All right, so I’ll have more than half an ass when this is all said and done… I ended up seeing the orthopedic oncologist (who is doing the surgery, I knew he did more than fill out papers! I knew it!) on Wednesday and he was perhaps dancing a little less around the issue of removing my (ahem) atypical lymphoid cell aggregate thingee (thingee is a technical term). Maybe it’s because he wasn’t so direct that he wanted the repeated needle biopsy last time around, and I didn’t immediately choose that option? I dunno. But it was kind of funny, because while the oncologist said he didn’t grok the idea of waiting four months to rescan, and the orthopedic onc was more along the lines of not wanting to wait even a month, I had to kind of lay it out this way: So if we did another needle biopsy, and it showed similar results that we couldn’t clinch this diagnosis — or even if we could and it’s what you think it is (but won’t spell out the finer details I’d want to know right now if you admitted it outright because… that’s what’s missing) — it’s going to have to come out anyway, huh?
The cool part of having the best friggin’ GP in the entire world, hands down, and the cooler part of knowing her so well and her knowing me so well, is that I get to hear what the specialists really think. Now, usually, that sucks serious amounts of donkey parts. Usually specialists think stuff like, “Patient seems to be ill, but it has nothing at all to do with my speciality.” Sometimes they do actually think real stuff. My sleep specialists do, for instance. It’s just I never had my sweet GP call before she heads off for the holiday about a note my sleep specialist sent.
First, she admitted she cried happy tears. And she used the word “bum.” And I thought: Is that what having kids does to you? This is the sweet doctor who has dropped an f-bomb or two and caught herself before she spit out a few more during the course of a physical? Is this the woman who respectfully (and I mean that, it was said in that reverential way) called my first sleep doctor a hardass?
After using the word bum, she then pretty much said what it was sure looking like from where we stood: they are reasonably sure there’s a low-grade lymphoma (of which there are many types) to be positively typed and subtyped, requiring the bum work to (as I saw on the pre-op notes yesterday) make the full diagnosis. Because as the orthopedic doctor said, “You can’t just treat any lymphoma on a hunch.”
She said, “I am happy for you. I mean, that’s a weird thing to say…”
No it isn’t. It could be a lot worse — say, if they’d seen a different presentation or look to the abnormality or if things had been extremely normal. And truthfully, even if it’s a particularly menacing bunch of stupid looking lymphoid cells and the malignant nature is questioned, it probably is getting handled similarly. And managing this stuff isn’t bad. It isn’t — it’s long term, but it can be long term because it is responsive, even if there’s the tendency to be very persistent and recurrent.
But as was mentioned (repeatedly) it would appear from the location and history and what they did see that it is a slow, chronic type, and there are boatloads of those and on the one hand they are kind of all handled alike, on the other hand, they aren’t, and since it is likely going to be a long haul and being overly aggressive shows little overall benefit by and large, it’s a long haul and under managing might not pay off either. And certain ones respond somewhat differently or better to some types of biologics — straight up chemo might not be necessary now or ever, depending. But there’s that depending.
So I’m losing the extra inch of atypical lymphoid weight. Next week. They were going to go this Monday, but alas, my doctor who does more than paperwork was booked. I will be on crutches for about two weeks. They might do a bone marrow biopsy at the same time (I asked if they would, I mean, if this has to suck, and in the same general area, I’d rather they do it while I’m out and I can suck all at once). I don’t know how feasible it is, really. I mean, they might not have someone who can do it at that time, or who feels comfortable doing so while muscle is being worked on, and I imagine if they used the other hip — I might be wishing I sucked at two separate points in time. It’s also not always warranted, but I just get this feeling as it was mentioned as a “we might have to” this time as opposed to “I can’t see why we’d have to any time soon” the first visit.
God’s honest truth is this probably it, and it’s one of the better outcomes. This can be dealt with. This isn’t much different than I was expecting in a “reasonable case” scenario.
Prior to surgery next week, I have to keep my surgical soap away from children, apparently simply because it is a red color and not because it is unhealthy to ingest antimicrobial/antibacterial soaps. Go figure. Afterwards, I need to make up a good story to explain the substantial scars all down my left side (four thanks to my thymus, and now a nice four incher or so on my hip). What do you think? Bar fight? Badger attack?