General introduction (long version)

If you want the short version it is here.

I had stopped blogging because I just had no time to do it. Or, at least, I no longer prioritized the time to do it.  I wanted to work on my house in Hilo. Or help my friends in one way or another. Or visit friends. Or go to an opera.  Not blog.

But, I'm back!  I was in Hilo trying to get my long to-do list done when my left tonsil interrupted the process.  An ugly lump developed there.  Maybe I will tell an even longer version of this sometime, but suffice it to say, I went to the Urgent Care place in Hilo for them to take a look.  Dr. Warsh took a look in my throat and was immediately a little cross with me.  "Why didn't you get this checked earlier?"  I felt a bit guilty.  I mean, I wasn't slacking—I did talk to my PCP in Santa Cruz about it;  I followed her directions.  Anyway, I realized he was just being like a parent to a kid—being freaked out about something the kid did, knowing that the kid would have no reason to know any better.


Clearly it looked bad to him.  Like cancer-bad. Oops.  He sort of apologized for looking so worried but said, "I have no poker face." I liked that he was so worried about me and we had just met. Anyway, he wanted me to get a CT scan—like right now.  He couldn't arrange it until the next day and that seemed too late to him.  So, he obviously thought it was cancerous.  And really time-sensitive.  And really serious.  That was a tad on the scary side.

I told Leslie the pretty bad news.  I mean, he could be wrong.  But, what if he wasn't?  I googled throat cancer and I realized that, geez, this could easily kill me. So, Leslie and I spent the evening doing the "what if" game.  She was, obviously, very scared, too.  But, she indulged me.  She promised that she would get another partner if I died. We decided to have a party if it was a bad prognosis so I could see my friends while I was feeling good. I started a database so I could track who I told what.  I made a list of things to do titled "If C". I did my and Leslie and a friend's taxes (needed to quickly knock off my to-do list) In other words, very "Robin-like" behavior.

The first problem that became clear is that I couldn't get care for it in Hawaii.  My HMO wouldn't pay.  The story of determining this for a certainty is long and tedious.  Bottomline:  I had to come back to California.  Yes, medical care in the USA is insane.  I admit, though, that I would have come home in any case to get treated for it, as the Big Island isn't exactly a medical mecca.

The fact that our house in Santa Cruz is rented, of course, creates a bit of a problem. (It's weird to have two homes and be homeless.) The fact that we had a puppy creates another mess.  But, pretty much as soon as I told anyone, I either had a key to their house or an invitation to stay. (I LOVE YOU ALL!!!) You need not worry—homebase is San Jose with Laura and Doug (my fabulous brother and sister-in-law via Leslie).  Leslie returns Monday with our puppy, Seiglinde (Ziggy for short). She is a Jack Russell Terrier so, as many people have pointed out, she is a lot like me, for good and ill.

To continue...I got the CT scan. That was a trip.  They shoot some stuff into your body and then put you under the scanner.  The stuff that they shoot you up with makes you feel like you are pissing when you are not. And your body gets really hot.  Very, very odd sensations.  They assure you that you aren't really pissing, though. So, I  kinda enjoyed it.

The scan people handed me the results (on a CD) and I drove back over to Dr. Warsh.  He was incredibly relieved that the scan seemed to rule out lymphoma and didn't show any lymph involvement.  Still, the next stop should be an ENT.

This actually created a problem because they way HMOs work is to use the PCP (primary care physician) as the gatekeeper.  Well, at the end of 2010, I had to say goodbye to my long-time PCP, Tracy MacClay, as UCSC changed their health care options and to keep her medical group would cost us about $1,200 more per year.  So, Leslie and I chose a new physician who is two blocks from our house (for locals—on Mission St where the Carpo's was), but I left for Hawaii before I could meet her. I had to get her to give me a direct referral to the ENT without seeing her so as to not waste time.  After Dr. Warsh sent her his notes, she did so with the caveat that her medical group insisted that she see me sometime within two weeks of the ENT appointment.

So off to Dr. Seftel.  Now, Leslie had seen him and told me that he isn't your hand-holding sort of doctor. However, he is a very straight shooter.  I don't need handholding; I need facts—so that wasn't a problem with me.  He comes in, asks a few questions and then looks at the throat.  He then quickly pronounced the lump "ugly" and, essentially, wanted to treat it as if it was cancerous.  He did a biopsy then (a local anesthesia followed by a quick clip of a chunk), but I would say he was about 100% sure it was cancer.  So, I was about 100% sure it was cancer.

He wanted me to get both an MRI and a PET scan (which is full body scan for cancer) and set me up with the Stanford "tumor board" for yesterday.  This was about 9 days ago.   His very efficient staff got permission from my medical group to pay for all this—and times for these appointments—within hours. 

A few hours after my visit to the ENT, I got to meet my PCP, Dr. Owens.  I gotta say this: she's great.  Hit the jackpot.  It was doctor-love at first sight.

The biopsy came back as squamous cell cancer but it didn't show that it was invasive.  Dr. Seftel just pooh-poohed the biopsy.  He said, "it's invasive; don't believe it."  The good news, though, is that the involvement of the lymph nodes—if any—is at the very early stages.  More good news  given the existing cancer (and this is counter-intuitive)  —I am positive for HPV-16, which is associated with both this type of cancer and a better prognosis.

It was my first MRI and I found it quite entertaining. As I have mentioned to some other people, for three minutes the sound I heard was:  bed bug, bed bug, bed bug, bed bug... Of course, I was supposed to stay still. It was totally hard not to laugh.  As for the PET scan, I slept through it.  It turns out I clearly do not have claustrophobia at all, which is a helpful thing.  Anyway, the scans showed no lymph involvement, which is great.

So, that brings you up to yesterday, when the Stanford tumor panel did it's thing.  That will be another post!  (Sorry to leave you all with a cliff-hanger...)