CARDIOLOGIST APPOINTMENT 2-14-23

 Had appointment with Cardiologist this morning.  Had an EKG which he said was OK.

Went over the incident with the CAT scan ordered by my ENT and how the premeds caused me to go into A-fib.  Told him I will not take any contrast or pre meds/steroids again.  

Informed him that I am still having A-fib episodes daily.  He changed my heart meds from Digoxin to Diltiazem.  He also put me back on the blood thinner Warfarin which he had originally prescribed for me. Have to attend classes at the clinic for a few weeks to learn how to use the blood thinner and equipment to monitor.

He explained that I should not worry about having a Cardiac PET scan with radioisotope as it is not a contrast.  I agreed to have one.  He said to schedule it when I am ready.

He said that if none of these things work he would order treatment of atrial fibrillation using intravenous infusion of certain meds which I would have to be in the hospital for this procedure.

Wants to see me back in 6 weeks.

FAMILY DOCTOR VISIT

Had appointment with my GP today. Informed him of the kidney pain I've had for the last 2 weeks since the CAT scan ordered by my ENT doctor with contrast and pre meds but no infusions.  I asked for a urinalysis and x-ray which he ordered.  Results showed no blood in urine ruling out kidney stone.  X-ray showed no stones in kidneys.  Now I'm really concerned that there is severe damage to my right kidney as the pain will not go away.  I believe it is damage from not having an infusion prior to the CAT scan.

My GP referred me to a Urologist but warned me that he will want to do a CAT scan with contrast.  If I refuse he may want to do a Cystoscope. Not happy about that.  

I asked if he could give me something for the kidney pain and he agreed to give me some Hydrocodone.  Warned me not to take it at the same time as the Xanax which I take to stop the A-fib attacks.

Informed him that my fasting blood sugar this morning was 177.  He said we may have to up the Metformin but did not order a stronger dose. 

Told him I am tired all the time and stay in bed all day.  Also have a little nausea which I attribute to the kidney problem.

Showed him a print out of the results of my CAT scan of my head and neck taken 2 weeks ago.  We went over the results.  He did not examine my lump on the left side of my neck.  I told him that I feel it is a recurrence of the cancer I had 5 years ago.  It's at the same place and is accompanied by an earache just like before.

Informed him about the heart doctor's order for a cardiac CAT scan several weeks ago.  Cardiologist ordered three hours of infusion to protect my kidneys.  I am allergic to the contrast so need to take pre meds prior to scan.  Could not complete the scan as I had the wrong premeds.   Sent me home and took me off blood thinner till the issue with the lump in my neck is resolved.  I see him next week to decide how to proceed with my heart condition.

Ended my session with the GP by me telling him that I feel that I am dying.  He said no you're not dying.  I said it feels that way.

 

ENT FOLLOWUP ON RECENT CAT SCAN

Had followup appointment with my ENT doctor today to go over the results of my recent CAT scan of my head and neck. It turns out that I misunderstood the results of the lump on my left side of my neck.  The results show a 5 mm stone within the right submandibular salivary gland not the left.  ENT told me that I've had that stone since he first diagnosed me 5 years ago and not to worry about it. 

They don't know what the marble size lump is on my left side of my neck in a lymph node.  It shows no tumor/cancer on the CAT scan.  That could be that it is still too small to show on the scan.  

Info found on my research:

Due to the physical limitations, however, the minimum lesion size that can be measured with CT is about 3 mm.  

Normal CT images showed high false-positive rates of incorrect interpretation 28.2% of the time.  CT scans often miss soft tissue injuries and other abnormalities.

It's important to note that some cancers may be overlooked on a CT scan. Lesions may be missed for a variety of reasons, including location and human error. Still, CT is more sensitive than a simple X-ray. A CT scan can find lesions as small as 2-3 mm.

My ENT said that if it grows to return to his office for further testing.  In my mind there is still a possibility that it a recurrance of the cancer in its pre stage.  Symptoms are the same as 5 years ago with ear ache and tenderness on the lymph node.  Remember... I've been here before.

He referred me to Orthopedic Dr. Chris Cenac for treatment of the spinal stenosis.

He wants to just wait and see what happens to the atrophic thyroid.  I am already taking thyroid meds for that.   

I explained to him about the reaction I had to the pre meds I had to take prior to the CAT scan of my head and neck.  The steriod pill was one of the pills in the pre meds that threw me into A-fib.  I called the clinic and spoke to the nurse and she said to drink lots of water to flush the kidneys out.  I took some Xanax which stopped the A-fib.  I should have had an infusion prior to the scan which would have protected my kidneys.

My kidney functioning gfr number went from 39 to 37.  Normal is above 60. 

I told him that I will no longer approve a CAT scan with contrast or take any premeds ever again. 

CAT SCAN 1-19-2023 RESULTS

Had blood work and then CAT scan yesterday at TGMC.   Got results today.

FINDINGS OF CAT SCAN OF HEAD AND NECK - 1-19-2023

1.  Atrophic submandibular glands and stable 5 mm stone within the right submandibular (salivary) duct.

     - Stress can result in salivary gland hypo-function, which will             reduce salivary flow.

     - Salivary stones and tumors can be smaller than a marble or                 larger.  Most aren't cancerous, but if left untreated can develop           into cancer.

2.  Degenerative changes in the cervical spine, especially C6-7, where there is moderate to severe spinal stenosis.

     - If left untreated, spinal stenosis can result in permanent damage         to the spinal cord. This could cause bowel and bladder                         incontinence as well as paralysis.

    - When the spinal cord gets injured at C6-C7, pain, weakness,             or paralysis may occur in one or more parts of the body below         the injured level. Reduction of bowel, bladder, and/or breathing         functions may occur in some cases. Typically, nonsurgical                   treatments are tried first to control the symptoms of C6-C7                 injuries.

3.  1 cm nodule right lobe of the thyroid, decreased in size. Remainder of the thyroid somewhat atrophic.

     - Thyroid atrophy is the end result of either severe thyroid                     damage or total loss of pituitary stimulation.  The possible                 causes are: (1) irradiation (2) atrophic auto-immune thyroiditis.

So I was wrong about this lump being a cancer recurrence.  However, there are some things to be concerned about in these results.  Notice how the words "stress" and "radiation" keep popping up as causes.  

I am relieved that the cancer has not returned.

CANCER CENTER APPOINTMENT WITh NEW ONCOLOGIST

Had visit with a new Oncologist today for my one year check up.  He examined my lump on my neck, looked at my throat, and took a brief history of my last cancer 5 years ago.

He asked if I had been scoped and I informed him that my ENT doctor did so a week ago.  He said that he would prefer if we continue to allow the ENT to do the scopes of my throat as he is not comfortable doing so.  That made me like him immediately.

He discussed the course of action he would take if my biobsy comes back positive.  I knew what he was going to say... surgery.  I asked about Proton Radiation Therapy and Immunotherapy and he was not for either one of these.  So it would have to be surgery to remove the lymph node completely.  No radiation.  He did not mention chemo.  He will be leaving the cancer center in April so I will be seeing another doctor when I return in 6 months.  All my future care will be through my ENT.

On leaving he said to me that he did not think that it was a return of the cancer I had 5 years ago but could not elaborate on why I had this lump on my neck in the same place as before as well as the ear ache, just like before.

Tomorrow I get my blood work and CAT scan.

HAVING A CAT SCAN ON MY HEAD AND NECK - HERE WE GO AGAIN

Saw ENT today and he examined the lump on my neck.  He ordered a CAT scan but said that he was not too concerned about it as it was a small lump.  It is the size of a marble.  He said that it could be from an infection or illness of some kind that my system was trying to fight off.  I have not had an illness except for the problems with my heart which is not an infection.

I did some research and this is what I found.

  

Swollen lymph nodes are a sign that your immune system is fighting off infection or illness. Swollen lymph nodes are more likely to be benign than malignant. Benign means the lymph nodes don't contain cancer cells.  Benign lymphoma can sometimes turn into cancer, although it is not common. 

There is a link between stress causing swollen lymph nodes and mental illness. Swelling lymph nodes can occur when we face stress triggers and is a physical symptom of mental problems.

Chronic stress induces signalling from the sympathetic nervous system (SNS) and drives cancer progression.  

A persistent lateral neck lump in an adult should be considered malignant until proven otherwise.

At this point in time, it is my belief that my cancer has returned due to the extreme amount of stress

I have endured for 8 months while caring for my son.

I may be wrong but it is my gut feeling.

Stress is a killer.

LUMP STILL THERE

Completed the meds given by ENT doctor and the lump is still there.  Only shrunk a tiny bit.  Seeing doctor a week from today. Am going to ask for a CAT scan. 

The steroids and antibiotics have given me a rash in my mouth and my genitals.  Have cream for the genitals.  This is very uncomfortable.