Postponement Upon Postponement

Saturday, March 28th, 7:09 in the morning.I’m waking up to Cycle 11 Day 24.So you hear the number 24 and you might be thinking: okay, isn’t Victor undergoing treatment in 21-day cycles? And that is correct.However, I had deliberately extended this cycle because I’m trying to combine the aggressive treatment and recovery I’m going through with my ongoing studies in arboriculture—so tree care, plant knowledge, and how to basically take care of a tree throughout its life cycle.This chapter in my life diary will be quite dense.I’ve already put down a number of bullet points that I will go through, so if you’re here for the long ride, it’s going to be quite a long episode.Sleep, Stress, and ResilienceFirst, let’s look at my sleep.This cycle has not had the best sleep of any cycle, but all of them have had crappy sleep, basically.Tonight I slept 7 hours and 12 minutes while only being in bed for 8 hours. So that’s actually quite decent: 90% sleep efficiency, over 1 hour of deep sleep—1 hour 10 minutes—and 2 hours and 20 minutes of REM.That has definitely not been the case most nights during these last three weeks.My lowest resting heart rate went down a little bit, which is good. But it’s been consistently high throughout the last few weeks. It has kind of reached the highest level ever, or at least the highest level in half a year.So now, over the last two weeks, it’s averaging 54 beats per minute, whereas my average heart rate throughout the night has been around 60 to 63 in the last few weeks.And my heart rate variability is consistently very low. As I mentioned before, I used to be up in the hundreds—around 100 milliseconds—but now my weekly average has gone down to 40, 46.And this composite scoring that is pulled from a lot of different measurements from my smart ring, which is called “Resilience”, is at an all-time low.You have the possibility to get the highest “Resilience” score there, which I’ve had for some periods of time. That bracket is called Exceptional. If you get lower, you’re called Strong, then Solid, then Adequate. And the last, lowest bracket is called Limited.I entered Limited on Saturday, March 21st, and it has been consistently going even lower since. So now I’m in the middle of the limited bracket.That score is based on my composite nighttime recovery—how well I sleep at night—daytime recovery, meaning how much recovery time I’m able to accumulate over the day, and daytime stress load, meaning how much stress I’m putting on my body, which also partially includes things like physical exercise.So yes, there’s only up from here in that sense.But then again, I don’t feel as bad as that resilience score makes it look. It’s numbers—they’re indicative—but they are not the only source of truth here.A Further Treatment DelayAnd speaking of numbers, I have now had to very last-minute postpone my treatment even further.The initial plan was to start fasting today, on Saturday, from noon, and then start treatment two days later on Monday. And then, as some of you know, I would proceed with the six-day fast—two days prior, two days during, and two days after treatment.My treatment goes on for around two days. I come home with this balloon of chemotherapy—yes, toxic chemotherapy—that is slowly infused through the port implanted below the skin in my chest area. From there it goes through a small hose that has been implanted and pushed down through a vein to the main outlet from the heart.So poison is able to be pumped efficiently throughout my whole blood circulation, basically.Lovely stuff… But the thing is that prior to every treatment start, you do a blood panel.This blood panel is there to see whether I’m able to withstand continued treatment without any of my organs basically failing. So it’s quite a low bar for continuing treatment. It’s about looking at some main blood markers for different organs in the body and seeing whether they shoot up or point in the wrong direction enough that you at least want to be cautious and maybe wait a while—delay treatment and see whether those markers come back down.What happened was that I had a blood test scheduled for Thursday that I couldn’t take on Thursday, so I took it on Friday instead.I took it before lunch, and the results came back in the afternoon.And without telling me, my oncologist canceled my treatment on Monday.Then a nurse from the treating facility called me up and told me: okay, your treatment has been canceled due to one of the markers sticking out.The marker was ALT, or ALAT, which is a marker related to liver health.So it’s a test of alanine aminotransferase—how much of that enzyme is in the blood. That enzyme exists mainly in liver cells, but it also exists in kidneys, heart, and muscle tissue.Normally it shows quite a small value in the blood, and that has been the case for me as well.I actually looked it up while recording this. The unit that ALT is given in is microkat per liter. Microkat is a catalytic unit, so it describes the catalytic activity of an enzyme in the blood sample.Normally I’ve been showing results for ALT around 0.3 to 0.4 microkat per liter.But in yesterday’s blood sample, my ALT showed a value of 2.23.So that is quite an increase from 0.4.The only other value I’ve had throughout my timeline that was higher was around 0.6. So this is a major jump.What the Elevated ALT Might MeanThen I looked this up, because I wasn’t able to talk straight away with the oncologist.If you have a high ALT, what you really want to compare it with is other liver markers. There is one called AST, which is another enzyme. But for some reason that had been removed from my blood panel, so we didn’t have a measure of AST.The only thing I had to go on was ALT, and then some other markers like bilirubin and lactate dehydrogenase (LD). None of those stuck out enough to show a clear pattern of liver damage.ALT can also be raised because of heavy resistance training, which I have exposed myself to throughout this cycle.There is also a lot of tissue damage in general from this whole treatment-and-recovery lifestyle.But it did stand out that the value was this high compared to any other time it has been measured in me.So the oncologist decided to postpone treatment until I’ve taken another blood test.And it was so late in the day when I got to know this that they had already canceled treatment, and they don’t work weekends, so I couldn’t do much about it.I’m going to do a new blood test on Monday or Tuesday to see what’s happened to this ALT, but also to get the AST value measured.Then we’ll take it from there.I’m not worried about my liver health because I don’t feel any symptoms connected to that.We’ll just wait and see.I don’t think it’s a direct effect of the treatment, and it’s most probably not a direct effect of tumor activity, because that should have shown in some other markers as well.So now cycle 11 is being extended another few days. I don’t know how many.In terms of resistance training, I’m not going to do that this weekend because I want to see whether it’s muscle breakdown causing this.I just had a quite intense strength-training session yesterday focused on the lower body. Every time you do resistance training, your muscles break down in order to be rebuilt.So this weekend I’m just going to do low-intensity movement, basically.Today I might be going out in nature with Jonna. Let’s see.And then in the evening I’m going to play some pool, some billiards, with an arborist friend, which is going to be nice.And then tomorrow I have other things planned, because now my whole life puzzle needs to be reshuffled. I suddenly have more time on my hands before going into the depths of the underworld.A New Friend Around the BlockAs it happens, I recently made a new friend who has his office—or rather his art studio—just around the block from me.He’s an original French man.I’m quite drawn in by his art. He’s very visual, very strong with perspective, and he has an interesting imagination in how he builds up his compositions.I had walked past his studio a few times, and then one day, when I was feeling very weak after the first round of retreatment, I was peering through his window and he came out from the shadows and knocked on the door to signal that I could be let in.Then we started talking, and now we’ve become friends.He’s a funny guy.Currently he’s working on a big commission where he’s not only painting, but also doing sculpture work. That has now led to a commission to recreate facade decorations for a building in central Stockholm.I’ve been following his process—the design work and how he’s creating the blueprint for the moldings that are going to be used to make the final building material.It’s an interesting process. He’s working with stencils, styrofoam, and different types of clay that he’s shaping in order to create the final blueprint of the decorations. That blueprint is then sent elsewhere, where they will make the final silicone mold and create the final pieces to be mounted on the facade.Because I want to get more momentum in visual art, I was thinking it would be a good idea for me to go and help him out a bit—and through that get inspiration and build more tools in the visual space.And as it turns out, he’s also having a workshop on Sunday for a few people to do painting.So we struck a deal where I will help him out a bit with the molding of these facade decorations, and I’ll also join him for this painting workshop on Sunday.So during daytime Sunday I’ll be doing some painting.I don’t know exactly what yet. I have a few ideas in mind, but I’ll bring those ideas to him and we’ll see what turns out.Really looking forward to that.On Weakness, Strangers, and ConnectionAnd on the topic of making new friends, I think it’s an interesting pattern I see in myself that often when I’m weak, I tend at some point in that fragile state of being sick—really contemplating life and death and interhuman relations—to be drawn toward strangers.There’s something special in me that feels drawn to them.Obviously I still socialize a lot with people I know from before, as most of you should know, but there is something special about meeting a stranger and having that stranger reflect your feelings, what you are communicating, and the energy you are sending out—without having any prior knowledge of who you were as a person, and without having any judgment of who you are as a person, or how you see yourself, or how someone who knows you would have seen you five years ago, ten years ago.There is no history there.And I think there is something beautiful when two strangers meet and they can connect on a deep level instantly.For me, that is not something I’m afraid of.Rather, it is something I am drawn to.And even when I’m weak, I’m drawn to it—maybe even more so.Because sometimes in those moments I really feel the capability and the potential we have to build new close connections with people we have no prior history with.And I think that’s one of the things that gives me hope about humankind in general.Because we are not all strangers to each other—not really.Even if we do not know people on the other side of the world, we could know them.So when we do get the opportunity to get to know an individual, unless we have too many other burdens in our lives, I think it’s worth taking the minute to check them out and to have them check you out as fully as possible.Not to build a facade around yourself that protects you from unnecessary social risk or ambiguity in how you relate to others.Rather, allow yourself to be vulnerable.Because that’s when you can actually build new bridges to people.That has been a common theme throughout my adult life, but even more so now, in these last 19 months, that despite being very weak and having low energy reserves, I’ve still been drawn to talking to strangers about my life situation.And when they are able to relate to that on a deeper level, it doesn’t matter where they come from. It doesn’t matter what their background is, how we met, where we met, or where they are about to head next. They might never come back to a place where we can meet again.It’s about that initial interaction.And then, of course, something else can build out of that.Another example: when I was in the gym, I was sweeping the floor a bit because I tend to do that. I was trying to get rid of weird residue people bring into the shower—fabric from socks or whatever. I was sweeping with a swab, or whatever it’s called, and a guy said to me, “Okay, you’re really making an effort here.”And I joked that no, I was just pushing the dirt to another side of the shower space, because I wasn’t fully pushing it into a drain.But then he saw what I have on my chest—my port-a-cath. He asked whether it was a pacemaker.I told him “No, it's where they push poison into my bloodstream”, and then I had to explain my life situation.That led to a conversation about my life situation, which made him open up about his life situation.I’ve had so many of those interactions in these past months, and I find most of them very valuable.Plant PhysiologyWhat else can we talk about?Well, the reason I postponed treatment the first time was because on Thursday I had an exam in my Plant Physiology course.Plant physiology, at its root, is everything about the life cycle of the plant.So it includes how a plant goes from being a seed into a seedling, then into something that grows roots and starts to produce either a stalk if it’s herbaceous, or a stem if it’s a woody plant.From that stem you get shoots, which produce leaves. For flowering plants, they produce flowers and fruits. Those fruits then bear seeds in turn, which can be spread.How are they spread? Through wind, or through animals.Before the seeds are produced, you have the pollination of the flowers, which can be done by insects, birds, and some mammals as well—bats, for example.Other parts of tree physiology include how water circulates through the plant, how energy is produced via photosynthesis, how the tree is able to protect itself from attacks by animals, fungi, and bacteria—so basically the tree’s immune defense.And then also how you as a human would cultivate trees from a seed or from a cutting taken from a branch or root.In the course we’ve actually done our own tests as well.I’ll include images in the post of those attempts. (will add these soon…)The first one was that we were to grow tree seeds.We were given seeds of different tree species, and I picked three different ones, all exotic to Scandinavia.I started preparing them for germination.Many tree seeds in temperate climates need to be put into cool storage, such as in a fridge—a process called cold stratification—in order for them to start germinating. Otherwise they don’t break dormancy.And I’ve actually succeeded in sprouting two seedlings from two different tree species.One is blue spruce, Picea pungens—kind of a blue-green Christmas-tree-looking tree.It has sprouted, though of course it does not yet look like a full Christmas tree. It just has one crown of its first leaves—seven, in fact—and it’s starting to get its second crown. Spruces and their neighboring species grow their branches in strict levels, kind of the way a Christmas tree looks, with rings of branches around the stem and then another level above.The other one I managed to get sprouting is Zelkova serrata, a Japanese deciduous tree.It is not a conifer, so it doesn’t have those thin needle-type leaves. Instead it has flatter leaves, and they’re quite decorative. The leaves are serrated—that’s why it’s called serrata—they have a saw-toothed edge.Then we had another assignment where we were to grow plants from cuttings. Our teacher brought a lot of different cuttings, mainly from bushes.Of course, I took home cuttings from my favorite bush: sea buckthorn, whose Latin name I’ve now forgotten.Sea buckthorn is my absolute favorite berry.It has this very acidic, tart, intense taste, with a bit of sweetness. It is super high in vitamin C—one of the densest vitamin C sources you get in nature.If you haven’t tasted sea buckthorn, I can definitely recommend it.However, some cultivated variants do not have the same unique taste. They are a bit blander, a bit sweeter.I don’t know whether that was an intended flavor choice. I think it is just an after-effect of those plants having been selected for large berries that are easier to harvest.Because the wild variant that grows around the Stockholm coastline and a bit north of Stockholm has berries that are really attached to the branches.So you have to pick them at exactly the right season, at exactly the right time. Basically there is just a window of a few days where the berries are ripe enough to remove without being too firmly stuck to the branch.If they are too stuck, you squeeze them when trying to remove them and they break, or you end up with part of the branch still attached to the berry.On the other hand, if they are too ripe, they just burst between your fingers when you try to pluck them. Then you get juice on your fingers, but there is no berry left in sight.The berries are also very small.And the bush is very thorny.So there are a lot of hurdles to picking them by hand in the wild.But I still love it.I’ve done it a few times.I even convinced my girlfriend that we should go specifically to the one spot I had scouted as the best place for picking sea buckthorn.I’m not going to tell you where it is.In Sweden we do not tell each other about our smultronställe—our special wild strawberry place—or our mushroom place.We don’t kiss and tell.And that’s sea buckthorn for you.The cultivated variants are harvested differently. Either they shake the whole stem of the bush or tree with a machine that clamps onto the base and vibrates it at the right ripeness, with a cloth spread underneath to catch the berries, or they do a more aggressive harvest by cutting off whole branches and putting them in the freezer. Once frozen, the berries become easy to shake loose.Spring Arriving FastWe’ve also been asked to observe the budding of leaves out in nature and in park areas around Stockholm, because now you have leaf budding beginning, but you also have pollen starting.Everything goes very fast in spring.The pollen season is beginning. I think it’s alder that is already sending out pollen. Some of you in Stockholm might already be feeling it.Of course, if you’re in another place in the world, it might be very different.And I was happy to be able to combine my hectic lifestyle—to say the least—with treatment and recovery, while still just about managing to combine it with this course.I’m going to try and do the same going forward.Next week we’re starting a new course—or rather the next part of a course we already started last term—namely Applied Tree Care.So we’ll see how I manage that.Looking Ahead, CarefullyAnd now, yes, let’s see if I have a few days of respite, or if I’m going to start feeling symptoms coming back.Because my tumor burden was so widespread on the last scan that I do not want to postpone treatment unnecessarily.I am quite convinced, and ready to acknowledge, that given the tumor burden seen on the last scan, I’m going to need to be in this for the long run.I do not like systemic therapy.I do not like the whole-body effects of it in terms of toxicity.And over time there is definitely a significant risk of secondary tumors appearing because of the toxicity of these chemicals—inducing DNA damage not only in tumor cells, but also in healthy cells, which might in turn, over time, become new tumor cells.But for now, I do not see any other route than to carry on with this aggressive treatment.And we are planning to do a follow-up scan after the third treatment at some point.So yes—let’s make sure I’m able to get this third treatment as soon as possible.Then within a few weeks after starting cycle three, I should know the results of my next scan, and we will take it from there.There are some alternative scenarios that can play out, but let’s not get ahead of ourselves.One step at a time.One step at a time…That’s all, folks.Be mindful of your life energy, and I’ll talk to you soon.Namaste. 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