22nd - John Larroquette...From a Distance

Thank you to the Kerrins' for bringing us an absolutely delicious pot roast over the weekend.  I will be enjoying the left-overs for days.  Thank you to Stuart's parents, Bill and Cathy, for coming down to keep us company and help out around the house.  Thank you to Shelley Typrin for the good-luck amber necklace.

Time has flown by over the last couple of weeks.  It is hard to believe that I am headed to see Dr. Frenette on Wednesday for my fourth treatment, which is the end of my second "cycle".  This one carries some additional significance, as it is protocol to follow the second cycle with a PET scan to check treatment progress.  The scan is not scheduled yet, but I suspect it will be next week at the hospital.  I am optimistic about it, but I would be lying if I did not admit to being nervous as hell.

As I mentioned in my last (very short) post, my third treatment went "fine".  I have come to expect a new experience (or more) each time I visit Dr. Frenette's office and this trip did not disappoint.  As I was sitting in the treatment chair waiting for my blood tests to come back, I found myself getting nauseous over just being there.  Apparently it is a pretty common phenomenon called "anticipatory nausea", which is when you get sick over the thought of something that has not even happened to you yet.  Next time, I will be taking the anti-nausea medication before I go into the office.  That said, the "hangover" from treatment was a little longer this time and I ranked the days following it as:

Friday: 5
Saturday: 3
Sunday: 4
Monday: 5
Tuesday: 6
Wednesday: 8 (fyi, I consider 8 "back to normal")

Since then, I have been feeling much better and my activity level has been pretty good.  I have done some work off and on from the house and have been walking regularly.  The walking is getting a little slower though, as I have developed tingling in both my feet.  Apparently, this "neuropathy" is a common side-effect of the Vinblastine (the "V", in ABVD), and there is not much you can do about it, other than stop that part of the treatment if it gets to be too much to handle.  I will certainly mention this to Dr. Frenette on Wednesday, but if history is any indication, he will not be impressed. 

During my last visit to Dr. Frenette, I complained of continuous pain in my groin, which I was afraid was lymph nodes acting up.  Rather than examining my groin, he carefully studied my neck...from his chair which was four feet away...and said I was fine.  Works for me.  Stuart has told me multiple times that Dr. Frenette reminds her of John Larroquette, of Night Court fame.  I can see it, from a distance, and his good sense of humor probably adds to the comparison.

Can you see the likeness?

Talk to you soon and Happy Thanksgiving!

5th - Bone Marrow Biopsy

Stuart and I went to Dr. Hellner's office this morning for a follow-up appointment after my mediastinoscopy last week and my PET scan yesterday.

Dr. Hellner reviewed the fact that the initial results of the biopsy were suggestive of Hodgkin's Lymphoma, Nodular Sclerosis subtype.  The news today was that the PET scan showed lyphadenopathy below my diaphragm, specifically in my abdomen.  My spleen was also involved, although I'd been told on multiple occasions that the spleen is a "glorified lymph node" and is often affected.  The fact that I have disease above and below my diaphragm means that I am now considered to have an advanced stage (Stage III or Stage IV) of Lymphoma.  Stage IV means that the disease has spread to organs outside the lymph system, such as liver, lung, or bone marrow.  It is for that reason that I had the privilege of a bone marrow biopsy today.  Dr. Hellner was leaving for a vacation to Napa that evening, so her day was incredibly busy.  She asked us to come back in the afternoon to have the procedure.

Back at the office at around 3:30 to have the bone marrow biopsy done.  I know that many of you have heard nightmare stories about how painful this procedure is, but my procedure was not that bad thanks to the wonderful Dr. Hellner and her capable nurse, Carol.  The procedure lasted about 15 minutes, 30 if you count the 15 minutes I spent stalling waiting for the Valium I took to kick in.  I assumed the fetal position on the exam table, hind quarters hanging in the breeze as Dr. Hellner pushed a thick needle into my lower back/hip.  The sensation was mostly one of pressure, with the exception of the time when the fluid marrow was extracted, which was more akin to feeling someone sucking the contents of your legs through a straw in rapid fashion.

We headed home knowing that results of this terrible test would not be back until next week.

4th - Intro. to Nuclear Medicine

Today was my introduction to the wonderful world of nuclear medicine.  From what I understand, I will become more than familiar with the science, as these scans are repeated throughout chemotherapy.  As I mentioned, Dr. Hellner ordered a PET scan to be completed, essentially to see how far the cancer had spread and to what regions.  The results of the scan help in determining the stage of the disease (I-IV).

According to Harvard Medical School, PET stands for positron emission tomography, which is an imaging technique that uses positively charged particles (radioactive positrons) to detect subtle changes in the body's metabolism and chemical activities. A PET scan provides a color-coded image of the body's function, which when combined with a CT scan can show detail on where cancer is active.  For the PET scan to be effective a substance called a tracer that produces radioactive positrons either is injected into a vein or inhaled as a gas.

In my case a nice gentleman named Bill, from Chicago he told me, injected me with radioactive material from a syringe sheathed by Tungsten.  Bill was a giant man and one of my favorites in this journey so far.  In addition to the radioactive material injected, you must drink two 16-ounce servings of a high-sugar solution.  Back in the day, this had to be some type of flavored Barium.  Bill is a magician and offered me a high-octane version of Dr. Pepper, which many of you know I love, although not as much as red wine.  Stuart was asked to leave to the waiting room as soon as I was injected as "I was radiating pretty good" and not safe to be near.

After two hours of allowing my body to absorb these materials, I was ready for the PET/CT combination scan.  It took 20 minutes and I was out of there with Stuart, who was nice enough to wait for me all day.  Results tomorrow...

Oh, I should mention that Bill told me to stay away from my children until the next day, as I was "no-joke radioactive."  Apparently he wasn't worried about my wife or mother-in-law (who did have me ask Bill if it was okay for "old people" to be near me).