Monthly Archives: July 2005

Health and wellness

Chemotherapy — day 1

6 Comments
Jeebus.
 
So first I go to UW Medical Center at 8am to make a deposit, just in case. That goes fine.
 
Then I go to the Seattle Cancer Care Alliance at the Hutch for a blood draw at 9:30am. They say, hey, you don’t need a blood draw. Go on up to infusion. I wasn’t supposed to start infusion until 10:30, but I went up anyway. They told me I actually wans’t scheduled for infusion until 1pm. Great. So after waiting around there until 10:50 or so, they eventually figure out that they have no idea who called me and told me to come at 9:30 and that 1pm is definitely the best time.
 
So my mom, Jon, and I go to Coastal Kitchen for brunch, which was very tasty if highly caloric. Then we went back to the Hutch at 1pm for my infusion. I get a room pretty quickly and lie down. Basically what’s supposed to happen at this point is for them to give me an IV, some anti-nauesa drugs, a test dosse of one of the chemo drugs (the Bleo), and then wait an hour to see if I have an allergic reaction to the Bleo. Then they’d push the rest of the Bleomycin, Adriamycin, and Vinblastine and then give the Dacarbazine as a drip.
 
This whole process should have taken about 4 hours starting at 1pm. But they were busy. Someone showed up 5 hours late to their appointment and so I didn’t end up getting out of there until 7pm. Sheesh. They assure me in the future it will take only about 3 hours from sit down to get up & leave.
 
Anyway, no crazy side effects yet. I do have a bit of an upset stomach and maybe the slightest twinge of nausea. I just took some ativan to help with that and am on some other crazy anti nausea drug called Ondansetron (brand name, Zofran), which is $250 for 6 pills (but of course MSFT insurance covers that np). It’s pretty leet the way it works — it selectively blocks serotonin receptors to keep "hey, you should vomit now" messages from reaching the brain.
 
So we went out tonight to Daniel’s Broiler for a tasty steak and chocolate desert. I figure may as well celebrate having no side effects. mmmm good.
 
Now I don’t know if my slight nausea is because of the chemo or the immense foodstuffs. I’m betting the latter.
 
Anyway, I’ll update on my status throughout the weekend. One of the drugs may give me a fever of 102, but so far no fever. We’ll see.
 
Here are some pics of me getting my treatment.
 
Too happy for chemo
 
You have approximately 7 minutes to live.
 
 
7 minutes — think fast!
 
 
 
They put on full hazard gear to handle this stuff.
 
 
Adriamycin is red!
 
 
Mom and Me
 
 
Battery powered IV Drip for bathroom trips np
Health and wellness

Off to chemo…

1 Comment
Up early this morning to head in for my first dose of chemotherapy. I’ll be getting ABVD (adriamycin, bleomycin, vinblastine, dacarbazine), which is apparently the "gold standard" of care for stage IA Hodgkin’s.
 
Anyway, time to suit up. I’ll report back later with any immediate notes from the day.
Health and wellness

CT Scan –> Stage IA

3 Comments
From the CT scan it looks like I’m in stage 1A of the disease. That’s pretty much the best result I could have gotten, so grats me! I’ll post pics of the CT scan if I can get my hands on ’em.
 
Findings:
 
Chest: There is right subclavian lymphadenapathy, measuring approximately 4 x 1.6 cm (2/108). This is incompletely imaged on this study. Please see CT of the neck from 6/24/05 for accurate extent of neck lymphadenapathy.
 
Visualized portions of the thyroid are normal.
 
No mediastinal hilar or axillary lymphadenopathy.
 
Heart size is normal. No pericardial effusion. Aorta and great vessels are normal.
 
Lungs are clear. No effusion or pneumothorax.
 
Abdomen: There is a punctate hypodensity in the dome of the liver, too small to characterize by CT but statistically most likely a simple cyst. Liver is otherwise normal. No intrahepatic biliary ductal dilation. Hepatic vessels opacify norally. Gallbladder is normal.
 
Spleen, pancreas, adrenals, kidneys, stomach and proximal small bowel are normal.
 
No retroperitoneal or mesenteric lymphadenapathy.
 
Distal small bowel is normal. Bladder is unremarkable.
 
There are two 6mm mesenteric lymph nodes (2/144) at the level of the aortic bifurcation anterior to the right psoas muscle, which are nonpathologic by CT criteria.
 
No iliac or inguinal lymphadenopathy.
 
No free intraperitoneal air or fluid.
 
No lytic or blastic bony lesions.
Health and wellness

No syndesmosis tear!

2 Comments
I saw an orthopedic surgeon yesterday that Carmen recommended. He did some more x-rays including a "stress x-ray" where he twisted my foot while the picture was being taken. He says that my syndesmosis looks like it’s not torn and thinks that I have a "3rd degree circumfrential sprain". Basically the other ligaments in my ankle are messed up, but my syndesmosis is ok, so I don’t need surgery and a screw.
 
Good stuff!
 
Now I just hope I heal up quickly enough to start chemo soon. I see my oncologist today and find out what stage I’m in from the CT scan yesterday. Wish me luck. Think low numbers.
Health and wellness

70 pounds down at end of phase 2

6 Comments
As of my final dietician appointment, I weighed 174.5 pounds and was 14.5% body fat. So that’s hella good.
 
Anyway, here are some pics my friend Dave took at work on Monday. I figure I should take and post some now before I get all whacked out and bald from chemotherapy. I also posted a couple before shots for comparison.
Health and wellness

Not my month

2 Comments
To add insult to injury, while playing ultimate frisbee tonight I pretty badly hurt my left ankle. Good Lord it hurt! I was down for a couple minutes, then some guys from my team helped me off the field. Everyone clapped when I got up. Old school.
 
Dave was watching our game and drove me to the ER at Overlake Hospital. Ali and Geeven drove down and brought us Chinese food and monkey cake. It was a happening room 11 at the ER, let me tell you.
 
To make a long story short, the doctor thinks I have a pretty severe sprain and that I may need a screw put in my leg to hold my bones together while the ligament heals. He said this was not like 95% of sprains that happen when you roll your foot one way. He thinks I rolled the other and may have a syndesmosis tear. In any case, I have to follow up with an orthopedic surgeon on Friday or so.
 
I hope this doesn’t affect my cancer treatment too much. Bleh. This is how they get you!
 
On that note, I have a CT scan scheduled for Thursday. lol. How absurd.
 
Thanks Dave, Ali, and Geeven!
Health and wellness

Pathology Report: Nodular Sclerosing Type

1 Comment
I got a copy of my pathology report. Here’s the relevant part:
 
IHC Interpretation:
The staining pattern hilights CD15 and CD30 positive Reed-Sternberg cells in a background of mixed inflammatory cells including CD20 positive B-cells and CD3 positive T-cells. Pax-5 stains the Reed-Sternberg cells with less intensity than the normal B-cell population. These findings are all consistent with Hodgkin’s lymphoma.
 
Final diagnosis:
Lymph node, (right level V), excision: Hodgkin’s lymphoma, nodular sclerosing type. See comment.
 
Comment:
Histologic sections are of a lymph node with an effaced architecture by collections of mature lymphocytes mixed with eosinophils and numerous Reed-Sternberg cells and variants. There are bands of fibrosis consistent with an early form of nodular sclerosing Hodgkin’s. No immunophenotypically abnormal B- or T-cell populations were identified by flow cytometry (see Hematopathology report HP05-5206)."