Quarterly scans (from yesterday) "all clear"

Just a chest CT-scan this time, and it was clear.  Yeah!  In 3 months (Feb 15), I go back for a Chest-Abdomen-Pelvis CT-Scan (you know, the one where I have to drink that flavored oral contrast).  Mmm-mmm -- I do love my "mochachino" in the morning!

The really good news is that I'll be hitting my 2-year NED anniversary in March, and starting then, my scan schedule will change to every 4 months.

I hope that everyone has a great Thanksgiving and Christmas break.  I'll talk to you in another 3 months!

Scans All Clear . . . Again!

Just a quick update to let you know that I had my quarterly scans today (Chest-Abdomen-Pelvis CT-Scan only) and, once again, I've been given the "all clear" by Dr. Monson!  So I'm good for the next 3 months.  Yeah!

The only odd thing is that I've noticed I'm developing a certain sense of complacency about what I've gone through and where I'm at.  It's like I told a friend of my recently: when you're diagnosed, you immediately go into denial since "this sort of thing can't happen to me".  Of course, that eventually turns to acceptance (the chemo will surely bring that realization).  But then, after your treatment is complete and life returns to "normal", you eventually start to shift back into denial as to whether or not you actually went through what you went through (and hence the complacency).  I've by no means forgotten where I've come from, but believe me, denial happens both at the time of diagnosis and some number of months after treatment and full recovery.

I'm just thankful that people are reading this blog as it forces me (in a good way) to remember what I've been through, talk about where I'm at, and think about the long-term, which I approach with cautious optimism . . . mixed with a pinch of denial that everything is perfectly fine (and nothing was ever wrong).  It's hard to explain, but I think you get the picture.

Well, time to call it a night here.  Talk to you-all again in another 3 months!

International Sarcoma Awareness Week

My apologies for being a little late with this announcement, but July 17 – 25 is International Sarcoma Awareness Week.  Across the country and around the world, this event is being promoted/celebrated by dozens of organizations, each hosting their own unique event, all for the purpose of raising the level of sarcoma awareness.  There may even be an event in your area (see http://www.team-sarcoma.net/2010-teams for all of the details).  And if you’re unable to attend such an event, there’s a "Sarcoma Knows No Borders" Facebook Event going on now that’s open to participation in many different ways.  Spreading the word about this forgotten cancer is what it’s all about.

Locally (here in the Atlanta area), the Southeastern Sarcoma Foundation is sponsoring a Walk for Sarcoma Awareness event this coming Saturday at the Meadow in Piedmont park.  Last year’s event was awesome and I expect to have a great time again this year.  Anyone is welcome to attend.

Oh, and one last thing: I forgot about my anniversary!  But after 22 years of marriage, Holly is neither upset nor surprised.  Why not?  Well, the “anniversary” of which I speak was my date-of-diagnosis anniversary (July 15, 2008), not my wedding anniversary.  I suppose that makes me a 2-year survivor of Liposarcoma (that’s apparently the way most doctors count it).  My apologies if I don’t sound too excited about that, it’s just that:

1. My date-of-diagnosis was not a very “fun” day in my life (memorable yes, fun no)
2. I personally prefer to measure survivorship from the date I was NED (No Evidence of Disease), which is March 18, 2009.  For me, that’s my big anniversary.  J

I challenge all of my readers (both of you!) to find a way to participate in International Sarcoma Awareness Week.  If you’re a Facebook user, please see the event mentioned above and decide on a way that you can participate.

Thanks!

It's Benign!

Just a quick update to let you know that, as of this morning, the biopsy results are in and the tumor removed last week has been confirmed to be a benign Lipoma.  Apparently Dr. Monson removed a small amount of fat and a lymph node sample as well from that area, both of which also came back clean.  Yeah!

On a recovery note, I went back to work on Monday (a little earlier than originally planned) and have been doing fairly well.  However, over the last day or so, I've definitely noticed much more pain and swelling in that area.  I'll try keeping an ice pack on it today as Holly swears that will help more than anything.

And man do I ever need a full shower!

Colonel Mustard, in the Dining Room, with a Camera*

This is a picture** of my right arm & shoulder area from yesterday, prior to quite a bit of scrubbing to remove the Betadine.  I was covered with this stuff from my chest all the way up my right arm and getting it off was quite the trick.  Simple soap and water couldn't "cut the mustard" (so to speak).  It took rubbing alcohol and a few dozen cotton balls just to tone down the stain.

The good news though is that I'm doing just fine.  I've had no problems with bleeding and the pain has been manageable.  What pain I do feel can best be described as dull, achy, and sore; it kind of feels like someone punched me in the armpit repeatedly (not that this has ever happened before or anything, but I can only imagine it must be similar).

My mobility with my right arm is somewhat limited, though mostly by choice at this time.  I'm purposely not trying to do too much with it as I don't want to risk disturbing the incision area.  But after the bandage comes off (Saturday afternoon), I'll likely start doing more.  Even so, I need to keep that area clean and dry, which means avoiding outside work (especially in our Hotlanta 90+ degree weather) and not washing that area for the next couple of weeks.  I'm sure the guys in the office are gonna just love that when I return next week!

Overall, I've got no complaints and I'm quite relieved that this all went so smoothly.  And I promise to post updates in conjunction with my pathology results and my follow-up appointment in 2 weeks (Mom!), though I don't expect either to be eventful.

Have a great weekend!

------------------------------------------------
* For those who don't have a clue about this title, it was supposed to be a reference to the Clue Game, where Colonel Mustard is one of the characters in this murder mystery.  And given my mustard colored arm and the fact that I'm in my dining room . . . well I think you see what I was shooting for.  And yes, I know: if I have to explain it, then it must not be very funny.  :)

** Some email clients block pictures, so if no picture is present, you can click on the Bold Blue Title in the email and that will take you directly to this post at my blog site, where all will be revealed.

A little off the top, please

All indications are that the surgery was a complete success!  So far, my pain is quite manageable, though I suspect it will likely go up a few notches by tomorrow.  My marching orders (post-op) are:

1. Take the dressing off after 3 days.
2. Follow-up with the doctor on Friday, July 9.
3. Do not drive or operate heavy equipment in the next 24 hours.
4. No alcohol for the next 24 hours.

I’m good with most all of these instructions, though I did make it clear “no promises” regarding the 24-hour moratorium on alcohol.  J  The Lipoma itself was approximately 4cm x 6cm and I'm told that the pathology results should be available within 7 - 10 days (though nobody is really expecting this to be anything other than Lipoma, which is benign).

Prior to the surgery, I got a little bit nervous when Dr. Monson mentioned, “Yeah, that thing’s in there really deep.  Removing that huge Liposarcoma on your leg was easy given where it was at; this will be a bit more complicated.”  Moments later, the Anesthesiologist followed up with the comment, “Wow – that really is an unusual location.  Surgery there can really be painful.”  All I can say is I’m just glad that I’m the kind of guy that really likes to hear people tell it to me straight!  Otherwise, a “panic attack” might have been in order.

Seriously though, this medical team is incredible!  I’ve got one of the best orthopedic surgeons in the southeast operating on me, awesome nurses, and an Anesthesiologist (named Heather) who really listened to my history of getting sick after surgery.  She described this as PONV (Postoperative Nausea and Vomiting) and told me she had it covered.  And sure enough, for the first time I didn’t get sick following surgery!  Yeah!

I’ve rented 2 movies and plan to start watching them as soon as I get something to eat.  Plus I plan on playing with my new iPhone 4, which was delivered today (perfect timing I might add).  I'm such a technogeek!

Thanks to all for your support, comments, emails, etc.  You-all are awesome!

A Cut Above

Yes, the time has finally come to get a new scar “tattooed” to my body.  At high-noon today, I will go in for that lipoma surgery that I mentioned in previous posts.  And this isn’t just any run-of-the-mill, dime-sized lipoma either (I have several of those); this one is much bigger and buried deep within my right armpit.  The main reason it’s coming out is because the location makes it difficult to monitor and we don’t want it to grow unchecked and become a problem.

I’m not really expecting this to be a big deal or anything, but I do think this is gonna hurt!  I just remember the pain that Holly was in after she had her right axillary node dissection (15 months ago) and I think this operation will be very similar.  I’m just glad I’m in the capable hands of Dr. Monson, who did such spectacular work on my leg 15 months ago.  Don’t know if I’m going to need any drains yet for this procedure (I’m hoping I won’t).  The surgery itself will be taking place at the Emory Spine Center (Executive Park) on an outpatient basis.

Once this is behind me, the exciting thing is that Holly and I will now have matching scars under our right armpits!  Now how cool is that?!?  I know that some couples like to get tattoos and all, but we (apparently) do things a little more “out of the ordinary”.  And trust me, the experience we’ve been through is just as permanently etched into our bodies, hearts, and minds as any real tattoo.  I’d say we’re a match made in Heaven!

Well, here’s to careful cutting, a speedy recovering, and a scar that’s just slightly bigger than Holly’s (for bragging rights, of course)!   J

Recent CT-Scan.  The area circled in red is the Lipoma that will be removed today.

Gwinnett Relay for Life – What’s it all about?

Though the actual 2010 Gwinnett Relay for Life wrapped up a week and a half ago, a lot of people still have questions as to what Relay is and what makes Gwinnett Relay the #1 relay event in the world.  If you’ve never been, it’s actually difficult to describe what all goes on, but I found something that might help.  Please check out this 4-minute video that summarizes the happenings of that evening:

http://v1.as48.com/hxpp1_hd2.asp?MSGID=B2D7DF9C-DF46-4A64-99E6-2470FF8BAC8B

Enjoy!

Quarterly scans “all clear”

Just a quick update to let you know that I had scans this morning (MRI on my left thigh and a Chest CT-Scan) and both were clear.  Yeah!  It’s always such a relief to get that kind of good news, even though I typically don’t worry about it (except sometimes the night before a scan).  My next scans (CAP) have already been scheduled for August 12th.

Still to be arranged is a date for removing the rather large lipoma under my right armpit. Dr. Monson will be doing that surgery likely sometime mid to late June timeframe. I just need to sit down and look at my calendar, Holly’s calendar, the kid’s summer schedule, and then make that fit with Dr. Monson’s surgical schedule.  I’m told that the surgery will be done on an outpatient basis and that I will be out of commission for about a week recovering at home.  Holly’s axillary node dissection surgery was similar to this both in terms of complexity and location, and I know it took her a while to bounce back from that.  Dr. Monson also said that a full pathology would be ordered on what they remove (to rule out cancer).

The other thing I wanted to mention is our Gwinnett Relay for Life results this year.  Thanks to contributions from many generous friends and family members, Holly and I together raised around $3,500.  That is really awesome and it’s all for such a good cause too.  I would encourage each of you to participate in the Relay for Life event in your area.  It’s really quite an uplifting experience.

More updates in another month or so . . . once this lipoma-gone-wrong gets the hatchet treatment!

Kyle, Bryce, Holly, and Dave about to share their story at Gwinnett Relay for Life last Friday (click to enlarge).  


You might notice that I'm wearing last year's shirt.  I like purple better.  :)

Gwinnett Relay for Life 2010

“Relay for Life” – what’s that? Isn’t that some sort of 10K race for charity? Oh, it’s for cancer victims? Well, I suppose that’s a good cause, though I don’t personally care all that much since I’m in perfect health and my family has no history of cancer. I don’t even know of anybody who’s fighting cancer. So, if you don’t mind, I’ve got lots of other things to take care of . . . .

Yeah, I’d say that would have pretty much summed up my attitude about cancer 2 years ago. To me, cancer was something that other people got, mostly due to family history of cancer, poor diet, a stressful job, or living too close to power lines. Given that I was clean on all of these counts, I figured “no way” was that in my future. Quite honestly, I had never even heard of Relay for Life back then.

Looking back, it was likely that same arrogance that led me to believe for almost a year that the bulge on my outer left thigh was simply a “big muscle”. Then came the shocking diagnosis: Myxoid Liposarcoma. A further review of my biopsy slides indicated the presence of the Round Cell component, which made my case “high-grade”. Because of the size of my tumor and the “high-grade” characteristic of the cells, my cancer was classified as Stage III. According to some sources, only about 1 in 400,000 people annually are diagnosed with my condition, yet somehow I drew the unlucky short straw here. It just goes to show that anyone (regardless of living conditions or pedigree) can become a cancer patient.

So, why do I Relay? Here are my main reasons:

1. I relay to honor and support my fellow brothers/sisters with cancer.
2. I relay in memory of those who have been taken by cancer.
3. I relay to raise cancer awareness as truly “sarcoma knows no borders”.
4. I relay to help find a cure.

Please support my efforts by making a donation to my Relay for Life team (or http://main.acsevents.org/goto/dave.novak in case your email client is hiding these links). Your donations go to the American Cancer Society (ACS) are tax-deductable. Click here to see how the ACS uses your donations. 

Incidentally, the Gwinnett Relay for Life Event (which is the largest such Relay event in the world), will be on Friday, May 7, or just a few short weeks away.  So, if you can, please make a donation by that time.  (And if you've already made a contribution to Holly, I thank you as this "counts" towards our team goal.)

Thank you for your consideration and support!

Holly and Dave at Gwinnett Relay for Life 2009 (click to enlarge)

For those getting e-mail notifications only . . .

If you receive email notifications about changes to my blog, my previous Happy 1 Year Anniversary post likely did not include the embedded music video links found on the actual blog site. If you're interested in checking these out, just go to my blog home here: http://dnovak-liposarcoma.blogspot.com/.


Alternatively, when you receive an email indicating that a post has been made, you can click on the Bold Blue Title in the email and that will take you directly to the post at my blog site.

Enjoy!

Happy 1 Year Anniversary!!!

Today (March 18, 2010) marks the 1 year anniversary of me being NED (No Evidence of Disease). It was a year ago exactly that I had surgery on my left thigh, removing what remained of my tumor (having already gone through both chemo and radiation.) So I am now 1 year NED! Yeah!

To help celebrate this first milestone, I’m doing a little happy NED dance here at home (with the curtains closed) while listening to some of my favorite “feel good” songs. These songs were really encouraging for both me and Holly as we both battled cancer during 2008 and 2009.

So, with great fanfare, I offer to you my top 3 most encouraging songs:

Nickelback: If Today Was Your Last Day

Another great Nickelback song that really gets you thinking.



My favorite lyrics from this song include:

My best friend gave me the best advice
He said each day's a gift and not a given right
Leave no stone unturned, leave your fears behind
And try to take the path less traveled by
That first step you take is the longest stride

If today was your last day
and tomorrow was too late
Could you say goodbye to yesterday?
Would you live each moment like your last?
Leave old pictures in the past?
Donate every dime you have?
If today was your last day

Against the grain should be a way of life
What's worth the prize is always worth the fight
Every second counts 'cause there's no second try
So live like you'll never live it twice
Don't take the free ride in your own life

If today was your last day
and tomorrow was too late
Could you say goodbye to yesterday?
Would you live each moment like your last?
Leave old pictures in the past?
Donate every dime you have?
Would you call old friends you never see?
Reminisce old memories?
Would you forgive your enemies?
…

So do whatever it takes
'Cause you can't rewind a moment in this life
Let nothin' stand in your way
Cause the hands of time are never on your side
…

New Radicals: You Get What You Give

Though I can’t say that I like (or even understand) everything about this song, it is definitely a very popular, fun, and uplifting song. The guy who sings it has a great haircut too. :)



My favorite lyrics from this song include:

…
But when the night is falling
You cannot find the light, light
You feel your dreams are dying
Hold tight

You've got the music in you
Don't let go
You've got the music in you
One dance left
This world is gonna pull through
Don't give up
You've got a reason to live
Can't forget
We only get what we give

…
But when the night is falling
You cannot find a friend, friend
You feel your tree is breaking
Just bend

You've got the music in you
Don't let go
You've got the music in you
One dance left
This world is gonna pull through
Don't give up
You've got a reason to live
Can't forget
We only get what we give

This whole damn world can fall apart
You'll be ok, follow your heart
You're in harm’s way, I'm right behind
Now say you're mine

You've got the music in you
Don't let go
You've got the music in you
One dance left
This world is gonna pull through
Don't give up
You've got a reason to live
Can't forget
We only get what we give
Don't let go
I feel the music in you

Fly high
What’s real can’t die
You only get what you give
You’re gonna get what you give [not in video version]
Just don’t be afraid to leave [not in video version]
…

Kris Allen: Live Like We’re Dying

This song actually came out after my treatment was complete, but it’s still a great song with powerful lyrics.



My favorite lyrics from this song include:

Sometimes we fall down, can't get back up
We're hiding behind skin that's too tough
How come we don't say I love you enough?
Till it's too late, it's not too late

Our hearts are hungry for a food that won't come
And we could make a feast from these crumbs
And we're all staring down the barrel of a gun
So if your life flashed before you,
What would you wish you would've done?

Yeah, we gotta start
Looking at the hands of the time we've been given
If this is all we got and then we gotta start thinkin’
If every second counts on a clock that's tickin’
Gotta live like we're dying

We only got 86,400 seconds in a day to
Turn it all around or to throw it all away
We gotta tell them that we love them
While we got the chance to say
Gotta live like we're dying

And if your plane fell out of the skies
Who would you call with your last goodbye?
Should be so careful who we left out of our lives
For when we long for absolution,
There'll be one on the line

Yeah, we gotta start
Looking at the hands of the time we've been given here
If this is all we got and then we gotta start thinkin’
If every second counts on a clock that's tickin’
Gotta live like we're dying

We only got 86,400 seconds in a day to
Turn it all around or to throw it all away
We gotta tell them that we love them
While we got the chance to say
Gotta live like we're dying

…

You never know a good thing till it's gone
You never see a crash till it's head on
Why do we think we're right when we're dead wrong?
You never know a good thing till it's gone
…

Right axillary lipoma to be removed

As a follow-up to my previous post, I wanted to let you-all know that I do indeed plan to have the large lipoma (located under my right armpit) removed sometime this summer. I had another conversation with Dr. Monson (my orthopedic oncologist) about this and he was able to clarify why this particular lipoma is “special”. (Please note that I have several other smaller, more typical-sized lipomas in other easily-accessible locations, but the doctor has no interest or intention of removing those.) I also got a second opinion from another oncologist, who said essentially the same thing as Dr. Monson.

The reasons to remove this particular lipoma include:

1. It’s difficult to monitor – given its awkward location, it’s difficult to monitor this lipoma for changes. Physical examination of the area is not a reliable means of detecting change and CT-Scans are primarily focused on abnormalities of the chest, abdomen, and pelvis and, therefore, not always fully inclusive of this area.
2. It could become cancerous – though this lipoma is not believed to be cancerous, there’s a chance that it could become cancerous (in particular for someone already diagnosed with Liposarcoma). Having said that, however, I should also point out that I was told (by the doctor) that this would be “unlikely”. Even so, this motivates me all the more to have it removed.
3. Don't wait for it to become a problem – given that there are critical nerves, blood vessels, and lymph nodes in that area, it’s probably best to have this removed before it has a chance to grow and become all that more of a surgical challenge.

I should mention as well that both doctors said “no rush” on the surgery, which is why I’m waiting until the summer to have this done. All-in-all, I’m not too worried about it, though I’m well-aware that this surgery comes with its own set of risks (especially given all of the nerves in that area). Even so, I think that a good surgeon shouldn’t have any problems with it.

Bottom line – having it removed is the right thing to do.

Quarterly scans all clear, but . . .

Thursday morning I had both an MRI of my leg and the full set of Chest, Abdomen, and Pelvis (CAP) CT-Scans. These scans, of course, were preceded by a Wednesday evening “nightcap” of “Creamy Vanilla Smoothie” (a.k.a., Barium Sulfate Suspension), with the same for breakfast Thursday morning. I have to admit, the Vanilla was the best of all the flavors I have tried. That’s not to say that I liked it either, but rather that it was the most tolerable of the ones I’ve had thus far. Next time though, I think I’ll press my luck and go for the (even newer) Mocha flavor! Mmm . . . Mocha . . . I just hope I can stand the anticipation between now and then! [No, not really; I can wait. :)]

Now for the good news: my quarterly scans where all clear! Yeah!!! This leaves me sitting easy for the next 3 months. Honestly, I never really worry too much about what may or may not be going on in-between scans. Yes, I typically do get a little nervous the evening before my scans, but the truth is there’s really nothing I can do that will make my results either better or worse than what they are going to be. And that’s not fatalism or defeatism by any stretch; that, my friends, is acceptance.

So what’s the but about in the title? Well, way back in July, 2008 (when I was getting my first full set of scans), it was noted that I have a rather sizable lipoma under my right armpit (see dark area within the red outline in the scan picture on left). Though my latest radiology report describes this as “a right axillary lipoma, stable from the prior exam”, Dr. Monson (my orthopedic oncologist) recommended that I get it removed.  (Note that I also have several other smaller, more typical-sized lipomas in various locations, but the doctor has no interest or intention of removing those.)  Though his advice was couched with “no rush”, the concern is that a large lipoma could change into something cancerous. I suppose he’s probably right (he certainly has an amazing reputation and impeccable credentials). Even so, I’ll want to get another opinion as well as find out more details about the surgery itself, particularly the risks and recovery time. I think my main hesitation here is I'm not looking forward to any surgery, especially if it will take days to weeks to fully recover.  Furthermore, it's not currently bothering me or giving me any type of discomfort.  If anybody has any information or advice for me here, I’m all ears.

And there’s one more but worth mentioning here: all my scans this time were done without IV contrast. Why? Well, recent blood tests showed slightly elevated creatinine levels (mine is 1.5) and there was some concern that the powerful intravenous contrast agents (those used with the CT-scans especially) might send my kidneys “over the edge”. What’s surprising to me is that I’ve always been good about drinking plenty of water and I’ve made a point of drinking 2 – 3 bottles of water immediately after each CT-Scan in an effort to quickly flush these from my system (as suggested by the radiologist).  Even so, it's possible that the sum of all these dyes to-date has led to my elevated creatinine levels. But it's even more likely (as one comment below suggests) that in my case what I'm seeing here is a late effect of my chemotherapy drugs. Either way, I will need to avoid contrast agents going forward.

To be clear, I’m not blaming anyone for this. Dr. Monson never ordered any contrast with my scans and has long since preached against this practice, arguing that the risk outweighs any perceived benefit. Furthermore, in my case, I am told that about 80% of any Myxoid Liposarcoma recurrence would show up as “chest nodules”, which is something you don’t need contrast to see.

So why was IV contrast used in the first place? Well, it’s the radiologists who seem to prefer it. But even there, they were fine with skipping it knowing that my creatinine levels were elevated. In fact, they were very appreciative that I had my levels tested and that I brought this to their attention.

So why even mention this? The point here is that one needs to be aware that cancer treatment and/or prevention can lead to yet a new set of problems. Also, if you’re having MRIs and/or CT-Scans with IV contrast, be sure to drink plenty of water immediately after the exam to help flush these dyes from your system. Finally, make sure that your doctor monitors your creatinine levels (especially if you've had chemotherapy drugs) so that any issues are caught early . . . before they have a chance to become big problems.

OK – I’m done. I’ve rambled on long enough. Expect to hear from me in another 3 months.