So fortunately for some most likely innocent souls at the Brigham, scheduling called to set me up with the biopsy yesterday morning. Yeah, I mean, I think the point of contention was starting to be that while I didn’t fully expect that the actual biopsy would happen within the week timeline the orthopedic doctor gave, I did think it would have been well and truly scheduled. And for some reason, the fact that that took so long to get done (and probably had little impact on the date itself) really is what irks me.
So anyway, next Wednesday, early, I get a good poke. It’s a quickie thing, and I was offered later times on Thursday if I wanted. Heh, no. What was even funnier was that the lady scheduling (who seemed like a nice enough broad) said, “I don’t blame you. That means you get to be the first appointment of the day, so they won’t be running late yet.” Yeah. My god, I know. At least they do as well. But like I said… emergency surgeries and procedures not going to plan and such are things that you have to be happy if they are only causing a delay for you as opposed to being performed on you.
Meanwhile, back at the ranch. Two family members with different malignancies are doing reasonably well. I think the lesson here is that diabetes (of the insulin types, not the more confusing, but less nasty to live with “diabetes in nothing but name” type I have) is an enormously shitty thing all on its own, but it makes other shitty problems take on a fresh, new shitty sheen. As Mr. Shoe said, it’s like the BASF advertisements. “Diabetes doesn’t cause the cancer, but it makes the cancer shittier!” At any rate, at least it’s familiar enough territory that doctors and nurses know to check and how to keep a handle on complications like that.
The other family member seems to be responding pretty damn well, from what I hear, to the massively crap leukemia chemo regimen and that’s a really good sign.
And Norman, our very elderly tibetan spaniel, is still kicking. At least, I can hear his stomach gurgling. If he had been a girl dog, we could have named him GERDtrude. Holy reflux, Batman.
Of course, the inevitable question I get is where from here… You know, once they poke my ass cheek. That depends on what they find there, of course. Let’s put it this way: overall, this is something, it’s pretty clear, that’s a nasty, evil, sonofabitch. It quite likely could shorten my lifespan, and of way more concern is the fact that it’s basically taken my quality of life and disemboweled it in the messiest way possible while still managing to appear innocent. As time passes, though, it’s obvious it is not so benign, and is progressive — though apparently it’s a low speed sort of progressive. There are things that cause greater generalized flu-like symptoms (like I have had), and many of the quirkier less flu like symptoms I have that they need to look at. These are things (like histiocytosis, other -cytosis bearing diagnoses, and various and sundry overlap/crossover/mashup immune dysfunctions with or without related malignancies) that keep bloodwork looking tame until these fires start popping up. And the fun part is that even though biopsies are pretty much the only ways to find this stuff, sometimes they don’t turn it up right away. Or consistently. Like I have mentioned, thymuses are awesome in that way — a thymic carcinoma is bad friggin’ news, but finding an overgrowth of cells (be it a thymoma or hyperplasia that isn’t chemotherapy induced) doesn’t rule out that there isn’t some cancer elsewhere. It definitely implies that there’s some immune screw up.
Good news is it seems we have zeroed in on a system. Sort of. Bad news is that we could be chasing this dragon for a long time before it’s clearly identified. Good news is many things are treated similarly, but with varying intensities. In as much as I don’t want to deal with the variable intensity management I might be looking at, I also am a little nervous they might just find not much and go solely with prednisone or a like steroid. Don’t misunderstand — I feel better on the stuff. I feel boatloads better. I know though, last time, I didn’t feel as better as I really should have. On the one hand, I could give two figs about the long term risks and I am aware we can minimize them, I want to feel better now, dammit. On the other hand, I know it doesn’t stop the process from happening. It might slow it a bit, and that might screw me over in the longer term. I also know I won’t feel better enough, though, that I won’t hit that tipping point fairly quickly where the side effects blur with the disease process and we wonder if it’s worth it. And I know feeling better tends to breed complacency on the part of the patient and the physician.
In a nutshell, I wish this wasn’t going to suck as much as it is probably going to… but if it has to suck, I think I’d prefer as many suck cards be on the table now so that any suck that comes later will be easier to identify and deal with. C’mon, is that too much to ask? (Feel free to bite your lips, folks).