Monday 25 June 2012

How did I know my Hodgkin's Lymphoma relapsed?

In recent years, I've been diagnosed with Hodgkin's Lymphoma on three separate occasions, and whilst you might expect that each time I would have found myself presenting with very similar symptoms, the reality has probably been more different than you would think.  So, in this post, I plan to focus on the latest relapse of the disease; I will go back to the previous diagnoses in separate posts.

I had just been to my three-monthly post-treatment check-up, where all appeared fine, when a couple of days later I started with a cough and some discomfort in my right-hand side just below my rib cage.  At first, I just assumed I'd picked-up some kind of cold, and it would sort itself out within a week or so, but a week later the cough was worse, the discomfort had become quite painful at times, and I also found myself more easily out-of-breath.  At this point, I had a chat with someone at the hospital, who suggested giving it a few more days, and getting back in touch if I wasn't any better.  I did get back in touch a few days later, and the hospital then suggested making an appointment with my G.P., as the pain sounded like a musculoskeletal pain, so the G.P. would be best placed to help.

As it happened, I spoke to the G.P. over the phone that same afternoon, but due to my medical history he wanted to examine me rather than just prescribe some antibiotics for what was in all likelihood a run-of-the-mill chest infection.  I saw the G.P. a couple of hours later for the examination, which highlighted that the air in-take in my right-side was quite low, as there was probably fluid in/around my right lung restricting my breathing; the pain was likely a result of the associated infection in that area.  The G.P. arranged a blood test and x-ray for the next morning, in order to get a clearer picture and determine whether the antibiotics would be strong enough to resolve the problem, or whether I might need some treatment in hospital; The G.P. said to take the next day off work (after which it was the weekend) to get the blood tests and x-ray sorted, as the infection was apparently pretty nasty at this point, i.e. in a couple more days I'd have most likely been in hospital with pneumonia.

After having the blood test, x-ray, and a discussion with my G.P., I ended-up on one of two antibiotics for a couple of weeks, and that pretty much did the trick; the cough had almost gone, the pain in my side had disappeared, and I wasn't finding myself as easily out-of-breath.  I also had another x-ray after completing the antibiotics to check that things now looked better; the intention was to have another x-ray a few weeks later, just to establish a new baseline, i.e. a "normal for me" x-ray.

About three weeks after completing the antibiotics, I noticed that the cough was starting to get worse again, so I asked the hospital about it, and at the same time enquired whether the x-rays I had before and after the antibiotics looked fine.  As it turned-out, the x-ray after the antibiotics didn't really look any better than the x-ray before the antibiotics, so I was asked to come into the hospital a few days later for a check-up.  When I attended the check-up, the doctor asked me a number of questions and listened to my breathing, and was clearly quite concerned, so decided to arrange an "emergency" CT scan to see what was wrong; It seemed like the doctor was quite sure that the cancer had relapsed, but he needed to see a CT scan to remove any doubt.  I had a CT scan the next working day, and the day after that received a call at work to confirm the doctor's suspicions and to admit me to the hospital the next day, so that my treatment could begin as soon as possible.

I had perhaps had some other symptoms typically associated with Hodgkin's Lymphoma in the weeks leading up to the relapse, but it is not easy to say whether they were truly symptoms or not, as they can be quite easily explained and seem quite innocuous; for example, I sometimes found myself itching a bit; my weight had dropped slightly; and during an unexpected week of hot weather (perhaps our summer), when I still had my winter duvet, I had been sweating at night.

Sunday 24 June 2012

Hodgkin's Lymphoma - Take Three!

In a nutshell, for those of you that have never heard of Hodgkin's Lymphoma, it is a type of cancer; more specifically, a cancer of the lymph nodes.  In the UK, young adults (aged 20-34) and senior citizens (aged 70-79) are the two age groups most at risk of Hodgkin's Lymphoma, and men are generally at slightly higher risk than women; It has recently been estimated that 1 in 440 men will be diagnosed with Hodgkin's Lymphoma within their lifetime, in contrast to 1 in 500 women.

Personally, it was a few weeks after my 28th birthday, towards the end of February 2009, that I was first diagnosed with Hodgkin's Lymphoma; the disease later relapsed shortly before April 2010, and has just relapsed again in mid June 2012.  The timing of my initial diagnosis fell pretty much exactly where the statistics would predict, and was coincidentally also on the median age of onset for the disease; the only slight deviation is that for the specific type of Hodgkin's Lymphoma of which I was diagnosed, i.e. Nodular Sclerosing, it is of slightly higher risk in woman for the younger age groups.

As you might imagine, in the last few years I have had quite a few different tests and treatments, as a result of the Hodgkin's Lymphoma, and one of the things that I really wished I'd taken the time to do previously was write a blog about my experiences of it all; partly as a convenient way to keep family and friends informed of my progress, but also to provide a patient's perspective on the various aspects of the treatment, as sometimes there is no substitute for a first-hand account; for example, the list of potential side effects for a chemotherapy regimen can give you very little idea of what it is really like.

With all of the above in mind, in the coming months, I hope to write a series of posts that describe my experience of the latest round of tests and treatments, whilst also occasionally winding back the clock to cover the history to date; There will be posts about things like: does a bone marrow biopsy really hurt that much, how does chemotherapy make you feel, does it all change your view on life.  It may surprise you to hear, but intermingled between it all, there are quite a few funny stories to tell!