My oncologist sent me to see a specialist, to help determine whether or not treatment would be appropriate at this time. The appointment with the specialist was on Thursday, October 25th, 2012 at a hospital in the city.
I had scheduled the afternoon off from work in order to go to the appointment. It was the type of fall day where the weather was in some state of change. The weather report had said that towards late afternoon, the temperature would get colder and there would be heavy rain and possible thunderstorms.
The day started out mild and fairly warm but the winds really set in by mid-day. As I was walking to my car to leave work, I felt the wind swirling around me. The sun was hidden behind a cloud. The weather seemed to match how I was feeling that day. I felt like one of the fall leaves being blown from the trees by a heavy wind, pulled in different directions, not knowing what the outcome of that day’s appointment would be – not sure where I would end up and feeling like I did not have any control over where the winds would take me.
In a little while, we were at the doctor’s office within in the hospital, waiting. The doctor came in and examined me. She checked for swollen lymph nodes. She was poking around in my armpits with her fingers. At one point she said, “Do you feel that?” I did feel something. It didn’t hurt but I could feel her push on something. She pushed it one way and then the other. She said it was a swollen lymph node. Oddly, it was kind of interesting, like, ok, now I feel what they are talking about! Even in the midst of a serious doctor appointment, there was that little light-hearted moment for me. Those type of moments come at the strangest times, don’t they?
The white blood cells that have changed into cancerous cells like to congregate in the lymph nodes. It’s like their hideout I guess.White blood cells are the warrior cells that fight against bacteria, viruses, and other germs.
When these cells become cancerous, they are like rogue invaders in disguise. The other cells can’t tell that they aren’t good warrior cells anymore but that they’ve changed into the bad guys. Since the other cells can’t recognize them, they don’t kill them off. The bad guy cells also have a longer life span than the good cells, ironic as that may be!
After she examined me, the doctor sat down to talk to us. She summarized everything we knew so far and asked if I had questions. I told her that I wished I could know for sure which sub-type of indolent (slow-growing) Non-Hodgkins Lymphoma that I have. There are many sub-types, and they didn’t know definitely which I had.
The doctor acknowledged that of course as a patient, a person wants to know what kind they have. That is normal, and something that anyone would expect. She said that unfortunately blood results don’t always fit neatly into the little boxes of which sub-type of disease it could be. Sometimes they have to sort of make a guess by process of elimination. But, the doctor said that in a way, it didn’t really matter. What matters is knowing how to treat the disease when I need treatment.
One way they determine what kind of treatment is by the antigens present in people’s bodies. An antigen is “a molecule that binds to an anitbody and initiates an immune response because of the body’s recognition of that molecule as foreign.” (from “Understanding Pathophysiology” by Huether and McCance). I don’t really understand this but I hope to some day! Apparantly, it’s almost like the different blood types. People have different blood types. In the same way, people’s bodies produce different antigens. So that is the most important information, and they do know which anitigen my body produces. With that information, they will determine how to specialize the treatment when I do need it.
I remember that the doctor then used the word “pesky” to describe the indolent (slow-growing) type of Lymphoma. She said it very seriously and very slowly but when she did, I could feel all the tension leave my body. Pesky, I thought. Well that doesn’t sound very scary, just sounds more annoying than anything else.
The doctor said that these cells would be hanging around and eventually build up to a level where I would need treatment to knock them into remission. For now, it is just time to “watch and wait.” This term “watch and wait” is the actual way they describe monitoring an illness like this. I will go to the doctor every three months (at least for the first year) for them to check on whether there are any changes from the last time. The doctor said that we will only know how things will turn out over time. She said it could be one year, or three years, or five years, or ten years before I would need treatment. She said that because of my (young) age, at some point in my life, it’s likely that I will need treatment, but I don’t for now.
We left the doctor’s office with a huge sigh of relief. When we stepped outside, we noticed that the temperature had become noticably colder. As we started to drive home, rain started pouring from the sky as if in some type of mad rage. I felt as if it was all the tension that I had felt before the appointment draining from my body and draining from the skies above.
