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Tuesday, December 22, 2009

The case of the soft-tissue mass

When last we met, I was going to see thoracic surgeon Dr. Joseph Boyer, who might have to remove the growing growth attached to the esophagus he created from the excesses of my stomach.

Dr. Boyer said the PET scan's all-clear might be inconclusive because the CT scan showed this growth had pretty much quadrupled in size since the summer. He felt a biopsy was needed, and suggested Dr. William Mayoral, a partner of Dr. Philip Styne. Well, he said he could do it but the procedure "would hurt more" if he had to surgically obtain the biopsy. Further, Dr. Boyer said if Dr. Mayoral pulled the biopsy, he might be able to suction the entire soft-tissue growth from my body if it was comprised of fluid.

So, the docs got together and scheduled me for the biopsy on Friday -- Dr. Mayoral was going to grab the sample via an endoscopy with ultrasound to locate the growth outside the esophagus, then use a needle or some other small surgical device to obtain the sample.

He did this procedure and it went well. As I was waiting for the car to be pulled around at Orlando Regional Medical Center, Dr. Mayoral phoned me to say it appeared the tissue was not malignant.

Whew! This confirmed the PET scan's findings: I apparently don't have more cancer growing inside me.

So Monday, I saw Dr. Lee Zehngebot, the oncologist who along with a slew of other docs and medical professionals saved my life through chemistry. Dr. Z spoke to Dr. Mayoral, who confirmed that the tissue was negative for cancer. But he was concerned: "I don't know what it is," Dr. Z said. And that concerns him.

So his office is setting up another CT scan for two weeks from now to take another look at the growth to see if it has grown further since my last scan Dec. 7. After that, it's likely he'll want Dr. Boyer to remove the soft-tissue mass.

I asked Dr. Z what the worst-case scenario is. He said I could have cancer. But the pathology tested negative, I reminded him. He agreed, yet was concerned because it was such a mystery.

(I always like a good mystery, but somehow this one I'm not enjoying so much.)

So there will be more tests and scans -- possibly surgery -- and I presume isotopes flowing through my veins as the docs solve "The Case of the Soft-Tissue Mass," coming soon to a blog post near you.

Sunday, December 13, 2009

Revisiting with Dr. Boyer

Since receiving the all-clear-sort-of from Dr. Lee Zehngebot last week, I made an appointment with Dr. Joseph Boyer, the surgeon who turned my cancerous esophagus and stomach into a stomach that acts like an esophagus.

I'll be at his new office across Orange Avenue from the main Florida Hospital Orlando building Wednesday morning. By then he and Dr. Z will have discussed the scans I've had last week and in August and maybe come up with a gameplan.

That's my hope, at least.

Meantime, I saw my new cardiologist, Dr. R. Charles Curry, who reiterated that whatever is causing my faux heart attacks, it's not the heart, it's not arteries feeding the hear and it likely is, as Dr. James Miner and Dr. Philip Styne explained, spasms of the arteries feeding the stomach and esophagus.

Still, no one is taking into account the cyst or whatever it is in my chest cavity and what role it may have in the attacks. Hopefully after Dr. Boyer works his magic, the attacks will go away.

Tuesday, December 8, 2009

A negative that is totally positive

How many times in your life has a doctor called you at 8:15 at night? Not too often, right.

So it's a testament to Dr. Lee Zehngebot, the Orlando oncologist who helped save my life, that he called a short time ago to give me the abbreviated version of the results of my PET and CT scans taken Monday.

In short, he's "100 percent" confident that I have no cancer in me. The PET scan, which detects probable areas of the body in which cancer cells are growing, was negative.


He said that the weird cyst-like confab in my chest, though, has grown since the last set of scans in August. While he's confident it's not a cancerous tumor growing, he's not sure exactly what it is.

Most likely, he said, it's "some kind of collection of fluid."

So Dr. Z said I should call surgeon Dr. Joseph Boyer in the morning to set up an appointment for next week. Dr. Boyer is the head of thoracic surgery at Florida Hospital, and the guy who cut and filleted my stomach and esophagus into a working organ from a cancerous one.

I imagine the next few weeks or months might involve a biopsy or two and possibly a surgery. But at least the doctors won't be treating a cancerous tumor.

And that's the best news this holiday season.

Monday, December 7, 2009

A day of testing

I'll be at the nuclear imaging building across Orange Avenue from Florida Hospital Orlando at 11:30 this morning for a PET scan, then a few hours later in the main campus for a CT scan.

This double-whammy dose of radiation hopefully will allow my doctors to complete a diagnosis begun in August and left undetermined until now.

Back then, a PET scan saw something.

What it was couldn't be determined. So they docs scheduled a PET scan.

The PET scan didn't quite notice the small mass in my abdomen that the CT did, but it found something very small in my lungs.

What it was couldn't be determined. So my docs did what all good docs do: They consulted other docs, and still others.

In the end, Dr. Lee Zehngebot, an extraordinary oncologist, consulted with Dr. Philip Styne, an extraordinary gastroenterologist. They both checked in with other internists, gastro docs, radiologists and the like.

The conclusion? Wait three months. As it turns, it's four, but who's counting?

This will give whatever is in me to either change or not change. The docs felt this was safer than "going in" and performing biopsies on the various spots they detected. The initial thingie in my abdomen is likely a cyst. Probably not dangerous, they thought but didn't know. I think it's the thing in my lung that drew the most concern.

So in less than a dozen hours I'll have radioactive glucose injected in me from something that looks as if it came out of a sci-fi movie and then will spend about an hour or two relaxing so my body can absorb said glucose. Then the scanning doohickey will determine which parts of my body, if any, absorb the glucose quicker than expected. If something does, it's possible that is a cancerous area, since cancer cells and very few others absorb glucose rapidly.

After all that's over, I will go across the street and drink an iodine-laced cocktail for the CT scan, which isn't nearly has complex.

By the end of the day, I'll be warned to stay away from pregnant women and small children for a day as a precaution. However, my eyes will be able to light up a dark road and my hands will glow in the dark. As for other exterior organs, well, we'll just have to keep that private.

A few days later, hopefully I'll get the all clear from Dr. Z. I don't want to get news about these tests in two weeks when I see him.