2.13.2013

Carlos the Pulmonologist

Willy Wonka and Scarface worthy.
I've spent the last 6 months working out 5+ days a week. And all for the cardiovascular glory of sitting in a little glass box and breathing on demand today. Not really, but it's always nice to get affirmation beyond my endurance on the treadmill or sweat in a Spin class to know that what I'm doing is worth it for my health.

I sort of snicker saying that. Am I doing anything for my health right now considering that it may not matter what I do at this point to be healthy? In the end, cancer trumps all!

For some naive reason I was expecting to have my lung biopsy today, and fasted accordingly. That means I not only had to wake up to an alarm that didn't come in the form of shouts from a crib, but that I had to skip the coffee that would help facilitate waking up before the sun. It was all in vain, as today just turned out to be a preliminary appointment with the pulmonologist.

On Monday, I'll go in for the outpatient procedure; a bronchoscopy. He'll stick a camera down my nose and try his best to find the nodules and biopsy them. I say do his best, because they really are very small. Small enough that even the largest one (at 7.1mm) won't show up on the x-ray he'll use as guidance. Instead, he'll use last week's CT scan as his map and head to the areas of greatest density. And I can assure that greatest density is probably not the greatest phrase to hear in my case.

"Areas of greatest density" shouldn't be hard, since apparently I have so many new little nodules that the radiologist reading my CT scan gave up and just described them as "too numerous to count." I never thought to ask how many on Friday when we were told of the new guys. I just assumed it was a few new ones, but that went out the window faster than some of the exhales I did for the respiratory therapist this morning. 

"Too numerous to count." That phrase will suck the air out of the ol' wind bags in a hurry.

The best possible outcome is that he's able to find numerous nodule sites and take a plethora of biopsies. The more samples he takes, the better the chances of them finding out if these are boring nodules or not. 

Should he not be successful, the next line of defense would be a needle biopsy while I was actively being CT scanned. Yeah for even more radiation! Another option is something call VATS (video-assisted thoracic surgery). With that procedure, they make a small incision in the lung and remove a nice little chunk of lung tissue about half the size of your thumb. This would require surgery and lung perforation and a few days vacationing in the hospital. So in the end, we can all hope this first attempt works, because we all know how much I hate to be left alone in a hospital room with the TV to myself, heavy narcotics and people bringing me everything I need.

I'm going to freely admit that I've spent every day since Friday in a bit of a daze. I walk around thinking about cancer. I can't sleep without dreaming about cancer. I can't look at my kids without thinking of the possibility of cancer.

Several times a night I wake up and for 5 fleeting seconds I think, "Oh, what a relief! It was just a dream." Then I remember that it's not, and I toss and turn while trying to drift off to other thoughts. It rarely works.

Even if this turns out to be nothing, I have realized that I became instantly complacent over the whole experience. I think I felt like I had a leg up on the disease because I had it all removed from my body. I had operable cancer. But I've had my reality check. I know I was as close to have metastatic cancer as you can get 15 months ago. Should I really be shocked if it shows up again? Or in this case, was there all along and playing coy.

That's why I prepare for the worst before I even know what's there. It's human nature and it's brutal, but it's what we do for our own emotional survival.
Lungs: Not intended as toys for children under the age of 18.
"Look mom, bronchi!!!"





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