Progress

Hi All,

Can you believe it, it is still me and I am afraid you will have to bear with me for a couple more days until Paul gets his acts together or generates more neutrophils (white blood cells that form the essential part of the immune system). He is on the right track though. His neutrophil counts has increased from his pit bottom of 0.8 when he was admitted in the ED to 1.0 yesterday and 1.2 today. Once the body's immune system kicks in, the body temp would go down, hopefully. At the moment, Paul has to be infused with different cocktails of antibiotics to fight the infection since the hospital could not identify the source of the infection that has been keeping his temp up. (Note: Neutrophil count of 3.5 x 10⁹/L is an average for healthy people).

Other than that, Paul seems to be comfortable under the care of the hospital. Below are photos of him progressing from the battered arms on the first day, to enjoying his lunch and reading DomPost in bed, to working on his book and talking with sister Mary from Australia at the same time. The other laptop belongs to Miang, who works alongside him to keep him company. Life is not totally bad, is it?

Paul is doing better

Hi All

It is me again because Paul is still in the hospital. His temp has not come down yet but his diarrhea has finally come under control in the last 12 hours. He is feeling much better and looking much more perky. However, he is feeling very tired from the diarrhea and dozy from the fever.

As usual, Paul is keeping his keen eyes observing all the happenings around him. He is fascinated by the hospital and the people in it. The nurses are beautiful and kind, except that they have poked too many holes in his hands for blood and IV lines. My heart aches to see the pain he has to endure. But Paul is such a brave man, not a tear was shed.

I did my routine before I left him this evening - a double dose of reiki. I am sure he will right tomorrow.

Good night and many hugs to all

Miang

Bam, Pow, Whack, Wham- round 4

Bam, Pow, Whack, Wham!........PLOP!

Darn, Paul lost this round. The score is now 2:2. Paul is in the ED again tonight.

He started having his diarrhea again last Thursday. We thought we had it under control till Sunday, with the BRAT (banana, rice, apple sauce and toast) diet sort of food and loads of loperamide. But he had 8 diarrhea events since this morning, despite given the maximum amount of loperamide per day. It has really taken a toll on Paul physical strength. His body temperature gone up to 38.7C after I got him in the ED and therefore they are keeping him there for observation.

But Paul being Paul. He will rise again tomorrow. Build up his energy and onward and forward for the next round of chemo, round 5, which probably will be postponed a week till his guts recover.

I am sure Paul will be back home by noon tomorrow and give you an updated posting.

Till then.................. hope you are well

Miang

Alan MacDiarmid Building opening

Last evening Victoria University of Wellington opened its new Alan MacDiarmid Building. It was a magnificent occasion, with over 20 members of the MacDiarmid family present, including Alan's widow, Gayl Gentile, seen here (photo by DomPost) with Alan's Nobel medal outside the building. The Prime Minister, John Key, opened the building accompanied by cabinet ministers Steven Joyce (Tertiary Education) and Wayne Mapp (Science and Innovation).

John Key spoke first and then I followed, pointing out how Alan had changed the New Zealand science landscape, and including the remarks "On a personal note, I have to say, that to know Alan was to love him. When he spoke with you, he gave you his undivided attention. He was genuinely humble, he was full of playful humour, and his wit found expression in his famous aphorisms, “Science is people”, “I am a very lucky person and the harder I work the luckier I seem to be”, “Will New Zealand be a leader or a follower in this 21st century of science and technology?” and Prime Minister, I know you will love this one, “Vision without funding is an hallucination.”

The building, which cost VUW $48m, is beautiful, and houses science and engineering teaching and research space, in an interdisciplinary environment. In the large foyer, Alan's Nobel medal is on permanent display, to help inspire the students.

I had the opportunity to have a good chat with the Prime Minister afterwards, encouraging him to keep the momentum going around science and technology initiatives. He was kind enough to question me about my health and, surprisingly, had heard about and wanted to know more, concerning my "Sydney option". New Zealand is an amazing place.

The picture is interesting because in the background are Gayl, and Sean McConnell, Alan's oldest grandson, who also travelled from the US to be at the opening.


PS: Thanks to university photographer Les Maiden for the PM shot. The wonderful portrait of Alan is by New Zealand artist, Marianne Muggeridge.

Miang's latest creation

In assessing my prognosis, Miang has turned to the oracle and come up with this astounding result. I am not sure which treatment will be responsible but the tentacles look favourable.

Ptolemy's Theorem and Pablo Etchegoin

Today I visited Pablo Etchegoin in Wellington hospital. He had developed a painful bile duct infection and was admitted to be given intravenous antibiotics. He was much better when I saw him. Indeed he was sitting up in bed with a notebook open and a pen in hand. I immediately noticed what looked like a problem in Euclidean geometry on the pages. "Working?" I asked. Later in the conversation Pablo returned my attention to the pages. "I decided to solve Ptolemy's Theorem", he said.

I had to scratch my head for a bit. In my teens I was an expert in Euclidean geometry, but I struggled to remember it. Pablo reminded me "It's the relation between the four sides and two diagonals of a cyclic quadrilateral. For a quadrilateral inscribed in a circle, the sum of the products of its two pairs of opposite sides is equal to the product of its diagonals.

Pablo finds hospital tedious. As a consequence he chose to solve an ancient problem worked out by the Greek Astronomer and mathematican Ptolemy, who lived in Alexandria from AD 90 to AD 168. He then explained to me his method. "I decided to use complex numbers", he said. "That means that the displacements between the vertices are just phase shifts in the Argand plane. It came out really nicely".

I was enthralled. "Poor Ptolemy didn't have complex numbers available to him", I said. "No, he had to do the geometric proof", said Pablo, who then went on to point out to me that Pythagoras's theorem was just a special case.

We had good conversation about our cancer treatments, the struggles we face, and the possible ways forward. But I walked out of Pablo's cubicle inspired again by his extraordinary intelligence, his curiosity, his physicist's love of mathematical beauty, and of course, his courage.


PS: Thanks to Wikipedia for the diagram. The entry on Ptolemy's theorem gives four different proofs, including the original geometric one.

Time for a cheerful posting

Here are my siblings. Me on the left, my younger sister Mary, my brother Jim, the eldest, and my older sister Jeanine. The photo was taken at the time of my 60th birthday.

We were all born in Wanganui, all 4 years apart in age. They are a wonderful family. Jim is a physicist as well, who inspired me as a kid to follow in his footsteps. He became one of New Zealand's most effective and respected physics and math teachers. Jim has four sons and several grandchildren. He is retired now and lives with his wife Sharron in Wanganui. "Big sister Jeanine" is the glue in the family, the one who looks out for us all and showers us with kindness. She and husband Murray ran a successful business for many years, and are they are now retired and living in Tauranga. They have three sons, and many grandchildren. And Mary, the youngest, lives with husband Tom in Melbourne, Australia. Mary has been a nurse, specialising in renal work, and now is involved in a medical research team, while Tom is a retired aircraft technician. They managed to produce a daughter, as well as a son. Mary, with her medical experience, has been a huge help to me.

I am very fortunate to have grown up with this family, and to have had their love and care through my adult life. And in recent times, Miang and I have gained so much strength from their support.

Bad blogger

I have been a bit remiss lately in not keeping my postings up to date. In truth, I've been having a bit of a rough old time on the chemo, feeling extremely fatigued, and a bit lacking in inspiration. However, I intend to drag myself out of the slough, lift my spirits, and communicate more effectively. I will be a better blogger!

Sydney foray

It's been a long silence since my last post. The flight to Sydney went OK and we were met at the airport by Miang's Uncle Andy, his daughter Lily and her husband, Anthony. The three of them live up in Curl Curl on the North Beaches about 30 minutes drive north of Sydney. After my two days at St George hospital in Botany Bay, they looked after us for a couple of days before our return home last night. The picture shows me and Andy on Palm Beach, at the tip of the Barrenjoey headland. Spending time with Andy and his family was a welcome break after very intense medical consultations and tests at St George Hospital.

Andy is a retired chemical engineer with extensive business experience in the petrochemical industry, and is a wise man. We had much to talk about including quantum mechanics and global climate change! He is also very generous, in the Lim family tradition, giving me and Miang a wonderful tour of the North Beaches region in his beautiful new Mercedes, as well as treating us to one of the top local restaurants for lunch. And Lily and Anthony were the best of cousins, driving us back from the airport and hosting us for two lovely meals in their home.

The "Sydney option" is something I have been considering for a couple of months now. My Wellington surgeon referred me to the team of Professor David Morris of the University of New South Wales. David Morris is world-renowned for his radical peritoneal cancer surgery, carried out at St George Hospital, using a method developed by Paul Sugarbaker in Washington DC. I won't write more about the option at this stage. The details are a bit overwhelming anyway. The purpose of my visit was assessment, them of me, and of course me of them. Once they have reported back to my Wellington surgeon, and I have had the chance to consult with him, I will make a final decision.

Meantime, I had some good news from my Insurance company. On the basis of my written appeal to them, they have decided to make an "ex gratia payment as a one off, the reason being that the information given to you at pre-approval was insufficient"

Naturally I am grateful to Tower and have accepted their offer.



PS: I have always been fascinated by the existence of a suburb in Sydney called Curl Curl. To those of us who were brought up on vector calculus, curl curl is the gradient of the divergence of a vector minus its Laplacian. When I first saw a Sydney ferry named "Curl Curl" back in the 1980's I was amazed at how mathematically literate Australians must be. Since then I have discovered that Curl Curl was derived from the Aboriginal phrase curial curial, meaning river of life.

One Hell of a Week

For all my superhero bravado, the bowel won in the end. The diarrhea just got worse, despite the loperamide and the fluids. I saw my oncologist at the hospital yesterday. He sent me for an x-ray and, sure enough, I had severe colitis. Now I am armed with some new drugs, one to counteract the bowel cramp pains, an antibiotic course, and codeine to help "bind" me. This reversal of fortune challenged me to find the right superhero graphic in which Batman is now on the receiving end, and in the appropriate place. I am quite proud of my achievement in this regard.

The week started with some adventure. I was invited by Palmerston North Boys' High School (the old school of my son, Chris) to address their Monday morning assembly for 20 minutes. The Hall was packed to the rafters with 1700 boys along with their teachers. I have to say, I did apparently entertain them and they gave me a great ovation at the end. I understand the culture of the "all boys school", having emerged relatively unscathed from one many years ago.

Tuesday was Avastin infusion day, Thursday my blood test, and then Friday, the long and helpful consultation with the oncology registrar at Wellington Hospital. My CEA result was not exactly what I had hoped for, not a halving from 23 to 11, but a 2/3 reduction to 16.5. So I am now off the exponential decay of the first two cycles. It may be that my colitis has caused an artificially high reading this time. It can do that. Or it may mean I am starting to "asymptote" to a plateau.

An important outcome of this week's experience, which is at the same cycle point as my hospitalisation in June, is another week's delay in my starting irinotecan/capecitabine. This last week has been my drug-free week (ignoring the benign Avastin), all these bowel problems being aftermath effects. I think from now on a two week recovery period rather than the usual one week drug free, will be my norm.




So, it's been a hell of week. And I had to pull out of "Waiting for Godot" on Thursday night! But the biggest complication is that my bowel status may prevent Miang and me flying to Sydney tomorrow. I have two days of medical consultations lined up at St George's Hospital. More on that little mystery later perhaps. As for the flight go/no-go, it's decision time this evening.

PS: 7-30 pm Saturday. Decision made. We go.