What is it about second opinions that reassures people? I can see circumstances where you may want reassurance for something traumatic. In most cases, I doubt a secon opinion is very helpful.

I am not talking about construction projects, or the installation of a furnace. We moved into our house 11 years ago. Our furnace seemed to have trouble keeping the house warm. The air conditioner that was highly praised by the previous owner was barely useful. Nothing more than an air circulator. I talked with the representatives of about 6 different furnace manufacturers. Like most industries. there are very few actual manufacturers. What looks like a diverse field is dominated by a few companies that market several brands. All claimed to have the best unit on the market and cited one item that distinguished them from the others.

One had an electronic ignition which they claimed was useful in that it was more efficient. Do not need a pilot light. Just saved myself $10 a year. Another had an anti-static drum that would prevent the accumulation of dust on the air intakes. Fantastic feature guaranteed to work for three years at least. Another had a 12volt fan which could stay on for ever circulating the air around the house. Highly useful. I guess. I came away from the exercise more confused than when I went in.

We finally replaced our furnace about three years ago. We hired the same contractor this year to install our central air without going fro a second opinion. We trust the contractor. He did a stellar job the first time, and again now.

One of my cousins visited me recently. One of the first things she asked is whether I was having liver surgery. No, I said, no such plans. She suggested I might want to go to Germany for said operation. It would only cost about $2,000. I should not rely on the opinion of my one doctor here. She understands that we are living with the constraints of universal health care. They often will not perform operations or provide other services to save money. I should not let that hold me back. Germany has wonderful services.

I accused her of having Health Care prejudices. This opened a whole other set of issues which I will not go into, a waste of time.

This advice was given without having any idea about how our system works, or at least the system in this hospital. There is a panel of doctors who look after us. Major decisions are made by the panel, not the individual doctor. This is a truly amazing system. Not only do you get a second opinion, but you get five of them. By the time I was set for surgery, I had four separate opinions. Why go after another?

The situation gets more complicated. We do not appear to understand the why’s and wherefores of cancer. We do know that I do not have liver cancer, but colon cancer in the liver. Same situation in the lungs. I finally understand the meaning of metastasized cancer.

An operation of the liver is a waste of time. The cancer cells are busy in both halves of the liver. Taking one half out, letting the liver regenerate, means that the cancer will just travel from the other half back to the first.

Why in the world would I want to second guess my doctor anyways? What makes me think for a second that I know better than my doctor. Should I go to Germany for the operation, who will look after me post operation? I have an appointment to see my surgeon tomorrow morning. This is 9 months after the operation. We talk and make sure all is right. It is not a long meeting. Am I supposed to after another local surgeon look after my needs following an operation in another country? Does not make sense to me on any level.

We were told that we have the right to a second opinion at any time prior to the operation. We were told to feel free to go to the Mayo Clinic or anywhere else we thought might provide some additional information or help. No one here would hold that against us. After being in this system for a year, researching, reading and contemplating alternatives, I can say that the doctors appreciate it when you know more, when you take the time to educate yourself and take charge of your destiny. At least my doctors do.

I think a second opinion is required because we do not like or trust the first opinion. We are hoping that the bad news is not as bad as it appears to be and want to hear a second voice.

I generally deal with people I trust. I trust my family doctor. We have been together for fifteen years and understand each other. She is a modern medicine woman, dispensing drugs to heal all. Anyone not comfortable with that should seek the advice of a traditional medicine person.

I trust my oncologist and his entourage. I trust my surgeon and her entourage. I am happy with the decisions taken. I will add resources as I see fit, as I can accept them, understand their significance.

The last Chemo session was followed by Neulasta and its effects. We took another week off to go to Montreal. No fuss from anyone. Live your life being our latest motto. And live we will.

Fetneh organised a lunch with a bunch of friends. I mentioned this before. We rented the Quartier Perse owned and operated by Mahin and her husband Siamack. They are friends of ours. Mahin barred Fetneh from making any decisions regarding the food.

We flew Porter from the Toronto island. What a Godsend that is. 15 minutes cab ride from our house is a small airport catering to short hauls. In this case Montreal. The Porter staff are very friendly and look after really well. We landed in Montreal and arrived at our apartment (courtesy Steve Mykolyn) at 3PM. This is more of a corporate apartment. Very sparse with the minimum amount of perks. Except for the abundance of magazines like Dwell, one of my all time favourites.

Fetneh joined us and I went to bed soon after she arrived.

This was very confusing. The flight was short and not tiring at all. Yet here I was exhausted and yearning fro a lie down. Janet and Fetneh went out for hamburgers which they brought back with them I was not hungry. Kept sleeping, waking up occasionally to the sound of the ladies enjoying their delectable dinner. Interrupted sleep is not an issue. My sleep is constantly interrupted by concerns of the colostomy bag coming off. I wake up regularly to check and make sure all is well. Waking up to the sound of people enjoying a meal is a whole other matter.

I was tired again on Friday. We went shopping int the morning. Had a cup of coffee and lousy apple turnover at this small coffee shop. Janet wanted to go to Simmons. Not sure why they do not open a store in Toronto. They would make a killing. Maybe Toronto is not fashionable enough for them.

I got tired very quickly. The nature of my fatigue appears to be changing. I cannot describe it very well. I seem to have energy until the batteries run out. I collapse and sleep off the fatigue only to start the process over again. Not much fun, and difficult to predict when the batteries are about to run out. I should talk with the Energizer people about this. I wanted to show Janet some stuff. No energy. I went down to the food court and sat down to see if that would help. It didn’t. I was not sure is If was noxious, or just tired. Was it fatigue or more than that. What more could there be. Janet wanted details which I could not supply. Working through the feelings.

I walked back to our apartment. Walking is often good for working things through the system. They would make us walk in the hospital. We had to walk three or four times a day. That was almost the first question the nurse would ask you. They made me walk a couple of days after surgery. I am not sure why walking has the effect it does. I often find myself burping a lot as the gases make their way out of your system. The stomach sometimes comes alive, which is a good thing. Walking is good. the walk back to the apartment was not long, just long enough. I slept until Janet came back. Still stayed in bed to rest for the evening.

We had dinner on Friday night with a few of our friends. Some of them would not be able to make it on Sunday afternoon. They wanted to see me, make sure I was OK. Don’t trust my entries in the blog. They want to hear it from me, see my face, make sure I am not lying. These are old time friends, since we first came to Canada some 42 years ago. We had a great time. Went to Chez Gauthier which has seen better days. The food was terrible, service went along with the food quality. No sense in rocking the boat. We were served an hour late. My brother went to see if he could speed things up to no avail. I went up to our waiter and told him flat out that I had cancer and needed to eat right away. Past my lack of food tolerance. Play the cards you have. They served our food within ten minutes, though I doubt it had to do with anything I said.

The company made up for the lack of quality elsewhere.

We spent Saturday having lunch with Ignacio at the very wonderful Hotel Saint Sulpice in Old Montreal Highly recommended. Good food and great service. I had a lobster club sandwich. Did not know club sandwiches came with lobster. On the other hand, why should they not? I have a soft spot for club sandwiches. Toasted brown bread, lots of mayonnaise, and more of it on the side. Mouth watering.

Fo’ad came by the apartment for a visit while I rested. Janet went, you guessed it, shopping. I rested and talked with my brother and eventually went to sleep. We had dinner at martin’s house. Great company and wonderful food made for a great evening. My main regret in all these things is that I have to leave early. Seems like I am cutting things short.

Brunch on Sunday at Fetneh’s apartment. Lunch at Mahin’s.

Fetneh tells me 56 people showed up, a lot of whom I do not know. A bit ironic that a lunch thrown in my honour attracted a bunch of people I do not know, who did not introduce themselves to me. It did not bother me any. Interesting to see all those friends and relatives. Interesting to see so many children. The next generation.

Mahin is an amazing cook. The food, all Persian was astounding. White rice, green rice, rice with fava beens, sour cherry rice (my mothers favourite). All of it complemented by kebab. Mouth watering, melt in your mouth, delicious Iranian kebab. I ate lots. No repercussions.

I sat outside and let people find me. I spent a lot of time talking with Barb Puky and her husband. Nushin and Mehran graced me with their time. Funny thing about friends of long standing. You do not need to get to know each other. You pick up where you left off. No conversation is taboo. We have gone through too much in our history to let small things get in the way.

Barb Puky has been friends with us since University. She was in the same dorm as Janet.

Nushin is related our family through one of my great uncles. My grandfather had two wives. The second after the first passed away. Nushin in related to us through this first marriage.

Mehran’s parents were friends with my parents. That is going back a long ways. Makes for easy conversations and a very relaxed afternoon.

The end of the afternoon was more emotional than the beginning. I had expected it to be the other way around. I was caught off guard. I did not cry when I met everyone. I did cry when we left. Everyone in Montreal has been very supportive. I cannot thank them enough.

Fetneh works for a lady called Hong Lan. The best description I have of her is that she is a Traditional Chinese Medicine Naturopath. Hong Lan asked to meet with me to discuss my situation. She appears impressed with the progress we have made and would like to contribute. I cannot tell you what we talked about. The conversation went on for over two hours including a deep breathing exercise. I was and still am overwhelmed by the amount of information she parted with. I will be back in Montreal in September for a second conversation.

I think that is all for now.

That is a strange expression if ever there was one. Janet and I went through a brief phase where we attempted to determine the origin of our expressions. It was taking too much time and effort. We gave up. I might have to start that exercise again.

I am bummed out. This has been an up and down week. My reaction to Neulasta went as expected. Tired, achy bones and so on. I only tool three Tylenol 1 pills to drive away the pain. Not bad considering my first experience with the drug. I got a lot done, which may be part of the problem.

I am not sure what it is that drives us constantly to the point of exhaustion. I discussed this briefly with a couple of other cancer patients and we all came up empty. It seems to be desire to feel useful again, after feeling like you are a parasite.

Did the laundry, OK, only half the laundry. Got the clothes in the washer, but no energy to transfer them to the dryer.

Visited my friend Sherry Ivankovic in Kitchener who has melanoma. She was supposed to be dead two and half years ago, but is still going strong. She also had a stroke to complicate matters which makes for interesting conversations. She loses track of what she is saying half way through a conversation. She repeats herself telling me a story on the phone, repeating the story in an eMail and again in person. Every iteration is as energetic as the first, as if is is the first time she is telling it. To all accounts, every time is the first time as far as she is concerned. We compared cancer notes. The similarities are endless. It helps to talk., Almost a sigh of relief when you notice the identical reactions to the drugs and our situation.

I visited another cancer patient, this one with pancreatic cancer who was admitted to the palliative care centre at the Princess Margaret Hospital. She should not be there right now. She was very strong when I went to see her. She was being released to go home for the weekend. She was admitted to allow the doctors to determine what pain medication would work best. Her pancreas and spleen were removed about eighteen months ago. She is still gracing us with her presence. I cannot imagine the amount of pain she is in. Stoic as ever, she still suffers. Morphine doesn’t cut it any more. New pain medication is being tested. I stayed with her for a while. Watched some soccer with her father. We talked quite a bit.

The conversations between cancer patients are very different when we are alone A lot more intimate. Small bits of information come out that are usually kept in the dark shadows of our existence. We allow ourselves the luxury of divulging and talking about stuff we would not normally discuss, even with our most intimate friends. A lot of stuff takes a while to digest, internalize, and finally verbalize in some fashion. The last part does not always happen. We prefer to keep some things very private. Don’t ask me for examples. Surely that would defeat the whole reasoning behind keeping some thoughts private.

I have been experiencing some pains for the past few days. I had to tell Janet about it. Notice the use of the word had. Did not want her to be concerned. I tend to think these things are normal and to be expected when we are subjected to our drug regimen. I had to tell her because I kept groaning and wincing every time I changed positions. The groans were totally involuntary and gave the game away. She is as always concerned and does not anything a being normal. Hard to know where the lines are.

I went to see an acupuncturist. My sister, quite rightly, thought it might help with increasing my energy levels, and might even affect my white blood cells in a positive way. I have tried acupuncture before quite successfully. That was years ago and I have lost track of my acupuncturist’s whereabouts. Hard to call her my acupuncturist when I saw her so many years ago. Went to a new person. A man named Tak. An experience not to be forgotten.

I arrived on time. Took off my shoes and went into his office which occupies the basement of what, I assume, is his house. I was asked to fill out the usual forms outlining the family history of diseases and conditions. Name, address, date of birth and so on. Illnesses during childhood: none. Illnesses during adolescence: none. Recent conditions and operations: colon cancer metastasized. Parental conditions: mother died of lung cancer, epileptic. There was last sheet that I presumed outlined side effects and conditions of taking the acupuncture. It was written in paragraph format while the rest of the document had questions and spaces for answers. I ignored the past page. This upset Tak enormously. I was chastised for not reading the page and providing answers. He was quite brusque about the whole thing. A man in my condition has other things wrong with him, and those are outlined in the last page.

I read the page and found nothing that pertained to me. I was fine except for the cancer part, and the fatigue, and low white blood cells. No gastro-intestinal issues, or whatever else he had on the list. You cannot imagine how upset he was by this. Impossible. This has never happened before. A man in my condition must have other things wrong with him. Whatever. I do not seem to fit into his mold. He seemed quite exasperated and finally asked: So why do you have cancer? The why question, as if we are to blame for getting cancer. There I was at the mall, there was a sale on and I thought I would give it a try and see how it fits. I replied that I would be more that happy to hear his reasons for people getting cancer. The answer to this riddle, should he know it, would make him a multi-billionaire. He did not appear to be amused by my response. I cannot help you, he says, since all you have is cancer.

We decided to give it a try anyways. I found the experience very relaxing. He left me on the table with the needles inserted in various parts of my legs, and a couple in my neck. The couple he inserted in the soles of my feet hurt a bit, but the rest were easy to get along with. He left me for a bit and I relaxed on the bed. Practiced my deep breathing exercises, and said some prayers. Almost fell asleep. He came back, removed the needles, made me lie on my side and applied some heat to various parts of the back and neck. Over. Done. Good bye. Paid him his $75. What a rough man. What a horrible way to treat a patient, let alone a cancer patient. I will have to write him expressing my dissatisfaction.

My nurse, Barb came by for her visit. She recommended another acupuncturist with whom I will get in touch shortly. What a flame out that experience was.

I have a lousy sense of direction. I am one of those people who would get lost coming out of a paper bag. I ask for directions all the time and fail to follow them, or misunderstand them or something. Such was the case when I went to Kitchener to see Sherry. A trip that should take a maximum of 90 minutes tool over three hours. I was quite out of sorts when I got home and went to bed at 6:30.

I have been totally exhausted ever since. I have been resting and sleeping a lot. Which is why I am bummed out. The Neulasta was supposed to have kicked in by now, boosting my energy. I will rest for the remainder of the day.

Tomorrow is a whole new adventure.

This has not been a stellar day. I have been very tired. I am guessing the Neulasta is taking its toll, quietly exercising its options on the bone marrow. The end result is good, more white blood cells. The trip is nothing short of horrific. I have to say that the last couple of shots have not been so bad. Hard to tell where each iteration of the drug will take you.

I sat in the backyard this morning, reading the paper, cup of coffee in hand. So cliche. So necessary. Why do we insists on living in a cold country? Warm climates are so much more hospitable, except for the deadly bugs and incessant hurricanes. Put that aside though, and you end up with a beautiful place to live.

There has been a lot of talk lately about global warming and rising sea levels. The possibility of islands disappearing and lives changing since the original habitat is about to disappear. There are always articles that prove the contrary, all going to show that we are really not certain about what is going on. There was an article recently that talked about an island that was changing to adapt itself to rising sea levels. I forget where I read the excerpt, but the original is here. Makes for an interesting read, if only you subscribe to the magazine. An island that is changing itself? Coral reefs reacting to rising sea levels?

Just goes to show that we, humans, as part of a natural species can also morph and change with the times. We have proven over and over again that we have the ability to adapt. We get sick and our bodies somehow change and adapt to the new conditions. We get tired and the body goes into overtime attempting to rectify the situation. Time and again, we discover how little we know. The more information we have, the more confused we get.

Malcolm Gladwell talks in one of his books about doctors being given information about patients and asked to provide a diagnosis. The more information they were given the more incorrect the diagnosis. The exercise found, in fact, that only four pieces of relevant information was required for a correct diagnosis. I think relevant is the operative word here. Only four pieces of information? We are now providing diagnostics on people with thousands of pieces of information. A CT-Scan creates 300 pictures with one click of the button. The technologist has to go through them and pick put the relevant picture that depicts the information he wants. Is there too much information?

I am not sure it would make much of a difference in my case. Reading the report is always a bit of a puzzle being deciphered. The last report mentioned the lack of tumor activity in the pancreas and kidneys. I did not know that was a concern, and it apparently is not. But the technician noticed the lack of activity and decided it was worth mentioning. By the way, no brain tumors either, not that we were looking there. And none in … Too much information.

The body has adapted. It is compensating for the drugs and allowing them to control things, but not have an effect on them. I was at the St Lawrence Market this past Saturday. One of the shop keepers who is aware of my situation asked how I was. I have developed immunity I said. Good thing no? No, bad. I explained why. He started laughing. It sounded like a good thing. Who knew developing immunity can be a bad thing.

I have been tired all day. Did some laundry, but am unable to finish it. Slept in the afternoon in spite of the construction next door. Still tired. Resting. Watching TV. I cried watching the opening scenes of Star Trek. I have seen this movie many times. There is really nothing to cry over. There I was, sitting on the couch crying. Weakness all around.

I am going to see a friend tomorrow who has melanoma. She was supposed to be dead three years ago. She says it is hard to kill a bitch. She has been so determined to stay alive that I am now forced to go see her. Not very considerate of her. I am looking forward to the visit. We are both putting on weight because of the steroids that are part of out diet. I wish I was building abs or something. I am, instead ballooning. I am up to 190lbs and rising. This after going from 210 to 180. I think there is a rest coming from the Chemo treatments, and therefore from the steroids. Weight should go back down. Hard to know what to wish for.

My new Chemo cocktail is called FOLFOX. It is comprised of three drugs. Always three. This regimen is given over a two day period. How do they come up with these things? One drug one day followed by 5FU over 22 hours. A second drug the second day followed by more infusion. Sounds exciting no? More side effects, though nothing new, White, red blood cell depletion along with platelets being affected. Nothing I am not going through now. All I need now is to develop immunity to Neulasta.

I get 5FU now. The attach the tube to your chest. Turns out the heat from the body improves the flow of the infusion. I give off a lot of heat. The 46 hour process of the infusion is usually done in 40 hours, and sometimes less, depending on my level of activity. The 22 hour process with the new regiment should also run for a shorter time period. Two days of treatment. Not looking forward to that.

This entry has rambled a bit. I am tired and will use that as my excuse.

I took public transit to the hospital. Janet and Devin are both working. This is really a non-issue. The streetcar is almost at our door. Very convenient. Arrived a bit early, taken in on time and released right on schedule. Another new nurse. Again, very official. Name, number and date of birth, over and over again.

The process is very normal and pain free by now. Even the side effects are taken in stride. Took a look at the blood results. My white blood cell count is down to 2.3 which is OK for Chemo. The cutoff occurs when the count goes below 1.5. My liver enzymes are not doing anything special. Some are up, others down. These are used as a guide more than anything else. Numbers going down would indicate stabilization, up would be a bit of a disaster. This has me a bit concerned. It is not a good sign and I am getting apprehensive about visiting the oncologist the next day. I will have the Neulasta shot on Thursday once disconnected from the baby bottle.

We went to see the oncologist on Wednesday, June 16th. It was a very short visit. Not much to say really. I am not showing any of the side effects they are looking for. No throwing up, lack of appetite, weight loss, upset anything. Just fatigue, discoloured skin, and cracking nails. Normal. I have stopped reacting to the treatments. The body has adjusted to all the drugs. This is as good as it gets. We are now in control mode. Five more sessions of Chemo, then maybe a rest for three months before moving on to the new cocktail.

We are planning to go to Montreal for the July long weekend. My brother Fo’ad will be joining us, some sort of small family get together. We did this about three years ago. We rent a restaurant called Quartier Perse for an afternoon. The owner, Mahin, loves us. Her food is amazing. Highly recommended. Tell her I sent you. We rent her place for an afternoon and invite all our friends to join us. Everyone gets to see everyone with very little fuss. No dishes to wash, house to clean, people to serve. I am looking forward to it.

We asked for another week off Chemo in order to enjoy Montreal with full strength of mind and body. Keep in mind that at the beginning of this adventure, a week off was not even a consideration. No fuss now. Too many chemicals in the body. Live your life. Go and enjoy.

Janet and I went home in a bit of a stupor. Not sure how to react to any of this. What do you mean this is as good as it gets, and live your life? My numbered days just appear to have become a lot smaller. The amazing Doctor Hedley does not give out numbers. So useless and build false expectations, or negativity depending on the numbers issued. Nor do we talk about Stage of Cancer. You are alive between stages 1 through 4, dead when you reach stage 5. Again, these are so arbitrary. They amount to nothing except making you fell either defeated or buoyant. Both false feelings.

The hidden message is unmistakable. I woke up from my stupor through the next couple of days. Spoke with Fetneh and Fo’ad. Kali and I had lunch and touched on the subject ever so briefly. No need to ruin a good lunch. Enjoy your life. Diana, Nancy, Judith all had words of comfort. None of us either know what any of this means, or are willing to broach the subject just yet.

I keep saying this, and I will say it again. I am feeling far too well for things to go awry now. I am strong and vital and am living a full life. I am in the process of designing a couple of web sites for a couple of friends. Both are computer businesses, but very different from one another. I am quite excited by the projects. I am living my life, and am not prepared for any interruptions.

We hired a gardener to look after our downtown hacienda. I no longer have the energy for it. He is very good and has made the garden look amazing. Very organized. Not my style. I like things to be more organic. Most people hate that. This is a good change, specially if we decide to sell the house at some point. I love to sit in either the back or front yards and just look at the garden, enjoy the trees and brush, and the very few flowers that manage to grow. We have far too many very mature trees in the backyard. The shady garden overshadows everything. Moss instead of grass. A pond in the back that gurgles in such a satisfying way. Calm and serene.

Janet and I sit on the front porch once in a while. Drink coffee and watch the passers by. Some one will occasionally look up and nod or murmur a very quiet and subdues “hi” as they walk by. No one feels comfortable opening the conversation, invading your space. I guess it does not help that we have a fence around our property, the better to protect the cats in a dog endowed neighbourhood. The dogs insist on chasing the cats who find refuge behind the iron fence. It is not a high fence allowing for easy conversation over it, but people are shy.

We have noticed that the bigger the house, the more likely people are to stay inside and not venture into the outdoors. A couple of our neighbours know about what is going on. Most just say hi and walk by. We had dinner last night at Marianne’s. She lives two doors to the east of us. John Brown who lives three doors to the west also joined us. I made rice. Marianne made steak. A glorious combination. I had a wonderful time. They are very supportive people full of love and comfort.

We are spending today at Philip’s, Janet’s brother, celebrating Fathers day. Devin is trying to take the day off, though I have no idea if he was successful. Philip has a swimming pool in his backyard. I might just go in for a swim and see how it goes. I have to cover my bag with one of those pregnancy skirts. All I need is for the bag to come off while in the pool. Yikes.

Live your life. New motto. Stay positive. Not that we weren’t. Just seems that a new sense of urgency is suddenly overshadowing everything else.

Janet and I will spend just a bit more time together, specially in the summer when there is so much to do and enjoy in this city.

Live your life. Good motto for all, methinks.

Thanks for listening.

All things become normal after a while. Repeat something often enough and you begin to believe it. So it goes with Chemo. I remember the trepidation of the first to or three sessions. What to expect? What will happen? You hear such stories from the good to the very bad. He went back to work [...]

I am going through a bizarre set of events. I keep thinking and thinking and the thoughts provoke new thoughts, and I reverse my position don’t care about this or that, come to new conclusions, confuse myself to all high hell. What else do I have to do? It turns out that I have a [...]

Cancer is a strange condition to find yourself in. I have written about this before.  People react as if you are dead already. They are then quick to tell you about their aunt’s best friend from high school who was given two months and lived for twenty years. 11.5 million people died from cancer worldwide [...]

This has been a busy week. Met with the surgeon yesterday. She is still very happy with the rate of progress. No talk of reconnecting the rectum to the colon yet. She is leaving the Toronto General Hospital and going across the street to join Mount Sinai Hospital.  She is taking her patients with her. [...]

Some rules of engagement first: 1. Do not insult or denigrate my mother 2. Do not insult or denigrate my doctors 3. Do not insult or denigrate my nurses 4. Do not insult or denigrate my family 5. Do not insult or denigrate my belief system 6. Keep your tone and comments civil so we can continue with the [...]

© 2010 I Have Cancer Suffusion theme by Sayontan Sinha