Wednesday, March 21, 2012

Bad News!

He sat in the examination room and waited for the doctor.  The nurse had been in earlier with her questions.  He glanced at the magazine he had brought with him.  Glancing.  Flipping pages.

The doctor came into the room, sat on his stool and said, "I've got some bad news."

His brain froze.  Bad News!  What Bad News!  No doctor just comes out with "Bad News."

The doctor said, "Last week's CT scan shows that you have an enlarged lymph node on the mesintery where the tumors were taken from.  In January, this lymph node was 2.4mm now it's 3.0mm."  The doctor took out a ruler and showed him how big 3mm was, about the size of a quarter.

The doctor said, "Are you under the care of an oncologist."

"No," he said.  "I know who to see and was going to start going to see one for follow-ups."

"It's time to see him."

As he drove home, a wave of sadness flowed over him.  Drowning him.  "Why couldn't it have waited longer?  I knew it would be back.  Why so soon?  I don't want to go through that again."

When he got home he Googled mesenteric lymph nodes: "With the advent of multidetector computed tomography, routine evaluation of mesenteric lymph nodes is now possible. For the first time, normal mesenteric nodes may be reliably identified noninvasively. Because of the increasing volume of cross-sectional imaging examinations being performed, lymph nodes in the mesentery are being detected with increasing frequency. This is often an unsuspected finding. Although the detected lymph nodes may be normal, there is a large number of disease processes that may lead to mesenteric lymphadenopathy. The most common causes of mesenteric lymphadenopathy are neoplastic, inflammatory, and infectious processes. Many of these causes may also result in lymphadenopathy elsewhere in the body. It is important to recognize mesenteric lymphadenopathy in patients with a history of a primary carcinoma because the lymphadenopathy affects the staging of the disease, which in turn will affect further management. In addition, mesenteric lymphadenopathy may be the only indicator of an underlying inflammatory or infectious process causing abdominal pain. The distribution of the lymph nodes may indicate the exact nature of the underlying disease process, and the correct treatment may then be instituted. Besides neoplastic, inflammatory, and infectious processes, many other disease processes may occasionally result in mesenteric lymphadenopathy."

Oh yeah, that's really clear.  

So, for now, he waits until next week to see the oncologist.

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