XIX: Recovering
It’s been a while. The last time I posted an entry was day +14, just four days after returning home from the hospital. Today is day +52. I’m not sure the time in between has flown, but it’s definitely happened and for the most part free of any significant complication.
As the weeks have passed I’ve slowly creeped closer and closer to “normal.” The vague chills and low grade temperatures (99–100 degrees) that marked the early days of being home abated after a couple weeks. Fatigue has slowly given way to restlessness. Exercise has progressed from very short slow walks around my apartment complex to 3–4 mile walks at nearby parks and even short runs. I’m definitely still a ways off from full strength — jogging two miles at a slow pace leaves me beat. However at this point I feel confident my body can make a full physical recovery from stem cell transplant.
While the potential of regaining and perhaps even exceeding my prior physical fitness is both encouraging and motivating, it’s only part of a multifaceted recovery process. Another aspect — effectively treating the cancer — is one over which I wield significantly less control.
The good news is my PET scan today showed no evidence of lymphoma. Given that I recurred 2.5 years after Stage IA disease I’ll pass on using the term “cured” but it’s safe to say salvage chemotherapy and stem cell transplant appear to have done their jobs for the time being. To further decrease the risk of future recurrence, I’ll likely begin consolidation therapy with brentuximab (the same targeted drug I received during salvage) in the next month. Without the more cytotoxic bendamustine to accompany it, hopefully the side effects should be rather minimal, but I guess we’ll see.
Yet the layers to recovery continue beyond physical recovery and treatment. I’m in the process of sorting out the details of transitioning back to my fellowship training. On top of that I have to figure out post-fellowship employment and how to reconcile more immediate term concerns (health insurance and ideally proximity to my current oncologist for the next year) with long term career goals.
In terms of fellowship programs I don’t think I could have ended up at a better one than UVA both in terms of size (and thus ability to absorb my absence) and more importantly the incredible support of my co-fellows and staff. Nevertheless, having a stem cell transplant during a one year training program situated between residency and finding employment is less than ideal.
Then there’s perhaps the most challenging aspect to recovery — dealing with the fear of another relapse. Balancing a positive outlook and the reality that a second recurrence is possible is tricky. No matter how many times others may insist upon optimism or balk at discussing the possibility of relapse, that possibility remains indelibly etched in your mind.
The good news is that with time the thought of that possibility becomes less frequent. I know this from firsthand experience. Ironically it was the fall before my relapse when I realized I was finally going days if not weeks without thinking of the diagnosis. I expect it will take even longer this time around to get to that point, but if enough time passes without incident I will get there again.
There‘s even more aspects of recovery — improving my diet, my parents moving back to Charlotte full time, regrowing my hair… heck, helping plan my wedding. It’ll be a while yet before things are back to “normal,” but my overall trajectory is aimed in that direction.
So how am I doing?
Well, I’m recovering.
