Thursday, April 29, 2010

Day 167-168
7 days of radiation have gone by. The 7th day should be one of rest. Jackie seems to be having slight throat issues and fatigue. She doesn’t want to admit it, but I know she is tired. Sometimes I wish she would just let me do things and not be so stubborn about what she is feeling. We having been talking a lot about weddings and prenuptual agreements recently. The subject comes up because this weekend is our first wedding anniversary, and a few of our friends are getting married. In the beginning I was expecting to become the breadwinner, the cook, cleaner, and entertainment. However, now she has become the cook, cleaner, and working a job. There is no fair solution in a marriage. There is no insurance policy when you dive into a relationship. There is only commitment and love. If I knew that Jackie was going to have Hodgkin’s lymphoma six months into our marriage, would I have signed up? Life is unpredicatable and marriage is full of challenges. If I was going to protect myself before even getting married with a prenuptual then I might as well have taken out the portion of my vows in sickness or in health. A prenuptual is just a foothold to a failed marriage.

Tuesday, April 27, 2010

Day 165-166
Jackie is going through radiation very smoothly so far. We keep reiterating to the oncologist that studies have shown treatment to be between 30Gy to 36Gy. I guess our understanding of radiation is a lot more simplistic than her knowledge. She says that difference between 30 and 36 is basically nothing. She recommends the higher dosage to insure that this disease is zapped once and for all. She says that only minimal damage is to the lungs and most will be to the thyroid. It has been 5 treatments so far and Jackie has not noticed much. She says there is a mild feeling in her throat, but I think I have more of a sore throat than she does at this very moment. She has to wear this two stickers on her chest for the remainder of her treatment so that technicians know the correct way of alignment. Warm weather is definitely setting in fast so we are trying to develop new strategies to conceal the stickers.

Sunday, April 25, 2010

Day 162-164
Solidarity is definitely tough. My life is no longer the single bachelor life. Jackie and I spent the weekend apart due to a schedule conflict. She went back home for the weekend and I went to visit my sister and friends. At first I actually had some anxiety because Jackie and I haven’t been apart for a weekend since we got married. For the last few months I felt cancer has stolen part of my marriage. My honeymoon period seemed to only have lasted up to the point when Jackie was diagnosed. We had to skip the greatest part of the beginning stage in marriage due to Hodgkin’s Lymphoma. No longer could we come home and just be “lovey dovey” but we had to be grown up and mature about treatments, bills, and even the future. I was afraid for this weekend that I would not have the feelings of missing Jackie the way I use to. I was afraid that this weekend would be a piece of cake. I was afraid that Jackie and I would be so complacent with being apart that it would become habit forming. When does that honeymoon period end and does it ever come back?
All my worries ended up premature. The weekend was great. We were both able to spend time with family and friends. We ended up talking on the phone and sharing about the our days’ events every night. I actually felt very loved and close to Jackie while she was away. I knew that she was constantly thinking of me and everything she does represented us as a couple. A strong relationship cannot be separated by distance. The distance only made the end of the weekend something to look forward to. We both came home in the afternoon early. It was so great to see my wife and she never looked so beautiful. I hugged and kissed her. We had a great dinner and definitely ready for next week. Next week is our one year anniversary. We made it this far and I can definitely say the honeymoon period is not over. I proved it to myself this weekend!

Thursday, April 22, 2010

The first two days of radiation seemed very easy, painless, and fast. Jackie was marked up the first day and then led into her chambers to be radiated. It seems to me that radiation takes very careful planning and patience. It is like an amusement park ride where you wait an hour for in line and then the ride ends in thirty seconds. The radiation procedure is thirty seconds in the front and thirty seconds in the back. The other fifteen minutes were meant for aligning and prepping. So two down and sixteen more to go. Jackie is feeling very restless spending most days at home. She has not worked a full week since November. People usually despise going to work everyday but then we miss what we cannot have. She wants to go back to work. Luckily, Jackie is almost done and she can do everything she wants.

Tuesday, April 20, 2010

Radiation begins tomorrow promptly after lunch. I have lots of mixed feelings about the whole process. I know that this is going to give a 95% insurance policy for cure. I know that Jackie has only two small areas to radiate. Her doctor and staff is very knowledgeable with the most advaced equipment out there. Jackie is getting a low dose of radiation for a very limited amount of time. I want to believe I am care free, but how is that possible with such an invasive procedure. The radiation oncologist said no breast tissue will be harmed, a slight nicking of lung tissue, and the thyroid will be affected. Scientifically speaking that is a very good prognosis, but as a husband I beg to differ. My wife is only 27 years of age, 1 year into marriage, and has plenty of life to enjoy. Its so sad to think that she may be on thyroid medication later on in the future. I just pray that God watches over the rest of her body. I pray that the radiation be straight and direct and calculations are exact. For the next 3.5 weeks she will be starting her morning in a patient’s gown on top of a huge radioactive machine that will be cold and claustrophobic. She definitely deserves a nice vacation after this. The body is your temple until cancer sets in.

Sunday, April 18, 2010

Day 154-156
Fun in the sun. Jackie had two weeks of no therapy, treatment, side effects, etc. Her body is gaining strength and she does not get tired as easily. She has no restrictions to what she eats or drinks. We are able to go anywhere we want without worrying about neutropenia or excessive germ alert. She seems a lot more happier these last two weeks compared to the last two months. Chemotherapy seems to wear down one’s body overtime. It is a endurance test. The first few rounds are a breeze. The event is fresh, your body is strong, and it can fight. The last rounds are when your energy is being sucked out of you. You become lackluster, side effects multiply, and you feel beat. Jackie did four rounds of ABVD but others do anywhere between 4-6 rounds. It is anywhere from half a year to a year of marathon abuse.
This weekend we were either going to san diego to visit family and friends or go enjoy Joshua Tree national park. It feels so good to be able to do anything we want. Anyways, we ended up going to Joshua Tree out in the Mojave desert. Who knew that there would be such a large park in the middle of nowhere. At different points of the park you could see the San Andreas fault line all the way to the Colorados. There were so many different varieties of nature. Every part of the park contained a certain type of plant life. We saw all different plants such as the Joshua Trees, Ocotillo, and the Cholla cactuses. There were different boulder and rock formations shaped like skulls, jumbo rocks, caves, and caverns. It was amazing how clean the air was and how nature designs its own architecture. We took lots of pictures and had plenty of great exercise. At the very end we had a satisfying dinner and a few hours of resting out bodies from a day’s event.

Wednesday, April 14, 2010

Day 153
I am constantly being misled by forums and testimonies from others. I was taught as someone in the health field to always study evidence based medicine. Studies are only significant when the study is over a long a period of time, a significant amount of subjects, and a control and trial group. With our recent good news about her mass shrinkage and radiation treatment. Jackie’s current treatment is going to be 36Gy (1Gy=100rads) over 18 days totaling 3600 rads. Of course, my personality always tries to find the wrong in every situation. I started reading other peoples' forums saying they had 2100 rads, 2600 rads, and 3000 rads. I started thinking why is Jackie receiving so much radiation and the specialist did not know what she was calculating. I thought my limited knowledge of radiation oncology would triumph her 16 years of experience. The forums consist of an international group of subjects with many different ages and staging of Hodgkin’s disease.
After a whole night of research with Jackie I did stumble on some reliable evidence based medicine studies. The first one came from Germany and stated that patients who had 2000 rads and 3000 rads all had very high prognosis rates. This study made me fall into more of a self validity. Then I found the U.S guidelines for treament of stage 2a Hodgkin’s. I found out that 4 cycles of ABVD and 3000-3600 rads were the best combined modality for treatment. Going to 3600 rads just insured beating this disease.
Reading forums are an addiction. Each posting is subjective, opinionated, and a non professional opinion. Everyone has very informative information that has to be taken with a grain of salt. Nothing beats the opinion of a specialist who has been trained to deal with disease. When in doubt go for a second opinion by another professional.

Tuesday, April 13, 2010

Day 150-152
The moment of truth is finally here. Scanxiety over the last two weeks has frazzled me. Have the last four months of chemo paid off? This feeling reminds me of waiting for a final exam score. I was able to take time off and accompany Jackie and her mother to the radiation oncologist. The building was exactly how Jackie explained, a waterfall leading to the front desk and everything was clean and well organized. The doctor was nice and friendly. She took her time repeating everything she told Jackie from before. The results were in fact what she predicted. Jackie started off with three masses. The first PET scan showed 2 masses in her supraclavicular and 1 mass in her mediastinal. Her right supraclavicular mass was taken out for biopsy, her left supraclavicular mass was not larger than her right, and the largest mediastinal mass was 5cm with a metabolic activity level (SUV) of 5.9. Her post results showed no evidence of supraclavicular masses and the mediastinal mass shrunk to 3cm with a SUV of 1.9. The oncologist educated us that normal mass is 1cm and any metabolic level under 2.0 was considered desirable. Overall, Jackie has responded very well with even more mass shrinkage to come.
Her treatment will consist of a 36Gy over a period of 18days. According to studies a treatment of ABVD x4 and 20Gy of radiation gives a 5year survival rate of 97.5%. She will begin treatment in one week. All measurements are extremely precise with lasers and scan. She spent forty minutes with a technician and a CT machine being tattooed up for radiation. Being tattooed for radiation consists of three small marks across the body that help the radiation technician line up the machine to make sure the treatment area is always same.
I am utterly amazed at how awesome the facilities were. There was probably a 3:1 ratio of staff to patients at the office. The dressing rooms were clean with new gowns and robes for patients. They have social workers and dietitians for supportive aid. They have a pet therapy program which has a small puppy that runs up to the patients and stares at you. There is definitely lots of support for patients during this emotional time. All equipment was up to date and very futuristic looking. Each radiation machine was probably similar to a airplane turbine engine. The best part of this whole experience is we are all very confident, comfortable, and optimistic of treatment.

Thursday, April 8, 2010

Day 149-150
Life is so normal. There has not been any thought of Hodgkin’s Lymphoma. There has been no talk of treatment or planning. Jackie and I are spending the weekend attending lectures. She has been eating salads, fruits, sandwiches, steaks, and anything she would like. Jackie has been eating more and more beef recently. Before chemo she did not eat any beef. She has such willpower because she knows that there is protein from eating beef. It is great to see that she is so open to new experiences. These new experiences will only bring more opportunities for us.

Tuesday, April 6, 2010

Day 142-146
Only one short weekend to celebrate four months of hard work. Chemotherapy has tested us to the maximum as a couple, as christians, as family members, and as humans. There was a total of 2.5 days to celebrate and I decided to make the most of it. Our first stop was to remember how much the Lord has done for us on Good Friday. The time spent in rememberance of how much we our loved by God keeps us going. I wonder if Adam and Eve had never eaten from the tree of good and evil would there be cancer in the world. The next day we went to the happiest place on earth, Disneyland. It was time to go to the happiest place on earth during the happiest time of our lives. We had a great day filled with non-stop laughs, snacks, pictures, and shopping. Our day started from 9am to 9pm. We usually try to make an annual trip to disney that starts from 9am to midnight. Jackie’s body has not entirely regressed back to normal. At about the end of our day she was telling me that she was cold and fatigued. I don’t want to risk Jackie’s health as long as she could have a good time and enjoy her celebration. On Easter Sunday we spent time at church once again. Easter is a time of new beginnings. Every Easter something new has happened to Jackie’s life. Two years ago on Easter, she accepted Christ into her life. Last year around this time, she was baptized. Today she will be almost rid of cancer and enjoy her life to the fullest. We also celebrated her cousin's second birthday. The innocence and charisma of a young child is very envious to watch. A small child does not need to fathom the complexities of life. The stresses of life, finances, jobs, love lost, and of course cancer.

Day 147-148
No food until 4pm! Jackie had to starve until early evening hours. She was not allowed any food because of her PET (Positron Emission Tomography) scan. They scheduled her scan to be at 2:30pm. The PET scan involves a radioactive glucose dye that is injected into your body. You sit in a dark room for an hour in order for the dye to stream through. Cancer cells are usually more metabolic than nomal cells. The area of high glucose uptake on a PET scan helps the physician pinpoint where the cancer cells are located. It has a high advantage over traditional MRI or CAT scans because PET scans can detect highly active cells. Of course, due to the radioactive nature of these scan the risk of secondary problems increase. As a result, the doctor and us only order scans when necessary. We pray that this scan shows no results.

Thursday, April 1, 2010

Day 141-142
I was definitely upstaged and impressed by out insurance group. Jackie and I thought we had two weeks of a non Hodgkin’s lymphoma life. At least one week to get the referral in and another week to get approval for the PET scan. Nobody wants to pay 4000 dollars for a test. Well it has been two days and we get a call from our insurace group, then from the imaging center, and finally from the radiation oncologist. Jacqueline’s PET scan is next week and she is getting her images read the end of next week. She will be mapped out and tattooed in preparation for radiation as well next week. We are definitely on a fast pace. So we have a limited time to celebrate the end of chemo. In fact to throw in a celebration we decided to go to disneyland for the weekend. What better to go to the happiest place in the world for the happiest weekend of our lives since Hodgkin’s lymphoma started.