Silence, a haircut and flowery shirts

I have been too quiet recently.  Silence usually means one thing in my world.  Worry. This week has seen the culmination of some full-on worry.  So I am very happy now to be able to provide an update. An update which does not contain bad news.

The key elements of the update are:

– A haircut.
– A Doctor in a flowery shirt, nay, an oncologist in a flowery Songkran shirt.  Because a Doc in a festive shirt can’t give bad news, can he?

Last year when I arrived in Bangkok Airport at the start of the Thai Songkran Water Festival, my passport was stamped by an immigration official wearing a flowery shirt.  That’s a first and I can tell you it made me smile.  All of the immigration officials were wearing flowery shirts and broad smiles. So a flowery shirt is a Good Thing. An oncologist in a flowery shirt is an unexpected thing. And indeed he cooperated by not giving bad news in his flowery shirt.

I still don’t now what is causing the spinal pain which has been troubling me recently, but a bone scan has ruled out metastasis to my bones.  Causes could be an old injury, calcium depletion (thanks to cancer meds) or old age.  Onc suggests old age.  I high five him.

Hence the hair cut. I never get my hair cut before hearing the NED words. NED – No Evidence of Disease. A haircut is an acceptance of NED. An acknowledgement that there is no imminence of nasty treatment.  Treatment which might cause hair loss.

As always, my preferred way of processing this mess that goes on emotionally is by writing it and there is a heap of blah coming in this space.  I have been scrawling in freehand in the waiting room, in my room at night and even in Starbucks after the injection of radioactive dye before the bone scan. Those scrawls capture what happens in a mind which does not know what the future holds.  They will be shared here very shortly.

But for now, there is no bad news. Just a very long overdue haircut and a Doctor in a flowery shirt and big smile.

Happy Songkran, Pi Mai and Thingyan Water Festivals to all.

Stargazing

I was on my home way last night from a regular supermarket trip, when I glanced out of the taxi window. My stomach turned over. There was a beautifully low lit half moon in the sky. Why did my stomach flip?  The previous evening when leaving the office, I had remarked to a colleague that the moon looked as if it was almost full. Yes, she replied, it would be full on April 4. The moon is important here, and we keep note of lunar phases.  Most festivals are based on the lunar calendar and we are in the final days of run up into the biggest festival here – Thingyan, famously known as the Water Festival. I was puzzling about the status of the moon and its relation to Thingyan when I saw the almost full moon on Friday and in my mind I thought meant that it would probably be New Moon for Myanmar New Year which falls immediately after Thingyan.

So I was more than a little freaked by the sight of a half moon last night. Firstly, I questioned whether the moon had indeed been almost full when I had remarked on it the previous evening. The conversation with my colleague was fresh and clear in my mind. I knew the moon had looked full.  Seeing something dramatically unexpected about the moon rocks our foundations and most basic beliefs and truths. My thoughts then moved to Murakami’s IQ84 where the parallel world had two moons. I did not want to take that train of thought any further and vowed to Google this weirdness as soon as I got home.

When I got out of the taxi, a couple of neighbours were lingering, chatting in the lane as happens most evenings. One pointed to the moon and showed me that he was taking a photograph on his phone. He knows that I am wont to take pictures of the moon and I thought he was suggesting I photograph it. I obligingly (I would have been doing this anyway) took out my camera and captured a few images, while staring at the moon and pondering the mystery of its sudden regression or progression to half moon status.  It was so clear in the sky and I could see the shadow of the other half of the moon quite clearly when realisation hit.  This was not a half moon shadow, because the moon had a “bite” out of it!  This was a lunar eclipse!

I watched as the shadow passed across the moon, the orange glow faded and the full moon I had sought appeared gradually again. I remember seeing pictures of the solar eclipse recently, and delighted for friends who had seen their first eclipse, posting their awe on Facebook.  This was not visible in South East Asia, but I admit to being secretly envious.  There was a total eclipse on my birthday in 2008 but I could hardly see it because of cloud cover as I waited patiently on the rooftop of the apartment block I lived in at the time in Colombo, Sri Lanka,, taking photographs of cloud and trying to convince myself that I could see a shadow. And apart from the tail end of a solar eclipse in Myanmar in 2010 which I could not really see properly I have never truly seen either a solar or lunar eclipse.

I was quite delighted to have seen my surprise lunar eclipse.  There had been no anticipation and with the lack of planning and expectation there could only be satisfaction. If we put this in perspective, this has more meaning than just a fifty-something woman seeing her first clear eclipse.  If you look at my wish bucket it is pretty clear that I have a fascination with the night sky.  I want to see the rings on Saturn, and I would dearly love to witness the Aurora Borealis or Northern Lights. I was fascinated by the night sky as a child and still love to gaze upwards in innocent wonder.  That is very clear too, in the second of my three words of the year too – breathe, stargaze and realise. How apt that just after writing about breathing a couple of weeks ago, and with a vague plan to write about stargazing next, that the planets should align to gift me a lunar eclipse!

Watching the shadow slowly move to reveal the full moon again

As I approach my next round of medical checks with some questions which I expect to be explored, and as life continues to throw challenges in my direction this is a timely and keen reminder that I need to strive to stargaze and stretch my creativity. Life is less about what happens to us, but how we deal with what happens to us. I must remember to breathe, to stargaze and to realise.

The Waiting Room

I knew that the word “breathe” was an important one for me this year.  So important, that I do believe that the choice was not in fact mine, and more an insistence.

Nor did I realise that I have in fact been holding my breath for some time now.  For at least three months in fact, since the last round of Big Checks in October.

I have been on six monthly checks since reaching two years on from diagnosis apart from a glitch following the embolism, and more recently with my endocrinologist requesting 3 month reviews.  My last set of checks in October were difficult in that there were some question marks around the tumour markers in particular.  Dr W2 did not find them alarming enough to warrant immediate further investigation, but he felt that 6 months was too long to wait for the next review.  Hence I turned up at the hospital doors on Thursday, clutching my appointment slips, my best nervous smile and that familiar sense of letting go as yu are led through the coming hours of medical process. As always I had fasted overnight, and as always turned up first of all at Counter 2 to set things in motion.  And that is where I was met by surprise Number 1. Yes, I should have the blood draw first, but then was X Ray.  X Ray?  I had no idea that had been requested and when I expressed my surprise the nursing team showed me the slip and the tick against X Ray box.

Things happen so quickly and in no time the blood had been drawn and I had had my surprise chest X Ray, was dressed again and back at Counter 3,  It was not even 9 am! The team suggested that rather than waiting to see Dr A, the endocrinologist later in the morning, I should come back at 5 pm and see both Doctors. This was a real bonus as it meant I could return back to the hotel and have the breakfast which I usually miss due to the fasting and subsequent appointments.  It was surreal being back in the hotel, breakfasting with fellow guests yet feeling that I had somehow already spent the best part of a day at the hospital. The surgical tape and dressing on my arm were a clear sign though that I had not imagine this.

Then begins the Waiting Time.  I adamantly refuse to use this time well because I feel it tempts fate to do anything which resembles planning or makes any assumptions about the future.  The hair appointment is a classic example.  I will not even phone for an appointment to rid my hair of an encroaching silver topping until I have met with the Doctors.  No point in planning a hair cut if the hair were to go again.  Paranoid thoughts, I know, but having had to change plans so many times in the past due to unexpected tests and worries means that I have swung to the opposite end of the planning spectrum during the the time of the checks.  Not until I am at the pharmacy counter with a new bag of meds and an envelope with my results and appointment slips for months ahead, do I return to a planning frame of mind.

After breakfast I headed out to do a few errands, and then headed to a favourite waiting place, a peaceful tea room in a quiet corner of an otherwise manic shopping mall.  This place feels peaceful and although my mind is not, I take comfort in extended pots of tea and people watching.

Eventually, it is time to return to Counter 2 and the start of the nervous, serious waiting.  By this time, I know the score.  I have a number of conflicting scenarios in my head which range from “everything is fine, I am worrying about nothing” through to “I must savour this time, because it is all going to change again…”.

Soon I am called to see Dr A.  Smiles all round.  He is pleased with my bloodwork and examination.  Sugar is stable, so diabetes still held at bay, thyroid stable, kidney and liver functions all fine and the cholesterol has gone down a good chunk.  I had been really upset when the switch to Femara had been accompanied by rising cholesterol levels which diet and exercise did nothing to slow.  So he was very pleased and happy to extend the review time a little.  Though when he saw that Dr W, the surgeon will see me in April, he suggested that we align the checks to save the need for separate visits. Very encouraging indeed.

I left his consulting room with a smile, and returned to the Waiting Area. I realised that he had not given me the set of results as he usually does, and I had not been able to catch sight of the tumour markers. And those were the key results which were in the spotlight.  It was those results back in October which had concerned Dr W2.  And I know that it is not the number which is important, but the trend.  This set of results would show whether there was an upward trend or not, and if so how dramatic that might be.  I started on a new worry trail.  That Dr A had seen the markers and knew that there was no point in worrying me before I would discuss with Dr W2. When I have commented on tumour marker results in the past during Dr A;s appointment he will agree that the result is good or that needs some conversation with Dr W2 if raised.  The longer I waited, the more I found it difficult not to speculate on the number, again veering between willing it to be low and fearing it to be significantly raised.

I never manage to read or distract myself in the Waiting Room.  I sit quietly, watching, waiting and worrying. Soon I heard Dr W2 arrive, his voice reaching his room before he did. The waiting cranks up a gear.

And then I am called to his consulting room and we exchange Happy New Year wishes.  He never beats about the bush and told me that everything was fine, bloods good and the surprise X Ray fine.  And the tumour markers?  I venture.  “33” was his answer.  And that was a good answer indeed. Still above the reference range (which is up to 22.  22 “whats” I have no idea, but up to 22 of them is “normal”.)  When switching to Femara my results jumped from around 20 to 32m which prompted the bone and CT scans and Great Angst.  They have since hovered between 30 and 32 until the checks in October which showed another jump to 37.  Not a huge jump, but again it is the trend which is important. A drop to 33 was good. Dr W2 was happy.  He asked usual questions about bone pain, and continues to keep an eye on bones.  And then he suggested that he review again at the same time as Dr W and then if all is good return to 6 monthly checks.  And that was the BEST piece of information possible, all things considered. Perfect.

I left his room beaming, really relieved and realised that it has in fact been a long time since all of the Doctors have been happy and that things are properly back on track.  As I slowly breathed out I realised that I have been holding my breath for a very long time. I had been particularly despondent at the last set of checks with their “five year” status holding such significance, and with me taking a step backwards it felt.  At last now, I feel I am moving forward.

As always, even with the best of news, I am never of a mind to celebrate or leap around “high fiving”.  Rather I find myself subdued and reflective.  And emotional.  By the time I was in the taxi back to the hotel, I was struggling to hold back those tears, trying to quietly blub.  But that is not easy – I am not good at silent sobbing, and found myself trying to swallow back the strange noises and not give the taxi driver cause for alert!  It was fortunate that the Bangkok traffic was typically busy and provided ample time for composure before I arrived back at the hotel, Relieved, depleted and quietly thankful.

I know that the Waiting Room in April will again be tense, and that there are no guarantees that the good results this time will automatically follow through.  But I do know that I feel lighter than I have for a very long time.  And that is something to hold tight and savour as I continue to breathe deeply and thankfully.

After Five Years

I cannot quite imagine how this roller coaster cancer ride might have been if I had been diagnosed years earlier. Not necessarily in a world before the internet, but perhaps in a time when it was not such an integral part of life and particularly before social media became more common than chatting to your neighbour. Back in the day when having a PC in your home was the ultimate in connectivity, and when we used to store our data on those unreliable floppy discs. How life has changed.

I know that life in this post diagnosis world would have been much more difficult for me without a major online dimension, even although it is hard to imagine just how that might have looked. From the time of first fear and concern, when I entered into an unhealthy co-dependent relationship with Dr Google, through a process which saw me using information forums and connecting with others going through treatment and similar paths. From the moment I closed my eyes, held my breath and clicked “publish” on the very first post of this blog. Through a process which saw me connecting more and more with the developing online community, discussing the most personal of medical details with “strangers” on the basis of trust and solidarity, crying when new found friends were taken, venting at injustice, inequity and instances of stupidity. For me, the internet and social media have played a major part in my cancer experience. An important element of that is of course that I am in a country so far from my origins. Where the medical experience is not so different, but the wrapping is unfamiliar. Language, cultural beliefs, non-medical support and even the availability of non-Asian wigs add layers of complexity when navigating a new and frightening terrain. Of course, this is individual and the choice which has worked for me. I have close friends who have gone through this similar path and had very different levels of engagement with the online world. It is not a case of what is right or best, but which approach works for each individual.

And for me, the online world was what made the difference.

Through this online community, I have connected with (mostly) women blogging through breast cancer and as with any friendships, some resonated particularly. I remember early in 2011, being directed somehow, to a blog called After Five Years. Very quickly I became an avid follower of Lauren’s writing. As the title clearly says, this was a blog about life five years after diagnosis. When I first started reading Lauren’s work I did not realise that this would become a full year of weekly posts, exploring a plethora of aspects of breast cancer, and its fallout five years later. I loved Lauren’s exquisite writing and thought-provoking insights. I could hear a southern drawl when I read her words and she brought a wisdom and understanding of great depth, in a way that was easy to absorb. I used to wait for the “ping” on my Twitter feed on a Sunday evening on my side of the world, to tell me that Lauren’s weekly post had just been published, and I would rush on over to read it.

So much of Lauren’s work resonated – fear of recurrence, anxiety and stress through follow up scans and checks, venting over lack of understanding and sensitivity of others, the burden of a cancer diagnosis on those around us. I realised the other day that I had adopted one of Lauren’s approaches when I shared my fear that I had “toe cancer” following some sudden twinge.  This was borrowed from Lauren’s experience of “thigh cancer”. I can share a fear in a way which makes people laugh instead of adopting an embarrassed or dismissive expression if I describe my worry about “toe cancer”.

However, while a great deal did resonate, there was one Very Big Difference between Lauren and me. The clue is in the title of her blog.  While I had newly emerged from that year of treatment and was in an early recovery stage, with fuzzy clumps of cotton wool hair shouting CANCER loud and clear, Lauren was a whole five years from her diagnosis. Five years seemed so far away, in some kind of far off and safe place. I was an infant in the first weeks of Kindergarten and she was a prefect at the Big School. I could not imagine, and was frightened to think of a time so far ahead as after five years.

Yet here I am. This evening I will step over what is seen as an important line in cancer terms, into the after five years. Late in the evening of October 2 2009, Dr W gently spoke those words which were to have a greater impact than any others any in my life that I can think of. “This is highly suspicious of cancer”. Today is the day which has become my “Cancerversary” even though the official diagnosis came three days later. This was the moment I stepped through a set of swing doors into a territory I did not want to be. A set of doors which close behind you and will not let you back into the place you have left.

Early in my treatment, I remember apprehensively asking Dr W about life beyond the immediate treatment. He explained to me that once the rounds of chemo and radiation were done, and if there had been no regression, then I would be recalled every three months for follow up checks. At the checks which were timed around the anniversary time of diagnosis, there would be a more in depth monitoring which he calls the Big Check. If all is well around the two year point, I would graduate to six monthly checks. And at the five year point, again unless there is any reason for more frequent review, you are released into a world of annual checks. I remember listening avidly as he explained a life beyond the one where treatment and appointments drove every other aspect of life, and felt a quiver of hope that there was a future, a tomorrow and that one day life could be different. It felt incredibly far away, but knowing that such a time could exist provided a wonderful boost. My own path has differed a little to this, due mainly to the embolism and its accompanying bonuses.  I reverted back to 3 monthly recalls for a bit and I do not expect to be waved into the distance for a year if all is well next week. Particularly while there continue to be little extras and while the endocrinologist continues to call me back for three monthly reviews.

I have approached this five year benchmark with mixed feelings. I cannot truly breathe out and say “after five years” out loud for at least another week. Because there is an unwritten, unspoken expectation in there. After five years with no recurrence, is wrapped up in those words. And I know I cannot even think that while the appointment slip for my Big Check is sitting in an envelope with frightening words on it such as “mammogram, ultrasound of upper abdomen, chest X-ray, blood work for CEA, CA 153, (tumour markers) PT/INR (for the embolism) and a range of other tests. The appointment slip holds me in a limbo for at least seven more days, with its bold 9 October against the various tests.  I have to get through each of these, without any “flags” for follow on tests, such as bone scans or the dreaded CT scan. I have to wait, holding my breath as Drs W and W2, my surgeon and my oncologist review the scan results and I wait for the announcement that all is or is not well, that there are or are not worrisome signs which need to be investigated further. Only if, and when nothing sinister is revealed can I close my eyes, and say after five years out loud.

There is another dimension to the after five years which I really need to articulate. That relates to the widely held belief that five years represents a magic line, when you step from a world of shadow and darkness into a bright, shiny world twinkling with some kind of protective fairy dust, shaking off any fears or anxieties. That after five years means CURED. Out of the woods. Cancer free and no more need to worry. Survival to five years suggests that you can relax, as it won’t come back after that timespan. With many cancers that is the case, recurrence after five years is so unlikely that you can be considered as near as you can be to “cured”. But breast cancer is one of those sneaky, deceitful cancers that can lie dormant for years and even decades before it decides to reactivate. Around one in three of those diagnosed with an earlier stage cancer will go on to develop metastatic breast cancer. Some cancers are just wired that way while others can be eradicated by the gruelling treatment. The thing is, we don’t know which ones are programmed to destruct and which ones can be truly banished. We live with the knowledge inside us that our cancer might come back, even though we can be living with NED for years.

For me, after five years is an important milestone, not because I can skip off into cancerfree land, but because it represents a serious chunk of time. Half a decade. And half a decade, when you have heard the cancer words and stared mortality right in the face, is a wonderfully long time. Half a decade brings a perspective to living beyond diagnosis, which is impossible in the earlier days.

So if you ask me how I am going to celebrate my after five years, please understand that I am not being negative or defeatist when I say quite clearly that I don’t want to celebrate. This is not a celebration. It is, however, a time for thankfulness even before the Big Checks of next week. There is such a difference between celebration and thankfulness.

I am thankful that even though my cancer was advancing, that it had not travelled beyond the lymph nodes. I am thankful that I have access to care and treatment of the highest standard and a wonderful medical team. I am thankful that I am surrounded by support and love of family, friends and colleagues and an online community. I am thankful that despite a rocky medical road, particularly surviving a pulmonary embolism and living on a cocktail of ongoing meds, I am in reasonable health and strong enough to embark on gentle adventures and visit new places. I am thankful that my own changed perspectives and priorities have galvanised me into a changed lifestyle to achieve life goals NOW and not let these slip from view. I am inordinately thankful that I am able to continue life and work in such an inspiring and fascinating environment.

It is also a time of unexpected and intense emotion.  I was blindsided by tears before breakfast this morning.  I shed surprisingly few tears at the time of diagnosis and through treatment.  Why I crumbled this morning, I don’t quite understand but I have a game face to find before I set about an ordinary day.

Of course I have no idea what is ahead, no sense of whether the Big Checks will bring a new, unwanted meaning to after five years if there is anything untoward in the tests. Of course I am acutely anxious and afraid of the checks. But I do know one thing. Today I have reached my after five years and I am still here to keep telling my story.

Aiming for boring, avoiding interesting and ending up complicated!

What a strange 72 hours or so it has been. I have travelled internationally, felt fraught and anxious, been unusually outraged, been carried along a conveyor belt of tests, scans, blood draws and appointments and finally emerged through other side. I feel as if I have been passed through one of those old washing mangles!

As has been the norm for the past however many checks I have been through now, the process began with a fast from midnight of Monday. On Tuesday morning I presented myself at Counter 2 (of my hospital) with my usual smile and received the usual warm greetings from the staff.Behind my smile there is the usual nervousness as I know I will be guided towards the first step of the day. Appointments, and especially the Big Check feels like a conveyor belt.  I turn up at Counter 2 and from there am set in a process which will spit me out later once I have passed the variety of stops on the way.

And indeed, in no time I was on the conveyor belt and heading towards the first stop – the lab and the blood letting. After that brief stop, I was back on the conveyor belt and being ushered towards the imaging department for the next step – mammogram. Within fifteen minutes I was off again and heading to the X-ray rooms, each time passing one of the places I hate most – the CT scan room.  Bleurgh.

Within 45 minutes of arriving at the hospital, X-ray was also done and I was being led to the ultrasound room, currently in a temporary space due to the installation of a new MRi machine.  Every year, the ultrasound brings a chill to my soul.  I am instantly transported to October 2nd 2009 when I was watching the technician find ghostly spaceship shapes and pegging contours of more than one mass. This year was no different in terms of the sensation of dread and fear, but in the temporary room there was no screen above my head for me to see the images on the screen.  If I turned my head and craned my neck I could see what was going on, but it was preferable just to lie still and let the process take place.

In contrast to the mammogram and x-ray, the ultrasound took for ever.  Occasionally I peered over my shoulder but knowing I understand nothing of the shapes on the screen I quickly gave that up and tried to zone out.  But that was not so easy.  She was paying particular attention to one part of my upper abdomen around and below my right armpit.  More and more cold jelly appeared on my skin and the pinging and pegging started as she worked her way around whatever she was working her way around.  I think that some “priing” noises were the sound of saving an image, another “beep” noise signified pegging a shape. Or perhaps it was the other way round.  At any rate, I could not work out which was which and just listened to the sounds as my stomach tightened the more this continued.  Eventually, she stood up, told me she was finished and walked out of the room.  And that really rang alarm bells – usually I get a little informal feedback, confirmation that there are a couple of small cysts and liver wibbles but nothing to worry about. I hate hearing nothing.  It freaks me out, even more than the undue attention which had been paid to that one particular area which had started out the freaking out.

It is sobering getting cleaned up and changed after these tests and scans.  It all becomes immediately real again.  And I cannot describe the torturing fear in that space of time between scans and review/results. I am extremely fortunate that having my checks in Bangkok , that time is far shorter that elsewhere. I was told to go and eat breakfast, but have no idea what that was or whether I even finished it. My head was focused solely on the repeated scanning of one area and the abrupt departure of the doctor.

Waiting in the area near Dr W2’s consulting room passed in a daze.  I did not even attempt to read my KIndle and could make no sense of the obvius images on the TV with reports of flooding in other parts of the city. I was in another, dimension, suspended and unable to move in any direction.

Eventually, my appointment with Dr W2 came round and I moved into his office. As I sat down, he was reading the scan reports.  There was a great deal of text on one of the pages and I could feel my heart rate increasing as he read over the results with a dead pan face.  Finally he looked up.  “It’s OK” he said.  Your mammogram is normal.  Your X-ray is unremarkable.  And the Ultrasound is mostly fine.”  I could feel my eyes welling as he spoke those words.

I of course asked about the alarming attention of the scan and he told me that there are some “wibbles” (that is my medical term not Dr W2’s – I can’t remember what he called them) on my liver.  My liver is not young – in fact it is the same age as I am and showing what is likely to be signs of aging. He will continue to monitor these marks.  Previously, CT scans have shown up liver wibbles, but (thankfully) I had not CT scan this time.  (I hate them SO much). There are more wibbles but “favoured benign” on the ultrasound.

He told me that my tumour markers were not worrisome – one had risen a little but has been consistently higher wince the embolism so he is not worried.  And the other one has gone down from the slightly upper range of normal to low!  Which is very welcome.  He asked me if I am taking my medication.  He asked me about three times, when of course alarmed me. Despite the heavy side effects I am taking my meds meticulously and told him so.  We went on to talk about the side effects. He has suggested another med which should help with the joint pain and stiffness.  Let’s see how it works. He examined me and noted that my right leg was slightly larger than the left which drew his attention.  In fact it drew his attention so much that he did not even notice my funky toenail art!  That is not comforting at all!  He is also requesting another bone scan on my next round of checks in 6 months which is also a tad disquieting.

Finally I got his verdict.  “Fine but complicated.” With the original Stage 3 diagnosis, the pulmonary embolism, side effects and the need to take a number of heavy meds that makes me “complicated”.  Which is ok, in that it is far better than being “interesting”. I was “interesting” when undergoing the chemo and he would have to calculate how many drips of toxins to give me to maximise the effect of the chemo without over toxifying me! I was “interesting” when I had spaceship lumps and unusual pathology.  No, it is not fun being “interesting to an oncologist”. It is not, however, as good as being “boring”.  That is what I really want to be.  So boring that my oncologist would have to comment on my funky toenails as there is nothing else of interest to talk about!  One day perhaps?

I also saw my lovely surgeon Dr W and he was also reasonably happy with the results.  He asked me how long now since diagnosis, and when I told him it was 4 years and 8 days he expressed surprise.  “That’s incredible” he said.  I am not sure why it is incredible – I prefer to think it is because time passes quickly and not that when I originally presented he did not expect to see me in 4 years time.  I did not ask him why in case I did not like the answer.

So, finally I reached the point where I could get off the conveyor belt, once I had picked up another six months of medication and the paperwork and walk out into the sultry Bangkok evening air two days after I had embarked on this round of checks.  Able to breathe out, at least for the next six months. Which I know is exactly what I wished for.

I guess that NED (No Evidence of Disease)and I are not exactly walking arm in arm along a sunny path, but we are kind of in the same town.  Maybe we can get a bit closer in 6 months time?  That sure would be good.