Sunday: progress with the slipway; the piles are all now in place ready for the main structural beams (visible on the deck ogf the work boat).

Update Wednesday: I have felt unwell, exhausted and depressed since I came back from London. I did not even have the energy to write diatribe on London buildings as I threatened in my last post. I made it to the river on Sunday with a lot of effort and I did a few things I had to do - like have a blood test. The rest of the time I have mooched around feeling that the valley (of the shadow of death) would soon open up ahead of me. I  am glad to say that I feel better today.

Tuesday - the new chemo regime started. It was a shorter session than many and the stuff has not yet had obvious side effects. I had helpful chats to a couple of the nurses in the Day Unit, which helped with the gloom and despondancy. I am also getting to admit that I need to plan my life differently, rather than living in (pleasant) denial.

Images of London in one go - the Tower and a real London bus with a platform at the back.

Wednesday to Friday: I went to London - met Aidan by the Tower and stayed over with him. Then visited Helen; we went on the river back from the Tate Modern (food and drink - not art) to the new pier at Vauxhall. Then to Covent Garden (old stamping ground) on Friday - more eating and drinking.

I was aware of it being much harder to breath - so I walked around quite slowly but still got too tired for comfort. I have the first chemo appointment booked in for Tuesday next week, with a blood test the day before - so I become medicalised again - better than the alternative but it makes me feel gloomy. There are weekly infusions (and blood tests) for three weeks and then a week without one - called a 'rest'!

I am not coping well with this - I feel too gloomy, breathless and tired to do so. But I am intending to go to geology as usual on Monday and to host a meeting here about the U3A web site on Tuesday. I am also trying to catch up with the general admin of life and writing to people.

The last pile put in place for the new slipway.

Progress on the slipway - last week - the last banging-in of the piles. This is just the start.

Also a new start in my life again at the end of the week. I had a review with the consultant on Friday and this time the Xray shows that the cancer is starting to stir again (like a volcano!). So an end to the carefree days of no chemo and not much worry.

We discussed various options and concluded that I should try something that is not as heavy as the stuff I had last time. So I am going to try gemcitabine. If this is not effective, then the choice can be extended to something else. It is not quite organised yet but I am likely to go to the Day Unit every fortnight for this and it will take about half an hour to feed it in.

I was upset and shocked on Friday - I had got used to life as it was, although I was not entirely surprised that it was starting up again. I have tried to draw on a few inner resources - not entirely successfully. But I went to the beach in sunshine yesterday and I have calmed down enough to write this update.

I am 70. I bought a badge and scanned it at a wonky angle for better effect.

I was looking for one that said 'I am 70' but they don't seem to have them in Ipswich or Woodbridge - they don't even have them for children. Maybe they are not in the best of  taste. Anyway - I will wear it sometimes as some sort of gesture of survival.

I visited the consultant yesterday - no long waits nor any boredom. The conclusion - the blood tests still show some effect of toxicity but nothing to get excited about. There is no sign of the cancer doing anything nasty - or indeed anything at all. So the Plan is to keep off the killer-chemicals and keep an eye on how I am and feel. So no side effects for a while - yippee.

I am going to try not to worry about it all as there is nothing I can do except eat vegetables and generally live a healthy life. Oh - and make sure I do not ignore symptoms that I ought not to ignore.

So am also finding a few brain-things to do - from geology to figuring out how to upgrade the U3A website - interspersed with scanning my photos - hard work and needs a new scanner.

Striding Edge in the Lake District - a metaphor

I have walked this several times - years ago. It is a metaphor for how my life feels just now. I walk in the sunny uplands rather than in the valley of the shadow - but it is often a narrow path with steep sides - and things can go wrong. It is a very beautiful, if scary, walk along the Edge to Helvellyn - so the metaphor is quite a good one.

Today I feel as if I might slip off the sunny uplands. Yesterday I was due to have a maintenance dose of Pemetrexed as usual but this was aborted becuase the blood test results for kidney function were outside the limits. Some more blood tests showed that it was not due to high blood sugar or leaching of calcium from my bones - which is a good thing. It is probably due to toxicities building up from the chemotherapy - and so I am off the drug for a couple of weeks. This has the advantage of no side-effects - but I worry about whether the 'holiday' from the chemo will allow the cancer to grow again (although I am told it won't grow in that short time!) and also whether it is knackering important organs. Fret - fret - worry - worry - all rather pointless but understandable.

So I take active steps to do stuff - a long session in the gym and now off nurture Lookfar in sunshine (for once).

Chemotherapy: Yesterday I was in the Day Unit in Ipswich hospital for (I hope) the last lot of the current chemo. I got there at 8-50 and left at 18-00 hrs. Typically - it was sunny all day whilst I was indoors - when I left - it clouded over and rained. The length of stay sounds worse than it was - I was not bored for very long - read the Guardian and looked at pictures of boats - and the chandlery catalogue.

I expect to feel OK for a couple of days - and then anticipate side-effects - especially fatigue - but not as bad as previously. At least there are some political sillies to watch on the tele.

The weather seems especially important - but it looks like cloud and rain into the future and I wonder whether I should stop looking out for the sun to shine - and then stop grumbling about it.

I have had some pleasant days - mostly in sunshine - since my last post. I did the usual things - ate out and walked along the river bank and watched the tide come in. I have also been to the shops (a big luxury if you have not been able to get to them much for a long time) and visited the marina and the boat. I have even sorted out getting the hull polished and the anti-fouling done by the boat yard, before launch in early May. This a statement of intent to potter around in the boat - in the sunshine - in the summer.

Black headed gull sitting on a life bouy. Most of the gulls around just now seem to be juvaniles - maybe the grown ups have gone off to lay eggs etc. 

Today - third lot of chemotherapy. This time it was in the Day Unit - which was much nicer as I was not in overnight - although it was a long process from about 8-45 to 17-30. I went with a lot of survival gear - magazines, newspapers, iced water and some food. I got a comfy chair next to the tea machine. I am not surprised that one gets side effects- for the chemicals themselves are fierce - and one also takes supportive medication for a few days.  I expect to feel OK tomorrow and then get fatigue for a week or so. Intend to sit it out - and avoid the rain. So I may even write emails but try to keep off the subject of symptoms and medical stuff.

Update: I went into Ipswich hospital to have the next lot of chemotherapy on Tuesday afternoon. It all went OK on Wednesday, although I got a bit short of sleep (as you do). The process is a bit trying as the infusion of various drugs and solutions takes 8 hours or so. It is immobilising but one can walk around with the drip machine - thank goodness  - as I am not good at sitting still. If there are side-effects they come later. Stayed in overnight on Wednesday as it was a late finish - so left this morning as soon as I could get out (after breakfast).

It seems to be working and I am due to go onto a different combination that does not require overnighters in hospital and is said to have fewer side effects - starts in about 4 weeks.

 I managed to sit out in the sun, overlooking the river, for a couple of hours - tee shirt and sun hat weather. So - let's hope the sun shines and the fatigue is just fatigue rather than life-zapping.

I saw the consultant this morning. The conclusion is that the chemotherapy is starting to work, so I will continue with it for a while (every three weeks). The side effects (even the fatigue) are, of course, better than the alternative.

All I have done is sit around feeling very much the worse for wear - just about able to totter at snail's pace around the flat. And do some very powerful sleeping.

I did get into Ipswich hospital - (a bed came available) - in ice and cold on Monday evening - ready for the chemo on Tuesday.

Tuesday - a heavy day. The complex infusions started mid afternoon and ended at half-past midnight. The morning a nightmare of wondering whether it would happen and being seen by various (helpful)  people. For example - a palliative care doctor. Exhausting. The afternoon and evening - a nightmare of boredom and exhaustion, especially as the machine that handles it appeared to malfunction - in fact it was the cannula - adding an extra 2 hours to the 7 that it takes in theory.

Today - I was released in the afternoon - after various tests. Good (if somewhat exhausting) to be home.

I have felt actually ill for over a week and since my visit to the caravan cafe last week I  have not been able to go out at all.

Add to that - I have yet to get chemotherapy (which involves an overnight stay) because there are no beds in the ward. I was hyped up yesterday for getting in and spent an unhappy day here instead - one of the darkest I have had. It seems as if it might take some time for a bed to be availabe - I guess I am in a queue - and meantime I still feel ill.

I saw the oncology consultant on Thursday.

There is no easy way to say this - it is easier to write about the nice things in life. I am in the valley of the shadow of death again, having lived in the sunny uplands (and some of them very sunny) for so long that I have perhaps forgotten the shadow.

The cancer is growing again, maybe not unexpected although the implications have not sunk in yet - and we do not have enough information to know where it will go. I have not taken cancer meditation for some time and  I cannot continue with the wonder-drug (Tarceva) on which I did pretty well for well over a year. I am to get another lot of chemo (combined peretrexed and cisplatin). The side effects are a lot harder than the chemo I have had in the last couple of years. I have to go into the oncology ward to get the treatment and then stay overnight, getting out the next day, all being well. This starts next Sunday.

 Dear friends - thanks for your support and communications - they comfort me beyond what I can express.

Appendix

Look back to around Sept 2009 for earlier references to the valley. It comes from:

Yea, though I walk through the valley of the shadow of death, I will fear no evil,
for thou art with me;
thy rod and thy staff comfort me.

What I had

I had pneumonia - which is a rather catch-all term. I may have had it for some time as I had not been well for a couple of weeks.

It all got worse - I breathed in part of a calcium tablet on Sunday (20th Nov). I did eventually ring 999 on Monday morning (21st - about 4-00 am) because I could not breath.

I was treated for aspiration pneumonia - which is an inflammation of lungs and airways due to breathing in foreign material. I was treated with high flow oxygen support, antibiotcs and steriods. I felt out of it and my memory of the first week is hazy, even if I spoke and wrote letters! Treatment was gentle and I very slowly improved. I think I came very close to death - it felt so and several people hinted as much  - - - .

Eventually I went into a normal ward and gradually got weaned off the oxygen support and each day got a small bit better. But I was in hospital for nearly five weeks. I think I left on the right day as I could just function OK at home.

I am now at home. I am reducing the dose of steriod very gradually. I think the recovery period is going to be long - months even. The worse you get with pneumonia - the longer it takes - apparently. Until now I have sat around, had a lot of sleep and managed to eat nice food. Getting netbook back on line is an improvement - I am watching for the onset of boredom.

Where are all the wigeon gone - - - -

9-40 hrs: I have only walked the river bank a few times lately - and only seen two wigeon - so I assume they have gone off somewhere exotic to lay eggs and generally work hard. There are fewer birds feeding along the river than usual - which I take as a subtle change ready for spring. There are lots of flowers on the sloe bushes - all ready to produce fruit for us to collect later in the year.

And my boat - still uncleaned - but I am going to get it in the water this month - so I can sit on it in the sun. I have not felt like doing it lately. Yesterday - rescue team training at the sailing club - mostly sitting on boats in the sun, giving my opinion about when to drop an anchor and drinking tea - fun.

I have not felt like writing for a while. I don't know if spending a couple of days on the Forums was too much for the system! But also I have been feeling less well for a few weeks and ran into the circular problem of living for the moment. If you live for the day - then there is no tomorrow - so you have to do everything today - and get exhausted and depressed as a result of not being able to do it all. I seem to have anemia as a side effect of Tarceva. It also seems that eating lots of beef (nice) and liver (ugh) does not do the trick because the Tarceva interfers with the development of red blood cells. Planning to do fewer annoying things - we will see - - -

A long view

18-00 hrs: I still produce graphs based on how I feel each day (according to my own score system) but I have not uploaded any of late. This one is a long view of this year - the single black line is a 28 day moving average.

I had a review with the consultant today and it looks as if Tarceva is doing the trick. I feel a lot better than I did and the Xrays show fewer cancer blobs. Keep on taking the pills!

The wonder-graph illustrates this and also shows the dip in July when Vinorelbine stopped working. I did get very used to the slight upward curve from March and found it hard to cope with the changes in July. So I am now glad to be able to demonstrate an upward curve again, especially as it has a much smoother trajectory such that I feel a little better each day - rather than having big ups and downs as I did before. The rash is very unsightly but - - I don't see it!

Next stop - rehabilitation - less boredom - more cycling and walking - and learning to like being retired.

10-50 hrs: Another review with the consultant at Ipswich hospital on Thursday - encouraging too much introspection. I was very anxious and walked around the hospital (to get an xray and a newspaper) like a zombie. The xray showed slightly less cancer than three weeks ago and the discussion was about further treatment. 

I am now taking Tarceva (Erlotinib). This is a different sort of substance which belongs to a group of cancer drugs known as an epidermal growth factor receptor inhibitors and is supposed to destroy the cancer cells without causing harm to normal cells. It is taken as a tablet every day and is apparently well tolerated - although there is a formidable list of possible side-effects.

No obvious effects or side-effects yet. Yesterday - the gym and a bit of hanging around in coffee bars. Today - the shops and a bit of hanging around at home. And then - less time spent looking inward and more going out - physically and metaphorically; and more pictures to flickr and on the blog.

Chemotherapy details

12-45 hrs: Very confusing - and several of you have asked about it - so I thought I would write it down and hope it lessens confusion.

• Sept to mid Dec 2009 - I was treated with a combination chemo therapy - carboplatin + vinorelbine. By November - the cancer did not show up on the Xrays anymore - although it was still there - just reduced in size and virulence.

• mid Dec to early August 2010- kept under control with vinorelbine, which keeps the cancer cells from growing again. This works for some indeterminate time and then the cancer becomes resistant and starts to spread again - called 'progression'. At this time my general health improved and I generally galivanted about - and got a lot stronger by going to the gym and doing weight training. From March I took this as a capsule once every two weeks - which was a user-friendly way of doing it.

I think it started to resist in late June - but gradually - and in a rather up-and-down manner. It was clear on an Xray in August that it was growing again quite scarily quickly.

• August 2010: I had one dose of a chemo-therapy combination called GemCarbo (Carboplatin + Gemcitabine) to keep further growth at bay (which it did) whilst it was ascertained whether I would be suitable for taking a relatively new substance - Tarceva (Erlotinib).

• From Sept 2nd 2010 - Tarceva (Erlotinib): I take this as a tablet every day. It too only works for a limited period - until the cells become resistant to it - but how limited is not known - it varies from person to person.

Brief update - chemo OK on Friday

18-40 hrs: A bit delayed with this post - largely through being out a lot day yesterday and today!

Feeding in the new chemo on Friday took until early afternoon and we came back and had sausage and chips to celebrate. How about this - - it seems to be working in that I felt better after lunch yesterday and have felt OK today - with much less breathlessness - with the result I have been walking around at a much more normal pace. I plan to chill out and maybe wander down to the boat and the sailing club - but not push my luck. How very sensible - -

Swallows and - a trip to oncology in Ipswich

19-50 hrs: The best bit about today was taking some pictures of the swallows resident under the roof of the clubhouse balcony - and watching the dinghy racing. A heavy shower and then no wind meant that a lot did not finish and some were towed home.

This morning - a review from the consultant - concluding that the cancer has started to progress again. An appointment made for tomorrow for some different chemo-therapy, this time delivered (as they say) through a cannula in the Day Unit in the hospital. Not nice - but better than the alternative. This is a temporary measure and I will eventually (when some other tests are done) go onto a further treatment with a newer substance. I suspected this but may not have said as much in so many words. It is difficult to know how to keep a balance on the blog - as I say every time I write about anything other than sailing! I have had a good year in many ways and would like the good times to rock on - - and on - -

 - dear friends and followers - I thank you again for reading this and for the support your very presence has given me - I will be in contact - am spending the rest of today preparing my survival gear for tomorrow and then grossing out. xx