Category Archives: Langerhans

Back to nursery

Today Casper did his first day at nursery since covid-19 tilted the world off its axis.

He’d only just settled again after the Christmas break when he had to stop going, when we started shielding. A lot has happened since then. Devon seems to be managing the disease better than the rest of the country. Both Casper’s condition and his medication (still twice a day, every day; still working) have been downgraded, so we no longer have to shield. I have worked from home, been furloughed, and am now partially furloughed and working again, three days a week. Nora managed to go back to school to do the last few weeks of her reception year. I had many detailed conversations with his medical team about community transmission rates and infection control and risk vs reward.

He sauntered down our driveway to the car this morning, telling me he was “going to nursery to play with my friends”. I was so proud. When we got there, of course, he cried, but apart from not eating lunch and being a bit sad after his nap he had pretty happy day apparently. I nearly cried on the drive there, as it occurred to me that – aside from the last couple of Tuesdays, when he’s been with grandparents – I’ve looked after him (and his sister) all day, every day, for the last six months.

And then, when Em told me at lunchtime that he’d be going to nursery again tomorrow – which I kind of knew on an intellectual level but clearly had not processed emotionally – I cried in the kitchen.

I’ve had prolonged, close care with Nora – two summers ago, when this all kicked off and he was in hospital all the time – but not with Casper, and I’ve cherished it. Obviously not every second – circumstances have not been easy – but for the most part being primary carer for my children has been wonderful. Especially Casper, for two reasons; two is a fun age, and also because, for so long, we had that paranoia that we wouldn’t have this kind of time with him. Em always used to say that she felt he was temporary, that he was only loaned to us when he was a baby. I must ask her if she still feels that way. Dark moments come every so often, but they’re fewer and further between for me now (especially since the waking nightmares about drug supply chains have dissipated after the first few months of covid-19). I feel like he’s going to be with us for a long time now.

The portrayal of childhood cancer in BBC hospital drama ‘Casualty’

Catchy undergraduate essay title, huh?

Em and I watch Casualty most Saturday nights. We have since we first moved in together. It’s something we both watched as kids, and it’s a little bit of routine, something to turn your brain off too (but not too much). We’re not religious about it – if we wanna do something else, we will, and in the age of streaming TV we often actually watch it on a Sunday or a Tuesday – but it’s an easy choice when faced with almost infinite options.

Watching the childhood cancer story unroll over the last few months has been… odd. Like, I imagine, many medical situations, it is being played for drama rather than realism. It’s not exactly triggering to us, but it is frustrating, because it doesn’t chime at all with our own experience of Casper’s cancer. Here’s just a few reasons why.

• Childhood cancer for most families means lots and lots of (expensive) travel. OK, so Faith and Lev both work at a large city hospital, but they’ve never had to go anywhere else. They even had a magic foreign super consultant fly over to them. They’ve never had to spend a night away in a house run by a cancer charity, for instance, or set up a ‘go bag’ that they leave by the front door in case they need to rush to hospital in the middle of the night with a temperature.
• Neither Lev nor Faith have taken any significant time off work to care for their ill child, and they regularly leave him on his own in a paediatric oncology ward for lengthy and uncomfortable chemotherapy sessions while they work. I have never – not once – seen a child left alone on a paediatric oncology ward for longer than it takes for a parent to go to the toilet. And in most cases two parents have been present most of the time, especially in the early, intense days.
• There’s a LOT of waiting involved in any cancer treatment. A LOT. Not for a course of treatment to begin necessarily, but just waiting… for the consultant to see another patient, for the nurse to arrive with the chemo gear, for a cup of tea, while treatment actually happens, while your child is in the operating theatre, etc etc etc. It’s oftentimes a very boring process. I know we’re dealing with a 50 minute weekly hospital drama, but they could have made a not towards this. Time passes quicker with a montage!
• The consultant was one of the least supportive and empathetic character I’ve ever seen on television. Ours have been nothing but caring and kind. Not once have we had a meeting with a consultant about our child’s health that took place across a desk like a scary job interview. I once cried my eyes out in a hospital school classroom while the consultant gave me a hug. Stony-faced paediatric oncologists don’t exist in my experience.
• Proton Beam Therapy – the magic bullet that seems like it might offer hope of a cure for Luka – is only actually available (as far as we can tell from google) at two hospitals in the UK: in London and Manchester. More travel. Yet Luka seems to be having it in Holby, during Lev and Faith’s normal working day. I understand the logistics and drama of TV programmes, but honestly the travelling and expense thereof (and all the sandwiches you buy) are some of the most emblematic (and problematic) things about childhood cancer. We were fortunate not to need to travel much, and I was still up and down the M5 to Bristol an awful, awful lot.
• Who’s looking after their other kids? What’s happened to them?
• Not a whiff of a social worker or a counsellor.
• Or their extended families.
• Or drug companies, research trials, medical journal articles, etc etc. Luka’s cancer, like Casper’s, is rare and weird.
• Or, and this might be the most egregious absence, the level of charitable support that is not just available and offered but symbiotic with and essential to the ‘standard’ NHS care. Exeter’s paediatric oncology ward would not function remotely like it does without the CLIC Sargent nurses and social worker. There is not enough money in the system (and yes this is political – fund the NHS not just adequately but SUMPTUOUSLY, sod HS2; make massive global corporations pay their fucking taxes) to provide proper childhood cancer treatment and support, so the system is propped up by charities. Don’t get me wrong, I am VERY grateful for those charities, but that they need to exist in the first place is a disgusting failing of our society and economy. Casualty’s been quite full-on about NHS funding in recent times, and this seems like a missed opportunity to hammer that message home again. As a parent of a child with cancer I wouldn’t be offended at childhood cancer being used as a crowbar for a political message – I’m offended at it NOT being. Cancer is political like EVERYTHING ELSE in life.

I appreciate that Casualty is a drama about the people and trauma encountered in a hospital emergency department and not a drama about childhood cancer. I also appreciate that our experience of childhood cancer is not universal – everyone will have different experiences, and perhaps for some the plight of Luka and Faith and Lev will absolutely ring true. But it really doesn’t for me.

Coping / corona

I wrote this for our work Teams platform to share with colleagues as we get to grips with what looks increasingly like national lockdown. Thought it was worth sharing here, too.

As you know, I have some experience of dealing with prolonged traumatic and unexpected situations, and I just started scribbling down some thoughts on coping, which might be useful.

Initially the novelty of it, the strangeness, is almost exciting – gathering resources, adrenaline flowing, all those post-apocalyptic films and books have prepped us for this, right?

But then comes suffocation, and denial – that sense that you might wake up from this shitty disaster movie you’re now living in, because this is not how life should be. Surely it’ll just stop, because someone got something wrong and we need to hit reset? It must stop. It’s not real.

But then the realisation- you’re not going to wake up from this, because this is life, get used to it, this is normal now, and you need to cope. You have to adapt. You can adapt. You are adapting.

When Casper was first ill in some ways it was easy – there was a medical protocol to follow, lots of support, the normal world fell away and we went into survival mode and just concentrated on getting him treated and looking after Nora.

That’s not the case with this. There isn’t a plan, there aren’t experts telling us exactly how to cope, and we’re trying to deal with work, family, home, emotional lives all at once, as well as the virus and that risk. And by ‘we’ I don’t mean just my family – I mean all of us, the entire country, the world, we’re all in the same boat. Or on the same ocean – our boats vary.

We can and we will emerge on the other side of this, and we will be scarred by what’s happened, but hopefully we’ll have learnt a lot of things about ourselves and each other, about our society and our culture, and some of the things that have had to change might actually improve the way we live in the future.

There will be days – and lots of them – when you struggle. And that is ok. It is ok to wobble, to despair, to cry, to be upset. Accept it, and be open about it. You’re not on your own in this, in feeling this way. Let people help, however they can. It makes it easier, trust me. People’s generosity will astound you, and if you let it your own capacity to cope will astound you too.

Caribou – Suddenly

Let’s try and write something about music again, shall we?

Dan Snaith might be the musician I’ve listened to most music by in the last 20 years. I picked up his debut album (Start Breaking My Heart) not long after meeting Emma in autumn 2001, and his albums since then have soundtracked my life – our life together – in uncanny ways. It helps that he’s about a year older than me, so makes records that reflect those life events and then releases them in time for me to have similar experiences (except he did a PhD rather than just thinking about it, made records rather than wrote about them, etc etc).

2003’s exuberant melange of psych, pop, jazz, and cascading drum samples (Up In Flames) was an epochal record of my time as a music journalist, defining my taste and the weird ‘scene’ or community I belonged to (loosely – geeky 20-something boys spread across the world, connected by the internet, adolescences defined by indie rock, now fascinated with pop, electronic, experimental music, downloading the entire history of music as fast as nascent broadband would let us and mashing it together in playlists, editorial policies, or our own records). I can still remember listening to it for the first time, in the spare bedroom of my parents’ house that I had set-up as a music room, squirming with delight every time a ridiculous sample took me by surprise. I hoovered up EPs, b-sides (“Tits & Ass: The Great Canadian Weekend”, “Air Doom”, give’r), and became a bona fide fanboy.

The Milk of Human Kindness almost passed me by at first in 2005, but then Em and I bought our first flat and moved in together in 2007, and it became our most-played record, used like a piece of statement furniture or an accent wall to stamp our style on the place and make it feel like a home. Cooking dinner? Stick Caribou on. Reading a book and sharing a bottle of wine? Stick Caribou on. Playing with the kitten? Stick Caribou on.

And a month before we got the keys he’d released Andorra, which had refined all the jittery tricks from Up In Flames, grafted them to some awesome songs, and perfected the whole electronic-psych-pop thing before pushing in new directions, with the final couple of tracks, towards that edge-of-collapse dance/electronic/jazz/kraut/whatever territory that I’ve spent the last dozen years exploring (James Holden, Floating Points, Four Tet, Daniel Avery, The Comet Is Coming, Battles, Blank Project by Neneh Cherry, Dan Deacon, Fuck Buttons, Moses Boyd, etc etc etc and on and on and on). 2007 was the final year I really thought of myself as a music journalist – the final year I wrote all the time – probably because it’s when Stylus folded, and it was also – for me – one of the best years for music in my lifetime. And Andorra was one of the best albums in one of the best years.

Fast forward through two years of career hell and minor health problems, and Swim came out in 2010 – the next best year of my life for music, and also when I sorted my career out, got married, started cycling again, began Devon Record Club, and felt like life was what it ought to be. Swim did exactly what I wanted it to, and felt like part of a tripartite of albums – alongside Four Tet and Owen Pallett – that I could call favourites in my 30s in the same way as In Sides or The Stone Roses had been when I was a teenager. Even if he was singing about relationships collapsing on “Odessa” and “Leave House”, the joy, surprise and craft on show was still delightful. We capped it off at the close of 2011 by seeing the Caribou Vibration Ensemble at All Tomorrow’s Parties in Minehead – James Holden and Kieran Hebden and Marshall Allen on stage, plus two drummers, modular synths, four-piece brass section, insanity and delirium.

Our Love in 2014 seemed like another weird synthesis with our real lives – a sonic refinement further into electronic dance territory, but crucially a reaction to having become a father, and a celebration of the way that changes you. Except that – maybe because of the very coincidence that 2014 was when Nora was born – it didn’t quite click with me emotionally or aesthetically like all the others had. “Can’t Do Without You” and “Silver” were amazing pieces of music, up there in my esteem and my heart with anything else he’s done, but nothing else really stuck or seeped under my skin. It was immaculate, but it lacked something crucial, some essence that had connected me to everything previous. Maybe it had stepped away from the edge of collapse?

And so now (and I know I’m discounting the Daphni records – I have them, I enjoy them, but they aren’t the main deal for me) we have Suddenly, a record reflecting adulthood, fatherhood, and the unexpected turns and traumas that can come along. It embraces juxtaposition and surprise, it surfs close to the edge of collapse, it feels more melancholy than anything prior but just as joyous – albeit tempered, perhaps – sometimes almost subdued and sometimes almost insane. And it comes 18 months or so after our horrific, traumatic, unexpected collision with childhood cancer, after Casper being diagnosed with LCH, and it hits me square in the feels. Because it’s a complicated record that covers diverse sonic and emotional territory, very often within the same song, and that’s how life has been since cancer entered our lives. Siblings apologising, parents lullabying, emotions and noise and changes blindsiding you, coming home to uncertainty but it still being home, moments of normal life when you dance and forget what’s happened, eulogies for things that haven’t quite passed yet, that horrific sense of the time that’s gone, that’s been tainted, that’s left ripples of pain through the future even amidst the good feelings.

I’m only three days into my relationship with this record, but I already know how rewarding it can be. I don’t know what’s happened in Dan Snaith’s life over the last few years, and I hope it’s nothing like what we’ve been through, but I’m so glad he’s caught it in music for me again.

So we took our cancer child to a music festival…

And it was alright.

In fact it was pretty good. Really good, at points.

We’d always wanted to take the kids to festivals, to give them that kind of experience at a young age, and with everything that’s happened over the last year+ we kind of just went ‘fuck it’ back in the spring, and bought tickets and a tent. We thought End of the Road might be the best bet, but the line-up for Green Man was so good this year that we couldn’t resist.

I’m glad we didn’t. Even though I’ve always (jokingly) maintained that standing in a muddy field surrounded by Shed Seven fans on drugs sounded like hell. (It still does.) Even though I’ve never camped properly before, let alone done a camping festival. (we have done All Tomorrow’s Parties a couple of times, pre-kids, but you get a chalet, so…)

So it rained – relentlessly – on the Friday, and was horrific and muddy, and Nora had more than one awful pre-schooler tantrum (including an immense one at half past midnight at the festival toilets which culminated in her yelling at me “it’s my body! It’s my decision! Don’t touch me!” when I was trying to get her onesie off and get her to have the wee that she’d requested I take her for. Yes, there were other people present. No, no one said anything. Yes, some people looked sympathetic, albeit in that ‘stupid fucker kept a 4-year-old up after midnight’ way).

But on the other days – Thursday, Saturday, Sunday – it was generally sunny and warm, and the mud dried up quickly, and the setting was exquisitely beautiful (surrounded by verdant Welsh mountains, in a natural amphitheatre with a babbling stream and a pond and gently undulating fields for camping), and the food, though expensive, was great – Dosa Deli I love you; Goan Fish Curry I love you, Los Churros Amigos I love you – and the kids’ field was brilliant, and the line-up was fabulous, and Em saw a Caitlin Moran talk, and Nora got to watch Kiki’s Delivery Service in the cinema tent, and I even got to see (at least some of a set by) the following:

These New Puritans
Villagers
Stereolab
Sharon Van Etten
Four Tet
Eels
Sons Of Kemet
Fat White Family
TVAM
Big Thief
Stella Donnelly
Emily Magpie
Poco Drom
Aldous Harding

I also got to listen to the following artists quite clearly from the tent:

Yo La Tengo
John Talabot
Father John Misty (Em got to watch this one, with sleeping Nora in the buggy, while I took Casper back to the tent)

That’s actually not a bad return considering that we had two very small children with us.

We managed Casper’s meds. We just about managed Nora’s emotions. We saw old friends, bumped into lapsed and distant ones, and made new ones too.

We’ll do it again.

Who are we if we’re not that cancer family?

We took part in a social bike ride on Saturday, jointly organised by three local community initiatives (Ride On, FreeMoovement, and Exeter Cycling Campaign). We cycled from Exeter quay to Turf Locks, Em pulling Casper in the trailer, and Nora and me each on our own bikes. We arrived last of the group of 25+ people, but everyone was incredibly impressed that Nora (still only 4 years old, remember) rode all the way herself – it’s more than 7 miles from our house to Turf!

(Afterwards I cycled home fast with Casper, jumped in the car and then fetched Em and Nora, whose little legs were understandably knackered – she made it halfway home though.)

When we got to Turf we had a spot of lunch and chatted to the people who’d ridden with us (the ‘social’ bit was the main point of the ride). I got talking to a guy called Andy who, it turned out, knows Ian, who used to be my boss and who recently rode the Nello and sought sponsorship not just for Force but also for CLIC Sargent in Casper’s name.

“This is Casper, who Ian was raising money for.”

Then I spotted Simon, Casper’s paediatric oncologist (our paediatric oncologist, I should say, because when your child has cancer, your whole family ‘has’ cancer), who had also ridden out to Turf for a spot of lunch with his daughter. Not really surprising – it was a lovely day, Simon’s a triathlete (the lunatic), and there are few nicer places to cycle to for a sandwich and a cider shandy than Turf Locks on a sunny July Saturday.

“And there’s Casper’s oncologist.”

Cancer conversation ensued. It gets everywhere.

(Though not with Simon; that wouldn’t be fair. We did talk a bit about bikes, though.)

Casper had only seen Simon two days before, when two significant things happened.

Firstly, Simon referred Casper to have his port-a-catheter removed. The port-a-catheter is, for those who don’t know, a button under his chest that looks like a third nipple, with a tube that goes from the back of it down a vein in his neck and into his heart. It’s how chemo was administered, and how bloods have been taken. He’s not had chemo in nearly nine months now, and is big enough for bloods to be taken from his arm. The port is an infection risk, his current meds are administered orally, so out it comes.

Secondly, Simon has suggested that he only needs to see Casper every month now (appointments are currently every fortnight). My understanding is that typically the paediatric oncology team meet people, see them intensively for a period of months (or years) while treatment is administered, and then say goodbye and fare well once they’re OK, seeing them perhaps once a year or so to check they’re still OK afterwards.

Casper is different – this is more like managing a longterm chronic condition than an acute cancer now, and we’re shifting to that pattern of treatment and monitoring. Casper is ready to not be seen so often, to be as close to a normal boy as possible.

The question is, are we ready?

If you’ve ever dealt with chronic depression, you’ll know that you can cling to it as if it was an intrinsic part of your character, your personality, rather than a disease that affects the shape of your character and personality. “Who will I be if I’m not depressed?” “What do I look like, sound like, and act like without depression?” You may hate this thing that’s affecting you, it may make you feel awful and unable to deal with the world, but it can become very, very hard to relinquish. I imagine bad relationships, and various other patterns of negative behaviour, are very similar.

Because even awful things can become routine, and by becoming routine become, somehow, sort of comfortable, just through familiarity and repetition. Very few things are 100% bad; we’ve received a lot of love and support from the medical team, and removing that (even if not fully) feels scary, for instance.

It’s the same with Casper’s cancer; who will Em be if she’s not taking him to hospital all the time? Who will we be as a family? We didn’t want to be “that cancer family” when this began, and we still don’t, but… We also are that cancer family, and the repercussions of this last a lot longer than the diagnosis or initial treatment. Casper is 18 months old next week – we’ve barely existed as a family of four without cancer being involved. Despite the frequency of appointments dropping and the prospect of his port being removed soon, we are not finished with cancer and cancer is not finished with us.

In other news, Neil at work is cycling LEJOG next week, and raising money for a charity that research the family of diseases that Casper is affected by. You should sponsor him.

12 months of childhood cancer

Depending how you look at it (Christmas or Easter, essentially) either today or tomorrow is 12 months since this whole cancer thing started. Tomorrow by date, today by day. It will always have happened on the Saturday after Em’s birthday, in the morning, just hours after I got home from a conference. Those are the signifiers burnt into my mind. The precise date almost doesn’t matter. Easter Sunday. Cancer Saturday.

Or did it start on that holiday to Brittany, those days in a French hospital? Or when he had chickenpox at three months old? Or when he was in the womb? Or at some other point? We will never, and can never, know. But today (or tomorrow) is the day when we met Simon the paediatric oncologist for the first time, and he said “it might be Langerhan’s Cell Histiocytosis”, and this whole fucking elongated, awful, frightening, boring, anxious nightmare began properly.

I could have requested his hospital notes for this post, totted up all the blood transfusions and X-rays and nights in hospital, reduced everything to brutal statistics (30+ transfusions of various blood products; 50+ nights in hospital; 12 weeks of chemotherapy), but as numbing and horrific as those numbers are, they don’t tell the full story. Nothing can.

Three weeks ago we managed out first family holiday abroad since this that trip to France. A week in Portugal, in a villa belonging to Em’s aunt and uncle. Our neighbour, who is Portuguese and a medical researcher, kindly translated the hospital’s letter for us, in case the worst happened. It didn’t. The worst thing about the holiday was managing two small children in a hot and unfamiliar environment. It was pleasantly uneventful.

Life is mostly uneventful now, if not always pleasantly so, and while somehow managing to still be busy. We camped last weekend – one night in Woolacombe – a dry-run for when we go to Green Man Festival next month. It was also pleasantly uneventful. We argued, of course, stressed, said we should just sack it off and go home before the tent was even up, because, even though life is “normal” now compared to the whirlwind of diagnosis and chemo and surgical procedures to install valves and tubes that can pump drugs into and extract blood directly from my baby’s tiny heart, life is not ‘normal’, and never will be again. “It’ll never happen to us” was a default setting. The worst thing imaginable happened. Why the fuck wouldn’t it happen again? We know now that it can. Every blemish, every cough, every dip in appetite, every odd step; is the cancer back? Has the gene inhibitor stopped working?

It’s a long time since I’ve had that weird, vertiginous sensation that this is all a shitty, horrible film about cancer that I’m stuck watching, or a dream, or someone else’s life that I’ve somehow been zapped into like Sam in Quantum Leap, and had that desperate, irrational hope that someone ineffable, somewhere, will snap their fingers and this will all be over. I had that feeling a lot in the early days, in those first few weeks. Every so often – only every few months, probably – it comes back, that sense of the world tilting and coming up to meet you as you realise and acknowledge, again, that your baby has cancer.

“He’s NOT a baby daddy; he’s a toddler now.”

There was a guy, with a homemade banner about god, preaching on the High Street today, telling us that only god can save us from hell and damnation, and I wanted to slap him, grab him by the shirt, and scream in his face that I’ve been there, that it’s here now, that eternal damnation is just that – eternal, low level, ambient somehow, a permanent disquiet that soaks into your bones, like lenses of glasses scratched so much that you barely notice, most of the time, that the world is scarred and blurred and unclear in ways it never used to be. And then you do notice, and you remember that it’s like this forever, and you can never escape. I wanted to ask him how he could justify his god having afflicted my absolutely innocent baby with cancer when he’d barely had chance to be alive. I wanted to name all the other kids with cancer who we’d met, name them and their cancers, the neuroblastomas and the lymphomas and all the others, and ask him how he squares this with his faith. But I just walked past, because what good would it do? I don’t believe in god. Christian values I’m good with. Love thy neighbour, etc. Do unto others. The meek will inherit the earth. I just don’t see our political leaders acting them out much. I do believe that we invented ‘god’ as a concept as a way of explaining love.

Casper is, as ever, oblivious to this, except when we give him his meds. We started a new delivery method this week; still via syringe into his mouth, but dissolved tablets rather than powder. It doesn’t taste as good; he used to actively like the last lot; now he fights you. The fear that he’ll spit it out, not get the full dose, and that the cancer will come back is there at every administration.

Casper is also, it must be said, an idiot. He plays the fool almost constantly, doing things to get a laugh from his sister or from us; plate on head, funny faces, waving his arms and making weird noises, then laughing, laughing, laughing. There is a glint in his eyes – Em has said this almost since he was born – that means mischief, which Nora never had. As if he’s not put us through enough already. And good grief does he love to touch bikes and cars, especially wheels and pedals. We went in the bike shop today to pick up my bike after getting it fixed, and his eyes went like dinner plates.

How oblivious is he really? He’s been unsettled tonight; I’ve had to settle him three or four times between 7:30pm and 10pm. Has he picked up on us being slightly unsettled? What will he remember of this in five years time? How will he explain his scars to girlfriends or boyfriends when he’s older? Will there be emotional wounds we can’t see now?

In a few weeks he’ll start nursery, at the same time as Nora starts school and Em goes back to work. His nursery is on campus – the same one Nora went to, except he’ll be the first cohort in their new building. The staff all know him and his story already. I take him into work to show him off so often; look how alive he is! Look how he can walk, and babble, and smile! When your baby has cancer you kind of convince yourself that he’ll never do the normal developmental things; he’ll never walk, he’ll never drink from a cup, he’ll never manage solid food, he’ll never… be more than a baby. Be a toddler, or a little boy, or a child. Your brain freezes time in the present, because the future could be unimaginably bad, so you can’t imagine it at all.

The last 12 months have been horrific. I am, at heart, a positive person; energetic, talkative, about solutions and newness and change – not glass half empty or even glass half full, but rather “let’s go to the tap together and fill the glass and talk about making sure it’s always full in the future!” – but I’ve been as close to suicide this year as I can imagine I ever will be. Not just suicide; in the darkest moments I’ve wanted to end it not just for me but for all four of us, because my family is the most important thing in my life, and the thought of it splintering, collapsing, decaying and disintegrating is my biggest fear, my strongest trigger, the one thing I cannot cope with.

But I got through that, and now, mostly, things are OK, and I am OK, and we are OK. To look at us in the street you’d never know, most of the time. Em has entered the London Marathon for CLIC Sargent next year. We’re making progress on getting the house how we want it. I’m beginning to care about work again, sometimes. We’ve had, so far, mostly, a nice family summer – Portugal and camping and bike rides and eating in the garden. But it’s all tainted, all stained, all a little spoilt, like when you buy something new and you scratch it almost straight away and even if you can polish the scratch away you know it happened, that it’s there underneath, and no matter how many people tell you “but you know it’s yours now” it doesn’t matter because you just wanted to have whateveritis perfect, unscratched, for just a little while.

We watched Arrival at some point over Christmas, despite several people having told us explicitly not to. If you haven’t seen it, the plot is… relevant to out recent experiences. At the end I cried – great big gobby tears that shake your whole being, like a damn is breaking and concrete is being pulverised by the pressure of the built-up water behind it. It was one of the most cathartic things I’ve ever experienced. I am OK, now, mostly. But I think I want to watch Arrival again soon, just to purge. Break that damn again. Feel the ground rise up. We are in this for a long time. My son has cancer.

My son has cancer.

My son! He has cancer.

My son.

My daughter.

My wife.

Me.

Our family has cancer. It’s in our son. It’s turned off right now, but it hasn’t left properly yet.

Our family has had cancer for a year.

No news is good news

Never quite knew which way to take that phrase. There’s no such thing as good news? Or, if there is no news, it must be good? The difference is significant.

There is no news about Casper. He remains well, and strong, and increasingly noisy. The dabrafenib does what it does. You still worry, constantly, and post traumatic stress disorder lurks around every corner – it’s approaching a year since diagnosis, and tomorrow morning we go abroad on holiday: last time we did that he spent three days and nights in a French hospital and was diagnosed with cancer a week after we got back. Every temperature, every blemish, every abnormal poo sets off alarm bells.

I promised that I’d keep posting here about treatment still going well as often as possible, just in case anyone in the place we were in 11 months ago finds this blog and needs good news and a longer-term perspective. Even when there’s nothing to say. Let’s take the latter interpretation. No news is good news.

Someone’s just reached out to Em on social media about their baby just starting chemo for Langerhan’s, so this post is for them. We’re a year in, and things are OK. We know what you’re going through. You’re not on your own, and you will get through it. Ask for help when you need or want it. Only work with the facts as given to you by your medical team (no dr google). Take each day as it comes and do whatever is necessary. The worst bit is probably when the whirlwind ends and the dust settles, and the emotional scars and fallout begin to manifest. You can do this.

Casper is still fine

He is crawling, and fast. He has stood unaided for a few seconds, and cruises a lot. He loves food. He shouts a lot. He smiles as much as ever. Trips to Bristol are every two months now. The Exeter paediatric oncology team only check his bloods every month. Life is pleasantly dull, albeit still riddled with an anxiety that you can probably only understand if you’ve dealt with cancer at very, very close quarters. The gene therapy is working, and we hope it will continue to work for at least another couple of years. And then we’ll see what happens. Constantly assessing. Never not worrying. But living, and hitting milestones, and being a family.

World Cancer Day / Casper’s birthday

So today, 4th February, is World Cancer Day. Em (and some friends) spent two hours in Morrison’s yesterday with a CLIC Sargent bucket and t-shirt. It feels like a significant date.

What feels even more significant is the fact that it’s Casper’s first birthday tomorrow. Whilst it’s not been a constant thought, it’s not an exaggeration to say that we didn’t always know we’d get here over the last seven months. We also don’t know, for sure, how many more birthdays he will have. I hope a lot – as many as anyone else who lives an average, boring, normal, healthy life – but I expect nothing. One tries not to dwell on these thoughts and feelings – and I’m pretty good at not dwelling – but they do cross your mind. And once they’ve crossed it, they leave a stain.

But we have got here, and, right now, Casper remains well. The gene therapy is keeping his symptoms completely at bay. His bloods are good. His calcium levels have stabilised at a normal level after those early high readings. There is no sign of his rash. He is weaning well (albeit not quite as well as Nora did), he has started crawling, and this morning at softplay he was considerably more mobile than he’s suggested he could be before. Boys, eh?

He is, to all intents and purposes, a normal baby right now, and our lives are, likewise, as normal as they can be.

There have been blips. A brief temperature the week before last meant a night in hospital – the first since early November – for what turned out to be pretty much nothing; a standard, minor baby virus. He had a rash for a couple of days afterwards. But it was nothing.

As it’s World Cancer Day, I thought now would be a good time to reflect on how we got to his diagnosis.

Almost from birth, Casper had baby acne, which we thought (almost) nothing of. Eventually it went away, but it’s fair to say he was a spotty baby. He was also sicky, vomiting far more than Nora ever did. Too much? How can you tell? When your first baby doesn’t really vomit at all, any increase with a second baby feels like too much. I remember friends’ babies with reflux basically constantly leaking out of their mouths. He wasn’t that bad, but still…

There was nappy rash, too; again, more than Nora ever had. Enough to worry us. Health visitors, doctors etcetera suggested it was nothing more than a touch of eczema. Nora has a bit of eczema sometimes, usually after swimming. We keep it at bay with a decent moisturiser. Neither Em nor I have ever had eczema. It was suggested that Em should go dairy free in case this was a cause. She did. Did it seem like it helped? Not significantly.

He was a big baby – over 10 pounds – and it was hot, really hot, from early May last year. It was difficult to keep him dry beneath his arms, in his neck, and round his nappy area during early summer. He got sweaty, it got red and angry. Again, health visitors and doctors suggested it was nothing more than eczema. Keep him dry, try an emollient, here’s some antibiotics. It’s nothing serious.

Em was always worried about Casper. More so than Nora. Nora never caused us to worry, not about her health. She seemed invulnerable. She said he felt temporary. I said – in my positive, everything-is-ok way – that he was fine. That everything would be fine. He’s just a different baby. And he is. He’s more dramatic than Nora. More easily upset. But he also has cancer. How much of his nature is him, and how much is his disease?

We went on holiday to France in early July. The day before we got the ferry we saw the doctor; is it OK to travel? They suggested it was fine, that the rash – almost certainly infected eczema – was getting better. It wasn’t.

In France it was as hot as it had been at home; a proper heatwave. On the first morning there we tried to bathe him and he screamed when the water touched his skin. We took him to the nearest hospital – 25 minutes drive away – that had a good paediatric ward. He was admitted. My French is good enough to order food and drink. Medical situations? No thank you. “Erpez?”What? “Erpez.” Herpes? That’s really not good in babies. One nurse suggested we just weren’t keeping him clean enough. Which makes you feel like you’re failing as a parent. Anti-viral drugs, antibiotics, infected eczema, getting better. Nora and I sought refuge in the campsite pool, in a roadside McDonald’s halfway between the campsite and the hospital, as I tried to give her the holiday we’d promised her. He was out after three days. Frank lent us his parents’ house so we could stay somewhere bigger, easier to manage a (slightly) poorly baby in a heatwave (we’d been in a caravan-chalet thing).

Got home, changed doctor, saw him for holiday follow-up on the Monday in the week after we got back. Then again on the Friday, because Casper was vomiting fluorescent yellow stuff; a side effect of all the drugs in France, perhaps. Keep an eye on him, get in touch if anything changes. Who worries about a baby being sick? Babies vomit; babies get rashes. It’s not unusual. I was away at a conference. That night he started vomiting again, and didn’t stop; every time something hit his stomach, he brought it back up. All night. More and worse than his regular sickiness. More than just a baby being sick. More than just a baby with a rash.

We called 111 at 6am; they referred us to Devon Doctors, who referred us to A&E. “I’m not concerned with the vomiting, but this rash…” said the consultant in the Paediatric Assessment Unit. He just happened to be a paediatric oncologist. He’s now our paediatric oncologist. One of them. Simon.

Langerhan’s Cell Histiocytosis was mentioned as a possibility that Saturday morning, almost straight away. An “auto immune disease”. “Highly treatable, but it does need chemotherapy”. A clue as to the fact that it is, essentially, cancer.

He was transferred to Bristol overnight Monday into Tuesday. Nora and I were given a room in a CLIC Sargent house in Bristol near the hospital. Back and forth up the M5.

Test after test after test. He was formally diagnosed on the Wednesday evening. More tests. A general anaesthetic for an MRI scan, and 15 hours later another general anaesthetic for a Hickman line to be inserted and biopsies to be taken. A whirlwind. Too much to take in. Social workers, psychologists, oncology nurses.

And that, roughly, is how we got to where we were when I started writing here again in August. Seven months with cancer. Chaos, pain, worry, anxiety, fear, joy, hope, disappointment, grief, confusion, fear, fear. Fear. Life with cancer. Your baby with cancer.