4 hours, 5 doctors, 6,000 forms...

and I'm not exaggerating! Okay, I may have estimated the forms a little high, but we did spend four hours at The James today and saw 5 different doctors, nurses, research coordinators, pharmacists, etc.

Let me start at the beginning. Dave and I had an 11:00 appointment with Dr. Blum, but she was running behind so we waited in our little 8 x 8 room until 1:00 when she walked in. Now don't get me wrong, this is really frustrating, but it's difficult to be upset with a women who holds an extreme amount of power. She is the one person Dave and I have decided has the knowledge and skill to treat him most effectively and you know we've shopped around. The other reason it's difficult to be upset with her is that she is calm, rationale, and never makes you feel as though you need to quit asking questions. She spends as much time as needed with her patients. Obviously this is also the reason she is running two hours behind. She enters and immediately apologizes for being so backed-up and, of course, Dave and I both respond with, "Oh, gosh...no big deal we totally understand." And we do understand, but I must admit the little voice in my head is saying, "Do you have any idea how hard it is to sit in that chair for two hours when your 8 months pregnant?" But I figure this is a little counterproductive at this point and opt to keep my thoughts to myself. :)

The last time we were in, Dr. Blum didn't have all the results of Dave's testing, but this time she does so she starts there. Just like the other oncologists we have seen, she makes sure we understand Dave is a Stage 4 Follicular Lymphoma patient with 5% bone marrow involvement. She talks specifically about the size of some of Dave's lymphnodes...some of them are pretty big. The good news is that none of them are pushing on vital organs and causing any concerns, but if left untreated, they may. She explains that she still feels the best treatment, at this time, is the clinical trial combining Rituxin and Epratuzimab. We had hoped this was the case and explain that we are in...and ready to get started.

Dave is really great about thinking both short and long term. He explains to her that his long term goal is to maintain the cancer much like a diabetic maintains their sugar levels. Short term he explains that he is hoping the clinical trial will knock him into remission before we have to decide on the next form of treatment. I know he wants to make sure his doctor has the same goals as he does and I'm proud of him for being able to so effectively articulate these to her. She totally agrees and takes it one step further saying that although there isn't really a cure, a bone marrow transplant may cure it down the road. It's the only possibility. And a cure is really her long term goal. We discuss Chemo after the trial and then the possibility of a transplant. Ultimately, we decide to focus on the here and now and begin to talk about the clinical trial.

I knew we wanted to start immediately, but I didn't know how quickly that would be. Dr. Blum fires away with, "How's next Wednesday? At this point, we begin to talk about the treatment itself and it's a little more involved then Dave and I originally understood. He needs to have a Petscan on Monday and then another CT scan to mark his start point Wednesday morning. He will be hooked up to an IV drip on Wednesday to administer the Epratuzimab. This takes several hours. On Friday, he will again be hooked up to an IV, this time for 6 hours, and the Rituxin will be administered. For the next three weeks, we will go every Wednesday, all day. On these days they will combine the drugs into one 6 hour treatment. After that the treatments are much further and fewer between, but ongoing for the next 9 months. Throughout the treatments he will have CT scans to monitor if the lymphnodes are shrinking...this is the goal in case I lost you.

After making the decision to jump in with both feet we had to meet with the research coordinator to sign the 6,000 forms I told you about and then the scheduler to make what seemed like 30 appointments. It was probably more like 10...pregnant women can be a bit dramatic. And that was the end of our 4 hour appointment....I wasn't exaggerating that part.

Regardless, Dave and I have a very long journey ahead of us. So many of you have commented on Dave and I's strength and positive attitude. Honestly, overall we are doing fantastic under the circumstances. We have found strength in our family, friends, and in prayer, but we aren't superhuman. :) I spent a few moments crying on Dave's shoulder in the stairwell at The James today. I couldn't tell you why exactly, but I do know this. I don't have cancer, my husband does and yet, he holds his head high and buries mine in his chest when I can't take anymore. He really is incredible!