Update: 22nd Feb

Needle-free Wednesday failure
Yesterday should have been my first needle-free Wednesday since I finished chemotherapy last week. However, as the day progressed, I grew more stiff and tired and developed a headache. During the afternoon, my temperature started to rise.

Nevertheless, we decided to go to the second meeting of our new Bible study group for 20-30 somethings at All Souls, which turned out to be an excellent decision. After having 7 people last week, this time we had 15! We're now thinking of starting a second group on Tuesday nights. This is very exciting and an answer to prayer as we seek to build a sub-community within the church in this previously under-represented demographic. We started a series on the passion narrative in Luke (very appropriate for Lent), in parallel with the sermons until Easter. The triumphal entry is such an interesting passage (Luke 19.28-40) - perhaps I'll post on it sometime soon on my main blog.

However, when we got home from the group, my temperature had breached the limits of the normal adult range. This, for a chemo patient, is potentially quite serious since the treatment reduces the body's ability to fight infections. An illness that might send a healthy person to bed for a day can be life-threatening if your white cell count is too low.

So we went to Emergency at RPAH and discovered that combining 'chemotherapy' and 'temperature' turns out to be one of those secret passwords that gets you lots of attention very quickly from the triage nurse. One of the 'benefits' of my condition is that I seem to jump lots of queues and have had less experience being forced to be patient than most patients.

As it turned out, my blood count was unexpectedly good so close to chemo treatment. Since they couldn't find the source of the fever, they decided to keep me under observation and hydrated (i.e. with a drip, requiring yet another needle and cannula, hence the failure of needle-free Wednesday). By morning, my fever had broken and by six this evening I was discharged. This is the first time I've needed to be admitted to hospital, which is a great blessing. I admire those who work there, as they can be very depressing places.

For now, the main task health-wise is continuing to rest and remain hydrated. The main task life-wise is still loving God and neighbour.

Update: 19th Feb

End of radiotherapy
Praise God - I have reached the end of this treatment cycle! I have just returned home from my final day of radiotherapy (#33) and last Wednesday received my 7th and final doses of chemotherapy. I am exhausted and in many ways at the lowest point I have reached physically, but remain filled with hope and feel great relief, since the next few weeks should involve gradual recovery. Since radiotherapy will continue to affect my body for the next couple of months, it will be many weeks before the effectiveness of this treatment cycle can be determined. I will have a full CT scan in a month (which will reveal how much of the growth remains) and then another full PET scan in about two months (which tests whether it is still active). We are praying that the growth will have entirely disappeared . However, it is more likely that a scarred area will still show up on the CT scan. If so, we're praying that it is no longer active.Side-effects
As for side-effects, the radiotherapy has really overtaken the chemotherapy in the last couple of weeks. Not only am I even weaker and more tired than ever, but recently it has become increasingly difficult to swallow due to radiation burns to my oesophagus. For the last week or so I have been limited to fluids (water, juices, thin soups, melted ice-cream (thank God for small mercies!), special dietary supplement drinks, yoghurt and the like) and even then require painkillers and an oral anaesthetic (which I gargle before meals) to get things down. It's not much fun. But this level of discomfort is only likely to continue for another week or two. I am now glad that I put on so much weight in December!

God is good
Each morning, Jessica and I wake up and remind each other "This is the day that the LORD has made", to which the other replies "Let us rejoice and be glad in it!" (Psalm 118.24). Despite not being able to do all that I once could (and might, God willing, one day be able to do again), life is good, very good. We are so blessed by the generosity and support of family, friends and strangers, by having a beautiful new church family at Leichhardt where God is clearly at work, by living in a country with a (largely) functioning medical system, and by having a sure hope that as we have died with Jesus to our old lives, so we will also rise like him when God makes all things new.

Work update
Jessica continues to enjoy her social research position at St Leonards and the occasional continued support she can offer to the EU Graduates Fund (where she was working for the last few years). Our time at All Souls, Leichhardt has started well. We have met many people, welcomed a number of newcomers even more recent than us and started a weekly small group for 20-30s. I have also preached twice (sermons can be downloaded here), led some services, done a little reading, begun planning a few outreach events in coming weeks and attempted to keep the church and many of you in my prayers.

Prayer
Speaking of prayer, here are some suggestions for those who pray.
Give thanks:

• For reaching the end of this treatment cycle and for its apparent effectiveness.
• For Jessica's thoughtful concern and love as primary carer. Also for the many others who give their time, energy, friendship, food and prayers in support.
• Because our Father is faithful, because Jesus' blood never fails, because the Spirit blows with the promise of a new age.

Pray:

• That the treatments will have been effective, that God will have used it to bring complete healing, that the test results will show only scarring and no active cancer anywhere in my body.
• For patience with eating difficulties and that I'll be able to maintain adequate nutrition despite limited options and little desire to eat. Also for patience and peace as we wait the next few weeks for results.
• For energy when I need it and the ability to rest at other times. For Jessica to also have good rest during this time of stress.
• For the new small group at All Souls, that it will be a place of life and peace, where we speak the truth in love to one another, welcome newcomers and care for those who are struggling.

Update: 14th Feb

Final Chemo
After waiting for three hours for blood results that usually take 30 minutes, we ended up back in the pack today rather than being one of the first. This made for a long day: 8 am start and just got home at 5.30 pm. But it's over - at least the chemo part (3 more days of radiotherapy). I've really enjoyed getting to know some of the nurses and their quirky sense of humour. Don't think I've overcome my needle squeamishness, even after so many (I lost count weeks ago).

Our oncologist was again positive today. Once all treatment is over, we'll wait a month and then I have a neck-to-toe CT scan. He said he would be surprised and disappointed if the news is bad, but since he's still unsure of the cause and nature of the growth, there are certainly no guarantees. After the CT scan, we wait another month and I have a PET scan to confirm there is no unusual growth activity (God willing). If that is also clear, then I'll keep having checks every 3-6 months for a few years before the all clear is given. If the growth is still active in a month or two, then the question of surgery will again be asked (which depends on how much it might have shrunk and in which directions. When I first presented, surgery was ruled out because the growth was inside my left bronchial tube and too close to my oesophagus and aorta). If the news is very bad (new growths), then that is a whole new ball game, probably involving a shift from curative to palliative treatment, but he said he'd be very surprised were that to be the case. We continue to trust God for the outcome, whatever it may be, though are very thankful for the positive indications we've been receiving so far.

As for side-effects, the radiotherapy has certainly overtaken the chemotherapy. The main issues now are still tiredness, but also swallowing and reflux. In particular, I am basically now on a fluid diet: soup and tasty dietary supplement drinks. Occasionally, I put in the effort to have something very soft, but it is quite painful, even using an oral anaesthetic (Xylocaine) that I gargle before some meals. The reflux is more a constant dull feeling of burning as the lower end of my oesophagus, weakened by the radiotherapy, fails to keep back the acids from my stomach. I take antiacids to reduce the effect, but it's particularly annoying at night and I still sleep propped up in bed (and with our bed propped up on some bricks) to get what help I can from gravity.

My second sermon on Sunday (on the two natures of Christ in the Apostles' Creed) was enjoyable to write, though due to tiredness, I ran out of time to cut it back as much as I would have liked. It can be downloaded here (or it will there soon, depends on the volunteer who manages the website). Here is a taste. Last night, we also started a new Bible study for 20s/30s and got off to a solid start.

Update: 8th Feb

Second Last Chemo
We can see the light at the end of the tunnel, at least for this cycle of treatment. After six weeks of chemotherapy, there is only one more to go (and about ten more weekdays of radiotherapy). Yesterday's treatment went smoothly. I had an earlier appointment than usual and so managed to beat some of the usual rush and be home by 2 pm. I also felt more able to concentrate and so managed to read with more concentration (that's some Kierkegaard photocopied on the table in front of me in one picture). I've included some images to give something of a feel for the space. The huge dose of steroids they give me to avoid another reaction did mean that when I woke in the middle of the night, my brain was very active and I spent an hour or two writing down ideas. Hopefully, I'll get better sleep tonight once the effects have worn off.

Update: 6th Feb

Tiredness
The main development in the last week or so is that I've been feeling more and more tired. This is partially the chemotherapy taking a lot of energy as my body destroys and replaces cells quickly, partially the cumulative effects of the radiotherapy as the weeks progress, and partially the effect of coming off steroids after being on them for the last six weeks or so. Also contributing has been a reduction in the quality (and quantity) of my sleep again; this time due to some back pain from lack of exercise and proper stretching. This is something I have experienced on and off over the last few years and is the result of poor posture and a largely sedentary lifestyle. No one to blame but myself! Though at the moment, I rarely feel like exercising or stretching.

Tiredness has been a significant part of why I still haven't finished the FAQ. Apologies, and I do still intend to get there before my treatment is over...

Keep praying that I would have energy when I need it and would be able to get good rest at other times.