As I write David Attenborough's documentary Life is on the TV. It is a veritable feast of unbelievably crisp and clear images (many in super close up or super slow motion) of insect life underscored by David's distinctive hushed tones. In telling their stories, David invites us into the often amazing life journey of creatures that we either no nothing of, never give a second thought to, or dismiss as irrelevant to (or even an annoyance in) our life journey. The butterfly's life is clearly not all flitting from flower to leaf to twig in a flutter of beauteous color in order to delight us humans. Life for the butterfly can also be surprising, challenging and a demonstration of strength and perseverance though ultimately fragile and beautiful. Perhaps there is more in common with humans than we might first think!

Today was a day of surprises in a week of challenges for us. We pray that we met the challenges with strength and perseverance whilst treasuring it for its beauty and fragility. In the last medical update we mentioned that Sue was to have a further CT Scan last Thursday and that management of her pain was still 'a work in progress'! On Tuesday morning we met with the Palliative Care Team again and further adjustments were made to medications with hope and (a measure of confidence) that things would improve pain-wise. They also recommended that we consider A week of radiation therapy for the sole purpose of pain relief. We then met with our Oncologist to discuss the results of the CT Scan, the increasing adverse impact on Sue of the chemotherapy, and the possibility of radiation therapy.

The CT Scan revealed that the primary abdominal tumor is increasing in size in spite of the chemotherapy. It is now 'about the size of a fist'. In addition to being connected to the stomach lining, it has infiltrated the abdominal wall and the musculature around the left ribs. It may also be connected to the outside of the colon. For good measure it is also putting pressure on the kidney. All these areas is replete with nerves so, in a classic piece of understatement, it was observed that "it is not surprising that you are experiencing high levels of pain". Good to have one's experience validated so completely!! Given this new information, and the escalating side effects, it was an easy decision to cease chemotherapy immediately (and permanently) so we did not proceed with the cycle scheduled for that day. It was actually a great relief.

We looked forward to an improvement in pain levels due to the changed medications (increased dosage of methadone and substitution of another opioid analgesic liquid, hydromorphone, for the oxycodone). Unfortunately his was not to be. In fact it proved to be a backward step that (we now believe) coincided with an increase in the severity of the pain. Things got so bad last night that we needed to call the Palliative Care after hours hotline. Further significant dosage increases overnight did not help.

This morning we had a scheduled consultation with a radiation oncologist. While we were at the Cancer Centre, the Palliative Care Team arrived to talk to us. They discussed various options and considerations but first wanted to rule out perforation leading to peritonitis (caused by leakage into the abdominal cavity). Next thing our surgeon arrived at the Centre to examine Sue and further review the CT Scans. Talk about feeling amazingly blessed and special. We sat in the one spot and had three sets of specialists come to us within two and a half hours and all without appointments or advance warning. This is akin to a miracle!!

The upshot of all this consultation was that Sue and I are spending a special intimate Easter Weekend away together at 'Club Hospice' at Royal Darwin Hospital. What a gift! We have a lovely large room with big windows looking out onto bushland. There is a private verandah, BBQ, in-room TV, an extensive DVD library, and includes all meals and free parking. How much would you expect to pay for this? $1000? $800? No, it is ABSOLUTELY FREE. Better still, you get $50 in vouchers for the local Coffee Club and all the drugs you want (well, Sue does!). This has got to be the deal of a lifetime. How lucky are we?!!

The doctors have 'started again from scratch' and are currently administering morphine subcutaneously (under the skin) by pump at a slow base rate, augmented by 'shots' as required. The idea is that by the end of the weekend they will have developed a regimen that provides acceptable relief on an ongoing basis, which will then be converted in to a selection of tablets or fluids that can be taken orally at home.

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Oh yes, I almost forgot...... radiation commences on Tuesday and will be repeated daily through to Friday. If all goes well this will shrink the tumor and reduce pressure on surrounding organs etc thus reducing pain levels further. It takes 1-2 weeks after administration to take effect though.

We pray that your Easter will be as blessed, relaxed and special as ours promises to be. 

Yours in the journey.......