Last day of the year, last day of treatment

So how strange is this? I get my LAST radiation treatment on the LAST day of the year in which I was first diagnosed. That was pretty cool. When the therapist said 'see you Monday' I replied 'No, you won't!' It was a good feeling to walk out of that room for the last time. And I finally felt I needed to take the day off of work to get some rest. I think the fatigue from the radiation has been slowly sneaking up on me, and it didn't help that since I had to drive to the hospital every day it made finding time to exercise difficult. I do remember having a pre-treatment conversation at the hospital. I was told that the side effects would probably get noticable about the time I was finishing treatment. That indeed proved to be the case. Now I'll get a four (not three) day weekend to start to recover, then figure out a 'normal' schedule come Monday.

So this 'done' is REALLY 'done.' Unlike the 'done' when I finished chemo - which was pretty great on its own merrit. I've done all I can to treat my Hodgkins, and hopefully it has been enough.

I remember in the spring telling my cousin I'd been sick for the whole year. That was right before I was diagnosed. Looks like I'm starting out this year NOT sick. I'll make that trade any time.

Hope everyones New Year also turns a corner for the better!

Got my latest blood work back

Red counts are completely normal. So, no more excuses. Well, except I'm still undergoing radiation to the residual mass. Which, if there were no side effects (and there aren't yet) really botches my daily plans of riding my bike to the subway, since I have to drive to the hospital every morning. I was motivated enough to put in 35 minutes on the trainer after getting home today. Maybe I'll be able to keep up 3 exercise days a week this month so when I ramp back up in January I won't be completely out of shape.

Still looking forward to the day when I can do some damage out on the road or trail.

Thinking seriously about buying a cyclocross bike as a finishing treatment present. Maybe get that new bike fitness boost. Missed it with the mountain bike I built last winter, since I got sick right after it was finished.

I find I've become a boring patient again. Most of my answers to the doctors' questions are "No." Not as interesting as the recent past but certainly not a bad place to be.

It IS all about the bike

Sorry Lance, but if anything has been foremost on my mind for this whole journey it's been getting back on my bike and getting back in shape. Under "interests" on any forum I could write "bicycle" and stop. Unless I got out the modifiers and then it's mountain biking, road biking, tandem, fixed gear ...

When I started treatment I was out the day after proving I could still do it. I'd go out for an hour and a half and pay for it, then have my doctor look at me cross eyed as I tried to convince here "That IS taking it easy for me." When I was in the middle of treatment I would wait for the day when I felt good enough to do some kind of ride. Sometimes I went out a bit early and felt like I had no gas, only to find myself enjoying the summer day nonetheless as I finished up. Near the end of chemo I stayed off the bike for 3 weeks while battling a bad case of hemoroids. When I got back on I'd debate each turn wondering if it would take me to a point at which exhaustion would overtake my modest effort.

After chemo was over I had a month of "free time." I rode to the subway to get to work, bemoaned the sunny weekend days I couldn't make a ride for logisical or lazyness reasons, and got thinking on my next purchase.

Now that I'm on radiation for the month, the riding is getting curtailed again. I started to get that sort of stir crazy/funk mood that comes when I don't have regular riding time. Today when I got home (late) I quickly set up the trainer and did about 35 minutes of work. I see my teammates posting rides and long to join them. I have visions of myself charging on, when the reality is I'll be lucky to hang on. I worry about my December "fitness setback" as I dutifully drive down to the hospital for 5 minutes of radiation therapy each day. I see pictures of folks riding to work in the city and I'm jealous of them. I worry about finding the motivation come January to ride regularly enough to have a good fitness base by April.

I hope like hell I'll find the joy in the future I've found on the past when every ride was something to look forward in the beginning to and be proud of in the end.

Next Stop, Radiation

So it is decided, I will have consolidative radiation treatment now that the chemotherapy is over, even though my scans were "negative" for cancer. I didn't think this would be the case earlier on. The medical oncologist I worked with at NIH and my current hematologist all warned against radiation therapy for someone my age. They cited the long term side effects of radiation as being significantly more dangerous than those of my chemotherapy regimen. They had me convinced that once I was done with the chemo that would be it.

As I neared the end of chemo I took another look at the role of radiation. I brought it up with my primary dr. near the end and she thought I should speak to a radiation oncologist at the Cancer Institute. I had that consult and he made some compelling arguments in favor of it. First, it IS the standard treatment protocol for the stage/presentation of my disease. Second, the impact of current targeted regimens is much different than the long term historical data which is mainly based on higher doses, and longer durations where radiation was the primary therapy for Hodgkins. Third, the impact of second line or salvage therapy would far outstrip that of targeted radiation should I relapse, not to mention the short term pain/suffering of that treatment.

In the end it felt like the most responsible course of action to take was, in fact, to go forward with the radiation. My final concern was weather or not my heart would be in the field of treatment which could put me at significant risk for cardiac damage; that's a big deal for me since I've got a family history of heart disease and it would really impact my cycling for the rest of my life. Call me short sighted, but it's just so much a part of me. That's my escape/therapy/etc.

Spoke with the radiation oncologist yesterday and got good news on the plan. The duration and dosage were even lower than I expected, the heart was completely out of the field, and there was minimal lung involvement. In fact, he said if the heart WAS in the potential target area he would likely have recomended against going forward. I was already fairly convinced but this sealed the deal.

So today I went back to do a dry run on the table. The machine was as described by other hodgkins patients. The procedure is quick and easy for each treatment. The main difficulty is that it's every week day for the duration. That's where the short duration comes into play. I've only got 17 treatments compared to a potential of 25. Much less taxing on my schedule since I'm back at work, now. When I spoke to one of the therapists afterwards she thought that by the time I noticed some of the short term side effects I'd be close to done!

So I get started Monday 17 treatments for a total of 18 Gy. I should be done by the end of the year.

Of course, I've found out on this journey that you're never really "done." But if your lucky, you wind up with a nice 40 year break!