PET Scan #2 - Friday, July 31

John and I will leave the house at 9:30 a.m. EST on Friday, July 31 to get to Duke Imaging for John's second PET scan. 

His first PET scan was April 2, 2026 which finally got the doctors to diagnose cancer. 

This second scan will check to see how well the chemo treatments are working. To me, we already know they are because after the first treatment his cough disappeared!

If we're lucky, the PET report will be written the same day and sent over to John's oncology doctor. Unlike many of the labs, this report is not automatically released to the patient; the doctor has to do that. Hopefully the doctor will review it Monday but I wouldn't be surprised if we get the results as late as next Friday.  

Either way, any news we get I'll post here. 

I will still do my in depth evaluation and compare it to the original PET to see how far we've come. My SWAG from the original report is there were thirteen "enlarged" areas--most of those were lymph nodes but a couple were "irregular" growths. 

Treatment #4

We arrived at Duke BCC at 10:15. We've done hematology and the doctor visit. It's 12:40 and we're setup in a treatment bay waiting for the pharmacy to bring the chemo meds. With the Benadryl and anti-nausea meds, he'll be getting sleepy pretty quickly. 

Catheter Day

My google-guess from yesterday was slightly off. John is getting the Subcutaneous Catheter, which he was actually relieved to hear. 

Things are running smoothly and on-time. They took John to the surgical room about 9:30 a.m.. He’s anxious but will be relaxing very soon. 

Upcoming Procedure - Catheter

It was a very tough week last week. The bad days were longer this time but John is up and about today looking more rested!

Tomorrow (Tuesday, July 14 at 8:45 am) John will be getting an IR Central Venous Catheter placed. I had no idea how many different types of catheters there were until my sister mentioned her experience with mom's catheter and her own. There are no specific details about which type John will be getting but I can make some educated guesses. 

My google-guess is that he will be getting a Cuffed Tunneled catheter. I base this on:

• how long he will have the catheter
• the risks of infection
• how frequently it will be used

All of this is a SWAG but, just critically thinking about it, here's why.

At a minimum he'll have it 10-weeks. At a stretch maybe 24 weeks, which will take him to the end of the year. Because of the relatively short time frame I'm guessing there's no reason for the more long term Subcutaneous Tunneled catheter. 

An alternate might be a PICC line but it holds higher infection risks that, I believe, the treatment plan avoids at all costs. 

For each treatment a single-use IV is used to blood draw and deliver medications. His chemo medications include the cocktail RCHOP. Along with saline, the blood draw, and chemo meds, the IV can be used up to nine times in one treatment. In the last treatment it was also used to administer Benadryl to treat the rash he developed. 

John doesn't mind the IV and can handle getting stuck as long as he doesn't have to watch. All the nurses in the Blood Cancer Center are experts and he says he rarely even feels it. At the end of treatment, though, he is happy to be rid of it. This is one of the downsides of having the catheter. 

The Bad Days

Raylan asleep with his lamb lamb.

John always has a couple of good days after treatment, although we both are just worn out. 

He felt pretty good over the weekend as well and took the opportunity to get some rest. He only worked two-days last week. 

The past couple of days have not been so great. This happens a couple of times between treatments. He is utterly weak and his appetite is ruined by bad tastes in his mouth and a constant upset stomach. He’s pretty good about drinking water and if he will eat, I don’t care what it is. He’s not been turned off chocolate milkshakes yet so that’s a plus. 

His left arm, where they had the IV trouble during the last treatment, has not completely cleared up. A week later, the rash is still visible and even looks a little raised again. He also says it burns. His wrist is green which tells me some blood leaked during the IV trouble. I didn’t even notice that until today. 

I tell John these terrible days are when big cellular fights are going on in his body. Wherever the cancer cells are, they’re being attacked by the poison. All of his body’s resources are going to help the healthy, fighting cells. It would be so much easier to feel exhaustion from punching something, then we could see and know where the energy is going and where the fight stands. 

Treatment 3 - home now

Everything went smooth after the nurses got the third IV in. We are all resting at home. John has the rest of the week off so he can get lots of rest and time with the dogs. 

Treatment 3

It was a very early appointment today--7:00 a.m.! We left the house around 6:15. 

We both are already so tired. 

John's bloodwork came back a-ok so treatment could proceed.     

Unfortunately, the blood draw problem happened again and much earlier in the process than before. And he started having an allergic reaction around the injection site! This was his left arm. 

They had four different nurses checking on him even though he wasn't feeling anything (itching, burning, etc), it was only visual: red and puffy. But they take things like this very seriously.  They set him up with an ice pack and plan on giving him intravenous Benadryl. They said he'd feel a little drunk. 

Because the reaction was around the IV in the left arm, they pulled that out and tried a new one in the right arm. Two different nurses worked on this and were having trouble. One said his veins are small and rolling, another said his skin was really thick. They ended up grabbing and ultrasound machine to find a deeper vein. 

The nurse said this will only get worse as treatment continues because the veins, with everything else in his body, continues to weaken. He will probably get a central port inserted on the next visit. He's not crazy about it but our day has already gotten almost two hours longer trying to fix this. At least he can sleep here.