Looking Back Over the Last Few Months

Starting this blog is probably harder for me than most people might think. In August of this year, I was diagnosed with Hodgkin's lymphoma, a blood cancer that attacks the lymphatic system of the body. For someone who has never had a medical issue in their entire life, this reality threw me for quite the emotional and physical loop. What made it even harder for me was that before I was diagnosed I was planning on the journey of a lifetime: I had been accepted into the United States Peace Corps, after a long and tumultuous applications process, to serve for 27 months in the country of Kazakhstan as an English-teaching volunteer. As a recent college graduate, I had deferred my ten-year scholarship, withdrew an application to Columbia University's Teacher's College, and arranged for my outstanding student loans to be paid off. Medical complications were the last thing I could have imagined to halt my entrance into the Peace Corps, but then again, cancer comes inexplicably and without notification.

As I finish my third round of chemotherapy, I find that it may be helpful for myself and others going through similar treatments to learn about my journey over the past few months. I say that it will be helpful for myself because, to be completely honest, I do not talk much about the effects cancer and treatment have had on my body and my mind. When people ask how I am I usually dismissively tell them, "I'm OK." However, most of the time I'm not. I try limiting myself from going too much into detail with my complications because I don't want to impose on my family and my friends especially. It is easy for me to do this because in comparison to others going through ABVD chemotherapy I have had minimal side effects. But that does not mean I do not struggle with my situation. Most of the time I think that no one could understand even if I tried to explain.

So, in an effort to explain, here's my story and what I can recall: For quite some time I had been very healthy. I exercised regularly and ate well--quite the opposite of most of my family. Exercising became a hobby that I shared with my close friends and it made me happy. During this past summer I lived in Ithaca, New York, at the top of a hill, which made traveling to the city center and walking to work a workout in and of themselves. I also took up bicycling, cliff jumping...I was active to say the least. The very first sign of something being different, or wrong, was when I was traveling south to Wildwood, New Jersey, with a group of friends and I could not hold my breath as we drove through a tunnel. After arriving in Wildwood and being there for a few days I also noticed some difficulty with holding my breath underwater, however, I shrugged both signs off because I had recently started smoking clove cigarettes. When I returned from vacation I got rid of any cigarettes I had in my possession thinking it would rectify any breathing difficulties.

To my chagrin, symptoms worsened slowly, but I never could've guessed the outcome. The next time I noticed something wrong was when I went swimming at one of Ithaca's gorges a few days before moving back home--something my friends and I did on a regular basis. As I hiked up the path back to the main road, I felt as if I were having an asthma attack. Taking in a deep breath released a deep, wheezing sound. After packing my things and saying good-byes, I traveled home for what I thought would be the last 18 days I'd spend in the country. While I tried to assemble good-bye gifts for my closest friends, make some last-minute phone calls, plan visits before I departed, and take on the herculean task of packing 100 lbs. of luggage for over two years of travel, I realized I may be sick. After an emotional good-bye with my grandparents at the Philadelphia International Airport, I decided I needed to go to my doctor because the night before I had suffered from horrible back pains and the same breathing problems. I thought I was coming down with a lung infection or a bought of bronchitis.

The next week or so would be the most difficult and revealing days of my life thus far. I remember almost every detail. During my physical exam, my doctor noticed a problem with my breathing and swelling in my neck--most likely swelling of my cervical lymph nodes. Her face displayed signs of shock as to how swollen my neck had become in a short period of time. I didn't even notice the swelling until she said something. She then sent me immediately for a neck and chest X-ray the following day. If you would've asked me if I thought something was terribly wrong during my neck X-ray, I would've said yes. The technician took an awfully long time examining my neck as she slowly scrolled over my cervical lymph nodes with a warming jelly, and she barely said a word. I remember joking that my neck felt as if it were having a sonogram. The next clue as to something being direly wrong was that the examining hospital told me I had to go directly to my physician and speak to her about the results. By this time, I was somewhat concerned.

I was quite calm as I drove to hear the results on that August 8th morning. I metaphorically prayed that the results wouldn't prohibit me from traveling with the Peace Corps. I then sat in the waiting room for an extended period of time as I realized my doctor was avoiding an unavoidable discussion. I was shown to an examining room where I then waited an inexplicably longer time--there was only one other patient in the entire office whom might have been impeding my results. I remember my doctor walking in and telling me that the X-rays showed numerous abnormalities in my neck and chest, and that I would not be able to travel with the Peace Corps for quite some time. She then asked if I wanted her opinion on the matter and, with my consent, said they thought it was cancer and I would have to see an oncologist as soon as possible. My mind went quite numb along with my feelings after hearing the results. I believe I was in such a state of shock that I couldn't express any emotion as I walked to her office to wait for a referral form. As I sat there in front of the two receptionists, I burst out into tears, all the while trying to hold in my emotions. As my mind raced, I blew my nose and took my referral from my doctor. On my way out, the Jamaican receptionist advised me to pray and that it would be the only thing that could help--quite the horrible advice to tell a 22-year-old secularist who has just found out they most likely have cancer. I kept my mouth shut, said thank you, and walked to my car.

I remember people staring as I sobbed my way to an olive green Hyundai Sonata in the parking lot and sat in the driver's seat for a while before I decided I could drive home. As I began hyperventilating and then immediately trying to control my breathing, I sent a frantic response to my ex-boyfriend and close friend via text message: something along the lines of, "the results weren't good. I'll call you later." As I stopped a few times on my drive home to let out some much excusable tears, I called my mother and told her to come home from work immediately. I had to tell her my results face-to-face and that I would be seeing an oncologist the following day. After a very emotional and frightening revelation of my current health problems, I let my closest friends know of my situation. The next month or so of inquiries about the Peace Corps would be hard for me to deal with. Each time a person asked how I was doing in Kazakhstan because they hadn't yet heard of the news, I would have to then tell them that I had cancer and wouldn't be joining the Peace Corps. What made it even more difficult was that my ex-boyfriend was scheduled to depart with the Peace Corps in September. I would be lying if I said I didn't feel jealous that he could go and I could not. My follow-up with a Dr. Bernard Grossman, one of the most reputable hematologist oncologists in the area who served as president on numerous medical boards and attended UPenn medical school, would reveal that I most likely had a case of lymphoma. However, discovering whether it was Hodgkin's or non-Hodgkin's, the two main categories of lymphomas, would be a tougher task.

I had a weekend to ponder my life and current health situation before I had to see a surgeon the following Monday about a neck biopsy. That weekend two friends who were preparing to say a final good-bye and spend a final few days with me came to support me during the next week of tests and surgeries. In total, I had a neck X-ray, chest X-ray, blood work, two biopsy surgeries, a CT scan, and a PET scan. These physically and mentally draining tests took a toll on my body, especially the second biopsy where they had to administer general anesthesia and post-operative morphine to relieve pain. The morphine was excruciating; I've never felt so horrible in my entire life. I remember hearing visitors come over to see me as I squirmed in discomfort in the guest bedroom, the closest bed to the front door of my house. I was probably the most scared at this point as family and friends tried to comfort me. I believe I lost a total of five to six pounds that week because I had to fast and also lost my appetite due to medicinal drugs.

I was finally diagnosed with stage 2A Hodgkin's lymphoma, the more forgiving of the two main categories. Hodgkin's disease, as opposed to non-Hodgkin's, infects the body in a uniform way, traveling from one set of lymph nodes to next closest set, making it easier to predict. Most people who suffer from Hodgkin's disease are in their 20's or 30's and male. Richard Harris (the original Dumbledore in the Harry Potter film series), Dale Carnegie (an American writer), and Jane Austen (the famous British writer) all suffered and died from the disease. Some fighters of the disease have a family history of blood cancers, some with exposure to Epstein-Barr virus, and some suffering from HIV/AIDS. I don't fall into any of these medical histories although I did have an aunt die at an early age from leukemia. To continue my diagnosis, Stage Two meant that the lymphoma had spread to more than just one area of my body: my neck and chest. Type A denotes that I did not suffer from systemic symptoms such as night sweats, excruciating back pains, and others. My oncologist said that out of most cancers mine was one of the most treatable, which gave me some relief, however, I would still have to endure 4 cycles of ABVD chemotherapy followed by minimal radiation, as oncologists have found that combination therapy proves more effective overall with cancer patients effected with abnormalities in the chest cavity.

After learning about ABVD treatment and the complications associated with each drug, I signed loads of paperwork allowing Mercer Bucks Hematology Oncology Center to administer the treatment. As I learned, the acute side effects included allergic reactions, vomiting, diarrhea, nausea, alopecia (hair loss), lowered blood counts, constipation, and neuropathy (numbness in fingers or toes). Out of these eight side effects I have experienced the latter six. In addition, I have also experienced the softening and bruising of my fingernails, extreme fatigue, collapsing of veins, worsened skin, and slight back pains. The scarier and delayed side effects of ABVD include infertility, pulmonary toxicity, cardiac toxicity, and secondary malignancies such as acute leukemias, tumors, and lymphomas. It's amazing the amount of knowledge one can absorb when suffering from a certain type of sickness. Sometimes I feel as though I'm an encyclopedia for Hodgkin's lymphoma. Furthermore, in order to track possible delayed effects, I routinely have lung and heart tests to make sure my body can handle further treatment. A whole new set of short and longterm complications accompany radiation therapy which I will receive a few weeks after the completion of my chemotherapy treatment.

After the lesson on diagnosing and treating lymphoma that I just gave, it may be important to say that throughout my entire treatment I have been surrounded by loved ones who consistently support me in my struggle to fight cancer. This along with the speedy improvement of my condition have helped to keep me optimistic. Within a week or so the swelling in my neck went from a measured 16.5" back to its normal 15" measurement. A follow-up PET scan revealed the abnormalities in my chest cavity normalized along with my left cervical lymph node. As I embark on my last cycle of chemotherapy with a full body of hair and minimal cranial hair loss, I can't help but wonder what my life will be like when I can function normally, work out regularly, and focus on starting a career in the education field rather than worry about if I'm going to pick up a cold from visitors, or a bacterial infection from using a public bathroom.

Now that I have reviewed most of my physical difficulties, I hope in another blog to discuss the mental struggle that accompanies cancer: the stigma of cancer, struggling with coming out about my disease, the negative effects on my social life, and dealing with the monotony of being an unemployed 22-year-old living at home. But before ending my first post, I would like to thank everyone that has written me a card or letter, sent me a loving email, or taken the time to call and check up on me. And even more importantly, I would like to thank the handful of close friends who have accompanied me throughout these past few months--those people who have consistently checked up on me, visited me at home, encouraged me to get out of the house, and those that have understood that I sometimes need time to myself and might not get back to my voicemails as I should. You know who you are. And to my family members, who care for me, cook for me, argue with me, comfort me, take me to my appointments, try to keep me active, and even those who offered to help shave my head, I thank you.