Since this past Fall, I have had a cough that would not go away. I always rationalized it as coming off of a cold and, God knows with five kids in the house, I always seemed to have a cold. This June, it got out of hand and was causing me to lose sleep. I went to an E.N.T. and she did a basic check up and said that it could be asthma or my blood pressure medicine (ACE inhibitors can cause chronic dry coughs). Since there was no fever and my lungs sounded fine, they didn't do a chest x-ray. Over the weekend I somehow got a fever with some chills. It went away quickly, but my old lady freaked and forced me to have the E.N.T. order a chest x-ray. That would be the beginning of they found out I had Hodgkin's Lymphoma.
The chest x-ray showed clear lungs but a mass in and around my aortic arch. I was handed back off to my Primary Care Physician (Dr. Joglekar) and ordered to get a CT scan on a Friday. Within hours after having the procedure completed, my cell phone was blowing up from my PCP's office. I had been doing some research on line (I love me some Wikipedia) based on the information my PCP had given me on possibilities. I had read about Hodgkin's and at this point, compared to what I could have, I was all but wishing it was Merrill "Hodge". Based on the CT Scan, he said that it was highly likely that it was Hodgkin's and that they would need to do a biopsy. This was scheduled within days and was a CT guided needle biopsy. This caused me slight discomfort for about 24 hours after the procedure and yielded inconclusive results (pain for no gain....rrrrrr).
An oncologist was contacted and they referred me to a thoracic surgeon (Dr. M.D. Stam in Winchester) for a better biopsy. The mass was in an area of my body known as the mediastinum. This is roughly the space in and around your lungs or the thoracic cavity. A biopsy of this area is known as a mediastinoscopy. Instead of a needle being guided through my chest wall, an incision was made giving doctors a good view of the area. Immediately after the surgery, an Oncologist from Shenandoah Oncology came by and told me they were 99% sure that this was Hodgkin's and that they would await the pathology to confirm and also get a second path done in UVA to be 100% sure that it was Hodgkin's and what type it was. I was diagnosed with Classic Hodgkin's Lymphoma, nodular sclerosing. This is the most common form. A PET scan would later narrow it down as Stage II-A. This means that the Hodge is in more then one node, but in a general area of my chest and the A refers to me being non-symptomatic.
What doctors focus on as symptoms of CHL are night sweats and weight loss. I have also heard people lump excessive break outs or skin irritations as well. I had none of these and it was found proactively. My current Oncologist, Dr. William Houck in Winchester, said that NOT being symptomatic is important. He has had/seen Stage IV-A patients react better to treatment and have less reoccurrences then those with any stage but symptomatic (lncluding Stage I-B). I was given a treatment plan of a chemotherapy called ABVD for six rounds consisting of two courses. This means 12 treatments total, every other week. My wife and I called around to other oncologists and confirmed that they would prescribed the same treatment. We also called around and were given glowing reviews of the doctors in the Shenandoah Oncology group. We have since settled on Dr. Houck as our main man and started treatment.
This blog has been long and will no doubt be it's own section, but since I need to backfill the story, it was needed. Now on to the first treatment.
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