Passing the piano

There is a piano at the top of the escalator, in Charing Cross and today we passed it six times.

We started by going to see Dr Savage and bombarding him with questions (things like "What were the results of the Xray?" from me and "Anything to stop me diving?" from Quent). I am not sure which questions Dr Savave prefers, but he answers them all with great patience and honesty.

The answers to the questions were as follows:

1. January's x-ray looked a bit better than December's, although this is not significant - it could just be that Quent breathed in a bit more or something. In spite of his warning not to read anything into it, I took great heart from it ... for half an hour or so.
2. No problem with going skiing and having a great time. Diving would probably not be a problem medically, but the insurance and the instructors would be unlikely to take Quent on.
3. We went through a list of "symptoms" that Quent has been showing. On top of the tiredness, night sweats, cold feet, clammy hands and a bit of coughing have all been registered on my symptometer - which is finely tuned to noticing any microscopic changes in Quent's demeanour. The doctor explained that with such "soft" symptoms, it is hard to tell if they are significant or not as they have many causes.
4. He also explained the cost of having sorafaneb or sunitinib privately (they are not available on the NHS) would be about £20,000 to £30,000. This should not be an issue as Quent has permanent health insurance through work, but it's good to know the facts.

We were then sent back past the piano for an X-ray and back again to bring the results to Dr Savage.

This was when I stopped being carried away with ideas of treatment being a year off and Quent showing improvements. The radiologist thinks there is a significant change in the spots on the right lung and that we should have a CT scan. Dr Savage said he couldn't really see it himself, so it's obviously not huge. He stressed it should not stop us having a good holiday, but sent us back past the piano (now complete with elderly player) to book a CT scan for our return (Thurs March 8th) . This will be approximately 3 months since the last one, so is about when we would have been having one anyway.

We then had to come back past the piano to book our appointment with Dr Savage for after the CT scan. And finally Quent stopped to thank the pianist for the tunes as we passed him to come home.

We each had a sobering moment during the consultation. Quent's was when Dr Savage stressed that Quent will never feel better than he does today. Mine was when Dr Savage pointed out that we can only count on two treatments - immunotherapy and sorafaneb / sunitinib. The vaccines and bone marrow transplants are very experimental. You therefore only get them if they happen to be doing a trial when you need them - and if you happen to meet their criteria for volunteers. That cut my perception of our odds, although you can bet that if we think a trial might help, no-one will fight harder than me to find one somewhere and get Quent accepted.