Not a Good Day.

So it seem to have been the right call to not buy that couch for my apartment just yet.

The results of the biopsy came in today, and it is now officially (once again) peripheral T-cell lymphoma, unspecified type.

I had a distant hope that things would play out differently and this wouldn't be lymphoma in the end, and I had a more realistic hope that at least it might not be T-cell lymphoma (because this is not the good lymphoma to have), but it is what it is, and at least now we finally have the answer in hand.

So it's time to move forward and deal with it. Bumpy road ahead, but at least I can begin to get through this.

--

I found out by a phone call from the surgeon's secretary (typical of us surgeons :-) while I was still at work today seeing patients. But things were wrapping up, and by the time I got to talk to Dr. H, I was essentially done for the day. We had a fairly comprehensive chat, especially given that it was just a phone call, and I'm starting to sort out what needs to happen now and how I'm going to need to proceed.

In the immediate future, I'm going to return to New York this weekend, and will have some staging studies done next week (A bone marrow biopsy again, another CT scan, an echocardiogram). The following week, I would potentially be starting chemo. Dr. H and I were able to have a brief discussion of the likely chemo protocol, mainly because it's one we've discussed before. See my post from last summer for a full rundown of the process.

The bottom line is, we're looking at a process that is 5-6 months long. It starts with relatively "easy" chemotherapy for about two months (CHOP), and then some more powerful stuff (ICE), finally culminating in a big chemo cruise missile and a bone marrow transplant (of my own previously removed marrow, being given back to me).

I've discussed with both Dr. H as well as the director of my hand surgery fellowship program the pros and cons of staying in Pittsburgh versus returning to New York. There is no possible way to keep up with the fellowship uninterrupted, but all else being equal the eight weeks of CHOP will supposedly not be that taxing. But the down sides are that a) I don't currently have any doctors in Pittsburgh, and would be starting from scratch, b) I don't have any family or other significant support system here, and c) even if I hobbled through 8 weeks of part-time fellowship, I would almost certainly need to take leave for some months after that for the more intense treatments anyway.

So taking all of this together, the rapidly-forming consensus decision seems to be that I will take a leave of absence from fellowship now, and return to New York for all of my treatments. This way, I can continue with my current team at Memorial Sloan-Kettering, and also be able to stay with family for the duration. The down side is that I have basically moved all of my stuff and leased an apartment in Pittsburgh for nothing, but for now, we'll leave that be.

Maybe I'll start referring to this as my "summer house", and come here for getaways? :-)

Anyway, just trying to look at the upsides of the situation (which include, as my friend Megan pointed out, getting to be back in New York for the fall, with time on my hands...)

Clearly, this once-idle blog will be reporting more and more news to you in the coming days. Wish me luck!

Comments

[Rivka Spivak]

Good luck, Sam. It's the news we didn't want :(

But medicine's a year better than it was last year ... right?

I'm rooting for you. Let me know how I can help.

[Shawn Bayern]

Sam - Best of luck with this ordeal. Once again, yours will be the only blog I read regularly. :)

You've got lots of people thinking about you.

[Andre Ramos]

Sam,
You are a tower of strength, but not one that stands alone. All of us are with you, available at a moment's notice. I'm thinking of you daily, Sam, and am ready to hear you talk about the 'blip' in your fellowship.

Sending positive vibes from Cali,

dre

[Natasha]

Dear Sam,
I think of you as this amazing doctor and person who is always helping people, always positive, always strong and intelligent and kind. I just heard about this, and I want you to know, that from Africa (Megan) to Upstate Newyork (I am here temporarily), we are constantly thinking about you, worrying but hoping for the best. I send all of my love,
Natasha

[Ken Stern]

Sam - so sorry to hear this news, and please let me know if there's anything i can do to help. I'm rooting for you.