Follow by Email

Monday, August 31, 2009

Tick. Tick. Tick. Tick. Tick. Tick. Tick. TIck. Tick.

I heard more from Dr. Lee Zehngebot the other day, who explained more about what he and, apparently, several other doctors have not found.

Dr. Z said they haven't figured quite what is going on with my body, and all agree the best course of action for now is to wait. For three months. Then scan my body again.

"Nobody thinks we should do anything now," Dr. Z told me.

He was referring to himself; my gastroenterologist, Dr. Philip Styne; two initial radiologists; an interventional radiologist; and Dr. Styne's partner at the Center for Digestive Health in Orlando, Dr. William Mayoral.

They'd all gone over my CT scan and PET scan from earlier in August and come to the same conclusion: There's something in there and they're not quite sure what it is.

"Nothing we could do would help right now," Dr. Z told me, and, in fact, doing some things "could make the site worse."

So for now there'll be no endoscopic ultrasound, as Dr. Z had initially proposed, and the CT and PET scans will have to be sometime in mid- to late-November.

There might be an up-side to all this: for now ignorance is bliss -- if there is bad news I don't have to deal with it right now.

Friday, August 21, 2009

So here's the deal

I had a good conversation with Dr. Lee Zehngebot on Thursday evening, who explained what they know -- and don't know -- about what's going on in my body.

Dr. Z said he consulted with a radiologist and they both agreed that I'm just going to have to be confused and frustrated for about three months.

That's because it's safer for me to wait that time and have a new series of CT and PET scans that it'd be for doctors to punch holes in my body to extract biopsies from where they'd need to extract them. A CT scan last week showed a 2cm by 3cm thingie in my chest, not far from the body cavity where the esophagus, the pulmonary artery and other important organs are located. A PET scan this week lit up a tiny spot in my carina in the bronchial airways that may or may not be something to worry about.

But pulling a biopsy from either site has risks and Dr. Z said the safer course is to wait. And wait. And wait.

"I know I'm scaring the crap out of you. But I'm in the scaring-the-crap-out-0f-you business," he told me.

One upside, though, is he wants me to have yet another endoscopic exam, but this time using E.U.S., which is endoscopic ultrasound. Basically, they'd be looking at these growths from the inside-out and that might help the docs determine the density of these masses or what they are.

My gastro-doc extraordinaire, Dr. Phillip Styne, doesn't do these procedures, but one of his partners does, and I'll be calling Dr. Styne on Monday to set things up.

So for now, to quote the Three Stooges, it's time to "hurry up, and go to sleep," or in my case, I guess, hurry up, and slow down.

Wednesday, August 19, 2009

And the results ... really aren't in

I really hate waiting -- especially for something as important as test results.

What's even worse is waiting after you receive test results. But that's what I have to do. The question now is how long of a wait?

Here's why:

Dr. Lee Zehngebot, the most excellent oncologist and iPhone user I can think of, said this evening after I waded through 35 minutes of phone-hold hell that my PET scan Tuesday found a "very small" anomaly in my chest. So small that doctors don't quite know what to make of it.

Dr. Z said he'd probably just have me wait three months and do another series of CT and PET scans. But he's consulting with other docs to see whether a biopsy would be worthwhile. I'll find out that answer on Monday.

The small mass may or may not be the 2 cm by 3 cm blob a CT scan picked up last week. I'm going to call Dr. Z on Thursday with a few questions I've come up with.

The mass picked up by the PET scan is located in the carina, which is the bronchial windpipe where the bronchi split into the two lobes of the lungs at the base of the trachea. (See diagram, courtesy of Wikipedia.)

"We don't know what it is," Dr. Z said.

Thus, my results that really aren't results.
So the waiting continues. Ugh!

Waiting ...

Monday, August 17, 2009

I hate when that happens

So I saw Dr. Lee Zehngebot today, a week after my most recent CT scan.

After small talk about our toys -- his new iPhone and me about my G1 Google phone -- we discussed results of the scan and other medical issues (imagine that!).

They were not as I had expected. In the past, it's been S.O.P. for me to go in and hear that everything was fine with the scans.

This time, however, the results aren't clean. "I don't know what it is," Dr. Z explained.

That's because the radiologist who went over the scan and reported to Dr. Z wasn't quite sure, either.

It appears there's a 3 cm by 2 cm nodule of either fluid or something else near my stomach/esophagus that puzzled Dr. Matthew Hesh, D.O.

"It is difficult to determine if this represents a recurrent neoplasm lesion, adenopathy, or loculated fluid." Yeah, I don't understand most of that either.

But this I do understand: "I would suggest a PET scan for further evaluation."

So that's what Dr. Z has done. Stat.

Tuesday at 1 I have to be at the advanced nuclear medicine lab across Orange Avenue from the main Florida Hospital campus for what will be my third PET scan.

I have a few instructions to follow before the scan. Starting about midnight today I can't have sugar, caffeine and such stimulants. No exercise or anything strenuous, either. After about 7 a.m. Tuesday, I can't consume anything but meds and water.

Then when I get to the lab for the test, a nurse will hook me up to an IV (always fun) and inject me with radioactive glucose. This stuff is stored in something right out of Star Wars or Star Trek -- a metal canister that is turned until the radioactive liquid in a glass vial is released. It's injected via the IV and then I relax in a closed room for about an hour, listening to bad music, and then basically travel through a tunnel like an MRI. This machine, though, scans for concentrations of the injected glucose sugar. Cancer cells absorb the glucose faster than other types of cells, so the theory is they'd have gobbled the sugar up in enough quantities for the scanner to pick it up.

Hopefully, this nodule near the upper right lung area is nothing and the test will confirm that.

I'll keep you posted.