Jun. 15: 6-month follow-up

The major component of the follow-up care since getting my clean-ish bill of health in December is that every six months I have a CT on my chest-abdomen-pelvis and a huge amount of blood is taken on which a number of tests are run. This was done last week and yesterday, with a mammogram thrown in for kicks. Victor and I met with Dr. O to review the results. 

And the results were good.

Chest: There is no mediastinal, hilar, or axillary lymphadenopathy.

That means my lymph nodes are in good shape. No cancer.

Heart size is within normal limits without pericardial thickening or effusion. Right internal jugular Port-a-Cath tip extends to the cavoatrial junction. There is no posterior mediastinal lymphadenopathy. Lungs are clear. There is no pleural effusion. Thoracic osseous structures are intact without bony destructive process.

Do you know how many of those words my spell-checker says are not words? Lots. But my spell-checker is an idiot, because they are words, and altogether they mean that I’m okay. Moving on now…

Abdomen: Geographic low density involving the left hepatic lobe medial segment projecting adjacent to the falciform ligament reflects benign focal fatty infiltration of no clinical significance.

There’s something on my liver, but they don’t care.

Liver is otherwise normal without intrahepatic duct dilation or focal hepatic mass.

Uh… yeah. I’ve never been a fan of intrahepatic duct dilation.

Spleen is normal.

I doubt this will ever be uninteresting to me. My dad had his spleen removed in 2001 because it was “enlarged”—turned out it weighed 18 pounds. A normal spleen usually weighs half a pound, at most. Because some chemotherapy drugs can enlarge the spleen—which is what Dad’s doctors thought was the cause of his spleen trouble—the memory of this made me incredibly nervous during my year of chemo. Does the tendency to grow a massive spleen run in the family? Probably not, but “spleen is normal” will always be good news, as far as I’m concerned.

Pancreas and adrenal glands are normal. Gallbladder is normal.

Yay.

Right kidney demonstrates moderate regions of chronic cortical scarring of no clinical significance.

They say this type of kidney scarring is usually the result of kidney infections, which I had frequently as a kid. Mom says if I wasn’t so weird about public restrooms that my kidneys would be in much better shape. Whatev, Mom!

 

Right renal upper pole calculus measures no greater than 0.1 cm and is unchanged.

This is a really weird way to say that I have a teeny, tiny kidney stone of no concern. How dare they use the term “calculus” when referring to my guts? I hate math!

There is no right hydronephrosis. Left renal upper pole demonstrates small focal regions of chronic cortical scarring. Kidneys are otherwise normal.

Hydronephrosis (I looked it up) is a swollen kidney. I don’t have one. Or two.

Visualized bowel within the abdomen is normal. There is no bowel mucosal thickening. Gastric and duodenal mucosal contours are normal.

No idea what this means, but I don’t really like the way they throw the term “bowel” around, like it’s not totally embarrassing that now you know I have one. Sheesh.

There is no intra-abdominal lymphadenopathy.

No abnormal lymph nodes in mah belly = no cancer.

Mild hazy fat stranding projecting along the right and left diaphragmatic crus reflect site of previous lymphomatous involvement. There is no residual lymphadenopathy identified.

Seriously, mild hazy fat? Now it sounds like a bad poem. And is lymphomatous really a word? It sounds suspiciously like hippopotamus, and I don’t appreciate that one bit. Oh, and crus? I am totally using that one in Words with Friends. I’m pretty sure they know no one’s actually reading the report anymore and they’re just throwing shit in here to sound fancy.

There is no mesenteric or omental adenopathy. There is mild, subtle fat stranding of the mid mesentery which is likely within normal limits and if real, almost certainly reflects treatment sequelae of chemotherapy. There is no definite “misty” mesentery. Scattered mesenteric lymph nodes are not enlarged by size criteria, all measuring substantially less than 1.0 cm in short axis dimension. Abdominal osseous structures are intact without bony destructive process.

Here we go again with the fakey words. Time for medical dictionary help.

• Mesenteric: pertaining to the mesentery, the double layer of peritoneum suspending the intestine from the posterior abdominal wall (I think the more common term is “guts”)
• Omentum: One of the folds of the peritoneum that connect the stomach with other abdominal organs (again, another way of saying “guts”)
• Adenopathy: Swelling or abnormal enlargement of the lymph nodes
• Sequelae: A negative afteraffect
• Osseous: Composed of, containing, or resembling bone; bony

Hee hee: bone.

Pelvis: Pelvic visceral organs are normal. Uterus and ovaries are normal. There is no pelvic lymphadenopathy or free fluid. There is no inguinal lymphadenopathy. Osseous structures are intact without bony destructive process.

Are you bored yet? I am so bored. We’re almost done. Here comes the radiologist’s summary.

1. Negative examination for residual/recurrent non Hodgkin’s lymphoma within the chest, abdomen, and pelvis by CT.

This means no cancer.

2. Minimal, nonobstructive right nephrolithiasis with a single right renal upper pole 0.1 cm calculus. No right hydronephrosis.

This means itty-bitty kidney stone.

If there’s one thing I’ve learned from all this, it’s that I never want to be a medical transcriptionist.

Basically, Dr. O was all smiles and rainbows and unicorns at my appointment yesterday. She says the radiologist’s report and my blood work show that I’m exactly where I should be, and we’ll do this all again in six months. The first two years after treatment have the highest risk of recurrence, so once two years have passed we’ll continue the same tests, just less often. She was not too concerned that I continue to have lingering side effects from chemo—fatigue, low energy, neuropathy, ugly hair—and says those things can take a few years to disappear completely.

In other words, I AM PERFECTLY NORMAL. No matter what any of you say, I will hold to that belief.

PERFECTLY NORMAL.

YES.

NORMAL.

…

…

…and that sounded a little more “jerk store,” than I meant for it to (à la 2:30 here).