Christmas week

I'd been worried, going into Christmas, about my first Christmas while in chemo. I had read on another cancer patient's blog about her problems on her first Christmas after diagnosis, attempting to do too much. I even put my chemo off for a week so it would happen during New Year's week instead. I don't have very much stamina so helping with the meals and housework is pretty much beyond me. Even entertaining is something I can do only in small bites, for an hour or so at a time.

All turned out well. My family came to stay and everybody pitched in. We had them change their own sheets on the beds and do dishes and help with the cooking. Barry and Amy did the whole Christmas day feast with turkey and gravy and mashed potatoes and stuffing and vegetables and pumpkin pie. I took breaks in bed when I needed to and everything worked out well.

Lucia was sooo excited. She pulled her first gifts out of her Christmas stocking and excitedly said "I got Diego bandaids for Christmas!". She had many other gifts and had to play with them all, in turn, before we could open any more. We were still opening gifts after dinner! Lucia got a digital camera, and her photos were pretty funny: peoples' knees and shots of the carpet, etc all taken from about 2 feet from the ground. She got lots of Diego stuff, her current fave.


Emma slept through her gifts, so Lucia opened them for her. They both got big, soft, cuddly teddy bears from Great-Uncle Dennis and Great-Aunt Evy.

Family Christmas party

We were able to go to my family Christmas party at my Dad's house yesterday. The oncologist said my neutrophils were high enough that I could go, and I was feeling well. We stacked the front seat of the van with enough pillows to support my arms and head, and reclined the seat. We had a winter weather advisory at home but decided to make the 2 hour drive to Toronto anyway, as it was important to me to go. There were whiteouts for the first 15 minutes until we reached Niagara Falls on the QEW and then it stopped blowing and was clear sailing the rest of the way.

It was lovely to see everyone who came. My 16 month old niece Keira entertained us all with her antics and ability to bow and to stand on one foot. We played a rousing game of Jenga in which most everyone but me participated. Wikipedia defines Jenga as "a game of physical and mental skill in which players remove blocks from a tower and put them on top".


We have a hilarious generic gift exchange that allows gifts to be chosen from the tree and then stolen several times before they are opened. It's interesting to see people analyzing packages to steal based on size and shape and the colour of the wrapping paper only.

Thanks to Donna who made me a beautiful quilt for my afternoon naps, in muted fall colours to match my house decor (you can see it in the photo). At a time like this in my life when I am under stress from the cancer diagnosis and chemo treatments, it's wonderful to be able to spend time with people who care about me.

Some good news

Yesterday, on Day 24 of my second cycle, I had an appointment with my oncologist Dr R. to review the latest blood work. The good news is that with no treatment this month with white cell booster Neulasta, nor a blood transfusion, my white blood cell count is up to 2.53 (normal is 4.0 - 11.0) and my hemoglobin is up also, to 10.8 g/dl (normal is 12.5 - 15.5). My neutrophils are out of the danger zone at 1.7 (at the low end of the normal range), and so I no longer have any restrictions on my daily activities. These higher levels mean that my body is fighting the cancer cells on its own.

As long as I feel up to it and the weather co-operates, I can go to my family party in Toronto on Sunday. This is great news.

Since I have my children and grandchildren visiting over Christmas, Dr R. has agreed to let me push my third cycle of chemo back by a week so that it takes place over New Year's week instead of Christmas week. This way I will be able to enjoy their visits as much as possible without being wiped out by chemo infusions.

Decorating the tree

I'm still doing relatively well. As time has passed since my chemo days I have been feeling more energetic. I still spend some of my day resting in bed, but I am able to help with the dishes and laundry. We have developed routines for our days and on weekends I often accompany Barry to do errands in the car, although I do not usually go into the stores. I'm supposed to wear a mask when I go out to protect myself from infection.

We had another visit from our daughter and our grandchildren a couple of weeks ago. Barry put up the Christmas tree while they were here and Lucia was a big help with the decoratng.

Day 15: Neutropenia

No blood transfusion or injections were done today. The blood tests showed that my hemoglobin level is at 10.3 g/dl, which is very good and explains the extra energy I have had for a few days.

But Nurse J. explained that my white blood cell count is low, and so are my neutrophils, and therefore I am considered to be at greater risk of infection. Neutrophils are white blood cells (WBCs) produced in the bone marrow that ingest bacteria. An abnormal decrease in the levels of neutrophils is called neutropenia.

I am to avoid crowds and small children, and wear a mask whenever I go out. I must take my temperature 4 times a day, and call them if I show any signs of an infection. Even catching a cold or the flu would be a very bad thing for me right now. It's a good thing my Christms shopping is done!

Day 15: labs today

I was scheduled for labs today, which means that I go in and they take my blood, and then I wait in a reclining chair in the infusion centre while they test the blood to see how I am doing. If the hemoglobin is too low I will be given a blood transfusion, and if the white blood cells are too low I will be given an injection of Neulasta.

It means that on lab days we don't know how long we will be at Roswell so we go prepared for a long wait. The testing takes about an hour if they are not too busy, the blood transfusion takes about two hours per unit, and they can't do the transfusion until they know if I need it.

We bring both our laptops (thank heaven for free wireless) and Barry works while I just surf the net. They provide a snack centre but there is no decaf coffee or tea so we bring our own. I also bring a small pillow for my back as the reclining chairs are not very comfortable, and another one for under my neck.

Each room or cubicle comes with a TV, so in my notebook I have a list of the cable channels, and I can quickly find the right station if I want to watch TV. Sometimes Headline News or an old black & white movie are just the thing.

Chemo brain

Cancer patients often joke about having chemo brain, a kind of brain fog that comes with treatment. It is associated with memory lapses and trouble finding the correct words, and with difficulty making decisions. Multi-tasking becomes nearly impossible along with the ability to concentrate.

We have noticed that I have some of these issues (and joke about it) but had put it down to the stress associated with a cancer diagnosis and treatment.

On the internet last night, on www.cancer.org, I found that it is indeed real and is otherwise known as "mild cognitive impairment". Imaging studies have shown that some chemotherapy patients have changes in the areas of the brain that deal with memory and planning, and those changes may last for 5 to 10 years after treatment, although the impairment may be gone within 2 years.

Barry insists that he is suffering from chemo brain too, even though he is not on chemo.

Cycle two, day five: Fludarabine

Yesterday was Black Friday, when most of the stores in the U.S open early for the start of the busy Christmas shopping season, and Roswell Park was busier than usual also. They expected to see 120 patients, many more than the 28 patients on Thanksgiving Day, and more than a normal day because so many patients opted to come yesterday instead of Thanksgiving Day

Fludarabine went well, although I am collecting a lot of needle holes in my left hand and arm this week. My right hand is still bruised from the missed insertion on Monday so all the nurses since then have used my left hand.

The pain in my arms is continuing but it is not as bad as it was during the first cycle. I have no other after effects except that sleeplessness continues to be a problem. I had yet another bad night and now have had two nights with only 3 hours sleep. I think it must be a side effect of the chemo.

Thankgiving Day

My second infusion of Fludarabine this cycle was scheduled for Thanksgiving Day in the U.S. We left our home at 8:45 for a 9:30 appointment and found no traffic on the international bridge leading to Buffalo. The streets were empty and we made good time. At Roswell Park the parking gates were up and there were no tickets issued when we pushed the button.

The valet parking was closed, the gift shop was closed, the information desk was closed and the coffee shop was closed. Phlebotomy was closed. I saw one lonely janitor washing the floors.

In the infusion centre there were no patients waiting. I was called in right away and put on the saline drip even before my scheduled appointment time. The chemo followed soon after and we were out of there by 10:30 am and home by 11 am.

Nurse S. told us that there were only 28 patients scheduled and they normally see 90-100 on any given day. Here is a photo of empty chairs waiting in vain for patients to arrive.

Cycle two, day three: Fludarabine

I was too optimistic today about my ability to do errands after chemo. On the last round I felt that the Fludarabine was the easier of the two chemo drugs I was taking, but this time I felt the opposite. The infusion center was especially busy today and we waited over 1 1/2 hours to be called in. Nurse B. did a fine job of putting the line into my left arm, and the infusion went well.

However, after the infusion we had to pick up a new prescription and go to the store as well. When Wal-Mart didn't have an electric scooter available, I had to go back to the car to wait for Barry to do the shopping by himself. I had no stamina to walk around a store. As well, my right arm started to ache and I realized that the three weeks of achy arms I went through last month was from the Fludarabine. I'm not looking forward to that again.

Cycle two, day one: Rituxan

On Monday Nov 24 we left home early, expecting traffic problems, but traffic was light and we arrived early.

My hemoglobin level was at 9.9 g/dl, the highest it has been since early August. Since the effect of transfusions don't seem to last that long, it could only mean the monoclonal B cells were dying off.

My second time around with Rituxan turned out to be simpler, except that Nurse A. missed the vein and another nurse had to come in and insert the second line into my other hand. The Benadryl this time was in tablet form and didn't affect me as much. The drip was started at 100 cc/hr and increased by 100 cc every 30 minutes. As a result it only lasted about 3 hours instead of 4 hours. It was done faster because it was my second time and they now knew how I would react to it. I had some dizziness and chills during the infusion but not as much as the first time.

At home that evening and the next day I had only a sore throat. Altogether an easy day.

Lots of visitors

The following week my husband had an unavoidable business trip, so my daughter came to take care of me. She brought her 2 1/2 year old, Lucia, and her 2 month old, Emma, and her sister-in-law, Teresa. Teresa had to take vacation days from her job to come over to Canada to stay and I was very grateful.

We had snow flurries all week and several inches on the ground, and it was Teresa's first real experience of living with snow. She comes from a more temperate climate. She was smart, though, and brought all her warmest clothes.

It was a wonderful week. My boost of energy from the blood transfusion had faded but it was still great to have my granddaughters here. I got to hold baby Emma as much as I wanted. Lucia came to visit me in my room often after dinner and we watched Baby Einstein DVD's together.

Our son Steve and his partner Amy came for both weekends and brought gourmet frozen meals from their local caterer so we were well stocked with food.


We had a lovely visit from my father and step-mother, who arrived right after lunch on Saturday with a big box of Tim Hortons doughnuts. The doughnuts were well appreciated and didn't last very long.

My husband came home on Saturday night, just in time for his birthday! My brother- and sister-in-law arrived on Sunday and brought birthday cake. We had a big dinner (thanks Amy) and presents afterward. The house felt very empty when everybody went home!

Day 12: blood transfusion

My next appointment with Dr R. was Friday November 7, at 10 am. I was to go to Phlebotomy first. After check-in at the clinic I was sent back to Phlebotomy to get my blood typed.

The test results showed that my hemoglobin was still dropping, down to 8.5 g/dl, and my white blood cell count was down to 1.19 10x9/l, as expected. Dr R. ordered a blood transfusion to help with the anaemia and the fatigue, which was quite profound by this time.

In the infusion clinic the nurse ordered the blood, but again there was a long wait. I was put on a saline drip as before. It was 1 pm before the blood arrived, and the drip was started. A unit of blood is about 2 cups or 450 ml, and takes about two hours for a transfusion. At Roswell Park all the blood is irradiated to prevent any risk of an infection being transferred.

I also had an injection of Neulasta (a stimulating factor) to help the white blood cells grow and mature, as the chemo had killed off most of my white blood cells and thus I would be prone to infection. I had no side effects.

I was finished about 3 pm and we could go home.

Cycle one, day three, four and five: Fludarabine

The next day (Tuesday) was a day off for me. On Wednesday we made good time getting over the bridge, as the appointment was for 9:30 am and the traffic was lighter. I did not have any blood drawn this day.

By 10:10 am the saline drip was started and at 11:40 am the Fludarabine had arrived. It was all over by 12:15 and I had yet to have any side effects.

However, by the time we got home I had mouth sores starting and very achy arms. Days three and four were much the same but the mouth sores healed quickly and did not return.

The aching arms and shoulders became much worse and were to plague me for the next three weeks.

Day one, evening

We went straight home as I wasn't feeling well. Fortunately we had filled my side effect prescriptions the previous week so didn't have to stop to get that done.

By 6 pm my chills were noticeably worse, I had the shakes and my teeth were chattering. I was having trouble catching my breath. I had a temperature of 100.8 F.

We called the on-call doctor as we had been instructed to do in case of any fever over 100 F. He said we didn't have to go to hospital immediately, but I could take Tylenol and wait until morning to see if the fever had diminished. Apparently shaking chills and fever are common side effects of Rituxan on the first evening and he was not too worried.

I was somewhat better by morning and we decided to wait to see if I needed to go to hospital. The on-call doctor called back and agreed. By evening my temperature was back to normal.

Cycle one, day one: Rituxan

It was Monday October 27, 2008 and my very first day of chemo. We didn't know what to expect that day. We packed a bag with my notes and medicines, an extra pillow, a book for each of us,and bottles of water. Barry took his laptop as we were told that there was free wireless internet in the hospital

My appointment at Phlebotomy was for 8am. We had to get up early. We have to cross the Peace Bridge from Canada into the U.S. and the lanes were all backed up. Unfortunately we didn't count on heavy traffic so early on a Monday, and we were late getting there. It made for a stressful start to a difficult day.

We waited at Phlebotomy and we waited again at the chemo infusion clinic. Nurse K. called us in to the chemo room. She would be my nurse for the day. I was weighed and measured, temperature and blood pressure taken, allergies noted.

The infusion centre is set up with rows of recliners, each one having an IV pole, a television on the wall, a guest chair and a privacy curtain. If you have a long day there are private rooms around the edges of the room with the same amenities and also a hospital bed. I was lucky and got a room at 8:40 am.

The nurse set up an IV line into my left hand at 9:40 am. Then two bags of a normal saline drip to flush out the line at 200 ml/hr while we waited for the chemo. At 10 am I had two tablets of Tylenol and one of my saline bags was replaced with Benadryl to combat allergic reactions to the Rituxan. Five minutes later I was light headed and five minutes after that my words were slurred and I couldn't lift my head. In the midst of all the stress it seemed mildly amusing to me. Probably the meds.

The Rituxan arrived at 10:40 am. It replaced the Benadryl. To reduce the chance of an adverse reacton it is started at a slow drip rate of 50 ml per hour, for the first hour. Nurse K. checked my heart rate, blood pressure, temperature and oxygen level every ten minutes and decided to increase my saline drip to 250 ml/hr, and then to 300 ml/hr to combat my dropping blood pressure.

By 11:30 am I needed to use the washroom, from all the extra fluids being pumped into me. That was an adventure in itself, the nurse had to disconnect me from the monitoring equipment so I could take my IV pole for a walk. I would take that trip several times that day, and Barry learned how to disconnect me himself. He had to walk me there as I wasn't steady on my feet. Fortunately there are lots of washrooms in the infusion centre.

By 11:45 am I was back in my room on a Rituxan rate of 100 ml/hr and having chills. At 150 ml/hr I had a headache, sore throat, my ears were blocked and my eyes were sore. The nurse brought me a blanket.

Around this time a volunteer came by with bags of snack food. I welcomed the cool yoghurt and applesauce for my sore throat. Barry went out and got a lunch from the cafeteria for himself,but I wasn't hungry.

At 1:30 pm with the Rituxan at 250 ml/hr and all the side effects still around, I decided to move to the bed. At 2:35 pm the infusion was finished. My side effects were diminished by then but still not gone. Fortunately I was used to having chills from the anaemia and had brought a warm coat with me, for it was a beautiful fall day. We could go home.

The week before chemo with Lucia

We were fortunate to have a visit from our daughter and her family one weekend before chemo. When it came time for them to leave, our 2 1/2 year old granddaughter Lucia didn't want to go home. So our daughter graciously allowed her to stay with us for the week before my first chemo treatment.

It was the best gift I could have had. Lucia took my mind off my fatigue and coming treatments, and was generally a joy to have. She helped Grandpa around the house, and we watched 'Dora the Explorer' videos together. We went to story hour at the library. We went shopping, with me driving a motorized shopping cart.

Lucia played football with Grandpa. I'm not sure who won.

The new diagnosis: SLL

We met with Dr R. on the following Friday, October 17, 2008. The CT scan had shown that I have some 1 cm enlarged lymph nodes in my chest and abdomen, but no liver or spleen involvement. We later learned these findings indicated Stage IV disease, because it's in my blood, bone marrow and lymph nodes in the chest and abdomen.

This information together with the blood work led the Roswell Park team to decide that I had atypical Small Lymphocytic Lymphoma, or SLL. The treatment would be the same as previously discussed, Rituximab on Monday followed by Fludarabine on Wednesday, Thursday and Friday, every four weeks for 6 cycles.

I asked for and received my annual flu shot. I had been told that you should get this done before chemo. I was told to get any dental work I needed done before chemo as well.

I met with the pharmacist Dr A. who gave me lists of what I could expect on the chemo, and the most likely side effects. I was warned the fatigue would get worse and that I might need a blood transfusion around Day 10 to 14.

Dr R. gave me prescriptions for side effect drugs, generic Zofran for nausea, generic Compazine also for nausea, generic Bactrim to prevent pneumonia and Acyclovir to prevent viral infections. The pharmacist told me to start the Zofran immediately as I was already experiencing some nausea.

We agreed I could start chemo on Monday October 27, a week later.

Canadian Thanksgiving long weekend

Our Canadian Thanksgiving long weekend fell immediately after the CT Scan. We were invited to our son Steve and his partner Amy's cottage near Peterborough. It was a lovely fall weekend, the trees were turning colour and we had some quite warm weather.



Neveretheless, I spent much of the weekend shivering in front of the fire, covered in sweaters.

We did have one hot afternoon and we went out in the kayak to glide down the Crowe River in the peace and quiet. An afternoon to remember. (Thanks for the photo, Steve.)



This is my family enjoying the lovely weather while I was wrapped up warmly in the hammock (not in the picture).

CT Scan

The CT (Computerized Tomography) scan was scheduled for Friday October 10 at 5pm. It's upstairs at Roswell, but I had to have blood tests done first, at Phlebotomy.

At the CT clinic I drank a Barium Sulphate suspension (tastes like a berry smoothie), to illiminate the digestive tract for the CT scan. Then I waited for 45 minutes for it to spread through my system. When I was called in I had an IV line inserted but no fluids yet. I was allowed to wear my own clothes.

Then I was taken to the CT chamber, it looks like a long table with a doughnut shaped chamber at one end. When I was settled comfortably, the iodine was inserted into the IV line and I was asked not to move. The iodine is a contrast dye used to identify whether my lymph nodes are enlarged and if there is any liver or spleen involvement.

The table moves back and forth through the tunnel several times and then I was done. I had no after effects at all and was able to go home.

Roswell Park Cancer Institute

Roswell Park is a well thought out space, with the parking garage immediately across the street and free, fast, valet parking. There's a garden for quiet meditation immediately beside the entrance. The central atrium is like an upscale hotel lobby and often has live music and entertainers from the BPO (Buffalo Philharmonic Orchestra) and from local dance and singing groups. There is a central coffee shop like the big national coffee chains. If you are waiting for an appointment you can ask for a beeper like many restaurants have, to go for coffee or just sit in another area of the lobby. Volunteers come around with crafts, knitting, card games, etc. for those who may have a long wait.

All the offices you will see on a daily basis radiate out from the lobby, such as phlebotomy and the infusion centre, as well as the clinic and examining rooms. Each has its own check-in procedure. Blood work results take only about an hour to get to your oncologist.

The specialized services such as X-ray, CT Scans, etc. seem to be on the second floor, along with an excellent cafeteria with reasonably priced food. Patient floors are above that.

New oncologist Dr R.

On Wednesday October 8 we went to Roswell Park. We met with Dr V.J., who was Dr R.'s resident in training. I answered many, many questions about my complete medical history, although it appeared they already had some of the answers from my family doctor. Then Dr R. joned us.

As far as my symptoms go, I was by this time starting to feel fatigued every day, and my balance was off. I continued to bruise easily. I dropped things as my hands would sudddenly just lose their grip. I had no pain.

Dr R. ordered more blood tests, and an CT scan to be done in the next two days.

She confirmed that my diagnosis was definitely Non Hodgkin's Lymphoma, a low grade indolent version, and most likely the same as Dr H. diagnosed. Treatment at Roswell, however, would be a less toxic version of chemotherapy, with Fludarabine in combination with Rituximab for 4 days every 4 weeks, for 6 cycles. This chemo has fewer side effects and my hair would not fall out.

We had already made our decision. Roswell Park is actually closer to our home than the regional hospital and is a national cancer centre to boot. The treatment would be less toxic. How could we go wrong? In addition, our drug coverage is U.S. based so we would have less trouble having prescriptions filled.

The CT scan was scheduled for Friday October 10 at 5pm.

Getting ready for the new oncologist.

The patient scheduler asked us to get my bone marrow slides from the regional hospital and bring them to Roswell Park. Apparently it would take 3 weeks to get them through the usual channels. We drove there that afternoon and went down into the basement of the regional hospital to find the lab and, curiously, I was asked to sign for them but no-one asked to see my I.D. They were packaged in a small styrofoam cooler that was sealed inside plastic.

Getting the digital copies of my chest x-ray and ultrasound was even easier. We dropped in to our small local hospital and asked for the copies, and after they figured out how to do it, they were just handed over. No-one asked me for I.D. or even to sign for them. We drove straight over the border to get them to Roswell Park that same afternoon.

Both my family doctor and my oncologist were asked for copies of my file and relevant blood work by phone, to be faxed to Roswell Park as well.

Our health insurance company has a special sub-group for cancer treatment and we were able to get the paperwork sorted out for that with just a phone call, so that all my co-payments for tests and treatments at Roswell Park would be waived. This contract can be renewed each year by phone.

My appointment for a second opinion was for Wednesday October 8 in the afternoon with Dr R.

Second opinion.

That weeekend was a very difficult one for us. We had received devastating news, and we had no time to process it because we had to decide on the travel and the treatment immediately. We cried a lot. We talked to our kids. We read as much as we could comprehend on the internet. We re-read our notes from the oncologist meeting. By Sunday we had cancelled the trips, but were not yet resigned to the diagnosis.

We are fortunate to live near Roswell Park Cancer Institute, a large national cancer center, and we decided to get a second opinion there. Barry found the email address for the top cancer guy in my disease, and sent him a short email on Monday asking for his help. Dr M.C. wrote right back asking for our phone number and called immediately!

He was so kind and so helpful. We talked for half an hour. He had me read him some of the lab results over the phone and discussed my likely diagnosis. He thought it was likely correct although there might be other very similar possibilities. He suggested other chemotherapy regimens that were less toxic.

The most important thing he said is that treatment is never so urgent that there is no time for a second opinion. He suggested that we could get my slides from the bone marrow aspiration and biopsy re-read at Roswell Park and not have to repeat the tests themselves.

Dr M.C. was on his way to a conference overseas and said he would set us up with a colleague for our second opinion. His group's patient scheduler would call us.

The road not travelled

The diagnosis was on Friday. The following Tuesday we were to travel to New Orleans for a 6 days for a conference. Then we had 5 days at home followed by a 7 week trip to New Zealand for business. Needless to say we wanted to know if my treatment could be postponed until after all our travel. Unravelling those plans would take a lot of work by many people as they were both business trips, and cost everyone time and money for prebooked flights and accomodation.

The oncologist was shocked that we asked if we could put chemotherapy off for a couple of months. He wanted me in chemo by the next week. He told us I would not be in any shape to enjoy the New Zealand trip by that time.

We said that we would think about it over the weekend and let him know by Monday.

The diagnosis

We came home from our daughter's house just two days before the doctor appointment. This time both my husband and I went to see the oncologist. By now we were sure something was wrong, because I had noticed that I was more easily tired, but we were hoping for a benign easily treatable condition.

We waited for a long time to see Dr H. It was a Friday afternoon. The 4 o'clock appointment became 5 o'clock, then 5:30. Finally he arrived. He told us a lot of things that it was not, and kept referring to it as my disease. Finally I asked straight out, "Is this cancer?". The answer was yes. It was diagnosed, at least initially, as Lymphoplasmacytic Lymphoma, low grade or indolent (meaning slow growing and incurable).

He wanted me in chemotherapy immediately. My anaemia was getting worse, and treatment was essential. My hemoglobin had gone from 9.8 g/dl in mid August to 9.0 g/dl at the end of August. All indicators were that it would continue to fall and that I would soon be too fatigued to do much of anything.

His nurse came next. She was very nice and explained all of the options, how long I would be on Chemotherapy (1 day every 3 weeks for 6 cycles), which drugs I would get (CVP-R: Cyclophosphamide, Vincristine, Prednisone, & Rituxan), what I could expect in the way of side effects (yes, all my hair would fall out), and so on.

No time to think

Between the tests and the appointment to get the results, we spent a delightful month watching over our two year old granddaughter while our daughter was on bed rest and then in hospital having another baby. We even took our granddaughter camping for the first time, but that's another story for another blog.

It was wonderful to fall into bed at the end of the day too tired to think (toddlers are hard work). I had a few moments when I tried to piece together the things the oncologist had said but mostly I just tried not to think about it.

Here's a photo of me and my daughter and my TWO beautiful granddaughters, Lucia age 2 1/2 and Emma Cristina age 2 days.

How it started

It all began with my annual checkup in January 2008. My physician said "oh, you are a little anaemic and there are some funny proteins in your blood, let's see you again in six months". At this point I felt no symptoms, although I bruised rather easily.

I didn't think any more about it. In seven months I had to call the office for a prescription repeat and the nurse reminded me about the follow-up appointment. So I went in and my doctor mentioned that my anaemia was not iron deficiency related and he ordered more blood work. Again I gave it no more thought.

In mid August his nurse phoned and left a message that I had an appointment with a hematologist, in a few days. This was a bit more alarming, but again, I wasn't going to worry. I brushed off my husband's concerns, and went to the appointment alone.

Then I found that my appointment was actually in the Oncology Clinic. Hmmm, I wished I hadn't come alone now. As I was shown into an examining room, there seemed to be a lot of nurses around. The oncologist said, "We'd like to do a bone marrow biopsy and aspiration today". I said: WHAT?

He said we could wait a week for the idea to be comfortable but we are going to have to do it anyway, so it's up to you.

OK, excruciating pain now or wait in nervous dread to have excruciating pain next week. No brainer for me, I took the pain now. It was not as bad as I had feared, although the nurse did have to hold my hand throughout the procedure. They took more blood and the doctor set my next appointment for September 26 and it was over.

One week later they called and asked me to have a Chest X-ray and an Ultrasound at my local hospital. As I was about to go away for several weeks, I asked if it could be postponed. No, I was told, it was very important that I have these tests, and they would see if they could schedule them before my trip. No mean feat with the Ontario medical system, but they got me scheduled on the very morning of my departure.