I have cancer...

On the 16th of February, 2010 I went into the doctor's office to have them look at a lump on my neck. I had noticed it a few days earlier and had decided that if didn't go down by Monday the 15th I would have someone look at it.

Here's the chronology of how that day went:

• 9:30, into see nurse practitioner. Diagnose - hmm, not good. Your healthy, no fever, no obvious signs of infection but you've got really inflamed lymph nodes in your neck. Not good.
• 10:30, over to the hospital to get a chest x-ray and CT scan of my neck
• 12:15, done with CT scan and chest xray. Back home to work for a couple of hours, waiting for the radiologist to look at the scans
• 1:55, call from my doctor's office. They've setup a 3:00 appt with an ear, nose and throat doctor to look at my neck.
• 3:30, into see the ENT. Needle biopsy of the glands on my neck. Also a scope (a 12" long fibre optic scope), up your nose, down your throat to look at your larynx, check for throat cancer. Sort of felt like having the worlds biggest snot go UP your nose. Not recommended.
• 4:00. Initial diagnosis, based on scoping and CT pictures - some form of lymphoma.
• Back to my primary care physician. They agree that a lymphoma diagnosis is the most likely one given the CT scan, chest x-ray and scope results. Great...

So there's a song that has a lyric in it that says: "I guess we're all just one phone call from our knees". That's pretty much what that day felt like.

And one other thought. Our health care system may suck in a lot of ways. But if you're reasonably affluent and live somewhere like Boulder, Colorado, it feels like a pretty kick-ass system. At least my Tuesday the 16th sure felt like I instantly had a set of super skilled, super caring people who were all strangers to me at the beginning of the day jump to my aid to help me figure out what was going on in my immune system. Of course, if your poor, non-white and not living somewhere like Boulder your care situation would be way different. And I guess that's the essence of the health care debate. But that's a topic for another blog post...

• Wed, 17 Feb. Call from the doctor. Needle biopsy shows no cancer cells. Sounds like good news! But, he's concerned that they just didn't get a big enough sample. Again, the symptoms indicate lymphoma. Healthy, no other signs of anything my immune system could be fighting that would make my lymph glands get this big. So, next step. Incisional biopsy. Under a general. In the hospital. Great...
• Thursday, 18 Feb. Meet with the ENT doc and Susan. We all agree on the incisional biopsy under a general. Day surgery, scheduled for a week and a half out. I ask to see if they can move it up. Waiting is hard; I want an answer so we can plan our response and get after a solution.
• Friday, 19 Feb. The ENT doc's office calls. They've found a spot for me on Wed morning.

Over the weekend, we get a nice ski day in on Sunday and manage to get through Monday and Tuesday without too much angst.

• Wed, 24 Feb. Into the hospital in the morning. Worried about the general because my throat and airway have seemed a bit congested over the last couple of days. Could be pressure from the lymph glands in my neck, could be anxiety, could be asthma, could be throat cancer. So basically I'm worried that I'll go to sleep a relatively healthy 51 yr. old guy with some lumps in his neck and (maybe) wake up (or not wake up) with a shit pot of problems. Susan is with me in the pre-op room and does a good job of keeping me sane. The surgery gets delayed about 90 minutes because of a backup in the OR which is actually really good for my nerves. At some point, it's just too much effort to stay anxious. The anesthesiologist comes in and I express my concerns and he assures me that I'll be fine. Finally, we're off to the OR, And with the wonder of modern medicine, for the next 90 minutes I have no idea what' s going on...

I wake up in the recovery room with Susan there to feed me ice chips and bring me back into the world of the living. Apparently I was quite entertaining in the post-op period (which I of course can't remember). Two things about my performance stand out:
- I was too hot and successfully disrobed down to my underwear before the nurses could get me covered up
- I immediately started asking if I could have sex with my wife that night.

I've been told that this second item is a not too uncommon question from male patients. So it's good to know that the reptilian parts of our brains are the first things to turn back on after a general and that our first thought is about intercourse. That strikes me as very comforting in some way...

As I'm at home relaxing on the couch, we get the call from the doctor. Initial pathology reports suggest Hodgkins Lymphoma. We'll know more in the next few days about the specifics of the pathology report and we'll probably do more tests (full body CT scan) to see if the cancer has progressed from my neck into other regions of my body.

Based on what research I've done and what we know from the diagnostics, I'm putting myself at either a type IA (one section of glands affected, no other symptoms) to perhaps IIB (multiple gland sections involved, all above my diaphragm, some symptoms; I've had some itchy skin that can be a symptom of lymphoma).

So that's the timeline to date. I now Officially Have Cancer.

Next steps:

1. - figure out more details on the progression of the disease
2. - interview and select an oncologist
3. - agree on treatment course
4. - get treated
5. - live (hopefully) long and disease free life.

I'm pretty sure the first four will happen. Will do everything I can to make 5 come true as well... Too many great things to do, too many great people to have in my life to call it quits anytime soon!