Thankyou for the donations

Enormous thanks to everyone for your donations made in Dad's memory. We have now been told that the total amount donated was £1150, which went to The Heart of Kent Hospice and Macmillan Cancer Support. A bit even managed to go to an Australian cancer charity. So, thank you everybody, you have all been really generous.

Goodbye Dad

Mum, my brother and i were all sitting with Dad tonight when he quietly took his last breath and left us forever. He was calm and peaceful in life and he was in his death. He did not seem to suffer, but simply slipped away from us and out of reach. I saw a tiny flash of Dad yesterday when he seemed to respond to me speaking about his childhood dog, but i saw none today. It is better for him that his illness is over. If he was in any distress or any pain that we could not recognise then he is not now. I wish i could have done more; I would have given anything to save him, but although i loved him dearly i could not make him stay.

A day of visitors but few words

Mum's cantankerous old cat excelled herself this morning by vomiting all over the lounge moments ahead of visitors arriving. She has been in disgrace all day since. Dad has been almost mute today. These visitors were a work friend of Dad's and his wife and although Dad communicated with hand-grabs, looks and eyebrows he didn't actually say a word. As soon as they left i said to Dad "It was nice to see them again wasn't it Dad?" Of course, it was at that point that Dad spoke and said "Yes". The Macmillan nurse came during the afternoon and couldn't really evaluate the effectiveness of the patch we put on Dad yesterday. She said it was better to reconsider the dose when we replace the patch (which will be Thursday) so we have seen it at its most effective. We are continuing with the oramorph too. I asked her if Dad is in the sort of condition that she would expect at this stage from her experience of melanoma (and other cancer) patients and she said he is. Dad's head is still fixed looking to the left. He doesn't seem in pain when he is still but when the nurses move him to wash him and change his pyjamas he makes such a face it looks like he is in agony. I find it really hard to see him like that, but the Macmillan nurse said not to worry that he is in a lot of pain as it is quite likely also an expression of displeasure at being moved around and messed with. He has never been a very touchy-feely person, so although that makes sense, it still worries us. He only does it when his head and neck are moved and the only other thing he said today was "Ouch!" when moved by the nurses in the evening, so i hope the full strength of the patch comes into effect soon. Partly because of the position of Dad's head and partly because he cannot understand verbal directions anymore we are now feeding Dad liquids only and through a plastic syringe. We have been told we can continue like this as long as he can reliably swallow, which he still can. Once he can no longer swallow a line can be hooked up to give him medicine and fluids.

Piccadilly Circus comes to Ightham

Today has been extremely busy. The head continuing care nurse came early this morning to assess what sort of care Dad needed from her team. While she was here the bed arrived and was erected. Mum and i played with it to test which button did what so we wouldn't end up folding Dad in half once he was in it... The Macmillan cancer nurse came at lunchtime and helped us walk Dad downstairs. He needed a lot of support as he is very weak and wobbly on his feet but we made it. He opted to get into the bed straight away and reports it to be very comfortable. He is clearly happy to be reunited with Sky television; he watched a combination of BBC and Sky news for 4 hours this afternoon. He even waved Mum to one side when she stood in his view at one point. Then we had a pair of continuing care nurses turn up earlier this evening to give Dad a wash and help him brush his teeth. Mum also managed to pop out to the surgery to ask the doctor to prescribe Dad's medication in liquid form, as he is now struggling to take pills. In between all of this i have dived in and out of my work email. We are all wiped out now, even the cat, not that she did much. Mum did lock her in the garage for a few hours earlier though, who knows what she got up to in there.
Tomorrow we expect Dad's brother, sister-in-law and Dad's mother aka Grandma. It is much better he is downstairs now as he can be involved in everything with everyone. Mum and i have taken a few of our lunches upstairs this weekend to eat with Dad in the bedroom, but we can't do that with three visitors.

Another Doctor

Dad has declined notably over the past week, even with an increased dose of steroids and now morphine. The days when he does not get out of bed are slowly starting to outnumber the days that he does. His appetite has vanished too and Mum has resorted to buying Dad's favourite biscuits, cakes and treats in order to tempt him to eat anything at all. This change in him provoked the Macmillan nurse to bring a doctor with her when she visited today. (Dad's specialist is on holiday this week and she wanted a doctor's opinion.) In evaluating Dad, the doctor asked Dad a few questions, most of which Dad gave complicated non-sensical answers to. Mum had been worried it might have been the effect of the morphine, but unfortunately the doctor confirmed this was due to the progress of the disease. I hate him being so muddled. It seems impossible that it is really him. I wait for him to tell me he is pulling my leg, an assurance that never comes. The doctor recommended we increase the dose of morphine to eliminate Dad's headaches. He also suggested the radiotherapy scheduled to start tomorrow may bring Dad discomfort outweighing the possible (but not guaranteed) benefits. So Mum is going to call the specialist tomorrow to see what he advises. Dad has some old friends coming to visit tomorrow, who he is looking forward to seeing. Will he or won't he get out of bed for them i wonder?

Heroic Mum

Dad is getting a lot of attention these days. He has always been a person happy in his own company, gardening, golfing or reading the paper, so i think is a bit overwhelmed by it all. He had breakfast in bed this morning, then I trimmed his toenails (how, when your body is battling cancer, do they still grow?) and my brother and i shaved Dad while he was sitting in bed. I helped him to the shower and to get dressed. He took a very long time to eat lunch and because he is so slow to do things we are all tempted to say encouraging things. I think we must be careful not to overdo it though as he gets irritated. He snapped at Mum earlier and it broke my heart to see it made her tearful. She is doing everything for Dad these days and trying to cope with how she feels about it all at the same time. I have a few days at work each week, but she has no escape from this. Dad is not ungrateful. He knows we are all trying to help. It is the disease's affect on his brain which makes him speak his mind more than he would normally (one of his brain metastases is in the frontal lobe of his brain, the area responsible for your personality) Mum is intelligent. She knows this but is struggling to not feel emotional in the face of Dad's snappiness. A friend told me that she doesn't know how i cope with Dad's situation. I don't know how Mum does.

Cancer is a bastard

A year ago today a dear friend of mine died after a long and courageous struggle against bone cancer. He was 36. He was an amazing character, optimistic, fun-loving and clever. Everyone who met him loved him and he is sorely missed. Another friend and i went to visit him in hospital in Marseille about 10 days before he died. Today, incredulous that a year had already passed, we raised a glass to his memory.
Dad lost an old friend to cancer last year and Mum too. All of our friends struggled on for a while against this horrible disease and our experiences of being aware of the situation and wanting to know how things were going, but without intruding, are part of what made me want to write this blog.

The Doctor will see you now

I find Dad's oncologist factual but not very forthcoming with information. I suppose I should not be surprised since melanoma is notoriously unpredictable. Having said that though he gracefully suffers Mum’s & my endless questions and we are grateful that he treats us intelligently and sensitively. At Dad’s most recent appointment on 1^st October Dr seemed happy with Dad’s progress after completion of his radiotherapy. He wants Dad weaned off the steroids on account of muscle-wastage concerns, since Dad is quite thin now. For the first time in a long time though, he expressed interest in the metastasis in Dad’s left armpit. Dad will have another full body scan in a fortnight and then they will make a decision on whether to operate or treat with radiotherapy or chemotherapy. Left to its own devices this metastasis would continue to grow and could become uncomfortable and painful. There is also a point at which it becomes too large to remove safely as well as a point at which, if Dad’s health deteriorated, surgery would not be safe (we understand this is due to the effect of anaesthetics on a poorly brain) To us this indicates that Dad’s brain is considered probably to be ‘well’ enough for surgery, as well as, more reassuringly for us, not anticipating anything scary happening suddenly. Mum and I were buoyed up initially by the brain metastases not being the priority for the first time in ages, although we are realistic and understand that may simply mean that everything possible has been done to curb the growth and effect of the brain metastases. We will see Dr again in three weeks; no doubt he is already looking forward to our next interrogation.

Events so far

In June Dad occasionally felt unwell, but didn't think enough of it to tell us. Then in early July he started to feel regularly nauseous. This became daily and he was occasionally productive, although he ate very little and had started to develop increasingly nasty headaches. A routine scan (he has had regular scans since his original diagnosis) found a new metastasis in his left armpit, but no explanation was given for the nausea or headaches. Four weeks later, in early August, Dad was very confused and had symptoms of CNS damage. He needed coaxing out of bed and help doing basic things like shaving and shoelaces. At this stage he was unrecognisable from his old self and although he was physically in the room with us, the real him was miles away. We were all very alarmed and scared, but tried to keep as normal as possible for Dad. Then on the 17th August Dad had a scan of his head. This confirmed that his melanoma (originally on his back, at his original diagnosis three years ago) had metastasised again, this time to his brain. Looking at the scan it was clear the metastases and the edema surrounding them took up over half of the space normally available to his brain. Dad was prescribed steroids and advised that once the steroids had reduced the pressure in his brain and it was safe to proceed, he would have a course of radiotherapy. The steroids had an amazing effect. Within days we saw clear improvements in Dad, some of his symptoms vanished completely and the nausea went away while his headaches gradually became less frequent and less severe. Basically, we got him back. He has now completed the radiotherapy and other than having lost some of his hair since treatment seems well. In himself, he is very positive and cheerful. I think he's amazing.

Why am i writing this blog?

Over the past few days I have decided to write a blog about my father & his melanoma. This may sound strange as it is my father afterall who has melanoma and not me. However, whilst enjoying email and online banking (!) my father has never properly embraced the online world, so the blogging is up to me! I have set-up this blog in order to keep family and friends informed of Dad’s progress. If strangers happen across it and find it interesting and it helps someone to guess what to expect in their own situation, then I am glad. If it encourages people to be more mindful of melanoma all the better. If you know Dad and want to leave comments please do. He looks at the blog occasionally and I will of course pass on messages.