End of Treatment

IMG_0799Journal: April 2002

My last week is filled with mixed emotions.  My treatments have defined and structured these last three months.  What will I do now? Donna the Peach is working at Big Eagle clinic that week.  I think back on how difficult the treatments were for me the first month, the violent rigors and the subsequent stupor. For the past eight weeks things were routine, predictable.  There was only one instance, when the CamPath was inadvertently set at too high a rate, that I felt the familiar sensation in my chest.  This time it progressed only to an increased shortness of breath changing to hyperventilation.  We turned off the infusion for thirty minutes and only ran the normal saline.  The reaction subsided without the need for medication.

My appointment to see Ray Markham was on the Wednesday before my last treatment. Tish took me on this day as she does whenever I have an appointment to speak with the doctor.  My appointment was not until the afternoon so we went out to eat Mexican and do a bit of shopping.  I had imagined that by the end of next week we would have results from both my biopsy and my PET scan.  I had imagined that Tish and I would leave on our twelve-day holiday with a sense of what I was and where I was going.
During this appointment Ray was generally optimistic, saying that my spleen was still about the same size, though certainly markedly reduced from presentation.  He said that we would not do the bone marrow biopsy for several weeks. With our planned holiday this would mean more than a month before we did the biopsy, more than a month without knowing, a long month wondering if I am in remission or not.  I was not prepared for this.  He offered that I could have the biopsy done a few days before we left town. That would mean that biopsy results would be available earlier, but still when I was out of town.  Could I resist calling for the results?  Would I even want the results in the midst of my relaxation?  He left it up to me to decide.

On this day Ray also mentioned traditional chemotherapy as an option in the event that I was not in remission.  Chemo has always been an option, I suppose.  But my doctor has never mentioned it as an alternative until now.  Then he seemed to relegate the stem cell transplant option to only one of several options open to us, pending results of the biopsy, pending the answer of remission or a continuation of my disease.  Not being in remission implies that the treatment has not worked.  Even though we know that I am in at least partial remission – my spleen has shrunken and my lymphocyte count is suppressed – not being in complete remission is a big deal, emotionally as well as medically.


About Dennis Pyritz

Dennis W. Pyritz, RN, BA, BSN, has been a cancer nurse since 1987 and a cancer and bone marrow transplant survivor since 2004. In December 2001 he was diagnosed with t-cell prolymphocytic leukemia (T-PLL), a rare aggressive form of chronic lymphocytic leukemia (CLL). Dennis was treated with the then new monoclonal antibody, alemtuzumab (Campath) as this disease has a median survival of 7.5 months. He achieved a 26 month remission but relapsed in February 2004. He was retreated with Campath and went into a second remission. In August 2004 he underwent an allogeneic peripheral blood stem cell transplant with his brother, Mark, as donor. Dennis has remained in remission since - a near miracle. Throughout his career as cancer nurse and patient, Dennis has had the opportunity to speal to both lay and professional groups. Dennis has spoken on cancer topics and survival issues across the country as well as in the United Kingdom, Norway, Austria, Portugal, Honduras, Panama, Guatemala, Trinidad, United Arab Emirates, Jordan, Cyrpus, Israel, and India.

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