the increasing demands of paid work all contribute to the fragmentation of relationships. (Recent events like a couple of bouts of lockdown only amplify this tendency.) The absence of social connections has been identified as a risk factor for an impressive range of physical and psychological ailments. A few dozen cards on a mantelpiece, the top of a piano, or wherever signify that, in spite of all the things separating us from our families and pals, we remain socially plugged-in.

There is, of course, a reciprocal principle lurking not too far beneath the surface. As that great philosopher and baseball coach Yogi Berra remarked, “You don’t go to their funeral, they don’t come to yours”. So it is that my beloved and I gear up for the annual Christmas card sendathon.

Our modest effort pales by comparison with my parents’ yearly communication blitz. Writing their Christmas cards seemed to take them the best part of a day. The bridge table was set up, cards, envelopes and stamps stacked in piles, and a serious list was worked through. Names were culled, and others added when, after several years’ silence, these lurkers sent them a card. Of course every one of the cards Mum and Dad sent was hand written — none of this wimpy Christmas Letter stuff! (I must confess we have resorted to that for the last few years, family members excepted. I think of it as our Annual Report.)

Unlike HMQ, I don’t have a Christmas Message. (No offence, but I will know I am really past it when I start looking forward to that!) I just hope that everyone reading this gets what they want, not just on Christmas Day, but as often as possible. Not too much, of course — just now and then.