Winter

We've had a consistently good winter in Tampere since the beginning of the year. That, in my opinion, means that skiing and skating conditions have been excellent. There are tracks for skiing on most of the lakes and woods around here and the city takes care of keeping them in good condition. On Sunday I went for a nine kilometer trip on the closest lake. The sun was shining for a change. The feeling of warmth from the sun made me think of skiing in Norwegian mountains at Easter time. Not that I have done that a lot, but those few times have been fantastic experiences. The dreams of Norwegian mountains slipped away when a woman overtook me. Slightly frustrating and I tried to blame my skis. The real reason is rather my physical condition. I'm otherwise fine but have been a bit sloppy with exercise. It also seems all those cafe visits during the autumn have had an impact and there are now some extra kilos to drag around.

Last week we had our sixth wedding anniversary. It was in the middle of the week so no big celebration. I guess the celebration was already on Saturday when we went to Vantaa Ikea without the kids. On the actual anniversary day I picked up the kids from the daycare and bought a bunch of tulips from the local grocery store. I naturally tried to hide for my wife the fact that I'd put in such little effort in getting her flowers. After the kids went in bed we ordered some takeaway food from a Turkish restaurant close by. While eating we watched Michael Palin's "Around the world in 80 days". At some point I fell asleep.

Going public

I decided to remove the access control to my blog. It is now open to the entire internet. Because of this I edited some of the old blog posts and removed all names and contact details.

Mr. Big

To go straight to the point, the results of last week's CT scan were good. Maybe not as good as I was hoping for, but the doctor said the direction is still right and that's the important thing. The blood values are more or less fine except the CEA value, which is now down to 108,9. It was 228,3 at the end of October and 3482,0 at the end of August so it has actually come down a lot. The initial CEA value you can find in this blog posting. CEA is supposed to be under 5,0 so there's still room for improvement.

Regarding the strategic measures of the tumours in the liver, some of them have shrunk in size while some haven't changed since last scan. In the report there is mention of six tumours while last summer doctors talked about more than ten. Mr. Big, which was previously 7,2cm x 5,0cm is now down to 6,7cm x 4,2cm. That is very good news but it seems Mr. Big may no longer be the biggest. The runner up hasn't changed in size since last scan and is 7,6cm x 3,7cm. The smallest of the six has come down from 11mm in diameter to 6mm. This is almost like following a car race.

We had otherwise the usual discussion with the doctor. About surgery he mentioned the situation in the liver is still too difficult. They would have to cut out too much of the liver as each tumour needs a two centimetres margin around it cut out too. Another problem is that the tumours are not next to each other but spread around. He wasn't very optimistic about ever getting to such a level that surgery would be possible either. We realise he bases his opinion on experience and he may well be right, but we also realise all patients are individuals and we still want to be optimistic.

The doctor said I'll continue the chemotherapy for another three rounds but now without Eloxatin because of the numbness in my toes and fingers. If they'd continue to push Eloxatin the nerves may never heal. The remaining drugs, Avastin and Xeloda, could still do the job though or at least keep the cancer at the same level. There's something positive in leaving out Eloxatin also. It means less side effects. I should not get the chemo-brain and tiredness the first week after injection.

And by the way, about that dog I ran over. I called up the owner a week after the incident. The dog was still alive and it would probably make it.

Laskiainen

Today there's a celebration called Laskiainen in Finland ("fastelaven" in Norwegian). my wife and some of her friends from university times have a tradition of family gathering on this day and we did the same also this year. First we went sledging with the kids and then barbecued sausages on an outdoor grill. I think those sausages taste better in -5 degrees Celsius and snowfall than hot summer weather. Afterwards we went inside to eat pea soup. For the dessert we had the traditional laskiaspulla. Those are buns with whipped cream, marzipan and home-made jam. We have something similar in Norway also and they are called "fastelavensbolle". Delicious.

When writing this, I wondered what the English term for Laskiainen would be and looked it up in a dictionary. Shrove Sunday, Shrove Tuesday, Pancake Day and Mardi gras hit my face. I continued to Wikipedia and found a rather interesting article on Shrove Tuesday. Apparently the traditions around the Christian world are many and very different. This is what Wikipedia says about the Finnish traditions:

"...this day is associated with hopes for the coming year. On this day, families go sledging and eat split pea and ham soup. A toy is made from the ham bone by tying the bone to a string and spinning it around to make a whistling noise. There is a tale told that if you cut your hair on this day, it will grow fast and thick for the next year. Finns also share the tradition of the marzipan and cream filled pastry with Swedes, although often the marzipan is replaced with strawberry jam. Finnish name for it is laskiaispulla. ..."

The bone toy and that hairy tale I've never heard of myself. Here's a funny coincidence. My wife has been telling me for a few weeks that I should go and have my hair cut. For no specific reason, this morning I asked her if she could give it a go with our electrical hair shaver. She's actually a pretty good with that thing. The shorter the better result. So, I got shaved while the kids were observing with a slightly worried expression on their faces. If that tale is true, my wife will get busy with the shaver this year.

Tomorrow morning we're going to the hospital to hear the results of last week's CT scan and blood test (including the CEA value). Some excitement or nervousness is building up. I'll try and put in another post to the blog tomorrow evening.

Tenth round

Today I started the tenth treatment round. I walked into the hospital 0850 this morning with my wife and didn't feel excited at all. I knew there would be a short doctor's appointment as they would only walk through the usual and basic blood values and probably listen to what I'd have to say about side effects. Then they would put me in a bed, stick a needle in my arm and pump bags of medicine into my blood. Sometimes there are some very talkative patients in the beds next to me, sometimes not. I always bring a book with me as backup.

I will reveal a secrete. I realised a long while ago, actually very shortly after I got the diagnosis in July last year, that my wife is at a totally different level concerning knowledge of rectal cancer and standard and experimental treatments. When I try and write a summary of the doctor appointments I tend to get some of the details wrong. My knowledge of the Finnish language could contribute to that also though I think I get it all. So, I asked my wife to become a co-author of this blog and write those parts where doctors have given us information.

The doctor said the blood values were ok and that the reason for meeting the doctor actually was to ask me about the neuropathy, i.e. numbness in finger tips and toes. If it gets worse they will have to consider dropping Eloxatin (oxaliplatin) chemo. She then also said that if the cancer goes more or less into a remission they can also continue with just Avastin as it is not a chemo medication and does not cause cumulative side effects like all chemo does. And then she said the same thing we have heard once before, that if the tumors in liver decrease in size enough they will consider resecting, i.e. cutting off the tumors from the liver. My wife asked if radiofrequency ablation, a promising radiation method, is a standard treatment as well and she said yes. It is supposed to give at least almost as good results as resecting the tumours.

My wife also asked about some more experimental treatments but she said that they are experimental and not done in hospitals in Finland as part of standard treatment at all, and they should anyway only be considered and given as last resort when all other means have been tried, and my situation is nowhere near something like that at the moment. She was maybe not that eager to reply to my wife's questions but it didn't matter as we were glad to hear what she had to say anyway. She said that we shouldn't think that they just keep pumping chemo into me and then sending me home for three weeks again, but that the treatment they give is given because they have a goal, to get the cancer into remission or get my liver in resectable condition. My wife said that we're glad to hear that they have such a goal as we also have a goal and it sounds like it's the same one. She then of course said that there's not guarantee this will happen, but that we already knew, of course. But it was very good to hear that they do have a goal because it has not been really clear to us, especially since originally in the summer I was according to the papers sent to "palliative treatment" which is to relieve symptoms only when there is no hope for cure really.

Today was a reading-book-day. I did close to 200 pages of Beatles, written in 1984 by the Norwegian author Lars Saabye Christensen. It is probably among the best Norwegian novels ever written. Actually, I've read it once before at high-school in late 80s. I could remember nothing of the story before I started it again. It must be the chemo, or?

Back at work

In December, after half a year on sick leave, I felt the need for a little change in my life. I discussed the possibility of returning to active work life with both the doctor at the hospital and the doctor and my manager at work. All parties were very positive and supported the idea. We decided I will do 60% for a three months period, from January until end of March. Then we'll review with the doctors my health situation and decide how to continue.

As we're approaching February it means I've been close to a month at work already. It has actually been a very good experience. There are lots of nice people there and I've got some interesting stuff to do. Hopefully I'll be able to continue working after this three months period is over.

The dog

I had an incident with the car. Some friends of ours from Norway visited us a this weekend. On Friday afternoon I picked them up from the hotel they stayed in and headed back to our place. We drove through a residential area where speed limit was 50 km/h. It was dark and the roads were icy. Out from nowhere came a small dog and ran straight into the road in front of us. We heard a bang as if we had driven into a large chunk of ice. It happened so fast I didn't even manage to hit the break before the impact.

I parked on a side street and ran back to find a woman, the dog owner apparently, lying on the road and crying. She was holding tightly onto the dog. The dog was surprisingly alive but didn't move and was bleeding from one eye and looked at me with the other. I felt horrible and didn't really know what to say.

There were some people around desperately trying to find a phone number to an animal clinic. They asked me and I replied I had no clue if even such exists in town. I said I was sorry for what happened but that there was nothing I could have done. There was a man there who seemed to be part of the family. After a short while he had found the address to the clinic and went to get his car. I got his phone number and they drove off.

Later on in the evening I contacted him. He said the dog was still alive and that the doctor had fixed him up. I didn't quite get all what they had had to do, but some bones were broken and the dog had taken a hit to the head. If it gets away with it it is a very lucky dog all in all. He asked if the car was damaged but I said that didn't matter. I will probably contact him again later this week to see how the dog is doing. My wife suggested we'd buy the dog owners something. I suggested a dog chain. That was a (bad) joke naturally.

Ninth round

Today we had another doctor's appointment and afterwards I started the ninth round of chemotherapy. Surprise, we were called in by yet another doctor we haven't met before. She was quite young and said all decisions are made by the senior doctor that we were told last time would become our fixed doctor. This appointment was obviously considered a routine follow-up that the junior doctor could easily handle. Well, she did handle it well, but there wasn't any new info really. Only the standard blood tests were taken last Friday and all values are still pretty much the same they have been since July. That's good, as usually they of course tend to get worse during chemotherapy.

My wife had as usual a long list of questions. Some of them were so tricky the junior doctor said we'd better ask the senior doctor. My wife asked when does the surgeon look at the CT scan pictures to see if a resection or radio frequency ablation of the liver tumours would be possible. The doctor replied that the senior doctor goes to surgeons' meetings and brings forth cases as he sees fit. We'll put this down on our questions list for next appointment as we expect to see our fixed doctor again then.

The senior doctor had confirmed before the meeting that we will continue with the same medication this round. However, we had an interesting discussion regarding one of the medicines, oxaliplatin (Eloxatin). The doctor told us that the long-term side effect, namely neuropathy (loosing feeling in fingers and feet) from oxaliplatin, tends to start getting worse from eight or ninth round of chemo, and they then need to consider if they should stop that chemo so that the damage to the nerves does not get bad. I have increasingly had the problem of numbness in my fingers, and I got my ninth round of chemo today. They may have to drop oxaliplatin soon. The doctor said that then they will continue with capesitabin (Xeloda) and Avastin only. They are effective drugs by themselves too, but of course they would then monitor if the tumours would start growing again, in which case they would add some other chemo to the treatment.

The next treatment is three weeks from now. Five weeks from there, on February 16th, there will be a CT scan. Until then there will not be very exciting news I am afraid.

Beat it!

A group of friends of ours got fed up with our inability to respond to their offers of help. They designed a t-shirt that people who know us and want to "support our cause" could get. To be frank, we felt a bit embarrassed about the entire thing at first but we also understood that this way people could feel like they are contributing. We probably would have felt the same if we'd been in the same situation. The shirt was going to look like a sports t-shirt so our friends asked for some input what number they could put on it. I gave them the magic number 20. They put in addition the text "Beat it!" on the shirt.

Just before Christmas two of our friends stopped by our home to tell us how many people had gotten the shirt, and to show us photos of people wearing the shirt. We were astonished. We had not realised how many friends we have and how many people my story had touched. We also got a list of e-mail addresses of everyone and we sent out a thank-you mail nd Christmas wishes to everyone. Many had been wondering about the number on the shirt and this is what we wrote about the magic number 20:

Well, it's simply the number the Norwegian footballer Ole Gunnar Solskjær played with during his many seasons in Manchester United. He's probably the most successful Norwegian footballer ever. So thank you for supporting Norwegian football! :o) Well, there's something more to the story. Ole Gunnar was a great football player but turned more into a second choice for the manager Alex Ferguson. However, he never ever complained and always tried to make the best out of the situation. In fact, he became very good at coming in at the end of games to make last minute goals. This positive attitude and "try to make the best out of it" are then two issues that are important to me as well at the moment.

Emergency visit at the hospital

We have had various rounds of flu running in the family the last months. Against all odds it has hit everyone else except me. That is until a week ago when I came down with a sore throat and running nose, and a pretty bad cough.

On Monday evening this week I got some fever and had to call the hospital to ask for advice. They have instructed me to contact them if I'd get fever higher than 38 degrees. I was told to check in at the hospital immediately.

I went to the hospital's emergency room and the doctors ran lots of different tests and concluded it most likely was a virus infection. I had chest and sinus X-rays and all was fine. I got antibiotics intravenously and had to stay the night over at the cancer ward. It was a rather sleepless night with diarrhea and vomiting. At home my wife had come down with exactly the same stuff. While she had to manage on her own I was surrounded by doctors and nurses running one test after another. Luckily, in-laws stepped in to help with the kids on Tuesday morning.

Tuesday morning my stomach had calmed down but I still had fever. The doctor said they still needed to find out exactly which virus(s) we were fighting against but the intravenous antibiotics treatment seemed to work as the level of infection in my blood was declining. I was told I may get home today (Wednesday).

This morning the doctor popped in to say that test and blood values all looked good, but as I still had over 38 degrees fever I was not allowed home until tomorrow. It seems they take a regular flu pretty seriously here at the cancer ward.

This evening a friend of mine visited me at the hospital and we played a few rounds of backgammon. That was a nice break from the many poor shows that run on TV.