July 11
I'm at home on Day 3 of being infused with chemo on the Third chemo
session of Regimen 2. So what happened over the past two weeks during the Second session:
So same experiences at the clinic with respect to the cold sweats: they really start coming on near the end of my infusion on site, and then the continue for the remainder of the day and well into the night on that first day. I basically was awake until 1AM until I felt somewhat comfortable enough to lie in bed with towels underneath me. Several cold changes over the night. The sweats start to subside by Day 2. As happened during the first session, no jaw pain on Day 2, so perhaps that is a thing of the past.
Over the course of the next two weeks, there were good days and bad days (sometimes good hours and bad hours). The neuropathy came on really strong, which was surprising to me as I thought it would start going away, and not get worse. However, I've since heard that the new drug Irinotecan, while not increasing any of the previous side effects, also does not do much for healing of those side effects, so I should expect the neuropathy to hang around a bit. I have to get Karla to open certain things and cutting fingernails has become a chore, but I'll deal with it.
I think the toughest thing is knowing that I am not going to get a break from chemo, and will continue to be on these two week schedules for the near to long future. I am scheduled out to September now and will just keep plugging away. I can work, and I can do some chores around the house, but I just have to take it slow and not overdo things. I am forcing myself to take naps on work days and that seems to be helping.
The family is all well. Graeme is starting to sleep for longer periods at night, which is giving Karla some breaks. He really is a great little boy. His favorite spot is the baby swing, which has a mobile suspended above him. He laughs and giggles a lot in their, more so than when he is held by Karla, Amarilis or I. It's really cute. Isla is fascinated with Disney's Frozen, and can't stop talking about Anna and Elsa. She watches the movie frequently and insists on Frozen books before bed. She and Amarilis are making full use of the complex's pool each day, and she has made many friends there, which is great.
I think I'll write a separate blog over the next few days to express my thoughts on the World Cup. It has been thoroughly entertaining, to say the least. And for all of you who send texts and emails, thanks so much. Sometimes it takes me a while to respond, and I apologize for that, but know that I love to hear from all of you, especially as some of us are so far apart.
Love to all of you.
Andrew
Friday, July 11, 2014
Tuesday, June 24, 2014
Third CT Scan and First Chemo (Regimen 2)
June 24
I'm at home on Day 2 of being infused with chemo on the Second chemo session of Regimen 2. So what happened over the past two weeks:
First off, the results of the third CT scan to see if tumors were the cause of my fatigue, or was it a virus, blood issue, etc. Basically, the doctors could not see anything that would be causing my issues aside from the chemo regimen itself. they had hoped to go at least one more session on the old regimen, especially as their had not been significant regrowth in my tumors. Remember that the goal of the chemo session is to shrink/reduce the tumors or at least slow regrowth. However, because of the serious issues I was feeling with fatigue and that I was starting to get more serious neuropathy with the first regiment, the decision was made to move on to the next chemo regimen.
I do want to stress that while there has been some regrowth in the tumors, I am nowhere near were I was in January. The tumors are still smaller and less dense, but as the third CT scan results showed, they were starting to make a comeback.
The second regiment would be like the first, still using the Antivastin, and still three days of the 5-FU infused slowly. The change would be to replace the Oxalyplatin with a new drug called Irinotecan. Its side effect are more moderate, mainly diarrhea during the three day infusion which can be managed quite effectively through Immodium. So no more increases in neuropathy (although it may take months for the effects of the Oxalyplatin to go away completely). Also, I may not experience the jaw pain that has plagues me on Day 2 of most of the first nine sessions.
So I got my infusion started, including a second blood transfusion because of low numbers in some of my blood levels. What is still frustrating is the sweats I get in conjunction with the chemo and the seem to last a long way into the night especially on Day 1. They are not painful in any way, but having to change you clothing constantly is somewhat unpleasant.
In any case the second regimen went fantastic and essentially was like the fifth or sixth regimen under the first chemo plan. The major fatigue, is gone, as is the jaw pain and I was able to put in some solid full day work for RSI. In a much better place which is great, as a lot of stuff has been going on.
Graeme is growing like gangbusters. He was well over 10 pounds at his one month session. He is feeding well and is having no issues with the breast milk, nor is Karla having any issues with production. When he poos, the whole house knows it as do the neighbors, I think, as he makes the loudest sounds. His sleep patterns are generally very good but so far, four hours seems to be the maximum at on time.
We had a nice visit last weekend from my brother Jamie and his family. Isla was ecstatic at having her cousins around fro three days. Jamie took Isla and Amaralis whale watching on one day and they saw over 30 humpbacks, some breaching which was very exciting.
Because the Vermont Steering Committee meeting is this Thursday, June 26th, we moved my chemo session to yesterday. So far so good on the second chemo session of the second regimen.
Also, having fun watching the World Cup, Can't believe the US let in a goal in the 95th minute this past weekend, but I think sitting with a win and a tie after the first two games is better than expected. Big game against Germany on Thursday.
So bye from a good place. Will write a new blog soon.
Andrew
I'm at home on Day 2 of being infused with chemo on the Second chemo session of Regimen 2. So what happened over the past two weeks:
First off, the results of the third CT scan to see if tumors were the cause of my fatigue, or was it a virus, blood issue, etc. Basically, the doctors could not see anything that would be causing my issues aside from the chemo regimen itself. they had hoped to go at least one more session on the old regimen, especially as their had not been significant regrowth in my tumors. Remember that the goal of the chemo session is to shrink/reduce the tumors or at least slow regrowth. However, because of the serious issues I was feeling with fatigue and that I was starting to get more serious neuropathy with the first regiment, the decision was made to move on to the next chemo regimen.
I do want to stress that while there has been some regrowth in the tumors, I am nowhere near were I was in January. The tumors are still smaller and less dense, but as the third CT scan results showed, they were starting to make a comeback.
The second regiment would be like the first, still using the Antivastin, and still three days of the 5-FU infused slowly. The change would be to replace the Oxalyplatin with a new drug called Irinotecan. Its side effect are more moderate, mainly diarrhea during the three day infusion which can be managed quite effectively through Immodium. So no more increases in neuropathy (although it may take months for the effects of the Oxalyplatin to go away completely). Also, I may not experience the jaw pain that has plagues me on Day 2 of most of the first nine sessions.
So I got my infusion started, including a second blood transfusion because of low numbers in some of my blood levels. What is still frustrating is the sweats I get in conjunction with the chemo and the seem to last a long way into the night especially on Day 1. They are not painful in any way, but having to change you clothing constantly is somewhat unpleasant.
In any case the second regimen went fantastic and essentially was like the fifth or sixth regimen under the first chemo plan. The major fatigue, is gone, as is the jaw pain and I was able to put in some solid full day work for RSI. In a much better place which is great, as a lot of stuff has been going on.
Graeme is growing like gangbusters. He was well over 10 pounds at his one month session. He is feeding well and is having no issues with the breast milk, nor is Karla having any issues with production. When he poos, the whole house knows it as do the neighbors, I think, as he makes the loudest sounds. His sleep patterns are generally very good but so far, four hours seems to be the maximum at on time.
We had a nice visit last weekend from my brother Jamie and his family. Isla was ecstatic at having her cousins around fro three days. Jamie took Isla and Amaralis whale watching on one day and they saw over 30 humpbacks, some breaching which was very exciting.
Because the Vermont Steering Committee meeting is this Thursday, June 26th, we moved my chemo session to yesterday. So far so good on the second chemo session of the second regimen.
Also, having fun watching the World Cup, Can't believe the US let in a goal in the 95th minute this past weekend, but I think sitting with a win and a tie after the first two games is better than expected. Big game against Germany on Thursday.
So bye from a good place. Will write a new blog soon.
Andrew
Monday, June 23, 2014
Chemotherapy and the Cath-Port
June 24 - Note: I wrote most of this a month ago, but haven't posted until now. Gives a good explanation of the chemo cycles I go through:
Chemotherapy is the treatment of cancer through medicines or drugs that attack and kill the cancer cells. It is a systemic therapy (unlike radiation or surgery) in that the treatment goes throughout the entire body. Most chemotherapeutic drugs are taken as a liquid injection into a vein, while others are taken as a pill. The cool thing about what's available to me today (as opposed to 20 years ago) is what are called combination therapies. There are many different chemotherapy drugs and often, they are used to treat the cancer more aggressively. It also reduces the likelihood that the cancer would become resistant to any single chemo drug.
Taking it a step further are targeted chemotherapy regimens, which are designed to attack specific cell pathways used by cancers to survive and grow. These new treatments capitalize on advances in understanding cancer at the molecular level. By interfering with the pathways, cancer cells are unable to grow, and instead commit a type of "suicide", called apoptosis. Also, blood vessels that grow and feed cancer cells are halted, called antiangiogenesis.
I have Stage IV Metastatic Colorectal Cancer (mCRC for short). What the doctors have set up for me, based on my tumors is a three-pronged approach using the following drugs: Fluorouracil (5-FU) plus Leucovorin calcium, Oxaliplatin, and the antiangiogenic drug Bevacizumab (better known as Avastin). Together, they call my treatment mFOLFOX + Avastin.
The 5-FU and Leucovorin is the more traditional chemotherapy for mCRC. This has been around for 40 years and works by binding to an enzyme needed for making DNA. Cancer cells that no longer have this enzyme available are more likely to die when they try to divide in two. Normally 5-FU binds it for only a short time, which limits how effective 5-FU can be. Leucovorin causes this binding to last for a longer period of time, which boosts the effect of 5-FU.
Oxaliplatin is a platinum-compound chemotherapy drug that acts as an alkylating agent. It stops the growth of cancer cells, which causes the cells to die. It is now used in conjunction with 5-FU. While it has been around a while, it really has only been in full use since 2009.
Finally, Avastin which is an antibody drug that binds to and neutralizes a specific protein directly related to the mCRC. It was approved in 2006 to be used in combination with mFOLFOX therapy. This is a wonder drug that is blasting away at my tumors.
How do I get these drugs? While I am at the hospital on the Wednesday, I get the half hour blast of Avastin through an IV connected to an IV "tower" that if you are not directly familiar, appears on most TV medical dramas. I also get the Leucovorin and Oxaliplatin through similar IVs, that also are connected to an IV Tower. These take a bit longer, from an hour and a half to two hours. I can take them all simultaneously through my cath-port which is convenient. They supply me with 8mg of Dexamethasone, a steroid that as mentioned earlier, stimulates the adrenal gland so I am not a zombie through this process, but can actively function from my hospital chair. I usually do a training course through RSI at this time, to help me acquire the necessary credits to maintain my Project Management Professional (PMP) designation. Because I am doped up on the one hand, and being drained by chemo on the other, I try not to do any "heavy-lifting" work wise - no detailed analysis or major decision-making that could affect my work. Training makes a good alternative.
Once the three iVs are complete, I am then hooked up to the portable infuser through the same cath-port. This will be hooked up to me for the next 46 hours, and then disconnected by Nurse Karla at home on the Friday. It also tends to drain me and cause some side effects, so I continue to take the dexamethasone, albeit is smaller quantities, over the next six days to help manage the "downs" associated with the chemo. As I have mentioned in the blogs describing each session, we seem to be getting to a point where the management of the ups and downs is quite successful, for the most part.
What is a cath-port? It's a small device (about the size of two quarters placed side-by-side) that was surgically implanted under my skin in the right chest area to carry medicine into the bloodstream. It has two small 'basins' that are sealed with a soft silicon top (the septum). The port connects to a small, soft tube called a catheter. The catheter was surgically placed inside one of the large central veins that take blood to my heart (so no need to search for veins every two weeks). The chemotherapy drugs are infused into my bloodstream through a special needle that is placed into the septum every two weeks. Medicine and fluids are sent through the needle and blood samples can also be withdrawn.
After my chemo session is over, Karla is currently hooking me up to an IV bag of saline to help with my hydration post chemo. After the IV fluids are finished, Karla cleans the port by injecting heparin through the needle - this prevents blood clots from blocking the port (heparin thins the blood). Once that is complete, she removes the needle, and apart from a slight bump on my chest, you wouldn't know I had the port at all. It's pretty cool that this is available to me - I have heard horror stories of nurses searching for veins for some patients. This also provides us with the ability to manage treatments from home without having to return to the clinic multiple times.
June 24 - Additional note: I will discuss this more in my next chemo blog, but on June 11, we stopped the use of Oxalyplatin and replaced it with a new drug called Irinotecan. I was developing too may side effect with the Oxalyplatin and the CT scans and my reactions to the drug drove my doctors to decide to move on to the next chemo regiment that included the Irinotecan. I should see less side effects, and hopefully an improvement in the progress against my tumors.
Chemotherapy is the treatment of cancer through medicines or drugs that attack and kill the cancer cells. It is a systemic therapy (unlike radiation or surgery) in that the treatment goes throughout the entire body. Most chemotherapeutic drugs are taken as a liquid injection into a vein, while others are taken as a pill. The cool thing about what's available to me today (as opposed to 20 years ago) is what are called combination therapies. There are many different chemotherapy drugs and often, they are used to treat the cancer more aggressively. It also reduces the likelihood that the cancer would become resistant to any single chemo drug.
Taking it a step further are targeted chemotherapy regimens, which are designed to attack specific cell pathways used by cancers to survive and grow. These new treatments capitalize on advances in understanding cancer at the molecular level. By interfering with the pathways, cancer cells are unable to grow, and instead commit a type of "suicide", called apoptosis. Also, blood vessels that grow and feed cancer cells are halted, called antiangiogenesis.
I have Stage IV Metastatic Colorectal Cancer (mCRC for short). What the doctors have set up for me, based on my tumors is a three-pronged approach using the following drugs: Fluorouracil (5-FU) plus Leucovorin calcium, Oxaliplatin, and the antiangiogenic drug Bevacizumab (better known as Avastin). Together, they call my treatment mFOLFOX + Avastin.
The 5-FU and Leucovorin is the more traditional chemotherapy for mCRC. This has been around for 40 years and works by binding to an enzyme needed for making DNA. Cancer cells that no longer have this enzyme available are more likely to die when they try to divide in two. Normally 5-FU binds it for only a short time, which limits how effective 5-FU can be. Leucovorin causes this binding to last for a longer period of time, which boosts the effect of 5-FU.
Oxaliplatin is a platinum-compound chemotherapy drug that acts as an alkylating agent. It stops the growth of cancer cells, which causes the cells to die. It is now used in conjunction with 5-FU. While it has been around a while, it really has only been in full use since 2009.
Finally, Avastin which is an antibody drug that binds to and neutralizes a specific protein directly related to the mCRC. It was approved in 2006 to be used in combination with mFOLFOX therapy. This is a wonder drug that is blasting away at my tumors.
How do I get these drugs? While I am at the hospital on the Wednesday, I get the half hour blast of Avastin through an IV connected to an IV "tower" that if you are not directly familiar, appears on most TV medical dramas. I also get the Leucovorin and Oxaliplatin through similar IVs, that also are connected to an IV Tower. These take a bit longer, from an hour and a half to two hours. I can take them all simultaneously through my cath-port which is convenient. They supply me with 8mg of Dexamethasone, a steroid that as mentioned earlier, stimulates the adrenal gland so I am not a zombie through this process, but can actively function from my hospital chair. I usually do a training course through RSI at this time, to help me acquire the necessary credits to maintain my Project Management Professional (PMP) designation. Because I am doped up on the one hand, and being drained by chemo on the other, I try not to do any "heavy-lifting" work wise - no detailed analysis or major decision-making that could affect my work. Training makes a good alternative.
Once the three iVs are complete, I am then hooked up to the portable infuser through the same cath-port. This will be hooked up to me for the next 46 hours, and then disconnected by Nurse Karla at home on the Friday. It also tends to drain me and cause some side effects, so I continue to take the dexamethasone, albeit is smaller quantities, over the next six days to help manage the "downs" associated with the chemo. As I have mentioned in the blogs describing each session, we seem to be getting to a point where the management of the ups and downs is quite successful, for the most part.
What is a cath-port? It's a small device (about the size of two quarters placed side-by-side) that was surgically implanted under my skin in the right chest area to carry medicine into the bloodstream. It has two small 'basins' that are sealed with a soft silicon top (the septum). The port connects to a small, soft tube called a catheter. The catheter was surgically placed inside one of the large central veins that take blood to my heart (so no need to search for veins every two weeks). The chemotherapy drugs are infused into my bloodstream through a special needle that is placed into the septum every two weeks. Medicine and fluids are sent through the needle and blood samples can also be withdrawn.
After my chemo session is over, Karla is currently hooking me up to an IV bag of saline to help with my hydration post chemo. After the IV fluids are finished, Karla cleans the port by injecting heparin through the needle - this prevents blood clots from blocking the port (heparin thins the blood). Once that is complete, she removes the needle, and apart from a slight bump on my chest, you wouldn't know I had the port at all. It's pretty cool that this is available to me - I have heard horror stories of nurses searching for veins for some patients. This also provides us with the ability to manage treatments from home without having to return to the clinic multiple times.
June 24 - Additional note: I will discuss this more in my next chemo blog, but on June 11, we stopped the use of Oxalyplatin and replaced it with a new drug called Irinotecan. I was developing too may side effect with the Oxalyplatin and the CT scans and my reactions to the drug drove my doctors to decide to move on to the next chemo regiment that included the Irinotecan. I should see less side effects, and hopefully an improvement in the progress against my tumors.
Tuesday, June 10, 2014
Second CT Scan and Ninth Chemo
June 7, 2014
Normally, you would have already seen a blog update from me, as I tend to write them just before the next session, and per the schedule, I should now be in the middle of the tenth chemo session. However, we did not start the tenth session on Wednesday (June 4) as scheduled and it has been pushed to next week. I'll get into that in a bit, but there's a lot that's gone on in the past two and a half weeks since I last wrote.
First, the ninth chemo session started on Wednesday, May 21st. My Dad brought me into the clinic for this session, as Karla was home with baby Graeme. Like all sessions, before it started, we met with either my doctor or nurse practitioner (in this case it was Nina the NP) to discuss how the previous session went, whether changes were needed, etc. This discussion was more significant because we would also discuss the results of the CT scan I had undergone the previous week. Karla was dialed in through the cellphone. Unfortunately, the results were not as great as the first CT scan. There was some slight regrowth in the tumors (7%) which Nina indicated was actually a positive result, as this showed the chemo had maintained stability over the tumors since the previous session (anything under 20% is considered stable). I don't think Karla and I could quite bring ourselves to look on this as positive, but we do understand the situation I'm in - there is very little chance that the tumors in my body will be eradicated, so the point of the chemo sessions is to keep the tumors at bay, either shrinking them or at a minimum, holding them steady(and thus prolonging my life). So, this is not bad news, more 'meh' news.
There are numerous different chemo regimens that can be used against the cancer, and what we are pursuing is just the first of those regimens. There are many more in reserve, so to speak. This regimen was going to come to an end soon in any case, before one of the drugs (Oxalyplatin) did permanent damage to my nerves (the neuropathy side effect I have discussed in previous posts). I had actually been feeling the neuropathy more prevalently in recent weeks. So, Nina's recommendation was to scale back on the dosage of the Oxalyplatin for this session but to continue with the current regimen for this session. So I got hooked up to the different IVs, and then after completing the on site infusion, went home and completed the three day home infusion.
One thing we noticed as the days progressed is that the fatigue I had been experiencing seemed to be a lot worse. I was waking up unrefreshed, and by lunch time, was almost out of gas. An afternoon nap couldn't really bring back my energy, and I was going to bed immediately after dinner. This was becoming exceedingly frustrating for me, as it was getting harder to put in a full day of RSI work, let alone have anything left for my family.
A quick aside here - during this session, Karla's brother Chris and his family came up and paid us a visit from New Jersey. They stayed at a nearby hotel (they have five children so there was no way all of us could have stayed in our small house) and came over each day to visit. It was great to see them again, as Isla had never met her cousins on the DeGaetano side. It was definitely an experience for her, having to share her toys with others, and there were a few blow-ups! Chris and his wife Jill have done an amazing job raising the five kids, ranging in age from 2 to 11 years old. We all went and visited the newly opened Legoland in Boston. Probably more age appropriate for kids 7-14, but it was definitely an experience. Chris and Jill went back to Jersey on June 1.
Normally by this time, I'd be feeling really strong, but the fatigue has only gotten worse. My friend Ron was coming over for dinner on Tuesday, June 3, and I was hoping I'd have the energy for his visit. But Tuesday turned out to be a really weird day, side effect-wise. At 9:30, I took some Ibuprofen and started with some cold sweats early on. These subsided and by lunch time around 1PM, it was like a switch got turned on and I had some energy again, like a normal day before the next chemo session. I cranked out some RSI work over the next four and a half hour, but then got really cold and shivery and no amount of blankets could cool me down. So Ron's visit consisted of me being under blankets the whole time having shivery conversations.
June 10
I picked up the blog a few days later, as I was quite fatigued over the next few days and a number of things happened. I went in the for the 10th chemo session on June 4, but unfortunately had a bit of a fever approaching 101% degrees, so no chemo this week, The doctor felt it would be better to wait a week and in the meantime, see if the could isolate my fatigue. So we spent the rest of Wednesday getting blood cultures, loading up on IV fluid and being rescheduled to next Wednesday for the 10th session.
Unfortunately, when we got back home, my fever went up again. Karla called Dr. Wolpin and he recommended going to the hospital. So we loaded back up into the car and drove downtown to the Brigham. I would be on my own here, as Karla and I did not want to bring Graeme into the emergency room. Luckily, Dr. Wolpin had called ahead and I was seen very quickly. I hate the Emergency room as it is like a petri dish of injuries, disease, illness, etc. and I just tried to keep myself separated as much as possible. I had a private room quite quickly.
They took more tests, blood and vitals, and my fever had come down. I also had a chest x-ray to make sure I did not have pneumonia. All tests were negative but they decided to keep me over night just in case. Probably one of the worst sleeps since baby was born, constant noise, and being woken up every few hours for vitals or bathroom break. Overnight, Jamie decided to come down from Ottawa for a few days to provide support which was welcomed, especially if I needed to go back to hospital. I was cleared to leave around ten, but traffic was so bad that Karla wasn't able to get me until around noon. Finally home, quite fatigues in early afternoon so went straight to bed. Jamie made it down, and provided major support over the next few days.
My fever did go up a bit over the next few days, but after consultation, with NP Nina, we decided to stay home over weekend and then come in on Monday for next attempt at chemo. Unfortunely, still had a fever so pushed off chemo until Wednesday the 11th. Instead we did another CT scan to see if tumors were the cause of my fatigue. So spend most of the day at the clinic and drove home for dinner. Still feeling fatigue on Tuesday, but drove in Wednesday for next chemo.
I'll describe things further in my next blog, as we actually did move forward with the next chemo on the Wednesday.
Talk soon.
Andrew
Normally, you would have already seen a blog update from me, as I tend to write them just before the next session, and per the schedule, I should now be in the middle of the tenth chemo session. However, we did not start the tenth session on Wednesday (June 4) as scheduled and it has been pushed to next week. I'll get into that in a bit, but there's a lot that's gone on in the past two and a half weeks since I last wrote.
First, the ninth chemo session started on Wednesday, May 21st. My Dad brought me into the clinic for this session, as Karla was home with baby Graeme. Like all sessions, before it started, we met with either my doctor or nurse practitioner (in this case it was Nina the NP) to discuss how the previous session went, whether changes were needed, etc. This discussion was more significant because we would also discuss the results of the CT scan I had undergone the previous week. Karla was dialed in through the cellphone. Unfortunately, the results were not as great as the first CT scan. There was some slight regrowth in the tumors (7%) which Nina indicated was actually a positive result, as this showed the chemo had maintained stability over the tumors since the previous session (anything under 20% is considered stable). I don't think Karla and I could quite bring ourselves to look on this as positive, but we do understand the situation I'm in - there is very little chance that the tumors in my body will be eradicated, so the point of the chemo sessions is to keep the tumors at bay, either shrinking them or at a minimum, holding them steady(and thus prolonging my life). So, this is not bad news, more 'meh' news.
There are numerous different chemo regimens that can be used against the cancer, and what we are pursuing is just the first of those regimens. There are many more in reserve, so to speak. This regimen was going to come to an end soon in any case, before one of the drugs (Oxalyplatin) did permanent damage to my nerves (the neuropathy side effect I have discussed in previous posts). I had actually been feeling the neuropathy more prevalently in recent weeks. So, Nina's recommendation was to scale back on the dosage of the Oxalyplatin for this session but to continue with the current regimen for this session. So I got hooked up to the different IVs, and then after completing the on site infusion, went home and completed the three day home infusion.
One thing we noticed as the days progressed is that the fatigue I had been experiencing seemed to be a lot worse. I was waking up unrefreshed, and by lunch time, was almost out of gas. An afternoon nap couldn't really bring back my energy, and I was going to bed immediately after dinner. This was becoming exceedingly frustrating for me, as it was getting harder to put in a full day of RSI work, let alone have anything left for my family.
A quick aside here - during this session, Karla's brother Chris and his family came up and paid us a visit from New Jersey. They stayed at a nearby hotel (they have five children so there was no way all of us could have stayed in our small house) and came over each day to visit. It was great to see them again, as Isla had never met her cousins on the DeGaetano side. It was definitely an experience for her, having to share her toys with others, and there were a few blow-ups! Chris and his wife Jill have done an amazing job raising the five kids, ranging in age from 2 to 11 years old. We all went and visited the newly opened Legoland in Boston. Probably more age appropriate for kids 7-14, but it was definitely an experience. Chris and Jill went back to Jersey on June 1.
Normally by this time, I'd be feeling really strong, but the fatigue has only gotten worse. My friend Ron was coming over for dinner on Tuesday, June 3, and I was hoping I'd have the energy for his visit. But Tuesday turned out to be a really weird day, side effect-wise. At 9:30, I took some Ibuprofen and started with some cold sweats early on. These subsided and by lunch time around 1PM, it was like a switch got turned on and I had some energy again, like a normal day before the next chemo session. I cranked out some RSI work over the next four and a half hour, but then got really cold and shivery and no amount of blankets could cool me down. So Ron's visit consisted of me being under blankets the whole time having shivery conversations.
June 10
I picked up the blog a few days later, as I was quite fatigued over the next few days and a number of things happened. I went in the for the 10th chemo session on June 4, but unfortunately had a bit of a fever approaching 101% degrees, so no chemo this week, The doctor felt it would be better to wait a week and in the meantime, see if the could isolate my fatigue. So we spent the rest of Wednesday getting blood cultures, loading up on IV fluid and being rescheduled to next Wednesday for the 10th session.
Unfortunately, when we got back home, my fever went up again. Karla called Dr. Wolpin and he recommended going to the hospital. So we loaded back up into the car and drove downtown to the Brigham. I would be on my own here, as Karla and I did not want to bring Graeme into the emergency room. Luckily, Dr. Wolpin had called ahead and I was seen very quickly. I hate the Emergency room as it is like a petri dish of injuries, disease, illness, etc. and I just tried to keep myself separated as much as possible. I had a private room quite quickly.
They took more tests, blood and vitals, and my fever had come down. I also had a chest x-ray to make sure I did not have pneumonia. All tests were negative but they decided to keep me over night just in case. Probably one of the worst sleeps since baby was born, constant noise, and being woken up every few hours for vitals or bathroom break. Overnight, Jamie decided to come down from Ottawa for a few days to provide support which was welcomed, especially if I needed to go back to hospital. I was cleared to leave around ten, but traffic was so bad that Karla wasn't able to get me until around noon. Finally home, quite fatigues in early afternoon so went straight to bed. Jamie made it down, and provided major support over the next few days.
My fever did go up a bit over the next few days, but after consultation, with NP Nina, we decided to stay home over weekend and then come in on Monday for next attempt at chemo. Unfortunely, still had a fever so pushed off chemo until Wednesday the 11th. Instead we did another CT scan to see if tumors were the cause of my fatigue. So spend most of the day at the clinic and drove home for dinner. Still feeling fatigue on Tuesday, but drove in Wednesday for next chemo.
I'll describe things further in my next blog, as we actually did move forward with the next chemo on the Wednesday.
Talk soon.
Andrew
Tuesday, May 20, 2014
Eighth Chemo
May 20th
So the Eighth Chemo. I was actually looking forward to this session as it would be the first time since I started that I would go three weeks instead of two weeks between sessions. I felt this would provide me with many extra days of feeling great, instead of the few days on the Monday and Tuesday before the next session.
Boy was I wrong. This has been one of the most frustrating sessions yet, and for the first time, I can't say that this session was better than the last.
I guess a harbinger of things to come happened immediately when Karla and I got home from the clinic on Day 1, on April 30th. I went inside the house while Karla walked a few laneways over to get the mail from the group mailbox. As I was hanging my jacket, I heard a thump and a cry of pain. I opened the door to find Karla down on the front step, where she had tripped. She did not think she had fallen on her stomach, but had taken some abrasions on her knees and hands. She had also banged her head on the front door. After calling the ob/gyn, it was decided that she needed to come into the hospital to be checked out. So we got back into the car, now with Amarilis and Isla as well and drove back into Boston, thankfully against traffic. Unfortunately, Karla HAD to drive, as I was hooked up to the infuser, and could not drive while chemo was being pumped into me.
We made it to Brigham & Women's Hospital where Karla was whisked upstairs in the maternity ward. She had started having contractions, and we didn't know if they had been triggered by the fall, or by the trauma of the incident itself. After some observation, it was decided to keep Karla in the hospital overnight. Our next door neighbor, Colleen, volunteered to pick up Amarilis, Isla and myself so we were able to get home sometime after seven. We also had offers from both sets of parents to drive up (from Myrtle) or drive down (from Ottawa) the next day.
The next morning, Karla was cleared to leave but she was still having contractions. The baby was fine (I think Karla's natural instinct when she fell was to protect the baby at all costs, which was why her knees and head were banged up). So Karla drove herself home. Her parents ended up driving up on Friday, because we really couldn't know when the baby might come, and they were so supportive over the two week period in which they were here. It turned out that this was just a scare, and Karla did end up having Graeme as scheduled on May 12.
So the three-day infusion went pretty much as expected. Jaw pain on Day 2 but managed with Tylenol/Ibuprofen. I actually had pretty good Day 4 and 5 over the weekend of May 3rd and 4th. We looked at some houses and in general I felt pretty good. I had a scheduled appointment on Monday with a Health and Fitness Consultant from the clinic. I was hoping to get put on some kind of program I could follow going forward, but it was a bit more vague. Targeting 150 minutes a week of physical activity, and getting set up with the Livestrong foundation in the fall for a weight-based program. Not much direction.
I did go for some long walks over the next three days, but found I was getting progressively more tired each day after the walk. I was fighting a bit of a cold so figured it was playing around with my energy levels. Friday was a very bad day as I ended up sleeping for a bout six hours over the course of the day. I seemed to come out of it by the weekend, so felt I would be ready to handle the birth of Baby G over the next week.
Instead, what I found was, as each day progressed, I would come home in the evening more tired than the day before. I was even feeling some slight pains in my stomach similar to what I had felt earlier on in the process, and called my doctor to determine if I should come in (especially as I was at the hospital right next door). However, they felt that as long as I was not experiencing shortness of breath, I should just manage with painkillers. By Thursday, I was wiped, but managed to get Karla and baby home.
And that is pretty much what I have been going through since last Thursday (it is now Tuesday). I wake up somewhat refreshed but as the day progresses, I get more and more tired such that by the evening, I'm ready to turn in, sometimes as early as 6:30PM. I have tried taking naps but I do not wake up refreshed. It is very frustrating as I really thought that this "extra" week was going to be a bit of a glory period. Instead, my taste buds and neuropathy have gotten worse and I'm dealing with this extreme tiredness. I will definitely talk with my doctor tomorrow. Karla and family feel it is the stress of the past week, the fact that I was out of the home four days straight, and maybe a lingering cold (Isla has also been sick with a cold this week) that have impacted upon me. Logically, that makes sense, but emotionally you do start going down deep, dark alleys for which I have been able to stay away from, for the most part.
One other thing is that I had a CT Scan at the clinic last Thursday, and I will get the results tomorrow. I am trying to keep a positive attitude going in, but this past week has thrown me for a loop. Today, one of my Vermont friends invited me up in a few years for some father-son hockey on his backyard rink, and all I can think about is that: "I have to BE there." I'm sorry that the joy and wonder I felt with the birth of Graeme has been tempered somewhat by my health. Let's hope that things get sorted out tomorrow.
All the best.
Andrew
So the Eighth Chemo. I was actually looking forward to this session as it would be the first time since I started that I would go three weeks instead of two weeks between sessions. I felt this would provide me with many extra days of feeling great, instead of the few days on the Monday and Tuesday before the next session.
Boy was I wrong. This has been one of the most frustrating sessions yet, and for the first time, I can't say that this session was better than the last.
I guess a harbinger of things to come happened immediately when Karla and I got home from the clinic on Day 1, on April 30th. I went inside the house while Karla walked a few laneways over to get the mail from the group mailbox. As I was hanging my jacket, I heard a thump and a cry of pain. I opened the door to find Karla down on the front step, where she had tripped. She did not think she had fallen on her stomach, but had taken some abrasions on her knees and hands. She had also banged her head on the front door. After calling the ob/gyn, it was decided that she needed to come into the hospital to be checked out. So we got back into the car, now with Amarilis and Isla as well and drove back into Boston, thankfully against traffic. Unfortunately, Karla HAD to drive, as I was hooked up to the infuser, and could not drive while chemo was being pumped into me.
We made it to Brigham & Women's Hospital where Karla was whisked upstairs in the maternity ward. She had started having contractions, and we didn't know if they had been triggered by the fall, or by the trauma of the incident itself. After some observation, it was decided to keep Karla in the hospital overnight. Our next door neighbor, Colleen, volunteered to pick up Amarilis, Isla and myself so we were able to get home sometime after seven. We also had offers from both sets of parents to drive up (from Myrtle) or drive down (from Ottawa) the next day.
The next morning, Karla was cleared to leave but she was still having contractions. The baby was fine (I think Karla's natural instinct when she fell was to protect the baby at all costs, which was why her knees and head were banged up). So Karla drove herself home. Her parents ended up driving up on Friday, because we really couldn't know when the baby might come, and they were so supportive over the two week period in which they were here. It turned out that this was just a scare, and Karla did end up having Graeme as scheduled on May 12.
So the three-day infusion went pretty much as expected. Jaw pain on Day 2 but managed with Tylenol/Ibuprofen. I actually had pretty good Day 4 and 5 over the weekend of May 3rd and 4th. We looked at some houses and in general I felt pretty good. I had a scheduled appointment on Monday with a Health and Fitness Consultant from the clinic. I was hoping to get put on some kind of program I could follow going forward, but it was a bit more vague. Targeting 150 minutes a week of physical activity, and getting set up with the Livestrong foundation in the fall for a weight-based program. Not much direction.
I did go for some long walks over the next three days, but found I was getting progressively more tired each day after the walk. I was fighting a bit of a cold so figured it was playing around with my energy levels. Friday was a very bad day as I ended up sleeping for a bout six hours over the course of the day. I seemed to come out of it by the weekend, so felt I would be ready to handle the birth of Baby G over the next week.
Instead, what I found was, as each day progressed, I would come home in the evening more tired than the day before. I was even feeling some slight pains in my stomach similar to what I had felt earlier on in the process, and called my doctor to determine if I should come in (especially as I was at the hospital right next door). However, they felt that as long as I was not experiencing shortness of breath, I should just manage with painkillers. By Thursday, I was wiped, but managed to get Karla and baby home.
And that is pretty much what I have been going through since last Thursday (it is now Tuesday). I wake up somewhat refreshed but as the day progresses, I get more and more tired such that by the evening, I'm ready to turn in, sometimes as early as 6:30PM. I have tried taking naps but I do not wake up refreshed. It is very frustrating as I really thought that this "extra" week was going to be a bit of a glory period. Instead, my taste buds and neuropathy have gotten worse and I'm dealing with this extreme tiredness. I will definitely talk with my doctor tomorrow. Karla and family feel it is the stress of the past week, the fact that I was out of the home four days straight, and maybe a lingering cold (Isla has also been sick with a cold this week) that have impacted upon me. Logically, that makes sense, but emotionally you do start going down deep, dark alleys for which I have been able to stay away from, for the most part.
One other thing is that I had a CT Scan at the clinic last Thursday, and I will get the results tomorrow. I am trying to keep a positive attitude going in, but this past week has thrown me for a loop. Today, one of my Vermont friends invited me up in a few years for some father-son hockey on his backyard rink, and all I can think about is that: "I have to BE there." I'm sorry that the joy and wonder I felt with the birth of Graeme has been tempered somewhat by my health. Let's hope that things get sorted out tomorrow.
All the best.
Andrew
Monday, May 19, 2014
Arrival of Baby G - Graeme MacLellan Cuthill
This post is not going to talk about chemo or cancer. It's all about the birth of my son. Graeme MacLellan Cuthill arrived in this world at 9:28 AM on Monday, May 12. He was a healthy 7 lbs. 6 oz. and was 19.25 inches in length. It was a magical experience to be present at his birth.
It was a planned C-Section so Karla and I left for the hospital quite early on Monday to both avoid traffic and be at the hospital in plenty of time. Karla was ushered into a prep room at Brigham and Women's hospital around 7:45AM, and we expected the whole process to start around 9:30. However, Karla's doctor, known around the hospital as the "Queen Bee", had no time for dilly-dallying (she is known for being the best surgeon, although sometimes her bedside manner is a bit short). So Karla was wheeled out around 8:40 to the Operating Room (OR). I waited outside for 15 minutes while she was prepped and then sat beside her as the delivery began.
They had offered us a see-through canvas so we could watch the surgery in its entirety. However, we opted to go the opaque route, not wanting "too much information". After about ten minutes, I was told to look over and watched as Graeme entered the world. I have tears in my eyes as I write this - he was so beautiful and perfect. Hearing him cry for the first time was also music to my ears. Karla was much more lucid through this delivery and I was providing her with a running commentary as best I could. I think my first words were: "Wow, he's got a ton of hair".
They took Graeme aside to clean him up, and measure and weigh him. I was able to come over and watch. He's got a great pair of lungs on him, as he expressed his displeasure at being removed from his home of the past nine months. Then we brought him over to see Mommy. We got to hold him, swaddled, for a good ten minutes as the doctors finished the surgery. He had tears in his eyes as he was fighting so hard to keep them open and see the new world around him, while at the same time trying to adjust to light for the first time.
After the surgery was complete, we went back to Karla's prep room. We had our own private nurse to watch over both Karla and Graeme for the first little while, her name was Melissa and she was also pregnant, expecting in July. She was awesome and provided all the information we needed (we had a lot of questions) and the best help possible for Karla. Unfortunately, Karla had some bouts of nausea initially, so we stayed in this room a bit longer than expected until her stomach settled down. At around 3:30PM, we were transferred to Karla's recovery room, where she was expected to spend the next four nights.
The room itself was quite comfortable, with a TV and table for food and drinks, and several chairs for visitors. We had hoped to potentially have Karla's folks bring Isla over to meet her brother, but the day was already late and we felt that it might be a bit stressful getting caught in traffic, as well as being separated from Mommy again so late in the day, when Isla is already a bit tired. That evening, though, we did Facetime Karla and Graeme from home while I was reading Isla bedtime stories. She kissed the screen multiple times and said: "I love you, Baby G". Karla's parents, with Amarilis, went in for a visit later that evening, as Karla was feeling up to it. I stayed home with Isla. We tried to make things as normal as possible for Isla, with me being home when she woke up in the morning, and also being back home when she went to bed (and like most nights, reading her three stories).
So for the next two days, I would head to the hospital around 9AM, followed closely by Karla's parents, Amarilis and Isla and all five of us would spend the morning with Karla and Graeme. Isla did really well, and was comfortable enough to hold Graeme by Wednesday. I would spend the afternoon with Karla after the others left, and then head home around 6PM.
We had initially thought Karla and Graeme would stay through Friday, but Karla was feeling up to going home on Thursday. So we left the hospital around 3PM and got Graeme to his new home not long after 4. Baby and Mom have now been home for several days and are doing very well. Graeme is sleeping for three hour stretches at night, which is fantastic, and is breast-feeding very well. He is very vocal about not liking his diaper changed, but so far, seems pretty mellow overall. It's funny how "coiled up" he is, basically keeping his legs tucked in like he was still in the womb, with the odd kick to stretch them out.
I often look at Isla with wonder and tell myself (as if I did not believe it): "I have a little girl". Now I find myself doing the same with Graeme: "That little bundle over there is my son." I do think he looks a bit like me, but so did Isla as a baby. Hopefully, the influence of Karla's genes enhances his better looking traits!
Here are some photos of the family, plus some studio type pictures that were actually taken in the hospital room.
It was a planned C-Section so Karla and I left for the hospital quite early on Monday to both avoid traffic and be at the hospital in plenty of time. Karla was ushered into a prep room at Brigham and Women's hospital around 7:45AM, and we expected the whole process to start around 9:30. However, Karla's doctor, known around the hospital as the "Queen Bee", had no time for dilly-dallying (she is known for being the best surgeon, although sometimes her bedside manner is a bit short). So Karla was wheeled out around 8:40 to the Operating Room (OR). I waited outside for 15 minutes while she was prepped and then sat beside her as the delivery began.
They had offered us a see-through canvas so we could watch the surgery in its entirety. However, we opted to go the opaque route, not wanting "too much information". After about ten minutes, I was told to look over and watched as Graeme entered the world. I have tears in my eyes as I write this - he was so beautiful and perfect. Hearing him cry for the first time was also music to my ears. Karla was much more lucid through this delivery and I was providing her with a running commentary as best I could. I think my first words were: "Wow, he's got a ton of hair".
They took Graeme aside to clean him up, and measure and weigh him. I was able to come over and watch. He's got a great pair of lungs on him, as he expressed his displeasure at being removed from his home of the past nine months. Then we brought him over to see Mommy. We got to hold him, swaddled, for a good ten minutes as the doctors finished the surgery. He had tears in his eyes as he was fighting so hard to keep them open and see the new world around him, while at the same time trying to adjust to light for the first time.
After the surgery was complete, we went back to Karla's prep room. We had our own private nurse to watch over both Karla and Graeme for the first little while, her name was Melissa and she was also pregnant, expecting in July. She was awesome and provided all the information we needed (we had a lot of questions) and the best help possible for Karla. Unfortunately, Karla had some bouts of nausea initially, so we stayed in this room a bit longer than expected until her stomach settled down. At around 3:30PM, we were transferred to Karla's recovery room, where she was expected to spend the next four nights.
The room itself was quite comfortable, with a TV and table for food and drinks, and several chairs for visitors. We had hoped to potentially have Karla's folks bring Isla over to meet her brother, but the day was already late and we felt that it might be a bit stressful getting caught in traffic, as well as being separated from Mommy again so late in the day, when Isla is already a bit tired. That evening, though, we did Facetime Karla and Graeme from home while I was reading Isla bedtime stories. She kissed the screen multiple times and said: "I love you, Baby G". Karla's parents, with Amarilis, went in for a visit later that evening, as Karla was feeling up to it. I stayed home with Isla. We tried to make things as normal as possible for Isla, with me being home when she woke up in the morning, and also being back home when she went to bed (and like most nights, reading her three stories).
So for the next two days, I would head to the hospital around 9AM, followed closely by Karla's parents, Amarilis and Isla and all five of us would spend the morning with Karla and Graeme. Isla did really well, and was comfortable enough to hold Graeme by Wednesday. I would spend the afternoon with Karla after the others left, and then head home around 6PM.
We had initially thought Karla and Graeme would stay through Friday, but Karla was feeling up to going home on Thursday. So we left the hospital around 3PM and got Graeme to his new home not long after 4. Baby and Mom have now been home for several days and are doing very well. Graeme is sleeping for three hour stretches at night, which is fantastic, and is breast-feeding very well. He is very vocal about not liking his diaper changed, but so far, seems pretty mellow overall. It's funny how "coiled up" he is, basically keeping his legs tucked in like he was still in the womb, with the odd kick to stretch them out.
I often look at Isla with wonder and tell myself (as if I did not believe it): "I have a little girl". Now I find myself doing the same with Graeme: "That little bundle over there is my son." I do think he looks a bit like me, but so did Isla as a baby. Hopefully, the influence of Karla's genes enhances his better looking traits!
Here are some photos of the family, plus some studio type pictures that were actually taken in the hospital room.
Thursday, May 1, 2014
Some Thoughts on Exactly How Much to Share
First off, I'm of British decent, so sharing my innermost thoughts and feelings is definitely struggle, both in words on paper, and also verbally in real life. But I've never faced something quite like this before, and I do feel that getting things down on "paper" serves several purposes. In no particular order, I think it does the following:
1. How much to share. I struggled with this but in the end decided that I would share as much information as possible for several reasons - so all you readers have a good idea (a full understanding) of the challenges that Karla and I face on a regular basis, and second, if I am gone at some point in later years and my children want some insight into who I am and what went on back in 2014 and forward, that a record exists that they can consult. There is some filtering going on - we share as much as possible within reason. Believe me, sharing as much as I have has been a struggle at times, but it is therapeutic to me. And hopefully it is somewhat entertaining, enlightening and has an impact on some of you, the readers,
2. Speaking of having an impact on the readers, I know that I have had an impact on some of you. I have heard directly or second hand that some of you have taken action to check with your doctors and to even go has far as having colonoscopies to address potential colon cancer earlier in your lives. I know that I always considered things like colon cancer as an older person's disease and not something I had to worry about. It has been a shock to me that several acquaintances, both of whom are younger than me, have also been fighting (and successfully holding at bay) colon cancer. While something like a colonoscopy is not an easy process, it may be something for people to consider in their forties rather than later on in life. At a minimum, have regular physicals that include blood tests. I oftentimes wonder if I had been more prudent in taking action, I might have been able to stop this disease before it got to Stage IV.
In addition, Karla and I consider ourselves lucky that we consulted a financial advisor a few years back, and took the proper steps to cover ourselves with significant life insurance policies when we did. I do feel somewhat secure that should I pass away sooner than later, Karla and my children will be well taken care of. I have heard that some of you are also assessing your life insurance coverage for sufficiency since hearing about my challenges and I think that's great. Do it before "the train has already left the station", so to speak. If I have one regret, I wish I had also taken out more supplemental permanent disability insurance. Luckily, my company has been open to both flexible work hours and assignments that fit within my chemo schedule. And while my health has an impact on my availability, it has not prevented me from being an active and productive member for my company. But who is to say things won't change in the future - I know we will find a way to manage, but the extra security would have been nice.
3. In this day and age, we just don't write letters to each other anymore. I think back to my youth, when my mother and grandmother would send weekly letters to each other. The letters would be six to eight pages long, single-spaced, on that old sky-blue tissue-like letter paper and sent by airmail across the sea from London to Ottawa each week and back again the next. Costs for making long distance phone calls on a regular basis were prohibitive so this was the most efficient and effective way for mother and daughter to keep each other up-to-date across three thousand miles of ocean.
With the advent of emails, the art of letter writing has slowly waned to nothing. There is no permanent record of what is going on in people's life. There is also no way I could sit down and write a weekly email, let alone a weekly letter to each of you, so think of this as my personal way of sending you a letter every week or two and keeping you up-to-date on my life. I apologize for not writing it down on blue tissue paper, but hopefully this format will suffice.
1. How much to share. I struggled with this but in the end decided that I would share as much information as possible for several reasons - so all you readers have a good idea (a full understanding) of the challenges that Karla and I face on a regular basis, and second, if I am gone at some point in later years and my children want some insight into who I am and what went on back in 2014 and forward, that a record exists that they can consult. There is some filtering going on - we share as much as possible within reason. Believe me, sharing as much as I have has been a struggle at times, but it is therapeutic to me. And hopefully it is somewhat entertaining, enlightening and has an impact on some of you, the readers,
2. Speaking of having an impact on the readers, I know that I have had an impact on some of you. I have heard directly or second hand that some of you have taken action to check with your doctors and to even go has far as having colonoscopies to address potential colon cancer earlier in your lives. I know that I always considered things like colon cancer as an older person's disease and not something I had to worry about. It has been a shock to me that several acquaintances, both of whom are younger than me, have also been fighting (and successfully holding at bay) colon cancer. While something like a colonoscopy is not an easy process, it may be something for people to consider in their forties rather than later on in life. At a minimum, have regular physicals that include blood tests. I oftentimes wonder if I had been more prudent in taking action, I might have been able to stop this disease before it got to Stage IV.
In addition, Karla and I consider ourselves lucky that we consulted a financial advisor a few years back, and took the proper steps to cover ourselves with significant life insurance policies when we did. I do feel somewhat secure that should I pass away sooner than later, Karla and my children will be well taken care of. I have heard that some of you are also assessing your life insurance coverage for sufficiency since hearing about my challenges and I think that's great. Do it before "the train has already left the station", so to speak. If I have one regret, I wish I had also taken out more supplemental permanent disability insurance. Luckily, my company has been open to both flexible work hours and assignments that fit within my chemo schedule. And while my health has an impact on my availability, it has not prevented me from being an active and productive member for my company. But who is to say things won't change in the future - I know we will find a way to manage, but the extra security would have been nice.
3. In this day and age, we just don't write letters to each other anymore. I think back to my youth, when my mother and grandmother would send weekly letters to each other. The letters would be six to eight pages long, single-spaced, on that old sky-blue tissue-like letter paper and sent by airmail across the sea from London to Ottawa each week and back again the next. Costs for making long distance phone calls on a regular basis were prohibitive so this was the most efficient and effective way for mother and daughter to keep each other up-to-date across three thousand miles of ocean.
With the advent of emails, the art of letter writing has slowly waned to nothing. There is no permanent record of what is going on in people's life. There is also no way I could sit down and write a weekly email, let alone a weekly letter to each of you, so think of this as my personal way of sending you a letter every week or two and keeping you up-to-date on my life. I apologize for not writing it down on blue tissue paper, but hopefully this format will suffice.
Subscribe to:
Posts (Atom)