The Diagnosis

If there’s one thing I learned in journalism school and now try to drill into my own students’ heads, it’s that you should never bury the lede. So here it is: I have classic Hodgkin’s lymphoma. As of now, I am officially a cancer patient, so I guess this just became a cancer blog. Welcome.

A few initial thoughts before I continue:

1. This is the best possible news. From what the oncologist told me today and what I already knew, if you have to get cancer, classic Hodgkin’s lymphoma is the one to get. The prognosis is excellent. Quoth the doctor: “This is curable. I’m using the word cure.” That’s not to say this won’t be a difficult road, but it’s also miraculous that I live at a time when the words “cancer” and “cure” can be said in the same sentence in the present tense.

2. Thank you, again, to everyone who has been sending me messages of love, prayers and support, jokes, funny photos and videos, flowers, Lou Malnati’s, and all kinds of other signs of care. My phone has been vibrating for two days straight now with incoming messages. This means the world to me and is absolutely allowing me and Theresa to weather these uncertain tides. I have to admit that being positive is not always my default reaction (no matter how much my chipper blog posts might fool you), but the outpouring of support has carried me to a place where I can’t be negative about this. Who gets a cancer diagnosis and spends the day feeling grateful? This guy, apparently.

3. I hope that anyone in my situation who finds this blog via Dr. Google will find this post first. This is obviously not something I wanted, but it’s also not a death sentence or even the end of life as I know it. The blow of this unfortunate news has been softened tremendously by turning it all over to God and allowing myself to fall into the warm embrace of those around me who care.

So what happened today? Well, we arrived at the progressive care unit for our appointment, filled out the usual paperwork (and by “usual,” I mean the same paperwork that I fill out every time I enter a new office in the same hospital complex). Then it was time to wait. And wait. With nothing to comfort us but the final hour of The Today Show (Matt Lauer playing a game of “guess the host of certain talk shows” with his co-host), I began to fall into a bit of a pre-diagnosis panic attack. It was difficult to think or breathe or ponder the fallen state of broadcast journalism.

IMG_8889Eventually they called my name, I got to tell a nurse about how I’ve been healthy as a horse my entire life until now, and then we waited some more. The biggest lesson I’ve learned so far is that you need to add two hours to however long a medical professional tells you an appointment will take. Clearly I was not alone, however, as there was a completed Sudoku in the trash, no doubt from the last patient’s patient waiting.

After we had been at the hospital for a full hour, the oncologist finally arrived. With Theresa’s help, I had managed to calm down a little bit (getting annoyed by the wait ironically helped…maybe that’s their strategy?), and the delivery of my diagnosis didn’t lead to a fainting spell or even a minor freakout. We both took the news with relative composure. It also helped that the news and the prognosis were as good as it gets.

After feeling me up for other enlarged lymph nodes, the doc said that I seemed pretty clean, except for a slightly enlarged lymph node on the other side of my neck. Lumpy’s sidekick? This was also good news though, as he said he couldn’t feel any lymph nodes in other potential problem areas, which would mean that the disease was actively progressing. I’m still basically without symptoms, except for a terrible itch on my upper thigh that I have rubbed to a bruise a couple times. It’s a real nuisance and also apparently a symptom of lymphoma. The more you know.

We then talked about what the immediate future would hold. The next step is the completion of a battery of tests to determine the stage of my lymphoma and how healthy I am, so they can make a treatment recommendation. Here are the tests I will undergo, in order of easiness.

1. Pulmonary fitness test.
This basically involves me breathing into a tube to measure the strength of my lungs. The traditional chemotherapy cocktail used to kill Hodgkin’s lymphoma is ABVD, which is short for the four drugs used. One of these drugs is particularly rough on the lungs, so they need to make sure I’m up for it.

2. PET/CT scan
I already had a CT scan, which involved the introduction of dye into my veins so that my lymph nodes would glow. This PET scan will send glucose into my body, which cancer cells see as food. Unbeknownst to Lumpy, this glucose is supercharged with radioactive chemicals that will make the cancer cells glow while they are feasting on the glucose and show doctors where they are hiding inside me. Hopefully they’re nowhere besides my neck. This will help them know the stage of my lymphoma. We’re hoping for a score of 1 here.

3. MUGA scan
Another one of the ABVD chemicals is particularly rough on the heart, so this scan will use some sort of radioactive dye to produce a movie of my beating heart and show its stamina. Bring the popcorn.

4. Bone marrow aspiration
Ah, yes. My unfortunate Google research had already made me aware of this test’s existence, so in my book, this was the worst news the doctor gave me. I actually winced when he brought it up. It involves the injection of a small needle in my hip, followed by a much larger needle that actually extracts a piece of my bone and the bone marrow. Google this if you want to see the horrifically-sized needle that they use. I’m not sure what the purpose of this test is, but it must be a punishment for something I did as a child. Actually, it’s to tell if the lymphoma has spread to my bone marrow (again, please God, no!). The clouds lifted a bit when the doc told me that I could have this performed under conscious sedation. I see no reason to remember this portion of my treatment.

Regardless of the results of these tests, the doc said that I am headed for chemotherapy, most likely of the ABVD variety. I’ve read a lot of terrible things online about the effects of chemo, too, but he told me that it would probably just make me tired and operating at about 75% of my usual steam. I’m thinking it’s probably too early to make that call, but I would love it if that were the case. Here’s hoping I’m not bitterly quoting this paragraph in some future, fatigued blog post. I’m also hoping to avoid radiation, which is way more intense and would probably only be necessary if my lymphoma had progressed to an advanced stage.

I have 8-10 days to complete these tests (many of which apparently are only given once or twice a week at 10 a.m….how convenient!) then I have to see the oncologist again and see another oncologist for a second opinion on the course of treatment to pursue. Then treatment begins. Then treatment ends. Then hopefully I’m cured. Simple, right?

IMG_8891Before I left the office, they of course had to take more of my blood. It’s as customary as the repetitive paperwork. Couldn’t some nurse have attended the surgery last Thursday with a cup to catch what was no doubt dripping in copious amounts? I was incredibly proud of myself, however, as she extracted two vials and I felt absolutely no effects. This whole thing might make a man out of me yet. Maybe I’ll be voluntarily giving blood when it’s all over. They unfortunately didn’t have a sticker to give me, but the nurse honored my valor by drawing a smiley face on my bandage.

So that’s where we stand. One other unfortunate side effect of this diagnosis is that I am going to stop teaching so that I can make my schedule a little easier, especially when it’s chemo time. I’m going to miss it tremendously, but I think it’s the right decision.

I apologize if any of this seemed rambling or nonsensical, but I’m writing it quickly before my last class tonight and wanted to get something up so people would know what was going on. Thanks again for your prayers (it’s not too late to hop on the novena train!) and support.

Bottom line: I am confident that I will beat this. I have no doubts. Let’s do this.

I know not all that may be coming, but be it what it will, I’ll go to it laughing. –Herman Melville




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