Sunday, 30th April 2006

My playlist

I was passed fit (just) for the fourth round of chemotherapy on Tuesday 18th April 2006. I chatted to the nurses in the oncology suite at the hospital and one of them reminded me that I was now two thirds of the way through this saga. I had two more cycles to go and then the endurance test, for this part of my treatment at least, would come to an end.

Blood test results

Haemoglobin 11.1, Platelets 363
White blood cells 3.8, Neutrophils 2.4

Chemotherapy does not get any easier with each successive treatment. As I steeled myself for the effects the drugs would have on me, I focused on the permanent damage being inflicted on any rogue cancer cells that may still be floating around my body. Also, not a day goes by without either a family member or friend helping me out in some way. In this respect I am very lucky: imagine going through all of this on your own? Apart from my ever supportive family and friends music has been constant companion – this predates my diagnosis by a long time but somehow songs I have always enjoyed have become even more enjoyable. I nearly always have the radio tuned into a music station in the car and I have a favourite set of CDs that are never far away. Theres are some songs that I keep coming back to: like friends they are always there in the background and never fail to cheer me up. They speak for themselves. Some are classics, some will fade with time, all are special for me.

1. Song title:It don't mean a thing (if it ain't got that swing).
Artist: Louis Armstrong
Composer: Duke Ellington - Lyricist: Irving Mills
Date: 1963 EMI Records.

There can't be many people in the western hemisphere that could fail to recognise the identity of the man behind this remarkable voice. All the more extraordinary given the racial discrimination he faced however, such was the size of his talent, he overcame this and abject poverty to become a name intrinsically linked to the jazz genre. His seemingly natural and charming ability to weave sunbeams into every note he plays or sings has secured Louis Armstrong's place not only in musical history but in the cultural development of America. Above all, it was Louis's trumpet playing that broke new ground. His distinctive voice, and the music of Duke Ellington makes this song one of my all time favourites. His performances have thankfully been recorded in several Hollywood films including High Society and Hello Dolly where he looks every inch a star. And you know what? The light shines as brightly as it ever did.

2. Song title: Come fly with me.
Artist : Frank Sinatra
Composer: James Van Heusen - Lyricist: Sammy Cahn
Date: 1957 Capitol records

This is the young Frankie at his best. The big band sound was arranged by Billy May who also conducted the fabulous orchestra, but, soaring above it all is Frank himself. I pack my bags and leave with him every time he flies away.

3. Song title: I've got you under my skin
Artist : Ella Fitzgerald
Composer/lyricist: Cole Porter
Date: 1956 Polygram records – New York

The purity and honey like sound of Ella Fitzgerald's voice has a mesmerising effect on me and I imagine countless other people. Ella can sing just about anything however this song by Cole Porter might as well have been written for her as it brings out the best in her vocal talents. When Ella starts singing it's as if an angel has found its way into your head-set and allowed you to hear what it sounds like when you get to heaven. She remains untouchable.

4. Song title: Help!
Artists : The Beatles
Composer/lyricist: Lennon & McCartney
Date: 1965 on Northern Song record label.

It's difficult for me not to continue with the entire album once I listen to any Beatles track however this song goes like a train from the start and I tend to want to listen to it more than the others. The close harmonies are sublime and I'm always disappointed when it comes to the end.

5. Song title:The Girl from Ipanema
Artists : Stan Getz and Astrud Gilberto
Composer/lyricist: Jobim/Moraes/Gimbel
Date: 1964 MCM records inc.

This has to be one of the most mellow and chilled out jazz songs ever recorded. I love the contrast of the two voices and of course the unmistakable saxophone solo that could only be Stan Getz . I sometimes dance to this song when I'm pottering about in the kitchen. Everything takes twice as long but somehow the chores become less dull.

6. Song title:Move on up
Artist : Curtis Mayfield
Composer/lyricist: Curtis Mayfield
Date: 1970 MCA records

Is there anyone that can keep still listening to this song? I have not a clue what Curtis is singing about however it's one of the most uplifting songs I have ever come across. That's not all. Someone is having a seriously good time with those Congo drums. A real floor-filler in the Kesselman home.

7. Song title: Dance me to the end of love
Artist : Madeleine Peyroux
Composer/lyricist: Leonard Cohen
Date: 2004 Rounder records corp from the album Careless Love

My sister bought me this CD for my Birthday one year. I had not come across Madeleine Peyroux before however, knowing Rosemary's good taste in music, I played the CD as soon as I had a moment to myself and was immediately struck by the haunting beauty of this lady's voice. There are echoes of Billie Holiday tinged with a Gallic influence that makes it very distinctive and the more you hear the more you want the music to go on. Works very well in the rush hour when you're trying to stay calm but ideally listened to when you have the sofa to yourself and you simply want to drift off. Every word is crystal clear;this song is a delight from start to finish. And yes, it's taken me till song No.7 to stumble into the 21st century.

8. Song title: Summer Soft
Artist : Stevie Wonder
Composer/lyricist: Stevie Wonder
Date: Originally released on the Tamla records label in 1976 as part of Songs in the key of life album.

Easily one of the most played artists in my record collection. There are over four million entries on Stevie when you type his name into a search engine such is the interest in his extraordinary musical output . He too had to overcome racial discrimination and poverty, perhaps not in the severe way Louis Armstrong did nevertheless it was a part of his life as was his blindness which makes him all the more remarkable. Not only does he write the music and lyrics for all the songs he sings, close scrutiny of original record sleeves reveal he plays most of the instruments and very often has produced the entire album.

As a teenager I was allowed to go to see him in concert with a school friend at Wembley Arena when he was on the 'Hotter than July' tour. In those days I could scream for England and, with the thousands of other hormone powered kids in the audience, we made sure he knew just how many of us were there to welcome him when he walked onto the stage. It was a dream come true for the Stevie Wonder fans that had managed to get a ticket. To see him, hear him sing live, and play all those instruments was an unforgettable experience. Towards the end of the concert he said that he had a couple of friends in town and that they were going to join him on stage. Then on walked Diana Ross hand in hand with Marvin Gaye. We held hands and danced as the three of them sang together with Stevie on keyboards. The cheers, screams and whistles went on and on when they finished. I couldn't speak for days after – but it was worth it.

This song is not often played on the airwaves however it bears the hallmark of his musical talent. Could anyone other than Stevie have written lyrics like “....Morning rain, gently plays her rhythms on your window pane...” He has received countless music awards most notably perhaps for those of us in the UK the Ivor Novello lifetime achievement award in 2001. I remain in awe of him.

9. Song title: Over the Rainbow
Artist : Eva Cassidy
Composer: Harold Arlen - Lyricist: E.Y. Harburg
Date: Recorded between 1993-1996? I have it on the Song Bird album.

Bryan said to me “How can you choose this recording over Judy Garland's original master piece?” It is true, Judy is a hard act to follow, but this interpretation arranged and sung by Eva Cassidy breathes new life into the music and stands on its own merits. E Y Harburg's lyrics have stood the test of time and Eva's voice is extraordinarily beautiful adding bright colour and subtle meanings that remained hidden until Eva discovered them. Eva's life was cut all too short by terminal cancer. Thankfully we have recordings like these to remind us of her wonderful gift. I always try to hit the notes as she soars to the top but of course can't get anywhere close.

10. Song title: Another star
Artist : Stevie Wonder
Composer/lyricist: Stevie Wonder
Date: As before

The man is too good. I turn the volume right up when I play this song and then lose track of time. An added bonus is the “La la la la la...” at the beginning and at the end. What more can I say? “There might be another song, but in my heart your melody will stay with me.”

Sunday, 16th April 2006

Back to my roots

There is a rectangular plot of land at the back of the house which we refer to as a garden. Certainly it looks more like a garden since we carted away all the rubbish deposited by the previous owners and cut back the bramble that covered much of the grass – I suppose an estate agent might refer to that part of the garden as a lawn however that would be stretching the description by a long way. Neither of us have a clue about gardening as the picture below shows although we have had the sense to maintain the fruit trees as we have grown to enjoy eating the apples from the garden.

Nevertheless the apple trees aside the garden looks unloved and, during my time at home either recovering from the surgery or chemotherapy, I have been plotting in my mind how we might make some modest improvements. The first thing that has to go is that shed. We have talked about that shed for years but with other demands on the household budget such as new windows, doors, and nursery fees the upkeep of the garden has taken a low priority. Consequently nothing much has changed there since we cleared away the rubbish almost seven years ago. However with Benjamin turning five during the Summer, and full-time school on the horizon, the monthly payments to his private nursery will soon stop. I have already worked out where we can spend some of the money. In the meantime I decided to cash in some savings to fund some initial improvements. The shed seems like a good place to start.

Thankfully we are still in touch with a very good local handyman: Charlie. We called him and gave him a list of jobs in the garden including the repair and replacement of fencing, laying down a concrete base for a new shed and demolishing a rather ugly bit of masonry installed by the previous owners. We have a date in the diary for him to start work and we will be all the happier once the transformation starts taking shape. But what to do with the rest of the garden? Well, we have also decided to install a playhouse for the children which will be a nice surprise for them, and the challenge really is to try and create a child-friendly, low-maintenance, attractive little patch at the back of the house. Bryan is not keen on the old garden path and neither am I. The grass needs uprooting and replaced with good quality topsoil and lawn turf. Some hardy perennials around the borders would probably be a good idea however with a hosepipe ban just coming into force we need to think carefully about what we buy. This is the little project which I am hoping will provide a positive way to direct my remaining energies during the second half of my chemotherapy.

During the Bank Holiday week-end we visited my parents and I found a newspaper in their living room which contained an article written by the gardener Monty Don. In the article Monty advocates the merits of mulching during April. What a wonderful word! I had no idea what he meant by this, but already I was keen, so I read on. Essentially, mulching involves laying down a collection of gardening fodder (mulch) onto flower beds to deter weeds and maintain moisture in the ground. So far so good. But, as Bryan quietly observed, we had mostly weeds in out garden so what was the point of mulching? Well, if he had read Monty's article he would have understood that the mulching would stop further weeds from appearing. And in any case, I was planning to uproot all those rogue weeds. A planting plan was formulating in my head and the first line of the plan involved weeding and, if I could manage it, some serious mulching. I can almost see Monty nodding wisely back at me from the page of the newspaper. Then I took another hard look at the little suburban garden at the back of our house and decided to postpone any immediate activity until Charlie had started some of his work.

The front garden looked pretty apart from some weeds, so when we got back home I set about pulling some out. I found an old pair of gardening gloves, checked there was nothing crawling around inside, and began to pull out some weeds, in a feeble sort of way I admit. Nevertheless I had started my gardening project which was a satisfying experience. After a little while an elderly gentleman stopped just outside our front garden and sighed heavily. We live opposite a Doctor's surgery so a number of people walk past every day. I am usually unaware of the activity as I am at work but in recent months I have noticed just how busy it gets during surgery hours. Anyway the gentleman sighed again and groaned audibly.
At first I felt like saying, “Move on buddy, I have my own problems.” Instead the following words left my lips, “Are you all right there?”
"Yes love,” came the reply “apart from my gout, that is.”
“Oh, sorry to hear that. At least you're heading in the right direction.” I said cheerfully nodding towards the surgery across the road.
“Not sure that will help...had this for years,” he responded.
“Well, they're very good in there,” I said, thinking that that would do, and that he would move on.
But, much to my disbelief he stopped walking and replied, “ Really?”
I couldn't believe it: I only came out to do a bit of weeding not provide a counselling service. “Oh definitely we've had all sorts of things fixed in there,” I responded in a reassuring a manner as I could muster. It seemed to work.
“Let's hope they can do the same for me” he replied and, with that, he turned to cross the road.
I carried on weeding before the size of the task got the better of me. I looked at my fistfuls of uprooted weeds and couldn't help but feel pleased with myself. I didn't see the gentleman again. Maybe they fixed him in there after all.

Friday, 14th April 2006

Meanwhile, back in suburbia....

Young children, and by this I mean the under fives, have an efficient if unorthodox way of coping with a runny nose. This will be a familiar sight to some parents. As liquid trickles out of their little nostrils, an equally little but perfectly formed tongue pops out and clears it away from the upper lip much in the way a car screen wiper might clear rain from a car window. This is what gave me my first inkling that Benjamin had a cold. Despite several demonstrations from me about how to take out tissues from his pockets, how to blow and wipe his nose, he doggedly stuck to his tried and tested lick-it-off-my-face method. Well, he's four years old, so why not? The runny nose was followed by a slightly croaky voice and a little cough but no temperature and,within two days his cough and cold went as quickly as it came. Little children have little problems. During this time I received my usual quota of hugs and slobbery kisses from him. Having a lovely child like this made me forget about how my immune system would react. It may have been pure coincidence, however, it was not long before I too had a runny nose: but I refrained from using the tongue method so beloved by Benjamin. I was very grown-up about it all and availed myself of several tissues. If only the cold had been restricted to that I would have been perfectly happy but matters took a turn for the worse. I lost my voice, developed a stabbing cough, a series of headaches that stubbornly refused to disappear without paracetamol and sprouted a cold sore on my lip: all I needed just ahead of cycle 4 of chemotherapy.

Life goes on and with Bryan's school breaking up for Easter a week after Joshua's and Benjamin's school I focused on the entertainment programme for the boys. For the first few days this entailed ferrying them between each set of grand-parents as I was not up to much. In fact, I had agreed to meet up with the mother of one of Benjamin's friends Helen and her son Edward. However I had to cancel at the last minute as I started to shiver and feel drowsy – an unusual combination. Thankfully, my parents and Bryan's came to the rescue and took care of the children when the heavy cold restricted me to staying in bed for a few hours at a time. That said, I began to feel better towards the end of the week and managed to pack a picnic for myself and the children to take to Aldenham County park. www.hertsdirect.org/yrccouncil/hcc/env/enjoy/places/aldenhamcp/ The park is managed by Hertfordshire county council and is home to a collection of rare breeds of farm animals. There are also thoughtfully planned play areas for the under fives and older children. It was a little chilly for a picnic I suppose, however, the boys didn't bat an eyelid and tucked into their sandwiches. We had some bread left over at the end and fed this to ducks who had been paddling in a hopeful sort of way at the nearby water's edge.

The next day Bryan was at home and I felt confident enough to book a bowling alley for the boys and we took Joshua's friend Lawrence with us (Lisa's youngest son). We had great fun and Benjamin perfected a technique of pushing his ball down a bowling ramp (supplied for small children who might not otherwise be able to play due to heavy nature of the bowling balls) while maintaining his grip on a chocolate chip muffin. By the evening, the persistent cough I thought I had managed to shrug off returned with more vigour together with the now familiar headache. I took more paracetamol and went to the pharmacist to get whatever he/she was prepared to give me. I came away with Benylin and Strepsils as my throat had become sore and I had started to lose my voice. By Saturday evening my usually mild asthma kicked in and I developed a wheezy chest. By Sunday 9th April I was taking so many cold remedies you could have heard me rattle as I walked. They all seemed to help in some way and I list them here;

Vapour rub – very good for blocked noses/wheezy chests at night-time.
Ventolin – Kept my airways clear.
Benylin – a cough remedy. It works in mysterious ways.
Zovirax – for cold sores.
Strepsils – for sore throats.

It was not usual for me to need such a colourful assortment of medicines to manage a cold but then colds have rarely taken hold of me in the way this one did. Nevertheless, I remained undeterred and went along for my pre-chemo blood test on Monday 10th April as planned. After all, despite the coughing and spluttering, I had no temperature and felt well enough to drive. When I went in for the chemo the following day the oncology nurse narrowed her eyes as she looked at me and said, “You do not look quite right to me.” She had a point. I was coughing, had a cold sore the size of a small raspberry hanging off my lower lip, my voice had been reduced to a strange hissing sound: to be fair, I was not looking my best. All I needed was to shove a cushion up my back and to drag my left leg behind me as I walked to complete an impression of Quasimodo. However before I got carried away with thoughts of bell-ringing, the nurse brought me back to reality with my blood-test results. She read them out like football scores:

Haemoglobin 10.2, White blood cells 5.2
Platelets 298, Neutrophils 3.1

At first glance the results looked as I might be fit enough to withstand the chemo. However, the nurse said the raised count for white blood cells and neutrophils confirmed that I was fighting an infection and that the chemo would weaken me further. She called the oncologist who concurred with her view and I was advised it would be wiser for me to postpone the treatment by a week to Tuesday 18th April. I was partly relieved and partly disappointed as I wanted to plough my way through this course of treatment according to the schedule. But I wasn't going to argue. I would have a week to recover, to gain my strength, and as I walked back to the car I consoled myself with the thought that I might even be able to enjoy a bit of Easter chocolate.

Sunday, 2nd April 2006

The power of the mind

The day before the third of my six cycles of chemotherapy I was inexplicably tired. Worse still, the nausea I experienced when I had completed the last course of anti-sickness drugs mysteriously returned as did the dryness in my mouth and the metallic taste. I puzzled for a while over this as it had been nearly three weeks since my last session of chemotherapy. It now seems obvious that the symptoms were psychosomatic. My mind had begun to anticipate what was about to happen and my body was simply responding to messages sent by the brain. I have often heard the expression 'the power of the mind' and here was clear evidence that this phenomenon existed and was real. Fortunately for me, I was lucky enough to spend the afternoon with one of the other mothers from school: Lisa. Our sons have been in the same class since they were very little so we have a common interest, also Lisa has been very helpful taking Joshua to school on days when I have had to go for scans and other medical appointments. Like many parents, she juggles jobs around the school timetable. One of these is beauty treatments such as manicures and pedicures. Lisa had previously offered to give me a manicure and I decided to accept her kind offer. A good decision the day before the next set of injections. It took my mind off something which, quite frankly, I was not looking forward to and we talked about home improvements, our children and holidays. Now, here is an insight into the workings of my brain: I can talk about holiday destinations all day and never run out of ideas of where to go and what to do:that is, before reality sets in. But who needs reality these days? Escapism is far more liberating. I walked back to the house and my symptoms evaporated into the Spring air as I began to relive memories of last Summer's family holiday in Scotland.

I had however gone for a blood test that morning and very soon began to wonder whether the results would be sufficiently high enough to certify me fit for the next series of injection. I consulted my record book and reminded myself what my blood results had to be in order to qualify for the third chemotherapy session. It was all quite simple and straightforward:

Full blood count readings ______My actual blood test results
needed to qualify for chemo. ____before cycle two.

Haemoglobin >10 _________ -_-.___12.6

Platelets >100 ___ _________ _____208

White blood cells >3 _______- _ ._.__3.1

Neutrophils >1.5 ___ _______ __ ___1.7

The blood count readings prior to cycle two of chemotherapy were not great; I barely scraped a pass on two of the measures. However I reflected on my strategy of regular exercise, my juicing regime, and my own determination. I was anxious although quietly confident my results would prove good enough to allow me to sail through the half way mark. I told Bryan I would be able to cope with this next round on my own and drove myself to the hospital singing along to Stevie Wonder at the top of my voice. The oncology nurse read out my blood results with a smile on her face: my recovery was improving and the results were good enough and in some cases better than cycle 2. I was passed fit to take Cycle 3.

My cycle 3 blood results

Haemoglobin 12, Platelets 280, White blood cells 3.3 and Neutrophils 1.7

As I was being hooked up for the drugs in the oncology suite at the hospital I chatted to the oncology nurse about my juicing, new diet etc. Whatever damage the drugs were doing to certain parts of my body, my mouth has thankfully remained in perfect working order. The nurse, waiting for a chance to get a word in edge-ways, then warned me that this next series of drugs might induce more severe side effects. I looked at her and thought, “Nice of her to tell me, but it probably won't be that bad.” For once, her predictions were borne out by what happened over the following week to ten days. Once I completed the course of anti-sickness drugs, the symptoms I had previously experienced, returned however in a more pronounced way. For forty-eight hours I felt like sleeping all the time. The nausea created a knot-like sensation in my stomach which made drinking water never mind my beloved veggie juices virtually impossible. The dryness in my mouth was more severe and the metallic taste pervaded everything I tried to eat. I suffered nosebleeds, dizzy-spells was unable to shrug off the tiredness all week and became constipated to boot. I was able to keep food down however and was not prevented from taking the children to school, taking charge of bed-time, cooking and filling laundry bags for my mother and mother-in-law. But it took over ten days before I felt I had my body back and I felt wretched, depressed and began to think the unthinkable: could I really face another three of these dreadful injections? I quickly came to my senses. I was half-way through this ordeal. On April 11th, I would be taking my fourth series of injections. The penultimate series is scheduled for 2nd May and the last 23rd May. These gruelling repetitive cycles were coming to an end. This was not the time to waver. It is true I have, on occasions, felt like a mariner lost at sea but I reminded myself I had a compass, better still I had plotted my course, had become a confident navigator and held the end of the voyage clearly within my sights.