POST OP FUN

I have been in the Victoria hospice nearly three weeks now. While laying around in a $10,000 exceptionally comfortable air bed with nary a chore to do may sound good, I am finding it a tad boring. While lying in said bed, in the last post I explained the first week was for new narcotics and old to come and go or increase or decrease all the while nurses and doctors carefully watching for any changes, given the very high doses of narcotics I had been on. Much has happened since then.

My 4th room and finally a single

One week after admission I had my first surgery. Done under a spinal anesthetic, a catheter was inserted into the intrathecal space surrounding the spine. The worst part for me was getting comfortable on my stomach given all pain I had, not to mention the bony parts from my original mastectomy and subsequent breast surgeries. Some twilight sedation fixed that and an hour and a half later I was shifted from the OR table while being told to cough and breathe deeply as my blood pressure was 62/26.  Any movement caused serious pain but surgical pain goes away, quite different than the other neuropathic pain. In any case, within a few days I was up and about other than the alarm of a leak which turned out to be mechanical rather than cerebrospinal fluid. It was easily fixed though it did delay my activity level which most of you know, is very hard for me~~I like to be active!l

September 3, 2019~~less than a week until the Stage II surgery. There has been progress for sure and my doctor continues to fiddle around with my meds in hopes to get it right. I have been home several times on passes for a few hours at a time. No overnight passes with an external intrathecal pump and to be honest I feel well taken care of here. The burning and throbbing in my hand continues when I am up due to circulation but it is so much better. All I can think of is that my hand is the farthest for the medication to reach. 


I do feel honoured to be here in the Victoria Hospice. I know most hospices do not have acute beds for pain management so that is one big thank you. I was so lucky when I was here just over a year ago for pain management but also to have met a doctor who had taken an interest in my case. He is an anesthetist first but also runs the Royal Jubilee Pain Clinic where he does several kinds of pain interventions. He did the stellate ganglion nerve blocks I had over several months but at best they are not long lasting. Frequently he and his team do simple epidurals and temporary intrathecal blocks  to relieve pain for those in end of life situations. They have not done a permanent intrathecal insertion with an embedded pump for nearly three years. Apparently it is costly and when my doctor first discussed the option, he said approval was needed~~not sure how high up, but it was approved so once I was admitted this time, he got the ball rolling and here I am. It was also explained by the doctor in charge of hospice, that I am simply a good candidate. I have chronic excruciating pain caused by a cancerous tumour but also have the expectation of "long" life expectancy given the slow growing cancer. He actually wrote something similar in his notes from last year. I try not to get my expectations too high but know that I am lucky already and to have a decent chance of pain relief if this works, is significant. There are certainly possible side effects, even so far as paralysis but we agreed that living with constant immobilizing pain is not an option. 

September 5th~~Wow, super annoying as yesterday I updated this post with photos but was  interrupted and unfortunately lost it all because I guess I forgot to save. F**K! 

I do want to describe what happened on my first pass shortly after that first surgery. I had wanted to go home for a pizza party with the family as all the kids were home. Andy had flown in from the north for a few days, Steven and Heidi were back home from Steven's year at the U of Nanaimo and Mary and her partner David were also around though it was their last night before heading east for a holiday.

Anyway I got my pass literally hours before this little pizza dinner and arrived home with my intrathecal IV via the external pump, a central port line and a couple of subcutaneous lines. I was dressed in hospital clothes not knowing what was coming. I noticed a couple we know on the deck as I came through the garage on to the deck but thought they had come for a drink. However as I walked into the kitchen I was so surprised to find a house full of friends and family there. It was my first ever surprise party and Dick did an amazing job considering that he had organized it long before I was in hospice. Every time I turned around I saw someone else. Friends from Victoria old and new, good friends from Vancouver who made the trip by ferry, Patti and Lyle by seaplane, Chris Worsley from Seattle and more. Mary's best friend Kath was there with 3 week old baby George and her husband Alan. Chris came on my 2014 Annapurna Base Camp trek along with his two sons Alan and Andrew. Kath was also there but did know the Worsleys. I love it that 5 years later Kath and Alan who met on the trek are now married and have a baby, making 3 generations there at the party. 

I almost forgot to mention the two orcas Lyle spotted in the bay. They breached and ate for as long as we watched them. What an addition to an already special night though we could not get a photo.

Heidi, Steven and Andy at the top with Mary and David in front

Elaine making sushi as always

Patti, Joanne and Bev

View of Gonzales Bay that evening

Mary, David, Kath with sleepy George and Alan

Chris, me and Suzanne

Baby George

PAIN

My last post was mainly about my uncontrolled neuropathic pain and where it had got me. It got me into hospice to start with. However I am not sure that I really emphasized how bad the pain was to get to that point. It had steadily been increasing for weeks but the last week was especially bad. By the end I would wake in what I call the dark and scary hours and kind of murmur to myself about giving up and going to ER. It is hard to mobilize when in pain so I just took my Hydromorphone every hour~~the 2-3 tablets prescribed and wait in hopes the throbbing, burning pain would stop. Usually 3 or 4 hours later I would fall asleep for a few hours only to wake up wondering if it would hurt if I got up. Yes would be the answer and just using the bathroom and brushing my teeth would start the whole cycle off again and back to bed I would go. I did manage to stay up long enough each day by late afternoon to play "Ticket to Ride" with Wayne, Anne and Dick, though few times I would have to lie on the couch for a few minutes to push the pain back. Every once in awhile I would actually feel quite normal and then would think that I had been imagining all the hours of lying down, taking my meds and hoping for relief. One highlight was managing to stay up long enough to teach Dick how to make Elaine's grandmother's biscuits. 

But Monday morning when the phone call from hospice came, so did relief come with it. The end game for admission this time was to get me a bed so that I could be guaranteed  surgery as soon as possible. However the immediate goal on admission was pain management. I had this neat little yellow contraption embedded in my upper arm that subcutaneously allows narcotics to be pumped in all by myself~~well there is an hourly limit! The Hydromorphone was infused through the pump into my arm via the little yellow butterfly thing.  Methadone in a higher dosage was given orally as normal plus a new one was added~~Ketamine. Ketamine I was told by doctor, was at one time a battleground drug, because it is easily given as an oral liquid that works quickly. I have also learned that it has been used as a veterinary tranquilizer, an anesthetic and also as a recreational drug. For me, this addition to my arsenal seemed to make all the difference and by Thursday things had really turned around. I could actually get up and do simple things like brush my teeth, wash my face and even walk to the end of the hall without that burning, shooting, electric pain that brought me here.

Back to the aforementioned surgery~~ it is scheduled for 0800 Monday morning. The procedure is the temporary insertion of an intrathecal catheter with an external pump. The  catheter will be threaded up the spine to the axillary area where medications will be infused from the eternal pump.  Following surgery I will be monitored for a few days to ensure that the  system works. 

Apparently this is Stage I. The next step if all goes well, will be back to the OR for the insertion of a catheter but with an implantable pump. Sounds like fun don’t you think? It will be done with a spinal anesthetic so I can let them know if there is unexpected pain as the catheter is placed. 

For now, I am laying around napping, doing the odd Sudoko, and reading books on the brand new Kobo Suzanne got me. She also added several books and got it linked with the library. Mary picked it up from her in Vancouver and I got it Sunday night~~perfect timing for my admission the next day. She knew I would love it as holding books had become so difficult I had virtually given up reading. After each page I had to put the book down to turn the the page, not to mention how hard it was just to hold the book in one hand. I read a whole book on my Kobo in the first 3 days here.

Dick has gone off today with Mary and David for on an overnighter on VK. I was supposed to with them but it is clear why I am not. I am just happy that they have this opportunity now.

Sunset from Van Kedisi in July

SUMMER UPDATE 2019

It has been my intention to post here for a couple of weeks~~in fact since the anniversary of my first diagnosis July 27th. The metastatic cancer anniversary is coming up later this month.

But things have changed so fast that every time I have started, either I have been in too much pain or I have not had the energy. July 19th (Dick’s birthday) we went sailing with Elaine and Suzanne and I am so thankful we did because I have not been out since. This week our friends Anne and Wayne came from Calgary to visit and sail with us for part of that time. When we made those plans I was able,  but just before they came I had to tell Anne that we might have to cancel the Van Kedisi part. Even up to Wednesday night I was protesting that we could manage. But we are glad they came nevertheless.  Dick got to cycle out to Sooke with Wayne while Anne and I hung out here. The three of them have cooked wonderful meals and this morning I  managed to teach Dick how to make Elaine’s grandmother’s baking powder biscuits for breakfast. It was a great break for Dick too.

I am now number #1 on the list for the Victoria Hospice. The pain has increased day by  day and my medications both routine and for breakthrough have gone up at the same time to the point that I have only been out twice all week, once for blood work and the other for chemotherapy. I started a new chemo drug on Thursday as my oncologist feels that Paclitaxel is no longer working plus side effects like tinnitus and neuropathy have crept in. 

So the pain is bad, but hopefully a surgical intervention will stop the pain even though though there are possible side effects. It is neuropathic pain caused by the tumour in my axillary area that is wrapped around the neurovascular bundle of the brachial plexus. Sometimes the burning, throbbing pain radiates from my scapula and and often goes right down my arm to my fingertips. That is happening right now and the fingertips feel as though electric currents are firing out. My recent scans showed nothing amiss but something is happening to create the pain. 

I am happy to say that I have won 2/4 games of Ticket to Ride while taking  Methadone on a regular basis along with frequent Hydromorphone for breakthrough pain so it seems that my brain is still functioning. Anne dislikes Settlers of Catan which is just as well as that game just may be beyond me at this point. 

Anne and Wayne leave this afternoon so Dick will be back to full time work here. Trust me, this is not easy for him with the changes hitting us so quickly. Nevertheless, this is not life threatening as my tumour is considered local or regional so far. Not to minimize the lack of use of my right hand and the debilitating pain but if the surgical intervention we are looking at is successful, then the pain may be eliminated. As my cancer agency pain doctor said a week ago, losing some more mobility is probably better than having to lay around most of the time. I agree. Despite knowing it s not my fault, I feel so useless.

Monday, August 12 update. I have been admitted one of what they call acute beds in the Victoria Hospice. There are 7 acute/respite beds here and 10 beds for those approaching death. I was here last spring for pain management too but this time the pain is far more severe.I will keep on a more regular basis but I already feel better in hopes that we will see progress sooner than later.

Also, Mary arrived last night and will be with us, working and visiting until she and her partner David head east to visit his relatives for a short visit. They both return after labour day to head back to Uvic. Before they leave Steven and partner Heidi move back from Nanaimo where Steven has just completed a university program. Andy who lives in Terrace where he finished his BASc in Nursing in May SUMMER UPDATE 2019is flying in on August 22 for a week. It is not often to have all 3 kids here in Victoria at the same time so I look forward that. Maybe I will even be home by then.

This photo was taken July 20th

LIFE IS PRETTY GOOD

Much thought goes into the beginning of a blog post for me and it usually there has been a reason for reasons for me to want to speak up. In the 7+ years since my first breast cancer diagnosis the roller coaster analogy is never ending though the ups and downs do have those plateaus where you catch your breath or the ride comes to and end. Unlike the roller coaster, once we are faced with metastatic cancer, stage IV or simply cancer that will never be cured, it is difficult to banish thoughts of what's next or how long do I have along with facing the necessary details like wills and end of life plans. Of course we all have to face these things but somehow having metastatic cancer can make it more imminent.

Back to the purpose here. Christmas came and went and was wonderful. Soon after everyone returned to school I fell back into a trap that happens once in a while. When this happens I find myself wanting to know more about my stupid tumour or the blob as I often refer it as. No matter how unreal it is, I want to think that there must be some way to attack and release the tumour. In early January I saw my family doctor who was sympathetic and sent me off to a plastic surgeon that I had seen before. But of course she said again that there is nothing that can be done. She had sent me last year to the best team in terms of surgery but once they saw the scans they said it was hopeless. I guess I buried it in my mind and had to hear it one more time. I cried a few tears, went home and called M.D. Anderson in Houston, Texas one of the two preeminent cancer centres in North America. After several telephone calls I was sent a package. If I wanted to have my case looked at by an assessment team I needed to send every single scan from the beginning plus just about every document also from the beginning. The cost of the team looking at my case would be US$16,000 to 32,000. We had called our insurance company and they would have paid for the second opinion. It only took me about 24 hours to think it through and know that it was really not worthwhile. The plastic surgeon also gave me names of two doctors in North America one in Toronto and the other in St. Louis who do brachial plexus surgery. I have pondered making phone calls but the reality is that no one will touch a tumour  entangled around the neurovascular bundle of the brachial plexus. Chances would be good for bleeding to death or losing all control of my arm. My oncologist says it is very common for patients to go back every once in a while try and find a way to make it all better.

Once I got over those few days in January my positive self emerged and I started yoga, exercise and meditation classes at Inspire Health again and decided to get some counselling. It is helping.

Here is a little excerpt from my journal which I planned to add to this post.

Sunday March 3, 2:17 PM lying in bed feeling very weak and suddenly a bit afraid. This is going into a  blog post but I will try to encapsulate my feelings around my health and how it has been for the last couple of weeks. The brachial plexus infusion which was nine days ago has done nothing in my estimation. I am feeling more pain now. Scary again.

So what are the things that are of concern with my metastatic breast cancer right now?

Continuing pain which is manageable as always with narcotics. So not a big deal? Yes or no? It depends on the situation and the timing.

Mental status. This one goes up and down and sometimes on an hourly basis or worse. But also it can be brought it on after several months of seeming normalcy.

Activity level. This one is very difficult to describe. I am sick right now well into week 2 on a cold and cough very productive with green phlegm. I feel as weak as I have ever felt well maybe not as weak as when I needed blood transfusions. But this is a weakness that I do not like but am getting used to at this point I guess.

Scaredy-cat level is at one of the more highs than usual.

March 9th, 2019. I had an MRI last Saturday night and I had a CT scan Tuesday morning along with the usual bloodwork and then chemotherapy on Thursday morning, the third Thursday in a row. Along with Paclitaxel I get Dexamethasone which is a steroid to ward off any allergic affects of the chemo drug. Mary was in a session called "Tremendous Trees" that was part of Ideafest at UVic this week and one of the things she learned is that Taxol drugs (Paclitaxel being one of the Taxols) originally came from the yew tree. That was kind of a fun trivia fact I was aware of, having had Taxol back in 2012 but it was interesting that she learned about it from a session on tree research. Hey this is one of the positives of having breast cancer~~ we learn a lot. I must add that allergic reactions come from the fillers used, not the Taxols themselves.

Back to chemo day. Then I get Benadryl, another allergenic drug along with Ranitidine in case of nausea. The dexamethasone and the Benadryl fight each other so I feel wired but tired. Usually I come home feeling a bit weird but also energetic. This week not long after chemotherapy I decided to do some pruning in the garden after Dick and I had gone for a walk. I pruned my way up to the road and tried to get up from a sitting position. However with only one arm/hand working and weak legs I managed to throw myself onto the roadway. Tripping and falling have become quite common no doubt due to medications, chemotherapy and stupidity on my part. Icing, Ibuprofen and bedrest seemed to do the trick and gave me time to work on fundraising for today's event.

That was Thursday afternoon and today as many of you know I walked 5 km with my special little team called "Breast Cancer Eh?" Dick, our daughter Mary and her partner David joined me on Inspire Health's major fundraiser of the year. Inspire Health provides cancer patients many resources such as counselling, yoga, individual exercise routines, nutrition planning and more. All of this is free with money coming from a grant and this big fundraiser today.

It was only Wednesday while lying in bed that I decided to form a team and get the word out to my friends all over the world. The response was heartwarming. Today was a beautiful day in Victoria, relatively warm (6C) with no wind and I actually managed to walk the 5K, something I did not think I could do. I have to throw in the fact that we came 5th in team donations.

I have left the best for last. My oncologist phoned late yesterday afternoon with good news. Both the MRI and a CT scan appear to show stability with no signs of progression.

Maybe there is another trek in me yet but I have a long way to go on strength and balance. For sure I am feeling positive.

Love to you all,

Marian

  

Relaxing on Dean and Marie's catamaran in the Bahamas in February.

Dick, me, Mary, David and Franny the pug today at the end of the inspire Health 5K walk.

CHRISTMAS 2018

With only a few days until Christmas I am feeling a mixture of happiness and excitement along with  a bit of of nervousness. I have written in the past about Christmas not being my favourite holiday. However my first Christmas with breast cancer in 2012 was one of the best. Two families got together in our home in Vancouver and for several days there were up to 13 people celebrating with good food, wine and company. Although my taste buds made everything taste like cardboard, including good wine, it was the companionship that made that holiday so much fun.

This year our kids and their partners along with a nine-year-old are now gathering. Christmas Eve we head for Mount Washington on Vancouver Island for four nights in a spacious townhouse. Everyone is pitching in for meals and all that goes along with that. My main job will be relaxing while trying not to supervise too often. There has been enough snow in the past 10 days for all snow sports. I hope to snowshoe at least once or twice and thankfully the Nordic area is right next to our townhouse and downhill is ski in ski out.

Just two days ago I finished my third IV chemo on my new regime. It is called Paclitaxel, one of the same drugs I had back in 2012/13. This time it is a reduced dosage given every week with a week off. Luckily I get Christmas week off. So far I am feeling good for the most part. I do need to rest and take myself off to quiet spaces when I feel overwhelmed.

The last chemo which was oral caused me hand/foot syndrome which made it painful to walk. One of the trade-offs this time is that I will lose my hair and I may still have some neuropathy in my feet and hands but for now I am okay. I am also hopeful that this chemo may push back the tumour that is wrapped around the neurovascular bundle of the right brachial plexus. I still have intense pain but it is managed.

My next post will be in 2019, 1 1/2 years into metatastic  breast cancer. There have been some rough times in the last while but I feel as though I am entering an upward phase with much hope. My family and friends continue to support me even when I am sad or angry.

I wish everyone a wonderful holiday season no matter where they are or who they are with.

Love Marian

This is my latest hairstyle. In 2012 Mary shaved my hair into a mohawk for fun but it only lasted an hour or so. This time I decided to have more fun with it and until it starts to fall out I will sport this mohawk, colours and all.

PROGRESSION AND HOW IT IS AFFECTING ME.

After writing several posts without publishing I am hoping that I  can form the words I want to in order to explain my hesitation. When I last posted I it was about the main events that can cause stress in our lives. That post spoke about how the move created stress in our lives.

The second stressor for us falls into the category of a "major illness or injury" When we/I bought our Victoria home in January, 2017 with possession in June I  had no idea that I already had metastatic breast cancer. We took possession June 20th and I returned to Vancouver on June 25th for removal of my implants. I really did think the problems I had had with my reconstruction much earlier and then with the second try for reconstruction in December, 2016 were part of the problem. Not so and two months later I was diagnosed with metastatic breast cancer. Fast forward one year and that metastatic cancer has progressed.

I feel lucky that this progression was found. The reporting of an MRI I had in June during my stay at the Victoria hospice for pain management showed stability. Fortunately my wonderful oncologist sent  the June MRI for review by the wonderful head radiologist in the Vancouver cancer agency. He had followed my testing last summer and also did the core biopsy which led to the diagnosis of metastatic cancer. With both MRIs, he was able to compare this new one with the diagnostic one from last year. Sadly it showed a lot of progression as well as some hot spots.

Last week I had a full bone scan and tomorrow I have a CT scan. In November I will have another MRI. Of course I hope that there is no change. The day after we knew there was progression, I was taken off the wonder drug Ibrance. Its purpose was to stop the multiplication of cells. After one year on Ibrance I am now on chemotherapy.

By the time the progression was found the pain had become excruciating despite a change to methadone. I have another narcotic for breakthrough pain and I would often find myself taking it five or six times a day. While I was in hospice I had a consult with an anesthetist who specializes in nerve blocks. I have had two Stellate Ganglion blocks so far and my pain has decreased significantly. However it is short acting so it must be done every 2 to 3 weeks. I am hoping for a block that is more invasive but is long term. My doctor has started the application process but it is very expensive and must be approved by the cancer agency and it is dependent on their funding. Also they must find me to be credible candidate.

I have no use in  my right hand and gradually the action in my wrist is diminishing too. One of the side effects of the chemotherapy affect the extremities and as I understand it, the toxins pool there. The bottom of my feet are bright red and painful but with the help of another woman in my metastatic support group at the cancer agency, I got ahead of it before any cracks or blistering occurred. I soak my feet several times a day in lukewarm water and apply a special cream that my friend brought me. Unfortunately it has affected my left hand and I have painful cracks appearing under my nail beds.

These side effects are more annoying than anything else but they make me feel useless and everything takes twice as long. However as in most of you know, I am not one to give up and I am often as busy as I was before.

This second stressor of a major illness has created frustration for me and I do wonder what is next. I know that I am not always easy to live with and it is difficult for both of us. I need more help which is hard to ask for as I have always been independent, again something that most of you know about me. Dick is not captain of this ship, but for five years he has been in sole charge of our catamaran Van Kedisi, often for several months at a time. Now that he and the boat are home I think it is hard for him, especially as he would have preferred to live in our old house in Vancouver. To come home  to Victoria to a house that he did not choose has been very stressful for both of us. He keeps saying that this transition will take time and maybe years in fact but for me, I do not know if I will be around when he finally settles here.

Metastatic breast cancer is different than breast cancer where we can hear that we are NED or no evidence of disease. The best that those of us who have metastatic breast  cancer can hear is NEAD or no evidence of active disease.  I am not at that point and I do believe that I will live for many years.  However It would be easier to live with my cancer with both of us on the same team. On a positive note, I do feel that it is possible but it has been important for me to write this post even though it has gone through several iterations.

Below, I have added some photos of our wonderful family and friends. For the most part as you can see we had a wonderful summer. If I find a computer friend soon I will put the photos into a better scenario and also add names. Meanwhile, it is fall and fall is my favourite season. I wish you all a wonderful fall too.

Our son Steven and his partner Heidi.

Patti and Lyle with us on an overnighter on VK.

Our good buddy Suzanne on VK~~she crossed the Salish Sea with Dick at the end.

Honeymooners Kath/Alan and our daughter Mary and her partner David with me on Saturna Is.

Honeymooners with Dick on VK.

Our wonderful friends Fred and Shelley who I have known for 40 years!

A selfie with the most amazing farmer I know.

I  cannot say enough about the cats of our lives, Flobi and Jake.

Elaine and me~~so lucky to have her in my life.

Steven and Heidi with me.

With super sailors Jane and Russell who we have known since our kids were toddlers.

Jana not long before twins June and Iona were born with old Saudi friends Marie and Dean.

Dean sailed the last leg on VK and Marie flew to meet the crew from Wisconsin.

She also sailed legs on VK.

Captain Dick on Saltspring Island 4 days after he made landfall in Victoria.

My wonderful yoga/hiking buddies from Vancouver. They came to Victoria for a 3 day reunion.

From left at the back~~Brenda, Wendy W and Wendy H.

Front row~~Claudette, Marian, Mary and Diane.

TRANSITION

This post was started several weeks ago but not completed.  I had just started writing again about the second major stressor in our lives when summer sailing with Dick again delayed it. Somehow I pushed the publish button without realizing it. When a friend emailed me yesterday about its contents I was surprised of course, especially because where it left off,  readers may have misunderstood. My apologies to any of you who read the unfinished blog post. I could have simply deleted it but feel that it is better completed.


Many blog posts have been written in my head since I last wrote. The past 14 months have been a period of transition. I like to think that I handle change well and so I expect others to do the same. Looking back, even before June of last year transition had begun. Before I explain this transition I want to talk about stress. We all know that there are some important events in life that create more stress than others.

The top five most stressful life events in no particular order include:

• Death of a loved one
• Divorce
• Moving
• Major illness or injury
• Job loss

There are other stressful events like marriage or the birth of a child but they are generally considered happy events. Most often, no matter which event we face, with time and/or personal or professional intervention, the stress may ease and in fact resolve.

For us, two of those five life events converged. Who knew back in January, 2017 when I bought our house in Victoria that cancer would reappear in my life soon after we moved? When I say "I" in buying the house rather than we is because Dick was in New Zealand having just crossed the Pacific Ocean from the Caribbean. We had been discussing a move to Victoria since the previous April and Dick had been gone for some months prior to that. Over those months I had not found the house that I thought would suit us but in early January the stars aligned, at least for me and I found the house of my dreams. Looking back, even though Dick agreed via Skype that we could buy the house, his heart was really not in it. Soon after the purchase and well before our move I spent two months in New Zealand with Dick. Near the end of that time the discussion of bringing Van Kedisi home came up. For me, the purchase of the house and the idea that our boat which have been like a family cottage for many years in Turkey would be in British Columbia made me feel the happiest I had felt in a very long time.

Little was I to know that this happiness would be fleeting especially for Dick. It took time for our Vancouver house to sell and that added stress. Yes, another facet of one of those most stressful life events~~moving. But eventually the house did sell. I had never loved that house and for most of our children's lives we did not live in it because we were in Indonesia or Saudi Arabia. However on our return from Saudi Arabia Dick invested hundreds of hours of renovations in it and did a great job. Over those years though I thought that we both had agreed that the work done was cheap and cheerful and that in five years or so we would move. Unfortunately neither of us really understood what we had said and it turns out that Dick's preference would have been to have live there for ever and die in fact in the house  just as Walter next door did. How can two people have been together for decades get it so wrong? And who is to blame?

For those of you who have been following my breast-cancer blog you maybe wondering why I am talking about the sale of our home in Vancouver and our move to Victoria. We now come to the second major life stress~~cancer, and worse~~metastatic breast cancer inoperable and incurable. When I went to Nepal in late April 2017 to lead my last trek, I had no idea that cancer was growing but I knew that I was slower, older and it was time to stop leading treks, thus I called that trek my swan song. I am glad for that as it meant I ended my time working in the Himalaya with Razzu on my own rather than cancer forcing it.

Back to the stressful move. No one knew that a new tumour was insidiously growing~~possibly for as long ago as when the first cancer was detected. Since we did not know when buying our new house and selling the old one that I would find I had metastatic cancer, we'll never know if staying in Vancouver would have been a better option.

Once we had moved in late June of last year it was becoming evident that something was wrong. Surgery had been done to remove my implants and I had hoped the growing pain in my right arm and hand would disappear at the same time. This is old news yes but it fits in with the second stressor, which fits under "major illness or injury." As the summer dragged on, my husband was unhappy and uncommunicative and there was nothing I nor anyone else could do to alleviate his pain. I went back and forth to Vancouver for tests yet we barely talked about the possibility of cancer reappearing. It was a very difficult and lonely time for both of us. When the diagnosis came in late August we were already burdened with such high levels of stress that I am sometimes surprised that we were able to continue on. Looking back, I believe that all the work we had put into our relationship in the preceding few years of living with cancer made the difference. It was not as though a light went on and we went from unhappiness to happiness but we did carry on with the plans that we had made for Dick to return to New Zealand to bring the boat home.

Here, this post ends and the next one will begin with the return of Dick and crew along with yet more difficult news. However,  I am happy to say that enduring more cancer and a move has not brought us down and we are well on the way up, readying ourselves for the next chapter of our lives.