There are several nodules in my lungs that my medical team have been keeping an eye on for over a year. They say the sophistication of equipment used in chest CT scans has improved so much that if they were to scan everyone, chances are pretty good they would find nodules in a good percentage. But, they preface this by adding, of course, they are not pancreas cancer patients.
The horrible thing about pancreas cancer is the seamless way it slips into cells in other major organs. There is a river of sorts with tiny tributaries that runs thru the pancreas sending enzymes to your digestive system and ultimately throughout your body. These enzymes are necessary for the body to absorb valuable nutrients our body needs to thrive. The pancreas also produces insulin important to maintaining sugar levels that support many other systems throughout our bodies. While it is a pretty important organ, you actually can live without a pancreas with the help of digestive enzymes and insulin that can be prescribed. (Disclaimer alert….I am not a doctor, and forgive me if I have misspoken, but this is how it was explained to me.)
For over three years there were no significant changes in my three month CT scans that are on the hunt for new masses, lit up lymph nodes and who knows what else. But, suddenly, one of the lung nodules they had watched for over a year seemed to solidify and grow from what is described as “ground glass” with no real form to a one centimeter spot. This was the size docs had told me it would have to reach before we could do a biopsy. After my team of doctors reviewed the suspect nodule, they agreed a needle biopsy should be ordered.
The out-patient procedure was scheduled and we were given instructions and of course the precautionary worse case scenarios that could occur. About 15% of patients undergoing a needle biopsy of the lung will experience deflation of the lung which is painful and you will be required to spend the night in the hospital while the lung is re-inflated. The worst part of the procedure was supposed to be numbing the area. Tommy and I agreed we had already beaten so many odds since our original diagnosis of PC that surely we could beat this too.
Doctors explained that there were three possibilities. 1) Inflammation causing enlargement of the node. 2) Lung cancer or 3) Metastatic pancreas cancer. While it seems odd to pray for lung cancer, we actually did. It would have been early stage lung cancer with a relatively high rate of cure. Option number three was not discussed in detail because we all knew that would change my staging to a four with lung being one of our major organs and a recurrence to battle once again. But of course we hoped it was just inflammation.
The day of the appointment came. We have a ritual prayer Tom prays as we make the left turn into Mayo campus. He grabs my hand and prays aloud to God to give us courage to believe He will bring us through this day and provide us with the strength we all need as a family to face whatever His will is for us. I told Tommy I would be going under Jesus’ wing feathers, Psalm 91 just as I did for every frightening procedure before. Power port access and blood draw began at seven AM. We registered and made our way to the second floor staging area. I was taken back to be prepared and shortly after Tommy joined me in the curtained waiting area bay #16.
There would be no sedation for this procedure explained the doctor. They needed me to be completely awake. I had to help with important breathing techniques that would enable them to penetrate that small nodule that was like a moving target inside my lung. The heart is beating and the diaphragm is working, so no drug that might deplete the lungs air capacity could be administered. The area would be numbed with Lidocaine which would be a sharp prick and then burning as the numbing took over. They said I should feel just a small amount of pressure when the actual biopsy was taken, a punch sound and then a little pressure. I was ready to go.
A young Asian male nurse wheeled me back to the CT room and asked me to transfer to the bed for the scan. Several nurses and technicians were in the room preparing whatever it was they were responsible for. They assured me the nurse would be there just to attend to me. The rest of them would be doing their jobs. They asked me to lay on my stomach and laid my head on a pillow facing the glass window to the adjacent office where more techs seemed to be discussing what they saw on the monitor. I was fairly relaxed and ready to have this part of the ordeal over with. The doctor entered the room and told me my job was a series of breaths that would help them to capture the tissue they needed. But, if I experienced any pain to let them know immediately. I told them I had a pretty high pain tolerance so I would be able to do whatever they needed me to do.
Suddenly they were prepping my back shoulder blade with betadine solution. Next came the Lidocaine shot…”Here you will feel a big pinch and then burning” , said the doctor. He was not kidding. It seemed like he gave me several injections of the numbing medication as I felt the burning subside leaving just some pressure. I would not have moved if I had to. This was serious. It was explained to me that it was just like piercing a balloon with a needle. They didn’t want that balloon to burst.
It seemed like I completed a thousand trips into the CT machine and requests to “take a short breath in, hold it, now breath.” as the doctor guided his scope aiming for that small moving target …the center of the nodule. He stopped for additional Lidocaine and instruction from the attending physician, eyes were glued to the monitor. Finally the other doctor took over and at long last…success. They quickly took two needle biopsy’s and removed the prob from my back. “It’s all over” she said. “We got two good tissue samples. Now lay completely still so we can check to make sure the hole we just put into your lung closes as it should. If you feel any pain, let us know.” She moved quickly to the office and I could see them in the window glued to the monitor.
Alone in the room I laid face down on the bed not moving a muscle. Suddenly I felt a huge cramping in my left lung around what I suspected to be my heart. I cringed and waited to see if it would pass. I seemed to move outward from the core and then engulf my entire lung. I couldn’t take a breath and I feared I might run out of breath.
A nurse entered the room asking if I was doing okay. I told them what was happening and suddenly the room filled. “Your vitals are fine, the scan shows the hole is closing just as it should be. You are going to be fine. Let’s move you.”
I didn’t want to move or to be touched. “Please just give me a minute.” I gasped.
But suddenly they were grabbing the sheet that I laid on and sliding me over to the gurney and moving me on my side. The pain was almost unbearable. The gurney began to move taking me out of the CT room and down the hall to the recovery area I had left just an hour before.
My sweet friend Kelly Winer lights a candle at beautiful Cathedral de San Juan
The doctor explained to Tommy and my son Scott who had just arrived, the procedure had gone really well and they would be giving me pain medication, Dilaudid, into my port and that should stop the cramping once I relaxed. It took two doses to dull the pain. I felt like a feather drifting through the room. The cramping continued but it allowed me to breath. Tommy held my hand telling me to breath through my nose and slowly let it out. I held his hand tightly and followed his prompting. We remained in the room for an another hour under observation and finally given the all clear to go home. We should have the results of the biopsy by Tuesday afternoon.
While the procedure was difficult it could not compare to the anxiety of awaiting a phone call to tell you if you are facing another life threatening cancer diagnosis. And, the anxiety touched not only Tommy and I, but our entire family and close friends too.
Would be have to put our plans on hold for trips during the holidays? Would I have hair for a Christmas card photo? Would I be strong enough to decorate, buy gifts and entertain? These thoughts ran through my mind the entire weekend.
Tommy and I attended evening mass a few days before the biopsy procedure and Msgr. administered the sacrament anointing of the sick. We had asked for prayer from my bible study groups and close friends we knew we could count on. Everyone was eager to get on their knees once again.
Family and friends gathered at our home most of the weekend. When Monday arrived we both jumped each time the phone rang. We didn’t sleep well and I had a throbbing headache most of the time, unusual for me. Finally it was Tuesday. Tommy didn’t know if he should go to work or not. He wanted to be the one to take the phone call. He stayed close to me all day.
The clock struck 6 on Tuesday evening and we were pretty sure we would not get a call so late. We tried to sleep to the gentle ping of our cell phones as text messages came in from family wondering if we had gotten any news. Every text and email told of more who were praying for good results.
When we arose on Wednesday morning Tommy made a pot of coffee and we read the paper together. Finally he asked me if we should call the doctor or just show up at his office? Suddenly the phone rang and it was a Mayo Clinic number. Tommy sprang from his chair grabbing my phone and made his way to our bedroom. I stood looking out of the kitchen window praying to God and thanking Him for our many blessings.
The call didn’t take long but I strained to hear any response Tommy was making. I couldn’t hear anything. He came to the kitchen and asked me to join him in the bedroom. We kneeled down next to the bed and he began to pray.
“God, we don’t understand how you continue to shower us with your blessing and grace. We are so thankful for this report of no cancer this morning……” I barely heard the rest of the prayer. We both sobbed and embraced.
God had heard the prayers. His plan was in place long before we were even born. It is all about Him truthfully. But I still believe He must have heard all of those voices asking for His favor. He must have figured, this lady needs to stay awhile longer. She has more work to be done. This was a time we all prayed and He answered.
Thank you Jesus.
The rest of the day I walked thru the house feeling like a bright yellow sunflower standing tall and swaying in the sunshine of a Tuscan field, thankful for my faith, for my husband and my family and for my prayerful friends.