#17 - Positrons are a +

I had an extremely hot date on Wednesday afternoon with a radioactive tracer.  Having been through a PET scan once before, I decided to go it alone.   The process was similar to the first time with some subtle differences.   Scrubs rather than gowns = Plus (+),  hospital rather than Bookmobile style bus = Plus (+),  13 year old Pet scan technician rather than Dude #1 who exuded medical know how = Negative (-). Seriously, it appeared that the Boy Scouts of America may have added the PET Scan merit badge to their list of awards. Apparently I was helping a local 2nd Class scout get his service hours.
I got over it pretty quickly, after all,  what could go wrong?  I had just been injected with a radioisotope which was currently undergoing beta decay, kicking off positrons and in turn, emitting gamma rays to be collected by a machine that by some accounts, turned Han Solo into a brick.  Rumor has it, that it was also operated by a 2nd Class Scout.

The scan went well.  It is amazing how  hard it is to try to hold still for 20 minutes.  Some people freak a little bit over the confined quarters of the PET Scan machine but for me it was keeping my arms above my head for 20 minutes.  I could barely get them back around after it was over.   After the scan, I was turned loose to expose the general public to gamma rays.   A walking dirty bomb on the streets of Houston. 

Angie and I went back to the Hospital early Thursday morning for the results of the scan and for a blood check prior to treatment that same afternoon.  The blood results came back normal, probably better than they have been in a year.  The written interpretation of the PET scan is as follows:

Diagnostic Imaging reviewed personally with attending, agree with radiology impression as follows:
PET/CT 1/23/13: Excellent therapeutic response when compared to the outside PET/CT scan which is suboptimal because there are no fusion images. There is some residual basically eumetabolic abnormality in the territory of the left iliac nodal groups in the left pelvis.

Assessment/Plan: 36 yo man with stage IIB bulky DLBCL, weakly CD30+, tolerating R-CHOP well with excellent response on PET/CT after 3 cycles.
1.                 Lymphoma: proceed with cycle 4 of R-CHOP14
2.                 Neulasta to be administered 24 hours after completion of chemotherapy
3.                 Follow-up: the patient will return weekly for fast track labs. He will follow-up with Dr. Fowler in 2 weeks for consideration prior to cycle 5.

A couple of notes here:

• BSA 2nd Class scouts are awesome!  
• C'mon All Knowing PET Scan Dude #1,  No fusion images?
• I thought I was originally told that each cycle for R-CHOP consists of 2 treatments per cycle = 12 treatments. Apparently I may have been mistaken. It was explained to me that I may only have 2 more treatments followed by Radiation. (keeping excitement in check as this was not my normal Doc)

The verbal assessment as it was delivered to me was that all the small stuff is gone, and that the large mass had reduced by half the original size and had minimal metabolic activity. It really was quite a contrast to the first images. I will post the two here if I can get my hands on them.

I was expecting good results based a few anecdotal things I had noticed but it felt great to see the weight lifted off of Angie's shoulders in those few seconds.  I knew this was a big checkpoint for us both, but didn't realize what it meant to her.  Watching her face as we were given the results was a great moment & a great blessing. The good news was also some much needed re-assurance for our older kids.

Non Lymph Related  (kinda)

I have spent a good portion of the recovery weekend watching the Winter X Games and some college hoops.  The X-Games made me a little home sick for the snowboard and friends, but it has also left me a bit inspired.  They have been advertising the "Go Pro" camera quite a bit. They are pretty amazing devices which can capture some amazing pictures at altitude and are super durable. You can mount them anywhere, and can take video of just about whatever you get into. I am pretty good at justyfying purchases, and decided I should probably purchase one.  I don't think anyone can argue the following points.

• No better way to induce motion sickness with your family and friends than video playback of extreme sports.
•  I can capture all the extreme sports that we (my family) participate in while living in the Houston suburbs of Katy Texas.  

Highlights of my extreme weekend!

 

# 16. Hypothesis Confirmed

Statements about backsides and not having danced the song were made prior to her reading the experiment.


booooooooooooyeahhh Woooooot! Lol

#15 3rd time is not quite a charm

I ditched Angie for my pre-treatment blood draw and check up with the doctor on the 7th.  My blood levels, hadn't bounced back quite as fast on my own so we made a plan to do what every other world class athlete does to stay on top,,,, blood dope.  I am back on the Nuelasta train, however, I was able to swing it as a prescription so Angie could give it to me at home rather than making a trip back to MDA 24 hours later.   I also made a few other executive decisions (after getting written pre-approval and public notary from Angie) and that was to move to a two week cycle rather than three.
It seemed like after the first couple of rounds, I was in a holding pattern for a couple of weeks and wasting a ton of time.  There was a serious sense of urgency to take care of business but couldn't do much but wait.  I would compare it to the sense of urgency that might come after downing 44oz of diet coke and being trapped in the back of a school bus.  Anyhow,,,, I was informed that I was possibly the first patient (for my doc) to ask for an increase in  frequency but that there was no reason not to go ahead and bump it up.  We all agreed, and I left the hospital excited to be cutting 2 months off the back end of chemo.

The treatment on the 10th went smoothly,  no port issues, no temp swings, and a decent chicken salad sandwich to boot.  We ended up in a bigger room and all was well in chemoland.  I returned home and promptly went downhill.  I was pretty sick into Saturday afternoon.  I didn't lose my lunch, but maybe it would have been better if I had.  I was tired of not really feeling alive so  I decided to take Trent's advice and get some exercise.  I walked out the front door and walked about a block before I decided to try to run a little.  I ended up running a mile and a half,  walking a half, and running a mile back to the house (I credit blood doping)  It seemed to work,  I have been good since Saturday after the run.    I followed up with another slow, tedious, and painful 3 miles on Monday.

Pet Scan to determine effectiveness of treatments next Wednesday.
If we see progress, treatment on Thursday.

So that's it,,

Time for an unrelated experiment:
Hypothesis:  Upon viewing the video below,  my wife will request that I remove said video from this blog.
 I would like to determine if the request will be based on one or more of the following claims.

• Extensive video was taken of her backside
• "That was my first time on that song"  (this alone merits additional studies)
• The house was a mess 

I can't tell for sure what is going on but it would appear that two individuals are trying to take flight while Gracie is throwing hay makers.

Three of my favorites having a good time!

#14 Tumoriffic!

Quite a bit has happened since my last post.  Angie and I went back to MDA on December 20th for round two.  The infusion center at MDA moved to their brand new, and much less roomy location on the second floor of the hospital.  They had been using a section of the hospital that was designed for inpatient care and the rooms were pretty roomy and had their own restroom.  The new area is an outpatient care area and the rooms are roughly 10X6 without a restroom.  During the first treatment I probably made my way to the facilities ~10X.  I was dreading making the walk down the hall every 30 minutes or so.

We got situated in the room and waited for our nurse to pop in.  She stopped by with her small cart of needles and tubing and we got down to business. I was wondering if we could take video in the hospital and I asked specifically if we could video her accessing my port.  I thought it was pretty cool the first time around and thought it might be cool to post it here.  It wasn't too big of a deal for me, but looking back, I'm sure that it added some pressure on the nurse.  She prepped the needle and tubing and gave me the same instructions to count to three and on three, take a deep breath and hold it.  I dont know what the deal was but she counted 1,2,3, and stuck me before I knew what was going on.  More medical humor that I wasn't picking up on?  Anyhow, the nurse went to draw blood to check the line and wasn't getting anything.  She proceeded to fish around with the needle and she still wasn't getting anything.  After attempt #3,  Angie started shaking her head and I started getting nervous.  I'm sure the nurse was feeling the same if not more so.  I would guess that she was afraid of becoming a Youtube star.  After try #4, we hit pay dirt.  Come to find out, my port is a bit tilted.  I couldn't give you a specific reason for the tilt, but I would guess that it has something to do with my massive pecs.  Just sayin,

The treatment itself went like clockwork.  I didn't have any reactions to the medication, and thus, didn't have any massive doses of Benadryl or hot flashes.  I believe the treatment lasted about 5.5 hours. As an added bonus,  I didn't have to make a dozen trips to the restroom.  I believe that this might actually be anecdotal evidence that the mass may be on the retreat.  I haven't had near the pressure on my bladder as of late.  My brother Trent mentioned that his Hodgkins mass made a significant reduction after his first treatment.  I hope mine did the same.  I guess we will find out in a few weeks after my next PET scan.

All in all,  I left the hospital feeling about as good as when I had arrived.  I was able to drive myself home and didn't start feeling poorly until 3 or 4 hours later. My blood test prior to the treatment indicated that my levels were close to normal.  The doc decided not to order a Nuelasta shot this round to see how I would bounce back on my own.  The shot is usually given 24 hours after chemo to boost blood cell production.  I don't know if it was the lack of the shot, or if it was evidence of the accumulative fatigue, but It took me a few days to feel normal.  I ended up getting sick late Friday and didn't really feel well until Sunday afternoon.


Other non-medical items
We spent Christmas eve, and Christmas day at the Great Wolf Lodge in Grapevine TX.  I haven't ever spent Christmas away from home, (still not sure what to think of it) but I was the odd man out and we made the trip up.  The lodge itself has a massive indoor waterpark and we had a great time with our friends.  It actually helped us stretch the Christmas magic out a little longer.  Check it out,  


Next up:

• 1/7 - Blood work
• 1/10 - Round 3  (only 9 more to go)