June 18th
It's time to leave for my doctor's appointment. I
know vaguely where it's located and I leave early.
I'm really in the dark about my prognosis. What
will happen to me? Naturally, on the drive
there I begin to reflect on the totality of my life.
I've
done nothing great, advanced the human race but
little, lived a basic simple selfish small life.
From a universal perspective, I honestly convince
myself that bacteria do about the same. There's a
weird kind of assurance that creeps over me brought
on by this apparent humility. "Hey, you've had a
full life already," I tell myself. "You've done
nothing earthshaking certainly, but you have no cause
to complain. You've lived the kind of life that 99%
of people who have ever lived never got the chance
to. You were born into a well-to-do family, had a
good education, have been financially unhindered,
have experienced great freedom, travelled far and
wide!" I'm
beginning to convince myself and a smile crosses my
face. "You're right," I think reflectively, "I have
had a good life and if it's drawing to a close so be
it. You've always told people you never thought
you'd make it to twenty. To thirty. Forty. Even at
fifty you said it. Now all that mindless talk might
make
sense. You may not see 52.
Thoughts like these filter smoothly through my mind
as I cruise the back country roads to the doctor's
office. I'm feeling rather smug, having reconciled
myself to possible death. I won't allow myself to
wallow in self-pity. I've got nothing to feel sorry
for. I've had a very fortunate life so far. It
soothes me somewhat.
I arrive at the office. It's a beautiful building in
a medical complex. The sign says "Hematology and
Oncology". I'm not up on my "ology's" but pretty
soon I see a sign about "Cancer patients". I think,
"OK there it is in black and white, they think you
have cancer." They, being my doctor, and Dr. Thai.
I enter the office and sign in. Several patients
are seated in the light filled room. Oak furniture
and magazines. "There's coffee over there if you'd
like some," the pretty, young receptionist offers.
"Thanks," but in my mind I think, "You don't need
any coffee, you're about ready to go thru the
skylight already." I take out Undaunted
Courage and
begin to read. I'm not expecting to see the doctor
very soon with this many people waiting. They all
look worse than I imagine myself to look. How can a
healthy guy like me be in a place like this, with the
proposed diagnosis of leukemia? I bury myself in the
travails of Lewis and Clark. It's a good book and in
no time I have my mind off my problem and on
theirs..lack of food, harsh conditions, unfriendly
Indians. Then a nurse calls my name.
She is a thirtyish, plump, blond-haired lady with a
pleasant
smile.
She leads me to a room with a scale. Something
seems familiar to me about her. "Oh no", I think,
"not deja vu". I say to her "Have we met?"
She says, "I don't think so, but you look familiar."
When at my questioning she says her name, it is
unfamiliar to me. Oh well, maybe its meant to be.
The fates have preordained this visit. I
weigh 174. Blood pressure is normal. She leads me
to another room where I read for about 30 minutes
waiting for the doctor to arrive.
I've noticed a blur going by the open exam room door
as I sit reading, waiting. Finally, that blur slows
down and enters the room with an arm full of papers.
My doctor is a pleasant looking Asian fellow,
casually dressed in Dockers pants, button down shirt,
no tie (that makes me feel comfortable), penny
loafers, glasses, closely cropped hair and exuding
effiency. He matter of factly tells me that the
suspicion is that I have Hairy
Cell Leukemia
It doesn't overwhelm me, because I'm prepared.
Thankfully he's quick to say that the treatment for
Hairy Cell or HCL is effective. Ninety percent of
the time one treatment is enough to put the disease
into remission (no sign of it in the body). Boy, is
that reassuring. Dr. Thai then goes on to give me
the basics about leukemia, cells, and blood,
confirming pretty much what I had read the night
before on the Net.
In order to confirm or reject the diagnosis I have to
have a bone marow test and a cat scan. The bone
marrow test will determine if the abnormal leukemia
cells are in the marrow of the bone and the cat scan
will show if the spleen is enlarged. The spleen
cleanses the blood of dead cancer cells and when
under severe attack can become enlarged due to the
number of cells it's removing from the blood stream.
So if the two tests confirm it, I've got it. The
lab report from the pathologist already diagnoses it
as HCL because of the way the white cells
look.
These tests will lend further credence to the
diagnosis.
Dr. Thai says he wants to do the bone marrow
extraction (called an aspiration) and biopsy (where
they take a bit of the hip bone) the following
morning. I'm to arrive at the hospital the next
morning at 9a.m. He says that it's an outpatient
service and that I will be able to carry on normally
afterwards. I mention to him that I had planned a
golf game for later that day. He says I can still
probably play. That reassures me too. Probably the
extraction won't be that bad. He has told me what is
involved and I'm not overly concerned.
Now, he explains, that if I have the HCL, I'll
probably undergo chemotherapy. The drug that is used
in this case, called 2-Cda, has shown marvelous
results with Hairy Cell Leukemia. I will receive a
treatment that lasts a week, if I've got HCL. That
treatment would involve having a small device on my
person with a tube that hooks into a port surgically
placed in my arm. The device intermittently pumps
the chemical in a diluted form into my vein. After
one week the thing is removed and on a weekly basis
my blood would be monitored to observe the
rehabilitation of the blood levels and cells. Sounds
OK to me. "See you tomorrow at the Outpatient Clinic
at the hospital. It's on the fourth floor."
I leave the office in a considerably better mood
than
when I went in. At worst, I've got HCL but it seems
treatable. At best, it might be something else
masquerading as HCL. I'm going to live!!
June 19th
