Tuesday, 5 January 2010

Day Two is pretty much over and I still feel fine. Both of my hopes from
yesterday came to fruition with a lovely clear, albeit frosty, morning
AND FedEx delivering my blood to NIH on time. It was a slow walk up to
the hospital for no other reason that my better half is now 7 months
pregnant. The distance is not great but we had to leave home with enough
time for a slow waddle to the other side of town.

Once there the process was simple: a jab into each arm and the deed was
done. Both arms ached for ten minutes or so after the injections but it soon subsided and after a coffee we meandered back home. Encamped on the sofa in the warm I sketched out my drug timetable to keep track of the variety of pills I now need to pop each day. With my immune system set to take a serious dip in a day or two I need to medically kill off any possible infections lest I end up in A&E.

Currently in my 'bag of meds' I have:

Aciclovir - A general anti-viral drug aimed at cold sores, shingles,
chickenpox, Bell's palsy, and a lovely collection of various types of
herpes. Any of which I could certainly do without. One pill to be taken
at regular intervals four times a day, every day.

Cotrimoxazone - A general anti-biotic aimed at Listeria, Traveller's
Diarrhea, and load of things I've never heard of ending in '...osis'.
One to be taken three times a day although only on Monday's, Wednesdays,
and Fridays. Never before have I ever had a pill that only works
part-time.

Domperidone - Sounding a lot like a top end champagne it is nowhere near
as enjoyable. It is an anti-nausea pill two of which can be taken up to three
times a day that ironically tastes absolutely foul. Nauseating in fact.

I'm holding off on the Domperidone until sickness sets in rather than
take a drug I do not need; I think there's enough of a chemistry set
rattling around in me for now.

The only other thing I need to take is water and lots of it. Whilst my
liver is working overtime to break down the cocktail of drugs I'm
ingesting, my kidneys need as much help as possible to flush out the
Hairy Cells that will soon be dying off, hopefully in great numbers. To
offer some assistance I need to drink, I'm told, six pints of water per
day.

This I am managing but I think I am beginning to slosh when I walk. I
have never been quite so hydrated or had to visit the loo quite so
regularly. If frequent peeing is all I have to contend with throughout
this treatment then frankly I'll have got off quite lightly.

Monday, 4 January 2010

Day one and as the rest of the world headed back to work we battled through the frost and headed up to the hospital. Just before Christmas a great deal of effort had been put in by many to get samples of my blood to the National Institute of Health in Maryland, USA. Everyone at my hospital put time aside in their busy days to do their bit and the tubes were filled and packed off on their way to an expectant team at NIH. Somewhat annoyingly Federal Express managed to make a complete hash of the ‘next day’ delivery so by the time the tubes finally arrived at their destination the samples were useless and by then we were into Christmas.

With the multitude of Bank Holidays that we’ve had of late today was the last, eleventh hour, opportunity to get a replacement set of blood taken and shipped so first on the agenda was a good deal of bloodletting followed by a tense and nervous wait in the coffee shop at the main entrance waiting for the FedEx van to arrive.

It was always going to be something of an odd day but it’s strange that my biggest concern was whether or not FedEx would manage to achieve the simple task of putting a box on a van, then a plane, then a van. Much to our surprise they accomplished the first step in a timely manner; tomorrow will tell whether they managed the rest.

Having dispatched some of my blood on its international adventure, the time came to treat the rest of it to something else quite new. Given the severity of my disease and its treatment at a cellular level the process of chemotherapy was oddly painless and without fuss. Cladribine used to be delivered into the body via a drip taking a few hours every day for seven days, medical science has moved on and the drug is now introduced to the body in simple subcutaneous injections over 5 days. Not unlike getting a flu jab: tiny needle; over in seconds.

Each day’s dose is split over two injections, in my case one into each arm although apparently abdomen was also an option. After a little consideration I couldn’t see any real advantage in the latter, and passed on the opportunity to strip off in a room full of others already with enough ills of their own.

And so it was, two small jabs and the job was done for the day. Resting up on the sofa thus far I feel fine, this is however only Day One. I’m advised that day’s seven to fourteen hold the potential to be the worst. One day at a time though.

For tomorrow I have only two hopes: One that it’s a dry enough for the morning trip to the hospital to be on foot, the other is that a box of blood arrives in a timely manner on someone’s desk on the other side of the Atlantic.

Friday, 1 January 2010

A new year, a new decade. 2010 was welcomed in a sedate manner: the two of us clinking glasses of water whilst watching the various firework displays being launched from neighboring gardens.

The week since Christmas has been a quiet affair, recovering from the excesses of food and drink consumed. The annual mid-winter feasting followed by the traditional detox, lots of fruit, vegetables and water this week as I try and ready myself for next week's events.

There is a heightened sense of nervousness in the house at the moment. Most days come and go quite normally but nights pass in uneasy dreams. Although not working I still set an alarm so that I can make the most of each day. I may not do much but at least I am up; about; awake.

Time is spent readying the flat for the new arrival due in March. Work that I know I will not be able to do in January and whilst I hope to be back on my feet by February that short month will be over before we know it and suddenly a crying, kicking, poo factory will be wanting somewhere to sleep. The ‘baby stuff’ is already being put to good use, a sterilizing bucket sits in the kitchen with cutlery, mugs, etc. for me to use once I have no immune system and we’re readying the antibacterial wipes to attack door knobs, light switches, keyboards and mice.

Planning for and talking about the time post-Chemo is the only way to stop ones mind from dwelling on the worst of the possible outcomes. We’re in an emotional quicksand at the moment: to keep moving forward, looking at the future is the only way through. To stop and dwell on my plight will just cause us to sink, the going will be harder and the outcome less bright. Excitingly most sentences start with the phrase “Next time we do this there’ll be a little one with us!”

Christmas gifts of books and CD's have been readied in the lounge. A pile for me to work through whilst I rest up praying that tiredness and nausea is all I have to contend with. I’m grateful for the glut of classic films on at this time of year. Battle of the Bulge being the recent highlight whilst I cupped endless mugs of tea, rain lashing against the window outside. I’ve also compiled a collection of old Western’s to see me through the days when I cannot go out. A happy reminder of ice cold Sunday afternoons at my grandmothers house when I was growing up. No heating, huddled around a tiny fire, watching cowboys on the telly whilst we ate jam tarts.

I had my final pre-chemo consultation yesterday. It was a bitterly cold yet thoroughly refreshing walk up to the hospital and then the usual routine of bloodletting and people watching in the waiting room. A good book is essential as appointment times seem to have a natural drift to them and are dependent more on the backlog of bloods in the lab than the time you report for duty. My current treatise is the thoroughly relevant “Bad Science” by Ben Goldacre and I highly recommend it to anyone, Leukaemia sufferer or not.

11:30 is the time it will start, or thereabouts once forms have been filled in and, no doubt, more blood taken. I fully intend to continue this blog as the treatment progresses but it is highly likely, I am told, that I will be admitted to hospital at some point so do not take an apparent cessation of writing to mean the worse. It is more likely that I am either very tired or failing to get comfy in a hospital bed and unable to commit my thoughts to the world wide web.

Happy New Year all; it’s going to be an interesting one.

Thursday, 24 December 2009

The date has been set. After what seems like an eternity of waiting I now know when my Chemotherapy will start. Until now, whilst I knew what lay ahead, it always seemed so distant but every other landmark event that originally stood in the way has pretty much passed and only now have I started to fully comprehend the next step.

I have got well and truly into the swing of working from home and the initial shock of diagnosis is a distant memory. I’ve been eating well, taking my vitamins, avoiding sick people and although it’s been frustratingly dull at times it’s not an intolerable way to live; if needed I could certainly carry on this way.

Hairy Cell Leukaemia progresses slowly but cannot be left to go unchecked forever so having spent a few months in effective retreat it’s time to start walking the path back to the real world and it could be a rocky journey.

The Consultant dealing with my case is very positive about the outcome of my treatment; the handful of other sufferers I have found online are all doing well post-Chemo, some are in remission; and friends and family are being very supportive. I have my low moments but I know that I can make it. I know that I can beat this thing. That said I am not ashamed to admit that I’m more than a little scared about what is to come.

I have spent life in pretty good health and aside from surgery to correct a deviated septum a few years ago I have never spent any time in hospital. I have never broken anything; I have never been seriously ill. Personally I find that it is much easy to deal with difficult times in your life when you have already been through something similar whether it is overcoming physical pain, emotional trauma, or dealing with difficult situations but for this I have no basis for comparison. I haven’t had any form of rehearsal, and therein lies the fear.

It is a fear that needs to be acknowledged and dealt with though as I have no choice. There is no other way. I remember in an interview some years ago illusionist, endurance artist and general weirdo David Blaine described that he dealt with plunging himself into a tank of ice cold water as just being something he had to accept as the next step in his life no matter how painful or uncomfortable. That is, I think, the only way I can see myself getting through this from a mental standpoint: accept the inevitable; learn from the discomfort; and grow from the experience.

After all what doesn’t kill you, serves to make you stronger.

Monday, 21 December 2009

Unable to go out much, due to a combination of my ongoing Crowd Avoidance Scheme and thoroughly inclement weather, a lot of this year’s Christmas shopping has been done online. Packages have been arriving almost daily from Amazon, Play, and a whole host of other internet shopping outlets. All have been eagerly awaited by my wife who relishes in the process of wrapping presents almost as much as she does in opening them.

Today’s delivery isn’t much of a Christmas present but was one that I have been looking forward to and was beginning to get concerned that it would not arrive in time. The delivery contained 9 empty blood collection tubes and now it was here I had less than a day to fill the tubes and “return to sender”.

A research team at the National Institute of Health in Maryland are conducting research into current treatments for Hairy Cell Leukaemia with a view to increasing their effectiveness, extending remission times, and possibly taking steps toward curing the disease. For any medical research to be worthwhile the number of subjects studied needs to be as large as possible and this is clearly a bit of a bugger for those studying rare diseases whose subjects may be few and far between.

Having contacted the doctor running the study, forms were filled in and arrangements made for blood to be taken here that could then be tested there. Not an easy task as it has meant coordinating the availability of someone to take the blood in my local NHS hospital in sequence with the work of another Phlebotomist in the US who needs to do more tests two days later once Federal Express have shipped the tubes the five thousand, nine hundred and three miles between the two.

The first half of this mission has been successfully completed although not without undue trials in establishing just what paperwork you need for shipping your own blood around the world.

That and the mild sting in the arm induced by filling all nine tubes is all behind me now and I hope that, in the same way that a group of my colleagues’ blood donations a few months ago have helped people in my position start on the road to recovery, my relatively small donation today can help in the quest for me, and the handful of other sufferers around the world, to live completely normal lives.

Saturday, 12 December 2009

Days like today are perfect for brisk walks. Brisk walks being the only exercise I am allowed at the moment. My eagerness to go to the gym and build up my stamina ahead of my impending therapy was stifled by warnings from my Consultant that right now I’d be putting to much strain on a system barely coping with getting the right amount of oxygen around and if I were to trip and fall I’d risk rupturing my spleen and worsening my plight.

We’ve had a lot of rain of late so days like today are to be enjoyed. Cold crisp air, utterly fresh, blowing off the river. Walking arm in arm with my wife as we stroll along a line of trees casting their long winter shadows on the ground. The weak sun glinting through leafless branches as it arches low in the sky.

With each deep breath I feel the cold air fill my lungs and imagine it going further, coursing deep into my body. Whistling through my bones, whipping up small tornados in isolated capillaries. Blowing all the hairy cells along in its path like autumn leaves being pushed along the ground and as I exhale all the hairy cells are conjured into a spinning cyclone in my core turning to dust as they pass my lips into the glare of the sun.

This is a particularly beautiful route to walk at any time of the year but particularly now, when it’s dry, I make a point of getting out. Not that I’ve needed any excuse to get out over the last few days. On Thursday, the weather similar to today, my Mum and I walked up to the hospital for my three weekly check up.

My blood counts are steady, still no increase in the white ones and my recent transfusion has given my red cells a much a needed boost. All being well that will be the last transfusion I need for a long time. Not that I mind them, I have a lot of other reading I could do with catching up on, but I just long to be normal.

On Friday I had a proper day off from work but the lay in I had hoped for was not to be. Once again I was of up to the hospital but this time with my wife and the bump. It was time for her to be the centre of attention and it’s a baton I am happy to hand over. All is well, the baby is growing as she should and once again we got to listen to her heartbeat. That’s actually what we call her, “Heartbeat” as on the very first scan, after only two weeks, that was all there was to see. Faintly beating in a gulf of space.

Feeling I’d seen the best part of the maternity visit I left my wife to watch the doctor repeatedly fail to log into his computer - it didn’t have to take two of us - whilst I walked to the other side of town for another medical pit stop: my second Swine Flu jab. Delivered with such efficiency I didn’t even get to sit down and was actually leaving the surgery ten minutes before the start of my appointment.

It’s now just less than a month before I am likely to start my treatment. I have my next hospital appointment on New Years Eve and, barring any upturn in the swine flu figures, the order will be placed for my Cladrabine. The drug that I’m hoping will whisk through my body, searching every nook and cranny where the hairy cells hide and on finding them shine so cold and bright that they all turn to dust.

Friday, 4 December 2009

Last week I had another blood transfusion and aside from a break to listen to Jacqueline du Pre’s incredible 1965 performance of Elgar’s Cello Concerto I spent the entire six hours of the process reading a book on Business Continuity Planning.

Whilst to most, if not all, I’m sure this sounds like one of the dullest ways to spend any time at all I’d argue that it is simply a matter of making the best use of all time available. With no access to phones or the internet I see the blood transfusion room as a pleasant sanctuary away from the world rather than a restrictive cage. This doesn’t mean though that I can’t engage in valuable employment. The book in question has been sitting on my desk for months and whilst I have had every intention to read it other work just always seems to get in the way. Eventually though even those tasks on the back burner need to be dealt with one way or another.

Engulfing myself in how and what a business can do protect itself from all manner of disasters that may befall it I was stuck with a number of parallels between the hypothetical business scenarios I was reading and my very own very real state of affairs.

Business Continuity Planning, and those reading this whom I work with are going to hear this phrase a lot in the coming months, is all about preparing an organisation so that if disaster strikes, in one form or another, everyone knows what to do and the business can continue to function and ultimately continue to make money. Most companies without such a plan in place simply crumble in the months following the disaster after all involved have either run around like headless chickens for a few weeks until they ran out of money or simply abandoned the venture completely.

I’m not suggesting that anyone prepare and document ahead of time a set of plans to follow should a crisis erupt in their lives. To do so would be a waste of time best spent doing pretty much anything else you can think of. The connecting theme here is that of an absolute need for continuity in the face of disaster whether it happens in business or our personal lives.

If you’ve just come to this blog having been very recently diagnosed then I know how you feel. Your life, however old or young you are, has just crumbled around you and you simply cannot see a future. You are absolutely desperate for none of this to be true; casting your mind back to find a way you may have changed this and looking forward to moments you’re dreamt about but now fear you may never actually see.

What is important now is finding continuity, making a plan. The past is unchangeable; from it you should take only lessons and leave all regrets. There is a future. But it is a future that may require change and adaptation, possibly only for the short term, but you do need to continue, you cannot lose focus, you cannot give up. Ignore the resources you can no longer use or the things you can no longer do. Develop, enhance, and embrace that which you can do and those who you can depend on. Work towards a new future, but importantly, find enjoyment and positivity in what is happening in the now. Every day alive should be spent living, truly living.

An old friend of mine who is suffering from Chronic Kidney Disease said to me recently that “Life is everything” and for me that really rang true. You cannot let disease or disaster mar your passions or the ability to delight in the simple things in life.

Business need not end with disaster and living need not end with diagnosis. Both can continue.

Thursday, 19 November 2009

A glass of red wine. To celebrate.

It won’t cure me but it will help mark a small success of sorts. This afternoon saw another blood letting session followed by a rundown of the results with my Consultant. Work has occupied my mind over the past weeks but yesterday evening I was noticeably anxious. It’s not that there is anything to fear. There’s no pain; no discomfort. But in getting on with life sometimes I forget where I am.

Often normality begins to seep into my extraordinary world. I forget. A hospital day is a reminder of how things are and what my reality is.

Three weeks ago, at the last meeting, my red blood cells and haemoglobin had stayed steady but my whites were on the increase. Were the increase to continue its possible that my chemotherapy would have been brought forward as such I’ve been marking time this week wondering if the run up to Christmas was going to be very different this year.

After a while in the waiting room, catching up on last month’s issue of The Word, the results were in. The meeting was quick and to the point and pretty much standard procedure. I report on me, then I get a report on my blood.

For me I still feel fine, if I hadn’t been to the doctor a few months ago I still may not know. My temperature is level. No fever, rashes, infections. I haven’t had a night sweat since the week I had my transfusion. The only telling sign of my disorder is that my spleen aches if I eat to much, squeezed against my ribs by my stomach, but its like a dull stitch. In an ordinary world I would have put it down to a pulled muscle from sitting awkwardly all day rather than that second (possible third) helping of dinner I just couldn’t resist. My appetite has certainly NOT been affected.

And so to the bloods. My red cells are holding steady, not giving up space to those hairy bastards. The hairies themselves are also holding level. This is very good news. The only count that’s down is my haemoglobin, it’s job is to bind oxygen to the red cells and dish it out as they float around my body.

So I’m definitely not getting some pre-Christmas chemo. What I am going to get is another blood transfusion. Time to top up the iPod ahead of next week. By rights I should be flying to Latvia to close off a project I’ve been working on all year but instead of taking that flight I’ll spend the day sitting in a chair staring out over a Day Ward. It will be less stressful though and it’s an excuse to get out but sometimes I miss being part of the action. Being normal.

Maybe my morning dose of beetroot juice is doing something, or maybe its the meditation, maybe its none of these or both of them combined. Whatever the reason my hairy cells have ceased the expansion of their empire for now and thats the best I can hope for at the moment so I’m enjoying a glass of red wine to celebrate. No matter what you think you’ve read though it really isn’t a cure.

Saturday, 14 November 2009

Even though I'm working from home everyday I still make the effort to get out.

As I look out of the window now rain is traveling horizontally and any birds that abandon the precariously waving branches of a tree are blown sideways in a manner that suggests they're not entirely in control of their final destination. Yet in spite of the current inclement weather I take a daily walk along a stretch of the River Thames near my home.

It's a beautiful walk, ever changing with the seasons, thoroughly refreshing for mind and body but even though I go out every day I very rarely interact with people. In the centre of town earlier this week I gazed through the large open entrance of HMV and saw the people inside not as fellow music lovers, buying the latest album from this week's favorite popstrel or trying in vain to find a fifth qualifying disc they actually want to complete the 5 for £25 offer, but as a throng of possible infecters. A seething mass of people potentially carrying all sorts of viruses and infections. I was genuinely concerned and heart pounding chose not to go in. Instead I passed through town, across the market square and got back home. Wherein I ordered an old Willie Mitchell CD online.

When I do go out and meet people invariably they all want to stick needles in me. Most of the time they want to take something out, blood or bone marrow, but today there was a change in the procedure because they wanted to put something in.

My treatment has been delayed due to the possible Swine Flu Epidemic that may or may not come to full blown, apocalyptic fruition. Much like the Millennium Bug there is a lot of fuss but it may not come to much; many may posthumously miss the point in wondering what all the panic was about when nothing actually happened. Failing to realise that the reason it didn't happen was because of all the furore, media attention and hard work by those best placed to stop it.

For Swine Flu the fuss is in the form of a media campaign telling us how to blow our noses properly and how often to wash our hands. Two actions you'd expect civilized society to already be doing. A third assault on the impending epidemic is vaccination. Targeted currently at the elderly, pregnant women, and certain other “at risk” groups.

At the age of 35 I never expected to find myself in an at risk group for anything.

Although relatively untested on humans I have no reservations about having the jab. It is likely that with a very low count of proper white blood cells I won’t build up an immunity to the virus but certainly I see no harm in it; some possible protection is better than none at all. The real key to protecting me from the virus both before and after treatment is to vaccinate those around me. My parents are going to have it, my brother is trying to have it, and my wife has also had it. It is her having it that has been the real quandary in all of this because she is pregnant.

There is an immense national, and possibly international, fear surrounding the subject of vaccines and babies, be they toddling around or still waiting to come out. The foundation for most of this fear is the link to MMR vaccination and autism. A link that is now known to be a complete fabrication by a single, financially motivated, doctor but that was so widely publicised it still causes knee jerk reactions when the subject of child vaccination is raised and continues to fuel web based conspiracy theories ready to be lapped up by those that want to find them.

Putting the MMR “scandal” aside there is a genuine base for concern over giving the flu jab to pregnant women but the only basis for that concern is that it is new and relatively untested. It is uncertainty that is at the forefront here, not proof or rumour of possible damage.

It has been routine in America for some time but pregnant women have only been given the 'normal' flu jab in the UK since 2008. That was started however because studies showed actual benefits to the health of the mother during pregnancy and of the baby following birth. The delivery mechanism for the Swine Flu vaccine is the same for this established, non-controversial jab. The only fractional difference is what is inside; it is a different strain of the virus and therein lies the unknown. To my mind however, the risks are small.

It may be that in five years time it is revealed that all mothers given the vaccine are all starting to shrink to microscopic sizes, or that their children will all turn blue when they reach puberty. Who knows!

It is important in all aspects to have an eye on the future, to plan for what might be or guard against possible threats but in all things we need to focus more on The Now. Life is not perfect - if it were I would not have Leukaemia - life is full of risks and sometimes if you don’t take those risks then a greater gamble lies in the future you are protecting against never actually happening.

Today we have taken a small risk with the future health of our child, a step into the unknown, but we have done so to ensure that we all make it to that future. With one immune system reduced due to pregnancy and one that is about to be wiped out by chemotherapy, Swine Flu is far more likely to kill one or both of us than the vaccine having a detrimental effect to our unborn child. It is a move that was not taken lightly but one that gives a far greater chance to all three of us being their to enjoy her thirteenth birthday. Even if she does turn blue.

Saturday, 7 November 2009

One month.

Has it really only been one month since I was diagnosed?

To me it seems like I have been living with this for years, life without it seems to be less a memory and more a hope of what, one day, could be. The month has been an emotional roller coaster that I could not possibly have imagined and that I find difficult to fully describe.

Things are settling now though. A new routine has evolved to adapt to new circumstances. And although much is still the same, a lot has changed.

My daily drive to work has been replaced by just under an hour of meditative breathing. There is scientific research and anecdotal evidence suggesting a highly oxygenated body is far better placed to fight off cancer than one that is not. Whether this applies equally well to treatment as well as prevention I am still not sure but physiological effects aside the mental effects are just as important. Taking the time to meditate on my condition and summon a determined resolve to fight it is a supremely energising experience.

I used to make occasional efforts to meditate and to improve my breathing as an avid diver and snorkeller eager to extend the time spent at the bottom with the fish rather than on the surface splashing around, but I never did it seriously or consistantly. The renewed energy I find from meditating I owe simply to a very good friend. One who, having survived cancer herself, runs a yoga and pain managment retreat on the south coast and who, on visiting London last week, filled me with so much of her inate energy and drive, left me absolutely believing in my ability to beat this thing for the long term. For that visit I am deeply thankful.

A sandwich at my desk or a hastily grabbed hotdog from the 'snack wagon' that services our office has been replaced by a thoroughly healthy salad that is absolutely divine. Not unlike finding time to meditate this too was an occasional indulgence I'd treat myself to in my former life. My previous job would often find me lunching somewhere in the narrow, winding, and often still cobbled roads of London's West End. At the top of Carnaby Street there is a cafe come restaurant called Leon that serves the most amazing food. It's not cheap, but given that the food is organic and fresh the difference between one of their offerings and a prepacked, mass produced sandwich from the "Pret" over the road is a price worth paying.

I used to occasionally indulge myself in what they sold as a "Super Food Salad". It's no exaggeration to say that having one for lunch gets you zinging all afternoon; no coffee required. The recipe can be found in a book released under the Leon name a year or so ago and now I make one of these every single day. Only now its not costing me six quid a pop!

For anyone battling with any form of cancer I can highly recommend it. From what I have read so far on cancer and nutrition, and there is still a lot to wade through, the ingredients in this little beauty are all top hitters in the fight you have on your hands. I'd publish the recipe here but that simply wouldn't be legal. Go out and buy the book. The purchase price is worth that one page alone.

Lunch is also now followed by a good walk, in fresh air.

I have a new chair. Until this month working from home was an occasional flirtation with solitude born out of a periodic requirement to get my head around something without the distractions of an office. These sporadic dalliances were usually carried out with my laptop on the dining room table; or perched on a cheap Ikea stool in our study. An environment more suited to an hour of emailing or processing photographs than a full day of work.

Restlessness is inevitable and it soon became clear once my treatment was delayed that I was going to need something decent to sit on if I didn't want to lose entire days to getting up and making tea simply because I was fidgeting.

A colleague in our New York office - his apartment - was very keen, and quite correct, in stressing the need for a good office chair if you're going to be working from home and I am inclined to agree. I reasoned that if nothing else good came from my diagnosis it would be an opportunity to own a chair I have often coveted but never found the justification to own. It sounds a strange idea, and whilst I am not one to indulge in 21st Century Man's desire to own and consume every 'shiny toy' going, I do enjoy the delights of a damn good design.

If you work from home, cancer sufferer or not, get a good chair. And whilst you're on the hunt for the one that suits you sit, sit for a long time and savour, an Aeron made by Herman Miller. Your partner or bank manager may not thank you. But your back certainly will.

It has then been a month of massive shock and of subtle changes. I have learned a lot about the strength within myself and those around me. I have renewed cause to evaluate my views on life. It has been a month wherein I have experienced incredible sadness and absolute depression but where I have decided the only chance I have of beating this disease in the short and long term is to enjoy every second I have left. Relishing more than ever the simple pleasures of daily life, the family I have around me, and the true friends I have around the world.

I am positive that my treatment will be a success but even so this period of my life is very much the end of an old way and the beginning of something very new.