First chemo, MUGA scan, and some lingering uncertainty over the exact type of leukemia I’ve got

• Things got a bit more intense today, though I think it was pretty tame compared to what’s ahead.  
• I suppose the most notable development was that I got my first dose of chemo, via a lumbar puncture.  Using a relatively small needle, and liberal amounts of lidocaine, the physician’s assistant tapped into the base of my spinal column to collect a few CCs of my spinal fluid for a test to determine whether the cancer is present in my central nervous system.  The data suggests that even if the disease is not yet evident in my CNS, it could emerge later, so it makes the most sense to get the chemotherapy going in there ASAP, which the PA did by injecting a few CCs of methotrexate.  It looks like I’ll be getting five more of these jabs over the next few months to complete the intrathecal methotrexate therapy.  From what we’ve read, the methotrexate is not likely to cause major side effects.   While the lumbar puncture and methotrexate was no fun, I realize that it’s a lot easier than the other chemo that I’ll be getting down the road.
• I also got a standard CT scan of my chest and a MUGA (Multiple Gated Acquisition) scan of my heart.  The latter test, which will give the docs a baseline study of my pre-transplant heart function (especially important to measure what, if any, damage might be done by the transplant process),  involved drawing a bit of blood via an IV, mixing the blood with a radioactive tracing agent (half life of six hours–so it should be pretty much gone in the next few days), injecting the now radioactive blood back into me, and then getting several scans of my heart in action. 
• The PA also told me that the Hutchinson doctors are now reviewing whether my leukemia truly was a lymphoid blast crisis of Chronic Myelogenous Leukemia (CML), or if it might in fact be a so-called Philadelphia-positive Acute Lymphoblastic Leukemia (ALL).  Both are very serious and only curable by a stem cell transplant, but if it’s ALL, it likely will require two rounds of chemo, instead of the one round that is typically done for blast crisis CML.  The key Hutchinson doctors will confer on my case next Wednesday, March 26, to reach a consensus re: my diagnosis.  While my previous doctors at both GWU in Washington, DC, and NIH in Bethesda, Maryland had both felt that I likely had CML, it was clear that neither had conclusively ruled out ALL.  In retrospect, I wish they’d been a bit more focused on getting a definitive diagnosis, since it appears that it will make a significant difference in the course of my upcoming treatment.  
• All of the action described above took place after mid-day today.  Lisa and I had the morning free, while the girls were in school, so we did a fun walk from the Cascade neighborhood, where SCCA and our apartment are, north to the UW campus, and then back via the Capitol Hill neighborhood.  The rain held off for our walk and we stopped along the way for some Stumptown coffee (based in Portland, OR, I think), which seems to be one of the preferred regional brands.