Star Wars Tai Chi

My Taiji lessons continue. I am trying to perfect the long form, with 37 moves. Taiji, being a martial art, can also be performed with a sword. Here is a version of the 42 move sword form, in an amazing animation passed on to me by daughter Catherine. It is quite enthralling.


http://vimeo.com/14250730

The plateau?

My latest CEA data point confirms our suspicions from last cycle, that the previously reducing level may have "plateaued." Certainly the rapid reduction seen in the first two cycles is no longer apparent.

What these data suggest is that there may not be a continuing benefit from further chemotherapy.
However, in consultation with the hospital oncologist, we made a decision today to continue with cycle 6 but to delay this by one week to allow my bowel to fully recover. This means I have another drug-free week to enjoy!

On the knife edge

I have just passed through the critical days at the end of the cycle when my bowel collapses. Well, it certainly collapsed on two out of the last four cycles, and sent me to hospital.

This cycle we tried a new strategy, namely, stopping the oral chemotherapy medication the moment the diarrhea began, in this case, on schedule at last Thursday. Since then I have been fighting the battle with the usual anti-diarrhea drugs, and a couple more. On Monday night my temperature started to rise close to the danger zone above 38.0 C. It hovered at 37.7 for an hour then slowly drifted back to the low 37s. The same happened on Tuesday night.

Today, Wednesday, the temperature was normal and my colitis pain was receding. The diarrhea seemed to have stopped. But this evening, I am again hovering at 37.7 C, occasionally hitting 37.8 C.

This teetering on the knife edge is becoming tedious. My prediction is that by tomorrow I will be back to the safe zone and ready to start cycle 6, albeit delayed somewhat. My poor bowel won't take capecitabine until several more days of recovery.

Given a successful navigation of tonight, this would make the score 3-2. To Batman.


PS: Thursday has passed, calm has returned, I am on the mend!

63

So yes, it was my birthday this week. I have made 63. My new target is 64.

It was an enjoyable week, though sadly Miang was unable to be here as she is back in Malaysia visiting family. My sister Mary came over from Melbourne to "look after me". Mary is a very experienced nurse, and has been vigilant in ensuring that I am behaving sensibly. On Tuesday this week we were joined by my older sister Jeanine and her husband Murray, who drove down from Tauranga to be with us for a few days. It has been a wonderful family time.

Highlight of the week was a lunch at One Red Dog organised by Mark Hunter and the gang from the lab and Magritek. My family joined in (Jeanine left, Mary obscured) and had the chance to meet some of the remarkable younger generation that I work alongside.

Normally, as we get older, birthdays lose some of their charm. For me, this one felt like a milestone.

Toly Pavlovsky-Meersmann

This wonderful young man is my friend Toly, the son of Thomas Meersmann and Galina Pavlovskaya. Thomas and Galina, who are based in Nottingham, UK, spent a 6 month sabbatical with us a few years ago, when Toly (Anatole) went to Te Aro School. Now they are back again to help us with our "hyperpolarization" setup, and Toly has given up part of his UK summer holidays to go back to Te Aro, where he has met up with old classmates.

Toly is a fine soccer player and when he arrived in New Zealand a few weeks ago, presented me with some precious soccer cards of two of our famous All Whites players, Ryan Nelson and Shane Smeltz. Here Toly is eating pizza at a birthday celebration which we held this week.

I have to admit, the birthday was mine. More on that in my next posting.

PS: Many apologies for a long silence. I have had my siblings visiting and have been rather pleasantly distracted.

PhD student 21 successfully defends

On Wednesday this week, my 21st PhD student had his oral exam. Stefan Hill is a scientist at SCION (previously NZ Forest Research Institute) in Rotorua and he carried out his research there and at the Australian Synchrotron in Melbourne, using Nuclear Magnetic Resonance and X-ray diffraction on radiata pine at various levels of drying. The results of his thesis show the crucial role of a very thin trapped water layer between the cellulose fibrils and the surrounding lignin and hemi-cellulose matrix, something which turns out to be of real value in undestanding the best conditions for wood drying.

The real supervision work for this thesis was carried out by two of my esteemed SCION colleagues, Roger Newman and Robert Franich. I was the link person to the University, providing overview advice and helping the process along to ensure it met the requirements of PhD. But strictly, I'll claim credit for this being number 21. The picture shows Stefan (left), Roger (middle) and me at my favourite "Galleria" cafe in the university, just before the exam. The oral defence (second picture) lasted just over 2 hours. Stefan was superb, fending a barrage of questions from New Zealand external examiner Philip Harris from the University of Auckland, and from local examiner Ken MacKenzie, who also passed on questions from overseas examiner Martin Mueller from Germany. All the examiners were very impressed with the work and Stefan passed his oral with flying colours. Stefan, of course, is a very experienced scientist himself, and now continues with SCION as an even more vauable member of the team.

Having a PhD student successfully defend brings a special pride to the supervisor, even in my case, where my role was a bit peripheral, but I'm especially pleased with Stefan, who is just just such a great guy, though he was responsible for once getting me horribly drunk in a bar in Aachen!

PS: To my delight, at the end of the oral exam Philip Harris (Professor of biological sciences at UoA), reminded me that he had first met me in 1970, when he was a Graduate Research Fellow at Oxford University, and I was a first year graduate student. We were both members of Wolfson College. That was 40 years ago!

Latest CEA data and current status

This blog is mostly cheerful but it is also intended to be informative about my health status. I apologise in advance for being a little stark with this current entry.

My latest CEA data at the start of cycle 5 (linear and semi-log plots as usual) suggest a continuing reduction in the number of cancer cells. Since last posted, at 16.5 ng/ml, I have had three new data points at successively 10.3, 9.1 and 9.2 ng/ml, though the 10.3 and 9.1 measurements were made by the hospital, and not by my regular blood testing agency, Aotea Pathology, so the calibrations may not be consistent.

At the start of chemotherapy I was 78 ng/ml and so it it is clear that the treatment has had some major effect. There is a suggestion however that the benefits may have "plateaued", and I am unlikely to drop below the 2.5 ng/ml "normal" level.

The response of my cancer to the chemo has been remarkably good according to my oncologists. However, there is absolutely no doubt that this treatment cannot cure the cancer, but only delay its return. The particular condition I have, peritoneal metastatic cancer, is incurable by systemic chemotherapy. The only known option for further treatment is a new type of surgery (peritonectomy with hyperthermic intraperitoneal chemotherapy) which has been pioneered in the US and which is available in Sydney. I am pursuing this option and once my route becomes clear, I will update you all about the details.

In the meantime, I have to confess, with each new cycle I am finding the chemotherapy regime to be more and more difficult to manage. Increasingly, the nausea, lethargy and a peculiarly uncomfortable skin sensation are taking a toll on me. I am really having to limit work activities to just a few hours a day.

PS: I have just had very sad news from my good friend and former PhD student, Miki Komlosh, whose father died yesterday, after a short one month battle with stomach cancer.

Mark and Jillian's addition

Mark and Jillian Hunter have a new son, and Sam, a new brother. Thomas William Hunter was born at 3-10 pm on Wednesday 4 August, weighing 3.08 kg (6 pounds 13 oz). It's been an eventful year for Mark, with his PhD thesis submitted and a new son born.

Clearly Sam is delighted with his new brother, and the family group portrait is a classic, with Jillian, Mark and Sam quite radiant.

Sarah and Joe visit

The weekend before I was hospitalised, we had a visit from Sarah Codd and Joe Seymour. Sarah is a kiwi lass, born and bred in Palmerston North, and a classmate of my daughter Catherine. After a Physics honours degree at Massey University, Sarah completed a PhD in Magnetic Resonance with John Strange at the University of Kent at Canterbury. She then returned to New Zealand as a post-doctoral fellow in my lab, where she met Joe Seymour, an American postdoctoral contemporary. The rest, as they say, is history. Joe and Sarah, now married, are both Professors at Montana State University in Bozeman, Montana. Miang and I visited them last year after the West Yellowstone conference and had a brilliant couple of days in this most beautiful place, including Joe and me hiking a peak in the Rockies.

Joe and Sarah link together so many mutual friends who have worked in my lab, including Ross Mair, Melanie Britton, Miki Komlosh and Andrew Coy. The upper picture shows from left, Mel (Andrew's wife), Andrew, Joe, Sarah and me (Miang took the photo) outside a new restaurant, Foxglove, on Queens Wharf where we had just enjoyed lunch together. The lower pic is of me and Joe celebrating after our "mountaineering feat"!

Sarah and Joe are both outstanding scientists. Sarah did some quite remarkable experiments in my lab on dispersion of restricted fluids. Joe introduced to our group the whole field of chemical engineering, and together we published one of our most highly cited papers. Now they both have their own exciting research programmes and are attracting excellent graduate students to work with them.

Sarah's visit had added poignancy for me. Her father, John Codd, died as a result of bowel cancer, on Christmas Day 2007. John was Professor of Policy Studies in Education at Massey University, my contemporary, and a man greatly admired and respected by all who knew him. To quote from an article by Paul Adams & John O’Neill, "John Codd seemed to have the admirable knack of saying what needed to be said (no matter how socially, educationally or politically critical) without offending people. He was a deep-thinking social theorist who knew implicitly the critical importance of education and teachers in creating a better society."

PS: In the group photo I am wearing my Icebreaker "beanie", a gift from daughter Catherine.

Taiji lessons

For the past few months Miang and I have been attending Taiji (Tai Chi) classes at the local community centre, under Master Ray Poy. We have been learning the long form, with 38 different moves. Taiji is a sort of slowed down martial art, first introduced to me by Yang Xia, who encouraged me again to learn a bit more about this art when he visited me in April. I am a poor exponent, as you will see from this video which Miang took at home, as I go through about half the moves of the long form.

Hairstyles

The deed is done-a nice "number 3", which has conquered the wisps and left me a sort of stubbled bald.

I must admit, the picture is a little weird, even sinister, an inevitable consequence of holding a camera out in front and clicking backwards into the unknown.

Also featuring in this "haircut achievements" report is my nephew Morgan (my Aussie sister Mary's son). Morgan has decided to have his magnificent locks removed to raise money for cancer, in dedication to his Uncle Paul. The transition from initial to final state was much greater in Morgan's case. Indeed his sacrifice is truly outstanding.

Yes, that is lipstick on his cheek, a "smackeroo" as they say in Oz.

Finally out of hospital

I am out. Finally. In truth I haven't really been that ill, though it took 3 days to get my temperature down, following which it showed an odd diurnal variation, rising to just above 38C late each day. I was taken off IV antibiotic Saturday and hoped to be allowed home that day to celebrate Miang's birthday. I was given "leave" to go out for a few hours and so Miang and I were able to take up my booking at Hippotamus restaurant, and to take dessert in Kaffee Eis. But after the meal I had to be delivered back to my hospital bed.

The problem has been that my neutrophil count has been too low for me to be safely allowed to leave. Each day, my blood test revealed a slow increase, but in the end, we went for the "nuclear option", injections of G-CSF (granulocyte colony stimulating factor). In 24 hours my white blood cell count and neutrophil count rose so much I was now above normal levels. It's enough to make you believe in biochemistry.

I spent six days in Ward 5 North. Readers will know that I am someone who finds hospital at least interesting, if not desirable. The worst aspect of my experience this time has been witnessing the terrible distress of some of my fellow patients. My room had two beds with a dividing curtain, and I shared it with three different room companions over my time. The last was a young man whose vicious, relentless, lung-hacking cough made me think of World War I soldiers stricken with mustard gas. It was truly terrible to listen to, but worse, to contemplate the suffering that accompanied it. In the end, I was desperate to escape, and I felt ashamed of that, and only full of admiration for the kindness and care given to this man, and his agonized parents, by the nurses and consultants.

PS: The picture shows me having a tub of Hazelnut ice cream at Kaffee Eis. I think the truth is finally out regarding my hair, or the little that remains. It is Einsteinian in its wildness. Something must be done!