So far so good

"So far so good"-- that's what I've been telling people that have been checking up on me since my first chemo treatment. I've had minimal side effects (thank goodness!) other than some slight nausea and fatigue but I have been taking my meds to minimize the effects. The biggest issue I've had to date have been hiccups. And they're not just little itty bitty hiccups- they're quite strong and make quite an impact. They've been coming at nighttime which has been rather annoying as its a little hard to fall asleep at night. Then again I've been going to sleep late every night because the prednisone drug which causes my increased appetite also causes sleeplessness. So hiccups+ sleeplessness = double whammy! But hey- I'll take that any day over nausea and fatigue.

I'm still going on my daily morning walks around the lagoon. I look forward to it every day as not only it gets me my daily exercise in but it also gives me time to unwind and not think about too many things. I allow myself to really enjoy the nature of my surroundings- enjoy the calm water of the lagoon, the ducks laying out on the grass by the shoreline and the ibises wading in search of food. I meet a lot of other walkers and joggers along the trail and I think I'm starting to recognize some of them now as I'm sure they probably recognize me too. All in all, it's a great start to my day after dropping the kids off at school.

The rest of the day I'm checking emails, cleaning the house, doing laundry, and running errands. Hmm...maybe I can get a side job as a house cleaner? I've also had visits from friends who stop by and we go grab a bite to eat or just hang out. It's been great seeing all the support I've received from my friends and family. I know I've had a lot to be angry about lately but I've moved past that now and am now just focusing on what I have to be thankful for: my family, my friends, my (relative) health and my (somewhat) youthful age. Though I'm in stage four, my health and age are all positive factors that should aid in putting the Lymphoma into remission. Cancer is a wake up call. It's a wake up call about one's own mortality. We all assume that we'll get to watch our kids grow older, take them camping, teach them to ride a bike and how to drive, put them through college, marry them off and then enjoy being with grandkids but this disease reminds me that life is precious and that we just can't take things for granted. I want to outlive this disease so that I can be their for my kids and watch them grow and enjoy all the wonderful things that is so great about being a parent (but maybe perhaps not just the temper tantrums).

It's Day 5 today and still so far so good. We're in Cancun at the moment. Just got in yesterday. All my doctors say it would be good for me to go on this mini vacation and relax. I'm going to enjoy the next few days sitting by poolside. No alcohol in my body (and probably not so for a loooong time if ever) but a small price to pay for my health. I'll be good with some Spinach and celery juice and a fresh bowl of fruit.

Day One Done!

Here I am getting the first drug of my R-CHOP
treatment. I was in this recliner chair the entire day.

So I just completed the first chemotherapy session today. Obviously I was anxious leading up to it; my blood pressure level was 143/91- the highest it has been in two weeks now since I registered in at 178/102 when I went to see my primary physician about my indigestion four weeks ago. I have since been averaging 121/76 which is for the just above the 120 average for normal blood pressure. Even the morning of before heading to the hospital, it was 134/82 when usually it's in the 112s. However, it did go down throughout the day as I got more comfortable going through the chemo treatment and I just measured it just now and it was the lowest it's ever been- 106/62. This was a direct result of my complete change of diet and cutting out salt/sodium and fat and any type of processed food from my diet. I weighed in at 148lbs- 23 lbs less than I was four weeks prior. My friends used to laugh at me for my stomach, my ponch, my beer gut...it's all gone now and flat as I-5 freeway! I can share with you my strict if anyone is interested in losing weight-- the healthy way.

Anyways, back to my first day of chemo. It went better than I thought and I'm relieved the first cycle is now over. I was there for a total of 8.5 hours. We checked in at 830am and left just about at 5pm. It could have been sooner but we had a slight hiccup. My nurse accidentally disconnected my ratuxin drug- the last of the IV drugs I was going to take. The reason was that I had an allergic reaction to the ratuxin (a normal reaction) an hour into the IV drip and started getting chills throughout my body and lower back pain. This is because the ratuxin starts breaking up the cancer cells right away and because of the breakdown, it releases potassium and other things that cause stress on the body. So, they stopped the IV and gave me some pain medication (aderall) and a cortisone steroid shot. The aderall hit me almost immediately and I started getting extremely woozy. Luckily Aylang had just gotten back from picking me up my lunch so I scoffed the veggie sandwich down before I passed out. Unfortunately, when we were ready to being the ratuxin drip again, for some reason, she disconnected the IV tube thinking it was the saline bag (they all look the same- clear plastic bag).

So essentially, for the next 1.5 hours, I was getting nothing into my system because the ratuxin was just dripping onto the floor! No wonder I couldn't feel any of the effects! It wasn't until she asked me if I wanted to take a walk around the floor to get some exercise in did we notice the drip on the floor. When she realized it was the ratuxin on the floor, she freaked out and obviously, I freaked out even more! She's been nursing 20 years and this happened during my first chemo treatment?!! She estimated I probably lost about 150cc during the 1.5 hours, so she said she would call the pharmacy to see if she should give me another bag to make up for the lost liquid. Of course, I was very worried whether she estimated the right amount that was lost-- I didn't want to OD on anything! She came back a few minutes later and said that she needed to talk to the oncologist to get his thoughts as he would need to make the decision. However, in talking to another nurse, she estimated that the lost ratuxin was more around 50cc as she had given me a smaller drip dosage due to my allergic reaction, to which my oncologist said it wasn't a big deal to lose that much. Even though it still worried me to not get the prescribed dosage, she reassured me that I had more than enough chemo injected into my system for a day so I guess I'll just have to trust my oncologist's judgment on that. So yeah...other than that slight hiccup, it went better than I thought. Truthfully, I thought it would be a lot more painful and I'd be really woozy after the treatment. Mind you, I was woozy but it wasn't that bad.

I'm on the R-CHOP (each letter stands for a different drug) regimen- a standard treatment plan for treating lymphoma. I'm told the first session is always the longest as they have to administer the drugs slowly into my body and then see how my body reacts, and ramp it from there. Subsequent sessions should be about half the time I spent today. I'm just glad the first and toughest hurdle is over. I feel pretty good at the moment but the Prednisone I took causes sleeplessness and increased appetite so here I am still up at 12am...  At least the reassuring thing is that I will have an appetite. The one scary thing about chemo for me was possible lost of appetite as you see other cancer patients rail thin from the chemo treatment but most likely for me, I'll be gaining weight which is a great thing because if I'm eating, then I'll have the strength to get through this journey. The other scary thing as possible side effects are nausea (but I have medication for that) and fatigue but so far so good. So, anyone up for a midnight snack run?

The day before

So I've never been one to write a blog or put my thoughts and feelings onto paper or online media but I thought this would be a good time to start so that one day I can look back on this and never forget the journey that I'm about to begin...

It all started back in late July when I started getting indigestion. I was experiencing bloating and discomfort  and had difficulty breathing  after every meal and had a feeling of fullness despite only having eaten only half of my dinner. I also had this metallic, almost ammonia like taste in my mouth. I was also going to the bathroom 4-5 times a day which was very unusual. I knew something was wrong after three days of these symptoms and it wasn't getting any better. I decided to email my doctor and let her know what was going on. She called me the next day which was Friday, July 24 and asked me to get some blood work done to see what was going on. I did the blood test later on that day and got the results the following day. The readings were all normal for the most part except for my creatinine level which had something to do with my kidneys. I got really worried as the number was extremely high relative to where it was 7 months ago and a year before that too. However, as it was a Saturday, I had to wait until Monday to talk to my doctor about it.

I went to see her Monday afternoon and after she looked at my results, she said she needed to call another doctor. I was already worried but became even more worried after she said that. She came back and said I needed to go see a kidney specialist right away. I met with the kidney doctor that same day and he informed me that based on my readings, it appears that I had less than 15% functioning left in my kidneys. He then started talking to me about dialysis and possibly a kidney transplant. Mind you, this was a lot to take in all at once! My immediate reaction was...my god, am I going to die? My first question to him was "is this fatal doc?" to which he answered no (thankfully). He said that plenty of people live quite normal lives on dialysis and if I'm a candidate for a kidney transplant, the success rate is more than 95%. So, at least we had some good news! He then said we don't really know what's going on in there to really make a prognosis so he ordered me an ultra sound and a CT scan. I got the ultra sound the next day which revealed the kidney had swollen up but they had no idea what had made it swell up. The CT scan that Thursday revealed that there was blockage in my ureter which was why the kidney was swelled. However, they also found a "blob" growing in my abdominal area which they had no idea what it was but surmised that it was the reason for the blockage of my kidney. BTW- I say "kidney" and not "kidneys" because the CT scan revealed that I only had one good functioning kidney and that the other kidney had been blocked and ceased to stop working "ages ago". (One can perfectly live a normal life with just one kidney). They decided that I needed a nephrostomy procedure to remove the swelling and would take a biopsy of the blob. So, now the flood of emotions all come back. What was this blob that was in my stomach area? Was it an infection? Was it a tumor? Or was it something else? I just hoped it wasn't anything serious.

On Friday, July 31- that same week after I went to see my primary doctor- I had the nephrostomy procedure to reduce the swelling in my left kidney. They stuck a catheter into my kidney which led to a tube and a bag so that the urine and toxins would be let out. The tube and bag is something that I'll have to live with at least for the next few months so that my remaining kidney could heal some and they would reassess later if it was healthy enough to not need dialysis. All in all, the procedure went fine. The only scary part was having an IV tube stuck into my veins as I had never had one before. They had to give me a drug to calm my nerves! (I hate needles!). They took a biopsy of the blob and said I wouldn't get the results until Tuesday. Obviously, I was anxious to learn the results but I tried not to dwell on it too much over the weekend. I was in severe pain from the procedure so tried to concentrate on getting better and adjusting to my new contraption that was hooked to my kidney.

On Tuesday evening at 5pm, I get an email from my kidney doctor and it said that the test results came back and the diagnosis was follicular lymphoma (grade A). I didn't know what lymphoma was so had to look it up. It said it was a blood cancer. Cancer??? You mean I have cancer and this is how you inform me about it...over email?!! Obviously, I was shocked and the flood of emotions that I felt just a week ago all came back. I replied to my kidney doctor and asked him what it meant. He called me a few minutes later saying that someone would be in contact with me soon to set up an appointment with an oncologist. I started to ask him a flood of questions about the lymphoma to which he replied that he couldn't answer them because it wasn't his area of expertise. This was incredible...I was just informed over email that I had cancer and there was no one I could talk to about it until I saw an oncologist. My first initial reaction was one of disbelief; the second was "why me?" I had heard of other people getting various types of cancer and there's an over alarming statistic of how many people get diagnosed with cancer each year but never in a million years did I think that I would be one of those statistics. Let me tell you, the 6 days of waiting until my oncologist appointment the following week was surreal. I had to break the news to my wife, my family and a few close friends; I went through all  the range of emotions one can go through given this type of news: I cried several times (yes, I'll admit it that I cried) as I didn't know what stage of cancer I was in and what the success rate of beating it would be; I had anxiety as to what this meant for myself and my family, what my quality of life would be from now on, and just in general, anxiety over not knowing what the next steps were.

I met with the oncologist on Monday, August 10 and he confirmed that I had lymphoma but the PET scan revealed that it was only mainly in my abdominal area and the tumor was the reason why my kidneys were blocked. But he wanted me to get a bone marrow biopsy to see if the lymphoma was also in the bone marrow as this would determine the stage of cancer I was in. He said that because of my age and my health, his expectation was that the chemotherapy treatment would be effective so he was talking more about and preparing me to understand that this disease is a chronic disease and that there is no cure of it and that even though we may be able to get it into remission, at some point, it would come back. It was a lot to take in obviously, but I found comfort in his words to know that his expectation was that the treatment would be effective. We did the bone marrow biopsy later on that week and this past Monday, August 17, I was diagnosed with stage 4 follicular lymphoma. They had found traces in my bone marrow hence the stage 4. But all that really means is that the cancer was in one main area of the body and they found traces in other parts of the body. Luckily, with lymphoma, the treatment is the same no matter what stage of cancer it is in. Despite the news to be not what I wanted to hear, the meeting with my oncologist was in a way, a little relieving. We now knew the full picture: what stage I was in, and what the treatment plan was. He put me on the R-CHOP chemo treatment plan, a pretty standard plan for non-hodgkins lymphoma. My treatment was to begin on Friday, August 21.

In the days since the diagnosis and waiting for my treatment to begin, I've been able to connect with a lot of people who had cancer, or know of people who have the same disease as me. I've started telling more people as the opportunities arise (I just felt a bit weird calling up my friends and telling them I have cancer so in the beginning, I kept it only to a small circle and only told other people if the opportunity arose). It's been very comforting talking to my friends and sharing the news with them. While everyone has been shocked, everyone has been so supportive and it's so encouraging to see how many people care about me- whether it be my family, friends, friends' extended family, work colleagues or just people with similar diagnoses. I went to a cancer support group this past week and met a lot of really good people who are going through or have gone through the journey that I'm about to go on. They gave me a lot of great insights of what to expect come chemo treatment and I feel more prepared for it more than ever. I will continue to go to this support group as I know it will benefit me a lot.

I am grateful for the friendships I have with everyone and I know that I can count on them as I start my journey. My dad's friend who was diagnosed with the same lymphoma that I have 17 years ago and is still cancer free gave me some really good advice which I will try to follow. He told me that this is the time to be selfish, to focus on myself and to rely on others who are there to support me. So, to those who have offered their help, I am probably going to take you up on your offers at some point- whether it's to take me to my appointments, going on my daily routine walks (I live right by a lagoon and it's a very scenic 30-40 minute walk), bringing me food (I am going to gain weight contrary to what people think of chemo as one of the drugs will give me an appetite), helping to watch the kids, or just making sure that I stay positive throughout my treatment. I really appreciate all the support and the care as I start on this new challenge in my life.