A day in the country

A couple of years ago, I finally subscribed to the Melbourne community radio station 3MBS-FM. Because I did this during their annual radiothon, my subscription was entered in their prize draw. Renewing my sub this year, I won 6th prize in the draw, which was a weekend hire of a car from Toorak Mercedes.

(If you think this is a plug for 3MBS, you might be right. As Bill McLaughlan, presenter of Exploring Music says, if you’ve been thinking about subscribing, don’t feel guilty – do something! You do get a lot for your $30. And from their monthly online guide, one can actually see what programs are being broadcast. (Luddites can get this guide in hard copy, for no extra charge.) Planning one’s listening is practically impossible with ABC Classic FM, despite all the time and, presumably, money lavished on the recent upgrade to their web site. Don’t live in Melbourne? Support your local community radio station.)

Getting back to the prize, a Benz is a nice piece of metal to punt around for a day and generally put on airs. This is particularly so, given that our cars are 14 and 22 years old. My beloved and I were originally going to have a weekend in Daylesford, or somewhere like that, in July. This was pretty close to the date of her work moving to Port Melbourne and all the stress associated with that process. (Former colleagues relocated to Bundoora can sympathise!) So we decided to defer the country excursion for a bit until she was more used to getting herself to Port Melbourne and back.

Cometh the hour, cometh the vehicle, in the shape of a GLC 350 SUV with only 7,000 kilometres on the clock. (We had expressed interest in borrowing a GLA or C class. This being near the end of the month, however, there weren’t many sedans in stock, so we got upsized into the GLC.) The logistics of picking it up were not straightforward. I had originally thought we would get to Toorak by public transport. Given that this involved getting to Riversdale station, a train from there to Burnley, then another to Heyington, and a hike up the hill to Toorak Village, we opted to drive there, then proceed by convoy home. So guess who got to drive it back to beautiful downtown Burwood?

A sales “executive” showed us the ropes beforehand. It has proximity unlocking. This means it detects when someone approaches it with the key. To open the door, just press a button in the door handle, then pull the handle back towards you. Inside, you can leave the key in your pocket, or put it in one of the cup holders. Seats, steering wheel, and external mirrors have power settings that can be saved individually. Gear selection is done by way of a lever mounted on the steering column, like a turn indicator. (Yes, that’s the one on the left hand side, like all Euro cars.) Want to open the tailgate? Wave one foot under the rear bumper bar; then step back. The tailgate majestically rises. Same procedure to close it.

The Benz is chockers with this kind of electronic gadgetry. Seatbelts tension themselves across your chest as you draw out from the kerb. If you are changing lanes, and someone is approaching on that side, it shows a red triangle in the mirror and beeps. Draw in to park it, and the passenger side external mirror angles down so you can see how close you are to the kerb. When driving up our driveway, lined with rather overgrown plants, beeping begins to sound. Squeezing it into our garage, past the less ancient car, the front camera automatically switches on.  This screen gives you red and yellow lines (with more beeping) as you approach obstacles like other cars and walls. Lights and wipers switch on automatically. You get the picture.

We just drove it up to the Dandenongs and back. On the road it gets along very well. There is plenty of mumbo on tap, albeit with a long travel accelerator pedal, but the turbo diesel is quiet. Even on the Comfort setting, the ride is not plush, something for which the run flat tyres are probably responsible. You feel the road surface, lane markers, driveways, and so on. However, the seats are great, controls are beautifully laid out, and it is generally easy to punt along. It isn’t actually bigger than either of our existing cars; the SUV packaging just makes it feel bigger, on account of its being higher. Could I get used to it? Certainly! You would probably walk away from most prangs. We don’t have 80 large to splash on a vehicle, though.

We had lunch in Maling Road, after which my beloved proceeded to have a mani and pedi. I made myself useful by buying some meat and vegetables for tomorrow (being Grand Final day public holiday), then having an iced coffee sitting on the pavement. Did I mention it was a sunny day? 24 degrees! On our way back to the Benz, my beloved saw a dress in a little shop. Trying it on was facilitated by my taking her top off for her in the change room (so as not to muck up the newly done nails), buttoning and unbuttoning the dress. The dress having gotten a guernsey, as it were, the process happened in reverse. Being a Thursday, it was not too busy anywhere. And we got home in time to miss the school pick-up imbroglio. Each of us had something on order for home delivery; both parcels arrived. The day would not have been improved if my beloved’s ticket had won the lottery.

Sunday miscellany

A cure for insomnia? That seems something we are as likely to see as as a perpetual motion machine. Nevertheless, this article from The Guardian has definite cred. (Apologies, as ever, for cross posting.) Merely by taking people’s insomnia seriously, Dr Selsick of the Insomnia Clinic in Bloomsbury is doing a great service. The method seems to work, too, in the experience of the article’s author. The good doctor is also refreshingly non-doctrinaire about sleeping tablets. No-one regards them as ideal, but, as he points out, sleep deprivation carries risk as well.  (I have tried the sleep medication mentioned in the article, Belsomra. It does something, just not quite enough.)

I am going OK with the aftermath of the chemotherapy. Thursday and Friday were pretty normal days. Yesterday and today I have noticed more symptoms, mostly a bit of discomfort in the legs and ankles. These symptoms are not new, but have become more noticeable over the last couple of days. So far a combo of paracetamol and a little Endone is making it tolerable. (Thanks, Jane, for putting me onto that.) I found a good booklet on cancer pain and medications online from the Cancer Council, updated, as it happens, this month. The booklet discusses various aspects of pain, medications, and pain management in a useful way. Of course what I am experiencing is not cancer pain, more a side effect of the chemo.

I didn’t write much before about the actual process of receiving the treatment. Being the first time, it took a bit longer, there being more to explain. The nurse was very thorough in doing this and walking me through the side effects that I may or may not experience. After putting in a cannula, they started with an anti-nausea drug, then put another drip in for the chemo (a drug called Docetaxel). Putting in the Docetaxel takes about 1.5 hours. I also got an implant just under the skin of the stomach; this lasts for three months. The implant is about the size of a grain of rice. I haven’t had any problems with wounds where the cannula or the implant went in.

On Wednesday night, my face felt a bit hot, and my cheeks were a a little red. I just put some face cream on from the sample bag of products donated by the hospital pharmacy. (Marketing, of course, but the products themselves all seem good.) There was quite a number of mouth care products: moisturising toothpaste, mouthwash, and gel. The nurse also suggested I could make a mouthwash from a salt or baking powder solution.

The chemo goes on a three week cycle.  I am to have six cycles, so five to go. (I should be finished in early January, 2019.) I will probably feel pretty ordinary in the middle week of the three as the red and white blood cells drop. As these recover in the following week, I should feel better. I have to have a blood test at the beginning of each chemo week. If all is well here, and I don’t have a temperature, I should be good to go. I still have about half the ADT tablets to take, but I should have finished those by the time the next chemo rolls around.

Fine so far

This is somewhat of a place-holder message. The good news: PSA is down to 2.0, down from about 8. (This is the first time it’s headed south this year, I think.) This is the ADT treatment doing its thing. I’m generally feeling fine after the first chemo this afternoon. I have just slightly sore muscles, a bit like having been to the gym. Also subtly out of it; not unusually, though! Other than these hard to pin down symptoms, pretty good.

[This par was pasted in from an email, so may look a bit squashed up.) The chemo goes in three week cycles for prostate cancer. (Lucky breast cancer patients get it every week.) Apparently one can feel pretty ordinary in the middle week. This is because one’s red and white blood cell count are then at their lowest. That is also the week in which one is most vulnerable to infection. (The immune system is compromised by the chemo, so colds, flu etc. are something to avoid more than usually. I asked about going to meetings in that week, and the nurse said, if you know that the people you’re meeting aren’t sick, go ahead.
Anyway, I have lots of information to process. Will be in touch as I digest it all.

Energy matters

Of course Father’s Day is a commercialised rort and an excuse for selling more stuff. Nonetheless, siblings, and anyone without a dad handy, will probably be feeling a pang today. I still have one of Dad’s old shirts, and his dressing gown. More practically  I have been honouring our Dad in a practical way, by doing a spreadsheet about energy use.

(To bring non-family members up to speed, our Dad, David, was an engineer. Toward the end of his career, he developed a particular interest in energy conservation. Unfortunately, as in other things, he was ahead of his time. In the eighties, most people thought fossil fuel energy was cheap, and would last forever. Peak oil and global warming were unheard of out here.)

Dad therefore would have been totally across my spreadsheet, which bears the catchy title “Cooling & heating costs with split system versus separate evaporative cooling + gas ducted heating” (Aron, 2018, unpublished.) You may not find this magnum opus in a bookshop near you, if there still is one. So I can upload it to Google Drive, if anyone is interested. (No? Fair enough.)

I will prevail on your patience with a précis. We have to replace our 15 year old evaporative cooler with a newer system. This has opened a bit of a Pandora’s box. Should we replace it with another evaporative system? Or go reverse cycle ducted? This would use more power, but wouldn’t use any extra water. What are the comparative costs of these systems?

This begs another interesting question. How much water do evaporative systems use, anyway? The answers are complicated. Modern evaporative coolers recycle their water. They can’t do this indefinitely, however, as the salts in the water become concentrated. This shortens the life of the cooling pads. The point at which a cooler will dump its water varies between brands, the salinity of the water, etc., and is just about impossible to find out. Different manufacturers’ web sites mostly say: it depends.

I consulted Dr Google on this matter and found two figures for water consumption of evaporative coolers: 58.6  and 113 litres per hour. The first is contained in a paper written under the auspices of the Federal Government’s Water Efficiency Labelling and Standards Scheme. (The link points to the .pdf format.) The second is derived from post to the Whirlpool discussion list. I included both figures in my spreadsheet, as Scenarios 1 and 2. (As you do.)

How much energy do different types of coolers and heaters use? This is much easier to find out. Sustainability Victoria has useful summaries for cooling and heating .

Those still awake will be on the edge of their seats, I know, so here is the executive summary of what I found:

  1. Reverse cycle would be cheaper for us, by between $239-$891 dollars per year.
  2. Reverse cycle systems are more expensive to purchase than evaporative. What would the payback period be? I did two calculations; one guesstimated the extra cost of a ducted system at $4,000, the second at $8,000. Accounting for multiple variables, the payback period varies from 4 to 33 years!

Anyway, we have pretty much decided to go with another evaporative unit. This is for non-financial reasons. My beloved has sinus problems, and the extra humidity of the evaporative is better for her. We can also use our existing ceiling ducts. Refrigerant system ducts are smaller, so we would have to have some new holes cut in our ceilings, and the old ducts covered over.

This is what we were leaning toward in the first place, but we now know why this is the right answer – for us. I hope Dad would approve.

Morning update & instapoems

As noted in the last post, I had the first Bicalutamide last night. I felt fine; maybe slightly dizzy: if so, it was very subtle. I slept well, and all was normal when I got up. After having hung out and brought in a load of washing, booked the car in for a service, made a phone call, driven down to Maling Road for a coffee and to get some meat, and other miscellaneous fiddling around, it still is. My beloved was going to take the day off today, just in case. However, this morning, I said “no need”. (I reminded her that I am a card-carrying wimp.)

Having thus gained your attention, here are a few instas.

Niobium

I’m glad I saw
the bust of Nefertiti
how many eyes
have stared at hers
felt her in the room
heart stop
to see her
blink

Technetium

Connoisseurs of the nature strip
delight in discards
rescue old crap
from lonely landfill
have antennae for what might
one day come in handy
they are optimists
creatives
adoption agents
suburban flâneurs
repurposers
they give the humblest object
a look over
then resume their
eternal rounds.
These old codgers all have
honorary commissions in
the army of utility.

Mercury

Words prayer flags
moved by hope
fluttered by love
prevailing breeze of habit
leaches colours
imperceptibly
do they mean the same
answered or not

 

Dr Parente mk. II

At the risk of repeating myself, there was good and not so good news from the appointment with Dr Parente today.

(Briefly to recap: the PSA had risen in spite of the radiation treatment. So there was obviously something going on with the cancer. The purpose of the scan I had last week was to reveal what this was and where it was.)

The first piece of good news – and it is a big one – is that there are no metastases in the organs. The ones he mentioned, the lungs and liver, are clear. (I had heard that mets in the latter organ are particularly undesirable.)

The second is something I have thought of, not something mentioned by Dr P, so all the necessary caveats apply. However, the mets that were there in the last scan, in the left hip and left femur, aren’t there any more. So it would appear that the radiation treatment was successful in getting rid of those mets (or spots, as they refer to them).

The less good news is that there are five new spots, all in bone:

  • sternum
  • rib (right hand side)
  • lower thoracic spine
  • L4 vertebra
  • left sacrum (AKA the tailbone).

(I am inferring that these are all still small. I base this on the facts that they weren’t there at the last scan, and I don’t have any symptoms or pain.)

The PSA has risen a bit more at 8.6, further evidence that things are progressing in an undesirable direction.

So I am starting on conjunct hormone therapy and chemotherapy. The last time I saw him, Dr P did mention a couple of trials that strongly support this combo: STAMPEDE and CHAARTERED . So his view, which we share, is: what are we waiting for? Obviously we have to fire the big gun, as he put it. He rang the hospital pharmacy (Epworth Eastern is literally just up the road) to see if they had a box of Casodex. They did, he wrote me a script, and I have had my first one. I will be taking one of these each day for 28 days. This medication can affect the liver, so I am avoiding alcohol for the duration. (Just when I could have murdered a drink, too!)

In a fortnight I start the chemo part of the treatment:

  1. Zoladex; one injection every 3 months, and
  2. Taxetere (Docetaxel), once every 21 days, for six cycles (i.e. an 18 week course).

I have to have a blood test, and see Dr P, before each chemo session. The consult with him ended quite late, so his practice couldn’t contact the chemo people to make the first appointment. They will do this tomorrow, however, and let me know.

It is all a bit daunting, and a lot of information to process. We both found the consult fairly stressful for these reasons. However, he seems very positive. He feels that, at my age, and with my (relative) fitness, I will get through the chemo easily. Maybe this geeing-up is what oncologists do. However, I am grateful for it, for both our sakes. From here, I am just strapped in for the ride.

I just want things to be as normal, and mundane, as possible. We are taking some quotes for a new cooling system. I went to the Deakin open day yesterday, to investigate doing a course next year. I am going to a session in October about how to write a (non-boring) family history or memoir. I want to go on socialising, listening to music, fiddling around in the garden, and everything I am doing now. Obviously we will have to see how far this is possible.

Bring it on!

Well, I had my appointment with Dr Phillip Parente this afternoon. (He is a medical oncologist, and adjunct clinical associate professor and acting director of cancer services, Eastern Health.) We were both impressed by Phillip. He is very concerned to explain treatment options and considerations clearly so that patients understand the issues. He even drew me a sort of ideas map, explaining that his handwriting is better than that of most doctors (it is). Phillip struck us also as energetic, positive, evidence-based, and fully seized of the need to get a move on. I said that I wanted the most aggressive treatment that he would advise, and this is exactly what he wants too.

He needs to find out whether my condition is low or high volume. The latter is three or four bone spots, or any visceral disease (for example, in the liver or another organ). If this is the case, he will recommend hormone treatment plus chemotherapy. Adjunct therapies like this have significantly extended efficacy over a single treatment. So I won’t need to come back so often to repeat or have it changed over to another drug. (As he put it, I have a lot of tricks in my bag.) It is difficult to say how long the effectiveness of a treatment will be, as individuals respond differently. He thinks that, with my (relative – my word) youth and fitness, I will be able to handle the side effects easily. Low volume disease – the former possibility – can be addressed by hormone treatment alone.

So what happens next? I need another blood test, which I had on the way home. I also need another PSMA PET scan, this one at Epworth Box Hill. Phillip’s practice initially made an appointment for me on Friday afternoon. The scan folk, however, have a cancellation for tomorrow afternoon, so I will be going in then. (I have had one of these scans before, and compared to an MRI, they are a walk in the park. I don’t have to fast – although I do need to be hydrated – I can drive myself there and back, and it the scan is done in a large, open space.) After the scan, I will be seeing Phillip on Monday, when he will discuss what is the most appropriate treatment, and (I hope) start it then.

Watch this space.