Remembering ‘The Bob Garratt’ – Blog 63

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The UK memorial for Dad will be held on Friday March 17th at The Parish Church of Saint Peter, Main Street, Awsworth, Nottingham, NG16 2QU. The service will commence at 15:00.

Afterwards there will be a gathering at The Crown Inn where we will have the opportunity to celebrate and remember his life and what he meant to us all. The Crown Inn, is just 100m away from the Parish Church.

My Dad was a much loved man and this was evident following his Cremation here in Spain on March 1st. A number of friends and family attended the service and the day was a fitting tribute and send off for one of life’s true gems.

This will now be the final blog I write on behalf of Dad. It started as an opportunity to not only keep friends and family informed about Dad’s progress but also to add to the information available out there for families who find themselves in similar situations.

What I hadn’t accounted for, was the level of support it would give us back. The love, loyalty, understanding and compassion that friends, family and total strangers have shown us has been overwhelming. All of which has helped us walk down the unknown path together.

In a world that is so often consumed with war and hatred, I have been honoured and blessed to be part of a story that has contained strength, courage, love and resilience. Cancer took my Dad’s life, but his spirit will live on forever more.

I would also like to take this opportunity to thank just a few of the people that have been there for my Dad. There are dozens more though these particular people have helped more than I can perhaps every truly convey:

Jim & Val Jordan: My Dad had nothing but love and respect for you both. He loved you both dearly. He would have been proud of the service you gave him on March 1st. I know I am. Despite it being brought forward 50 years.

Tom Rigg: There are not enough words I can find to express the sheer gratitude for the support and love you have provided my Dad and family. Without you, this situation would have been unbearable. Eres una Estrella. Gracias.

Gloria Brook: You have done more than you may very well know. Your compassion and understanding has helped us navigate the unknown in a more clear, positive and grounded manner. Thank you.

For those that attend next Friday, I look forward to seeing you.

Thank you & God bless you all xxxx

P.S.

Two cannibals eating a clown, one turned to the other and said: “Does this taste funny to you?”

I have a gravel path in my garden while my neighbour’s is concrete. I think mine wins on aggregate.

Two snowmen in a field – one says to the other “Can you smell carrots?

xxxx

 

 

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Final Goodbye – Blog 62

Dad in his prime...
His favourite photo & how he wants us to remember him

Thank you everyone for all your continued love, support and kind words.

Whilst this is not the blog I ever wanted to have to write, the day has finally come. My Dad passed away this morning at 7:25am Spanish time.

He was not alone and died peacefully when the time came. He is no longer in pain and no longer suffering. He battled courageously for 21 months and despite the initial prognosis giving him just 6 months to live, we were blessed to have been given so much more time, thanks largely to just how strong and resilient he was.

We have so many happy memories and it’s those I want you all to remember and celebrate. With this in mind, it is our intention for Dad to be cremated at a service held in the Tanatorio at Xativa. This will be held on March 1st at 12pm. For those that can attend then we look forward to welcoming you in celebrating Dad’s life. For those that are understandably unable to make the trip over we are planning to have a secondary memorial to be held in England.

I do not have a confirmed date for the English side of things at present. It is our intention to hold it at the Church in Awsworth (TBC) with a gathering at a local venue shortly after. As and when these details are known I will look to share accordingly.

By no means do we feel defeated by today’s events. Whilst Cancer may have claimed Dad’s life, his spirit will live on in all of us. The strength he showed in his darkest days will stay with me forever. My Dad was a proud, happy, loving man and always will be. His jokes were questionable at the best of times but we will always love him for them.

Sleep well Dad, we love you so much and always will xxx

Bowel Cancer Chemo – Blog 60

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Part one of the new Chemo cycle targeting the Bowel Cancer has started with a 3 hour session in Xativa Hospital. Dad was put on an intravenous solution to kick start this new phase. It also gave him chance to reconnect with the countless number of nurses/girlfriends he has gained during his time attending all his various appointments.

He has also now been prescribed part 2 of the Chemo treatment which is Capecitabina – a tablet to be taken orally, twice a day, for the next 14 days.

As expected the standard list of side effects that could occur during this round of Chemo is quite lengthy:

Stomach pain or upset stomach, Constipation, Loss of appetite, Changes in the ability to perceive the flavours of food, Increased thirst, Unusual tiredness or weakness, Dizziness, Headache, Hair loss, Rash, Back, joint or muscle pain, Redness, swelling, itching or tearing of the eyes, Difficulty sleeping or staying asleep.

The Serious side effects that we need to keep an eye out for though are as follows:

Diarrhoea, Sickness, Vomiting, Sores in the mouth, Swelling, pain, redness, or scaling of the skin on the palms of the hands or soles of the feet, Fever, chills, sore throat or other signs of infection, Swelling of the hands, feet, ankles, or lower legs, Pain or tightness in the chest, Fast heartbeat, Dark urine, Yellowing of the skin or eyes.

The Oncologist is going to see Dad on a weekly basis to ensure that he is coping okay with this cycle of Chemo. She is highly concerned of the side effects that could occur for Dad and wants to ensure that the treatment is the right choice at this late stage. She did give the option to postpone it this morning as Dad was feeling a little worse for wear and very tired.

It is touch and go if this cycle of Chemo will do anything other than upset the balances of Dad’s other organs which have currently stabilised. The Capecitabina tablets can cause complications for patients that have current issues with their liver, kidneys and heart. The fact that Dad has liver metastases, fluid round his heart and had kidney failure over Christmas are all areas of concern that the hospital must keep a close eye on. Salt levels are also going to be at risk if diarrhoea occurs due to the fact this will flush out liquid intake which in turn will flush out all the sodium causing even more complications for the kidneys.

The counter argument of this is that he is barely now eating anything anyway. So, in some respects this is helping as the less he takes in the less he needs to process through his body. To better understand what he was up against we have asked if surgery was possible in order to remove the tumour in his bowel. This would have meant Dad having a Colostomy Bag, which is something he doesn’t really like the thought of but we wanted to know anyway.

Unfortunately, surgery to remove the tumour is not possible. The tumour is big and is inoperable. It is also the reason he cannot toilet properly. It’s not just that he isn’t eating, the tumour is so big that the colon is almost fully blocked. As a result, should he start being sick and not toileting at all, then he will end up having a Colostomy Bag whether he likes it or not, despite the fact the tumour will remain in his Colon.

Both Dad & Mum are understandably concerned with regards to the lack of eating and the Oncologist has said that it is not a problem. Her words were basically that whilst not eating will cause him to die, he will die anyway. This was done in a pleasant and tactful way though the answer is only what we already knew.

This coming Wednesday we will see the Oncologist for a follow up review; Dad will have his blood tests done and this will give them the chance to decide whether the treatment should continue or not.

On Thursday, Dad will then have a biopsy done on his liver. This will be a full day appointment with careful monitoring needed throughout the day. He will be put on an intravenous drip in order to administer medication if required and will be on bed rest, after the biopsy, within the oncology department for between 2-6 hours.

Should Chemo work and not impact Dad’s quality of life too drastically then the cycle is repeated every 3 weeks. (The next one being 10th March).

Should Dad not be strong enough then his options are limited. It’s highly likely a Colostomy Bag will be fitted and he will then be in the realm of the palliative care team to ensure he is as pain free as possible until the end.

Despite Dad being shattered, feeling ‘wuzzy’ and a little worse for wear, we did still head out today for a walk around a nearby lake. Dad wanted to and so this should be taken as an encouraging sign. I have to admit, he doesn’t look half bad either. Well, not half bad in this picture.

 

Carrots & Love: Part 2 – Blog 59

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Following immediately on from last night’s blog, I feel it’s only right to provide an update despite it being less than 24 hours.

Today we attended the hospital for the planned Scan to assess just what was going on in Dad’s bowel. The appointment lasted just 30 minutes and we were then asked to see the Oncologist later in the afternoon for the results.

The news unfortunately is not what we had hoped. Whilst we expected that fluid around the heart would cause the next complication and halt the Immunotherapy treatment, this was not the case.

Instead, Dad today was dealt with the blow that, as originally feared, they have discovered a new tumour in his bowel. The Bowel Cancer has grown quickly and is now to be the main focus of any future treatment efforts.

This said, Dad will also need to have a biopsy performed next week on his liver due to the cancer also causing more concern in this area. The cancer had already spread into his liver so this is nothing new but sadly it appears this side of things has also gradually got worse.

Immunotherapy is no longer an option for Dad. The Immunotherapy is designed to work with the protein found in the Lung Cancer. The Bowel Cancer does not contain this protein and treatment must now be focused on the bowel and not the lungs.

Seeing Dad’s reaction to the news was gutting. Watching someone you love be dealt the cruellest of blows when the finishing post was within spitting distance was awful. His colour vanished immediately and the realisation that he was being pushed down the road of no return quickly dawned on him. The dangled carrot has effectively been well and truly removed.

The next step for Dad is to start a new round of chemotherapy, a new phase of hope. This is due to start on Friday morning. He will receive the chemotherapy intravenously for 2 hours. He will then be free to go home. The difference this time is that he will then be on chemotherapy pills to be taken at home for 14 days.

Oral pills are known to cause their fair share of side effects though until I know exactly which type he is given, it’s impossible to say. We will know on Friday though the side effects are likely to be nausea, vomiting, diarrhoea, febrile neutropoenia (fever) and peripheral neuropathy (nerve damage).

The Oncologist will also be keeping a close eye on Dad every week, if not more frequently. This will include blood tests and general health checks. They are concerned that the complications we have seen over the last few months, of kidney failure and low sodium levels, could make a comeback. It is not to say that they will, just that extra caution is needed to ensure it’s known exactly how Dad is at each stage of the bowel chemo.

With regards to his pain relief, his doses have also now been increased. This includes the Morphine patches he has to wear, as well as countless other tablets that he is now on. The Actiq lollipops he craves have also been increased in dosage. These should only be taken during severe episodes of onset pain. They almost now seem like sweets to Dad though.

There is no time limit set for how long Dad has left. There are signs, indications and reflections on situations that have occurred that lead us to wonder if its days, weeks or months. At times, we have been given some indications, though nothing concrete can truly ever be stated or relied upon.

Please know that whilst we may struggle at times to deal with the language barrier that the Spanish health system may present, I can confirm with the utter most confidence and assurance that Dad’s care has been second to none. The doctors, nurses, porters, specialists, receptionists, cleaners etc. are all truly wonderful, patient, caring and accepting people. The treatment he has received and continues to receive is incredible; he never goes without. Some of the information can seem overwhelming though this is because we are dealing with something that affects us where it hurts, our hearts.

Today is a major blow. Our job is to now build him back up. He is worried. He is concerned. He is questioning how much fight he has left. He is however open to continued treatment efforts. He is not ready to give up despite naturally at times feeling like the end is in sight.

Whatever happens, do not take today’s news as bad as it may sound. Immunotherapy was a chance of an extended life, with a hope of a cure. Whilst the eligibility has been whisked away from him, the pure fact that he was even possibly going to be able to take part has kept him going. This hope was enough to keep him battling on. This is not the end.

Dad is a fighter. He still is a fighter and still has fight left in him.

xxx

 

 

 

 

Carrots & Love – Blog 58

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The immunotherapy ‘carrot on a stick’ is still being dangled in front of Dad and it’s hard to say if he will ever fully pass all the eligibility checks.

Days and weeks continue to pass by and whilst we are blessed that he is still with us, his health continues to take a battering. It can only be due to how strong he has been during his life that he has been able to battle on so courageously for this long.

He is however tired of it all now. Each time we get to a decision point, another obstacle is put in front of him. This is wearing him down as he feels the road is blocked and he isn’t daft, he knows without the treatment his future path has already been decided.

Following the last batch of scans, we had hoped that a decision would have been reached by now. Unfortunately, they stumbled across the bowel issue which thankfully at this stage turned out not to be a tumour. They have now discovered that there could be a build-up of fluid around his heart (pericardial effusion). If found to be true this again would call time on the treatment hope. As ever though he battles on the best he can.

This current week is full of more tests. We always knew that on Wednesday he was due to have a repeat scan on his bowel to ‘bottom’ out the issue. We also found out though that the trial team needed to repeat all the other tests before Immuno would be given the green light. This is because too much time has now elapsed following the bowel issue discovery.

This meant having a repeat of all the general health checks in Valencia yesterday (blood pressure, blood tests, ECG, EKG etc…). It also included having an ultrasound to fully assess the heart situation. As Dad went in alone we are a little unsure of the result. As far as Dad is concerned, the medics said that all was okay and that his heart was “sound as a pound”. I hope this truly is the result though this fact remains to be seen.

Luckily we will get to see the Oncologist again tomorrow following the bowel scan and hopefully we will have a little more knowledge if the fluid issue is still present or not. It will also give us the opportunity to review the current batch of pain killers Dad is on. The pain is getting frequent now and increasing in its severity. His shortness of breath and inability to muster up the energy to do anything is also taking hold. As there has also been a lot of muscle wastage he is getting a lot of pain in his legs and continues to feel pain in his chest area.

Once we know the outcome from this week’s tests, I will look to provide an update as to what happens next.

As ever, thank you to everyone for the love you have all shown to not only Dad but to all of us. Happy Valentines Day one and all xxx

One Step Closer – Blog 57

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The last few days have been quite fraught for Dad due to today’s impending Colonoscopy. The whole situation has been draining for him psychologically more than anything else.

He has coped well with the restricted diet, even managing to take to drinking black coffee with relative ease. Black tea has been a no go, though this was expected. Otherwise he has been eating just fish, toast, rice and soup. Quite a healthy diet in some respects.

More than anything though the expectation connected with the taking of an enema and what may or may or not be found, has caused him much worry and to feel uncomfortable.

Three laxatives and two enemas later, we arrived at Xativa Hospital and Dad waited ‘impatiently’ to be called through for the procedure; 45 minutes passed by and it was all over.

The news is technically great though the procedure itself failed. Although they were not able to fully assess the bowel where the suspected issue was, doctors are confident enough that we are no longer dealing with a further tumour.

This means that the Immunotherapy treatment (at this stage) will more than likely be given the go ahead; although we have still not received the full thumbs up yet.

A further scan on Dad’s bowel will be carried out next Wednesday, though this time he will not need to follow a restricted diet and will only need one enema the evening before. They have not said what the scan will be but it sounds like it may be a barium style scan or some other such specialist scan; either way they do not seem unduly concerned, they simply want to get to the bottom (ahem) of what may be happening down there.

It remains to be seen if Valencia will give the go ahead for the Immunotherapy treatment before next week’s second bowel scan, though the Oncologist has said she will let the team know that Colon Cancer is not suspected.

Having left the hospital, you could see Dad’s mood lift; like the weight he has been carrying, has been lifted from his shoulders.

His main concern continues to be his weight loss, especially with regards to his legs which have become very skeletal in their appearance. His arms are not much better and due to the small levels of food being consumed his energy level remains very low.

Due to his tiredness, he also becomes easily agitated and has bouts of grumpiness that would give even the entire cast of ‘Grumpy Old Men’ a run for their money.

To restore a bit of light and positivity, one good news story I have read this week was on February 4th (World Cancer Day).

Immunotherapy is advancing tremendously and trials have been taking place for some time. A patient with what I believe to be just Lung Cancer with no spread to other areas of his body was given just 12-18 months to live. This was 3 years ago! After receiving a trial course of Immunotherapy, he now has NO traces of the disease.

Different results are clearly seen across those that have taken part in past and current trials. However, this is the first time I have read that Immunotherapy has actually cured someone!

I’m not going to get too far ahead of ourselves but rather than believe we are facing the end, I thought for once even whilst the odds may be stacked against Dad, there is still time and there is still a chance that his resilience and fight will pay off.

Nothing Ventured, Nothing Gained – Blog 51

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Dad managed to make it to the scheduled appointment on 4th January for his progress review. The appointment got off to a bad start with a misunderstanding as to the fact that we were meant to have arrived earlier for blood tests however, thanks to English naivety and the batting of our eyelids the medics took pity on us. He had blood taken and we were asked to wait a couple of hours for the lab to get the analysis done.

Surprisingly at this stage his sodium levels had kept themselves stable though he was still showing signs of dehydration. His kidneys were also not at full capacity though the Oncologist was happy with how Dad was in himself and the balance that had been found.

The Oncologist suggested an appointment be made for Dad to attend the hospital at Valencia on Tuesday 10th so that a specialist could look through his medical file to consider him for Immunotherapy treatment. Whilst this treatment is still in ‘clinical trial’ status for Dad’s advanced stage of cancer, it has at least been tested on other forms of lung cancer with some promising results.

Don’t get me wrong, at this stage of the game, Immunotherapy is very much a shot in the dark and it is unknown as to how it will impact Dad’s cancer. However, the Oncologist has said that if she were to pick which road to take; between either a third round of Chemo or Immunotherapy then she would recommend Immunotherapy without a doubt. This is mostly because she believes whilst a third round of Chemo is possible, it may actually cause more harm than good.

The thing with clinical trials is that whilst all protective measures are taken things can go wrong so, more than likely if he is considered, a disclaimer will need to be signed. Personally, my view on this is that it is worth the shot; nothing ventured, nothing gained. It also means he still has ‘hope’ to cling onto which is to be welcomed.

Things going wrong was made ever more the clearer with another unanticipated hospital visit yesterday! Dad had started to have a ‘fuzzy’ head and pains in his sides as well as diarrhoea. This time, rather than second guess and wait, we took him straight to hospital. Having waited a couple of hours and following numerous tests it was confirmed his sodium levels had fallen and that he would need to stay in for 24 hours.

They confirmed also that he is still showing signs of dehydration. The thing is he is NOT drinking the required amount of fluids. He claims he is but the evidence shows otherwise; he isn’t drinking and will do anything and everything to avoid drinking, including trying to fool those around him.

I once said I was proud of him and I am. However, one area where my patience is tested is in his attempts to subvert his fluid intake. He knows he will die if he doesn’t drink enough. We have tried the nice approach, nasty approach, informed approach, the medical approach, the sneaky in other food approach and none are working.

The best thing I can say is that his mind is still quite focused on going forward. He is, deep down, aware that his time is nearing an end however, he does also believe that a miracle cure will eradicate the cancer from his body. It’s this mindset that has kept him going, possibly in some respects more so than any fluid intake requirements.

Good news came today in that he was released from hospital. It has been confirmed that he will need sodium ‘top ups’ quite frequently as his levels are expected to constantly drop. He has also been informed that without drinking, he will suffer. Still he does not listen….

Spirits were boosted this week by a couple of family reunions.

Steven & Nicola visited on Monday and got to spend some quality time with Dad in his own environment. We visited the local town of Canals and had a nice few hours together. Dad especially liked being able to see Nicola, having not manged to see her when Steven and his two kids visited just before Christmas. More visits are planned.

On Wednesday night, Dad’s two sisters and niece all arrived to visit. They didn’t get to the house from the airport until 23:15 though. Dad had stayed up, especially to see them arrive at the house; normally he would be in bed by 22:00 so you could tell how excited he was about seeing them. I won’t go into too much detail about Thursday’s events, but I will say the day was brilliant and gave everyone the opportunity to enjoy each other’s company and build some lasting memories.

Dads’ presence in Spain does make it awkward for family and friends to see him, but I can assure you all, that he is happy here and content that this is where he wants to live out his days. It does mean that for some they won’t get to see Dad before his time comes, but it doesn’t mean that he isn’t thinking about you as much as you will be about him.

I would encourage family wanting/able to come and visit, to do so sooner rather than later. Regrets take seconds to form but can last a lifetime.