Life often throws you a curveball, as they say in baseball. In our case, it was a major medical issue and this post explains what we were facing this last year and why we've been blogging less than usual. A few days before we began our A2 Portuguese class in Miranda do Corvo in late October 2022, Jana had her annual mammography. Unlike in the U.S. it's common to include an ultrasound (ecografia) at the same time, which was a very good thing. The mammography was fine, the ultrasound was not. Her left axillary (armpit) lymph node was bigger than it should be and a biopsy was recommended. The biopsy results told us she has Non-Hodgkin Follicular Lymphoma (NHFL), a blood cancer. That was a stunner. Follicular lymphoma is very slow growing and is not currently curable. Our best guess is that this cancer has been doing its thing for well over seven or eight years. Because of its slow nature treatment options range from "Watch and Wait", which is exactly what it says, to chemotherapy and/or radiation. Every patient's situation is different. Some are on W&W for years, others need treatment immediately. To figure what to do next, we had a choice: We could go through the national healthcare system, or go private since Jana has health insurance (Médis). We'd already had experience with IPO, the national cancer center in Coimbra, when Harold was referred there for a sore in his mouth. Fortunately it was not oral cancer, but our local healthcenter doctor wanted to make sure. IPO's staff was great, but clearly they were at full capacity and then some. Unlike our neighbors, we've not paid into the national health system for years and years, and taking a slot at the center denies someone else treatment in a timely manner. Someone who has no other option. Given the situation, Jana opted to have treatment at Hospital da Luz in Coimbra. After a series of tests (bone marrow biopsy, an echocardiogram to determine if Jana's heart was strong enough for chemo, a PET-TAC scan at ICNAS Coimbra and various lab tests, the verdict was in: The cancer was Grade 1/2 and Stage 3. Unlike solid tumor cancers, NHFL' s staging is different, just indicating if the disease is above or below the diaphram. The hematologist's recommendation was for immunochemotherapy given where the nodes were located. Since follicular lymphoma can transform into a more aggressive form (DLCBL - Diffuse Large Cell B-Lymphoma), it was best to kick this stuff hard right up front. He also warned us that Jana's hair would "fall down" and it did. In mid-March Jana had a port placed in her chest that would be used to infuse the chemo drugs and she had her first treatment a week later. Throughout the entire six sessions of R-CHOP (a session every three weeks), the doctor, the nurses and the office staff at the Oncology Center were wonderful. The nurses helped Jana work on her Portuguese since the sessions were 4-1/2 hours long after the first one, which was closer to 7. Midway through the treatments another PET scan was done and it showed there was complete metabolic response to the medications, which was great news. Here's Jana's Report on How It Went: As of August 10th I completed all the R-CHOP immunochemotherapy infusions. I got lucky, folks. The treatments didn't cause major issues during the infusions, unlike for many people. Issues such as difficulty breathing, heart arrthymias, allergic reactions, etc. etc. Neither did it damage my heart. That chemo cocktail is damned nasty to the things we want to kill, but can also be the same to the host receiving those meds. Someone was watching over me, and I'll always remember that. Yet another PET scan (#3 and counting!) shows the lymphoma sites are significantly reduced and now I'm on Maintenance, as it's called. One of the parts of my R-CHOP treatment was Rituxin (aka Rituximab), an immunotherapy drug. I'll be receiving an infusion of that med every 8 weeks for 2 years. Rituxin is a monoclonal antibody that specifically targets a protein (CD20) on my cells. If it finds it, it kills that cell, or my immune system does. Our aim is remission, if possible. That can last for months, years or decades. As they say "your mileage may vary." Unfortunately, Rituximab also messes with my immune response so I will continue to mask, be careful what I eat (no raw fish means no sushi!), avoid crowds, and have regular blood tests to monitor how my infection fighting capabilities are during these treatments. Through it all, Harold took great care of me and ferried me back and forth for all the treatments, tests and such. Our friends in Portugal (and around the world) were very supportive. That support meant everything to both of us. Now that we've hit the rainy season, I'm rebuilding my stamina, eating lots of protein and getting on with my writing. And yes, my hair is growing back. :-) We both consider ourselves incredibly fortunate to face this diagnosis here in Portugal. The healthcare was topnotch, and we have no doubt the cost of that care was considerably less than in the U.S. So that's our "curveball" for this last year. We're hoping that'll be the only one for this lifetime.
2 Comments
JEROME BEGGS
4/5/2024 08:08:51 pm
Hi Harold and Jana,
Reply
Jana
4/6/2024 02:01:18 pm
Jerome,
Reply
Your comment will be posted after it is approved.
Leave a Reply. |
Your HostsHarold is a former software engineer. Jana is an author. Together they're exploring their new life in Portugal. Archives
December 2022
Categories
All
|