Archive for the ‘Doctor visit’ Category

13th Treatment

Monday, June 9th, 2014

We encountered some heavy traffic this morning, so since I was driving, Sandi called the doctor’s office and told them we’d be about ten minutes late for my appointment. It wasn’t a problem, and I didn’t have to wait too long to be treated.

I had another appointment in the afternoon with my primary care doctor. When I last saw her, she was only clearing me for the biopsy surgery. We filled her in on the whole drain ordeal and my current treatment progress. I was a bit concerned about my weight, which was about 185, but she said it’s a good weight for me. 175 pounds was too low, and 200 was too high, so she would like to see me maintain my current weight.

Sandi is off all week, so she can drive me to my appointments in the morning if I don’t feel up to it.

Dry run

Tuesday, May 20th, 2014

Went to the Radiation Oncologist’s office this morning before work. I changed into my sheet again and was led into the treatment room. I laid down on the table with my legs on top of the mold. After positioning me, an x-ray was taken, more marks were made, and more stickers placed on them.

Afterward, they gave me my treatment schedule. I begin treatment tomorrow at 7:45 a.m. Most of the appointments are for 7:45, with a couple at 8:00.

When I arrived at work, I sent an email to my manager to let her know I’m applying for leave from 2-20 June.

Pre-treatment appointment

Tuesday, May 6th, 2014

Had my second appointment with Dr. F. today to go over my treatment and put markings that will help them line me up under the treatment machine. She did mention that radiation treatment, although it will prevent the same kind of cancer from recurring at the treated site, may cause other kinds of cancer, but that rarely happens.

A tech took me back to the CAT scan room after I used the mens’ changing room. I was able to keep my t-shirt and socks on, with a sheet wrapped around my waist.

I had to lie down on the scanning table, with a foam pellet-filled bag placed under my feet and legs. Once I was positioned, air was sucked out of the bag and it hardened into a mold that will be used in the treatment room. She also made markings on me (lines and ‘+’ symbols) to assist in aligning me correctly, and placed transparent stickers over them.

An initial CAT scan was done, and a head shot photo for my records. The next appointment is a “dry run,” where they place me on the table under the actual treatment machine, and take an x-ray. That appointment is scheduled for Tuesday, May 20, at 7:30 am. For the daily treatments, I asked for afternoon appointments. I’m still not quite sure how this will work out.

It’s not a problem if I’m working, because we can just leave work early and go home after the treatment. When I’m not working, If I have morning appointments, Sandi will drive me to the appointment and drop me off at her friend’s place, who offered to let me stay there while she’s at work.

I plan to file for Short-Term Disability at work, but have to use five days of leave first. That will leave two weeks: the final week of treatment and the week afterwards. Unfortunately, I have only a few hours of leave, so I’ll have to have a negative balance approved.

Drain out

Monday, April 21st, 2014

Saw the surgeon this morning to take a look at the hose and drain. He thought the drain may be acting as a wick, preventing the area from closing up and healing. Before I knew it, he had pulled the drain tube out – I didn’t feel a thing. He said it had been nearly all the way out anyway. He wants me to call him by Thursday to let him know how it’s doing.

So now it’s a small hole (no stitches) with a huge pad of gauze over it in case it leaks. I have a feeling we may be leaving work early…but maybe it’s just deja vú…

Now that it’s gone, it seems strange how the drain had seemed to be a part of me. It’s great to finally have it out, though.

Surgery Follow-up

Tuesday, April 8th, 2014

Saw the surgeon today for another follow-up. Sandi had wanted to ask him when he thought the drain could out. He had a look at it and noticed the stitch that held it in place had come out.

He wanted to see how big the cavity was, so he cleared the tube and injected some iodine. It didn’t hold very much, so the fluid cavity may have shrunk a little.

Sandi asked him what he cleared from the tubing, and he said it was just protein matter that got sucked into the tube. I had actually thought it was tissue, so that’s good to know. He asked what the daily output had been lately. I said it was 100 ml or more, and he said he’d like to see it go down to about 10 ml.

The plan is for me to call him in two weeks to let him know the daily amount at that time. We told him I would be getting radiation treatment, and the radiation oncologist would like that area to be free of the drain and starting to heal.

However, he said radiation might actually speed up the healing process and help the open lymph node fluid tube to seal shut. He’s going to give her a call, and one of them will be calling me if the plan changes.

Tonight I’m feeling a bit woozy and having chills – hope I don’t have another infection.

Radiation Oncologist

Monday, April 7th, 2014

Had my initial visit with Dr. F. today. I took my PET/CT results DVD with me, along with my prescriptions list. She spoke about the drain, which will have to be out with the wound healed before we can start treatment. She said that remaining cancer cells could be preventing the area from healing, and radiation might slow the healing process. Average drain output is still 100cc/day, and needs to be 5cc or less.

Our options are to treat it with Rituxan only, radiation only, or a combination of both. She said I am a good candidate for radiation treatment. Dr. K. would probably want to start Rituxan after the radiation. I asked her about my R.A. meds, and she said radiation shouldn’t have any affect on them, so I wouldn’t have to stop taking anything.

The treatment would be for three to three and a half weeks, but I may be able to keep working for the first couple of weeks. She said that after the second week, I may want to take time off, plus the following week or two. My energy level will probably be very low after week two.

After the drain comes out, I’ll need to call to make a follow-up appointment, as well as letting Dr. K. know. In the meantime, Dr. F. will be looking at my treatment history from Dr. K’s office.

Marrow Extraction Results

Wednesday, April 2nd, 2014

I am happy to say the bone marrow sample was negative. The lymphoma has not affected my bones, so I’ll be having radiation therapy with no chemotherapy. Well, except for one medication. Dr. K. said he would probably treat me with Rituxan (rituxamab) again. The dosage is calculated by body surface area (BSA): 375 mg/m2. There are two treatment schedules – one infusion every eight weeks for two years, or four weeks in a row every six months for two years. The PET/CT scan had shown no uptake on the right side.

He wants Dr. Y. to call him this friday while I’m at my appointment so they can discuss my treatment plan. I know I definitely don’t want to stop any of my DMARDs, because Rituxan isn’t enough to keep my R.A. under control. I don’t want to risk another flare-up and end up with even more joint damage, like last time.

Dr. K. also said the radiation oncologist would most likely not start my treatments until the drain was out and the incision healed over. The original incision is doing great – it was sewn up tight with New Skin or something similar, which has since washed away.

So it may be awhile before my treatment starts because the drain shows no sign of stopping. I’m still getting over 100 ml per day. Dr. K. looked at the fluid, which is yellow in color and cloudy, and confirmed it was lymphatic fluid. He said sometimes the spot from where the node was removed needs to be sewn shut instead of left to heal by itself.

Marrow extraction

Tuesday, March 18th, 2014

Since we had another snow day yesterday, we had a four-day weekend. Sandi had to drive me to my bone marrow extraction appointment today with the oncologist. At least I didn’t have to fast for it. No pain medication this time, just some needle jabs to numb the area, which is the left pelvis in the back. I had to take two valium before going in, which only seemed to make me walk a little wobbly.

I didn’t feel a gurgling this time when the marrow was extracted, and it didn’t bother me too much. Now it’s just a matter of waiting for the results.

Two doctor visits

Thursday, March 13th, 2014

We didn’t spend much time at work today. The incision from the biopsy on 21 February was still draining fluid this morning. Dr. K. had actually not received a copy of the biopsy results, which the surgeon had given us a copy of earlier in the week. I hadn’t brought it along because I’d assumed he had it. Fortunately, the surgeon’s office was upstairs and the surgery center was across the parking lot, so the pathology report was available in the system in no time.

All in all, he thinks my prognosis is very good. First, it is a less aggressive form of lymphoma than I had the first time. It is the same type I had in 2009 which was treated with Rituxan only, but a grade 2 instead of grade 1. He said my follicular B-Cell lymphoma could easily be treated with radiation instead of chemotherapy. Also, since the cancerous cells survived chemo, they probably wouldn’t respond to the same medications.

However, if the lymphoma has spread to my bone marrow, then radiation wouldn’t be enough. I would need chemo again, with a different medication cocktail. So the next step is to do another bone marrow extraction and send the sample to the lab.

He also said there were other nodes that were marble-sized, but after radiation, the cancer would be gone from that area, and would never return. So that is good news. I’m hoping I won’t need chemo; I would much rather take three weeks of radiation therapy than six months of chemotherapy.

Next, we went upstairs to see the surgeon and he ended up aspirating the seroma twice. He then made a surgery appointment for me for tomorrow to put in a drain. It’s at 1:30pm, so it will be no breakfast and a very late lunch for me. They’ll be putting me under again, so it’ll be over before I know it. Right now I have bandages over my bandages because a couple of times a small patch of skin came off with them. This procedure will allow the first incision to finally dry and heal normally. I might even get the stitches removed in another week or two.

I sure am looking forward to not having any leakage or wetness most of the time. It was a challenge to get through the day at work – even with jeans and rugby shirts, sometimes a wet spot was visible. Otherwise, it was easy for me to disguise by holding my coat in front of me. One reason to be grateful for a long winter!

Sandi was my chauffeur, of course, and was so kind as to buy us lunch. We each had a half sandwich and a bowl of turkey chili at the café in the medical pavilion. I couldn’t ask for a better caregiver than her, and sometimes feel that I’m just another source of worry and stress for her. Although, probably not as much as others might be.

In (more) stitches

Friday, March 7th, 2014

Sandi called the surgeon for me this morning (her office is more private and not as quiet as mine), and he said to come on in. Once again we left work early, and he put four more real sutures in to hold the other half of the incision together. Needless to say, it’s left me a bit sore, and I’m also missing a couple patches of skin that peeled off with the tape and some point. Hopefully the eight new sutures will do the trick.