Paul's Heart

Life As A Dad, And A Survivor

Archive for the tag “survivor”

Why Travel To New York When You Live Here?


“Don’t let economics determine where you get your care.”  Linda (a friend of mine and former long term survivor).

It is really an exhaustive day, a nearly five hour commute each way, sometimes just for a 45-minute appointment.  On a normal day, I have several appointments scheduled up in Manhattan at multiple locations.  One of the most frequent questions I get asked almost as frequently as I travel, “why do I go all the way to New York City for my care, when there are so many doctors around where I live?  It is a reasonable question, but unfortunately has a historical and statistical answer.

First, you need to understand what it means to be a long term survivor.  There is no set number of years to qualify.  Although statistically, five years seems to be a magic number. ” 80% of such and such live to five years without blah blah blah…”  It used to be that not much attention was paid to patients who survived decades later.  Not by the doctors.  Not by the pharmacutical companies.  Not by society.  So there really was not much in the books concering long term cancer survival.

If there are others, I apologize, but I am currently aware of only one doctor who has done this study for decades.  That would be Dr. O up at Memorial Sloan Kettering Cancer Center.  Dr. O has been studying Hodgkin’s Disease and late effects from treatments for decades.  Along with Dr. H out at Stanford U., the two of them are the top doctors in this field.  They both operate what are called “survivor clinics.”  A survivor clinic is where I go for all of my long term side effect issues.  They know the follow up testing that needs to be done based on the treatments you received.  And here is the crazy thing, at least in Dr. O’s case, he routinely has my primary care doctor back home do all the work, treatment and follow up.  And they work like a team perfectly.  My doctor admits that this discipline of knowledge is relatively unknown to her, just as most other doctors as it is not included in their studies.  Where I benefit, is that she has an open mind.  If I were a normal forty-seven year old man, most likely she would not order certain tests once, let alone annually.  But Dr. O has the background, the studies to support how to follow up and treat those of us who were never expected to live this long.

Over time,mor clinics have popped up across the country, Duke University. Dana Farber in Boston, Vanderbuilt, and I believe there is one in Seattle.  There are plenty more.  There are also facilities that specialize in particular systems effected by cancer treatments such as radiation.  The Clevelan Clinic is one of the, if not the best cardiac hospitals for patients who have had radiation therapy to their chest area.

Through internet support, I had known so much about MSKCC already, I just had to figure out how to get there, and if needed to frequently, the logistics of how that would work out.  I could have gone down to Philadelphia where there is another good survivor’s clinc, but unlike MSKCC, I had not heard of anyone going there.  This is not to say they were not good.  Of course they are one of the top hospitals in the country for treating cancer, it would only make sense that they would be great at managing survival as well.  But I had the opportunity to see Dr. O, who I consider the best in the world for dealing with long term effects.  And I was lucky as well as blessed to get to be his patient.  He does for me, what should have been done twenty-three years ago, and what is done automatically now for new cancer patients, follow-ups.  He has a plan, just for me.  He has another plan for another patient, and so on.  I see several disciplines of medicine from gastrointestinal, cardiac, pulmonary, physiatry, psychiatry, and ENT.  We are all different, but under his care, we are all treated with the best care available.

Because some of our side effects are so unusual, it requires knowledge of all the radiation strategies used decades ago, and the various side affects of chemotheraputic drugs.  This is where I come in, where you might come in.  Many of us do not have our records any longer from decades ago.  Mine were incinerated.  But Dr. O was able to figure out the protocol for 1988 for me, and the dosages, and that is what determined his plan to follow me up with.  Now of course, it is not spot on.  My body has decided not to follow even Dr. O’s book.  But anything that occurs with me, he is made aware of it.  My primary care doctor is made aware of it.  I make sure that everyone involved in my care is made aware of it, and has copies of all pertinent reports.

So why do I go to Manhattan, on average once a month, if not twice?  Peace of mind.  I do get a lot of time to meditate to help me relax which is something I have a hard time doing.  But I know Dr. O will leave no stone unturned if I complain about it.  I knew each doctor that he refers me to, will treat my case as legitimate without having to waste time justifying everything.  But as part of my treatment team, I need to know that I am included in everything being decided.  And he does just that.

Why Me?


(Thank you for another good topic sent to me to write about.)

Why me?  Maybe the question should be why not me?

I spent only one evening on the first question when I found out that I had cancer.  It is like spilling grape juice on a white carpet.  You can either stand there and stare at the deepening stain or you can get right to work cleaning it up.  I worked very hard to rid that cancer from my body.  I had no choice.  A stain in the carpet, you can at least replace the carpet when it did not come clean.  My life would not have that opportunity.  I could not worry about how or why the juice was spilled, I had to clean it up, now.  There was no length of time to ask “why”, I had to start treatments, now.

That is not to say that I left myself off the hook.  It just took me a lot longer to get there.  In a short number of years following the end of my treatments, the question that would haunt me, and do so repeatedly, was why not me?  I had gotten through my treatments of course with the short term side effects, but only one would show any kind of permanence to it, the hair loss from the radiated area.  Within a couple years of treatments, I would find out that also my thyroid had been compromised from the radiation, and chemotherapy left me infertile.

But in 1997, I met a group called the American Cancer On-line Resources web site, www.acor.org .  I went on to the link for long term survivors because that is what I wanted to be, a long term survivor.  I was around seven years out, so hopefully that qualified me.  It did not take long for me to realize the web site was not what I thought it was going to be.  Yes, the people here were long term survivors, but they were dealing with so many horrible and severe issues that they were blaming their cancer treatments.  I did not stay long on the site because I did not feel that I belonged in that arena.  But something made me sign back on again.

I began to meet people at least over the internet who had gone through similar experiences with even the same diagnosis and staging as me.   But they were at a stage now, where they were either dealing with another cancer, heart issues, muscular issues, bone related concerns, and so on.  It was hard for me to relate because I was not experiencing those issues.

Then I met one particular list member who to this day, is one of the most important survivor that I have ever met.  For privacy reasons, I will call her Tina, and if she reads this, she knows I will talking about her.  It was over fifteen years ago when I first heard her struggles.  Tina had gone through treatment for Hodgkin’s Disease, just as I had.  But her treatment was done in a hospital network up in New York.  My treatments were done in Allentown.  She had been treated the year before me.  But there was a huge difference between one year, and several hundred miles.  The amount of radiation that she was exposed to was double what I had been, which was 4 times the lifetime limit.  Our chemos were similar.  By the time I had met her, she had already had another cancer (thyroid) and over two dozen surgeries.

Why did she have to go through so much?  Why not me?  Tina was not the only one.  I personally met dozens more long term survivors, some had the same staging, same treatment, different treatment, and most all had different issues they were dealing with.  But why them and not me?

I have often wondered about the three other patients who were treated with me in the oncology suite.  I never met them or even knew their names.  I only know that I opted for additional preventive chemo, and they obviously had not, evidenced by their absence.  I did find out at the time that two of them did have to have their chemo adjusted for their low blood count levels.  Some how, I took 8 full dose complete cycles.

But along with the people going through Hodgkin’s, or other cancers, patients who relapsed, patients who lossed their battle, or other long term survivors, I forever asked, “why them?  Why not me?  The relapse patients and my friends who passed away either from their cancer or secondary issues often left me with empty and hurting feelings.  I relied on them for hope and inspiration.  In spite of what they were going through, they were still living a long time, much longer than cancer patients were supposed to.  And since I had no serious issues at the time, I counted on that.  Why them?  Why not me?

Before I go any further, I must state, as I always do, times change.  Everyone’s bodies are different not only in physical being, but how they react.  Geography, schooling of the doctor, attitiude, diet, sleep, and many more factors all play into how well you do with treatments.  Then of course, there is progress.  That is something we often take for granted.  We think that it takes forever for new things to be discovered, when in reality, new treatments are discovered nearly every day.  If the treatments work better, and are less toxic, and produce less side effects, the patient will get those treatments, and the former treatments will become obsolete or at least last resort like those that were used on me.  The same was said to me decades ago, by other survivors who came before me.

Like I said earlier, I do not spend a lot of time asking “why me?”  But around the time that I met the survivors I now know today, I did begin to ask, “why not me?”  Why were others who were treated around the time I was treated developing such side severe side effects and I am not?  Why are people who were treated with the same modes of radiation and chemo in bad physical condition and I am not?  Why does Tina have to repeatedly go through life arrest and I do not?  Why them and not me?

Here comes another one of those “yeah, but…” disclaimers.  Back as late as the mid 90’s, cancer survivors still were not expected to surpass five years statistically, in spite of the fact that millions of cancer patients were doing just that.  But once it was realized, protocol was developed and the need was understood, to follow up cancer patients, even if completed with treatments.  There is still some discussion as to which doctor should be doing this, your primary care doctor or your oncologist, but now a cancer patient is followed up, forever.  And as cancer patients we know, the earlier something is caught, the better the chance of survival.  And by the continued follow-up care, any secondary cancers or issues that develop will be caught earlier than the critical care that was needed to prevent what would have been my fatal heart attack.

There is a lot to miss, if you spend too much time asking “why me?” or even “why not me?”  Just like the time passes if you stared at the expanding, wet, purple spot of grape juice still sitting on your white carpet.

If You’re Going To Get A Cancer…


The following story suggestion was made by a fellow Paul’s Heart blog reader and fellow Hodgkin’s Disease Survivor.   Thank you Cathy. 

Imagine that you have been just told that you have cancer.  The very first thought that came to my mind was, “I’m going to die.”  That is all I knew about cancer.  I would be subjected to horrible chemotherapy that would make me vomit, was painful, go bald, and would eventually cause me to lose so much weight that it would look like I was starving.  No one survived.

Not even knowing what an oncologist-hematologist was, I was sitting in a waiting room of one.  My name had been called, and I was escorted back to an office, not an exam room.  This had never happened before.  In walked Dr. G, who resembled Jeff Goldblum in The Fly.  He walked around his desk and sat down.  There was not even an introduction.  He just went right into this speech:

“Hodgkin’s Disease is a cancer of the lymph system.  It is very treatable either with radiation or chemotherapy.  It has a cure rate of 85%.  It is one of the more curable forms of cancer.  In fact, if you were going to get cancer, this would be the cancer you would want to get.” 

I do not know which was harder to comprehend, the fact that he was telling me that I had cancer, or that if I wanted to get cancer, I got the good one.  I was twenty-two, healthy, somewhat physically fit, engaged, and happy.  Cancer was for other people who were not… happy-ish with other things going for them.  I had never even heard of Hodgkin’s Disease.  But now I had to embrace it with the confidence of getting over a common cold.

I was still going to have to deal with the chemotherapy and/or radiation therapy.  I was going to puke.  I was going to go bald.  I was going to die.  I did not want to die.

Three months later, following months of testing and biopsies, I began my treatments.  It did not take long to confirm, that I did not want any cancer.  Treatments were not easy though I put on the brave face for each one.  It took four weeks for my hair to fall out, I puked in less than an hour from treatment, and I gained sixty pounds.  But in the end, I did beat it.  I was hopefully not only going to be one of the 85% to be cured of Hodgkin’s Disease, but perhaps help move the stat up to 86%.

I get it.  From a survivorship standpoint, Hodgkin’s Disease is a very curable form of cancer when caught early enough.  On March 10, I will recognize my 23rd year having beaten HD.  I very rarely celebrate it just out of respect for those who still battle the disease, or worse, have lost their lives.  It does not feel right for me to celebrate this.  But as I come across so many other people who have beaten cancer, and look for something, hope, inspiration, perhaps celebrating at least the milestones,   Because there are millions today now looking to find people who have beaten cancer.  If you know someone who beat cancer but wants to know someone who has lived longer, send them to “Paul’s Heart”.

I feel that I want to finally celebrate my longevity now.  With so many offering such nice compliments, support, and comments and suggestions, the cancer that I beat has given me an oppotunity to reach so many more.  I am hoping in time, we will see even more progress made in other cancers such a lung, colon, breast, and leukemia just to name a few.

I would make a safe bet, that of my readers at Paul’s Heart and beyond, there would probably be a minimum 15 people, usually younger in age, who have Hodkgin’s and were told it was “the cancer to have.”  But I think as we meet other survivors with similar cancers or different, the message is getting out.  We are winning the battle against cancer.  We are still far away, but we are getting there.  Soon, another cancer may take the place as the one to have.

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