We signed the papers with the lawyer today for our new house! Only four more days until we close and then we move on Saturday. We're almost packed and super excited.

Kim has continued to do well for the past few days and so other than her being tired and bored, there is not much to report.

Instead, I'm going to post a fun image I saw today. Rob Ford is already busy declaring Transit City and anything resembling LRT or streetcars to be dead. Toronto residents want subways apparently. Whatever your views on this matter I think you'd have to admit that the preliminary subway plan from the independent council Save Our Subways is pretty cool. How awesome would it be if that was the baseline subway system in Toronto and the only problem was how to get people to the nearest subway stop?

Of course just because something is cool, doesn't mean it is possible. I'd love to see this built, but it would take decades and billions of dollars and some sort of long term plan that couldn't be overturned by the first disapproving government. I don't think any of these things are just going to appear. Rob Ford is trying to will the subways into existence which probably won't work. If he does manage to kill Transit City then I also hope he succeeds with his willpower, because it would suck to have nothing at all.

Kim is home! After almost exactly a week in the hospital, she was discharged today around noon. She had a really good weekend after the chemotherapy finished and the fever never returned. I could tell she was about ready to freak out from boredom/monotony if they kept her another day so I'm really glad they let her go. She's super happy and excited to be home and she spent all day today going over financial stuff for the house and contacting the lawyer to make sure everything is ready to go.

There was almost no nausea from the chemotherapy. There are really good anti-nausea pills now and they worked perfectly. There has also been no hair loss yet, although apparently that could start at any time. We're prepared for it though, Kim's mom ordered her a bunch of fun scarves and things to help keep her head warm.

She has a follow-up appointment on Friday just to make sure everything is still going well. Then, the next round of chemotherapy will probably be on December 23rd assuming her blood counts have recovered enough. Merry Christmas, I guess. It's all good though, after the 23rd, there will only be 4-6 more treatments to go!

One more thing, both Kim's mom and my mom have been super awesome and helpful this past week. They both came up to stay with us so that there would always be someone with Kim at the hospital (the three of us took turns). This meant that Kim's nurses didn't have to work as hard and also that there was always someone with her to talk to when she got scared. It also meant that I was able to do some packing and other stuff for the move despite Kim being in the hospital. So yeah, the moms are awesome.

Due to the fever, Kim's doctor decided to keep her for observation over the weekend. Thankfully, things have been quiet since the fever cleared and there have been no strong reactions to the chemotherapy drugs she received on Friday. The hope is that they will discharge her on Monday and things can go back to being semi-normal.

I got a flu shot yesterday to help keep me healthy and my arm is a little sore but no other reaction so far. Mentally I am definitely feeling a stronger urge to blindly obey authority (everyone knows flu shots are mostly made up of mind control serum).

Last night I managed to pack a couple boxes, which breaks the inertia of the last week. Hopefully I can pack some more today after I sit with Kim for a while.

Last night after I left the hospital, Kim spiked a fever of 102 so they started running antibiotics along with Benadryl for itching. They also did another chest X-ray just to make sure nothing serious was happening. She just has an infection of some sort. It's probably something she had before last night and the Rituximab simply aggravated it. By the morning she was back to normal more or less and they were able to continue with the chemotherapy around noon.

The three drugs today (cyclophosphamide, hydroxdaunorubicin, oncovin) were administered without any difficulties, and the anti-nausea medicine seems to be working for now. Hopefully it continues to work tonight and tomorrow. My mom is staying at the hospital with her to give Kim's mom and me a chance to catch up on some much needed sleep. In my case, I'm catching up on house stuff too.

Also today we had a bunch of visits from hospital support staff including a social worker, dietitian and the case manager. All of these people were super friendly and helpful. The dietitian had some cool books that deal with all the eating problems that occur as a result of chemo.

Tomorrow I have to go get a flu shot to help make sure I stay healthy over the next six months. I've never had one before (not even sure I've ever had the flu before) so hopefully I don't react funny to it or anything.

We got the final count from the fertility clinic today. Before freezing, one of the good embryos failed and so only four were able to be frozen. Also, the special procedure for the immature eggs was not successful in any of the cases so the final count will be just four. This is still enough, but there's obviously not a lot of room for error or complications when we go to use them. It's a little disappointing, but we did the best we could. Kim's health is more important.

I stayed over at the hospital last night with Kim (on a reclining chair) so I'm a bit tired now. However Kim managed to get a good sleep. She was pretty nervous for today, the first day of treatments.

Rituximab is essentially an antibody that targets and destroys B-cells, thus helping to treat conditions where B-cells are problematic (like Diffuse Large B-Cell Lymphoma). The first time it is given to a patient it must be given slowly as there is a relatively high risk of adverse reaction while it is entering the body. By starting slowly the doctors can react to any problems before they become serious.

Before beginning the Rituximab today, Kim was given Benadryl and Tylenol to pro-actively reduce the symptoms of any reactions to the drug. She was also given Allopurinol to help combat the possibility of "Tumour Lysis Syndrome," a problem that occurs when cancer cells are destroyed and break down releasing toxic material into the body which can ultimately cause kidney failure.

For the most part the administration of the Rituximab went well. The only problem occurred when the flow rate was increased the second time. Kim starting shaking uncontrollably. This is a common side-effect and so the nurses were ready to deal with it. They temporarily stopped the Rituximab drip and gave Kim Demerol intravenously and within a couple minutes she stopped shaking and actually started feeling pretty good (Demerol is a synthetic opiate after all). They were able to restart the Rituximab after the Demerol and get it up to the same flow rate as when she started shaking. There were no more problems after that and she was in good spirits the rest of the day.

I'm at home now so that I can try to get a good rest tonight. Kim's mom is staying with her at the hospital. The nurses are going to get her a stretcher to sleep on instead of that awful recliner so that should be nice. Just before I left I got an update from the fertility clinic. As of today we have five embryos. This is less than expected, but apparently it is enough to work with. Many of the eggs were still immature because we had to rush a bit and because Kim had to start the steroids before the fertility doctor wanted her to. However they might still be able to create embryos from the remaining eggs through a process where they inject a single sperm directly into the egg. This is not ideal since it may not be the "best" sperm (survival of the fittest and all that) but they label the embryos and so when we go to use them we will obviously try to use the natural ones first. At this point we're happy to have anything really.

The other update is that Kim's potassium levels are low, so they are giving her some of that tonight so that she'll be nicely prepared for the rest of the chemotherapy tomorrow. The doctor also said she might be able to come home as early as Saturday!

Hi everyone. I haven't posted much lately and many of you know why. But for anyone I haven't managed to tell yet, on November 5, my wife Kim was diagnosed with Diffuse Large B-Cell Lymphoma (i.e. cancer of the lymphatic system). The cancer has also moved into her lungs, and as a result is automatically classified as a stage 4 cancer (one that has spread into other systems from the initial site).

It started back in October when Kim noticed a couple lumps in her neck. The doctor prescribed antibiotics and that seemed to help for a while. But the lumps came back and became painful and Kim eventually ended up in the ER due to the pain. They did various tests over the course of three days, cumulating in a complete biopsy of one of the swollen lymph nodes. We had the results a week later. Since then things have moved fast.

We met with a wonderful hematological oncologist at St. Michael's hospital and she ordered lots more tests to help stage the cancer. The tests included CT scans, radioactive dye tests and a painful bone marrow biopsy. As I mentioned, it is at stage 4 due to the lung involvement, but the cancer is not in Kim's bone marrow and so the treatment is more straight-forward.

This type of lymphoma is one of the most common types and so the treatment is extremely well researched and standardized. The treatment is also very effective at not just reversing the cancer, but ultimately curing it in many cases. Kim will be doing six to eight cycles of chemotherapy at three week intervals. The specific chemotherapy protocol is known as R-CHOP which is an acronym for the drugs that will be used (rituximab, cyclophosphamide, hydroxdaunorubicin, oncovin and prednisone).

We were well aware that chemotherapy has lots of side-effects, however we were totally unprepared for the fact that cyclophosphamide (particularly in the doses Kim will be getting) has a high potential for sterility. As we are planning on having kids in the next few years this news was upsetting. However, the fact that we were already planning on having kids meant that we were excellent candidates for In Vitro Fertilization (IVF). The idea is that they extract eggs from Kim, fertilize them with my sperm and freeze them for future use. Although it is possible to just freeze the eggs, embryos freeze a lot better so it's great that we were already at this stage of our life.

We were referred to a fertility clinic as soon as the initial diagnosis came in and we got started on the process to get Kim ready to extract eggs. This process was projected to take about two weeks which was also the estimated time it would take to prepare Kim for chemotherapy. So a lot was going on in parallel but it seemed like it would all line up nicely.

The IVF process was extremely involved. Both of us had to get lots of blood tests, and Kim had to go into the clinic every day to get injections of drugs to stimulate egg production. She also had to get ultrasounds and blood tests every other day to monitor her progress. The whole thing added a lot of stress to an already stressful time, but we managed. Unfortunately, the IVF treatments were well underway by the time we got the information about the cancer being stage 4. Looking back, we probably would have skipped the whole IVF thing if we had known the cancer was so advanced. However at that point we had already invested lots of time and money into the process and the oncologist assured us it was OK to continue. So we kept going.

Then about a week ago, it looked like Kim wasn't going to be ready for egg harvesting before her first chemotherapy treatment. She also started having more problems breathing due to the cancer in her lungs. This combined to produce a lot of stress. We contacted the oncologist and she was concerned enough about Kim's breathing to admit her to the hospital (St. Michael's) on Monday afternoon of this week. They started her on steroids (prednisone, the P from R-CHOP) to help clear things up and that worked quite well. They've also been running lots of fluids through her intravenously to help flush out any toxicity from degrading cancer cells. Despite all this craziness, we were still able to go the fertility clinic today to complete the egg retrieval. That process went extremely smoothly and they managed to extract 24 eggs (we will find out how many were successfully fertilized tomorrow). An hour after the procedure we were able to head back to the hospital and Kim has been resting ever since.

Tomorrow Kim starts on rituximab, the first part of her chemotherapy. Friday she will receive the rest. Saturday will be recovery and hopefully she can go home after that. As long as all goes well future chemotherapy treatments should only take a day and will be done as out-patient procedures. The first treatment was originally scheduled to be done as out-patient as well, but we're all pretty happy to have it done while Kim is admitted as an in-patient. It means we will get immediate help for any side-effects and it should make it easier for us to handle recovery from future treatments at home.

A lot of people I talk to about this are surprised that Kim is being treated at St. Michael's and not Princess Margaret or Sunnybrook. Although it is true that both of those places are great for cancer treatment, St. Michael's also has an excellent cancer treatment program and we have been nothing but thrilled with the care and treatment provided so far.

Both Kim and I have also had a ton of support and understanding from our employers, for which we are truly grateful.

Finally, all of the kind thoughts, emails and phone calls from friends and family have been much appreciated and will continue to be appreciated in the future. Anyone should feel free to send messages whenever, just understand that we may not reply right away due to the craziness of treatment plus the fact that we have still have to move to our new house in three weeks.

I intend to try to update this blog regularly now with how things are going. This will be easier for me than trying to contact everyone individually with updates. It's not that I don't want to talk to people, just that there isn't always enough time.

This and this both explain a lot. Unfortunately our new house falls on the other side of the magical boundary.

Update: The National Post has the nicest version I've seen of the mayoral results broken down by ward and if you haven't seen it already, check out Rob Ford's first post-election fail (a pre-scheduled interview with the CBC that was just awful, as a result of which the CBC is apparently now cut off from Rob Ford, just like the Toronto Star).

Today while blindly browsing teh interwebs I came across the Armstrong, Beere and Hime Panorama which is a set of the earliest know photos of Toronto forming a panorama of the city as it was in 1856 from the corner of King and York. I love seeing old pictures of the city because you can see landmarks that are still around today and it's neat to see how things have changed around them. In this panorama in particular you can spot Osgoode Hall, St. Lawrence Hall, and St. James Cathedral (before its spire was built!). It's amazing how different the city was back then.

You can read more about the panorama at the City of Toronto Archives. They also have a map of the city from the year the photos were taken. It's bounded by Bloor in the north, Strachan in the west and the Don Valley in the east. Toronto was so small back then!

Dinosaur Comics is my number one favourite web comic on the whole Internets. Not only is it hilarious and fairly nerdy, but the author, Ryan North, lives in Toronto so there are often vague references to things happening here.

Anyway, the purpose of this post is to help spread the word about an awesome book that is going on sale which was inspired by a particular Dinosaur Comic. Ryan North and twenty-nine other people (including Randall Munroe from xkcd and Ben Croshaw from Zero Punctuation) contributed short stories based on the premise of that comic which have been combined into an anthology called Machine of Death (if you haven't checked out the comic yet, go do it now so you can understand the title).

Unfortunately they could not get a publisher to pick up the project and so had to publish it themselves. They are not bitter about this, as it is clearly a niche market, but they also don't want to just let the book slip quietly into obscurity. If you're interested in the book please buy it from the Amazon link above on October 26th. Apparently top sellers on Amazon only sell a few hundred books a day, so if everyone who is interested in this book buys it on the same day it should reach the number one selling book on Amazon for that day. That could be enough to make a difference in the future of the book and would be a great win for an independent publisher. For more information check out the Machine of Death website.

If you're not interested in buying the book without more information they are planning to release it for free as a PDF on their website eventually. So you could read it when that happens and then if you like it, support them by buying the book at that time. DON'T WORRY, THEY'LL STILL TAKE YOUR MONEY AFTER THE 26TH! :)