Tuesday, October 22, 2013

What Happened Today

I spent 50 minutes waiting to see the doctor.  Was somewhat reassured when they 1) brought me to an examining room rather than his office, and 2) didn't ask my husband to come back with me. A lot of folks don't realize that these, like the word "suspicious," are telling.  They're code for "this ain't good."

When the doctor came back, he shook my hand and asked how I was.  I asked how HE was, then said, "I don't know--how am I?"

He whipped out the radiology report and said, "There's nothing there."

Nothing there.  This is a 6+ centimeter mass that is growing--it is noticeably larger than it was a year ago, and it is even larger than it was 10 weeks ago.  But there's nothing there but fat.  He even took me out and showed me the MRI.  It's clear as a bell, and it's fat.  Nothing else.

Not showing on an ultrasound?  That's not necessarily surprising, considering I'm overweight AND some neoplasms just don't show on ultrasound.  Not showing on an x-ray?  Even more understandable--x-rays aren't great for soft tissue masses, and, again, my weight could negatively impact the quality of results.  But an MRI?

That's the standard, and, of all the imaging options, it's the one that isn't affected by adipose tissue.  Which isn't to say that an MRI can't miss stuff--just last year, an MRI missed a fibroid/mass.  But a clear x-ray, a clear sonogram, AND a clear MRI?

He offered a biopsy, and I've taken him up on the offer.  Some folks might say I'm being obsessive at this point, but here's where my mind is:

Two weeks ago, this doctor looked at me and said, "The time for an MRI was right after the ultrasound came back negative."  I don't want to be sitting in an oncologist's office a year from now, being told that "the time for a biopsy was right after the MRI came back negative."

Soft tissue sarcomas come in all shapes and sizes, and, while none of them are GOOD, some are particularly BAD, and the prognosis can be devastating.  This is especially true when they've been missed, have had ample time to have their way.  

So tomorrow I'll call the insurance company and figure out whether or not they'll pay for a biopsy performed in a "free standing surgical center."  Then I have to figure out if the surgical center will send the lab work to the correct lab.

Single payer.  I have a dream, you know?

Thanks for the concern, advice, and care.  I'll keep you posted.

3 comments:

  1. Last year I had a small lump in my breast. Several years ago I had cancer in the other and went thr surgery and radiation.

    My oncollogist kept checkin this lump every three months, and finally said she was sure it was not maglinent, but best to have it out.

    It was a small fatty toumor. No cancer, but we didn't ignore it.

    I have had several biopsies over the years. All were negative, except one. If my doctors hadn't continued to check on every one, they would have missed it.

    Get the biopsy if you can. Nothing like conclusive evidence to help you sleep and put this behind you.

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  2. I was just listening to David Sedaris, telling a story about a lump he found that turned out to be a fatty tumor. He was living in Paris, utilizing their great health care, and the doctor told him, "It's a fatty tumor, dogs get them all the time!" So, I hope it is just a fatty tumor, and that's it. Dogs get them all the time!

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    1. That's the crazy thing--it's not a "tumor" at all. There's no walls, no lines of demarcation, no encapsulation at all. There is nothing that sets this apart, radiologically/imaging-wise, from the surrounding adipose tissue. It IS adipose tissue, and it's a part of the surrounding layer of fat--it isn't in any way different or set apart. In fact, all you can see on the x-ray, the ultrasound, or the MRI is a dent and bump in the fat--same as you can see from the outside with the naked eye. There's no tumor, this isn't a lipoma. So yeah, biopsy. Definitely.

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