Day 204-Finished but not finished

Last Friday we got the news we have been waiting for since Anna’s first diagnosis back in September. THE CANCER IS GONE!

I can tell you that I have been outwardly positive and the biggest cheerleader I know how to be but, to say we approached our visit with Dr. Kaplan without trepidation would be a bold faced lie. When Anna and I would talk about our nerves approaching the results of our final scan I would just say “Its going to be fine, of course its gone” but both of us knew that if it was a sure thing, we wouldn’t have a final scan. The PET-CT was scheduled for last Thursday and unfortunately I was in Port Townsend for work when Anna had to go in for the scan. Not being there for the scan was tough but Anna is tougher and we have a great support network here to take care of us. When I got back home Thursday night Anna was pretty tired but doing well. Her nerves were a little fried, but as I keep saying, she is a tough cookie.

We drove down to the appointment in relative silence, trying to break up the drive with small talk. We had discussed that no matter the results, our lives would again shift and we were ready. We moved through the now familiar process of parking garage, elevator, waiting room, nurse until finally Dr. Kaplan came into the room. He gave us a big double thumbs up and stayed quiet. At the same time, both Anna and I asked “Does that mean its gone?” and he nodded. The nurse told us she had wanted to tell us the entire time as well.  We hugged Dr. K like a man that had saved Anna’s life and I may have cried a little.

When we first got to meet Dr. Kaplan it was late in the evening and we had a tiny newborn Shiloh with us. We were both pretty scared and trying to figure out what life in cancer treatment would look like. Dr. Kaplan was sweet then and explained patiently the process and prognosis. Anna and I were a mess (mostly me) and I remember telling him that I was just so happy we were meeting the man that would fix Anna. Now I realize it was Anna that did the fighting and fixing and I am thankful for her strength. Dr. K and the team at Swedish were and are amazingbut it is Anna that beat this thing.

We are now moving on to a life after cancer. Anna has said that she doesn’t want to define herself as a “cancer survivor”. I get that and wouldn’t want to be defined by an illness either, but in my mind Anna is defined by her fight and her Kung-Fu is strong. 

Day 181- Being Done

Few things can compete with completion. Not to be too alliterative, but we are arriving alive, complete with chemo and terribly tired.

Anna made it to Friday with the usual grace and patience that I have come to expect from her. We have been looking forward to the last treatment from the first, and at times we have even discounted it as even counting towards the total. The truth is, for me, this will be the hardest.

Anna has fought to keep this whole treatment in check and has done well. It has built and built, and pushed and pushed until she was ready to break at times. However, never, not once, did she let this break her. I have watched as chemo has ravaged her body, taken her hair, squashed her energy and rattled her emotions. Each day, I watch and I struggle. As her husband, her protector, I want nothing more than to take the pain, take the struggle away but I can’t. We have arrived at the end and the compounding side effects will be their strongest this time.

This is going to be the hardest round for me because it means we are done with the fight. The fight keeps us moving, it allows us to focus negative energy at a “thing”, an opponent. Now, we are done, and we wait. Waiting is the hard part for me. Anna does ok with it until we get really close, but for me, the long wait till our last all clear is hard.

Anna will have a PET CT scan on the 24th of March to confirm the absence of cancer we expect. Dr. Kaplan has indicated that we have every reason to see clean scans but the test will still bring anxiety.

Anna is healing well after her treatment. Aside from built up fatigue, the symptoms seem to be about normal or perhaps even a little lighter this time around. Her spirits are up and there is a new light in her. Knowing that she wont have to get in the ring with Chemo again is giving her a new energy. We are talking about the next months and year, instead of the next few days and week. The next steps for us will be without cancer and that is a path we are excited about.

I cant say that I will be writing more here as often as I have so far, but I will continue to update as Anna heals and we get back to normal.  

Day 167-So Very Close

Its tough to help the capable and it is extremely hard to assist those that excel at everything. Anna is one of those people and she is the one I want to help most.

Showing off our kiddos to the best nurses around.

I have just gotten back to Seattle after a three week delivery of the boat I work on from Oahu, Hawaii to Seattle. During that period Anna had a round of chemo without me. While I would like to think that I am a huge part of the process, that would be seriously over stating my value. Anna’s mom Colleen moved down to Seattle for the winter to help our family make it through the treatment for Anna. She was there for the last treatment with Anna to take my place. Anna told me she kept asking “What does Chance do?” or “Just let me do whatever Chance does”. Anna would laugh and tell her she was. Truth is, Anna should have told her to make some bad jokes, look at her phone, sit in the nearest comfy chair, etc. Anna does all the work, I just go to do what I can, typically very little

Like I said, helping the competent is tough.

Anna is doing really well. We are 11 out of 12 treatments in and looking at the end soon. Each treatment session has gone well, and Anna’s blood counts have been stable and response to the chemo good. While we have not had any more definitive tests since the last x-ray, we are confident in the treatment’s success.  As is Dr. Kaplan, our oncologist. He refers to Anna as his “best looking patient” and according to some of his nurses, he speaks of her often. We feel very lucky to have him leading the team and on our side.

Shi and Momma keeping up with the times.

As we approach the final treatment, a lot of emotion is coming to the surface. I have really grown fond of our “date days” when Anna and I spend all day together. It is easy for me to relish as I get to hang with her and she is doing all the work. I will miss some of the rituals we have formed around the chemo days. From the funny parking attendant who repeats the EXACT same sentences each time, to the funny nurses in the blood lab. Our exploration of the food to be found near the hospital, the fun and nervous banter between us on the way in and the tired comfortable silence on the way home. I have gotten used to and come to appreciate these days, but alas, I am so, so, so very happy that we are coming to the end. Anna will be done and we will be out of the fog that cancer can bring to a family.

The fearsome foursome. 

Moving onward and upward. 

Day 140-Progress

We are officially 75% done, a huge number to hit. So close now, three quarters.

We had a great last two weeks in Anna’s world of medical care. We have spent time with rheumatologists, neurologists, and radiologists... so many ‘gists. The “gist” of it is, Anna is getting better with a bright future ahead.

During the lead up to Anna’s diagnosis she had met with several different doctors to determine the cause of several issues plaguing her. After chasing several different varieties of auto-immune diagnoses we had turned up nothing until cancer. During the course of treatment Anna has her blood tested a lot. During those many blood tests Anna has tested for an elevated ANA levels. This be a basic indicator of one of many auto-immune diseases. So, we were referred to a rheumatologist to discuss what it could mean. This particular doctor just so happened to be the son-in-law of our beloved Dr. Kaplan. He boiled it down to this: He isn’t worried. The timeline lines up too closely with the lymphoma. We will see him again after all the chemo is over but he thinks it very likely that we wont be pursuing treatment with him when we are done.

The second doctor we saw was a neurologist referred by Dr. K. Anna has had a few things that started after chemo that were of concern to us. One was a tremor or twitch in the muscle in the heal of Anna’s right hand. The other is best described as a hitch in Anna’s step on her right  side. Being as both were on one side of her body and neither was something that was commonly associate with chemo, off to the brain doc we went. The doctor asked a lot of questions regarding the symptoms, poked some nerves in Anna’s arm,  and finished by electrifying a couple of acupuncture needles stuck in Anna’s arm. All a little weird and hard but he said from those results, the nerves in her arm looked great. He ordered a blood test and an MRI of her brain and upper spine that would be completed a few days later. We got a call from Dr. K when the results came back in. All good in the brain department. Anna’s MRI was clear and the effects are just one of the many mysterious ways that chemo effects Anna’s body.

Finally, on chemo day, Anna had a chest x-ray. She has had a tickle in her chest during deep breathing and Dr. Kaplan ordered imaging to check it out. Any time someone with cancer says “My chest feels _____” your heart drops. We have had a few of these situations where I didn’t know there was something to worry about until the panic sets in. Waiting for the results of this x-ray was exactly that. As we talked with Dr. Kaplan about the next round of chemo and effects of the last, the nerves built. Almost like an afterthought, or perhaps for effect, Dr. K said “Oh, right, the x-ray, completely normal” with a  sly smile. He showed us the scans and the notes that said exactly that “results all normal”. He then showed us the x-ray taken just days before treatment started and pointed out where the cancer had been and where it wasn’t anymore. Angels sang, clouds parted, and we cried a little.

The scan on the right is the first x-ray showing the cancer in Anna's chest, the one on the left is the clear image showing only her port and no cancer. Her heart is visible in both.

After the previous period of hardship, this week of great news has us in much better spirits. The taste of freedom is nigh. Days spent in the fluorescent light of hospital waiting rooms are numbered. We are almost done!

Day 131- The Monotony of Hardship

As we sit, we are two thirds through, 66% complete, or in the back middle. Anna is still showing great signs of beating the cancer and we are happy to be on track but.. this is hard.

For the last few treatments the weeks after have been harder than before. During the first two months of treatment Anna would enter the start of her chemo cycle on Friday feeling ok. She would fade into a tough 7 days before starting to improve on day 8. Days 8-14 were ever improving and by the next chemo day, she was feeling relatively good. However, the last two months, the weeks following treatment have been getting harder and harder. We have entered a new stage where the second week after treatment is now just another week of hard.

The chemotherapy is doing its job but it is breaking Anna’s body at the same time.  Fatigue is omnipresent, nausea is also a constant companion. There is pain associated with the Granix shots and their effects that comes and goes. Like I have said, it is just hard. The emotional toll that has been taken on her is immense and if it were me, I would be completely gone. She isn’t. Anna is maintaining her spirit despite the load of suffering that chemo can be.

Sometimes these days and weeks can seem like a never-ending string of getting by, a constant strain on a person, a family, and a time. The truth though, is that we are getting through it. With the support of our family, a wonderful group of friends, and a generous and caring employer, we are doing this. We are not only surviving but our family is growing into a fun foursome. Even during the slog of chemo, we are taking care of ourselves and each other.

As we enter the week of our ninth treatment we are talking about life after cancer. We are talking about celebrating the end with family and friends. We are focusing our attention on real life again. The boredom with the hard times is coming to an end and we are again going to be overwhelmed with the craziness of real life.

March 4th, we are coming for you…

Day 122-A new year.

2015 brought our first day of being a family of four.

2015 has been a hell of a year but this right here is what I will most remember from it. Giving birth to Shiloh, watching Dexter become a big brother, and seeing my husband's enormous heart grow even bigger, all in one perfect moment. Our year may have been touched by hardship but it was defined by love. Thinking about 2016 is like staring directly into the bright sun. It feels good and hard and it makes me cry a little bit. Finding out I was sick was the easy part. We knew exactly what we had to do and so our life in Hawaii, my masters program, Chance's professional goals, and all the rest of our big plans were set aside without hesitation. But now here we are, so close to finishing treatment, and I'm left to wonder, what happens next? Here is the gift of it all: I now understand, in the deepest part of my soul, what used to be a simple cliche. Family is everything. And so, while there are many things I may hope for in 2016, there is nothing I need that I don't already have. Happy New Year, sweet friends!

-Anna

Day 96-Grateful, Halfway, and New Friends

As we make it past the halfway point in the treatment for Anna I am realizing that I could start now and continue forever to thank those that have helped us and not finish. There is a gratitude in my heart that borders on overwhelming guilt. Not to say I feel poorly, just that I am unsure I can do enough to repay the kindness we have received. I also realize that I have not thanked personally many of you, and for that, I apologize. Please know that I am more grateful than I can express.

Getting good at this, and always stylish. 

Friday was Anna’s 6th treatment of 12. We are Halfway! Counting down towards the end is easier for us now that we have less to go than we have done. The actual treatment wont change, and Friday was no different in theory than the previous 5 but it felt different. Anna and I discussed the fact that we are getting good at the process and it is an odd thing to become practiced in. We know the majority of the staff at the Cancer Center on the floors we visit. We can discuss the effects of different IV chemo drugs in detail. We even have mapped out which reception areas have the best candy depending on the staff working that day. Like I said, it is an odd thing to be good at.

As we spend more and more time in the different areas of the Swedish facility we are getting to know some folks pretty well. Anna has a nurse in the blood lab that has been with her for a few tests that is one of those people. Karen managed to work her way into Anna’s heart on the first “date” by cracking wise about the problems with living in Seattle. Her take on health food stores was tainted by the fact that she would rather spend her time at the casino chain smoking and drinking. She is loud, a little obnoxious and probably the sweetest lady around. The day I met her I managed to receive a dozen kisses before we had exchanged ten words. Wonderful people like Karen are one of the few unexpected delights that has made a big difference for us during the process.

Karen the Great.

So, we are thankful to be at the halfway point, joined by our new friends. 

Day 83-Ups and Downs, the rollercoaster of cancer care.

We had a wonderful Thanksgiving with family and celebrated the great news we received the day before. We toasted the treatment, the doctors, and the love and support we receive everyday. It was a wonderful night to be with our family and revel in the joy of the clean scans. 

The high from the night continued through until the next morning when we showed up for treatment at Swedish. Anna got a blood draw for her counts and we waited for treatment to start. After a while, a nurse returned to tell us that her white blood cell count was borderline but low and that she would have to check with the doctor on call to see if we could administer treatment.  We waited, and waited, and finally she returned only to tell us that we would have to go back home to try to get Anna’s counts back up. Anna would have to give herself the Granix shots until Monday and we would come back to check her counts and hopefully get treatment. The nurse wasn’t sure if this would be possible and told us that we may have to skip a treatment and tack it on to the end. Not good news. 

We returned home pretty down. This was the first time since the diagnosis that the plan had changed or we had received anything but promising news during treatment. It put a damper on the joy of finding clean scans. The treatment schedule has Anna finishing her last chemo treatment on the fourth of March, two weeks and two days before her 30th birthday. This has been our target date for things getting back to normal, for us to celebrate a big birthday and being cancer-free. If the treatment got extended two weeks, Anna would be feeling really crummy on her birthday. While not earth shattering, it is hard to think about the end date getting pushed back. We also use that birthday as a goal to get to, a day that we look forward to when the treatment starts to wear Anna down. 

Anna, as I have said before, is a strong lady. By Saturday morning she was back in gear and we moved beyond the news and back into life. 

Fashionably relaxed, even in chemo. 

Today, we are sitting in the chemo ward of Swedish. Anna is getting her treatment, and we are back on track. We are thankful that her blood counts went right back up and she is able to continue as before. We won’t be changing the schedule, we will be done before that birthday, and we are going to party like its… March 20th 2016. 

The ups and downs of this process are probably the most unexpected part for me. I knew that it would be hard but didn’t realize how much I would have to be happy about. The news of Anna’s diagnosis was devastating but the initial prognosis from Dr. Kaplan gave us immeasurable hope. The clean scans from last week gave us boundless joy but being turned away from an expected treatment and possibly extending the process, was a real bummer. Being back on track gives us determination and fortitude to finish the task. 

She may be small but she is mighty.

The mighty one and her sidekick. 

Day 78, Thanksgiving

Just a quick note to let you all in on our reason to give thanks this year.

Anna had her PetCT scan today to check the progress of the treatment. We had the same test done in the beginning of the treatment to stage the cancer and identify tumor locations. We heard that we could see anything ranging from some reductions to no more cancer. To say we were nervous about the results would be a bit of an understatement.

Today, the scan came back CLEAR!!! No evidence of cancer, no tumors. This is the best possible result on the spectrum of answers we were prepared for. The doctor indicated that the scan looked like someone that had never had cancer. 

This doesnt mean we are done, it just means that success is in our grasp. Anna will still need to complete the remaining chemo treaments and our timeline is the same. We still have another three and half months of battle to go. 

We are beyond happy and celebrating the success with family tomorrow. Thanksgiving is an appropriate day for us to celebrate this victory.

We are happy beyond belief and know that the support of those around us fought just as hard as Anna and her chemo to get us here. Thank you

More to come in the next few days. 

Day 57- 25%, Thankfulness, and Aunties/Uncles

Anna has made it through her third dose of chemo, putting us 25% of the way through the anticipated treatment. The joy of this milestone has been tempered a bit by the side effects being tougher on Anna this round than any of the previous. 

This is how you go to Chemo on Halloween. 

We met with Dr. Kaplan on Friday prior to chemo and he was, as always, a positive guy with positive things to say. He indicated that Anna's blood counts were really good which meant we could dial back the Granix shots (a wonderful change for Anna) from 7 to 3 days. The Granix has been prescribed to help Anna produce white and red blood cells faster as the chemo is doing its best to kill them off. It causes pain throughout her body as the bone marrow works overtime. 

Another side effect that has gotten worse is the fatigue. We were aware the effects could be cumulative for the first 3-4 treatments and this is all within that scope. Anna is tired a lot from the treatment and having a very active 2.8 year old and a 2 month old on top doesn't help. Lots of rest is in order and we have been able to accommodate that with the help of friends and family. This brings me to my next point. We are thankful.

We are thankful these days for so many things. Shiloh is turning into a wonderfully chubby smiley little bundle. Dexter is growing into a loving big brother with boundless creativity and joy. Our kids have kept us centered during this wonderfully.  Not much time left to dwell when they are around. 

The Big Bad Wolf getting his candy on. 

The Big Bad Wolf and Little Red Riding Hood playing their parts.

We are also thankful for our immediate family. We have the support of the best kind in our them. They have given us time, effort, patience, childcare, and lots of love. While you would expect family to do these things, they have done more and better versions of it than we could imagine.

Thankful for PCC

Speaking of family, there is something I took away from Hawaii that is coming to light now. In the islands most of the folks that live there use Auntie and Uncle as a term of endearment to explain close friends. It is sweet and appropriate as everyone there seems to be family in some way or another. As we have had more and more people around helping and giving us their best, I have been using the terms in our life. Not because I think I am Hawaiian after 12 months on Oahu, but because it is the best way to express how our friends have become our family.

When the news got out of Anna's diagnosis the outpouring of love and support was humbling. People came from all sides of our lives and gave their support. They called, emailed, messaged, and visited. We have had food cooked for us, gifts delivered, babysitting offered (and taken), house cleaned, cars found, kids placated, ears and shoulders lent.

Thank you, from everything we are, thank you. 

Day 50

We cut Anna's hair. It was a hard day but chemo had started to make it fall out, so it needed to be done. It was emotional for both of us, Dex and Shiloh helped in their own way and we made it through together. Cancer is hard, chemo is hard, cutting off all your hair is hard. This whole thing is hard but Anna is the strongest woman I know (and I know some of the strongest around...)
 

Day 40, Round Two

After a busy couple weeks between treatments we are now complete with round two. 

The effects of the chemotherapy were hard but as always, Anna stepped up her game and managed to come through smelling of roses. After the first couple days, the symptoms decreased slowly with the exception of fatigue (which will probably be around for a while). Not that you could tell with Anna that there was any issue... 

The side effects of chemo are a strange beast. Anna has had some neuropathy in her fingers and hands (numbness and tingling) that was unexpected and a little disconcerting at times. She has experienced nausea in different forms but,  for the most part, can treat it with medication. She has also had some lingering muscle control issues in her legs (makes walking a little weird sometimes), but nothing more than a little hitch in her step. Exhaustion is something we expected and have not lacked. Chemo is hard work but Anna is doing it, and doing it well. 

Overall we feel really positive that Anna has experienced side effects on the easier side of the spectrum. While I don't want to downplay how hard this has been for Anna, we know we are lucky (and she is tough).

Anna had an echo cardiogram to check her heart function as it relates to the effects of chemo. Dr. Kaplan indicated that Anna was within range. She also had a pulmonary function test that  came out well. Both tests were aimed to make sure that the cocktail of chemicals that is killing the cancer won't create or worsen any problems we might not have known of. 

We moved again... After a very sweet 5 weeks in our rental on Queen Anne we finally moved back into our house in Ballard. The transition was nice and easy and the setup of our house just like it was before was a really nice homecoming. We have just a few more days of unpacking slowly and we will be back to "normal". 

During our visit with Dr. Kaplan on Friday we discussed the results of Anna's blood draw (great counts), the effects of treatment and corresponding medication (no real changes), and finally the effects on the cancer. While we haven't had another full Pet CT scan, the tumors in Anna's neck are visibly smaller! Dr. Kaplan was excited (as much as he gets excited) about this, as are we. We both expressed that we had held off being too excited but he assured us it was something to celebrate. Not that it will change the course of Anna's treatment but that it was a really good sign. 

Overall, things are going well. Each day brings new or repeated challenges but nothing we have not been able overcome. We are everyday reminded of those around us sending love and prayers. We are so appreciative and feel so lucky to have the support we do. Thank you. 

Speaking of support, our wonderful friend, Heather Fernandez, has setup a Meal Train site for us. You can access the schedule here or here (https://mealtrain.com/w7939q).  

Days 24-26, Chemo and recovery

Anna completed her first round of Chemo on Friday. It went surprisingly well. After the installation of the port, a blood draw, and a meeting with Dr. Kaplan, we made our way to the chemotherapy area of the Arnold Pavilion in Swedish First Hill. We were met by yet another very nice staff of doctors and nurses. They put us in a private room and began the process. Anna received her first dose of each of the four drugs in the cocktail along with a cadre of anti nausea medications. All of it was administered via IV pump and through the port in her chest. 

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This amazing smile keeps all the folks around us smiling back. 

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That red stuff is one of the drugs in the ABVD cocktail. The red is a vegetable dye used to track its movement. 

The chemo segment of the treatment lasted about 3 hours including an education on the process from a very kind nurse named Jenny. We learned a LOT about what this treatment will look like.

• We will have the same treatment every 2 weeks for 24 weeks
• The treatment will be the same each time, 2-3 hours
• The cocktail will remain constant
• The side effects will probably increase until the 3rd or 4th treatment before leveling off
• Fatigue and nausea are going to be the two most constant side effects
• Anna will probably lose her hair in 10-14 days. 
• There will be a Pet CT scan after 4 treatments (8 weeks) to determine effectiveness of the treatment

Anna did really well with the administration of the treatment. Good spirits and lots of smiles the whole time. She indicated that during the process she felt mostly tired but not sick and it wasn't unbearable. She is tougher than the average bear, so I don't know what it would feel like for an average human... 

The last two days have gone well. Anna is spending time recovering and so far the effects are being mitigated by the medication pretty well. We have to give her an injection each day for seven days of a medication to increase blood cell production that makes her bones ache. The port area is sore from the surgery and nausea is omnipresent. Chemo is hard, but as I said, Anna is strong and handling it really well. One amazing lady.

We have had visits from some friends and lots of support from everyone. All of this makes this so much easier for us. Thank you. 

Day 24, News and a Start

We received word last night from Dr Kaplan that the bone marrow test for Anna came back clean! Huge news and made us really happy. 

Today we start. We are at the hospital all day today getting things started. Anna had a port installed in her chest to provide direct and long term access to a vein. The procedure went really well and in an hour she was out again and we were off to the next stop. She has a blood draw from the port prior to chemo and we should be starting the administration of the chemo by early afternoon. 

Anna is doing great and is excited to get things rolling. 

We should be done and back home by early evening and we will update more then. 

Chance

Day 22, Treatment Scheduling

We went yesterday afternoon to meet with Dr. Kaplan and get some more information on the Pet CT scans. As usual he was wonderfully informative and gave us lots to think about. 

While were there, Anna had to get a bone marrow sample taken along with a bone core sample. While a normal procedure, it was pretty damn painful. They used some local anesthetic to numb the skin in an area on her lower back. They then used a large bore hollow needle to go into her pelvis and take out bone marrow and a core sample of bone. Anna, like always, was strong and both Doctor and nurse complimented her on her strength. 

We asked lots of questions this appointment and got lots of answers. Here are some key points:

• The results of the bone marrow and bone sample will confirm staging for Anna. Dr. Kaplan was pretty confident that the chances are very low of spread to these areas. This is to confirm stage 3. 
• Anna will have her port installed on Friday morning. It will remain in place until all treatment is done. It will be in her upper chest and below the skin. It provides a direct access to a vein near her collar bone for blood samples, medication, and administration of the chemo cocktail.
• Chemo will start mid day on Friday and continue every two weeks for 24 weeks. 
• Each chemo treatment will last between 6-7 hours and we will be in the hospital for most of the day. 
• Unfortunately no kids under 12 can be in the chemo area so we will not have Shiloh or Dex with us. 
• After 4 treatments we will have another Pet CT scan to determine progress.

The nurse assisting with the sampling was talking to us after the procedure and was very nice. She was really surprised by Anna's strength during the procedure and indicated that she and her husband had done the procedure as students and it was not easy. She was also surprised that we had gotten in with Dr. Kaplan as he was the "best" and hard to get as your doctor. 

Anna is ready for treatment to start. While our lives will shift yet again, we are ready to start the process and get on track. We have had a very special three weeks with Shiloh and feel strong as a family and ready to face this next phase. Each day we receive notes, phone calls, care packages and prayers from friends and family. While we have not been able to get back to everyone, please know, we feel the love.

Chance

Day 20, More News

After a weekend of waiting for results from the Pet CT scan we spoke to Dr. Kaplan today. After examining the scans he was able to determine that Anna has Stage 3 Hodgkin's Lymphoma. It is made stage 3 because in addition to the tumors in Anna's neck (the ones that presented first), and the tumors found by x-ray in her chest, there is a small tumor on Anna's spleen. Dr. Kaplan was very positive and made it seem like it was more like a 2.5 than a 3 (thats not really a thing though). While each time you get news about cancer it is scary, we are very happy to understand it is a stage 3 and not stage 4. 

Dr. Kaplan also indicated that we would be starting treatment later this week with the first round of Chemo-therapy. We should have a long term schedule and treatment plan in place shortly. 

We meet with Dr. Kaplan tomorrow afternoon and we will get more detail. Anna will also have a bone marrow sample taken for more testing. All the above info is our understanding after a short phone call. I will update more tomorrow night. 

Chance

Day 16, Starting the Process

Today was Anna's Pet CT scan. After 24 hours of no carbs or sugar, Anna went into the "tube" at Swedish for her scans. Aside from a bit of a blood sugar low, it was an easy day. Anna also had blood drawn for baseline testing and confirmation.

We should have results from the Pet CT by early next week and that will give us a clear picture of any areas that the cancer may be. We are thinking that Chemo will start next week and continue for 24 weeks.

Anna is doing great and feeling really good. Our focus is taken up with Dex and Shiloh these days and that helps a lot to keep us pointed in the right direction.

Anna and I are so appreciative of all the support we have received during this. While we know the road ahead will be long and bumpy, Anna is made stronger through your thoughts and prayers.

Chance

Day 11, Settling In

When you have a good doctor, you just know it. Last night Dr. Kaplan called Anna at a little after 8pm to check in. He had gotten some labs I had forwarded on from Hawaii and wanted to share the news and see how she was doing. He joked that he was just "at the bar having a Mai Tai", when instead he just cared enough to be working late checking in with his patients. Like I said, when you have a good doctor, you know it. He indicated that the labs and biopsy from Hawaii showed that Anna had one of the 4 most common types of Hodgkin's Lymphoma (known from now on as HL). This is great news as it means that we know it isn't the one really bad version.

We are scheduled to have Anna's Pet CT scan on Thursday (9/24) morning of this coming week. We will also be visiting the lab for some blood draws and tests there. This process should be all we need to provide staging for Anna. We know that there has been some spread to Anna's chest but this scan should give us a very detailed picture of that and confirm all tumor locations. Dr. Kaplan didn't indicate that the spread to Anna's chest was a surprise, considering the time that Anna has had the growth in her neck. We have a few other tests early next week before starting chemo.

Anna is doing really well. She has plenty to keep busy with now and our kids are providing plenty of entertainment. Our spirits are high and each day brings another silver lining to our lives. The amazing outpouring of support from everyone has really shown us that we are where we need to be.

Thank you all for caring enough about Anna to be here reading this and thank you to all those of you that have shared your thoughts and love with us. 
 

Day 9, Meeting Doctor Kaplan

After a wonderful week just spending time as a family of four, we have started down the path with treatment. We met with our oncologist Dr. Henry G. Kaplan at Swedish Cancer Institute in Seattle.

So, here is what we learned at the doctor tonight. First, Dr. Kaplan is amazing. His bedside manner and confidence are truly inspiring and he told Anna she was super pretty. We felt really comfortable and confident his care. We are in the very beginning and more testing will refine the treatment plan but here is the overview:
 

• There are six types of Hodgkin's Lymphoma, 1 bad and 1 very good, and 4 middle of the road.
• The 1 bad and 1 very good are both very rare, the 4 other are by far the most common
• Everything below is based on the assumption of Anna having one of the 4 common types, to be confirmed next week
• Pet CT scan will be scheduled for early nest week to clarify staging and if/where the cancer has spread from Anna's neck
• Anna had a chest x-ray and there is evidence of spread to the chest, more info after Pet CT
• Probable treatment is 6 months of chemo, no radiation.
• 12 doses, given once every 2 weeks for 6 months
• Chemo side effects are exhaustion, hair loss, and possible nausea for several days after each dose
• All chemo will be given via surgically implanted port in Anna's upper chest and done in office hopefully without any kind of hospitalization.
• Chemo type is ABVD (name of drug cocktail)
• Prognosis, although limited in scope of knowledge, is very good.

Some other great news is that the Doc indicated that Dexter wont need to avoid contact with peers (ie preschool) which we had anticipated as a possibility due to germ exposure.

We will be scheduling scans and further testing tomorrow and we think that all testing will be done by the end of next week and we should be starting treatment shortly there after. We will also have a long term treatment plan in place by then.

We are feeling really positive after our meeting tonight and both feel like we are moving down the road towards being healthy.

Day 1

Today we went to the doctor here in Hawaii to hear the results of a biopsy taken last week. The surgeon indicated that they had found a tumor, specifically a Hodgkin's lymphoma in Anna's neck. The news was more than a little tough to hear but to make matters a little more complicated, Anna is 37 weeks pregnant today with our second child, a little girl.


With this news we have made a move. We packed up our house with the things we would need right away and booked tickets back to Seattle.


As I write this we are sitting in the Honolulu airport waiting for our flight. Tomorrow we meet with the OB in Seattle to set a due date for our baby girl and set a plan in motion for Anna.


We will be keep the info updated here as we know more.