Much Too Young

I really don’t know where to start.

It was Sunday afternoon, I was day three into chemo, and I wasn’t feeling well.  I had a fever, my cough was worsening, and I just… well, something just wasn’t right.  By 6 o’clock I had spoken with the on-call doctor twice, my fever was up to 100.7, and we agreed that I ought to be seen at the hospital.

I was in so much pain from coughing.  I could barely stand or walk, but Seth managed to get me into his truck and off to the ER.  (We now know an ambulance would have been a wiser route.)  The wait at the hospital was unbearable, and the actual ER experience was the worst I’ve bared.  The nurses couldn’t access my port, but their antics in trying to do so rallied a crowd.  Once they finally put a needle in me it took three tries to relieve my pain.  I imagine that happened sometime around 11pm.  And I suppose that’s when I started vomiting too.

For hours.  I would pass out, wake up, vomit, and repeat.  At some point I was admitted and transferred to a room upstairs.  I had to have been sick for 5 or 6 hours, but only Seth would know for certain.  The Dilaudid which controlled my pain also made me quite ill.  Or maybe it was the chemo; we will never know.

The next thing I knew it was late Monday morning.  I was starting to ‘come to,’ and I sent Seth home to take care of the bunnies and try to get a couple hours of sleep.  It was the first overnight he ever had to spend with me at the hospital.

The doctors heard sounds in my chest consistent with pneumonia, so they started me on some heavy-duty antibiotics right away.  They needed a CT scan, but since I have an allergy to the contrast dye, I had to be ‘prepped’ for 12 hours first.  Nothing more would happen on Monday.

My scan was scheduled for 8am, and it went off without a hitch.  And then, then I got the results.  There were three things to discuss:

  1. I had pneumonia in my right lung.  No big shocker here.  I was on the antibiotics, and my fever was already improving.
  2. I had a pulmonary embolism in the lower lobe of my left lung.  Wow…  How did that get there?
  3. There is a small ‘spot’ on one of my vertebrae.  Um….  What?

Seth was with Gracie at the vet.  I knew he would be by shortly, and it really wasn’t news I wanted to deliver via text message.  Plus, nothing was confirmed.  This was just a red flag that there might be a problem.  Left to my own devices, I reached for my phone.  The message went to my ‘cancer penpal’ in Pittsburg: “They just told me that I might have a spot on my spine. 😦

The march of the doctors began.  I needed a bone scan, and the earliest available was Wednesday morning.  Yet another day in the hospital.  Each time I saw another doctor, I learned a little more.  Finally my oncology nurse made her rounds, and I got the scoop from her.  If it was cancer, the chemo drugs would stay the same, and I may need an additional injection too.

My bone scan was Wednesday morning.  Yep, that confirmed things a bit.  First, I had a fractured rib – probably from coughing.  And there was definitely something in the spine.  So more tests were ordered.  An MRI and ultrasound of the legs.  The MRI would give a better examination of the tissues in the back, and the ultrasound would make sure I didn’t have any other blood clots.

The ultrasound took 45 minutes, and I was in the MRI tube for an hour and a half.  The good news: no blood clots.  The bad news: “a focal lesion within the T8 vertebra, consistent with osseous metastatic disease.”  More cancer.

My oncologist returns from vacation on Monday.  Until I speak with him, I’m just trying to keep things in perspective.  Maybe this is something we would have never seen unless I got a scan during this point in time.  That is to say, maybe the chemo would have squashed it, and I would have never been the wiser.  The radiology report didn’t measure the spot either, so maybe it’s very tiny, and I’ve started chemo just in time.

I have a lot to think about.  I’m still very sick from, well, the reason I went to the hospital in the first place; on top of that, I feel like I’ve spent the last three days in the spin cycle of a washing machine.

More than anything, I need everyone else to stay calm right now.  And if you are part of my mom, brother, or Seth’s support system, please be strong and brave for them.  No matter what this means for me, I know it would be harder watching someone you love go through it.

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15 responses to “Much Too Young

  • Sjoukje

    Oh sweetie, that just brought tears to my eyes…..Let’s hope that the chemo will tackle whatever it is that is on your spine. Like you said, you might have started on time for this one! We’ve got everything crossed for you and send you lots of love (and nosebonks from the boys) from the Netherlands.
    xxx

  • Craig

    Yikes, what a crummy week this was.

    The antibiotics should bring the lung infection under control and you’ll learn how to be careful to avoid picking up another.

    Treatment should dissolve the emoblism. (You might be kept on a blood thinner just to be safe, and might need a “greenfield filter” placed inside to catch any clots.)

    I’ve read that chemo is often used to treat spine mets. I think targeted radiation is more common, but usually not at the same time as chemo if the combo could be too strong. It seems good you found that spot it early.

    Yes, a crummy week on the cancer battlefield. I hope everything will be brought under control soon.

    Best hopes,

    Craig

    • Jessica

      Thanks Craig. Your comments are always informative and comforting. They started me on Lovenox shots twice a day – what a pleasure that is! Radiation oncology wanted to meet with me in the hospital, but I wanted to talk to my onco first. Not sure how I feel about radiation. Especially when I’m not having pain.

  • Denise Rowell

    My best friend’s mom was diagnosed with Stage 4 lung cancer and given three months to live. Four years later, she is CANCER FREE! Tarceva did the trick. Keep up the fight! Saying big, big prayers!

  • Craig

    Denise,

    Mutation-targeted inhibitor drugs like Tarceva are certainly a blessing for people with cancer with the driving mutation that is vulnerable to that. Most get a year of benefit and a few get years of benefit like your best friend’s mom, but some already have a drug-resistant mutation variant.

    For what it’s worth, I can’t help but wonder if there might have been some kind of testing error in Jessica’s driving-mutation test for sensitivity to Xalkori since that miracle inhibitor drug didn’t work well for her. Or maybe she already had a kind of drug resistance that some new experimental treatment might have had a chance of controlling for a while. For now, though, I’m hoping chemo crushes the cancer without being so hard on Jessica.

    Best hopes,

    Craig

  • Denise Rowell

    Thanks Craig! Do you mind sending me your email address? Thanks!!

  • Denise Rowell

    My email is denise.rowell@gmail.com. (I guess I should have told you that. hah!)

  • Jennifer Scheps

    Oh I am so sorry to hear this Jessica. I can say that for me, the carbo/alimta chemo has done a great job of shrinking the tumors in my bones!! Hoping and praying that it does the same for you!!

  • Craig

    Denise, I replied by email.

  • Craig

    Jessica,

    Your doctors will be able to advise you about using targeted radiation on spine mets. They are the experts with lots of experience with it.

    FWIW, the couple of comments I read on online forums made me imagine (my guess) that it could be pretty easy and safe to zap spine mets with radiation, especially if chemo shrinks it first. It sounded like the risk was from simultaneous chemo making the zaps too potent. Maybe if the chemo works great there might not be anything left to zap?

    Best hopes,

    Craig

  • gethealthynewjersey

    Jessica,

    I’m not sure if you’ve been getting my messages. I have left a few comments on your posts before. I am so sorry to hear this news. From reading your blog, I feel like i am going through it with you. I am on your side, fighting lung cancer together!

  • Jennifer Scheps

    Just a note about radiation on your spine. I had radiation on my spine – the lower spine and as a result of the radiation I suffered from radiation enteritis. IT WAS HORRIBLE. The pain in my spine was gone for the first few weeks after radiation, but now it’s back. Be very careful with radiation on your lower spine. I was incredibly sick for almost 3 full weeks. 😦

    • Jessica

      Thanks for your note, Jenn. Radiation is something I really want to avoid if possible. Mine is in the middle of my back, so I’m not sure I would have that problem, but from reading about it, I’m sure you would have preferred death itself for those 3 weeks.

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