I’m going to be slightly lazy and repost my various Facebook notes below which summarise what happened from first diagnosis through chemo/radiotherapy and ultimately to my final prognosis.   

Wednesday, 29 June 2011

It all started with back pain in September 2010, initially I ignored it and put it down to bad posture at work but eventually the pain got so intense I saw my GP, got some painkillers and a referral to a physiotherapy clinic up in Harley Street. After a few months of not much progress the physiotherapist recommended I get a second opinion and arrange for an MRI scan. Another GP visit later and I had an appointment with an orthopaedic surgeon who I saw in early March. He did a quick examination and booked me in for an MRI scan the next week and I went to see him for the follow up after the scan.

I remember thinking beforehand how much I hoped it was something on the scan like a damaged disc, rather then nothing specific meaning there was nothing that could be helped with surgery or otherwise. As soon as I walked in his office I knew something was wrong, he jumped up and immediately started asking how I felt, whether I had night sweats or had lost weight all of a sudden before informing me the MRI showed there was nothing wrong with any disc but that the radiographer saw signal changes in my marrow that indicated there was something wrong with the bone marrow.

Several blood tests, a Bone Scan and a an X-ray later he booked me straight into see a Haematologist the next week who arranged for me to have a CT scan. The signal changes in my blood indicated a possible Lymphoma or Leukaemia and the CT scan would hopefully confirm that. I had the scan and the results showed a definite issue in my bone in two places (2 big black spots) as well as swollen lymph nodes and secondaries dotted about the place (ribs, lungs). In order to get a more definitive diagnosis I needed to have a bone marrow biopsy (yes, they hurt) and a lymph node biopsy (yes, they also hurt).

I got the results back which annoyingly showed it wasn’t a lymphoma or a leukaemia but confirmed it was definitely cancer of some kind. Another referral later and the next week I’m speaking with a general oncologist who gives the most positive news so far which is that given my age and lack of smoking (for any significant length of time :/) it was highly unlikely to be any of the serious carcinogenic types like lung, bowel etc. Instead he said it was likely to be a germ cell cancer, which is essentially testicular cancer and arranged for an ultrasound. The scan does nothing for your dignity but up to that point it was the first pain free procedure I’d had in a while. The ultrasound didn’t show any lumps and during the follow up with the oncologist he said the Marsden in Sutton were now involved and looking at it. They contacted me around the same time for an appointment with one of the professors and so I went along with Taz the next week.

I’d say up to this point that while all the referrals and moving about Dr to Dr was somewhat frustrating for me, my then fiancée and my family it did all generally happen very quickly. From first knowing something was seriously wrong mid March to seeing the Marsden was just over a month.

The professor we saw at the Marsden was a delightful guy, much like an old school professor. It turned out he was in fact the dean of the institute of cancer research and one of the leading top guys for testicular cancer in the country which was quite reassuring. My final diagnosis unfortunately was one of uncertainty, all the tests and scans to date couldn’t identify where the primary site for cancer was and as you can imagine, it would normally be a lump in my testicle (or somewhere else) and the normal course of action would be to remove it and do chemo. In my case they felt confident that the cancer in my bone, lymph nodes etc were all secondaries (i.e. spread from a primary site) but just that the primary had disappeared (it can happen, sometimes the primaries kill themselves off by blocking off their blood supply). On top of that, I have no tumour markers in my blood – cancer normally gives off distinct markers in your blood that can be tracked and measured.

The decision however was to treat me as if I had testicular cancer as given my age group, the spread to my lymph nodes and the fact I had an un-descended testicle which was operated on when I was 3 (increases your risk of getting testicular cancer a fair bit) it was the logical treatment.

Testicular cancer treatment is one of the big success stories with chemo, if you catch it early the curability is above 95% and even once it’s spread the chances are still reasonable. Normally when you have testicular cancer you’ll have an operation to remove the affected testicle followed by what’s called BEP chemotherapy. BEP is essentially a combination of 3 drugs, Bleomycin, Etoposide and Cisplatin which attack fast dividing cells like cancer, and hair amongst other things. All chemo is essentially a poison, hence the large long list of not pleasant side effects.

In my case however, because of the fairly reasonable spread of cancer to other places, in particular the bone as its slightly unusual the type of treatment they put me on is called CBOP-BEP. Developed at the Marsden as a much more intensive treatment designed for those considered “Poor Prognosis” patients (those with significant spread and reduced chance of success from the somewhat cosy 95%) – it’s akin to your body being smashed by a sledgehammer. As the professor put it, you’re young, fit and healthy other then the back pain so you can take it and if it is a germ cell tumour this should sort it…. Gee, thanks :/

The difference between this treatment and BEP is the first 6 weeks you have intensive chemo every week for most of it with little break and they use 2/3 additional chemo drugs on top of what they use for BEP. Once those first 6 weeks are out you start the traditional BEP cycle of 1 week in for chemo followed by two weeks of just a simple injection once via outpatients. This then repeats 3 times bringing the whole treatment time to 15 weeks.

Once we understood quite how intense the treatment would be and that I’d be unlikely to work for most of it Taz and I came to a decision the next week to move our wedding up to 2 weeks from then. It was very much a case of well we can kick it in the long grass and do it when originally planned or say screw it and have a registry office ceremony. As it turned out, getting married then was the best decision we could of made and the right one for us. It wasn’t the wedding we originally wanted but it was an utterly amazing day and we plan on doing a reception next year to celebrate with those we didn’t have space for or weren’t able to make it!

I’m now on week 7, the first week of BEP so in hospital until Sunday 3rd. Weeks 1-6 were as expected, hard work both physically and emotionally. Fatigue hit me very hard though it has eased up and generally comes in cycles. Dealing with it emotionally has been something of a rollercoaster the last 3 weeks but I generally feel in a better more positive position about it all. The biggest frustration is it’s hard to see the end of this when nothing is definitive in your diagnosis, and my prognosis not being the happy 95% curability end… not to mention the whole feeling of this not being quite fair having to deal with this aged 27.

On the positive, my back pain disappeared about 2 weeks ago. I was at that point on some pretty heavy painkillers (Tramadol – an opiate) but decided to wean myself off while at home and see how I went. To my pleasant surprise the back pain went and the professor told me it was a very good sign. It was also the fist time since November last year that I wasn’t on some type of painkillers for my back!

On Monday I had a CT scan to check my progress. Because of the lack of tumour markers in my blood the scan is the only real way to show progress and the hope was to see some shrinkage in my lymph node size. I saw the prof yesterday just before starting BEP and he informed me that the scan showed the lymph nodes had shrunk by almost half. This showed the treatment was working extremely well and that they wanted to continue with BEP. It was an utter relief to know the treatment is actually working and we’re on the right track and really the best news I’ve had since this all started. It at least allows me to feel that their predicted diagnosis was right.

Anyway, I’m almost half way through with just under 8 weeks left until my last chemo injection. I have a long recovery after that as it takes a good 3-6 months to get your energy and strength back (not to mention hair) and I have no idea when I’ll get an all clear (assuming I’ll get one… ahh pessimism) but it certainly feels like there’s light at the end of the tunnel (ahh euphemisms).

End Of Treatment Results

Friday, 9 September 2011

Well the results were ultimately the best we could hope for.  The scan showed continued reduction in the size of lymph nodes in my lungs and other areas.  The doctor said the reduction wasn’t as dramatic as from the first scan but that was to be expected.  The cancer in my spine will take longer to heal and so I’m due another scan in three months to check on progress.

It’s the news we were expecting though of course it would have been much nicer and more definitive to be told “it’s all cured”.  The doctor was very positive though, and I don’t have to go back into hospital at all until December which is great.

Recovery is proceeding very slowly.  I’m a little bit more mobile and managing short daily walks trying to build up strength.  Still dealing with nausea on an almost daily basis but that should pass once my stomach recovers.  One other frustrating newer side effect is peripheral neuropathy – basically the chemo has destroyed nerve endings in my hands and feet.  The result is a tingly pins and needles style sensation in my hands and feet whenever I move them.  Its intensity varies and it’s worse in my feet.  Unfortunately it’s a long lasting side effect, measured in years and for some it never goes.

Otherwise though things are improving and I felt strong enough to drive back from the hospital, the first time I’ve driven since treatment started.  Steadily losing the eyebrows still and most of my eyelashes have gone but in a couple of months I should hopefully be back to fuzzy beardiness.

Taz and I really want to thank everyone for the immense amount of support we received during this extremely difficult time.  We both feel incredibly lucky to have such wonderful family and friends.  I’m not out of the woods yet but it really helps to know we can rely on so many people.  With any luck my recovery will be quick, my cancer will be gone and we can get on with enjoying life again.

General Health Update

Saturday, 19 November 2011

I know its’ been a while since I last gave a proper update on post chemo recovery but now’s as good a time as any as I have some good news. It’s a long one but It has been quite some time since my last update.

Initially recovery was to be honest, slow and not all that pleasant.  It took quite some time for the last cycle’s nausea to subside as well as a frustratingly bloated stomach.  But at last I knew I didn’t need to come back for more treatment so it became easier to feel positive about it all.

Around mid September I felt strong enough to get to my workplace and was able to catch up with my team who I had

been massively missing and hadn’t seen since just before my wedding in May. I started working from home initially from the next week and a couple of weeks later felt strong enough to make it into work.  1 day a week at first and then increasing as I went depending on how strength I had.

Annoyingly I continued to get lower back pain and once I got to the point that I needed to take much stronger painkillers the Marsden got me in for an MRI to see if they could work out what was going.  I had the MRI last week of October and the next day the Doctor was on the phone to say they found that at several points along my lower back the bone had swelled and was beginning to crush my spinal cord.  There was a third point right at the bottom of my back which they said wasn’t as serious or urgent to treat as the ones higher up so would leave it for the moment and get the top two treated immediately with radiotherapy.  The other part of the treatment was a high dose of steroids which would then taper off over the next few weeks.  Made me feel pretty bloated as a result.

The therapy started the next day and lasted luckily for one week.  As I have only recently finished chemo and because they didn’t want to risk any long term permanent damage on my spine the treatment length was reduced accordingly.

It firstly involved having to get a very small tattoo on my chest which they used during treatment to line up the laser targets. The Doctors weren’t sure whether spine issue was just damage from before I started treatment or something new that developed after chemo finished.

I was warned there were a few side effects, tiredness and potential for nausea.  But I had lots of anti-sickness medication to deal with it.  Another common side effect is it can flare up the treatment area as well as make it quite sensitive.  Luckily radiotherapy is not anything like chemo so the level of tiredness that came as result wasn’t anything like the fatigue and weakness I had during the summer.  It did knock me back though and I ended up with additional back pain higher up my spine.

The tiredness while not severe still managed to feel a lot like how I felt energy wise in September quite soon after my last cycle of chemo.  The extra back pain made moving about quite difficult and strenuous so I was only able to work from home and not venture out too much.

My wife was brilliant throughout and was able to take care of me while I was too weak to move about much.

One of the side effects from the chemo is the peripheral neuropathy which is the tingling/pins and needles and lack of

feeling  in your hands.  This has continued to worsen over the last few months and has gotten to the point of making it very difficult to hold things as it feels like your whole hand is cramped all over.  The feet almost feel completely dead and it’s become more difficult to drive as it’s hard to feel your feet on the pedals.  Playing my guitar or keyboard has become difficult along with typing which is now a bit more challenging… especially when it comes to fast typing.

It was pretty hard dealing with this set back.  Particularly with additional back pain which the painkillers weren’t quite covering and the horrid feeling in my hands and feet.  Not to mention the fact the Doctors didn’t know if this was new or old.  The Doctor also mentioned that if it was new they might have to look into alternative new types of chemotherapy as a potential cure.

I was able to get a bit more used to the hands and feet thing.  The peak time is generally 3 to 5 months and it should start to improve after.  So with any luck I’ll see an improvement hopefully around February time.

Around a week ago I started to get a bit of strength back and so embarked on a bit of a flat tidy and clear up.  This meant a fair amount of chucking out unneeded boxes and variously electrical cables and wires and well as getting up the loft and rearranging bits and carry some bits down to sort out.  What I didn’t realise at the time was after months of not having a huge amount of exercise or strength it probably wasn’t the smarted idea to shift quite so much.  The strong painkillers managed to hide this fact from me until I woke up the next morning with intense knee pain.  It started early morning until it got to about 6 am where it was absolutely excruciating.  I had never experienced such an intense pain in my life and my wife came pretty close to calling for an ambulance.

Luckily enough the pain began to subside later in the morning but not before a fair amount of outright screaming and crying in agony.

I found that in addition to the knee pain the afternoon was spent dealing with more back pain as well as in new locations.  The next day while the knee pain had generally gone I was still experiencing quite a lot more severe back pain so ended up speaking to the hospital and getting a prescription for some oramorph (morphine, but not a particularly high dose).  Luckily I could take it alongside my tramadol painkillers.  Come the afternoon the pain got a bit too intense to deal with so I ended up taking the morphine.  Definitely quite an entertaining experience and you don’t quite feel all that there at all.

I started developing a cough on Monday which only got more and more intense as the week went on.  Come Thursday night I found I couldn’t take a deep breathe without coughing uncontrollably and wasn’t able to catch my breath.  We ended up having to call an ambulance as I had started to have a major anxiety attack.  I had several over the course of my treatment and for those who have never experienced them  it’s extremely difficult to calm yourself down and you have a great deal of trouble believing that you’ll actually survive the event at the time.

They fortunately arrived very promptly and ended up taking me to A&E, but I had to try and explain what was going on via typing on the laptop as I wasn’t able to talk through fear of coughing.  Initially they said they would leave and get a Doctor to come out to me but once I tried to move I had an excruciatingly painful coughing fit and wasn’t able to catch a breath.    They put me on oxygen which seemed to help and took me to the A&E in Epsom.  They ran a whole load of tests and an x-ray to find I had a chest infection but didn’t have a spare bed in the hospital so I had to be transferred to St. Heliers in Sutton.

By this time it was about 7.30am on Friday morning.  Got to St Helier’s and luckily they had a private room for me but I couldn’t go to sleep as we had to wait for the doctor to come round with an update on the situation.  Eventually they came and were talking to the Marsden to see what the result of Wednesday’s scan was but put me on antibiotics in the meantime to help the infection. A bit later on the Doctors came back to say that the Marsden had confirmed from their scan that I had something called  leomycin-induced pneumonitis.  It’s a reasonably common potential side effect from one of the chemo drugs I had over the summer.  It turns out it can be quite fatal so it was a good thing I was able to get to the hospital when I did.

Today I got transferred to the Marsden and will probably remain here until Wednesday while they keep an eye on my recovery.  The treatment annoyingly is to go back on hi-dose steroids for a while.  What they also said was that there is potential for more radiotherapy on my lower back again as they only treated 2 out of 3 of the affected  areas in my spine.

The good news out of all of this however is that they were able to confirm that my lymph nodes hadn’t changed size and so there is no new spread and treatment is continuing to work.  I do still have lower back pain and need to take strong painkillers to deal with it but they said that the radiotherapy was still working so it was expected and at any rate if I do end up needing more therapy it should  sort the issue out.

Having only managed a few hours sleep for most of the week due to the cough and then having to stay awake for 36 hours it was relief to be able to have a good sleep last night and recover a bit of sanity back.

It’s never fun being stuck in hospital but at least this time I won’t have to deal with too many needles as well as not being hooked up to a noisy machine all night.

I want to say again to everyone thanks so much for all the wonderful support.  It continues to reassure my wife and me that we have wonderful and caring friends and family.

In particular I want to thank my superstar wife Tamsin for being an absolutely brilliant wife and who managed to stay completely calm throughout this whole ordeal.  I also really want to thank my parents for coming to help and for helping take care of me.

It’s never a lot fun to have these sorts of “blips” but we feel generally very positive about the future.

I will continue to post updates as and when I have and news.

It seems I spoke too soon

Tuesday, 22 November 2011 

The consultant, Prof Horwich came by to see me to say that they are going to continue to treat me using radiotherapy as they want to nip my back pain in the bud as well as heal the bone damage from the cancer.  So I’ve got 10 sessions to do starting tomorrow.  Not the end of the world even with the extra tiredness as the Prof is confident it will sort out my pain and stop me needing heavy painkillers.

On the negative we asked about changes to my lymph nodes and he confirmed that there was a very minor increase (2mm) in size.  He stressed though that at this stage they don’t know what it means and so they’ll concentrate on the lower back and get my pain sorted.

On Thursday while I was having my mass anxiety attack about not being able to breathe, it occured to me that there was a  good chance I might die. (and as it turns out there was indeed a good chance I could die).  Fortunately I’ve managed to convince my brain that there’s bugger all I can do about it and rather then get frustrated about not being able to plan ahead I’ve decided to say screw it, plan everything, do everything as I’ll be damned if this thing will win.  Probably the healthiest attitude I could adopt and I certainly feel more positive and more determined then at any point since my wedding.

Months, not years…

Wednesday, 25 January 2012

So we started the New Year on a bit of a low.  After feeling very positive and coming out of the whole lung infection experience Taz and I both tried to keep the situation out of our minds and just try and enjoy Christmas and carry on planning things as normal.  I’d say all of this worked until we hit 2012 and the reality of will I or won’t I need more treatment hit again.  On top of that my back pain went up several notches and I managed to get shingles on my lower back and upper thigh.

When I last saw the doctor mid December he explained to me that for my current situation it was highly likely I would need further treatment.  But given my diagnosis i.e. the source of my cancer still being unknown he said there were two paths I could go down.  One was to have more chemotherapy and undergo a standard regime know as TIP – It’s a treatment used for second line testicular/germ cell cancer.   The other option was to consider trial/experimental drugs and for that he referred me to see another team.

Come end of the first week of January I met with doctors from the trial drug team and they explained the various types of treatment available and recommended a combination treatment that involves both chemotherapy drugs as well as a trial drug.  Eligibility for trial drugs is a little more complicated so I needed further blood tests as well as another CT scan on my lungs to see if I was eligible.

By this point the painkillers I was on (Morphine + Tramadol) just weren’t doing the job on my back pain and I was assigned a Macmillan nurse who deals with Palliative care.  I met her last week and she was able to sort out changes to my painkillers which since the weekend have started to make a difference although it’s a bit of cocktail of pills with a slow release morphine and nerve painkillers and other bits and pieces.  The main thing is that it is mostly working apart from a sharp intense pain in my ribs/upper back that comes and goes.

We had a follow up appointment today with the trial drug team who were able to confirm acceptance into a trial.  They felt it was the probably the best option for me versus the standard TIP Chemotherapy and I too felt it was likely the best option.  I should start treatment in two to three weeks but will find out the specific date in the next few days.  I haven’t quite got the details on what chemo/trial drugs I’ll be on but I expect the usual side effects of extreme fatigue, nausea and hair loss will be part of it.

The idea of more chemo has been especially difficult for me.  On the one hand I’ve had it already so know what I’m in for but by the same token I know what I’m in for and having to face that level of fatigue again is really not something to look forward too.

One question I had never asked during all my treatment was what my prognosis was.  I had gathered from the start that if it was a testicular cancer I was in the poor prognosis group but even that has a high degree of successful recovery.  Given where we are now in that a very intensive form of Chemotherapy didn’t do the job and the fact I was about to start using trial drugs I felt it was important to understand my situation.

The Doctor came back and explained that without any treatment I would have months, not years.  This as you can imagine was pretty hard to hear…  I’ve certainly thought recently that things were clearly not good and I guess it was obvious in a way that if I didn’t have more treatment it would spread and eventually kill me.  But hearing that it would be as short as a few months and accepting what that means is difficult to say the least.

We don’t know what the outcome of the trial treatment will be and ultimately it could work and at the very least make those months many years.  But of course you have to accept it both ways and that given it’s an unknown cancer and given it’s a trial drug with an unknown response for me there’s a good possibility I won’t see out 2012 (Of course the world could end so I wouldn’t necessarily be missing much).

This evening we booked a weekend away to Paris for this Saturday.  It seems sensible to try and make the most of the next two to three weeks before treatment starts and I inevitably end up completely sofa bound, bald, fatigued and nauseous while having to regularly build up the will power to go for a piss.

I’m of course as positive as I can be that the trial drugs will work and cure me.  But I will be making every effort to enjoy every second I have whether it’s for the next few months or the next 50 years.

Fingers crossed for the latter.

People stare at you on the tube when you cry

Friday, 10 February 2012

Yesterday was my last proper day in the office prior to treatment starting next week so I went for a few drinks with my colleagues as a little send off.

As they started saying goodbye to me I noticed it wasn’t said in a normal manner… I wouldn’t expect it to be a normal “see you next week” hug but at the same time it wasn’t a “good luck with your treatment” hug either.  It felt like a “good luck with treatment and I hope I will see you again because I know there’s a chance I won’t” goodbye.

It was very much all in the eyes and expressions and some of the words which were all hugely supportive.  One of my colleagues walked with me to the tube station and the same happened again when she said goodbye.  She gave me a big hug and said I’d be really missed and it just felt like a final goodbye.

I walked down the stairs to the tube and started balling my eyes out.. this continued pretty much all the way home.  I think it was acknowledging that it absolutely could be a “final” goodbye – Not in that I won’t see them again as I’m sure I will during treatment but that I may not return to work at all.  I’m probably lucky in that I really enjoy my job and love all the people I work with.  It was hard enough last year when I had to just suddenly stop it all for 6 months and now I have to do it all again which is hugely upsetting.

Treatment starts on Tuesday morning and I’ll be taking a combination of two drugs.  One is a standard chemotherapy drug called Docetaxel – commonly used for the treatment of breast cancer.  The other has the uber-friendly name of GDC-0068 and this is the trial drug.  The Docetaxel is given in the usual way of via a cannula in my hand and the trial drug is a much simpler pill.  I’ll be in hospital until Thursday and will continue to take the trial drug while at home after.

In total I’ll only need to be in hospital overnight a few times throughout the treatment which makes a nice change from the 30 odd nights I spent at the Marsden last year.  Though it remains to be seen how I actually react to the combination of these drugs the side effects should be less intense then last time.  I can still expect fatigue, nausea, hair loss etc but they shouldn’t be at the level I had before.

After I’ve had 6 weeks of treatment I’ll have a CT scan to see if it’s working.  If it is they’ll continue for 1 or 2 more cycles (3-6 weeks), if not then they’ll have to look at other options.

The level of support from everyone continues to be overwhelming and again my wife and I want to say a huge thank you and that we appreciate it so much.

The fun and games continue…

Sunday, 18 March 2012

So the first 5 weeks of 2nd round chemo have been luckily quite manageable.  Last year’s treatment involved about 7 different drugs and 30 odd nights in hospital whereas the trial only involves a single chemo drug, a few overnight stays plus the trial drug taken orally.  As a result the number of side effects and intensity of them are far less compared to last year so I’ve only had to deal with some nausea on occasion, dry mouth and throat ulcers haven’t been much fun and the always enjoyable fatigue but I had very much prepared myself for it feeling much much worse.

I’m back to bald again which came quicker then I expected but a part of me enjoyed not having to mess about with doing my hair in the mornings so I get to enjoy that again.

Probably the most positive thing for me has been that without the really heavy fatigue I’ve been able to get on with a fair bit from home.  My concentration hasn’t been affected like before so I’ve been able to do a decent amount of work from home plus my usual hobbies.

Unfortunately my overall mobility has worsened due to a pretty significant increase in pain over the last few weeks.  Just over a week ago I started developing severe nerve pain running down the back of my right leg which I hadn’t had to date.  I came in for my check-up appointment on Tuesday and they decided to move up my CT progress scan by a week and do it that afternoon as the Doctor’s were concerned that I might have a new lesion on my spine.

The results came back as positive for 2 new lesions on my spine, one in a place I had before which they had radiated and one in a new place lower down on my back.  Both of which appeared to be crushing on my spinal chord/nerves and would require immediate urgent treatment.  After some back and forth discussion over whether they could do surgery they decided instead on more Radiotherapy so I have 10 sessions to complete over the next 2 weeks which should hopefully along with the now obligatory heavy steroid dose clear the lesion issue and relieve the heavy pain.

Unfortunately the appearance of these new lesions since the pre trial scan basically means the trial drugs aren’t working and so the treatment has stopped.  The immediate concern is to sorting the lesions before they cause any permanent nerve damage and I’m seeing the Doctor’s again this Wednesday to discuss what my next chemo options are.

The truth is that we are starting to run out of options for me on treatment.  There are some standard chemo regimes similar to last year that may be the next best choice.  Similarly there are potentially other trials I could go on as well but I wouldn’t be able to start a new trial treatment for at least 5/6 weeks due to stricter entry requirements.  My trial team are going to speak with my original urology team and discuss again the next best option but as my primary cancer is still unknown treatment choices are a shot in the dark as to whether they will work.

It’s obviously not the news we wanted to hear.  I’m of course keeping my trademark positivity about it all and my wife is continuing to be the utterly dependable rock star she always is.

Thanks as always for the wonderful support… I know I mention it every time but it really makes all the difference for us to know we can depend on such wonderful people during what is obviously a pretty difficult time.  I’ll let you know the latest when I know and can only ask for you all to keep your fingers crossed for us.

To quote Lenny Kravitz… “It ain’t over ‘til it’s over”….. Damn right!