Monday 21st October to Sunday 3rd November, 2013
I turned up to my routine pre-chemo appointment with my haematologist with a bit of attitude this time. I walked in, sat down in the chair and said “I need answers. I need to know what the future holds for me.” I left the last appointment with him a fortnight earlier really having no idea if he thought my PET scan results were good, or if he actually thought they were bad because I didn’t have bulky disease and the scan wasn’t negative.
I think he was a little surprised by my assertiveness. He turned and faced me and looked me in the eye. I asked him a lot of questions about whether he thought the PET scan at the end of treatment would be negative, what would happen if it wasn’t, what my chance of relapse was and what sort of treatment would be involved if I relapsed.
He said if the PET scan after 4 rounds of chemo had been completely negative he would be “super bolshy” (I think that means arrogantly confident or something like that) about the PET scan at the end being negative. Since that PET scan wasn’t negative, he said he was “bolshy” rather than “super bolshy” about a negative PET scan at the end. If the PET scan is not negative, I will probably have radiotherapy to any spots still showing activity, as long as they are not widespread.
If the PET scan at the end is negative, does that mean I am cured? He said he hoped so, but of course there are no guarantees. I will continue to see him every three months initially to see how I’m travelling. I had asked him at one of the very first appointments about how we would know if I relapsed. I assumed I’d be having fairly regular PET scans but he told that wouldn’t be the case. Apparently they do that in America, but not here. Obviously it comes down to money. If I relapse with lymph nodes involved in my neck, armpits or groin, I can feel them, but if it’s in my chest or abdomen, I can’t feel those lymph nodes, so the lymphoma could just march along with me completely unaware….unless I get itchy again. I didn’t really go into it too much at this appointment, but diagnosing a relapse is definitely something I’ll go into in great detail if I am given the all clear after the next PET scan.
If I am given the all clear, there is about a 10% chance of relapse in the first two years. After two years, the risk of developing other cancers is actually higher than having a relapse of lymphoma. The risk of other cancers is higher than the general population because of the chemotherapy I have received! Good chemo for the good cancer. It might cure the lymphoma but then give you another cancer. Awesome! If I do relapse, the treatment is likely to be a stem cell transplant. He was a bit hesitant to go into too much detail or commit to what sort of treatment I would have, as any treatment for a relapse is likely to be performed in Melbourne under the care of a different doctor.
I left the appointment feeling a little clearer about his thoughts on my prognosis. He doesn’t have a crystal ball so I guess I couldn’t ask too much. It seemed to me that a negative PET scan at the end of treatment was the most likely outcome but the possibility of a relapse and how that might be detected was a concern.
I went downstairs to be hooked up to chemo and was back in the naughty corner again. Getting number 7 under my belt was a bit of a milestone as it would mark the first time I had less chemo ahead of me than behind me. The nurses informed me that my neutrophils were 0.6. I was neutropaenic again having not G-CSF after the previous round of chemo. I wasn’t even the slightest bit concerned that I wouldn’t be having chemotherapy that day but the nurses told me they’d have to run the results past my haematologist to make sure he was happy to proceed. I was OK with that. They were just following protocol.
Of course, my haematologist was happy to proceed but he also told the nurses that I would now be having G-CSF after every round of chemotherapy. I guess I had earned it now, being persistently neutropaenic. My lazy bone marrow hadn’t realised that it needed to work a bit harder so it would be getting some help. My chemotherapy infusion was otherwise very uneventful. Given my episode of vomiting after the last round, which I forgot to mention to the haematologist, I made sure I was sent home with some extra anti-emetic drugs.
The fortnight after chemotherapy was fairly uneventful too in terms of the effects on me. I spent Tuesday, Wednesday and Thursday in bed feeling completely drained, but there was no vomiting which was very fortunate. I hadn’t spent three days in bed after previous rounds of chemo. I had been told the tiredness would be cumulative and it felt like that was exactly the case.
It was in this fortnight that I started the dodgy hodgy chemo cuts reveal challenge and formed ‘The Good Team’, which was soon after re-named ‘The Good Tittie Team’. So it was quite fortunate there were no particularly nasty after effects as I was very busy fundraising and blogging.
I had to go back to the hospital on Monday 28th October for a routine flush and change of dressing on my PICC line. I was fortunate to have an earlier than usual appointment that day which meant I could get out in time to pick up my daughter and her friend from school and take them to gymnastics. This has always been left to the parents of my daughter’s friend, which they have been very happy to do and for which I am extremely grateful. They also usually take my daughter back to their place for tea and then deliver her home, fed and happy. Thank you Tash and Richard! The support from the school community really has been amazing. Although taking my daughter and her friend to gymnastics is really no great feat, it is important to me that I do simple things like that in the ‘good’ weeks as I know my daughter hates the ‘bad weeks’ when I spend a lot of time in bed and everyone else runs her around to school and other activities.
On that Monday, I developed quite severe bone pain, due to the good old G-CSF. It was a strange, throbbing pain around my hips and sacrum. It was constant but made much worse with any change in posture or position, like moving from standing to sitting or vice versa. I also had a band of throbbing pain around my chest when I moved. It was quite a bizarre kind of pain but fortunately it settled considerably after that day. I didn’t take anything for it. As I later told a nurse, I just sucked it up.
This fortnight was also the first time I was asked what once would have been a very confronting question by a complete stranger. I was in Adairs, doing a spot of Christmas shopping (taking advantage of the good week and getting organised early) when a man who looked like he was in his 70’s came up to me and said “Excuse me, have you got cancer?” I thought it was really quite odd to ask that question to a stranger and I did wonder about the state of his frontal lobe (for the non-doctors reading, people with frontal lobe problems are disinhibited and often socially inappropriate) but I wasn’t upset or offended. I actually thought it was pretty funny that he’d just blurted it out so I smiled and said, “yes, I have cancer”. He then told me that his wife had died of cancer about a year ago. I think my behaviour then was even more inappropriate than his! As I was in full-on fundraising mode, I thought “Hmmmm, I could get a donation out of this”. I asked him what sort of cancer his wife had and he said “ovarian”. Bingo! A women’s cancer. So, I told him about the walk to end women’s cancers that I had signed up for but he just said “Oh, good luck with everything” and walked off.
I mentioned in the previous post that my hair loss had not been quite as advanced as I had expected it to be. I think every chemotherapy regime is different and every person is different in their response to it. My hair had thinned considerably, so there was no question it had to be shaved off, but I had very thick hair to start with so I was far from completely bald. The hair that was there was even starting to grow so I really was starting to look quite a sight with very thin hair exposing much of my scalp. I thought I was looking like a balding old man. In fact, I thought this hair style was quite similar to that of my good friend Ev! I promised Ev that if he joined ‘The Good Tittie Team’ or made a sizeable donation, I would dedicate a blog post to him. Everyone loves a blog mention! Unfortunately he couldn’t join the team due to work commitments (whatever!) but he did make very generous donations to both Lisey and myself. So Ev, this is your time to shine……sort of, because it won’t all be nice.
I’ve already mentioned Ev a few times throughout this blog. He is a high school friend and one of the very few high school friends I have kept in contact with in the now 21 years since we finished. Ev was a cycling fanatic in high school; he still is but age has slowed him down a bit. He used to call cycling hammering, so I bought him a hammer, and got it engraved, for his 21st birthday. I wonder if he still has it. As we got older and our lives got busier, the face to face catch ups became less frequent but there were still fairly regular phone calls and text messages between us.
After I was diagnosed with cancer, Ev stepped it up and really has been a tremendous friend and support to me. When you’re diagnosed with cancer, you really find out who your true friends are and Ev is definitely one of them. There have been many text messages and phone calls, a good percentage of which haven’t been responded to but he hasn’t given up on me! He has visited me several times, once straight after finishing night shift and he even brought dinner! He did confess however, that his beautiful wife prepared that meal, not him. That visit was the day before my PET scan so that Shepherd’s Pie became the celebratory meal when the results were good. We went out for brunch that day and I remember the day well as I talked like a woman possessed and I don’t think poor Ev got a word in, but he sat patiently and listened.
Sadly Ev’s father passed away very recently. Fortunately for me, the funeral was in my good week, so I was able to attend. There were at least seven people, and a few partners, from high school at that funeral, which I think says a lot about Ev. I told him that to have that many high school friends there, so long after finishing high school, really is testament to the great guy that he is. I’d say Ev’s wife is lucky to have him but I actually think he’s luckier to have her!
Sorry Ev, but it can’t all be nice. With any glowing reference there needs to be a bit of a slap in the face too. When I told Ev I thought my current hairstyle was resembling his, I asked him to send me a photo of himself so I could put it next to mine on this blog. To my great surprise, he did send me the requested photos with the accompanying text “Very uncomfortable doing this. It’s just for u and that fucker cancer”. I was also very surprised to learn that these were not Ev’s first ever selfies. So here is Ev and myself sporting our very similar hairstyles.
The front on view……..
And the more telling, top of the head view……..
Fairly similar I think (although Ev carries it off much better), so I have dubbed that hairstyle of mine ‘The Ev’ as a tribute to my good friend. After taking that photo, I shaved all my hair off again as it really was looking very average. Quite vain of me!
So that was the end of the fortnight after chemo round 7. Seven down, five to go wasn’t sounding too bad.