Today is one of the good days. I had a severe headache for about 1.5 weeks as a result of the spinal tap I received during treatment. That has finally subsided, and I am able to walk around the apartment without any trouble.

I also had another blood transfusion on Tuesday to increase my red cell counts and get me out of the anemic zone. White cell counts are good, which means that I should be returning for round three of chemo soon. The current estimate is that I will need six rounds of chemo, which puts me at the halfway mark. We'll see.

It turns out that the second round of chemo left me anemic (low red blood cell count), so I needed a blood transfusion yesterday when I went to the doctor. This is not unusual, considering the aggressive administration of the chemo. The transfusion seems have gone well, which will not only help me feel better but will also allow me to get back into the hospital for treatment on schedule. I have a follow up with the doctor on Monday (2/25) to reassess blood levels.

I underwent a pretty rough second round of treatment last week, staying in the hospital for four days. I keep getting old men as roommates, all of whom are incredibly needy and lack a basic understanding of their own illnesses. This has been a challenge in and of itself.

Recovery has been slow and difficult. Until today, I was incapable of sitting upright for any prolonged period of time without developing an epic headache. Even now it's tough, but if recovery goes anything like last time, I should be feeling much better in a couple of days. Susan aided my recovery today by breaking the rules and giving me some Coke (not even diet). It's probably the best Coke I've ever had, though two days ago I wouldn't have even wanted a sip.

Only a bit of fuzz remains on my head -- maybe I'll upload an image soon.

I randomly started losing hair today. If I'm lucky, I won't have to shave for a while....

2/8/08, Friday - My blood results are positive, including my white cell count, which means that I am ready to go back to the hospital for round two of chemo next Tuesday (2/12). I will be there at least three days. The second round includes different drugs than the first, and the main one is called methotrexate, a drug that basically stops yor DNA from replicating.

Hello friends and family,

The sad news I have to report this past month is that I have been diagnosed with Lymphoma, a “blood” cancer that originates in the lymphatic system. This type of cancer is very serious, but it’s also very treatable relative to some other cancers. This news came out of the blue when I went to the doctor to be treated for a cold recently—it’s certainly not something I would have anticipated. It’s also a cancer with unknown origins, so I am unsure how this happened or if it could have been prevented. Nevertheless, I am fortunate to have good health insurance and a short-term disability plan through work, as treatment for this cancer will require a significant amount of hospital time, in addition to all of my (and Susan’s) strength and energy. Treatment will likely take months.

Again, the prognosis is upbeat, and I am optimistic about the success of the treatment (chemo therapy). I have a fantastic oncologist (Dr. Perry Cook at the NYU Cancer Institute), and we have been moving forward appropriately against this aggressive cancer.

Thank you for your thoughts and prayers as Susan and I tackle this issue. It will surely change our lives, and I am looking forward to the flip side when this is behind us. Your good wishes are appreciated.

With love,
Dan

Some info:
Since the cancer is part of a system that circulates throughout the body, the cancer can show up anywhere at any time. This makes surgical treatment essentially impossible, which is why I am engaged instead in a very significant amount of chemo therapy. The chemo requires hospitalization for several days straight every few weeks. In between treatments, my body recovers from the damage that the chemo does, particularly to my blood. During this time, my blood counts are low and I am susceptible to disease and infection, so aside from the standard side-effects of the treatment, I must also pay special attention to avoid getting sick. One way I do this is to only eat cooked foods and avoid too much sugar, which can weaken the immune system. I also avoid dry foods (like chips) and drink plenty of fluids.

Currently, the cancer is present in my bones in several places and in the middle of my chest as a 12cm tumor. Treatment should contain that and eventually send the cancer into remission. However, my current treatment can just as easily target the cancer if it manages to spread.

How you can help:
The best way to help is to send me your good wishes. My physical condition changes quickly depending on what’s going on, so it’s difficult for me to call people or see anyone in person with any predictability. Just the fact that you drop me a line means a lot to me. I don’t expect anyone to try to relate to this situation, and I actually hope that you never can. Susan is my head nurse and Chief Operating Officer, so if you ever have any questions, just ask her what to do.

Brief Timeline:
1/11/08, Friday – I go to the doctor to get some antibiotics for a cough that hasn’t gone away in one month. Some people at work have had bronchitis, so it seems likely that I have something similar to that. I had actually had bronchitis as a kid, so I figure this is different, but I still hope for a magical antibiotic to help out.

1/15/08, Tuesday – My five-day antibiotic pack runs out, and I still have a cough. I’m very tired (physically) after a month of being sick. I have lost weight and am feeling generally depressed.

1/17/08, Thursday – Waking up exhausted, I call in sick and go to the NY Downtown Hospital ER to see another doctor. They bring me in pretty quickly since it’s not busy. They screen me and give me a face mask, thinking I might have TB. This is quickly determined to be inaccurate once a doctor comes in and starts asking questions. However, the doctor doesn’t know what’s wrong, so he orders a series of X-rays and a traditional CT scan, all of which takes several hours to complete. The X-rays show a mass in my chest and the CT scan confirms what the doctors now believe: I have lymphoma. The doctor refers me to the NYU Tisch Hospital in Midtown to see a surgeon about the fist-sized tumor in my chest. I go ahead and take the subway up to Midtown.

After a brief conversation with the surgeon, I am admitted to the hospital for surgery, a biopsy in my chest. I call Susan to let her know where I am, and she gets to hear the news upon arriving at my hospital room.

1/18/08, Friday – I have my surgery, which involves the surgeon taking a sample of my tumor directly out of my chest. They also install a “Mediport” (a device that essentially makes IVs easier) and a tube to drain fluid from my right lung.

Next Several Days – I also have a number of other tests over the next several days (both in and out of the hospital) in order to help diagnose the exact type of cancer. The fact that I sweat profusely at night leads them to think it might be Hodgkin’s Lymphoma, but after numerous tests and blood work, the doctors determine that it is an aggressive T-Cell Non-Hodgkin’s Lymphoma. Luckily, this type of cancer is very treatable. Unluckily, it requires a significant amount of chemo, administered over the course of several days straight each time.

1/25/08, Friday – My blood tests dramatically worsen, causing fears of major liver problems or other severe issues that could escalate beyond treatment very rapidly. A PET scan from earlier in the week also shows the presence of the cancer in my bones, which was unexpected. This prompts the beginning of treatment the next day.

1/26/08 – 1/30/08 – In the hospital, I undergo four straight days of chemo therapy, including the administration of Cytoxan for three hours every twelve hours and various other drugs. The fifth day, I remain in the hospital since I am suffering from nausea and generally feel terrible. The tube installed on 1/18 is taken out of my lung before I leave, since I no longer require the painful draining of fluid.

I undergo a series of further tests during this time: 1) bone marrow test, 2) spinal tap, 3) echocardiogram and MUGA scans (heart tests), etc. The cancer is not present in my spinal fluid/brain, and I receive a preventative dose of chemo to make sure it stays that way.

1/31/08 – 2/5/08 – Recovery from the chemo was very shaky at first. I am practically bedridden for four days. By 2/4 and 2/5, I am feeling much better and capable of doing things like check my email and take a walk down the street.

2/6/08, Wednesday – A trip to the oncologist shows that my blood levels appear to be improving. I am in pretty good shape and feeling almost normal. A further blood test on Friday will determine if I have recovered sufficiently to receive a second round of chemo.

Links:
http://www.leukemia-lymphoma.org
http://www.lymphoma.com
http://www.lymphoma.org