Postponed portacath leads to preaching possibility

 If the doctor, and not COVID, had had his way, I would have been straight into hospital for the first cycle of chemo last Thursday, including the installation of the fabled portacath. But that would have kept me in hospital and would meant that I'd have missed church.

 As it is, the visit to hospital is happening tomorrow (Tuesday), and will mean that I'm in for the first cycle of chemo until Friday.

But that postponement meant that I could also fit in the planned preaching for yesterday. The passage was Psalm 13, and you can catch the reading and the sermon at 22:00 in this video. It's a bit rambly, could have done with a sympathetic editor, sorry about that, but what a great Psalm.

Here's Psalm 13, a Psalm of lament:

Psalm 13

English Standard Version Anglicised

To the choirmaster. A Psalm of David.

13 1 How long, O Lord? Will you forget me for ever?
    How long will you hide your face from me?
2 2 How long must I take counsel in my soul
    and have sorrow in my heart all the day?
How long shall my enemy be exalted over me?
3 3 Consider and answer me, O Lord my God;
    light up my eyes, lest I sleep the sleep of death,
4 4 lest my enemy say, “I have prevailed over him”,
    lest my foes rejoice because I am shaken.
5 5 But I have trusted in your steadfast love;
    my heart shall rejoice in your salvation.
6 6 I will sing to the Lord,
    because he has dealt bountifully with me.

'Sickness' by JC Ryle

I'm a bit blog-rusty after basically only visiting this blog a few times over the last several years, so I only just figured out how to fix the widget at the top of the right column. There I was falsely promising a free first chapter of a book on Encouragement that I wrote many moons ago, but the link was long dead. 

(You can still pick up a copy of that book here if you want. The basic message is still one I believe and you may find it a subject that is of help. There's also a course that goes with it that some churches have used over the years.)

But that's not what this post is about. I've now changed the widget to link to a different booklet.

"I invite you to look with me at the subject of sickness. The subject is one which we ought to look in the face frequently. We cannot avoid it. We don’t need to have a prophet’s eye to see sickness coming to each of us in turn one day. “In the midst of life we are in death.” Let us pause and think about sickness as Christians. Thinking about it will not hasten its coming, and by God’s blessing may even teach us wisdom."

—From J C Ryle. Sickness (Kindle Locations 38-41). Matthias Media.  

This is a really good, brief and pastorally minded treatment of the subject of sickness and its relationship to death and the grace and providence of God. Won't take you long to read, and there is much of value in it to contemplate when you are sick.

JC Ryle was a 19th century bishop of Liverpool in England, yet his language is clear and blunt. Charles Dickens it ain't, he was writing for communication and not literary entertainment. Hey, Charles Dickens is great but you can watch screen versions of that on a streaming service these days. JC Ryle, not so much, you still have to read the words.

You can pick up a slightly language-updated version from the wonderful people at Matthias Media, here (in e-format as well). It's useful to have a physical copy or three because you can have them available as a resource at your church, or to give to friends who might benefit from it. Not me thanks, I've already read it several times. It's really good and gives you a lot to think about.

If however you want to be a cheapskate like me and read it for free, in slightly olde-worldier language but still really good and direct, then check it out here. In that 19th century version it's called Some Thoughts on Affliction. If you understand that title then you'll have no trouble at all understanding the rest of Ryle's text.

Oh and if that all sounds worth chasing up and reading, then while we're on the subject of straight-talking 19th century Bible preachers check out Charles Spurgeon's article on Depression, or as he titled it, The Minister's Fainting Fits (also free). He spent much of his life in the throes of depression and knew what he was talking about.

A fabulous pharmacist functions fittingly 29 January

 Yesterday Fiona and I got our #3 COVID shot; I wanted to get mine out of the way before chemo started and now that's done. Need a PCR test tomorrow afternoon as well.

Let me tell you though about our fabulous pharmacist Kev, a friend from Christ Church Gladesville years ago. He became a Christian there and in his spare time learnt Hebrew, just because he wanted to read the Old Testament a bit better. He knows of my cancer diagnosis and wanted to hear the latest. Being a typically efficient pharmacist he was able to do that whilst simultaneously giving both Fi and me a COVID booster each (Moderna), explaining that research showed that most negative vaccine effects had occurred amongst young men who had had their shots too close together, reassuring us about side-effects and giving us his family news as well.

The unexpected and blessed element was that after our COVID shots he offered to pray for us, and he did pray for us, asking for God's care and healing and entrusting us into the hands of our heavenly Father. He is a busy man, running a pharmacy and—as are so many health professionals—over-run by COVID matters, yet he took the time to do this. 

We have many lovely Christian medical friends and we have seen some professionally over many years. Prayer has never been a part of the expected service, but on this occasion we accepted with gratitude and thankfulness this encouragement from a brother in Christ. And really, if Jesus is our great healer—as Isaiah 53:5 teaches us—then what could be more fitting than such a humble prayer, acknowledging in the act the limitations of human medicine?

From Handel's Messiah, here is Isaiah 53:5 set to music.

Speeding up needs slowing down 27 January

 I was wrong. Today’s appointment was, I thought, to get a portacath inserted. Not so; that has to happen and soon but first a bit of jaw-jaw with oncologist SC and a briefing session about what to except during the chemo treatment cycle. 

But also, I was right! I’ve had the feeling that the cancer has been developing pretty rapidly—new symptoms like a persistent dry cough, an ache developing in the liver. Old symptoms, mainly fatigue, increasing. Ignorable nausea becoming unignorable nausea (‘oh no! I always have seconds but now I’m going to have to wait a few hours! What, I can only manage one Frosty Fruit for dessert?')

So this morning the doc wanted to book me into a hospital ward at RNSH and get me hooked up to chemo straight away. Couldn’t happen. Ward shut due to COVID in there. 

Earliest possible is Tuesday. At least this means I can preach on Sunday. And, although we’ve run out of Frosty Fruits, I rediscovered my stash of mango Weis bars. They were in the freezer all along! I'd been looking everywhere.

Booster booked while battling belligerent bureaucracy.

Quite tricky finding a place for a COVID booster but got Friday appointments for me and Fi.

Here are a few thoughts jotted down in the process: 

Looks like the doc is busy. Been waiting on phone for an hour, listening to a looping music tape with a voice that repeats ‘still queued announcement comfort message’. 

I’m sure it’s unintentional but I can’t think of any better substitute message they could have come up with.

Edit: At the sixty minute mark, a voice came on and said ‘no-one is available to take your call. Please leave a message’. 😧 

No great loss. Watched tennis and updated Facebook. Thought about the schedule for this evening and tomorrow morning (phone waiting does muck up the work routine a bit. Fiddles and juggles). 

Thankfully when the med practice dumped me from the system after an hour, I phoned the chemist next door and took just five minutes to get two appointments. Pharmacists save the day!

Interview at church Sunday 23 January

This Sunday morning I was interviewed briefly at church about the latest. Starts at about 13:00. There may be a little gap in the video—the bit where I explained  that I had to leave home rather suddenly due to daughter Ruby receiving a text notification about a positive COVID test. I went to stay with my dad.

Thankfully Ruby has now had a couple of negative RATs so I have just returned home today. Hooray and praise God!

I did have a planned PET scan on Friday. Nothing to report as yet. They don’t design those above-ground submarine-like structures to radiate comfort and assurance do they? They shoot you full of radioactive dye, your tumours start glowing in the dark and the machine zaps you with positrons, which sounds like it could be positive but I can’t really say. That supplies some images that doctors can use to refine treatment. 

I suppose if I wanted to feel a bit more comfy I could have sought out homeopathy. 

This would be maybe a good time to give a disclaimer about my medical expertise: ‘I don’t know much about medicine, but I know what I like.’

In any case, our Lord Jesus is the great physician and he will decide how matters unfold. 

Oncologist says yes to chemotherapy

 Met with oncologist (Dr Stephen Clarke) this afternoon. Diagnosis further confirmed, yes it’s still cancer. Through testing for certain genetic markers they have excluded any immunotherapy at this time. 

However the chemotherapy is all systems go. Before that certain steps need to happen.:

1. Some more tests to rule out or open up specific treatment options.

2. Insert a porta-catheter, in about a week, to facilitate safe and effective chemotherapy delivery. Information about that is here.

3. Ideally get a third COVID booster before chemo begins, as this should happen when the immune system is strong. Chemo weakens the immune system so best to get this done now.

Because of these steps in the process, plus the Australia Day holiday, actual chemo (which is a day procedure) most likely will start the following week.

The other advice was to keep working (if I want, which I do), keep exercising, and don’t lose weight. That includes no major dietary changes.

The chemo is highly unlikely to remove or cure the cancer. But the idea is to shrink any tumours down to improve the possibility for successful surgery.

Dr Clarke by all accounts is a master of his craft. He is also a nice guy with a genuine concern to know the person as well as the problem. We have a number of people we know in common, including an oncologist on his team.

As a family we are concerned, wanting to get chemo going, and convinced that God is king.

Oh and happy 37th anniversary Fi! After all these years we still love each other. 

A tired day (Tuesday 18 January)

 Managed a little work including some church planning.  The ache in my liver is increasing daily and today it was restricting my breathing. I know nothing but my intuition tells me that whatever is happening, it is happening fast. 

We shall see. Oncologist tomorrow afternoon, Wednesday, at 2.20. 

Waiting music

 Just waiting for a call from the oncologist today to work out when I can see him. Got a few cancer specialist friends who speak highly of him.

Not everybody appreciates dark humour at a time like this, so if that's you scroll on. But if you have a taste for the mordant and absurd, here is Norm Macdonald, a Canadian comedian who died of cancer late last year.

And here is my favourite version of Norm's driver's famous moth joke.

COVID negative so carry on

 Thanks to my wonderful church, St Barnabas East Roseville, I was able to get a Rapid Antigen Test fairly straightforwardly (thanks Alby). Negative result which is good news and confirms yesterday morning’s negative RAT result.

That means I will stay at my dad’s place, separate from my family for the moment (Ruby has COVID), but with greater confidence that I’m not a risk to my dad, and that any other medical treatments will not have COVID-related complications. 

All proceeds according to God’s perfect plan.

A colonoscopic COVID complication

 So far, so good, in the sense that our great God continues to work to his glory and our good. 

But the path has taken a sudden COVID-related turn. 

I’m feeling a lot better, especially after taking advantage of some Uber Eats (thank you kind friends) to have the first proper dinner in days, after some necessary fasting.

However during dinner Ruby got a text; the results of a COVID test. She’s tested positive. At time of writing, that was just over an hour ago.

That is complicated in all sorts of ways, especially given my medical appointments and possibly starting chemo in the next few days. Not the best time for me (or anyone really) to need to isolate.  

I’ve had two RATs in the last three days, negative both times including this morning. I’ve had virtually no contact with Ruby today and don’t fit the current rules about close contacts. Also no symptoms. 

What now?

I said to Fiona and the girls: Girls, I love you. But not enough to hug you, or kiss you, or even stay with you. I am about to be the RAT deserting a sinking ship. But you are in my prayers. Goodbye. 

They took this with good grace. Fiona was going to see her sisters tomorrow. Matilda has a modelling gig on Sunday. Lily would like to go to church. So really, complicated for everyone. Ah well.

Anyway  I left home straight away and now I’m at my dad’s. His place is big enough that I can, even tonight, have my own room (ventilated and separate) and my own bathroom. We are communicating by phone. As usual he is relaxed about the situation, which I guess you might be if you’ve reached the age of 91 and can still play tennis twice a week. 

This is less than ideal for all sorts of reasons, including my need to assume for his well-being that I’m COVID positive until proven otherwise. Praying that I can find a RAT tomorrow. 

[Edit 15/01 I found a RAT! Thanks to God as always for the faithful members and leaders of St Barnabas East Roseville]

Nothing is conclusive in this life but if it’s a negative, that will be good enough. Three strikes and COVID is out. Or at least, if I can then stay isolated until my next medical meeting.

Sadly that cuts out church on Sunday. They, like most, only got this news less than a week ago. It would have been great to see people personally and thank them for the many ways they have rallied around during a crisis.

That day will come, just a little later than anticipated. To God be the glory.

Colonoscopy confirms diagnosis, oncology next week.

 I must say those colonoscopy prep solutions they give to clear the system are singularly effective. 

Anyway, yes it is confirmed metastatic bowel cancer, and I’ll be seeing oncologist specialist Stephen Clarke of Sydney Uni next week, then probably chemo. 

The anaesthetics guys are good too. I just went to sleep and woke up, no grogginess, no fogginess, just ready for my sandwiches. No driving, no signing legal documents for a day, that’s it. Oh, when family members give you life insurance documents to sign, that’s just pre-approval isn’t it? Asking for a friend.

Some lovely church people have been sending food and flowers. Now that I don’t have to fast, I will enjoy both and not just the latter. 

Colonoscopy postponed

 Now scheduled for Friday. 

I’ve been asymptomatic except for fatigue but have noticed a continual ache in the liver area developing over the last few days. 

Health update 11 January 2022

 Visited colorectal specialist yesterday. Given the words of my GP and looking at some reputable websites, I was expecting to be in surgery in fairly short order. However the plan is colonoscopy and then most likely chemotherapy.

We had a useful discussion about five year survival rates. If you have a look at this article you will see that the second paragraph gives a five year survival rate (for my type of cancer) of just 13.4%.

However my specialist made the following points:

1. Due to improved treatments in recent years, even the recent data will be somewhat out of date.

2. This is a national figure that doesn't take into account any specific demographic or other distinctions. Even within Sydney, if you go to a particular treatment centre in Western Sydney the five year survival rates sit at about 20%. The place I'll most likely be treated at, on the North Shore, is probably closer to 40%. Clearly other factors are at play, most likely demographic rather than relating to quality of treatment.

3. Five year survival rates are a useful but blunt instrument. You may be completely cancer-free after treatment, and then at the five year mark die of a (probably) unrelated cause like a heart attack. You would still be included in the statistics, even though the death couldn't be specifically ascribed to cancer.

It was a good conversation. Clearly 20% or 40% survival rates are significantly better than 13.4%, though still cause for concern.

If you or someone you know has a cancer diagnosis, there is a lot more relevant information to consider than just what can be discovered via Dr Google, as my friend Dave McDonald reminded me.

Speaking of which, find his book about his cancer experience, Hope Beyond Cure, here. The clever title gives the clue as to what it's about. Recommended!

  

A surprise: Cancer 2022

 Our great and perfect God is full of surprises for those who trust him!

I learnt on Thursday, in the course of apparently unrelated tests, that I have advanced metastatic bowel cancer. I will see a specialist today and expect that events will now move quite swiftly. It was a little unexpected in that apart from fatigue it has been largely asymptomatic. 

I have no fear whatsoever for the future, but complete trust in a loving God who gave his Son that those who know him might have life. I feel sadness for my family and my 91 year old dad, but no sense that this is anything but God’s perfect plan. 

I am thankful for friendship and if you pray, that would be appreciated including for the family, and that God’s glory would be revealed.