Summer Fun and Surgery

Soon after James was done with chemo we were ready to move on and have some fun! And by soon I mean two days after his treatment was finished, we met with his doctor, had his port removed, I picked him up from the hospital and we hit the road! We were so ready to move forward with our lives. So we headed to Idaho for the summer to beat the Arizona heat. It was pretty nice feeling like snowbirds this year.
Before we left though, James had to have more imaging and lab work done. His tumor markers were normal still so that was perfect. There was one lymph node that was still enlarged though. It was measuring at 1.3 cm and they wanted it to be less that 1. We had done the imaging a little early though so the doctor just told us to have more imaging done in a month and we would go from there.
Our summer was perfect. We went mountain biking, boating, running, to weddings, saw family, everything we wanted to do! We were care free and having fun and the lingering lymph node was the least of our worries.
One month went by and we went in for more imaging. His lymph node was the same. We were slightly disappointed but by this point we just kind of expected things like this to happen so we just went with it. Our oncologist in Arizona had found us a doctor to work with in Idaho so we met with him and decided what our next step needed to be.
Originally, we were told that if it didn't shrink we needed to have it removed immediately. Now we were being told to monitor it again and go from there. Of course we didn't really want to do more surgery so we took that advise. Well, after about a month we didn't feel right about our decision so James spoke with his AZ oncologist who recommended that we meet with a surgeon about the lymph node. Sure enough, he was surprised we hadn't had the surgery and suggested that we remove it immediately.
James and I talked about going back to Arizona to have it done but we found out the surgeon there wasn't covered by our insurance and James would have to stay in the hospital for at least 5 days post surgery, so it just made sense to stay where family could help. We did our best to squeeze in some more summer fun with a quick trip to Bear Lake and a camping trip in McCall and then it was time for surgery.
James ended up having a RPLND, a retro peritoneal lymph node dissection, basically they cut him open from sternum to bellybutton and then remove all of the lymph nodes in the area of the enlarged one. This was the most major surgery we had dealt with by far but everything went well and we were just glad to have it over with.
After the surgery they did a biopsy on everything they removed and found that all of his cancer cells were dead and the enlarged lymph node was a teratoma, so by removing it, they were basically able to consider him "cured". They can't really tell you that you're cured until you have gone 5 years cancer free, but this was the best news! Even with the surgery, it was a great note to end the summer on.

     

And we spent our 6th anniversary in the hospital, it was still awesome.

She just wanted to jump on Daddy the whole time.

Sorry, it's a little graphic

     

 

                     

Chemotherapy

About a week prior to beginning chemotherapy, James had surgery (again) to have a port placed in his chest. This was an access in his chest, under the skin, that they attached his IV to for all of his treatments. For some reason, this was emotionally the hardest surgery for me. It was the smallest scar, it wasn't that serious of a procedure but for me it just screamed cancer. With his other surgeries no one could see the scar and no one knew he was sick. This one everyone could see though and it was just a daily, visual reminder to me that my husband had cancer.
With his treatment, he did 3 cycles of treatment that each lasted 3 weeks, for a total of 9 weeks of treatment. The first week of each cycle was the long week. He went Monday through Friday for about 6 hours every day. These were long weeks. By Wednesday the drugs would catch up with him and he was just exhausted. Luckily, his side effects usually wore off by Sunday and he was feeling much better. The next 2 weeks of each cycle, he only went in for about a half hour on Tuesdays. The drug they gave him this day made him feel the worst, but it didn't seem to last long and by Thursday he was doing better.
James started his chemo on March 25th, 2013. Of all of his days, this was really the only hard one. Not knowing what exactly was going to happen and how James would respond was our first obstacle. Throughout the day, treatment went well. It was pretty boring to sit in a lazy boy all day while they just pumped James full of one drug after the next, but it did give him the opportunity to study so he could keep up with his classes. (That's right, my husband is AMAZING! He finished his first year of medical school while going through chemo and still got above a 3.0 GPA! He is my hero.)
The end of the day was our hardest part. James was supposed to be prescribed two different anti-nausea medications to help with his side effects. The nurses said it was sent to our pharmacy and so we went right over to pick it up. It wasn't there. I called the nurses, they said they sent it, I asked if they'd send it again, they said be patient. I waited and watched James get more and more sick as the afternoon went on. I called the pharmacy, still not there. I called the nurses back, be patient they said. I waited, when I called the pharmacy again, it still wasn't there. When I tried the office again, they were closed. I had no idea what to do. James was sick and I felt like there was nothing I could do.
I went into the pharmacy and tried to find something over the counter. The best the pharmacist could do was give me Dramamine. It was useless. I went back to the pharmacy to see if there was anything else or if the prescription had come through, there was nothing. I cried. I hate crying, especially in front of other people, and even more so in front of strangers, but I cried. I just wanted to do something to help.
When I came home empty handed, I remembered that James' doctor had given him his cell number. It was late, the pharmacy was about to close, and I had no idea if his doctor would even be able to help but it was worth a shot. I called and he was able to call in the prescriptions for us, something the nurses should have just done hours ago. I called the pharmacy and he said he would stay open until I came in to pick it up. A little compassion goes a long way.
The our doctor didn't have to call in the prescription and the pharmacist didn't have to stay longer. The five minutes they spent to help us, meant more to us then they could ever know. Soon after James was able to take his medication he was already feeling much better. He was able to relax and get the rest he needed.
We were so fortunate in that James responded to treatment really well. After his first 3 weeks of treatment, his tumor markers were already normal. Theoretically that meant the cancer was already gone. With the help of his medications he had little side effects and other than an extreme lack of energy, he felt pretty well. We did have a few hiccups along the way, there were a few weeks we had to delay treatment due to low cell counts, but those were minor.
James started loosing his hair about 4 weeks into treatment. It would fall out on his pillow or if he would rub his head so finally we just pulled out as much as we could and then buzzed it. I thought that would be a hard day for me but it surprisingly wasn't, and James was a pretty sexy bald man, so that helped.
I am so thankful that his treatment went as smoothly as it did. Every time we went in to the chemo room I could see how hard it was on so many of the patients. Some of them were going on years of treatment or had every possible side effect they could have.
I am so thankful that James never complained, seriously not once, he never complained. He would tell me if we was uncomfortable, or if he needed something, or that he wasn't feeling well, but he never complained. He never said why me, he just did what he needed to do. I know that his positive attitude helped with his healing and with his treatment. Some might think that is silly but I saw it make a difference. There is so much power in a positive attitude.

See, I told you he was sexy!

Ringing in the New Year...The Ball Drop

The holiday's were over and we headed home. We quickly got busy getting back into our routine and became caught up in too many things. James was busy with school and I was (I still am) adjusting to taking care of a new baby. It was a few weeks before James finally made it to the doctor. He went in early January, on a friday before school. The school has a clinic that was free to students and easy to get into so he just stopped in before going to class. The doctor was calm and sent him to get an ultrasound because there was definielty something there, he just couldn't be sure what. Around noon, James called me and said I needed to hurry to the school. His doctor wanted to meet with him during his lunch break and I needed to be there as soon as I could. I was sick to my stomach with panic. I knew that there was only one reason why we both needed to be there. It wasn't to tell us any good news. I gathered up Isla and we went over to the school. Things were going so quickly but it felt like slow motion all at the same time. In less than an hour we had been told that it was indeed a tumor, met with a specialist, and had surgery scheduled for the following Monday. We met with his doctor, his dean, his surgeon, he had imaging and blood work done... it was crazy. People always say "don't do this or that, it will give you cancer," and I always said, "everything will give us cancer." Never in my life though did I really imagine being told that my husband has cancer, especially at 27 and 25 years old. The whole thing was surreal to me. The following Monday, James headed into surgery to have an orchectomy (his right testicle removed). His doctor and surgeon were very optimistic about his case and we all hoped for the best, that this would be the end and we could just move forward. James healed very quickly and even went back to school the Wednesday after his surgery. We were ready to continue as if nothing had happened.

In My Opinion, Get a Second Opinion

When we learned of James' vericocele, our first question was if we could fix it surgically. We were hoping that if we fixed the problem, we could possibly increase our chances of having children naturally.  The doctor we were seeing at the time simply told us that IVF was our best option for having children and that any surgical fix for the vericocele would not only be too expensive, but would also have little effect on our fertility. He sounded pretty sure of himself so we took his word for it and left it at that. That was our first mistake. Here are a few suggestions for whenever you get a serious diagnosis.
1- Go to the proper doctor. The doctor we were seeing was a general physician, or a family practice doctor. We should have been seeing a urologist or reproductive specialist. Doctors specialize for a reason.
2- If, like us, you're seeing a general physician and they suggest that there is something wrong, ask to be reffered to a specialist. Don't have their suggestion even be the first opinion.
3- After seeing a specialist, if you can, get a second opinion. Or third or fourth... Don't look for someone to tell you what you want to hear but be sure that you are given correct and up to date information.
It wasn't until after our 2nd cycle of IVF that my MIL actually recommended that we have the vericocele fixed. We told her what our doctor had originally told us but she still suggested that we see someone about it. James was also covered under his dad's insurance and they had already met most of their deductible that year, so it was worth a shot. We set up an appointment with a urologist and discovered that not only would the surgery be affordable,but it could also have a great impact on our fertility! Though it wasn't guaranteed, it was worth a try. That September James had the surgery. Looking back on it now, to be honest I don't know why we decided to do our third cycle of IVF. After the surgery we had to wait 6 months to find out if there was any improvement in James' sperm count, which there was. He went from less than 1 million to over 10 million. You would think that sounds like a lot but "normal" for a fertile man is at least 15 million sperm. I don't know if we were too impatient to keep waiting for improvement or if we were just inspired, maybe it was both but I'm so thankful we decided to go ahead with our final cycle anyway.