Run a half-marathon... checked

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

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

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

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

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

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

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!