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Rituxan # 4

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Rituxan # 4

          On Wednesday, 11-28-01, the physical therapist came by again and we reviewed the exercises she taught me on her first two visits and said I was making very good progress.

          She made her last visit on Friday, 11-30-01, we went through the exercises and she bid me goodbye and good luck.

          Sometime in the middle of the week, my IBM 75GXP 40 gig hard drive took a dump.  When I bought it, the reviews all indicated that this was THE hard drive for geeks to have, mostly because of it's speed and reliability.  The reliability factor was based on other drives in the series before it that actually were.

          To make a long story short, I had to do a lot of re-arranging to get my computer running again.  I had to re-install the operating system and all my essential programs for making art and working with this site and all that stuff.  Luckily, I do a lot of backups of my hard drive stuff (and you should too!!)

          My daughter, Casey, spent the weekend with me and we went to see the movie Harry Potter.  Mom took us again and we also took my niece Ashley and my great-nephew Steven.  We all had a great time and enjoyed the movie very much, though it was pretty long.

          I don't consider games 'essential' programs, so they didn't get loaded up, which disappointed Casey a little.  She's a geek's daughter who grew up with a keyboard and monitor in front of her, so she dug in to fix the problem herself.

          While going through my CD's, Casey came across a lot of computer games.  She saw one she hadn't seen before and asked about it.  We loaded up Max Payne for her to try and she fell in love with it, being an old Quake hand.  After a few false starts because of some minor monitor resolution problems, she was downing bad guys with the best of them.  I had a lot of fun watching and since I'd already finished the game, I was able to help with a few of the puzzles she had trouble with.  As always, we had a lot of fun together.

          George Harrison died of cancer, which was sad for me, particularly now that I have lymphoma.  His battles with cancer were much different though, being that they were throat, lung and brain cancers.   Casey and I watched a tribute to him on VH-1.

          On Monday, 12-3-01, I went back to the Cancer Treatment Center and got my 4th Rituxan treatment.  It was my final treatment in this series.  I was out in the lounge area with everyone else again, and got a little nap in the recliner while it dripped in through the IV.  Again, I had no ill side effects and everything went fine.

          Before the treatment, I had my blood drawn as always and then saw my Oncologist.  I had several questions for him again, and his answers explained to me that the tumor causing all this is in one of my 600 or so lymph nodes.  Which one is the question that can't be answered.  Also the sub category of my particular lymphoma makes it a "Nodal Marginal Zone B-Cell Lymphoma."

          Here's the official explanation on the surgical pathology report from the biopsies on the lymph nodes they took out while I was in St. Joseph's Hospital:


          "This biopsy is characterized by a lymphoplasmacytic proliferation with open sinuses.  The lymphocytes have a nodular orientation, and appear to colonize germinal centers.  The plasma cells are predominantly located within the sinuses with scattered binucleated cytometric findings revealing a CD-5 negative, B-Cell, light-chain restricted population.  This lymphoma is best classified as a nodal margin zone lymphoma.  Given the numerous plasma cells, an M-protein may be present.  Correlation with serum protein electrophoresis may be helpful to monitor the disease."

          Clear as mud, right?!  My new job as cancer patient is to decipher that stuff over the next few weeks, get a bead on what it all means, and get my questions about it ready for the next visit to my Oncologist.  Actually, I've already covered most of it over the last few weeks, so there's not much there that's new to me.

          The doc examined me then and went over my blood work with me.  He said that some of the nodes still appear to be somewhat swollen, but that he was happy to see my lower extremities were getting back to their normal size.  

          He noted that I'd lost 20 pounds over the past 2 weeks since I last saw him and asked if I'd been eating.  I reported that I eat meals, snacks and everything else I can get my hands on lately, so he figures it's the fluid coming off my legs, ankles and feet.  Losing that weight has me lighter than I've been in years, taking me below 180 lbs.

          The blood work showed increasing good signs again, and I finally have some numbers back in the 'normal' range.  Specifically, my blood platelet count.  Others are on the rise, and it's looking good on that front.

          Over the last few weeks I've had opportunity to read a lot and talk with other patients and caregivers about the disease and treatments.  There are a lot of opinions out there because it's a disease that cannot be cured, only treated to the point of remission.  That's the best we can hope for, and getting there is not an exact science because everyone's cancer seems to have a will and a stamina all it's own.  What works for someone else may not work for me and vice-versa.

          Still, all that info raised several questions in my mind, specifically about the doc's intention to continue the fight with a series of chemotherapy treatments next.  I asked the doc why he felt we should go with chemo next when I'd heard that some patients are doing 8 Rituxan treatments instead of 4, and it seems to be working for them.  He explained to me that the data on 8 treatments is not all in yet and that because my cancer is already quite advanced, he felt it prudent to go with the chemo next.  At my questioning, he explained that the series will consist of what is known as C.O.P., which stands for the drugs that will be used:
          Cytoxan, a.k.a.: Cyclophosphamide, Oncovin and Prednisone.

          The Cytoxan and Oncovin recipe will be dripped in by IV and the Prednisone is a pill I'll take.  This series of treatments will last 4 - 6 cycles, a cycle being: I get the treatment of all three on day 1, then take the Prednisone for 4 more days.  3 weeks after the 3 drug treatment, on day 22, I start all over again.  So that's a total of 12 - 18 weeks of treatments.  I start about 3 weeks from now, on 12-27-01, so it will go on till between the end of February and the middle of April. 

          He reminded me that it might make me sick and my hair might fall out.  I smiled and told him, "Luckily, I'm a 'HAT GUY' anyway!"  As for the sickness, at least I know it's coming this time.  I can't imagine I'll feel any worse than I did in Knoxville while I was dieing,  just before I was diagnosed, so I'll get through it OK.

          I told him about the numbness I've been feeling in the thumb and forefinger of my left had.  He examined the area and suspects that I have a pinched nerve somewhere in that arm, so I'll pay close attention to what I'm doing to see if it's being caused by the way I position it or rest it on things and get back to him on it.

          So far, so good, I reckon...  I feel pretty good, swelling is still going down and my ankles and feet look almost normal again, though they're still kinda sore, along with my legs.  The exercising is getting easier though, so I can tell they keep getting stronger.  Getting up and down stairs isn't as much of a chore as it was either, which feels great!
                                             The force is with me! 

          Next:  Phantom Menace