Marrow, anyone?

So things are progressing rapidly on the diagnosis, treatment front. Today I got the opportunity to meet with my oncologist, Dr. Cirenza. He's quite a charming fellow - friendly, straightforward, seems knowledgeable. All in all, a good guy. He's trying to make a final diagnosis which will determine my course of treatment. The question, as I understand it, is whether my cancer is mediasteinal or diffuse large B-cell. If it's mediasteinal, then there's a different, and somewhat more intense treatment regimen. If it's large B-cell, I'll just be going with the CHOP-R therapy. That means only a few more tests to run. There will be a PET scan to further confirm the areas to which the cancer has spread. That's tomorrow - so more fasting and waiting. I love scans.
Oh, and did I mention that during this visit, the doctor wanted to confirm that no cancer has migrated to the bones. And did I mention that the only way to do this is to extract some marrow from my hip bone?

If you haven't had a bone marrow extraction before, it helps to know what they do. First, a local anesthetic is administered. Then the doctor drills down to the bone, and pulls some fluid from the cavity around the bone. Then a drill is inserted to drill into the bone and marrow is pulled. The coup de grace is the final step, in which a corkscrew like device is used to pull a piece of bone, from the bone itself.

The anesthetic is just a bee sting - standard old stuff. Actually closer to a yellow jacket sting - I was stung by both a yellow jacket and a bee while mowing yesterday and it's definitely closer to the former.

The first needle insertion is uncomfortable, but the local seems to fend off most of the pain.
The syphoning of the fluid from around the bone is a sharp nail-like pain and is unpleasant, kind of like a very sharp needle exerting pressure in an strange place. It's little difficult to describe, but it is much like an intense pressure on a sensitive nerve.

Ah, but I neglect the joy of the final stage - plans for which were heretofore unannounced by my doctor. After concluding the marrow removal, he explained that he'd also like to have a bit of v. I have never, ever, in my entire life encountered this intensity of pain. I'm not given to hyperbole, but if I were, I would be at a loss for a way in which to exaggerate. Apparently, unlike other parts of your body, bone is completely filled with nerves. I was, I'm ashamed to admit, driven to screams of agony - like you might expect to hear when entering a dungeon. How those civil war soldiers had un-anesthetized amputations, I can never imagine. I feel sorry for anyone entering the doctor's office at that time.

It still hurts now. But at least I'm off that table.

Tomorrow I go for a PET scan and an ECG for some final tests, and tomorrow evening I'll be admitted to the hospital for treatment - chemo. The doc recons that there will be 6 months of chemo, followed by some bad ass radiation to destroy what remains of the tumor. That's the plan today anyway.

On a happier note, my dad helped me to bottle 10 gals of my fresh hop Cascade American Pale ale. Most of this will likely be given to lucky friends as I'm going to be on the wagon for a few months. Enforced due to possible conflicts with medication and liver sensitivity. I have high hopes for this one...

Before and After Shave

As promised, pix - before:



















and after -
















This will take some getting used to...

Here's the Situation

Hey everyone - so this is my entry into blogging - an act which I swore I'd never become involved in, as it's so shamelessly exhibitionistic. That having been said, I guess it's best not to knock it til you try it... My primary objective with this thing is to document my experiences with this non-Hodgkin's lymphoma thing I seem to have picked up - more on that later. I'd kind of like to have a forum in which I can save my thoughts to look back on as the treatment progresses, and get out some of my thoughts and feelings on various subjects. So here's the story - and what I told my friends last Tuesday in a bulk email. I think it'll be easier to block quote than to reconstruct the message - and it still remains accurate:

A couple of months ago I began to experience experienced a pain and tightness in my chest. The initial indications were for a condition called chostrochondritis, which is essentially an inflammation of the muscles or ligaments in the sternum. The pain persisted and increased during subsequent weeks. The doctor ordered an x-ray and additional follow-up visits, but the diagnosis still seemed to be the same. The pain subsequently spread to my back and shoulder and my primary care physician wisely suggested a CT scan. When the doctor reviewed the results with the radiologist found a tumor in my mediastinum. Following additional blood tests and another CT scan, I've been diagnosed with a carcinoma - non-Hodgkin’s large B-cell lymphoma (stage III-AS for those of you with medical backgrounds). The doctor feels that this is likely the result of a random mutation, and with treatment, my long-term prognosis is relatively favorable. I'll begin treatment next week - in the form of radiation and chemotherapy. The regimen is expected to last 36-48 weeks, after which, we'll see. Expect to see me roaming the halls - sans hair :)

The response was incredible, and so many people have been so supportive. It's really great to be surrounded by such positive people and great friends.

Well, that gives us a starting point, and I don't want to make these things go on for too long, so just one or two other points - just for the record:

Pain - this thing hurts like hell. I'm told the mediastinum is pressing on nerves in my back and chest, and that's causing it. I'm not currently (this morning) taking any medicine for the pain, and I'm on the verge f screaming almost every third minute. My temper is about as short as its ever been. The pain is spectacular...

Hair - I still have my hair for the next 20 mins or so - after which I'm going to shave off. I'm told that there's no point in prolonging the inevitable. I do like my hair, so this bums me out a bit. I'll try to post before and after pix. "Make it so number one"

Ok - that's enough for now. It's a testament to the ease of use of this media that I've been able to keep writing for so long. I don't like to be too verbose. I'm hoping narrative about this stuff will prove to be a good experience for me and that it will keep my friends informed.