I went through my 2nd chemo this past Wed. I had already shaved my head in preparation for this treatment. This time I got my IV infusion at Vanderbilt's Cancer Center which was a lot more streamlined than getting it in a hospital room, taking about 6 hours from start to finish. I drove to Vandi and they gave me the usual drugs on top of drugs (100mg Prednisone in the morning followed by 2 tylenol, 2 benedryl, more stereiods, anti-nausea meds, etc).

During the first 4 drugs/injections I did fine sitting in my chair watching TV and listening to music. Rituxan (the last drug) is usually the one that kicks my butt. When the nurse started the IV it made me feel like I was going to faint/pass out in my chair. I told the nurse about this so she gave me a shot of Ativan (sedative) which seemed to calm me down a tad. I drove myself home and woke up every couple of hours during the night to go to the bathroom. My toilet smelled really bad from all the chemicals, but I kept drinking a bunch of water which seemed to flush me out.

On Thursday I rested all day and was really tired. I needed to teach on Friday as my classes at Belmont have a few more lectures to get through before the end of the semester. Before going to Belmont, I stopped by Vandi Friday morning to get a $2500 shot of Neupogen. I am going to get these now on after every chemo (thank God for insurance) to keep my immune system strong. This shot stimulates your bone marrow to make more white blood cells.

Anyway, when I started teaching classes at Belmont I felt like I was going to faint in front of the class. I couldnt stand and would have occassional flashes. I guess I was more tired than I thought. Luckily, Kellie Meeks and I co-taught the class for the next 3 hours and I got to rest in a chair talking to the class until collecting enough energy to drive home. I may have to put my last lecture(s) on quicktime for the class to watch. I'm still playing it by ear. Saturday I was dead tired from Friday and Meghan took care of me all day. Today is Sunday and I feel a little more rested, going to try to head to church and then come back and rest.

Thanks again for all your support and prayers,

Dave

I just got out of the hospital again. I went to Vanderbilt's ER this past Sunday. I had been having severe stomach cramps (it felt like someone shot me in the stomach) all weekend. I always am of the opinion, 'better safe than sorry' so I reluctantly checked myself in again, even though I had been there the week prior. The doctors bequeathed me with more x-rays, blood work and CTs of my stomach. They said the CT showed my lower colon was swollen up, but didn't know if it was due to constipation or my low white blood cell count. So the question remained, was I stopped up or did I have a colon infection? To answer this they starved me for two days. I was on an IV only diet with sugar water infused into my veins. I got hungry at first and then just irritated. It's one thing to just have sugar water for 2 days, but another to take a bunch of meds with the sugar water...it makes you grumpy for sure! The good news about the whole stay is that the doctor said the newest CT showed that my mass had shrunk from the 1st treatment! They never really figured out what had caused the original problem but I was flowing and eating solids. My next chemo will be Wed April 18th.

Needless to say, I stayed my 2 nights in the hospital, got prescriptions for my new meds and was allowed to leave on Tuesday at 12pm. This relieved me because I had a prescheduled recording session at County Q studios at 3pm the same day. I played bass on the session with my buddy Howard Duck (keys for Rascall Flatts) and had fun cutting vocals with Shayne Hill (Sawyer Brown). We finished my song (co-written with Justin Busch) named "American Idol." There were some other great players on the session as well. I have put the lyrics below as I secretly infused some of my current situation into the song ;-)

American Idol
(J Busch / D. Tough)
April 2007

Daddy was a good man
Taught me wrong from right
Worked full time with his cancer
Knowing God's grace would get us by

When he'd come home from work
He'd always set me on his knee
He'd say "Son, love your country and protect your family"

He'd charged burning buildings
Fought the war in '73
And I knew from that day on
He's who I wanted to be

An American Idol
Standing strong in his faith,
Don't need a million people,
To show him the way
He can't dance like a pop star
Can't sing a song in tune
He's an American Idol
Red white and blue, for me and you

Now mama's gone back to work
The late shift every night
Serving dinner to the locals
With some coffee and her friendly smile

Daddy's sickness came back strong
And so did the bills
And now every little tip
Goes to paying for the pills

She's dead on her feet
But never looks for sympathy
And to me she represents
All I want to be

An American Idol
Stands up for what is right
Don't need to hear the crowd roar
In the bright spotlight
She's never dyed her hair
No crazy tattoos
She's an American Idol
Red white and blue, for me and you

BRIDGE:
From up here on the stage
Looking back at me
Are everyday American Idols
Defining who I want to be

You're an American Idol
Stand up for what is right
You don't need to hear the crowd roar
In the bright spotlight
Don't need to dye your hair
Don't have to sing in tune
To be American Idols
Red white and blue, for me and you

The last 3 days have been quite a rollercoaster. Dr. Morgan switched my steroid meds from Dexahexamethasone to Prednisone on a taper down schedule on Tuesday. I was able to get through the day teaching at Belmont on Wed. However, when I was driving home, my heart started racing and I had shortness of breath. This continued as I tried to lay on the couch to relax. I felt like I was hyperventilating. I called Meghan to find Dr. Morgan but spoke with another doctor on call. He suggested I head to the ER at Vanderbilt to be safe. Luckily, my good friend Andy Seale was coming by to bring me dinner and he was able to rush me to the hospital. We waited in the ER for approximately 30 min and I was seen. I was crying, rocking back and forth and my blood pressure and heart rate were way up (heart rate was 188 when I was finally checked by the nurse). I felt like a junkie on withdrawl.

Meghan arrived and settled me down. I was kept in the hospital Wed night for observation. During Wed night I had several bloody stools and stomach cramps and could not sleep at all. The change in medicine had really done a number on me. The next day the doctors gave me a GI test to make sure I didn't have any internal bleeding or other issues, but it checked out fine. Thursday I received a chest xray, CT scan and a echocardiogram. I had done all of these at MD but the doctors at Vandi wanted to see if anything had changed. I was finally prescribed Nexium, which helped control my stomach bleeding.

Friday was chemo day and my third day at the hospital. I received a permanent IV line up my right arm to give easy access for all future treatments. After that I waited in my hospital room until 4pm. At that point the nurse started chemo, which ultimately ended up lasting until midnight. The only drug that really effected or scared me was the Rituxan which made my heart race and made my blood pressure rise. Meghan slept on the chair next to my bed and helped calm me down. I swear, you have to have a strong heart to endure all of this!
Today I woke up feeling completely exhausted--like one might feel the day after running a marathon. I couldn't move, eat or get out of bed. I did get a little sleep, but that's hard to do when the nurses come in every 30 min during the night to check your vitals. I just had a Smoothie King and I am now at home, typing on my laptop and trying to enjoy and relax with my family as they leave tomorrow.

Dave

Just got back from my first Drs appointment at Vanderbilt today. My doctor is really cool there. His name is David Morgan and he is very laid back. His teaching fellow is really great and personable too.

He loves musicians and tries to play the cello... admittedly not that good. He says that everything from MD looks great and wants to start me on my first RCHOP chemo treatment this Friday. I won't be getting a shunt as of now, so they will just administer the drugs through 6 IVs as I sit there and surf the web, watch DVDs, etc for 6 hours. I am so thankful for my colleagues at Belmont who have generously agreed to cover my Friday classes. I owe you guys one!

My doc also told me I have been going through steroid psychosis the last couple of days. I described to him that I have been really worn down as I haven't slept but 3 hours each night for the past 5 nights. I have literally been running around wired, like I am on speed. I even have been having some hallucinations*!#. He asked me if I had thought of buying expensive things and I told him went into the guitar store and was pretty close to buying a $2800 Sadowksy 5-string bass this morning.

He said I definitely need to tone down the steroid dosage. So hopefully I can sleep and think more clearly sometime soon with a new taper down dosage.

The bright spot of the day with all this cancer cloudiness? I opened my mail tonight and received a sizable royalty check for licensing two songs from my last CD to a commercial and a training video for a company out of Portland. I guess God is giving me a little encouragement to climb this mountain!

-Dave

After two trips down to MD Anderson Cancer Center in Houston I finally received an official diagnosis from my doctor. My disease has been classified as Non-Hodgkins Lymphoma, Stage 2A Diffuse Large B Cell, mediastinal mass with intermediate to advanced growth (w age adjusted IPI). The doctor was very young, but very knowledgeable. You can tell they have the best cancer care and research team down here at MD. I would recommend them to anyone in this situation.

The doctor mentioned many other medical facts (for those who love biology). She actually thought I was a biology prof until I told her I taught music. Oh, well, I seemed to still understand her… My white blood cell count is up, perhaps due to internal compression of my heart from mass. The chemo treatment should cause this to go down. My white blood cell count has gone up since last week 16.5 H to 14.1. However, the mass has shrunk from 7x8 cm to 6x6 cm (about the size of a baseball) just from taking the steroid Dexamethasone 4x daily (which Meghan will tell you sometimes makes me grumpy and very sleepless). Lets see, what else?
From the blood tests, my LDH (Lactate Dehydrogenase) is normal. My liver had unusual shape on CT, but this could just be my strange anatomy (or maybe my past heavy drinking problem – jk ;) My PET scan however, shows liver is clean with no liver lesions. SUV 34.9. My tumor is conglomeration of lymph nodes, one smaller additional effected lymph node in chest was found as well, that’s why it is stage 2 as the cancer hasn’t metastized in any other part of my body besides my upper chest cavity. The hospital lab couldn’t get MUM 1 or Key 67 counts from original biopsy so another question was whether to do another. I think in most doctors’ minds it is better to just start treatment.

So in general, the tumor seems very localized and very curable. In a way, I am actually excited to start treatment. It is like climbing a tall mountain. You know you’re going to have to climb it and it is going to be an adventure, so lets get started! I have my initial appointment with Dr. David Morgan at the Vanderbilt Cancer center next Tuesday afternoon (that’s right after the sperm bank, gotta save those guys in case the chemo kills them!).

The chemo protocol prescribed by MD will be 6 rounds every 3 weeks (RCHOP protocol) followed by 4-5 weeks of radiation. That’s another reason I want to get started ASAP. The chemo shouldn’t be that bad the first couple of cycles (except most people lose their hair on the 2nd one). Starting now would allow me to teach normally through the end of the spring semester. The only problem I may encounter is at the very end of the summer when my radiation treatments begin, but that should only be for a short while.I’m still not sure what I’ll be doing this summer. Mainly resting, exercising and eating well. I may pick up one class at TSU, practice some bass, do some dissertation writing, some songwriting and studio work. I want to spend more time with friends and Meghan. All of these activities would allow me to stay indoors and re-couperate.

As far as the treatment goes, my doctor at MD informs me that Rituxan w/CHOP (RCHOP) has been used since 1998. Before then, studies showed approx 50% chance of remission of the cancer regular CHOP treated. Today, with the Rituxan drug, the cancers of this type have an approx 90% cure rate and an 80-90% chance of disease free survival after the treatment regime with RCHOP (6 courses, every 3 weeks) followed by radiation (4-5 weeks).
My doctor tells me the main key in both the chemo and radiation treatments is to make sure the radiation provider is the upmost expert (equipment and staff) in order to prevent long-term damage to my lungs/heart around the mass.

After 2-3 courses of chemo they will do another PET/CT at MD Anderson or Vandi for more staging to see where I am. If the PET can clears after 2-3 rounds of chemo, that is a very favorable sign. After the entire treatment there is still a PET/CT given every 3mos for about 3 years. After that, things are progressive eased down and checkups are given less frequently.
"Cancer" is such a generic term. I have found it scares a lot of people when you say the word. I guess fifty years ago it was a death sentence and that attitude is still carried over by most of us. You also look at the statistics from places like the American Cancer Society and they look bleak, but only because they take in all ages, disease stages, etc. Some friends thought I was going to die last week…but then again, any of us could die at any time just by getting in a car accident, fire, etc (sorry to be morbid).

I think of all the other trials and tribulations other people have gone through, such as my Grandfather getting shot at and gassed by Germans in WWII, or my dad’s friends having to go sleepless night after night in the Jungles of Vietnam, or someone getting paralyzed from a car crash, or Jesus dying on the cross. Those are the real people we should embrace.

My battle is moderate, simply a small bump put in my way by God to teach me a few things that I need to change in my life. The nurse at MD argued that God didn’t allow this to happen, but I believe God allows everything to happen, he is in control. Meghan cited the story of Job where God allowed Satan to kill his family, take his land, property etc. but didn’t allow him to touch his person. Even after his friends tried to convince Job to hate the Lord, he refused. Job’s bounty returned ten fold in the end. I guess my point is, you don’t know what God has in store, so have faith, perservere, and enjoy every day on this earth!

I hope that fills everyone a little for now. I will blog more when my treatment starts and let everyone know how it is going.

-Dave

I just wanted to update everyone on Dave's status. He went to the Nashville Oncologist, Dr. Patton, and got his results back from the biopsy this afternoon. Dave has non hodgkins lymphoma cancer. This type of cancer is very common in males Dave's age (15-34) and is very curable. The doctor says he is in the intermediate stages of the disease. His family and him were able to get an appointment with a great caner hospital MD Anderson and have left today and have an appointment for this Thursday at 6:30am. They plan on being there for a few days while the doctors run tests to see if the cancer has spread anywhere else. According to Dave's blood work everything looks like it is just in the one place, but the doctors will want to make sure that it isn't anywhere else. After that the doctors will decide what the best course of treatment is for Dave. Then Dave will be able to come back to Nashville and get his treatment here.

Once again, please email Dave at dave@davetough.com if you want to send immediate wishes or call me on my cell at (615) 308-3877. We are going to be setting up an update page on his website to give more immediate information as we receive it through this whole process so bookmark it for later reference and updates.

Dave wanted to let all his friends in Los Angeles know that he unfortunately will not be making the MEIEA Conference this upcoming weekend (and subsequent party) but plans to be back in full force next year.

Please continue to lift him up in prayer as he and his parents travel to Texas, for the tests that will be ran on him, wisdom for the doctors and the course of treatment that he will need. You will never know how much your prayers have meant to us. From the bottom of my heart thank you.

Meghan

John 14:12-14 Verily, verily, I say unto you, He that believes on me, the works that I do shall he do also; and greater works than these shall he do; because I go unto my Father. And whatsoever you shall ask in my name, that will I do, that the Father may be glorified in the Son. If you shall ask anything in my name, I will do it.

Hello Everyone-

I wanted to e-mail all of you to ask for your prayers for Dave Tough (my boyfriend). I know I have spoken with some of you but wanted to keep everyone updated on the latest with his situation. On Thursday he went to the ER because he had been having some swelling pain in his arm and neck, he has had this pain for the last 2-3 weeks. Thankfully, they were wise enough to take some x-rays and did a CT scan and found a 7 x 8 cm mass on the exterior of his lung. He then got a biospy to see if the tumor is cancerous. We stayed the night at Southern Medical Center just to make sure that there were no complications with the biospy procedure. We don't find out the results until Tuesday afternoon, but the preliminary results do show that he has abnormal cells. Dave is holding up pretty well. The medication they gave him has a lot of side effects, so he is experiencing some of those symptoms and sometimes can't speak. We ask that you email him at dave@davetough.com. We/he may not respond back, but we will keep you updated. We just ask that you keep us in your thoughts and prayers. Thanks, I am so thankful to have each of you in my life.

Meghan