Oncology Appointment #2

One thing I haven't complained too much about in this blog is arm pain, although I'm sure I've mentioned it.  This is a side effect which is likely being caused by the dacarbazine, or the D in ABVD.   It is a side effect that has caused me a noticeable amount of discomfort, however.  In the first week, it caused pain which made the nurse wrap my arm in a hot blanket as well as increase the saline rate to dilute the drug.  In the second session, they diluted the drug in the actual IV bag and started the line further up my arm where the vein is larger.   Last session, they did those things again, but as of right now, I have a decent sized knot in my left arm as well as blue streaking up the vein, visible through the skin.  There is also pain.


I've been worried about this some, and so I had one of the oncology nurses look at it last week.  She suggested heat and ice, and although that helped, the "vein bruising" only got worse this past week.  So, I emailed oncology again, and today had another, impromptu appointment.   Because Sarah contacted oncology independently to tell them that I had been having increased complaints of chest pain at home, I also was ordered to get a chest x-ray.


The good news is that my chest x-ray is improved from my pre-treatment x-ray.  On the first x-ray, the large lymph node was obvious even to me.  When a pharmacist can read the chest x-ray, it must be an impressive abnormality.  This node is apparently shrinking, and the oncologist is pleased.  Between this finding and the fact she can no longer feel an enlarged lymph node under my clavicle, she believes my cancer is responding.  The chest pain is likely dying cells, shrinking nodes, etc.


The mixed news is that on Friday I have to go to interventional radiology to have a central line placed.  I have 9 chemotherapy sessions left, and my arm is fairly beat up.  I had wanted a port-a-cath but because of my neutropenia, the risk of infection is too high.  So, I will have a central line put in, which is apparently not going to be tunneled, right near the clavicle.  I was (and am) very apprehensive about this since long term lines in the world of infectious diseases typically mean infections.  (Although, why else would ID be called?  So, there is a lot of bias there).  Additionally, this just means extra hassle for working out, changing, showering, etc.  I'll have to flush it.  I'll have to dress it.  Furthermore, with a playful boxer around, I am nervous that she might rip it out accidentally while rough-housing.


I was assured that this was unlikely to happen if it is covered appropriately.  In fact, the oncologist said that some ways people lose them was one guy chopping logs, another lifting weights above her head, but most commonly in young people, it is during sex.  She said these people come by with the catheter in hand giggling.   (I'm not sure why that would be funny).  While I'm not nervous about that, I do not want to be the story for her next Hodgkin's patient about the pharmacist who lost his catheter doing some other weird activity like rolling on the floor trying to teach the dog a trick or something.   Yoga is also something that can be done, but carefully.  We actually got an in-office demonstration of that one.


So, while I am very much not looking forward to have this foreign body sticking out of my chest for the next five-plus months, it is difficult to be too down about it.  There are two positives to today, the first being that my arms will now be spared, and the second being that there are signs of my cancer responding.  Plus, it is an "off" week.  It is nothing short of amazing to me how different I feel comparing Wednesdays and Thursdays of an "on" week to Wednesdays and Thursdays of an "off" week.   Today, other than my arm, I feel pretty great.  I've been sleeping great and even got on the trainer last night.  Last Thursday was a day I was not necessarily thankful to be alive, and even somewhat doubting I could finish 9 more rounds in the ring with this opponent.  Now I'm ready to go again.

On the lighter side of things, today was Lucy's graduation from Obedience School I.  She has learned so many things!   That said, she almost didn't pass and she still has a lot of trouble with stay in both the sit and down format.  We'll keep working with her before the Obedience II class this summer.  Who can blame a boxer for wanting to play instead of stay?  She has so much energy.   At the end she got a diploma with her picture, and I've scanned the picture to show since it makes me smile.  It would have been a perfect night if not for accidents not just on the way TO class, but on the way home as well.  (One accident out of each end, and a TON of drool).   She was probably having an upset stomach.   I'm sure she had fun, though, because after class, all the puppies had 10 - 15 minutes of play time together.  Perfect.