Bad News - Maybe

Two weeks ago I wrote about having cancer but not being disabled by it. That I knew my cancer had to be taken serious but wasn't ready to cut back on my life:

"And it makes me wonder - should I go on disability? Am I just fooling myself that the cancer is all behind me and I can just go on with life, tra la la?"

Last week things changed, suddenly. Maybe my luck has run out.  

I'd been having some back pain for a couple of weeks and then some rib pain - I thought it was just general aches and pains, maybe connected to the upper back pain I've had for several months.

Last Wednesday I woke very early morning, probably around 3 or 4 a.m., and felt sharp pains in my back. I couldn't turn over without pain. I was having a bit of trouble breathing, but I eventually found a comfortable position and went back to sleep. And went to work that day as usual, a 10-hour shift at the ER where I work.

The next day, Thursday about 2:30 a.m., I woke again and the pain was much worse. I was definitely having trouble breathing and the pain took me out of bed, pacing, trying to decide what to do. About 3 a.m. I called my ER and asked how busy they were - not busy. I said I might be coming in. I waited another five minutes then called them back - "What doctor is on duty right now?" I'm not sure why that made a difference, but it did - and some of my co-workers have said they'd do the same thing.

I decided I needed to go in to be checked. I got dressed and woke my husband. He said he would drive me in but I said no, I'd drive myself. It's only about a mile away, and he had to be at a business meeting at 7 a.m.

I got to the ER and was checked in at triage, then taken back to a room. The nurse made me go in a wheelchair. I wanted to walk but hospital policy ... :-)

The Dr G came in quickly and ordered blood tests and a chest x-ray. She thought it might be a pulmonary embolism - a blood clot in my lung - partly because of my long plane ride a couple of weeks before, returning from Maine.

Results came back, something funny on the x-ray, and my D-Dimer blood level was a bit high. I went down for a chest CT scan, but Dr G wasn't sure about what the off-site radiologist said about it. Overnight our imaging tests are sent out of state to be read elsewhere - we don't have radiologists on staff 24 hours a day. Dr G. said she wanted to have me stay in the hospital, upstairs in a regular room, at least for a few hours until another radiologist could evaluate the CT. I reluctantly agreed. This was a few hours after I'd gone to the ER, I hadn't slept because of the pain (but I'd declined pain meds) ...

This set up the process of admitting me upstairs. The hospitalist, Dr R, came in and introduced herself. A hospitalist is a doctor who's in charge of the care of all the patients who are inpatients, up on the main medical floors. She went through my medical history, did her own exam of me (lungs, heart, checked for swelling in legs, etc.)  And somewhere around 8 a.m. I think I was taken upstairs.

My husband came by later and stayed until about 10 a.m. I was sleepy and just wanted to rest. And then 15 minutes after he left, Dr R came back into my room with a serious look.

She said the daytime radiologist had found nodules on my lungs. She showed me the CT scan on the monitor. Both lungs affected, the right one more so. That's where I'd been having the pain. She said I should have a lung biopsy, but because of some medicine they'd given me down in the ER, when they thought I might have the blood clot, it couldn't be done today. She said I'd need to stay overnight and they'd do the biopsy the next day.

I refused. I said I wanted to go home. I was upset about the lung nodules - the cancer had spread to my lungs, and that was not good. I wanted to go home and hug my dogs. Be in my own space. I insisted that I could have the biopsy done the next day as an outpatient.

Dr R is new to our hospital and wasn't sure if that would work. She said she'd have to check with the radiologist - the biopsy would be performed under CT guidance for correct placement.

She left to make some phone calls, and I suddenly understood why some patients leave the hospital against medical advice, AMA - eloping, we call it. They pack up their stuff and just go. Sometimes they take out their own IVs, sometimes they make a nurse do it. Patients can't be held against their will except in some psychiatric cases. Some patients just don't want to be in the hospital.

I was one of them. I was going to leave AMA if they didn't agree to release me. I needed to go home and deal with this horrible news.

I was stunned - just two months previously I'd been given clear results from pelvic, abdomen, and chest CTs. There was one nodule on my lung but that had been there for over a year, and was stable. A nodule can be the result of an long-healed infection.

Several new ones, growing rapidly - that's a whole other scenario.

I was allowed to leave late in the afternoon. Biopsy was scheduled for Friday afternoon. It was simple and done under conscious sedation and took about an hour. Results would be ready in a few days.

My oncologist had been notified and because of the lung nodules, more CT scans were scheduled for Tuesday.

Today is Thursday, and I'm going in this afternoon to get the news. This is tricky. Since I work at the hospital, I had received permission to access my own electronic medical records. I can look at the reports myself.

I haven't. I decided to wait and read them at the oncologist's office. I'm dreading the news, and I needed to just hide it away until the last minute. I've just avoided thinking about them. If I thought about them and wondered what the reports said, I'd be too tempted to just pull them up and read them myself. And then possibly come undone.

I needed to keep working this week so I haven't looked at the reports. I alternated between tears in the restroom and being strong out in the pubic eye.

Last night, by coincidence, Dr R was in the ER to speak with another patient. I said hello and she asked how I was feeling.

And then she said, "I read your biopsy report ... " and I held up my hand.

"I haven't seen it yet. I'm waiting until I meet with my oncologist tomorrow." She nodded and asked if I was still having pain. I said some, but it had gotten better. She wished me good luck and smiled, and we parted.

I thought about that encounter a little bit - she didn't look sad when she said she'd seen the biopsy report, but doctors are trained to hold in their emotions. So I'm trying not to make too much of that.

My oncology appointment is for 1 p.m. today. My husband is away on a business conference, scheduled months ago. He thought about canceling the trip but I said he needed to go - if he might be our only source of income, then he needs to be up to date with everything.

I'm going to go to the hospital and print out the biopsy and CT reports - and not read them. Put them in a folder and take them to the oncologist, and read them there. 

 

Crossing my fingers that it won't be so bad. Those reports - those reports may decide my future. I want to feel some hope but am afraid to be optimistic, because it could be totally false. I just feel numb.

Some days I still can't believe this is happening to me. This can't be my life.