The Cancer Chronicles: Week 5

THANKS FOR WHAT

On Sunday we had a full-on Thanks-christ-giving-mas dinner. Roast turkey, stuffing & dressing, mashed potatoes, Brussels sprouts, cranberry sauce and gravy. With pumpkin pie and mincemeat tarts for dessert. Nothing but lethargy and a big stack of leftovers afterwards.

YET ANOTHER SCAN

Tuesday was the CT scan. This involved her wearing the mask they’d moulded last week as they took a bunch of pictures – slices – of her neck region. Dr Wu will then use these to plot exactly where to target the radiation.

START DATE

And the very next day they called with the start date for treatment! On October 27th she’ll check in and it will all start. This means we’re looking at an end date of Monday, the 15th of December. So she’ll be done just in time for Christmas.

Counting down the days…

EMPTY CALENDAR

And now there’s nothing else on the calendar until the treatment starts, which means next week’s Chronicles could be very brief.

 

The Cancer Chronicles: Week 4 (and a bit)

APPOINTMENTS, APPOINTMENTS, APPOINTMENTS!

Friday morning the appointment schedules came flooding in – finally! Radiation planning, face mask, and CT scan. Suddenly there were THINGS HAPPENING.

PET SCAN

But before all that, the PET Scan. After fasting for most of the day (well, she was fasting) we were back at the cancer centre Tuesday afternoon. Another form to fill out, then a short wait and they took her in to prep for the scan. In a little while I got a text from her saying it would be over an hour so I left and wandered around. She was all done in about 90 minutes and then we went home to, you know, wait.

MISTAKEN PHONE CALL

Friday afternoon we had back-to-back appointments scheduled. First would be with Dr Wu for radiation planning and then to the Mould Room to have her face mask crafted.

This isn't hers, but it's the same thing

This isn’t hers, but it’s the same thing

At 8:30 that morning I her her phone ring, and judging by the sound of her voice, I could tell it was both important and good news. Turn out Dr Wu didn’t see that we were coming in that afternoon and didn’t want her to have to wait all weekend to her the results of the PET scan. And it is the very best prognosis we could have hoped for! The cancer is both small  (3 cm) and localized (that is, it’s only in one area.) Needless to say we were elated.

It looks like treatment will start sometime between the 20th and 27th of October. Which means it will be over by mid-December. We’ve read that the couple of weeks following treatment are some of the worse, so … Merry Christmas!

UP NEXT

The CT scan is scheduled for Tuesday and that will give Dr Wu the information he needs to plot how the radiation treatment will be applied.

The Cancer Chronicles: Week 3

Previously.

CHEMOTHERAPY

We met with the chemo doctor on Friday. Dr Maggie Knowling all but oozes warmth and comfort and immediately put us both at ease.  She talked about the role that chemo would play in the treatment, that it was there to assist the radiation and make it more effective, but that it was not the treatment itself. She told us that there would be three sessions, one right at the start, another midway and the final one would be in the last week. And that these would be in-patient procedures, to better monitor fluid levels and for easy administration of lots and lots of anti-nausea medication.

EATING RIGHT

Monday we met with the nutritionist at Inspire Health. Again he dreaded feeding tube was discussed and what we could do to avoid it. Lots of good fats and protein. Shakes and smoothies. Soups, stews and other liquid meals. This is going to be quite the culinary adventure.

THE SCHEDULE THAT WASN’T

When we met with Dr Wu, he said that within two weeks all the testing would be done and we would be well on our way to having a treatment schedule and plan set up. But that certainly didn’t happen. It turns out that one of the PET scanners broke down and there was a backlog of patients (not that they bothered to tell us that!) But this was finally resolved when they phoned on Wednesday and set up a scan appointment for the following Tuesday.

STILL MORE DENTAL

This week also included two more dental appointments, with a third on Monday morning, to get all that work done before she gets a tray impression done on Monday. This tray will be used for frequent floride treatments after the radiation is all done.

MILES TO GO

Three weeks since the initial diagnosis and we have precious little more in the way of facts. Hopeful that next weeks PET scan will fill in a lot of very frustrating blanks.

Month In Review – September 2014

Unequivocally, Worst.Month.Ever.

Well, not so much ever, but so far as the ones ahead will be their own types of grueling. Between the not-bad-but-not-good news from my cardiologist, Siobhan’s devastating news and a knee injury this month has been a non-stop suckfest. The only bright-side is that I mostly enjoyed myself at the Coho Run. Hopefully I’ve turned the corner in my knee rehab and I can start piling on the distance again.

So, the horrible numbers:

Distance: 99k
Time: 8 hours
Calories: 5.7k
Climbing: 765m
Weight: Haven’t weighed in in weeks, certain I’m north of 185 though

The Cancer Chronicles: Week 2

Previous on The Cancer Chronicles – Week 1.

DENTAL, NOT MENTAL

One of the things that Dr. Wu talked about last week was dental work. He said that Siobhan would have to go see their oncology dentist and if any teeth were bad enough, they would have to be pulled. Although after looking in her mouth, he said her teeth looked great and they would be fine. Of course, all Siobhan heard of this was We’re going to have to pull all your teeth and leave you as a toothless hag!

On Monday we went back to the Cancer Clinic to see their dentist. As I had expected, the checkup went very well and they won’t have to pull any teeth. She still has a little work that needs to be done with her regular dentist before treatment starts, but overall excellent oral health.

While she was seeing the dentist, Caroline – a nurse practitioner – who would be our Quarterback (Dr. Wu’s term) for the duration of the treatments. Siobhan quickly rebranded her the Project Manager. She arranged to meet with us on Friday, when we would be coming in to see Dr. Knowlings, the Chemotherapy Oncologist.

CURRENT MISSION: EAT ALL THE THINGS

One of the long-term side effects of the treatment will be a loss of Siobhan’s ability to taste, and this could last anywhere from 6 months to a year. Because of this, she’s on a mission to eat all the wonderful things and taste all the wonderful tastes. A benefit of this purge, is for her to put on weight. It’s common during treatment like she’ll be receiving to shed pounds. Typical weight loss is 5-10%, but if it creeps up to 15% then they have to put in a feeding tube and pump stuff directly into her stomach. Um … no thank you please. So the goal from now until the treatment is done is calories. Butter sauces, gravies, avocado on everything.

Even more important will be once the treatment starts. We’re going to use a calorie-tracker to make sure that she hits daily and weekly goals – and hey, if it means she has to eat a bowl of ice cream every night before bed, so be it.

STRAIGHT FROM THE HORSE’S MOUTH

Earlier this week she spent a couple of hours on the phone with John, a friend-of-a-friend who twice dealt with this cancer (the first time he had surgery but they didn’t get it all, the second they used radiation and he is now cancer-free.) He gave her some practical advice and outlined what the experience was like for him and what his post-treatment recovery was like. It looks like he’ll be a good resource to drawn on as this process continues.

INSPIRATIONAL

One of Siobhan’s relatives gave her a membership to the Inspire Health Centre. We’ve only just dipped our toe into their amazing depth of information, help, and support, but we can already see that they’ll be a fantastic resource – especially after the treatment is over and we’re done at the Cancer Clinic. Because that’s when the real work of her recovery will begin.

STILL WAITING

We still haven’t heard when Siobhan’s getting fitted for her mask, we still haven’t heard when she’s going in for her P.E.T. and C.T. scans, which means we still don’t know how bad the cancer is and, of course, we still don’t have a treatment plan in place. But as we’ve been told more than once, there is so much of this that is out of our control that we need to accept that these things will all happen and that these people are well versed in what they’re doing.

The Cancer Chronicles: Week 1

BIOPSY RESULTS

Last Thursday, around 9AM, Siobhan’s ENT called and told her that they’d found cancer in the biopsy. He said she should come down and talk to him in person, and arranged for that to happen at 3PM.

It turns out they’d found squamous cell cancer cells, and all indications were that this – the lump in her throat – was a secondary location. Odds are this cancer originated at either the back of her tongue or in her throat, but in rare cases the primary location is never found. Dr. Irvine, the ENT, said the most likely course of action would be a P.E.T. scan. He also said that this type of cancer was very common, very treatable and very survivable. But best-case-scenario is 5 radiation treatments a week for 5 weeks, with maybe some chemotherapy thrown in for good measure.

Next steps were to “go home and wait” for the cancer clinic to call with an appointment to see an oncologist.

That call came early the next week with an appointment with Dr. Jonn Wu, a radiation oncologist at the BC Cancer Agency, for Thursday. He would go over all the test results we had so far and from there a course of action would be drawn up.

INITIAL ONCOLOGY MEETING

The meeting with Dr Wu was very productive, if not more than a little overwhelming.

We met first with his nurse Holly and she interviewed Siobhan and took down a bunch of information, in addition to weighing and measuring her. Then Dr. Wu joined us and asked a bunch more questions. He then did a bit of an examination in Siobhan’s mouth, then they went into another exam room so he could stick a camera up her nose and take a look down her throat (she wouldn’t let me come with her for this part – can you imagine the great selfie I could have taken?)  Once all the examination stuff was done, he talked about what was next – other doctors and staff that there would be consultations, appointments and tests with.

Then he talked about treatment plan. Of course everything is really determined on what the results of the P.E.T. scan will be, but based on what he knows now it’s looking like 7 weeks of radiation treatments (5 times a week) with three chemotherapy session – at the start. middle and end of the radiation.

Next up was side-effects. There are a lot. Most are short-term, some are long-term, but there are a couple that will be permanent.

Finally we stopped by the 3rd floor so she could have an x-ray of her jaw and have some blood drawn for a battery of tests.

There was a LOT of information gathered today – we have a manila envelope stuffed with pamphlets and documents that we have to read and grasp. But THINGS are HAPPENING and for two people who are as control obsessed and impatient as us, this is a good thing.

THE SILK RING

Read this.

Race Report – Coho Run 14k 2014

I ran the Coho back in twenty-aught-ten with Clint. Clocking in at about 1:10 in the pouring rain. This year was shaping up to be quite the change.

It was already warming up when I left home and walked down to Broadway to catch the bus, with a clear sky and bright sunshine. I arrived at Kits Beach a little over half an hour before the start (which was to be at 9AM), plenty of time to drop my bag at gear check, hit the washroom one more time and then relax in the sun.

Pretty soon we were lining up and then we were off! The first k, a loop around Kits pool, was pretty crowded. Maybe I’d seeded myself too far back, but it was pretty tough to move here. Once we got back to the beach and were heading east towards Vanier Park, things opened up. Then we were under Burrard Bridge, where Candice was marshaling:

I’ve been having some issues with my left knee, so I was conservative on the bridge’s climb – if I’m going to blow out the knee, I want to wait until the Portland Marathon to do that – and got passed by two people, both of whom I caught by the time we reached the Inukshuk aid station. Here I grabbed a cup of water as I ran by and headed towards English Bay. As we looped around Second Beach Pool we hit the half-way mark and I hit the lap button on my watch. Exactly 7k and a time of 32:29. Then we were at Third Beach and we left the Seawall and headed up Meriless Trail. It’s a fairly steep climb, 44m in the first kilometer, and resulted in my slowest split of the race. My second slowest was the next split with its 22m of climb, towards the end of this one we started to catch up with the walkers, who’d started an hour ahead of us. But then we were past the 2nd aid station at Prospect Point, dropping down to Lion’s Gate Bridge and starting its climb. On the bridge’s downhill I started to push it, passing the 11k marker. Then down some stairs and across to the Park Royal parking lot, along the same path we take out to Dundarave Pier. Past the dog park and into Ambleside Park itself. The Coho Run is notorious for being shorter than 14k and just after passing the  13k mark I can see the tents of the Coho Festival where the finish line is, and there’s no way it’s 1000m ahead. The final push to the end. Done, 1:04:11 on my watch. Hung around at the end for a bit to see a couple people I know come in. Plus I’d beat the gear truck, so I had to wait for it to arrive and unload. Then I took a leisurely, slow run back to Vancouver.

Overall I’m pretty happy with the race. My average pace was a little slower than my half marathon a couple of months ago, but as I was nursing a twingy knee. All-in-all though it was a fun race, great views crossing the bridge, and having the finish coincide with the Coho Festival makes for an ideal endup. Definitely would recommend it to any runner.

Official Results: 1:04:12 (average time of 1:24:22), 57th out of 573 overall; 46th out of 222 males; 11 out of 53 in my AG.

Cardiology: The On-Going Saga

Part I and Part II, if you need to catch up.

Recently I went for the Transesophageal echocardiogram. Arriving at the Jim Pattison Pavillion, a name that I will always associate with car sales, with Siobhan and heading to Station 7 and get checked in. Then down the hall to the cardiac imaging area where, after a short wait and some questions, I was in exam room. The nurse hooked me up to a heart rate monitor (62!) and attached a blood pressure cuff (78 / 122) and inserted an IV. Then my cardiologist, Dr Tsang, stopped in and introduced Dr Spencer, who would be doing the actual procedure.

After a few more questions and an explanation of what was going to happen – like I hadn’t been reading up on it! – he had me sign a release. During this time, in the space of about 5 minutes, there were two “Code Blue. Code Blue in room blah, blah, blah” announcements on the PA. I asked if Code Blue meant the same as it did on TV, if they were both cardiac events? But he said no, code blue just meant that someone was unconscious, and usually it just meant that someone had fainted.

“Oh,” I said, “well no better place than a hospital to faint, right?”

“No no.” He replied. “This is the worst place to faint, You wake up with 200 people crowded around you and someone’s doing chest compressions when you don’t need them. Terrible place to faint.”

Pretty soon he was spraying the back of my throat with a numbing agent and they added the sedative to the IV. I’m pretty sure I remained awake the whole time, after all this is called Conscious Sedation, but I may have dozed off once or twice. Eventually we came to the part where they were adding the agitated saline to do the contrast ultrasound and he had me bear down and relax a couple of time to get images of how much was passing through the hole and to see how big the hole itself it. And then he was done and – this was the worst part – the tube came out and he told me that from what he saw the hole was small (good news!) but he’d send all the images to Dr. Tsang and she would be in touch.

After that they wheeled me to the recovery room – as far as I can remember, this was my first time in a wheel chair – and sat me back in a recliner and told me I had to wait for an hour before leaving. Boring. Just before noon a nurse came by and looked at my docs and said I could go – she went and got Siobhan from the waiting room. They took out the IV and taped some gauze over it and left. So I stood up and took off the hospital gown I had on and started to put my shirt on, one of the nurses rushed over and started pulling the curtains closed.

“Hey, no free shows here!”

And then we left, opting to walk home (it was just a couple of kilometres) because I was feeling pretty clear headed.

Now I had to wait to hear from Dr. Tsang. So fast forward a week and a half and I’m in the waiting room on the 9th floor of the Diamond Health Care Centre. Waiting. And waiting. Finally she calls me in. First up, the hole. Turns out mine is 3.8 mm which is bigger than I’d wanted. 4 mm is the point when intervention is warranted. But. still, I’m under the limit so that’s good.

Next we talk about the enlargement itself. The question is, what’s causing it? Do I just have a big heart? Or is it being caused my the hole? Based on the two measurements she has, Dr Tsang says that it’s getting bigger, but given the margin for error in these measurements, she can’t be sure. Add in the fact that I’m totally asymptomatic and we decided to wait until next March and do another echocardiogram and see what that showed. If it’s getting any bigger, then we move forward with plugging the hole. If not, then we’ll look at doing another echocardiogram further down the road to monitor the situation.

So, as has become the routine with visits to Dr. Tsang, the news isn’t bad, it’s just not as good as I’d hoped.

Month in Review – August 2014

I had hoped to have a run streak this month – ideally continuing through September – but a couple of medical things got in the way. While running the infamous Boot Camp Route on the 14th I did something to my left knee. I suspect it’s a bursa issue, but time will tell. Anyway, when I went out for a run the next day my knee was having none of that, so that broke the streak before it was even half way. Some icing and judicial application of ibuprofen meant I was able to continue running on the 16th and the knee has mostly behaved since then. To further dampen the streak spirit I had a medical procedure (more on that in a future post) on the 21st and that meant no strenuous exercise for 24 hours following.

But hey, good stuff too, right? At just over 450k, August is my biggest running month ever, and its final week – with 110k – one of my biggest ever.

Coming up on September 7th I have the Coho Run, which I did back in 2010. As I didn’t race at all in August – haven’t raced since the Knee Knacker – I’m really looking forward to this one.

The Numbers:

Distance: 456k
Time: 40 hours
Calories: 22k
Climbing: 3524m
Weight: 181.2

Drupal feed import file error 1002 1003 401

I know, cryptic post title and definitely non-standard content. But I spent more time than I should have banging my head against this problem so I thought I’d write it up in the hopes that it helps at least one other person.

Here’s the situation. I has a CSV file full of data that I wanted to import, as nodes, into a Drupal site (in this case, Drupal 7) using the Feeds module. One of the pieces of data for these nodes is a PDF file, initially represented in the CSV file as “file name.pdf”. I’d read somewhere that if I put this PDF into whatever folder Drupal expected files to be in, for example /sites/default/files, then the Feed import would automagically see the file and it would be added to the node in the appropriate field. Needless to say, this didn’t work and resulted in a 1002 error and a message in the log saying something about a download failing.

So I went about trying various other values for the filename in the CSV file: “sites/default/files/file name.pdf” and “/home/gburnham/www/sites/default/files/file name.pdf” and even “C:\Users\Greg\Documents\import\file name.pdf”. No joy. I tried replacing the space with %20, not having a space at all. Nothing would work.

But something about the log message about failing to download the file was nagging me. Was Feeds expecting a URL there for the file? Could it be that simple? So I uploaded the files to a server, changed the CSV file value to “http://example.org/files/file name.pdf” and voilà, the node in question was updated and the PDF file was right there in its field as expected. Finally.

So there you have it, looking to import nodes and include files? Remember that the Feeds module is expecting to be able to download the files from somewhere. It’s not a lesson I’ll soon forget.

Oh, and one thing to mention. The import process renamed the uploaded file. Rather than the original “file name.pdf” it became “file_name.pdf”, so if the original name is important to you, you may want to look deep into the module code itself.

And this write up obviously is dealing with importing via CSV. I haven’t tried importing from an XML file but my initial suspicions would be that the behaviour is the same.