Tag Archives: biopsy

Awards time

I started reading some of my old posts tonight. Remember when cancer was fun? When I’d make fun of my doctors and talk about Miley Cyrus and come up with word games? Then shit got serious. Then I was really tired all the time. Then I had radiation and the hair on my chest fell out in the shape of a heart. Then I got tired of being tired and just wanted to be better. Then I was better. Then I got cancer again. And, I guess, now its time to be funny again. Such is the circle of life.

A lot of people have done a lot of great things for Jen and I these past couple of weeks. I thought it was a good time to give out a couple of awards:

Best Hands – To Dr. Jay Lee. For using VATS (Video-assisted Thoracoscopic Surgery) to remove the tissue for my biopsy and not cutting me open like a watermelon on the 4th of July. He also removed the fluid from around my heart and, I think, gave me a creamy, nougat center. Here’s to you, Dr. Lee, for being a Super Doctor. (Seriously, he won the Super Doctor award for 2009-2010. You can’t make up that kind of stuff.)

Best Food – To Cooper Spellman. For unexpectedly delivering us a giant pan of lasagna one night. Sure, Cooper is only 5 months old and his mom and dad, John and Michelle, claim that they made it. Then how do you explain the sauce on Cooper’s hands? Or was that really sauce…?

Best Catheter Removal – To Sylvia the nurse. Smooth like butter. If only her IV poke was as smooth and she didn’t dig into my arm with a needle like a gold prospector.

Best Combination Pulmonary Function Test While Talking About Fantasy Football – The really cool Korean guy who gave me the test while talking to me about fantasy football. No, sir. A team should not get double points if a player returns a kickoff for a touchdown. However, it does count towards his individual stats as well as special teams points. A debate that will rage for all time. And thanks for the help breathing into a tube.

Best News of the Week – To Dr. Jay Lee. For telling me that I’m cleared to fly. A week in Italy will do me a lot of good. Grazie.

MVP – This week the MVP award goes to my Dad. For making me feel a hell of a lot better after delivering him some really bad news. Thanks.

Unfortunately, with the good comes the bad (see my next post). And so, some awards for sucking:

Worst Bedside Manner – To the surgical intern, who I won’t name. He was creepy, ill-informed and told me they would be cutting into my back when really they were cutting into my side. Thanks for spazzing me out.

Worst Chest Tube Removal – Also, to the surgical intern, who I still won’t name. Who’s bright idea was it to take out my epidural BEFORE removing my chest tube? And when I tell you that I can’t turn over because it hurts really badly…or that I can’t breathe on my side…don’t tell me what a good job I’m doing. Get my nurse and give me a f*cking pillow and shut the hell up.

For all award recipients, please send me a check for $25 to cover printing, shipping and handling costs. A frame costs $40. And if you want me to send you an autographed photo, please send me cool hundy.

Thank all of you for participating. There will be plenty of time to win an award in the months to come. Trust me.

This just in – hospital food hasn’t changed in the past year

Hello all. Quick update.

The surgery went pretty well on Wednesday. The doctor was able to go into my side with cameras and remove two good samples – one from near my lung and one from near my heart. The pathologist said that these samples contained enough tissue for them to perform a few tests on. At that point, my surgeon decided not to pursue the much more invasive thoracic surgery and he stopped at getting the two samples. There is still a lot of scar tissue, infection and ‘unusual’ tissue in the samples – we just have to wait and see.

I’ve got an epidural to help with the pain. The surgeon was able to drain the fluid around my heart and I’ve had a chest tube for the past couple of days. Uncomfortable but I can deal.

Most of my pain actually comes from my right shoulder and upper back from my arm being strapped down over my head for the 3 hour procedure. The epidural doesn’t do anything for this pain so the nurses give me the occasional dose of Diloted. They are all about pain management while I’m in the hospital. Most of the time it makes me sleepy and I nod off pretty regularly.

I slept better last night and my strength is slowly coming back. I don’t have a good idea of how long my recovery will take – I’ve got a pretty good sized incision in my right side and a lot of soreness so I think I’ll be out of action for a few weeks.

And then, we have to get the biopsy results – which won’t be until next week. I still don’t have any clear idea if it is an infection or Hodgkin’s or something else. One step at a time.

I should get out of the hospital tomorrow. In the meantime, it is time for World Cup and Gatorade and slow walks around the hallway.

Will see you soon.

Choose my own adventure

Page 412:

You enter the hospital. Your wife is by your side. You are wearing a comfortable grey shirt and dark grey track pants with a red stripe down the side. You go to the 3rd floor and check-in at the desk. You are escorted to a room filled with hospital beds and equipment. Curtains separate each of the beds. You change into a hospital gown with booties on your feet and a cap for your hair. It is chilly but the nurse gives you a warm blanket to put over you. With just a small prick, the nurse puts an IV in your arm. Your anxiety builds as you wait for another 30 minutes. Your wife keeps you preoccupied with jokes. Eventually, a nurse comes in to wheel you to surgery. You kiss your wife goodbye and breathe deep.

The surgical room is brightly lit and there are monitors mounted to the ceiling. The nurses help you hop from the bed onto the surgical table. It gets even colder in the room. The nurse folds down your gown and props a blue sheet over your head, obscuring your view. Someone rubs cold alcohol onto your chest. The surgeon comes in and says hello as he begins preparing for your procedure.

The ceiling begins to spin. You begin slurring your words as you tell the surgeon to take his time and get it right. Slowly everything fades to black…

You have 3 options:

1. The surgeon puts a scope into your chest and is able to take sample tissue with minimal surgery. You leave the hospital that night under your own power with only a small cut at the base of your throat.

2. The surgeon makes 3 small incisions on your side and is able to get a tissue sample by triangulating into the affected area. You leave the hospital that night under your own power with some soreness in your side.

3. The surgeon makes a 6 inch incision in your side, cuts through a rib, reduces blood flow through some of your collateral veins and is able to get multiple tissue samples. You spend 5-6 days in the hospital recovering from the surgery. Brazil wins the World Cup and you miss 4th of July.

These are my options. Wednesday I am getting a surgical biopsy to see what the PET activity is in my chest. The surgeon has to work around my 11cm lump of scar tissue in order to get tissue samples.

Jen is going to have a lot on her plate the day of the surgery. We will post an update here as soon as we can to let all of you know how it goes. I’m sure I’ll be fine, it is just a question of how much recovery time I will need. Then we wait for the biopsy results.

Although all of your love and support is greatly appreciated – we would also appreciate your patience. Please don’t call or text unless it is necessary. Sometimes it all gets a bit overwhelming. We will reach out when we can.

Talk to you soon.

This update is in poor taste – you are warned.

Quick update: I’m having another biopsy in the next week. Might be as soon as Friday. More likely it will be next week.

The surgeon is going to try less invasive techniques to get a tissue sample – starting with a scope in my chest.

If that doesn’t work, he will proceed to more invasive techniques. I’m not going to have my chest cracked open, but they might have to go around a rib or two. At best, I walk out the same day. At worst, 5 or so days in the hospital.

All this to get a clean sample to find out what the PET activity is in my chest. This would be a straightforward procedure if it wasn’t for the 11cm lump of scar tissue left over from my Hodgkin’s chemo and radiation treatment.

I’m trying to stay calm. I’m juggling a lot of communication with friends and family.

Personally, I figure the real worrying will come if I have to go back into cancer treatment.

This could be lymphoma.

Or maybe this is just an infection.

Or maybe I shouldn’t have taken that mining job on LV-426 (damn you Burke!).

You look how I feel.

I’ll be in touch.

Round 2…?

Ding!

Word has been getting around that I’m heading back for another round of tests. I figured it would be a good time for an update.

Firstly, I haven’t posted here in a few months because…well…I thought this was a chapter in my life that was behind me. Especially after I laid my good friend to rest in February, I wanted to concentrate on moving forward. I wasn’t trying to forget my experiences or the memory of my dear friend…but I wanted to apply some of the life lessons I learned over the past year instead of dwelling on the past.

After I returned to work in March, it was easier to try to file away my experience fighting Hodgkin’s Disease and get my life back on track. However, it seems that Mr. Hodgkin’s – or some relation of his – isn’t done with me yet.

Around October 2009, after 4 rounds of chemo, I had a PET scan that showed I was in remission. And there was much rejoicing. In December, a follow up scan showed a small amount of PET activity. This was shortly after I finished my radiation treatment and the doctors assured me that having vague PET activity was not unusual and we would check again in another 3 months. Scans in March showed a slight uptick in PET activity. I was told that this PET activity was located pretty deep in my chest and it wouldn’t be easy to get a biopsy of the area to see what was going on in there. I was comfortable to continue a ‘wait-and-see’ approach.

The beginning of May I got hit hard by some kind of virus. It was very similar to how I felt in October of 2008 when I first started having my Hodgkin’s symptoms. A lot of people were sick around this time and I got some antibiotics which seemed to clear things up. However, I was left with a nagging cough that persisted for weeks. I was also feeling some headaches and dizziness that was similar to my SVC symptoms. Long story short, I had an angio CT and a PET scan in the beginning of June.

The CT scan showed that there was narrowing of my vena cava where it entered the right atrium of my heart. This is occurring in an area between my stent and my heart (my stent is working just fine). The PET scan showed increased activity in this same area.

To help you visualize what is going on inside me, here is helpful diagram of the heart. The PET activity and narrowing of my veins is occurring at about the exact place where the diagram identifies the superior vena cava (from upper body).

A helpful diagram of the heart.

This is a very sensitive area to get a biopsy because my PET activity is located near my heart, bronchial tubes and important blood vessels. On June 15, they tried a needle biopsy which was less invasive – but the tissue samples only showed scar tissue and were not usable.

This coming week I have an open biopsy planned to be performed by a thoracic surgeon. They will put me under general anesthesia and go into my chest to make sure they get a few useful samples. This is a more exact method of getting the tissue samples but it is also more involved and complicated than the needle biopsy – which is why the doctors tried to avoid performing a surgical biopsy. However, with the added complexity of the surgery also comes the reassurance that – if anything were to happen, such as bleeding or a collapsed lung – the surgical team could take care of things more efficiently. I will also spend anywhere from 24 – 48 hours in the hospital after the surgery for observation.

My thoracic surgeon showing his excitement upon extraction of useful tissue.

You may be asking yourself – what could be going on in Steve’s chest? Why didn’t the chemo and radiation take care of everything? Upon waking up from the surgery, what will Steve want to eat?

Considering the size of my tumor (16cm to start, now currently 11cm of scar tissue), it is not surprising that some of the little bastard cancer cells avoided the treatment and may have ‘transformed’ into a different kind of lymphoma. Or there might be some other kind of tissue growing near the tumor. Or it might be something completely different. The doctors aren’t taking guesses as to what it could be – that’s what the biopsy is for. All we know is that there is active PET activity in my chest, something is restricting the veins into my heart and we have to figure out what it is and how to treat it.

Also – I want a turkey sandwich and soup.

I’ll do my best to keep you updated on my diagnosis.

I’ve got great doctors and an amazing wife. I’ve also got a fresh outlook on life which has prepared me to take things in stride.

Talk to you soon.

So long sweet marrow

To-marrow

Not too bad with a little morphine, some Adavan and Dr. Hart’s soft hands rubbing the back of my hips. Oooh Dr. Hart. Like a poor man’s Noah Wylie from ER.

Actually, it felt like I hit a log on my ass at full speed while snowboarding. For about 5 minutes.

But I got a 10/10 for Aspiration. Nice.

Off to the lab with you! Tomorrow, Pet Scan at 9am. Then we will know the extent of the damage. Chemo might start as soon as Tuesday afternoon.

Oh, and the doctor said I am clear of lower back fat demons. So that’s a relief.