Say Hello to My Little Friend

I knew the past two weeks were going to be less than fun, but you know how it is: brace for the worst, hope for the best, and then something that you wouldn’t have ever imagined in a million gazillion years happens.

Last week I got my repeat chest CT to follow up on that little nodule that they spotted last year. Monday, Mr. Shoe saw our lovely GP who said “By the way, tell your adorably wonderful wife that the report came back and the nodule is unchanged.” Tuesday, I saw the rheumatologist who I realized I wasn’t giving a fair shake. My records got sent to the wrong office, so I come in to the visit and he sees — me. For what that’s worth. And then he makes the (very logical, and very correct, but so not the heart of it) pronouncement that I have a sleep disorder that must be taken care of. I said, “No duh.” I did. Because I knew he wanted me to say “No shit, Sherlock!”

Needless to say, that’s one of those things that makes me defensive now. And I am used to being just dumped when it’s not all apparent immediately. I wish (as does my sleep doctor, who is very good and who I see every two to three months, dammit) that instead of fighting with me about how badly things are managed in that department, they’d call my sleep doc and tell him how to do his job, because obviously specializing in neurology and then sleep medicine didn’t learn him nothin’.

Wednesday morning, I call my GP to let her know that I think I need to give the rheumatologist the chance, in good faith, to prove he’s not like the jerks I have seen here and again. Oh, and please resend my records. My GP wasn’t in yet. But when she called at noon, I figured she’d gotten the message.

She said, “You know, I got the full report from your lung CT.  Your nodule is the same, but… there’s something else.”

There’s this gland in your chest, I guess (anatomy lesson time) that is huge and active as a fetus and throughout childhood and adolescence, and then it shrivels up and stops working when you are an adult. Some people have it basically disappear, some people have just a really little one. Some people, people with things like myasthenia gravis or neuromyotonia or blood and autoimmune disorders have something happen where it stays enlarged — or it develops tumors.  It’s called a thymus gland, and it kind of shows your immune system how to get going and work when you are young, and then, when you’re old and decrepit, it quits and lets your now oh so knowledgeable grown up parts manage your immune system.

My thymus has a growth. Because of its jackassedness, and (while not all of these things are cancerous) they are classified as malignancies, I named him Don Thymus.

What does this mean? Well… We don’t know really. The surgeon thinks we will. Don Thymus will need to come out (he’s about an inch and a half around). The surgeon says it doesn’t look cancerous, and given my history, is likely going to yield some kind of clue as to how to treat this thing as we go along. He says at this point, he doesn’t think removing it will help my current state greatly (although, sometimes it does help keep things away longer and requires less management on other fronts), but he is pretty confident that we will learn something worth knowing from pathology testing on Mr. Thymus.

In other words, it’s really bizarre to have one of these things pop up… they’re only present in a small percentage of people with autoimmune stuff. But if it isn’t cancer, and I am having the problems I’m having, it’s almost certainly a damn big piece of working it out and getting under control.  The chances of it happening, my feeling like I do, and it not being related are pretty slim.

Not sure when they’re yanking it. It’s an overnight thing, and the surgeon’s sure he can get it on the first swing (and he says two minimally invasive surgeries beat the crap out of one splitting open of the sternum… and I think he’s on to something there. I like my sternum intact, please). The pathology testing will take some time, and because it is considered malignant just by being there (but it’s a benign malignancy, sure, makes loads of sense) it’ll be staged, as well (with a top hat and tails). After that, some rheumatologist (will it be this last guy? I don’t know) will take over management.

Betcha didn’t know you had a thymus. The actual growth is loosely termed a thymoma… which makes me think of Shakespearean “Yo mama” jokes. “Thymoma’s eyes are nothing like the sun…”

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2 Responses to Say Hello to My Little Friend

  1. Momshoe says:

    So Don Thymus needs to come out … I guess that means he’s gay as well….?
    So – OK – I’m researching it on the internet. Just think how educational all this is (grin).
    Hope you’re feeling well today, and having more good days (or good hours) than bad.

  2. shoe says:

    Oooh, imagine leaving the closet laproscopically! I think I might imagine it that way, because leaving my chest laproscopically sounds a lot freakier at the moment. ;)

    After further meetings with the anesthesiologists and such, it’s a little freaky. Especially since I get the impression that the rheumatologist I saw — who did indeed call me back — wants absolutely nothing to do with it. But for once, thinking about the long term scary implications is far better than thinking about the short term ones. Things I wish I didn’t know, but am kinda glad I do: My throat will hurt more than the usual post-anesthesia scratchiness, because they use a much bigger tube. I am glad I know that. They use a bigger tube because they have to deflate each lung as they work in its general area. Wish I didn’t know that, except it does minimize risk of nicks and cuts, which I am glad I know.

    Anesthesiologists are all glad I told them about the diabetes insipidus (I had to push to see them… nurse who did admissions testing assumed it was a blood sugar/insulin/pancreas related thing, not a “patient could dry out because they don’t make this antidiuretic hormone and then lose blood pressure and have heart failure while they have one functioning lung” situation). Endocrinologist cleared that I can take the fake antidiuretic hormone that morning and anesthesiologists now know to keep an extra close eye on that and administer it again prior to surgery.

    Y’know, let me post this up above. :)


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