A bit of a downer again

Derek phoned a little while ago to say that he hasn't been able to keep his food down, and that the nurses inserted a tube through his nose to empty his stomach. He says that he's feeling a lot better. His team of nutritionists and doctors will assess the situation in the morning. There is a possibility of a partial blockage somewhere - only partial apparently, because the ileostomy bag is receiving some output from Derek's intestine. We'll know more in the morning.

Continuing on the path

We just came back from a visit with Derek - he is on a controlled IV drip and his blood sugar is back to normal. He is tired from the medicines, but is eating some food and having tea. The meals that arrive are supplied by contract with outside caterers, and it shows. They send food which is a no-no for Derek (after all, he is diabetic and should also not have fibrous food), so Derek has to check the menu before he touches anything. The nurses then have to hunt around to find something suitable for him. This needs some work. The doctors and nurses are doing a first-class job. Derek is constantly monitored. It is gratifying to see that every effort is being made to keep him on the road to recovery.

Upward again

Derek phoned this morning from the hospital; he sounds like his old self. He's asking for his deoderant, some fresh pyjamas, a couple of the books he's reading, and a couple of other things. It's obvious to us that the withdrawal routine is responsible for his down periods. Derek said that he will try and eat this morning, including some "power food". I think that means some of the fortified liquid foods usually used by athletes. In any case, he sounds and feels a lot better this morning. More after we've visited him.

The Rollercoaster

As you know from Derek's blog, he's going through the morphine withdrawal routine. In the last couple of days the symptoms have become bad enough for him to be unable to keep food down. So, we decided that it would be better for him to go back to the hospital. He'll have his electrolytes, and blood sugar levels brought back to normal and be under observation. We want to thank the hospital staff for the quick attention Derek has received so far - we had a bed in emergency quickly, and he's now got a bed in the regular hospital ward. Derek felt fine over the weekend - now he's down again. It is a rollercoaster recovery.

One step at a time

For those of you who are wondering why Derek hasn't been blogging the last couple of days: Derek's feeling pretty tired these days - the withdrawal routine and the general healing is having some effect. He has an appetite, but is not eating overly much. We're trying to "fatten him up" by providing him high-calorie, sugar-free food and drink. It's up-and-down. Derek's sleeping and waking times are all over the map, he says. We're lucky to be next door to him and that's good for both him and us. We can help quickly with anything he might need.

Another way

Yesterday, I wrote at some length about the cells that make up a good part of "life" on Earth now. In particular, eukaryotic cells of which we humans are made up; a human can therefore be considered one way of assembling these cells. There are many different ways (i.e. insects, mollusks, etc...). Here is another way:
http://www.flickr.com/photos/mimiandpapa/831136542/

On life

I'm not a biologist, far from it. But I have an open mind and am interested in reading up on subjects about which I know little. For Christmas 1991, Derek (who has a degree in marine biology) gave me a softcover book whose title is simply "Microcosmos". I suppose Derek's intent was meant as a juxtaposition to my interests in the "macrocosm" which is a subject of study in astronomy (a hobby of mine). This book was written by Dr. Lynn Margulis and Dorion Sagan. Its subject is the evolution of life from the beginning (four billion years ago) to now.

After many partially successful starts, so they write, the most basic form of life was found in the form of single cells without nucleus (prokaryotic cells). Other cell forms evolved which preyed on these prokaryotic cells and invaded them. Most of the prokaryotes died as a result. Since killing the host takes the invader with it, this is a self-defeating process. There were some prokaryotes, however, which got "sick" but did not die, even though they now contained the foreign invaders. Over time, the invaders, whose task it was to subvert the cell machinery to their own purposes (any virus does the same thing today), gave up some of their own functions (those that duplicated the identical function in their hosts), and the hosts acquired some beneficial functionalities from their invaders which they had not had before. This result then made host and invader dependent on each other - we call this process a symbiosis. Eventually, our current cell system evolved in such a way that these formerly foreign invaders are a necessity for a viable cell. Cells that contain this symbiotic arrangement are called eukaryotic cells. The inclusions are seen easily under a microscope - we call them mitochondria and nuclei. Most life forms, especially we humans, are made up of eukaryotic cells whose individual function depends critically on this symbiotic relationship.

Why am I mentioning all that? As may you know from my previous posts and Derek's own blog (http://www.penmachine.com/), Derek developed colon cancer within the last year. The aforementioned book states on page 148 of the softcover edition (Simon and Schuster Touchstone, publisher): .... "The body is totalitarian in its regulation of genes. Once a cell becomes a muscle cell, for example, it is so forever. The only exception to this rule of permanent roles within the body is during cancer, when cells seem to revert back to the more promordial condition of reproducing continuously, without regard to their place or function in the body. During cancer, chromosomes break apart and mitochondria reproduce even more rapidly then the cells of which they are a part..... ..... It is as if the uneasy alliances of the symbiotic partnerships that maintain the cells disintegrate. The symbionts fall out of line, once again asserting their independent tendencies, reliving their ancient past. The reasons, of course, are not all that clear, but cancer seems more an untimely regression than a disease. Genes are regulated and cells differentiated in the body by a complex interaction of biochemicals within the body. When these biochemicals are diluted by the introduction of cigarette smoke, sodium nitrate, and other carcinogens, they cannot perform their task. Consequently cells tend to behave like children in a class room whose teacher has left: they go wild, they get out of their cellular 'seats', they play and reproduce in an unregulated, wanton fashion."

Who knows what kicked off this serious turn of events in Derek's colon? It is easy to describe this condition in physical terms, but the emotional component for those who are afflicted, and their family and friends cannot be so easily understood. Derek never smoked, but what about the preservatives in our foods (among which are nitrates), second-hand cigarette smoke, pesticides used in agriculture, cosmic rays? We'll likely never know.

The irony of Derek giving me a book years ago, some of whose content describes a situation of which he is now a victim, is not lost on me.

For those of you who are interested in the book, it is still available here:

http://www.amazon.com/Microcosmos-Billion-Years-Microbial-Evolution/dp/0520210646

The Beauty of Saturn

Those of you who read an earlier blog entry of mine know that one of my hobbies is astronomy. Besides scientific exploration, and a quest to find out our place in the universe, astronomy can also have real artistic value. As an example, here's an image transmitted from a NASA probe orbiting the planet Saturn, showing a "solar eclipse". This is an occasion when the probe (called Cassini) travels through Saturn's shadow, which means that the Sun is behind Saturn from this point of view. Therefore, Saturn appears here "backlit", something that can never be seen from Earth. Anyone who's ever seen Saturn through a telescope will realize that, though the view from Earth is impressive, Saturn looks quit different in this picture. It's almost like a "negative" image. If you click on the picture to enlarge it, you'll also see a faint, tiny blue dot to the left of Saturn outside the brightest part of the ring and inside the first faint "dust ring". That is the Earth, as seen from Cassini at the time, over 1000 Million km (620 Million miles) away. It is humbling to think that all humanity, it's joys and sorrows, are concentrated in this insignificant pixel. You may need to look at the picture in subdued surroundings, bright light will "swamp" the tiny image of the Earth.

Anyone interested in technology, as I am, will appreciate the immense amount of engineering and technical know-how it took to make it possible for anyone to view this picture on his or her computer (rocket flight, communications, internet, computer, and many other techniques, including software, etc...). We tend to take all these things for granted, but even one glitch in the technological chain would prevent this picture from reaching you. It is a testament to human ingenuity to have this view. See an enhanced version of this image at Seann's blog (that link shown in the accompanying comments section. Click on comments below)

http://www.nasa.gov/mission_pages/cassini/multimedia/index.html

This is the URL for more images from Cassini and other "Saturnalia"

Blogging again

It didn't take long for Derek to resume his activities on his blog. For those of you who haven't already found out, here's the link: http://www.penmachine.com/

Nobody could be happier than we are. Blogging will likely channel Derek's mind back to his community, and you'll have all pertinent information first hand.

In any case we'd like to thank all who take an interest in Derek's current problems for your support and concern. As parents, it is gratifying to know that Derek has so many friends.

Home

Around 5:30 pm this afternoon my wife and I brought Derek back to his home. He is quite tired at this time but no doubt happy to be away from the hospital (no reflection on the great staff there!). He had a big day, visiting his friend Simon and dealing with the minutiae which go with hospital discharge. He even managed to walk up one flight of stairs at the hospital and did it again at home. We are all happy to see him back with his family. Airdrie and the kids prepared the house for him and got everything ready so that he'll be comfortable in his recovery.

I'm not sure when Derek will "reappear" on his blog, but since it does not require a lot of physical exertion, I expect that you'll hear from him directly sooner rather than later.

Coming home?

A phone call this morning from Derek has given us another upswing on his way to recovery. He said that he's feeling pretty good and that the withdrawal control program seems to be working. Yesterday evening, he had enough stamina to visit his good friend Simon James in Simons' hospital room five floors below. Simon had to have a heart valve replacement, due to a congenital problem which has plagued him all his life. Simon had his operation on Wednesday and is still pretty groggy, but is coherent and happy to see visitors for short periods. I'm sure that he and Derek have a lot to talk about. Derek intends to visit him again today.

Derek said that the staples used to hold his incision together are going to be removed today. The incision seems to have healed (note to Christa Giles: "knitted") very well. There'll likely always be a scar, but I think that the idea of stapling is to "minimize" its appearance.

It's Derek's choice regarding whether to come home today or stay another day. It all depends on how he feels later on. We'll let you know. You may see Derek on his blog soon.

Upward again

Today, my wife and I both visited Derek again and are happy to report that he is a lot better than yesterday. He's back on controlled doses of morphine - which proves that he really was showing withdrawal symptoms. While I stayed for about an hour, my wife spent an additional two with him. They went to the hospital's retaurant patio - and had a good discussion about things (big bands,various kinds of music, the inventors of overdubbing and multi-channel recording, Les Paul and Mary Ford, etc...) totally unrelated to Derek's fight with the cancer. It was Derek's first time in the open since his hospital stay began.

Derek is now going to follow a regimen of gradual morphine withdrawal, with lower and lower doses stretched over longer and longer periods. This should go on for about a week. Most of this is likely to happen at his home - we'll provide whatever needed support we can help with. This includes looking after our grandsdaughters - not a chore in any case; we love having them at our place.

Things are looking up again.

Morphine

Derek just phoned from the hospital. He has asked me to post the following information: There seems to be a consensus developing among his medical support team that his current symptoms (described somewhat in my previous post) are a manifestation of morphine withdrawal. Derek had this idea earlier and it seems as though the team is leaning toward the same explanation. Before his operation, he was prescribed morphine tablets to control severe abdominal pain caused by the undetected perforation of his bowel by the colon cancer. There now appears to have been some leakage into into his bowel causing the pain. He was given morphine intravenously by the doctors to control post-operative pain and subsequently was able to use a control setup to self administer it when the pain got to be too overwhelming. The hospital team discontinued its use a couple of days ago, and instead prescribed an oral painkiller medication. According to medical literature (I did a quick "google"), the kind of symptoms he's experiencing are consistent with withdrawal symptoms (chills, twitching muscles, perspiration, abdominal and muscle cramps, etc...). Morphine withdrawal symptoms are at a peak 36 to 72 hours after stopping its use. Untreated, withdrawal symptoms take 5-7 days to disappear. Derek says that the hospital is consulting with the appropriate in-house doctors to establish a course of action. More on this when we know.