Sunday, December 28, 2008

Cycle 5 underway

Cycle 5 on the 26th Dec. brought the usual array of symptoms, nothing unexpected, if not unwelcome.

I have received my appointment from the Stanford medical centre, Jan. 5, I am very grateful to get an appointment so soon, with any luck they can shed some light on why the mass is no longer shrinking.

I'll post the results, if any, of said appointment as soon as I can.

Until they, I hope you all had a Merry Christmas and here's hoping for a more prosperous new year for us all.

Wednesday, December 24, 2008

All quiet on the southern front!

Well, it's Christmas eve, or whatever you choose to call it. Yesterday I suffered the indignity of yet another colonoscopy, and I am happy to report that, other than early signs of diverticulosis I am all clear.

The diverticulosos, a bulge in the colon wall, is often caused by constipation, from which I have suffered as a result of the chemo therapy, all that straining and what not. Happily, most people are able to cope with this problem by maintaining a proper, high fiber, diet, so I am buying shares in Kellogs ---- the makers of All Bran.

Christmas day tomorrow, the girls are so excited, I am really looking forward to watching them unwrap their presents.

Chemo on boxing day so I will post again once I am felling better.

Tuesday, December 16, 2008

Stalled

Well, Nicky and I met with my oncologist today to review my latest PET scan. I wish I could tell you that I am in remission and that all is well but, as indicated by my climbing SED rate, things are not going as well as planned.

My mass has not responded to the last two cycles and is, in fact, the same size as it was two months ago, 9cm * 9cm. You may recall that after the first two cycles it had reduced significantly.

Dr. Kankipati is going to refer me to Stanford, a lymphoma center of excellence, to determine whether there is any need to adopt an alternative strategy.

I remain, in the main, optimistic that this is simply a bump on the road to recovery but one can not help but entertain some dark thoughts.

One thing I am resolved to do is to simply forget about this until after Christmas, I am determined that this will be the best Christmas ever for the girls and for Nicky.

Happy holidays to you all and a prosperous new year.

Tuesday, December 9, 2008

Cycle 4 complete

Had the last treatment of cycle 4 today, no problems other than the obvious.

Alice has saved Christmas by moving my next treatment from the 23rd to the 26 so at least we, that is I, will be able to enjoy Christmas dinner. I am however, having my colon scoped on the 23rd, so I may be sitting a little awkwardly.

I'll update as soon as I get some results from the PET.

Thursday, December 4, 2008

Big week next week

Tuesday marks the end of cycle 4, the following Friday I am having my bimonthly PET scan. We are hoping that it reveals that I am in remission which means two more cycles and then radiation. If there are any traces of the enemy then it will likely be another 4 cycles.

The girls are starting to get really excited about Christmas, I have to admit, I am dreading it. I have chemo two days prior which is going to impose a punishing Christmas day. All that wonderful (BRITISH) food and I am going to be sick as a dog.

My dad is arriving in two weeks so hopefully he will be able to keep the kids entertained while I feel sorry for myself.

I'll jot another note after chemo on Tuesday. Till then.

Tuesday, November 25, 2008

Cycle 4.

Cycle 4 has begun, with predictable results. Feeling a little under the weather but nothing I am not familiar with.

A couple of unknowns have come up:

1. My SED rate. which had dropped precipitously from the 90s to the 20s (Good), has risen into the 30s. There is no rationale for the climb and we will have to wait for my next PET scan in a couple of weeks to confirm that it is nothing ominous.

2. I have developed a pain in my chest when I take a deep breath, my excellent Doctor's and Nurses are monitoring this development so I am not unduly worried, I am taking Warfarin so I am somewhat insulated from pulmonary edema which if you recall the clot in my shoulder is something that could occur.

So a few clouds in an otherwise clear sky, nothing to worry about now, lets hope they blow away.

Tuesday, November 11, 2008

halfway

Today marks the halfway point in my planned chemo schedule. It's a pretty big milestone for me as I feel like the long tab up hill is now a gentle jog down the other side, still I wish my Bergen were lighter and I wasn't carrying the LAW, if you know what I mean?

Observed my minutes silence at 11, not quite the same, not being at the Cenotaph and all, but nonetheless 'We will remember them'.

Hope the Dukies had a smashing weekend and sank a pint or two for absent friends. As with every year, I am planning on attending next year.

FYI the Duke of Yorks Royal Military School is the high school I attended from 11-18 yrs of age. It's a boarding school so the friends I made there are firm friends that I will never forget. Once a year, around Remembrance Sunday, the old boys of the school return to participate in the remembrance parade and regret the amount of alcohol consumed the night before. It's a fantastic weekend that always leave me longing for simpler times.

Signing off now before I start rambling about how the Army was just an extension of boarding school .......

Thursday, November 6, 2008

Don't any of you bastages laugh

Went to see the surgeon concerning my butt lump.

The general consensus of opinion is that it is 'not' a tumor, but something called a fistula.

I know, I know, it sounds like I have been participating in jolly naughty botty pranks, but the reality is that it has probably been there since my clumsiness in Bosnia; my butt was pretty much peppered by the mine and the military doctors told me they could not get all the shrapnel out of my body, although it would probably work its way out eventually, I guess this piece has been stuck for some time.

The plan is to wait until my chemo is complete and then remove the lump in a minor surgical procedure, something else to look forward to.

Wednesday, October 29, 2008

But it's worth it

Started Cycle 3 today, the nausea is much worse this time, I think I might have fallen asleep for 1/2 hr watching TV, otherwise I have been hugging the great white telephone.

But it's worth it. The official word from my oncologist is that my main tumor is now 25% its original size and is DEAD; effectively we are just waiting for the remaining tissue to be broken down.

I still have an active spot in my left buttock which will be biopsied in the near future to determine what action, if any, we need to take. But from where we were to were we are, I couldn't be happier.

I will have another PET scan after cycle 4 (8 weeks from now) and if the cancer is completely gone, then I will have an additional 2 cycles and then radiation, if not, an additional 4 cycles will be required before the radiation. I would be happy with 6!

I am going to take a risk and try eating something to see if it settles my stomach so i'll sign off; robust though my Mac is, I am not sure the keyboard is vomit resistant.

Thursday, October 23, 2008

Great news

I have not spoken directly to the oncologist but Nicky had a brief conversation with her this morning. Regardless the news is excellent.

My main tumor has reduced in size by 75% and all signs of hyperactivity have ceased. This is fantastic. Of course I still have four cycles of chemo and four weeks of radiation to endure but it is the first piece of news that gives us hope for the future, and tremendous hope at that.

Nicky and I are taking her mum out to lunch to celebrate. I'll post specifics about the scan on Monday when I meet with the oncologist.

Ta Ta For Now (For the W3 challenged)

Monday, October 20, 2008

Big day tomorrow

I am scheduled to have a PET scan tomorrow at 8AM. By the end of the day I should have a fair idea as to how effective the treatment has been, at least thus far. Obviously, I am hoping for a significant reduction, if not elimination, of my primary tumor, but simply being in the know as to what is going on is somehow empowering.

Whatever the result, I'll let you all know soonest.

Saturday, October 18, 2008

Pulmonary function test

I had my pulmonary function test today, basically the B component of my ABVD chemo is lung toxic, so they are monitoring me for potential lung problems as the damage is permanent.

Great news, my lung function has actually improved, probably because of the steroids, but still, it is a relief to know that, at least thus far, I am not being permanently damaged by the treatment.

Wednesday, October 15, 2008

Cycle 2 complete

Had my 4th chemo treatment yesterday, cycle 2 is now complete 8 more treatments and I will be done with the chemo.

Can't sleep, it's the roids, and I feel particularly crap but that is to be expected.

My cumidin level have finally reached an acceptable level so my clot should start to dissipate soon.

Not much else to report, hopefully I will have a slightly better disposition, I'll post again by then.

Deep, apparently I am a bit of anomally. With Arythromiacin (sp) your hair is normally gone in three weeks, mine is thinning but still holding on, so maybe a refund is in order :-)

Thursday, October 9, 2008

A big shout out to Doug

Just wanted to give a big shout out to Doug, part of our extended family.

Doug and I went to the same school, both attended Sandhurst and both did our bit for Queen and country.

Doug has just been given the bad news that he has the big C. I know he has the mettle to stare it down and beat it into submission but I will be channeling some of the abundance of good will I have been receiving in his direction.

Our standing orders are still in place: Find, Fix, Destroy.

Feeding the honey monster

The honey monster, aka me, received a package today. It was from Honey Monster Foods, Teresa, a very good friend of ours, emailed them and told them of my plight. How awesome is that, I am now the proud owner of two boxes of sugar puffs which will be consumed immediately. Sugar puffs are to Honey Smacks what Cadburys is to hersheys, that is fantastic.

Give me the honey mummy.

Wednesday, October 8, 2008

Justin getting his chemo

Here's a quick snap of me getting my chemo, the lady in the background is Alice, she and Lilia are responsible for administering my chemo; they are both totally awesome. I often have small niggling questions for them, sometimes I am embarassed about asking questions that they might consider foolish but they both give each and every question a complete and considered answer; they are both heroes to me.

Tuesday, October 7, 2008

My own private chernobyl

Nicky and I met with my radiation oncologist today. Once my chemo is finished I will have a three week break before I start my radiation therapy. I will get a does of radiation 5 days a week for 4 weeks.

Although I understand it is absolutely necessary, I am more worried about the radiation than anything else. Even though the probability of lung and thyroid cancer as a result of the treatment is very low, I think it is the nature of it that scares me so much; I was really glad Nicky was with me, the insecurity I felt was similar to my first day at boarding school.

I'm sure I'll get used to the idea it's just not something I am looking forward to.

Like porridge

Apparently my blood is not thinning as effectively as they would like, my warafarin does has been upped to 10MG and the daily shots continue.

The clot is causing some discomfort in my shoulder that makes normal day to day activities quite painful, driving for instance. Vicodin is effective in addressing the pain but somewhat incapacitating.

Hopefully, the dosage will stabilize soon and the clot will dissipate.

British Airways has issued a voucher for future travel for the full amount of our tickets. It would have been nice to get the money back but at least we didn't loose it all. As to whether the voucher will cover the cost of flights, when and if we take them, depends on a multitude of economic factors, most of which I do not understand. It seems that most of the economic intelligentsia don't understand either so I am in good company.

Friday, October 3, 2008

A welcome visit

My team at Apple, that is the team I belong to, have just shipped version 2.2 of AppleTV; so I was very honoured that rather than celebrate the result of their hard work by taking some down time and having a few bevvies, three of them braved the somewhat arduous trek to Concord to visit me.

I can't tell you how much they lifted my spirits. I am sure I was not very good company, I tend to tire fairly quickly, but it was marvelous to see them and experience a little of the banter that makes working with them such a pleasure.

Thanks chaps.

Tuesday, September 30, 2008

blood is thicker than water

Sooooo, during chemo today my oncologist saw me rubbing my shoulder, it's been bothering me on and off for a week or so. Nicky and I had put it down to a trapped nerve and we were hoping simple massage would alleviate the symptom, my oncologist sent me to have my shoulder scan and I was immediately called back to the office.

It was like a bad drug ad, side effects of chemo may include nausea, vomiting, diarrhea, etc, etc, oh and AND DEEP VEIN THROMBOSIS.

I have a clot in my Axial vein (Shoulder->Limb). Blood thinners have been added to my regimen, shots for the next 6 days and warfarin until my treatment is complete. Its not quite what I was hoping for but what are you going to do. Oh yes, Nicky's and my idea of using massage to ease the pain, a complete no no, apparently it can cause the clot to break up and make its way to the lungs where it will do naughty things to me. So if Drs Henzie and Henzie ever give you advice do the opposite and you should be fine.

On a positive note, I sat next to a lady today who was having her final treatment, it was very motivating to see the end game.

later.

Monday, September 29, 2008

Cycle 2

Well, tomorrow sees the start of cycle 2. Once the cycle is complete, in addition to the PET scan, I will be meeting with a radiation specialist; I can't say I am very excited about said meeting, I was really hoping to avoid radiation therapy if at all possible, but the bulkiness of my mass is such that it will be required.

Starting to loose my hair, just a little at a time, but it is definitely starting to fall out; another month and I'll be fully Yul Brinner.

So far the chemo does not seem to have damaged my lungs or heart, I will undergo pulmonary function testing in about a month to confirm.

It really is amazing how toxic these drugs are. I remember seeing my mum, just before she died and thinking to myself that she had endured two years of pain and suffering for naught, but I never realized quite how unpleasant it must have been, there's nothing like first hand knowledge. Still my prognosis is so much better than my mums, I just hope I am bearing this illness half as bravely and selflessly as she bore hers.

I'll sign off now and update as soon as the unpleasantness has passed. I'll leave it to you to decide what the unpleasantness is:

A. Side effects of chemo.
B. Watching my already meager retirement account dwindle to nothing at all.
C. Watching Sarah Palin explain foreign policy in hockey mom analogies. (Oooh eer, political, sorry)

Thursday, September 25, 2008

Looks like it's going to be a good weekend

My latest blood test reveal continuing improvement in my white counts, no more drugs for the next couple of days.

I am still experiencing significant pain in my abdomen & chest, I'm not sure if its the neupogen or some sort of protest from the mass.

One more cycle, that's two sessions of chemo to the uninitiated, and I will be going in for a PET scan. I am looking forward to seeing what, if any changes have taken place. I am, of course, hoping that the mass is significantly diminished, but I will settle for any progress.

So, all things considered, I am ready for a pretty normal weekend, then back on the juice on Tuesday, YUM.

Tuesday, September 23, 2008

Neupogen is the racing hounds tackle

I went in for my post chemo blood tests today. My white counts have improved, week on week, by 6 points, apparently the neupogen is working really well. Likewise my hemoglobin is almost normal which is a phenomenal improvement.

There are consequences however, I am suffering from some fairly unpleasant bone and muscle pain. It's a side effect of the neupogen and a small price to pay.

Other than that I am feeling much better than last week, almost human again, another couple of days and I should be fighting fit and ready to take on the next treatment. It's funny, but the treatments seem to sneak up on you, you would think that 15 days between treatments would be a long time but they absolutely define my schedule with the intervening time somehow compressed.

Hopefully, Thursdays blood tests will be likewise positive and I might be able to enjoy some claret this weekend.

Tuesday, September 16, 2008

2 down

Last weekend was fantastic, I felt healthier than I have for about 6 months, maybe a little longer.

So I was quite cheerful when I went in for my second infusion of cytotoxic juice, aka chemo. While I was there, Nicky nicked off to have her hair done, she looks fabulous BTW; she referred to it as her 'appointment' because she felt it would be insensitive to say 'haircut' amongst a bunch of chemo patients loosing their hair. Made me chuckle.

The actual treatment went off without a hitch, but I have been brought back down to earth with a bump, and maybe a bounce or two. The after effects are compounded by the accumulation of junk and I have to admit that I am not up to much at the moment. I have all the right medications so it is totally manageable, and will probably pass in 3 or 4 days, but still, uurrrgh.

We have finally sorted out my disability pay and I should be getting my first check within the next couple of weeks, phew, I was beginning to wonder how I was going to pay the AppleTV bill.

We have yet to hear from BA regarding the refund of our flights, hopefully there will be some progress this week.

Right, I'm off to the couch to be waited on hand and foot.

NIIIIICCCCKKKKYYYYY, CHOCOLATE MILK, NOOOOOWWWW.

Thursday, September 11, 2008

Counts are up

My latest set of blood tests show both white and hemoglobin counts are climbing which is really good news; no meds for the next couple of days, hooray!

No news on the sed-rate, should get that result on Tuesday, all the signs suggest that it should be lower which would indicate that the treatment is working.

Aside from general weakness I am actually feeling pretty good, this weekend should be relatively normal, of course the next batch of chemo is scheduled for Tuesday next, so it wont last, but even so.

We continue to be fed and watered by our amazing friends, I can't tell you how grateful we are for the sustenance, especially as I am currently eating like a horse, Nicky is going to have me fitted with a nosebag to save on washing up.

Dad went back today, which is very sad, hopefully he can come back for Christmas, the kids may actually demand it.

Nicky says that I am grumpy, which I know I am; I'll do my best to not be but there are only so many episodes of spongebob you can watch before you take on the persona of squidward.

Tuesday, September 9, 2008

Checking the counts

Nicky and I have just returned from the oncologists. They checked my counts and I am relieved to say that my white counts are great and even my hemoglobin is improved. Great news.

I still feel particularly weak, especially in the legs, but that is to be expected.

Everyone continues to be incredibly kind. Nicky had a girls night out on Sunday and was basically prevented from opening her purse at every turn. Thanks ladies, she really appreciated it.

We also have a constant supply of dinners turning up at the house which really relieves some of the day to day rigmarole. The dinners are always delicious and because of the steroids, I am always hungry! Danielle dropped of ribs and corn this afternoon, I can't wait.

Missing work, not that I could contribute much at the moment but I miss my friends and the feeling of being involved. Still, I am enjoying watching the progress they are making, even if from afar.

I have more blood tests on Thursday in readiness for the next chemo, we should get a small measure of how effective the last treatment was, something called a sed-rate, hopefully I'll have more good news for you then. Ta Ta.

Friday, September 5, 2008

No sleep for me

Well this is the second night in a row that I have managed no more than two hours sleep.

It's not a case of not being able to close my eyes and drop off, more a sudden waking with a million thoughts rushing through my head.

It could be the steroids, which I am almost done with for this session but definitely worth a query to the powers that be.

Dad arrived today which lifted my spirits enormously, he's only here for a week which seems ridiculously short but I'll take what I can get.

Nicky continues to fire on all cylinders, taking care of an occasionally grumpy Justin can not be that much fun. An old military friend of mine who had a similar experience with his beau suggested I apologize now for all the things I might say, good advice I think.

I am going to go and lie in front of the TV and see if early morning TV can dull my mind enough to make me sleep.

Wednesday, September 3, 2008

Definitely knackered

Well the anti-nausea medicine seems to be doing its job, at least nominally; but I have to admit I am absolutely knackered.

Slept a lot today, but still feel incredibly drained. I forced myself out of the house just to walk around the block but I wasn't up for much more.

One day at a time, soon be through.

The day after....

Well the day after yesterday, otherwise it sounds a little too dramatic.

Its been almost 24 hrs since the treatment and normal still seems to hold sway, but normal has some qualifications:

+ I am pretty dizzy but that could be the Hemoglobin count. It manifests as a rocking boat sensation, it is very strange.

+ My hand eye doesn't seem to be what it should, it has taken me some time to write this post!

I'll let you know if anything else materializes.

On a positive note, my Father arrives tomorrow, for a week. I am fully committed to taking him out onto the golf course, even if that means all I do is drive the cart. He loves playing here, the weather is a little more agreeable than the UK.

Kids are back in school and 'seem' to be doing well; Nicky has instituted a mandatory hand sanitizing regime in the house, if you visit expect to be bathed in Purell.

Chin Chin.

Tuesday, September 2, 2008

1 down, 13 to go

So my first treatment went off without a hitch. I definitely feel a little strange but not at all how I thought I would feel, still it is early days, still plenty of time for the nausea to take hold.

My nurse was called Alice and she was brilliant, very attentive and reassuring; it was a bit of a madhouse though, because of the holiday, a lot of appointments were stacked up, she tells me it will be much quieter next time.

One worrying development is that my hemoglobin continues to fall; they mentioned that I may need a transfusion soon; I'd rather not.

Anyway, not much else to say, feeling a bit icky now, heading for the couch. I'll pop back later with an update.

Friday, August 29, 2008

Chemo training

Well that was a bit of a shock!!

Nicky and I were expecting a cordial tour of the facility, but instead it was a full on, this is what chemo is and these are the other drugs you will need after each session in order to remain part of the human race. OMG, or as a good friend would say, zomg.

I have started a course of Alugodknowswhatanol in order to protect my kidneys from the impending assault;

Once through the actual treatment, which last 2 1/2 hours, I start a 5 day regimen of anti nausea and anti anxiety medicines which should lead to a slight rattling sound when I move (having driven English cars my whole life, I should be used to that).

To top it off, Nurse Nicky will be trained in the art of sticking Justin in a variety of painful ways as I have to have a daily shot of something called Neupogen, to help my white cell count.

It doesn't sound like much of an existence, but neither is the alternative.

We are in the process of trying to cancel our flights to England, but it seems as though we may have lost that money, which is a little frustrating; you would think that, regardless of what restrictions they place on tickets, there would be some form of dispensation for medical problems. Anyway, we'll see how that plays out.

I am going to sign off and I probably will not be back until after my first treatment; ta ta til then.

Wednesday, August 27, 2008

Drum roll please ....

We have just returned from the oncologist, I officially have Type IIB Hodgkins lymphoma; the prognosis is good.

I start ABVD chemotherapy on Tuesday next week, receiving a dose every 14 days for 6 - 8 months depending on progress. I am guaranteed to lose my hair, so for those of you that I do see, I will be sporting the latest in bald-as-a-coot styles; there is no way I am going to let Deep persuade me into on of his jaunty coverings.

Unfortunately I will be immunosuppressed for pretty much the whole time, which is going to affect my interaction with the kids (germ factories) and their ability to invite friends (other germ factories) to the house.

Unfortunately we have also been told that we need to cancel our planned Christmas vacation to England which is very disappointing, actually very demoralizing; but needs must when the devil drives.

I am going to sign off and let this sink in a little bit, I have chemo school tomorrow, when I will learn the ins and outs of the procedure, I'll bore you with that, and any of the thoughts that I have had concerning today's news, then.

Monday, August 25, 2008

That feels strange

Just got back from my bone marrow biopsy. My NP, Stacy, numbed me up good, but there is no disguising the sensation of something being sucked out of you bones, very odd indeed.

Still waiting for complete diagnosis, Wednesday at the latest.

Friday, August 22, 2008

Ready for treatment

I had my echo cardiogram today, since the chemo I will be treated with is heart toxic, they need to make sure I have a healthy heart before I begin and I am pleased to report that I was give a clean bill of health in that regard. I have my bone marrow biopsy on Monday and then there is nothing standing in the way of treatment starting next week.

Frankly I can't wait, I know its only be two weeks since initial diagnosis but you know what they say about a watched pot.

I keep receiving messages of support and encouragement from work which always cheers me up, one specific message was particularly touching and made me feel much better. I will not reveal the source in order to protect his/her otherwise impeccable reputation as a grouch. :-)

It's the weekend, and I am looking forward to it, two days when I don't have to be stuck with a needle and when I don't have to sit by the phone waiting for the next diagnostic. Small victories.

Here's to Monday and a complete prognosis.

Thursday, August 21, 2008

Running on empty today

I am feeling less than robust today, I am very sore from the surgery yesterday and just about every lymph node in my body is showing its displeasure.

I haven't been able to sleep and my chest feels like I have spent 10 hours in the gym benching my own body weight, having never done so before.

I am scheduled to have my echo cardiogram tomorrow and bone marrow biopsy on Monday; I think I might save some vicodin for that special moment.

My oncologist, Dr. Kankapati, told me that we will not have an accurate diagnosis until Monday, but all signs point to Hodgkin's lymphoma or, more usually, Hodgkin's disease. My grovelling around using Google suggests that if we have caught it early enough, the prognosis will be excellent, otherwise, well, less excellent :-).

Slowly but surely the information streams are converging and by Monday I will know what's what and I will share it with you as soon as I am able.

I was feeling particularly sorry for myself today but I received a really nice email from my boss, Greg, and that seems to have lifted my spirits. I really need to have a word with myself about the self pity thing, it really is out of character, not only am I am disappointed in myself but it is the last thing Nicky needs.

Off to rest now.

Wednesday, August 20, 2008

Under the knife

I went into hospital at 5:30 this morning, surgery at 7:30, to have the tumor biopsy. Initial pathology suggests the lymphoma diagnosis is correct, but there are some other tests that need to be performed on the biopsied tissue to identify the specific type; we should get a more conclusive report tomorrow and absolute diagnosis on Friday.

I have to admit that I feel like I have been run over by a bus. Thankfully, the pain meds Dr. Straznicka prescribed are working well.

The VAP (venous access port) was installed at the same time; it feels very strange, but I am sure I'll get used to the lump. I am very grateful to have the VAP, rather than the external catheter that my mother had; at least with the VAP I can shower and swim without having to waterproof the area.

Yesterday I had my PET scan; again I do not have conclusive results, but preliminary observations suggests an active tumor with perhaps two other points of infection. A complete report should be forthcoming tomorrow.

Nicky continues to be a rock; I could not ask for a more loving or sympathetic partner. I think I need to speak with her friends and make sure that some regular nights out with the girls are planned. I don't know if she realizes how much I appreciate how strong she is being, and whilst I can't alleviate my symptoms, I can make sure that she has the occasional brush with normality.

Time to sign off. I will update with the results of the biopsy and PET as soon as I have them.

Sunday, August 17, 2008

Target identified

I met with my thoracic surgeon on Friday, 15 August 2008, Dr. Straznicka.

She was kind enough to show me my CT scan, so I have seen the beast. The mass is approximately 10 * 10 cm and has developed in between my lungs, growing around the major blood vessels that occupy that space, notably the Aorta and Superior vena cava, the mass is squeezing these blood vessels and restricting blood flow which is causing my breathlessness and seemingly permanent headache.

With any luck the biopsy will take place on Wednesday this week and by Friday I will know the gory details. When the biopsy is taken they will also be inserting my VAP, through which my chemo therapy will be injected, so at least I will not have to schedule another appointment.

I have to admit that I am looking forward to being fully in the know; Simply starting the war of attrition with this thing will be a major step forward.

Wednesday, August 13, 2008

Frustrating delays

As anyone who knows me can attest, I am not the worlds most patient person, so it is very frustrating to have my tests delayed by the need to have a nameless, faceless, department at my health care insurer approve the procedures.

It is not that the delay is going to change my prognosis or treatment, but it does amplify the anxiety of not knowing.

To my mind, the presence of the mass in my chest should preclude the need for any further authorizations; denying tests at this point would be a fiscal decision and have nothing to do with my well being.

Patience, that's what I need, has anyone got a surplus that I might borrow?

Telling the kids

We spoke to a friend of ours who has strong kung fu in the head game hoobajooba and she advised us to tell the kids as soon as possible.

So, after my blood tests this morning, I sat them both down and gave them a precis of what is happening. Caitlin, bless her sensitive soul, held it together for a couple of seconds then fell into her mums lap, Abbie, true to form, asked if she could go back to the game she had been playing, that's my girl.

Anyway, job done, I'm sure its not the last conversation we'll have but I feel better knowing that they wont hear this from anyone else.

More later.

Tuesday, August 12, 2008

Made a note in my diary, simply says "BUGGER"

You know, this blog has never been about reaching people, more a place for me to rant.

Having said that, its readership was never higher than when I used it as a conduit to communicate with friends of family concerning my brother's accident and his fight back against pretty damning odds.

So in the interest of raising my number of readers, I am going to do the same with my own little tussle; so here goes:

On Friday, 8 August 2008, I had a CT scan which indicated a lymphatic mass in my chest. It's very hard to determine what exactly it is without a battery of other tests, but it does qualify as something 'not good'.

Today, 12 August 2008, I met with my oncologist for the first time, which was a frustrating experience only because I know no more today than I did last week -- other than the fact that I have to perform the following in the next week:

1. Lymphoma specific PET CT scan.
2. More blood tests that I care to mention.
3. A biopsy of the tumor by a thoracic surgeon.
4. Insertion of a chemo catheter.
5. Bone marrow biopsy.
6. Echo cardiogram -- The chemo can damage you heart so they need a baseline.

I told Nicky that she could come in to see the oncologist as long as she didn't blub, which proved to be useful in getting out of there as quickly as possible. Nicky told me afterward that when the doctor asked her if she had any questions, she was so close to crying that she simply shook her head, good girl.

How do I feel about all this?

I am little fearful about telling the kids; they are camping this weekend, so Nicky and I will tell them next week.

I am worried about how this and the following treatment will affect work.

I am, of course, worried about the worst possible outcome and having to leave Nicky and the kids behind.

Other than that, I have always had a matter-of-fact approach to my own mortality; I have always believed that when your number is up, it's up. Only time will tell.

All of our friends, including my colleagues at work have been absolutely smashing, although being English I am never quite sure how to deal with sympathy; my dad has always told me, sympathy can be found between shit and syphilis in the dictionary :-).

Anyway, I will sign off now. I will update as soon as I have more news.


EDIT:

Sorry about the number of re-posts but Nicky insists on copy editing everything I write nowadays.

Thursday, July 17, 2008

ATI, saviour or ruthless sadist.

I admit it, I love my Mac, my Mac is no ordinary Mac, I spit on dual core, I laugh in the face of four cores, only eight are sufficient to satisfy my browsing and email needs.

When I ordered my Mac Pro I didn't have the patience to wait for the respected NVIDIA 8800GT so I went ahead and ordered it with the stock ATI 2600XT. ATI, at the time, were falling behind NVIDIA and the 2600XT was clearly the budget choice; that being said, I used it for eight weeks and was pretty happy with the performance.

Once the 8800GT was available I immediately placed my order and waited with bated breath to complete my power system with a stonking graphics card. Within minutes of it arriving it was installed and I was booting OS X, anxious to witness the glory that is eight cores, 4GB of ram, and a beast of a graphics card.........

Needless to say, within a week the 8800GT was pulled and the ATI 2600XT reinstalled. In this machine, using Leopard, the 8800GT is a pile of pooh. NVIDIA are dead to me.

ATI may have been behind the curve but the drivers are well implemented and the performance is acceptable, so ATI win, right? Maybe not!!

So there I am with my massively powerful system and a budget graphics card, then, out of the blue, ATI announce they are bringing the 3870 to the mac. The 3870 is supposed to be a significant upgrade over the 2600XT, akin to a more power friendly and quieter 2900XT, a pretty decent card in its own right. Finally a card that will properly compliment my system, I should be happy, right? Not exactly!!

ATI announce that the card will ship in a month, no problem, I have waited this long, another couple of weeks wont kill me. But hang on, over the last week I have read pretty much every article that I could find concerning the 3870; pretty much all of the articles confirm that it is roughly the same ball park as the 8800GT and is indeed a considerable upgrade over the 2600XT, but what's this, all of a sudden the 3870 is being mentioned in the same breath as the 4850, mentioned, as in, the previous generation 3870 is eclipsed by the 4850.

So ATI have a graphics card that is superior to the 8800GT and the 3870, shipping now for the PC but the Mac is to get the 3870, no mention of the 4850, to add insult to injury they are both at the same price point.

So is ATI the saviour of my Mac Pro, or do they simply know a sucker when they see one? I can imagine the conversation at ATI /AMD .....

Exec 1: 'So we finally have an architecture that is competitive with NVIDIA, but what are we going to do with this stock pile of 3870 cores'

Exec 2: 'What do we usually do with out last generation graphics chips'

Exec 1: 'We sell them to Mac users then rush home for tea and medals'

Exec 1 & 2: 'Hooray'

Will I buy a 3870, it seems I have very little in the way of options, but if NVIDIA and ATI keep up the untermensch attitude to the Mac community one can only hope that Intel's ray tracing, many core strategy is bang on and the pair of them are left to pick up the scraps from the legacy mac users, you know, the ones with only 8 cores.

Wednesday, June 11, 2008

Pay now or pay later

We have all heard this phrase but I think it is worth looking at what it really means and what the consequences are.

Paying now is to give the problem full consideration, evaluate proposed solutions, fully implement the selected solution, and ensure it is appropriately tested, according to the processes and procedures of the development methodology derigeur .

In some circumstances there simply is no choice, a piece of functionality must be in place for some specific reason, and most of us respect that reality, but, it has been my experience that there is an entire breed of managers out there for whom pay later represents a planning and scheduling methodology.

What are the consequences of this mindset:

1. The complexity of the problem space will be significantly higher. You can guarantee that whatever happens between the time when the decision to pay later is made and the time when the debt collector calls, the system will be considerably bigger and more complex than it is now.

2. Any cost estimates are completely invalid. Cost estimates are based on performing a piece of work in a given time frame, pay later makes that time frame unbounded.

3. Your more capable developers, note I did not say senior, will spend most of their time attempting to coax and cajole the system back to some sense of normality whilst your inept developers will be creating the next nightmare.

4. Eventually the team will realize that, despite being asked to sacrifice increasingly large parts of their personal life to make up for poor planning and inept decision making, their opinions contribute naught to said process.

5. The pay later crowd will be mindlessly promoted as they got the job done, regardless of the future cost, but eventually will reach their glass ceiling and spend the rest of the professional, term used loosely, lives managing a non critical systems staffed by like minded idiots.

6. The IT industry will lose lots of talented developers who can not bear the crushing mediocrity with which it is managed.

The pay later phenomenon has a sibling in the finance industry, the fiscal year bonus. We have just witnessed incredible turmoil in the financial markets, that, were it not for central bank intervention, would have seen several major institutions fail and the world economy with them.

The financial industry hands out bonuses based on current year performance, that seems appropriate, but when you consider that the future cost of trades and deals made in that year have significant and ongoing financial impact for years to come, one might expect the bonus calculation to factor in the cost of maintaining the instruments traded over their lifetime, and yet we continue to see large, maybe not so large, bonus payments being made. So it is for the pay later manager being promoted.

The next time you are involved in a pay now - pay later discussion, think about the consequences and remember that the person advocating pay later is probably the only person in the room that will benefit from the decision.

Wednesday, January 30, 2008

Conceptual integrity

Most, if not all, of the software developers I know, when hearing the name Fred Brooks, immediately, and correctly, identify him as the author of 'The Mythical Man Month'. Of those only relatively few understand that the mythical man month was, albeit incredibly important, only one of several ideas presented in that legendary tome.

Another phenomenally important idea, described by Brooks as Paramount in System design, is Conceptual Integrity, concretely described as a system that reflects a single set of design ideas, as opposed to a collection of independent and uncoordinated ideas.

Conceptual integrity can only be maintained by separating architecture from implementation, that is by ensuring that architectural decisions are made by a small number of people, preferably a single architect, with the authority to approve or deny the inclusion of features if they do not fit seamlessly with the system architecture.

I think anyone, with an IQ higher than their European shoe size, recognizes this as common sense; which begs the question, why do so few systems exhibit this quality?

It all comes down to a lack of authority and the behaviour of inexperienced or perhaps arrogant developers in such an environment.

Having been asked to design a system, one expects to evolve the design as new features are added and deployment environments change, but, it is imperative that the architect have the authority to deny or defer a feature until the system can accommodate it, it is the visibility of these features and environmental conditions that allow the system to evolve in a controlled and consistent manner.

If the authority of the architect is circumvented, the conceptual integrity of the system will inevitably fail and ultimately the system will become intractable and a candidate for yet another rewrite.

Without explicit authority, it is common for the initial design to be seen as the foundation upon which the house is to be built, a static, solid base, never to be seen again. The application is seen as incidental to the system, not part of it.

How does this happen? As you would expect, it comes down to human weakness, lets take a look at a couple of scenarios which I have experienced.

The technical director
In some cases there exists, in the management chain, a beast, the beast will appear generous and the beast will cajole with soft words and mighty bonus checks, but the beast has a secret! The beast used to be you, (s)he used to be a developer, probably a damn good one, but it is this very background that persuades the beast that (s)he understands the system and what it can or can not tolerate, combined with the fact that the beasts authority supersedes the architects and the decent into hell begins. If the beast is amongst you there is very little you can do but look forward to the next rewrite. Note, not all technical managers are the beast, but the beast dwells within them.

Look before you leap
In some cases, the conceptual integrity of a system can be undone by a developer who refuses to become familiar with the system. For instance, if a particular subsystem does not exactly match the needs of the developer it will be abandoned in favour of new code, specific to task. The developer delivers the feature on time, management is happy but the system is now less than it was.

Look what I can do
We have all said or thought, at one time or another, wouldn't it be awesome if the system did THIS.

THIS being some function that is not part of the design but, to you at least, would make the product better.

The right thing to do with THIS is submit it as a feature request, and hope it makes it into the system.

I am not saying that you can not engage in skunkworks projects but unless you have enough experience to ensure that the feature is implemented in a manner that is consistent with the system design, you can guarantee that your must have feature will be the source of significant bugs and instability.

Whether these activities are motivated by a genuine desire to make the system all it can be or they are the arrogant actions of a DS watching* scum-bag, the potential for drama is the same. If you are going to engage on little side projects, it might be worth having a quick chat with the architect about your plans.

* DS Watcher -- Military phrase, implying that a soldier only puts in effort when he knows that his superiors can see him. Commonly found bleeding in the shower block.

The next time you look at a code base and wring your hands, furrow your brow and vilify the original development team, try and remember that the system probably started life with conceptual integrity and was undone by ignorance of that quality; then modify your own behaviour accordingly.

Tuesday, January 22, 2008

The Efficient Market Hypothesis

Much of finance theory depends on an efficient market, essentially the condition whereby all participants have access to the same information at the same time, more or less. It is the operation of the efficient market that eliminates arbitrage opportunities.

In my youth I had an exceptional finance lecturer, Eve Hicks, her position on the efficient market was that it clearly didn't exist, but in the absence of anything better, it formed a conceptual framework upon which finance theory could be built. I have respected and subscribed to that point of view ever since, even believing that the fall of open outcry and the emergence of the electronic exchange has made the efficient market that little bit more real.

How then, if indeed the efficient market is to even be considered as a valid model, did the sub-prime collapse catch so many 'experienced' traders off guard, the collective genius at Goldman Sachs excluded of course. Surely, with equal access to the same information every risk department of every bank and fund should have been hedging against the CDO's that have ultimately triggered the current volatility.

The answer lies not in flaws of the efficient market hypothesis but in the plain fact that success flatters to deceive. For many, the CDO proved to be a license to print money and while the good times are that good, one tends to overlook glaring compromises or risk factors that would otherwise be great cause for concern.

And so it is with technology, as a product becomes a run away success, the impetus is to build on that success and the suggestion that the foundation may need shoring up is eschewed by management and marketing in favour of 'more things that made us successful'.

As with CDO's, when reality hits and the wheels come off, do not expect management and marketing to offer a sincere 'my bad', they were simply doing their job. As software engineers, the code base is our efficient market, when we see gathering problems, it is our responsibility to begin hedging against them, re-factoring is our derivative.

Re-factoring needs to become an every day part of your role as a software engineer, you will never be given large blocks of time specifically for re-factoring, it is a day to day responsibility; ignore it at your peril, unless of course there is someone else you can blame.

POUNDY!!!!!!!!!

Sunday, January 13, 2008

The hundred year language

I have just finished reading a very interesting post from Tim Sweeney

http://lambda-the-ultimate.org/classic/message6475.html#6501

While I don't necessarily agree with him regarding the adoption of ML (OCAML / SML / F#) and haskell, I think the salient point he makes is that, in all likelihood LISP will outlive all the popular languages of today. That is not to say that LISP will become the hundred year language, merely that it will still have an enthusiastic user base long after C++ and Java et al are pushing up daisies.

What is it about LISP that is so compelling. They say that unless you have used it you will never know, and that once you have used it you will become a better programmer, regardless of language. From my own experience I would say that their is some truth to this; the barrier to adoption really comes down to syntax. Just as with Haskell, Erlang and OCaml, the syntax does not conform to the majority dialect and therefore faces an up hill battle for wide scale adoption.

This is one of the reasons that Dylan, despite its banishment from Apple, continues to peaks my interest. Its difficult to see a future for Dylan, but every time I decide to move on I find myself drawn back into the fold.

I think with a concerted effort, perhaps a carbon / cocoa back end for DUIM and a Dylan port of Uncommon Web, there may yet be traction. By the way, who is the patron saint of lost causes.

Thursday, January 10, 2008

A lost opportunity

Hindsight as they say is 20/20.

Clearly, the acquisition of Next, positioned OpenStep and Objective-C as the immediate tool chain for Apple.

Don't get me wrong, I admire Objective-C and have enjoyed programming in it for many years, moreover, Apple has some exceptional people who are trying to drag the language into the 21st Century, kicking and screaming.

But one of the casualties of the merger, and, to be fair, other circumstances, was an alternative programming language which, at the time may have seemed a little odd, but amongst the current crop of scripting and functional languages seems positively normal, Dylan.

Dylan is effectively a LISP, with a combination of C and pascal syntax. It is an object oriented language which uses the same semantics as CLOS.

When Dylan was in its infancy it suffered many of the same problems as Java, at the time, namely, performance and resource usage; Java, however, had marketing muscle and a robust Sun Microsystems behind it. Dylan was merely another project that was not critical to the survival of Apple.

While objective-c continues to serve Apple well, one cannot help but wonder whether, now, when Apple is no longer precariously balanced on the precipice, Dylan might be considered a much more appropriate choice for the future.

Many of the modern features at are being added to objective-c are already present in Dylan and it remains to be seen if objective-c is malleable enough to have those features added in a natural seamless way.

below is a contrived example from the Dylan wiki, that serves to illustrate the sophistication of the Dylan programming language, I ask you only to review and consider how like facilities might be made available in Objective-C, my hypothesis is that you may find some significant holes.

define constant <zero> = singleton(0); // is an integer subclass that encapsulates the value 0.

define method factorial( n :: <zero> ) => ( n! :: <integer> )
1
end;

define method factorial( n :: limited( <integer>, max: -1) )
error( "factorial: Bad Argument");
end;

define method factorial( n :: <integer> ) => ( n! ::<integer> )
n * factorial( n - 1 )
end;

The purpose of the above is not to hold up functional programming as the most appropriate paradigm, clearly we can be more efficient than this, but it is a concise example of how polymorphism can be used to avoid the conditional code that often plagues the behaviours attributed to objects in objecttive-c

Wednesday, January 9, 2008

Tipping point or tripping point

Yesterday Apple released new base Mac Pro configuration with 8 processing cores. These are truly workstation class machines at, albeit high end, desktop prices.

If we take for granted that Leopard, Vista or Linux can make efficient use of the raw processing power available, any given application should perform better on these machines than on the previous generation, however, I think that many people will be surprised by how modest those performance gains are. Unless the application was developed with concurrency in mind most of the cores will likely sit idle.

To me these machines represent a tipping point, a point in time when concurrency becomes mainstream. While I accept that these machines are targeted at professional users, how long do you think it will be before your laptop has a similar core count?Two years, maybe three?

I hope that means that functional programming languages gain greater momentum and acceptance, but at the very least, we, as a community, need to accept that knowing what a mutex is, does not a multithreaded programmer make. At a minimum we should be looking to trade in the mutex hammer for the Software Transaction Memory rapier.

Alas, for some software engineers this is not a tipping point, but a tripping point, one paradigm shift too many in a career littered with the wreckage of objects, aspects, templates, functors and categories. There is no shame in this, to you I ask only this question, can I have a raise?

Friday, January 4, 2008

Finding my way

In June 1996 I cleaned my rifle for the last time and said goodbye to my platoon and brother officers to engage in a career in IT.

It was a difficult and probably poor decision but one can not look back to far before the mists of time confuses what was with what one wanted it to be.

One of the most difficult challenges has been in maintaining an enthusiasm for my current pursuit that was taken for granted when one lived on an adrenalin drip.

For me, I found this in the ongoing discovery of programming paradigms and methodologies that in one fell swoop would increase my productivity and, along with it, ability to tackle increasing complex problems.

When I exhausted Visual Basic (not a difficult task) and moved on to C++, the transition to Object Oriented from Object Based was enlightening, exciting and, to a certain extent, empowering, leading me ultimately to Java and then Objective-C. From there i went through a long period of stagnation.

C# was interesting and I enjoyed it far more than Java, but it was nothing new.

Ruby seemed promising and Rails has certainly changed the web development framework landscape but, again, nothing new.

I dabbled with lots of different technologies while plying my stock in trade with various employers, but nothing really excited me until a long time infatuation with Lisp was finally sated with Peter Seibel's excellent Practical Common Lisp and subsequently Paul Graham's On Lisp. My only problem was that I couldn't see a way of making any money with Lisp, however, I had been bitten by the functional paradigm that Lisp espouses but does not necessarily enforce.

Since then I have enjoyed, as time and tide allows, several dalliances with functional programming languages and more significant outings with OCAML and Haskell; it has been so much fun that it has peaked my interest beyond programming languages and encouraged some tentative steps into category theory and its application to computer science.

With the advent of multi-core CPUs and the promise of many core processors in the near future it occurrs to me that my interest in functional programming languages could not of happened at a more opportune time. It is not that imperative programming languages are not as capable, merely that functional programming languages seem to be more natural fit.

More to follow.