Weirdness Continues

I started writing this in the recovery room, feeling remarkably good after coming out of general anesthesia, light though it was.  It was all very quick, leaving me unharmed except a lot of packing in my nose. I can only breathe through my mouth, and I sound particularly sexy.

I'm in no pain.  One of the advantages of having had a tumor that destroyed the third branch of my right trigeminal nerve is that certain parts of my face just don't feel pain.  Also, apparently, they did not pop my dura mater, so my brain is still is its protective bath of fluid, and I didn't mess up the floor with it, which is nice for me.  This is all much better than I expected, and it gets even better.

After the recovery room, they transferred me to the 19th floor of the hospital, the deluxe floor.*  Apparently, patients who are only going to be in for one night get to stay on a luxury floor if there is a free bed.  So I'm sitting on an easy chair, feet on an ottoman, in a carpeted break room that looks like a very dignified office.  There is a big wooden desk with a globe and comfy furniture, surrounded by dark wooden bookshelves and crimson walls with a wooden running board.  A window looks out on the East River.  A few feet away, French doors open to a wood-paneled living room, and, beyond that, a small dining room for people to eat with their families.

But enough about me.  What about this story's main character--the tumor.   This morning in the OR, Dr. Nariz went in again and took a more extensive look.  Easing the schnozoscope into my right nostril.  The image appeared on a monitor next to him.  He peered at the invader and cursed quietly under his breath.**

"Get Skully,"*** he called.  A nurse went running, and alerted Dr. Skully, who whizzed in with her characteristic speed.  She saw it, and her jaw dropped.  "What IS that thing???"  The two if them  stood transfixed.  Then, they quickly took selfies with it and got back to work.

Seriously, though, neither Dr. Skully, nor Dr. Nariz recognized anything about tumor.  We won't know for sure until the pieces have been properly marinated in dyes, and the genes sequenced (if appropriate), but they did do something called a frozen section.

To do a frozen section, you take some of the specimen, and you throw it into the freezer next to the Haagen Daaz.****  Once its frozen, you slice it very thinly and look at it under a microscope.  The lack of staining with dyes limits what you can see, but, usually, a malignancy is fairly obvious.  There would be lots of chaotic, densely-packed cells with large, irregular nuclei.  Dr. Nariz expected to find something like that in some spot in this enormous mess, but, so far, it all just looks like inflammatory schmutz.  But from what?  Pathology and microbiology may have something to say in a week if they don't all resign in frustration.

Now the scary part.

When we saw him a couple of weeks ago, Dr. Nariz was pretty certain that, whatever this was, complete surgical removal was not an option.  Dr. Nariz was able to take out about 25% of the mass today, but the rest of it has weaved itself around vital structures like my right carotid artery, my right optic nerve, and my right temporal lobe, invading nothing,***** but threatening everything.******

But, clearly, Dr. Nariz has gone over it more in his head and with his colleagues.  He now says that, with an infection even with helpful antimicrobials that would help, and even in a benign tumor, anything this big in these places, might be curable only with a long, highly invasive surgery more dangerous than any I have had before, and there would be a big risk of knocking out something essential.  But, damn, it will be fun to write about it!




* The staff told me it is a new thing in all of the major hospitals in the Big Fruit.  Apparently, a lot of people demanded it on patient satisfaction surveys.  If the luxury suites aren't full, and they expect you'll only need one night, you get to stay here.

** To my knowledge, he did not, but it helps to imagine that way.

*** Not real name.  Neurosurgeon we met during the previous fiasco in 2016.

**** I just ate a couple of serving-size containers of Haagen Daaz.

***** Cancers, by definition, invade other tissues as well as spread to different parts of the body.  There is an area on my MRI and CT that looks like invasion of the bone, but Dr. Nariz says that he is virtually certain that is dead, radiation-burned bone, so it's not applicable.  (That's good.  When I saw the word, "invading," I was certain I would be toast.)

****** I had been quite worried about the fact that it was in my cavernous sinus, because a sudden clot in the cavernous sinus is deadly, but, when I saw her last month, Dr. Hygeia said I was being ridiculous.  A sudden clot there is highly unlikely.  The tumor is in lots of other places that are much deadlier.

Sweet 16 (or 17?)

Well, off to the races again!  I sit now in a train travelling south to the Big Fruit.  I do love trains.  I don’t love surgeries.  You might think I did from the number I have had.  This will be the 16^th or 17^th, depending on how you count.  That’s more than Michael Jackson had on his entire face.

Last week, in preparation for tomorrow’s surgery, I went down to F’in’ Famous Cancer Center for a CT scan.  You would think the surgeon would be satisfied with the nice MRI I brought him from up north, but, no.  He wanted his own CT scan, so I came down and got it.  K/BWE and I just looked at the results.  It’s pretty much a rerun of what they saw on the MRI, but it’s still exciting.  Once again, I have to ask, how in helicopter am I still alive?  How the Schmidt am I not at least a blind, blithering, wall-eyed, slobbering half-vegetable in a wheelchair?  It’s crawled into everything.  It’s cozying up to my brain.  It’s cuddling with the muscles that control my right eye.  It’s groping my inner right ear, and yet I still hear as well (or badly) as ever.  I have a little headache, which may just as easily be stress*, but I drove to work, did a good job, and did not soil my underpants even once.  I can talk, I can walk, I can sing, I can dance.**

Am I overreacting?  I’m sure there are lots of people with huge, unidentified groping objects*** rubbing against their brains, and it doesn’t bother them.  I can’t help it though.  This thing gives me the creeps.  It looks very malignant, although the first biopsy says it wasn’t, but whatever it is, it’s big and scary and does not belong there.

And so, tomorrow morning, Dr. Nariz will take out a few more samples while trying to not pop my dura mater, the balloon that encloses my brain.  Is it cancer (still a possibility that part of it is)?  Is it a crazy big benign tumor (which is still a problem)?  Is it bacterial?****  Is it fungal?****  Is it the earthly remains of Jimmy Hoffa?  Only pathology or microbiology will tell.

Next update will be postop!

Be well,

Tom

*Hmmph. Stress.  I really need to lighten up.

** That part’s a lie.  I never could dance.  Not even Rachel Settlage could teach me to dance.

***UGOs

****If it is bacterial or fungal, it could be a whole new organism resistant to all antimicrobials (antibiotics and antifungals), which would be good.  I could get it named after me, and I could probably get them to make me first author on any articles they publish.  It would be an unusual way to advance a career, but I’ve hear stranger.

This Stellar sea lion thinks it's just the world's largest booger.

Say what?!?!?!

Yesterday, I had a sinking feeling.  It hit me.  I was going to die.  And soon.  For that moment, at least, it didn't feel very funny.  I thought about my family, my friends, my patients, my cat, and my dog.  I thought about all things I wanted to do while there was still time.

But the moment passed after a few hours, and I moved on to more mundane issues, like what would be the most memorable last words?  Unless you're some sort of improv genius, it's not the sort of thing you can come up with on the spur of the moment.*  And what music should be played at my funeral?  The recessional would have to be Eric Idle's "Always Look on the Bright Side of Life."  Probably no Weird Al.

That was yesterday.  Then came today.  It started out normally (for me).  I did the same disgusting nasal cleaning routine I have done since 2005, took Willow to the park up the hill so she could run like a maniac, and then, I made my usual giant smoothie and went to work.

I was doing paperwork in my office when my cell phone rang.  It was Dr. Nariz, the surgeon at F'in' Famous Center in the Big Fruit.  I was surprised, because we had all expected that the pathologists would be having a field day arguing over my weird tumor.  And he said. . .

Here, to add to the suspense, I have placed a totally irrelevant picture of a Galapagos Tortoise so you will have to scroll down before you see the diagnosis.

Keep Going. . . 

More. . .

it is benign.**  WHAT?  Benign, BENIGN, B-9, BEEEENIYEEEENNN!!!  Huh??  How the smell could that possibly be???

That was the ugliest MRI I have ever seen on anyone!  None of my docs had outright said that it was going to be malignant, but you can tell by their faces and voices.  They get kind of downcast, and their voices go down a register or two.  "We aren't sure what this is.  Maybe it's not malignant.  By the way, there are some really exciting clinical trials for incurable cancers.  Here.  Sign this consent form.  Yes, the side effects are a bit embarrassing.  By the way, this would not be a good time for you to buy season tickets for the Red Sox. . ."

Wow!  Wow!  WOW! 

The surgeon was as surprised as I was.  So were my other docs!  When I told them the good news, one of them cried.  We all thought this was going to be the big one.

I've had half a dozen scares over the course of my life.  The worst was in 2016, when the surgeons at Wicked Famous told me I had 2 years to live (Do the math!), but F'in' Famous did another biopsy, and it was nothing but radiation schmutz that you would expect to find in my Chernobyl of a face.  But this one was a deadly-looking MRI, and the docs at F'in' Famous Cancer Center looked like they might wet their pants.  But no.  Not for now.

Is that the end of this chapter?  No.  Although the tissue that Dr. Nariz got was benign, that is still a big, ugly thing behind my face.  He wants to do another biopsy, this time under anesthesia on June 19th.  I still get to visit an oncologist (never a joy ride) on the 12th. After all, there still may be cancer cells buried deep within it.  

And, even if it's all benign, I don't particularly love having a giant mass behind my face, getting into important blood vessels and pressing on my brain.  At best, it's a giant colon polyp in my face (without the farts), and those are risky in the long run.  Or is it a weird kind of infection? 

So, as they say, it ain't over until the fat lady sings (or passes out at the cast party), but I really like how things are going.  More in 2 weeks!

* The best ever: "Either the wallpaper goes, or I do."  --Oscar Wilde

** 'Benign' never means normal, mind you.  It's what's between normal and cancer.  It's not malignant (generally equivalent to cancer), because, though the cells are weird, it does not invade surrounding tissue or spread to other parts of the body.  

Tumoriffic Tom's, and His Parents', and K/BWE's Terrible, Horrible, No Good, Very Bad Day.

Didya ever have one of those days?  Ya know, the kind of day when you go down to New York for a consult with an ENT cancer surgeon, Dr. Nariz, and he takes a giant pair of forceps that are like 2 feet long, and he yanks a pea-sized piece of tumor out your nose, making a giant 'SPLOING' sound like a rubber band?*  And when he's virtually sure that ya got a tumor, not just an infection?  And when it looks like there is no way a surgeon is going to be able to take it all out unless you want him to take off your whole head?  (Believe me.  I thought about it.)  Yeah, that kind of day.

And, on such a day, don'tya hate it when you get to the airport, the TSA decides that the salt for the nasal lavages you have to do is suspicious and searches your bag and then does the equivalent of a colonoscopy on you?**  And doesn't it totally suck when it's one of those days when your 9pm flight home gets delayed until at least 11:36pm (and counting)?

And on such a day, you find that, at each of the airport gates, they have installed several really nifty-looking iPads that invite you to order food and wine, and you think it may be past time for a glass of wine, but, because it is such a day, the credit card slot next to the iPad doesn't work?  And, meanwhile, the two guys sitting on one side of you are watching something really skeevy on the internet and talking about it loudly, and the toddler across the room is having a meltdown?  And the old man sitting next to you (on the other side) is making love to his tonic and gin, and that's really gross if you think about it?  And the interior decor at the airport is just atrocious?  And they're playing the Eagles' Greatest Hits on the PA?  And you think that guy sitting across from you might be Anthony Weiner?  Don'tya just hate that kind of day?

And, sitting there, all sexy with tissues shoved up your nose so the biopsy site doesn't drip on your clothes, all you can find to do to work out your frustrations is to pump out another Tumoriffic piece?

Don'tya hate it when you have a day like that?  I know I do.

Be well,

Tom


PS:  It could have been much worse.  I was accompanied by my amazing wife K/BWE, and my sweet parents for moral support, and we got to hang out with one of my very best friends, and she fed us home-cooked Indian food.  Her apartment is right across the street from F'in' Famous Cancer Center, because she has my kind of luck, so she's being treated there for the second cancer she has developed since her kidney transplant.  We understand each other.

And this is not the end.  In a week or two, once the tumor has been soaked in a special blend of herbs and spices, I will have the diagnosis.  It is the beginning of another adventure.  Whatever it is, every tumor has a silver lining.



*That's the sound the tumor makes, not the surgeon.

**Actually, the colonoscopy part was a lie.  The TSA officer was quite nice.  She was very interested to learn about nasal lavage, since her son has bad allergies.

He doesn't like those days either.