Today I was reminded of a statement made to me by Dr. Kaplan nearly four years ago when I first transferred the care and feeding of my CLL/SLL to his clinic at UCSF - "You will never be any better than you are today". Kind of an ominous statement, but very true when heard in the context of living with CLL/SLL.
As I approach the conclusion of my fifth year since diagnosis (my Cancerversary is February 19th), I look back and can see that my physical condition is slowly (make that VERY, VERY slowly) declining, though generally I'm in pretty good shape according to my recent visit with Dr. Kaplan, as well as my observations. Granted, I am also getting older (unfortunately, not wiser) and simultaneously experience the natural effects of aging that one observes near the end of their sixth decade of life - more grey hair, reduced skin and muscle tone, etc., but I am also observing more of the long-term effects that go along with having a slowly progressing cancer. This was brought to light a bit more today with my visit to my dermatologist, Dr. Fox.
For the past five months I've been on low-dose Methotrexate to control symptoms related to my Systemic Lupus Erythrematosus (SLE). The drug (a chemotherapy agent) works by suppressing the immune system and hence reducing the ability for my faulty system to attack joints, organs and other tissues in my body. The treatment has been quite effective at reducing instances of joint swelling and pain. However, in recent months I've had relentless bouts of rashes and extreme pruritus (itching) at my elbows and upper arms as well as on my knees. At first it was thought that I may be having a reaction to the drug, though I had previously used it successfully nearly two decades ago. My rheumatologist, Dr. Chaganti, referred me to Dr. Fox for evaluation of the symptoms after her analysis failed to point to a drug reaction.
After multiple lab tests and a skin biopsy, Dr. Fox has ultimately determined that the symptoms are a side-effect of my CLL/SLL and that there is little to do but treat the discomfort when it arises. On a scale of 1 to 10, the discomfort involved is generally a 2 or 3; just a minor annoyance that I can live with as long as the topical steroids prescribed to control itching work, though the scars that remain are a bit bothersome. No biggie, though Dr. Fox's determination was just another reminder of the slow progression of my CLL/SLL and a sign that, though for all appearances I look well, there is actually a slow progression of the cancer and its side effects within my body.
All-in-all, everything is going swimmingly. I generally feel well, but for frequent periods of fatigue. I've started eating in a more healthy manner in recent weeks and have been able to drop 18 pounds from my pudgy frame - only 57 pounds to go to achieve my former svelte profile from a few years ago. Once my weight drops below 200 pounds (14 pounds to go), I plan to begin running again; or at least walk/run at a slow pace until my cardiovascular fitness level increases. Hopefully at my next check-in I'll be able to report that "fit" Bill is "in the house"!
Anyway, that's it for now. My next check-in with Dr. Kaplan is in January, 2015 so I likely won't be updating the blog until after that visit. Onward and upward! Be well...
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