FIRST Oncology Appointment

More Paperwork!

So, Mom told me to "Make it upbeat!" I think she's crazy...but I'll try. ;) But really, our day started off kind of funny. After going the wrong way into the cancer center drop-off circle (but in my defense, it wasn't marked well!) and getting a tongue lashing from the parking attendant for going into said exit, we made it safely (is that considered safely?)! We got into the center, took the elevator to the second floor after hearing a nurse mumble something about "if it weren't for the time clock, I wouldn't get any exercise...", and got her registered. Poor Mom. I really hated seeing her sit there giving insurance information and her license for something like this. She should only be "carded" because she looks so young. I didn't get paid to say that. ;) On a side note, apparently The Jackson 5 is the band to listen to when you need to lighten the mood in
registration. I was seriously going to break out into the Thriller dance had it come on the speakers. I would've either gotten a laugh by the eagerly waiting families and patients or a one way ticket to the psych ward across the street. Anyway, after waiting about 5 minutes by the window, watching other poor souls going in the "out" of the circle and probably getting a tongue lashing like we did, Mom was called back. The glass doors opened and she was
weighed, measured, and then taken back to a room. Mom whispered to me, "What if we don't like this place?" (Probably because of the Jackson 5 music we'd just been subjected to.) "We get a second opinion. We see someone else." On the way, we could see people sitting by the windows in their own partitioned areas getting chemo. It was painted with bright colors- bright blue, yellow, purple- very cheerful-looking in an otherwise not-so-cheerful place. Mom of course, lit up the room. She's so gorgeous. Anyway, we get into the room and a plumper version of Karen McCluskey from Desperate Housewives walked in, asked Mom a bunch of medical history questions, and left. A man came in to draw 1.5323434 million vials of blood, left, and took them to dracula...I mean, the lab. Then came in a man. He introduced himself. "I'm Doctor Rrrrrrr(tongue roll)odddd(tongue roll)rrrrr(tongue roll)iguezzzz." Mom looks at him for a brief second and says, "Doctor what?" Ahahaha. Mom. I'm actually shaking my head at this point. "Dr. Rodriguez," he chuckles. (Phew! Good things he's good with ladies with limited filters.) He begins by asking her what she knows about lymphoma. Mom says she doesn't know much about it.

Here's what we learned (the good, the bad, and the ugly) during the course of the conversation:

Lymphoma is a cancer of the white blood cells. The only difference between that and leukemia is that lymphoma is a solid mass, whereas leukemia is kind of a free-floating cancer. Lymphoma can have a wide range of aggression. On one side of the scale, it can be very slow-growing, and people can live their lives with lymphoma and no treatment. On the other side of the scale, it can be very aggressive with months to live. Mom's lymphoma is very aggressive. He said without treatment, she wouldn't last longer than a few months. (Mom said this was the scariest part to her...I think it is to all of us.) BUT...the good news is chemotherapy responds VERY well to quickly replicating cells, and mom's cancer cells are quickly replicating. The quicker the replication, the better the chemo responds. That's why he gave her an 85% chance of remission. Chemotherapy is administered in "cycles". These cycles last exactly 3 weeks. She will have chemo on day 1, and for the next 2 weeks 6 days, her body will recover (while she's taking additional medications for treatment). She's expected to have 6-8 cycles, or approximately 6 months, of treatment. She will lose her hair approximately 10-14 days after her first treatment (soft hats are welcome!!!!!!). Dr. Rodriguez did a physical assessment on her and found another mass in her abdomen that worried him. We shall see with the PET scan. She had her bone marrow aspiration today (poor Mom! I won't even get into that...you might pass out just reading this!), and tomorrow (Wednesday) she'll have a PET scan and echocardiogram. Thursday she will have a double lumen port placed, which can be removed after her treatments have ended (and she's in remission!). The PET scan, along with the bone marrow biopsy, will determine the stage of the cancer. Depending on the stage, she will have chemo, OR chemo and radiation. Stage I (localized) and II (not localized, but on the same side of the diaphragm) mean chemo AND radiation, with less cycles of chemo. Stages III (both sides of the diaphragm) and IV (spread around body) mean only chemo, with more cycles. We're hoping the mass he felt in her abdomen is nothing, because that would mean both sides of the diaphragm. Chemotherapy will begin Monday. She'll receive it Monday and Tuesday, broken up into two days, to prevent lysed (or dead) cancer cells from overwhelming her organs (tumor lysis syndrome). With her chemo, she'll have hair loss, fatigue (meals are welcome!!!!), diarrhea, vomiting, poor appetite (meals are welcome!!!), and above all else, a HIGH risk of infection. PLEASE, if you are visiting or want to visit, if you have even the SLIGHTEST runny nose or tickle in you throat, the best thing to do is pick up the phone and calling, instead of visiting. The best time to visit is at the end of each chemo cycle, so around the third week of the cycle. During her chemo, she'll have PET scans after every 2 cycles (so about every 6 weeks) to evaluate progress. The treatment plan is x amount of cycles (like I said, they are thinking 6-8), and then an extra 2 cycles AFTER NOTHING is seen on the PET scan. The rationale for this is because the PET scan can only detect cancer after it reaches a certain size. Cells can still remain and not show up on the PET scan. Therefore, 2 cycles of chemo AFTER nothing is on the PET scan should knock it totally out, and she'll be cancer-free! As for bone marrow transplants, they will only do bone marrow transplants if her lymphoma returns (which it won't...that sucker can stay far away).

After Dr. Rodriguez obtained a bone marrow biopsy and left, the pharmacist discussed in DETAIL the treatment she'll be receiving (after we all discussed our parking circle snafu...), which will be R-CHOP. I won't get into the details of that, other than it's chemotherapy drugs, combined with prednisone (steroid...NOT an anabolic steroid...she won't be getting some crazy muscles out of this deal!).

What are the things we'll be doing around the house to prevent infection and encourage healing? 

-Shoes off at the door, or wear surgical booties

-We're installing hand sanitizer dispensers at the doors of the house

-Masks and gloves at the doors of the house

-Limiting foot traffic (no more late night raves, Mom and Dad!)

-Exercising at least 30 minutes daily per Dr. Rodriguez

-Flu shots for immediate family

-Mom gets her VERY OWN thermometer! (This might be the only thing she's had of her very own since she's been a mom! Amirite, moms? ;) )

Mom's ready to kick this cancer's butt!

But seriously, thank you for the thoughts and prayers. 

Tentative CELEBRATION PARTY- JULY 2014!!!!!!

Oh, and by the way...after all of this? We went out the "in".