Medical: Memorial Day Size

The lump & pain in my hip has not been heard from for at least a week.

ROLLING BACK TO MAY

The lump in my neck is back to about the size it was on Memorial Day. It is getting hard to see if you didn't know it was there.  With sucking or puckering I can make it invisible, except that it is tucked above the biopsy scar (about 3cm long), and the scar itself is much thicker and tougher than normal, loose neck skin.

That's the way it was for our Grandma's Treat Beach Vacation around Memorial Day. You could see it then, if I pointed it out. I would pad into the kitchen each  morning and night and explaining (to a family that is deeply suspicious of microwaves) "I have this lump that isn't an aneurysm that I'm hoping is a drainage issue."  Microwaving a cute, clear pad full of little silicone beads was a barely-accepted use of radiation.  Then everyone went out and exposed themselves to EMF radiation capable of burning and mutating skin (aka, UV from the sun). <waves to family readers>

THINKING BACK TO APRIL (OR MAYBE MARCH)

Recall, though, that I first noticed the lymph lump in my neck in March or April. I'm not actually sure when. It was morning and I felt a thickened area, perhaps the size of a quarter, entirely invisible from the outside, but that I could feel with my fingers as it sort of "floated" between my neck muscles and skin.

I was just coming off a mild cold, and the mass was exactly where my lymphs had swollen before when sick, except that it was only on the right side, and not on the left. This asymmetry was a little bit alarming. It was also a bit more vertically-centered on my neck, not tucked up under my jaw, the way cold-enlarged lymphs are.

My initial guess was that it was a clogged lymph duct and that some combination of heat and massage would get it draining again. I also, on a chiropractic visit somewhere in there, had my right ear tugged very hard (not my idea, I assure you) in the hopes of opening the duct from ear to clavicle.

So by the time I had my first doctor's appointment, on May 18th or so, when  he asked "how long have you had this," I had to come up with a date. I didn't want say a date that was too distant (like I was stupid for not coming sooner) nor too recent (like I was alarmist for coming in for a minor thing). My mind raced to come up with a supportable  date.

COMING UP WITH THE DATE

There is a scene in the movie The Manchurian Candidate, where the hapless Vice-Presidential Candidate (a Senator riding an anti-communist wave that he himself has stirred up), cannot remember the lines being fed to him by his wife (played by Angela Landsbury). He pleads with her that they come up with one, precise, easy-to-remember figure for the exact number communists known to work in the Defense Department.

As I sat on the crinkly-papered exam table in Dr Gullapallis over-air-conditioned exam room, and as I searched my memory for "the date I first noticed" I felt like this guy at breakfast:

I think the Manchurian Candidate scene actually played in my head before I answered.

Since no month has 57 days, for ease of recall, I have set April 20th as the "first morning I noticed".  It was probably more like April 1 or April 10. But April 20th is the 57 Varieties of calendar dates, particularly good for calamities.

I answered "since April 20th."

April 20th is all three of Hitler's Birthday (1889), Columbine Shooting (1999), Deepwater Horizon's explosion (2010). April 19 isn't bad either, as Branch Davidian Raid/Fire (1993) and Oklahoma City Bombing (1995), but April 20th is also nice and round. So April 20th it is.

COMING UP WITH A PRIMARY CARE PHYSICIAN

Finding a primary care physician is about as arbitrary.

When I saw my Primary Care Physician back in mid-May, it was after 2 years of seeing no doctor at all, and the lump had prompted me to find a doctor's office that was convenient (it is a 10 minute bike ride, or a 10 minute car trip, or 13 minute bus from my house). It is just next to the Davis Square subway entrance and directly on the path of many "city" trips, including my bike commute and how we drop the kids off for their subway ride to Community Boating.

Shopping for a doctor based only on name, Dr Anil Gullapalli had availability, I suppose, because he was "new" to the Davis Square Family Practice and because his name embodied more excitement than most of my neighbors are looking for (the other doctor I was offered was named Shapiro, but he was much more fully booked).

Technically, it was not my "intake" appointment, nor my physical, but an "urgent" appointment, the point of which was to get somebody to look at my lump.

FIRST RUNGS OF THE DIAGNOSTIC LADDER

That very first appointment, he felt a pulse in the lump (we later figured that it was a big vein pushing on it from behind, but the lump was then small, and the pulse loomed large). That made it a pulsatile neck mass, and possibly an aneurism or other blood vessel ready to burst. I had a super-urgent sonogram either that evening or the next, in case it was a life-threatening condition.  The sonogram "read as lymph" (and not hollow or blood filled) and so I was off the "urgent" track and slowly began to climb the diagnostic ladder to a cancer diagnosis.

I will always wonder whether, if we had found the cancer by needle biopsy at that point (might have been hard to "hit" it was so thin), would it have prevented the spread to my ileocecal valve, or was it already spread and would we have missed it in my hip, had we looked/scanned "too early."