Treatment #10 (Cycle 5B) - Easy Like Sunday Mornin...

"He's not human. He's like a piece of iron."
Ivan Drago, "Rocky IV"

Hey, you lurkers! Just because I'm squeaky clean of cancer, having fun and no major issues (outside the weakness and tiredness), y'all mind LEAVING some messages? It gets lonely being the only one writing to this blog.

So, here we are in the 4th quarter of my football game against Hodgkin's. Still doing treatments, yada yada, and hoping Hodge never wants a rematch after I kick its rear. My hair is growing back in everywhere (finally), and my symptoms seem a bit easier to manage. My hair apparently is normal and can happen. The symptoms are more likely attitude more than a lessening (hey, three docs say I'm clean, I'm near the end of chemo.... Yeah, I'm gonna be happy).

This weekend will suck, as I'll be tired and weak. I'm staying home Monday too for that exact reason. However, the other effects that go into the week really haven't been so bad. I have my appointment with the youngster radiation oncologist tomorrow (she's good, I just call her that because she's only a few years older than me), but she's more of the 2nd opinion, as for practical reasons I need to be treated downtown (so I can work).

So, I'm happy since I'm clean. No way in hell was I letting my cousin come out the winner in this race, haha - We'll tie and both be cured.

And that's alright with me.

Preparing for the Future

Well, tomorrow takes us into the home stretch, the 4th quarter of my treatments. I feel GOOD. I don't know if that means the treatments aren't bothering me as much, if I see light at the end of the tunnel, or what. I know I'll be tired again tomorrow, and for the next 4-5 days, but no biggie.

So, as most of you know I've worked throughout treatment (minus some days here and there as needed). Honestly, a lot of that had to do with my new role at work. I was named Solutions Architect for our division a whopping ONE DAY before I was diagnosed and this nightmare began. I stepped out of my supervisor / management role, and went into a entirely new role within the company - I didn't want to screw it up.

Well, while it leaves me wanting to get a refund on my MBA, I've had more fun in the role than I've had in years. I'm back doing some coding, while having a leadership role and say in the strategic design of our systems. As the role gets more exposure and work (as it has), I'll probably get some staff to assist me (there just wasn't headcount for this year). The fun is what's kept me trying (and its nice to hear your manager say your work effort is "Herculean"). I'm learning very current technologies, Microsoft's toolset: .NET, Reporting Services, Analysis Services, C#, SharePoint, PerformancePoint. This is good stuff - Its awesome putting together my company's next-generation portal, and it doesn't hurt the resume (not that I plan on going anywhere).

Its odd, but after my manager made me feel... Secure... With my job, I have some serious loyalty towards my company. Will I be a technical manager at 35 as was my personal goal (which is hard in my stodgy company)? Possibly, but probably not in my new role. Am I happy? Hell yeah. I can take my experience as a Solutions Architect and apply it in plenty of places; I just happen to love my company as well.

OK, enough gushing over my work. However, I'm starting to finally have thoughts of a future beyond cancer. As curable as Hodgkin's is, as great as the treatments are at nixing this stuff, its still CANCER. Your mortality definitely comes into focus, and stays there.

Now? I'm thinking of other long-term, strategic tasks I want my role / group to take on, tools I need to learn, a camping trip this summer to plan for, and a "Couch Potato to 5k" running plan to enact. I've applied to join a board committee for the Leukemia and Lymphoma Society, as well as offerred to speak publically on its behalf. I'm also trying to start a "Light the Night" Corporate Team.

Beyond that though, I'm really making sure I make more time for the kids and Suzanne. While I think I'm cured and my doctors feel the same... You never know when you might take a medical test and hear something you don't want to hear. That's the biggest lesson I'm taking out of this.

ARRGH!

Well, I got to see Dr. Glatstein today down at HUP. Amazing doctor, he reminds me of the old Norman Rockwell style docs. He's also on Philadelphia Magazine's top docs list as well as the national Top Doctors in Cancer list.

And he's going on sabbatical about a week before I'd start radiation.

He's going to Oxford for six months. SON OF A B**TCH!!! Don't get me wrong, the doctor I'll see in his place is good (Dr. John Plastaras), but I was going to see THE MAN. The guy was involved in research on Hodgkins way back in the 70s for crissakes.

The good news out of today:

1. He's the third doctor to confirm I'm PET negative and in remission (yay!)
2. Based on what he's seeing, he thinks shielding my heart and lungs will not be difficult - The mass shrunk in the right places.
3. Paralysis is highly unlikely (1 in 10,000 chance).

Reports of my Demise May be Greatly Exaggerated...

"We came, we saw....we kicked its ass!"
- Dr. Peter Venkman, "Ghostbusters"

So, do I have some goodies for you all today! As I have my appointment with our Radiation Oncologist on Monday, I received copies of all my chart reports, surgery info, and SCANS! Naturally, I took a look and made a copy. So here goes the slide show:

Here is a picture of a comparison of my October scan (when I first found out) to my February scan. In a PET scan, I get injected with radioactive sugar. Cancer cells tend to eat this sugar a LOT faster than other cells, so after some time they appear on the scan. Some other cells also chew this stuff up: The very dark, large black spots on my head and in my groin are normal things - my brain and my bladder. The heart, liver, and kidneys can also show some uptake safely. What's not normal is that nice big set of black in the middle of my chest on the left, as well as up in my neck. That's called Hodgkin's lymphoma, friends. The right hand scan looks much nicer, don't you think? It all cleared up! Oh, and don't worry about my bones showing in the newer scan - That's from the growth factor (Neulasta) they give me so my bones produce more blood cells (to keep up my immune system). All in all, can't be too upset with that.

Here are some more detailed scans, that combine PET and CT imaging. I think its pretty neat stuff, but really shows how incredible these technologies are. The images are both showing me from the back, on my right side (first being from October, second from February). The images in the upper left and right, and the lower left are CT images showing "slices" of my body. Check out the glow in the upper left frame on my October picture -- That stuff's dead, woohoo! Oh, and one edit -- I accidentally circled part of my heart in the October frame (the lowest circle) - That's safe stuff, and not bad.

October, 2007:

February, 2008:

Worries and Resolutions

So, I've been given a clear PET scan - So why do I still have constant feelings of dread, feelings like nodes are popping up on my neck like corn in a movie theater popper? Why can't I just trust my doc that it's clean?

In any event, I think we've started the downhill slide with treatments. As I've mentioned before, these things are additive: Treatment 2 will be worse than Treatment 1, since its a combination of 1 and 2, etc. Well, I haven't been this weak or achy yet, so the annoying effects of treatment are definitely picking up. However, here's hoping it whacks any remaining cancer out of my system.

On the puppy front, we found a small breeder in upstate PA who was VERY sympathetic to our story, and seems like the kind of people we'd want to deal with. They have a few wheaten terrier pups that would be available in six weeks that we may decide to look at, giving the current situation a little time.

Sometimes Life Isn't Fair... And Sometimes its Downright Evil

As I mentioned last week, we bought a puppy as a surprise for our daughter. He was a lazy sucker, but nothing out of the ordinary (other than picking up going outside very quickly). on Thursday, he was lethargic all day, and stopped eating. We got him to the vet on Friday (in the middle of a snowstorm, but homie don't play when it comes to his dogs).

The vet wasn't sure what (or if) anything was wrong with him either, but wanted to keep him overnight to get some xrays and bloodwork. Well, it turns out he had pneumonia, and didn't respond to antibiotics. We got the call this morning that he died.

My daughter is devastated, as are the rest of us. Talk about highs and lows this week.

Treatment 9 (Cycle 5A)

"You will not laugh, you will not cry. You will learn by the numbers. I will teach you."

Gunnery Sargeant Hartman , "Full Metal Jacket"

So, why do I have Gunney Hartman yelling in my blog? Because after tons of good news, I'm still freaking myself out (probably for no better reason than being obsessive compulsive). Let me explain:

First, the news that has me worried:

• On the official Radiologist's report for my PET, it says there is "slight to absent uptake, same as background" in my chest still. Per my oncologist, it's a hedge on their part because they can't really see anything, as it is blending in with the chest scar tissue (and probably is part of the scar tissue). There's also a 1.2 cm lymph node still in my right neck, but there is zero PET uptake anywhere in that region (meaning anything that's there is scar tissue, normal lymph nodes, or dead cancer).
• My chest mass hasn't shrunk as much as I'd hoped. It was larger than originally thought (it was 12x9cm, not 10x9), and shrunk down to 8x6cm. Its about a 40% drop, but we still have a grapefruit in there.

Now, onto why it probably doesn't matter (which Suzanne will tell you is completely the case and I'm paranoid. She probably enlisted Gunney Hartman above. Evil woman ;-)

• My oncologist has no worries about that label on my PET report - Her evaluation is that its nothing. My PET scan says we are NED (No Evidence of Disease). We're cancer-free at the moment.
• I asked about getting the port out before our vacation in July. She said yes - She chemo'ed me with curative intent and believes at the end, based on these scans, I will be. No reason to keep the port around. If she was spinning the confidence I'm good, there's no way she would have agreed to that. This is probably the most important factoid for me.
• Mass doesn't bother her, as we're going to radiate it, which will shrink it some more. Anything in there will be dead (if there's anything left at all).
• She is stating we are looking at a 90 to 95% chance we're cured now, following these scans (of course, everyone has a 0 to 100% chance of relapsing, it depends on the person, yada yada. But statistics dont lie).

Her POV is we're either cured or will be by the end. That's some pretty nice info from an oncologist who is known (both from my personal experience and others I've asked) to be a no-BS kind of doctor (another reason we love her).

So why am I so friggin spooked? Honestly? If I think about it some, its probably due to the fact that we're approaching the end of treatments. Right now, if anything is in there, chemo is going to kill it if it decides to show its face. In less than two months, there won't be any more chemo, just radiation. Then a few weeks after that, there will be nothing but follow-up scans. That really is a scary thought. I need to get out of this whiny mode. I need Gunney Hartman to beat the crap out of me and remind me I have b*lls ;-)

Thank you all for the support you're giving me. We're near the end friends, and we can get on with life. I'm going to have scanxiety every 3 months for the next year, then 6 months the year after that. But I think we're good, just have to get over this silly nagging thoughts.

On a side note, the chemos are really starting to hit me kinda hard now right after treatment. I'm weak as hell, and TIRED. Only three more to go, but that "additive" effect is definitely kicking in