The Pulmonologist, A Major Problem, Next Steps, and a Flight

James made it to the pulmonologist last week, which turned out to be excellent, if not without a little drama. This pulmonologist is an internal medicine doctor who has worked in critical care for decades...and is definitely not okay with James coughing like he's been doing.  

"I heard you from the other room [examining another patient].  You don't exactly have a subtle cough going on there."

He spent a good 30 minutes with us, trying to get read into the total picture of James's health history which we certainly appreciate - not all doctors have that kind of time - but we know that helps with diagnosis. 

Some of our conversation was somewhat amusing.  
Dr P: Have you been checked for histoplasmosis?
James: No.
Me: Oh, well, see, that's one of the things we initially thought this was since, you know, 30-something non-smokers don't get lung cancer. [Grin.]
Dr. P: [Chuckling] Riiiiight. [Writes up lab order to get that checked.]

Then later on, Dr. P is explaining to us that lungs don't have pain receptors but rather, they have cough reflexes. Thus, when there is something irritating the lung tissue, we don't feel pain. We just cough. So perhaps there is something [else] in James's lungs that is causing the cough.

Dr. P: When you did your bronchoscopy, did the doctors mention anything about blockage?
James: Well, there was the tumor that was blocking my lung that made it collapse.
Me: I think once the doctors saw cancer, they just went with that. 
Dr. P: Ooookay.  

And then, a less amusing portion...
Dr. P: Did the doctors share your CT results with you?
James: Yes.
Dr. P: Did they tell you that you have a blood clot in your chest?
Us: [Eyes wide, mouths agape] Nooooo.
Dr. P: Well, I'd encourage you to get that checked out [with the surgeon who placed the port].

So that was kind of how our week went last week.  

Actually, our week went really well.  Other than thinking through the possibility that my husband could die from an anuerysm or a stroke rather than cancer (the location of the clot was in his port, so if one of those things did happen, it would be death via the cure).  Strangely, James and I were not worried at all. We did think about how it might mess up our plans for the next few weeks, but otherwise were kind of like, "Whatever.  Let's go find out what's next."

Maybe getting diagnosed with a highly fatal the deadliest form of cancer does that to you. You can get news of a potentially fatal blood clot and think, "Oh, something else that could kill me but probably won't. Won't it be interesting to find out what they do to fix this?!"

To make a long story short - we went to the surgeon's office and made an appointment for the following day. (Which actually freaked out some people we told: IF A SURGEON GOT YOU IN TOMORROW, I THINK THIS IS A MAJOR PROBLEM.)  I remained convinced that it was either something that could be easily resolved or just nothing.

As it turned out, we are happy to report that it turned out to be nothing. James does not have a blood clot in his chest, inches from his heart, brain, and lungs. Yeah! 

And we had a really great conversation with the surgeon. ("You look good, James. Do you feel good?") And then an awkward moment when we had to tell him why we were visiting (despite already telling his nurse that upon arrival). Needless to say, the surgeon nearly ran out of the exam room to re-check James's CT. 

The blessing of getting to see the surgeon, though, (other than the no-clot diagnosis) was that he was able to lay out his perspective on next steps. His hope is that James will qualify for surgery at the end of March and that at that time he will surgically remove James's right middle lobe, the site of the initial tumor. If James has that removed, chance of recurrence is reduced by 20%. Sounds good for someone in their 30's. (Of course, less than 2% of people in their 30's getting lung cancer sounds pretty good and we all know how that turned out!)

We do not know yet what next steps will be. 

But it's nice knowing a potential next step. 

Other highlights...
*James does not have histoplasmosis. 
*James is back on prednisone & will remain on it until his end-of-March PET scan. (The pulmonologist really wants to see what happens & looks forward to comparing his scans.)
*James is now using an inhaler. This, together with the prednisone appear to be helping.
*James is now back home with his family in China! He left on Sunday and arrived yesterday. I'll post more (from him) soon. 

Geesh this is a long post. How do we pray?
*Thank God for the pulmonologist and his desire to get to the bottom of James's coughing. 

*Thank God that whether or not the pulmonologist really did see a clot, twenty-four hours later, James did not have one. (We really don't know what happened - was the first doctor confused or did James get healed?  Either way, we figure that God does not get enough credit on a daily basis for keeping us alive. Give Him glory & praise.)

*Thank God that James is healthy enough to return home & that he went with the blessing of all of his doctors. 

*Ask that these meds would work, and that James would be restored to full and complete health. 

Thanks!  More to come...