Monday, November 3, 2014

Yay PET scan! Boo Lovenox!

Between last week's PET/CT scan, the pulmonary embolism, and my new twice a day jab of Lovenox, it had been quite the week. Thankfully, things seem to be slowing down a bit, and aside from some very grotesque bruising on my stomach where the Lovenox blood thinning shots are administered, I'm feeling pretty good.

As I mentioned earlier, I had a follow up appointment with my oncologist, Dr. Peterson, to go over my PET/CT scan in more detail, as well as to talk more about the implications of my blood clot. The good news is that my PET scan came back negative, which means there are no detectable cancer cells in my body! This does not necessarily mean I'm cancer free (yet). There still could be some stragglers hodging about that are too small to be detected, but this is a really good sign and was just the result that my doctors were hoping for. This does not change my treatment plan -- I still have 7 more chemo trips to go -- but this does give a good indication that I should hopefully make a full recovery after this "wonderful" journey of ABVD.

If the PET scan is the barometer to measure the actual cancer, the CT part of the scan examines the tissues and other structures of the body. This is the part of the scan that I wasn't 100% perfect on, but that's okay because it has less to do with my overall prognosis and likelihood of a full recovery. The CT scan showed significant reduction of the tumors and inflammation, but, unfortunately, they're still enlarged from what is normal. Dr. Peterson said that these could take awhile to go all the way down -- or they might never return to their normal size, which is still okay, but it just means it might be harder to monitor in the future if there is any sort of hodgy changes. While I'd like to have had a perfect scan around the board, I am very satisfied and excited about my negative PET scan! Hopefully there will be many more of those to come in the future!

Me, after receiving the news of my negative PET scan!
So, now for the less fun part: the pulmonary embolism caused by a blood clot. Since I had no symptoms and it was only detected from the scan, they called this an "incidental finding". After an ultrasound of my legs -- as this was most likely source of the clot -- came back without detecting a noticeable clot, everyone's just kind of shrugged their shoulders about this phantom clot. Maybe it's in my arms? A smaller vein in my leg the ultrasound may have missed? Either way, my doctors do not see this being a long term issue -- it will probably clear on its own in a few months. However, they do want to be proactive to make sure I don't develop another one. This is where the Lovenox comes in. Every day, twelve hours spaced apart, I need to shoot up with this crap. Thankfully, this whole cancer process has taught me to suck it up in a lot of ways -- I am not really bothered getting pricked and jabbed by medical professionals and will pretty much hand over my body to anyone with scrubs in the name of Fighting Cancer.

However, I do have a problem when it comes to pricking/jabbing myself. Luckily, my mom has been administering these for me the past few days, but I do know that I have to start taking over soon if I want to have any semblance of a social life -- ahh, the days before Lovenox where I could just make plans after work! 

If it was just a question of jabbing them into my stomach, maybe I could do them and not get totally grossed out. The problem is these little assholes leave MASSIVE bruises (do not click that link if you're squeamish) and you're really only supposed to shoot up in the lower stomach underneath the bellybutton, as that's where the best 'fat' is. Apparently, if you inject them in the fat and not the muscle, you shouldn't have any bruising. WRONG! I by no means have a six pack -- which means that this medicine should go in nicely, painlessly, and without bruising -- but after 5 days I am unhappy to report that is not the case. I'm reading up on some other tips to minimize the bruising, such as icing before and after, and applying more pressure to the spot of injection, but so far nothing has worked.

So, hands down this has been the worst side effect of chemo. I'm almost half way done with treatment, and up until this point, I really didn't feel that much different. Sure, I would get a little bit more tired than usual and would have a few days where I felt pretty crappy, but my day to day life wasn't drastically impacted. There's something about an injection happening twice a day that is really draining. At least with the bi-weekly Neulasta shot, which stimulates the bone marrow to grow more white blood cells, I knew that once it was done with, I had another two weeks before I even had to think of it again. With the Lovenox, it feels like I'm never really done. T-minus 8 hours! 4 hours! 2 hours! Sigh! It already feels like a never-ending cycle and it hasn't even been a week.

So, while I have to be on this for six months, the good news is that I only have to do the shots throughout the duration of chemo (another 3 months or so). Then I can start taking pills instead. The reason they do it this way is because the pills take a few days to enter your system -- and likewise take a few days to exit -- so if, say, I had to have an emergency surgery for something hodge-related, having really thin blood would complicate things. I'm going to give myself another week to see if my body starts having a better reaction to these things. If not, I may try to push for the pills instead, as I don't really see why I would have any emergency surgeries in the near future, especially following my negative PET scan.

Here are a few other updates:
  • Chemo: After meeting with Dr. Peterson last Thursday, October 30, I had chemo #5. Minus a little vein bruising afterwards -- due to my nemesis Lovenox -- it went very well. The next time I'm in the infusion chair on Nov. 13th will be for chemo #6, which will represent my half way point! 
  • Lung issues: While this seems kind of counter-intuitive, my blood clot in my lung is unrelated to any sort of chemo-induced lung damage that may come with the Bleomycin or Neulasta. If you remember to the early days of this whole saga, I had to take a pulmonary function test to make sure my lungs were strong enough to withstand 12 rounds of Bleomycin (the 'B' in ABVD) and Neulasta, both of which can cause some nasty lung damage if your lungs aren't in good shape to begin with. So far, I don't notice any lung damage -- I get a little more winded power-walking up hill than I used to, but after mentioning this to my doctor, he assumes it is just because my body is weaker in general. Still, I have another pulmonary function test to look forward to on Nov. 12 just to make sure things are still going smoothly. 
  • Veins: So far, so good on the vein front! Following chemo #5 I have not had any vein pain or issues. The very irritated vein I got after chemo #2 is still pretty bruised, which I was told may take months to go down, but thankfully the rest of my veins seem to be holding out. Since I'm almost halfway done with treatment, I think I've officially stopped my on-and-off again flirtation with the port.
  • Vain things: 
    • Hair: Believe it or not, I need a haircut! Before you get too excited, this does not mean I suddenly have a ton of hair to work with -- I wish -- but it seems that I've plateaued in the hair loss department (at least for now). Unfortunately, though, most of the loss has occurred on the top of my head, so I'm still confined to my wigs and hats for the time being, but the hair around my crown is still growing, so I guess that's good news, right? What I'm even more excited to report is that I still have eyebrows and eyelashes. The optimist in me is thinking, hey, I've made it this far. If they're going to fall out, they would have fallen out! But again, ABVD effects people differently, so I guess I should be open to the possibility that one day I will wake up looking a little freaky. 
    • Weight: Ah, every woman's favorite topic! Many people envision the average cancer patient as emaciated -- or at least much thinner than before he or she got sick. Well, that is simply not true, and it really depends on a variety of factors -- most especially, what type of cancer you're being treated for and what combination of chemo drugs. Most people who go through ABVD for Hodgkin's -- at least that I have come across in the blogging/message board universe -- seem to gain weight from the chemo. The reason for this seems to be due to fatigue (ie. the body isn't moving as much because it's tired), steroids (hello, water retention!)  and a less healthy diet (hey, if you're not feeling that great, you're going to go for the comforting mac and cheese, rather than some lean protein and veggies. Doctors even tell you this is okay!). Thankfully, I have stayed about the same weight these last few months, most likely to continuing to eat a healthy diet and trying to get as much exercise as possible, which has mainly been power walking and yoga. Now that it's getting colder and the days are getting shorter, I am really going to force myself to keep trying to stay active. Not only is this good for my body, it really makes me feel better mentally as well. Unless I'm watching something really good on Netflix, I am not a very good couch potato. 
    • Fashion: What does fashion have to do with cancer? Aside from headwear, not much. Oh yeah, that is if you are lucky enough to escape the horrors of Lovenox, which I've so kindly and meticulously detailed for you above. Since my lower stomach is completely bruised, I have unfortunately had to institute a moratorium on pants or jeans of any kind, unless they're super low rise. Oh wait, that was (unfortunately) a thing in my preteen days and shall never came back as long as I have dignity and an understanding as to how to dress my body. So, for the near future, it's all about the dresses, leggings and tights, Jessica Day-style:
    • After all, who has time to wear pants when you're so busy being quirky, adorkable, and fighting cancer?

That's about it, folks! Thanks for all your support and positive energy -- it is always appreciated, and it was even more so this last week! Here's to hoping that this week is less crazy than the last one!



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