fertility

The latest video update is below. If you’re unable to see the embedded video, click here to watch it on YouTube.

If you don’t mind, please be sure to “like” the video by clicking the thumbs-up while it’s paused. Thanks!

Additional, non-video updates

  • If you live in central Iowa, be sure to pick up a copy of The Des Moines Register this Sunday (May 27) and flip to the Iowa Life section. As I’ve hinted in some of the video blogs (and totally given away in the latest one), the Register is running a story about Libby and I, our journey, this blog, the Let’s Do This documentary, etc., complete with photos and even video (the video will only be available online, of course). In addition to the photographer and reporter being at treatment number six, I’ve done several interviews and they’ve taken both photos and video at my church — I’m excited to see how the whole thing comes together. I know Libby and I will be picking up a copy or five this Sunday!
  • You may recall that the issue of fertility after chemotherapy has been a significant one for Libby and I, and for many others undergoing chemo treatment as well. During our last oncologist appointment, I was asking our doctor how soon after treatment I can get tested for fertility and his response was something along the lines of “You won’t need to. You’ll be totally fertile.” Say what?! From many of the things Libby and I had been told and read, we assumed I would probably be sterile and so responded accordingly. Now, our oncologist reassured us that he would have recommended sperm banking anyway, but we were (and are) still pretty shocked and —obviously — very happy.

    Just to be sure, I did some digging and found this 2008 article published in the Annals of Oncology which says, among other things: “With ABVD [the chemotherapy regimen I am receiving], azoospermia1 was observed in fewer patients, ranging from 0% to 4%. In our cohort, all patients treated with ABVD have preserved spermatogenesis.2” Translation: There is a very good chance Libby and I will be able to conceive children naturally, despite being treated with ABVD chemotherapy. Praise the Lord!
  • In the video, I eloquently allude to the fact that “my butt hurts,” and then hop into an epsom salt bath. I should explain. (Warning: In the interest of full disclosure, this will be TMI for some people, but please recall that I’m trying to be transparent in order to help others who are going through the process.) As you’ve no doubt ascertained by now, one of the side effects of both the chemotherapy itself and the medications I’ve been taking is extreme constipation and other gastrointestinal issues. Well, a side-effect of those side-effects has been unpredictable and at times extreme duress on my lower rectum, which has produced anal fissures (read at your own risk). Essentially, every time I am actually able go to the bathroom is a very painful experience. Lately, the pain subsides rather quickly and returns later in the day to be almost unbearable — hence the epsom salt baths. Libby and I are trying to be proactive about it; we tried to get a referral to a colorectal specialist, but it turns out I’m not allowed to see anyone until after treatment has concluded due to my super-low white blood cell count. Until then, it looks like I’ll be taking a lot of baths.
  • I am scheduled for a second pulmonary function test today, which will give the doctors an indication of how much (if any) the chemotherapy is impacting my lungs. If nothing else, it will be fun to go inside this machine again. Keep praying that my lungs are holding up!

That’s all for now. Thank you for your continued prayers and support! (Oh, and if you haven’t purchased and/or listened to the new John Mayer album yet, what are you waiting for?!)

  1. Via Wikipedia: “Azoospermia is the medical condition of a male not having any measurable level of sperm in his semen.” []
  2. Via Wikipedia, again: “Spermatogenesis is the process by which male primary sperm cells undergo meiosis, and produce a number of cells termed spermatogonia, from which the primary spermatocytes are derived.” []

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Recently, our lives have been defined by Wednesdays.

My first visit to Chest, Infectious Diseases, & Critical Care was on Wednesday January 25, and I have had a doctor appointment on every subsequent Wednesday since. This past Wednesday we found out there might be an issue with my heart. At this coming Wednesday’s appointment with the oncologist, we hope to have enough information regarding my heart and other particulars to schedule my chemotherapy.

The video below documents a portion of the current Wednesday-to-Wednesday activities: Meeting with a cardiologist, scheduling a MUGA scan, making sure things are squared away at the fertility clinic, etc.

If for some reason you can’t see the video below, click here to watch it on YouTube.

The Good News

There are a couple of “good news” items to report:

1) I was able to square everything away at the fertility clinic before the next oncology appointment. In case chemotherapy does negatively impact (or completely destroy) my reproductive capacities, Libby and I have 21 million back-up plans cryogenically frozen in Clive, Iowa.

2) Based on the initial reading of my MUGA, my heart might not be as weak as the echocardiogram report indicated, and could actually be just fine. Because we have yet to go over the analyzed results with the cardiologist (I merely asked for the initial result from a woman in the scan room), I don’t want to publish the actual numbers, but I am optimistic that the news will be much better than we anticipated.

As always, thank you for your continued love, support, and prayers. If you’d like, please join Libby and I in praying that this coming Wednesday is definitive in regards to a treatment start date.

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Jake's echocardiogram

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[Above: A printout from last Thursday’s echocardiogram in which my heart is clearly displayed.]

Yesterday was a big day. Aside from being my 28th birthday, I had an appointment at the fertility clinic and an appointment with our oncologist to discuss test results. Most of this is captured in the video blog embedded below, but I flesh out some details further down in the post.

If for some reason you can’t see the video below, click here to watch it on YouTube.

My heart

I could have included much more audio from our time with the oncologist, but one can only watch subtitles for so long, in my opinion. Here’s a bit more information that wasn’t included.

Last Thursday, I had an electrocardiogram and an echocardiogram, and according to the doctors’ records of those tests, my heart is “weak.” Not only is this is abnormal for someone my age, but it’s particularly concerning because in the chemotherapy drug regimen I will receive — ABVD (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine) — the Adriamycin has particularly deleterious effects on the heart.

If you imagine a heart-o-meter that starts out at 100% (totally healthy) and chemo drains the meter to 60%, that’s not a big problem. But if my heart is only fuctioning at 60% for some reason and chemo drains it to 20%, then we’re in for some rather serious potential complications (N.B. These are totally made-up numbers).

Hopefully meeting with the cardiologist will provide some more clarity with regards to all of this.

Fertility

I don’t think I’ve yet shared this on the blog, but chemotherapy often results in infertility for male patients. So Libby and I have begun the process of A) having my sperm tested for fertility and B) sperm banking in case I do in fact become infertile after treatment. That’s why I was at the fertility clinic yesterday — to do the initial testing. I will have to go back soon to do the actual storage part so that we can begin chemo ASAP. Neither Libby nor I had even thought about the prospect of infertility for the few weeks before the biopsy, until we read about it in some lymphoma literature.

Now, there is a possibility that chemo won’t make me infertile and/or that my sperm production will resume a few years down the road, but for the two of us it’s a no-brainer to make this a priority.

Timeline

If, by next Wednesday (when we’re scheduled to meet with the oncologist again), we’re able to get all of our fertility stuff done and the heart issue examined with the cardiologist (not to mention a meeting tomorrow with a radiotherapist), it’s possible that I could begin chemotherapy as early as next Thursday or Friday. The oncologist has already submitted a request to my health insurance for chemo treatment, so as soon as they deem my body ready, I could start.

Afterword

Yesterday was a crazy day to be sure, but it was nevertheless filled with many pockets of joy. For my birthday, Libby gave me the “Okay let’s do this” Marc Johns print to which I linked in the first post, and my buddy Shawn got me an awesome set of neodymium magnets. I was also able to enjoy both lunch and dinner out with Libby and even squeeze in some time with a student. Our church’s Ash Wednesday service was absolutely magnificent and moving — a perfect way to wind down the intensity of the day.

As always, thank you for your continued love, support, and prayers.

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