March Update

Well, the pressure is on to write something more. Not that I’ve had fans clamouring for more but I just feel that if I start a blog, I should actually provide updates.

I’ll first start about some admin issues, since this is what I dealt with the first week I was back in Canada. As I work for the federal government overseas, I am a non-resident which means that I am not eligible for provincial health insurance. Though I must point out that I am a deemed resident for tax purposes and pay full federal and provincial taxes. Anyway, I have private insurance through Allianz Global Assistance (SunLife).  It’s usually not a problem to get reimbursed for medical claims (unless there is a Phoenix problem which is the subject for another blog) and they pay reasonably quickly. For services in Canada, in fact, they accept direct billing so I don’t have to pay up front for the services. The problem I had was that the Saskatchewan Cancer Agency, which provides cancer treatment throughout the province, only provides services to Canadian residents and does not accept fees for services. Somehow, someone had the good sense to realize that a Canadian who works overseas representing the country, and who comes from Saskatchewan, should get medical care in this province.  Anyway, it got sorted out but it showed how powerful bureaucracy could be - until the decision was made, nothing got done. 

The weeks after that were filled with various tests and scans. Of note was the PET scan which is a slice by slice look at the body showing bones, organs etc and where the cancer activity is focused. Very high tech and interesting, if not for the fact that it was my body and I was seeing where the cancer was. The bone scan was interesting as you are placed between two large pieces of machinery, with the top one thisclosetoyourface. That part was only a few minutes long but it was a wee bit stressful. Deep breaths!

I’ve started with the medical treatment - daily doses of pablociclib and letrozole and a monthly injection of zoledronic acid for the bones.   While it’s only been a week, so far, so good. The only complication was that the chemo drug comes in a capsule and I have a difficult time swallowing capsules. The first day I took it out of the bottle and thought “Yah, that’s going to get stuck”. And it did, for about half an hour. The drug information sheet said not to break the capsule so I had to find another way of taking it. The pharmacy, which has been very helpful, phoned the drug company which provided an alternative way for me to get the medication (essentially, dissolving the capsule into some water and drinking it). I’m on it for three weeks, one week off, then another three weeks. After that, they will see whether it is working and if I should continue. I would just say that while the insurance company pays most of the cost of the drug, I have to pay the difference, which is a hefty sum. Which means that getting provincial residence is a priority.

The cancer in the bones is a bit of a pain, literally and figuratively.  Coming back to Canada in the winter, I was motivated to buy new cross-country skis and boots, as well as skates. A week later, the medical oncologist said that I couldn’t ski or skate given the risk of fractures. So, brand new skis and skates sit in the corner until next year at which point I can use them if my bones are stronger or I can sell them. 

I met with the radiation oncologist last week about treatment for pain reduction. I’ll have a shot of radiation next week to my back and right hip, as those are the spots where I get the most pain. I now have three little dot tattoos to guide the radiation which is odd yet cool. I don’t expect that I’ll be getting other tattoos at this stage of my life.

The fibrosis is still near my esophagus, causing problems with my vocal chords and impeding swallowing. It’s possible it’s related to the radiation from 20 years ago or to the current cancer. No one has a clear sense. I had my esophagus dilated a bit to help ease the swallowing. Apparently this is not uncommon. Who knew?

So, a lot going on and much to be grateful for. I am grateful that I am back home in Saskatchewan, close to my family and friends, and that I have a large amazing group of friends around the world. I am grateful that I have access to high quality medical care and the necessary resources. 


One of the amazing group of friends overseas told me about a US surgeon Dr. Atul Gawande (https://en.wikipedia.org/wiki/Atul_Gawande) of Harvard Medical School who has written about how medicine can better treat patients at the end of life. PBS did a documentary based on his book “Being Mortal: Medicine and What Matters in the End” which I highly recommend.  https://www.pbs.org/wgbh/frontline/film/being-mortal/

Beautiful painting at the Cancer Centre in Saskatoon. Note the "DC was here" - I did not write that.

View of the law school, where I spent 3 years, from the Cancer Centre.

More beautiful flowers - appreciated on the cold winter days.