My doctor put the order through for a CT scan. But it was up to me to schedule an appointment. I'd seen my doctor on a Friday. I went right home, picked up the phone and called the radiology department. I got an appointment for Tuesday, at 11:45 a.m. "Don't eat anything for four hours before the test," the woman told me. She didn't say why. I wasn't going to get anesthesia, was I?
So much about this was unknown. And I had four days to wait and wonder and worry. The doctor had said it's probably not a nodule, probably not a growth. "That's not where they think this is going," he'd said.
But he didn't know for sure. And how was I supposed to know what kind of misdirection he might use to mask the cold reality. I mean, not even a doctor wants to be the one to tell someone they have cancer.
Four days to think about what might be wrong. It wasn't too bad during the day when I was busy. But the question hung in the background.
B seemed not at all worried. "The doctor told you it wasn't any kind of growth," she reminded me. She was making dinner, and I was hanging around the kitchen. "He said not to worry, so why are you worrying?"
"Well, it could be ..."
"I'm sure it's nothing," she said. "Look at you. You're as healthy as can be."
That was easy for her to say. She wasn't the one with the shadow on her X-ray. After dinner I went to my computer. I checked some emails. I was planning a trip to Florida. What if the CT scan came in positive -- would I have to cancel my trip and take more medical tests instead?
I found myself poking around on WebMD. I went to the symptom checker and started answering a series of questions. I had a cough. I had pain in my chest. Suddenly a red box popped up: "If you are experiencing dull or achy chest pain or discomfort please seek prompt medical attention."
I laughed. WedMD says I'm having a heart attack. At least I know I'm not having a heart attack. Besides, I've already sought medical attention. I answered the rest of the questions and read down the list of possible conditions: coronary heart disease, heartburn (GERD). That's one possibility my doctor suggested. But I couldn't believe I had heartburn. I don't eat greasy, spicy food. I never get an upset stomach.
Pneumonia; hernia; muscle strain, pulmonary fibrosis; bronchitis; panic attack. I wasn't having a panic attack. But I was experiencing anxiety. Couldn't I just stop thinking about it? The doctor did say it was probably nothing.
And then I saw it: lung cancer (non small cell); and lung cancer (small cell). So it was a possibility, after all. What's the difference between small cell and non small cell? I didn't want to know, at least not that first night.
I tossed and turned through the night. Daybreak brought a more sensible frame of mind, as daily routine kept my mind off the issue. But that night I again was on the computer, searching for lung cancer. My family had a history of cancer. I knew that, even when I was a teenager and started smoking. How could I be so stupid? I probably deserved whatever I got.
I found some information about low dose CT scan screening for lung cancer. Is that what I was getting? The guidelines suggest that people with a history of heavy smoking get the screening, because like other cancers, if you catch it early it can often be cured. If you wait until symptoms like coughing and chest pain occur, it's probably too late.
I saw a recommendation that anyone with a history of 30 or more pack years should be screened -- that's the equivalent of one pack a day for 30 years. I did the math for myself. Part-time smoking in high school. Full time smoking in college and for about two years afterwards. Then I gave it up. But I was a cheater. I wouldn't smoke for a couple of months; then I'd be at a party, and someone would light up, and I'd bum a cigarette. I smoked a cigar when I played poker. My ex-wife smoked, and so I breathed in my share of second-hand smoke.
I figured I had a history of about 8 or 9 pack years. Was that enough to give me cancer?
My logical mind told me, no. B was right, I was worrying over nothing. I'd been to the doctor over the years with a pain here, a pain there. It always turned out to be nothing. Why would this be any different? But then the prickly heat would break out. People do get lung cancer. Why should I be exempt?
The morning of the CT scan finally arrived, and it felt like a relief. I got up and drank one cup of coffee at 7:45, four hours ahead of time. I showered; I walked the dog. B went to work. And I finally got in the car and made the drive to the radiology department.
I filled out a form and waited in a small room, sitting with five or six other people. A nurse opened the door and called my name. She led me inside to a tiny room, told me to strip down to my underwear and put on a gown. When I came out she walked me to the CT scan room, explaining she'd be putting an IV in my arm to inject some dye. The dye would highlight my chest, make it easier for the doctors to see what they were looking for.
"Is that why I couldn't eat?" I asked.
A man came up by my side. "I'll be doing the scan," he said. "We don't want anyone to get sick. We just like to be careful."
The scan was quicker and easier than I thought. It only took a few minutes, and all I saw was a few flashing lights on the big circular machine. The man told me he sends the results right away. "The doctor usually gets back to you the next day," he said.
I jumped off the table, got dressed and walked out, feeling relief that the test was over. Until I realized that the test itself meant nothing. It was the results that count.
The next day was bringing a snow storm, and I didn't even know if the doctor's office would be open. I resolved that I wouldn't panic if I didn't hear anything for a couple of days. At least we were doing something about this, I reasoned, and that's better than sitting around doing nothing.
The next day did bring the promised snow storm, and no phone call from my doctor. I wasn't even sure if he was going to call me himself, or if the nurse would call to make an appointment. If they'd told me, I hadn't been paying attention.
Whatever was wrong with me gave me no reprieve from the snow. I spent the day shoveling out the front and back of the house. I watched TV, did some work on the computer, and waited. We had dinner, and oddly enough, I slept soundly that night.
The phone rang the next morning, after breakfast. B answered, as she usually does. It was for me. The doctor, she said.
The CT scan showed no mass, no nodules. There was no sign of cancer. But the doctor went on to say that a couple of little things did show up. He wanted me to make an appointment with the pulmonary specialist. "I just want him to check you out."
"But I'm clean?" I asked, my stomach doing flips.
"You're fine. I'm much less worried than I was before."
"Do I need to make this appointment right away, or can it wait?" I asked, thinking about my trip to Florida.
"There's no rush. Just do it in the next month to two."
I thanked the doctor and hung up with a sigh of relief. Then I reflected back on what he'd just said, that he was "much less worried than before." So he had been worried. I did have reason for all my anxiety, after all. And, what? Am I just lucky? Did I dodge a bullet?
So I went to Florida, and last week I had my appointment with the pulmonary specialist. I have some fibrous tissue, some scarring in my lungs. Could be from an infection, or any insult to the lungs. I thought about the time, a couple of years ago, when I cemented the back wall, and how I breathed in cement dust and was coughing for three days.
But it's nothing to worry about, he said. It's normal for someone my age. He told me I also have a hernia. My liver is pushing up against my chest cavity. But again, nothing to worry about; it looks like it's been that way for a long time. Maybe I was born that way.
And so after all was said and done, I got a clean bill of health ... at least for someone my age.