This was a big year.

My Green Card arrived. If you look carefully, the residency officially started December 28th 2022, but hey, we can sneak it into 2023, can’t we? Look, below, it is green, and it is a card!

Bees. I’ve had a quiet hankering to keep bees for a while, and in spring 2023 I set about making it happen. Charlie and Rosie helped me get, build and stain the hives, the president of the Nashville Area Beekeepers Association (NABA) sold me the bees, and a local friendly Brit, Ian, became my mentor. I loved it. Bees are important, there is the promise of honey, beginning in year two, and it develops a certain “zen-ness” to open up hive and have thousands of bees getting a little agitated in front of you.

After a successful summer growing the colony, in September and October, first one hive then the other were “robbed”, that is the queen was killed (so all the other bees fly off), and the hive is stripped of all its honey. We think the culprits were yellowjackets (a mean type of wasp). It was really sad. I’ll try again next year.

Cancer. On 26th July I finished my two years of androgen deprivation therapy (ADT). It’s a treatment that removes all testosterone from the body. That was a big date. After six weeks I had my first meaningful cancer test. NO DETECTABLE CANCER. That’s a big thing. I have had another test mid – December and also, no cancer. At the beginning of the journey I heard some pretty downbeat doctors tell me some pretty grim stats. So I’ve done well. Though I am still left with some horrible scars. Some are physical; seriously compromised sexual functionality, some bowel and urinary functionality, chronic and very inconvenient lymphedema, and some strange numbers on testosterone (too high!), cholesterol and pre-diabetes which are probably due to the two and a half years during which my body was seriously screwed around with. The mental scars are as tricky; some to do with my masculinity, esteem and ‘male’ confidence, some more to do with aging (I suddenly feel old and disabled), and some to do with a more general “is that it then?” feeling. But, I am alive. And, though it sounds dramatic, it’s better to be planning to live than be planning to die.

I think I should write more on this, perhaps when I can put it in a greater perspective. All I’ll say for now is that every man I know fifty plus should get checked, especially in the UK, where prostate cancer screening is NOT routine and you have to go ask for it. There needs to be greater awareness so men DO ask. No culture of annual medical check ups only compounds the situation. I am extremely unlucky to have got this cancer with this level of aggressiveness (stage 4a), diagnosed at fifty seven. Yet I am extremely lucky that is was picked up when it was in the US. If I was still in the UK, it would probably not have been picked up until it was too late, and I’d have incurable cancer.

Sixtieth birthday. I rented a deck on the Battersea Barge, a static barge on The Thames. Ollie’s present was the music. It made a fabulous evening even better, one of the best and most memorable ever. Thank you, everyone who came. It was so much fun. (And thanks to Rupert for this video)

Then George took me to Istanbul. I had always wanted to go there. We had a brilliant time. Thanks George. Amazing.

Keith, who was responsible for getting me over to New York and my boss when I got there, happened to be in Istanbul at the same time. We met up. That was a crazy coincidence!

Wedding #1. The legal ceremony was on 26th Oct in a small town called Viola, Tennessee, about 90 minutes drive from Nashville. Tiffany has a lawyer pal, Bill Ramsey, who is qualified to perform weddings, and we were married in the garden of his house. It’s been in his family for generations. The boys read Corinthians 13:1-13. It was idyllic and beautiful. Our legal wedding feast was cheeseburgers and fries at Tammy’s that we had to make haste to get to as it was due to close at 4.30pm. We just made it in time and they stayed open a little longer than normal on account of us having just got married!

Wedding #2. This was the big bash ceremony, though it wasn’t that big. About fifty people. The perfect autumn weekend at the Tennessee Arboretum: still warm and the colours of the fall. It was absolutely lovely. Forever thankful that George, Ollie, Charlie, Anna, Rupert, Andy, Fiona, Dan, Ade, Roger and Vicky made it over. The boys were so supportive in helping out and reading Corinthians again. Michelle, our officiant, did an amazing job. She was wonderful, and there was so much love in the air. Tiffany looking absolutely stunning – clearly the most beautiful person ever – and had done so much work to get everything as perfect as it could be. And it was. Thank you to everyone who came. And thank you most of all to Tiffany for saying “yes.”

Chief Creative Officer. At the back end of the year, I was given a job I had been doing in an interim style since May. As Chief Creative Officer I am responsible for all of the agency’s creative output. It’s a great job and very exciting to be given this role at this stage in my career. I’ve always liked the creative side of the business. It’ll be a good test, and hopefully fun and rewarding too.

– – – – – – – – – – – – – – – –

It’s been a big year. Many many good things. Real change takes a long time. The upheaval and chaos I created almost a decade ago is settling down. It has been, at times, an extremely challenging journey – literally life threatening – and will continue to be challenging. Yet, the most important people in my life are still the most important people in my life. And I have nothing but thanks, gratitude and as much love as I can generate for you. Happy Christmas, Happy Holidays and Happy New Year. Cxxx

Well that went quickly! My last post was in January. So, it’s about time to put fingers to keys and give a bit of an update, and it makes sense to do so as a wrap on the year, with a glug of Christmas spirit too. So here it is, my 2022 report:

Health

In short; holding up. I am on ADT (androgen deprivation therapy) which removes all the testosterone from my body, until August/September 2023. The idea is that the ADT denies the cancer the “food” it needs to grow i.e testosterone. The cancer is sufficiently serious for two years of ADT. The side effects are not great: hot flushes, weight gain, no interest in – or capability for – sex, potential loss of bone density and muscle mass, possible cognitive impairment and mood swings/depression. You’re right, it’s a real laugh! The best things I can do are resistance training to the mitigate bone and muscle side effects (thank you Jim, the trainer), eat well (thank you Tiffany), and try to keep fit and stay positive. After I come off the drugs I’ll take tests regularly and hope the cancer is gone. The chances are about 50:50.

I also have lymphedema. This is a side effect of the surgery and radiation which have either removed or radiated lymph nodes and the lymphatic system around my pelvis. Lymphedema causes swelling in my legs (especially left) and abdomen, as the lymphatic fluid, which has to flow against gravity in the body to get to be recycled, backs up. To help the fluid to flow I have to wear compression garments: left leg stocking and underwear. Aside from the physical discomfort, it’s been very tough mentality. I’ve gone from being a very fit 5,000 mile cyclist in 2020 to feeling like I’ve hit old age like smashing into a wall prematurely. That’s been a thing to get my head around.

Green Card

Well, what should have taken a couple of years will end up taking four! COVID has caused a massive backlog in the application process. The lawyers who are acting for me tell me I’m through the trickiest part of the process. Hmm, well perhaps technically it is, but I’m in the phase now where I can’t leave the US, and that period, which normally lasts three to six months is typically taking six to twelve months because of the backlog. On top of the two year wait to get out of the US to get the visa stamp in my passport in 2020/21, here’s another long wait. That wasn’t the plan at all. Still, I’m so invested and so far into the process, I’m not quitting now! So, until I get permission to leave the country, non-US friends, you’ll just have to come visit me!

T&C

Tiffany and I became an item in early 2020. We bought a house together in late 2021. We got engaged in late 2022. I’d call that a positive trajectory.

A life-threatening cancer diagnosis and global pandemic lockdown could be tricky for thirty year relationship but we were just getting going when it all kicked off. Completely coincidentally, the first week of lockdown was the first week we decided to try to spend the whole week together at Tiffany’s condo. Back then people were thinking in weeks, and we made a quick decision to just carry on, even though I had to cycle everyday to my apartment to “work from home” because the company we both worked for didn’t know we were an item and with her dogs around we would have been rumbled pretty quickly.

Tiffany claims that having done lockdown (and the cancer), we’ve probably done as much relationship as many couples with many more years to their name, so we must be good. It’s like we’ve done dog years.

House

Our house, is really feeling like a home now. We’ve done a fair amount to it, particularly on the aesthetic front. We’ve also sorted the drainage, the HVAC and some precarious trees but pictures will not be as inviting as these:

Guests, and boys in particular, like it. It has all the things, including a lovely guest room and guest bathroom. So, please don’t hesitate to invite yourselves to stay, especially as it’s impossible, my non-US friends, for me to visit you.

Boys in US

Charlie in April

We hung in Nashville, eating too much, seeing the Predators, going curling and playing pool. We went on a road trip, taking in Chattanooga, Knoxville (thank you Ben and Michelle), Atlanta (even after six or seven trips I still can’t get my head around it), Savannah (very colonial and pretty), Hilton Head (coastal homes for the rich), Charleston (another attractive colonial city where we had some excellent seafood and met Ted, a colleague from New York), and back to Nashville via Columbia (state capital of South Carolina) and Tryon (to pop in on Tiffany’s mum, who had had a surgery a few weeks prior). All in all we had an absolute blast.

George in August

We signed up for a cycling camp in the Georgia mountains, with ex-pro Todd Nordmeyer, of Endeavor Performance. The big day was 70 miles and 10,000ft of climbing (Strava, above, seems a bit wonky). Pretty epic. Inspite of the drugs, I was pretty pleased with my performance, and super impressed with George, who kept up with the fastest. We stayed in this fantastic cabin in Smithgall Woods State Park. Tiffany cooked. That was tip-top too.

After three days in the saddle, George and I chilled in a fantastic Airbnb near Blue Ridge, then decamped to Chattanooga for a couple of days. We rode – more gently – wandered, ate and drank. It was great.

Back in Nashville, we had some more fun, including an aura reading! All in all, we had an absolute blast.

Ollie in October

This was Ollie’s first trip to Nashville. He and Mitzi were booked to come in April 2020, but we know what happened a few weeks prior to that. By the time travel opened up, Ollie was deep into his Master’s. So, after he finished, he came over.

For the first few days we hung out in Nashville; with the dogs at home, eating and drinking locally, and building the electronic drum kit I had been wanting to buy for ages, and Ollie’s visit gave me a good excuse to do. We saw some Mozart at The Parthenon, Nashville’s own full-sized replica of the Greek one, built for The Tennessee Centennial and International Exposition in 1897, and some bluegrass at The Station Inn, an untouched legacy of the old Nashville in the middle of The Gulch, a cool urban neighbourhood within walking distance of downtown, where I had an apartment when I moved to Nashville.

Then we headed off to Memphis for a few days. I chose Memphis because of its musical heritage. We checked out Sun Studios, where Elvis first recorded, Stax Studios, which produced a bunch of famous soul artists, with a rawer edge than Motown, in the 60’s and early 70’s. We also went to Graceland, the home of Elvis. It’s like a shrine to him, much of the house preserved as it was in the 1970’s. The photos above give you a glimpse. I guess today’s superstars have multiple, and probably massive, houses dotted around the globe. Elvis, arugeably, the most famous individual of the lot, had one decent sized, super pimped out property in the town he grew up in, into which he moved his parents – they had the downstairs bedroom! That said, he had a couple of private planes and a whole heap of cars. Still pretty modest by the standards of some of today’s much lesser well known performers.

We also visited the National Civil Rights Museum, which is situated in the Lorraine Motel, where Martin Luther King was shot. It’s fantastic. We also, on Ollie’s insistence, visited the Bass Pro pyramid; a bonkers hunting shooting, fishing, eating, hotel madness in a massive glass pyramid (again, picture above), and drove across the river to West Memphis, just to add Arkansas to our list of states visited. It was pretty grim. We stopped and bought some ham and crackers, just to say we had really been there!

Beale Street, the home of the blues, seemed a rather poor imitation of Nashville’s Broadway scene, but seeing the Grizzlies beat the Knicks was good, especially as Ollie clearly knows his way around the basketball scene, as was The Arcade diner, where Elvis liked to eat, and the Central Station Hotel, where we stayed, and had a delicious meal.

Hawaii

As I can’t leave the country until I get my travel permit, Tiffany and I decided to go to Hawaii, as it felt like leaving the country. We went in November when the weather is still good but it’s not so crowded. After speaking to a couple of pals, thanks Gale and Scott, we decided to focus our time on the Big Island and Maui, staying a couple of nights in two locations on each. First, after 10 hours flight time from Nashville to get there (it’s a long way away), was the Volcano House in the Volcanoes State Park.

Volcanoes State Park is an amazing place. It has largest active lava lake in the world, a huge caldera (the 2018 eruption created a collapse of the cater rim road and a five hundred car parking lot), at least one wonderful park ranger and guide (thanks John Owens), and wonderful views of bright lava at night. It’s also a really good place to get engaged too!

We drove around the island for our second stop. Tiffany found this fabulous Airbnb, Holualoa Sunset Cottage, up in the hills of coffee country, Holualoa. It was so good, we bought food and cooked in, eating outside, overlooking the Pacific. We snorkelled, popped in to see the founder and executive chairman of Revive, Brandon Edwards, who has a place up the road, and chilled a little. Then it was off to Maui.

We picked up our rental car, after our $35 flight (the bags cost more than we did at $45) and headed off to Hana. We decided to go there after speaking to a colleague, Gale, who grew up there, and billed it as the “real Hawaii”. The drive was amazing; 15 mph for 45 miles of very winding roads. When we first arrived it was hard to really work out what was where, so we resorted to a drink and some food at the very lush Hana Hyatt Resort. But over the next couple of days , we really started to piece it together, and fell in love with Hana. We walked through the bamboo forest to the Waimuko Falls, paddled in the Pacific at Hamoa Beach, and found Charles Lindbergh’s grave at the Palapala Ho‘omau Congregational Church. Gale’s grandfather, a longstanding friend of Lindbergh, is also buried there. The two created a fund to keep the church restored and in good order. That evening we ate at the food trucks that Gale had recommended. Great atmosphere and food. We had found Hana, and would have happily stayed longer.

Our last day was spent in Wailea, a resort, with a good beach and a very good restaurant, Lineage. The road leaving Hana was even more treacherous than the one to get there. Not only winding, but in parts, little more than a gravel track. For three hours.

A really packed eight days, and we felt we had only scratched the surface. There are so many places still to go to in the world, but I feel there is still much more to be seen in Hawaii. I’d go back.

Boys

Boys are all in good shape. They are such a source of pride and joy. In all this lockdown and Green card waiting I miss them the most.

George changed jobs in the Autumn. He is now coding for a subsidiary of Toyota on autonomous driving cars. It’s a great job for him. Between leaving Cambridge and starting the the new position, he decided to go to India. While waiting for his visa to arrive, he started to cycle from Land’s End to London, but the visa came far quicker than he was expecting so he did a big cycle day across Dartmoor, got the train home, packed (7lb!), and set off for Mumbai the next day. He had a great time, and is now living in Ferntower Road, the London house, with Ollie and his pals, Ollie and Ben. He is really beginning to settle into his London life. It’s cool to see.

Charlie seems to be having a ball at Aberystwyth. He’s in his second year studying international relations, living in the town, off campus, playing a lot of footie – in fact captaining the second team – and has a lovely girlfriend, Rosie.

In the summer he did an internship at New Scotland Yard. Very cool. He got to do a project that involved a fair amount of interviewing different staff and spending time out on patrol. It’ll be interesting to see if he wants to go back around with the marines when he has finished.

UK Trip

I managed to get back to the UK in July. I had to come in the summer, as there was only a relatively short window of time in the Green card process for me to leave the US, before I had to return to submit the next round of forms.

I returned for four weeks, taking two (separate) weeks of holiday and working remotely for the other two weeks. I brought my bike, in my as yet unused bike bag, and I’m really pleased I did.

Charlie picked me up in the old Fiesta, which was was cool, and just as well, because my luggage was a problem, tricky for one person to take very far. We just squeezed it all in the car. We picked Ollie up and the three of us had lunch at the pub where Ollie had been working during his time in Brentford. We managed to jam Ollie in with everything else and set off to Herts. We dropped Ollie off at Mitzi’s, picked George up at the station and went to Anna’s for supper, after which my luggage and I stayed.

Taking full advantage of my bike, I cycled to The Peels and then cousin Jane’s a couple of days later (Anna drove the luggage over). It was a delight to spend some quality time with Jane, talking about the family, walking the dogs and opening the family treasure trove of papers, which included a lot of previously unknown (to me, at least) detail about my maternal grandfather. He was a photographer for the London Evening Standard, before spending World War Two in the Middle East, setting up dark rooms for the services, including one in Cairo. One evening Matt and Briony came over. It’s always a joy to see them. We had a lovely dinner. Big love to Jane and John for having me to stay.

I cycled over to Jill’s for lunch. Anna brought the luggage (god bless Anna). We had a lovely time catching up and talking about the kids. Then it was off to Julia’s on the train. This time I took the bike and luggage!! Fortunately, there is a direct train from St. Albans to Herne Hill.

It’s great staying with Julia. We do very well together. I don’t feel guilty when I work US hours into the UK evening because she is often in Coventry in the week. And when she’s back we hang out pretty well, though her passing suggestion that we watch Love Island turned into a bit of a curse as I got addicted to it. Never again mind. Thanks again, for all Julia.

I managed to get all boys together for one weekend – quite a feat – and booked an Airbnb in Canterbury. Always the most top fun, we mooched around, visited the cathedral, played footie, ate and drank, did an escape game, and took a bus to Whitstable for the day, hanging out on the beach and eating some really good seafood.

I managed to catch up with pals: some pictured below, like Ade and The Snows (a lucky strike when cycling around Richmond that turned from a quick cuppa to dinner to an impromptu over night stay), and others whose pictures I didn’t get; TomWood, Andy, and James.

Having navigated the hottest day on UK record, 19th July – my colleague in Austin, Texas was experiencing a regular 107F that same day btw – I decided to cycle to Winchester, well, Micheldever actually, to see Anne and Simon, who I hadn’t seen for ages. It also gave me a good reason to use the bike pack that George gave me when we were planning to cycle the Natchez Trace pre-pandemic and pre-cancer. Getting out of London seemed to take forever , but once I did, it was lovely.

It was so good to see Anne and Simon, their lovely house, and their son, George. And as a bonus, Jackie was there, who I couldn’t have seen in 20 years. We had a great evening.

George came down the net day on the train and joined for the Micheldever to Bath leg of the trip, another 70 miles or so. Giles came to meet us at the last hill. The next day we rode to the white horse at Westbury. Giles and George were strong. We got back, showered, changed and bombed off down Ralph Allen Drive at top speed to make the train. We did, just.

The last few days, I was back in Brixton with Julia, watching Love Island, spending as much time as I could with boys. The Wooz and Rosie came to stay. It was the first time I had met her. She is lovely, and the two of them seem a pretty good item. I also managed to get to Felixstowe, thanks to cousin Roger, to see Gillian, Simon, Joan and Richard (I fell asleep on the couch after lunch. I couldn’t help it. I hope I didn’t snore!), and Bexhill to see Jean, which was lovely as I hadn’t seen her for a few years. We had a lovely fish lunch and chatted about her forthcoming trip to Australia – Jean is so active; she’s an inspiration.

And in a nice piece of karma, Charlie who had picked me, my bike and my other luggage up four weeks earlier, stayed with Julia and got up very early to help get me, my bike and other luggage to Heathrow via bus and tube because there was a train strike. Honestly, I don’t know how I would have managed without him.

I had a super time. I miss the UK, Europe, boys, family and friends very intensely. I couldn’t have predicted COVD and cancer and my extended restricted travel. It’s been tough, but I hope in 2023, I’ll be able to travel more easily.

If you’ve got this far. Well done, and a very merry Christmas!

P.S. For those of you in Nashville, I’m thinking I ought to write about y’all too, but, to be honest, I see more of you, and can convey all this in person. Also, it’s getting increasingly hard to write anything because the longer the post gets, the longer the uploading takes. It’s about a second a character right now! I have to sign off. See y’all in 2023.

Tiffany and I bought a house in October 2021. It’s in the area of Nashville called Crieve Hall, about 10 minutes drive from downtown. It’s a ranch style house, with a basement. We’re making it a home, though with supply chain problems deliveries are taking a little longer than usual. We’ll get there. The guest room is ready mind. So come stay.

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I finally finally finally finally got home to the UK for a month, mid-December to mid-January. I had a wonderful time, reacquainting myself with boys, family, friends, my country and myself. So good. I also finally got the visa. I was in and out of the US embassy in London in less than an hour, and less than five minutes in front of embassy officials handing over documents and answering a question. Just one. I understand why they want people to attend in person, but that 18 months of waiting was a long time.

I also managed to avoid the Omicron variant, goodness knows how, as I was in central London a fair amount, staying in various places and seeing a good number of people. I was extra careful and had to change plans a bit but at least the whole thing wasn’t kiboshed by having to isolate.

It was great staying with cousin Julia in Brixton. So nice to be back in London. Big thank you Julia.

And an equally big thank you to Anna and Rupert for picking me up at Heathrow, letting me stay, organising a couple of delicious meals, including with cousins Jane and Matt, and Christmas Day. Oh, and the delicious roulade for New Year’s Eve.

The house rental in Aldeburgh worked out pretty much perfectly. Boys and girlfriends, lots of presents. A delicious New Year’s Eve and lovely walk on New Year’s Day. Thank you to Tiffany for managing to make it over too for the week, also dodging the virus and navigating the testing requirements. So pleased she could do that. She was particularly taken with the Suffolk pig farms that provided a little hut home for each pig.

A bunch of university pals gathered in Surrey the day before I flew out and we have a lovely lunch at The Stag on the River in Godalming.

And big thanks to Jill for the coffees, catch ups and conversations.

So a massive “hello” and “thanks” and “see you sooner next time” to a whole of people, including George & Jo, Ollie & Mitzi, Charlie, Jill, Anna & Rupert, Tom & Jen, Lizzie, Emily, Matt & Briony, Jane & John, Julia, James and Flo (Sword & Stoners), Roger & Vicky, Giles & Sarah, Andy & Shelley, Ade, Gillian & Richard, Andy & Fiona, Paddy & Jane, Mike & Clare, Mark, Charlie Snow, Anne Freeland, Dave Westland, John McE, Margaret Peel and William.

And sorry to those I didn’t get to see in person. There’ll be a next time.

Oh, and to see any of the pix in full, just click on it. And to see more then scroll through them.

Saturday 25th September.

My birthday. 58. Quiet morning. I opened presents from Tiffany; a book on Greek mythology, a fab eau de cologne and very hi-tech pillow. I treated myself to my own birthday present; a clever little $50 Secrid metal “card protector” (wallet) and a $15 money band. Then Tiffany and I had a gentle cycle together exploring our soon to be neighbourhood, Crieve Hall. She had told me we had a date at 5.30pm so I mustn’t arrange anything, though she wasn’t telling me what.

We just had time, before the 5.30 date, to go look at a chair. I have very few “have to haves” for the new house but a comfy chair is one of them. I kept looking for a nice Scandi designed one, but every search I did kept coming back to the Eames Lounge Chair. It’s a classic modern American piece of design. There is one store, in The Gulch, the area of Nashville where I had previously had my rental apartment, called Design Within Reach, which stocks the Eames chair. The name of the store must be some kind of joke; it’s a total misnomer. Anyway, if we were quick, we’d have enough time to pop in and try it out. I wanted to, and I wanted Tiffany, who thought the chair was ugly and unhappy about having one in the house, to also try it out, as it might help my cause. There were few we could sit in, and they were as good as I had hoped. Tiffany seemed to like them as well. In the event, we were pushing up to deadline for the evening date, and that helped me even more. Tiffany cracked and said “come on, just get it, just get it”. So I did.

The evening date was a lovely. Tiffany had arranged for friends to meet up and surprise me. We went to Locust, a fabulous new restaurant in Nashville. The highlights were the oolong tea cocktail in a can (forget name, sorry), the beef tartare wraps, the sashimi style flounder and a perfectly cooked whole sole. It was all followed by the shaved ice almond milk cake with salted caramel drizzle (pictured above, sort of).

A great time was had by all. I felt, 36 treatments out of my 39 done, tired but loved. And that’s been really important on my cancer journey.

Sunday 26th September

I had decided to ride 70 miles this morning. I had ridden this route a couple of weeks earlier but missed 14 miles because I screwed up the Garmin, so I wanted to do it properly this time, if only to get the stats. It was also some type of personal gesture of defiance in the face of the cancer and the radiation. I did it, at a respectable 17.2 mph too, but I was dead beat at the end, and recovery takes longer. I don’t know how much this is due to the hormone therapy, or the radiation or even the hangover, but it’s harder. Still fuck it. Fuck the cancer.

In the afternoon, boys and I did some present opening and some Red Alert action. It’s one of the few computer games I know. It was very 1990’s, with its CDs and whirring old start up noise, and no version for Mac. All boys have played it at some point, and George found a way of us all being able to play online. George is quite the expert at the game, able to combine smart attacks with solid defence. Woozy has a rush “do or die” tactic straight out of the gate and Ollie and I are “turtles” according to George. Apparently, it’s some gaming term for players who like to get wait and build their defences patiently before making their attacking move.

We also did presents. Boys have been brilliant during the pandemic. I can’t wait to see them. I love them so much. They got me a pair of AirPods, which are brilliant, a fantastic kitchen knife and a gamer’s overlit mouse – some kind of ironic joke given my Red Alert ability.

Monday 27th September

I see Dr. Kirschner every Monday. This the the last time I shall see him during the radiation. I won’t see him until February 2022 unless there is a big problem. He’s not given to hyperbole nor is overly emotional. He says my response has been “excellent”; that I’ve dealt with the radiation really well and that the lymph node with the cancer in has shrunk considerably (see pix above). He can’t say if the remaining image on the “after” scan is dead lymph node, a functioning lymph node, scar tissue from a lymph node or whether it has any cancer in it or not. But his best guess is that the cancer in the lymph node has been killed. He also thinks that any microscopic cancer cells in my pelvis should have been cleaned out. His biggest worry seems to be that after the ADT (Androgen Deprivation Therapy) has ended, that we discover some cancer cells have found their way outside of the pelvic area and taken route in other areas of my body. He says with some patients you end up in a game of chase the cancer as it manifests in different parts of the body, it’s zapped, then it manifests somewhere else. This worries me. However, that’s some way down the line, and the general feeling I’m left with is that I did as well as could be expected. I hug Dr. Kirschner and shake the hand of his resident. I like him a lot. In part because he’s doing his best to save my life and in part because I just like him. I think though, he was a little shocked when I hugged him.

Tuesday 28th September

Tuesday was the day I came bearing gifts. I desperately wanted to say “goodbye” and “thank you” to Rifka in person, and she wasn’t going to be around on Wednesday, my last day, as it was her birthday. So as well as her gifts, I thought I would do everyones on the same day. It also meant that Wednesday could be focused on sneaking in friends and colleagues who wanted to witness the bell ringing.

I bought three plants (one for Gigi on the check-in desk, one for the staff in the office, and one for the radiologists to brighten up the waiting room a little), four bunches of flowers (for Jessie, Alyssa, Mark, and a spare for whoever was there; it was Anthony that day), cookies and cupcakes for everyone and a card. Rifka got a specially made bouquet (of course she did) and a birthday card for tomorrow. It became very emotional.

A few words on Rifka. We first got friendly when she saw me on using my Mac Air in the waiting room. She come over and said that she had one too but couldn’t get it to work (aka get online). I persuaded her to bring her Mac in and I showed her what to do. From then on we were firm friends; making fun of each other, accents, my treatment, song choices over the speaker system in the treatment room, my underpants, my bladder, anything really. She brought a sense of levity without ever being anything than totally professional. But there was also some pretty raw emotion too. One day I asked her about the progress of another patient and she started to tear up. I instinctively hugged her and she held my hand, tightly. I never heard how the patient was doing but Rifka’s reaction told me everything I needed to know. I’ve recounted the story in a little more detail here.

After my treatment and lots of hugging and gift-giving, Rifka walked me to the elevator. I asked her if she ever felt exhausted after giving and giving and giving all day long. She said “no”. She told me this was the job she was born to do. Her mother died of breast cancer, aged 53 and this was the impetus for Rifka, who started her college course only days before her mother passed, to do this job. It was her calling. She’s a remarkable woman.

Wednesday 29th September

After 39 treatments, apparently a pretty hefty number, one per day every weekday, I was done. The last day ritual is to ring the bell outside the office. I was treated my Alyssa, Jessie and Mark, three of my favourites, after Rifka of course. I was happy to have three people I had a good relationship on my last day. We played “Ring my bell” by Anita Ward, the original and a remix, over the speaker in the treatment room, loud. Then we went to the bell.

On Monday, Jenna, one of the nurses, was checking my vitals before I met Dr. Kirschner and asked if anyone was coming to ring the bell with me. I replied, “yes, a handful, eight to ten people”. She looked a little agog and told me that one or two was acceptable, but this number was not allowed. So we had to get sneaky. Rifka had given me some inside advice. I issued some very careful instructions about how to get past Gigi at the check-in desk and hoped that the little orchid I had given her yesterday would help. In the event Tiffany, Donna, Lauryn, Ashley, Riley, Jared, and Ryan made the ringing of the bell and a few more who made the post bell ringing drinks at Flatiron. By 8 pm I was shattered. I barely remember the take out pizza and had no recollection of getting into bed.

Thursday 30th September

For so long I haven’t been able to get back to the UK for a visa interview at the American consulate in London, and without an interview I can’t get the visa stamped in my passport and without the visa stamped in my passport, I can’t get back into the USA. I had been planning for June 2020 but the pandemic combined with a toxic Trump policy around visas (the lawyer dealing with my case advised waiting until Trump was out of office) plus the American consulate suddenly cancelling ALL visa interviews in the fall and then need to stay in Nashville for the radiation treatment all meant that I haven’t been able to get the interview. Until today. Yippee!

My lawyer at IPG, Allison, who has been wonderful all through this ordeal, told me she had been able to secure an emergency interview December 13th! In theory I might have been able to get one sooner after the radiation finished but Tiffany and I had a short cycle trip to Death Valley planned (booked before the radiation) which we really wanted to do and it made sense to make the trip back and extend it over Christmas and New Year, so mid-December became the target date. I had trouble going into the system and rescheduling my appointment from March 2022 – yes the earliest I could get otherwise. But Allison managed to do it. I was overjoyed. What a week!

. . . . . . . . . .

P.S. After a couple of days it became obvious that I wasn’t able to get my DS 160. This is mandatory and I need to bring it to the interview. EXTREME PANIC! Neither Allison or I could find it, nor could the US Visa services, inspite of there being a confirmation and interview instructions and an interview attached to the application. The best the US Visa services could do, after 5 hours of hold time between Allison and myself, was to suggest I download and use Microsoft Internet Explorer 7 and a Windows machine!

We gave up. I had to make another application which I did in a record four hours (I’m getting well practiced now), and call the US Visa services in London to see if I could use the same appointment with a new application. I prepared myself for a long wait, but pick up was within thirty seconds! Amazing. I couldn’t keep the same appointment, but by taking a risk with the scheduling software I was able to cancel and get the same slot. Amazing. Hopefully now, after almost two years of waiting, I’m able to get this part of my (new) life sorted. Fingers crossed!

Wednesday 24th February 10.30am: Regular check up with Primary Care Physician. Dr. McGee. I had waited for two months for the appointment on top of waiting for the initial COVID surge to die down. Sunday 7th March: Received results from the check up. My PSA was very high. I was baffled. It was so much higher than the normal range – perhaps they presented it without the decimal point? Monday 8th March: Referral to Dr. Pazona. I got a call from a nurse practitioner at Dr. McGee’s practice that I needed to see a urologist. I was referred to Dr. Pazona. Thursday 11th March 4pm: Appointment with Dr Pazona. He suggested there was a chance of cancer and we had better check. Thursday 18th March 1.30pm: MRI Scan. Friday 19th March 11am: Dr. Pazona told me that the MRI scan was showing prostate cancer probable. Thursday 1st April and Friday 2nd April: Biopsy and unexpected overnight stay in hospital. Prostate cancer was confirmed; an “interesting” form too, called cribriform. So interesting, the hospital wanted to take a specimen for research. It’s not a great one either. As a side note to the story, though the main attraction for a while, as I came around from the general anaesthetic my pulse plummeted to zero, for as long as 90 seconds, and Emily W from the PACU (post anaesthetic care unit) apparently leapt on me, and administered CPR. I came around looking at many doctors and nurses looking down on me to be told that “she’s (Emily) saved your life.” Apparently I, very politely, said “thank you very much.” I was kept in overnight and wore a heart monitor for a month. Nothing much happened. The conclusion of the cardiologist who specialises in the heart’s electrical system was that I had had an extreme vasovagal response. Monday 12th April 8am: CT scan. The scan revealed something suspicious, a lesion, on one of my ribs. If it was bone cancer the 5 year survival rate is less than 30%. With my numbers I had a 10% chance, which is a darn sight higher than the less than 2% chance of getting prostate cancer in the first place. I was scared. The scan report said there were no enlarged lymph nodes in the pelvis, which we know now to be false*. Tuesday 20th April 2.30pm. Second COVID shot, Pfizer. I had side effects: shivers, a headache and I couldn’t sleep, which didn’t help my worries about the bone cancer. It was the worst night of my life. Thursday 22nd April 7am: Bone scan. The technician was SO nice, I was convinced he had seen something. They did a close up of my ribs. I thought “they are scanning my cancer now”. I had an appointment scheduled for the following day. Dr. Pazona, no doubt as relieved as I was, called me within an hour or so of the scan to tell me the lesion was a calcium build up. No bone cancer. Tuesday 4th May 7.45am: Meeting Doctor Daniel Barocas, surgeon. He comes highly recommended. I had also met a radiology oncologist at TriStar, who I didn’t much care for. The system and the protocols drive someone with my numbers to surgery. We had a long chat about the implications of both radiation and surgery. It was clearly pretty serious by now. I didn’t feel there were many sensible options. I elected to have surgery. There was a slot the following Friday. Friday 14th May 5am: Surgery. Using a da Vinci robot, Doctor Barocas removed my prostate (the surgery is called a radical prostatectomy). He said it went very well. I was in the hospital for one night. Home on Saturday. There was considerable abdominal pain, no surprise given the six incisions all around my stomach. I was immobile, had more prescription drugs than a village pharmacy and had a catheter. I couldn’t get into bed as my abdomen was too painful, so I slept on the couch for 4 nights. Monday 24th May 10am: Catheter removed. Removal didn’t hurt (though was weird), but had three incredibly painful spasms, apparently like birthing pains, within the following 24 hours. Drugs were helpful. Wednesday 9th June 5pm: Ultrasound due to scrotal pain. Nothing too worrying. Something to monitor. Not unusual after a radical prostatectomy. Tuesday 15th June 7.45am: Follow up appointment with Doctor Barocas. The pathology report was very positive: No cancer in the margins (at the edges of the prostate), no cancer in the nearest lymph node (that was also removed during the surgery). Feeling good. Friday 18th June 1pm: Hernia concern. After a long drive back from NC, Memorial Day weekend, and after a flight back from MN Wednesday 16th June, the inner thigh of my left leg swelled up. No-one had told me to expect this. Barocas had reported two little hernias after the surgery, and after some googling about hernias, I wondered if the swelling was a hernia. So I went to the Hernia Center. They suggested it was more likely to be a backing up of fluid in the lymphatic system as the system has to get used to having a lymph node removed. They wanted me to return if it swelled up again. Tuesday 22nd June 7.30pm: Trip to the Emergency Room. Left leg swelled up again. Went to Hernia Center but arrived just as they were closing. They sent me to the ER, where I waited for four hours. The doctor who saw me (and the swelling) agreed with the theory of the lymphatic fluid backing up. It’s not unusual and should, over the next year, work itself out. I was told to keep an eye on it. Tuesday 29th June 8am: Survivorship Program Appointment. My six week blood test. Also a pretty depressing meeting about side effects, particularly sexual function. The results of the blood test showed the PSA numbers still too high. This was worrying. I needed a PET scan to see what was going on. Thursday 15th July 2pm: PET Scan. I have a radioactive dye injected into me which will highlight where identifiable cancer is – it can’t show microscopic cells though. It shows I have a cancerous lymph node, a few centimetres from where the prostate was. The cancer had skipped the node that was removed during surgery and gone to this other node deep in my pelvis. Tuesday 20th July 10am: Meeting Dr. Barocas. This was a bad meeting. Probably the worst in the journey. He told me the chances of completely getting rid of the cancer were less than 50%, because the PSA is still high. And if the cancer isn’t killed then there’s a very good chance that it will kill me. He wasn’t sure if it was as low as a 10 or 20% of getting it. That was scary to hear. What’s more, if they don’t get it, he continued, I am young enough to die from it. Older men will generally die of something else because meds can slow down the progression of the cancer, whereas I am young enough to die of it. I asked how many years I have if they don’t get it. He threw out 3,5,7 or 10 years. I wasn’t ready for that! He also laid out the best treatment path; radiation and ADT therapy (Androgen Deprivation Therapy), the latter basically removes any testosterone from my body. The testosterone is essentially the food for the cancer so ADT denies it the nutrition. The side effects though, are not great: loss of bone density, loss of muscle mass, loss of libido, hot flushes/flashes, weight gain, slower metabolism, fatigue, possible depression and mood swings! I could tell it was a difficult meeting for Barocas – he’d actually suggested not having it and me going straight to the radiation doctor. It was also a difficult meeting for me. I was very emotional for a couple of days. Monday 26th July 8.30am, 10am and 5pm: ADT administered (8.30am), meeting Dr. Kirschner (10am), and CT scan to set up for radiation (5pm). I had two heavy loading doses of ADT (Firmagon) injected into my abdomen, which caused considerable pain and then discomfort for a week or so. At 10am, I met Dr. Austin Kirschner. I liked him; academic in style and friendly in tone. He said the chances of getting the rid of the cancer are, for someone like me, generally 50:50, though he thinks for me specifically more like 50-60% because the cancer is very concentrated in that lymph node, though there may be microscopic particles that the PET scan couldn’t detect, and they may have gone beyond the pelvic area. This is a risk but we wouldn’t know about that for about two and a half years because of the ADT. Nevertheless, this was relatively cheery after my meeting with Dr. Barocas a few days prior. Wednesday 4th August 5pm: Therapy. After the last few weeks I feel the need to talk to someone, especially around getting the story straight in my head for why I didn’t find this earlier. I’d been beating myself up and that’s where the therapy would start. This therapist specialises in cancer patients. She was recommended by a friend. It’s been really good. Thursday 5th August 4.30pm: Radiation starts. 39 treatments, one a day every weekday. I choose to have them at end of the day so I can exercise in the morning (to mitigate against the effects of the ADT) and crash out after the radiation if I need to, and I do, at the end of the day. I have to be positioned in EXACTLY the same place everyday – remember, we are dealing in millimetres and I don’t want my bladder or bowel radiated by mistake! Not only do I need to be positioned on the table in the same place every day, but my ‘insides’ need to be in the same place every day…..so an hour before my treatment I have to “evacuate my bowels”, “void my bladder” and drink exactly the same amount of water, and hope that my insides are EXACTLY the same everyday too! The staff are fantastic, full of good humour and hi-tech. It’s like a fling, short-lived, intense and preoccupying. Every day revolves around it and the 4.30 start to the ritual. I park in the same place (too late for the valet parking so I get a slot right outside the door), generally greet the same people and then see (a) whether they are running to time, which is important given that a delay of more than 20 mins is not good with a full bladder and (b) which team of radiologists are working today, so I know how much fun it’ll be. I see Dr. Kirschner every Monday for a check in to see how I am doing – more on that in the next post. The waiting room is the stuff of sad drama and tragedy: generally older men, women of a greater variety of ages, inpatients who get brought down in their beds who, on occasion, look translucent and close to death, and children and teenagers who look baffled, stunned and lost. The TV relentlessly plays the home improvement channel. I got quite used to it over my 39 visits. The treatment doesn’t take long: always a CAT scan to see if I am positioned correctly and then about 5 mins of radiation. Just time for a couple of songs over the treatment room speakers. Friday 3rd September 6am: Jim at the gym. In response to Dr. Kirschner’s advice to focus on resistance training to mitigate the effects of the ADP, Tiffany found Jim at the YMCA in Green Hills. He’s my/our age and good. He has a philosophy – based around failing between 45-90 seconds rather than number of reps – and a laid back manner. Wednesday 29th September 5.30pm: Final treatment. The last few days have been pretty emotional. I’ll write about that in my next post. I’ve said goodbye to the folk not working on Wednesday and already bought flowers and cookies and cupcakes galore. Today is the bell ringing, part of the last day ritual. One of the staff recites a short poem and I ring. I am the only patient around, I have a good group of friends and colleagues who have come to witness the bell ringing, and three of my favourite radiologists. I requested Anita Ward’s “Ring my bell” as the song to accompany the treatment today, to be played loud. The end is both anti climatic in so far as there is no single “event” like the surgery, but in many ways it is way more profound – a unique, terrible, wonderful, crazy, surreal couple of months – each day spending time with some amazing people that I’ll always feel something for.

*Either the cancerous node wasn’t picked up by the scan, or the doctor reviewing the scan didn’t pick it up or the node just hadn’t become enlarged at the time.

This isn’t the end. In some ways it’s just the end of the beginning. I have two years of ADT to go, if I can last that long (apparently only about 50% of people stick it out for the whole two years). After that the body has to readjust to having testosterone again which can take 6-12 months. And only then can they take readings to see if my PSA is up. I had a PSA test on 4th Oct and the score was where it should be: undetectable.

Friday 17th September was one of those ordinary days in which ‘out of the ordinary’ things happened. And, unless I recorded all of those things as belonging to the same day, they would get lost or rearranged into little snippets of stories that get disconnected from the day itself. I like that they are all connected, because together, they add up to a really varied, rich and, in its own little way, a rather extraordinary day. In fact, many days are like this, if you look carefully enough. Here’s this one:

Gym training with Jim. 6.30am. I have to do weight resistance training to mitigate the hormone suppressants I’m on. This was the first time he really loaded me up to the “fail” point. It was hard, but I was pretty happy with how I did, for such a skinny guy, on hormone suppressants and two-thirds of the way through radiation treatment.

Breakfast with a business pal who opened up about their porn addiction. 8am. They had been asking about my cancer, and I think it might have prompted them. I’ve never had a conversation about porn addiction with a porn addict.

I cycled. 10.30am. Nothing out of the ordinary there, even the time.

A couple of work meetings. Noon. I am on medical leave for a couple of weeks. This was the first day. It’s the last couple of weeks of my radiation treatments. 17th September was the 31st out of 39.

Therapy. 3.30pm. I see this excellent therapist who specialises in cancer patients. It’s very useful. I cried today because I feel good about myself and my future, and I’m doing well given the situation, but the cancer might kill me first.

At radiation today, I asked Rifka, one of the radiologists, how the young lady in the wheelchair was doing as she was being wheeled away. She is treated a couple of times a week, is always slumped in a wheelchair and has a couple of companions who keep her company and wheel her in and out. They don’t talk a lot. Rifka is my favourite. She’s a lovely woman, probably about my age. We get on great. I helped her with her Mac Air one day. She was being upbeat and kind to the girl woman in the wheelchair. After I asked, she teared up. I gave Rifka a hug. She reached for my hand and I held her hand tight. It was a very emotional moment. 6pm

Jimmy Kimmel’s daughter is getting married on Sat 18th Sept. In Nashville. To the son of one of Tiffany’s friends. Tiffany is invited to the wedding, and we were both invited to the wedding rehearsal dinner the night before. 7.30 pm. It was more like a big party with a big BBQ cooked by the local maestro of the BBQ, Pat Martin. We chatted with Jimmy Kimmel’s mother-in-law. I asked her if she received payment if he made mother-in-law jokes about her.

To recognise the end of each week of radiation, I go and have Jeni’s Brambleberry Crisp ice cream in a waffle cone. 10 pm. It is quite simply, delicious. But the last couple of weeks there has been none. Zip. Zero. Nothing. Not a jot. I have told the servers it’s tragic but all they can do is attempt to look empathetic. So I have to choose different flavours. The nearest sounding is ‘Wild Lavender’ but the server recommended Golden Nectar at the bottom with Darkest Chocolate on top. Anxious to try some of the Wild Lavender I asked a little scoop on top. I’m glad I took the recommendation. Wild Lavender isn’t in the same league as Brambleberry Crisp. Just saying.

Everything is remote. Family is remote. Friends are remote. Boys are remote. The UK is remote. Work is remote. At times my feelings are remote too. Remote and discombobulated. Being unable to get home for so long. Having the visa appointment delayed again – it’s now March 2022 and who says that won’t move again. Having to deal with the unexpected and dramatic cancer, the surgery and its side-effects. And the deaths back home that I would normally have got on a plane for, like Molly and Alick. Folks back home have been fantastic. Tiffany and my work colleagues at Revive likewise. And Nashville gets good in the summer – with bikes and courts and pools – once I am allowed to be active again. But it’s not the same as going back to the source: to boys, family, friends and places. To get closer. Because remote isn’t good.