The winning strategy appears to be fungus, ya know, like mushrooms. Except, no, I am not having hallucinations (too bad), and it's probably not yeast, so I'm not making myself drunk on head beer. It's something called asparagus. (No, not asparagus. Aspergillus.)
Aspergillus tends to grow in people who are immunosuppressed such as AIDS patients and cancer patients on chemotherapy. Luckily, that's not me (at least for now), but, in my Chernobyl of a face, it's such a mess, anything can happen. Overuse of antibiotics (or, in my case, intense, but necessary use) kills off normal** bacteria, leaving a vacancy for dangerous bacteria*** or fungus, but usually bacteria or less dangerous types of fungus. I'm special, so, even though my immune system is OK, all the dead bone in my head is a buffet for the Aspergillus.
Why do they think it's Aspergillus? They can see it on the stains of the tissue, and it can do the kind of damage that they are seeing in the microscopes. It's not growing in the cultures, but Aspergillus often does not grow in cultures. If it does turn up eventually, that's a touchdown, but, if there is no cancer, it is the best explanation we have, so it would be a field goal, and Infectious Diseases wins the game either way.
But the Oncologists have not lost yet. Literally, every pathologist in F'in' Famous Cancer Center has taken a stab at my slides and not found cancer, but they still have a couple of tricks up their sleeve. They are running some genetic tests, and, as has happened before, I will be the star of Tumor Boards in at F'in' Famous Cancer Center. ***** Between these two, there is still a chance for a fumble or an interception that will be run all the way down the field for a touchdown and chemotherapy, but no one is putting any money on it.
It's so unlikely, that infectious diseases gods, Ski Buddy and IDSA Guy are considering starting me on voriconazole tomorrow, which would be nice, because, even though I feel great, I'm afraid my head will pop open any day now. Then, they will take successive MRIs to see if the monster shrinks in response.
This is not going to be easy. Fungal biochemistry is way more similar to ours than to plants' or bacterias'. That means that medicines that are toxic to them are toxic to us. Voriconazole is no exception. This is going to be a tough course that I think will go on for months, but, at least, it's not cancer chemotherapy.****** With the proper timing and symptomatic treatments, I expect to go on about my odd life as usual.
So, go team Infectious Diseases! Go fungus!
Be well,
T
* It looked like it was such a clear win for oncology that, when he heard what was going on, IDSA guy kind of patted me on the back and said, "nice knowing ya, dude. Don't make any long-term vacation plans." (No, no, no he didn't. He's a very nice guy.)
** But, let's be real. What would be normal for my unique facehole?
*** (TRIGGER WARNING: HIGHLY SCATOLOGICAL but medically informative) Of course, unless an antibiotic is very local (like an ointment), it will kill of bacteria everywhere it goes. I get fungal infections in my ears all the time. K/BWE finds that really hot.
But, for those of you whose faces aren't some Mad Max, post-nuclear-armageddon hole, the bacterial die-off that is most likely to kill you is in your gut. See, there is this bacteria called Clostridium difficile. Known to friends as Clossy. Clossy is the kind of guy who might show up at your dorm party (or your bowels) uninvited and hang out in a corner ogling the women and mooching your liquor. But, once the beer pong with Kirsten Gillibrand has gone 20 rounds or so, everyone else is practically dead from alcohol poisoning (or, in this case, antibiotics), Clossy is the only one standing.
Clossy has a liver of steel, and he deals with most antibiotics the way a honey badger deals with snake venom. Honey badger don't care, and neither does Clossy. Free to take over the place (your gut, not your dorm room), he goes wild, and ruins the place. He'll give you horrible stomach cramps, and explosive diarrhea. He'll burn the whole place down with a high fever. Clossy kills a lot of people.**** I expect to run into Clossy one of these days, since I chug antibiotics like a Supreme Court nominee chugs beer.
**** Amazingly, if the two antibiotics that may kill Clossy don't work, the only option left, and I am serious, is a stool transplant. If you refill your gut with healthy bacteria, you can send Clossy out the back door. What is a stool transplant? It's as gross as you think.
***** Tumor Boards is a musical review where my surgeon and my oncologist will sing all about my tumor, and all the wisest heads in medical and surgical oncology try to make sense of the tune.
****** Cancer is just a piece of you that has gone a little nuts, so it's very hard to kill your cancer without almost killing you.
Happy 4th!
**** I have heard that they have refined the stool transplant and indeed, are experimenting on transplanting thin-people shit into overweight people and transforming them magically into thin people because of thin-people gut bacteria. Having been a candidate for C.Diff (still female but a really difficult personality)/Clossy, I realized that yes, I would eat sh!t if it could make me thin, but only if they could give me temporary amnesia.
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