Sunday, September 19, 2010

CT results and the Joys of Denial

I have been slower than my usual tortoise pace since my 25 hour fast for Yom Kippur.

I wore no leather, did not anoint myself, had no "familial relations", skipped a shower, ate nothing, but I did drink water.

That morning I had my CT scan of my abdomen and the barium in my gut and more importantly the IV contrast iodine in my fragile kidneys needed to be purged so I drank lots of water.

After all the Talmud teaches we are to live by the commandments, not die by them.

But the not eating and the long hours in the shul, pounding my chest for my sins, doing the hard work of repentance, took its toll and I have still not fully recovered.

So did the CT scan tell whether on this day of judgement would I be one of those inscribed and sealed in the Book of Life for a year of peace and health and prosperity?

It was indeed like cracking open a fortune cookie and reading the note inside that foretells my future.

And like any good fortune cookie, the news was generically good, but non-specific.

After being on a manly dose of cyclosporin (that has raised my blood pressure, strained my kidneys and put me at risk for gout) for almost 4 months, and having had 6 weekly doses of rituximab that finished more than 2 months, there was only one question we were trying to answer. Was my cancer retreating?

The CT says YES. Big time. My largest cluster of mesenteric nodes had shrunk in volume more than 80% from 6.4 cm x 3.4 to 3.8 cm x 1.7 from the CT on 6/1/10. The next large node is in the inguinal area and measures in at 2.2 cm. The rest have all shrunk or at worst stayed stable.

Careful readers may be scratching their head. I thought you said your last CT was a year ago, and then the largest cluster was a mere 3 cm though I had suspected significant growth had occurred as my cancer was relapsing, making it hard to know what the findings from last Friday's scan would mean.

But I had honestly, totally forgotten about my June 1st CT, a scan of all of me, a scan of my neck, chest, abdomen, and pelvis.

I was in complete denial.

Its memory was not to be found anywhere in my head, When the radiologist told me I had less disease than before I was thrilled and surprised. Less than the 3 cm a year ago. WHOA! Then I was confused as he was comparing my images to those just a 100+ days earlier. I struggled to get my bearing as I listened to his findings. In the preceding weeks, I had discussed with my doctors the difficultly of not having a measurement just before I started therapy to help gauge my response to therapy when in fact I did. They didn't question me. Only my wife tried to tell me she had a different recollection. I didn't listen (always a mistake) for she was again right.

But the denial had served me well. I would have been so much more worried if I had been constantly conscious of my big gut notes. Their fate is my fate. I would have fretted and been down. Even more.

So the reality altering full blown denial in my case turned out to be a healthy coping mechanism, not that I recommend the ostrich strategy to any of my readers facing a tough enemy.

For me it bought me a few months of less fear.

This result is very good news. My greater than 6 cm nodes were sensitive to pretty gentle treatments of rituximab and cyclosporin. Not an easy task for such light weight therapies. It was hardly a given, many would argue a most unlikely outcome. No-one would argue it is not a reason to celebrate. And I would add, to push on.

In the next post I will deal with what the scan means in more detail. The picture is starting to get clearer. The path is straightening out.

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Blogger Mikha'el said...

To another year of joy and health!!

September 20, 2010 at 10:06 AM  
Blogger Dragon Slayer said...

That is great news considering the treatment you had was mild comparable to others. Now you can sit back and have time to explore more options. You respond to treatment and that is a GOOD thing. Yippee!

September 20, 2010 at 11:06 AM  
Blogger Marcia said...

Best wishes on your latest good milestone!

September 20, 2010 at 9:01 PM  

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