M went to see Dr. L, a neurosurgeon that is well renowned for the Gamma Knife. The Dr thinks M is a great candidate, “can you be here tomorrow?” Well, no, but it’s nice to have a doctor with a sense of urgency. At this point it had been a month since diagnosis.
Category: nsclc
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June 8, 2016 – CT Guided Biopsy
M had a CT guided biopsy and it went well and was successful. Because they use a series of CT scans to place the needle, they can make sure they get into the tumor to get a snip.
So now we have a type, non small cell, specifically a poorly differentiated adenocarcinoma.
Now that we know that, M can see the neurosurgeon for a consult for Gamma Knife.
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May 26, 2016 – PET Scan
The PET Scan went smoothly. It showed the lung mass but none elsewhere in his body so hey, there’s a positive.
Still doesn’t answer the question of what type so we have no plan of attack yet.
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May 20, 2016 – Bronchoscopy
M had his bronchoscopy to try to get some of the tumor for sampling. He sailed through it, the pulmonologist was optimistic that they got a sample.
We found out a few days later that it was unsuccessful.
Still no information.
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May 12, 2016 – Radiation Oncologist Visit
May 12th was the first followup visit after hospial discharge. We saw the radiation oncologist. He said that treatment for the brain tumors would depend on the type of lung cancer. If it was small cell, it would be whole brain radiation which could be done there. If it was non small cell it would be Gamma Knife for which we’d need to travel into the city.
I got some measurements while the Dr was flipping through the MRI & x-ray:
- Lung mass: 26.5 mm x 11.9 mm
- Brain tumor A: 12.3 mm x 13.1 mm
- Brain tumor B: 10.7 mm x ?
- Brain tumor C: 2.5 mm x ?
M’s back and arm pain, that he’d had for weeks, has disappeared since starting the dexamethasone. It seems that the steroid has reduced the swelling around the lung mass which must have been pressing on nerves.
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May 7, 2016 – The diagnosis
For weeks M had pain in his back, around the bottom of his right shoulder blade. He thought he pulled a muscle sneezing. Then the pain headed down the back of his upper right arm. Still blamed the sneezing. So, M said he’d go to the doctor, but he didn’t.
Saturday, May 7th – I was getting ready to shower, as I was heading out for the day, M was mowing. I heard the mower shut off, no biggie. M came in, I was in the bathroom combing my hair, something sounded off and then I heard my nickname that M calls me. Out to the kitchen and it’s very obvious something is very, very wrong. M was flailing his arms and had very garbled speech. My brain screamed stroke, he’d had one in 2014, so I screamed, “you’re having another stroke, we need to get you in the truck.” (Note: M is very opposed to 911, it’s not an option unless he’s unconscious and then he’d probably be pissed when he came to.) Got him into the truck, said hold on, I’ll be right back. Well, I didn’t have shoes on, was still in what I wore to bed, and needed to grab some things so we could go. I ran back into the house, grabbed my phone from the charger, saw a bra on top of my dresser, grabbed that, stuffed it in my bag, looked out into the garage and M is flailing around in the middle of the garage. I went out, screeched, “get back in the fucking truck or I’m calling 911” and went back in and got my shoes on, grabbed my bag and off we went. M hit my hand away when I tried to help fasten his seat belt. As we drove, he’d try to get words out. After about 15 minutes he started to be intelligible.
We got to the hospital, I said stroke symptoms, told them the times, and they had him whisked off to the back instantly. I went to park the truck, came back in, and he was already hooked up to monitors. We answered a bunch of questions, and the ER doctor stated he didn’t think it was a stroke, maybe the garbled speech was from anxiety. (WTF? Anxiety? This was the same ER doc that said he didn’t have a stroke in 2014 then the tests proved him wrong.) But he sent him for a CT scan of his head. After M was back from that, Dr. Asshat came in, and said, “it doesn’t look like he had a stroke, but there’s some abnormalities, we’re going to do an MRI. It looks like there might be tumors.” And he left. (WTF? How do you drop a bombshell like that and then just leave?) The MRI showed 3, possibly 4 tumors in M’s brain. They did a chest x-ray and yep, there’s a mass. Thankfully Dr. Asshat was not the one to give us the rest of this news.
M was admitted, essentially for observation. In working up the next steps, there was a snag. M takes clopidigrel, can’t go rooting around in his lungs until he’s off it for a week. So he was discharged the next day, with a bronchoscopy for biopsy scheduled for the 20th. Preliminary diagnosis: likely lung cancer with brain metastases. New meds: dexamethasone and levitericeum.