Discomfort

Some of you may have figured out that there is a lot of stuff that gets done to you when you get a suspicion or diagnosis of cancer. The definitive test for determining if you have CLL is a bone marrow biopsy/aspiration. You are given a milligram of Atavan via IV (not nearly enough, IMO), your ass is loaded up with Lidocaine (think tooth extraction numb) and then a well-intentioned specialist attacks your hip bone with a medieval torture instrument. Yes, there is a stinging from the Lidocaine injections. Yes, you feel pressure as the sadist twists the Jamshidi needle (I think of it more as an Arctic deep core sampler…) into your friggin’ hip bone. But what nobody tells you about is the crunching sound that needle makes as it breaks through the hip bone to pick up bone shards and then slurp out marrow. And when that Lidocaine wears off you are damn sore. For a long time. For next time:

1. Repeat the selection of boxers.
2. Repeat the selection of mondo-expandable basketball shorts.
3. Either more Atavan or conscious sedation, please.
4. Ear plugs (although I suspect they will not help).
5. Not a first thing in the morning appointment. I want to pretty much go from the procedure to asleep for the night.
6. Request something for the “discomfort” for the few days post gouging.

Opinions & Fear

Earlier this week I spent a day at Houston’s MD Anderson Hospital, the #1 ranked cancer facility on the planet.  I was getting a complete evaluation from Dr. Michael Keating and his team for a second opinion on my treatment plan.  My oncologist/hematologist had recommended a chemotherapy regimen termed FCR, which is a combination of 2 chemo agents and a monoclonal antibody.  It has shown excellent results in helping folks with the type of leukemia that I have.  But it is still chemo and I wanted to be sure.

Dr. Keating is acknowledged as pretty much the top guy in CLL.  Many of his research findings, such as the FCR regiment implementation, are the basics of modern CLL treatment.  The long and short of it is that Dr. Keating thinks there is absolutely no hurry to start chemo for me.  He’s doing even more specific testing of my blood to confirm that the type of leukemia that I have will benefit from very specific types of immunotherapy and targeted monoclonal antibodies.  And he thinks that the answer is very likely yes.  FCR would work, but it’s like using a nuclear bomb when all you need is one good sniper… So why put the patient through needless discomfort?

And then his comment of “besides, I’ll have this cured in 3-5 years!” was delivered in all seriousness.  The field of cancer research and treatment moves so fast that I now know that relying on just one opinion is not for me.  So I still have cancer, but the specter of chemo has been removed for a bit.

Testing, Testing, Testing

Tomorrow I have another date with Ms. Barium. I get to have another diagnostic imaging soiree’ know as a PET-CT scan. Hopefully, I’ve got enough going on to keep my mind off the fact that I will be friggin’ hungry. The scan is at 1:30pm. No food or drink for 8 hours before. I have an 8:00am appointment with a doctor, a 10:30 with my physical therapist and then the barium chug-fest. I guess the positive side of this is that as long as they are doing the diagnostics, I’m not starting the chemo…