Day 1. The beginning.

It took me a while to come up with a title for this entry.  Everything I kept typing out was negative, making references to doomsday and today being the worst day of my life.

But finally I settled on a simple "day one."  Because this isn't the end of life as I know it.  In fact, this is the beginning of the rest of my life.

Today I found out that I have cancer.

God, that sentence really sucks.  I don't know what's worse, typing it out and seeing it laid out in front of me, or having to say those words out loud to my family and friends.  No matter how many times I have to say it or read it, it doesn't get any easier.

I'm not surprised, though.  Honestly, I've been expecting to hear that word for weeks.

This whole mess started in late July, when I was at work and noticed that my right armpit was kind of sore where my bra was hitting it.  When I got home and undressed before bed, I noticed a visible lump between my breast and the crook of my armpit.  It wasn't huge, but it was large enough to the point I was surprised that I hadn't seen it sooner.

I googled "armpit lump" and came up with a few possibilities, including lymphoma.  I got a sinking feeling in my stomach, but I immediately dismissed it - there was no way it could be cancer.  I read a few places that it was most likely enlarged lymph nodes caused by infection, and would probably go away on it's own in a couple of weeks.  So I left it alone and waited.

A couple of weeks later, when the lump hadn't gone away (and had actually gotten a bit larger), I called the doctor and made an appointment.  The doctor said it was probably an infection, but sent me to a radiologist to have an ultrasound done.  The ultrasound showed that all of my right axilla lymph nodes were enlarged, with at least one of them being about 6cm in diameter.  The radiologist said that it could be lymphoma, but it could also be an infection, most likely cat scratch disease.  So he and the original doctor decided to go the cat scratch route, and put me on antibiotics.

I did a round of antibiotics, and they did nothing.  I decided at that point to go see my parents' doctor in my hometown and see what she thought I should do.  She took one look and poke at the lump and said it most likely wasn't cat scratch because cat scratch is extremely painful.  Aside from the initial discomfort from my bra, the lump wasn't painful at all.  She also said that since the only scratch I'd gotten was on my foot, it would have been the lymph nodes in my groin that were affected, not my armpit.  She said it was either some weird, painless form of cat scratch, a funky bacterial or fungal infection that didn't respond to antibiotics, orrrrrrr it was lymphoma.  It was at that point that I realized it was a good possibility that I could have cancer.

Dr. D immediately ordered blood work and referred me to the surgeon for a biopsy.  I'd seen her on the Friday evening of Labor Day weekend, so I couldn't do anything until the following Tuesday.  I spent the weekend abusing the crap out of Google.  I realized how many symptoms I had that I hadn't associated with lymphoma until all of this was happening - fatigue, red splotchy rashes and itchy skin (I have psoriasis, so I thought it was related to that), lower back pain (I injured my back in high school and have recurring back pain, so I thought it was a flare up).  Things that I now realize had been going on for about 2 months before the lump showed up.

The Tuesday after Labor Day, I got a call from Dr. D's office.  All my blood work was normal except my lactate dehydrogenate (LD) levels, which were high.  A quick check with my new best friend Google showed that high LD levels indicate only a couple of things - anemia (which had been ruled out with my other normal blood work), liver disease, muscle injury... and lymphoma.

I went into "hope for the best but expect the worst" mode at that point.  I started worrying about how much sick leave I have available at work, and if I could arrange my schedule to make it easier during chemo.  I had a talk with my mom about the worst-case scenario, and how we would handle things if it came down to it.  I even started pricing wigs online.  The couple weeks before I met with the surgeon were really stressful.

I had an excisional biopsy done last Friday.  The surgeon recommended doing this versus a needle biopsy, because sometimes the latter doesn't get enough tissue to biopsy.  It was a no-brainer - I agreed to the excisional.  The surgeon removed just one lymph node during the surgery - the 6cm node that I've been calling "big fella."  I didn't know it until today, but my mom had asked the surgeon afterward about the chances of it being cancer, and he said based on his experience and how it looked, he thought it was malignant.

The first couple days after surgery were a Percocet fog, but I was wide awake by the time Monday rolled around.  I wanted the results.  But Monday turned into Tuesday, and Tuesday turned into Wednesday, and I still hadn't heard anything.  I was going nuts.  So I called the pathologist's office and bugged the crap out of the receptionist.  I'm glad I did, because it went from "the report is not ready yet" to the pathologist calling me back and giving me the results just before he was supposed to go home.

I’ve been diagnosed with nodular lymphocyte-predominant Hodgkin lymphoma.  It’s a very rare sub-type of Hodgkin lymphoma - only about 5% of Hodgkin’s is NLPHL, and only about 500 people in the United States are diagnosed with it each year. But, like other lymphomas, it's very curable with a high survival rate.

That’s pretty much all I know at this point.  Because NLPHL is so wonky, the pathologist is sending my lymph node tissue off to a specialist in Washington DC to confirm that this is the type of lymphoma I have.  I have to go meet with an oncologist next week, and soon after that I’ll have to go through a bunch of tests and a bone marrow biopsy.  That will determine what stage my cancer is, and if it’s spread to my liver, spleen, or bone marrow.  Once they know what stage it is, they’ll decide what treatment will be best - chemotherapy, radiation, or both.

I'm scared shitless, and I'm overwhelmed from trying to process everything.  But I'm also trying to stay positive.  I will beat this thing.  I'm so lucky that I have family and friends supporting me, and a job that has great medical benefits.  I've been dealt a crappy hand, but it could be a lot worse!

I'm ready to start fighting!