I HAD A LYMPHOMA/ 35/ THE RED DEATH.

POST DECISION DAY ACTIONS.

 It is now a full week since my meeting with Consultant Dr Cervi and the decision to take another PET/CT Scan was made by said Doctor and also the conclusion that if no new activity is found, that treatment will be considered as concluded but that if there is, then I would have, subject to Prof Linch agreeing, High Dose/Stem Cell Transplant asap. A week on and time to assess and determine my own actions based on that has been, hopefully well spent in a variety of ways, some logistical, some physiological and some psychological, with the hope of producing a Holistic approach for the future and especially for the next few weeks till the Scan determines future policy and actions.

Logistically, I needed to confirm with my Hospital, scan date potential and again, the excellent Haematology Nurses, Avril and Rachael worked the oracle for me. The result is that they secured me an April 13 date for the scan and are looking to bring forward, if possible my result meeting with Dr Cervi by a week from the currently arranged time of April 28. Either way , by the end of next month, the die will be finally cast. I shall either be preparing for Hospital or for an extended stay in Turkey from later May.

I also had to catch up with Dr B my excellent G P and update him as well as get replenished prescriptions for non- gluten food requisites and also some drops for an eye infection. The crafty Practitioner threw down a gauntlet when Iwas discussing exercise by telling me I would never be the same as Iwas. Crafty indeed! He knows that that alone would be enough to get me at it, just to prove him wrong! Anyway, as I record later, progress is good on that front so far. Logistically also the PET Scan people have been in touch direct with me, confirming details and fixing a 10 am time for the Scan. This will be Scan No 4 for me, so I know the ropes by now, except that this time as I am not now on Chemo, I can drive myself there and back to the centre where the Scans are taken. This is in the next town Hospital Car Park ,where the mobile unit stays for the day.

Physiologically, after my meeting with Dr Cervi, Idetermined two things. Firstly that without delay, I would re-commence a daily exercise programme that Iwould keep up, whatever, till after ther the Scan results are known. Secondly, I would research into the left ventricular ejection faction and seek to find out why my fraction has decreased from 55% to 35% as a result of Chemo. This I have done, so below are the results.

DOXORUBICIN , "THE RED DEATH" and THE LEFT VENTRICULAR EJECTION FRACTION.

The left ventricular ejection fraction is the name given to the measurement of blood being expelled from the heart to travel round the body to fulfill the requirements. The fraction is the measurement they determine as that relating to the amount thus expelled. 50% is standard and indicates the muscular walls of the heart are doing their job. Mine at 55% prey- Chemo was as I would have expected, in good shape. Thus, 35% post Chemo shocked me but the Doctor told me it was nothing to worry about. My research has revealed why an Oncologist would so say1

The CHOP treatment, of which I had 8 doses remember, is made up of 4 drugs. One of these is DOXORUBICIN, which, as I found out also carries the nickname of "THE RED DEATH" Nice name! This is primarily because one side effect is that it can also affect the muscular structure of the Heart and reduce the efficiency of the organ. Clearly, if efficiency drops below a certain level and blood no longer circulates in sufficient quantity to meet bodily needs then things break down.

 Fortunately, the heart wall can self repair when treatment is concluded and apparently, my fraction level has not dropped low enough for great concern and is in the parameters for self repair over time, and with sensible exercise. Thus, my decision to increase my physiological output was doubly justified. "Listen to your body" ,my old GP had said years ago. Best medical advice I ever received! I commend it to everyone.Anyway, we are now on the treadmill every morning pre- breakfast and apart from feeling like the tin man through stiffness, I am benefiting daily from the activity. Good weather has also promoted Gardening activity which my wife and I can attack jointly or separately with the result that a variety of tasks requiring sensible effort are now underway for the Spring and Summer ahead..

Psychologically, we decided this week to "HOLIDAY AT HOME". Living near both sea and country, we have benefited from a sea-front promenade walk of over an hour, then on another day taken the train out to the end of the world"s largest Pleasure Pier{ 1.33 miles long,.with very little at the end of it save for shipping lanes and a lifeboat station}. This was followed up by another promenade and next day, a country ramble to feed stale gluten free bread to ducks! All simple but with the good weather invigorating and uplifting nevertheless.

So,  the summary here has to be , preparation, and more than ever, a return to "normal" living. I am told to expect at least another couple of months to finally shed the remnants of Chemo {my toes still tingle, and my hands are not yet back to full grip, for example}. Allowing for things like that, and the fact that this cannot yet be considered as "over", life like the early Spring weather here is improving it seems, by the day. PMA says "and so it should be", whilst caution is still the byword to avoid over-optimism. We shall report further developments of course, but for today it is good just to be alive and enjoy what is all around me. 

 

 

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