About every five minutes as I type this, I'm stopped by a harsh, gasping cough as my lungs rebel against the constraints of the fluid that surrounds them. The same cough that has kept me awake nights for weeks now. The same cough that kept me awake until well after midnight last night until exhaustion finally overcame me and I drifted into a fitful sleep.

At 10:30 this Happy Father's Day, my daughter Kathy will arrive to take me on the long drive down deep into the City where I will be admitted to the Toronto General Hospital for best part of the week to have the fluid finally and completely drained from the pleura surrounding both lungs and to seal the pockets of the pleura to prevent this ever happening again.

I will be taking my laptop with me, but have already decided not to do any posts this week, even if the hospital has internet access. So don't expect any updates on this blog until at least next weekend. If anything really interesting happens, Linda will be sure to let you know.

In the meantime, I have some packing to do and a flood of pills to take.

Let me wish all the father's out there a Happy Father's Day.

As for me, like the President of BP once famously said, I'm looking forward to getting my life back. And hope this week will do the trick.

It is early Thursday morning and I'm sitting on the bed in the enclosed examining room at the back of the Chemo Day Care Center, my feet dangling over the side and my head resting on the surface of a pillow that's been placed on top of the table beside the bed.

My back has already been sterilized and injected with a local anesthetic.

"You shouldn't feel this," the doctor said as she inserted the long needle between my ribs and into my pleurae.

There are two pleurae, one around each lung. The pleurae act as a protective wrapping, fitting snugly over the lungs. Pleurae are made up of two layers. Normally, there is no space between the inner and outer layer. The layers are joined at the edges, so that the pleura might be compared to a closed balloon, completely empty of air and wrapped tightly around the outside of each of the lungs.

Normally, there is nothing but a thin layer of fluid between the inner pleural lining and the outer one. The smooth pleura linings and lubricating fluid allow the lungs to move freely in your chest, as they do in normal breathing.

In my case this space has fill up with fluid that is restricting the movement of my lungs. Crushing them, in effect.

A large bottle suddenly appeared beside my nose, filled with what looked like a fine ale, or light urine. Take your pick.

"Here's the fluid that was around your lungs. It looks clear. So, luckily no infection" the doctor went on.

"So we're trying for a litre?" I ask.

"Well, lets see what we get," she said.

And, about ten minutes later, she had three bottles full, a little over a litre and a half, when the flow ran out.

"Your lung has been cramped, kind of like a sponge, for the past couple of weeks, now it's time for it to expand into the space we've just created." she went on. "Do you notice any difference in your breathing?"

But I didn't.

So it was down to X-ray to see what was going on.

Half an hour later I'm back up in Chemo Day care, two doctors now pondering my latest chest X-ray. There is the possibility my lung may have collapsed during the procedure, in which case I'll be admitted to the hospital overnight while they re inflate it.

But something very different is going on, and at least as problematical.

"In a few people," the doctor explained, "The space between the inner and outer walls of the pleurae isn't just one empty space, but is divided into pockets. And you happen to be one of those people. We thought we'd removed all of the fluid around your right lung, the one that was the most problem, but it seems we've only tapped into one of the pockets. A large one, but a pocket none the less. The rest have remained filled with liquid. And that's also likely the case with your left lung as well. So there is still a significant amount of fluid trapped against your lungs and your lung can't expand to the extent we'd hoped."

"I am experiencing some relief," I told her. "I seem to be thinking more clearly and haven't coughed in about an hour."

"Well, you're seeing the thoracic surgeon on Tuesday. The fluid we've removed should make life more comfortable for you until then. You should be able to sleep better and have less of a cough. But, well, the problem will remain. The symptoms will just be less intense."

And so I'm home again where the symptoms are less intense and more tolerable, and I'm waiting until Tuesday.

As is Lindsay who hasn't had a good run with me for over three weeks now.

And on Monday I have my first visit with the Palliative Care Unit.

"So, we have a new plan," said the oncologist.

Linda and I waited. It was Tuesday and it had been a long and exhausting day at Princes Margaret Hospital. A day of concern and support and additional testing. A day of confirming, once again, the power of reality over hearsay.

I always thought I was a good communicator. After all I it had been the way I made my livelihood back in my working day, not so very long ago. But for the nurses and doctors my phone calls reporting on my condition paled into insignificance with one look at me panting and choking for breath in their office.

Suddenly my back and chest were being stethoscoped, my blood pressure taken, my oxygen level monitored. I was being given new chest X-rays and new blood samples were being taken. And Linda and I were urged to report on the increasing devolution in my condition that we had been experiencing over the past week.

Then Linda and I waited while the medical team huddled and conferred, coordinated and came up with a new plan for my future.

"So, we're canceling your chemo for this Thursday and moving forward the suctioning off of the fluid surrounding your lungs."

"Surrounding my lungs? I thought the fluid was actually in my lungs?"

"No the fluid is between the surrounding membrane and your lungs, putting pressure on them from the outside. Crushing them, in effect. We'll be suctioning off about a litre of fluid"

"A litre! Good Lord. A full litre of fluid?"

The oncologist smiled, "There's actually about a litre and a half of fluid there, but we're going to leave half a litre as a buffer and let the thoracic surgeon decide what to do about the more delicate work when you see him on the 8th. The risk isn't great but whenever your poking around the lungs with sharp pointy objects there is always the risk of puncturing and collapsing your lungs and we'd rather let the surgeon take that risk because then there'd be the need for more and immediate surgery."

Linda and I paled a little. Or a lot.

"He might also want to install a permanent tap in your chest to ease the risk of damage when further fluid extractions are required, because unfortunately, once you've had this done once, it may have to be repeated, unless the chemo proves even more effective at fighting off the disease this time around."

We paled again.

The oncologist smiled again, "But I promise, once the fluid extraction has taken place on Thursday you will notice a dramatic difference almost immediately. Not only will that panting and cough stop, but all your old energy levels will come back. And you should have no difficulty sleeping."

And so Linda and I left the hospital with a completely revised schedule of appointments including a plan for three new chemo cycles stretching forward into mid summer.

And later today we return to the hospital where they will finally suction off the fluid that has been causing me so much grief.

Leaving Linda and I something even more precious--hope.

Despite a couple of nice things happening, it has been a miserable week.

And I'm not much looking forward to this one either.

I look back and marvel at the rapidity of my decline. It seems that everyday brings a noticeable increase in the intensity of my symptoms or the erosion of my strength. Linda has become so alarmed she has taken the day off work today, no longer certain I can be left on my own.

Tomorrow I have a visit with the Medical Oncologist and Thursday I begin a new cycle of chemo. On Monday the 7th I have my first appointment with Palliative Care and the next day I finally have an appointment to drain my lungs of the fluid that is nearly crippling me.

Everyday pulls me further from the series of radiation treatments I have just completed, but whose cumulative side effects will continue to build for a some days yet.

Poor Linda, my conversations become entirely focused on my own internal condition, my aches and coughing, wheezing, panting, crushing fatigue, bloating, diarrhea, pain and sorrow.

I am miserable company. Even Lindsay will attest to that.

I have never gone into chemo from such a low ebb and know chemo will add its own layer of side effects.

But it is the hope I cling to for some return to normalcy.

There are so many things wrong with me at the moment that if they all decide to act up in unison, the result is quite spectacularly miserable.

That was my day yesterday.

After a very promising morning (did I over do it?), my brother John took me downtown for my second last radiation treatment and had me home by 3 pm.

But by that time I felt nauseated, constipated, was gasping for air due to the fluid build up in my lungs, my abdomen had become a swallowed bowling ball pushing outward against my rib cage, my head hurt, the bottoms of my feet hurt, I ached and I was agitated and I coughed and I coughed.

But I no longer had sharp pains in my back.

"So, how are you doing today?" asked Linda as she arrived home from school, a lilt of hope upon her voice.

But there was little good news to be had from a husband in misery.

By bedtime things seemed to have settled to a tolerable level and I awoke this morning feeling not too badly, although my breathing is laboured and still I cough, the fluid rumbling around in my chest.

Today is the last day of radiation. John is picking me up around 8:30 and by 11:00 I should be back home again, this phase of treatment behind me.

Next Wednesday I begin a new cycle of chemo, which should put in check a lot of these symptoms, exchanging them for chemo side effects.

A change, they say, is as good as a rest.