Picking up where I left off this morning: after 2 appointments with the nurse practitioner at my local clinic attempting to troubleshoot the source of my chronic cough, she refers me to National Jewish Hospital in Denver, warning me I may not get an appointment for a month. Looking back, I realize there was a lot of grace in this time – first, to be referred for more tests so quickly (many docs would never suspect a tumor as a source of a cough in a healthy nonsmoker and would continue going down the standard protocol of antihistamines and anti-reflux regimens), AND I was able to make an appointment in just a few days rather than having to wait another month.
National Jewish Hospital is considered the # 1 respiratory hospital in the country – I met with a pulmonologist, who explained the many reasons for a cough and basically had the same plan as my local clinic – more antihistamines and a acid-free diet. Luckily however he ordered a chest x-ray and bloodwork as a precautionary measure. I left the hospital a bit deflated, thinking I may be on my own trying to beat this frustrating cough. However, less than 30 minutes after leaving the hospital, I’m driving down US-36 on my way back to Boulder and the phone rings. Its the pulmonologist. Uh oh. They never call, unless…
Keith, there is something in your X-Ray, we need to get you back in for a CT scan as soon as possible. I asked if it was on the left side and he said yes (I had an intuition it was my left lung causing the cough). I hung up – and the next moment is one that will stay with me forever: Traveling at nearly 80mph down an open highway, it was as if time slowed down and nearly stopped. ALL of the chatter, the discursive thoughts, past, future, all dropped. Just this. My mind wasn’t guessing or even curious, there was just a direct meeting of my own mortality and the presence that it delivers. After what felt like an eternity but was probably just a couple of minutes, in my mind appeared the people most dear to me, a lightning bolt reminder of what is actually of greatest importance to me. My relationships.
I arrive home after running a few errands – the hospital calls and I schedule a CT Scan for the next morning along with a follow-up with the pulmonologist a couple of days later.
In the CT scan they inject me with a dye through an IV to get a clearer picture of what’s happening in the chest and lungs – a CT scan is a highly advanced x-ray machine that essentially takes a series of x-rays from different angles and creates ‘slices’ of images that a radiologist can use to make a much more accurate determination as to the extent and location of a mass, as well as its effects on any nearby organs or blood vessels.
A few hours after the CT scan a message appears in my inbox saying a new test result is available in my patient portal. I quickly open it and with my own eyes, read and slowly comprehend the magnitude of what is growing inside me:
Large heterogeneous 8.5 x 5.8 x 7.9 cm mass centered in the anterior left upper lobe without a fat plane separating it from the left superior/anterior mediastinum. Differential considerations include a mediastinal mass with extension into the left upper lobe including lymphoma, thymic neoplasm, or germ cell tumor; alternatively, findings may represent a primary left upper lobe mass with invasion into the mediastinum such as a primary lung carcinoma. Recommend further evaluation with tissue sampling.
Mildly enlarged left mediastinal and hilar/perihilar lymph nodes, metastases not excluded. Abrupt vessel cut off of the left subclavian vein likely due to external compression, with associated surrounding vessel collateralization.
And I have two days to wait before meeting the doctor…