By the time I got to Texas Med Clinic, M had already checked out and was waiting on the orders for the CT scan that we needed to take with us to the imaging center. After we got those, M and I dropped my car at my office and drove together to Baptist M&S Imaging near the Medical Center. On the way there, M gave me the run down on the results of the blood work Dr. Scalzi had ordered. M’s red blood cell count was a little low, meaning he was slightly anemic, but, like back pain, this wasn’t necessarily an unusual thing for M, he’d been mildly anemic before. His platelet count was also low, quite a bit lower than normal, and his white blood cell count was in the normal range, but also at the low end. None of these facts, by themselves, seemed to worry Dr. Scalzi terribly. Another test, one that measures the blood content levels of alkaline phosphatase, an enzyme involved in the production of bone cells, showed a quite-a-bit-higher than normal count, but, again, Dr. Scalzi didn’t seem alarmed. Kidney stones seemed the logical culprit. The story we told ourselves was that the CT scan the doctor had ordered was primarily to confirm the presence of kidney stones, and secondarily, it would rule anything else out.
There was a cautious sense of relief on the drive across town to the Medical Center. After a month of pain and discomfort, it looked like we finally had a diagnosis.
We checked into the imaging center at around 6:30 p.m. Sitting in the waiting room, we joked about how Dr. Scalzi hadn’t needed to examine M’s nuts and what a bummer that was and that maybe the CT scan people would need to touch his nuts. We looked up remedies for breaking apart kidney stones and getting them to pass. We checked our emails. After about 20 minutes, M was called back for his CT scan.
As I waited for M to return to the waiting room, I learned the first of several lessons learned this week: you can’t count on waiting rooms to have a decent magazine collection, so always bring your own reading material. The guy sitting across from me had a book. I had envy issues.
M returned to the waiting room after about 20 minutes. “Still didn’t touch my nuts,” he told me, and we laughed.
We were to remain at the imaging center while the radiologist reviewed the results and sent them over to Dr. Scalzi. They said it would be about 30 minutes. By now it was well past 7:00. We were both getting hungry, and M wanted water. Second lesson learned: bring water and snacks if you’re going to be sitting in a waiting room. I went across to the Shell station and bought water and beef jerky.
Lesson three: for whatever reason, waiting rooms are fucking freezing, beyond what a light sweater can fix. Bring a blanket. Earmuffs. Mittens. It was positively arctic in there, made worse by a case of nerves brought on while waiting on the CT results.
After about 30 minutes had passed, the front desk people advised us that Dr. Scalzi wanted another test run. Apparently she’d talked over the CT scan results with the radiologist, and they’d decided an ultrasound of M’s testicles was in order. Finally, someone was going to touch M’s balls! This made us laugh…but it also made us nervous. I didn’t ask M, and still haven’t, but I think he really wanted someone to perform some kind of exam on his testicles, as the left one was hurting him, and he wanted to understand why. So, while the order for the ultrasound was disconcerting, there was a sense of relief to knowing the test might tell us why M had pain in his left nut.
As late as it had become, the ultrasound technician had gone home for the night, so we had to wait for the on call technician to come in. M and I walked around in the parking lot to warm up and stretch our legs.
Another 20 or 30 minutes passed before the technician, a sweet young woman named Beth, arrived and we were called back to the ultrasound room. Beth left us alone in the room long enough for M to undress from the waist down and get himself positioned on the exam table.
“I’m gonna get my balls touched. Yes!” M joked, accompanied by a fist pump.
“You could have gotten that for free at home,” I told him. We laughed. It seemed like time was unwinding in little moments, little bursts. This seems to be a theme that’s continued over the last few days. Little moments of love, laughter and beauty I wouldn’t have fully noticed, didn’t fully appreciate, before this slow motion trainwreck started. Getting into my car after work yesterday, I noticed how blue the sky was and how pure white and fat and fluffy the clouds were against it, and how a flock of birds were flying around high, high above me, how black their bodies were against the white of the clouds. I know moments like this happen every day, but I’ve rarely, maybe never, experienced them like this. Despite the fear, the sense of dread, the not knowing exactly what we’re up against, I am grateful for the gift of these previously unnoticed moments of beauty.
Back to the ultrasound room. Beth started the exam. I sat in a chair behind her, a little to the left, where I could see the computer screen. I had no idea what I was looking at. She would stop periodically to digitally measure stuff. There was what looked like a heat map–little areas of red and blue–that she would overlay on the black and white ultrasound images. There were words describing the area we were looking at. Lesson four: I’m going to learn a LOT of Latin on this journey. I sat there on my phone, looking up words and only mildly understanding the definitions and/or where things were located. There was a view where you could detect M’s pulse, hear the blood moving. I joked that the baby had a heart beat, but otherwise we didn’t say much.
When the ultrasound was done and M was dressed, Beth walked us out. She didn’t give us any feedback on the ultrasound, but she did provide us a copy of the CT scan report.
It was nearly completely dark when we got in the car. I drove, Michael read the CT scan results. Neither of us said much. M would tell me later that the radiologist’s comments on the CT scan report noted that the results suggested testicular cancer.
Dr. Scalzi called as we were merging onto 281. She said the ultrasound showed M’s testicles were fine, no testicular cancer. Biggest sigh of relief, ever. EVER! I felt at once exhausted and giddy.
Dr. Scalzi explained the other findings on the CT scan. M’s lymph nodes were swollen in the lower abdominal/groin region. There were some abnormal spots on his lower vertabra. His prostate was slightly enlarged. She explained that swollen lymph nodes are indicative of some sort of infection or inflammation in the area. The abnormalities on his spine could indicate some sort of age-related deterioration, but for an otherwise healthy, 44 year old male, this would be unusual. As for the enlarged prostate, pretty much all men experience an enlarged prostate in their later years, but for a still relatively young and healthy man, such a condition is unexpected and odd. All of this taken together with the abnormalities revealed in the blood test gave Dr. Scalzi reason to continue investigating. She wanted M to have a nuclear bone scan done the next day, Tuesday, July 3. And she wanted M to have the PSA test run on his blood. She said we could come by the Texas Med Clinic the following day to do the blood draw for the PSA, and pick up the orders for the bone scan.
Kidney stones never came up.
M and I were hungry. We stopped at Red Lobster on the way home. Walking from the car into the restaurant, the shared relief we felt was practically a tangible thing. Testicular cancer was ruled out. We still didn’t have concrete answers, and our inherent paranoia combined with Dr. Scalzi’s explanation of the CT scan finding, led us both to the conclusion that prostate cancer was a real possibility. So, too, was bone cancer. But the internet told us that prostate cancer was 100% treatable, and bone cancer nearly as much so. And we were catching it early. That’s the story we told ourselves, and it’s honestly what we believed.
We placed a to go order at the bar and had a celebratory beer while we waited.
Hope for the Best, Prepare for the Worst: Cancer and What Came Next 