Getting off the Information Overload

Here in the Tumourland Fun Park, there are many rides. Not all of them much fun.

The one which has occupied me most recently is The Big Dipper,  the rollercoaster while hurtles the lumpy thrill-seeker from the pits of fatigue to the peaks of steroid anxiety over and over again, by way of an afternoon's entertainment.

I've been off work for a couple of weeks playing on that one. I don't recommend it - it gives you all the low bits first, which is kind of rubbish, then a quick reintroduction of the old dexamethasone chucks in all the highs and subsequent plummets in quick succession: now I'm wired, now I'm tired, now I'm tense, now I'm knackered, now I'm anxious... woooargh!, throw hands in air, go for a wee nap. There are better ways to spend your time. One of my friends told me my last blog had a "great amphetamine flavour". It was intended as a compliment. but I've never had many aspirations to be Hunter S Thompson.

The other popular ride in the Tumourland Fun Park just now is the Information Overload. I've written about this before: it's the one where you get handed a huge tightly-wound tangle of difficult to process data and are somehow expected to unravel it for use; to work things out for yourself and explain them to other people without doing too much further damage in the process. That one's a real blast.

Just to make it a little more exciting, the Information Overload also throws in the internet and the press as an exciting twist. Then it spins you round and round until you're really very confused and quite dizzy.

The internet is one thing, uncurated as it is: if you must journey into its hinterlands, at least remember that you're also probably reading randomly, and check things out with a trusted source – don't just accept everything as if publication somehow bestows an equal value on it all. The news media, however, ought to be one of those trusted sources, providing its readers with reasoned, balanced analysis in easy-to-understand form.

It doesn't, though.

Take the case of Sally Roberts, who ran off with her seven-year-old son Neon (I know, I know) in order to prevent him receiving radiotherapy which medical opinion says he quickly and desperately needs, because she was frightened of its potential side-effects and wanted to investigate more "holistic" alternatives.

Although I think Roberts is a very silly woman, and I don't believe for a second she had the right to make that decision on behalf of her son, I have some sympathy for her insofar as I presume she is also very afraid, and very shaken around by the Information Overload.

Look at it this way…

Suppose you were presented (as I was) with radiotherapy as an option. And the doctors (ooh, suspicious, authority figures) explain that they've done years of research (ooh, scary difficult science funded by big evil companies and probably involving bunny-blinding) and they've worked out that it works very well (ooh, why isn't it perfect?) but there are some risks, some of them potentially quite nasty (ooh, scary, it'll happen, it'll happen, aargh!), but it's the best they've got, and actually very good for most people.

Supposing instead you were presented with… let's call it fluffytherapy, as another option. And the alternative therapist (ooh, alternative!) explains that after centuries of natural holistic chanting (ooh, natural, holistic!) done by some Amazonian tribesmen for no related purpose at all, they've just decided it works (ooh, just works!) and because it's never been tested but is quite possibly too ineffectual anyway it has no known side-effects (ooh, no side-effects!) and it smells quite nice (ooh, natural, therapeutic!) so it must be good for you.

And so the Information Overload spins the gullible, and even the not so gullible, around until they're too dizzy to get off on the side without the cliff. Did I mention the cliff? That's the third option, which is that the major side-effect of not taking the radiotherapy is death.

All that data, so much of it worthless, and no-one except for the medical establishment Roberts seems to regard with such suspicion to put it in perspective, to explain why the evidence supporting radiotherapy carries more weight than any supposed alternative. It's a shame that she sees them like that: they were very good to me - I had a meeting with an oncologist, a radiotherapist, a specialist nurse and others right back at the beginning, pretty much just so I could ask questions, and it was very useful even if I've barely stopped asking more since.

But maybe she needs another trusted source. Yet even in the quality papers, in the last week I have read columnists who instead of trying to analyse the situation have reinforced her silliness by wittering about how not enough consideration is given by doctors to parents' instincts, as if some vague feeling somehow has to be given equal weight to years of research and experience. Sure, doctors should take parents' feelings into account, insofar as they should be making sure that they understand why the recommended treatment is the recommended treatment, and not Hopi ear candling or whatever. But there the line is drawn - after that, parents have to realise that they have a responsibility to protect their children, not a right to endanger them. Some parents are full-body resurrectionists who want to prevent their sick kids from receiving blood transfusions, others think the vile practice of  female genital mutilation is in the best interests of their wee girls. Against hard evidence, instinct, belief and mere preference mean nothing at all.

So that was the quality press. Worse again, though, was the huge steaming turd of an article dumped by one of the mid-market tabloids on its readers, under the headline "Do Cancer Alternatives Really Work?".

I'm not going to link to it, because I don't want to encourage it. But, below the meaningless headline (what is a "cancer alternative"? – a new way in which our cells can explode into uncontrolled growth?) this piece of non-journalism used the Sally Roberts story as a run-in to a seemingly random selection of descriptions of supposedly alternative therapies, some of them quite dangerous in themselves, others inherently useless, but all potentially harmful if regarded as in any way alternative to the properly researched and continually developed treatments which we know work and are getting better. And so a British newspaper and its website managed to give apparent equal weight to the stupid and the real.

It's not unusual. The standard of health and science reporting in the country has long been appalling. Once again, I recommend Dr Ben Goldacre's insightful but also very funny book Bad Science for a well-written and clear take on this, and for some pretty shocking stories about so-called alternatives therapies, too. Why not try his new one, Bad Pharma, as well?

I also recommend the website Sense About Science, which aims to help us all decide what's real and what isn't when it comes to science and health. It claims a database of 5000 scientists from whom to draw, including Nobel Prize winners and famous names such as Dr Simon Singh. It also currently carries a corrected version of the tabloid piece I mentioned before, and I do encourage you to read that, because it manages to point out some dangers and clear up some misconceptions.

I'd also like to point to Sense About Science's excellent leaflet I Don't Know What To Believe. Please give it a read, and bear in mind its ideas when you read science and health stories. More so if you write them. It's nice and clear, even to us journalists, who were quite often the arty kids who weren't that good at sums.

It doesn't contain all the answers, but it makes getting off the Information Overload just a little bit easier.

This year's Dexmas season begins...

Just a year ago I was sitting in a bed in the Southern General's very fine neurosurgery department, bored and slightly bewildered  from a night rendered sleepless by general hospital racket, an octogenarian escape artist in and mostly out of the bed opposite and his nightwear, a 3am catheter removal, and regular unironic professional awakenings to check I was sleeping naturally and knew who the Prime Minister was.

Either through the sleep deprivation or some sort of morphine hangover, I felt particularly disinclined to open the second door on my advent calendar – the previous day's had been in the side of my head and the choccy had been horrible. But I otherwise felt pretty good, under the circumstances.

Now, exactly 12 months later, I feel pretty good again. Well, actually I feel slightly sick because one of the cats licked my hand while I was typing that last par and left a brown residue. Other than that, though, post shower I'm all right.

I haven't been feeling so good for the last couple of weeks, though. Not ill, but tired again. I was told that chemo fatigue could last for up to six months after I stopped popping the poison back in August, but it had calmed down a lot and I'd hardly had to take a day off since September. Yet just around the beginning of November it started to come back, and around a fortnight ago it got worse, this time with an exciting new edge of… well, a kind of low feeling (I'm hesitant to use the word "depression") which made the weariness just that bit more wearisome. I'd also had a weird set of intermittent allergy-like symptoms - sneezing, runny nose and congestion, but none of the other nasty cold stuff - for about six weeks, and the pressure in my sinuses was starting to give me headaches.

I'd been warned to watch out for headaches, but these were mild and passed quickly, so I wasn't concerned. I emailed The Beatson, but they didn't get back to me, so I assumed they weren't very concerned either. But I went to see my GP, who took some bloods, gave me an antihistamine, and signed me off for a week's rest.

Which I needed. I went in to work the next day because I had a meeting and wanted to make sure everything was set up for my absence, but I must have looked a bit unfocussed and was told to go home. I then spent the next few days flubbing around the place doing little more than eating or sleeping, with the cats watching me with a triumphant air, seemingly convinced they'd won the larger of the two feeding monkeys over to their ways. One of them also began to see me as a conveniently well-padded immobile warm thing on which to sleep, but that was OK because I was starting to regard her as a sort of personal furry draft excluder. For most of the past week I've slept the days away, and it has been chillier.

I don't really like sleeping during normal waking hours because it seems like a waste of precious, escaping time. There are also side-effects, one of which turned out to be further headache potential from failing to nod off in a comfortable position and waking up with a stiff neck until I could crack it out. Another turned out to be waking up and reaching for my Android tablet, only to find its black, shiny surface covered in sticky pucker marks, as if someone had been repeatedly kissing it. Well, I quite like it, but I'm not that taken with it. Seems one of the cats had been sitting on it. So that made me feel a bit unwell for a while.

At least the antihistamines had sorted out the sinuses. But I'd discovered the other ill-effect of daytime sleeping, which is letting broadcast media get too deeply into my psyche when I'm in a suggestible state.

As usual, I was starting my day with GMS on the radio for the Scottish news and an entertaining grumble at the presenters for not asking the questions I would have asked, followed by BBC Breakfast on the telly, which I watch largely because I feel slightly sorry for Bill Turnbull ( it's his wee face when he has the latest point-free celebrity talent-vacuum plonked in front of him for interview, and I feel I can almost read in his expression: "I used to report from The White House, you know", a sigh, and then, "never mind, just two and a half years to the next general election".) Problem was, though, that if I then fell asleep during Olly Murs or Joss Stone or whoever that morning's personality gap was, I'd be out until lunchtime, which meant I'd wake up irritatedly humming the theme from Bargain Hunt. 

At least, I think it was Bargain Hunt – it might have been Cash in the Attic, I'm not certain – the one presented by the slightly effete, mustached man who reminds me vaguely of Lenny the Lion. Actually, it might have been the theme from the one about the rescue helicopters instead. I really don't care much – it's just the start of the evidence that falling asleep in front of the telly just doesn't work for me in terms of relaxation but subconsciously adds to my inner pool of bile and spite. 

If I've managed to switch to a news channel and it's midweek during the day, I might just wake up shouting during PM or FM Qs, but if I've gone to Channel Four I might sleep all the way through Countdown and then wake up feeling hate-filled because Noel Edmonds has come on. Sleeping later is worse – I've been so tired that kipping off  mid-evening hasn't affected my night's sleep, but I have now found myself with a compulsion to enter Masterchef, not because I fancy my chances as a cook, but because I want to stand face-to-face with Greg Wallace and say, "right, baldy, you and me, car park, square go, now".

So, anyway, that was my pattern for last week – sleeping, despising… oh, and hoping for a virus. That was because the blood tests I'd had were for a viral cause for the tiredness, but also for diabetes, so a wee bug seemed like the far preferable option.

Then on Thursday I went back to the GP and it turned out I didn't have either of these things, so she gave me some antibiotics and signed me off for a further fortnight. Later on she phoned me to say she'd been in touch with The Beatson, who weren't terribly concerned but wanted me to go in for a scan ( I was due one soon anyway) and to start taking the steroids again.

It's a low dose – 2mg a day – but that's four times as much as I was taking when I came off them back in July. So I took that on Thursday afternoon, and took the same again on Friday morning, and by Friday mid-day I was ripped to the molars on dexamethasone and no longer doing the dinosaur after I'd hauled myself to my feet. Instead I almost skipped down the road for lunch, insofar as that is possible for an overweight, middle-aged Scottish man, and then felt a bit of a con as I emailed into the office to say I'd been signed off for another two weeks' rest. But I couldn't have gone in then – I'd have been unbearable. Anyway, once I'd finished my paper and got myself all worked up about Leveson I was exhausted again and had to go back for a bit of a sleep, from which I woke up hyper at teatime and chattered at Clare all evening. I thought I was being quite insightful and witty, and she rather charitably agreed when I checked, which suggests I was possibly also being slightly paranoid.

I've been much closer to normal levels of energy since, but there is still a slight steroid edge – looking over what I've scribbled here this morning,I can see it in my own writing. It doesn't exactly read like The Diary of a Drug Fiend, but it does read a little like The Blog of a Slightly Cynical Man who's had Too Much Coffee.

Under more normal circumstances I'd probably have left out the bits about the cat residue and Greg Wallace, for instance. But this is supposed to be an accurate record of what's going on for me as the cancer treatment proceeds, so here you go - you can keep the weird bits, too.

It's now Sunday evening, and I think I need a nap. By tomorrow, I think I'll be more used to the steroid again. I've been on higher doses before, and coped fine.

By then I'll be waiting for my MRI appointment, and then comes the scanxiety. More on that next time.

A new hope?

There isn’t a good place to get cancer (I really don’t recommend the head, for instance) but some are better than others.

For a while there, it looked like America was about to become one of the others. Again.

But the good guy won their weirdly complicated election, and although ObamaCare doesn’t really come close to our free-at-the-point-of-need NHS, it’s a step in the right direction, and it’ll be nice when it’s finished. It’s also a progression Mitt Romney had pledged to reverse, despite having introduced something similar in Massachusetts during his tenure as Governor there. Which seems odd, unless you uncharitably see Mitt as a spineless flip-flopper who only won the Republican candidacy over his more extreme (no, really) opponents because he dribbles less and can dress himself, but is nonetheless in thrall to the far right, which thinks ending ObamaCare is the right thing to do.

It’s odd that there are people in the world who think that it’s morally correct to deny people accessible healthcare. Apparently it’s to do with their right to choose. The choice between them paying a little less tax and someone else getting to live, I presume. Yay for civil liberties.

But that’s not a choice to be made for now, because Obama gets to keep the nice Washington mansion for another four years. Which is good: he must have just got the couch in front of the telly worked into his shape. That’s something to strive for, and it’s a terrible thing to deprive a man of his own properly-grooved sofa. Happily, Barack gets to watch his West Wing box-set in comfort, and US patients get an era of renewed hope.

Which is apt, because this is a hopeful week, running as it does towards Remembrance Sunday. Which should be a day of hope, each scarlet flower a symbol of optimism that the human species can renew itself after horror and will remember not to repeat the stupidity.

Of course, we don’t always remember. Which is why we need the reminder.

One spectacular example of forgetfulness recently came from our plate-faced pudding of a Prime Minister, who seems to think that despite the economy remaining in the toilet, a postal order for £50million would be just the ticket for a wizard wheeze marking the start of the Great War, to “capture our national spirit in every corner of the country”.

Right, Dave. Because the First World War was just like the Jubilee and the Olympics, which went awfully well. Let’s have another one! After all, we won, didn’t we? There must be some brand advantage in that.

Or you could just buy a bloody poppy. It would be a lot cheaper, and commemorate the end, not the start, of one of the least laudable periods in our history, when for complicated political reasons an almost entire generation of youth was encouraged to trot enthusiastically off to conveyor-belt death by disease, drowning in mud, and the exciting new inventions of chemical warfare and machine-gun fire.

It’s because of buffoons like the leader of the Eton Mess that poppy day is at all controversial, that white poppies become a popular alternative for those who wish to celebrate peace rather than war and others simply refuse to wear a poppy at all.

I appreciate that sentiment, but I don’t agree. Abandoning the symbol doesn’t help: we need to keep the red poppy, not as a celebration of war, but as a annually-renewed reminder of its bloody foolishness; of the needless, wasteful horror and terrible loss; that Dulce et Decorum est really is an old lie.

We need to keep that splash of blood with its blackened core, the gunshot wound worn above each of our hearts, centre stage amidst the military show of Armistice Day.

That’s our renewed hope. Every year. Sometimes, it even works.

Happy birthday to me...

My earliest memory, I believe, dates from 42 years ago today: November 2, 1970. It’s dark, I’m lying down and my father is bending over me, saying “and tomorrow you’ll be two”.

I think this is a true memory. I’ve always thought it to be so, and I seem to have recalled it many times throughout my life, particularly as my birthday approaches. But whether this has refreshed it, or merely rebuilt it and I just remember my own construct, I can’t be certain. According to Wikipedia’s entry on childhood amnesia (the phenomenon that adults cannot remember early childhood clearly), "memories from early childhood (around age two) are susceptible to false suggestion, making them less trustworthy". A bit like Wikipedia. 

I mentioned my memory to my dad some time ago and he doesn’t believe it happened, but that could be because he doesn’t believe I could remember it. I think it is more or less accurate, but I may have altered some details. I’m pretty convinced of the words spoken, but my father’s face is blurry – it’s undeniably him but I’ve no clear picture of him in his late 20s. Also, I think I’m in a bed, not a cot, and in my own bedroom: that’s dubious because of another early memory I have, of being just a little older and breaking out of my cot, which was in my parents’ bedroom.

That apparently quite regular escapade is still occasionally the subject of an amusing family anecdote, but I'm convinced of my memory of doing it because I remember what it felt like. One end of the cot was an integral blanket box, the outer face of which was a curved roller door. I remember clambering onto it from inside the cot and then the discomfort, the pressure on my ribs, as I spun myself round on my chest on its angular surface so I could slide down over the roller. It hurt, but not enough to stop me doing it over and over again. I think it would be hard to construct a memory of physical sensation like that.

And tomorrow I’ll be 44. How very middle-aged. Still, it’s fashionable to be middle-aged – everyone I was at school with is doing it, even the cool kids.

I’m not quite sure when you become middle-aged. Not halfway to three score years and ten, anyway – 35 is young these days, and counting anything by Biblical reference leads to nonsense about the Earth having yet to reach its 6000^th birthday and our ancestors having the opportunity to own pet stegosaurs. 

The generally-accepted gateway to middle age seems to be at 40, and that is closer to the halfway mark suggested by UK National Statistics, which is just about 80 (except for viewers in Scotland). So by that token, I have been middle-aged for four years, or ten per cent of my life. But these averages don’t really mean much, middle-age is more a matter of mind than of numbers. I think it happens when mortality first bites, at that point when our sense of invulnerability quietly slides away and we see the final curtain flapping in the wind, even if it is still some way away.

In my case, that was just about a year ago. In the run-up to my 43^rd birthday various doctors interviewed, examined and scanned me to ascertain why I had thrashed epileptically across the office floor at the start of October; a week later I went for my first MRI, and disturbingly quickly after that had what is probably still the worst day of my life so far - November 16, 2011 - when I woke up to a phone-call telling me my lovely wee Gran had died, and then went into hospital to learn that I probably had a brain tumour. 

Less than a week after that I was chatting with neurosurgeons who asked nicely if they could cut into the side of my head to check. And on December1, they did.

Just days before that operation I started this blog, so everything that followed - the whole unpleasant business of being told that I did have a tumour and it was likely to try to grow a new head, having to tell other people, and then the vaccines and radiation and chemo, the tiredness and sickness and hair-loss – have all been well documented.

So if you've read at least some of that, you'll realise that on the whole 43 hasn't been a great year for me. But while I hate to cast myself as relentlessly optimistic – I do like to examine all available silver linings for clouds – I can’t help seeing the upsides to this year: I married the love of my life, had a couple of great holidays, and my new-found sense of mortality reinforced my sense of how precious time is, which has given me greater ambition to do things for the fun, satisfaction or hell of them (more on that in later posts, perhaps).

And tomorrow, I’ll be 44. So tonight, Clare and I are off for some posh drinks and then a nice meal in a new and highly-recommended restaurant. Tomorrow, I will go out with my mates for some not-at-all posh drinks, some increasingly badly-focussed pool-playing, a curry, and further beerage to finish.

Wish me a happy birthday. And if you want to make it happier, click the donate puff at the top of the page and give The Beatson some money.

They’re the reason I’m feeling good and ready for another year, after all.

Enjoy yourself (It's later than you think)

Autumn was always my favourite time of year. Specifically now, mid-autumn, when Keats' mellow fruitfulness is coming into its own but we haven't quite got to the mists yet.

I should perhaps add that Keats' poem goes on to witter about bees for whom "summer has o'er-brimm'd their clammy cells". I'm not keen on the image of clammy cells o'er-brimming at the moment; what with the brain cancer and everything, I feel there's been quite enough of that sort of thing going on.

Still, I like mid-autumn. I like the light and the colours and the smell of the season, and even though it's the time of year when things are dying off, ready for the bleakness of winter, for some reason it always gives me a sensation of excited optimism. And not just because there are conkers to be had.

So it was into all this that I stepped from hospital yesterday, walking into the cold, low sunshine of a beautiful autumn afternoon in which it was good to be alive and abuzz with the knowledge that, for the time being at least, I'm fine.

I'd just had my latest set of scan results, the pics from my third quarterly intra-cranial photoshoot. They came out nicely, thanks. No change - I'm still prettier from the inside out.

I still have a hole in my head, but that's it - no extra tumoury bits are visible.

So I have another clear quarter to look forward to. That's the pattern from now on: another scan, another set of results, another all-clear. Grabbing life in three-month chunks.

The next session in the big, bangy machine is around Christmas, with the results due a couple of weeks later. Until then, no worries.

Yesterday was also something of an ending, as it was the last time I was needed at the Beatson's Clinical Research Unit, where I'd been taking part in an experimental vaccine programme. I gave my last round of blood, and my involvement was over.

When I joined, at the end of December last year, I was among the first on this programme being conducted at the Beatson and a few other centres around the UK, which was slowly accumulating willing and suitable subjects on whom to test a vaccine which had been used successfully against other cancers, but not yet on glioblastoma.

Sure, there was some small risk, but it seemed like no choice at all. I was assured it would have no adverse effect on my other treatment, and since at this stage they were testing for side-effects, I'd get a full therapeutic dose, not a placebo. So if it failed, I reckoned, no problem, I'd still be getting the gold-star treatment in which the Beatson specialises; but if it succeeded... well maybe, just maybe, it would help that treatment along, maybe even save my life.

So I signed on the dots and since then I have had eleven pairs of itchy intradermal injections into the same bit of my leg, and given blood in various quantities, but no ill-effects. The programme is getting close to its required number of subjects, which is heartening, my inner geek is pleased at getting to contribute to cutting-edge science, and my sense of social responsibility is satisfied, too. I'm proud to have been part of it.

Looking at my MRI pics, each shows a kind of rind around the hole where the tumour once was, and that's apparently been seen in other recipients of this vaccine. It's not cancerous and is perfectly harmless, and I like to think of it as a barrier, either defending against or containing the bad cells: I realise this is probably nonsense in medical terms, but I like the image.

I'm under no illusions: I know that radiation, chemo and vaccines notwithstanding, the cancer is likely to come back. Not least because the doctors keep telling me that, which I think is a good thing, as time is short and precious and it's important not to fritter it away in the warmth of a false sense of security. With or without cancer, we all waste too much of our least renewable resource when we should be making the most of every minute.

And right now, I feel good. My fatigue is less frequent and less unpleasant, and the stiff legs are easing off.

I was told yesterday, "This is your time feeling well. Enjoy it."

Yes. I think I will.

Welcome to paradise

A year ago from Tuesday, I was to all appearances perfectly well, just back from an autumn break in the Highlands.

A year ago from Wednesday, I was sleep-dancing across the office floor, on the right side of my ribcage and with the sides of my tongue clamped between my teeth, wakening in a wheelchair to a paramedic's kind offer of air and a bewildered trip to hospital. The first of many.

The time between has been packed with scans, bad news, surgery, worse news, fear, intra-dermal injections, radiation, blood tests, chemotherapy, fatigue, steroids, stronger adjuvant chemotherapy, more jags and sangrial sampling, a gastric problem which could have pebble-dashed a warehouse, marriage, euphoria, more adjuvant chemotherapy, more fatigue, more scans, more blood, even more fatigue, stiff legs and the resultant Cyberman stride. Yet it honestly doesn't feel like a year. Time flies when you're enjoying yourself.

One year ago today, October 4, 2011, I was at home; slumped, drained and bemused, on my leather couch with which I would become so familiar, on my first of so many sick days with which I would become so bored, wondering what the hell was going on.

A year later, I'm sitting at a picnic bench under a big tree, in an almost perfect little cove on the north shore of Bermuda. It's 28°,  the sea is blue, something's singing in the next big tree along, and there's just enough cloud cover to let me see my tablet screen and type this. Soon I will go in search of beer. Life's tough.

We're here in this island paradise as guests of my friend and former colleague Raymond Hainey: gentleman, journalist, and all-round good chap; and also one of the finest operators the Scottish press has allowed to escape. While he has been chained to the type-face, Clare and I have beached and lunched and beered, and when he hasn't, Raymond has generously driven us to the sights while we have generally got under his feet and cluttered his flat.

And I feel much better for it. Sure, I sunburned my feet on day two (I never burn anywhere normal, like on the shoulders - for me it has to be somewhere awkward, such as the ankles or forearms or feet), and I twisted a knee falling down the stairs in a pub (it was lunchtime, and I'd only had the one pint), but I feel so much healthier; lighter even.

I'm not going descend into hippy wittering about a healing atmosphere, because that would be nonsense. But sunlight lifts the mood, warmth relaxes, and the light exercise of sight-seeing is probably doing me no harm. The Boris Karloff stomp has eased off as my legs feel stronger, and although I still get tired, it feels cleaner, a warm sleepiness compared to the sickening, bone-deep fatigue which hit before. It would be nice to think that easing will continue back in Scotland.

Of course, I will have to return to the results of the scan I had just before leaving.

But in the meantime, I'm relaxing in Paradise. Still with a hole in my head, but relaxing.

I'm not worried. I feel good.

So far it's a happy anniversary

Walking the walk

I’ve started making the old-man groaning noise when I get out of chairs, except with more swearing. I’ve got to say – this cancer thing’s full of surprises. My legs have seized up.

Not entirely, I should say. But it’s not comfortable.

Every hour or so I try to remember to get up from my desk and take a stiff-legged stroll around the office; to the kitchen, the toilet, the vending machines - any destination which has some point to it and which takes me out of view for a bit, so I don't look like I'm doing some kind of circular Boris Karloff impersonation among the islands of workstations.

My wife Clare was first to call it my Frankenstein walk. Frankenstein was, of course, not the monster but the scientist, who as far as I remember had no mobility problems, but Clare's far too sensible to let that get in the way of a perfectly clear description which everyone will understand instantly. I, on the other hand, am far too much of a pedant not to, so I privately call it the Bangles Bimble: I'm thinking of the mummy from Scooby Doo - I Walk Like an Egyptian.

The stiffness is the result of coming off steroids about six weeks ago. I've mentioned it here before, but it's currently the after-effect of my treatment which is bugging me most, so now it's going to bug you again.

Apparently the ligaments in my legs and back have loosened up, but it doesn't feel like looseness: quite the opposite. I stomp around straight-legged until things slacken off, I haul myself out of chairs with my arms if I have sat for too long and am having difficulty with the knee-unbending and thigh-stretching, and going up stairs is difficult. Which is a particular bugger when you live up four flights. My adventures on Google suggest this could last for three or maybe up to six months.

But it will pass.

I'm also now off the chemo. Its abiding after-effect is fatigue, which is much worse than the locked-up legs. But at least it comes and goes, while the stiffness is always with me.

As usual, day one of the final chemo was fine, but then... who'd have thought there could be so many flavours of tiredness? Degrees, yes - but types?

Over the remaining four days of the course and for a day or two after I experienced a weird series of ups and downs ranging from mildly sleepy to bone-sick exhausted.

At my worst, while I was still popping the poison, I noted that each type of tiredness had a different feel or texture, and wondered if I should become a connoisseur of fatigue and catalogue them here like whiskies. Then I wondered if I might not just be rambling: I was quite tired - at that point a dull little number with a sort of numbing sensation in my shoulders and arms, if you're interested.

That was about three weeks ago. Since then I have had days when I have been alternately energetic and shattered, days like yesterday when I have woken up tired, and days like today where I feel more-or-less normal.

I’m told the after-effects of the chemo could also last perhaps six months. It might not be so long, given my relative youth and strength, but I'm prepared for the days of unpredictable tiredness to continue for a while.

And eventually this, too, will pass.

In the meantime, the trick is to make the most of things even when the symptoms are making their presence felt. Just marking time, looking forward to the end of the stiffness, the end of the fatigue, and ignoring the present would not be healthy. It would be like treating the working week as days to be endured until the weekend comes, the month as time to be tolerated until payday; people do that, but it's wishing your life away, and those of us on the cancer-go-round are a bit sensitive about that.

So I get on with things. I go to work. I make plans to do stuff as I always have and, mostly, I keep to them. I went to see Patti Smith in concert last week and loved it, even though my legs were in agony after the two-hour stand.

Maybe if I were a sporty type all this would be harder, but I play with gadgets and with words, and I don't have to move much for either.

Anyway, most days aren't tired days, these days. It's getting better.

But when they are, I read and write and watch and listen and generally learn new things. Oh, and play obscenely violent computer games - that's a good one. Obviously, all that is as far as concentration allows; the fatigue regularly dictates that I put down the newspaper, Kindle, laptop or handset and just kip. I do resent that a little as wasted time, but it can also be pleasant, so I feel I should just enjoy it.

Here in the Tumourland Fun Park, it's important to enjoy all the rides.