A Tale of Two Scans
Medically it has been an eventful 7 days – I had not one but two different very important CT-scans: one in the ER, the other scheduled to check the success of my August lung surgery and current Erbitux treatments. If you remember my previous post about the end of the runathon, I mentioned that my lungs had been giving me some trouble. I wrote: “Purely from a health perspective, even though I didn’t want to, I knew that I had to take 2 brief walking breaks during the run to stop coughing & catch my breath… I’ve probably run a hundred 10k runs over the past couple of years – running one should be as easy as falling off a log for me. The 10k runs lately (and especially the final one) were not.”
To Breath or Not to Breath – That is the Question
I wrote that runathon post on a Saturday, later that day and on Sunday my lungs started to take a turn for the worse. By about 8 PM on Sunday my coughs were very painful and I had a lot of shortness of breath even while lying down. I knew something was wrong – and the accelerating “trend line” had me worried. What was really weighing on me was the fact that I had had a minor pneumothorax (collapsed lung) during my lung RFA surgery in late August. The shortness of breath, very painful cough in my surgery area and oh I forgot to mention… a bit of coughed up blood – had me “self-diagnosing” a re-collapsed lung… Thoughts were racing through my mind about running that last 10k, had I made a mistake distance running after my lung surgery? Both my surgeon and oncologist knew I had resumed running without showing concern but still… did I cause this? The guilt was weighing on me as much as the physical symptoms.
The symptoms had become bad enough that I decided I needed to go into the ER. The trend line and oh I don’t know, having trouble breathing made up my mind pretty clearly. A complicating factor was that Veronica had a medical procedure scheduled for early the next morning. We have two small kids. It was 8 PM on a Sunday night. Talk about juggling a lot of things!
One thing we have worked hard to do is shelter the kids from having their childhood impacted from my disease, as much as possible. Amelie knows I am being treated for cancer (Eleni is still cluelessly young) but we try hard to minimize impacts on their day to day lives. They only have one childhood. Along these lines, I intentionally put the girls to bed like I always do & immediately afterwards I called a cab for the hospital. I figured I would get checked out by the ER. If it was a false alarm I could be back home in time for Veronica to have her procedure without the girls even knowing I was gone. If it was something more serious, we would cross that bridge when we got to it – thankfully we had a close friend on call to help if needed.
I found out a new trick for cabbies. Tell them you are a cancer patient needing to go to the ER and they drive really really fast. Like 85-90 mph fast. The driver was actually an awesome guy. He gave me his personal cell phone number to call for a ride home. During the entire ride, my mind was a blur. First of all, I have been very lucky. Most cancer patients need to do the occasional ER trip – either for a disease complication or for a chemo complication. I was diagnosed almost 3 ½ years ago – this was my very first ER experience. After 3 ½ years, I still don’t have any symptoms of the actual disease – that Sunday night & the wild cab ride were the first times it really felt like I was sick.
Paging Doctor Google
Based upon some Google searches and watching the TV show “ER” in the 1990’s, I imagined going into the ER, telling them that I had a collapsed lung a few weeks prior and was now coughing up blood & having trouble breathing – and they would rush me STAT into a bed and thrust a chest tube into me to re-inflate my lung & save my life. Nope that didn’t happen. They told me to take a seat in the waiting room. They warned me that it could be a 3 hour wait. So much for my mental self-triage. Have I ever mentioned I’m a scientist & not a MD? Ha
Putting Things into Perspective
The closest ER to our house is in the center city so I was expecting an interesting ER experience. It was that and more. Sadly the waiting room was mostly homeless people, some of them with obvious mental illness. I took a seat, preparing myself for a couple hour wait. My wait ended up being >4 hours. Some of the most interesting 4+ hours of my life. The homeless patients around me were very chatty. I realized that the majority of them simply wanted someone to listen to them. I did. I had hours to kill anyways w/o a book and I like making people feel better. I ended up talking to about 5 homeless people that night. Some of the details I heard seemed unlikely true (e.g. one woman near to me was obviously mentally ill albeit very friendly) but much of what I heard I believe was true. They had different backgrounds and reasons for their homelessness – and different reasons for being in the ER. But all five simply wanted to be listened to.
A very easy way to stop feeling sorry for yourself & realize how good you have it is to get outside of a societal protective bubble for a while. I didn’t tell anyone in the waiting room why I was there or what my background was, I mostly just listened. One homeless woman with a wounded leg (she said she was a lifelong San Diego resident) told me how she was very lonely & completely alone in the world. I listened to this as I was in constant contact literally all night long via texting with one of my Colon Camp Sisters. A man from Boulder, Colorado (he had moved to San Diego to start a business, it fell through & he lost everything) said he was there due to very painful untreated pancreatic cancer & he probably had months to live. I listened to this as I sat there with slow growing no-symptom colon cancer & being treated by the absolute best cancer medical team I could hope for. Another man (from Beaumont, Texas) had arrived in San Diego by jumping box cars. He said he had only one functioning lung due to serious damage caused by being jumped by a knife attacker a few years ago. Suddenly my shortness of breath & cough, in a relative sense, seemed like not the worst problem in the world. Was every detail they told me absolutely true? I have no way of knowing. The fact that I found details in their stories very plausible as we talked made absolute accuracy non-important and that alone made it very clear to me how lucky I am in many ways.
After 4+ hours, I was called back into the treatment area. The waiting room was mostly empty by that point (once again my non-MD “self-triage” imagination had been wildly inaccurate!). I was very thankful for the constant contact with my friend via text to further help keep my mind occupied from worry! They took a physical. Yes, my right lung sounded bad in the stethoscope. I got a chest x-ray. Something looked funny – but it was inconclusive. Even though I was scheduled for a cancer checkup PET-CT scan a mere 2 days later, they then gave me a chest CT scan. The results? No collapsed lung! (My non-MD self-diagnosis was even worse than my non-MD self-triage!). All they could tell conclusively was that I was not experiencing any surgical complications. No chest tube – woo-hoo! It was not 100% clear what was causing my obvious & significant clinical symptoms but in the absence of clear proof, they decided it was most likely pneumonia and began me on antibiotics. I never imagined being so glad to get a pneumonia diagnosis!
I began to feel a bit better almost immediately. All in all it was 9 hour visit to the ER. I left the house at 9:00 PM right after the girls went to sleep. I arrived back at home at 6:10 AM about 10 minutes before Eleni woke up. The girls never had any idea I was gone or the adventures I had been on that night. Good. And Veronica even made it out the door at 7:15 for her procedure. Amazingly, all the juggling we had been doing had not dropped a thing! But, a little too close for comfort… 7 days of antibiotics have made my lungs feel great again. One thing I learned though, is that it is really tough to run 10k’s if you have pneumonia!
That CT-scan at about 4 AM on Monday morning was my first scan for the week. But the title to the post is “A Tale of Two Scans”. My second scan was 2 days later on Wednesday morning – a full pelvis to neck PET-CT scan to see how my cancer was responding to surgery and the Erbitux treatment I have been on since March.
The good news? My lung RFA surgery in August was a success! The two tumors they ablated were successfully fried to a crisp! Take that cancer!
The not so good news? It now looks confirmed that my current Erbitux anti-EGFR therapy is running out of steam. It was known that this would happen eventually – evolution and natural selection are the bane of targetted therapies such as Erbitux…
The Plan? I’ll be meeting with my oncologist next week to start to decide. A return to the relatively harsh chemo I had in 2012 is a possibility – but I will be looking into some other possibilities as well… Thankfully my cancer continues to be very slow growing!
Let’s see what the Mad Scientist and his team can come up with, ideas are already cooking, we just have to decide how tasty they are 😉 – stay tuned…………………..