A Long, Strange Trip -- Checking the Map

What I'm doing in this posting is "pulling off to the side of the road and hauling out the Rand/McNally..."

Here's a capsule summary of the trip so far: Driving home from visiting my Dad in Baltimore two weeks ago, I felt a sharp, intermittent pain in the area of my heart. Given my issues with blood clotting, this could have been extremely serious -- possibly lethal.

On the advice of my family doc (who is absolutely terrific), I drove to the closest hospital and went to the Emergency Room. The hospital was in Jennersville, PA, and the staff there got me an X-Ray and CT scan remarkably quickly. Since J'ville is a small, regional hospital, they didn't have anyone on duty capable of reading the scans, and so sent them off to a facility in Michigan for analysis. When the results came back, the ER doc announced -- rather happily, I thought -- "Good news! It's pneumonia!" The consequences of which, when you think of it, are much less severe than having a blood clot lurking around your heart. So it certainly did qualify as "Good news."

The doc then told me he wanted me to stay at the hospital for a day or two for treatment and continued monitoring. While I thought this was excessive (I'd been treated for pneumonia before as an outpatient back home), I didn't feel qualified to argue with the doc, so I signed myself in as an inpatient and spent the next two days cooling my heels in J'ville.

The doc also mentioned that the CT scan showed a spot in one of my lungs that was somewhat worrisome: the formal report on the scan mentioned that this type of structure could have been caused by a tumor. And, quite frankly, I'd been concerned for some time about the possibility that my cancer from two years ago might have metastasized elsewhere in my body -- and I thought I recalled some doc mentioning that the lungs were a likely target. So "Good news" was really "Good news / Bad news."

When I (finally!) got home, I got a recommendation for a pulmonary (i.e., lung specialist) doc from my family doc, which was a group practice that other members of my medical "team" knew well and respected highly. And we made an appointment. And the appointment was last Friday.

And the doc was very good. He spent considerable time looking at the CT scans by himself, and then invited Deb and me to look at the CT scan along with him on an office computer while he explained where the spot was (actually, there's two of them...) and what it might mean.

He was nowhere near assuming that the spots represented cancer, and explained that spots like the ones on the scan had numerous possible sources, including bacteria (a number of which carry pneumonia-like names), viruses (which require a considerably different treatment regimen), and environmental causes (such as dust from the 50-year-old paper from my Dad's house that I had been shredding for days just before I got sick...). Or metastatic cancer.

And the way this was coming together for me, the likelihood of the spots being cancer seemed more and more remote: in addition to the paper shredding extravaganza I had recently completed, I had been performing at the Academy of Natural Sciences for two straight days, playing with a lot of germ-laden kids.  So the lung doc put me on (yet another) regimen of antibiotics -- and this one carries some pretty dire warnings, so it must be powerful stuff -- and told me to arrange a PET scan for several days after the antibiotics were all consumed. And then make an appointment to see him again.


The PET scan, I was told, "lights up" around a tumor -- although other conditions could also cause this "lighting up." So if the scan comes back negative, I'm in the clear -- just recovering from pneumonia. If the scan comes back positive, then a biopsy will be in order. And the doc says that, given the fairly small size of the spot, the biopsy might be able to remove it completely.


Oh, and the other good news is that a PET scan covers the entire body, so that if there were any other "hot spots," (i.e., potential metastatic tumors) they would also show up. Nose to toes.So Deb and I left the doc's office with a much clearer picture of things -- and a plan for the next couple of steps.


And with that, I will fold up the Rand/McNally and get back on the highway. Thanks for coming along!