From the category archives:

Diagnosis

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Something in Dr. R’s message does not add up. First I have an old pneumonia scar. Then it is radiation damage on the left lung lobe. But I had my right side radiated.  If anyone could solve this mystery, it would be my radiation oncologist, Dr. Alpha.

I call Dr. Alpha’s number, fully expecting to get his voice mail, but he picks up on the first ring.

No, he never took any x-rays of me, but I had a CAT scan before I started radiation. (How could I possibly have forgotten that?) He will look at it and call me back.

In less than an hour, Dr. Alpha is back on the phone. He has compared my  CAT scan from five months ago with the new one. The 8 mm granuloma on my lower left lobe does not worry him. It was there before I started radiation and has not changed at all.

“More worrisome,” Dr. Alpha tells me, “is the growth on the lymph node just below your heart.”

I try to steady my voice so it will not quiver. All my bluster and bravado from my days of radiation have  evaporated. I hear how meek and scared I sound. He must have heard it too.

“They never told me anything about a growth under my heart.”

“No, they wouldn’t. They try not to give you all the information. You want to come down and see?” offers Dr. Alpha. “I will show it to you and explain.”

I want to take him up on the offer and drive down and see for myself. But I also do not want to crash into his busy schedule. What do I know about x-ray images anyway? I did not even know you had lymph nodes under your heart. I will have to take Dr. Alpha on his word.

“You definitely need a PET scan,” Dr. Alpha says. “This needs to be fully investigated. I will schedule one for you.”

“But I have one scheduled for tomorrow at 1 PM. I guess I have to go ahead then?”

“Yes, you do. I will read it and get back to you as soon as it is done,” said Dr. Alpha.

I feel doomed. Dr. Alpha’s words – this definitely needs to be investigated – throb in my ears. “Investigated,” has a serious ring to it, like a grand jury inquiry or Senate investigation. And, yet, the idea that Dr. Alpha will get to read my PET scan calms me and reassures me. I know he will level with me no matter what the outcome.

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Whatever it was that showed up on my friend Elise’s mammogram, it needed a biopsy. A different doctor might have said “Let’s wait and see. Come back in six months.” But not Dr. Guru, he claimed that a biopsy was “the medically prudent thing to do.” So Elise went ahead and had her biopsy “just in case.”

It was a lucky thing too. Elise’s voice was shaking a bit when she told me they found cancer.  This was the second time in twenty years she had received this dreaded diagnosis. You’d think one gets jaded, but that is not how it works. If anything you are far more scared the second time around. You cannot help but think: “What is wrong with me?”

Dr. Guru assured her “it ” was early and extremely unlikely to have spread. She was relieved thinking she could probably avoid the much feared chemo therapy. Elise had a mastectomy, what the heck, her other breast was already gone. Why not even out the front side and avoid radiation?

That evening in the hospital, Dr. Guru stopped by her bed to check on her, and to tell her that he found a cancer cell in her sentinel node. On top of that, it was a different kind of cancer than the one he found in the breast. Elise could tell how shocked the normally cool Dr. Guru was at this unexpected turn of events.

After a review of the pathology report on both cancers, Elise’s oncologist allowed her to skip chemo therapy and opt for hormone therapy only. She is doing fine – so far. That is the horrible thing with cancer: you look good, feel good, and whoops, a little cancer cell jumps up and rakes havoc with your life.

I am telling you this to let you know: always look into something that is “probably nothing.” Yes, a breast biopsy is not pleasant, but it is no worse than getting a crown at the dentist, and infinitely much less painful than a bee sting. Remember the words from Dr. Susan Love: breast cancer is not about statistics, it is about the individual.

When you hope for the best always plan for the worst. Medically, it is the prudent thing to do.

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Oncology: A Second Opinion.

January 10, 2010

The sign “Magnolia Cancer Center” does not look as surreal as it has during my previous visits. After all, I do have breast cancer and this center is for me. Although I do not yet have the hollow eyes, the waxy complexion, the bloated body, or the shuffling gate of so many of the other […]

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Breast Cancer Tends to Sneak Up on You

December 2, 2009

Dr. Weary piles on the good news about his chemo regimen: “You will not suffer for five months straight. Only for six week-ends. You may have your treatments on Fridays so you can recover over the week-end and be at work by Monday. Maybe by Tuesday.” “Great.” “We give you medication to control nausea. You […]

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Onward to the Oncologist(s)

November 15, 2009

The Breast Consultants at Vanderbilt University confirm the previous findings in my pathology report. And Dr. Guru assures me that “he would not do a re-excision on his own wife.”  That does it for me. I cancel the appointment  with the second surgeon, the one set by my sister-in-law. After all, the second surgeon has […]

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Totally in a Funk

October 22, 2009

My husband and I are both stuck in the glue of our gloom, unable to reach out to each other. I am restless, crabby, scarred, impatient, and distracted both at home and at work. I cannot concentrate on anything. All I do is obsess about a second surgery. It is not the surgery that scares […]

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All Other Edges Free of Carcinoma. Meaning?

October 10, 2009

Three weeks after after my lumpectomy, and after some prodding and probing,  my pathology report arrives in the mail. I polish my bifocals. — the better to see you my dear —  and sink down in my favorite reading chair. On page one, I immediately zero in on these worrisome phrases: “All other surgical resection […]

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Stumbling on a Piece of Humble Pie

September 22, 2009

“Yesterday was horrific, “ says  Dr. Guru’s assistant when I call to complain that he never called with the pathology results, as promised. “I had to snatch him to even get one second.” She lets out a deep sigh, the kind that seems to come from  the bone marrow, not from the lungs. I feel […]

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Stepping Up My Level of Care: But How?

September 20, 2009

No Pathology report .  It seems that I am off Dr. Guru’s radar screen. Who cares? Not me! I am upbeat and sure of myself, thanks to the book “What Your Doctor Didn’t Tell You About Breast Cancer.”  I have been devouring it the past couple of days while waiting for the pathology results. Tamoxifen […]

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Procrastinations on Pathology Report

September 17, 2009

Friday. No news on the oncogene.  No news from Dr. Guru’s office all day Monday. Finally, I call his assistant just before closing time. “We are waiting for your pathology report,”  she says. “Have you been to post op yet?” “Yes, I had my ten second post-op  a week ago.” It seems like his office […]

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