The C Word

I was not really sure how to go about this.  But this blog is our family journal and I am going to document everything.  

I'm going to go back a few months where John noticed a lump under his right nipple in his breast.  We knew he needed to make an appointment but he didn't fit the criteria for male breast cancer.  The internet actually assured us he didn't have it.  He didn't see the doctor until a couple of months later and she ordered a CT scan of his chest, then a mammogram.  They decided it was Gynecomastia which is harmless, but we needed to find the cause of it.  He was sent to an endocrinologist where he found his estrogen to be very high.  He ordered a CT scan of his abdomen that was to be done this coming Friday.  

Fast forward to Saturday.   John began having back pain.  Yes it was my birthday dinner, and yes I may have told him to suck it up.  That may have not been the best response looking back...

But the pain continued as we went to the family Christmas gathering Sunday.  Sunday night, the pain was in the lower right side of his back, right side of his abdomen, and right testicle.  We had decided he would go to the doctor the next day.  Around 2am Monday morning, he jumped out of bed in severe pain.  It was very obvious we needed to go to the emergency room.  

My mom rushed over to sit with the boys while they were sleeping, and we headed to Collierville Baptist.  John was in so much pain by now that his head was in the toilet.  I'm very glad we went to Collierville because it is so slow and has very few patients.  They were able to get us right back, give him morphine, and order a CT scan of his abdomen.  We were told this was most likely kidney stones, which I hadn't thought of, but it did make sense.  

The doctor came right in after the scan and told us it was not kidney stones.  He felt around a few areas and called the on-call surgeon at Baptist East.  They read the scans together and decided it was best to transport him by ambulance there.  Baptist East can do a lot more than where we were.  He told us there was a large area of inflammation showing up and we needed to see a vascular doctor.  

Baptist East is so much busier.  He needed more morphine by then and was in so much pain.  It took a couple of hours before they finally got him the meds, but he was uncomfortable most of the day (it had me scared that Morphine of all things wasn't helping).  The vascular doctor came in and explained there was a very large mass showing up on the CT scan and it was compressing on the main artery and vein running through the body.  Fortunately, it was only a mild compression and doing no damage.  As far as the vascular doctors were concerned, he was okay, but needed to figure out what this mass was.  

Next the general surgeon came in to talk to us.  He was the one who wanted us to come to Baptist earlier that morning.  He explained there was, what they thought, a very large lymph node behind his abdomen and in front of his spine (actually in the peritoneum which is the lining of the abdominal cavity).  This is what is causing pain in the back.  He said normally they would do a biopsy of it, but it is in a very dangerous spot... and he wasn't touching it.  He said he was a straight forward kind of guy and wanted us to know they were thinking Lymphoma....

Lymphoma?!?!  What in the world?!  I could hardly listen to much more because I was in shock.  He told us he had a call into a Dr. Weeks (a hematology/oncology doctor) and he would be by to see us later.  It was all a blur.  But he did say it still could just be some type of infection so we were hanging onto that hope.  

We were pretty upset and called our family (who had all JUST left) and they all came back.  

We sat around for what felt like forever.  Then another vascular doctor came in.  He drew a diagram to explain where this mass was and seemed very hopeful it was not cancer.  We all felt much better and everyone left for the night.  

Right after they left,  Dr. Weeks (oncologist) came in to talk to us.  He was able to pull up his CT scan on the computer and read it with us.  I only know dental.   I am no doctor, but this "mass" as he kept calling it was giant.  Just entirely too big.  He did an exam on John, asked questions, and then started talking.  He said it could very well be testicular cancer, lymphoma, or something else.  He never even mentioned the word infection, so we were pretty confident this wasn't going to be good.  He wanted to run a ton of blood work to check a million different things.  His first thinking was testicular cancer because of the extreme pain in the right testicle.  And turns out, there was a 1mm mass that the ultrasound revealed.  He wanted a biopsy done the next day on the mass in the abdomen. 

We waited around all day and finally, the surgeon came in.  He told us we were not going to do the biopsy after all...it was entirely too dangerous due to the location of the mass.  He told us the blood work had come back and his Alpha-fetoprotein was high.  This is an indication of a germ cell tumor which is the type of tumor that would be in the testicle.  At this point, they are pretty confident he has testicular cancer that has spread to that large mass.  You can imagine the immediate fear that came over us all.  

The surgeon came back in to let us know that he had spoken with the oncologist.  Dr. Weeks wanted him to tell us John will be cured in 3 months.  This was much better information.    

Now that we have spoken to all of the doctors, we know a few more things:

1.  Testicular cancer is very treatable. 

2.  If you were to choose a cancer to have, this would be it. 

3.  Dr. Weeks has NEVER lost a patient to testicular cancer. 

4.  John is 30 and healthy.  He will be able to take whatever they throw at him like a champ.  

Because of the extreme pain that brought us into the hospital, we are in a better situation than if we had found out at a doctors office.  We already have an awesome team of doctors with an immediate game plan.  For this, we are so very thankful.  

So the plan is tonight, Dr. Greenberger, the urologist, will remove the right testicle during surgery.  It is a simple procedure and generally outpatient, but since we are already at the hospital, he can do it now and begin treatment sooner.  

We will also need to have a port-a-cath placed where they will deliver the chemo.  We are hoping to have this done before we leave the hospital.  He will need shots of Heparin (blood thinner) in his stomach three times a day.  Because the mass is compressing the major vein and artery, they want to make sure there is no clotting.  

The sooner we can start on the chemo, the better.  Maybe even right after Christmas.  We will be able to mark how well he is responding to treatment by the protein that was elevated.  Once we get that to a normal level, he will need two more cycles of chemo.  He could even get it to normal range after the first cycle.  That would mean only three cycles of chemo (hopefully).  A cycle is 5 days in a row of chemo (takes about 2-3 hours a day to deliver it) and then two weeks off.  

Unfortunaely for John, the back pain will not subside until the chemo begins to shrink the mass.  He has been able to manage the pain with medication though.  

He should be able to work.  He will obviously not be able to pull these extremely long hours he is used to and will need a couple of hours every day during the weeks of chemo.  

The doctor is not worried about our runny nosed kids getting John sick.  He said if they are snotty and want hugs...let them hug all over you.  This was very important to John.  He has been so worried about what the kids will think and that they won't understand.  If anything upsets him, its the kids.  So he was happy to hear that.  

The worst side effect is the hair loss.  But he is a guy and it will grow back.  No worries there. 

Through this emotional roller coaster we have been on, we have learned several things:

1.  We have an amazing, close family.  They have all been up here and been on this ride with us.  It has been just as hard on them as us.  My parents have had the boys at night.  John's family hasn't left our side.  Everyone has been awesome. 

2.  We have oh so many friends.  It took me forever to make sure everyone knew.  I don't know what we would do without them all.  I know they will be here throughout this entire process. 

3.  We are getting immediate attention because of being in the hospital.  It scares me just thinking how long it could've taken if we had found this out in the doctor's office.  They think this has been going on for about four months and that mass is huge....I can't even think what we would be looking at months later.  I spoke with John's endocrinologist and he agreed, we are in a much better scenario.  

4.  God knows what he is doing.  I don't know how long I questioned why we got pregnant so much earlier than planned.  We knew we wanted kids, but not until closer to 30.  Every doctor has told us if we want more children, we need to bank his sperm.  It is very likely he will be sterile after this chemo.  If we had no kids, or just one, I can't imagine what that would feel like.  I am just so thankful for those two sweet, healthy little boys. 

(Please excuse the horrendous picture)

The bottom line is, we've got this.  John is going to beat this and be back to normal in a few months.  We have a ton of support around us to keep us lifted.  

Becca said it best, "Where are we going in 3 months to celebrate a remission?!"