Wednesday, August 26, 2009

CHAPTER 10: UNEXPECTED SURPRISES

How could this happen to me
I've made my mistakes
got nowhere to run
The night goes on as I’m fading away
I'm sick of this life
I just wanna scream
How could this happen to me
“How Could This Happen to Me” by Simple Plan


I watched as the crimson B+ fluid inched its way slowly through the tube to disappear into my veins. Greeeeeat! Now I had to get a blood transfusion because my hemoglobin was low. Was there anything that I was going to skip in this ordeal?! Again, being a med student I always picture the worst case scenario, and in this case it was me getting a severe reaction to the foreign blood I was being given. Ok, so that did not happen, I was fine and my hemoglobin numbers went up, but still I was angry that I needed blood in the first place.
It seemed like lately anger has been the emotion of choice for me…and damn it, I had plenty of reasons to be angry about!

I had finished treatment-eight grueling rounds of chemotherapy followed by 20 days of radiation, and waited 8 weeks to have my body scanned again to see if we had defeated the cancer. The PET/CT scans came back with unfortunate results that I was so not expecting. See, the whole time while waiting for scan results everyone around me was being super-positive, telling me that the scans will come back clean, that I will be cured and live happily ever after. I, however, was definitely not as optimistic; I had doubts that it was all going to be this “easy.” I also wanted to prepare myself mentally for bad news; I couldn’t just keep myself too positive only to be crushed by unpleasant news, I had to keep open the possibility that I could receive bad news that my cancer was still there. Apparently I did not prepare myself adequately, because my imagination did not stretch far enough to hear Dr. Scotty, my oncologist, telling me that the scans came back showing newly lit spots, which meant there were new tumors in my body. His good news for me? The original mediastinal mass had shrunk considerably to almost a negligible size, and the supraclavicular node was not involved anymore. Wow, awesome! I should go celebrate! WTH! My cancer had spread during treatment?! How is that possible? I now had tumors in my right lung, both kidneys, pancreas, and GI lining! I was in shock, so much for preparing myself well. Dr. Scotty, the ever-positive soul, said that these were too many new spots that appeared in such a short period of time, and thus could just be that I have some sort of infection. I informed him that I had no signs or symptoms of infection, but he said some common Arizona fungal infections can be symptomless. Ok, so I could have an infection. For some reason, I just did not buy that this is what I had; in the back of my mind I knew it was still cancer. However, I had to go through the motions of getting blood work done. Also, I got scheduled for a kidney biopsy to determine what these new masses were.

As I was leaving Dr. Scotty’s office I asked him: “if this is cancer, could it be Non-Hodgkin’s Lymphoma since Hodgkin’s Lymphoma does not normally spread in such a manner?”

He replied: “anything is possible, but it is highly unlikely because this is very uncommon.”

I thought to myself ‘I am used to having rare things happen to me’ and left the office feeling numb and…praying big time for an unlikely infection!

I underwent the kidney biopsy on a Friday. A day later I went to the ER with severe abdominal pain. First thing they did was put my pain under control by giving me the wonderful drug Dilaudid-which the inept ER nurse decided to just push it really fast into my IV putting me in a panic for a few seconds as the drug sent my heart racing and made my entire body heavy, but after I got over the initial shock (or “high” as some people call it I guess) I was in bliss-land, pain-free and in a sleepy/loopy state. Then, they did the usual blood work and a CT scan and came back to tell me I had pancreatitis (inflammation of the pancreas). Ok, seriously? Where did that come from? I thought for a second about my Vegas escapade ten days before with my best friend K (since I know as a med student the 2 most common causes of pancreatitis are alcohol and gallstones), but I was no alcoholic damn it! Thankfully, the doctors agreed and quickly ruled out this possibility as well.

Anyways, I ended up being hospitalized for my pancreatitis. The doctors could only guess at what caused it, and the most likely culprit was the tumor sitting there on my pancreas. The only positive experience of that hospitalization was that now I was being seen by the Internal Medicine team as well as the oncology team. The IM team had interns and residents. The interns and residents who came to see me were all nice, cute and obviously smart guys! Yeah, I can enjoy that even when I’m lying in a hospital bed sick; plus they all were conversational when they knew I was a med student (which I don’t tell anyone but apparently it’s written in my chart in the doctors’ notes.)

The kidney biopsy report came back a couple of days later. I had Diffuse Large B-Cell Lymphoma (a very aggressive and fast-growing type of NON-Hodgkin’s Lymphoma). What happened to the Hodgkin’s they told me I had initially back in Nov.? I was being treated at one of the top most-renowned clinics in the world and I get misdiagnosed/not fully diagnosed?

My anger could just no longer be contained…I was ANGRRRRRRRRRRRRRRY!

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