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!
Sunday, March 27, 2011
Tuesday, March 22, 2011
A Long, Strange Trip -- with a Rest Stop
Well, well, well... things are starting to settle a bit:
My dry cough is pretty much gone -- replaced by an occasional "wet" cough, which is to be expected if one is recovering from pneumonia. (If that, in fact, was what was going on with me in Jennersville. I'm starting to wonder... Reading the X-Ray and CT scan reports, it surprises me that I don't see any mention of a pneumonia situation in either report. But maybe that's to be expected. How would I know? I'm just a passenger on this particular trip -- albeit a front-seat passenger. I'll ask the lung doc on Friday -- as described below.)
The antibiotics are a thing of the past and either:
(A) they worked and I feel much better or
(B) they had no effect on my illness but I feel better anyway.
But in either case, I feel much better. And the diarrhea that the antibiotics did cause is almost completely gone. At least now, I don't have to make sure I'm within sprinting distance of a bathroom at all times.
And people that I know and love dearly have been so supportive -- and their wishes and prayers are almost palpable. I know people who, when they are ill, do what they can to keep their condition a secret rather than letting their friends and family know. And I feel sorry for them, that they've decided to isolate themselves from such a powerful source of healing and strength. Yes, it takes a village to raise a child, but when do we truly stop being children in this context? My hunch is never...
I had an MRI on my head (Including my brain! I'd like to say it tickled, but it didn't.) and neck areas late last week, and everything came back normal. Further proof that the cancer has not returned locally.
Deb and I visited my chemo doc yesterday, and we talked extensively about the CT scan from Jennersville. He's dubious that a CT lung scan of someone who is suffering from pneumonia can give a totally accurate picture of what's going on. He supports our upcoming visit to a lung doc on Friday, and expects that he/she might well have us wait another couple of weeks to let my lungs return to a condition as normal as possible before any further investigation takes place.
He also suggested (this is important! pay attention!) that the cancer I had has a reputation of recurring locally, but not so much metasticizing elsewhere. So he's looking askance at the notion that the thing in my lung is another tumor. (Pretty cool, yeah?)
I then got a phone call from my E/N/T doc -- who left a message on our home phone -- asking what was going on, and would I please call him on his cell phone? Oh yes! So we talked for 5 or 10 minutes, and he seems to share the scepticism of my chemo doc: there's no reason yet to assume that the inclusion in my lung is cancerous. And then, he all but implored me to call him on his cell phone whenever I wanted to talk something over. I mean, geez!!
You know how, when you've pulled the car over into a rest stop off of I-95 or other major thoroughfare, got out of the car, filled it with gas, visited the bathroom, picked up a snack and/or some coffee, walked around for a while -- you know how you can wind up feeling totally refreshed and ready to hit the highway again? And that you've decided that life is good and that you're one lucky person to be who you are and where you are?
Well, that's how I feel right now. Let's hit the highway!
My dry cough is pretty much gone -- replaced by an occasional "wet" cough, which is to be expected if one is recovering from pneumonia. (If that, in fact, was what was going on with me in Jennersville. I'm starting to wonder... Reading the X-Ray and CT scan reports, it surprises me that I don't see any mention of a pneumonia situation in either report. But maybe that's to be expected. How would I know? I'm just a passenger on this particular trip -- albeit a front-seat passenger. I'll ask the lung doc on Friday -- as described below.)
The antibiotics are a thing of the past and either:
(A) they worked and I feel much better or
(B) they had no effect on my illness but I feel better anyway.
But in either case, I feel much better. And the diarrhea that the antibiotics did cause is almost completely gone. At least now, I don't have to make sure I'm within sprinting distance of a bathroom at all times.
And people that I know and love dearly have been so supportive -- and their wishes and prayers are almost palpable. I know people who, when they are ill, do what they can to keep their condition a secret rather than letting their friends and family know. And I feel sorry for them, that they've decided to isolate themselves from such a powerful source of healing and strength. Yes, it takes a village to raise a child, but when do we truly stop being children in this context? My hunch is never...
I had an MRI on my head (Including my brain! I'd like to say it tickled, but it didn't.) and neck areas late last week, and everything came back normal. Further proof that the cancer has not returned locally.
Deb and I visited my chemo doc yesterday, and we talked extensively about the CT scan from Jennersville. He's dubious that a CT lung scan of someone who is suffering from pneumonia can give a totally accurate picture of what's going on. He supports our upcoming visit to a lung doc on Friday, and expects that he/she might well have us wait another couple of weeks to let my lungs return to a condition as normal as possible before any further investigation takes place.
He also suggested (this is important! pay attention!) that the cancer I had has a reputation of recurring locally, but not so much metasticizing elsewhere. So he's looking askance at the notion that the thing in my lung is another tumor. (Pretty cool, yeah?)
I then got a phone call from my E/N/T doc -- who left a message on our home phone -- asking what was going on, and would I please call him on his cell phone? Oh yes! So we talked for 5 or 10 minutes, and he seems to share the scepticism of my chemo doc: there's no reason yet to assume that the inclusion in my lung is cancerous. And then, he all but implored me to call him on his cell phone whenever I wanted to talk something over. I mean, geez!!
You know how, when you've pulled the car over into a rest stop off of I-95 or other major thoroughfare, got out of the car, filled it with gas, visited the bathroom, picked up a snack and/or some coffee, walked around for a while -- you know how you can wind up feeling totally refreshed and ready to hit the highway again? And that you've decided that life is good and that you're one lucky person to be who you are and where you are?
Well, that's how I feel right now. Let's hit the highway!
Wednesday, March 16, 2011
A Long, Strange Trip -- Chapter 2
The story at the end of the previous chapter/posting looked like it was ready to close out: Randy gets sick, Randy goes to the hospital, Randy gets better and goes home. Geez, I wish...
The wheels started to fall off that story during a visit with my family physician on Friday morning. (That would be March 11, for those of you keeping score...) She looked at the reports of the X-Ray and CT scan and just shook her head and said: "I don't think pneumonia had anything to do with your chest pain." While that was a bit disturbing (missed diagnoses are never reassuring!), it sounded "right" somehow. I had pneumonia several years ago and what I was feeling on Tuesday during my drive home to West Chester was totally different from what I felt back then. But I guess I was so relieved that there was no sign of a blood clot that I wasn't really paying close attention to what the pain was (as opposed to what it wasn't).
But more important than the chest pain issue was the wording in the CT scan report. And I was hoping that she would be familiar with a couple of terms that I had never heard, but which didn't sound very encouraging. (And Google searches on the words in question were even more alarming.)
The report said my lung(s) might have "primary or metastatic neoplasm; [and that] bronchioalveolar carcinoma often contains [such structures as those identified in the scan]." I won't bother putting in links here for the puzzling terms -- you probably recognize the "hot button" words the report uses...
So, just in case you're losing track here (which would be perfectly understandable), allow me to summarize where we are: I go to an Emergency Room because of a pain in my chest. The pain is (quite possibly) misidentified as caused by pneumonia. But the lab tests to help diagnose the source of the pain show up the possiblility that my cancer has spread to my lungs.
So that was last Friday, and it's now late Wednesday. And I've been trying ever since I got home to get the attention of one of the doctors who treated me for cancer: What does this all mean? Has my cancer metastasized? Why haven't we ever scanned my lungs or liver or anywhere else to check to see if it's moved to somewhere else?
My family doc has been terrific, but she readily admits that the terms in the scan report are beyond her training and experience. (That's one of the things I like so much about her! She will readily admit that there's stuff she doesn't know and needs to find out about.) I've taken copies of the scan reports to my chemo doc and my E/N/T doc, but haven't heard back from either one of them. So she's put in a separate "professional" request to my chemo doc to try and get his attention. My specialist docs are busy people -- and I think they're pretty well convinced that I'm out of the woods on this cancer thing.
And I hope and pray they're right and my anxieties are baseless.
Oh yeah, one more thing: the treatment I got at the Jennersville hospital (which included up to three different types of antibiotic at the same time), seems to have wiped out all the "good" bacteria in my digestive tract, leaving me with a severe case of diarrhea. I kind of wish I had the time and energy to get annoyed at that...
And what, pray tell, caused the serious chest pain that started all this?
More later when things clarify.
The wheels started to fall off that story during a visit with my family physician on Friday morning. (That would be March 11, for those of you keeping score...) She looked at the reports of the X-Ray and CT scan and just shook her head and said: "I don't think pneumonia had anything to do with your chest pain." While that was a bit disturbing (missed diagnoses are never reassuring!), it sounded "right" somehow. I had pneumonia several years ago and what I was feeling on Tuesday during my drive home to West Chester was totally different from what I felt back then. But I guess I was so relieved that there was no sign of a blood clot that I wasn't really paying close attention to what the pain was (as opposed to what it wasn't).
But more important than the chest pain issue was the wording in the CT scan report. And I was hoping that she would be familiar with a couple of terms that I had never heard, but which didn't sound very encouraging. (And Google searches on the words in question were even more alarming.)
The report said my lung(s) might have "primary or metastatic neoplasm; [and that] bronchioalveolar carcinoma often contains [such structures as those identified in the scan]." I won't bother putting in links here for the puzzling terms -- you probably recognize the "hot button" words the report uses...
So, just in case you're losing track here (which would be perfectly understandable), allow me to summarize where we are: I go to an Emergency Room because of a pain in my chest. The pain is (quite possibly) misidentified as caused by pneumonia. But the lab tests to help diagnose the source of the pain show up the possiblility that my cancer has spread to my lungs.
So that was last Friday, and it's now late Wednesday. And I've been trying ever since I got home to get the attention of one of the doctors who treated me for cancer: What does this all mean? Has my cancer metastasized? Why haven't we ever scanned my lungs or liver or anywhere else to check to see if it's moved to somewhere else?
My family doc has been terrific, but she readily admits that the terms in the scan report are beyond her training and experience. (That's one of the things I like so much about her! She will readily admit that there's stuff she doesn't know and needs to find out about.) I've taken copies of the scan reports to my chemo doc and my E/N/T doc, but haven't heard back from either one of them. So she's put in a separate "professional" request to my chemo doc to try and get his attention. My specialist docs are busy people -- and I think they're pretty well convinced that I'm out of the woods on this cancer thing.
And I hope and pray they're right and my anxieties are baseless.
Oh yeah, one more thing: the treatment I got at the Jennersville hospital (which included up to three different types of antibiotic at the same time), seems to have wiped out all the "good" bacteria in my digestive tract, leaving me with a severe case of diarrhea. I kind of wish I had the time and energy to get annoyed at that...
And what, pray tell, caused the serious chest pain that started all this?
More later when things clarify.
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