Staying the Course

Two weeks has passed and Richard's physical state has changed significantly in some areas and not too much in others.

His belly incision dried up a while ago, so no more dressings and he finally got to get into the pool! Since the week before last he's worked up to over fourty laps (about 45' lengths) which he does gently and takes him 30 minutes. He then does push ups and has gotten up to 10 at a time. Not bad, most people would agree! He's not being fanatical about it and in fact has not swum for the past two days.

He also is no longer on any pain medication. That stopped about ten days ago and he seems not to miss it at all. I have also stopped filling in my endless charts as there doesn't seem to be much point. Richard is seeing to his three daily flushes of the jejostomy (feeding) tube, he gets his antibiotics three times a day and his new congestion medicine two times a day and takes his tummy acid pills in the evening just before bed. He's also been largely responsible for his mid-morning snack, his supplement drinks, his yokut (active culture yogurt drink) his mid afternon snack (tho' this one is harder to remember as napping sometimes interferes) and his twice daily steam inhalations. Besides all this Richard has also resumed driving and took himself to the Loxwood Surgery to see his GP so he coould listen to his chest. He's quite good at picking people up at the train station, as well!

His weight has stayed about the same after he lost that five pounds a couple of weeks ago. To me he appears to be eating quite well. He has diarreah about every other day but we put that down to the antibiotics.

We saw Dr Kon, his chest doctor, at St. Mary's a week ago and after taking an xray and letting us examine it with him he concluded that it would be best to continue the antibiotics for another two week course as, though improved, there is still a bit of infection in the lungs... mostly in the right one which had been collapsed for the op. So, I guess, technically Richard still has pneumonia. Dr. Kon also gave Richard a perscription for something that is supposed to help expectorate the mucus sitting in the lungs. So far it is not hugely apparent that it is having any effect. Richard is still coughing what seems to me less, though Richard declares is still the same. I do know that it now only takes him about 15-30 minutes of coughing to settle at night and then he is quiet and peaceful until about 7:30am.

This past Wednesday we went in to see Prof Hanna on Harley Street. Richard was feeling particularly exhausted (I think from the swimming) so just decided to lay down on the floor in front of the receptionists desk using my backpack as a pillow. Richard is still a wonderful eccentric. I had to just smile and nod my head at the smart ladies and gentlement who arrived and found a body in the fetal position laying at their feet!
Inside the treatment room Prof Hanna asked how everything was going and stitched back the three places on the jejostomy tube that keep it attached to Richard's skin so it won't come out. The previous week Richard was doing a flush in a rather relaxed position and not having much success getting the plunger down. I noticed that the tube was coming out (about 1 1/2") of his belly. That's when I screamed at him to get up! I thought that it was just a short length inside and was ready to pop out but have since found out that its about 12" of tube inside him, so no wories.

Prof Hanna thinks Richard is doing really well and again said he was not suprised that Richard developed pneumonia after the op but they had to do it when they did.

Yesterday we saw Prof David Cunningham, Richard's excellent oncologist at the Royal Marsden. He reviewed a CT scan Richard had done on Wednesday before seeing Prof Hanna. It showed two little patches of infection in both lungs but everything else seemd good. The chemo is now set to begin March 22nd if Richard's chest has suitably improved.

I think the continued chest problems which manifest as a cough and a slightly painful tightness are getting Richard down psychologically. That's also coupled with knowing he has to get through the 63 days of chemo which Prof Cunningham has warned might not be tolerated quite as easily as the first rounds. There is also the risk that Richard will become neutropenic (no immune system) and pick up pneumonia again during the chemo. So, for the past few days he's felt pretty down and today disolved into tears muttering that he didn't think he could make it. I, of course, try to rationalise with him....that he IS doing better; there IS progress with the chest infection; his cough IS a lot less. But I realise what I realy need to do is just listen and acknowledge his suffering and fear.

We talk about going away to the sun for a few days but the prospect of getting on an airplane which at the best of times usually ends up giving Richard some illness, makes us reconsider. There has been some idle talk about renting a private jet! Who knows. I think I'll just have faith and hope that a benign power will work this one out for us.