What a long strange trip it's been... Part 1

Part I - The Saga Begins
Once again, it's been a long, long time since my last post. This time I have a pretty good excuse, though.

I apologize to those I should have been in touch with about all this, but to be honest, it's all been pretty overwhelming. I've been out of the hospital for just over a week now, and I'm just now getting around to posting this.

This is just part 1; I'll be posting part 2 as soon as I manage to get it written, which most of you know can be just short of an eternity. Anyway, here's part 1.

In early December I noticed a lump about the size of a large peanut in the center of my left breast. It had never been there before. About the same time I began having bad pain in the right side of my neck and back, and a numbness along the right edge of my forearm and hand. I soon noticed a fairly large knot (about the size of a gumball) on the right side of the base of my neck. Within a few days, the lump in my breast had increased to the size of a gumball as well. I made an appointment with Dr. Rodwick for December 27.

By the time of my appointment, the knot on my neck had become a cluster of two or three knots, and the lump in my breast had grown to about 2 inches in diameter and nearly an inch thick. It sat flat under the nipple, atop the rest of the breast. Dr. Rodwick immediately made an appointment with the imaging center at St. Anthony's for an ultrasound of the neck mass, a chest X-ray (because I hadn't had one in a zillion years), and a mammogram. I was lucky to get all three scheduled for the same day. (I don't have any schedule in front of me, so all the dates that follow are the products of my frequently-faulty memory.) I think the appointment was for January 17.

Well, I screwed up the time and showed up some 2 hours late, so they were only able to do the sonogram and the chest x-ray. I had to return January 24 for the mammogram. The mammogram showed pretty much the same thing as you could feel, a big mass sitting on top of the breast. The mammogram person decided I needed a sonogram of the thing as well, so I went to a nearby room and a sonogram was done. A doctor from the breast center came in and, looking at the mammogram and the sonograms of the breast and neck, said it was obvious both were enlarged lymph nodes, but that that didn't really tell us anything; the question was: why are they enlarged? She ordered a needle biopsy for January 30.

I was back on the 30th, and the biopsy was quick and nearly painless. The worst part was the shot of novocaine to deaden things. I was told that it was slightly possible the lab would have the result the next day, Friday the 31, but if not it would be the following Monday.

Of course it was the following Monday, February 4. Dr. Rodwick called me about 10 am and told me the results were back, and that the lumps were both lung cancer.

Lung cancer? In my neck and breast?

Yes, apparently I had somewhat advanced lung cancer which had spread to my left breast and the right side of my neck. He gave me the number of Gulf Coast Oncology Associates, also in St. Anthony's, and told me to contact Dr. Michael Diaz. I thanked him for letting me know so quickly, and hung up in a bit of a daze.

It was a special sort of kick in the head that it had been one year, almost to the day, since I quit smoking. I immediately called and made an appointment with Dr. Diaz for Wednesday, Feb. 6.

Michael Diaz impressed me immediately. He seemed completely confident in his knowledge and abilities, without being arrogant and overbearing. He really listened to my questions and concerns, and actually attempted to answer them as best he could rather than sweep them away with platitudes.

I asked him straight out at that first meeting if he would be able to treat a pre-op trans woman the same as he would any genetic female. His response went beyond just being reassuring, convincing me that the only way in which he would treat me differently would be in anything directly involving questions of genitalia (for example, the thought of cells spreading to the testes). He later proved this to me by placing me in a room in the "Women's Unit" when there was no room available in the oncology block.

All questions answered, he made appointments the next day for blood tests at 9:30 am, an MRI at 12:30 pm, and a PET/CT scan at 2:30 pm. Unfortunately, the MRI at St. Anthony's wasn't available that day, so I had to drive to another St. Anthony's facility in the Carillon center, then back downtown for the PET/CT scan. Amazingly, I made all three appointments.

Near the end of PET/CT scan, after which I was supposed to go home, the scan operator got a phone call from Dr. Diaz, telling her to leave the IV in place in my arm when we were done and to send me up to his office.

I duly rode the elevator up and he sat me down in the now-empty offices. He explained that one of the things small-cell lung cancer cells do is secrete a hormone which basically causes the body to dump sodium and retain water (it's a lot more complicated than that, but that's sort of the net result). This causes your body's sodium levels to plummet, and this is not a good thing.

He had already gotten my blood test results back, and the sodium level had immediately jumped out at him. If he didn't know that I had walked into the office for the test, he would have thought I was lying in a coma somewhere near death.

Normal levels are from about 135 to 145. Mine was 108. This is apparently considered life-threatening; the only reason I was even standing was that the drop had occurred slowly enough, over a long period of time, for my body to adjust somewhat to the low levels. Anyway, he said he was admitting me to the hospital right then and there. I said I would go home and pick up Nickie and a few things, and he said no, I'm walking you through the emergency room right now.

Luckily, a friend of ours was visiting when I called home and was able to give Nickie a ride down to the hospital to see me and pick up her car. By the time she got here, they were about ready to take me to a bed in the ER. Dr. Diaz actually wanted to get me into the Intensive Care Unit, but there were no ICU beds available yet. I spent Thursday night in the ER.

End of Part I.
More to come in Part II.