I apologize for the exceedingly long delay in updating this page, it's been a long long month, most of which I've spent reclining for one reason or another. To give you an idea of my habits the last few weeks, here's a post I started to write several weeks ago, but never finished. I titled it "Oxygen Depravation:"
"It's been a slow week. As I reported previously, Monday was Round 4 of chemo, which hopefully will be the last. Clinically speaking the tumors are gone (i.e. you can't see or feel them anymore), which means I'm likely cured. The next phase will be several doses of radiation therapy to the affected areas in my head and neck, which should give us the best chance of avoiding a relapse. So that's nice.
The downside is that after four rounds of chemo I am a weak little man. Each time it's taken me a little longer to bounce back from the fatigue brought on by the treatment, and this time is proving to be no different. The added bonus of this round, however, is that Monday's bloodwork revealed I'm a touch anemic, which is great, because the primary symptom of anemia is fatigue, "because organs aren't getting enough oxygen." Awesome."
After writing that I had to take an 11-hour nap, and I never got back to it. Should give you an idea of my level of activity the last four weeks (hopefully you also caught Jenny's
comment on my epic inaction). Chemo fatigue is a serious pain in the ass.
As soon as my energy started to come back, and my stupid blood improved (eating redmeat helped -- lots of iron means lots of red blood cells), I submitted to another barrage of tests identical to what I had at the
beginning (no MUGA this time, thankfully).
I also had a spinal tap, to test my spinal fluid for cancer (they didn't find any). The procedure itself really wasn't bad, which was a pleasant surprise. What was less pleasant was the 72-hour migraine that followed, which is a side effect caused by spinal fluid leaking from the wound created by the puncture. The leakage causes a pressure imbalance, which causes the ridiculous headache, and generally feels like your head is filled with fluid, although it's not, obviously. Strange.
The good news is there's nothing but good news. Each test confirmed that my cancer appears to be completely eradicated, which means the chemo worked exactly as it's supposed to, and I can move on to radiation therapy, which is basically a preventative measure at this point. Every day for four weeks (starting this Wednesday, the 17th) I'll head to Sibley, get strapped into a bizarre plastic mask designed to keep me still and keep the beams focused in the same place every time, and get zapped. I think it lasts something like 20 minutes each day, and by the 3rd week it's supposed to get pretty irritating as my skin, and whatever's underneath, gets burned to hell. That should be interesting.
It's expected I'll permanently lose facial hair in the affected area (there's not much to lose anyway), and my right salivary gland will probably be wiped out for good. They tell me the left one will likely kick in extra to compensate. We'll see. I may be drooling significantly less.
There's a major debate among oncologists at the moment over whether radiation is still necessary now that modern chemo drugs are so effective, especially since radiation comes with such sucky side effects. I got a lot of opinions on this one, Dr. G (my main oncologist) recommended radation because it's been standard for years, and there's literally decades worth of data on its effectiveness. Other doctors I spoke to argued that chemo is strong enough on its own to completely kill off the disease (and it has, probably), so why subject yourself to radiation. They may be right (I think they probably are), but the fact is they don't have the data yet, so I went old school and opted for radiation therapy. In ten years we'll probably learn that I killed my chances of ever sporting the ZZ Top beard look for no reason. What can you do.
The next question is whether to get a course of chemotherapy in my central nervous system. As I said, my spinal tap came back clear, which is good, and given the early stage of my cancer and whatnot the chances that there's anything in my brain or spinal fluid very very low. Nonetheless, regular chemo drugs don't cross the brain/blood barrier, so if there are two lymphoma cells floating around in my spine, they've been unaffected by the four treatments I've had, and that's of course a bad thing.
Dr. G thinks getting chemo injected into my spine (called 'Intrathecal Chemotherapy') is wholly unecessary, given that the chances are so remote there's anything going on in there. The docs at Johns Hopkins though, who I've gone to a few times for consultations and 2nd opinions, think eliminating that tiny chance makes it worthwhile, though they agree with Dr. G that the chances are indeed remote. I'm thinking on it. It would entail getting 4-6 spinal taps, every couple weeks or so (I think), and they say the side effects are actually pretty negligible, just that awful damn headache over and over.
So that's where we are. I'm still bald (I'll stop shaving my head after radiation, then we'll see what grows back), and I've gained 15 pounds since this fiasco began. I blame the steroids, and the fact that I've spent most of the past four months moving as little as possible. Other than that, I can't complain.