Martin's personal blog

Hospitalisation

2011-01-25T16:06:00.000-05:00

This is to tell you that I have been in the hospital entering my third week now. Food was not passing through my intestin anymore so we had to deal with the issue urgently.
The situation is getting better but I am still in the hospital for an undetermined lenght of time.

I'll try to keep you posted with my progress as often as I can. You can get news through facebook also.

until next time!

Postponed chemo

2010-10-21T11:48:00.001-04:00

Tuesday morning 6:00 am, Marie-Josée and I are en route for the hospital. As you know I must start my treatments by 7:30 am no later. Our eldest son is the babysitter for this morning. He is a certified babysitter now, with his two day seminar on babysitting and CPR.
I get into the hospital while my wife returns home to prepare lunches and snacks for the children and send them off to school. The third floor ward in oncology opens at 7:30 so I have time to go have breakfast at the hospital cafeteria.

7:30 am the first nurse shows up. She seems a bit surprise to see me there but since she knows how long my treatment is she tells me to go sit in one of the treatment rooms so she can set up my port-O-cath. When she comes in the room she asks me if the coordinating nurse left me a message. I say no. She them tells me that my neutrophils count (white blood cells) is too low so they won’t give me my chemo today. It is delayed for a week. To be sure, I wait for G, the scheduling nurse, to arrive. Upon her arrival she confirms that she left a message yesterday around 3:30 pm to say that upon consulting with Dr L., she rescheduled me for next week.

Conclusion my wife and I woke up early and travelled to the hospital for nothing.

I call MJ who has to get in traffic again to come and get me. It was a rock'n'roll morning for her. Plus it’s my fault because I did not get my Neupogen injection which serves to boost the number of white blood cells. I told my wife that I felt in top shape and thought that I did not need the injections…I was wrong.
You can be sure that this weekend MJ will inject me a couple of times with Neupogen so that next week I will have enough WBC to receive my chemo.

Clinical trials

2010-10-12T11:24:00.000-04:00

I think you have waited enough with my message on Facebook. I apologize.
Here's the situation.
In my last appointment with Dr L he told me about a research protocol in the United States. A former colleague of his left for Bethesda, Maryland at the National Cancer Institute (NCI), part of the National Health Institute (NIH) for a fellowship in surgical oncology. This colleague presented a protocol that is in the field of immunotherapy and Dr. L thought of me as soon as he heard the details of the study. I seemed to be the ideal candidate.
The protocol
In summary, the research is as follows:
They remove a tumour (surgery) and in laboratory they extract TIL cells (tumor infiltrating lymphocytes). Lymphocytes are a type of killer white blood cells. Those sought have successfully penetrated the tumour therefore have good potential to kill the it. If it did not happen yet, a theory is that perhaps they were not numerous enough. The researchers then multiply in test tubes (in vitro or ex vivo) the TIL that were extracted. they then enrich the multiplied TILs with another kind of cell called CD8+, another specialized cell killer. A kind of "Marines" lymphocytes.
This enriched cocktail is given back to the patient after having weakened his immune system to receive the autologous transplant. After that the cells "boosted" are supposed to re-enter tumours and do their job until the end.
It is a treatment that has been tested in other cancers such as melanoma, with enough success so that now researchers are trying it in other cancers such as colon cancer.
Our excitement was very high, particularly in our conversation with Dr. L where he said that this protocol was a potential cure. Word he never mentioned when talking about chemo.
Conclusion
We submitted all the necessary elements to Dr. Turcotte in the United States. After a week of waiting, I received the following message from him:
I received:
- Pathology reports of HSC and HND,
- A CT report dated 13/04/2010 which raised the possibility of recurrence in the left hypochondrium
- A PET-CT report of 06/08/2010 that supports the idea that the abnormality in the left hypochondrium could be a recurrence.
There is no evidence in these reports of liver metastases, pulmonary, peritoneal, good size tumour (at least 3 cubic centimeter) that we could resect to produce cells that serve in your treatment.
There is also no measurable lesions frankly (at least 1 cm) that could serve as a witness to the effectiveness of our treatment.
These data do not qualify you for our study, they suggest, and that's good news, if there is a recurrence, the therapy used presently seems to control the spread and progression of your cancer.

So you read the same thing as me. I'm not accepted in the study because my illness is actually too small right now. In a sense this is extremely positive as it reaffirms that I have no damage to the liver, lung or peritoneal lining big enough to meet the requirements of the study.
At the same time I have some disappointment because I already saw this treatment as a cure BUT I must continue the chemo for now.
My focus now is on achieving the same result as the protocol but without it. Maybe I can boost my TILs myself.

Keep going

2010-09-21T14:38:00.002-04:00

That’s what we are doing. Last week was my third FOLFOX chemo treatment with the new prolonged protocol. This time though we added an infusion of calcium-magnesium, an extra hour. My case puts a lot of pressure on the medical personnel, nurses and pharmacists, because timing is very tight. In order to have my treatment fit within the day I need to be “plugged” no later than 7:30 am so to finish around 5:00 pm. Since the first shift of nurses in the oncology clinic starts at 7:30, you can imagine the type of rush that M. Raymond creates. I am starting to be known around the department for not quite the reasons I wish for.

The calcium-magnesium infusion is supposed to help with the neuropathy caused by Oxaliplatin. Neuropathy=finger tingling and throat that stings when exposed to cold (sometimes without the cold also). For now it is not that bad but I need to adjust like when I go to the hockey or figure skating practice. I wear gloves and it helps a bit. The effect is worst when I take something in my hands, when there is pressure on my skin. But again it is not all the time for now. It may become permanent later on, we’ll see.

I want to tell you about our last appointment with Dr L my haematologist but in order for you to understand the whole story I need to update you on my situation. I have not done that yet because I wanted to spare my children and I think that my eldest son reads my blog from time to time.

My last scan showed a small progression.Two new small tumours appeared, there 1 cm long (half an inch) and the tumour that was stable at 1 cm since January is now 2 cm (close to an inch). It’s not big but the progression triggered my haematologist to change protocol. Since there is no more choices for me we had to revert to the first cocktail that was used, FOLFOX, to which I had had a bad reaction in 2009 (drop in blood pressure, sweating etc.). In order to be able to try this again we needed to use a modified protocol on administration. Where it used to be infused in 2 hours is now 8 hours. Very diluted solutions at first with slow increase through the 8 hours. I also take anti allergic medication the two days prior to the chemo. The other effect of the progression is the cessation of Avastin (Bevacizumab). This product is one of the most recent discoveries of cancer research (about 10 years ago). It has to be given at the same time as FOLFOX (or FOLFIRI) and it increases progression free survival or straight survival time. But since there was progression while using Avastin, government says no more Avastin (it stops paying for it). But there are some data that suggests that Avastin should be continued because there seemed to be a benefit. Unfortunately these studies are open label and not randomised so the government do not consider them. As you may remember, Avastin in my case cost $2000 each dose to repeat every two weeks.

We discussed this situation with Dr L and MJ wants me to have Avastin. We both believe this product was fundamental in the great response I had in 2008 where my tumours shranked enough to open up the possibility of surgery. Dr L mentioned that it was possible to get Avastin in a private clinic if we had insurance. So MJ started working on it with Manon, her benefits manager, and with the extraordinary collaboration of the people from the insurance broker and support from her boss. They were successful in getting Avastin reimbursed for 6 months. I take this opportunity to thank everyone that work and make decisions that directly impact my life.

Back to the appointment

When we arrived in his office Dr L was anxious to hear from my wife if she was successful in getting the reimbursement. He sat back in his chair with his arms behind his head as if to say “so how did you do it”. MJ explained that she worked hard for two weeks and that she got Roche, Avastin’s manufacturer, involved. When she finished relating the details Dr L had a big smile on his face and said ”you’re very efficient, sometimes I wish you were on my team”. He added that he was not really surprised because he had come to know my wife in the last two years. He has witnessed her drive on a few occasions namely the white blood cells episode. MJ has a knack for getting her way without making enemies. He has come to know her character but he never asked about what she does for a living. What do you do for a living? He asked. Vice-president of Human Resources for a company of 4000 employees, I responded. I jumped in because MJ tends to say she is an HR manager which I believe is a huge understatement. Dr L nodded and said: you have what it takes to do that job.

I’m telling the story because I am extremely proud of my wife. I don’t think people that meet her have an idea of her qualities and the depth of her professional achievement.

Latest books

I just finished “My Life In France”, from Julia Child. It tells the story of her days in France in the fifties and the sixties. I stumbled on that book while browsing the Kindle catalogue. It was fun reading, light hearted and it takes you back in another era. It also made me curious about the recent movie Julie & Julia. I will definitely rent it soon.

Just before that I finished Outliers that I mentioned in my blog “crossroads”. I recommend this book to everybody. It is very interesting. Now I am reading Energy Leadership from Bruce D. Schneider. This book is the introduction to a certification course on coaching that MJ wants to register for. She was asked to read the book before making her final decision. The certification is spread over 9 months with four weekends in New York in a group. She is very excited about learning at a high level, a bit like it would be her masters degree. I am behind her 100%, she just needs to have the OK from her boss.

Have a good week!

Dr. Oz’s colonoscopy | The Dr. Oz Show

2010-09-08T16:54:00.001-04:00

For those of you who didn’t know Dr Oz turned 50 this summer. Since he tries to practice what he preaches he had a colonoscopy done. They taped everything for his show. It is really interesting to watch as much for those of you who already went through the procedure as for those of you still procrastinating. Maybe these videos will make you act and get screened.

Directly from his site.

See how colon cancer grows and spreads through the body, and how a colonoscopy is performed.

Dr. Oz takes you behind the scenes of his routine colonoscopy and the shocking outcome he never expected: the discovery of a precancerous polyp. Watch Dr. Oz as he deals with the reality of his diagnosis and emphasizes the need for preventive screenings. Learn more about the test that saved his life and what you can do to save your own.

Click here to watch Part 1: Dr. Oz at home as he prepares for his first colonoscopy.

Click here to watch Part 2: Witness the actual procedure and the moment when Dr. Oz’s physician discovers the precancerous polyp.

Click here to watch Part 3: Dr. Oz’s physician delivers the diagnosis: an adenomatous polyp, the kind that would have likely developed into cancer if left undetected and untreated.

Click here to watch Part 4: Dr. Oz becomes the patient. Here, he discusses the reality of his results and stresses the importance of getting a colonoscopy screening. Fact: 32,000 people die from colon cancer every year because they were never screened.

Click here to watch Part 5: Dr. Oz discusses how colonoscopy is a major preventive measure in protecting your health and explains the colon cancer risk factors.

Hospital Admission

2010-08-16T17:00:00.001-04:00

I just got the confirmation. I will be admitted into Sacre-Coeur Hospital tonight at 8. On vient de me confirmer le tout. Je serai admis à l’hôpital Sacré-Coeur ce soir à 20:00.

They even told me my room number, 342. Don’t bother visiting thoug because my stay is short and I will probably be sleeping most of the time.

More news as soon as I can.

Ciao!

Crossroads

2010-08-14T17:42:00.000-04:00

We're back from vacation and as I had announced I had a PET scan on August 6 and we got the results on the 10. I have lots of things to talk about so I'll start with the news.
The scan report triggered my haematologist to change my treatment . Those of you who have read read my blog for a while know that I don’t have many options because I am KRAS mutant which eliminates therapy with Vectibix and Erbitux. So we can do two things: Clinical trials or resume Oxaliplatin. Oxaliplatin is the ox in FOLFOX, the cocktail that I took at the beginning and that was pretty effective. Unfortunately, I had an allergic reaction so we had to stop therapy in January 2009.
My haematologist considering the significantly positive response that I had to FOLFOX (shrinking of tumors), thinks it’s worth trying a challenge to Oxaliplatin. That’s why I'm going to be hospitalized on Monday and Tuesday of this week. I will be on tight medical supervision and they will try to give me Oxaliplatin over eight hours instead of 2. An infusion much slower than usual which could allow my body to tolerate the treatment.
We'll know soon enough.
Otherwise there are three studies currently in the U.S. on promising products for cases like mine. I must discuss them with my haematologist in order to decide which one to register into. In my next blog I will give you the details of these studies.
Apart from that our holidays were fantastic. Aside from the three cockroaches in our rooms and the iffy temperature on the cruise, everything was perfect.
The photos are on Facebook but for those who are not connected with Marie-Josee the following links will allow you to see the albums.
Cruise and Orlando and Palm Beach.
During my vacation I read a lot. I started with two magazines bought at the Montreal airport. One on the topic of technology in the medieval times and the other on the theory of evolution revised because of new discoveries. Some very interesting reading.
Then I read the latest novel by Michael Crichton, Pirates Latitudes. Interesting story since I was always sailing the carribeans while reading it. Then I read Jordan’s youth novel because he found it so good. Then on my new digital book reader, the Kindle DX, I read Blink by Malcolm Gladwell. I had already read his other book called The Tipping Point and I appreciated his style, a cross between a research report and an opinion piece. Blink speaks of the phenomenon of intuition or what he calls Adaptive Unconscious. It attempts to show that sometimes it is better to make decisions without much analysis, but instead to follow our gut feeling.
I also read an old story, Shogun, a novel about medieval Japan. I then started reading Malcolm Gladwell’s (again) Outlier, after reading Stanley Gold’s story: Cancel the Funeral, I'd Rather Play Golf. He shares with us how he survived a metastatic melanoma.
All this reading motivate my children to read to. At the restaurant, people would comment on their concentration on their books.
Tomorrow I will start my preparation for hospital stay. I have to take Singulair to help my body fight any reactive inflammation.

I will write again as soon as I can.
Ciao!

Time

2010-04-16T13:55:00.002-04:00

Time is a fascinating subject, complex and simple at the same time. I wanted to talk about it because lately at the end of a day I thought that time goes by fast. My reflections led me to want to do more in my day, don't lose your time, don't waste it. Especially since we don't really know how long we have left, you and me the same.

So I told myself that as I need to accelerate my tempo so to fill my days. But there is a paradox. Since my diagnosis the message I perceive from my readings or my conversations is: Take your time, enjoy the moment, slow down and embrace life.

In addition, some studies show that stress can promote the development of cancer so the goal is to reduce stress, in other words slow the pace of life.

But there is another paradox, the slow pace can reduce stress and impact on the physical but at the same time it can increase my mental stress because I did not do everytthing I wanted. I exaggerate a little to illustrate my state of mind ... An internal conflict that sometimes I have between wanting to do a lot and wanting to slow down and enjoy the moment.

Note: The basic assumption is that you can not enjoy the present moment by having a life at full speed. It would be like trying to smell a flower on the side of the road while driving at 100km / h.

I hear you telling me it's about compromises and choices. That's life: a series of choices.

I hope that everyone adheres to this idea that everything in life is a matter of choice (read Stephen Covey to be convinced). There is great freedom in being able to choose and it is also a heavy responsibility sometimes. So much so that some will deny their responsability by blaming genetics or external factors. Example: after an angry outburst someone would say sorry it's not my fault I was born like thiss or sorry sweetheart but my boss asks me so many things that I could not leave the office before. Wrong, these people must accept that they have chosen to throw a tantrum or not to leave the office earlier. The reasons for their choices may be valid or not but the fact remains that it is a choice they made.

Let us return to our subject of time and choices to make. I'm curious by nature so I want to touch a lot. I want to do yoga, judo, practice guitar, listen to music proposed by our club. I also want to be a good husband and a good father, so I want to spend time with my wife fully concentrate on her needs and I want to play with my children and focus completely on their needs. I also want to start a business and be proud of it and I want my father-in-law to be proud of the support he gives me in this venture.

All these things do not easily fit into an agenda that is not open from 6:00 in the morning to 23:00 at night.

Therefore I need to make choices and I do. I take my responsibility for these choices, but not always easyly. There are days like the one that triggered the text where I question myself. Did I do enough? At this moment, I am reminded of my friend Sylvain who once told me: Everyday, Martin, you do your best and you can not demand more of yourself. God himself does not ask more than that.

So, what is time for you, does it go quickly or slowly. Do you enjoy time passing by, the present?

Santé!

Folding socks

2010-03-10T13:05:00.001-05:00

I just finished folding fifty pairs of socks. Any fan of this activity among you guys? People who thrive on folding socks...

I can't say it's my favorite activity, but if there is one one thing that MJ, my wife, lets me do without arguing it's that. Me, I let her do the dishes, laundry, grocery ... Finally, pretty much everything else that comes with managing the household. Folding the socks is a minor contribution.

It has gotten to the point where I have developed a method. I had to when 80% of our socks are navy blue or black. In fact the easiest part is Elodie's. They are brightly colored, like pink or purple, and smaller. The challenge is the boys'. My method is to group by colors first or should I say hues, less dark blue together, black in another package and the rest in a final package. Of course, beforehand, I separated the white and sports socks.

In the three dark socks piles, I separate again based on the "pattern" or style. Some are textured only on the upper half, others throughout the length. I can also subdivide based on fabric, polyester or cotton.

Then I take each package separately and spread each sock next to the other in line as for a military review. At this time the operation is done in a very bright light to properly detect the subtle differences in color. I begin to "pair" but sometimes there are still more than 2 socks that can form a pair. At this point I need to rely on my judgement and decide.

After this whole process always remains some orphans. Tonight ... about fifteen ophans are on the table. They will remain in the basket until the next batch unless I find their soul mate in a drawer, alone, awaiting a reunion.

I hope my story put a smile on your face. For me, it brought back memories of my youth. On Saturday evenings watching hockey it was the only personal contribution that my mother would ask of me in the management of her household: folding socks and face cloths on the kitchen table. I was not doing the dishes or my bed...

Santé!

It Ain't Over

2010-02-24T18:26:00.004-05:00

Hello everyone,
I know there is some delay between my messages but don't worry things are going well even though I don't write as often.
My time is shared between the chemotherapy treatments, doctor appointments or my psychologist appointments and my family activities.
Indeed since January we went out 4 times (three for me) for cross-country skiing and went to Stowe, Vermont for a ski weekend.
My father-in-law is now back in Canada for his retirement and he spoils us often dining out or with homecooked meal by Loulou (his wife).
We celebrated Valentine's day at home with the family of Marie-Josée. Big party with loud music which had Windows shaking.
Two of my brothers come to spend time with me during my non-chemotherapy week and helps me keep my morale up playing X - BOX 360. Football and hockey of course although we haven't managed to beat the system... yet.

Of course in the last week I spend a lot of time watching the Olympics (day and night).

Yesterday, we had the opportunity to introduce our two boys to a rock show at the Bell centre, Clapton- Beck tour. Fantastic! Thanks to my niece Myrelle for the tickets at an incredible price.
So little time and little inspiration to write...

The meeting with Dr. L mentioned in my previous message was special and here's why. We had not seen him since December 2, not seen since the pet scan. Our nurse called to tell us that he wanted to see us on January 14 even if he was not seeing patients that week. Naturally, the reaction of Marie-Josée and I was a little anxious. Why was it so important to give us the results of the scan while there is no appointments that week. To Josée this meant bad news. For my part, I was scared too. We therefore had an OMPAC counselor (Multi resources agency for people with cancer). Charming lady who has helped us to prepare for all eventualities. Finally, news were good as I mentioned in my other message and Dr. L explained to us that he was leaving for two weeks, and he did not want to leave us without news that long. That is why he made a special effort to see us in-between two commitments at the hospital... not because the news were bad. It goes without saying that we were very excited by the news, Marie-Josée even more than myself because I believe she expected the worst.

We also had an appointment with my surgeon Dr. Y. He got the pet scan results by his Secretary who read the summary on the phone. We could see his face illuminate. It was excellent news for him also. He had unfortunately had to leave a tumour in place in June because it was too dangerous to attempt to extract it, so he expected to see some tumor on the pet scan. He was pleasantly surprised to find that out that the scan didn't show any. It is therefore possible that the HIPEC procedure has successfully eliminated whatever he had left. As for the 1cm ganglion, he told me he could not go in to remove it because he would not find it. He said that at this size, with blood in the cavity, it would be impossible to locate.
What this tells me is that it is not worth worrying about it for the moment. We will monitor it with another scan in 2-3 months and we will not let it become a problem.
If you go by the hospital Sacre-Coeur on Wednesday 24, I will be getting my third chemotherapy. You can come and say HI between 10:00 and 14:30.
Have a good day!

Martin

H1N1

2009-11-07T13:04:00.000-05:00

What are the odds that someone in my family develops influenza A (H1N1) the week we've been vaccinated? I do not know but it happened. My little Elodie 6 years old started having symptoms the same day that we have been vaccinated. The whole family was vaccinated at home because of my health status. We were very pleased to receive this service. But after three days of intense fever, Mom went with Elodie to the Lakeshore hospital emergency where Grandma works. In a snap, they diagnosed Élodie with strep throat. They still proceeded to test for influenza A (H1N1). In the evening we received a call, the test is positive for influenza. Is it H1N1, we'll know later. Friday evening, another call IT IS H1N1. Emergency procedures are put in place, everyone wears a mask. Marie-Josée disinfected the entire master bedroom and adjoining bathroom so that I can be in quarantine. No contact with Elodie, or even the boys. Marie-Josée brings me my food with gloves and a mask. She is the only one to come in and out of our room. I talk to my children from a distance. All this affects Jordan quite a bit, he saw the news of the boy who died and is totally stressed.

I try to tell them to take this as an adventure. We must be diligent and keep our masks on and wash our hands more often than not. Given the period of contagion, we must keep this protocol until Tuesday at least, unless another child or Marie-Josee develops symptoms. Currently Jordan is a little bit tired but he does not seem to have the flu ... yet.

I started on Tamiflu for prevention and I remain isolated, I am not taking chances.

I will keep you posted.

Santé!

October 23rd, 1965 -

2009-10-23T21:49:00.000-04:00

It's my birthday. No this is not the beginning of my epithet. I am 44 years old today. 15 months post diagnosis and 4 ½ months after surgery.

The situation is stable. The markers are 9.7 (4.4, 9.5, 8 and 9.7). The scan does not show anything significant according to my hematologist. By pushing a little, he explains that inflammation is visible around the stomach in the region of the anastomosis, but it's nothing unexpected considering what has happened in my abdomen in June . As for cancer nothing is visible, which is a good sign. We will continue the hunt to catch it as it appears.

This is my third treatment with the addition of irinotecan. After 48 hours it goes well ... it is OK. I will not deny that this combination weakens me more. I am really lying down for 48 hours not eating much. After I gradually introduce food according to my hunger. This morning toast with peanut butter with green tea. At noon a mini salad: boiled egg, cherry tomato, feta cheese with a dressing made of olive oil, turmeric, black pepper, balsamic vinegar small green onions (scallions).

Tonight at 20:30, a dish of vegetable couscous with red cabbage salad, half a pita with garlic sauce, washed down with fruit juice.

I'll get a final green tea in front of the fireplace where Jordan started a fire and then take drugs just to sleep until tomorrow.

Good Health!

Life with cancer, perspective of natural care-giver

2009-09-20T03:41:00.001-04:00

Let me share with you how I live daily with Martin's cancer. As you may imagine, I lived through all kinds of emotions, amd I'll continue to do so: shock, anger, denial, sadness ...

These emotions are surfacing at any time without warning. A song, a look, a hug, a comment and BANG! But eventually I was able to accept them and say tell myself: they are only passing through. Then we return to our life, one child asks for a glass of milk and life continues.

Luckily life gave me a great mental and physical strength, perhaps in anticipation of what would happen later. That determination combined with Martin's made us break down doors to get answers. We really took over the illness and as you know so well "no" was never an option for us. The most amazing is that the days when the strenght dips in one of us, the other hastened to restore it. Martin and I are definitely an amazing team.

The disruption that followed the diagnosis in July 2008 quickly gave way to a new routine. One comes to accept the disease, it is part of the family dynamics and it revolves around it. I assure you that the days where he is top shape, we take full advantage of it. The other days we surround him with our love while he recovers. My sadness on thos difficult chemo days is now replaced by my appreciation of the fact that he is still with us and he leads the battle with such humility and courage. I consider myself so lucky to have him in my life.

The most difficult for me in this adventure is the uncertainty. The resulting insecurity of our children saddens me. Anecdote, during a recent business trip to Toronto, my daughter called me several times saying: "But Mom when are you coming back? What happens if Dad is sick without you, we're children and can not care for him. "I did my best to reassure her.

When people ask me the question but how do you do it? I'd say my salvation over the past 14 months was to keep busy, taking charge of the medical file, taking care of my loved ones, my career keeps me busy and of course running. The more I keep busy with projects, the better for me.

In conclusion, I would encourage you to break your silence and show your support by writing to us. I know many of you read the blog and send positive vibes. If only you would see the smile on Martin's face when one of his faithful readers leaves a word of encouragement. It feeds him for the day!

We continue the battle and we need you all. After all, strength is in unity ;-)

Yours truly,

Marie-Josee
The wife of a cancer survivor

How much is life worth?

2009-09-11T02:43:00.001-04:00

It's Friday 4:00 PM. François just disconnected my 5-FU bottle. I have not slept as much as I would of liked today, but now that my bottle is off I'll try to get an hour of sleep (after writing this of course).

I got feedback on my last blog. The consensus is that I should write more regularly, even if only to say that all is well. So I told myself that I would try to have some regularity, say once a week.

Yesterday, Barry Stein sent me an article published in the Globe and Mail, written by Andre Picard, which was attached to his reply as president of the Colorectal Cancer Association of Canada. My wife was furious after reading the article and has also written to the journalist. The latter replied almost immediately (it was midnight). For my part, the article kinda upset me a little. As my wife mentioned in her email to the journalist, to be able to write this kind of thing you can't possibly have lived the horrors of cancer, near or far.

The article is titled: We do have to put a price on life. You can read it by clicking the title or just keep reading because I reproduce the article and the response from Barry and Marie-Josée's e-mail.

Before let me give you my opinion which I have not sent to Mr. Picard. Every citizen is entitled to his opinion and as a journalist he has the right to try to raise a debate on a matter of public interest because our health system is financed by the government (so all of us). However I find unhealthy to oversimplify complex ethical questions. The basis of his text is an article published in the United States by two oncologists who supposedly analyzed the cost-benefit of the use of certain new drugs against cancer. Mr. Picard does not seem to have made a critical reading of the text in question because he has not made the effort to check prices in Canada which are lower than those cited. Then, what bugs me the most is that they look at the statistical median to question the effectiveness of drugs. As you know, I decided not to worry about statistics, especially the median, because when we speak of human life and death, the average is worth shit. I can not imagine they would refuse a potentially life-saving treatment based on the fact that the average survival is not long enough. If that person was one that was above the median. Worse, in statistics they take out outliers. So somebody could survive 15 years and it would not influence the average because it is not part of the calculation. In any case, I am very happy that, thanks to Barry, the Quebec government reimburses Avastin (bevacizumab), I could not have fought advanced cancer successfully without it. I have 14 months of survival that is already more than the median that of clinical studies show, and I know I'm going to extend this figure by far (like 35 years). Imagine if Mr. Picard refused to treat me with Avastin, he would have made a great mistake.

I initially said it was unhealthy as a discussion point because if we consider the cost in all our actions we would not have finished analyzing all kinds of expenses. Should we try to rehabilitate hardened criminals or simply reinstate the death penalty? Prisons cost a lot of money don't they? Should we keep a coast guard to go rescue people at sea at astronomical costs (helicopters are expensive). Why do ministers travel in limousine instead of a Honda Fit? It's a dumb question, right? That's what I think of his' as well.

Here is the article and Barry's response:

Original Article is copied below.
Dear Sirs,
As a colorectal cancer survivor and as president of the Colorectal Cancer Association of Canada, I read with great interest André Picard’s article of September 10, 2009, “We do have to put a price on Life”. I was in fact quite dismayed by the position of the author and by the absence of many important facts weighing heavily in favour of the new targeted therapies mentioned in the article.

First and foremost is the fact that many patients taking these medications have had the opportunity to extend their lives for periods much greater than as represented in the article. In fact, in combination with other chemotherapy drugs traditionally used in the treatment of colorectal cancer, patients have been able to extend their lives by almost two years. One might recall that in 1996 the mean survival was approximately one year.

Second, patients whose disease did not originally permit the surgical removal of their cancer may further benefit from these therapies. In some cases, patients are able to prolong their lives or even obtain a cure by having surgery to remove their cancer after having received treatments that include these new therapies.

In provinces that have not as yet covered the cost of some of these new drugs, patients are obliged to personally cover the costs or forgo treatment recommended by their physicians. In some cases, patients are even forced to leave the country to obtain access to the standard of care they should receive in Canada in accordance with treatment guidelines.

While the costs of these new cancer therapies are significant, they are in line with the costs of other medications for other diseases such as heart disease, and to my understanding they are not as high as quoted in the article.
These new targeted therapies are pointing the way to the future of cancer treatment. It is true no home run has as yet been hit, however steady progress is being made and we must ensure that Canadians have equal and timely access to the standard of care in the treatment of their disease. These are not drugs of desperation and they do provide a real and significant increase in survival and in the quality of life to cancer patients.

Barry D. Stein

President Colorectal Cancer Association of Canada

Andre Picard

Last updated on Thursday, Sep. 10, 2009 09:06AM EDT

How much is a life worth? What price can we put on extending a life for a few years, a few months or a few days?
Increasingly, those are questions that, however unsettling, need to be asked, particularly in the cancer field.
There are a growing number of cancer therapies. They are increasingly expensive.
And many produce only a short extension of survival. That combination can pose some serious dilemmas, clinical as well as ethical.
The issue is underscored by a recent article in the Journal of the National Cancer Institute.
Tito Fojo, a medical oncologist at the U.S. Center for Cancer Research at the National Cancer Institute, and Christine Grady of the department of bioethics at the U.S. National Institutes of Health.
The pair published some hard data on the costs and benefits of several high-profile cancer drugs that help provide some important perspective for this discussion.
Here are some examples to ponder:
Cetuximab (brand name Erbitux) is a drug used to treat lung and colorectal cancer. Treatment costs $80,352 (U.S.) and increases survival by 1.2 months.
Bevacizumab (Avastin) is used to treat lung, colorectal and breast cancer. A course of treatment costs $90,816 and it extends survival by 1.5 months.
Erlotinib (Tarceva) is used to treat lung and pancreatic cancer. Treatment costs $15,572 and the drug extends survival by 10 days.
Sorafenib (Nexavar) is used to treat kidney cancer and advanced skin cancer. A course of treatment costs $34,373 and it extends survival by 2.7 months.
These figures are, in themselves, thought provoking. But they tell only part of the story.
Every one of the cancer drugs cited is essentially a drug of desperation. They are used only after many other surgical interventions and drug treatments have failed.
As with all drugs, there are also side effects, in many cases debilitating ones. This reminds us that survival needs to be measured in more than days kept alive.
Let's take a more in-depth look at one of the drugs, cetuximab. It was a highly anticipated drug because it tackled cancer in a new way.

In May of this year, the medical journal The Lancet published the results of a study about the use of cetuximab to treat non-small-cell lung cancer.
The researchers concluded that adding the drug to the standard platinum-based chemotherapy drugs cisplatin and vinorelbine "sets a new standard" for the treatment of patients.
One month later, at the conference of the American Society of Clinical Oncology, which is considered the world's most important cancer meeting, it was stated that the findings "are likely to have a significant impact on the care of patients."
Neither the published paper nor the press briefing touting the wonders of the drug underscored that many patients treated with cetuximab suffered severe febrile neutropenia (a combination of fever and low white blood cell count that puts patients at risk of infection), along with diarrhea and rashes.
Nor do those singing the praises of the drug much like to talk about its cost. The $80,000 cost for an 18-week treatment is also misleading. That is the cost of the drug, and does not include the time of health professionals to perform the infusion and related tests nor the cost of treating side effects.

In their paper, Dr. Fojo and Dr. Grady offered this dispassionate analysis of the data: "The only reasonable conclusion is that a magic anti-cancer bullet aimed at an important target missed by a wide margin."
They describe cetuximab, bluntly but fairly, as a "treatment offering marginal benefit at very high cost."
Survival rates for most cancers have risen steadily for a number of years. But cancer is still a big killer.
Last year, an estimated 166,400 Canadians were diagnosed with cancer and about 73,800 died.
In cancer treatment, everyone hopes against hope but, at some point, the disease often gets the upper hand.
As treatments become more desperate, we need to ask ourselves some tough questions, many of which Dr. Fojo and Dr. Grady set out in their paper: What should count as a benefit in cancer treatment? What is the minimum amount of benefit required to adopt a new drug therapy? In the case of cetuximab, is 1.2 months of additional life a "good" in itself? Or does the quality of life during that time matter? And does cost matter?
There are those who will protest that cost should not be an issue when treating someone with a grave illness such as cancer. But, however callous it may seem, cost must be an issue and a cost-benefit analysis must be done.
In our health-care system, money is not unlimited. The $80,000 spent on cetuximab to potentially extend a person's life by a few weeks could be used in other ways and, undoubtedly, to more effect.
For example, is money best spent on a desperation drug with limited effect or on palliative care for dying cancer patients?
The all-too-common practice of administering new, marginally beneficial drugs to dying cancer patients is a losing proposition, for the patient, the health system and society at large.
Yes, every life is precious, some would say of infinite value.
But we have to stop deluding ourselves. People will die of cancer. Every reasonable effort should be made to ensure a good life and a good death.
But that does not mean mindlessly throwing huge sums of money at so-called miracle drugs.
Quality of life matters - for everyone.

Correspondance between Marie-Josée and André Picard (translated by myself since it was originally in french)

From André Picard

That is precisely the challenge: How to target treatments to maximise benefits to the individual and society.

It's another huge challenge created by cancer which as you said is already cruel and ungrateful.

-----Original Message-----

From: Marie-Josée Lafrance

Sent: 10 septembre 2009 23:59

To: Picard, Andre

Subject: Re: article cancer

Thank you! The question remains how do we know in advance if the patient will ahve marginal benefits or like my husband a very favorable response to therapy. Food for thought.

Picard, Andre wrote:

> Thank you for your comments but I beg to differ, the public needs to have those discussions and debate.

> It is remarkable that your husband benefited from Avastin (and other interventions) and that he is in remission. But a lot of patients do not benefit as much from these costly treatments. In those cases money would be better spent in palliative care.
> That is reality. We must be realistic, and not create false hope.

> Santé!

> André

> -----Original Message-----

> From: Marie-Josée Lafrance

> Sent: 10 septembre 2009 23:18

> To: Picard, Andre

> Subject: article cancer
> M. Picard

> I read your article on the astronomica costs of medications and became nauseous.
> My husband was diagnosed with colon cancer (inoperable) in July 2008. A 30 cm (12 in) tumour was reaching far up touching his liver stomach and kidneys in addition to his peritoneal wall. His life expectancy was a few months only
> Well, thanks to Avastin combined with other chemotherapy treatments, he is still alive 14 months after diagnosis and he bacame eligible for surgery in June 2009. He went through surgery combined with a state of the art technic called HIPEC, which is hot chemo directly into his abdomen. Cancer is 98% gone and he is in remission and doing pretty well today. He was able to see our daughter start in grade 1 in September.
> How can clinical studies show differences inlongevity with or without medication when age, cancer spread, type of cancer, personal predisposition, medical history are all factor that influence outcome
> My husband is 42 and still alive to see his children grow thanks to Avastin. Without this medication he would not be here anymore. Life does not have a price. ¨
>It is apparent to me, sir, that severe illness never touched you.
> Cancer is already cruel and ungrateful enough as it is. The public does not need articles like yours to take away their hope.

> Santé!!
> The Spouse of a cancer survivor

3 months

2009-09-06T16:39:00.000-04:00

September 3 marked the third month of convalescence. When I am not affected by the chemo (between day 7 and 13) I'm pretty good. I think I could be better but still not bad. I can not complain. In fact, there is one thing I complain about, my bowel function is really not optimal yet. I am told that it could take up to one year but deep down inside I hope that it will be quicker. I manage the situation still better than the first two months of convalescence.
My appointment with Dr. Y was delayed to September 29 . This will be almost 4 months since I last saw him. I look forward to hear what he has to say.
MJ commented that I was not writing as often on the blog ... Maybe a little. I really do not know what might interest you. In the last year I told you everything and now I am a little afraid of boring you. If you have specific questions to ask me, go ahead it will feed the blog.
Apart from that we continue to pray and make the every effort to keep cancer at bay.

Santé!

Things are good

2009-08-28T10:40:00.004-04:00

Just a quick note to say that I am beginning to see light at the end of the tunnel. Even if the situation (south of the navel) is not quite perfect, it is improving slowly. Chemo interferes a little in the restoration of optimal intestinal function but I know it's temporary. Speaking of chemo, I received my third treatment post-surgery. I will be disconnected in about an hour.
Dr. L had to hear me cry a little. I confessed that I sometimes fear the return of the cancer. He listened with empathy and comforted me on the fact that fear is normal and it was healthy to express it. Yes, there are those days where I am really scared. On these days I am even afraid to say that the cancer is gone in case it would hear and decides to return. This is silly.
That's the ups and downs of living with cancer. Even if I want to be strong there are days when it's harder. Don't worry though these moments never lasts long.
Dr. L told me when we talked about the surgery and my recovery and chemo treatments: you are strong. This is the first time he told me that. I was flattered. I know many of you tell me the same thing but for me it's like a pat on the back at work, you always want more.
I'm going to see Dr. Y in September. I look forward to that appointment. I look forward to when I can start doing real exercises. I look forward to his "thumbs up".

We went camping in August. A few days in a tent and the following week in an RV (Class C). The tent was hard. It was the week following chemo and it rained a lot. Two conditions that do not help enjoy the experience. The week in RV has been fantastic. A whole new camping experience. If you want to see the pictures you can click here http://www.facebook.com/album.php?aid=2027702&id=1057565304&l=3ad6134168 . This is MJ's facebook album for summer 2009 (158 photos).

Finally, I leave you by saying that Tristan started school. It is his second day today. Yesterday the bus dropped him home at 17:50. They had left school at 16:45. It seems that the traffic was terrible. We hoped that there will be adjustments to the route. Jordan and Elodie start Monday. Both are very excited.

Good day to all!

Who Am I?

2009-07-31T16:49:00.000-04:00

Odd question, eh!

Let me explain my point. Since July 2008, I defined myself as as a man with stage 4 colon cancer stage 4. Even once in a conversation with the social worker, I made a freudian slip, I said I am a colon cancer. She replied by saying you have cancer, you are not a cancer. Of course that's what I meant but the slip made me think for a moment on how I perceived my illness.
So, I said that I saw myself for a year as a man with a diagnosis of colon cancer. Except that since June 3, there is no visible trace of cancer and my markers are in the normal range. Do I still define myself the same way. Instead, I want to see the positive side. I could define myself as a survivor. The survival period is not very long but still.
I talked to my mentor (Barry). He suggested that i say that I am NED, which he uses for himself. NED means No Evidence of Disease and in his case it's been about 7 years. Talking to Barry is always comforting, I think it's appropriate to say that I have been NED for 2 months. It's similar to Alcoholics Anonymous, they count the number of days of sobriety. Also there is something in the act of saying "no evidence of disease" which puts a smile on my face.
Some of you will say it's simple you're Martin Raymond. But you see this is not the same Martin as before the disease. Cancer changes you and like it or not it is part of me now (without evidence or present). So to define myself simply as Martin seems incomplete, not very precise. This is not a question of wanting to feel sorry or attract pity, I think it's just who I really am a cancer survivor NED since 2 months. Have you ever asked the question, Who are you? ... What is the answer? You are welcome to share your thoughts with me via email (more private) or via comments on the blog.

Santé!

Follow-up appointment in surgery

2009-07-10T13:48:00.001-04:00

Met Dr. S. today to follow up on the surgery. The surgeon found I was top shape considering the time elapsed. Her comment was "you had to be a great athlete before the operation to recover at this speed." ;-)
Great athlete I don't know but she was nice. She said that normally after 6 weeks they expect to see patients who walk slowly, sit up slowly, speaks slowly. She felt I stood very straight (posture) with a near normal walk and a normal speaking rate. To all my questions on weight loss, the amount of faeces per day etc.. she replied "normal".
According to her, there will be another month like this and then it should start to return to normal. I told her that I did not think I was in good shape. When I mentioned my walks at 3Km / h, she said that's fast. When I told her that I played golf on the WII (Woods 2010) and that I regretted it cause I spend the afternoon aching. She forbided me to play for another month. No muscular effort before another month (walking is good). Such an appointment helps to put things in perspective. It serves as a milestone. She boosted my morale for sure.

Santé!

We'll get there!

2009-07-07T13:24:00.001-04:00

Lately I think I just forget who I am and my core principles. In the last month I was waiting for my energy to come back to feel good. It's as if I told myself when I have the energy I will make plans, smile, get involved.
This morning I listened to a recording of Dr. Simonton provided by my wife's doctor. This recording reminded me that the healing process is opposite to the one I was living recently. That is to say that this is not the body that dictates the level of energy of your spirit, but the opposite. I temporarily forgot that what my thoughts defined how I feel. I had an awakening, a kind of "Ha Ha" moment. This is not instantaneous but I did set a new foundation for my healing, some new thoughts.
I have no excuses for this but I realize now that I dreaded my first appointment post surgery with my hematologist Dr. L. I realized that I had mixed emotions. I was happy to see him because he always gives me confidence but I did not want to disappoint him by admitting that I was not ready for a round of chemo. At the same time I was afraid he would tell me it had to be done now. But Dr. L is a great doctor. I did not feel any pressure. I felt great compassion and from the beginning I felt that we were a team.
He told me the level of my markers: 3. He said it was excellent the lowest level since the beginning. He was happy with the situation except that I lose a lot of weight. He suggested I meet with the nutritionist to establish a plan. I have an appointment next Monday. I will see DR L. in two weeks to reassess the possibility of starting chemotherapy.

A former classmate of MJ has a brother who was diagnosed with brain cancer. He is followed by the same hematologist than me (coincidence?). This classmate told him about me because she follows my situation through facebook and my blog. Her brother said that my story inspired him and gave him hope. As he is hospitalized, MJ and I went to visit him yesterday. Even though I was not a portrait of energy, I wanted to tell him in person not to quit and keep the faith.
Today he is going for brain surgery. I prayed for him all night without being able to stop it's as if we had a cosmic connection. My mind was constantly thinking about him and praying. At the point where I did not get to sleep. I made up for it this morning sleeping from 10am to noon. I tell you this story because yesterday's visit put things in perspective for me.

Thank you again for all your support on facebook on the blog or in my email.

Santé!

Patience is a virtue

2009-07-04T01:10:00.001-04:00

I thought I was a patient guy, I am not so sure these days. The days are redundant, the same TV shows, the toilet routine, the medication. Always looking for a position: sitting on the sofa, lying on the bed, sitting on the bed with my legs crossed, yoga position (the child) with cushions under the belly. When my mind feels combative I get on the treadmill, 10 minutes @ 3 km / h, then I lie down on the bed again.
Although I eat my three meals a day, the quantities are small so I am now at 153 lbs. The lowest weight since my teen years. The good thing about it is that I can rebuild my body and I am sure that I will never return to what I looked like before cancer. It's been a month of convalescence, I was told it would take about three. I believe another month I'll be back to my normal energy level. Time will tell me.

See Ya!

Back home

2009-06-20T15:39:00.000-04:00

Since June 19 I'm back at home. I made a surprise appearance at the Relay for Life during the evening. Since then I rest a lot. The recovery will be lengthy, it is necessary process that I have to accept.

Success

2009-06-04T15:31:00.002-04:00

I take a moment to inform you of the good news. Wednesday morning 8:30, Martin found himself in the operating room for surgery, a long-awaited moment.
Doc Y, accompanied by a good medical team, was ready for a long and delicate intervention that lasted 11 hours. They removed the cancerous masses, rebuilt the duodenum, took out part of the stomach, removed 51 cm of small intestine and 50% of the colon and ended with the HIPEC intervention . The doc has accomplished its mission, 98% of the cancer was removed, a total success.

Martin was then transferred to the intensive care unit for observation. I welcomed him by saying "You've won my champion, you are now in intensive care and everything went according to YOUR predictions, He responded with a huge smile. He could not talk, was still intubated but I could read his thoughts "I told YOU!". Nurses taking care of him turned to me and said "WOW we have never seen an conscious intubated patient as calm as he is and on top of it smiling! What an extraordinary patient" and I replied "Yes, yes, you're right he is a man quite out of the ordinary " This morning, after a short stay of 12 hours in intensive care, he was transfered on the surgery-oncology ward. The battle is not yet won, a long rehabilitation begins but knowing him, he would tell you tonight "Don't worry, watch me, I'll get there in no time" Speedy recovery my love.
We look forward to your return.

Your wife

See You Later

2009-06-01T22:44:00.003-04:00

This is my last post before surgery. Tomorrow, I'll get a call from the hospital telling me at what time and where to go. I am admitted the day before because of the preparation needed which includes a total "oil" drainage ;-)

I thank everyone who sent messages of support on Facebook, by email, phone, in person or on the blog. I am telling you, I feel all the energy you send me.
Today MJ and I went to the St-Joseph Oratory. We prayed, attended mass, prayed again and bought souvenirs (we bought angels pins, a book of prayers and medals of St-Joseph). We lit lanterns and I believe I got a sign from God. Marie-Josée and I climbed up a very narrow staircase to light 5 small lanterns, we were stopped in our descent by a small boy about 8 years old. He, also, wanted to lit a lantern as high as possible, to a point where he leaned on me to do so. After ligthing his lantern, which took some time, he joined his hands to pray. All this time I watched him because I could not get down. I lifted my head a moment and saw his mother signaling with her hand for him to get out of the way. I responded to his mother with my hand saying that I was not in a hurry, he could take his time. I was very calm. When we got at the bottom of the stairs I told MJ: "God sent me a message through this boy, he gives me his blessing and will let me live longer so I can look after my children, his children. I was filled with a holy certainty if you allow me the expression.

If you are up for it, I've found an example of my surgery in a video on the web. The link is: http://www.or-live.com/WFUBMC/1478/event/rnh.cfm . You need the RealPlayer plugin installed to view it. It's really interesting, you can see the installation of tubes to circulate the hot chemo. You can also see what the cancer cells in the abdomen look like.

Many people sent me messages of support and I appreciate it. Since I will be unconscious I don't believe that day will be so bad for me but for my wife... June 3 will be hell for her. She will not be under anesthesia and she will live every minute of this long day. In my unconscious state I will try to send positive and reassuring thoughts, but I doubt that this will be enough. Think of her on this day of her birthday. I will talk to you through MJ as soon as there is new development. She will write on the blog and also on her Facebook account. If you want to contact her write to mjlafrance@videotron.ca because her phone won't be on ;) in the hospital.

A bientôt!

Vélothon Gaston-Pilon (Gaston-Pilon Bike-o-Thon)

2009-05-28T14:21:00.001-04:00

Some of you are aware of this event but I wanted to advertise it even more since it’s coming soon.
Tristan (my oldest, 12 years old) in 2007 had the desire to organize a fundraising event. I had not been diagnosed at the time so it is not connected with my situation. It was just something natural for him, encouraged by the philosophy of the school that has an important community component. He talked to his two best friends who were immediately enthusiastic about the idea.

Then the date was chosen in June 2008. With the help of my brother Omer and the parents of his two friends we organized a bike ride from school to the house of my sister Lucie in St-Janvier. 80% of the ride was on the cycling path of “Le Petit Train du Nord”, 43 km with 15 cyclists including 4 adults. Thomas's mother and I followed as best as possible with our cars to ensure safety at intersections.
This project, conceived and developed by young people, has touched the entourage of Tristan, Thomas and Olivier. So they have managed to raise $ 1655 for La foundation de l’Hôpital Ste-Justine (French children’s hospital in Montreal). The choice of charity was probably influenced by the death of our friends’ son(he was 10 years old and lost his battle against leukemia in late 2007).
Given this success, the three buddies decided to do it again in 2009. The date is June 14. They obtained the support of the school and the parents' committee.
This year's ride will be 60 km as they will travel up to the St-Jerome train station to picnic and back.

I talk about this today of course because I want to invite you to attend the event. I know that several members of the cycling club Le Suroît read the blog and I hope you'll be tempted to come ride with Tristan and his friends. For information and registration visit the website http://www.velothongastonpilon.org/.

My second goal is to solicit your help. Normally I'm there to help the organization, but this time I'll be in the hospital recovering from my surgery. So if some of you are willing to lend a hand to Tristan it would be greatly appreciated. You can contact him by email at tristan.raymond@live.ca or call home at 450-434-4833.

I hope you understand that what I have done here is very difficult. Asking for help for oneself is one thing because you can communicate your needs, but do it for someone else is more complicated especially when it's your child. When it's your child, you always want to be the resource person. In this case I can not be that person. I could ask someone in particular but I do not want to impose this on anyone. I prefer that the help comes spontaneously and voluntarily.

Finally, if you can’t be present and you can’t help either, I encourage you to financially support the event. You can donate through the site of the bike-o-thon where there is a link to the foundation’s donations page. These electronic pledges are easy to do. Please indicate in the comment box that you made the donation for the Vélothon Gaston-Pilon. You can also donate by check or cash directly to Tristan. If you want to send a check to Tristan, send him an email he will reply to you with our address. Make checks on behalf of La Fondation de l'hôpital Ste-Justine.

Thank you for helping my son and his friends achieve their goal of $ 2000.

A proud Papa

Ottawa Race Weekend is Over

2009-05-27T12:40:00.001-04:00

It was a beautiful weekend. Marie-Josée had a brilliant idea to get all of us to participate in the family 2 km run. The whole family was very excited at the finish line.
Well ... Élodie was somewhat in pain because we wanted to finish as a family, hand in hand, and Tristan accidentally tripped her. She fell on her knee. Her mother had her by the hand so she was lifted up pretty quickly. I would say she floated in the air for a moment before putting her feet back on the ground.
The family made the 2 km in 13:57. This puts Élodie 39th of 371 in her category (- 8 years old but she is 5). The boys could have run much faster but the goal was to finish together so they slowed for me.
It was the first race for Tristan and the third for Jordan. "They got the bite". Both now have the objective of running the 5 km run next year.
In my case, I liked the friendly atmosphere but at the same time the competitive side. Running by yourself is one thing but to run beside someone motivated me to keep going;-)

If you want to see full details of our results visit Sportstats. Search by the person's name and you'll have the results of all their official races.

The next day, Mom ran the half marathon. She did it in 2:21:01. It is 15 minutes less than her winter half marathon in Montreal. Good job my love! We were a great gang, Yves' family, Christine's family, MJ's aunt and uncle and Michelle's in-laws. In all 25 people either ran or cheered. All these people in a sea of 36,000 runners and 50,000 supporters.
Yes, you must be patient when you move around in Ottawa during that weekend but it's worth it especially since the weather was fantastic.

For photos, see the Josée's Facebook album at http://www.facebook.com/album.php?aid=2022586&id=1057565304&l=1c0200e2c1.

Ottawa

2009-05-23T02:55:00.001-04:00

We are leavingg for Ottawa in a little while (it is 3:00 in the morning) for the race weekend. Saturday 16:00 the five family members are running the family 2 km. Élodie (5 years old) did it in 14:29 min during training. And it's because she has to slow down to wait for her oldman.
Sunday, Marie-Josée is doing the half-marathon. There will be a big group: Yves my brother, his wife Danielle, their children Michelle, Christine, Julie and Stéphane (I can not remember if Patrick is running).
Those who wonder why I'm not sleeping at 3 o'clock, my brain is doing overtime. This is my third night like this. Is this due to withdrawal from my Hydromorph Contin? Yet I gradually decreased my dosage using my Dilaudid. Is this due to surgery anxiety ? Consciously I say no, but unconsciously? Anyway tonight I could not get out of my head the last song that we downloaded, Thks Fr Th Memrs from Fall Out Boy. That endless loop of the chorus in my head, it's stupefying. I have to try to sleep 3-4 hours ...

Good night!

John Fogarty Tour

2009-05-22T16:00:00.000-04:00

Yesterday I was at John Fogarty's show at the Bell Center. For those who don't know him, he is the principal member of CCR, Creedence Clearwater Revival. Extremely popular band of the 70's. Their hits include: I heard it through the grapevine, Susie Q, Proud Mary, Up Around the Bend and others.
Thanks to my friend David I saw a show, for the first time in my life, in row A, the very first row. Yes Yes I spent two hours standing and leaning on the security fence to see John Fogarty within 3 meters.
He changed his guitar every song, he had at least 5 different ones. As a guitarist, he is completely different from Eric Clapton, but he is equally fascinating.
His drummer was excellent. Unfortunately I have not heard his name, Kevin something. If any of you play Rock Band on xbox 360 he looks like the bald drummer. He has biceps of a bodybuilder and wears big rock sunglasses with a white T-shirt. The sound of his bass drum has probably disintegrated my remaining tumors since my body vibrated so much with each beat.
There were two guitarists, a bassist (David Santos), and two musicians who played guitar, fiddle, mandolin, keyboard and conga.

What a show. I can tell you I got goosebumps a few times.

Speaking of show, my cousin Genevieve is organizing a fundraiser event to benefit Relay for Life of the Canadian Cancer Society. My situation was her motivation. It will take place at the Bourbon in the west-island on Sunday, June 7. There will be several local groups to discover and of course Genevieve will sing some songs. I urge everyone who can go to enjoy a great show for a good cause. If you want info contact Geneviève de Léry through email (gendelery@hotmail.com) or on facebook. By the way for those of you who were at my birthday in October, Geneviève had sung.

HIPEC

2009-05-16T15:45:00.002-04:00

I found this information on the Internet for a portion of the operation that I might have. This is the part that brought me to Dr. Y because he is one of three or four surgeons who are trained to do it. In addition I am told he is the best.
HIPEC means Hyperthermic Intra Peritoneal Chemotherapy.

Note: Peritoneal refers to the membrane that wraps abdominal organs.

Before connecting the HIPEC, the surgeon must remove all visible cancer. It must be understood here that surgeons do not cut into a tumor, they take a margin all around the tumour of healthy cells. This, (having an acceptable margin), can lead to difficulties and that is why Dr. Y does not give me any guaranties. Once all visible cancer is removed (in my case probably colon, duodenum, part of the stomach, part of the mesentery and perhaps more) the doctor installs tubes and the abdomen closed temporarily to perform HIPEC ( read the description of HIPEC below). HIPEC is therefore expected to kill all traces of cancer that can not be seen with the naked eye and even perhaps some that can be seen but are not possible to cut(no margin).
Then he opens the abdomen, removes the tubes and proceeds to clean the cavity and finally close it permanently. Note that if the rectum is affected by cancer and there is not enough room to connect the small intestin then there will be ileostomy (an opening in the abdominal wall for elimination of feces in a bag).

How HIPEC Works
Below is an animation of the HIPEC procedure.

During the HIPEC procedure, the surgeon will continuously circulate a heated sterile solution containing a chemotherapeutic agent throughout the peritoneal cavity, for a maximum of two hours. The HIPEC procedure is designed to attempt to kill any remaining cancer cells.
Giving the chemotherapy in the abdomen at the time of surgery allows for greater concentrations of the drug where it is needed. Adding heat has a threefold advantage:
Heat at 42 degrees Celsius kills cancer cells while not affecting normal cells.
Heat makes the killing effect of the chemotherapy more powerful.
Heat softens the tumor nodules so the penetration of the chemotherapy into the tumor is enhanced.
The procedure also improves drug absorption and effect with minimal exposure to the rest of the body. In this way, the normal side effects of chemotherapy can be avoided.

Elodie wheels around

2009-05-13T17:10:00.002-04:00

Last weekend, Saturday, Elodie started biking without the safety wheels. I was very proud of her. I do not know if it is because she's a girl but it was the first child who expressed her feelings.
When I asked her why she stopped pedaling she answered: "I'm stressed out." She was afraid of falling. It was cute her way to tell me ... I am stressed.
And when she felt she was on the brink of success she said: "I feel good today, and when we feel good we can do great things." She wanted to tell me,I feel I will be able to do this. And she succeeded on the next try.
If you are in the neighbourhood, stop by, Élodie will show you how she has taken all steps to successfully ride her two-wheel bicycle.

The Faculty

2009-05-12T16:57:00.003-04:00

On May 6, MJ and I were invited to participate in a continuing education seminar at the Faculty of Nursing of the University of Montreal. The subject is “soins aux familles” which I have a hard time translating. It would be something like how to provide support and care for the family members of a chronically or seriously ill patient.

This week long training provided to nurses included a live interview of a family touched by serious illness (usually cancer). The head of the training, Ms. D, knows a nurse at the hospital Sacré-Coeur. She is MJ’s angel which introduced us to my hematologist Dr. L. Ms. D was looking for a family for the week of training and our names was proposed.
We did not bring the children but we had a picture of them and they were a major part of the discussion.

18 nurses were enrolled in this session and watched on closed circuit television, or through a window, the interview conducted by the head of training. One objective was to show participants a method of approaching the family to get to know them better(not just the patient) and provide more appropriate care hence better care.

Note: Ms. D, if you read my blog and you want to correct me, please contact me anytime.

The main interview lasted almost 2 hours. We responded to questions, expressed emotions, cried a lot. We talked about the disease but not in detail, rather as a backdrop for the rest. Then the participants gave feedback to Ms. D. What did they retain? What had touched them? What would they do different when they return to work?
During the debriefing it was our turn to be the observer behind the window.

Finally we had the last word by having the opportunity to comment after their debriefing.

The basis of the method of interview is a tool Ms. D calls a genogram. It is a kind of drawing resembling a family tree. Ms. D said that it helps to see the patient in a broader context. He is not the only one affected by the disease. All the people who gravitate around him are affected too in one way or another and they in turn have an impact on the patient's response to the disease.

Without giving too much detail on the genogram it is important to know that this tool opened the door wide to emotions. This is a simple way to get the person in front of you to share some very deep thoughts.

Those who know me well know that I don’t need to have the door wide open to start talking and I wonder if on a few occasions Ms. D did not ask herself the question: "how can I stop him and return to my questions." But, but, but I still managed to stop at one point so MJ could also share her point of view ;-)

Moreover, this directed discussion period has allowed Josée and I to discover a little more about each other. Even though we’ve been together 25 years, our perspective of the other on some issues has changed ... or evolved.

In summary we have discussed the following topics:
· Relationship with our respective parents (also with my brothers and sisters)
· Relationships with our children
· How did we get the news of the disease
· How have we communicated the news to the children
· What each of us bring to the other
· How each of us live or respond to the disease
· Identify the strength of the other to defeat the disease (not just the patient)
· Identify the strengths of children to pass through this test

Out of everything that was said that morning, I asked each of the participants to retain at least this: If you can not find a way to give hope to your patients at least have the wisdom not to remove the hope they have, because hope is the basis of any treatment. Hope does not cure everything, but you can’t heal without hope.

Josée's message was: as much as possible focus on the person in front of you, make him/her feel important, be it the patient or a member of the family.

MJ and I were delighted with this half-day. I believe that all participants were also appreciative. Many were waiting for us outside the room to thank us for our candor. I can tell you that it's always nice to be told that you’re good and nice ;-)

One comment that touched us most deeply: "we would all want to be adopted by you guys." For a couple with a main objective to be the best parents possible, these are words that go straight to the heart.
Marie-Josée and I thank Ms. D to have invited us and we thank all nurses for their warmth and their comments. We wish them good luck in the continuation of their work that requires great compassion for their fellowman.

Port-O-Cath

2009-05-02T15:14:00.000-04:00

As you know this week I had a new distribution system for chemo installed. Instead of a PICC line I now have a Port-O-Cath.
Not many images are available on the Internet but I found one that is OK.

As you can see it is a plastic box (mine is white) with a membrane and a central tube.

It's in the membrane that we insert the needle that brings the liquid flowing in the tube then to my right jugular vein. All this was inserted under my skin so when healing is complete I will not have to worry about a bandage or an opening in the skin (open door to infections). The needle going through the skin to distribute the chemo is like this.

The nurse takes the white part between the fingers of one hand. With the other hand she feels the skin to locate the valve and maintains it in position while the right hand pierces the skin. The attached tube stays outside on the chest so they can plug in pouches of chemotherapy or other treatments. My scars are still fresh but it should be less apparent with time. The Yellow or blue is a bruise, it will disappear eventually ;-)

The operation is done with local anesthesia. I am laying on my back with the head turned to the left. Nurses install surgical blankets leaving only the part where surgery will take place (neck, part of right shoulder and chest). Injections of anesthetic is what hurts most then you feel fingers pushing and pulling and lifting your skin but it don't feel pain. There are two incisions because they have to install the tube in the jugular (upper incision) and then adjust the length at the other end where they have inserted the valve (other incision). By the way the tube connection on the valve is similar to the fittings on a engine's carburetor.
When everything was installed I had to stay 3 hours on the back under observation. She was watching for bleeding but also the connection that I mentioned is quite fragile so I could not use strength from the right side (not lift my head, not lift my arm etc..) in case the tube wold dislodge and start floating in the jugular.

Anecdote: Toward the end of the operation, the doctor said: YIKES!. So I said, this is not the kind of sound a patient wants to hear from the doctor operating on him (do not forget that I do not see anything because the blanket covers my face). He hesitated and said, no no everything is fine is just the thread that came out of the needle. A little later he sighed and immediately said that this was perhaps not a good thing to do under the circumstances because I could interpret it negatively. We all laughed.

Discovery

2009-05-02T02:03:00.001-04:00

I wanted to share a discovery on the web with you. It is an online database for books. I am in the process of entering our own collection. You can view it in the left column. I find it fascinating because we have a large collection of books (habit taken from my parents) and I like the fact that you can easily identify them with this online tool. By the way if you're interested in any of our books send me an email I will gladly lend it to you. The site is called Library Thing. It is available in several languages.

YES YES YES

2009-04-23T21:22:00.000-04:00

Anyone who has attended a Tony Robbins conference understands the reference in my title. The reference is also used to its simplest expression, as a statement of acceptance. Dr Y agreed to opening up my belly and explore the possibilities.

Note that I did not say he will operate because he was very careful to tell me he does not know if he can operate. Clearly he needs to see for himself, with his eyes, the extent of cancer spread and the impact in my abdomen before he can decide if he can resect anything.

The various images (PET scan and others) do not give enough details to confirm the actions to be taken though they are specific enough to say that my liver is not affected. So it seems he will not have to touch it.

This is great news since the partial liver resection is a challenge and furthermore this support the thesis that my cancer has not spread through blood, but probably by contact (until now). If you remember this was one of the strikes against me in relation to the success of the operation so it's one less now.

The surgery will take place either May 25 or June 3. I hope it will be June 3 because it is MJ's birthday. I believe it would bring me good luck. Moreover, June 3rd 2009 marks the 25th anniversary of our relationship. We dated for the first time on that day in 1984. Christine and Marco will surely remember.

As you can imagine I am very happy (Marie-Josée also). Things are going as I had imagined even in the slightest details. I visualize every day and I saw the operation in late May early June... Huh! Huh!

Here is how I see what's coming.

I see myself sitting in my hospital bed with a big smile listening to the doctor telling me that things were not as bad as expected, he was able to remove all apparent traces of cancer and that I will recover quickly from the surgery. The recovery is not easy, but I see myself going through it with a smile surrounded by those I love.

My visualization continues a little more down the road. Once I returned I finally put the finishing touches to really start the company and also I am helping my friend Barry at the Colorectal Cancer Association of Canada. I even have a vision of me in 20 years surrounded by my wife and children.

Thank you to everyone for the support and encouragement.

Don't stop praying, sending positive thoughts, etc..

Ciao!

We're Back

2009-04-21T21:17:00.000-04:00

Back to everyday life.
It is certainly a contrast to our two weeks in Dubai. The trip was fantastic.

Many of you have followed our activities through the photos. We celebrated the 12th anniversary of Tristan in a restaurant specializing in fish, The Seafood Market at the Meridien hotel. A memorable evening marked by the new tastings like shark.

Most of the things we see in Dubai are exceptional. It's big, it's expensive, it is clean, everything is new, but in unreal proportions.
In any case I can say I have re-energized. To a point where I wonder if there is cancer. I feel better than in the past 5 years. This is a good sign. I meet Dr Y. Thursday and I'll be set for the operation. I can not wait because I'm ready mentally. Inregards to the household organization, we will finalize the plans when we have more details.

Good day to all!

Dubai

2009-04-12T02:10:00.002-04:00

News: It seems that even if youre not on Facebook you are able to see the photos publlihed there. So here are the links but tell me if it does not work
http://www.facebook.com/album.php?aid=2019344&id=1057565304&l=0693fd993c
and this one
http://www.facebook.com/album.php?aid=2019655&id=1057565304&l=6505ec4400

Here are pictures of our trip to Dubai for those not on facebook. http://picasaweb.google.ca/martinraymond.qc/Dubai?feat=directlink

Varia

2009-03-28T11:03:00.004-04:00

A little note to let you know that things are going well.
The trip preparations are going well. MJ is taking care of everything.

The Pet scan is done and the other scan as well. I also received a letter telling me that Dr Y as ask to put me on the surgery waiting list. This does not confirm that he will operate but it gives me real hope that he will. Why would he go through the trouble if he did think lean towards a yes. If he really did not want to do it he would not bother filling out the paperwork. I stay grounded though, he can always say no but the script I have in mind is more on the positive side.

Wednesday I had my bottle unplugged and at the same time they took out the Piccline. I was told to keep the bandage for 2 days but I kept it for 3. I was a bit scared to see the hole not completely healed. By the way, the tube they took out was 45 cm long (about 14 inches).

I will post some pictures from Dubai as soon as I can.

PET scan

2009-03-21T10:20:00.000-04:00

Positron Emission Tomography – Computed Tomography (PET/CT)

What is Positron Emission Tomography – Computed Tomography (PET/CT) Scanning?

Sample image obtained using a combination of PET and CT imaging technology.
Positron emission tomography, also called PET imaging or a PET scan, is a type of nuclear medicine imaging.
Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose or treat a variety of diseases, including many types of cancers, heart disease and certain other abnormalities within the body.
Nuclear medicine or radionuclide imaging procedures are noninvasive and usually painless medical tests that help physicians diagnose medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers.
Depending on the type of nuclear medicine exam you are undergoing, the radiotracer is either injected into a vein, swallowed or inhaled as a gas and eventually accumulates in the organ or area of your body being examined, where it gives off energy in the form of gamma rays. This energy is detected by a device called a gamma camera, a (positron emission tomography) PET scanner and/or probe. These devices work together with a computer to measure the amount of radiotracer absorbed by your body and to produce special pictures offering details on both the structure and function of organs and tissues.
A PET scan measures important body functions, such as blood flow, oxygen use, and sugar (glucose) metabolism, to help doctors evaluate how well organs and tissues are functioning.

What are some common uses of the procedure?
PET and PET/CT scans are performed to:

detect cancer
determine whether a cancer has spread in the body
assess the effectiveness of a treatment plan, such as cancer therapy
determine if a cancer has returned after treatment
determine blood flow to the heart muscle
determine the effects of a heart attack, or myocardial infarction, on areas of the heart
identify areas of the heart muscle that would benefit from a procedure such as angioplasty or coronary artery bypass surgery (in combination with a myocardial perfusion scan).
evaluate brain abnormalities, such as tumors, memory disorders and seizures and other central nervous system disorders
to map normal human brain and heart function

How should I prepare for a PET and PET/CT scan?
You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing.
You should inform your physician and the technologist performing your exam of any medications you are taking, including vitamins and herbal supplements. You should also inform them if you have any allergies and about recent illnesses or other medical conditions.
You will receive specific instructions based on the type of PET scan you are undergoing. Diabetic patients will receive special instructions to prepare for this exam.

Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the CT images and should be left at home or removed prior to your exam. You may also be asked to remove hearing aids and removable dental work.
Generally, you will be asked not to eat or drink anything for several hours before a whole body PET/CT scan since eating may alter the distribution of the PET tracer in your body and can lead to a suboptimal scan. This could require the scan to be repeated on another day, so following instructions regarding eating are very important. You should inform your physician of any medications you are taking and if you have any allergies, especially to contrast materials, iodine, or seafood.
You will be asked and checked for any conditions that you may have that may increase the risk of using intravenous contrast material.

How is the procedure performed?
Nuclear medicine imaging is usually performed on an outpatient basis, but is often performed on hospitalized patients as well.
You will be positioned on an examination table. If necessary, a nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm.
Depending on the type of nuclear medicine exam you are undergoing, the dose of radiotracer is then injected intravenously, swallowed or inhaled as a gas.
It will take approximately 90 minutes for the radiotracer to travel through your body and to be absorbed by the organ or tissue being studied. You will be asked to rest quietly, avoiding movement and talking.
You may be asked to drink some contrast material that will localize in the intestines and help the radiologist interpreting the study.
You will then be moved into the PET scanner and the imaging will begin. You will need to remain still during imaging. The PET scan takes 45 minutes.

What will I experience during and after the procedure?
Most nuclear medicine procedures are painless and are rarely associated with significant discomfort or side effects.
If the radiotracer is given intravenously, you will feel a slight pin prick when the needle is inserted into your vein for the intravenous line. When the radioactive material is injected into your arm, you may feel a cold sensation moving up your arm, but there are generally no other side effects.
It is important that you remain still while the images are being recorded. Though nuclear imaging itself causes no pain, there may be some discomfort from having to remain still or to stay in one particular position during imaging.

Upcoming schedule

2009-03-17T20:07:00.001-04:00

This message is just to keep you informed of my schedule in the days to come.

March 18 (tomorrow): I will spend the morning at the Notre-Dame Hospital for pre-op tests: blood work, ECG, urine analysis.
here will be a scan of the thorax and abdomen but perhaps not tomorrow.
Dr Y, the surgeon, wanted to have these scans done by his hospital on top of those done at Sacred Coeur.

March 22 (Sunday) is the day of my PET scan (nuclear medecine imaging). This review is essential for my surgeon's decision-making: to operate or not.

March 23: Chimio # 15, the doses of all agents were reduced. It has been 5 weeks that I did not have chemo.

March 25: I get my bottle of chemotherapy unplugged and also my Piccline. This will allow me to swim whule in Dubai. Upon my return, according to the planning of the operation, I will have a port-o-cath installed, it's another distribution system for chemo that sits under the skin in the pectoral region, a bit like a peacemaker.

early April: departure for Dubai.

23 April: meeting with Dr. Y. Decision on the operation.

Medical appointment update

2009-03-12T20:40:00.000-04:00

Well! We had a big day for appointments and information. I will summarize it.

Dr C. prescribed chemotherapy next week. It will be Wednesday. The doses of each chemotherapy agent have been reduced. For the PET scan that we wanted to have Monday, it's pretty hard. If the trend continues I will go in the private sector even if it costs an arm and a leg.

Dr. Y told us his vision. It seems that I have 2 strikes against me even before you begin: metastasis to the liver, the extent of the disease (he explained that even if we do not see cancer anymore several areas were still affected). He told me about the statistics and as you know they do not interest me. He had to do it because if he accepts to operate it is a very difficult procedure. My stay at the hospital will be about a month (including a week in intensive care) and recovery should be about three months. So he wanted me to take an informed decision. I also believe that he tested my determination.

He now has to talk to a colleague before making his final decision (operate or not). In the meantime he will have me go through the pre-op testing. A series of tests before the end of March for a possible late April early May surgery. If the doctor agrees to operate, and I am confident he will accept. The three months of recovery will be very hard but not as much on me as on my wife and children. It will be in this period that I count on you a lot to offer support and assistance to Marie-Josée. I will have a single focus, get back full health with the fewest complications.

Finally, there is good news, my markers are now 5.4, very near the normal range.

Good weekend!

Stabilization

2009-03-10T20:25:00.000-04:00

I am writing today March 10 to announce that my condition seemed to stabilize more than two weeks after the beginning of my diarrhea. As I said earlier it was a difficult period, both physicaly and the psychologicaly. It is a vicious circle which I managed to get out of today thanks to my wife and my brother Omer. Marie-Josée found this period difficult but she was able to give me reason to hold on to and change my paradigm. Let me explain: My body was losing strength because of diarrhea and so was my mind. I could not explain why this was happening, even though deep down I knew that it was a side effect of my new chemo. Being aware of this fact did not really help me justify the severity of the effect. The first turning point was provided Marie-Josée. In her readings on the Internet, she shared an anecdote of a patient who received irinotecan, whom also had diarrhea. This patient sayd It was a strong dose of irinotecan that gave such a severe case of diarrhea but the outcome was that all her metastases had disappear after this treatment. This story gave me a positive spin out of my downward spiral. Now my position is that the diarrhea was caused by a high dose combined with the fact that I probably have no more cancer so the chemotherapy only had my gut to attack. Me, I buy this version. This can not be confirmed until a few weeks but now my mood is in better health. The cherry on the sunday was the call from my brother Omer today. He offered to have a coffee in my neighbourhood. Omer and I do this from time to time when his work brings him in my neck of the woods. It had been a while so today's invitation was welcomed. Even though my moral was better, I lacked a little something to be fully motivated. 30 minutes chatting with him pumped me up and completed my recovery.

Thank you to my wife and my brother. It's amazing what a good timing can do for someone.

Here is the schedule for the coming days:
Thursday I meet with Dr. C, hematologist. She will probably prescribe chemo next week.
Then, Thursday at noon I meet the surgeon dr Y. I look forward to have his opinion and at the same time I fear will not hear what I want.
Since diarrhea delayed my treatment, Marie-Josée saw an opportunity to do the PET scan earlier. So we are waiting to see if next Monday, there would be a spot for me. We strongly hope.

Finally we continue to plan the trip to Dubai. The aircraft is booked and the hotel too. Children are keen to go skiing in the inside ski resort. There are plenty of other activities that we expect to do. We will be glad to share the first eight days there with grandpa Yvon and Loulou. We are fortunate to have our reception committee on site. I will let you know about my medical visits as soon as I can.

A week in Hell

2009-03-05T21:08:00.000-05:00

Hello to you all.

The last week has been painful. In fact, it was the worst week since the beginning of my treatments. Normally after the chemo I sleep a few days and I feel like Sleeping Beauty who wakes up a little more each day. Except for last week when the day I usually feel normal, I began diarrhea. It was Friday 18:30. It lasted until Wednesday of the next week, or yesterday. Diarrhea as I've never had in my life. I followed the Imodium protocol I had received from the hospital pharmacist, but things did not change. This protocol requires taking 2 tablets of 2 mg at the onset of diarrhea followed by one tablet every 2 hours (2 tabs every 4 hours at night). I continue this until 12 hours has elapsed since the last diarrhea.

I did that Friday, Saturday and Sunday. Come Monday I called the hospital because the danger of this type of diarrhea is dehydration, and all of its consequences. I was therefore instructed to go to the hospital Monday to meet Dr L, to do a blood test and then receive a glucose solution intraveinously. I saw Dr. L. He looked at the results of my blood sample and I was not dehydrated so I didn't get the intraveinous solution. Still, I am really tired. My next chemo is scheduled for Wednesday but the doc believes that we should make the decision Wednesday morning.

In the meantime, he prescribed Sandostatin. A powerful drug, given by subcutaneous injection, to control peristalsis (bowel movement). It is imperative to calm the frenzy in my belly. As I have a generalized itching and I think it is the Imodium, he substituted it with Lomotil. For Sandostatin I receive the first dose at the hospital under observation in case of allergic reaction. Small administrative errors were made so I had to wait 3 hours before receiving my injection. That evening my wife stuck a needle in me once for Neupogen and 2 times for Sandostatin (the pharmacy had only vials of 100 mcg while I need 200 mcg). My stomach began to calm down. I could sleep a little better.

Sleep. It was not so easy with the Imodium protocol since I had to set my alarm clock for the night dose, at least Sandostatin provided a good night.
The next morning my upper lip looked like itwas injected with collagen. Josée thought I was having a stroke. I reassured her but my mouth really looked weird. I therefore decided not to receive the morning dose of Sandostatin should it be responsible for the swelling (or allergic reaction).

I turned to Lomotil, 2 tabs q4h (2 tablets every four hours). Wednesday morning, a day of planned chemotherapy and where I met Dr. L. at 8:30. Danielle (Josée's aunt) came to the house to babysit. Upon entering the office of the doc, he noticed that I did not look my best. I confirmed that it was slowly getting better but I am still very tired. We agree to postpone chemo to next Monday. I want to be in top shape a few days before falling down again with chemo. In discussing with Dr L., I admitted I was scared this week. He said "me too".

I was afraid of not being able to get out of this diarrhea or to have to eliminate Irinotecan from my arsenal too early (three doses). He reassured me. Several options are still available and the first is a reduction in the dose of irinotecan. He mentioned that as we have an aggressive attitude, so was the dose. For the next treatment everything will be adjusted. It will be adjusted not only according to the scale but also because I lost 7 pounds (about 3 kg) in the last week. I went from 170 to 163. When the hospital pharmacist called me to check my weight she had 175 pounds in her notes. I hope, I am sure that the difference will be noticeable when my next treatment comes.
Regarding the itching, we don't know the cause. Wednesday while returning from the hospital we purchased some Benadryl. As Danielle was at home she kindly agreed to stay a little longer so I could take Benadryl and sink into sleep. That's what happened from 10:00 to 14:00. A very deep sleep and rest. Today, Thursday, my bowel movements seem under control. The content of my stools are still very liquid, but it's a slow return to normal.

In any case my energy level now is quite reassuring. I have 2 more chemo before taking a break in preparation for the PET scan. I do not want to relive a week as the last.

Run a half-marathon... checked

2009-02-25T15:08:00.002-05:00

Not me, Marie-Josée. You remember she was training for that. She wanted to do it in September 2008 but things happened.
Well she ran the hypothermic half-marathon this Saturday February 21 at Parc Jean-Drapeau.

A race of 21.1 km along the river at -15 celsius with westerly winds of 25 km/h. She did it with an injured knee but still managed a time of 2:34. Note that I'm not saying that she finished it, because for me that was a given. It's her time that impresses me. Imagine in the summer with a healthy knee she will certainly do it in 2h15, a very respectable time for a second half-marathon.

After that I feel small when I can not kick myself in the ass to go 3 km on the treadmill.

Here are some photos:

Chemo #14

2009-02-17T08:59:00.002-05:00

I'm sitting at the dining table sipping my green tea after my peanut butter toasts. Marie-Josée is in front of me making her morning tour of her favorite websites (Facebook, email, blog about cancer, my blog, news). I take the time to write this blog before leaving for the hospital where I should receive my chemo # 14 (3rd Folfiri).
Yesterday I had an appointment with Dr. L.. Guess what? He talked to me about surgery. He said he had reviewed my case with my surgeon and Dr. P the best radiologist in the hospital. They agreed that the reduction in cancer was important. This led me to ask if I was in remission. He said in partial remission ... YES!

Then he told me he had spoken to a surgeon at Maisonneuve-Rosemont for the super specialized operation called HIPEC. The surgeon, given the presence of a spot on the liver, no matter how small, has refused to take my case. He considers that I need to continue chemo to reduce whatever is left, the less there is the better.

But in our conversation with Dr. L. we talked about another surgeon that can do the HIPEC, Dr Y.
Dr L. said he would call to ask for his opinion. We must understand that in the case of this kind of surgery there is no consensus among surgeons. Dr Y is at the CHUM (Montreal University hospital network) therefore practice philosophy is sometimes different from one hospital to another.

Yesterday evening I received the call from Dr. L who told me that he spoke directly to Dr Y about my case. The latter agreed to meet me in 3 weeks. This will be a preliminary meeting where I expect he will explain the reasons why I am a candidate or not for this surgery. Dr Y has requested a PET scan before giving its final decision on the feasibility of the operation. As this examination requires a cessation of chemotherapy for a period of 3 weeks before, we will take this opportunity to go to Dubai. We will be there 2 weeks and my stepfather and his wife will be with us for 8 days (they live in Kuwait, just next door ;-). They will retrieve my Piccline and I'll get a port-o-cath installed when I come back. A Port-o-cath is a system of distribution for the chemo which is implanted under the skin like a pacemaker. This has the advantage of allowing me to bathe, take a shower without worry of a bandage and a direct opening to my heart.

All this to tell you we were excited yesterday, partial remission, exploration of the possibility of surgery, yes sir!
There was just a little news that brought us back on earth, my markers went up rather than down. My CEA were 8.8 (6.2 last time). Dr L. as usual is quite stoic. His comment was "This shows that we made the change in treatment at the right time." In other words, it could be a possible indication that FOLFOX started to lose its effect. There was a slowdown when one considers the trend of the CEA markers(13, 12, 10, 7, 6.7, 6.2, 8.8). Of course the toxicity forced us to change but what he says is that the efficiency points to this change also. So for him Folfiri is a good deal at this point.

I gotta go. There may be no blog for a few days but don't worry too much.

Confirmation of the good news

2009-02-05T16:30:00.001-05:00

Tuesday I went to the hospital because I had an appointment with a haematologist. It was also the scheduled day of chemotherapy but the results of my blood test on Monday was 1.1 so in theory too low for chemo. I will talk further about it later. In the absence of Dr L this week I met Dr. C. a haematologist who returns from a one-year fellowship in Australia. We were told she was excellent and very nice. She saw my file for the first time. As soon as we entered the office her first comment was.
-Wow! You have an excellent response to Folfox. Marie-Josée and I have looked at each other with an amused look. Our faces seemed to say: Well! We kind of thought so but we were waiting for confirmation from a haematologist.
At this point I said:
-In fact, it's over with Folfox since I had a severe reaction to the oxaliplatin, so we started Folfiri two weeks ago and that is why we have this appointment... a question of checking if there is any issue with the new treatment.
- And how are you?
-Very good. I answered her.

Then she takes a glance at my record, she looked at me and said: "I imagine that you want to receive your treatment today. Again Josée and I looked at each other with a smile. Well, for sure it would be great but I'm 1.1, we are kind of resigned for a delay.
She replied:-There is no reason.
She continued.
-Recent studies have shown that the treatment may, in some cases be given at 0.5. As you were at 1.1 yesterday, I am convinced that you are this morning at 1.3 ... 1.4. Plus you look young and fit then I see no indications against treatment today.
Should I prescribe it?
-Let’s go!

That sums up the story of the treatment that was cancelled but finally got prescribed. Nurses were kind of ready for it to happen because it seems that since Dr C. returned she is somewhat rewriting the established guidelines, with a smile of course. Looking at my records she raised another important point.
-You have consulted Dr. W.
-Yes, we were referred, and we wanted a second opinion on the exploratory surgery in July (see blog of August). In addition, this allowed me to be listed as one of his patients for surgery when appropriate.
It was a question of planning.
-What did he say?
-He confirmed the report and confirmed with great empathy that I was a very advanced case. He also opened the door to hope by saying that if the chemo worked well and I became a candidate for surgical specialist (called Hipec), he would submit my case to his colleague.
-Dr Younan.
-No, Dr Loungnarath.
-I know Dr. Younan and if you want I can submit your file to get his opinion as to the suitability of your case for surgery. Naturally in agreement with Dr. L.

Here, I went wild. A month ago I had the idea that it would be a longer battle than I had visualized. Finally, the doctor gives me hope that a late spring early summer could be possible. In any case it is the first haematologist to open the door to the surgery which was the objective from the beginning.
I was so pleased that throughout my treatment Josée observed that I had a smirk just like a little boy. She smiled widely herself.

In conclusion, an excellent day for our family. I continue to work on the remaining small spots around the liver and we’ll be talking about surgery soon.

Celebration time

2009-01-28T10:14:00.002-05:00

Today was a day of celebration.

You've read my blog on the visit to Dr. L and the scan results that were vague?
Dr L did not give us more details yet but we, through our connections, obtained the opinion of the surgeon who operated me in July. In essence the person that really saw what I had in my belly.

In fact, Marie-Josée had an appointment with her to receive the results of her breastst ultrasound. On this subject, everything is good. The surgeon ruled out the presence of breast cancer. That's our first celebration.

Then, Marie-Josée took the opportunity to submit all my scan reports. The July 21, the October 14 and the January 13 reports. Naturally, she did not really read the July report because she already knew the content since she had requested it. She read the January 13 and went back to read the October 14 . She, who had described to Josée the tumors in my abdomen, is adament. I respond remarkably well to the chemo and Avastin because the 30 centimeters mass is gone. She even said it was a miracle. Celebrations are in order. Marie-Josée is ecstatic. I am very happy too. I refrain from too much joy though. On the one hand my hematologist has not shown the same enthusiasm and on the other hand there are still a few small spots near the liver and right colon area. The battle is not over.

Don't get me wrong, I am not pessimistic. I am extremely happy. I have a large grin, the kind that says: Told ya this / "$ @ tumor would vanished. But I admit that I am looking forward to Dr L telling me: Mr. Raymond we have reached our goal, you are in remission. There is no doubt that I will be ecstatic then.

In the mean time we continue to smile, fight and tonight we made a toast to the disappearance of the monster in my belly.

To Health!

90 degree turn

2009-01-21T09:49:00.000-05:00

Yesterday I received my 12th Folfox treatment (leucovorin/5-FU/Oxaliplatine).
In fact, I have not received it in full because only 3 minutes after the start of the oxaliplatin (which is given over 2 hours) I had an allergic reaction with a major drop in blood pressure. That was enough to spike the stress level of the nurse and my wife. The nurse who took care of me was tensed when she saw my pressure drop to 80/53 in a few seconds. I went from scarlet red to green/white according to my wife. I sweated profusely. I felt like a rock was in my stomach that gave me nausea. I had also an urgentneed to defecate. All this despite 50 mg of Benadryl given in prophylaxis. This whole episode lasted about 10 minutes during which they gave me a shot Solu-Cortef to stop the reaction and try to raise my blood pressure. When my blood pressure started to come back to normal they added another 25mg of Benadryl. Naturally they stopped the Oxaliplatin right away.

We knew that one day I would no longer tolerate this poison but I believed it would be later. Let's say we had to go to option #2 a bit earlier.
Option #2 is is Folfiri. It is almost the same cocktail with the exception of oxalipatine which is replaced by Irinotecan (Camptosar). The latter has different side effects than the Oxaliplatin. Instead of the neuropathy which gave me a hypersensitivity to cold in the form of tingling in the fingertips, nose and toes, I will now have to manage diarrhea.

So I went back to hospital today to get my Folfiri. It is 22:30 when I write this blog and the treatment is well tolerated.

The positive side:
-My fingers are expected to return to normal within a few weeks
-The product change could have a beneficial effect and accelerate the disappearance of the lesions. You should know that cancer cells are smart and can adapt to the poison that we throw at them and successfully resist after a while. So, changing the poison can surprise the cells and lead to better response. Cross our fingers.

Conclusion we must always be ready to take a 90 degrees turn.

A Beautiful Holiday Season

2009-01-20T09:45:00.000-05:00

The holiday period is already over but it was lots of fun. We had a schedule to our taste. We attended two shows. The first was High School Musical the Ice Tour. For those familiar with this ice version of this musical it incorporates HSM 1 and 2. High School Musical III will b e out soon. Thank you to Francine and Geneviève which enabled us to see this show. The timing was perfect since Tristan is preparing a year-end show at school based on HSM 2.
The second show that we saw during the holiday season is the classic Nutcracker at Place des Arts. Last-minute decision, typical I believe, of families in our situation. An excellent show for the well known musical pieces as well as its magnificent decor. A great way to introduce children to live classical music and ballet.

We also had rest days, without specific schedule. During these days we were out of bed later, the day was spent in pyjamas playing some of the games children received for Christmas. Mom played dolls (Barbies) with Élodie and Dad played with the boys on the Xbox and a game Monopoly World Edition.

We also played street hockey with Jordan putting on his new goalie equipment. Jordan loves to play in goals and Tristan with his experience in hockey cosom is an excellent forward. Élodie, she likes to be outside with her brothers but do not like hockey that much.

The children were given beautiful gifts. They played a lot during this holiday season. They also love their digital photo camera. Grandpa Santa, gave them an excellent quality compact camera with which they can all let go their artistic side with glee. Long live digital!

I’d like to say thank you to all our hosts. It is certain that the holidays are less tiring when you are not the host but the guest. I speak mostly on behalf of Marie-Josée because she has the most to do in these situations. So thank you to Pierre and Sandrine, Lilianne and Bob, Johanne and Gen, Danielle and Bill and Grandpa and Loulou.

Thank you to Grandpa who invited us to the restaurant where he made sure to have live piano just for us during dinner… and after. Beautiful evening where Josée took the opportunity to relax completely (with a little help of an excellent bottle of wine ;-).

I say a big thank you to my brother Jocelyn who came before Christmas to clean the garage under the instructions of MJ. Thanks to him, now we could fit MJ’s car in the garage. That is until we bought the treadmill. It occupies all the space but now it's for a good cause. Josée can continue her training when the temperature does not allow for outside running. I also use it when I can, and even the children use it. Élodie is doing her 1 Km while Tristan and Jordan go for 3 Km. Mom is very motivating for her children, they want to imitate.
Finally, I want to thank Guy Boucher, a friend who is primarily a friend of Pierre, who coaches in the junior hockey league. He was appointed assistant coach to Pat Quinn at the world junior hockey championship, which took place in Ottawa. He called me to offer me tickets. I unfortunately had to refuse his offer but I am grateful to him for thinking of me and my boys for the occasion.

This message can be late but I started to write on January 6. I delayed it because I had the inspiration for other shorter messages more relevant over time and so on. Still, I really wanted to express our thanks to everyone who is part of our support network. You are so important in the situation we live.

Thank you!

Appointment with my hematologist - Dr L

2009-01-19T09:28:00.001-05:00

Yes, this morning we had an appointment with Dr. L. Important appointment as we reviewed the report of the last scan. Time goes by so fast. In short, the results are positive. There ais a slight regression in the words of the radiologist. One of the spot around my liver has shrunk from 11 mm to 7 mm. I bet you this one will be gone on the next scan. The Dr was happy even though he was not super excited. He shared MJ's view, to say that the regression is slow. Yet again things are going in the right direction. The report also indicates that Dr. L should continue with treatment without any change yet. Markers? My CEA is now at 6.2 (6.4 last time) It is a small difference but again in the right direction.

What has been the most fascinating in this meeting is that the radiologist's report is rather vague and we noted that in all three scan reports no mention of the 30 cm mass seen by the surgeon in July. When we asked Dr L what happened to this mass, he could not answer us. So it is intriguing. Stay tuned because Dr. L has promised to call the radiologist and ask for more details.
Remember this, Qui va piano va sano, slowly but surely... it is a philosophy that fits my character. When it comes to beating cancer I have all the time on earth.

Stay tuned!

It's Not Fair

2009-01-11T14:04:00.001-05:00

MJ recently told me with great emotion that it was not fair that our children have to live with the cancer of a parent. I immediately played it down by saying that this would make them even more able to listen to others, they will get mature faster, that it is a test of character.

Yesterday we went skiing. It was the 4th day post chemotherapy # 11. I felt better than I would have thought. I contributed to the preparation and I even drove all the way up. We arrived at Mount Habitant and we were on the slopes at noon. The cold didn't seem to affect me too much. I made two runs and we took a break. Lunch, rest and restroom ... I did not return. The energy had left my body like thief, quickly without warning. Marie-Josée returned on the slopes with the three children. Meanwhile, I took off my boots, put the equipment in the van and fell asleep in the front seat. I was awakened by a call on my cell phone. It was MJ but I did not respond in time. So I got out of the van and went towards the lift. I saw Josée going to the bathroom with Élodie. The two boys went for a run on their own. I felt horrible when I realized that I could not help my wife to handle the children, ouch! Marie-Josée despite my insistence tok care of Élodie's needs. I went back in the car. I did not go back to sleep but I rested enough to the point where I felt my energy replenished. So I participated in packing up the equipment at the end of the day of skiing: 15:40.
In less than three hours of skiing, the family managed to do 7 runs (even 8 for Tristan who made a solo run). Then I insisted on taking the wheel even if my wife offered to take it. Although it felt essential to have a coffee at Tim's in St-Sauveur. Despite the caffeine, my wife watching me, begged me to let her drive. I finally agreed when we got to Mirabel, where as soon as I sat on the passenger seat, I fell asleep like a child. I woke up in the Costco parking in Boisbriand when my wife and my oldest emptied the shopping cart. I had been sleeping for 45 minutes. My wife was smiling and my oldest was just as excited to be the man of the family.

This is where I cracked.
I started to cry and I said to my wife, it's not fair ...
MJ surprised, wondered what's wrong? It's not fair that my children have to live with my cancer. It's not fair that my kids have to grow old so quickly.

Tristan continued to act as a man when we arrived home. He emptied the van with his mother, he got wood inside for the fireplace and he did everything with a smile and the strength of a young man. Remember he is 11 years old, not 13, not 15, eleven years old. Jordan, my 9 year old son, pitched in by starting the fire. Emotions are mixed in a period like that. I am proud to have children like mine, but at the same time, I felt like half a man. Unable to help. My wife has to bear a huge burden because of cancer. A life that we were strolling through with two active adults in full possession of their means, it is quite another thing when it becomes 1 and a quarter of an adult. The division of labor is not equal, MJ is now taking 1 and 3 / 4 of the responsibilities while I take a mere 1 / 4. Worse, in my days post-chemo, I do nothing and I become a burden.

This is not fair.

It's crazy because justice has always been close to my heart. Most of the quarrels of my life have been because of injustice (perceived or real). Hockey, soccer, referees and players were yelled at in the name of justice or fairness. Finally, we say that cancer gives lessons that we must listen to and understand. It's hard but I try to be attentive. In this case I think someone is trying to make me understand that being too proud pride is not a good thing. Also, it is necessary that I learned to live temporarily with limitations due to my treatment and accept help from others even when others are my wife and children. I cried a bunch yesterday, I was probably due ... or I was weak because of my treatments (wink ;-) I'd have other things to say but I'd feel redundant so have a great day!

To write a book...

2008-12-30T13:10:00.000-05:00

Jordan came to us yesterday with an idea.
He said: "I want to do something but I'm too young."
I replied: "what do you want to do."
-I want to write a book about cancer he answered.
-You gotta do a lot of research to write a book about cancer.
-Well, It 's not really about cancer, but about the emotions of cancer.

Wow! I said to myself.

-So you're not too young, you can start right away. Use your little diary to record your thoughts.

He went to get his small notebook. He wrote the title: The Emotions of Cancer.
He then wrote his first sentence: I think the hardest part is learning that the person you love has cancer.
I can tell you that I had water in my eyes. At the same time I had a feeling of pride to see my 9 year old boy able to express his emotions and ready to put it in writing.
You say what you want but it's not easy to cope with our emotions and to identify them precisely. When you are capable to do it at this age we are well off in life.

Report on ... a Big Day

2008-12-29T20:34:00.003-05:00

I know many of you think there is a bit too much time between blogs, especially with the last blog “Tomorrow…A Big Day” left open. Sorry.

Our meeting with Dr. L was not quite as we planned. Let's say we were, Marie-Josée and I, a little too enthusiastic and we felt he wanted to bring us back on earth. We asked very specific questions about my possible surgery: when how the decision will be taken, what are the triggers, How much the masses have to be reduced, etc.).

All these questions with a tone and an attitude of certainty in the advent of this surgery. Dr L responded with terms and particular language that had the effect of a cold shower. I felt that he thought we were a little too optimistic, that we may have had our expectations too high, and he wanted us to refocus. He mentioned that the treatment was progressing well but it is difficult to predict the response of cancer, things can change quickly. He mentioned that the main objective for him was to bring me into remission and keep me there as long as possible, suggesting along the way that the recovery was not possible. He also mentioned but without much conviction that the decision to proceed with surgery would be taken by a team of specialized surgeons, not by him. Needless to say the rest of the appointment found Marie-Josée and I pretty depressed.

However, he didn’t say anything that we did not know already. It's just that we had started to hope that things would move quickly, like having an operation in the spring, but the doc brought us back to another reality.

In these circumstances you will understand that we took a few days to reflect before we were back in the game. In the end, the doctor did his job, he tried to manage our expectations based on statistics and/or on his experience. I plan not to correspond to neither. I have said from the beginning, I have no issue being being an exceptional case and I will be in all phases of my recovery. I even told the doctor before leaving the appointment, "one day you'll use my case in your conference as anecdotal potential for Avastin.

Furthermore there was not only negative news, that day we also learned that my CEA were down to 6.4. Getting close to 5, check out the results next month.

In January, at the same time as my markers, I will have my third abdominal scan. I expect to surprise Dr L with an unexpected reduction of my large tumours.

If you were wondering about the chemotherapy of December 16, I received it as expected with a double dose of Benadryl (50 mg intravenously). I have not had an allergic reaction which is good. I had quite a buzz though. I would say that I now know why I have never taken drugs in my life (except alcohol)… because I hate the feeling. This feeling of my head in the clouds with a body that weighs a ton and sleeping without sleeping because you hear everything going on around you. I take it because it allows me to continue my chemo treatments according to plan but it is not something I would do for fun, no sir.

Until next time!

Happy Holidays

2008-12-24T17:57:00.002-05:00

Allow me to use my blog to wish everyone a happy holiday season and an excellent year to come. I hope everyone will get what they wish for in 2009 but in my mind nothing is more important than health. As someone once said: when you got health, everything else is gravy? OK, I made this one up myself ;-) but don't you agree?
Think about it, when you are healthy what problem is worth thinking about?

Merry Christmas and happy new year!

Tomorrow... a Big Day

2008-12-15T21:08:00.001-05:00

Tomorrow, Tuesday 16 December

What a coincidence that I have an appointment with Dr. L, my hematologist, the day of the birth of my mother. The meeting is important because I will learn how the doctor wants to manage my allergies. I also have questions to ask on what is coming: 2 treatments according to the original plan but how many more will I receive? How will he assess when to refer me in surgery or in other words what kind of reduction of the tumors does he hope for? What will be the date of my next scan? Can I have a break from chemo for a week during the holidays without jeopardizing the progress achieved? What is the level of my markers, yes! It's been a month.

I am sure that my mother will be there behind my shoulder ... What I am saying? She will be right in his face prepared to give him a slap behind the head if he does not give me the right answer. I can hear her say: You are going to heal my son or else my name is not Raymond.
Note: for those who read this blog without knowing all the details about my family, my mother passed away, I refer to her presence in spirit of course.

Yes ... Tomorrow is a big day.

On another topic, our boys competed over the weekend. They each collected a silver medal. They demionstrated beautiful judo as their father loves it. Flexible, diverse, respectful but with a nice determination without misplaced aggressiveness . In both cases it was close to be a gold medal but Judo is a sport where quick turnaround happens. Moreover Tristan has learned the lesson that "it's not over until it's not over". He was losing his second to last fight when with 10 seconds left he counter attacked and scored the decisive point: Ippon. He was proud to have persevered and thus enabling him to participate in the final. Jordan has shown much progress in his judo groundwork. He has won two fights with his follow through standing-to-ground techniques. Friday will be the last judo session before Christmas. Luc invited parents to step on the tatami mats. Guess what? Marie-Josée has decided that she would participate. In three years it is the first time she agreed to wear the judogi and to battle on the mat with her sons. I am sure she will be pretty sexy in my new competition judogis. I'm will be not quite in shape to join them (three days post chemotherapy), but if I have enough energy at all I will not miss the opportunity to tease my wife on the mat. Of course Élodie dress up and so it will be a real family affair.
Finally, our outdoor Christmas decorations are installed, tree included. It was very cute to see Jordan and Élodie collaborate on the little Christmas village. It began with an argument but finished with a smile. Élodie is at the age when the wonder of Christmas is at its maximum. Hers eyes light up when she talks about the coming of Santa Claus. Jordan, for the first time, participates in the enchantment of her sister by explaining the relevant details as to why we leave biscuits, milk and carrots for Santa Claus and his reindeer and especially why you have to well sleep... because if you are not sleeping Santa Claus does not come ;-) You all know, no? I have to go to bed because tomorrow the appointment is at 8:10, it's early with the traffic on the highway 15.

Good night!

It's winter my friends!

2008-12-10T10:08:00.001-05:00

I begin this blog by reassuring everyone on my psychological shape. My morale is excellent and no doubts haunts my mind. I hope that everyone feel reassured. I think some believe that my morale is low because of some circumstances in recent days. The past weekend I had invited my two younger brothers to come watch football in high definition on our big screen TV. The same day my step-sister Sandrine had the good idea to confirm that everything was well for the visit. Everything was fine except she told me on the telephone that the PITCHOUNETTE (Clara) had a cold. So I hesitated before taking a decision but I had to resign myself to postpone this visit. Sandrine was wondeful because she left me no doubt that she understood very well my position and that it was not a problem. The reason we have postponed this football afternoon is, as you all know, my immune system is affected by chemotherapy. For me getting a cold means an hospital visit. So as much as I wanted to hang out with my brothers I did not want to catch PITCHOUNETTE's cold. Furthermore if it was not me it could have been one of my children who could have caught this cold, which would have forced me to wear a mask at home for a while and avoid contact with my kids. I hear you say: "Yeah, but your children go to school, they can catch it anyway." Yes, but it is certainly easier to postpone a visit from family then to not send my children to school. We manage risks the best we can. Speaking of my immune system, I'll give you details on the reaction of my body. As I said I had an allergic reaction during the eighth treatment. In the ninth treatment they gave me Benadryl in prevention but I still, at the end of treatment, had an allergic reaction (less powerful than the first but still). This can be problematic or maybe not, we will know next week when we talk to Dr. L. He certainly has several options from which to choose. Discontinuation is not the only one and certainly not desirable. The other element that worries me a bit (I say a bit) is my bleeding nose. Since the eighth treatment I have nasal concerns. My nose is very dry and I get a good congestion during the night. The morning when I'm undisciplined and I blow my nose without preparation, I disturb my nasal walls (I bust a vein) and my nose begins to bleed quite heavily. OK, I have seen other people bleed more than that but for me it is very unusual. After the ninth treatment I began to bleed just because I contacted my abdomen to evacuate my bowels. In addition, compared to the post 8th, this time it took 6 days to calm down. The source of this problem can be multiple and even combined (home drier due to heating, Avastin, low numbers of platelets), but it is certainly something I will discuss with Dr L.

Change of topic, I shoveled the entry yesterday ... twice. The first time it was about 15:30, the children were back from school. They all helped me according to their capacity. Tristan really impressed me. He's only 11 years old but you can feel the teenager, the man growing in him. He showed great strength and determination in the removal of the snow. When Marie-Josee came home around 19:00, it was as if we had not done a thing. This time I decided to try to start the snowblower. Don't you worry I have not exerted any force, it is equipped with an electric starter. So a few strokes of thumb on the siphon, a few strokes of the thumb on the starter and it finally went Zoom Zoom. So I redid the full car path for a second time. I was very proud to have the strength to do it but like any good macho, I was keen on doing my favorite neighbor's entry before he was back from work. I couldn't finish before he arrived. I still helped him a bit since he opted to make his entry with his shovel. I was pleased to give him a hand with my old snowblower. I was so absorbed by the task that I lost sense of time and when I finally got back in my house, it was 22:00. The whole family was in bed.

It is not only the strength that I was glad to have to remove the snow, there is also the fact that I managed to dress in an adequate manner to prevent my fingers and face to sting ( side effect of the chemo). It gave me hope that I can go skiing and do other winter sports as far as I am well dressed. It is not that easy, you know, especially for the nose. It is a problem because I can not completely hide it without suffocating or creating a icy zone on the hood. Still, my combination of polar hood and fur hat with ears worked well last night.

Thank you for your continued readership and have a great day!

New York

2008-12-03T14:36:00.000-05:00

We left home at 7:30 Thursday morning. We arrived at the hotel around 14:30. Overall the trip was very pleasant and seem to go by quickly. I summarize the trip this way: we walked like crazy. So much so that Marie-Josee is considering the weekend as cross-training for her running regime.
We saw what we had planned. Elodie was amazed by the American Girl Place store. M & M and TOYS'R'US struck the minds of our three children. As far as meals go, we made a discovery that we recommend to all. The restaurant Becco is fantastic. Excellent Italian food in a family atmosphere for a price acceptable to downtown New York.
Anecdote: the maitre D at Becco wore a badge saying "Cancer Sucks". I pointed it to MJ and the guy told us that two years ago at age 40 he was diagnosed with stage 4 colorectal cancer with liver metastasis. He has since undergone 9 operations and finished chemo. He could not say more but we connected when I told him that I had the same thing. MJ found the coincidence striking. This restaurant had been referred to us by the hotel concierge.
MJ has managed to find tickets for the show "Lion King", quite a phenomenal show in the management of scenery and animal characters . The giraffes and the hyenas impressed me the most.
For those who are not friends with MJ on Facebook, here are photos of our trip. Click on the image to view the album.

New York

Chemo... #9

2008-12-03T14:30:00.000-05:00

Yes!
I am connected until tomorrow on my 9th chemo. Despite the Benadryl given in prophylaxis (to prevent), I still had a reaction towards the end of the infusion of Oxaliplatin. They injected a dose of Solu-cortef, to control the reaction without putting me to sleep like Benadryl. In my next chemo they will consult Dr. L. to know what to do. They could discontinue oxaliplatin, replace it with another product or use the alternate approach, which means treatment without OXA and treatment with. We'll see. Today fatigue is not so bad even if it is day 2 post-chemo. Perhaps tomorrow I will crash because the effect of Decadron stops.
Again we will see, one day at a time.

Read my next blog which I am writing at the moment on our trip to New York.

Good day to you all!

8th chemo +4 days

2008-11-22T14:07:00.002-05:00

Hi everyone!

I derogate from the list of topics mentioned in the previous blog because I wanted to tell the story of this chemo. As usual this chemo has its peculiarities. First, I had an allergic reaction during treatment. The nursing staff is accustomed to this but Marie-Josee found it quite impressive to see me red like a lobster with a nice swelling on the forehead. When you see this you start to ask yourself if you are going to stop tolerating the treatments. As you know chemo is "it" for me. If I was not be able to take it I would be pretty Fuc... Uh, stuck. So a small shot of Benadryl and the reaction was gone. Naturally I dosed off like it or not. The next time the Benadryl will come immediately before oxaliplatin.

Another particularity this time is that the tingling in the hands are very present. Much more than the last time when I concentrated my visualization exercizes on the reduction of this side effect.
The last story is about my markers. They had forgotten to measure them in my blood samples of Monday. So Tuesday before chemo, my nurse asked for two other samples of blood because the markers were due. The result did not come out before we left the hospital Tuesday so we called Friday for the results. The disclosure of these results must be made by the doctor, since he could not call us on Friday, we had to wait until Saturday. We had begun to worry a bit. Is he not calling because the results are not positive? Friday night when Marie-Josee raised the topic I told her: "Forget it, if it was important he would call, no news is good news". When he called Saturday he gave us the following results: CEA @ 7 and CA-125 @ 17. The latest measures were respectively 10.6 and 16. A level of 5 and less is considered normal for CEA and under 35 for the CA-125. I am at the door to have both markers in the normal range of the general population. We are very encouraged. What happened to my tumours? I do not know but I can tell you that I look forward to the month of January for my new images.

Have a great weekend!

3/4

2008-11-17T13:18:00.000-05:00

3 / 4 of the first round of chemo. Tomorrow in fact, because that is when I get the 8th treatment. 8 of 12 treatments completed ... still a while to go. I admit that in recent weeks I have had some mental fatigue. It is as if I had just understood that I have to stick with the treatments for a while still. Foolish no? It's a bit why I have not written much lately. It is as if unconsciously I wanted to pretend that I do not have cancer. I went about my occupation without thinking of the hospital, the treatments etc. So I couldn't find things to say on the blog. Finally, the arrival of the next chemo brought me back to reality. I made a list of topics on which I will write in the days to come:
-Our dinner at the restaurant Trattoria Mundo
-My last conversation with my oncologist
-Visualization workshops
-I 've asked Marie-Josee to write the adventure of organizing my birthday
-Our next trip to New York (26 to 30 November)
-The 7 habits of Stephen Covey (it will come)

So don't let me down, I will continue to write even if a break from time to time is necessary. Have a great day!

Video: African drums

2008-11-12T22:15:00.000-05:00

Here it is finally.

Some of you let me know subtlely that you were impatient to see the video. It lasts about 7 minutes when the actual raw footage is about 30 minutes long. I had to pick and choose clips to show you. I hope you'll like it and don't forget to pumo up the volume.

What a party!

2008-11-02T22:01:00.000-05:00

Hello all,
I know some of you were beginning to ask questions. Is he sick or too tired to write? None of the above. This week I was in great shape and I have taken advantage of this energy to accomplish several tasks that had been delayed. There is also the fact that I wanted to accompany this blog with a video clip of my party celebration. Quite a party that my wife organized in secret. There were more than 100 persons. She worked for three weeks on the organization and and typical of Marie-Josée everything was carefully planned. The highlight of the evening was the opening performance by the group Drum Cafe with all the guests. This agency specializes in corporate events so it was unusual for them to perform at a private party. This session of percussion by all these people with the facilitators were quite an experience. These vibrations penetrate the body and re-energizes us. Play the video in the blog that will follow and you'll get an idea. Of course experiencing it live is much more sensational but just by listening I hope you'll get a chill.
I received a lot of gift which I sincerely thank all the contributors. The piano is already installed and Jordan and Elodie have spent quite some time playing. Jordan has talent and we are looking for a teacher that comes to our house. Elodie also has a good ear. Tristan is more concerned about his computer at this time then music. It will come.
I said it during the evening but I repeat it here for those who have not had the opportunity to be present: my wife is extraordinary. For three weeks she managed to invite 110 people, coordinate their arrival at the cultural center of Lorraine, order and pick up the buffet at different suppliers, plan the performance of Drum Cafe (build a crescendo beginning with my children on stage, then my brothers and sisters followed by my wife's family and all my friends). The emotions was high and tears were shed.
Thank you to my wife and all those who were present. You made me live the most beautiful birthday of my life.

Check out the video in the next blog,

My disease through my daughter's eyes

2008-10-24T17:12:00.004-04:00

I can't help but publish this drawing from Elodie and the story around it, it's too cute.

This week, coming back from school Élodie shows me her drawing and tells me that these are electric wires in my belly. She said that it's my cancer because it is connected everywhere. I have to say that she listens to us a lot and often when we tell the story of my cancer we explain that surgeons could not remove my tumors because they are too large and they are connected everywhere (to the liver, to the stomach etc. ..). So for her, it's like her electrical wires. Cute No?

The other story I have to tell regarding Elodie and my cancer is that almost everyday she asks: Is it your chemo day today? She asks me because it is often the reason why I will not pick her up at school early and thus she must go to daycare. So when she "feels" like returning home right after school she asks the question. When I say no, the next question is: Can you play doll with me. You can be the dad, OK?

My children are a bundle of love everyday

28

2008-10-18T20:14:00.002-04:00

What is this number? You will never guess. It's the level of my neutrophils (white blood cells) Friday morning before my chemo. When G told me the number I reacted:
-What! 2.8 you mean.
-No, 28. With Neupogen and at your age, it can happen.

You should have seen my face, a mixture of disbelief and a nice smirk. In any case, they're is no hesitation now. This shows how much Doc L knows his business and how he is aggressive like I like it. So I'm connected to the chemo # 6. It will be a weekend in slow motion for me but at least I will be fit for my birthday.

Talk to you later!

Latest news

2008-10-15T16:50:00.004-04:00

We interrupt our programming to announce the results of the control scan and the latest results of my blood test. News are good. Indeed, Dr. L gave a "thumbs up" when he listened to the verbal report by the radiologist. In summary, lesions on the peritoneal wall are all gone. There is one lesion left on my liver while there were 2 or 3 in July. As for the large tumors there is no evidence of shrinkage yet, none the less my hematologist is very enthusiastic. He said that large tumours may take more time to respond but with what he heard from the radiologist he knows I'm on the right track. In addition, cancer markers level is continuing to reduce. The CA-125 went from 65 to 22 to 16 and CEA stable a month ago is now down to 10.6 (13 previously). Dr. L prescribed Neupogen again so that I can get my chemo this Friday (no reasons to wait next week he said).

I don't know what part of my healing process is more important but please don't stop what you do. If you pray or send me positive waves don't stop. On my side I will continue to eat according to the principles of Dr. Béliveau and pray, meditate and visualize.

Thank you for your support!

Indian Summer

2008-10-11T12:30:00.000-04:00

Today was a day full of energy from the sun shining and also because I am at day 10 post-chemotherapy. We had lunch anti cancer style. We had an egg over easy with turmeric and garlic in a grilled english muffin, mustard and mayonnaise. I accompanied it with fresh mini potatoes slightly fried in the pan and nice slices of italian tomatoes. Marie-Josee and I savored with this feast an infusion of Japanese dried green tea leaves (Sencha variety). After the visit to the hairdresser of our three munchkins, we prepared for an official training of team Raymond-Lafrance. The three runners in their specialized hi-tech clothes and Tristan and I with our regular running shoes. After a short warm up, we were off for a 1 km run. Elodie this afternoon was not quite in the mood but Jordan was, as usual, full of enthusiasm. Me, despite my energy being at the top, I did not even run the kilometer. I walked the last third of the way. Anyway I am handling the video camera at the Cross des Couleurs in Les Cèdres. After the training, with the fresh air and sunshine, the kids and I played touch football in the street. Mom was gone to the hairdresser, it was her turn. Touch football did not last long because the asphalt is not the best surface for it. But we continued to throw the ball for a while the four of us and then three of us since Élodie got bored. It was so pleasant to play ball with my kids. The Guys were running patterns and I was throwing cigars like a pro ;-). It was a great time in the outdoors, a lot of fresh air and fun. Time for sleep now because tomorrow is the race at 11:00 in Les Cèdres.

Disney On Ice

2008-10-10T22:23:00.001-04:00

François thank you!

I thank him because he had the generosity to invite the whole family to see Disney On Ice in the Emergis/Telus loge. François is the father of Tristan's best friend . We have known each other for about three years now. Our boys are together all the time. François and Chantal, the mother of Thomas, are people with a big heart and of exceptional generousity. That is why Thomas and Tristan get along so well because Tristan also has a big heart. To illustrate this, these two boys aged 11 along with their friend Olivier organized last spring a cycle-o-thon to benefit the Hospital Ste-Justine foundation. They collected a total of $1605. It demonstrates their social conscience which I believe is very inspiring. They will do it again this year, I will call upon your generosity when the time comes.

Disney on Ice was a show worthy of ... Disney. Marie-Josee and I are fans of Disney. We brought our children twice already to Disney World (Florida) and we expect to return in 2010 when Élodie turns 6 years old. When she went the first time she was only 1 year old. Anyone who has kept in them the spirit of a child should go at least once to Disney World. In my case there is the child in me who loves Disney but there is also the "business" side because in my university studies they were mentioned often for their remarkable management of the theme park concept.

To See this show in a loge was a also a powerful experience. After that, watching a hockey game in the reds doesn't have the same appeal. The loge is spacious, comfortable and well stocked. In my case, something significant was the presence of private toilets. During a hockey game it's an asset that is worth its weight in gold and especially when, like me, you don't quite control your bowel movements. We were treated like distinguished guests and we spent a very enjoyable afternoon .

Thank you again François.

Cooked in the squat

2008-10-10T09:55:00.004-04:00

This message is a follow up on a comment made on the french version of my blog. My brother and sister-in-law reminded me of a story I had told them 15 years ago. At the time I had finished reading See You At The Top from Zig Ziglar.

Pierre et Sandrine you are reminding me of a lot of moments when you talk about Cooked in the Squat. And Pierre you are right it is Zig Ziglar that tells this tale. I went on the web to find an audio recording of this Ziglar story of the biscuits that get cooked in the squat. The biscuits story starts around minute 2 and lasts until the end. In total the recording below lasts 6 minutes that are really worth a good listening. The heavy southern accent may be difficult to comprehend sometimes but my english readers should not have to much of an issue.

Well, this is a good start for the series of blog I am preparing to write on the philosophy that I embrassed when I was in my mid twenties after listening to loads of cassette and read plenty of books on motivation, positive thinking and "How to's". The book that summed it all up for me is "7 Habits of Highly Effective Pepole". I wish all could read this book and apply its teachings.

Action is the name of the game. It is the common element preached by Stephen Covey, Tony Robbins, Zig Ziglar and others. It is in fact the subject of the little video I edited for you here.

Listen with pleasure and get into action!

No judo for me this week

2008-10-06T23:31:00.003-04:00

I missed judo tonight ... and for the week. I don't control my body as I want, especially post-chemo. Tonight is one of my soft period, in scientific terms: diarrhea. It comes with every chemo around the fifth day. Unfortunately this week my guys are going just once, tonight. The other two nights, Wednesday and Friday are reserved. Wednesday, Tristan will spend time with a private teacher to help him prepare for admission exams to secondary school. He is interested in three schools: externat sacré-Coeur, College St-Sacrement and St-Gabrielle school. The first two are private, the third is public but with IEP (international curriculum). The three schools have selection criteria including a written exam.
As for Friday we are invited by a friend to see Disney On Ice. The show is in the afternoon but it ends too late for us to return for judo. It is such a generous offer that we accepted with so much joy.

Other major news today: Élodie will wear glasses. A month ago during the normal pre-school visit, an optometrist detected astigmatism in Élodie's eyes. This afternoon she did further test to confirm the diagnosis. Élodie was not very pleased with this new accessory. I tried to put a smile on her face by saying that her father wears glasses and he is goodlooking anyway, to which she agreed of course. But the real turn around came when mom told her she also had to wear glasses and she showed her. Suddenly it was not the end of the world anymore it was, in fact, very cool and "sexy".

* The sexy part came when I made the comment that her new
rectangular shaped raspberry color frame, chosen by her mother, would be so
beautiful. Elodie added "it will be sexy" with the associated gesture
that you can imagine. She is five years old ...

I'll post pictures when she gets them.

Watch my next blog because I want to begin a series of texts on an author who has influenced my life. I can hear Yves and Jocelyn say: "not Tony Robbins". No, not him even though I appreciate thoroughly what he advocates and that it's a part of what Dr. Stephen R. Covey wrote in his bestseller: The 7 Habits of Highly Effective People.

Until next time!

In Between

2008-10-05T12:34:00.002-04:00

Funny title, no?

This is the description that came to my mind when I wanted to write about the period I'm plugged into the bottle. I am writing this note because Marie-Josee looked at me this week, lying down, apathetic, asthenic, and she made the following comment: they don't really know what you're going through. "They" referring to all those who read the blog. I started to tell her that I had nothing interesting to say during those days or at least nothing positive. I would rather write nothing then write depressing things .
Then I thought for a bit and I told myself that this can still be interesting to know what happens during the days 1, 2 and 3 and sometimes 4 post-chemo. I know that I have described briefly the low energy that builds back up after a few days.

What I want to add today happens in between the ears. My brain, shortly after connecting to the bottle, has developed a pattern. It settles in a kind of soft cloud but at the same time not very comfortable (like a water bed, for 5 minutes you say wow that's nice, after half an hour you have backache). It's as if I have an out of body experience. I observe myself be soft and apathetic, heavy and slow. The majority of tasks require energy that my brain could force my body to do but it doesn't. It's as if it was saying "why should I get out of bed, it is not really necessary." It is certain that I'm spoiled by my entourage so there is a certain complacency. But my brain rationalises the behavior, I have to rest so I can recover quickly.
It's complicated, no. Get up, don't get up, rest, move your buttocks. There's this internal struggle during those three or four days. This intellectual rollercoaster projects an external image of depression. Marie-Josee watches me through a magnifying glass to see if it is temporary or if I will sink into despair. The reality is that I am certainly not the Martin you know during that period but I am not about to fall into real depression.

After the fifth round of chemo, sometimes I wish it would be over, that I'm cured. I would like to use my energy to live rather than survive. I'm not sure what I just said is clear. In any event, I reached the fourth day post-chemo, my brain is getting out of this cloud and it starts thinking about what to do during the period in which energy is better. Then, he realizes he has no time to do everything and must prioritize.

It's the fourth day, I am trying to prioritize ... write my blog, play with Elodie, play with the my boys, give a hug to my wife ...

It will be for...

2008-09-30T19:50:00.001-04:00

We got a call from the hospital this morning at 8:15. Dr M who is the doctor contacted by G, the scheduling nurse, decided that treatment should be delayed to next week. Marie-Josee challenged the decision by calling my coordinating nurse to see if she could get in touch with Dr. L and try to reverse the decision. She explained that a week does not affect the outcome of treatment. The danger with giving chemo with such a low level of white blood cells is too great to proceed this week.

For sure this was a disappointment for a short time this morning. For me it was a sign of failure ... for 15 minutes. After that, well, I looked for the positives in this situation.

If my white blood cells are so affected by chemo, imagine cancer cells. Especially since they don't receive any help compare to my white blood cells(Neupogen the super hero to the rescue).

I can enjoy a full week with plenty of energy while I usually have only 4 - 5 days before resuming chemo and drop quite a bit. I will be able to complete a lot of work for the fledgling company, Vita Ethica Laboratories. I will also work to boost my immune system: exercise, nutrition, sleep.

STOP!
Wait a minute. The phone is ringing. It's my coordinating nurse. She made the effort to contact Dr. L and discuss the situation. She told him that we are insistant. Dr. L accepts a compromise, I must return to the hospital to redo a blood test and we will advise according to the results. I got dressed and we left for the hospital. I got there around 13:00. The advantage to do this in the afternoon is that there is nobody. The needle is in and in 30 seconds they have a new blood sample to analyze. Now the wait starts. G promises to call me on my cell phone as soon as the results come out.

In the meantime, I went for lunch and run some errands. I am at Ernest trying on some trousers (I went from 38 to 34 since July) when my cell phone rings.
-Yes hello!
-Mr Raymond it's G in hematology.
-Yes ...
-You're at 1.8.
-YES !!!!!
-You know it's very rare that ... in fact, you are an exception Mr Raymond.
-G this will not be the last time I will be an exception, believe me.
-Then would 10 o'clock tomorrow suit you.
-It 's perfect, thank you and see you tomorrow.

Yes ladies and gentlemen, I will receive my chemo tomorrow with a day's delay, not a week.

Effective... or not?

2008-09-29T23:58:00.000-04:00

I received a call from the hospital around 16:30. The lady tells me that the blood test done this morning indicates a level of white blood cells of 1.4. Remember that 1.5 is the lower limit under which chemo is usually delayed for a week. Well, she did not cancel tomorrow's chemo yet because only a doctor can take the decision and she could not find one at this time. So I go to bed tonight not knowing if tomorrow I get my treatment. I can tell you that this call was like a speed bump on the road. You drive a bit too fast, you don't see the speed bump and bang! You hit your head. The call was a bit like the analogy of the "speed bump". I was temporarily stunned, disoriented ... I had the blues.

My first reaction was not to go to judo. I felt like letting myself absorb in self-pity, not so much in the mood to take care of young "judokas". I did not have the energy to tell the world "things are going well" with a big smile but neither did I want to explain the details of that call.

My second reaction was to get my biology and pharmacology books out to see what I have not done or what I could do to boost my white blood cells. 20 minutes of reading and I did not learn much. The immune system is a complex subject.

My third reaction was: "this 200$ a dose sh*&%t is not working."

Finally, I started to breathe through the nose and I started to think things through. Since the beginnning blood test are done for the specific purpose of detecting these predictable low levels. Ultimately the question is not WILL I get under 1.5 but rather WHEN will I be below this threshold. If the result is to delay by one week my treatment, it is not the end of the world, just a little bit demoralizing.
Understand that since my appointment with Dr. L, my hematologist, where he said "here's the plan", my path has been positive all the way.
Let me explain:
-I had to be in a good enough shape to start chemotherapy quickly: check
-I had to tolerate the poisons they give me to get rid of cancer: check
-I also had to tolerate Avastin: check
-I have impressed many people including the president of the association by my apparent good shape: check
-Even at 1.5-the doc prescribed the chemo since my case was good: check
-That same day the cancer markers trend gives renewed hope: check

Only good news ... Today is not such a bad news after all. It's just that I was flying high with all my good news so this bad news came as a shock. It felt like right after a big rush of adrenaline. You don't come down at normal level, you crash.

The Neupogen may not be effective? Or it is very effective and thanks to it my level is at 1.4 when it could have been much lower. I will propably never know the true answer but by now you're starting to know me, if there is a positive angle to a story (and there's always one) that's the version I'm sticking to. So thank God I took Neupogen.

In addition, my last chemo was a Wednesday and this one is on a Tuesday, one day short for my white blood cell production. I am sure that if we took another blood sample tomorrow I'd hit 1.5.

Watch the blog closely tomorrow to see if I received the treatment or not. .

Ciao!

Neupogen, do you know what it is?

2008-09-28T23:02:00.000-04:00

I did not know before it was prescribed to me. It is a product that boosts the production of white blood cells.

By the way...

A quick reminder that white blood cells are like the policemen/garbagemen of the
human body. They are one of the three main cells of the human blood (with red
blood cells and platelets) that doctors monitor when they ask for a blood test.
They're the ones that fight infection. Chemotherapy kills bad cells (cancer) and
good cells (White blood cells are destroyed unfortunately too). Naturally, our
body produces new cells continuously but with the chemotherapy sometimes the
production of new white blood cells does not compensate for their destruction.
The decrease in the level of white blood cells is therefore normal in this
context but we must still watch it because when it gets too low the risk of
serious infection increases. It is delicate balance between avoiding death by
cancer without causing death by infection. When we speak of infection, we talk
about something trivial to the normal homosapiens. A flu, a cold or pneumonia
does not cause serious problems for people with a normal level of white blood
cells but for people like me it could be fatal. The instruction that I have is
that if I develop a fever of 38.1 °, I have to rush to the hospital .

Let's return to Neupogen. This product has been prescribed by the hematologist whom I met before my fourth treatment. On that day the blood test showed a level of white blood cells of 1.5 which is low (that is 1.5 X 10 ^ 9 I believe). We had been warned that treatment could be delayed to allow more time for the system to produce more white blood cells. But the hematologist on duty, after a review of my file and observing my young athletic body, decided to go through with the treatment while giving me a boost so that my white blood cells factory (bone marrow) would work "overtime".

Neupogen must be refrigerated. Getting the drug from the pharmacy was a little funny because the hospital pharmacist had provided us with a bag with an icepack on the inside. It was very important not to allow the product to warm up in transport between my local pharmacy and our house. I must mention that this product is sold just shy of to $ 200 a dose. I was prescribed 5 doses now and 5 doses after my next chemo. That's some serious cash. Fortunately, Marie-Josee is insured and the product is reimbursed to a certain level.

What you also need to know about this product is that it must be administered by subcutaneous injection, yes yes a needle in my skin. The first dose had to be given by a nurse from the CLSC(local health services) in case of an allergic reaction... and to train Marie-Josée. Yes sir, my wife turned into a nurse for the love of her sweetheart.

She admitted that the first few times she had to stick the needle into my arm, her head was spinning and was afraid of passing out.

But not at all she did it like a pro and she conquered her fear. Marie-Josee also thanks her aunt Johanne, a nurse, for her reassuring presence during the first injection. The only side effect I felt, and for which I was warned, is bone pain in my lower back. For a while I had the impression of having the heart in the lower back. The pain was throbing at the same pace as my heartbeat. Tomorrow I will see if the product is effective because I'm going to the hospital for my blood test pre-chemo # 5.

Good night!

It's amazing...

2008-09-27T13:31:00.000-04:00

A small note just like that because today I was chatting with Isabelle and Sylvain, our neighbors, they told me they gave the address of the blog to a friend. This friend told Isabelle that the texts she reads on the blog motivate and inspire her. I was fascinated by this story and thinking about it made me realise there are other stories like this one. My father-in-law did the same with his boss and some colleagues. So I now have people from Kuwait who read the English version of the blog. I received a message from an American childhood friend, David Gerwatowski, who was told of the blog by his mother who had been told by my brother Omer. It was then that I decided to translate the blog because I realized that several people showed an interest in reading the blog but couldn't do so in French.
There is also Sister Louise, who has taught Marie-Josee and her friends at Ste-Marcelline, which read the blog from Italy. She was told about it by our friend Andrée. Christine, who also lives in Italy, visits the blog. Several friends in Ontario come take a peek, including Vince, who has had a major impact on my career in pharmaceuticals. This morning came a comment from the Alarie family. This family was without a doubt an important part of our family life on Ile Bizard. Ms. Alarie was the best friend of my mother, Mr. Alarie was the best hockey coach I had. Robert was my best friend and Gilbert was Jocelyn. Isabelle, the youngest of the family wrote the commentary. Not to mention my sister-in-law Sandrine, born in France:-), which communicated the blog's adress to her family and friends in France, I therefore have readers there too.It is a fascinating web that is woven from the blog.

I am amazed because I never imagined that my blog would be such a communication tool and a therapy at the same time. What I want to tell you is that I am very touched by everyone's reaction. To know that you think of sharing with others what I write here is deeply moving. It is also very therapeutic because if for a moment, and I say "moment", I doubt or worry, I read the comments and messages to get back in the saddle. Your support is an incredible source of energy.
All of you tell me not to quit, I in turn ask you, dont't quit reading.

Élodie, Jordan and Mom are running

2008-09-25T13:54:00.000-04:00

I have not yet figured out how to upload quality video so sorry if it's unclear. The music chosen is part of Mom's running selection.

Running, it's a family affair

2008-09-21T18:11:00.001-04:00

Running is contagious. Elodie our 5 year old daughter had already started to emulate her mother this spring. She trained with her (see video) and participated in a 1 km race in Ste-Therese. She finished third in the girls 5-6 year old category with a time of 7:05 (on sportstats.ca look for Élodie Raymond). Today, after a few training sessions with Mom, Jordan joined the family group of runners. The three participated in the 1 km race in St-Jerome. Jordan and Elodie did this like champions. Jordan ran his kilometer in 5:01 and Élodie in 5:50. With the Mom's Garmin watch we know that Élodie reached a top speed of 13 km/h and ran on average at 9.8 km/h. For a 5 year old girl it is impressive. The reason for her speed is that she wanted to catch up with her brother, who ran in front of her. It was a beautiful day for such an activity. You can watch a small video of the race in my next blog. This race was sponsored by Jacqueline Gareau (9 times marathon winner in her career). We said hello to her before leaving the site of the race because she had noticed Élodie's participation medal around her neck.

Congratulations to the Raymond-Lafrance group of runner!

Courage

2008-09-19T17:16:00.000-04:00

I wanted to speak about courage because I received some messages congratulating me for mine.

But what is courage?
Eight words define the moral code of Judo as edicted by its founder Jigoro Kano, courage is one. The definition given in this moral code is: Courage is doing what is right. In the french Larousse dictionary ( that I losely translate here) it defines courage as strength of character, firmness when facing danger, suffering or any difficult situation.
Seen from this angle am I brave? Maybe.
On the other hand, to honor my parents, I don't know any other way to react to situations like this. They gave me the best possible example of courage so I don't have much merit. Especially because, as I said in another blog, I have an extraordinary support network. I have only one thing left to tackle it's to beat the cancer. Everything else my wife, my in-laws, my family and my friends are taking care of it.
The subject of courage was also inspired by a video that three of my friends at Pfizer have sent me. Pfizer has established a website called http://www.morethanmedication.ca/en/home/ where you can see the video in question "Graffiti". Once you have you watched it you are invited to send an invitation to someone in exchange Pfizer will make a $ 5 donation to the Foundation for the Starlight Children. At my last glance, they were at $ 16,145. So I encourage you to watch it and send it to someone who inspires you courage.

Sometimes I am a little bit more serious but I am still smiling ...

Chemo #4...some news

2008-09-17T22:45:00.000-04:00

Hi everyone,
Today was a pivotal day. Before I could receive my chemo I had to meet an hematologist to assess the situation and adjust if necessary. Well, it is certain that three chemo treatments is nothing to write home about but ... You need to understand that this is 6 weeks since I started chemo, or 42 days. If you calculate since the operation I am approaching two months, 60 days that I know about my cancer and that my mind (mon mental) began the fight. During all this time the battle is all in my head in the sense that I do not see my opponent. In judo in randori or shiai (combat or competition) you can visually assess your impact on the other combatant. You can see if he is weakening, if he still has tricks up its sleeves to surprise you. You can touch and feel its strength or its weakness.
With cancer, for the past two months, I lead a blind fight (not sure about this expression). It's OK I wanted it like that as I explained in the blog on the book by Lance. It remains that at some point you become a little curious. You want to know if you're on the right track. In my case, there are two main ways to verify that.

Please note that what follows are statements based on my understanding and I can be way out in left field, but I'm very open-minded and if anyone wants to correct my assertions they are welcome.

The best way is the abdominal scan. My first one was made on July 21st. Doctors believe that doing another scan before the three months mark is not representative. So my next scan will be between the 10th and 20th of October. A small wait again.
The second way is the calculation of tumor markers. Several different markers are used according to the cancer cause. In my case they seem to follow the evolution of CA-125 markers and CEA. Ca-125 is Cancer Antigen 125 and CEA is Carcinoembryonic Antigen. The presence of these markers and their level is a complex area but if I symplify it, we can say that hematologists look for trends. Decrease, stability, increase: guess which are positive? Too easy would my daughter Elodie, a decrease and / or stability in the trend are positive elements. Before giving you my results, I want to be clear that positive results do not mean a cure, it simply indicates that we are on the right track.
My levels of CA-125 went from 65in June to 23.2 today. According to the doc the current level is in the normal rangen (even for people without cancer).
My level of CEA is stable, 12.9 in June to 13 today.
Conclusion the trend is positive.
I think I have presented these results sensibly and with a good control of my emotions. Let me now present them you as a hyper positive salesman. My level of CA-125 has decreased by 64% in two months. A significant change since this marker now shows no difference between me and a person without cancer. This is an excellent result in my assessment, don't you think? The CEA is a capricious marker which can go up and down between two cycles of chemotherapy. Doctors are wary of the interpretation that can be done with it, but there seems to be a consensus that the stable trend is definitely a good sign. Combine these results to two other elements. Scatologicaly speaking, my stools are larger in diameter than ever. Personal Interpretation and visualization, my tumors are regressing (to be confirmed in October).
The president of the association of colorectal cancer of Canada, Mr. Barry Stein, which I finally met in person yesterday evening at a meeting of a support group made the following comment: "You look great Martin, as a matter of fact you look damn good. "
Barry was diagnosed at age 40 with colon cancer. This was 14 years ago. In the last 6 years they have detected no signs of recurrence. He is my inspiration. It is totally committed to the fight against colorectal cancer and has seen many people suffering from cancer. having him tell me I look great was a total morale booster. Add to this the results this morning and you can believe that, despite some fatigue thanks to the chemo, my morale is # 1.
My wife said in the support group yesterday that I had a the moral of a bull (loosely translated), it made me smile and I really liked it. And don't forget that all your messages of encouragement and your comments on the type of relationship that each one of you has with me are very important in maintaining my morale. You're part of my team.
So this evening when reading this blog, smile, things are going well.

Congratulations Jocelyn!

2008-09-17T22:06:00.000-04:00

I want to congratulate my brother Jocelyn who went for his colonoscopy yesterday. It was not in vain because they found a small polyp that they took out instantly. For Jocelyn it is the third polyp that he has removed. The other two were there about 4-5 years ago. If you do not know about polyps they are not cancerous tumors and once removed there's nothing more to be done. But polyps, which are not removed can become cancerous over a period of 3 to 5 years. So polyps are usually benign, but they must be removed because their potential for malignancy is high in the medium to long term.

English Version

2008-09-15T23:18:00.000-04:00

As I was mentioning it on the french version of my blog... here it is. I received several messages from English-speaking friends who tell me they have received news of my health and the address of my blog. They tell me that even if they can not understand what I wrote they feel that I lead the fight in a positive way. To leave no one behind I decided to translate my blog. So those who prefer to read my text in English can go to the address: martinraymond-eng.blogspot.com. Perhaps you also know someone with whom you want to share reflections of my blog but that person speaks only English. I translate the blog with Google translation. It works quite well. I only have to correct the inevitable mistakes made in a litteral translation (eg Lâche pas MJ becomes coward not MJ when it should say don't quit MJ). I have to forego some of my French humour because it does not translate well. It would require that I redo the text directly in English. The important thing is that my English friends can have all of the messages that I write on the french version. You will, I hope, forgive my gramatical errors and french syntax.

Until next time

Bravo Marie-Josée!

2008-09-14T22:13:00.000-04:00

1:03:06. An hour three minutes and 6 seconds. Here is her official time based on the chip. It's an excellent result with a knee injury. That's 4 seconds faster than the 10 km in Ottawa in May. She is proud of herself and I am proud of her. She told me that this race brought her more satisfaction than Ottawa because her motivation was different. This time she ran for me. Also the finish line is inside the Olympic Stadium, it's quite a feeling. Especially as MCs were naming as many people as possible upon their arrival and we heard the name "Marie-Josee Lafrance" echo in the stadium. Of the women who ran the 10K, my Love finished 475 (of 829) and 53rd in her age category (of 96 women aged 40-44). In mentioning these stats, I feel like talking about the world of running for a second. The logistics behind these events is incredible. It is a sport that demonstrates that they are used to organize events with thousands of participants. The company Sportstats is present almost everywhere, even in small events as the race in St- Therese in the spring. It provides chips that you attach to your running shoes. These chips are detected (read) at the start and finish lines. That's how they get the running time for each runner, accurate and fast. 10 minutes after the race all the times are displayed on sheets at the site of the race and simultaneously on the website of the company (sportstats.ca). Go take a look, you can search by athlete or race. Search for Marie-Josee Lafrance or for any member of Yves family (Michelle, Stéphane, Patrick, Julie, Christine or Danielle). You'll find the list of races for everyone with the rest of their individual statistics (time, placement by category or general). It blows me away. If judo was 10% as effective as this during competitions, the sport would be transformed logistics wise.
Back to Marie-Josee's race, I would like to send a thank you to one of her coworker: Maja. This woman is extraordinarily generous. Already in May, she had demonstrated it by running with Josee in Ottawa. She is a runner, yes, but she had not plan to run in Ottawa. She did it because Josée was doing it and it was her first race. This weekend she was already committed to participate in another race, the Terry Fox event on Mont-Royal. But she still made the effort to support Josée, she was standing between kilometer 6 and 7 of the course. A place that Josée had indicated as strategic for her because of a tiring "faux plat" and for a psychological boost at three-quarters of the race done. There were very few spectators but Maja was there and Josée saw her and heard her shouting "looking good MJ". Meanwhile Maja and I were communicating through MJ's blackberry by messenger. She wrote: I saw her, she looks good. That reassured me and confirmed that I had to waste no time if I wanted to be present at the finish line at the right time.

Thank you Maja !
Bravo Marie-Josée!

10 km - Tomorrow

2008-09-14T02:00:00.000-04:00

It is tomorrow that Marie-Josee runs the 10 km during the Montreal Marathon day. Given the delay in her preparation, she settled on running the 10K when she initially wanted to make the half-marathon (21 km). She injured her knee this week but she will run anyway. She says that her suffering is nothing next to mine. I am touched by her gesture. What she does not understand though is that I don't suffer at all. I have a good drug pusher of morphine derivative from whom I get my stock. Perhaps I don't feel a buzz but I am pain free 98% of the time. I try to be funny because I don't really know what to say to my wife who gives me her support in every way possible including this one and I am concerned for the health of her knee. I have already mentioned it, my wife is driven ... so what am I to do except to support her and carry a nice big bag of ice to put on her knee right after she crosses the finish line. ;-)

Good luck my love!

Otagai ni Rei

2008-09-08T23:33:00.000-04:00

I was looking for a way to intrigue everyone with my title. I hope that I was successful. Otagai ni Rei is the call to salute partners in training in some martial arts. This call is delivered at the beginning and end of sessions following the two other calls to salute: Shomen ni Rei and Sensei ni Rei. If I simplify, this is a way to greet everyone with respect. Why did I start like that? Because tonight I had enough energy to endorse my judogi and act as a Sensei aid, like a teacher-aid. I have to say that we have a phenomenal start this season. We have at least 30 enrolled in the less than 13 years old, while last season we were about 15. 30 to one ratio in any discipline is huge so I wanted to support Luc Sensei as much as I could. Finally it went well and Luc would have been OK without me since Jacques was there, Jasmin, his son, helped him and also others like Richard and Jesse. Let's say that I did help a little, but the main thing is that I enjoyed the evening because I love to share my passion for judo with young people. By the way if anyone reading this is interested in judo, don't be shy, call me or come see us at 48 St-Louis in Ste-Therese (above the arena) every Monday, Wednesday and Friday from 18:30 on.
Sayonara!

Screening for cancer

2008-09-05T14:28:00.001-04:00

You know, once you have cancer you wish you could have avoided it. If only I had known ... you say to yourself. In most cancers there are ways of detecting early signs and my experience is an example that too young doesn't exist with cancer.

I say... if I had known? What about you? Do you have cancer?

If not, when was your last test? In the case of my family, at the hospital they all said they had understood the message and had or were going to make an appointment? Is this done? Pierre when is your colonoscopy? Omer, Louis, Yves? Lucie? Lilianne and Jocelyn, I know that you were already aware but you should not delay much more. I am pushing hard on my family because one of the questions from doctors concerns family history. Well now my 5 brothers and 2 sisters must respond that colorectal cancer runs in the family. My own children will be monitored very early (in their early twenties). For other people who are not my immediate family, a simple test can save you so many concerns and offer a prognosis so much easier to handle. So what are you waiting for? Many of you wrote to me saying that I had, in one way or another, a positive influence in your lives. I'm happy. I would like my next influence on you to be a positive action regarding early detection of cancer.
Act now!

Chemo... #3

2008-09-04T13:00:00.000-04:00

We are Thursday morning. A day after the third chemo that I received Wednesday instead of Tuesday, back to school day. Marie-Josée and I wanted to be present for this special day since our last child, Elodie, started kindergarten. The view of our three children walking to school with their backpacks, the two big brothers explaining to their sister the school routine, the summer sun and a mix of emotions of pride and nostalgia. Nostalgia because the realization that we have no more baby hits you in the face on back to school day. I admit that this day also brought me an even greater resolution to fight for my survival. We may not have babies anymorebut, 5, 9 and 11 years do not make them adults yet. I have so much to share with my children that there is only one solution.
Back to chemo # 3 until now it is a far cry from # 2. I slept well and this morning, except for the fact that I did not attend the morning routine, I'm in pretty good shape (all things being relative). Unlike two weeks ago, I have enough energy to write on my blog and do one or two follow up on the business plan.
I could not explain why there are differences in the reaction of my body after each chemo but when I think about it there may be some elements or actions which have been different.
First, there is my diet. For two weeks I'm seriously working at integrating the research of Dr. Beliveau. So I drink three cups of Japanese green tea per day, I eat a meal with turmeric per day, I swallow quantities of garlic and / or onion like never accompanied by a series of selected vegetables (brussels sprouts, leeks, asparagus etc.).. All this on top of my Ensure and Boost drinks to ensure a good amount of protein, vitamins and minerals. I am still limited because I can not take too many fibers. My tumor on the right, that the surgeon estimates at 25 cm long (almost a foot), is largely blocking my ascending colon. It is important for me to avoid an obstruction, thus the limitations on residual fibers.
Also, there was a good boost to my morale when I attended the official opening of the season at the Judo club youngest class. The group that I had the responsibility last season. It was not much but it gave me an incredible feeling inside. Just putting my judogi on, participate in the opening protocol (greetings) and have the opportunity to address the kids to explain that I can not give all the courses this year was a beautiful time for me. My wife has even noticed that during the Mokso (meditation at the beginning) the sun entered the dojo and gave the illusion of enligthning and wrapping its divine light around me.

Finally, have these elements been a factor or not in my reaction to chemo # 3 we will never know but as they say, perception is reality so ...

Good day!

Chemo # 2, addition of Avastin

2008-08-19T22:49:00.000-04:00

I have aready talked about chemo briefly. This time I will go over more details since today I received my second treatment and Avastin was added.

9:00 Arrival at Hôpital Sacré-Coeur (Sacred Heart Hospital). I had my blood work done the day before so I can report my presence immediately to the coordinator of treatment. I saved 45 minutes today this way. She is responsible for preparing, in collaboration with the pharmacy, bags for intaveinous infusion along with the specific protocols that she will give to the nurse in the treatment room.

9:15 The nurse in the treatment room calls me up and I get set-up in a leather armchair the reclining kind. This room contains 4 seats therefore 4 patients at a time.

9:45 The nurse now comes to take care of me. She must remove the bandages covering my transparent piccline then sanitize the region of insertion in the body. She flushes the piccline meaning she introduces a saline solution in the piccline tubing to be sure it is free of obstructions.

9:50 She installs my bag of Avastin (Bevacizumab) said this ten times in a row.
This bag is empty in 90 minutes. I read and listen to the radio at the same time. Josée sits on a small stool beside me. It is not very comfortable for her.

11:30 Avastin is now done. I get Kytril (granisetron) as my next perfusion. It's an anti nausea drug that lasts 24 hours. It is administered in 10 minutes.

11:40 Now the Oxiplatine and Leucovorin (folinic acid). Two bags at the same time for 2 hours. At this point I read half of Lance Armstrong's book. The Oxiplatine is the product that gives me the impression of having the fingertip like a pin cushion. This takes several minutes and then disappears. Then it returns from time to time during the evening and the two days following. My skin is also sensitive to cold for some time but all in all I tolerate pretty well all the poisons they give me.

13:45 Now time for the last part of the protocol FOLFOX (Oxaliplatin + Leucovorin +5 FU) : 5FU or Fluorouracil. This is the one that I have in my bottle during 46 hours. It begins with a bolus infusion over ten minutes and then the nurse installs the bottle on the piccline (see photos).

14:00 I am heading home. Josée took advantage of the time we were at the hospital for a few administrative details (copy of scan on CD, monthly parking packages, etc.). She also brought me lunch. I realise it is a long day for her but I know I could not do it without her present.

The Avastin has now added 90 minutes to the routine. In the third treatment they can make the infusion in 60 minutes and after that in 30 minutes.

Now you know to the minute the unfolding of MY chemo because you must also understand that each case is treated a little differently depending on their situation. Next to me today I had another man who had colon cancer. He was about my age. He had the privilege of having discovered the cancer early enough to be eligible for a radical total colostomy without a bag. He had a different catheter, implanted in the chest like a pacemaker and received preventive chemotherapy or in other words a chemo which ensured that there was no remaining cancer after surgery. His process and medicines was a little different from mine.

Good night!

Finally Some Sun

2008-08-16T20:20:00.000-04:00

Not that I am complaining but I admit that the last few days of sun are fully appreciated. The weather was perfect for the garden party at my sister's. I can not eat corn because of its known effect in the colon. Should I say more? I still practiced a visualization exercise while watching the family enjoy their corn on the cob. I closed my eyes and I could se myself with a hot corn on the cob with butter dripping on all sides on which I poured an excessive amount of salt. The late afternoon sun made it glisten like gold. I was turning the corn with my fingers to make sure that the butter had moisten all kernels. I was seeing myself taking a big bite out of this magnificent summer treat. I was so good in my visualization that I was drooling. Yeah right, I was still hungry but still. Bob's spaghetti sauce was excellent and my Ensure (liquid nutrition) plugged the remaining hole in my hunger.

Appointment at the Pain Clinic

2008-08-15T20:14:00.000-04:00

Today I went to the pain clinic at Sacre-Coeu, a follow-up appointment. I met Dr. B while during my hospital stay Dr. G was taking care of me. A little waiting but not too bad, time is a changing concept when you have cancer. A review of my case by Dr. B has taught us some new information on my case. At each meeting, we are more precise with our questions and answers are therefore also more accurate ... whenever possible. So I have a new pain killing cocktail as the other one worked very well but contributed to my constipation. They're not major changes but they will perhaps allow me to go do my # 2 without feeling like I just finished a marathon ;) Tomorrow we visit my sister Lilianne and Bob in St-Clet.

What's up with chemo?

2008-08-12T19:50:00.000-04:00

Hello, I thought that it would be interesting to explain how I receive chemotherapy. Of course there are variations in each case but I will describe my own situation below. I received my first chemotherapy treatment on Tuesday the 5th. It went well. I had no side effects except being a little bit tired 48 hours after the start of the treatment.
Let me explain treatments: Every two weeks I go to the hospital Sacré-Coeur where I intravenously receive a series of cytotoxic products (which kills the cells, yes, good and bad). The perfusion is done through a catheter installed on the inside of my left arm near the armpit. The catheter is installed for at least 6 months (it is called the Piccline). It consists of a tube of a few millimetres in diameter and about 20 cm long. So it enters my arm and goes through a deep vein almost up to the heart. That is so treatments are distributed to the rest of the body in the most direct and quickest possible way. Back to treatments, the first product injected into the catheter is an anti-nausea drug with a 24 hours effect. It seems to work very well because I did not experience any nausea after the first treatment. Then comes the chemo, the cocktail that I receive is called Folfox-6. It is a mix of three drugs which are regarded as the best of the best for colon cancer today. To this mix will be added another agent, Avastin, in the second round of treatment. Let me explain why later. Folfox is started at the hospital. Two of the three drugs are given to me over a period of about three hours. Then a nurse attaches on my catheter a bottle, they call it the "Biberon" in french (Biberon means a baby bottle in english), it contains the rest of the 5FU agent which must "infused" on a 46 additional hours schedule. I therefore leave the hospital around 13:00 (having begun treatment at 9:00) and for two days I have my bottle in a bag tied around the waist. I look like a tourist with my banana bag but at least I'm mobile. When the bottle is empty, a CLSC nurse comes to my house to unplug it. Why? The catheter installed on my arm is very convenient but it is also a direct opening to the inside of my body that does not offer any protection. Therefore the manipulation of the bottle must be done with a lot of safety and precaution (sterile conditions). Especially since chemotherapy treatments can possibly reduce the effectiveness of my immune system, therefore I must avoid infections at all cost. Once the bottle is removed there is nothing special. I take drugs to control the pain every day but nothing more. This cycle is repeated every two weeks for about 6 months, after which my oncologist will compare the new images of my abdomen to check if my tumors have reduced in size. As far as Avastin goes, one effect of this product is that it prevents scar healing. As I have a big scar on the stomach there needs to be at least a month between any operation and the start of Avastin.

Dr W

2008-08-11T19:42:00.000-04:00

We met Dr W today (Marie-Josee is of the opinion that I should not identify docs). It is an oncology surgeon . He came higly recommanded by a friend. Our visit goal was to identify a plan B if I were suffer a complete blockage of my colon. We also wanted to discuss the newest surgical techniques available. Dr W is a charming gentleman. He speaks impeccable french in a soothing and calming manner. He reassured Josée on actions to be taken in case of obstruction without calling it a plan B. He reiterated persuasively that the best scenario is that there is no blockage period. That we kind of knew. Finally, the visit has not provided much more information but at least he has my file and he is ready to come into action whenor if the time comes.