Nailing It Down - the testing phase

When your doctor suspects cancer is at play, wrecking havoc in your body, there's a lot of uncertainty. One thing you can know for certain, though, is that you're in for a lot of tests. And enough blood draws to make you fret for your iron levels. You have to brace yourself, mentally, and decide that this isn't something being done TO you, but something you are actively engaged in to help YOU and your medical team get to the bottom of things. Bone up on what the tests are, what they're for, and what to expect. Ask questions. 

(Get yourself a little notebook immediately and start taking notes. Write down questions that hit you in the middle of the night. Write down details you come across in your own research that you'd like to bring up with your doctor. Write down what your doctor tells you. You may understand everything you read and all that's said in a meeting, but when you have two or three meetings in a day, plus errands, meals, research, and helping the kids with their school work, the information bleeds together and you'll find yourself at dinner assigning surgical plans to the radiologist and wondering why you forgot to ask about the port placement while you were at the phlebotomist. Not helpful. Even the sharpest minds need notes. This is not a sign of weakness. It's a signal of sanity. Spool up now.) 

Also, get a couple of books you can read while you wait in lobbies and visiting rooms. Take a water bottle and drink, drink, drink. (Unless a test requires you not to, obviously.)

My regular doc (sports med guy - absolutely awesome, and generally unflappable) jumped through flaming hoops to not use the word cancer. I'm sure he was concerned I'd whip out a bucket of chicken, start crying and eating, and he'd never get me out of that room. (I wouldn't have, but he may have previous experiences that made him leery.) So he sent me to a surgeon to find out for sure before breaking out the ugly words.

The surgeon wanted images. Ultrasound of the cervical (neck) lymph nodes, and hey, while you're there, let's do the axillary nodes, too. And a mammogram. And a full blood work up. You're not pregnant, are you? OK, good. 

Then biopsies. My surgeon opted not to do a punch biopsy because he said the results that come back from the lab are invariably, "Yes, it's lymphatic tissue. We can't tell anything more and need a larger sample." So we went straight for an excisional biopsy (where they remove a piece of tissue - in my case, a cluster of lymph nodes) so they can slice and stain and poke and prod to their heart's content without having to knock me out or poke me more than absolutely necessary. If they're doing it on the cervical nodes, expect to be put under for that.

And then, the scans start. PET scan. CT scan. MRI. These scans can show a visual representation of where the cancer is in your body. It gives you a better idea of how widespread it is, and what you're up against. Aside from the Redi-Cat liquid prep you'll need to drink (it tastes vaguely like disdain, and metallic faux chocolate), these are minimally invasive and mostly boring. The IV MRI contrast will make you feel like you may have just urinated on the table - you didn't (in case they don't warn you about that - the tech I had said that even though he warns people, most of them check reflexively anyway.) If you're claustrophobic, ask about OpenMRI. 

If you have an aversion to needles, consider taking up meditation. I'm sorry I don't have better advice on that front. (My inner child sits there with me, remembering the days when it took the doctor, two nurses, the receptionist, and my own mother to hold me down just to give me a shot. She thinks I've become a complacent wimp. But the nurses I've had during this procedure, had they known of my violent youthful tendencies, would have been quite proud of me. I bought myself a milkshake for being so brave. There are perks, even if you have to make them yourself.)

If you're very lucky (OK, not really, but if you need it and you can have it, then that is sort of lucky), you'll also have a bone marrow biopsy and a spinal tap, to check for involvement in your bone marrow and Central Nervous System. I'm fairly stout-hearted, for the most part, but reading about the bone marrow biopsy made me a bit queasy. When my oncologist offered to put me out for that one, I jumped on it and considered getting a kitten to name in her honor (we're well past child-bearing, or I'd have offered to name the next one after her). Some people go through it without general anesthesia and they are fine. To be honest, the after effects were significantly less traumatic than I'd expected, and it probably would have been fine to do it awake, but I'd hit my wall at this point and needed to *not* have to face something with a stiff upper lip for a moment. So, that was nice. The spinal tap is done while you're awake. I had a magnificent doctor do that. We had a good chat. He let me watch him work. He's most definitely in my top ten favorite doctors, and the spinal tap is probably in the top five Lease Offensive Procedures I've experienced. Your experience may vary, but if you can go into these tests with an attitude of cooperation and a sense that you are on a mission, this helps. These tests, if they're ordered, are helpful tools to give you a clearer view of the path ahead.

There may be other tests, but these are all I had done.

The blood draws are frequent and copious. God bless the inventor of the Vacutainer blood collection system. One stick, all the vials you need can be filled, and you're done. Granted, by the time you're done with this whole process, that's still a lot of sticks, but it's significantly fewer than it could have been. There will forever be a place in your heart for those who can do a painless blood draw.

All of this happens very quickly. It can feel overwhelming. It's OK to take a step back from all your researching and spooling up from time to time. The information will be there after a nap, or a coffee break with a friend. Just be sure to come back. 

Be encouraged,

~Dy

At Least Now I Know Why!

The last time I blogged, all I could say was that I was overwhelmed. And I was. I'd adjusted everything I could adjust (eating really well, staying hydrated, working out four days a week, reading great books), and from November to January, I felt like I was maybe keeping up. Then... I just wasn't. I wasn't sick. I wasn't depressed. I was just overwhelmed and tired. My runs dropped from 3 miles and working on best time (which, in itself, is amazing, because even at my most active in my youth, I couldn't run a mile) to sucking it up go get 2 miles under my belt. I went from making mad progress on my weights to topping out at some embarrassingly low upper body numbers. What was wrong?

"Eh," I thought, "I've got five kids and too much to do. I'm still only marginally qualified for what I *am* doing, and let's be honest, I don't get enough sleep. That's probably it."

So we built a wall in our living room. I've got to tell you, that was kind of awesome. And we have a pocket door in the hallway, now, so we can stay up and watch movies without the children languishing in bed to the soundtrack of all the Fun they aren't having because we sent them to bed so we can party. (That's not really how it plays out, but that's how it feels when you're seven and you just KNOW Mom and Dad are watching the really good shows and eating the good ice cream without you.) Loving that pocket door. And the good ice cream. And although I still wasn't feeling 100%, I sucked it up enough to enjoy a really great visit with Z's Aunts, and get most of the new spaces painted before one afternoon when my lymph nodes swelled up like grapefruit and I just had to stop moving.

That's when we figured it out.

Why the long lead in? Because saying "cancer" sucks all the oxygen out of the room. And that's what it was. Is. Turned out to be. Whatever. Time is a bit fluid. Cancer.

Fortunately, I have a very lethargic cancer. It's slow-moving and not very aggressive. We call it Slacker Cancer (the doctors call it Follicular Non-Hodgkin Lymphoma). That was the good news. The bad news was that it's absolutely everywhere. It's in all the lymph node clusters, in my bone marrow, and there are bulky bits in my chest, lungs, and abdomen. There are masses pressing on my arteries and colon.

More good news: it's not in my brain. (By the time we got that bit, it was the first good news I'd had in months, so I'm particularly attached to that one.)

How did it get everywhere? Because I put things off, discount when I don't feel well, compartmentalize anything that falls outside the parameters I can function in. I'd tweak my diet, double down on hydration, do better about getting rest (at least for a bit - I'm terrible about going to bed at a decent time). And I'd feel better. It was only in the last year or so that I haven't been able to squeeze the processes to get maximum output anymore. So, don't do that. I mean, obviously, if you can tweak your behaviors to put you in a healthier, stronger position, PLEASE DO - we credit at least some of how well therapy is going with the kick ass condition of the rest of my body going into this - BUT don't discount that something may have gone awry within your body. If you're not feeling well, talk to someone. Get checked. Have an accountability team. Make sure your doctor is a part of your team. Ask questions and educate yourself. Seriously, be your own advocate and go get yourself the kind of care you work so hard to provide for the people you love.

I'm halfway through a six-month chemotherapy plan. (Third round coming up, anyway.) It's going very well - at least from a side effect standpoint. I haven't had more scans done, so for all I know, I'm taking bags of saline every week and we're not even touching the cancer. (Not really. I trust that we're knocking it out. But we won't know until we re-check and see what's what at the end of that.) There may be radiation, or we could be done. We don't know. My doc was thinking we'd wait and watch it for a year or two, based on how healthy I am in all other respects, and was downright shocked when we got the scans done and saw how widespread it is. We've got to be flexible and ready for whatever comes. Of course, we're all pulling for that to be the end of it.

Interestingly, it turns out there is no "cure". You're never done with this stuff. It will come back, and the focal point of all treatment is "when" - how long can we beat it back. So, yeah, that'll be fun. Also? A good oncologist is worth several healthy kidneys on the black market. Find one who will be your partner and your MVP on your cancer-kicking team. Seriously. I pray you never need to take that advice, but if you do, you'll thank me.

I hesitated to blog about this. It's awkward enough having to tell people in real life. To be honest, it feels awkward seeing how very much the people in our lives love us (it's a GOOD problem to have - I'm not complaining, but I am significantly uncomfortable being on the receiving end of help - and thankful to be in a position that I know that, now). I didn't want it to take over this blog that's supposed to be about our adventures (the ones we wanted to have!) But when I first received my diagnosis, I looked for blogs about this. The first three I found ended with a final post about funeral services for the author. Gah! No! What? (*escape-escape-escape!*) This is not my plan! (*click-search-click*) Who else has blogged about this? (*clickety, click, click*) WHY HAVEN'T MORE PEOPLE BLOGGED ABOUT THIS? I did find a couple of blogs that were very helpful. There's that isolated period where you have your diagnosis but you're not ready to talk about it (don't even know quite what to say, or what there is to learn about it), and yet, you want to connect with someone - anyone - who has been there. Something to help take away the Unknown Factor from some of it. So I will blog and pay it forward. The next few posts will be repeat information for anyone who also knows me on Facebook and is in the group we set up, but hopefully they'll be encouraging for anyone who finds themselves waiting for a call on a biopsy at some point...

Be encouraged,
~Dy