The Anticipated Staging Results are Here!

Today was a big and eventful day! I got the results of all the numerous tests I had been doing all along. I am sure you will recall how anxious I have been to know how far the cancer had spread. Thank God! its Stage I - II and referred to as early stage lymphoma! Its funny that on receiving the news, I felt ambivalent. Just that state of having simultaneous, and unexplainable conflicting feelings. Suddenly, after learning the stage of my cancer I did not feel that excitement one would expect given I am a Stage II not a Stage IV - I know it could have been worse.  But, guess what, the struggle continues. Aluta Continua! Anyway, call me a cynic - I don't see the reason for celebration yet, because I am still inducted in the "Hall of Cancer" despite being in the early stages. It does not change the overwhelming emotions and fear of the unknown let alone the aches and pains. Don't get me wrong, I appreciate that it could have been worse but please, does that change my situation? Certainly not! I still feel crappy about this whole journey. Don't worry people, chemo is going to knock some sense into my head, so I am told. By the way, before I saw the oncologist, I had the good pleasure of meeting my pleasant oncology nurse/case manager who will be working with me and at my disposal 24/7. Of course, not literally. Well, we spent a good half hour doing the blah, blah, blah blah of chemo side effects and how I may need to purchase a children's very soft toothbrush because my mouth will become tender, sensitive and develop mouth sores the most feared side effect of chemo. And blah, blah blah, its better to cut your hair so you don't experience the emotional toll of it falling off in the shower or everywhere.

My Hodgkin's lymphoma diagnosis has been staged and is classified as Stage IIA ("A" means no symptoms of unexplained fever, night sweats etc). Hence, this is considered early stage cancer which is good according to my doctor. I do not have any "B" disease which means "bulky disease". I have multiple enlarged lymph nodes in my neck and a few mild enlarged lymph nodes in my chest. Bulky refers to cells greater than 10 centimeters in diameter and require more chemo. The only downer is that the doctor explained that apart from the initial large tumour cells on my neck, the results revealed more tumor cells on the left hand side of my chest. which require further investigation.What that means is that I have to go back to the place I hate so much - the nuclear place to do this urgent special test called Gallium scan. The Gallium scan is an important indicator of Hodgkin's activity in the identified tumours in the left side of my chest.

Let me give you a brief overview of how Hodgkin's is staged into different groups. Remember earlier in my blogs I mentioned that Staging helps determine prognosis and treatment options. Hodgkin lymphoma stages include:
Stage I - means that the cancer is limited to one lymph node regions or a single organ.
Stage II - means the cancer is limited to a section of the body either above or below the diagram.  In this stage, the cancer is affecting two different lymph nodes or the same side of the diaphragm.
Stage III - the cancer has moved to lymph nodes both above and below the diaphragm or its in the spleen.
Stage IV - This is the most advanced stage of this type of cancer. It means cancer cells are in several parts of one or more organ tissues. In this stage, the lymphoma affects both the lymph nodes and other parts of the body such as liver, lungs and bones.

My treatment plan involves 4 cycles of chemo in combination with radiation to the areas of the involved lymph nodes instead of the traditional 6 cycles. Each cycle is broken down into two - meaning one cycle will be administered as an outpatient twice in one month with a two week break in between to allow the blood counts to recover. The A, B, V, D will be administered through an intravenous line. I got a whole bag of different prescriptions to take prior chemo to manage the common side effects such as nausea, etc. Given the very nature of chemo and its potential to destroy both good and bad cells, the two week break in between is kinda like a holiday for me to build strength to take in some more chemo. The radiation treatment plan will only occur after the 4th cycle under a different radiation oncologist who will determine how many cycles. I believe the radiation will be targeted to only the parts of my body known to have the cancer (like its some kind of relief).

Final Staging Procedure # 5 Chemo Overview Session for Patients and Family

You are all wondering how is chemo overview part of staging? It is part of staging because once all the tests are done you have to be prepared and reminded again about the notorious side effects of chemotherapy and how it would drastically impact your life - the usual blah blah blah blah! Shall I save you from the gory details, I think not! The nausea and vomiting, diarrhea,  constipation, skin and nail changes(who knew breaking or falling off), the fatigue, the hair loss, mouth sores and reproductive changes (not that I care much about that)! What else? They tell you to save yourself the trauma - "don't go finding answers on Google!" Really, who doesn't go on Google when they are freaking out about something concerning their health? Yeah, scary no wonder you have to take a class and some more literature to read (I need a whole space for lymphoma on my bookshelf) topped up with a guided tour of the place where its all gonna happen - not very private but who needs it anyway. I wish we could just focus on the positives - I guess there are not so much positives apart from how chemo shrinks the cancer cells and hopefully gives you your life back. This really feels like school except I am paying more attention and exercising more due diligence this is my life ya'll.  I need to have a handle on this so I need to take everything in. Don't want any surprises once the chemo shit starts sending me on a roller coaster. After the class, I wanted to reflect more on this but realized that I am not in a position to diss how chemo is toxic or how bad it is because I need this toxic shit to shrink these cancer cells causing me much distress. You know how they say, people who live in glass houses should not throw stones?

Anyhoo, yesterday was the D-day, the final part of the staging process. Phew! no needles and no machines for now. What a relief! My right arm is hurting from all the poking and proding so far, I deserve a break. This was just a training session on Questions and Concerns before you begin chemo. No, its not a one-on-one its a group session. As I looked at the agenda I wondered, if some of the stuff pisses you off, do they think any one of us was going to get up and say "Fuck That! I am not going through with this damn chemo?" You look around and see the look in everyone's eyes full of anticipation and shouting lets do this! For myself including the others in the room it appeared no matter how scary it all sounded, we were all ready and prepping for starting chemo next week. It was interesting that as people introduced themselves around the room, the different types of cancer were represented, pancreatic cancer, lung cancer, colon cancer, breast cancer and lymphoma. It looked like one of those diversity classes except this class makes you even more aware that cancer does not discriminate. It affects all of us whether you are black, white, brown or yellow - everyone is susceptible to cancer! Cancer does not care whether you are rich, poor or somewhere in between. Damn this cancer! As we introduced ourselves we also mentioned who our different Oncologists were. For a minute you forget about your own cancer and just go Wow! I am not alone in this battle, we are an army fighting this formidable battle! When I saw the people who came for this appointment alone - unaccompanied by family or friends, it broke my heart and compelled me to count my blessings as I watched Tinashe sitting beside me as she intently proceeded to take notes and ask pertinent questions about how she can support me like she is back in University! Gosh! it brings tears to my eyes. Tears of joy and gratitude. I appreciate you Tinashe more than you will ever know! You are my pillar of strength! Thank you for your dedication and sacrifice, you are amazing!

Anyway, let me bring you back to my earlier blog where I mentioned that I really like my Oncologist because unlike my not so good experiences earlier on in this journey, he treated me like a person deserving dignity like everyone else, not a statistic to be entered into a database. So, the good news is that - I was right! The first thing the charming and friendly Oncology Nurse facilitating the overview said repeatedly, "I love your Oncologist, he is the best!" I just beamed and confirmed that I loved him too! She kept repeating..."He is the best!" Let me tell ya'll, I felt so comforted and privileged that I was in good hands after-all. Of course, the other people in the room may not have received this news well because who wants to be second best? I think this session was really helpful because it prepares you while at the same time gives you control of the more difficult part of the journey that lies ahead. I will not bug ya'all with the nitty gritties but what we covered was, getting to know your health care team, what chemotherapy is and how it works, a typical treatment day, tips to help you manage side effects and tips to help you cope.

I will go over my own regiment since each person's treatment is different. Like I have said before, my course of treatment is called ABVD which is a four drug regimen. A-Adriamycin;B-Bleomycyin; V-Vinblastine and D-Dacarbazine. These drugs are usually given in that order (A,B,V,D) lasting 28 days and consists of two treatments given two weeks apart over a period of about six months. Each drug listed above works in combination and treats Hodgkin's differently and has its own side effects.

I will not address the anticipated fear and dread associated with my impending chemo next week because re-harshing my fears is not going to benefit me in any positive way. In fact, apart from sounding like a broken record, its just escalating my anxiety levels! Whoever came up with the theory that fear is a survival mechanism in response to perceived threat was crazy! Fear is what it is. It is what it is.....You are afraid, you are worried, you are anxious and you are nervous. I think I have said enough about my fear and so far it has not worked for me. So, with that said, I will remain with the understanding that because fear lies in my sub-conscious mind, I just need to  understand that often things always look impossible until its done. Who said, courage is not the absence of fear! Remember to stay tuned......

As the Countdown for chemo Begins....

As the countdown for chemo begins the emotional toll is incredible. The sadness and sorrow continues to linger even when I think I am feeling better. I find that my feelings of anxiety have increased so has the apprehension grown about all the heavy and depressing stuff associated with chemotherapy. I find myself spending more time just trying to keep it all together given I gave up the odd compulsion to put on the brave face and opted for my strong and natural desire to just look up into the blue sky and weep whenever it feels like. Anyway, today I went in for an appointment with a social worker to harsh out a few things before my treatment begins in two weeks. Not a good idea if you ask me because I could not even say a complete sentence. I just could not stop crying, I broke down uncontrollably. Thank God! she was understanding and handed me a box of kleenex and allowed me just feel whatever I was feeling and tried to comfort me. Unfortunately, I didn't stop feeling. Damn! these tears are just too much! I did cry me a river! I don't think I made a lot of sense because if you ask me or accomplished much. I cannot even recall what the discussion was about. Oh boy, just trying to deal with all the emotions and making that decision not to feel defeated is so hard. On the bright side, the chest pain appears to have given me a slight break. The fatigue, well, I guess will be there for the long haul and will get worse with the chemo. But, as always I am keeping my chin up and allowing the tears to roll unabated!

Relax Everyone Things are now Moving

Relax everyone, I am so happy to share with you that things are beginning to move and fast. Despite the aches and pains, I am not complaining! I am sure everyone has been wondering what the hell happened since I have not blogged since ???? What happened? How did I abandon you all like that?  Even, I was asking myself the same question. Well, the truth is, I spent the whole weekend sleeping because of this fatigue that is debilitating. I kept dragging myself in and out of bed only to use the washroom because my chest continues to hurt and makes it difficult to sit upright for long periods. But, I am feeling much better than last week. This situation has taught me not to live in nostalgia but live in the moment and appreciate every single day because I realize looking back at all the weekend aches strains my neck and inhibits my progression. Today I went in to meet my oncologist for the first time at one of the best cancer hospitals. I never imagined in my lifetime I would be entering this cancer hospital. Its funny how we always think its them not us. Here I am, who knew? After registering we sat in this huge waiting room and as you look around you realize there are so many people with all sorts of cancers. This place looks completely different from where I have been going since May.  Like the British say, it looks "posh" but depressing. I even forgot about my own cancer for a while or that I was one of them. I must add, I feel blessed to have Tinashe by my side because this is not a place you want to go alone for sure. Every appointment just brings me to tears. It feels like just re-living the same nightmare over and over again except this is not a dream but my reality. I guess, that is the part that makes me tear up every time.

Anyway, this waiting room was exceptionally clean and sterile for good reason which you will appreciate later. In the middle of this amazement, someone came around and started serving juice and cookies to everyone. The coffee was just there for every one's fancy. Not that I care for a cup of coffee - I have a thing for Cappuccino or a Macchiato from Starbucks. That was something being availed eats and drinks! A first for me anyway!  Anyhow, I appreciated this gesture but, I was too focused on eating the sushi Tinashe had gotten for me. It don't matter how ill I am - I love some sushi! The room was full of both men and women but what caught my eye was that most of the patients are much older. Some looked very ill and bald while some appeared to be doing well. I felt very young and for a moment thought wow! my age group is not represented. And that fleeting thought of why me did cross my mind but, I quickly remembered that God does not give us more than we can handle. I remembered Paul's words in Corinthians 10:13 explicitly states, "God is faithful and he will not let you be tested beyond your strength but with your testing he will also provide the way out that you may be able to endure it". That scripture stopped me in my tracks and I looked beyond my self-centeredness to the pain and severe testing of others right before my eyes were enduring. Anyway, the rest was not very eventful apart from hearing from the doctor the reality and gravity of my situation. We went over what to expect, CT scan, bone marrow biopsy, staging, baseline tests then treatment. All appointments have already been scheduled in advance which is great. Based on the tests done so far, ABVD, a chemotherapy regimen will be used. It is the first line treatment of Hodgkins lymphoma and may be used in combination with radiation. Will tell you more later about this because I have to share with you the most frightening thing that the doctor told me. He said, I am going to lose my hair in a few weeks. I know what you are all thinking, "it will grow again".

Please don't even say it or think it! Just allow me to start grieving for the loss of my hair in two weeks which I know will be traumatic given the pep talk that I got today from the doctor. Its like he knows the impact on our psyche as women! I guess the guy has experience with how we are attached to our hair. I am thinking, coping is fine but how do you embrace going bald, losing eyebrows, lashes and all the hair everywhere? Did you hear that bald? I am going bald and I know for sure that is going to make me cry because my hair is so pretty. I have sister locs y'all - these tiny little locs that are off the chart. I will take a picture and show you before I shave my head. Its inevitable, I mean the hair loss. Maybe, I will throw a Pity Party for myself and ask Tinashe to bake some cupcakes for the sad event and invite a couple of people. Anyway, just discussing what to expect in terms of treatment gave me perspective of this roller coaster I have embarked on. I also had my first staging tests today which will be followed by other tests the following two weeks. One of the tests that is giving me the jitters is the bone marrow test - removal of tissue from the bone marrow. Ouch! I am so terrified about that one because the doc said it will be painful.

Anyway, before I forget, I must say, I fell in love with my oncologist and I can tell y'all that such a connection with a doctor makes this ride much easier. He is warm, friendly, compassionate and everything you asked for in your prayers. I can see the heaven opening up for me already... for good things to come. He gave me a book on lymphoma and more literature on the treatment and what to expect. After all my tests, I am seeing my doctor in two weeks, I guess that is the end of September when I complete the tests. He advised that is when I am beginning treatment.  Just saying those words feels so good and relieving. I told you earlier about the discussion, that it was very intense. One of the critical things the doctor talked about was to ensure that we be diligent with contact precautionary measures to avoid any infection in whatever type or form. I have to wash my hands constantly and limiting contact with other people when I begin treatment. And, as usual Tinashe was making me laugh as we headed home. She said to me, "Mom, as your caregiver, I am going to make a big precautionary poster for the house urging visitors to wear masks or stay away if they are sick or recovering from coughs or colds and no hugging. She says, I don't trust anyone so, I will be screening each and every person".  She just cracks me up and I am thinking, what am I going to do, I love hugs. But, I guess we have to adhere in order for me to be well. This is it for now people, I promise I will not keep you in suspense again. I promise to write at least two lines even when I am not well because I believe God sent me some strong shoes for these stony paths. Stay tuned......