Wednesday 28 March 2018

Follicular Lymphoma Maintenance Treatment

I've had a great week! I enjoyed a wonderful dinner and evening with friends when we went to see Foreigner on Saturday night. I also really enjoyed the show by Chilliwack as the opening act. On Sunday, Hubby and I went for a good long walk in the cold sunshine. There is still some snowy bits in the woods where the sun has not been able to reach it and melt it. It's been too cold for the snow to melt on its own.

I'm going to back up a bit to my January 31 appointment with my oncologist. That was the first time he had mentioned that I may have to have a maintenance program of Rituxan for a period of 2 years. This is a normal procedure for patients with follicular lymphoma. At that appointment in January, my doctor decided to wait before starting the maintenance program. On March 7, when the PET scan came back showing something new in the right side of my abdomen, my doctor was torn whether to start the rituxan maintenance program or wait and see if this spot grows bigger. The rixtuxan may cause it to shrink and then they wouldn't know what it was. Another form of lymphoma? More follicular lymphoma? More serious chemotherapy to treat it? Nothing could be decided about any of that until a biopsy is done. When I saw my oncologist on March 14, he again mentioned that I may have to start the rituxan maintenance program before the end of March. Apparently, our medicare (OHIP) will cover the cost of the rituxan maintenance if it is started within 6 months of my last rituxan chemotherapy. This was done at the end of September. The end of the 6 month window is the end of March. On March 14, he was still undecided about what to do.

On Monday of this week, I received a phone call from my oncologist. He had decided that it would be prudent to start the maintenance program. If we started it after the 6 month window, I would have pay for the injections. That would be $10,000 for each injection. Thank goodness my doctor made the decision to start the maintenance program asap. I had my first injection yesterday morning. It takes 3 hours to have the rituxan intravenously. I will have to go every 3 months for 2 years and this will help to keep the lymphoma in remission longer. Because I started it yesterday, I do not have to pay the price tag of $10,000 each time. That math adds up to $80,000 in the course of the 2 year treatment plan.

Because I had an allergic reaction to my very first rituxan treatment way back in January 2012, I always have to have 2 benadryl pills before the nurses can start the rituxan. One of the side effects of rituxan is flu like symptoms like headaches, joint pain, fever and nausea. So, again before treatment can be started, I also have to take 2 tylenol. Once those pills are downed, I am started on a bag of fluid for hydration and then the ritxan goes in. Yesterday, I was very tired when I returned home in the afternoon. That was a result of the combination of the benadryl and the rituxan.

This morning, I am still tired and unmotivated to do anything. Thank goodness I don't seem to have any nausea although last night I wasn't very hungry for my supper. Even this morning, I forced myself to eat some breakfast although I didn't really feel hungry. Life goes on. This is just a part of my life with lymphoma. I'm hoping to do some light cleaning this morning and then maybe even get outdoors and work in the yard. On Monday afternoon, I was able to start raking up the leaves that I was unable to rake in the Fall. I'm hoping that I can tackle that again this afternoon. It will all depend on how I feel. I know from past experiences with chemo that if I push myself and do too much, then I feel ill.

With Easter coming up this weekend, I have been thinking about the crosses we all have to bear. There is always someone worse off than me. I know that sometimes my "cross" gets a little heavy and that's when I realize that God has given me strength and support through prayers and the love of family and friends. So although we all have our "crosses", this Easter I am going to enjoy my weekend with family. I'm going to enjoy my time with Hubby. Life is good!

Saturday 24 March 2018

Despite Uncertainty, Life is Good!

I have had a great week! This past Sunday, Hubby decided to get me out of the house and take me for a drive along the shores of Lake Ontario. What a gorgeous drive it was! Highway 33 is one of my favourite drives whether it be in the car or on the motorcycle. The sun was shining brightly and made the car feel very warm inside. However, once you stepped outside of the car, the wind still had a cold bite to it.

Monday was another sunny, blue sky kind of day here where I live. I wanted to be outside and was tempted to work on the yard. I am the one who normally rakes up all the leaves in our yard throughout the Fall. Unfortunately, this past Autumn, I was not well enough to work on this chore. So now as the snow is melting away, I see all those leaves on the lawn which will inhibit the new growth of grass. I want to get out there and rake it all up. I am not supposed to work with soil or leaves as my immune system is still compromised and I would inhale the mold and bacteria that would be disturbed. I am still tempted to tackle the leaves and I love to work in my gardens. I'm considering wearing a mask and using my gardening gloves to protect myself. Anyway, on Monday there was still too many patches of snow on the lawn that I could not get out there and do a good job of the raking. I still wanted to be outside so I decided to go for a brisk walk and at the same time find some geocaches. As I stepped outside, I realized that the wind was still bitterly cold. I came back inside the house and grabbed my toque and mitts. Now I was ready for my walk. I was very pleased with the pace that I was able to keep. I reached my destination and found my first geocache of my list of three that I intended to find. As I continued ,my walk, I realized that my right heel was beginning to feel like it was blistered. I need to be careful of cuts and open sores because it would be very easy for me to get infected and my body would have trouble fighting it. I decided to forego my second geocache and walked towards home. My third geocache was closer to home anyway so I could still go get it.  As I continued to walk briskly, I could feel the blister getting worse. By the time I reached my subdivision, I realized that it would be foolish to continue to the third geocache. I went home and then checked the heel. Yes, there was a nasty blister and it had broke open. I treated it. Then I spent the rest of the day indoors with no socks on so that my heel could dry up. Today it is looking better but I continue to wear a bandage over it when I have to put on socks or shoes.

The rest of my week was spent visiting with friends. I went for another 45 minute brisk walk with a friend on Wednesday. Yesterday, I went for a 2 hour walk with my cousin-in-law through the woods and along the shore of the local conservation area. We had a terrific visit and the 2 hours went by very quickly. Last night Hubby and I went to our favourite Indian restaurant and then to the local OHL playoff hockey game.

This afternoon, Hubby and I will go visit a local funeral home as we lost a good friend earlier in the week. He and his wife have been so kind and generous to us over the years that we have known them. He will be sadly missed by many people. After our afternoon visit with the family, Hubby and I are meeting up with another couple of friends and going out for a lovely dinner at a local Italian restaurant and then we are going to see Foreigner in concert tonight. I've been looking forward to this concert for a couple of weeks.

I've had a great week but I often wonder about the spot that showed up in the PET scan. I wonder if it is getting bigger. I'm showing no symptoms at all. Any tiredness that I feel this morning is due to all the fun activity that I've been enjoying. I do worry about "the spot" (as I call it) though. There have been a couple of nights when I wake up around 2 a.m. and worry. Normally when this happens, I pray not just for myself but for various friends who are also currently going through their own challenges. I did have one night this week where I was frustrated and angry with God. My questions for Him were "Why are you not answering my prayers and all the other prayers that have been said on my behalf?!" "Why are you letting this lymphoma continue create havoc within me?!" That particular night, I worked myself into an anxious mess emotionally. I realized what I was doing and then relied on The Lord's Prayer to calm me. As calm and peace came over me, I realized that God has answered prayers last Fall. I was told to expect to be in hospital for 4 to 5 weeks. Instead I was there for 2 weeks and 2 days. The lymphoma had disappeared and was not apparent in the CT scan done on January 2. Perhaps prayers are being answered. Perhaps "the spot" is not lymphoma. I then recalled that I saw a medium in October 2016. She had mentioned that I would have a "small blip" with my health and then that would be the end of the major illness. On Monday night, there was a local call-in show on television that dealt with tarot card readings and something called "channeling". The host, who read the tarot cards, had a special guest who did "channeling". An email was sent asking about my cancer journey and the "cloud on the horizon". Both ladies answered that I was going to come out of this turbulence and into calm, healthy waters. Both ladies said that they did not believe "the spot" was cancer. I know that I sound like I'm grasping at straws. I know that I sound desperate to receive good news regarding the lymphoma. Does what the two ladies do and fully believe in work? I don't know. I do know that my faith has been shaken in the past couple of weeks. I found that the ladies on the show on Monday night gave me hope.

I still think I've had a great week. Of course, there is uncertainty. I think it is normal to be concerned. I'm really trying not to let that concern overtake my life. I still believe in not letting cancer take one more day from me than it needs to. I feel great right now so I will take each day and wring as much joy, activity, enjoyment and love from it as I can. I truly am trying to seize each day and live it to the fullest.

Friday 16 March 2018

The Emotional Toll of Lymphoma

The majority of the time I continue to enjoy life to the fullest. However, sometimes tears suddenly well up and anxiety grabs hold. I awoke last night around 2 a.m. to find I was weeping in my sleep. As I laid in bed trying to orient myself, I was overcome with melancholy. I realized that this was my subconscious dealing with the uncertainty of the future. Once I recognized that, I snuggled down under my covers and thought of my favourite places. They are Sauble Beach on Lake Huron, the Niagara Escarpment throughout Grey County and of course, Scotland. As I lay in bed, I imagined the sunsets as viewed from the beach at Sauble Beach. I imagined walking through the fields of my grandparents' farm and hearing the birds of my childhood visits there. As I relaxed back into sleep, I had a feeling of being settled.

This morning, however, I awoke feeling sad. Sad that I have to think in terms of weeks for planning and not months. Hubby and I had been hoping to take a motorcycle trip in the summer for 3 weeks. This could still happen but we can't plan it as I, at the very least, will continue to have doctors' appointments and more scans. The worst case scenario would be more aggressive treatments. The melancholy has been hovering over me this morning.

I know that I have a full day ahead of me that will distract me from this emotional rollercoaster. I am meeting a friend for breakfast and a long overdue visit. After that, I intend to clean and then have a visit with my hubby's cousin. I haven't seen her in a couple of weeks and I'm looking forward to the visit. I've missed seeing her. Tonight, Hubby and I will probably go out for dinner and then off to the hockey game. This will be a good day and the warm visits will pull me out of this funk that I'm currently in this morning.

I felt it was important to write about my feelings this morning because the truth of living with lymphoma and the distinct possibility of more treatment let alone my mortality is part of this cancer journey. I want people to understand that although I'm "strong" I do have moments of "weakness". This blog helps me to acknowledge and confront my feelings and fears. Once I've done that, I am more able to move forward into a good mental space. Writing in my blog is a bit like a meditative moment. I have these moments when I write but also when I pray. So off I go now for my day and moving forward into a better emotional place. I will wring all the enjoyment out of my day that I can. Carpe diem!

Thursday 15 March 2018

And the Results and Decisions are.....

Yesterday I had my appointment with my oncologist. My file was discussed at length in the doctors' meeting on Monday. The doctors had a good look at both my PET scan taken on February 27 and my CT scan taken on January 2. They compared the scans and they discussed options on what to do.

The suspected lymph node is located on my right side behind my bowel so the option of having a IVR (ultrasound/CT scan guided needle) to get a biopsy poses too many risks of perforating my bowel. I asked my oncologist if the IVR can be done not from the front of the abdomen but from my back. His reply was that the bowel curls around the lymph node and doesn't allow clear access so again, the risk is high that my bowel could be perforated accidentally.  The doctors discussed the option of getting a piece of the lymph node or removing the lymph node completely through surgery. At the moment, the lymph node is too small for the surgeon to confidently see and feel it in order to remove it.

So we are left with the option of watching and waiting. I will have another CT scan within 6 weeks and I have a followup appointment with my oncologist in 7 weeks.

I have no symptoms that I can tell. I feel really good. My energy levels are good. These are all good signs. If the PET scan hadn't been done on me, I would have no idea that there is anything of concern. I'm thankful that my oncologist is very diligent and will follow me closely now.

After the appointment yesterday afternoon, Hubby and I went out for dinner at our favourite Vietnamese place and then we went to the Kingston Frontenacs hockey game. I absolutely intend to live life fully until symptoms or treatments make me unable to do so.

I have already visited a friend in hospital and while there saw another friend who I haven't seen since the Fall. I'm meeting with friends this afternoon to make music with. I'm off to another hockey game tomorrow night and will probably enjoy a dinner with my hubby before the game. Hubby and I will spend Saturday with friends and enjoy our annual prime rib dinner with all the fixings including yorkshire pudding. I'm so spoiled that Hubby will be making the dinner. Seize the day!

Monday 12 March 2018

The Emotional Rollercoaster of Lymphoma

In my last post, I was dealing with heightened anxiety as I awaited the results of my PET scan. On Wednesday, March 7, I saw my oncologist to get the results. The whole point of going for the PET scan was to check the 2 slightly enlarged lymph nodes in the left side of my abdomen. The PET scan showed that this was not due to cancerous tissue but it was in fact scar tissue. That was good news. Then came the concerning part of the appointment. Something new showed up in the PET scan. The PET scan lit up something that is 1.7 cm big and is on my right side. All my lymphoma in the past has always been on the left side. My doctor is not sure of what it is. It may be cancer or it may not. A biopsy is going to have to be done but it may be too small to get a biopsy at this point.

Hubby asked the doctor directly if this is cancer. His reply is he didn't know. In my doctor's words, "The primary suspect would be lymphoma, but we won't know until we get a biopsy." This new spot is not attached or near any organs. It is my understanding that it is located in a soft, floppy area and can jiggle around that area. To get a biopsy, I will have to undergo an IVR which I did in July 2017. That is a procedure where a radiologist uses ultrasound and CT scan technologies to guide a needle to the spot, stab the spot and withdraw cells to test/biopsy. My doctor seemed to think that at this point it would be like using a toothpick to stab one single olive in a jar of liquid. My doctor needs to confer with other doctors and the radiologist to determine if it is possible at this point to get a biopsy.

I haven't blogged about this because I've been in the process of contacting family to give them the update. I would feel absolutely terrible if family found out through the blog. After the appointment on Wednesday, Hubby and I were in shock. I have no symptoms. My energy levels have been increasing. I've been gaining weight. I feel for Hubby because he has to continue going to work and try to get to a place of acceptance while he continues to capably do his job. I am fortunate that I am at home.

On Thursday, I went into an emotionally deep hole. I was very sad. I was very discouraged. I wallowed in self pity which is not like me to do. I was looking ahead to the "what ifs". By Thursday night, I had got to a logical place of acceptance and waiting for results. This could or could not be lymphoma. The truth is we don't know. My file has been put on the agenda for a conference which takes place every Monday between the hematologists, medical oncologists and radiologists at the Cancer Centre. They will look at the facts and determine if we go for a biopsy or take a "wait and watch" approach. That would mean waiting and watching this grow until it is big enough to get a biopsy. My doctor did warn me that sometimes there are too many patient files to discuss and when they run out of time, the files that haven't been discussed are discussed the following Monday. On Wednesday, he told us that if my file is "postponed", he will try to search out and meet with the pertinent doctors individually to get their opinions. I'm scheduled to have an appointment this Wednesday to meet my doctor and find out the course of action. If he hasn't been able to meet with the doctors needed by that time, my appointment with him will be rescheduled for next Wednesday.

In the meantime, I refuse to waste another day having a "pity party". I've had a great weekend visiting with friends and my son has come home for a brief visit. I had a wonderful walk with Hubby yesterday and enjoyed the fresh air and sunshine. I have a terrific circle of friends and family that are my safety net. I know that I can call certain people at any time of day if I need to talk. Hubby continues to be my rock even as he continues to have is own journey to deal with all this.

It bears repeating that life is short and I want to wring out every bit of enjoyment from each and every day. So no more wallowing in sadness, self pity and anger. I will deal with any upcoming information and action plans when they happen. In the meantime, carpe diem. Seize the day!!

Monday 5 March 2018

Coping Strategies to Living with Lymphoma

I know I have blogged about coping strategies in the past but it is always good to remind myself how to cope. In the last several months, Hubby and I have been asked by various people, "How do you manage to be so positive?" For me, there are two answers to this question. First and foremost is my strong and committed belief in God and the guidance and help of the Holy Spirit that lives within me. The other answer to this question is I use my coping skills and strategies to keep me grounded and sane. When I do this, it allows me to live each day to the fullest of my physical ability.

As I have gone through the chemotherapy in the past, there are days where I'm just not feeling well enough to "do" anything. In the midst of chemo, as I struggled with side effects, it was all I could do to just breathe and take one breath at a time. It was in these harshest moments that I would rely on my God and my faith to get me through. I would envision Christ cradling me in comfort and carrying me in big hands that enfolded me and comforted me. I would also use the mantra "One breath at a time, one moment at a time, one step at a time."

Prayer, meditation and quiet moments are necessary to face and acknowledge the seriousness of my illness. That the lymphoma may always be with me. Part of living with lymphoma is the constant tests and appointments with my oncologist that are needed to determine if the disease is truly in remission and "gone" or is it still in my abdominal lymph nodes. The waiting for tests and then the results is very difficult to endure.  These are the times that I become anxious and restless due to the anxiety. I acknowledge those anxieties and then I have to find the strategy that works best for me in dealing with it. One of those strategies is keeping busy and living each day to the best of my ability. I don't want to become debilitated by the worry which is understandably easy to do. So I plan visits with friends and family. I go for walks with Hubby or friends. I read to keep my mind occupied and also to escape the worry. Hubby and I plan activities to keep ourselves distracted. We're not running away from our worries. We're not ignoring them. But we are living with the worry and deciding to distract ourselves and give ourselves a break from it.

I must admit that I also use my blog to help cope. By writing down what I'm feeling and how I cope with it, the feelings and the lymphoma have less of a strangle hold on me. I also find it comforting and helpful to have my cat, Frodo, sit on my lap while I just quietly stroke him. There is something very soothing about the slow rhythmic strokes that works to calm me.

I mentioned reading is an escape for me but so is watching movies or television programs. As I get stronger and if I feel restless, then I go for brisk walks or I vacuum and clean my home. The physical activity helps to work off my restless stress.

Knitting is another one of my coping strategies. When in treatments or recovering from treatment and I have not been strong enough to go for walks, then the knitting helps relieve my restlessness. The act of knitting and purling is very comforting to me just like petting the cat. I assume it is because knitting is also very rhythmic. Knitting and following a pattern is also good for my mind because while following a pattern, my mind is occupied and I can't dwell on the anxiety and worry of my situation.

Another reason I decided to blog about coping strategies today is I needed a reminder of what is in my "strategy tool box". I had my PET scan last week and on Wednesday, I will get the results of that. Hubby and I have spent the weekend attending the Kingston Canadian Film Festival. In 3 days, we attended 11 films together. This helped us to escape from the worry of the upcoming results. It tired us out physically as we walked briskly from one venue to the next to pick up tickets and/or get to the next film on time. Attending the film festival helped us to forget about our worries for the weekend.

This morning I am physically tired so I have to listen to my body and rest. Unfortunately, this is also when the "what ifs" and worries about the upcoming results of the PET scan like to make themselves known. So for today, I am reviewing my coping strategies. I am using these various strategies to get me through until Wednesday when I will get the results of the PET scan. So for the rest of the day, I will vacuum, clean, read and hopefully go for a brisk walk to clear my mind and work off any residual restlessness. However, after stating all this, I still have to listen to my body and probably adjust the activities I do today. So if the physical activity is too much, then I will read to escape the worry. Escapism is not running from my problems but another way to cope and give myself a break from the anxiety that I have already acknowledged. I absolutely refuse to let this disease (and all the fears that go with it) suck the life out of me. I will enjoy each day to the fullest of my physical ability. Carpe Diem!!