Diagnosis

The first step to solving any problem is to clearly define it. You look at your system, analyze the inputs, and compare your expected versus your actual outputs. Throw away the noise and the irrelevant data points, and hone in on what the signal is telling you.

First Symptoms

Summers in San Francisco aren’t hot, so it wasn’t the heat that woke me up one night in the middle of August. It was a sudden sting of pain in my abdomen. I didn’t think much of it, and you wouldn’t either, because it was the type of pain that was just normal enough to be irritating, but not concerning. I took an Advil and went back to sleep — twist, pop, gulp, problem solved. Until it came back the next day, but still, I wasn’t worried. I’ve been healthy my whole life. This is just some weird aberration. It’ll pass. Hey Judy, fiancée, let’s definitely not skip our friend’s wedding in Denver this weekend. I’ll be better in no time.

Now we’re in Denver. Now it’s worse. Now I’m curled over in pain. I’m feverish, I’ve got chills, something isn’t right. We’re going to the hospital first thing in the morning. The doctor asks me about my symptoms. Hmmmm, sounds like a kidney stone. Kidney stone! Yes, of course, that makes a ton of sense. I knew I should have been better about drinking water and staying hydrated. It’s not going to be a fun time for you, but we’ll give you some drugs and send you on your way. Let’s do a CT scan first — we just want to be sure.

Actually…there is ‘something’ in your abdomen.

Well, that escalated quickly.

It’s probably just a cyst, maybe congenital. Here’s your brand new friend, the IV pole. Look, it goes wherever you go!

We’ll need to keep you overnight for observation. Why are you in Denver again? A wedding? Yeah, sorry, you’re not gonna make it to that.

Treatment is all about stages, steps, short-term goals. Our first goal was just to get home, back to SF, to figure things out in a place where we’d have the resources we’d need to deal with everything: family, friends, Bailey, and the occasional burrito.

Surgical Extraction

Now that we know there’s a ‘thing’ in my abdomen, it’s high time we get it TF out of there. Everything would be done at UCSF’s state-of-the-art new facility in Mission Bay, only a 7-minute Lyft ride from our home in SOMA. Lucky in that respect, but it’s probably too early to start posting #blessed. I found a great surgeon, and we got that ‘something’ out. It wasn’t easy, but nobody said it would be.

Stanford football makes the hospital stay go by a little quicker.
Daily walks with my trusty friend, the IV pole.
Hey doc, so you got it out, what can you tell me about it?

Well, it doesn’t have the characteristics of a cyst. Rather, it’s more likely to be a neoplasm (neo from the Greek for ‘new’, and plasm for ‘tissue’). As in, it probably grew sometime recently.

Wow, ok, that’s a bit alarming.

Oh, by the way, it was the size of a plum (WHAT!!?), and it didn’t go without a fight; it dragged 18 inches of small intestine out with it.

Fun fact that I learned from Google: we each have about 22 feet of small intestine. Losing a foot-and-a-half doesn’t actually have any long-term effects, but I wouldn’t exactly compare it to ripping off a strand of Bubble Tape.

Three nights in the hospital until I was able to go back home, pain meds in tow. Tell Mary Poppins to skip the spoonful of sugar, she’s obviously never tried Oxycodone.

Nothing to do now but wait for the biopsy and figure out exactly what we are dealing with, but I mean, there’s no way this is cancer. It has to be benign. Right?

Non-Hodgkins Lymphoma

Sorry, my bad. I should have given you a spoiler alert. Yeah, the biopsy results came back on October 7th, 2016. Day Zero. I officially have Non-Hodgkins Lymphoma, or NHL. More specifically, I have Diffuse Large B-Cell Lymphoma, the most common form of NHL, that also has the great acronym DLBCL.

It’s a fast-growing form of lymphoma. The oncologist said that the tumor went from cell-sized to plum-sized in just three months. Three. Short. Months.

This is a plum.

Next Steps

Remember how we talked about small steps and short-term goals? The last couple months have been chalk-full of terrible, awful, no-good news. So it’s time for some good news. The oncologist gave me a full pat-down on Friday, checking for any unusual lumps: neck, cheeks, armpits, even down by my ankles. Clean slate. Good news.

This form of cancer is very treatable. Good news.

The surgeon also informed me that while they were in the process of extracting my plum, they felt around my intestines and saw no abnormal or diseased tissue. They also pulled out some nearby lymph nodes and ran some tests for good measure. Note from the biopsy report: Lymph nodes adjacent to the atypical lymphoid infiltrate appear reactive and show no large atypical cells. More good news.

Monday, I’ve got my first PET scan scheduled, which can detect baby plums down to 1-cm in size. That’s my goal, no baby plums.

There’s a decent chance the cancer was localized in my abdomen, but these cells like to travel, so you need to be careful. Despite the successful extraction of my tumor, there’s no getting around the fact that it’s very likely there are still mutated cancer cells floating around in my system. And the only way to fully knock them out is with chemotherapy. Chemo starts on October 18th, and while I’m going to take it one day at a time, I’m looking forward to knocking this thing out of my body, one way or another, from Day Zero to cancer-free. #nodaysoff