I seem to have acquired a permanent companion. I'm loathe to call it pain, rather it's discomfort at worst and just a nagging presence at best. Occasionally it's a sharp prod but not very often.
Now the worst thing at the moment is the not knowing. Is my new companion simply my imagination? Might it be nothing more than the normal aches and pains of the aging process? How about just being unlucky enough to have become arthritic and coincidentally just in the area where I was told the cancer was detected by the bone X-Ray?
Logic would say no.
Part reasoning and part enquiry has to led to some better understanding of the medical thinking behind not putting me back in the machine that goes 'ping' (a Monty Python's Meaning of life reference in case you don't already know).
So, some months back Charlie was found to have spread his tentacles to three spots or places (I have no idea of the size nor where exactly - I wasn't told and I didn't ask) in my pelvis and a lymph node. From my understanding, cancer reacts and grows differently according to type. Much of how rapidly it grows depends on the type of cancer and to some degree upon the host. Genetics plays a part and is why the government recently announced that they are going to ask volunteers to donate DNA for individual genomes to be mapped. The idea is that where aggressive cancers are slow to spread, there may be something in that particular genome that could point towards possible benefits for those less genetically fortunate.
Following along those lines, no-one has any real idea how long Charlie has been burrowing his way into my bones. He could be any age. Depending on my particular genetic make up, he could have been a couple of years old when first spotted or only a few weeks old. Finding three locations where he's set up home doesn't give any indication of how malignant or how benign he his. Well not until someone has another peep at him to see if he's spreading out into the neighbourhood. The time for taking another butcher's is considered best left until the first anniversary of his discovery and that should provide a measure of his voracity or hopefully his torpor. That's why the consultant didn't offer any treatment beyond the current hormone suppressant. No-one knows how fast or how slowly Charlie is doing his thing, if he's doing anything at all.
Which brings me back to the beginning of this entry. For a month or so my new companion has been fairly consistently present. I think I've reported before that the best description is like having had a needle left in my hip. There's a centre of the discomfort and a dull ache radiating outwards from it.
This is accompanied by an ache spreading down my left femur. Sometimes it's near the hip, at others it reaches down to my knee.
Of course there's the possibility that it's something unrelated and I'm just being a big girl's blouse. Quite why I seem to need twelve hours sleep in every twenty-four hours could just be an instinct to hibernate at this time of year and my (some think, irrational) hatred for the Christmas binge but that would be more understandable if the sleep was an unbroken period instead of the four or at best five hours I seem to manage.
I cannot rule out that I'm just being a big jessie and it's really all in my head. Who knows? Once the "festivities" have been and gone, I might perk-up a bit.
Tuesday 11 December 2012
Sunday 7 October 2012
Don't Ask - Don't Tell.
"Don't ask, don't tell" was (is?) the shorthand used to deal with homosexuality in the US Military.
For those of a nervous disposition, don't worry. This isn't about my sexuality, an announcement regarding my orientation or even sex. I just want to use that neat little phrase to explain something as it applies to my condition.
I know that some people are concerned that I may becoming withdrawn, that I'm not as gregarious as I may once have appeared (truth be told I never have been an outgoing sort of bod. I'm much more sparing, inclined to ration-out myself. More it has to be admitted in an effort to not inflict myself upon others than anything else).
In this context "don't ask, don't tell" is best described by Christopher Hichens in his last epistle to the world, he writes about dealing with the question "How are you?" He writes:
'But it's not really possible to adopt a stance of "Don't ask, don't tell," either. Like its original, this is a prescription for hypocrisy and double standards. Friends and relatives, obviously, don't really have the option of not making kind enquiries. One way of trying to put them at their ease is to be as candid as possible and not to adopt any sort of euphemism or denial.'
I find myself just avoiding contact with people. I do understand that such enquiries are genuinely meant. That the emotion is not prurient or anything other than a real desire to know and to extend sympathy. Some may feel that not asking will be misread as apathy or worse.
How do you answer? Is the "How are you" really just another way of saying hello? Is the question posited in the expectation of a detailed answer? A short, "I'm okay thank you" might leave the interlocutor feeling shut-out, kept at arms length. Launching into the minutiae of hot flushes, debilitating torpor and aches might cause the questioner to regret asking.
There are a handful of perceptive people who don't ask. They just treat me as they always have, they never begin any meeting or telephone conversation with that awkward question. It's not that they don't care or don't want to know, rather they know that there's no need to ask, that not asking won't be misunderstood as not caring and that if I feel the need to say how I'm feeling I'm comfortable to do so.
I don't care if someone doesn't care either. I certainly wouldn't think badly of anyone not caring. In some ways it may even be preferable, it spares me the responsibility of knowing that others are affected.
This isn't an instruction or a plea to act in opposition to one's natural inclinations, rather it's my explanation for seeming to withdraw slightly and a plea that it's understood in that context. No slight is intended by me and I hope that none is taken.
For those of a nervous disposition, don't worry. This isn't about my sexuality, an announcement regarding my orientation or even sex. I just want to use that neat little phrase to explain something as it applies to my condition.
I know that some people are concerned that I may becoming withdrawn, that I'm not as gregarious as I may once have appeared (truth be told I never have been an outgoing sort of bod. I'm much more sparing, inclined to ration-out myself. More it has to be admitted in an effort to not inflict myself upon others than anything else).
In this context "don't ask, don't tell" is best described by Christopher Hichens in his last epistle to the world, he writes about dealing with the question "How are you?" He writes:
'But it's not really possible to adopt a stance of "Don't ask, don't tell," either. Like its original, this is a prescription for hypocrisy and double standards. Friends and relatives, obviously, don't really have the option of not making kind enquiries. One way of trying to put them at their ease is to be as candid as possible and not to adopt any sort of euphemism or denial.'
I find myself just avoiding contact with people. I do understand that such enquiries are genuinely meant. That the emotion is not prurient or anything other than a real desire to know and to extend sympathy. Some may feel that not asking will be misread as apathy or worse.
How do you answer? Is the "How are you" really just another way of saying hello? Is the question posited in the expectation of a detailed answer? A short, "I'm okay thank you" might leave the interlocutor feeling shut-out, kept at arms length. Launching into the minutiae of hot flushes, debilitating torpor and aches might cause the questioner to regret asking.
There are a handful of perceptive people who don't ask. They just treat me as they always have, they never begin any meeting or telephone conversation with that awkward question. It's not that they don't care or don't want to know, rather they know that there's no need to ask, that not asking won't be misunderstood as not caring and that if I feel the need to say how I'm feeling I'm comfortable to do so.
I don't care if someone doesn't care either. I certainly wouldn't think badly of anyone not caring. In some ways it may even be preferable, it spares me the responsibility of knowing that others are affected.
This isn't an instruction or a plea to act in opposition to one's natural inclinations, rather it's my explanation for seeming to withdraw slightly and a plea that it's understood in that context. No slight is intended by me and I hope that none is taken.
Tuesday 25 September 2012
Update
I think that I've got things straight in my head now and I've assimilated what it means.
You may recall that my PSA score, when it was first tested, was 55. The "acceptable" level, by which the medical profession mean an increased PSA that requires only "watchful waiting" is 4.
Following my recent blood test, mine has fallen to 1.75. On the face of it, that's good news and I was pleasantly surprised. However, the consultant went on to explain that it was expected but that as Charlie has metastasised, it isn't necessarily a sign of remission. In fact, it is largely palliative, removing the symptoms that I first presented with.
In that respect it has worked. As reported, I don't have the issues that first made me seek medical help, or at least I don't have the worst of them, some persist but much less intrusively.
The prognosis hasn't changed. I still have cancer. I have to accept that until anything to the contrary is established, the cancer is still present and still in my prostate, pelvis and one lymph gland. I specifically asked if the lowered PSA meant an improvement in the prognosis. The consultant reiterated that lymph cancer is too unpredictable to be able to accurately foresee how things will advance.
So I continue on the hormone blocking injections at the same dosage for as long as is necessary. In about six months I'll provide another blood sample for PSA analysis and if it remains low, the next step will be to do some more scans to see what's happening. That's not likely to be before April at the earliest.
Apparently, the side effects of the injections will continue unabated. My age is against me in their severity. It was explained that as the body ages, hormone production weakens naturally and the body gets used to the reduced levels and energy levels decline anyway. At my age, the lack of testosterone is being felt, the mental torpor and physical lethargy that I experience much of the time is the result. There is nothing that can combat this except a determination to resist.
Well that's about it. Some change. Not enough to warrant optimism but better than another round of bad news.
Worse things happen at sea!
You may recall that my PSA score, when it was first tested, was 55. The "acceptable" level, by which the medical profession mean an increased PSA that requires only "watchful waiting" is 4.
Following my recent blood test, mine has fallen to 1.75. On the face of it, that's good news and I was pleasantly surprised. However, the consultant went on to explain that it was expected but that as Charlie has metastasised, it isn't necessarily a sign of remission. In fact, it is largely palliative, removing the symptoms that I first presented with.
In that respect it has worked. As reported, I don't have the issues that first made me seek medical help, or at least I don't have the worst of them, some persist but much less intrusively.
The prognosis hasn't changed. I still have cancer. I have to accept that until anything to the contrary is established, the cancer is still present and still in my prostate, pelvis and one lymph gland. I specifically asked if the lowered PSA meant an improvement in the prognosis. The consultant reiterated that lymph cancer is too unpredictable to be able to accurately foresee how things will advance.
So I continue on the hormone blocking injections at the same dosage for as long as is necessary. In about six months I'll provide another blood sample for PSA analysis and if it remains low, the next step will be to do some more scans to see what's happening. That's not likely to be before April at the earliest.
Apparently, the side effects of the injections will continue unabated. My age is against me in their severity. It was explained that as the body ages, hormone production weakens naturally and the body gets used to the reduced levels and energy levels decline anyway. At my age, the lack of testosterone is being felt, the mental torpor and physical lethargy that I experience much of the time is the result. There is nothing that can combat this except a determination to resist.
Well that's about it. Some change. Not enough to warrant optimism but better than another round of bad news.
Worse things happen at sea!
Monday 24 September 2012
Full Update to Follow
I'll post something in a day or so. I just want to go over what was said today and make certain that I have things straight in my head.
The one thing that I'm certain of is that my PSA score has fallen and a long way.
The one thing that I'm certain of is that my PSA score has fallen and a long way.
The Condemned Cell
Well today, 24th September, I am to return to the Oncology department of my local hospital to keep a (slightly delayed) appointment.
A couple of weeks ago I gave a blood sample to check my PSA score, the purpose being to see if it has altered since the last one.
Today, I read a newspaper account of a death row prisoner in Texas who has twice got as far as the door of the chamber where he is sentenced to be "humanely" executed by means of a lethal injection, only to have the hand of the executioner stayed by the Supreme Court.
I feel a strange sort of empathy with that man.
Yesterday I gladly accepted the opportunity to be distracted but it was only a partial distraction. I had a rotten night. This morning, despite having some things to do that should offer further distractions, I'm unable to drag my attention from the clock. I'm counting down the hours and minutes to my appointment just as the convicted man's account of the last four hours before the allotted time with his appointment draws nearer.
I'd be lying if I didn't admit to hoping for an intervention equivalent to that of the Supreme Court but hope doesn't seem tangible enough to place much trust in.
I, unlike the condemned man in Texas, can at least do more than sit and wait. So I'd better get on with something purposeful.
A couple of weeks ago I gave a blood sample to check my PSA score, the purpose being to see if it has altered since the last one.
Today, I read a newspaper account of a death row prisoner in Texas who has twice got as far as the door of the chamber where he is sentenced to be "humanely" executed by means of a lethal injection, only to have the hand of the executioner stayed by the Supreme Court.
I feel a strange sort of empathy with that man.
Yesterday I gladly accepted the opportunity to be distracted but it was only a partial distraction. I had a rotten night. This morning, despite having some things to do that should offer further distractions, I'm unable to drag my attention from the clock. I'm counting down the hours and minutes to my appointment just as the convicted man's account of the last four hours before the allotted time with his appointment draws nearer.
I'd be lying if I didn't admit to hoping for an intervention equivalent to that of the Supreme Court but hope doesn't seem tangible enough to place much trust in.
I, unlike the condemned man in Texas, can at least do more than sit and wait. So I'd better get on with something purposeful.
Wednesday 15 August 2012
Ouch!
Today I received the latest instalment in my anti-testosterone medication. It was distinctly uncomfortable. Odd that the last one I didn't even feel. I remarked to the nurse that she'd lost her touch but she blamed it upon bad luck in hitting a nerve. I think that I may have hit one too.
The last month has been mainly dealing with the hot-flushes. I have a fairly large multi speed electric fan that I use in the garage for when I need to have a bike running (to keep the bike from over-heating). It's a bit too noisy to have in the bedroom so I've knocked-up a Heath Robinson affair out of an old computer fan, a hobbyist "third hand" and a power pack that takes eight 1.5volt re-chargeable batteries. It's nice and quiet yet produces enough of a cooling breeze to be effective. I put it on the bedside table and it runs all night quietly directing a cool breeze on me.
The last month has been mainly dealing with the hot-flushes. I have a fairly large multi speed electric fan that I use in the garage for when I need to have a bike running (to keep the bike from over-heating). It's a bit too noisy to have in the bedroom so I've knocked-up a Heath Robinson affair out of an old computer fan, a hobbyist "third hand" and a power pack that takes eight 1.5volt re-chargeable batteries. It's nice and quiet yet produces enough of a cooling breeze to be effective. I put it on the bedside table and it runs all night quietly directing a cool breeze on me.
I think that there may be a marketing opportunity here!
I haven't found as simple a remedy for the lethargy. The remedy I have found is a lot more involved, it requires an old motorcycle and many hours of tearing it apart, fixing bits that need it, polishing and cleaning things before sticking it all back together. It works too (so does the motorbike fortunately).
Apart from the above mentioned side-effect of the medication, I've noticed that certain things are shrinking (both of them that live in a little pouch made up of spare elbow skin). Still, at least I can multi-task now but my sense of direction is deteriorating. The up-side is that I now find myself prepared to ask for directions.
Smile. Things could be worse.
Tuesday 17 July 2012
Right Royal Flush(es)
Since my last entry, the discomfort has largely subsided, there's still the sensation of a needle having been left in place in my hip but I've not taken medication for a week as it's not been necessary.
When I saw the consultant (back whenever that was) he stressed that the hormone blocker would mean that I'd experience hot flushes among other side-effects. As the injection was around three times the dose of the first, I expected that such an effect would begin almost immediately and I was happy that the hot flushes didn't seem either very noticeable or very frequent.
In the past two weeks however, they have come thick and fast. They seem to be more frequent in the evening and at night, the latter strong enough to wake me to seek relief (usually a cold water splash or if more insistent the use of a fan).
The flushes don't seem to affect my whole body, it's mainly my upper torso and particularly my head. The best description I can think of is to imagine what it must be like to be a cup being filled with boiling water. The heat starts low down and rapidly travels up my shoulders, neck and head culminating in the sensation of beads of sweat bubbling-up on my forehead and scalp.
I'm somewhat bemused by the onset of this. I cannot quite understand how something injected into me two months ago has the capacity to alter its effects when logic would dictate that the effects diminish with time. Still, I'm not complaining, I'm happier to cope with the hot flushes than the discomfort of a few weeks ago.
I'm sometimes surprised by my lack of stamina. Not physically, I can do everything that I want to do, it's this weariness that overtakes me so quickly. It could be exacerbated by the interrupted nights but I don't think so as on the occasions where I sleep well I'm still overwhelmed by tiredness within a few hours of waking. It doesn't seem to matter what I'm doing when I feel drowsy. I might feel fine, jump in the car to pop to the shops and just down the road I find that I could happily go to sleep.
I can ignore the urge but it takes quite a lot of concentration. Activity helps and I have often lately found myself in company and had to excuse myself and leave so as to fight the urge to close my eyes. I must appear quite rude at times. Being on my feet, walking and active helps to stave-off the urge to sleep but as a recent weekend away showed, I pay for it later by needing a couple of days to recover.
So if you are reading this and have wondered why I seem at times to be paying less attention to you than I would or should, if I've suddenly declared that I need to leave, that's the reason. It may also explain why I sometimes don't answer the door or the 'phone, I'm probably asleep!
When I saw the consultant (back whenever that was) he stressed that the hormone blocker would mean that I'd experience hot flushes among other side-effects. As the injection was around three times the dose of the first, I expected that such an effect would begin almost immediately and I was happy that the hot flushes didn't seem either very noticeable or very frequent.
In the past two weeks however, they have come thick and fast. They seem to be more frequent in the evening and at night, the latter strong enough to wake me to seek relief (usually a cold water splash or if more insistent the use of a fan).
The flushes don't seem to affect my whole body, it's mainly my upper torso and particularly my head. The best description I can think of is to imagine what it must be like to be a cup being filled with boiling water. The heat starts low down and rapidly travels up my shoulders, neck and head culminating in the sensation of beads of sweat bubbling-up on my forehead and scalp.
I'm somewhat bemused by the onset of this. I cannot quite understand how something injected into me two months ago has the capacity to alter its effects when logic would dictate that the effects diminish with time. Still, I'm not complaining, I'm happier to cope with the hot flushes than the discomfort of a few weeks ago.
I'm sometimes surprised by my lack of stamina. Not physically, I can do everything that I want to do, it's this weariness that overtakes me so quickly. It could be exacerbated by the interrupted nights but I don't think so as on the occasions where I sleep well I'm still overwhelmed by tiredness within a few hours of waking. It doesn't seem to matter what I'm doing when I feel drowsy. I might feel fine, jump in the car to pop to the shops and just down the road I find that I could happily go to sleep.
I can ignore the urge but it takes quite a lot of concentration. Activity helps and I have often lately found myself in company and had to excuse myself and leave so as to fight the urge to close my eyes. I must appear quite rude at times. Being on my feet, walking and active helps to stave-off the urge to sleep but as a recent weekend away showed, I pay for it later by needing a couple of days to recover.
So if you are reading this and have wondered why I seem at times to be paying less attention to you than I would or should, if I've suddenly declared that I need to leave, that's the reason. It may also explain why I sometimes don't answer the door or the 'phone, I'm probably asleep!
Tuesday 19 June 2012
Is this a taste of things to come?
In the past few weeks Charlie has been pretty much constantly in the background. It began with a dull ache in the region of my left hip. It started as the sort of level of discomfort that was noticeable only when I thought about it, when my concentration wandered from whatever I was doing.
Slowly it has increased to the point where I'm always conscious of it unless something deflects and holds my attention. It's best described as the sensation you have during an injection; after the needle has gone in, you are left with the knowledge that the needle is there, a single point that seems to focus your attention upon it. It feels as though someone has left a needle in the back of my left hip just above the femur socket. It's not muscular pain, it's not like the discomfort that comes with a strain or heavy bruise.
There's also a similar sensation around my coccyx although not as consistent or as persistent.
I can gain relief by popping a double strength Ibuprofen. Not something I do with any enthusiasm and I try to avoid doing so until just before bed. I'm loathe to become too reliant on pain killers too soon and I'll avoid recourse to them for as long as I can. For that reason, I'm not going to mention it to my GP yet. Pain is such a personal thing and what I consider painful might not really rank very high on the scale; I'm quite possibly making a mountain out of a molehill. As someone who has escaped living with pain all my life I don't really have a meaningful comparison (I'm eternally grateful for that fact).
Probably the most debilitating aspects so far are the tiredness and the intrusion into my thoughts.
I get so weary at times that I give-in to it and go to bed mid-morning or mid-afternoon. Whether I do or not has no effect upon how well I sleep at night. Sleep also has the benefit of keeping the thoughts from intruding. I can push through the weariness when it strikes if I need or want to. Doing so has the beneficial effect of making me so tired by the time I go to bed at night that the dark thoughts don't have a chance to intrude.
Let me try and explain: Normally, before sleep overtakes me, I think through the day, or recent events, sometimes I look forward to things to come. In the past months, no matter what I'm thinking about as I drift off, Charlie and all the possible ramifications, charges to the front of my mind like a small child demanding attention. Like an insistent spoilt child, Charlie is hard to ignore.
I'd like to place on record how humbling I find the kindness of people. I can remain fairly dispassionate and unmoved by Charlie's affect upon me but the concern and kindness of others moves me more than I can say. I really don't deserve the compassion.
Slowly it has increased to the point where I'm always conscious of it unless something deflects and holds my attention. It's best described as the sensation you have during an injection; after the needle has gone in, you are left with the knowledge that the needle is there, a single point that seems to focus your attention upon it. It feels as though someone has left a needle in the back of my left hip just above the femur socket. It's not muscular pain, it's not like the discomfort that comes with a strain or heavy bruise.
There's also a similar sensation around my coccyx although not as consistent or as persistent.
I can gain relief by popping a double strength Ibuprofen. Not something I do with any enthusiasm and I try to avoid doing so until just before bed. I'm loathe to become too reliant on pain killers too soon and I'll avoid recourse to them for as long as I can. For that reason, I'm not going to mention it to my GP yet. Pain is such a personal thing and what I consider painful might not really rank very high on the scale; I'm quite possibly making a mountain out of a molehill. As someone who has escaped living with pain all my life I don't really have a meaningful comparison (I'm eternally grateful for that fact).
Probably the most debilitating aspects so far are the tiredness and the intrusion into my thoughts.
I get so weary at times that I give-in to it and go to bed mid-morning or mid-afternoon. Whether I do or not has no effect upon how well I sleep at night. Sleep also has the benefit of keeping the thoughts from intruding. I can push through the weariness when it strikes if I need or want to. Doing so has the beneficial effect of making me so tired by the time I go to bed at night that the dark thoughts don't have a chance to intrude.
Let me try and explain: Normally, before sleep overtakes me, I think through the day, or recent events, sometimes I look forward to things to come. In the past months, no matter what I'm thinking about as I drift off, Charlie and all the possible ramifications, charges to the front of my mind like a small child demanding attention. Like an insistent spoilt child, Charlie is hard to ignore.
I'd like to place on record how humbling I find the kindness of people. I can remain fairly dispassionate and unmoved by Charlie's affect upon me but the concern and kindness of others moves me more than I can say. I really don't deserve the compassion.
Thursday 31 May 2012
Spoke too soon?
Ha ha! Sod's law I suppose but having posted yesterday, last night I had some mild spasms. Is it Charlie coming or going?
One thing is certain, I find too much of my mental capacity is being used-up thinking about things connected to Charlie. Unless I am able to completely distract myself with some sort of activity I find my mind wanders to the topic. I don't want to dwell on it but it creeps into my consciousness nevertheless.
An echo of my old school reports: Must try harder!
One thing is certain, I find too much of my mental capacity is being used-up thinking about things connected to Charlie. Unless I am able to completely distract myself with some sort of activity I find my mind wanders to the topic. I don't want to dwell on it but it creeps into my consciousness nevertheless.
An echo of my old school reports: Must try harder!
Wednesday 30 May 2012
No Change
I thought that I'd just post to say that the increased dose of hormone-blocker hasn't manifest any new side-effects, nor has it made any of the ones that I have experienced any more pronounced. There's still the occasional hot flush and I do feel lethargic from time to time but that's about it.
Our Charlie seems to be quiet. I'm starting to feel a bit of a charlatan. Still, as long as Charlie is not making himself felt, I'll live with that (no pun intended).
Our Charlie seems to be quiet. I'm starting to feel a bit of a charlatan. Still, as long as Charlie is not making himself felt, I'll live with that (no pun intended).
Wednesday 23 May 2012
More Hormones
Today, I had the first of the 11.25 mg dose of hormone-blocker. Oddly enough it wasn't as uncomfortable as the lower dose and was over before I knew it. Next injection is scheduled for 15th August (I couldn't arrange it for my birthday as it falls on a weekend).
When I collected the prescription from the pharmacist, I was given a slightly pitying look. I guess that a pharmacist will know the use.
I have noticed one thing lately. Whereas I used to take a fair bit of interest in the news or big issues of the moment, I find that I seem to be ignoring anything except that which is fairly immediate. The Euro crises doesn't seem terribly important any more, climate change? Nope. Not bothered.
Funny how my horizons have drawn closer.
When I collected the prescription from the pharmacist, I was given a slightly pitying look. I guess that a pharmacist will know the use.
I have noticed one thing lately. Whereas I used to take a fair bit of interest in the news or big issues of the moment, I find that I seem to be ignoring anything except that which is fairly immediate. The Euro crises doesn't seem terribly important any more, climate change? Nope. Not bothered.
Funny how my horizons have drawn closer.
Monday 21 May 2012
I wonder
When preparing yourself mentally for the worst possible outcome stops being positive and becomes resignation or simply fatalism?
The news that Robin Gibb (of the BeeGees) has died from his cancer after seemingly to have "beaten" it, is proof that it's possibly unwise to believe that it has gone away. I'm all for a positive outlook but is the dread-news of its return not likely to be even worse than the first time that you hear those words?
Perhaps it's because Charlie is making his presence felt again? Am I being hyper-sensitive? Is the fact that I'm due for another hormone-injection 48 hours from now, convincing me that the effects of the last dose are wearing-off? Does the effect wear off? I should do some research or ask the medico on Wednesday.
Is the occasional dull ache near the base of my spine due to Charlie worming his way about or is it completely unconnected?
I'm certainly beginning to notice a return to some of the earlier symptoms. Not as pronounced but once again, I'm experiencing interrupted sleep and this is adding to the lethargy that sometimes overwhelms me.
I'll be interested to see if the increased dose of hormone-blocker increases the few side-effects that I experienced with the lower dosage and whether the relief I experienced is higher too.
The news that Robin Gibb (of the BeeGees) has died from his cancer after seemingly to have "beaten" it, is proof that it's possibly unwise to believe that it has gone away. I'm all for a positive outlook but is the dread-news of its return not likely to be even worse than the first time that you hear those words?
Perhaps it's because Charlie is making his presence felt again? Am I being hyper-sensitive? Is the fact that I'm due for another hormone-injection 48 hours from now, convincing me that the effects of the last dose are wearing-off? Does the effect wear off? I should do some research or ask the medico on Wednesday.
Is the occasional dull ache near the base of my spine due to Charlie worming his way about or is it completely unconnected?
I'm certainly beginning to notice a return to some of the earlier symptoms. Not as pronounced but once again, I'm experiencing interrupted sleep and this is adding to the lethargy that sometimes overwhelms me.
I'll be interested to see if the increased dose of hormone-blocker increases the few side-effects that I experienced with the lower dosage and whether the relief I experienced is higher too.
Saturday 19 May 2012
Prostate Cancer - Bugger!
I thought that I might make use of this medium to share my experiences of what is one of the most commonly diagnosed forms of cancer around today.
Unfortunately for me, the cancer that I have is quite advanced and has spread (metastasised). However, not to scare people, it should be stressed that prostate cancer is most often something that men die with, not from. and many die with it never knowing it was there. The most common forms need no treatment, just regular monitoring.
So how did I find out?
For me, the early indications that something might not be right were occasional discomfort when urinating coupled with increased difficulty in fully emptying my bladder.
I'll be 57 in August this year (2012), so not exactly aged. I'm reasonably fit, a little over-weight but not by much. I've been a keen motorcyclist from the age of 19 and in the years since I was able to give-up work in 2004, I've travelled quite extensively by motorcycle seeing those places that have been long on my list of ones to see before I die.
In that pursuit, I'd often spend all day in the saddle and there would be some numbness in the groin in those circumstances. This I just put down to a natural effect of long days and long distances. I did begin to notice a restricted, slower flow when urinating but I put that down to a combination of advancing years and the temporary numbness. It wasn't a persistent problem and seemed to be linked to specific circumstances.
I'm not someone who visits the doctor very often, twenty-plus years between visits isn't uncommon. It isn't that I'm chary of the medical profession or that I wanted to tough it out. Rather, just that I had very rarely any need to visit a doctor.
In the latter part of 2011, being on the bike for more than an hour began to be uncomfortable to the point where I avoided riding it for anything other than short, local trips. Then just sitting anywhere for any length of time started to be as uncomfortable. The best description I can think of is that I was sat on a golf ball situated near the perineum. Along with this was an increasing need to get-up in the night to empty my bladder, an urgency to urinate when the need arose and discomfort becoming pain if this urgency was ignored, either because there was no opportunity to empty my bladder (peeing in public places is still frowned upon in the UK) or when asleep and it took the insistent need to wake me.
For those who are familiar with the film "Green Mile" there's scene where Tom Hanks' character wakes in the night, staggers outside, drops to his knees and pees on the lawn in agony. He then collapses face down in relief once he's finished. This is a good representation of the condition I sometimes experienced. Added to that was the need to re-visit the toilet within a very short time because I could never empty my bladder in one go.
In February this year (2012), when returning from a family gathering in my car, I was in such discomfort and had to stop so frequently that I resolved to see a doctor.
I'd moved home since I'd last seen a doctor and needed to register with one near my new home. This done, I duly presented myself at my new General Practitioners practice and recounted my symptoms. His initial diagnosis was Prostatitis, a condition caused by an infection, one that is treated with antibiotics.
Once home, I set about looking-up the condition and true enough the symptoms matched but as my GP had rightly decided that a PSA blood test was worth doing before starting any treatment for Prostatitis, I looked that up too. Reading that the PSA test was prone to both false positive and false negative results didn't exactly fill me with confidence.
The time-scale I'd been given, was one to two weeks for the results, I'd be called back once they were known. I was in fact called within three working days and told that the PSA level was higher than expected and that I'd therefore be called-up to the local hospital to hear the results and to discuss the possible treatment. Not expecting to hear for some time, I was surprised to get a call that day making an appointment for the next afternoon.
At the hospital I was given a Digital Rectal Examination. That's more of a surprise for anyone not used to things "going against the normal direction" than it is either painful or uncomfortable. The chap doing it was very pleasant but I vowed that someone is going to at least have to buy me dinner before it happens again!
My prostate was declared enlarged and hard. I'd guessed that much for myself but the next words got my attention. The acceptable PSA level for my age was 4, mine was 55. I gathered from the demeanour of the chap that it was pretty serious but I was still thinking of false positive PSA tests and Prostatitis when I was strongly advised to have a biopsy.
I wasn't too keen. My thoughts were still upon Prostatitis. I asked what the biopsy entailed and when I was informed that it was little or no more uncomfortable than the digital examination, I concurred. After being sent hither and thither to different departments, the arrangements were made to return to the hospital for the biopsy at 12 mid-day, two days later.
So it was that at noon on Thursday 5th April, I found myself with four other men being subjected to the biopsy process. Four of us reported that it was as described, no more uncomfortable than the digital exam. The exception, was me. Owing to how hard my prostate had become, I experienced serious, excruciating pain when the sample material was taken, so much so that they only took 6 samples instead of the usual, planned 12. Discount for pain!
There was no long lasting pain or discomfort but I resolved that if another had to be done, I'd insist upon a general anaesthetic in place of the local.
Part of the follow-up was a course of antibiotics and over the three days that this course lasted, some of my symptoms were relieved. This only confirmed my suspicion that it was Prostatitis and that the biopsy had been unnecessary.
I returned to taking the occasional Ibuprofen when the effects of the antibiotics wore-off and the discomfort started to intrude again. Eventually I was recalled to the hospital for an appointment on Wednesday 18th April. I guessed that things might not be as straight-forward as I'd hoped when the doctor was joined by a specialist nurse.
It was cancer. 90% of the biopsy sample material was cancerous. My cancer was rated as T3, worse than T1 or T2 which are contained within the prostate and can be just monitored to a greater of lesser degree. It wasn't as bad as it could be, or so it appeared without further examination. I was told that as long as the cancer hadn't spread, after some hormone-blocking treatment, I'd be given a couple of options of radiotherapy treatments. One of these involves a probe introduced into the prostate to deliver radiotherapy directly into the cancer. This would mean a stay at another hospital for a few nights while the treatment was carried-out between waking and sleep.
That was a non-starter as far as I was concerned. After the biopsy experience, I did not relish anything being stuck into my granite-hard prostate again. The next offer was a daily, external dose of radiotherapy at my local hospital, for seven weeks. As much as I did not much like the idea of daily trips to hospital, that seemed much more attractive than the alternative.
However, all this depended upon a CT scan and a full bone X-Ray to see if the cancer had metastasised.
As prostate cancer feeds upon testosterone, blocking the production of it is part of the treatment. This is done by an injection. However, the body's response to testosterone production being blocked is to produce more. To prepare the body for the introduction of female hormones (part of the testosterone blocking method), a three week course of pills is required to begin with and after a few days, the injection is given. This would be repeated every three months for as long as the patient can tolerate it or for as long as it's required (until the PSA level falls).
There are some potentially unpleasant side-effects: hot flushes, sensitised nipples, weight-gain, appetite swings and in extreme cases, lactation type symptoms.None are worse than the alternative however.
I've been lucky. Apart from some occasional increased sensitivity around the nipples, an occasional hot-flush, not much has happened. Apart that is from an urge to buy handbags and shoes!
The following Friday 20th, I had the CT scan and the bone X-Ray was scheduled for the following Monday. The CT scan was over in minutes and apart from some sort of intravenous marker, completely unremarkable.
The bone X-Ray would take an hour, a radioactive dye is injected into a vein carrying blood into the bones of the arm and then it's a case of waiting two hours for it to get around the system. I was instructed to drink a couple of litres of water to flush the excess dye out of my system. This reduces the chances of the X-ray being "over-exposed".
While this two-hour waiting period was ticking down, I had an appointment with the specialist nurse who gave me a 3 mg injection of the hormone-blocker. We had bit of a chat about how I was feeling (more on this topic later) and then I was released to while away the remaining time before the actual X-Ray procedure in the ominously named Nuclear Medicine department. Before being sent on my way, the nurse did say that usual practice was to inform patients by telephone if the scans were negative, ahead of the scheduled appointment with the consultant.
The X-Ray was of course painless. It took an hour for the slow scanning process to complete. Unfortunately, my bladder interrupted the process and I had to be allowed out of the machine to spend 15 minutes trying to get rid of the last of the water that I'd consumed at their request. There was a sign in the department that asked patients not to enquire after the scan results. It would be available within two days at most.
When after nearly three weeks I'd not heard anything, my feeling that there was no good news for me deepened. Taken together with the speed at which each step of the process had followed each other up until now, I began to take-in the consequences.
Eventually I received a time and date for a meeting with a consultant oncologist set for 10.20am on Friday 11th May and I duly presented myself at the hospital at the appropriate time.
Again, a nurse was present. The consultant informed me that the cancer had spread. No surprise there. It was in three places in my pelvis and the complicating factor, it was in one lymph node.
The way I understand things, these secondary cancers cannot be treated. Treatment has to be directed at the primary cancer and the complication created by the secondary cancers means that radiotherapy is no longer an option, either because it won't do any good now that it's beyond the prostate or it cannot be targeted effectively once it has metastasised.
When pressed, the consultants opinion was that without the primary cancer retreating, the bone cancer will begin to make its presence really felt within five years. However, the lymph node cancer is a wildcard and may well reduce the period considerably.
On the good side (being positive here), my symptoms have abated somewhat since the start of the hormone-blocking treatment. With that in mind, the dose will be increased to 11.25 mgs, repeated three monthly and after the second of these (in late August), I'll provide another blood sample for a further PSA test in time for my return visit to the consultant in mid-September. The hope is that the PSA level will go down indicating that the Prostate Cancer is being affected through being starved of testosterone.
My consultant did say that the higher dose will mean more pronounced side-effects and as I'm not due for the first of the higher dose until next week, I have yet to discover to what degree this will be. It may be that I will have to remain on this prescription of three-monthly injections indefinitely. Time will tell.
So how is this affecting me?
Well to begin with it was bit of a shock because I had been "positive" and convinced myself that it was Prostatitis. No-one ever wants to hear the words "it's cancer". Even if it is the most survivable sort. Cancer is the modern bogeyman. We have it drummed into us that it is a killer and in some circumstances it is.
People talk about "battling" or "fighting" cancer. I don't subscribe to that. I'll live with it and its consequences for as long as it allows. I will make allowances for it, I will alter my life and those habits that will make it more easy to live with. It is a part of me. It isn't a welcome addition but nevertheless it is there and sometimes I sense it's presence.
With that in mind, I've decided to give it a name and henceforth 'it' will be known as Charlie. Charlie the cancer.
I'm not always conscious of Charlie's presence. Most of the time I forget him because he doesn't make himself known but every so often I get a twinge in my groin or feel a slight stab in my pelvis. Other times I feel a sort of knotted sensation near my coccyx, usually after sitting or standing for a while. None or this is particularly uncomfortable, it might even be sensations that I experienced before I knew about Charlie or even before he grew in the first place but the new knowledge has made me overly-sensitive to every twinge, pain or stab that is just a part of growing older daily. Who knows?
What about my mental condition?
Well I've never been one to cry over spilled milk. What happens happens. It isn't bad karma, punishment from on-high, bad luck or destiny. It's a physiological disease. I've never had anything bad in the way of illness, injury or inherited conditions. Many people do and they live for longer with much more debilitating consequences than I have so far experienced. I still consider myself one of the more fortunate and I will (I hope) continue to do so even if or when Charlie becomes more intrusive.
I have no religious faith or beliefs. I am not afraid of death, perhaps the manner is a bit scary but I'm reassured to hear that pain does not have to be a part of the consequences. It is the unknown that creates fear. I know that death is the end, no different to the lack of consciousness when we sleep only it is permanent. I have no fear of that.
I long ago recognised that at the end of my life there would be a list of things that I didn't get to do or see. Even with the time and the financial resources to reduce the list, if you have an ounce of curiosity in you, you'll never do everything you desire.
So far the most unpalatable, crushing thing in all this is off-loading it onto others. I dread the degree of upset that my news creates and I thought long before breaking the news. If it wasn't for the fact that I've had to accept certain changes to my life that either affect others or cannot go unexplained without causing concern, possibly even hurt, I'd rather have said nothing.
However, having told people, I'm now of the opinion that telling everything is the best policy and it's to that end that this blog is taking shape. I intend to use it rather like a diary. I won't make daily entries but I will do so when there's something to say. I'll apologise here and now, some of it will be introspective and it might open my thoughts too far for comfort. Looking inside my head might not be a very nice experience. I'm not going to talk about other people, at least not by name and not to their detriment in any circumstance .
As I will only make an entry when there's something to report, it could become a litany of unpleasant reading. Please try to remember that for every entry about some thoughts or discomfort, there were many hours of equilibrium where no such things accost me.
Unfortunately for me, the cancer that I have is quite advanced and has spread (metastasised). However, not to scare people, it should be stressed that prostate cancer is most often something that men die with, not from. and many die with it never knowing it was there. The most common forms need no treatment, just regular monitoring.
So how did I find out?
For me, the early indications that something might not be right were occasional discomfort when urinating coupled with increased difficulty in fully emptying my bladder.
I'll be 57 in August this year (2012), so not exactly aged. I'm reasonably fit, a little over-weight but not by much. I've been a keen motorcyclist from the age of 19 and in the years since I was able to give-up work in 2004, I've travelled quite extensively by motorcycle seeing those places that have been long on my list of ones to see before I die.
In that pursuit, I'd often spend all day in the saddle and there would be some numbness in the groin in those circumstances. This I just put down to a natural effect of long days and long distances. I did begin to notice a restricted, slower flow when urinating but I put that down to a combination of advancing years and the temporary numbness. It wasn't a persistent problem and seemed to be linked to specific circumstances.
I'm not someone who visits the doctor very often, twenty-plus years between visits isn't uncommon. It isn't that I'm chary of the medical profession or that I wanted to tough it out. Rather, just that I had very rarely any need to visit a doctor.
In the latter part of 2011, being on the bike for more than an hour began to be uncomfortable to the point where I avoided riding it for anything other than short, local trips. Then just sitting anywhere for any length of time started to be as uncomfortable. The best description I can think of is that I was sat on a golf ball situated near the perineum. Along with this was an increasing need to get-up in the night to empty my bladder, an urgency to urinate when the need arose and discomfort becoming pain if this urgency was ignored, either because there was no opportunity to empty my bladder (peeing in public places is still frowned upon in the UK) or when asleep and it took the insistent need to wake me.
For those who are familiar with the film "Green Mile" there's scene where Tom Hanks' character wakes in the night, staggers outside, drops to his knees and pees on the lawn in agony. He then collapses face down in relief once he's finished. This is a good representation of the condition I sometimes experienced. Added to that was the need to re-visit the toilet within a very short time because I could never empty my bladder in one go.
In February this year (2012), when returning from a family gathering in my car, I was in such discomfort and had to stop so frequently that I resolved to see a doctor.
I'd moved home since I'd last seen a doctor and needed to register with one near my new home. This done, I duly presented myself at my new General Practitioners practice and recounted my symptoms. His initial diagnosis was Prostatitis, a condition caused by an infection, one that is treated with antibiotics.
Once home, I set about looking-up the condition and true enough the symptoms matched but as my GP had rightly decided that a PSA blood test was worth doing before starting any treatment for Prostatitis, I looked that up too. Reading that the PSA test was prone to both false positive and false negative results didn't exactly fill me with confidence.
The time-scale I'd been given, was one to two weeks for the results, I'd be called back once they were known. I was in fact called within three working days and told that the PSA level was higher than expected and that I'd therefore be called-up to the local hospital to hear the results and to discuss the possible treatment. Not expecting to hear for some time, I was surprised to get a call that day making an appointment for the next afternoon.
At the hospital I was given a Digital Rectal Examination. That's more of a surprise for anyone not used to things "going against the normal direction" than it is either painful or uncomfortable. The chap doing it was very pleasant but I vowed that someone is going to at least have to buy me dinner before it happens again!
My prostate was declared enlarged and hard. I'd guessed that much for myself but the next words got my attention. The acceptable PSA level for my age was 4, mine was 55. I gathered from the demeanour of the chap that it was pretty serious but I was still thinking of false positive PSA tests and Prostatitis when I was strongly advised to have a biopsy.
I wasn't too keen. My thoughts were still upon Prostatitis. I asked what the biopsy entailed and when I was informed that it was little or no more uncomfortable than the digital examination, I concurred. After being sent hither and thither to different departments, the arrangements were made to return to the hospital for the biopsy at 12 mid-day, two days later.
So it was that at noon on Thursday 5th April, I found myself with four other men being subjected to the biopsy process. Four of us reported that it was as described, no more uncomfortable than the digital exam. The exception, was me. Owing to how hard my prostate had become, I experienced serious, excruciating pain when the sample material was taken, so much so that they only took 6 samples instead of the usual, planned 12. Discount for pain!
There was no long lasting pain or discomfort but I resolved that if another had to be done, I'd insist upon a general anaesthetic in place of the local.
Part of the follow-up was a course of antibiotics and over the three days that this course lasted, some of my symptoms were relieved. This only confirmed my suspicion that it was Prostatitis and that the biopsy had been unnecessary.
I returned to taking the occasional Ibuprofen when the effects of the antibiotics wore-off and the discomfort started to intrude again. Eventually I was recalled to the hospital for an appointment on Wednesday 18th April. I guessed that things might not be as straight-forward as I'd hoped when the doctor was joined by a specialist nurse.
It was cancer. 90% of the biopsy sample material was cancerous. My cancer was rated as T3, worse than T1 or T2 which are contained within the prostate and can be just monitored to a greater of lesser degree. It wasn't as bad as it could be, or so it appeared without further examination. I was told that as long as the cancer hadn't spread, after some hormone-blocking treatment, I'd be given a couple of options of radiotherapy treatments. One of these involves a probe introduced into the prostate to deliver radiotherapy directly into the cancer. This would mean a stay at another hospital for a few nights while the treatment was carried-out between waking and sleep.
That was a non-starter as far as I was concerned. After the biopsy experience, I did not relish anything being stuck into my granite-hard prostate again. The next offer was a daily, external dose of radiotherapy at my local hospital, for seven weeks. As much as I did not much like the idea of daily trips to hospital, that seemed much more attractive than the alternative.
However, all this depended upon a CT scan and a full bone X-Ray to see if the cancer had metastasised.
As prostate cancer feeds upon testosterone, blocking the production of it is part of the treatment. This is done by an injection. However, the body's response to testosterone production being blocked is to produce more. To prepare the body for the introduction of female hormones (part of the testosterone blocking method), a three week course of pills is required to begin with and after a few days, the injection is given. This would be repeated every three months for as long as the patient can tolerate it or for as long as it's required (until the PSA level falls).
There are some potentially unpleasant side-effects: hot flushes, sensitised nipples, weight-gain, appetite swings and in extreme cases, lactation type symptoms.None are worse than the alternative however.
I've been lucky. Apart from some occasional increased sensitivity around the nipples, an occasional hot-flush, not much has happened. Apart that is from an urge to buy handbags and shoes!
The following Friday 20th, I had the CT scan and the bone X-Ray was scheduled for the following Monday. The CT scan was over in minutes and apart from some sort of intravenous marker, completely unremarkable.
The bone X-Ray would take an hour, a radioactive dye is injected into a vein carrying blood into the bones of the arm and then it's a case of waiting two hours for it to get around the system. I was instructed to drink a couple of litres of water to flush the excess dye out of my system. This reduces the chances of the X-ray being "over-exposed".
While this two-hour waiting period was ticking down, I had an appointment with the specialist nurse who gave me a 3 mg injection of the hormone-blocker. We had bit of a chat about how I was feeling (more on this topic later) and then I was released to while away the remaining time before the actual X-Ray procedure in the ominously named Nuclear Medicine department. Before being sent on my way, the nurse did say that usual practice was to inform patients by telephone if the scans were negative, ahead of the scheduled appointment with the consultant.
The X-Ray was of course painless. It took an hour for the slow scanning process to complete. Unfortunately, my bladder interrupted the process and I had to be allowed out of the machine to spend 15 minutes trying to get rid of the last of the water that I'd consumed at their request. There was a sign in the department that asked patients not to enquire after the scan results. It would be available within two days at most.
When after nearly three weeks I'd not heard anything, my feeling that there was no good news for me deepened. Taken together with the speed at which each step of the process had followed each other up until now, I began to take-in the consequences.
Eventually I received a time and date for a meeting with a consultant oncologist set for 10.20am on Friday 11th May and I duly presented myself at the hospital at the appropriate time.
Again, a nurse was present. The consultant informed me that the cancer had spread. No surprise there. It was in three places in my pelvis and the complicating factor, it was in one lymph node.
The way I understand things, these secondary cancers cannot be treated. Treatment has to be directed at the primary cancer and the complication created by the secondary cancers means that radiotherapy is no longer an option, either because it won't do any good now that it's beyond the prostate or it cannot be targeted effectively once it has metastasised.
When pressed, the consultants opinion was that without the primary cancer retreating, the bone cancer will begin to make its presence really felt within five years. However, the lymph node cancer is a wildcard and may well reduce the period considerably.
On the good side (being positive here), my symptoms have abated somewhat since the start of the hormone-blocking treatment. With that in mind, the dose will be increased to 11.25 mgs, repeated three monthly and after the second of these (in late August), I'll provide another blood sample for a further PSA test in time for my return visit to the consultant in mid-September. The hope is that the PSA level will go down indicating that the Prostate Cancer is being affected through being starved of testosterone.
My consultant did say that the higher dose will mean more pronounced side-effects and as I'm not due for the first of the higher dose until next week, I have yet to discover to what degree this will be. It may be that I will have to remain on this prescription of three-monthly injections indefinitely. Time will tell.
So how is this affecting me?
Well to begin with it was bit of a shock because I had been "positive" and convinced myself that it was Prostatitis. No-one ever wants to hear the words "it's cancer". Even if it is the most survivable sort. Cancer is the modern bogeyman. We have it drummed into us that it is a killer and in some circumstances it is.
People talk about "battling" or "fighting" cancer. I don't subscribe to that. I'll live with it and its consequences for as long as it allows. I will make allowances for it, I will alter my life and those habits that will make it more easy to live with. It is a part of me. It isn't a welcome addition but nevertheless it is there and sometimes I sense it's presence.
With that in mind, I've decided to give it a name and henceforth 'it' will be known as Charlie. Charlie the cancer.
I'm not always conscious of Charlie's presence. Most of the time I forget him because he doesn't make himself known but every so often I get a twinge in my groin or feel a slight stab in my pelvis. Other times I feel a sort of knotted sensation near my coccyx, usually after sitting or standing for a while. None or this is particularly uncomfortable, it might even be sensations that I experienced before I knew about Charlie or even before he grew in the first place but the new knowledge has made me overly-sensitive to every twinge, pain or stab that is just a part of growing older daily. Who knows?
What about my mental condition?
Well I've never been one to cry over spilled milk. What happens happens. It isn't bad karma, punishment from on-high, bad luck or destiny. It's a physiological disease. I've never had anything bad in the way of illness, injury or inherited conditions. Many people do and they live for longer with much more debilitating consequences than I have so far experienced. I still consider myself one of the more fortunate and I will (I hope) continue to do so even if or when Charlie becomes more intrusive.
I have no religious faith or beliefs. I am not afraid of death, perhaps the manner is a bit scary but I'm reassured to hear that pain does not have to be a part of the consequences. It is the unknown that creates fear. I know that death is the end, no different to the lack of consciousness when we sleep only it is permanent. I have no fear of that.
I long ago recognised that at the end of my life there would be a list of things that I didn't get to do or see. Even with the time and the financial resources to reduce the list, if you have an ounce of curiosity in you, you'll never do everything you desire.
So far the most unpalatable, crushing thing in all this is off-loading it onto others. I dread the degree of upset that my news creates and I thought long before breaking the news. If it wasn't for the fact that I've had to accept certain changes to my life that either affect others or cannot go unexplained without causing concern, possibly even hurt, I'd rather have said nothing.
However, having told people, I'm now of the opinion that telling everything is the best policy and it's to that end that this blog is taking shape. I intend to use it rather like a diary. I won't make daily entries but I will do so when there's something to say. I'll apologise here and now, some of it will be introspective and it might open my thoughts too far for comfort. Looking inside my head might not be a very nice experience. I'm not going to talk about other people, at least not by name and not to their detriment in any circumstance .
As I will only make an entry when there's something to report, it could become a litany of unpleasant reading. Please try to remember that for every entry about some thoughts or discomfort, there were many hours of equilibrium where no such things accost me.
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