Sunday, June 24, 2007

Thought for Sunday

"We know not what lies ahead of us. We know not what the coming days will bring. We live in a world of uncertainty. For some, there will be great accomplishment. For others, disappointment. For some, much of rejoicing and gladness, good health, and gracious living. For others, perhaps sickness and a measure of sorrow. We do not know. But one thing we do know. Like the polar star in the heavens, regardless of what the future holds, there stands the Redeemer of the world, the Son of God, certain and sure as the anchor of our immortal lives. He is the rock of our salvation, our strength, our comfort, the very focus of our faith."
-Gordon B. Hinckley, President of the Church of Jesus Christ of Latter-Day Saints

Friday, June 15, 2007

THE Diagnosis!!!

What a difference the Huntsman Cancer Institute makes! We received a call at 11:59 am from the oncology doctors. (They were sure to point out it was one minute before they promised.) It is nice to finally be able to piece some of this together.

The official diagnosis is: Diffuse Large B Cell Lymphoma, Intermediate Grade. It is a "fairly fast" growing cancer--they believe it started growing 1 or 2 months ago.

We are busy researching and seeking out second opinions, but the plan for now is:
1. Have a great weekend with our friends & family (including the championship baseball game & Bryan coaching Jordyn's volleyball team)!
2. Bryan will begin Prednisone today which will reduce the swelling in his arm & neck.
3. On Monday Bryan will have a Bone Marrow Biopsy (to determine if the cancer has spread to the bone marrow, which will determine the stage of the cancer) and Echocardiogram (to determine which chemo drug to use/how it will affect the heart).
4. On Tuesday he will begin chemotherapy.

Chemotherapy: This will be performed on an outpatient basis. Chemotherapy is an infusion (IV) which they expect to take 8 hours to complete. He will have the infusion once every 3 weeks for 4-6 cycles (depending on the stage of the cancer).

Outlook: The doctors are optimistic. We don't have accurate survival rates yet because we don't have the staging information. Bryan's tumor is an intermediate, fairly fast growing lymphoma. Low grade lymphoma is resistant to treatment; high grade can kill you suddenly. So, of the lymphoma options, intermediate is the better grade. When we discussed the different cancer diagnoses, Dr. Ward & Dr. Pollack were both hoping the pathology would come back as lymphoma because it is the most curable and no surgical resection is necessary (as opposed to Germ Cell & Thymoma).

More Information: I'm including a link to a website with accurate information about this type of cancer. It also has links to reputable websites for more information. As you read the information, you'll see why it was difficult to detect in Bryan. He does not present many of the symptoms (fever, night sweats, etc) or age categories (people over age 60). Dr. Pollack says that half of the those with this type of lymphoma don't have symptoms and Bryan's health is to his advantage.

http://patients.uptodate.com/topic.asp?file=blod_dis/6595

Thursday, June 14, 2007

Still No Answer...

We met with specialists tonight and the answer is that we still don't have an answer!

They are releasing Bryan from the hospital and will let us know when the pathology is done. We expect results late tomorrow or Monday.

The Latest Update

We do not have biopsy results yet, but we have an idea of what the day will look like. We have an appointment with specialists this evening around 6:30. A diagnosis will be given and we'll talk about treatment plans at that time. I don't know how long the meeting will be. After the meeting, we will talk to our kids and Bryan's parents. After those discussions, we will post a blog explaining the diagnosis and treatment. I'm expecting that to be later tonight, maybe around 10 pm.

Of course, this is all subject to change. The medical world has its own timetable (something I'm learning to deal with all over again).

Wednesday, June 13, 2007

Partial Biopsy Results

The news from the pathology department is they need more time. They think they have narrowed the tumor to one type, but within that type, there are MANY categories. They will do further testing today and tomorrow and hope to give us a definitive answer tomorrow afternoon. (They say the report has been written, but they won't release it until their additional testing is complete.)

The doctor said the good news is the pathologists think they have a good enough sample to work with, but he cautioned they may change their mind tomorrow if there isn't enough sample to run additional tests (which would require another biopsy, possibly the invasive type).

Interesting Tidbit. This doctor also told us that he is a pessimist, but then corrected himself and called himself a realist. Bryan & I burst out laughing because Bryan says the same thing about himself. We all laughed when the doctor said that I sound like his wife. I asked him if he also believed in conspiracies & he said that he probably does. This should be funny to those of you who know Bryan--I told the two of them that they were two peas in a pod! Honestly, it helped me understand why I have difficulty listening to this doctor. I'm used to Ashton's doctor who is an optimist (& has been right 100% of the time). It is difficult to switch gears, but now that I know more about this doctor's personality, it is easier for me to understand why he says some of the things he says.

I am actually encouraged by today's news. They gave us just enough information to hold me over until tomorrow. I think I feel encouraged because we are finally narrowing down the possibilities and a diagnosis is around the corner. For those of you who know me, you know I love to research. What has been frustrating is researching 20 types of tumors and the 20 variations of those (& knowing that 99% of the information didn't matter). Now that we're closing in, my research can actually be meaningful. (The other reason I'm encouraged is that I didn't feel like I was pulling teeth to get information out of the doctor!)

June 13...1:30 am...an amazing view!


I can't sleep so I decided to post a note.

I have an incredible view of Salt Lake City because I am on the 5th floor of the University of Utah Medical Center hospital in a private room and sit and stare frequently. Most rooms are semi-private. I want to thank Kevin, the head nurse, for making the necessary changes so I can enjoy my surrounding in private.

I feel fortunate to have this opportunity to stop and think about my life, what I have accomplished, what I have yet to accomplish, and my developing testimony of the Gospel of Jesus Christ. I hope all of you will take some time to do the same, but not in a hospital!

PAIN:
I am asked about pain, it seems, every hour. My left arm and neck are still swollen because the tumor will not allow normal blood flow through my left subclavian vein, back to my heart. I still have constant, but manageable, pain in my left elbow and occasional pain in my right elbow, left shoulder, left thigh muscle and headaches. I cannot feel the tumor in the middle of my chest. I can feel, however, the pain and soreness in the middle of my chest from the CT biopsy done yesterday at about noon.

I feel overwhelmed by the circumstance that brought me here .....and by the selfless thoughts, prayers, deeds, assistance, service, sprinkler fixing, baseball game video taping, flat tire fixing, birthday party coordinating (Ashton's), caring for our kids, .....kinds people in our lives.

To all of you I/we say thank you!

Bryan

Tuesday, June 12, 2007

Back from biopsy

Bryan is back from the biopsy. He's been back for an hour or so. He is sleeping (with the help of a sedative).

If you know Bryan, this tidbit will not surprise you. He was fascinated by the CT and biopsy equipment. He was happy to know that the CT scanner is only a few weeks old and that the University is a testing ground for Siemens--he says they get the latest equipment because of that. (He also said Utah Valley is getting the U's old CT equipment and Utah Valley is very happy about it.) He also wanted to know the angle used when inserting the needle and other "interesting" info like that.

He has an "x" on his chest written in purple marker (where the needle was inserted). I know our boys will love that!

Now we wait for pathology results (and keep our fingers crossed that this sample is adequate for a diagnosis).