Diagnosis

Initial Diagnosis - 5/13

My first visit with Dr.  Bentley was on the afternoon of 5/13.  His office drew blood, and took some chest X-Rays.  The doctor then asked me a lot of questions about my symptoms, what made it worse, etc.  and said that based on the results of the X-Ray, he wanted to have some more tests run.  The mass in my chest was quite large (14 x 9 cm) and pressing on my lungs and heart, making it difficult to breathe.

I was scheduled for a biopsy of some of the lymph tissue in my next the next day at 9am.  I arrived at the hospital, feeling somewhat nervous, but reassured by the fact that this would be a routine outpatient procedure, and that I would walk out of the hospital to go have my CT scan later that day.  After being made to take a hospital shower (that little washcloth is also sold as sandpaper at home depot) and change into the famous hospital gown with a plethora of ties designed to cover nothing at all, I proceeded to wait for two hours to be taken to surgery.

Once I got down to the surgical ward (where I used to work as an orderly one summer when I was in college, lots of familiar faces) I met the OR nurse, the nurse anesthetist, the physician's assistant, the surgeon himself, and what seemed like several other people who would all be involved in the biopsy surgery.  They had me draw an 'X' on the spot where the the lymph node would be removed, so every time someone approached and said 'what are we doing today?' I just pointed at the big blue spot on my neck.  The last thing I remember was being taken into the OR, and moving over to the operating table.  One small injection later and lights out...

In The ICU

I woke up about 5 hours later surrounded by my parents and what seemed like a hundred nurses and doctors.  Apparently there were complications when I was coming out from my anesthesia, and I had to be put onto a ventilator.  I was in the ICU (in restraints!) which was quite a shock given my earlier expectations of strolling out of my own accord.  I finally got my breathing back to normal once I was able to sit up (thanks Dad for reading my scrawled notes!) and they took me off of the ventilator.  I was on Morphine and a cocktail of other drugs that were making me loopy and disoriented.  I was very gabby and kept repeating myself incessantly, according to my family.

It was quite unsettling being in the ICU, good to be a little doped-up still.  They removed my IV and my catheter at some point (that is a visual I will not soon forget), so I was able to rest comfortably until morning, although sleep was not really an option.  I had breathing treatments every four hours through the night (felt like I was smoking a big peace pipe filled with dry ice) which made my heart race, and had my blood pressure cuff inflating to incredible proportions every hour on the hour.  So as you might imagine, sleep was not really an option.  I watched a very interesting documentary about Charles Darwin and the struggles he faced trying to convince his peers of the merits of evolution.  It was either that or watch the public access channel in the hospital, which was infinitely worse.

The day started early on 5/15, with a switch back to the day nurse, Kristina, and a return of my parents and girlfriend, who had been called down from Kansas City during the ICU drama.  Probably the worst day to that point, when I met my oncologist and he gave me the suspected diagnosis (Nodular Sclerosing Hodgkin's).  I learned that I would have a bone marrow sample taken and shortly thereafter two men came up to do the dirty work.

There are two small bones below the small of your back, and this is where they draw the bone marrow.  I had to roll to either side, and get a topical anesthetic before the real fun began.  There was a needle (I can't say how big as I never saw it, but it must have been quite intimidating judging by the look of horror on the face of my nurse) designed to break through the bone surface, and it must have been fairly sturdy.  I could hear the tech struggling with it, and could feel the bed shaking as he tried to break through the bone.  A moment later, he was actually drawing out marrow, and that was the most painful moment of the whole ordeal.  He showed me the two little core samples floating in glowing yellow liquid.  Very impressive.

Next was a big barium milkshake that was not too bad, given that I had not eaten but one meal in the past 36 hours, required for my CT scan.  When I got to the scanner I also had to eat some nasty pudding (still not sure what purpose that served), but the procedure was quick and painless.  When I got out the nurse asked me if I had to pee, she said my bladder looked 'huge' on the scan.  I was just testing to see if that thing really worked...

One More Test

Walking out of the ICU was one of the greatest feelings I can remember for a while.  I had all day Thursday to rest, then a visit to my new oncologist (can't ever remember wanting one of those) on Friday.  It was a pretty short visit, he confirmed what we had suspected, that I had Nodular Sclerosing Hodgkin's.  He wanted to conduct a PET scan on the following Monday, and then begin my chemo on Tuesday.  It was quite a whirlwind, considering that I had only been to the doctor a week prior.

The PET (Positron Emission Tomography - say that three times fast) scan was a very interesting (and long) test.  It uses radioactive glucose to identify where the tumors are located, and is helpful for determining how effective treatments have been before and after.  I was injected with a syringe of radioactive sugar basically, then fed into a scanning machine.  Laying still for an hour was the hardest part, but I was able to doze off several times.

The only thing that made me nervous was the way the tech who administered the glucose handled it.  It was wheeled into the room in a heavy steel box on a dolly.  When he took it out of the box, he used tongs, then handled the syringe only behind a lead shield.  It was placed inside a heavy steel casing, then injected into my (*gulp*) unprotected arm.