I Owe You One Swine Flu

A timeline of the events leading up to and following Diagnosis Day ("D-Day"):

• D-Day -5: I had a cough that had been nagging me for a week or so, but nothing out of the ordinary. Peak of the swine flu hysteria: lots of Purells being distributed around the office and increased communications encouraging employees to stay home if exhibiting any flu symptoms
• D-Day -1: Annoying cough still around but no flu-like symptoms so figure I'm fine. Return home from work to hear that one of the roommates may have the swine flu
  
• D-Day, Oct 13. 2009: Decided to make an appointment with Dr. Huang, my primary care doc, just to be sure I didn't have the flu; was able to book a same-day appointment as soon as I mentioned the dreaded swine flu. During my appointment, doc concluded that none of my symptoms indicated swine flu, but decided to perform some other routine checks since it had been a while...eyes, ears, heart, stomach. While performing the standard stomach palpitations, he noticed something that did not feel quite right. I couldn't see anything different while I was laying there on the table, but I could definitely feel it. A bit firmer on the right side. Doc used his fingers to tap around my stomach - the sound from his taps on the right side were noticeably different. He recommended I get an ultrasound as soon as possible.
• D-Day +1: Ultrasound at Fairfax Radiology confirms that there is indeed an abnormal mass of approx. 7 cm in my lower abdomen. Doc recommends CT scan for further analysis.
  
  
• D-Day +2: After drinking two horrendous barium "berry" smoothies, my CT scan also confirms the preliminary findings - large mass in the lower abdomen suggestive of lymphoma. The picture above was from my CT scan - that round shape in the bottom half of my stomach is my unwanted visitor.
  
• D-Day +3: Appointment to discuss test results with Dr. Huang. Today I learned that I almost definitely have some form of lymphoma. Doc lets me know that this is about as much as he can help me and recommends seeing a hematologist/oncologist ASAP.
  
• D-Day +6: Appointment with Dr. Spira at Fairfax Oncology. He agrees with the preliminary assessment on lymphoma and recommends a CT-guided biopsy, a procedure in which an interventional radiologist uses long needle to collect a specimen from the mass. Also in my last weeks of tapering for the Marine Corps Marathon on 10/25...Dr. Spira assures me that there should be no problems in running - good news, although not the advice Mom wanted to hear
  
• D-Day +8: Appointment with the interventional radiologist at Georgetown to discuss the CT-guided biopsy procedure. At this point, I start to hear concerns from others regarding the effectiveness of the CT-guided procedure. There is the chance that this procedure will not be successful in obtaining a large enough sample for pathology to interpret. Start looking at a laparscopic biopsy as the better procedure to obtain a sample...
  
  
• D-Day +13 (Marathon Day): Nerves are high for my second marathon and I hoping for significant improvements over my first time last year. Weather ends up perfect for a long run and the spectators are out in full force. Andrea and me both end up running well and beating our PRs, despite bronchitis beating her down and my little friend hangin out underneath my abs. My final 2009 Marine Corps time: 3:55:32, almost 15 minutes faster than my 2008 time!
  

• D-Day +16: Thanks to Andrea's connections at Georgetown, get squeezed in for an appointment with Dr. Cheson at the Lombardi Cancer Center to discuss a plan going forward and Dr. Bhanot to discuss laparoscopic biopsy procedure. Dr. Bhanot's one of the country's top-rated surgeons and treated us very well, so I was confident that I was in good hands. Surgery scheduled for Friday morning with full anesthesia (was a little nervous about this since I'd never been under before).
  
  
• D-Day + 18: Into pre-Op at 7am sharp. Lots of paperwork and repetitive questions to answer for the surgery team. Head into the OR at approximately 9:30, where Dr. Bhanot makes three small incisions (for camera and tools) to remove a small sample of the mass. All finished and sent to the recovery area within an hour. They send me home with Percocet for the pain (actually didn't experience too much discomfort overall) and tell me no strenuous activity for the next 4 weeks (don't want the sutures blowing out).
  
  
• D-Day +25: Still waiting on results from pathology. Go into Lombardi to get a bone marrow biopsy (allows the docs to see whether disease has spread to the marrow). Fairly quick procedure but certainly not the most pleasant. I heard the needle was sizeable but luckily I didn't see it before it went in. Don't even know how to describe the feeling of needle penetrating your bone...not enjoyable. Also learn during the biopsy that there is some uncertaintly surrounding the exact pathology of my biopsy sample taken last week...they've sent the samples to Dr. Jaffe at NIH, a world-reknowned pathologist specializing in cancer.