I have renewed faith that there are plenty of doctors who care a lot even if they can’t help, and I have renewed faith that really, we don’t know anything at all. Just most people have stuff malfunction in the same sorts of ways. Know how teenagers want to be different, but still fit in? The hell with different, I wish my carcass just would… get some plebe cold or something.
And as we learned in library school, the answers you get depend on the questions you ask. So here: Monday I saw my sweet GP and I got a call from the oncologist. I am scheduled to see a guy — an allergist — that my sweet GP says is far more immune system keen than a straight up allergist (I had two years of allergy shots as a kid — I know that allergists classically either beat around the bush with treating things or, like the one I had, say you need to live in this reality in this world, and deal with it). Anyway, he’s another member of the unholy trinity comprised of Allergy, Immunology and Rheumatology. Sweet GP rolled out the typical “really smart” (doctors should be, but smart only goes so far) and a nerd. I like when she calls other doctors nerds (or hardasses. That’s even better.). One, she consistently qualifies nerd as “not a bad thing.” (I think dweebs are bad in medicine. Dorks are par for the course, and geeks always kick ass.) And every one she has referred to as a nerd I’ve gotten on well with and felt like they were giving it a go.
So I see the immunologist in a week or so.
When I saw the oncologist last week, he said that he didn’t think it was an autoimmune issue or cancer — citing no positive labs for ANA and such. He said he’d ask the pathologist what all was done, and what any differentials would be, but he felt it was probably a fluke.
Thing is, immunology is a field that changes rapidly. In the 60s no one was 100% sure what the hell a thymus did (and we’re still not) and it seems like medicine makes leaps and bounds and we still know jack. The oncologist said my thymus was removed because it was oversized — this is true. It wasn’t a tumor, it was just big. The pathologist said that yes, it was bigger than it ought to be (the anesthesiologist said the size of a baseball, which makes me wonder if he grew up in a place with really small baseballs). It was made up of thymic tissue (which you expect) and follicular b-cells (which they say should be there to some degree, though t-cells are usually associated therein). It was the fact that there were boatloads of follicular b-cells (hyperplasia) that made my thymus grow, the pathologist told the oncologist, that was abnormal — and that that means there is an autoimmunity problem (though no one knows what that link is and why it happens).
I am thinking the pathologist (and surgeon) probably see more of those from people with an autoimmune diagnosis already, so it was assumed on the pathology guy’s part that I was diagnosed, and the surgeon wasn’t going to hedge his bets. And it explains why the oncologist was confused. The oncologist took back his doubts it was an immune issue, and said he was sorry he couldn’t be of more help and he hoped it worked out soon. Honestly, his giving a crap enough to ask the pathologist, follow up, and taking the time to clarify and rework what he’d been thinking previously means the world to me. That helped.
That was Monday, which was. coincidentally, my birthday. Hearing more about what was looked at and what they saw but didn’t work up further on the path labs was a gift in and of itself (and tissue samples are on file if someone can figure out what the hell they might want to work it up for). For now though, I’m taking a rain check on most holidays and anniversaries. It’s just easier that way.
But I think everyone ought to eat some cake on my behalf.