w00t

 

"Your PET scan showed activity only in the right neck down to the right collarbone. There was no other evidence of lymphoma anywhere else (ie chest, spleen, groin, etc looked fine), which correlates with the CT scan."

 

Good times.

Well sheesh. Turns out there is a massive link between aspartame and lymphoma: http://www.wnho.net/whopper.htm

 

Someone get a class action lawsuit together. I want my money!

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.

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.

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.

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!

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)."

So the bad news is I have Cancer. The good news is that it’s Hodgkin’s Lymphoma, which is apparently 80-90% curable.

 

I went to my surgeon’s office last Tuesday to hear the results of my biopsy and that is what they were. I think I was actually relieved when I heard that it was Hodgkin’s. I was worried that it was going to be non-Hodgkin’s Lymphoma, which is not nearly as cowardly a disease.

 

Anyway, I got an appointment to see Dr. Stephen Petersdorf on last Friday, which I did. We talked for a while and he did a physical exam and drew some blood. He said that in the physical exam he couldn’t find any obviously enlarged lymph nodes except the ones on my neck and possibly some under my right armpit. Based on this and my lack of symptoms, his "hunch" was that I was in an early (I or II) stage of the disease, which would be good.

They drew some blood and I got the results from that: it looked "very good". My blood counts (white cells, hemoglobin, platelets) were normal. My ESR was 2, which is apparently well within the normal range. And my LHD was normal, which is good. The doctor said my liver function npanel (ALT and alkine phosphatase were mildly elevanted), but only about where they were elevated in 11/04. The doctor doesn’t think the liver results have anything to do with Hodgkin’s disease since it’s rare for it to directly involve the liver, but we’ll know more after the CT and PET scans.

 

After the CT and PET scans, I’ll likely move on to a few months of chemotherapy and some radiation treatments. The doctor said that if it was early that I’d do about 3-4 months of chemo and 1 month of radiation, so that’s what I’ll aim for.

I had my surgery today. It went well. No blown up arms or skin falling off or any of that monkey-business.

 

I woke up at 5, got showered with some antibacterial Dial and headed to the UW Surgery Pavillion for my 6am checkin time. My father met me there and in maybe two minutes they called my name.

I went back into the pre-op waiting room and they gave me one of those smocks to change into (the kind without much of a back). Then I waited on the bed, a nurse came by and asked lots of questions, then another nurse came by and asked a small subset of the first nurse’s questions.

 

Eventually the anestheiologist came (an M.D. Ph.D. according to her nametag — turns out her Ph.D. is in neural anatomy, which we discussed a bit) and asked me some more questions. Her funniest question was whether I had caps or fronts or something else on my teeth. I didn’t really understand the question. I said, "They’re just normal teeth." She seemed stunned by this. She thought they were some of the best looking teeth she’d ever seen. To be fair, she was a bit obsessive.

 

Anyway, she put an IV into my hand, explained everything they were going to do and what drugs they were going to use, etc. Then she offered me a drug cocktail to ease any anxiety I might be having. I told her I’d love it after I got a chance to talk to the surgeon a bit.

Let me tell you this: if an anesthesiologist offers to give you a drug cocktail to ease your anxiety, you should accept. Good stuff!

 

A few minutes later, they wheeled me into the operating room and within about 20 seconds I was out. Next thing I know I woke up in the recovery room a bit groggy with a big bandage on my neck. Maybe 30 minutes later I was feeling basically fine. I had some applesauce and tapioca pudding (a very tasty treat, I must say, in this mental state) and then my dad drove me home.

 

The surgeon told me that it would take about 5 days to get results from the pathologist. They were able to rule one thing out quickly (squamous cell carcinoma), but the rest of it would take a while longer to run tests, etc.

 

So now I just wait a week to hear the good news.