So, not really. I was in the room that Monday night when Mike woke up with acid pooled in his throat. This was almost 6 weeks ago. He got up and started sipping water to wash away the acid out of his throat. He took a bunch of medicine and went downstairs to sit up. He turned on the TV to distract himself from the burning in his chest. After a couple of hours he fell asleep in the chair and got up around six. He wasn’t burning anymore and his stomach didn’t feel that bad but he was coughing. He coughed up some nasty stuff for a few days, and that seemed to clear up. However, by the middle of the following week he spent two nights when as soon as he lay down he started coughing and he had to sleep sitting up. That led us to Friday just over 4 weeks ago. It seems like forever ago. He and Judy had appointments at the audiologist that day, and they went to the Kroger store where they buy their food for Passover. Mike said he was going to stop by at urgent care and get some cough medicine so he could sleep. They went over to the WellStar urgent care where he had been two years before to have a cyst removed from under his arm. The young woman doctor who removed the cyst had been beside herself with joy, a veritable Dr. Pimple Popper. Anyway, Mike went in and got checked over by another young doctor who couldn’t find much, but she said that she ought to get an x-ray of the chest just to be sure that he hadn’t developed pneumonia or something. About 30 minutes later she walked back in with this look on her face and said “I hadn’t expected this.” She had a monitor and showed Mike the chest x-ray. There was a large mass in the chest above the heart. The radiologist report was that the mass was at least 7 cm in diameter and that it was highly suspicious for lung cancer. Mike stared at the chest x-ray for a while in disbelief. Judy was out in the waiting room thinking that he would come back with a bottle of cough medicine and they would go home and have a nice evening together. Mike did get a prescription for cough medicine and told Judy when they got out to the parking lot that he had a mass in his chest. Try as he might, he could not think of anything other than cancer that would look like that. Anything else would have been very oddball but still possible. The doctor at urgent care had given him a referral to pulmonary medicine but as everything of significance happens on a Friday afternoon, he had to wait until Monday to call and try to schedule an appointment. He was able to get a Tuesday appointment. He had to cancel out all his Tuesday afternoon patients and he and Judy went to see the pulmonologist. She was great. She was very positive and scheduled a CT scan for the same afternoon. She called him the next day and said that it looked like lymphoma. This was a great relief because this is a more treatable disease than lung cancer for the most part. It’s hard to grasp what goes through the mind of a person who feels well and thinks he’s going to be able to enjoy a few more years of life and then wonder if he’s about to celebrate his last Passover with his family. In the interest of transparency, he let Michelle know what was going on once they had met with the pulmonologist. She was understandably upset. Neither she nor Judy are ready to let go of Mike yet. That week was a rough week for our family. Uncertainty is very difficult to deal with. Mike lives by a program that advocates taking life one day at a time, but this is easier at some times than at others.
The next step was a biopsy. It was scheduled for the following Monday afternoon. Mike had to be NPO since the previous midnight and showed up at the hospital quite dehydrated. He normally is an easy stick for an IV but two nurses each tried twice and failed. The doctor got it on his second attempt. If he had done it the first time the nurses never would’ve heard the end of it. He told Mike that there were three possibilities: lymphoma, small cell lung cancer, and sarcoidosis. Mike thought that sarcoidosis was an extreme long shot but he would’ve taken it right then and there, no questions asked as it is generally not a fatal disease. Small cell lung cancer on the other hand is very bad. Lymphoma would have been the most likely preferred option and so that’s what Mike was going for. He could tell, however, that the doctor thought it was small cell lung cancer. The kind of procedure that they did to get the tissue was called a ultrasound-guided trans-bronchial mediastinal lymph node biopsy. It was done under general anesthesia. Mike felt fine afterwards. They had an appointment two days later with the oncologist. More uncertainty and trying to remain calm. The oncologist had good news and bad news. The good news was that it was a lymphoma. The bad news was that it might be a more aggressive form of lymphoma. More tests on the biopsy sample were needed and being done. Mike and Judy were considerably relieved, in part because they were told that it was likely a treatable illness that he wouldn’t die from. The oncologist was a very nice fellow who suggested that they meet again the following week and also that whatever they found and recommended Mike probably ought to get a second opinion. He also mentioned that the more aggressive tumor was potentially curable with an autologous bone marrow transplant. That means that they would take bone marrow from Mike, treat it, give him intensive chemotherapy, and re-infuse his own bone marrow into him. Mike read up on bone marrow transplantation and was pretty sure that he didn’t want to do it. It would take 4 to 6 months out of his life and he would’ve had to close his office. It would’ve also placed a huge burden on Judy. And he couldn’t sleep with his cats.
Almost 2 weeks ago they met with the oncologist again and he informed them that it was a fairly aggressive form of cancer called a mantle cell lymphoma. He presented a treatment plan which included chemotherapy with two drugs. Mike had an option of entering a study in which he might get a third drug that was also approved for this tumor but only as second line therapy. That means that when the first therapy fails patients could move on to the third drug. They were doing a study to see if using all three drugs at one time produced a better result. This time when they met with the doctor he was backtracking on the bone marrow transplant. He said that Mike might be too old. Mike was in otherwise excellent health for his age, but still, it was very borderline. Mike told the doctor that he didn’t want a bone marrow transplant. Mike did some investigating and decided to get a second opinion consultation at the Emory University Winship Cancer Center. This is a highly respected center in Atlanta and several people offered to try to help him get in to be seen quickly. The oncologist also offered to help him get a consultation. Mike will see the doctor there tomorrow, and is feeling very positive. It takes a while to get used to the idea that you have a chronic and potentially fatal illness, and that you’re going to have to endure intensive chemotherapy, especially for a person who has never been sick. Up until now, Mike has probably not missed 5 days of work in the past 40 years because he was sick.
Mike has a friend, Robert, who is about 12 years into surviving cancer. He has been to the top cancer centers in the country and had about a dozen major surgeries and much chemotherapy. Robert has been very helpful and encouraging to Mike and has tried connecting him to people who might be able to help him. Another friend of Mike’s, Mario, who is a cancer survivor, has gone out of his way to encourage Mike and give him support. Mike has let quite a few people know what is going on with him, mostly friends, family, and synagogue members. He’s also let his patients know that he has an illness that may take him out of the office from time to time and that they may have to see other doctors who will be filling in for Mike as needed. The amount of love and support that Mike is getting is quite overwhelming. There is a lot of prayer and loving energy coming his way. I think that, plus Mike being the kind of person he is, is going to get him through this. Judy and Michelle are holding up very well which is also very helpful not only to them but to Mike.
The main question in all of this, of course, is how is it going to affect me? I, after all, am a self-centered cat. Excuse me for being redundant. I’ve heard Mike tell many people that you never know what challenges are going to come your way in life. It’s one of his 90% rules. He says that 90% of the stuff you worry about never happens, and 90% of the stuff that’s really bad that happens to you never would’ve dreamed of ahead of time. They say if something doesn’t kill you makes you stronger. This is only true if you decide that you’re not going to be defeated by something. It also helps to believe in something greater than yourself. I think Mike is going to be just fine, and I think the same holds for me. Thanks for your concern.
Mike and Judy are ready to go ahead with treatment. Once they meet with the doctor at Emory they will make a decision and move ahead forthwith. Life is an adventure. Mike has decided to embrace this one and see where it takes him. I should mention that yesterday Judy twice saw a red-tailed hawk in the Japanese Magnolia outside of our dining room. This is probably the same hawk that came and visited Mike when he was so upset about things after that stupid Selection (please see the post “The Hawk”, December 4, 2016). Mike also saw a hawk as he was leaving work a few days after he found out that he had cancer. The Hawk is Mike’s spirit animal. People with the Hawk spirit are intuitive and visionary. Hawks can see great distances and with clarity. They are powerful and courageous. They mate for life and are devoted to family. They are loyal. I won’t say that Mike has all these qualities in great measure but he values them and draws on the universe to carry them in his own spirit.
So, that’s whats happening in my little corner of Happy Meadows. I will keep you informed as things move ahead. Here’s hoping that you had a lovely Easter, or Passover, or whatever you celebrate. If you are motivated, please say a little prayer or send us some positive energy, because it will help. We will do the same for you. As I often say, if it ain’t about love, it ain’t about nothing. Be well!