Tuesday, May 14, 2013

Another clean CT scan - yeah!

Yesterday I went in for my 24 month post stem-cell transplant CT scan. Today I got the results - everything looks OK! Before every one of these I manage to hypochondriac my way into believing that there is all sorts of problems looming. So far, this has all just been me misinterpreting the various groans and false starts you get from a body that has been through 2 years of chemo and a stem cell transplant. So it looks like I'm doing pretty well - no signs of any problems with my lymphatic system. Yeah, me!

That's the big news - other than that, I've been basically just living life. I'm working hard to get fit and have been making some progress, although my blood chemistry isn't totally great. I'm still a bit anemic and I really feel it when climbing uphill on my bike in the mountains of Colorado. This may get better in time or this may be as good as it gets. On the bike I get a little angry and frustrated at times but whenever I apply some perspective, I'm really happy with where I am. A few other check points on my overall health:

  • My left arm still has some venous scaring - probably from the failed port I had in my chest 3 years ago. I went to a vascular surgeon and the only possible remedy now is some major thoracic surgery - remove a rib, pull out some chest muscle in an effort to increase the pathway for the major vein in my upper left arm and hope that it will expand a bit. No thanks! But my swimming is getting a little better - a few weeks ago I swam 800 yards of freestyle and although my hand was a little purple, my arm basically worked. This is a big improvement from last year when I could only swim about 200 yards before my arm really got tired and swollen.
  • Had a cardiac stress test in March. I'm down about 8% in performance from 2009. Adjusting for age, this isn't bad. No signs of heart problems. Good news. I can hammer on the bike without fear of dropping dead from some undiagnosed heart condition.
  • Had a PFT (pulmonary function test) in March. Also good news. I've got about 130% of predicted function for a guy my age. This is a good sign that the bleomycin toxicity I had in 2010 hasn't seriously damaged my lungs. Some days my lungs don't feel totally right but I have some tree pollen allergies and it's spring in Colorado so it could be some allergies. I'm deciding not to worry about this.
  • As I mentioned, the big inhibitor to my performance (I think) is my red blood cell chemistry. Two issues here:
    • My hematocrit is hovering between 38-41. Low normal is 40 and I used to be 46 so I'm down about 10-12% from what I was in 2009. 
    • My red blood cell average size is 110% of normal. This usually means that I have immature red blood cells - my understanding is that your RBCs shrink a bit as they mature so my guys are young and not as good at O2 transport as more mature RBCs. Hopefully this will get better over time.
But in general, all things considered, I would say that my health is good. Susan and I have traded a nasty upper respiratory tract viral infection over the last month but I'd say that I did as well with that as a person with a normal immune system. So no complaints there. And that's a funny thing about my blood chemistry. You'd think that with lymphoma and a whole bunch of chemotherapy that targets my white blood cells that my WBC counts would be the ones that are abnormal. But those are all very normal - WBC count, ANC count, neutrophils all normal. My RBCs are a bit off normal and my platelets are also a bit low (125, low normal is 150). My last dose of chemo (SGN-35) was last May so maybe my blood cell chemistry is still rebounding.

So that's the quick update. To close, I'll post a fun note I sent to my oncology team today. I got a chance to do a fun obstacle course race with Kyle and Caitlyn over the weekend so I sent some photos to my oncology staff and thanked them for helping me return to a relatively normal, healthy life. I hope you enjoy the pictures and remember what you promised me 3 years ago - keep getting all your preventative checks - as bad as cancer is, it's WAY better to find it early than late. Early = treatable. Late = not so much.


Team – you all have diagnosed, treated and healed me over the last 3 years, for which I will be eternally grateful. On Saturday, roughly two years from my stem cell transplant and 39 months from my initial diagnosis, I got my Christmas present from my two children – we ran a mud/obstacle course race together outside of Glacier National Park in Montana (http://www.spartanrace.com/). In no small part you are directly responsible for me being healthy enough to be a Spartan Warrior! I thought you would enjoy these pictures:

Caitlyn, Kyle and I before the race:

Trying to get to the top of the rope obstacle:

Dammit, didn’t make it! So, 15 burpees:

Caitlyn and I leap the fire obstacle at the end of 5 miles, 900 feet of climbing, 38 obstacles of mud, climbing, crawling, rock dragging and javelin tossing:

The happy warriors post-race:


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