Diagnosis: no bueno
So, I am 0-for-2, in terms of diagnosing myself with my own gut feelings. When the doctors first told me I had a mass in my chest, I was sure that I was one of the rare and unlucky non-smokers with lung cancer- and I was wrong, thankfully. And after the doctors told me that the bronchoscopy I had was inconclusive, but did not show any cancer cells, I was sure that my illness was just sarcoidosis: not something you want to run out and get, per se, but a lot better than the alternative.
So I didn't exactly skip and whistle into last Thursday's surgery, but I went in pretty damn sure that the more-invasive but much-more-definitive mediastinoscopy, which involves an incision in the throat and the removal of all or some of a lymph node, would clear lymphoma's name. Sarcoidosis, the pulmonologist told me, is pretty much diagnosed by elimination; you go in, and when you don't find anything else, you are pretty safe assuming that what is there is sarcoidosis. The doctors told me that they would not have a full pathology report for a few days, but they would have a preliminary diagnosis (i.e. sarcoidosis or lymphoma) the day of the surgery. So, as the anesthetic was wearing off, as I was drinking my second Coke (they were out of Sprite), and as my mood was brightening, the doc came in to check on me. I said, with the positive intonation of a guy who's sure that he's about to receive the less-bad news, "so, you think you'll have some kind of diagnosis this afternoon?" The doctor didn't exactly do the index-finger-trying-to-loosen-a-too-tight-collar thing, but I'm pretty sure his answer started with "um, yeah, about that..." The thing is, they had run off, node in hand, to a microscope immediately after the procedure, and had seen as much as they had to see. Diagnosis: no bueno. Lymphoma.
(Side note, and the only thing so far that has made me raise an eyebrow at the medical-industrial complex: Going into the bronchoscopy, the doctors were quite confident it was either sarcoidosis or lymphoma. There was a slim chance it was one of several lung infections, but those usually occur in spelunkers and bat-tenders and those who travel to steamy, exotic, dung-laden locales, so my likely options were more pat. An inconclusive bronch (which is what happened- remember, sarcoid is the diagnosis of exclusion) would necessitate the mediastinoscopy. A conclusive bronch (i.e. lymphoma) would require a mediastinoscopy for a more specific diagnosis, as well as to "stage" the cancer. In other words, I was getting the mediastinoscopy, regardless of the results of the bronchoscopy. I mean, I'm not saying I got ripped off- I just feel like I got my tires rotated when they knew they were gonna replace 'em anyway.)
And now it's Tuesday, and that's still all we know; we don't know whether it is Hodgkin's lymphoma, non-Hodgkin's lymphoma, or Bob Hoskins' lymphoma. Apparently the pathology lab is taking their sweet time ( I don't really know that- maybe they're just very busy) and my doctors don't have enough suction with them to hustle it along. Maybe they'll call me today or tomorrow- I don't know. Next step is for me to meet with the oncologist, Dr. Peacock, on Friday- in the conservatory, with the candlestick.
So I decided to blow two years' worth of dust off of this blog instead of emailing updates- you can follow it if you want. I did not change the "blogger profile" that I wrote a few years ago- most of it is still true. I did notice, however, that I listed "rarely going to the doctor" as an "interest." Ah, what a brash, young, healthy, smug little fuck, that would write that. That was true, at the time, and it was a perfectly reasonable thing for a fit vegetarian with a healthy love of wine to write- I had cracked the code on health.
Ha! Not. So. Fast.
PH
So I didn't exactly skip and whistle into last Thursday's surgery, but I went in pretty damn sure that the more-invasive but much-more-definitive mediastinoscopy, which involves an incision in the throat and the removal of all or some of a lymph node, would clear lymphoma's name. Sarcoidosis, the pulmonologist told me, is pretty much diagnosed by elimination; you go in, and when you don't find anything else, you are pretty safe assuming that what is there is sarcoidosis. The doctors told me that they would not have a full pathology report for a few days, but they would have a preliminary diagnosis (i.e. sarcoidosis or lymphoma) the day of the surgery. So, as the anesthetic was wearing off, as I was drinking my second Coke (they were out of Sprite), and as my mood was brightening, the doc came in to check on me. I said, with the positive intonation of a guy who's sure that he's about to receive the less-bad news, "so, you think you'll have some kind of diagnosis this afternoon?" The doctor didn't exactly do the index-finger-trying-to-loosen-a-too-tight-collar thing, but I'm pretty sure his answer started with "um, yeah, about that..." The thing is, they had run off, node in hand, to a microscope immediately after the procedure, and had seen as much as they had to see. Diagnosis: no bueno. Lymphoma.
(Side note, and the only thing so far that has made me raise an eyebrow at the medical-industrial complex: Going into the bronchoscopy, the doctors were quite confident it was either sarcoidosis or lymphoma. There was a slim chance it was one of several lung infections, but those usually occur in spelunkers and bat-tenders and those who travel to steamy, exotic, dung-laden locales, so my likely options were more pat. An inconclusive bronch (which is what happened- remember, sarcoid is the diagnosis of exclusion) would necessitate the mediastinoscopy. A conclusive bronch (i.e. lymphoma) would require a mediastinoscopy for a more specific diagnosis, as well as to "stage" the cancer. In other words, I was getting the mediastinoscopy, regardless of the results of the bronchoscopy. I mean, I'm not saying I got ripped off- I just feel like I got my tires rotated when they knew they were gonna replace 'em anyway.)
And now it's Tuesday, and that's still all we know; we don't know whether it is Hodgkin's lymphoma, non-Hodgkin's lymphoma, or Bob Hoskins' lymphoma. Apparently the pathology lab is taking their sweet time ( I don't really know that- maybe they're just very busy) and my doctors don't have enough suction with them to hustle it along. Maybe they'll call me today or tomorrow- I don't know. Next step is for me to meet with the oncologist, Dr. Peacock, on Friday- in the conservatory, with the candlestick.
So I decided to blow two years' worth of dust off of this blog instead of emailing updates- you can follow it if you want. I did not change the "blogger profile" that I wrote a few years ago- most of it is still true. I did notice, however, that I listed "rarely going to the doctor" as an "interest." Ah, what a brash, young, healthy, smug little fuck, that would write that. That was true, at the time, and it was a perfectly reasonable thing for a fit vegetarian with a healthy love of wine to write- I had cracked the code on health.
Ha! Not. So. Fast.
PH