Back from the Hospital - 12/21/07
All -I hope this will be the last update e-mail I send in lieu of specific replies to specific people, or blog posts or something like that, but I wanted to let everyone know the latest.
On Wednesday, they got some preliminary results from a few of my tests (PET scans, a bone marrow biopsy). Incidentally, if any of you are looking for something exceedingly unpleasant to do while laying on your stomach, I strongly* recommend a bone marrow biopsy. Sometimes it can be liberating to whimper like a kicked puppy while a doctor is working on you… okay not liberating, more like humiliating, but still. Anyway, point is: both tests had good results.
PET scans scan for the metabolic effects of tumors - they consume glucose (marked with radioactive dye for visibility) differently than normal cells. I had a full-body PET scan and it detected no tumors beyond the big one they originally spotted and a questionable lymph node in my upper chest. The biopsy appears to be negative as well, which means the disease has not spread to my marrow. This precipitated a somewhat amusing incident where the doctors reported this news and said that while it’s good, it changes nothing about how I get treated. My mother, in top form, countered that according to her recently acquired medical knowledge, the absence of tumors below the diaphragm differentiates Stage 2 from Stage 3 lymphoma. The doctors agreed with this, but again pointed out that it has no effect on my treatment. However, as heuristic categories for public health analysis, Stage 2 and Stage 3 patients have different survival rates - so putting me into Stage 2, in some statistical sense increases the odds that I will survive. She joyfully cried and no one took the time to give her a quantitative analysis lecture.
It IS true that I have a very good chance of being cured, and an even better chance of surviving this disease. Categories aside, that is good news.
Also on Wednesday they gave me my first dose of chemotherapy and the Good News about the cocktail I’m receiving. The first round of chemo lasts six months, and I get the injections every two weeks. I get 4 drugs, which are a standard treatment for this kind of cancer. Chemotherapy for those of you who don’t know, works like carpet bombing does - it kills rapidly dividing cells, including tumor cells. Good chemo regimens kill tumors faster than they kill patients. Successful chemotherapy depends on the body’s ability to tolerate and recover from the treatments while keeping the dosages up high enough to kill off the tumors. So the bottom line is, it’s a game of endurance and strength, especially for the immune system and bone marrow (which are really hit hard by chemo). This is why nausea is such a big deal - if the medicine makes it hard to eat, you don’t get the energy you need to stay strong, so everything gets worse, etc.
I passed the first hurdle okay - I had no immediate allergic reactions to the medicines. But it takes a while for the negative side effects to kick in, and since Wednesday I have been starting to feel it. A good word would be “depleted.” That and “nauseous.” The real test always comes one week after the initial dose - that’s when your immune system “nadirs” and you are at the highest risk of opportunistic infections. No eating takeout, no sushi, no shaving or cutting nails, no fruit without skin, no making out…
After they observed me for a night, they decided I was ready to go home. I have a ton of prescription bottles, a bunch of packets with names like “chemotherapy and you” and an impressive list of instructions to follow. The hospital even sent a special bed to my apartment (it’s safer for me to sleep with my head inclined, it minimizes pressure on my lungs). I also will have my family around for the next few weeks while I adjust to this new way of keeping myself healthy.
So far, so good. Thanks to everyone for their e-mails and kind thoughts - it’s not rational or scientific, but it helps knowing that people are out there thinking about you.
DS 8 months ago