It Might Get Messy

Indeed. And we’ve been here before. Having completed whirlwind visits to Europe and Asia and spent two wonderful weeks at the beach, I’ve settled back in to the office routine (as best I can—it still takes me a while to get my shit together in the morning. But I’m plenty strong enough to work a full day now, so I often end up at my desk until well after 6 pm). But that sticky pain down at the base of my tongue on the right side seemed to be more consistent. I was happy to have incipient appointments scheduled with doctors. Because it was starting to strike me that that pain might be problematic.

I put my best people on it.

Dr. N and Dr. H, both at GBMC, got together and designated Dr. H as point person. Actually, they figured if there WAS something there, as surgeon, he’d have to biopsy, so it was best to get him on board early. Last week, Dr. H and various associates took turns running a scope through my sinuses and peering around my throat (more on this in a bit). Everything down there looked as smooth as a baby’s bu…well, no, they actually looked liked the cooked remains of a dog found at ground zero in Hiroshima or Nagasaki in the summer of 1945. But they did NOT look tumorous. And they even showed me. I could see on the screen. Indeed, there was nothing the least bit disturbing down there.

But.

I was by then convinced that the pain was real, not some figment. So Dr. H, skeptical as he was, went ahead and scheduled a PET scan. He didn’t think the insurance company would pay for it. Actually, they took out a 10% co-pay ($190), which they hadn’t done the first time. I’m not sure what the hell they’re thinking. Absent early diagnosis, presumably it’d cost a lot more to reestablish my viability. Anyway, I paid the $$, and sat down for the injection of radiolabeled fludeoxyglucose intended to show metabolic hotspots of unusual intensity.

Took ‘em 20 minutes to come back into the waiting room and tell me there’d been a screw up, the isotope had been sent to another lab facility. But it wasn’t that far away. So I drove over, and after some additional contretemps in the parking lot, got settled in for the imaging.

Hell, apparently in the year since I had this done last, the technology has already improved fantastically. Just look at these images!

First up: my liver.

It’s the big orange chunk in the upper left photo (in my browser, if you click on the photo, it enlarges to full screen and you can see just how cool this imaging is). It’s orange because it’s cranking, keeping things clean. Including busting up the radiotagged glucose molecules. The torso image in the lower right is, on the CD of the entire 300-some-odd suite of slices, a nifty 3-D, rotating avatar that you just click on to select the slice you want to examine.

Like this one. 

Look at my kidneys. Also working hard, sorting the dissolved solids from the body fluids and shunting the recyclable good stuff out one end of the plumbing, the waste material out the other.

My brain? 

Not as dim as it seems most of the time. See here? Nice and bright and radioactive, keeping itself in creative thought and storing more scientific names in its data base than god.

And my heart. 

Robust and healthy. Never a problem there. Muscular, and, per James T. Kirk, “steady as she goes”.

But.

HERE’S the problem. They did an extra close-up set of images of my head.

Here’s one, a slice through my throat at the base of my tongue. See that really bright yellow spot glinting in the top left PET image? That’s probably new tumor material. It’s the place the original set of post-treatment images showed unsettled tissue of indeterminate makeup. Then, it was probably just inflammation. Now, it’s a new growing tumor. Look close, you can see it as a black, walnut-sized blob in the 3-D black and white image in the lower right, which is a composite of the PET and CT imaging.

This is icky. Dr. H needs to biopsy, which is a hospital surgical procedure. On Wednesday, I go in for an MRI, because the PET and CT imaging like the above don’t provide adequate resolution for planning the cutting.

Dr. H still doesn’t think there’s anything there. He says his scoping would have shown something if there was tumor tissue blooming. I’m afraid I think he’s wrong (for once). I’m pretty sure I can feel something growing down there. The pain gets incrementally more steady, and when I swallow there’s the sense that the food bolus is slipping around a protuberance.

And not in the good sense. My apologies for this blip of bad news in the otherwise sunshiny path to recovery and full health. Check back at least weekly from here on out, as I’ll keep things updated and they’re likely to move fast from here. I’m guessing more radiation and chemotherapy and follow-up surgery, but it might be that they follow the more classic pattern with this newer tumor, and try surgery first with radiation to suppress regrowth.

I’ll let you know. Meantime, I haven’t updated either docviper.com or aehsfoundation.org in the past couple weeks. I’ll get back on those this week, so check over there at http://docviper.livejournal.com/ and http://aehsfoundation.org/ . I’ll keep writing as long as the treatment lets me access the keyboard. Love you all. Hang in there!