Tuesday, September 30, 2008

A bit more focused

I woke up this morning with focus; I had a few things to book and take care of.

I started by calling the Pathology department at WRH to see when they could have my slides ready for me to pick up to take to Karmanos in Detroit (for the second opinion). I called and hit the extension of Dr. Allevato (the actual pathologist) - this caught me completely off guard. He was soft spoken, very nice and knew exactly who I was. He remembered speaking to Dr. Hamm the day before about my case and provided me the same information she had. (Dr. Hamm had called me last night to tell me that she spoke with Dr. Allevato and told me what he recommended). His recommendation, which I completely agreed with, was that I should try to send the slides to a location that I could also be seen at easily. This meant that I should send them to Karmanos. He asked me to call back and ask for the pathology secretaries. I called back and spoke to Erin (Dr. Allevato had already gone to speak with her between calls) who said that she would likely have them done by first thing tomorrow morning, or later today...This was great. I could go ahead and call Karmanos and get it taken care of relatively quickly.

So - I called Karmanos and spoke with Lena who is a customer service rep in the International department at DMC...I told her that I wanted a second opinion of the pathology report and a follow up appointment with Dr. Schiffer (whom is a leader in lymphoma and the head of the department at Karmanos) and I wanted it ASAP. I embellished my situation a little and turned on my charm! Mind you, I am a paying customer and should be able to demand what I want...(btw - 2nd opinion of path report is $200 and consultation is $400 - in my opinion, not a bad price for peace of mind. I cannot make a decision this important based on what 2 people I barely know tell me...so I'll pay for it and make the decision based on what 4 people I barely know tell me...ahahhah...). One last caveat for me was that I did not want to give them my pathology report - only my slides and medical history. She didn't understand this at first and I ended up getting a call from her colleague who attempted to explain to me that I had to send the slides...uhhh...yaaaaa.....we figured it out and all was good.

Erin (from Pathology) called me back at 11am and the slides are ready!!! woooo whooooo

Now to begin task 2! Sperm Banking. I have to pay someone to masturbate. Great. First, Diletta's OBGYN referred me to a Dr. Martin in London, who then referred me to a clinic at University Hospital told me that I had to have blood work done prior to even attempting to ... drop off a 'sample'. So they are a NO (I have to get this done quicker). So then I called a private clinic in Hamilton. They could do it fairly quickly, but I would have to get some blood work done ASAP (today) testing for Hep B/C, VDRL, HIV 1&2 and HTLV 1&2 and it would cost $430 +GST for first year (including all tests and 1 year banking) and $255/yr for banking. So I called a clinic in Birmingham Michigan...of course...no problem...but you'll have to pay for it! (btw - OHIP does not cover this - even though I have cancer and the treatment is almost guaranteed to make me infertile). The cost for this, $200/sample (they recommend 5 samples spread at least 3 days apart) and the first sample costs $200 to 'test' and each sample costs $85/yr for storage...BUT, there was a 'deal' - the first year of storage for the first sample is free! yippe. So the first appointment will cost $400 and each subsequent will be $285 (I may or may not be able to give more samples depending on what is done to me). Theoretically, I could get a bill each year for $425/yr. Anyways...I have an appointment for 1:30 tomorrow.

This all happened while I was driving to and from the hospital and going over to the states...but in the meantime, I also got a great phone call.

A friend of Diletta's, Patrick, was 34 when he was diagnosed with a similar type of NHL while living in Chicago. His was a stage 4 and he had a large lump on his collar bone. He had drastic surgery that removed his collar bone and the large mass. He is now 4 years post his ordeal and is fantastic. He is in great health, shape and spirit. I distinctly remember the first bit of time that I was able to spend with him. Diletta and I talked about him on the drive home and were both envious of his attitude towards life, his wife, kids, fun, working out, work, new people...he is a great guy and I am happy to know him. Also, he went through the exact same treatment I am about to go through. the CHOP-R. The R (Rituximab) was an experimental drug at that time that he decided to try...and it all worked out for him! He confirmed some of the symptoms and side effects...hair loss and fatigue. However, he had no nausea or vomiting (but others did). One thing I am concerned about is my activity level...I don't have a cruise control or moderate speed button doing things...how can i be active and not compete. Ug. Patrick walked...a lot and far. Anyways, he and I are going to be staying in close contact...I am excited for this.

So after getting the slides from WRH I went over to Karmanos to drop them off...this was seamless. The one problem...I ended up having to give them the Allevato pathology report...they need to know how the slides were prepared. Oh well...I just hope they don't copy and paste.

I then talked to Meghan from Medcan who is going to proceed with a second opinion, regarding my treatment path, from John Hopkins in Baltimore. As i had mentioned previously... the one thing that kind of bothers me is that I have been diagnosed with one thing and am being treated for another...no matter how similar... I question it.

Finally, I got a call from Dr. Hamm's office...they booked me for my Port surgery on October 14th. Apparently this is a day surgery that will take all day. I have to be there for 11:30 and won't get out until about 5pm. They won't put me out, only local anesthetic.

All in all - not a bad day. I generally leave out all the personal stuff that happens. But please know that we are ooooing and awwwwing over Isabella constantly. She is amazing to watch...We think we discovered her 'poo' face...a nice calm look on her face but her lips are puckered like a fish - it is hilarious. I figure that as the days go by and not as much happens I'll start to write about the side effects and good/bad stuff that happens.

I hope you're enjoying!

Monday, September 29, 2008

Let's go meet the Oncologist...

To start, thank you all for your support. I really enjoy reading your comments and emails. I read all of them more than once and have gone back to read them day after day. I bet most people don't know what to say to me...and no worries, I know you're there. Remember that I am working at keeping the best possible positive attitude I can right now. I am nowhere near what I need to be because I am in shock and scared silly right now. BUT, I am working on it and will make that transition to having the bestest positive attitude possible and I'll need you there with me.

With that said...What a ______ day.

Started this morning with an appointment for Isabella at MET hospital. All is great. Isabella is at perfect weight, hearing test was perfect, breathing was great, breast feeding was great...couldn't have asked for a better appointment. Everything has been soooo perfect with Diletta and Isabella that there is really nothing to report on ...

Diletta, my Aunt Kathy the nurse, went to my 12:30 appointment with Dr. Hamm at the Cancer Center just behind MET hospital. It was a bit overwhelming...and I forgot my damn health card...the only thing I had to remember. hahahah...the lady at the front gave me a small lecture and I had to take it with a smile...

We were told to wait in the large waiting area by the front desk. The first person to come see me was a social worker named Glenda Fisher. She called us into her office and spoke ttttoooo uuuuussss rrreeeeaaaallllllyyyyy ssssslooooooowwwwlllllyyyyy. Enough said. However, as I said to her...I'd like to think that I won't need any 'support' that a social worker could provide, but I likely will. And so too will some of my friends and family. {I especially realized this at the end of the appointment...} She gave us a bunch of resources (internal = nutritionist, social workers and pain/treatment management) and guided me to some websites. She told us that the best place to find support is through Hospice (http://www.hospicewindsoressex.com/). She recommended a Life Style Change Program to be run at Hospice. A 4 weeker...I guess I'll find out...

She then took us up to the second floor where we were to meet with Dr. Hamm's nurse (first) and then Dr. Hamm. It was ok walking around the place. I didn't know what to expect...I expected to see a bunch of people to be walking around with bald heads (you do), people looking sickly (you do) and sad people (you do) ... but it wasn't that bad. The center is fairly new, updated and there are a ton of volunteers around. Glenda introduced us to Marilyn. She is a 60ish year old volunteer that had rave reviews for Dr. Hamm, who apparently helped Marilyn cure her cancer.

We then met with the nurse. This was 'ok'. I was very anxious and trying not to be impatient. She was trying to help...but I was getting annoyed that she was giving me info about everything before I was even able to talk to the doctor. However, some things that I did find out were ... that I should be taking 1000mg of Vitamin D daily, chemo is going to tire me out, i have to reduce my stress, think positive, listen to my body, sperm bank, what? sperm bank? ....ug.

Then I met Dr. Hamm. I am very impressed with her. She is smart, confident, knowledgable, confident, kind, understanding, open minded and confident.

She had this printout and walked me through Diffuse large B-Cell lymphoma. Essentially, this is the same as my dx (follicular non-hodgkins lymphoma) but the cells are slightly different. What I understood the important point to be is that if you treat DLBCL like FNHL it will act like it.

Grade III is a great Grade to have because it is CURABLE. This is because the cells are aggressive and fast growing and the chemo will work better on them, especially at my AGE. Grade I and II are slow growing and are generally too far advanced when they are discovered.

At this point I brought up 'second opinion' - she raved about the Windsor pathologist saying that she would be willing to put him against anyone and be confident that the result would be the same. She trusts him 100%. She also noted that the pathology department in Windsor had been cleaned up and that if someone else had analyzed my samples, she wouldn't be as confident. I mentioned university hospital in London and Princess margret in Toronto and Medcan who is associated with John Hopkins in Baltimore. She said that Dr. Armitage in Nebraska is likely the best lymphoma guy and that a Randy Gaskoin in BC is also very good. Gaskoin gets to see ALL lymphoma cases in BC, which is unlike most systems that typically deal locally. She is going to call the windsor pathologist and see what he recommends (seems odd to me...we'll see).

We asked about the fact that Dr. Ling thought that he got it all out...apparently, it doesn't work like that. He was only able to get all the cells that looked abnormal, cancerous cells can look normal. Kind of like a few of my psycho ex-girlfriends....the 'looked' normal.

She talked about risk factors...but nothing really pertained to me.

She talked about symptoms - the only one that I have was a small/medium mass (holy crap - i would hate to see large). NO to the SVCS, TC, Nerve damage or bone issues...and NO to all the B-Symptoms (no fever, no unexpected weight loss, no night sweats). This is all GREAT.

Staging - to determine what stage the testing has to be done. However, I am a minimum stage II because the cancer was in both tonsils. (I wonder or not that if I would have had my tonsils out whether or not I would have got this...I would guess that I would have got it somewhere else and it would not have been found for many more years and I'd be dead by 40 because it would so far progressed - so thanks mom for not getting my tonsils out).

Diagnosis and Future tests...Ug.
  1. Blood work for LDH levels (thursday)
  2. Bone marrow biopsy from the hip (thursday)
  3. Spinal tap
  4. CT scan (abdomen, Pelvis, Chest and neck)
  5. Gallium Scan
  6. MUGA scan to test Heart Function (left ventrical)
  7. X-rays
  8. PET scan - this is done post chemo to see if all the cancer is gone (I anticipate this being a big day)


Essentially, she is recommending the CHOP-R (5 drugs) for 8 cycles and no radiation. The chemo is designed to attack all growing cells. These include Hair, Mouth, Lymphoma, white blood cells. So - I will lose all my hair (I got all the jokes with Isabellas picture...) and likely have mouth problems. She went into detail about these drugs. Essentially, I go for 1 treatment every 3 weeks. The first one will be about 8hours long, the 2nd/3rd about 3-5 hours and the last 5 may get down to 90min. I will have to take another drug to control my white blood cell count. This will be a needle either once a week or once every other day. I will also have to have blood work done once a week...oh ya, and maybe more drugs for vomiting, or diarrhea, or temperature control, or UG.

This part was very confusing for me. She went over each drug and briefly explained what they do. Some key parts are that the Rituximab (R) is the new wonder drug. Upon the creation of this drug cure rates go up 20% across the board and generally speaking all epidemiological research that has been performed is from more than 10 years ago (before the drug was introduced). So anyways, the main drugs are Rituximab (Rituxan); O = Oncovin (Vincristine); C = Cyclophosphamide I.V. (cytoxan, Procytox); H=Adriamycin (Doxorubicin); P = Prednisone (steroid).

One thing I had no idea of is that I will likely have to get a "PORT" .. a what? what is that....it is only a day surgery ... they insert a place for me to get all my needles under my skin. WTF? It's essentially a catheter that will be inserted in my chest and the tube will come up by my collar bone that I'll have for 6 months. Didn't see that coming. I wonder if I can pour my beer in there?

Side Effects - you name it! One scary potential is that I will become infertile. The only guarenteed one is that I will lose my hair after about 3 weeks. I am ok with this...not 100% sure why - likely cuz it is going anyways....I did ask if it would restart the entire process so that I get what I had when i was born....like a system reboot. Apparently not.

The keys for me to watch for (hit the panic button) are high temperature and little red spots on skin. I am sure that there are more but I haven't re-read the material yet.

Prognosis (I should have put this at the top because it is very important)....Based on the FLIPI score, of the 5 possible points, I am not >60yr old; I have great performance status; and likely NO extranodal sites (based on results of CT Scan - but I am having more CT scans done on my abdomen to see if there are extranodal sites). So the only 2 other things to find out are my LDH levels and the stage.

This tells us that I am a Low to Intermediate Risk ( IPI Score of 2). So, based on the table at the bottom of this page - my chance of being alive at 5-yr is 70-93% and a full remission rate of 87-100%. This is AMAZING and something I have to remember. As per Dr. Hamm, I have added 20% because of Rituximab to do the fact that these stats are from a study published in 1993.

We didn't discuss clinical trials at all.

She then gave me a once over to feel for all my gland sites and none were swollen (this is GREAT).

So after all this great information from Dr. Hamm, the nurse came back in and started reviewing all the drugs and their side effects. This really got to me. I got really annoyed and wanted to leave. Like I said earlier, there are a ton of side effects and for some reason she wanted to talk to me about all of them...I nearly lost is. We had been there for about 3 hours at that point and had just focused my ass off listening to the doctor ... I was done. Ok, so then we went for a tour of the chemo room - this sucked and it was hard to walk through there...I was avoiding all eye contact cuz I knew I would lose it. I was very very drained.

Where from here...Ug.

I am working on getting a second opinion through John Hopkins in Baltimore and Karmanos in Detroit. I hope to get them soon. Even though Dr. Hamm holds the Windsor Pathologist is such high regard, we are making decisions based on his opinion - so it logically should be checked.

I have my blood work and bone marrow test on Thursday. I have to find a place to bank some sperm (either Hamilton or Birmingham in Michigan).

I just wrote in an hour what happened in 4...so it isn't all here....but most is.

I like comments.

Sunday, September 28, 2008

First Entry

I suppose that if you are reading this, you know that I have been diagnosed with Cancer. More specifically, Follicular Non-Hodgkins Malignant Lymphoma. When I see something I don't understand online, my first instinct is to 'google search' the term...DO NOT do this. The conflicting information is generally inaccurate and can be scary. However, the best site I was directed to is: http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/patient

I am writing this Blog so that I can have record of what I am going through and as a means to keep my friends and family informed. I am fortunate to have a very strong support system of friends and family who I know would like to keep updated...so I will attempt to do so through this blog...

Let me start at the beginning...

August- At the beginning of August I noticed that my throat was starting to feel like I was at the beginning of getting a cold or strep throat (which I generally get about once a year). I started taking 1000mg of vitamin C and generally ignored the weird feeling in my throat.

Diletta and I travelled to Toronto on Friday, August 15th so that I could attend a Foundation meeting on the Saturday and Diletta could get her hair done! Sunday was the Cobourg Baby Shower and Diletta and I planned on going to the cottage for a few days with Grandma Elaine and my mom Lynda. On Tuesday August 19th my throat felt very 'weird' and I went into the bathroom to see if I could look and see what was going on...what I saw shocked me. It was a large lump on the back right side of throat...my first thought was "it's cancer". I came out of the bathroom to my Grandma and Diletta "I don't want you guys to freak out - but please take a look at my throat"...they both looked down there and said "that's tonsillitis"...oh, thank goodness...I'll go to a walk-in clinic when I get home to Windsor...

I proceeded to stay at the cottage that night, then I headed to my good friend Caley's house and we headed to Wooden Sticks for 2 days of eating, drinking and golfing bliss! We both tore up the course...but not is a good way.

When I got home, I went to see a Doctor at a Walk-in Clinic and that Doctor did a quick inspection and said "Tonsillitis". We discussed my symptoms, which were inconsistent with tonsillitis, and he prescribed me 10 days of Biaxin. It did nothing.

On September 2nd I went to see a doctor at the West Windsor Urgent Care Walk-in Clinic where I saw a Dr. Joclyn Warwaruk. She was awesome. She was very concerned...she ordered x-rays, blood work and called Dr. Ling (an Ear, Nose and Throat (ENT) Specialist herself to make me an appointment). Her initial thought (at least what she told me) was that it could be either an infection or an abscess and she would call Dr. Ling to determine how to treat it (ie. which antibiotic to prescribe). I stayed for the xray and then went for the blood work.

On September 3rd, Dr. Warwaruk called me (personally) and told me that she spoke with Dr. Ling who wanted to treat it as an abscess and that he wanted to see me next week. She also told me that the blood work and chest xray were clear. I went and got a prescription for Clindamycin and started taking 9 pills a day for 10 days.

On September 11th, I got in to see Dr. Ling. He walked in we chatted a bit and then he looked down my throat. He looked for about 10 seconds, slid back in his chair "we have to get that out, and we have to get it out now"....my response, was "why, what do you think it is" - he paused for a moment and said "cancer". I didn't really react too strongly at first (you all know that I'm a crier)...but it slowly kicked in. My first reaction was really...I want to get this done faster...I didn't really even give him a chance to tell me what was about to happen. We talked for a bit and I don't really remember all the details - but I do remember him saying that it was 50/50 cancer/fungal infection - but that it wasn't acting like a fungal infection. We asked what type of cancer...he mentioned quite a few (Squamish, lymphoma, throat, etc..- he didn't know). I also think that at this point I remember the gland under my right jaw being inflamed and wondering if it had spread? After a few moments, that i don't really recollect, he took us out to his reception area and booked me for surgery the following Wednesday (Sept 17) - I remember him saying "bump someone else if you have to, just make sure you get him in". He was booking me for a Tonsilechtomy at MET Hospital - a fairly routine surgery. His only concern was bleeding, as the tonsil is fairly close to the carotid artery. This is a concern for all adults receiving this type of surgery. At the same time he was calling the radiologist to get me in for a CT scan (which I assumed would be hard to get in). Diletta and I then left the office and cried on the way to the car...in the car...then some more at home. Ug.

Did I mention that Diletta is 39 weeks pregnant at this point. Ug.

Diletta and I started calling...mom, aunt Kathy the nurse, aunt Kym, Uncle Brian and friends at Medcan in Toronto. This time was a blur. In the meantime, the hospital called and they had booked me a CT scan for the next day, Sept 12 (Holy Fast). The quick bookings scared me. Why are they moving me so fast...

Sept 12, my CT scan was booked for 6:45 am. The CT scan was no problem. They injected me with the dye and everything went well. The CT scan was booked for my chest and head. When I got into the room, the tech said to me "I am a little confused at this request for only the head and chest CT scan - they left out the neck" - I was thinking in my head that I wanted to get as much scanned as possible, so I told her that the doctor told me chest, neck and head and that someone must have made an accidental omission. She said no problem and proceeded to scan all 3 areas. I also got an x-ray - which they told me is standard for getting a CT scan. I requested a copy of the CT scan and X-ray which they provided me on CD.

Sept 12, 13 & 14 - this was the University of Windsor's Alumni Weekend. Me and a good group of guys (Dante, Hackett, Piche and Lippert) had planned a somewhat elaborate weekend of lancer volleyball alumni debauchery. It was a great weekend spent with some great friends and it really helped keep my mind off things...All the guys have no idea how this weekend helped me. Thanks.

Sept 15th - Diletta had a doctors appointment today with Dr. Brkovich who told us that Isabella would be in there for at least another week (good news). Also, I called the hospital to make sure that they send the CT/xray results to Dr. Ling. I also called Dr. Ling's office to remind them to call and ask for the results...

Sept 16th - I had a pre-op appointment with Dr. Ling to discuss the CT scan results. When i got to the office I asked if they got the results and yes they had. We discussed many things and Dr. Ling spent a lot of time with Diletta and I discussing the surgery and what was going to happen. The results of the xray were great - all clear. The CT Scan noted the following:

"There is a lobulated mass arising in the right tonsillar bed measuring 2.4 x 2.5 x 4.1cm....There is a lymph node on the right anterior to the carotid vessels at the level of the mass 1.2 x 1.1cm in size which is enlarged."

He confirmed that he was going to perform a tonsillectomy and enquired whether or not I wanted him to take out the other tonsil. I asked what he thought and he said that the tonsils are often compared to one another for diagnostic purposes, so only having one would not help this method. In light of this, I just told him to use his best judgement - but I am all for taking it out.

Sept 17 - Surgery Day. This was a day surgery booked for 2:15pm and I had to be there 2 hours prior. They called me the day before and told me I was moved up for 1:00 and to be there for noon. I got there at noon and they got me right in and told me I had been moved up and would be going in very shortly. I was somewhat calm...but kinda scared. I knew that I wouldn't be getting any results for about 2 weeks post surgery. I was escorted to the pre-op waiting area. Dr. Ling came to see me along with the anesthetist and a nurse. They gathered some pre-op data and Dr. Ling once again reassured me. When I was checked in, it noted on my file that I was booked for an Adenoidechtomy and a Tonsillectomy - I enquired about this with Dr. Ling and he said it was wrong and crossed it off of my file. About 15min later I was escorted to the surgery room - this was around 1pmish (I later learned that he bumped someone else to ensure that I was able to get in for my surgery - because the hospital 'kicks' him out at 3pm).

When I woke up I was in Post-Op and I remember the nurses constantly watching me, never really leaving my side by more than 15 feet - and they were fantastic! I requested that Dr. Ling come and talk to me...the nurse said that they don't normally do this, but would ask anyways. A few minutes later, he walked in (again - he is fantastic!). I barely remember what he said (which is likely why they don't come in) but I do remember him telling me that it was not a squamish cancer and it looked more like a lymphoma type. A frozen section had been done and the pathologist was not able to make a diagnosis - Dr. Ling must have been with them because he told me that he pressed them hard to make a decision - but they wouldn't. So at this point it was still 50/50 cancer or not. He also mentioned that he thinks he got all of it out and that it looked like it had not spread to the muscle or tissue surrounding the lump. He also told me that he took out the left tonsil. I think also that my mom and Diletta came in to visit and told me a few more details and confirmed what Dr. Ling had told me. All out. Not spread.

From Post-Op I was moved to Recovery. The nurses here were great too! I was in quite a bit of pain and was requesting more drugs. Recovery closes at 8pm so they try to get you out by then. The problem with me is that I react strongly to narcotics (I get very nauseous). So they were having to give me demerol and gravol. I think I got 100mg of demerol and 50mg of gravol at around 6pm. By the time 8pm rolled around I was still very nauseated and ready to barf - the nurses were great and offered to send me to the 7th floor so I could stay the night...I opted to go home (I regret this decision greatly). I was given a scrip for T3's to be taken every 4 hours as needed.

When I got home, I was a little groggy and a few hours later I tried to take some T3's ... we weren't sure how to do this - so we crushed the pills and mixed it in with some chocolate pudding. BAD IDEA. The pudding came up...along with whatever had entered my body in the last day.

Now it was time to wait for the lab results...and hope that our little Isabella would not decide to come out until I was healthy. I was on a constant feed of T3s every 4 hours...I was not able to eat and barely able to drink water at this point.

Sept 18 - 24 - Holy crap does my throat hurt. Can't talk, can't eat, can't sleep, can't drink...ouch! T3's every 4 hours are not enough. Losing weight at about a lb a day. On the sunday I was in way toooo much pain and went to the Emergency Dept at MET hospital. They gave me a shot of Morphine and some Oxycontin. I went home and slept for 5 hours, woke up and took an Oxy...slept for a few hours...woke up and took another Oxy. These made me very very drowsy - too much so. I couldn't take these anymore, so I just started to take the T3's more frequently...now 2 every 3 hours, and sometimes sooner.

Sept 24 - WOW --- What a DAY!!!! Diletta started contractions at 2am. She had set the alarm clock for me at that time to take my drugs...she woke me up and had a contraction at the same time...we started timing them and noted the duration. I noted the timing was around 5-8 minutes...so between contractions I would run downstairs and prepare 'stuff" (unloaded the clubs from the car, loaded the car, took out the garbage, cleaned, etc) all between contractions. We held off for about 8 hours and then decided to go to the hospital...

We went to Triage and the two nurses there were great! Diletta and I had a hilarious moment to the point that tears were running down her face and peed a little...I wasn't able to talk all that well and it sounded like I had some sort of disability - the nurses were looking at me as such and Dil seemed to find this quite hilarious...It was great to see her laugh so well in the moments of intense contraction pain.

Diletta progressed quickly and we were admitted within an hour. Dr. Brkovich (Diletta's OBGYN) came to the hospital right away - which was great. She was surprised and impressed with how quickly she was progressing and thought that Isabella would be born by about 4pm. Holy crap. Diletta was in quite a bit of pain and we were quickly enquiring about the epidural - she got this around 2pm and things quickly changed. No more pain! the monitors gave us immediate feedback on the babies heart rate and the timing and duration of the contractions. All was still running smoothly...I had made the calls and people were on their way.

Isabella Elaine Casey was born at 5:48pm @ 7lbs 11oz.

Beautiful and healthy!

September 25th - I had set up a doctors appointment for today because I was in way too much pain and wanted more meds. After my experience the previous Sunday, I needed them. I went to the appointment thinking (and hoping) that we would only be dealing with me getting meds and finding out if my healing was all good. However, when I got there I asked if they had received my results...the secretary told me that they had. My grandmother was with me as Diletta was still in the hospital.

Dr. Ling came in and we chatted a bit about Isabella (I showed him some pictures) and we discussed how my throat was healing. He had in his hands the lab results and didn't jump right into discussing them - we knew something was wrong. He said my throat was healing well and I asked him for more T3's. Then he got a call from a Dr. Hamm on his private line - so he left the room and took the lab report with him. He came back in and we got into the results. He told me it was a lymphoma called "Follicular Non-Hodgkin Malignant Lymphoma Grade 3 (high grade)". I really only remember the key points from here on out...NOT A Death Sentence, Upwards of a 85% CURE rate, my chest xrays are good, my chest CT scan is good, I am young, I am in good health, likely a stage 1, grade 3 (high grade) . I was concerned about my health because I haven't been able to eat for 10 days (I have currently lost 19lbs).


I had a few questions, most of which he answered generally, but really focused on the fact that he is not an oncologist and said that these questions should all be asked of the Oncologist - Dr. Hamm. So he had made a call first thing that morning to talk to the oncologist before I even saw him. Amazing. Seems to me that I am getting the best health care possible. He said that he hoped i would get in to see her within the next week or 2. He told us that this is the worst part of his job. He is expecting his third child in November and really feels for me. I gave him an attitude pin and told him to wear it on the right side because we have the right attitude - he put it on immediately. I also gave him a "Baby Casey 2008" golf ball (I had 10 doz ProV1's logo'ed with that).

Sept 26th - I received a call that I have an appointment with Dr. Hamm Monday Sept 29th at 12:30. WOW is that fast. Once again, I think that I am getting the best health care possible.

Sept 28th - I sat down with my wife and cousin last night (Erin who is first year med school) and typed out a list of questions to ask the Oncologist for Monday. My three main lines of questioning will be around: 1. What exactly do I have? 2. What is the prognosis? 3. What are the treatment Options?