Canada Remembers

 

11 - 11 - 11

World War I was finally brought to an end with the signing of an armistice on the 11th hour of the 11th day of the 11th month of 1918.  On November 11, 1918, 93 years ago, the "war to end all wars" was over. The 4 years of brutal fighting claimed over 20 million lives, about half of which were civilians, and brought an end to the German, Russian, Ottoman, and Austro-Hungarian Empires.

The Fallen

For 91 years we have marked November 11th as a day to remember those who have lost their lives in military service and to reflect on the continued presence of war in our world.   This year we particularly remember those Canadians who have died in action since last Remembrance Day.

Corporal Steve Martin
Corporal Yannick Scherrer
Bombardier Karl Manning
Master Corporal Francis Roy
Master Corporal Byron Greff
(from CBC "In the Line of Duty")

---------------------

They shall grow not old,

as we that are left grow old:

age shall not weary them,

nor the years condemn.

At the going down of the sun

and in the morning

we will remember them...

 Mount Royal Kantorei - The Kontakion - from Kantorei on Vimeo.

"Give rest unto your servants with your saints
O God, Give rest, Give rest.
Where there is neither pain nor sorrow
Neither sighing but life everlasting."

A Musical Blessing:  "Kontakion" by Rupert Lang 

Hope

And still, we long and pray for peace in our day...

  
Amabile Boys Choir (Canada)

1- 'Peace Drum Song', Will Schmid

'Peace, bring us peace. Peace, bring peace.

Feel the heartbeat. Peace, understanding, hope to all.

Bring peace, blessed peace'.
2- 'Oseh Shalom', traditional Jewish prayer.

'May the One who causes peace to reign

in the high heavens, have peace descend upon us

...and let us say: Amen'.

Lest we forget, Lest we forget...     Rob; in Vancouver

Rob on the Radio

Mark Forsythe - BC Almanac

Last week I was a guest on CBC Radio's noon hour show "BC Almanac", with host Mark Forsythe.  The topic of conversation was "The Language of Cancer", inspired in part by the recent cancer death of NDP leader Jack Layton.  We were particularly speaking about the use of "battle" type metaphors when referring to the cancer experience.

I was on-air for about 20 minutes.  The opening part is a conversation with Mark and the second half is a call-in format.  You can listen to the show at this link... Rob on CBC Almanac.  My piece starts at about 20:19 in the podcast.

It was a wonderful experience to be able to speak on a matter which is so close to my heart.  Mark is a skilled interviewer and an easy guy to have a conversation with.

Be well enough...  Rob; in Vancouver

"Use what language you will, 

you can never say anything but what you are." 

Ralph Waldo Emerson

Keeping Our Fingers Crossed!

Chemo Radiation Finished!

I've just finished the last of 25 treatments of radiation for a final delivered dose of 4500 centiGrays of absorbed radiation.  With the end of radiation I am also finished the side program of chemotherapy.  The radiation effects continue for the next several weeks but I should start feeling better tomorrow now that the daily chemo is finished.  My radiation oncologist says that now we "keep our fingers crossed".

Dr. Paul Klimo Retires

It is fitting that as I finish this last round of treatment my principal oncologist of the last seven years, Dr. Paul Klimo, works his last day.  He is moving into a very well earned retirement.  He will be missed by his many cancer patients on the Northshore and throughout BC.  I will personally miss him very much.  He has been a steady presence to me throughout this journey and I shall miss his compassionate and competent care.

Seven Year Journey

Here is a quick look at this cancer journey so far, by the numbers...

• 7 Years  of living with stage 4 colon cancer.
• 5 major operations involving about...
• 45 Hours of surgery, and...
• 100 Days and nights in hospital.
• 40 Treatments of radiation.
• 100 Weeks of chemotherapy.
• 6 Weeks of intense rehabilitative therapy.
• 5 Pet scans.
• 5 MRI and/or Bone scans.
• 10 Chest X-rays.
• 20 CT scans.
• 100+ Blood tests.
• 20+ Doctors: GPs, oncologists, surgeons, physiatrists, urologists, etc.
• 50+ Lab techs, radiation techs, physio-therapists, occupational therapists, etc.
• 200+ Nurses: chemo nurses, O/R nurses, homecare nurses, etc.
• 7 Years of living with cancer.
• 2,500 Days of prayer and hope.
• 60,000+ Hours of Living FULLY... with fingers crossed!

All I can say is "Thank God for Medi-care".  And Thank God for the awesome community of colleagues, family, and friends who have walked with us every step of the way.  I cannot imagine enduring the trials of this journey without you all.  Thank You. Thank You.  Thank You.

With the completion of this program I am now finished all of the treatments related to my most recent recurrence.  I will update this blog periodically as any new information becomes available.  But for now it is mostly a focus on recovery.  

The Underwear Affair 2011

Pam and I are again joining with others to participate in "The Underwear Affair".  This is a BC Cancer Foundation fund-raiser to raise funds and awareness for cancers that "hit below the belt".  "Bringing awareness to down there-ness" is the theme.  The options are a 10k run or a 5k walk.  Pam and I will be doing the 5k walk and are walking to raise a few thousand dollars between us.  Please sponsor either one of us with a donation if you are able to.

• Pam's Underwear Affair Page
• Rob's Underwear Affair Page

For information and pictures of last year's event click here.

Thank You!

Peace and blessings... Rob; in Vancouver

"Life is not a matter of holding good cards, but rather, 

of playing a bad hand well!" 

Robert Louis Stevenson

"The Underwear Affair" 2010

Still Some Work to Do...

I have been enjoying a time of convalescence at home since my discharge from G.F. Strong in mid-April.  With the holiday of Easter and a delightful visit from Robyn, Brandon, and baby Jordan, not to mention the reading of copious quantities of fiction, I have hardly found a moment to do any "blogging".  I have also been waiting for some definitive direction to be determined with respect to my ongoing cancer journey.  With such direction now clear it seems like a good time to issue a "health update".

Surgical Recovery and Mobility

I have continued to make great strides in my recovery from February's surgery.  I am now walking comfortably with one cane and able to cover 1-2 km. in an outing.  The pace is somewhat slower than I would like but is improving.  I hope to be able to walk in the 5 km "Underwear Affair" walk in late-July.  Or at least half of it.

All wounds associated with the surgery are now well healed.  There was a pesky little portion on my lower back that was slow to heal but is now fully closed and looking good.  My general, neuro-spinal, and plastic surgeon's are all very well pleased with my recovery thus far.

Cancer Status

One of the big questions of course is "what of the cancer?"  Did they get it all?

I must preface the answer to this question with the sober realization that there is rarely any "unambiguously good news" for the metastatic colon cancer survivor.  Most of the great gains I have made in this 7 year journey have been tempered by the reality that stage 4 colon cancer is a very slippery and persistent disease, recurrences are common.  A "wait and see" attitude is often prescribed.

That being said, the news form my surgery is very good indeed.  The goal of the surgery was to achieve a complete "en bloc" resection of the sacral tumour and all of the associated soft-tissue cancer with clear margins all around.  The pathology reports do indicate that this was achieved.  YEAH!

HOWEVER... some of the sacral margins are only "marginally clear".  There is a section along the right side of the sacrum where the cancer was within a few millimetres of the surgical margin.  My spinal surgeon was concerned about this and referred me to the radiation department.  The radiation oncologist explained that they tend to treat such margins as though they were "not clear".  They reviewed my previous (Oct. 2009) radiation report, CT scanned my pelvis, and concluded that a program of radiation would help to reduce the possibility of recurrences along the surgical margin in question.  They further advised that this particular radiation treatment was made more effective by the concurrent administration of chemotherapy with capcitabine (aka Xeloda).  My own oncologist has concurred with the recommendation of this approach.

Radiation and Chemo 

SO... I will begin a 5 week program of radiation and chemo this coming Wednesday, May 25.  The radiation will be the same dose I received back in 2009, administered over 25 treatment sessions rather than 15,  meaning a much lower daily dose.  Side-effects will include fatigue.

The chemo program is intended to augment the radiation.  Xeloda is an orally administered version of the standard colon cancer chemo drug fluorouracil or 5FU. I had this same drug back in 2007.  Side-effects include the standard nausea,  fatigue, and reduced blood counts as well hand/foot rashes and mouth sores with prolonged usage.

With both the radiation and the chemo, the side-effects are cumulative and tend to be worse in the later stages of the program.  If the chemo side-effects become too bad we will reduce or eliminate the chemo dose.

So basically I am hunkering down for 5 weeks of a daily grind of radiation and chemo.  With luck I will be finished before the July 1st, Canada Day weekend and free from there on to enjoy the great Canadian summer!

After that... we will "wait and see"...

TTFN... Rob; in Vancouver

"The dream of wellness sustained me throughout the reality of the treatment."

Vickie Girard

It's a Girl!

Jordan Jeanette Fentie  

b. March 31, 2011

7lbs 6oz

Mother and Daughter

Brandon, Robyn, and Jordan Jeanette

Jordan is derived from the Hebrew yarden (to flow down, descend). The name is that of the chief river of Palestine, in which Jesus was baptized. Jordan originated as a given name in the Middle Ages, being bestowed upon those baptized in holy water said to be taken from the Jordan River. Jordan was one of the top names on Robyn and Brandon's "Girl Names" list.  They settled on it after the birth seeing that it was the name that best fit their new baby.

Jeanette is a female name, a diminutive form of the name Jeanne. Other variations are Janette and Janet.  The name is derived from the Hebrew "God is gracious". Jeanette was chosen as a tribute to Grandmother's Jean and Janet.  What a great way to carry names and memories into the future!

Jordan was delivered at 12:08pm after Robyn and Brandon arrived at the hospital at 11:30am!  Phew!  What a close call!

Jordan Jeanette Fentie
b. March 31, 2011

___________________________

Weekend Pass

I'm home from the Rehab Hospital on a full weekend pass, which means I am able to stay home overnight on both Friday and Saturday nights.  What a treat to sleep in my own bed with Grandma!  

I continue to make good progress and am now maneuvering indoor spaces with the aid of one cane (right hand to support left leg).   I'm still using the 4-wheeled walker for outdoor strolling.   

I had visits with all three of my surgeons this past week (General, Plastic, and Neuro/Spinal).  They are all pleased with my progress and see no particular problems.  Next on the agenda is a visit to the Cancer Agency to determine more definitively if there is any residual cancer left in the sacrum and whether or not radiation is advisable if there is, or even if there isn't.  I'll also be following up with my regular oncologist.

I'm scheduled to finish my rehab program on April 19th.  I'll be home after that and following an ongoing physio regimen as an "out-patient".  My physio-therapist is setting up a program that will include work-outs at my local community centre.

That's all folks!

Rob; in Vancouver

"A new baby is like the beginning of all things - 

Wonder, Hope, a dream of possibilities."

Edna J. Le Shan

Rob in Rehab!

Greetings Family and Friends, Far and Wide!

In the past week I have been transferred from Vancouver General Hospital to G.F. Strong Rehab Centre.  This is a significant move and indicates that I am sufficiently healed from the surgery so as to be ready for a rehab program.  G.F. Strong is a residential rehabilitation facility where people, like myself, with spinal, neurological, muscular, or skeletal injuries go through intense therapy towards regaining as much function as possible.  Rehab programs may be from 6 weeks to 3 months depending on the nature of the injury.   

A look at my Thursday schedule will give you a snapshot view of the kind of rehab therapy that happens at G.F. Strong.

• 08:00  Breakfast
• 08:45  W.O.W. :  Walk on Ward (15 minutes)
• 09:30 Dressing Change and Doctor Consultation
• 10:00 Physio-Therapy (30 minutes)
• 10:30 Home visit with Occupational Therapist (2 hrs)
• 12:30 Lunch
• 13:00 Meeting with Social Worker (1hour)
• 15:00 Doctor Consultation (30 minutes)
• 15:30 Physio-Therapy (30 minutes)
• 17:00 Supper
• 17:30 Taoist Tai Chi (1 hour):  Optional Program

Thursday was a little busier than a typical day but it does give you an idea of the range of of activities and programs that I am engaged in.

The Rehab Centre is staffed by a wonderful team of therapists, nurses, doctors, social workers, dieticians, care aides, and support staff who work together in a well coordinated, integrated approach. I have both an Occupational Therapist and a Physio-Therapist who will work with me for about an hour each day during the course of my program. 

Whereas in many medical institutions you feel like an anonymous number, at G.F. Strong you feel like the staff are honestly getting to know you.  This "patient centered", personal, and holistic approach is essential if true healing and wellness are to be realized.  I feel very fortunate to have this type of rehabilitation available to me.

Getting Around

I took my first steps last week and have been walking for short distances with a walker every day.  I have significant "nerve pain" in my left leg which limits the amount of walking I can do at this time.  Yesterday I was only able to walk for 4 minutes before the pain in my calf did me in.    In the meantime I mostly get around in a wheelchair, in which I am becoming more proficient each day.  I am most grateful for the memories of my paraplegic Aunt Shirley McFeat who I am reminded of daily.

Home Visits

One great advantage to being at G.F. Strong is the benefit of being able to go on home visits.  I am home on a day pass today (Saturday) and will be home again tomorrow.  Next weekend I hope to be able to stay Saturday night at home as well!   What a delight it is to be home.  And so much easier for Pam too!  I hope to be able to come home each weekend while I am in the residential program.

Thank You!  Thank You!  Thank You!

Pam and the Girls and I can not say or do enough to express our thanks for the many cards, notes, prayers, and expressions of love and good will we have received from so many family, friends, and colleagues.  We truly do feel held in the midst of a large community of caring and support.

Peace and blessings... Rob; in Vancouver

“I wake each morning with the thrill of expectation 

and the joy of being alive. And I'm thankful for this day.” 

Angela L. Wozniak

Surgery Prep Day

Today marks the day of final surgery preparation.  Tomorrow morning I'll be admitted to Vancouver General Hospital for the sacral resection surgery.  I will be in the hospital for at least 2 weeks.  It could be longer depending on complications and mobility issues.

The highlight of the preparation day is the bowel cleansing procedure which will start later this morning (never my favourite part!).  New to the pre-admission procedures is the requirement for a full body "skin cleanse" with an anti-biotic soap.  This is to prevent the spread of disease resistant MRSA and other "super-bugs".  I'll do one skin treatment tonight and another tomorrow morning at the hospital.  My diet for the day will be clear fluids only.

New MRI

I had a detailed MRI on Monday so the ortho/neuro surgeons will have an up-to-date picture of my sacrum going into the procedure.  I am most appreciative of this since it means they will be able to refine their approach based on current conditions rather than guessing where the cancer is.  The objective will be to retain as much healthy bone tissue as possible, while ensuring that the cancer is all resected.


Post-Surgery Update

Kelly will write an e-mail note on Saturday or Sunday to let family, friends, and colleagues know how the surgery went.  I'll also ask her to post something to my Facebook wall.  It is a 2-day procedure and I understand that they will keep me asleep through the intervening night.  They will also keep me asleep for sometime after the procedure.  It may be Saturday before I'm revived.

Many Thanks

I am again overwhelmed with the depth of care and support which we have received from family friends and colleagues.  I have received hundreds of notes over the past week.  I have not been able to respond to them all yet but I'll try to finish today.   It truly leaves us with the sense that "we are not alone"!  Thank You, Thank You, Thank You!

I will not be posting here until I am out of the hospital.

Peace and blessings... Rob; in Vancouver

"Life is not a matter of holding good cards, 

but rather, of playing a bad hand well!" 

Robert Louis Stevenson

Surgery Date Set

February 3 & 4, 2011

Further to my last post, I have now been approved and scheduled for the sacral resection surgery.  The surgery will take place over two days on Thursday and Friday, February 3 and 4.  Overall surgery time is often over 12 hours so they have recently broken the procedure into a 2-stage approach.

Day 1: Anterior Incision

On the first day the procedure will involve a removal of the rectum and any other cancerous soft tissue from within the pelvic cavity.  I will be fitted with a colostomy at this time.  In preparation for the second day, the arteries feeding the sacrum will be clamped off and a "flap" of abdominal muscle will be cut to eventually fill the void created when the sacrum is removed.    I'll go into recovery following this procedure.

Day 2:  Posterior Incision

On the second day the orthopaedic surgeons will perform an en bloc resection of my sacrum.  The intent of this procedure is to fully remove all of the sacral tumour, leaving clear margins all around.   In my case it will be a "sub-total resection".  Most of the S1 vertebrae will be retained, which should preserve the structural integrity of the pelvic girdle and spine.

Recovery

I'm scheduled for the hospital for 2 weeks.  Whether it takes longer will depend on the surgical outcome, complications, and mobility issues.

Future Mobility

I have been told that the left sciatic nerve will be lost in the surgery and that I could be "wheelchair bound".  Having spent much time with my dear paraplegic Aunt Shirley, I have very few qualms about this.  We really won't know what mobility issues there are until after the post-op assessment.

I will have a few appointments with various doctors and clinics over the next week as I get ready for the surgery.

Curative vs Palliative

Cancer treatment is often classified as either "curative" or "palliative" depending on whether the intent is to eliminate the cancer and cure the patient or to alleviate symptoms and provide comfort.  I've been told that there is not a large enough "population" of this particular procedure to deem it curative.  But there is no doubt that "cure" is the intent of the doctors performing the surgery and of us going into it.  We would not undertake a procedure of this scale if there were not a reasonable hope of a curative outcome.

That said, we will not know for several months as to whether the operation successfully excised all of the sacral tumour or not.

That is about it.  We are of course very excited and hopeful.  But not without some trepidation on my part!  We have the best of surgical teams and are in good hands.  We will do what we have done for the last 6 years, forge ahead and hope for the best.

By for now...

Rob; in Vancouver