Monday, January 24, 2011

Fear of the Unknown


It all started in November right before Thanksgiving. I had gotten a cold. I was feeling under the weather. My lymph nodes in my neck were swollen. It all seemed so normal. Now, I have an unidentified mass in my neck. And it has gotten so huge. Let me back up a bit.

I went to my primary care physician on December 20th. Right before Christmas is not the time to get for real sick. He pushed me to get into get some blood work done. Check my thyroid levels... have an ultrasound of the mass done. I complied. I went in the next day to get the test done, but they didn't reveal anything. Blood work all came back Normal. The ultrasound confirmed that I wasn't being a freak... there was a 2.5cm, unidentified mass on the left side of my neck and an enlarged lymph node too. My Dr. wanted me to go in for a CT scan now... It was scheduled for December 29th.

I went to my parents for Christmas. I brooded over the CT Scan. Was it really necessary? My parents pushed me too. My father had just had a diagnosis of an infected sebaceous gland. It seemed like I was following the same diagnostic time line. Why wouldn't they just send me to the specialist for a biopsy and get it over with. I returned to my primary Dr. on December 27th and canceled my CT appointment. They called the specialist at Upstate. The office was closed for the whole week. More waiting ensued.

New Years, I indulged in home-made gnocchi, English toffee,a lot of wine and time with friends. I sort of forgot about my lump and the choking feeling it was giving me. I waited some more... January 3rd my primary's office called. I had to have a CT and an FNA (fine needle aspiration) done before my appointment with the specialist. They were scheduled at Upstate on January 5th. Once the results were in the specialist would schedule my appointment.

I was so nervous to get the FNA done. I envisioned it being horrific. For some people it would have been, but I found that it wasn't as bad as I thought it would be. I hoped for relief when the results would show it was nothing. Unfortunately, the results were "Normal." But, the pathologist didn't get much material out of my lump. He said it was very fibrous, hard and showed signs of scaring. They didn't see any obvious cancer cells. I was kind of relieved. But, the pathologist did warn that they may have to repeat the procedure with ultrasound guiding in order to get a representative sample of the mass. I didn't feel complete relief because of that statement. The CT scan with contrast was easy. Packed waiting room, warming sensation and horrible chemical taste aside, I was in and out without much of an issue.

More waiting... less information. January 19th finally came. My specialist appointment was at the same hospital. Busy doctors office and the wait was about an hour and thirty minutes before I saw the Dr. He was immediately endearing. A very good quality in a a doctor. Given the long wait, I knew he was very busy, but he didn't act that way. As soon as he popped into my exam room, he had a warm smile mixed with an easy but caring demeanor. He quickly got into a description of what we could be dealing with. He spoke in easy but clearly knowledgeable terms and didn't sugar coat any of the possibilities. Cancer was uttered more than once. I felt good about this approach. I like to be aware of what I could be dealing with good and bad. I think it is better to be pleasantly surprised than devastated by a horrible diagnosis that you hadn't even thought about yet.

My voice was scratchy that morning and had been quite a few mornings before. I explained this to Dr. Hsu. He was concerned that if this lump was a tumor that it may have grown into my voicebox. He left the office to get a scope so he could look at my vocal cords. I wasn't too nervous yet. He came back and mentioned something about it feeling like a noodle going down my throat... that was not the case. He inserted a small scope in my nose and down my throat. It was tight feeling and I could taste the lubricant. It was a mix of metal and antiseptic and it was awful. But, it was over quickly and he didn't see anything that concerned him.

Onto the next test. The results from my first FNA being "normal" didn't satisfy Dr. Hsu. He asked if we had time to wait for the pathologist to come down to perform a second FNA. We did. We went out to the cafe in the lobby of the hospital. Dave drank some coffee and we shared a muffin. We ended up waiting for about an hour for the Pathologist to get out of there meeting. They came down and performed the FNA again. It was the same Resident and student who had started my FNA the last time. She only did one pass and wasn't happy with her results. She told me she'd get the Attending down here quickly to perform the subsequent passes as she didn't want to put me through any unnecessary pain. A very confident, dark haired, medium skin toned women strode into my curtained exam space. She quickly got to work. Her passes were confident where the residents were tentative. She continued with three passes of her own and was confident with the material that she collected. I was spent and very sore. They assesed the material... inconclusive again.

Dr. Hsu came back after a bit. They had passed the inconclusive result onto him. He explained that initial results like these usually stuck. That the further processing, didn't normally make for a clearer result. He wanted to look at his calendar and schedule a more invasive biopsy. One that would require me to be put under general anesthesia. Once he got into my neck, he'd know more. So, he sent me on my way.

Up next time... surgery.