A trip to MD Anderson

Back a few weeks ago, when Carl was in the ER for his pneumonia diagnosis, they found an enlarged lymph node that they recommended that Carl follow up with his primary care doctor to get a biopsy. His primary care doctor referred him to MD Anderson for their recommendations of what to do next. MD Anderson called us on a Tuesday a couple of weeks ago and got us in for Carl's first appointment on Friday. 

MD Anderson in Arizona is affiliated with the Banner system. When we returned to Mesa this season, we set about to get doctors within the Banner system instead of independent practitioners. It has turned out to be very helpful to have all our records in one place, and since MD Anderson is also affiliated, their records are integrated in as well.

The first appointment was with a nurse practitioner. When she came in, she told us upfront that she was not an oncologist, but rather was a nurse practitioner in family medicine, but that she had worked with oncology for 20+ years. Her goal was to get the appropriate tests scheduled and to get Carl in to see the correct oncology doctor. She said that, prior to using this intake method, the schedulers would try to get patients scheduled with the right specialty area, but sometimes there was a wait to get an appointment (6+ weeks) and then it would turn out to be the wrong specialty area and the patient would again need to wait to get an appointment with the correct specialist. In addition, the first appointment with the specialist would just schedule tests so it would seem that nothing would get accomplished for many weeks. Suzanne identified the tests that she thought would be necessary and got those scheduled. Carl had bloodwork drawn, a sonogram done, and then an MRI scheduled. An appointment with a genitourinary specialist (urologist) was also scheduled.

In the meantime, Carl's primary care doctor had also scheduled bloodwork to rule out Valley Fever (it has to be tested 3+ weeks from onset of systems for the antibodies to be detectable in the bloodstream) and tuberculosis. He also had a follow-up x-ray ordered by his pulmonary care doctor to ensure that the pneumonia was gone.

Through the Banner online records, we could see the results from all of the tests -- nothing abnormal seemed to be indicated. His white blood count was normal (it had still been elevated when he was discharged from the hospital). He didn't have Valley Fever and the TB test was negative. One of the tests indicated that he was not pregnant (whew!). We couldn't see the results of the MRI but were hopeful that we would see the oncologist and he would say, "No worries, go on your way and have a great summer!"

Well, that didn't happen... as we thought, none of the tests indicated anything abnormal, but the enlarged lymph node was still there. So, the doctor referred Carl to have a biopsy via Interventional Radiology (from wikipedia: Interventional radiology is a medical specialty that performs various minimally-invasive procedures using medical imaging guidance, such as x-ray fluoroscopy, computed tomography, magnetic resonance imaging, or ultrasound.). In this case, they will use CT scanning to direct the biopsy. After the biopsy, there will be 1-1.5 week wait for biopsy results before we meet with the oncologist again.

As we were walking out of MD Anderson, Carl said, "So, in the ER they said I had an enlarged lymph node. The oncologist just said that I have an enlarged lymph node. Have we made any progress in the past 4 weeks?"

I guess another way to look at it is:

The good news is that there is no bad news.

The bad news is that there is no good news. 

We're thankful to have a nice house to stay in while we await the go-ahead that we can head out on our travels!