Friday, March 13, 2009

Busy Couple of Months

I am happy to report that my last radiofrequency ablation (RFA) was successful, with almost no side effects whatsoever -- very little soreness, no cough, etc. Because of the location of the tumor, I had a small pneumothorax (collapsed lung), which we anticipated. This means that Dr. Georgiades is only about 80% sure that he ablated the entire tumor, but I'm confident that he got it all. If not, he'll do another RFA and finish the job. It's not that big of a deal in the grand scheme of things. (I told Dr. Georgiades that I think of him as Yoda, teaching his young Jedi Knights how to ward off evil with their magic light sabers, or RFA needles. He was not as receptive to this analogy as was the Fellow who was assisting with my RFA that day. The young doctor seemed excited at the prospect of sharing my analogy with his entire class.)

So where do I stand now? We believe that all "declared" or "detectable" tumors have been killed! I do still have 3 or 4 tiny spots on my lungs, but we can't tell what they are. Lots of people have spots on their lungs because we live and breathe in a dirty world. But unless they grow to a point where they light up on a PET/CT scan, I am going to assume that I have no traceable cancer anywhere in my body. I can't even begin to express how it feels to say that. It's pretty amazing and staggering. It stops me in my tracks.

I reported earlier that I had a total of 11 tumors since being diagnosed with lung metastases. I had 3 removed surgically in October 2006, and 7 have been ablated in the last 6 months. Either the last one disappeared (which is unlikely, given the growth pattern of all the other tumors), or it shrank down to one of the tiny spots that we're now following, or it may have been double counted. In any case, it's hard to keep track of these things because the lobes of the lungs are shaped in all kinds of crazy ways, and doctors are trained to follow what's there at the time, not what might have been as seen on prior scans, taken at a different hospital using different equipment. I'm just taking things one scan at a time. My next PET/CT will be at the beginning of June. We'll be able to tell at that time whether this last tumor is completely dead, and if there's been any changes with the other tiny spots. I will never be "cancer free," "cured," or categorized as "in remission," but, thanks to Yoda, I think I'm close to being "tumor free" right now, and it feels pretty good!

I'm very grateful and relieved that this last ablation was the easiest one to tolerate, but it was not without drama. The ablation was originally scheduled for February 12th. However, it had to be postponed because my dog - a sweet Silky terrier with a major fear aggression problem (which I thought was under control), turned on me one night and bit off a chunk of the top of my ear. Although the piece of ear was too small to sew back on, I was lucky that my ear filled in and I recovered completely. My dog was a stray, found by a shelter. He had the aggression problem, unknown to me at the time, when I adopted him a year ago. Since this was not the first time he bit me, I had to make a difficult decision. I gave him back to the shelter, where he will now live as a permanent part of the shelter's pack. I think that he'll be happier around other dogs and more people, and although I adored him, I'll be safer and under less stress. Anyway, the bite to my ear introduced a threat of infection, which caused the ablation to be postponed.

Next, I started having gallbladder pain. Gallbladder polyps were first detected on a CT scan last August. The pain was extreme and came and went for over a week. Since my blood work didn't show any infection or inflammation, and I didn't have a fever or chills, Dr. Georgiades said that I could go forward with the ablation, which had been re-scheduled for March 3rd. I headed down to the Baltimore/D.C. area the day before the ablation, as I usually do, but ended up driving straight to the emergency room at Johns Hopkins because the pain was so bad. I was told that I had Biliary Colic, a condition usually caused by gallstones. It reminded me of a baby that cries all the time -- when I ate, my gallbladder screamed like a baby. I was advised to schedule a laparoscopic cholecystectomy to have it removed once I recovered from the ablation. In addition to the morphine shots every two hours and a consult with a surgeon at 3 a.m., I had a roommate that makes this story read like a bad Scrubs episode. She was a sweet elderly woman, a bit senile, with insomnia. She would hit the overhead florescent light button instead of the nurse’s call bell, tried to watch the news at 5 a.m. after I finally got to sleep, and asked my cousin, who flew in from Pittsburgh to be with me, to give her an enema. I could go on, but it would be too much information. The next morning I went for the ablation completely exhausted, with a morphine headache. But once the ablation was over and I got a good night's rest, I was as good as new.

I drove home last Thursday, went to work Friday and Monday, and had another 911 gallbladder attack on Monday night. I ended up at the emergency room again on Tuesday, this time closer to home, had my gallbladder removed on Wednesday, and came home yesterday. I'm doing really well – just resting at home feeling a bit like a blowfish. I'm glad the attacks are over and I no longer have to worry about the polyps, which, if they grew, could have become cancerous. My surgeon said that I could have had gallstones in addition to the polyps, or the polyps themselves could have caused the pain if one or more were blocking the bile ducts. The pathology report should be interesting.

Looking back on the last two weeks, I hardly remember that I had an ablation. Looking back on the last two months, I'm ready for a break! Since late January, I've shared a bout of food poisoning (possibly the Nurovirus or Cruise Ship Virus) with about 25 others who attended a client function at my firm, had the top of my ear bitten off by my dog, resulting in a heart breaking separation, had a tumor burned out of my chest, and had my gallbladder sucked out of my belly button. I'd say that constitutes a busy couple of months.

Here's to a calm, relaxing, healthy Spring!