July 2016 Update CT Scan

Hmmmm…. Where do I begin with this update?  I received the expected CT scan early last week.  They handed me a copy of the CD with the pictures of my lungs.  I was excited to get home and analyze the data on my laptop.  Having spent lots of time investigating previous PET scans and learning a lot about reading the information, particularly after viewing it along with the doctor… I was fairly confident that the CT info would be a piece of cake to understand.  I was wrong.  I looked at the pics over and over again and although I was able to determine some areas that didn’t appear normal, I was completely lost in my self-diagnosis.  I had to wait anxiously for the call from the doctor after she received a copy of the report.

I received a call from my Radiology Oncologist’s office the following day… not the doctor herself by the way… but from the nurse.  I admit, the nurse is very knowledgeable in this field of study and I appreciated her conversation and responding to the questions that I had the mind set to ask in that moment, although some remained unanswered.  I have since developed a number of questions… okay… several pages of questions… that I’m not certain that ‘anyone’ can answer with any degree of accuracy.

The nurse said that I had Pulmonary Pneumonitis/Fibrosis with scarring.  Not reversible.  Symptoms could possibly be lessened somewhat with steroids, but no cure and symptoms may worsen with time.

As all of you know who have followed my recovery process of radiotherapy for lung cancer, I will indeed tell it like it is.  So… directly from the report… this is the good the bad and the ugly of it all.

Impression:

Focal area of consolidation posteromedial right lower lobe at the base of the hemithorax measuring approximately 9 cm in size consistent with radiation pneumonitis.  Adjacent pleural effusion.  The consolidation obscures the site of the previously noted pulmonary nodule.

As you already know from previous updates… I did my research.  I’m still very much confused as to where I stand exactly.

Pulmonary Consolidation is a region of normally compressible lung tissue that has filled with liquid marked by induration (swelling or hardening of normally soft tissue) of a normally aerated lung.  It is… Alveolar space that contains liquid instead of gas.  The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood.

Hmmm….

Pulmonary edema can be a number of things and caused by a number of things, mostly due to the heart.  Since radiation therapy can also cause edema, well… I’m going with that… even though… well… you are all familiar with my various heart conditions.

Inflammatory exudate is well… like pus… Sorry… I know you didn’t want to read that word in any form.

Inhaled water?   I don’t think that I have drowned yet… so I’ll rule that one out….

And then there is blood.  Since the mucous associated with the cough has a pink tinge to it… I’ll assume that at least a portion of that liquid is blood.  From what?… I have no idea.

Radiation Pneumonitis… Inflammation of the lung.  Symptoms… Shortness of breath, dry cough (mine’s not so dry), low-grade fever, chest tightness, chest pain, and general malaise including fatigue and weakness.  I can say ‘yes’ to all of the above, with the addition of pink in the not so dry cough.

Pulmonary Fibrosis… a respiratory disease in which scars are formed in the lung tissue leading to serious breathing problems.  Scar formation, the accumulation of excess fibrous connective tissue (fibrosis) leads to thickening of the walls and causes reduced oxygen supply in the blood.  As a consequence patients suffer with perpetual shortness of breath and a list of other factors.

I know that I must be boring most of you with all this information, but a journal being written in order to demonstrate a true study of a patient’s journey through cancer and associated treatments must include some technical and detailed information.  Sometimes I bore myself with this stuff and often it becomes such a heavy prey on my mind that I have to stop and read one of my more humorous poems… like “Poultry Poetry” or “The Finger”.  After reading them and realizing how un-normal my mind works at certain times, I realize that there are still plenty of things in this world that are not so serious after all and laughter can be so very healing… even if it is just temporary.  If you have tired of the technical crap… or just don’t want to delve into the details… please scroll down to the green line and enjoy what my dearest friends have had to say about it all…

Pleural effusion:  the build-up of excess fluid between the layers of the pleura outside the lungs.  The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing.  Symptoms include… Chest pain, dry, nonproductive cough, shortness of breath, labored breathing, the inability to breathe easily unless the person is sitting up straight or standing erect.  Again… all symptoms fit… with the exception of the not so dry cough and the fact that the inability to breath easily is present in ‘all’ positions.

It seems that all of these things associated with the diagnosis, all have virtually the same symptoms.  What symptoms come from what?  Nobody knows… not even Wikipedia.

So… where do I go from here?  What’s the next step?  The area of the lung which contained the malignancy most recently is hidden by the scar tissue.  How do we know if it raises its ugly head once again in the same area?  The nodule was still there on the last PET scan.  Hmmm…

No cure for Pulmonary Fibrosis… Corticosteroids have side effects that can cause atrial fibrillation which I already have… irregular heartbeat, which I already have… it can affect the firing mechanism of the heart which in my case is located in a remote area quite un-normal… the lower center portion of the heart instead of in the atrium… which often causes the chambers of my heart to beat out of synchronicity with one another.  Hmmm…. maybe I should just deal with the symptoms instead of the odds that the medicine carries with it.  The medical professionals have offered ‘no’ alternatives.

I’m really confused… finding myself in a dilemma that no one seems to have any kind of a solution to resolve.  The good news is (well… I guess the ‘good’ part depends on your point of view)… but the ‘good’ news is that I’ve had cancer in three areas including the lymph nodes of the neck and the lung and in spite

of the fact that my heart was too diseased to tolerate chemotherapy or surgical removal of the cancerous areas… I have survived.  The bad news is… (and there seems to be only one point of view for this one)… after having cancer in three different locations over a period of the last three years, the odds of it appearing in some new remote location are quite high… which would mean more radiation… which would just perpetuate the vicious cycle.

So… to my wonderful and enlightening readers and followers…. Any suggestions?

___________________________________________________________

I have discussed the matter with a couple of my dearest friends and taken to heart their sincerest ideas and solutions… I’ll share a few of them with you.

Oliver (Ollie) has suggested a number of ideas to deal with my dilemma.  His first suggestion was that I just put my paws over my ears and don’t listen to all the negative things the doctors are telling me…

Cover your ears

He then told me that if that wasn’t successful that I could just cover my eyes so that I couldn’t read all those terrible things about my illnesses that I research online…

Hide your eyes 2

His last idea was that if both of those ideas failed… that I could just play dead.

Play dead

Miracle had this to say….

If you find yourself in the uncomfortable and embarrassing position of having a monkey on your back…

Monkey on your back

there is just one thing that you can do…

He told me that if you really want to solve a dilemma, there  was truly only one way to take care of it for certain… Crawl into a cardboard box… close yourself off from all the stress and commotion of the world around you… sink deeply into the tranquility, solitude and silence… and the answers to all your questions will appear before you… or at least… all your problems will seem to fade… and you will begin to have wonderful thoughts about wallowing like an idiot in some catnip… I think Miracle just might be a very wise little creature.

Miracle in the box

I’ll be looking very forward to your comments… open to your suggestions… or perhaps you might choose to share some of your own dilemmas… or maybe you could just send me the pics of you wallowing in the catnip…

Hope your day is most beautiful….

Namasté

Michael33

July 2016 Update

I believe that the time has come for an update of my physical well-being… although perhaps my mental state should be the real subject of discussion, I will mostly stick to the physical.  At this moment in time, I can truly state that nothing has improved… nothing.  All symptoms listed in the previous post have continued and some have actually worsened.  It’s getting very, very old.  No… I have not lost hope nor will I ever do so.

I developed a chronic cough in April and it has been quite persistent and worsening in recent weeks.  I won’t bother you with the details of what accompanies this cough, but it is of colors that are not of the ordinary.  Three weeks ago I talked myself into going to a walk-in clinic to determine what the heck was going on because I could not stop coughing.  As usual… the results were… they don’t really know.

Here’s what they found.  Lymphocytes exceptionally low.  The doc listed several possibilities including the fact that the bone marrow may have been damaged from the radiation therapy and four or five other possibilities.  Other white blood cells were below where they should be.  The red blood cell count was a bit low also, but nothing dangerous.  When the doc listened to my lungs, he found that the sound from the lower right was… umm… un-normal.  An x-ray was taken to see what they could see.  The result from the doc was that bronchitis and/or walking pneumonia (whatever that is) was most likely.  There was also a very strange looking… well… I don’t want to say ‘mass’ because it was rather odd looking to him and to me.  To me… in the lower portion of the right lung… it appeared that a cotton ball had exploded and strings of cotton were shooting up from that explosion.  Maybe one shouldn’t snort cotton balls.  Now… that’s my non-professional interpretation of the x-ray.  The doc’s interpretation wasn’t much different.  He just didn’t know.  The x-ray was sent to a radiologist for analysis.  I was prescribed antibiotics for ‘possible’ bronchitis and pneumonia.  Since my immune system function is somewhere between zero and subzero, I need all the help I can get to fight things off like this.  The doc said I would take it for five days and it would stay in my system for approximately another five days after that.

Two weeks later… I was coughing worse and feeling weaker than I was before I started the medication.  I returned to the same doc with hopeful anticipation.  He did another x-ray of the lungs to compare the two images.  He told me that the image in the right lower lung could be cancer… could be scar tissue… could be and could be and could be.  What he did say for certain, was that it was restricting my breathing capacity.  Of course… I already knew that something was constricting it… I just wanted to know ‘WHAT’ was causing it.

He prescribed a second antibiotic that he said was more powerful and I should take it for ten days.  I took the prescription to a Walmart pharmacy, where the clerk informed me that the price would be $115.00 cash.  I told the clerk that the doctor said it was a generic… The clerk said, “yes… it is, but it’s not on our four dollar list”.  I said, so if it’s not on the four dollar list… it’s a hundred and fifteen dollars?  She said, “yes” and acted a little put out that I was questioning the cost….  I spoke with the pharmacist and asked her if there was a similar drug that the doc cold prescribe that would be less expensive.  She said that there were other drugs available in the same class, but the price would be about the same.  I left without filling the prescription.

When I left the doctor’s office, I had noticed a tiny independent pharmacy just behind the doctor’s office.  I went there to see what they would charge for the same drug.  They said they could fill the prescription for $33. 80.  I said, “Thank you so very much”… And now… let me take this moment to thank the wonderfully greedy little bastards at Walmart’s home office for making prescription drugs so very UNAFFORDABLE for people who are truly ill.

Now… I know that the little independent pharmacy was making at least a small profit at the price of $33.80… so what was the mega-pharmacy of Walmart making?  Oh well… I saved myself eighty dollars by driving a very short distance and that little pharmacy will most likely get my business in the future. Nice friendly folks there.

To continue… The next day following my second appointment, the doctor called me on the phone… to my surprise and to even more surprise… it was on a Sunday.  He told me that my liver and kidney functions were close to normal…. (?)  I’m not real sure what that means.  He asked if I had an oncologist and I told him only the radiation oncologist because that was the only therapy that I could have due to my other wonderful illnesses.  He indicated that I should follow up with her and probably have a CT scan for further assessment.  Well… okay.

I picked up the report he copied for me to take to my other doc.  The interpretation of the x-ray taken from the first visit read:  There is persistent or recurrent air space disease within the posterior aspect of the right lower lobe.  Hmmm… What the heck is air space disease?  I knew I had that when I was in a crowded room or an elevator, but I didn’t know you could have that in your lung.

The interpretation of the x-ray taken at my second visit, made by a different radiologist read:  Persistent opacity posteriorly on the lateral view representing atelectasis.  Yeah… I know… don’t you just love those kind of words?  I had to look it up too… It means:  Complete or partial collapse of a lung or a section (lobe) of a lung.  My own definition of ‘persistent opacity’ is of course… the apparent inhalation of a cotton ball into the lung.

Now… you are up to date with additional info coming in the near future.  Monday was one of my worst days.  I coughed until I thought I was going to croak.  After which I could not get enough air into my lungs to function in any semi-normal way, no matter how I tried to breathe.  Not a pleasant experience.  Yesterday was a bit better during most of the day until the late afternoon.  I started getting extremely weak and overwhelmingly sleepy.  I kept nodding off when I didn’t want to.  As the evening progressed, so did the difficulties.  Chest hurting on both sides around to the back, the right side worse than that left.  A deep breath caused pain more in the middle, but places along the side in the area where the lung was radiated was the worse.  Didn’t sleep much at all… dozed for five minutes or so at a time, then awake for thirty.  This morning I was very weak when I got up.  Chest is hurting in various places.  At this moment… I am a bit better.

So… until the end of the week, after I obtain the delightful news that the radiation oncologist is going to add to this situation… I remain… humble within the universe… perhaps at the mercy of powers beyond my control… wandering within my humanness… with hope filling my heart.

No… I’m not going to leave you with that whiny sadness… I want to introduce you to a few of my newest friends that have chosen to cross my path, bringing me many smiles and sharing with me their love… and I thank them profoundly…

Baby Jay

This baby Blue Jay was learning to fly when he/she managed to flutter recklessly onto the birdbath.  It was so adorable to watch it attempt to walk the sloping concrete side to the water line.  It certainly enjoyed the drinking though.  I suppose it had been a hard morning for the little creature.  It wasn’t a bit afraid of me or it was just too tired from flying lessons to fly away when I approached.  Its mom and dad were yelling at it the whole time I was near to it… “Stay away from the human”… We bonded a while before she/he returned to the Oak tree with mom, dad and some very loud siblings.

Posey

This is Posey.  For some reason, Posey has decided to take up residence under my house.  She generally comes out after dark, hangs out with the cats a while and digs holes all over the yard.  On this day, Posey decided to come out for a delicious cat food breakfast.  Yes… Posey thinks she is one of the cats.  The cats just sit around and watch her eat with their paws over their mouths… snickering.  I think she is trying to learn to purr.

Kitten

This precious creature is the sole survivor of a litter of three.  Born beneath the bench just outside my kitchen window to a feral feline that actually stays a block or so from my house.  Two days after they were born, the mamma cat moved them somewhere up the street.  About six weeks later, she returned with this one, very hungry kitten.  Then… she left him here for me to care for.  She’s done this several times before although I have pleaded with her not to leave them here.  As she was walking away, I hollered across the street saying… “Hey… you forgot something.”  She didn’t look back.  She comes here to eat breakfast most mornings… but leaves alone.  She’s been around the neighborhood for many, many years.  She must be a very wise creature to have survived for so many years in the great outdoors of the city.

The kitten doesn’t have a name as yet.  It’s a boy… any suggestions?

Hope you all have a most beautiful day…

Namasté

Michael33