Spots on the move

Yesterday was scan day and unfortunately it showed the metastise spots in both my lungs were growing and on the move again. This development is not unexpected although disappointing that it has happened so soon plus you always hope that the little buggers will just disappear. We've been enjoying a couple of great months of relatively good health and good times. Unlike other times I don't feel ill but we know that the situation will change quickly unless we take some positive action and start an effective treatment that will nip the progression in the bud.

We think the most effective treatment option for me at this stage is Votrient/ Pazopanib. Votrient has only been recently FDA approved in the USA and is a smart new drug which targets the Sarcoma Cancer cells; it's not a curative treatment but interferes with the growth and reproduction of the cancer cells and slows their spread in the body.

Unfortunately this very new and niffty drug is not funded by Pharmac in New Zealand; but very fortunately for me GlaxoSmithKline have decided that I'm a good candidate to be provided the drugs on compassionate grounds. I still have a few hoops to jump through to get the drugs but very excited about having this effective option. I suspect the 'compassion' is more of a marketing exercise with the large Drug Company showing off their new drug and how clever it is. But whatever I am extremely happy to be given this option and the generosity and I will endeavour to do my part and live a long and happy life and sing the praises how effective this treatment option is. 

Reviewing a dozen individual cases on our synovial sarcoma online forum it is well regarded and the drug is very well tolerated with few side effects; for some it has had very positive impacts, for most it has brought quality time for a few months, for a few it has no impact. The advertised efficacy is that it has extended life by 3 months compared to no treatment. Such where things are at, I am very happy to take those odds. More about Votrient here.

I need to have a few more scans and tests and expect to start treatment early in new year. 

Merry Christmas 

Gary

Me and a Flamboyant Tree, Queensland Dec 2012

The Best Birthday Present

Yesterday was my birthday and untimely it started with a visit with my Oncologist. Historically and generally my doctors contacts are negative i.e. you're dealing with the progressing situation of your disease or the full on procedures or side effects that you have to endure. But yesterdays one was very positive and I came away with the feeling that we are creating small miracles here.... Backstory In July things had gone pear shape and I had many many aggressively growing tumours in both lungs, plus some large ones causing pain and breathing difficulties. Our treatment options was limited to chemo (Ifosfamide) with expectation that this was unlikely to be effective. So timewise and in theory things should be a looking pretty grim for me about now, but fortunately we've rewritten that story and have a different or at least extended version.

Earlier in the week I had some more imaging work done and yesterday my Oncologist took us through the timeline of images and showed how the cancer had regressed. The large tumours were essentially gone or shadows of themselves and an area we called the "milky way" of many small tumours has got significantly better. The expectation is that it wont stay this way and that the tumours will get a footing and start progressing again, also unfortunately I am at the end of the road with Ifosfamide and although we talked on some other treatment options there is doubt on availability and effectiveness.

But for now I am very thankful for a great birthday present and looking forward to a long hot summer.

Zach and Macca with Birthday Brasier 

 

Romance in our Garden

Of late Ive been spending plenty of time in our lovely garden, resting, reading and puddling making a deck for Kat; during which I've noticed a vast amount of romance occurring in our garden last week & I spent some time trying to catch some pics. The three most noisy and interesting culprits i.e. birds were:

Firstly the Grey Herons who were making a commotion in the bottom tree of lawn, lots of feather frilling, squawking courtship going on there.

Secondly the Tui, I had two of these doing formula 1 around the garden. I couldn't get a good pic, they were going so fast and so borrowed this pic off the net (Tui explosion in city) . 

and finally my favourite:

The Riroriro (Grey Warbler) which Ive only discovered this year. These  little wonders live in most kiwi gardens and make a very distinctive ethereal noise every spring.  They are difficult to spot mainly because they are very small and don't stay in in the same place for long. But they are easy to hear, very loud and distinctive song. You may find that like mine that they are singing outside your window right now and that you've never noticed them before. 

Spot the Riroriro here (Grey Warbler)..

There he is Sporting Zachs new haircut 

Smaller than sparrows, a little like waxeyes

 Fliting and calling for its partner.

Bottom line... Its amazing what you will spot and learn if you take the time to notice.

    

Cruising with Zach

Zach is our youngest child and is a charming 16 year old. He has always been great with people; he is fun with a good sense of humour with strong faith and integrity. He's already 6 foot 3 inches tall and continues to grow physically and personally and growing into a very nice young man; during my cancer journey he has been the muscle around the house, picking up additional responsibilities and generally doing jobs with a smile and good attitude.

Oct 2011 pic Giving mum a hug

Zach has just obtained his learning drivers licence and I've been teaching him to drive. Last week we had a great boys trip to North Otago which provided us with some good 1on1 time together but also allowed us to immerse Zach in some good driving practice. It was a lot of fun and a successful trip on all fronts. A highlight of the trip was cruising around in a mates classic cars (see pics) - cheers TC.

Its been a joy to watch and participate in Zach's growing up and life to-date. An anxiety you have with terminal illness is that you're not going to see how it turns out with your children including participating in key events in their lives and influencing better outcomes when they need support. I guess its another one of those areas that you've got to learn to let go and have trust that all will be good; Plus still lots of time yet.. 

2011 Dodge Challenger

1963 Buick

Zach License to Drive

Chemo Cloud Clearing

3 weeks post chemo and the cloud is clearing and I'm returning to better health. I got my pick line (catheter used for administering giving chemo drugs) removed this morning and I have no immediately pending hospital appointments, which feels great and a sense of freedom.

The chemo treatment has been very successful and it blasted the tumors in my lungs which is fantastic and beyond our and our oncologists expectations.  Im likely to be called in for a CT Scan in the next couple of months which will confirm how effective the treatments been and how many tumours remain; it will also be a benchmark to monitor how active the remaining tumours are.  But for now we have an oasis of freedom and setting up for a wonderful summer.

Pear tree in backyard looks like it will be bountiful.

I've been pretty sick and rundown after chemo but I'm progressively getting energy and motivation back. When I started feeling better post chemo I started charging around like the energizer bunny but soon realised that was premature and this week have been far more restful with my nose in a book or watching some therapeutic sports TV or good movies.

I find chemo treatment so tough, as well as all the medical side effects it also robs you of energy, your vitality and kills your "Joile de vivre" & motivation. But it also kills cancer and you need to keep reminding yourself about that.

We've got some nice micro trips coming up with friends and family:

• Currently meant to be buzzing around in a helicopter and deer stalking in a remote mountain range; but postponed due to spring storm coming through.
• Zach just getting his learning drivers license, so taking him on a short boys trip next week to North Otago. 
• Plus short trips in next month planned to Christchurch and Wellington to catch up with friends.
• Kat and I planning a more exotic trip over summer to somewhere hot with good beaches, maybe a Pacific Island (Rarotonga/ Samoa / Tahiti) or Queensland.   

Were hoping that my health holds up and we have a good summer.

Sorry for not posting, energy levels have been so low and Ive been hiding away; but now feeling a lot more motivated to communicate.

Regards
Gary
    

Good signs

Gaz in the kitchen cooking himself sausages and planning trips with friends and his boy.
Still doing the morning Quiz and getting most of it right.
Ordering wood for the Studio deck and deciding on what wind break to use..

Final Cycle of Chemo

After 5 cycles we've decided that we have done our dash and starting the final cycle of chemo today and will be in for the next 4 days. The chemo has been very successful and knocked back the large tumours significantly and eradicated many of the smaller tumours; saying that there are still many (Dozens?) smaller ones visible and its likely that some of these are less sensitive to the chemo and still active. The advice is that these will spring away once treatment finishes and this has just brought us time but we will wait and see.

As well as knocking the tumours it has also knocked me around and part of the decision to stop one cycle short is part on quality of life and getting back to best health so we can enjoy the summer.

So off to the hospital for another dose...

Spring Picnic with Sister Sue and Dog Mango

A post from Kat

http://katandadls.blogspot.co.nz/2012/08/pet-bananas-mushy-play-lists-and-spring.html

Chemo cycle 3 starts today

Feels good coming in and knowing that chemo is making a positive difference. Been feeling pretty fatigued and tired of late, could be the chemo or maybe the grey and wet weather which is keeping me indoors and less active. Reminder to-self, get out and active post this round. Cycle 2 went so well and need to apply the same structure (eating, drinking, prayer) and positive stoic attitude. Kia Kaha G

Pic below nephew Tom and Jens wonderful wedding last weekend.

Busytown boys (& Belinda)

(From back left) TC, Crim, Scobie, Zach
Jerry, Grindles, Belinda
Calv, Kim, Me, Dev, Twissy 

Remember the Richard Scarry Busytown books when you were a kid; well we had a Busyproperty over the weekend with 13 hardcore mates charging all over our place giving it a makeover. The work involved painting, fencing, tree work and firewood, hedge pruning and chipping.

Graeme Master Builder

Jerry got into the tight holes

It was a play hard; work hard group and Kat and I were amazed how much the team could acheive over 2 days. It was wet weather most of the weekend but that didn't dampen the spirit and fun. We've had a lot of outstanding DIY and property maintenance issues and this was just a practical way for mates to help plus setting the property up and making it easier for us going forward; the guys travelled from throughout NZ and it was also a great and meaningful opportunity for us to get together and catch up.Thanks to all involved, esp. Kim and Dev for initiating and also those who provided food over weekend, it was delicious; Kat and I are thrilled with the outcome. Thanks G

Kim & Geoff - Skidding logs uphill

a

Project Planning at Portobello Pub

Ha ha, he he... a very good day!

Just back from the oncologists office and we've had a sensational result! The large and problematic secondary tumour has responded to chemo and has reduced in size by 40%, some of the smaller tumours have disappeared. One stubborn marble sized has stayed about the same sized (on the flip: its not grown).
Due to the positive response we're approved for 4 more cycles of chemo.
The palliative nature has not changed. but this has certainly given us some a wonderful window and quality time. Pix coming soon. :-) G

Wish me luck!

On Friday I'm having some important imaging work done at the hospital which will decide the next course of medical action. The imaging is to analyze the tumour development in my lungs and to assess if chemo treatment is making a positive difference. Obviously doesn't make sense going through such a tough treatment if it's not working; yet concern is what other effective treatment options they have left; are we getting to the bottom of barrel?
I am feeling good, breathing better and in less chest pain and loving this mid-winter sun; something has positively changed.
I think Chemo is my 'Devil I know' treatment and I would be happy if they roll for 4 more cycles which they've discussed although they will only do assuming good imaging. Maybe there is a better option?
They've also talked about using a new technology drug for sarcoma called Yondelis which is getting positive press on the forums and research sites; but the drug is not funded in New Zealand and some complexity trying to get sorted although not impossible.

So what I'm I wishing for? I hope that their technical analysis is accurate and that the medical team make good decisions. I want a positive day when I meet my oncologist next week, with evidence of stabilizing or slowing progress and no significant new developments. I hope that Kat, I and Whanau have the courage and strength with whatever the outcome is to understand, accept and positively move forward. Overriding all, I hope for time, lots of it.
G :-)

2:00am haircut aftermath

Cycle 2 : Countdown 8 Hours and thumbs up!

8 hours before I'm out of hospital and another milestone through. Cycle 2 has gone substantially better than the 1st cycle. I've had nausea but managing medication better and sleeping lots and eating and drinking well. Takeaways from this improvement: better plan leading in, eating & drinking well (better food & better attitude), better rest leading in, working on faith and prayers (me and others), communicating and working with medical team.A motivator was if I get through the cycle better I will also bounce back quicker, no time to waste.

You can let chemo and the side-effects take charge; Kia Kaha be strong fight back.

I've had a lovely supply of regular visitors including afternoon napping visitor Faye and my girls in watching movies at night (Nemo, Braveheart).

A highlight was getting a nurse to give me a 2:00am #0 haircut as hair falling out and being annoying. Photo coming.

Also I have a lovely custom design pillowcase with wonderful and supportive messages from around the world. I'm sure that's made a positive difference.

G

Chemo cycle 2 begins

Morning Moon over Dunedin

My New Office

Calm after the Storm

When your prognosis takes an unexpected and detrimental swerve off a perceived existing course it takes awhile for you to take stock and collect yourself. Many things swirl around in your storm cup (mental, medical and practical) and there is urgency in resolving or at least prioritising the issues. For me the issues were many many and included;

• What are these new pain issues; I am experienced with pain; but this is new, uncomfortable and debilitating; Is it going to get worse?
• I can no longer work; I like business, my customers, colleagues, business networks etc; I am not ready to leave my profession yet but I must and now.
• Getting the out of control medical situation in control; dealing with the resulting and horrid side effects. Restarting or facing new procedures is always difficult and I don't like it.
• They've started using the words 'palliative' care and that I'm now allocated to the 'hospice' support team. I understand why and I really like the people and care that I'm being given but I don't like these words and the implications. My hospital team, whom I respect, have made a decision on likelihood on curable outcome. There is always hope but I also want to be prepared.
• How will I talk to my children about all this? 
• What are our priorities for living now, mid term, how much time?
• Whom are my support team I need around me; who are the fun team?
• What will I have for lunch, food is very high on my priority list at present thanks to some medication.

I have not separated Kat from my storm list, we are so interconnected; although our issues are different, "You are going ... But I am staying" and we've been processing this all together which has been extremely helpful.

Even Dolly Parton threw in some random and helpful input during the week:

We've ended up in a pretty calm and good place. Lots of talking and gaining acceptance of current situation; making plans for doing some fun stuff; plans for getting some practical things sorted; plans for getting through next chemo better and more smoothly, no time for waste; lots of time for reading and learning and becoming stronger in faith. Lots of time allocated for nice people and hugs.

First Round

Gazza into third day of chemo..Not as bad as last time so far. The doxorubicin seems to have been the culprit for more extreme side effects last time and hes not having it.
Seems to be less nausea and more sleepy. Although in saying that gaz feels pretty yuck. I am pleased he's sleeping through it. He is more knowledgable about his drugs..anti nausea etc and takes control himself which is good and asks for them.
Home tomorrow. Raining buckets of water here, I have the fire on early, hoping to bank it up and come home tonight to a warm house. Zach got some wood in and I am cleaning and organizing house after a chaotic few weeks. Time for a winter clean up and chuck out I think. Lots of accumulated clutter that does not add to required ambience.
Kat

Hot Chocolate at The Governors with Kids

Good Week: Bad Week

What started out as a routine monitoring scan with my sarcoma and dealing with pain from a perceived muscle spasm issue has resulted in a few days in hospital and a whole lot of new information, mostly bad.

The mid to long term outlook of my sarcoma has always been been poor but the speed of progression and biology indicated that it was slow moving and this was very good, e.g. the single and only tumour in my lung they cut out in November was just .5 cm (after maybe 3 years growth); with slow growth they have lots of treatment options. When tumour pops up they just spot radiate/laser or surgically remove. Many people last 20 years with this approach. When you get metastasis spread (secondary cancer) of synovial sarcoma it seems difficult to cure but they are very good at delaying any spread.

Arrows identifying some of the Mets, round cricket ball
likely cause of pain issue

Bottom line; I now have multiple new tumours in and around both lungs, one very large 5 cm in right lung (See Pic) which is causing the pain issue and is also starting to impact breathing. The main issue is its aggressive nature and speed that this is developing and the limited options for treatment.

 
They've ruled out surgery and I am in palliative care; the aggressive nature of the tumours has opened one door on a chemo (Ifos) regime which is good at attacking fast growing tumours; I'm expecting to start this treatment next week. There is an outside chance of cure, but most likely this will just buy us some time. 

Heathier lung - Dec 2012

The medical team have done a great job settling things down and getting me on a new pain regime. Its still uncomfortable and I'm am very limited on what I can do physically, but its manageable and I'm enjoying life.  They believe the pain is being caused by the large tumour pushing the lung lining against the rib wall and catching nerves which are on the inside of the ribs. I do believe in miracles and if I'm due one I'm hoping it will come soon. 

But I have things to do and the fat lady hasn't started warming up her singing voice yet.
- Family holiday, assuming treatment goes well, beaches, heat, water and piña coladas sounds like a good idea, or maybe a holiday or two in a central otago or otematata crib.
- Family wedding, Nephew Tom and Jen are "going to get married ", thats going to be so much fun
- Few old mates incoming for property makeover (& a few beers and tunes)
- and finally my favourite thing; just time with Kat, the kids, whanau and friends.

How am I feeling?  Its a bit surreal, we've grieved and been sad at many times during this cancer journey. We knew the odds weren't great but certainly didn't think that it would accelerate like this.  I want to be in the best possible state (mind, body & soul) to again fight and overcome if possible. My Christian faith is providing me with a strong base and comfort as we face the next few months. Please add me and our family to your prayers. 

Life is such a wondrous and precious thing.

Gary

GARY from KATANDADLS Blog reposted for Gaz x

Ok so I havnt blogged in a while and the reasons are..I have started my new job and feel a little time poor, although the hours the great and the job is good and the staff are supportive.

I catch up on everything else on my days off and even thou they are plentiful they are never enough..how does that work?

I have been distracted lately waiting for Gary's scan to happen.The week before its almost impossible to concentrate on anything and we just circle around things. Furniture, the dog who seems to always be close to our feet, each other and big highlighted circles appear around around thoughts and words that seem so clumsy and inadequate.

This time it was harder, as it was the sort of scan that defines what happens next.

In between scans when news is good we live in a bubble. An enclosed space of protection.

This weeks news changed all that.

Gary has metastases throughout both lungs and of the size that they are impacting his functioning and breathing and he is in significant pain. The news from the scan came the same day Gary was experiencing pain. His back and abdomen went into spasm to protect his lungs as his body was reading signals that this needed to happen.

He has been into hospital and the pain is sorting itself with some new drugs. He is currently working at home and we have been cuddling and playing lots of scrabble.

I can write this now as I feel calm. People are praying for us. I know this because you can feel when the prayer kicks in..it is the most amazing feeling. I think it is a bit like Gary's horse tranquilizer he was given when he first went into hospital. Gary and I decided that prayer anesthetizes our heart pain. The whole world needs more of it.

We are both looking forward to chemo which seems a contradiction in terms but it is an extended life life for Gaz. It will shrink the tumours and give him quality of life back. Gary really is an amazing person to be with. He is funny kind supportive, did I say kind. His spirit is such a shiny button.

When I was small, my nana used to give me the button tin to sort through and count I always went for the shiny ones and made treasure piles imagining how I might use them. She taught me to sew and I made soft toys with button eyes.

When Hana left home I was so sad, I went to the salvation Army shop in Mosgiel and sorted buttons on the beds at the back for about an hour..it made me feel alot better.

I feel better when I am near Gaz than away.

xx

Oasis of Good Health : Oasis of Ignorance

Scan time again and I am due to get the results back of a scan last week. This is the first scan for 6 months and since my last surgery. We are a bit more anxious than normal.

We've had a wonderfully late Summer and Autumn; nothing much of note, just enjoying living life and plenty of family time and good and interesting work balance.

Kat has resumed working in Mental health as a registered nurse and I am very proud of her. She seems to be working with some nice people and doing well.

I am a little behind in keeping my blog up to date and about to rekindle communication.

Back soon...
Gary

Dog walk in Otematata

Autumn Fires

At present we've been experiencing some pretty amazing autumn days in Southern New Zealand; with cold crisp mornings and stunning blue hot "its too good for work" sunny afternoons. We've had the odd fire at night in our old fashioned open fire which most often these days you only experience on movies. We especially like the first Autumn fires when early season storms come through. In front of it is a favourite spot for our cat, dog and teenage son Zach who compete for the best position and them flop around on their backs making blissful noises.

We've had some woodwork angels turn up last weekend and they chopped down a tree on our property plus spilt wood and made a big stack of firewood for winter. We've had a lot of woodwork angels in our life over the last couple of years making a positive difference. Often the primary reason its a great opportunity for getting together and mate-ship.

Life is going along very smoothly for us at present; it's very normal and we love normal. We've had too much drama in our household in the last two years which impacts everyone not just the patient. We're hoping to have a clear run in 2012 with no further significant medical procedures. I was meant to have a routine monitoring scan in March but no invite has been sent and I'm not in a hurry to chase them.

Kat has returned to psychiatric nursing and is doing great and I'm very proud of her. She is enjoying it and making a positive impact on people's lives who struggle with mental illness and all that that brings. It saturday morning here and she is just off to the market to get provisions for the week; I'm kicking back having a nice breakfast and about to watch sport on TV. Life is good.

:-) Gary

Staring at the Sun: Overcoming the dread of Death

I have just finished reading this book written by Irvin Yalom and found it very good and if the topic is of interest or you have these fears I recommend that you read it.
"Ideas have power ... insights of great thinkers and writers .. help us quell roiling thoughts on death and discover meaningful paths through life." - page 77.
"Staring at the Sun is a profoundly encouraging approach to the universal issue of mortality. Dr. Yalom helps us recognize that the fear of death is at the heart of much of our anxiety. Once we confront our own mortality we are inspired to rearrange our priorities, communicate more deeply with those we love, appreciate more keenly the beauty of life, and increase our willingness to take the risks necessary for personal fulfilment"
Here is a very good book review of Staring at the Sun... thethinkingmother.blogspot.co.nz
Or buy the book here.. Amazon

About the title: "le soleil ni la mort ne peuvent se regarder en face" (You cannot stare straight into the sun, or death) Francois de La Rochefoucauld, Maxim26

10 Ways to Help a Friend With Cancer

I came across this blog and they make some amazing observations on cancer and life. It is well written and worth reading.

If it takes a village to raise a child, you might say it also takes one to care for the sick. Cancer is at once personal and communal. Disease lives in the sufferer’s body but the experience of illness is shared, often intimately, by our loved ones. And yet, caring for the sick can feel like writing a travelogue about a country you’ve never visited. You can’t know where you haven’t been.

“What can I do to help??..Click to read more”...

Thanks for the help and support!

Thanks for your comments and emails of support. It has been a funny old time dealing with this, the surgery was relatively easy to deal with, the head stuff far harder. The spinal surgery I had was pretty brutal so anything else seems pretty easy in comparison although you still need to get through it. I am a little at the end of my tether with medical procedures after having so many over the last couple of years, so when the doctor first rung to say "more surgery" I was less than enthusiastic. But you have no choice and you need to stump up and confront the procedure and get through. Mentally giving yourself a badge and remembering how well you coped with previous procedures helps you when you are confronting a new procedure.

Way back in the beginning I found this inspirational guy and made this post:
  
An SS Survivor to admire: 
Kirk Souder Read his story, not a treatment plan and prognosis I would like to follow but you have to admire his tenacity and courage.

Comparing notes I've nearly had as many procedures in my treatment plan, just now hoping to also come out with the 20 year positive outcome and attitude.

In answer to questions:

- Ribs were very sore post surgery although progressively gets better, 6 weeks post still tender although not limiting or requiring pain meds. Nurses said the pain from a thoracotomy surgery is up there with knee surgery and immediately post surgery it was pretty uncomfortable and good pain management is a necessity.

- Scar, yes another good one on the back although it healed well and quickly. If you look at pic closely I have a couple of freckles for eyes and it looks a bit like a demented happy face. Nurse referred to it as a shark bite scar.     

- Michelle,  I have no great desire to join the 1 lung camp but its comforting to know that we have a lot of spare lung capacity if the need arises. I follow your blog and its great to see you out and about and living life, its inspiring! Personally I haven't found any difference with breathing.

- Ola Flavi, Elodie, Lynda, Simon, Malcolm, Paul.... thanks for the words of encouragement. 

Pretty much I had recovered from the major surgery 3 weeks post, but if you seeking a guide for how long you need off work for thoracotomy I would suggest 4 weeks.  We had a very restful time at home over recovery, it was a very hot summer downunder and our large property was an oasis where we were able to hide away. I went back to work a couple of weeks ago and thats going well although inevitably it just takes awhile to pick the pace up and participate.  

Officially I am in remission, although high risk and another scan due in March or April. We are hoping that this is gone completely, but a short term goal of getting through 2012 with no further surgery or treatment would be pretty cool.

Ciao fo now

Gary

Spoonbills have been feeding in the harbour at the bottom of our garden

"Time heals what reason cannot" - Seneca

I think the Roman philosopher Seneca made a good point when he threw this idea out into the word. When first hearing news of a poor health prognosis the world as you know it is shattered; you are overwhelmed with grief and it is very difficult to come to terms with the information. Your mind goes in a spin thinking of all the possible scenarios and consequences; initially all bad.
Our wellbeing seems tied to the concept of certainty and a romantic ideal of what the future may bring. But time heals... it brings perspective and allows time to process and digest the new information and adjust to your "new normal".
I find information helps and reading article like these helpful ;
http://www.nytimes.com/1988/10/09/magazine/facing-your-own-mortality.html?pagewanted=all
http://www.macmillan.org.uk/Cancerinformation/Livingwithandaftercancer/Advancedcancer/Copingwithadvancedcancer.aspx
Coming to terms with this material helped me face my fears and return to getting on with living life.
No man is an island... often the most useful source of help is your family and close friends around you who are also coming to term with situation and uncertain future. Initially you may not be ready to talk and you will be selective with who you share with; but from experience I encourage that you open up; it is great for you and them.
The world is far from certain for any us and we can't control the future; but we can control our participation and happiness today. Follow the example of this guy:
http://www.youtube.com/watch?v=vwDVvKetRv4&feature=youtube_gdata_player

Ciao
Gary