Stuart Smart



One day, like any other, I was at the office and went to grab a sandwich for lunch. That afternoon, I had discomfort in my abdomen that developed very rapidly that afternoon into a very uncomfortable and intense pain. That night, I was taken to the ER for a scan, and immediately had my appendix removed– as it was about to burst.

From the Pathology of my appendix tissue, I was diagnosed with Diffuse Large B-cell Lymphoma, as many with Non-Hodgkins Lymphoma are. Only on my 2nd and 3rd opinions at large teaching hospitals did they request the additional testing (Cytogenetic FISH study) to rule in or out the Burkitt’s variant. Glad they knew what to ask… as R-CHOP would NOT have cured me!

My story is at Below is a post from right after my Appendectomy/diagnosis.

After lunch last Wednesday (11/12/08), I got what seemed like a stomach ache. Thinking it was something simple and temporary, I stuck around the office… in modest discomfort. When I got home, I laid on the couch but just couldn’t seem to get comfortable. A close friend of mine who is an ER doctor was kind enough to come by and take a look at me. I was very tender to the touch in my lower right abdomen. He suspected that it was either gas lodged in my digestive system that would eventually pass with time, or less desirably, it could be my appendix.

I tried to fall asleep, despite the discomfort, only to wake up an hour later just after midnight with the most intesnse and uncomfortable pain I’ve ever felt. It was a combination of being kicked full-on in the groin plus having a thousand pound weight sitting atop my bladder. Natually, I hobbled to the bathroom, trying to go. No such luck. When I stood up, the low blood pressure, coupled with the intense pain, caused me to pass out briefly — only to utter to Candace to I needed to get to the ER – and quickly.

I was unable to walk down the stairs, so I had to scoot. I must’ve yelled out to Jesus, audibly, a hundred times. Despite that unbearable pain, He guided me one baby step at a time to the car. Once at the ER, being unable to get vital signs on me, they proceeded to hook up an IV and deliver some pain meds. This was a nice surprise. Five minutes later, I felt neutral to good. Wow. I remarked on how happy I was that someone, somewhere, figured out what we can put in our bloodstream to disconnect us from our pain. What a concept. It took on a whole new importance and relevance when it was me who was being guarded from the pain.

After a CT scan confirmed that it was indeed appendicitis, I was eventually rolled back to a pre-op area and then finally into the OR around 4:45am. The general anesthesia was, again, a marvel to me. They removed the appendix laprascopically. One incision at my belly button to insert a cauderizing cutting tool, another small hole below my belly button to insert a camera/scope, and finally another small hole below that to pump my abdomen full of CO2. Wow.

I was fortunate enough to be the only male who was admitted to the OB/GYN floor for my recovery. Got some funny looks when people would come in and wonder why the male was tucked in bed, while the female was sitting bedside in the chair. Surely something wasn’t right about that. I spent a day there. Walking to the bathroom was pretty much the highlight of the day. Oh, yeah, and throwing up was an added bonus. Once able to keep down a little cup of sugar-free jell-o, enough progress was made to get the clearance to head home… which we did.

To fast forward, after some shaking (rigors) and a fever north of 101 and change, I had to head back to the ER two days later for an x-ray and some blood work. This revealed an infection due to the catheter used in the operation. More meds – yyyeah. So back at home, I slowly got back on my feet. I even hobbled into work the Tuesday after. Daytime TV made me do it.

Wednesday of this week is when it got interesting. I went alone to a simple post-op doctor visit at Piedmont where they were to make sure my incisions were healing nicely. And they were. The doctor then added that they had sent the appendix off to the pathology lab, as is customary, and the results had come back abnormal.

In addition to being “extremely enlarged” (instead of being pinky-sized, was >5″ long by >1″ wide), the cells demonstrated an abmormally active growth pattern consistent with a blood cancer called DIFFUSE LARGE B-CELL LYMPHOMA. Simply put, your lymphocytes are white blood cells that travel in a unique network among your numous lymph nodes, fighting infection and bacteria in your body. Mine are abnormal and propagating much too rapidly. This hyper-growth caused the appendicitis, and was indicative of cancer being in my body.

I spent the rest of the afternoon telling close friends and family. I am ever-grateful to all of these people who droppped what they were doing, sat with me, listened, prayed, and reflected on what I had just learned. Thank you, thank you. While this is only the very beginning, I trust you will be alongside me every step of the way and cannot thank you enough.

The very next day, I had a long afternoon with an oncologist. He said that my type of Lymphoma is a ‘good’ one to have, as it grows very aggressively, making it more responsive to treatment. While he would stage it (I, II, III, or IV, an indicator of how extensive the cancer has spread), the treatment protocols would largely be the same: chemotherapy.

The spcific regimen is called ‘R-CHOP’. This are a cocktail of chemo drugs designed to attack all of the growing cells in my body. He wants us to start in the next week or two. In addition to losing all my hair, it will kill my sperm count for an indefinite period of time. Candace and I have been trying to conceive for a few years now, so this is a particularly harmful side-effect for us. I am hoping I will be able to freeze some ahead of time to have on backup. In addition, nausea and immune system depression are the obvious side effects to chemo that I don’t like to think about.

In order to stage the cancer, I needed to have a PET/CT Scan (which I did today) and a bone marrow biopsy, which I went ahead and had done right there and then when I was speaking with the oncologist yesterday. I wanted to check a box — anything — to make some forward progress in my journey!

Having a bone marrow biopsy kinda feels like someone sticking a big needle into your pelvis and sucking out some of your bone marrow(!) I just hate it when they do that. I was lying on my stomach, making awkard noises and making rapid jittery movements — anything to distract me from the sensation of a needle thrust through the walls of my bone or the very life being pulled out, 5 ml at a time! One point worth mentioning, as the doctor’s muscles quivered to push the needle through my pelvis, he said, “yep, yep, good strong bones here…” I got a laugh… well after the fact, however.

The PET/CT scan was fun. I got an IV with a radioactive glocose inserted into me. It is a fluouride solution mixed at a nuclear pharmacy within hours of being administered into the bloodstream. After 45 mins of sitting still (no reading or iPods allowed, as the mental activity would draw too much blood into your brain), I laid on a thin gurney, with my arms above my head, for 30 mins in ‘the tube’ — completely still. It was interesting to see just how stong the mind can be when you feel the urge to scratch several itches — yet cannot.

And so here we are. 48 hours +/- after my world got a little more interesting. Thanks for sticking it out thus far. This blog will probably be the place to get an update on how things are progressing with my chemo, and hopefully I will be able to capture some of the sweet moments, called life, along the way.

I feel, at the outset, that this entire experience will be a faith-building (and strengthening) experience for me and hopefully those around me. Having no choice but to slow down in life will force me to connect my head to my heart a little better, and really tabernacle with the Lord in the here and now. That’s really the only place that He can meet us: not in the nostalgia of the past, or the fear of the future… but right here, right now. There is no grace for events that never come about, so let us not spend any time worrying about whether they may come or not.

Let us just sit for a moment, at these crossroads of uncertainty, and meet God right here. To Him be all the glory. It is well.

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