One thing that was quickly clarified: we had in mind that the heart of the process would take 90 days. Bzzt! Wrong! That’s for allogeneic transplants, where the donor and the recipient are not the same person. Fortunately, that’s not what I’m doing. The type of transplant we’re starting up should take more like 30 days. Some take less, some take more.

It sounds like everyone is actually pretty sure that the extra radiation of my brain is a good idea. We’ll be meeting with a neuro-oncologist on Friday to check out the results of tomorrow’s MRI.

In the last week I’ve: had a physical, recounted my entire lymphoma history, declined to participate in some studies, had some blood drawn, and had my teeth examined. Coming soon: MRI, MRSA check, PET/CT, bone marrow aspiration and biopsy, and pulmonary function tests. Some of these are to make sure that the cancer is in remission, and some are to make sure I can handle the transplant conditioning.

And yesterday reminded me that when I say “the cancer is” I actually mean “both cancers are”. I met with the attending doctor for my team and he noted that stem cell transplants have been found to be curative for more aggressive cancers (like the one that was found in my nervous system), but that the slower-moving (indolent) one may still (just barely) survive.

On the plus side, indolent cancers don’t seem to develop resistance to treatment as quickly. And if they do get resistant to specific attacks, there is still a broad spectrum of treatment options. And more on the horizon.

For now it is important that the radiation and that transplant totally destroy the aggressive lymphoma. All energy toward that goal.

After waking up I had the pleasure of finding that all attempts to get out of bed were met with intense pain. Pain that motivated me to stay in bed and not move a muscle. Except for the muscles used in taking two Percocet, and calling the oncology nurse (Sharon) that works with Dr Norman.

I described the pain (shoulder pain, likely because of spleen interacting with diaphragm) and she paged Dr Norman to ask his advice. She called us back with the request that we head to Urgent Care, where she’d ordered some pain medication and a CAT scan.

We also called our friend Lauren (an EMT) for backup.

I got into the car verrry slowly and Jana drove Lauren and I to the hospital post-haste.

We checked-in at Urgent Care and were admitted right away, skipping triage and much waiting. Vitals were recorded, a bit of blood was drawn, and then we got started on medication.

First was the awesomely-named anti-nausea drug Ondansetron, which would be a great name for a disco robot.

Then they got to the actual pain medication: Dilaudid. It’s just about as close as you can get to pure opium. I didn’t notice tremendous effect, but my dosage amount was pretty low.

Then: a surprise visit from Dr Norman! He stepped in to give us a briefing on the next steps. He didn’t have the full pathology report on the lymph node yet, but he was hearing unofficially that there appear to be colonies of more than one type of lymphoma. His suspicion is that I could have LPL that has spun off an instance of DLBCL along the way.

That’s right… I may have double cancer. Trump card for sympathy! Twice the bounty when I beat them both!

The chemotherapy would be intended to attack and destroy both cancers during the series.

We launch our attack tomorrow at 10am.

After some time to let the medication kick in, they took me downstairs for another CAT scan. We wanted to ensure that this pain wasn’t due to some sort of rupture or bleeding. Sure enough, my spleen is totally intact.

As the level of pain itself was not reduced, and judging from the serious effort it took to get out of bed this morning, the doctor in Urgent Care recommended that I stay in bed overnight in an observation room. A scant hour later we were on our way to the room.

And so here I sit, just about ready to fall asleep. Tomorrow will be a big day: the beginning of a long series of chemotherapy. I feel anxious about having my body burned from the inside, and dealing with sickness and reactions I’ve never known. But I’m ready to start removing uncertainty, to continue trusting in the support of friends, and to give these cancer cells a much-needed “etiquette lesson.”