Friday, May 30, 2014

Nothing Else Matters

Change of Plans

Mark and I are taking hot, pressurized showers, doing laundry in a machine, driving a car to the grocery store and spending time away from Irie. I enjoy ice cream, almost every day. No, we are not on a holiday, even though we planned to treat ourselves to a week of vacation on Easter Island in May; it would be the first real vacation for us in over seven years (even though that is probably hard to believe). Instead, a very eventful May has passed and we are in Newburyport, Massachusetts, USA.  Not by choice, but very glad to have friends and family around. Mark has been here almost a month and I arrived two weeks ago. When we will be back on Irie is anyone’s guess. How plans can change fast and unexpected…

Just Like That…

In January, Mark fell with his torso on a winch. He was in a lot of pain. Two weeks later, he noticed a bump under his right nipple. It had to be a result of the injury. Taiohae does not have the right equipment for an analysis to check it out; we didn’t bother. A month later, the bump was still there, seemingly of the same proportions. It would have to heal soon. Apataki does not have a hospital. We dealt with crappy weather and a successful haulout. Another month later, we went to the infirmerie (clinic) in Fakarava. There is no doctor in the village; the nurse thought the lump was related to the injury, but recommended us to go to Tahiti to have it checked out. About two weeks later, we arrived in Papeete on a Friday and immediately went to the public hospital. An ultrasound was scheduled for the following Tuesday. No conclusion was reached, but the doctor managed to do a biopsy the same day to not delay any further investigations. The biopsy result arrived another two weeks later. “I have bad news for you. You have cancer!” The world around us collapsed.

Biopsy report of the hospital in Pape'ete
Are We sure?

The emotional roller coaster ride started and would last for a long time to come. We translated the French biopsy report and different doctors and surgeons had a look at it. It could be cancer. Or, it couldn’t. Is it? Or, is it not? We were shocked. We were relieved. We were in disbelief. We were confused. The diagnosis was a bit ambiguous, but all agreed that removing the lump would be the next step. Would we have that done in Tahiti? Or in the US? How about insurance? A few visits to doctors’ offices in Pape’ete followed. Four days after hearing the initial diagnoses, Mark was on a plane to Boston. Cost: $1800!

I stayed on Irie, still hoping the tumor was benign and that Mark would be back in three weeks. I could use a little personal time to work on a few projects and cruising friends kept my spirits up and had me over for dinner. Mark underwent a successful operation in Newburyport and another biopsy followed. Conclusion: he had, indeed, breast cancer… against all odds. He was a male of under 60 years old and – definitely – not obese, but… his sister had the BRCA1 gene mutation and passed away last year after a long fight against ovarian cancer. Everybody now assumed Mark had the bad gene as well.

A Hell of a Day

Once this news came to me, Monday afternoon (May 12th), all hell broke loose on Irie. I spent hours on Skype, through a crappy internet connection, to secure a flight for Wednesday. I had one full day to prepare Irie and leave indefinitely (a scary thought in itself). To make matters worse, the swell was unusually high that night and the following day(s). Irie was pitching wildly during the rest of my stay in Tahiti. I didn’t sleep at night, and got up at 4am to start prepping the boat and communicating with Mark and friends. In between chores, every ten minutes or so, I had to rush outside and gag, losing a lot of precious time to let my stomach settle. The combination of stress, emotions, seasickness, heartache and adrenaline is not a good one. But, I survived and – with the help of good friends – got the task done before dark (6pm), when I really had to start packing. Another bouncy, sleepless night and I was picked up at 5am the following morning to get to the airport.

Massive waves created a very bouncy anchorage before I left

Our heartfelt gratitude goes out to Chris and his family on SV Iona, Leo and Gesina on SV Seluna, Cheryl and RenĂ© on SV Gypsy Blues, and Lisa and Fabio on SV Amandla! More names will undoubtedly be added to this list based on how long we are separated from Irie. 

Invasive Papillary Carcinoma

It took a few weeks and a whole lot of appointments and opinions before we came to the point of knowing for sure what Mark’s cancer is all about. I will not bore you with the details or the array of emotions involved while waiting for results. We went from a suggested double mastectomy to a less drastic lumpectomy in combination with radiation, possible chemo and a predicted treatment period of 3-7 months. All pretty shocking, when just weeks before, you were planning on sailing in the Society Islands, looking forward to a scheduled visit from family in June and then slowly heading west to Fiji for cyclone season.  No more anticipation is to be had, however, and planning anything at this point is useless.

Waiting for a check-up by the surgeon
 The diagnosis of Mark’s cancer is invasive papillary carcinoma, a very rare type of breast cancer, but – apparently – a “good” one; one that is less likely to spread and that is responsive to treatment. 1 out of 1000 breast cancers is detected in men; less than 1% of all invasive breast cancers is papillary carcinoma! 10% of the breast cancers in men is caused by the BRCA2 gene, not the BRCA1… Mark is unique (nothing new there :-)) and presents an interesting case study. As of now, his suggested treatment consists of an operation to take out the sentinel lymph nodes (scheduled on June 3rd) to make sure the cancer has not spread, 5-6 weeks of radiation after the results of the pathology report will be known and radiation mapping has taken place (all time consuming), and 5 years of hormone treatment. Things might change based on the lymph node report.

To Be Continued…

Mark is in the good, but busy, hands of Dana Farber in Boston right now. This is one of the world’s top cancer institutes and we are very happy and fortunate that he can be treated there. The downside is that everything takes a long time (according to our antsy minds and purposeful reason to be here), with a plethora of specialists involved and many patients needing treatment. Over the coming months, I will post updates about our progress fighting the cancer and – hopefully – about some fun (summer) activities in New England. Our sailing adventures and stories are on hold!

At Dana Farber to meet with the genealogist - patients are "branded" and can be tracked!
Meeting with the head of the radiation department at Dana Farber

After problems with the first BRCA1 test (for insurance reasons), Mark has to send another sample

A new spit sample is packed up and ready to go to the lab in California

Monday, May 19, 2014

Thumbing through Tahiti – A Day of Island Explorations

I had been in Tahiti for over three weeks, without seeing anything of the island - the capital Pape’ete aside - when my friend Rachel from SV Namaste and I made plans to “hitchhike Tahiti”, one evening during happy hour. It would be a girls’ day out and it would happen on the national holiday of Thursday, May 8th. We figured that if the whole country had the day off (again!), we might as well join the ranks and forget about the usual household chores and boat errands and go on a little exploration ourselves. Since the buses don’t run on holidays and since we all had good experiences hitching rides in and around Pape’ete before, sticking our thumbs out would only enhance the sense of adventure.

Before we hit the main road, which runs in front of Marina Taina in Punaauia, Rachel and I had a look at the map, singling out which sites seemed interesting, and practicing their pronunciations. Our first stop was marae Arahurahu, reconstructed ruins of old stone platforms, at PK 22.5. The setting was pretty and peaceful, well taken care of, and informative with signs in French, Tahitian, and English (which had never been the case on the outer islands). There were even a few other tourists strolling around. Yes, this is Tahiti and tourism does exist here! Our driver-turned-guide Koko kept us company, since in all his years of living in Tahiti, had never set foot on this site. He was even nice enough to bring us to the next place of interest: the Mara’a caves and Paroa cliffs.

Right along the coastal road, at PK 28.5, people stop their cars to fill water bottles. Faucets spew incredibly clear and fresh water from the mountains and three caves are set back in the cliffs. The most impressive one, Grotte Mata Va’a goes pretty deep and sports a clear pool of water, while the green foliage droops and drips overhead. It was very inviting to go for a refreshing swim, but we didn’t think our future drivers would appreciate wet car seats, so we refrained. Grotte Teanateatea was less spectacular, but the different ponds with lotus flowers made up for it. The third cave stayed hidden.

An expat from France picked us up and dropped us off at km 39, where we expected to find marae Maha’iatea. Instead of more ruins, we found a hill covered with shrub, hiding the ancient rubble underneath. We contemplated a walk over a black sand beach to reach a popular surf spot, but time was starting to run out already, so we walked back to the main road instead, picked up lunch at a grocery store and stuck our thumbs out again.

A Tahitian father and son took us along and deposited us at the Vaipahi water garden at PK 49, between the Mataiea and Papeari districts. The site of these botanical gardens (not to be confused with the Paul Gauguin museum and gardens) is definitely worth a stop. Our friends Leo and Gesina from SV Seluna recommended this place to me and I am glad they did. It is organized very well (I am still impressed with the Tahitian tourist facilities) with labelled plants, a few ponds (better when the flowers are in bloom, however), a beautiful waterfall, charming and modern toilet facilities and a few hikes. Before we explored this area, Rachel and I crossed the road to have lunch in a park along the water. To our surprise, we found picnic benches and a great view over Tahiti Iti, the island-like peninsula SE of Tahiti Nui, Tahiti’s main part.

After finishing a whole baguette, a chunk of cheese and a packet of smoked salmon (with the help of a young stray dog), we set out into the hills, following one of the hiking trails. After climbing for about an hour, we took the “river path” back. As its name indicates, we followed a muddy trail along the river, crossing it several times and taking in the multiple waterfalls along the way. Once our shoes were cleaned off enough, we decided to head back to the marina. We didn’t think we had made it that far yet and it was “only” 3:30pm, but when realizing we had to travel over 40 km to get back home, we quickly used those thumbs again. 

A friendly young couple from Bora Bora and Tahiti picked us up and – after a brief stop at his grandparents’ house – drove us all the way to Marina Taina, where we arrived just after happy hour (5pm) started. That evening, Rachel and I didn’t mind repeating the adventure in a different direction the following week. Unfortunately, more explorations were not meant to be.

Information about marae Arahurahu in three languages

With Koko in front of the "first" marae (Photo by Rachel Bianco)

Lotus flower in a pond near the caves

Tahiti Iti seen from our picnic bench across the botanical gardens

River walk on the way back down

One of the waterfalls along the river walk

And a smaller one

The heart of Tahiti (Photo by Rachel Bianco)

One of the many river crossings along the hike (Photo by Rachel Bianco)

Time to get back home; the sunny skies turned grey (Photo by Rachel Bianco)