NHL confused with TB

A long journey of 3 months, from Symptoms to diagnosis:

I am a 44 years old electronics engineer living in Jaipur, India and have led a healthy life till now. Lymph node under my left armpit started growing in July 2008. In Sept, 08, it grew to a considerable size of about 2cm and I started feeling difficulty in breathing. The doctors suggested chest X Ray and FNAC of the enlarged Lymph node. The X ray showed enlarged lymph nodes in lugs as well and FNAC indicated granulomatous cells. The doctor diagnosed it as TB and started treatment. After about 15 days of TB treatment, in Sept,08, I got fever ( 102 deg F). The doctors again experimented with anti malaria treatment, multiple blood tests and different antibiotics. Finally, on 20th Oct, the biopsy of the lymph node under the left armpit was done. First report of biopsy again indicated TB, but the 102 deg fever remained unaffected. I lost about 7 kg of weight in these 3 months and sweating in nights was common. I was taking 4 Crocins a day for the last 45 days to control fever and to remain alive. Second and third opinions on the biopsy sample were sought and NHL. follicular, grade III was confirmed.

R-CHOP treatment starts:

Chemo therapy treatment ( Mabthera and other chemo medicines) started on 17th Nov at Apollo, Delhi after Dr SH Advani ( a leading Oncologist in India) reviewed my case and informed us, to mine and family's great relief that NHL and its relapse are curable with a very good prognosis. First chemo had magical effect. Fever and lymph nodes vanished overnight right after the first chemo cycle.

After effects of chemo kept under control:

I have so far undergone 5 cycles of chemo and final, the sixth one is due on 9th of Mar ,09. The after effects of chemo were kept under control to a great extent by effective use of medicines prescribed by experienced and able doctors of Indraprastha Apollo Hospital, New Delhi. Gastric problem was the only one which bothered me after the first chemo for about 10 days. I discovered that eating jaggery was far better than taking Digene or Mucaine Gel for gas. I also learnt that drinking a lot of water, about 5 litres a day,  in the post chemo period flushes out the toxins introduced by the chemo and reduces its bad effects. It has been a relatively smooth sailing since the first cycle.

Neopogen injections ( WBC count booster) are prescribed on 5th and 6th days from the day of chemo. It is said the counts drop from 8th to 12 day in particular. I feel sleepy and lethargic during those days.There have been no after effects in the 4 cycles so far. The average WBC counts during the first 4 cycles have reduced marginally to a level of about 4.5k/uL. Neopogen, however, can cause a severe bony pain and throbbing in the lower part of spine. This happened with me once. To reduce pain, the doctors advised taking a number of 'Crocin 500's' at an interval of 6 hours. I had to increase the dose to Calpol 650, and with this, the pain vanished. It lasted for 16 hours and gave me hell. Next time it happens, I should take 650 mg dose instead of 500 mg.

Hair started falling in the third week after the first chemo. They will re-grow once the therapy is over. The main risk of catching infections was reduced as I remain confined to my room  for 2 weeks after the chemo. I am given only home cooked food. The blood counts are measured after Neopogen injections and again 2 days before the next chemo. WBC, when last measured, a week ago,were touching the lower limit of 4k. A good diet with plenty of fruits and vegetables would soon make the WBC increase steadily.

I am also a type II diabetic for the last 2 years and was on oral medicines. For the period of therapy, I am now on insulin injections. I need to take about 30 units of Actrapid, 3 times a day, before before each meal. I also take 20 units of Lantus, Glargine before going to bed. With all this, my blood sugar is under control in the second and third weeks of chemo ( fasting levels maintained from 95 to 105). During the first 5 days after chemo, the blood sugar levels are more and pp can shoot upto 350. This is due to Steroids which are taken for 5 days after the chemo.

Cancer remains a dreaded disease but my experience tells that it is no longer incurable. If you are in good hands, ie,  good doctors, relatives and friends, it's only a matter of crossing a difficult bridge in life. When god gives problems, he shows the way too. God has no hands, so he sends people to help you out. With time, things start falling into place.

Supportive Measures:

Wheatgrass Juice:

Friends advised me to take wheatgrass juice. I am grateful to them.

Home grown wheatgrass in pots ( mainly wheat and 10% barley), has shown good results in my case. I have seen significant drop in my blood sugar levels and insulin requirement during the chemo therapy period. Steroids are prescribed for 5 days after the chemo cycle. As a result, the blood sugar shoots to above 300. But, with wheatgrass intake , I noticed this time that fasting sugar level was controlled well below 110.