Yesterday was my semi-annual checkup with my oncologist at the Cancer Center. These visits are probably the most stressful thing I have happening in my life personally over the last 5 years, since I finished treatment for Mantle Cell Lymphoma and went into remission.
About 6 weeks before – I have to go for a special blood test (to detect the presence of cancerous cells/genetic cellular damage) which can only be done at the Cancer Center. This is kind of a “warm-up” for my visit. The test takes about a month to come back, so we always schedule my visits about 6 weeks afterwards. This time we actually pushed everything back a month because of COVID, at my request. The fact that they thought I could wait another month was a good sign.
Then about a month before the actual visit I like to go for a regular CBC (Complete Blood Count) with my primary care doctor and if it comes out as normal – I know there’s nothing serious that can be going wrong with me relating to lymphoma. It puts me in a better frame of mind knowing this beforehand.
About two weeks before the visit I start thinking about the experience and mentally preparing. I try to gather all of the reasons why I should walk in there like a champ and be excited to find out how well I’m doing. I reflect on my good recent CBC, the fact that I feel good, the fact that I have no fevers/lumps/weird visual things, the fact that other doctors tell me I “look healthy”.
The week before the visit I start feeling the adrenaline rush of stress when I think about it. My resting heart rate goes up a few points. I get headaches from muscle tension. I don’t think as clearly – I am distracted easily. I want to spend time doing mindless things to not think about it.
A couple of days before the visit I can’t sleep, can’t eat, and worry that I won’t be feeling well the day that I go and this will cause my doctor to be concerned. I worry that feeling miserable will affect my “performance” so to speak. I am almost obsessed with the visit and can’t think much about anything else.
A day before the visit I imagine myself there, try to cheer myself on again reflecting on all of the positive indicators that lead towards nothing being seriously wrong. I try to eat well and plan on getting a good night’s sleep so I am feeling good and strong for the visit. I imagine that in less than 24 hours it will be over, and I’ll know what my “fate” is.
The morning of the visit – I can’t think straight because I literally didn’t get any sleep the night before. It’s all I can do to get ready. I feed the cats, which helps give me something to do to keep my mind on something else for a little while. Then we leave. It takes approximately a half hour to get there.
On this particular morning, yesterday, as we were driving to the Cancer Center, our veterinarian called to give us abdominal ultrasound results for our 15 year old cat Eureka (aka Fawn Girl). Over the last few months she has been losing weight and just not feeling right. We could tell something was off. After blood work and a physical exam, our vet suggested the ultrasound to rule out abdominal lymphoma. There was that word again. My husband and I were sick over the possibility. Well our vet called to tell us that there was NO sign of cancer and it appeared that she has Irritable Bowel Disease that was happening due to something in her diet, After a dose of steroids and changing something in her diet she could be just fine. WOW. Pretty incredible stuff! Heading into my own visit, I actually felt happiness over Fawn Girl’s great news, which helped to somewhat distract me from my own situation. Could we make this 2 for 2?
We get to the Cancer Center and as always, I have to go to the lab first for another CBC and to check my vitals. My blood pressure is normally 100/70 or so and my resting heart rate is around 55. When I am there, they have to not tell me these numbers because they are sky high and hearing this makes me even more anxious and then this feeds into the anxiety already there and so on. Then we go upstairs to the waiting area.
Because of COVID, they are definitely spacing people and appointments out and so we had the whole section to ourselves. Very quickly they called me in. My husband and another friend were allowed to come in with me, all of us masked up. I had hoped that we would be seen and out of there quickly.
Probably the worst of the worst is sitting in the exam room waiting for the doctor. You sit and wait. Wait and sit. Sometimes he is delayed because there is something major going on in the hospital that he has to deal with it whenever it pops up. There are times where I just want to get out of the room and bolt. My husband and friend are chit chatting about whatever and I am sitting there frozen in terror, praying for it to be over already.
Finally, the doctor comes in. We were probably waiting about 30 minutes. It seemed like an eternity. He asks me how I’m doing and I tell him I haven’t felt this good in years. Due to COVID – I have not been around as many people and places as I normally would be and so I’m not catching anything, not to mention the mask wearing, hand washing, and hand sanitizing. I haven’t been so healthy. Well except for the stroke I’m giving myself for being so anxious.
He does a cursory physical exam to check for swollen lymph nodes and then I hear what I’m waiting for. YOUR BLOOD WORK IS GOOD. See you in 6 months. He turns to walk out of the room and I ask “so you mean I’m fine” and he says “yes”. Immediately the feeling of relief overtakes me. I cannot tell you what that feels like but if you’ve ever had cancer and they tell you you’re fine after your test, then you know.
But then…the medical assistant walks in and hands me some papers. It’s the actual result of the blood work for the genetic damage to my tumor suppressor genes. I glance quick at it and I see the words “Low Level” and “Poor Prognosis”. I’m in shock. The doctor was in with the next patient and all I wanted to do was get out of there. I couldn’t believe it. Why would he say I was fine????
Fortunately, the friend who was with me is a retired doctor and so he took it home to read through the three pages of background and translate it for me.
They tested about 50 genes of mine. For one of them, DNMT3A – which among other things is a cancer/blood cancer suppressor gene – there was a low level amount of damaged genes out of the total. In reading the fine print – he told me that it said that this would be the result: if you’ve previously had chemotherapy for lymphoma, if you are over 50, and in healthy people randomly tested. So basically I fit into all classifications. There’s no way I could’ve gotten a different result. My doctor was looking for a result that was more than “Low level” which I didn’t have. And none of the other genes tested had any type of mutation(s). Whew!
The interesting part is the people who could also have low levels of this damaged gene – could be normally healthy people walking around – of any age. We do know that as you age, there is more damage to your cells and so a higher likelihood of cancer. That makes sense. But what about normally healthy people? This is because everyone makes/has cellular damage which affects the DNA inside the nucleus of the cell that contains your genes. In a healthy person – your body’s immune system recognizes cells that are dead, damaged or don’t belong and gets rid of them through a process called “autophagy”. When the immune system is suppressed or not functioning well – your body doesn’t get rid of these damaged cells and then they start to grow uncontrollably. This is cancer. This is why it’s critical to keep all of your cells as healthy and protected as possible and keep your immune system functioning properly.
How do you do this? By eating proper nutrition (VERY simplified – mostly/all plant-based), moderately exercising, limiting stress (working on this one), taking certain supplements that help prevent/repair cellular damage (antioxidants), and limiting exposure to toxic cellular damaging substances (radiation, drugs, tobacco, pesticides, etc.). By doing/not doing these things – you give your cells a fighting chance against damage and reproducing out of control. We are only as healthy as the health of our trillions of cells. I call it my “Cellular Insurance Policy”.
So for now – while everything is in turmoil across much of the world – I will celebrate the good news that Fawn Girl and I got yesterday and ride on that high for as long as I can. Yesterday we were 2 for 2!
