Wednesday, July 15, 2009

Hoping for a hemangioma

Yeah, you read that right... sounds weird, especially if you know me and know about the hemangioma on my temple that looks like a big purple mole. I had it mostly removed via laser about 5 years ago but it grew back. At this point it's not really top of mind though, and isn't the kind of hemangioma I am hoping for.

This afternoon Jim met me at the cancer center for my appointment with Dr. Rini, to go over the results of the CT scans that were done on Monday. I was running slightly late for my appointment, since I'd left work a bit later than I should have and encountered multiple slow drivers on my way to the Clinic. Then my usual luck in the parking garage did not hold, so I had to park almost on the roof. But they were running a bit behind at Taussig (cancer center) anyhow, so I had a chance to relax for a few minutes.

When Dr. Rini came in, I could see the paper in his hand showed a printout of an image from my scans. Not good news, that... never good news. As he started to explain to me the two areas of concern that were noted by the radiologist, I could feel the sick buzz run through me... this can't be happening again! I am supposed to be NED again. I could feel the tears welling up as he talked. The disappointment and fear welled up for a while, though now I am feeling calmer and in fight mode.

First up was my right ovary. The radiologist noted that it is enlarged "with abnormal enhancement, increased from prior examination of 1/13/09". What happened to the April scan? I was scanned in April, but apparently the radiologist who read that film didn't see anything of note. Dr. Rini told us frankly that he didn't see any increase either, and that in his words, of 2,000 patients he's seen, he's never known RCC to go to the ovary. I like his opinion better than the impression noted on the CT results: "possible ovarian mass/metastasis should be considered." I'd had ultrasound in March when I had the endometrial biopsy done, but unfortunately nothing about the ovaries was noted in that report. Dr. Rini is going to follow up with my gynecologist to get her opinion. He mentioned that the radiologist may have "overread" the scan. Hopefully that is the case, but now I'm probably going to have to have some more testing of my girl parts. *sigh*

The second part of this one-two punch was the more upsetting. "There is an apparent enhancing lesion in posterior medial segment left hepatic lobe measuring 2.4x2.1cm". In other words, there's something showing up in the middle of my liver. Super. Just super. The recommendation of the radiologist was to follow up with a MRI. Even more super. Guess who has had one brief MRI in her life and who quietly freaked out the entire time? Guess who has hoped and prayed never to have another? Yes, that would be yours truly. But the MRI is a must. Bless his heart, Dr. Rini prescribed some Xanax for me to take before the test. And I need to remember to keep my eyes closed when I am in that damn tube.

It is possible that the liver spot is a hemangioma. If so, then I'm still in NED status and will have follow up CT scans in October. My sister told me, and I later remembered her mentioning it at the time, that when she saw a gastroenterologist about some issues, he noted that she had several hemangiomas, which he referred to as being as common "as dirt". So maybe I'm just spotty like Barbara? Hope so, anyhow.

If the MRI shows that this is not a hemangioma, then Dr. Rini says we will look into having it removed via Radio Frequency Ablation. This was one of the procedures that had been considered when we were looking to remove Spot earlier this year, but based on Spot's proximity to my intestines, it was ruled out. As we discussed before, Dr. Rini says that you can't keep chasing the cancer around, taking it out over and over from the body surgically. And if I keep having things pop up as frequently as I have, then it will be time to look at systemic therapy. However, he says I am not yet at that point. Yay for that! He and I will talk on Tuesday to go over the MRI results, and will talk about whatever the next steps might be.

In good news: my wound closed completely over the weekend. On Sunday morning I removed my bandage and realized that the Hydraferra was no longer in place. Oh my god, I thought, the wound closed around it. Great... now they will have to open it up to remove it. I called Jim into the room to take a look. He noticed the Hydraferra sitting behind me on the bed. Apparently it popped out when the bandage came off. RELIEF! Tomorrow's medical journey is to see the nurse at the wound center. I am curious to see what she will say about it. It is definitely closed; there is no drainage any longer. The only thing on the bandage surface is bits of the silver nitrate stain on my skin, which looks like gray dead skin flakes (because it probably is?). So yay for that.

In general, my health is good, I feel good, I just keep growing these extra "things". I cried some at the appointment, and told Dr. Rini that this wasn't the news I was hoping for, but that I am so grateful that he is watching me so closely. Later I told Jim that if Dr. Rini ever leaves Cleveland, we are moving to follow him. heh heh

So let's see, what am I waiting for at this point, medically?
- MRI and results so we see what we are dealing with hepatically
- information from my gyn about my ovary, and possible future appointments
- information from my PCP about my hypertension medication. I probably need to have the dose increased. For the past 3 months I have been taking low estrogen birth control pills to control my PCOS. I had to have my blood pressure checked to make sure the pill is not causing it to increase. Well, it was elevated. The nurse took it in both arms, sitting and standing. (Never had that done before) I had brought my wrist monitor and it was way off. She told me that the wrist monitors are not very reliable; mine seemed to be for a long time. Maybe it's too old? At any rate, I need a new monitor, and I need to find out about the hypertension med so that we can decide what to do about the pill.

So it seems I may be very busy in the upcoming weeks. Not really the summer plans I had dreamed of, but all things considered, they could be far worse. While I am absolutely upset and disappointed, I know how lucky I really am.

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