Bones but not the Marrow

Friday - May 25, 2012

Back along the corridor of green trees that crowd beside 1-64 .... This morning Joe and I drove once more to Richmond and VCU's Massey Cancer Center's Dalton Oncology Clinic - say that ten times fast!  (TANGENT:  I had to say "unique New York" multiple times fast to prove that the cytarabine wasn't impacting my cognitive function - not easy!)  Today, I had labs as well as a consult with the chief nurse practitioner for the unit.  Kevin has given me my 2 completely discomfort-free spinal taps and has been a great source of info on the Hyper CVAD protocol when my oncologist was at another clinic.  He is amiable, approachable, and available, answering our many questions with thoroughness and clarity of language.  I particularly liked how he used the word "curable" on more than one occasion when discussing my kind of lymphoma.  Yeah, I liked that a great deal.   "Curable" sounds just perfect to me.  Best word of the day!

Anyway, Kevin said that despite the PET scan showing lymphoma in my skeleton (predominantly upper arms and shoulders), my bone marrow is clear.  Yeehaw!  While this news alters neither treatment nor prognosis, it's still a lovely, lovely feeling to tick off another body part that is lymphoma free:  brain = no lymphoma, lungs = no lymphoma, bone marrow = no lymphoma. Doesn't that sound grand?!

Today's blood work was also strong.  "Neutropenic" is a term I would prefer to remain OFF my chart for the next 3 months.  My darling neutrophils are 1.4 rather than the desired 1.5 but apparently no worries, just general precautions and no need for isolation.  SO far, so good; I am not at high risk for infection.  Next Tuesday's bloodwork will tell the tale about when I can return to see my class.  Apparently, my fatigue is consistent with recovery from chemo AND if I haven't yet experienced nausea, I may escape this side effect - at least for my even Hyper CVAD cycles. 

In the last bit of Kevin-delivered news, he laid out my schedule for the next cycles.  I will be going into Dalton on Mondays for a Rituxan infusion and then go into the hospital the next day (on Tuesdays) for my 4 days of chemo.  I'll send out a revised schedule.  Of course, this plan remains tentative because my blood labs need to be at specific levels before I can begin chemo.  If I need to have a transfusion, become neutropenic, or need to be admitted to the hospital between chemo treatments, then the schedule will be revised.

Home for a nap and some Jonathan and Joe time!  I am not yet acclimated to this new life rhythm.  I am far too tired to get much done (except to google Kevin).  I'm going to have to learn to adjust my self-expectations.