A wedding

Our daughter Helen is to marry James in December. James rang me last week and asked for my permission. Isn’t that very traditional? Of course I gave him ‘permission’. A few minutes later he confessed that he would have married her anyway, even if I objected. I like his style!
The wedding is going to be very small...around 20 guests with a celebrant in a park and lunch at a riverside restaurant ‘The Red Herring’. The Red Herring is a quite old restaurant starting out as oyster beds in the early part of the last century. Great spot with much to see as the rich folks cruise past in their ships.

On Sunday James and Helen came down and we went for a drive around a few sites we thought would be a nice setting for the short ceremony. Along the Swan River there are many lovely small picturesque venues suitable for a wedding ceremony....some of them below the monstrous houses of the wealthy..very wealthy! As my mum would say... ‘Where do they get the money?’

The site we all liked most were the gardens at Minim Cove. The ponds are fed by an artesian bore across the river. I previously briefly wrote about the gardens here. It is a great spot and those who know about it aren’t spilling the beans to all and sundry. When we were there on a nice sunny day on Sunday (is that coincidental?) there was not a single person enjoying the place. Even if there are other people about on the day, the gardens have many places suitable for the ceremony and river views for later photographs.

Yesterday I took the ‘Instructional’ flight in a Royal Aero Club Cessna 152. A beaut little plane, and I mean little. The pilot was a young guy and a bit bigger than me. If we were slightly larger it would have been a very comfy situation. Joan and Helen gifted me the flight for my 70th birthday and I had to take it now as the year is almost up since then.

I didn’t take my Nikon DSLR camera and foolishly took a $88 digital compact camera. The photos show why a good camera cost much more. We flew south for about 30 minutes and the view was great. As we flew over our neighbor Dave's business site I had the pilot do a go around and I took a couple of pics to give Dave. Sadly the quality is too poor to enlarge.
Doing a 'touch and go' on a regional airstrip.
Shoalwater bay and Penguin Island.

As for the ‘Instructional’ part of the flight I gave it a miss. I have done that before a few times in Papua New Guinea and I really did want to observe what we were flying over. When we are flying on a commercial flight and we don’t get a window seat I get really angry when I see some ‘seasoned traveller’ who never looks out the window.

Joan is getting stronger daily and we hope she will be ‘running on all cylinders’ for the wedding. She has done quite a lot of walking over the last few days and whilst she has found it very tiring, she is getting better only using her walker over longer distances.

The goodness of strangers, friends, neighbours and family.

Years ago in the last century..probably in the 1950s there was a singer named Donald Peers and one of his numbers was ‘Friends and Neighbours’.

It’s a shmaltzy number which appealed to the masses at the time. Your friends and neighbours were just ‘peachy’ and could be relied on to step in and help out in a crisis. I can’t remember him singing about family? Donald was a Brit and I suppose the masses just after WW2 lived in close contact with their neighbours and probably relied on them in times of need.

Don has long gone now but yesterday I was thinking about the goodness of strangers and family and friends and I was reminded of Donald’s song and the sentiments therein.

A couple of days ago when Joan fell, strangers immediately rushed to help. Our family, neighbours and friends are all poised to help if necessary. So there...Donald was right on the ball!

On YouTube there are a number of songs by Donald, but I have not been able to access ‘Friends and Neighbours’.

I was never a fan of his, but I do remember the song, so it had some sort of impact on me..over 60+ years ago.

A setback

Yesterday was pretty horrible. Joan was home feeling much better and all looked good. She had some difficulty getting up from the toilet and although we know it is because of weakness due to not being able to eat over the last month, we decided to go and buy a commode to sit higher.

After purchasing the commode, Joan decided to use the stairs outside the shop instead of the ramp. She fell down five steps and I couldn't get her up by myself. A couple of good Samaritans helped and after they left she fell again near the car. Again with the help of a couple of beefy GSs I was able to get her into the car. At home, completely exhausted, she rested in a recliner chair. Not good! She couldn't get out of the chair and when I attempted to stand her up she slowly fell down to the floor. Once again the dead weight was too much for me and our neighbors were not yet home from work. I rang brother Graham and he drove the 10k down here to help us. Success due to Graham's athleticism. Today Joan has a very smart wheeled walker, a commode and a shower chair. We hope that a few days of good food will see an improvement and we won't need those aids for some time.

Home sweet home

Joan is home after 10 days at St John's hospital. Even though she was pumped full of potassium she has severe oedema in her feet and legs. The oncologist told her that she would be better off at home rather than languishing in a hospital bed.

One small benefit from all this is that she now is taking no medications for her cholesterol and blood pressure. So there. if you don't eat you don't have high cholesterol problems...simple. Joan now has low blood pressure so no need for that medication.

She has regained some of her appetite and is eating small, regular meals. Still very weak and tired though.

We are scheduled to meet with The Man in another ten days and listen to what ideas he has for Joan's treatment. Surgery, radiation, different chemo or a combo of the lot.

The hospital admin is nice and they are going to post the bill. Don't want a heart attack right there in the oncology ward.

Soon to be discharged

Joan is disconnected from the IV machine. No more potassium drip, no more antibiotics etc. She is now on 'soft foods' and able to eat quite well. She should be able to come home on either Monday or Tuesday

The oncologist has visited and suggested a few possibilities......radiation, surgery and a milder chemo. We are scheduled to see him in another week to discuss his suggestions. We will also be asking about a prognosis on each treatment and also one without any more intervention. The surgery would be on the primary bowel tumour. The radiation would be for the liver tumours of approximately 30 in number. I am guessing the chemo would be just to try and keep the tumours dormant...something that the current heavyweight stuff hasn't been doing. Can only hope.

Joan's recovery has been slow, but treatment was methodical. She has many bruises from IV ports, blood sampling and antibiotic injections. She has fluid retention in her feet and legs which should dissipate now that she can walk around. As soon as she comes home I will get her pushing a lawnmower to speed up her recovery. Just joshing!

A non-cancer post

Some other happenings besides the depressing stuff.

A couple of days ago I noticed a very young Raven on the roadway near our house. Yesterday I saw it down on the hot bitumen and decided that I should see if I could save it. This is a time when life seems pretty important.

It was still breathing so I carried it home and forced some water down its beak. After a few minutes it got a bit brighter and opened its eyes. It, or is it he/she? was too weak to stand so I gave it a little beef broth and put it in a cardboard carton, taping the lid slightly open and putting that end over the outdoor table edge to foil any attempt by our moggie to get at it. I watched through a window and sure enough PC Lock had her arm through the small opening trying to hook the poor crow. I had to shift the box into my shed. Today I gave it some more sustenance...like Joan's re hydration, and it was standing by itself and looking around, so I decided to take it to an animal rescue place near our house. A volunteer worker cleaning out a pen told me that he wouldn't be bothered with a 'bloody Crow', but the boss of the place took it off my hands.
Previously I would have euthanased it (cracked it on the head), but just lately I have come to at least admire their resourcefulness when collecting food and decided that it should have a chance. Birds are very cruel when one of theirs gets sick and usually kill it off. If this babe does survive he/she may well be ostracised and killed in the wild.

Driving home from the hospital I was stationary at a major intersection waiting for an ambulance to get through. Everyone except a young blonde lady saw what was happening and she cruised through in a large BMW forcing the ambulance to screech to a stop. He blew his horn and she instinctively blew her own horn and gave the ambos and extended digit high in the air for all the assembled drivers to see. As she passed me, her hand and finger were still extended but she had the bright red face of embarrassment. I reckon she is still cringing about her little act.

A difficult decision

Joan is still losing lots of fluids....in and then out. The oncologist visited this afternoon before I arrived at the hospital and stated matter of factly that the tumours have progressed....no indication of how much or which ones. He has a great bedside manner..NOT!

As I left to come home, Joan told me to be prepared for the decision to forgo further chemotherapy. We will try radiotherapy; not external beam radiation, but the irradiated particle infusion type.

Joan is not prepared to spend the time that is left in a chemo hell. We will discuss the options we have left when we next visit him.

The doctors suggest that Joan will not be well enough to be discharged until next week sometime.

reinserting a PICC line

We have just had a bit of a setback with Joan's recovery in hospital. She has been told that her Potassium levels are dangerously low and that as they are having trouble with veins they have decided to insert a PICC line again. This will be done this afternoon some time and that will allow all the fluids to be administered and later the chemotherapy drugs.

She is, of course, not very chuffed at this, but the alternative is not pretty.

I will visit her around 6pm this evening.

A vast improvement

Joan has had the works at St John's hospital. All her meds and antibiotics went IV and she has avoided the nausea and most of the diarrhea. The potassium drip continues and she been transferred to the oncology ward.

The oncologist scheduled a CT scan aimed at diagnosing the cause of this major gastric attack. The report seemed, to this non-medic, inconclusive, however the onco said that it suggested that the tumours had progressed. We could see no reference to tumours or cancer in the report and assume that there must have been a second report describing the tumours. The onco told Joan not to worry because he couldn't see how they could make such an assessment as previous scans had been done at a government hospital, Royal Perth. He is to get back to her today after he looks at both this scan and the last one from Royal Perth. Hope he is right.

The nurses we have been dealing with at St John's are excellent. The doctor assigned to Joan's case seems a little lost and his English language skills are lacking.

She has been sitting up and reading, and that is a good sign, and there is a chance of being discharged before the weekend

Our son, Martin visited Joan with me and Helen also dropped in after work.
Helen, stayed over last night and we cooked a nice roast pork with baked vegetables. Lovely!

Time for a specialist?

Please don't read this if you get a bit queasy.

Joan is suffering badly with diarrhoea and vomiting. The fluid she is getting can barely keep up with the losses. She is on a strict no food diet and cannot take even water by mouth because it causes her to immediately vomit. To top all that, she has a urinary tract infection and the doctor in her ward feels that she also has a stomach infection, but they cannot get solid samples for analysis.

I have brought home her underwear and clothes and washed and dried them to take back today. Serious treatment must be determined today as she is getting extremely weak and the current treatment is not working.

I have cancelled an appointment she had for today and will do the same for a couple more she has tomorrow. She is not in any condition to be discharged from hospital.

Inconclusive

Joan is still venting from both ends. She cannot even sip water without vomiting.

The oncologist visited whilst I was at the hospital and he ordered two X-Rays be taken; of her abdomen and chest. When the results came back, he told her that she had inflammation of the small intestine and stopped all food for two days.

She had her gall bladder removed some 15 years ago and without food she is getting painful gas and very loud stomach gurgling. My guess is that the liver is still producing acid and it is attacking Joan rather than doing its job on food. A different duty oncologist will see her today.

They are continually infusing fluid and at this time she has had about 3 litres and still more to come. More blood tests today.

She has had a very bad night and I will visit her with our son around 10am. Daughter Helen visited yesterday afternoon and a nurse told her she shouldn't come again until her cold was better.

Hospital for my Joan

Joan slept for 12.5 hours and when she got up this morning she immediately vomited the small glass full of water and her anti-nausea tablet. After that effort she returned to bed with the spins and almost no strength to walk.

I decided to ring the oncologist and after explaining what was happening he told me to bring her into the hospital to be admitted to do a full blood, urine and stool analysis and give her some intravenous fluids. When we arrived the onco's secretary had already made a booking of a single room in the general wing of the hospital and Joan is to be transferred to the oncology wing when a room becomes available.

A very efficient Asian nurse did all the necessary paperwork and called a doctor to start things. He introduced himself as Mohammad and in a heavy accent asked lots of questions about medications and treatment and previous illnesses. He then looked at Joan and said 'Why are you here?' I am guessing that it was 'lost in the translation' because it didn't sound good. Never-the-less things are starting to move, albeit slowly. When a nurse took the blood samples she asked if she was to mark them urgent. He said 'No'. Today being Friday I guess we may not get a result until Monday. He did however tell us that he was changing her anti nausea and anti gastro medications. Let's hope that does some good.

I left Joan and drove home. Coincidentally, as I was driving, a small white car raced up behind me and when I looked in the rear vision mirror I saw it was a delivery vehicle for a well-know auto parts company. The driver was a woman wearing a Hijab. Usually these delivery vehicles are driven by young blonde gals. Strange, but not bad at all.

Clutching at straws

Joan is sleeping more during the day which is not a good sign. Her inability to eat, or keep down what she can eat, is making her very weak.

Our neighbors are medicos...he is head of emergency surgery at a large private hospital and is she is a nurse. They have urged us to try acupuncture with a colleague of theirs who is also a GP. After last night’s sudden vomit attack where Joan lost her food as well as her chemotherapy tablets I am going to urge her to make an appointment with the acupuncturist today. Can’t hurt!

A friend who visited recently is sending us a bag of leaves of a native shrub from the desert areas of Australia which is claimed to cure cancer....once again we will give it a try, but once you get some knowledge about fighting cancer, you realise that each different form of cancer is fought using different chemo and it seems unlikely that one specific ‘herb’ is a cure all for cancer. The people who are selling the small bags of this ‘remarkable herb’ think that it is good so they are charging lots for it. Scaevola spinescens can be found here. Like acupuncture, it can’t hurt.

Joan is having another visit with the hypnotherapist she visited last week. This time he is bulk billing her...probably because we felt that he did no more than give her a pep talk. We want him to put her ‘under’ and suggest that the aversion to the smell, taste and texture of food is no longer present. Worth a try!

Ravens or Crows?

After the good news that Joan's chemo treatment seems to be working, she had a horror night and day with a constricted throat almost choking her when she attempted to drink in the morning. She will probably take another few days before she is able to eat and drink her meagre ration properly and ready herself for the next assault in three weeks. Too many other side effects to list. All of this is just to keep the tumours at bay!
A couple of days ago I was standing out the front of our house farewelling a friend and we observed a Raven land on our Pencil Pine tree (Cupressus sempervirens var. Sricta) right alongside us. The Raven had a tasty morsel in its beak and it pulled aside a branch and 'squirreled' the morsel into the tree, breaking off a small branch to cover up its cache. As I feed the various birds in our backyard I notice that Magpies take one piece of the offering and worry it as though killing an insect and then tossing it down the hatch, before looking around for more. The Crows (Ravens actually) go around collecting as much food as they can get in the beak and then fly up and hide their stash in a gutter and come back for more. Smart or greedy?

At last some good news

I am home waiting for a phone call from Joan to collect her at the Oncology ward at St John's Hospital in Subiaco. We had a meeting with a partner of her regular oncologist as The Man was overseas on a conference. Wish we could change over to this young doctor who was much more conversational and gave clear and detailed answers to our questions. The regular man should have my name on Joan's file, but every time we enter his office he greets Joan and ignores me. Not hard really....he could look to see what my name is or even say something general like 'Welcome folks'. I guess he may feel that the partner doesn't need as much attention as the patient.

Going in for the three weekly verdict is difficult. Has the CEA (blood tumour marker) continued to rise? etc etc. Today's visit was good in as much as the CEA had fallen from 4.400 to 3,500. Hooray! Getting back on Oxaliplatin did the job. It is difficult to describe the relief when getting good news.

I left Joan there for her 3 hour top-up of rat poison and will collect her around 3pm. The fill-in onco suggested that one of the drugs Joan started a week ago should kick in in about another week and it could help her appetite.

So it looks like Joan is back to a stable disease situation rather than one of a progressing disease. We hope that the next CT scan will show more tumour reductions.

We will celebrate with a nice bottle of Champagne.

PS. I collected Joan and we are now home. The infusion of Oxaliplatin really knocked her around this time. Swollen face, tingling mouth, throat and eyes and the Champagne will have to wait a couple of days until things settle down.