One of the side effects of morphine in general is sleepiness. From a mental acuity point of view my best time appears to be morning. Thereafter, my alertness level can be variable and I've found myself asleep in my chair at odd times of the afternoon, evening and night. Sometimes I experience what you might call an enhanced daydream. I have a feeling the doctors may refer to it as an hallucination and possibly a sign that I've overdone the Oromorph. The transitions though can be spectacular, moving seamlessly from reading a blog post or newpaper article to being in the middle of the live event, or having dinner with someone who was in the story. The daydreams are incredibly vivid, rich in detail and content. I certainly have a somewhat better understanding of why addiction is not uncommon for those who take high levels of painkillers.

Recently though I've been experiencing a much less glamourous outcome of the sleepiness which I thought I'd share with you for a laugh, although you must promise me not to snort too much bearing in mind the general loss of dignity implied by what I'm about to tell you. Basically the problem has become falling asleep with a drink in my hand. What happens is that I slowly become aware in my sleep that I have fluid beginning to soak my shirt or trousers, I come round enough to work out that I'm spilling the drink in my hand onto myself and experience a kind of physical knee jerk that flings most of the rest of the drink over the rest of what I'm wearing and the chair I'm sitting in. This is disconcerting the first time it happens, it becomes both funnier and more annoying the more times it happens. It's easy to say that I should just put my glass down when I'm not actively drinking from it, but as a relatively high functioning individual, I can only say that I hear where you are coming from, but you try it!

The immense lack of dignity is going to come when I finally have to accept that I can't control this any longer and need to use a children's sippy cup. How mortifying.... but I have a feeling that in the fullness of time I think I may come to see this as one of the lesser losses of dignity involved in my care.

On the news front I was not in any shape to travel any distance today (Saturday) so I had to put my trip plans on hold for now. I have a call to return on Monday morning which I think is about arrangements for me to start my chemotherapy, I remain hopeful that we can start on Thursday but it's not yet in the bag. The other thing on my mind today has been the why of blogging about my cancer. I think I have two reasons. The first aligns with the view of the Macmillan Cancer charity who remind us that cancer will affect all of us at some point in our lives and 1 in 3 of us will actually be diagnosed with the disease. I'm just doing my bit to help with that awareness campaign. I'm not sure to what extent there is still a stigma attached to being diagnosed with cancer, if I'm honest I think those diagnosed with depression and other mental illness probably have a tougher time in that respect, but if there remains a cancer stigma, this is me doing my bit to help clear that away.

I think the other reason is that if I can help one person, someway down the line, who when faced with neck muscle and shoulder blade pains which then start to move randomly around the back can push for further tests to diagnose cancer as early as possible (and therefore improve their odds or life expectancy) then I will have been able to leave that help as part of my legacy. My other score for the day was a trip to the Apple shop in Leicester to buy an AV cable for my iPad. Sine I've had the iPhone I've been building up a collection of TV programmes and movies, which I have been playing on the iPhone in the evenings when travelling away on business. More recently I've been watching them on my iPad, but now I have the cable I can play them from the iPad through the huge TV in the living room - using the iPad as as a kind of portable DVD player. Awesome! I've gone right back to the start of Life on Mars and I have every episode of "The Wire" and "House" up my sleeve.
Sent from my iPad

This is probably the hardest to put together note that I've ever written. It's taken me almost two days just to get from the input - my first meeting with my Oncologist - to sitting down in front of a computer to write. The facts are relatively straightforward.

I have adenocarcinoma, and no point beating around the bush any longer, that means lung cancer. According to Wikipedia this is the form of lung cancer that is more prevalent in non-smokers, and I probably keep quoting Wikipedia that in the forlorn hope that my cancer may not be self inflicted and nothing to do with the twenty years I did smoke. In reality I'll never know and it really doesn't matter. I have the damn thing now and, self inflicted or not, the battle lines are being drawn. I gave up smoking several years ago, I must go back and work out when I quit for posterity's sake but for the sake of argument it's 7 or 8 years ago. I vividly remember some of the circumstances. I'd coughed up some blood and was worried I had early signs of lung cancer. I saw the doctor, who ordered a chest x-ray and three days later I found out I had viral pneumonia. When he told me that I laughed in relief - he probably thought I was mad, but that was the kick start I needed to give up.

We knew that the lung cancer had spread to my bones. That aligned with the pain that I've been having but then came the first of the hammer blows. I have a second secondary cancer. They've found liver cancer. Ruddy marvellous. But hey bring it on. A fights a fight and I'm not expecting cancer to play nice. I'm expecting it to fight mean and nasty. All I can say is that mentally I'm tough and I'm ready for that fight. I've been spoiling for the fight for three weeks now. It also accounts for some of my other symptoms, so I'm glad it's come out and we can start to address those other symptoms with knowledge of where they are coming from.

We move on to talk about treatment. Some immediate radiotherapy targeting key areas of pain - my breastbone and a couple of hot spots on my spine was are causing the referred pain in my ribs. The downside is that the pain might be worse for a couple of days. The expected upside is a release from the pain for awhile. And then, chemotherapy. Four or six sessions (or cycles), 30 days apart.

And finally the prognosis. And here comes the hammer blow I least expected. As expected they want to see how the chemotherapy goes before they can put some accuracy around it, in any shape or form. He allows me to push for a ballpark. I was hoping to hear two to five years. He says it's six to 12 months. I don't swear that much in writing, but FUCK! Even though I know that it comes with a huge number of caveats, that's just not fair.

There's a bit of a gap in my memory from that single point in time to much later that evening. In retrospect it's caused by a combination of a re-run of the shock of when I first got the Big C diagnosis and just complete overload. I think I'm trying to find the positive way to look at this news. It takes a while but finally I find it. And it's this. There's a conversation everyone gets round to eventually. Usually, but not always, when you've had a bit much to drink. And the question is this... If you found out you had 12 months to live, what would you do! What actually happens is that most people never get to live that question out for real. So many things that people want to do get put off for retirement, or when I pay the mortgage off or when the kids leave home or whatever. And they never get round to living out their dreams. When I get through the chemotherapy I will have a fair idea of the time that I have left. I'll have a prognosis drawn from the best information available. I only hope, when the time comes, that I can come up with a plan worthy of having been given the opportunity.

Strangely enough the day after the news I then have one of the best days I've had physically in weeks. I'm able to sleep in my bed, rather than in my recliner. I get several hours of unbroken sleep. I awake in the best shape I've been in for weeks. I'm ready for the fight. Today, I've been for the radiotherapy. True to form I'm now in more pain. Hopefully it will dissipate rapidly because I'd like to be in a position to take a trip at the weekend. Knowing my luck that will go pear shaped too, but we've got time to see if I can recover.

There are a couple of things that need to happen a week in advance of chemotherapy starting and we've made them happen today. As things stand I'm in a position to start next Thursday, the question is can everything that's needed be lined up by then. I have to say I'm thoroughly impressed with my Oncologist. He's just come back from an important international conference on exactly the types of cancer we're dealing with here. Which means he's as up to date with what might be possible as anyone else I could get referred to in the UK. More than that he's a great way about him. In a very short space of time I've given him my trust. It's going to be one of the most important relationships of my life.

Everyone I've spoken with since I've gotten this new news of the third cancer and a ballpark opening prognosis, really hasn't known what to say. Well, that goes for me too. What can anyone say. It's all been pretty devastating stuff. I'm probably slightly ahead of the curve in processing the news and dealing with it; as this has really played out over about three weeks or so for me; from the original point at which I was told in the very broadest of terms that I have cancer. Whatever you now hear or read, for the sake of clarity, the request to give me a call or drop me a note still stands. I'm still the same Chief Happiness Officer I was three weeks ago. And I know you won't know what to say and neither will I, so we can have conversations about iPads and iPhones and technology and Inbox Zero and work in general, life in general, the news and the weather. See, we'll have plenty to talk about!