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.