Heal me, O Lord, and I shall be healed;
save me, and I shall be saved,
for You are my praise.  Jeremiah 17:14

July 2:  Primary Care Dr Juan Soto Lopez  -  This is a follow up to discuss lab results from June visit.  My cholesterol is a bit high so we are adding generic Lipitor to my drug list.  Made it to 63 without prescriptions but now I have blood pressure and cholesterol meds, plus two vitamins - B12 & D3.  I bring him up to date on visit with cardiologist Dr Choudhry.  

July 2:  CPAP Machine pickup at Monitor Medical  -  Takes me a couple of nights to get comfortable with it and it makes me look like a Star Trek BORG, but my wife can now sleep in peace and I believe the literature which says I will begin sleeping better and feel better during the day.

July 6:  Cardiac Calcium Score (Cardiac CT) at Texas Health Hospital in Allen  -  $85 diagnostic test seems like quite a bargain.  Technicians will tell you nothing, but I'll find out in a couple of weeks when I see Dr Choudhry.  I have a little bit of anxiety over this and wonder if I'm a candidate for any advance artery clearing procedures in the future.  Put this thought out of my head as it is nearly two weeks before I see the doctor.  

July 10:  Dr Amir Choudhry  -  Despite my relative lack of experience with doctors I inherently know it's generally not a good sign if you get a call from the doctor's office after a test to hear that the doctor wants to see you right away.  Good news is that my calcium score was really low meaning that I am at very low risk for blockage of any sort.  Bad news is that the scan had an incidental finding - a spot on the upper lobe of my left lung.  A spot.  On my lung.  He says he is letting Dr Soto-Lopez know and I can expect a rapid response, more testing, more referrals.  And he says there is a good chance surgery may be in my future so he wants me to schedule an echocardiogram for surgical clearance.  My world just changed.

July 10:  Dr Juan Soto-Lopez  -  I get a call from Dr Soto-Lopez before I leave Dr Choudhry's parking lot.  He is ordering a detailed CT Scan of my chest, setting up a referral to a Pulmonarist and >gulp< an oncologist.  

July 13:  Resilient Healthcare  -  Drive-Thru COVID19 test  I've been hearing about these "rapid drive-thru" tests since the whole COVID thing started four months earlier.  The staging is like the serpentine waiting lines for a ride at Six Flags, except you're in the car.  The line moves at a snail's pace.  Once I arrive at the sampling station I get the long swab up the nose to check for active infection as well as a blood draw to check for antibodies.  I'm the kind of patient that averts my eyes when a phlebotomist is drawing blood, but I find it is hard to look away when you are asked to drape your right arm out your driver's side window for the blood draw.  The needle is literally six inches from my eyes.  She tells me if I'm positive I'll hear from them within 24 hours and that "no news is good news."  Fortunately, no one calls.

July 13:  Envision Imaging  -  Chest CT Scan  This is a detailed scan with iodine contrast to examine the entire chest and the full imaging of both lungs.  The cardiac scan had turned up the spot in my lung which was basically in the background while looking at my heart.  This test is to see if I have additional masses anywhere else in the lungs.  I am watching the technician like I would watch another player at a poker table.  I think they are trained to give nothing away.  She will be sending the report to my doctor is all she will say.  

July 16:  Colonoscopy  -  This seems almost a distraction considering the news of the past week.  But here I am.  I arrive at the hospital at 7:00 and am home by noon.  A phone call a few days later tells me the removed polyps were benign and I should have another in three years or so.  Yeah, looking forward to it.  Thanks.

July 17:  Dr Sonabar Kable  -  First visit with my Pulmonary specialist.  She walks in and is talking within minutes of surgery to remove the upper lobe of my left lung.  She wants me to see a thoracic surgeon and needs to schedule me for a Pulmonary Function Test right away to make sure I have enough lung capacity to survive if they remove half my left lung.  Slow down, please.  You did hear we caught this early, right?  She explains that because the one spot is all they see, surgery to cut it out is considered curative and my best option.  It's been one week since Dr Choudhry broke this news to me and we are talking about major thoracic surgery to remove half my left lung.  

July 20:  Echocardiogram at Dr Amir Choudhry's office  -  I don't see the doctor today; this is just for the echocardiogram, which is a sonogram of the heart.  Interesting to watch and listen.  All good.  Essentially normal & cleared for surgery.

July 20:  Pulmonary Function Test at Dr Sonabar Kable's office  -  After the echocardiogram, I jump in my car and drive up to Denison for this test.  A few days later I find out that my function tested out really well.  Terrific news, I qualify for having half my left lung removed!  

July 22:  Dr Nithya Palanisamy, Oncologist  -  Did I ever think I would be sitting in an Oncologist’s office?  Yet, here I am.  A little heart to heart with the doctor.  She wants me to have a PET scan – already set up – and she wants to make the recommendation for the thoracic surgeon.  She wants me to see Dr Fred Lee.  She says that some patients don’t like him but he is the best recommendation.  Given the choice between delightful bedside manner or high marks for surgical skill, I tell her I will vote for the better surgeon.  Dr Lee it is, she says. 

July 23:  Verity PET-CT Center  -  Here for a PET scan of my entire upper body, from the base of my skull to my pelvis.  I don't even try to guess what the technician is thinking or seeing - she's not going to tell me anything.  The front desk hands me a CD as I leave saying I need to deliver it to my doctor.  I of course try to boot it up in my home computer but can't open anything.  

July 24:  Dr Sonabar Kable  -  This lady is always full of good news.  The PET scan gives us a good high definition image of the intruding mass in my left lung but also shows a suspicious spot in the bone of my right shoulder.  This may mean that the cancer has traveled and metastasized.  Prospects dimming.  Outcomes less optimistic.  Life expectancy dropping.    We need more tests!  This is my eighteenth medical visit in the last six weeks and I still don’t actually have a diagnosis.  She wants a biopsy of the shoulder, a biopsy of my lung and an MRI of the brain.  And, of course, another COVID test.  I’m going to have a busy week next week.  But first, I have to take the PET scan disc to the oncologist and the hospital imaging department so everyone has a copy – the medical version of sharing a photo on Facebook.  If only it were that easy.  

July 27:  CareNow Clinic  -  New week and my Monday begins with another COVID test, this time at a local "Doc in the Box."  Same instructions, "no news is good news."  No one calls, so no news is good news.

July 28:  Baylor Scott & White Hospital McKinney  -  Here for a biopsy of my right shoulder.  Not enough anesthetic!!  Wow, this one hurt a bit.  

July 30:  Medical City McKinney  -  Biopsy of lung, EBUS procedure  -  Early morning again.  Another blood sample.  Another IV.  When did I last eat?  When did I last drink?  Have I had anything else this morning? My first conscious memory afterward was seeing Dr Kable talking to Deedra who was giving me two enthusiastic thumbs up!  Wait – is this the first shred of good news in two months and I’m too out of it to comprehend the information?  Dr Kable was telling her that she was able to get a very good sample of the mass and that her visual examination of the lymph nodes was good.  Off to pathology.  Results sometime next week.

July 31:  Dr Fred Lee  -  First consultation with the thoracic surgeon.  I may have been misinformed.  This guy is very pleasant, takes a lot of time with me, answers questions and draws a really nice picture of a pair of lungs.  Although, he was a bit unceremonious when he drew a slash line across the top of the left lung while saying “cut it out.”  He explains that we are still in diagnostic phase.  Where is the cancer?  What kind of cancer?  Next will be the treatment phase.  Surgery.  Possibly chemo, maybe even radiation.  Then we will be in monitoring phase which will begin with CT scans every 90 days.  Still much to know before we know.  He asks if I have any critical life events on my calendar in the near term?  Any births, weddings, graduations, trips, etc?  No.  So, we can operate as soon as possible?  >Gulp<

What is the surgery like?  Robotic surgery, five incisions to slice & dice and remove the upper lobe of my left lung.  About a two and a half hour surgery.  Overnight in the ICU and then two days in hospital.  Two weeks of very limited activity but I will be able to shower and take care of myself.  I can even do stairs as long as they don’t seem too much for me to handle.  No driving during this time.  Then, six to eight weeks of rebuilding my strength to get back to normal.  My lung capacity will be down 25%.  If I could briskly walk two miles and feel a bit winded, I would now be winded at a mile and a half.  I’ll take it!  In a lot of ways this was the most informative session I've had all month, even though so much is still up in the air.  I am at peace with my treatment plan.  

July 31:  Baylor Scott & White Hospital McKinney  -  Busy day.  Saw Dr Lee.  Showed some  $500,000 houses to a buyer prospect.  Now off to Baylor for an MRI of my brain.  This is my fifth medical visit of the week.  Three diagnostics done this week and a long wait until I see Dr Kable and Dr Lee a week from today.  I’ve learned that no news is relatively good – certainly better than a call that says the doctor wants to see you in office as soon as possible.  I want to wait a full week before seeing any of these people again.  I am beginning to think a lot about all the work I need to do in my home office to get everything in order.

What a month!