Essay by Rex: August 2004

The Lumps...

I first noticed it in the shower in 1993 while performing the normal exploratory functions with a sudsy washcloth and a spray of water. That walnut sized lump in the right armpit was an instant attention getter. I knew it was more than an ingrown hair because it appeared to be deeper, larger and closer to the upper ribcage. It was firm and there was no soreness. It was something that I'd keep track of almost subconsciously afterwards like one might keep checking a chipped tooth or an ugly hair growing out of a mole on one's face.

I even had Hurricane feel the lump. Hey, she was a registered nurse and certainly more familiar with the anatomy than I was. For all I knew it was a collection of old pizza stored in a humongous fat cell. Her advice was to have a doctor check it out. Good advice from someone who hadn't as yet earned the nickname I would later give her.

My visit with the surgeon, who was also head of the large medical group next to the large medical center in town was less than I expected. A quick exam by him and he said I shouldn't worry about it. If it bothered me, he was willing to remove it. At the time I did not see it as a threat although I was having some strength, muscle control and numbness problems with that arm and shoulder. Two years later, in 1995, the two symptoms would be linked by two surgeries performed within 3 weeks of each other. That first surgeon's casual lack of concern for the lump would become a costly oversight. To me, not him.

Anyway, I figured if he wasn't worried, then I shouldn't be worried. I equated it with me being at his house on a home repair call. If I advised him to get the dry rot fixed ... he would consider it. If I said not to worry, that it appeared to be dormant or already treated and under control somehow, then maybe he wouldn't worry. ( Maybe the analogy doesn't work but I tried.)

Note: I don't mean for this to be a "lump by lump" description of my medical history ... like a sports announcer describes the back and forth pounding two boxers dish out on each other. I really am trying to set up an experience that took place last year which rattled my comfort zones and someone else's.

During 2001, another lump started ... in my throat this time, below the jaw line, left side. Pea sized at first, I grew a beard to hide it as it got visibly noticeable. Dumb, You say? You're probably right.

There was no money for health insurance as I was dealing with the District Attorney's Family Support Division office who didn't like deadbeats to get behind in child support. Stiff penalties are meted out to those who mock the system or genuinely don't have the kind of money coming in to support two separate households. I know this through experience.

The summer of 2002 my employer offered me medical coverage which I jumped at. After locating a good primary care physician (PCP) that autumn, I was set up with a surgeon to do a biopsy, labs and eventually my PCP referred me to the oncologist. Radiation followed over the holidays of 2002/2003. Then it was "sit and wait" to see if the diagnosed lymphoma would respond.

As you might imagine, I had by this time begun to equate "lumps" as being ... problematic, ...prone to painful procedures ... and costly. I tried to be aware of any new lumps that might show up. Last year one did and I was not thrilled with it's location.

Setting up an appointment with one's PCP isn't difficult until the young lady on the phone starts asking too specific questions about the reason for making the appointment.

"Well, uh, I've located another lump." Now she doesn't know me from any other male caller she's dealt with that day but gives me a day and time.

Once in the exam room, days later, the anxiety is ramped up a bit. A nurse takes the vitals and asks what I am seeing the doctor for.

"A lump. I have a history of them."

"Where is it?"

"Uhhh, the...uh... (my high school biology and anatomy terminology is a bit rusty) ...the scrotum."

She makes a note, quickly mentions the doctor will be right in and leaves. I am not anymore comfortable when Dr. Yee comes in, asks the reason for the visit, and asks me to drop my pants to check things out. I jokingly tell him it seems that I have gained another 'family jewel'. The rubber gloves go on and he says that considering my history, this needs to be checked out by a sonogram at the hospital. He would set one up. He asks if I've had a prostate exam lately, plunging me into a near state of panic which I tried not to show.

"Nope. Never had one". I was just about to turn 49.

He said "Let's do it." Apparently I hesitated because he asked if I wanted to think about it a little. I really did want to get the heck out of there but had already passed thru a couple levels of comfort zones. Refusing ... and having to go thru this again just to be probed seemed dumb. After all, I had showered before coming, Mom would be proud that I was wearing clean underwear, and at the moment they were around my ankles anyway ... Go for it.

Assuming the position, I was surprised that there was no foreplay but, in retrospect, didn't know what foreplay might consist of during such a procedure. He said it felt fine. I said that was only his opinion, not mine. He said to be glad he didn't have larger fingers. I was just glad it was over but for the rest of the day it felt like I'd been in to Quik Lube for their $49 oil change and lube job special.

Arriving at the hospital for the sonogram had me a bit stressed. I had also heard the word 'ultrasound'. Someone was gonna be checking out "my boys" with a machine I was unfamiliar with ... and taking pictures besides. Sure, the machine had been rolled around on my wife's belly during pregnancies but that was a much bigger target. The procedure never did show a little guy with a 'johnson' in those pictures. I had fathered all daughters. I was also worried about just how photogenic I might be.

My name was called after signing in and I began following a cute little brunette, 27ish with very long hair, down the halls towards wherever this was going to take place.

"Hi, my name is Kiersten." followed by a bit of small talk. The small talk was hers, not mine. I was busy passing thru mental comfort zones as we walked. Some doctor guy would soon be taking my picture and it wasn't going to be a "glamour shot" either.

She looked at the clipboard and said "Ok, we are going to be taking an ultrasound of your....... skuh......(a pause)... skuh...rotum." All I could say was "You?" Now, if this had been a blind date I'd be thrilled, but it wasn't ... and I wasn't. Apparently she wasn't either.

She was very professional as she reviewed with me the steps of the procedure about to be done, maybe for her own benefit as well as mine. Neither of us really wanted to be there at that moment.

The machine was turned on and there was a blanket of sorts for modesty. She produced some towels and a lubricating gel, warmed for comfort. Awkward attempts were made to let her have the best angle with the handheld scanner being rolled over my privates. My focus was to think very generic thoughts and not react to stimulation. I succeeded in spite of everything mentioned.

After about 10 minutes of searching for the '3rd jewel' she admitted she wasn't having any luck and it wasn't showing up on the monitor. I said it tended to make itself more available when I was standing rather than lying down. This was a problem. She then asked if I "could find it" and help her to locate it. So now my hand, her hand, warm lubricant and a wand thingy was down there. The comfort zones whipped by like traffic signs on a freeway.

Eventually, it appeared on the monitor and she was getting the pictures. She then said a doctor or someone else should look at this. 'No snickering' was a request I thought to myself. She left and soon a tech guy or doctor type with a white smock came in, studied the monitor a couple minutes and said they'd better try to get some color pictures of what they were seeing. I think to myself "they can do that? take color pictures? I couldn't imagine. Maybe I misunderstood. They both left... (for some instamatic film from Walmart perhaps?) Then she came back in to finish up the new series of pictures.

She offered me the towels and apologized for the mess she made. By that time I'd been celibate for almost ten years and I may have forgotten some things. To break the tension ... an "R" rated question popped into my mind. "Did we just have sex?" ...Gosh, I'm glad I didn't ask it out loud.

I've been writing these experiences partly for my own therapeutic reasons, maybe to gripe or to vent. Sometimes to just to enjoy laughs with those who read them. I also wish to offer these experiences to educate readers of the challenges one may go thru in the grind of medical procedures. A diagnosis may take many return trips to a doctor who will order tests before something might be found. Keep after it.

A casual conversation with Craig Ewert once re: 'lumps' and the one he found is something to get checked out. He did and I'm glad for his sake and for that of his family.

My advice is to take any lump you may find or other symptom seriously. Also, in my case a second initial opinion may have saved me a lot of grief or at least gotten me an earlier diagnosis.

Something else which may have aided me and the doctors in finding lumps sooner would be to watch your weight. If you get too portly, the lumps from consuming pizza, burgers, that late night dish of spumoni ice cream ... or even your wife's RS homemaking night inspired good cooking may hide that lump that isn't merely a fatty tissue deposit. (Whew, sorry for the long sentence.)

Now that my diagnosis has been fine tuned a bit from Non-Hodgkins Lymphoma in general to Mantle Cell Lymphoma I told my oldest daughter Rachel just what I had. She did a search on Google and called me back a day later giving me a few details of what it was. She was not very cheery about it but we had a good conversation. One of those daddy/daughter conversations that I cherish. That night I looked at 2 or 3 websites dedicated to MCL. It came close to crushing my positive outlook on the treatments.

My doctor has not mentioned anything like how much time is left but early on he said people live for years with this condition. That would be comforting except for the fact that I already have been living with it for years. More or less since '93. Just where on the timeline am I?

I will say that the treatments are most unpleasant but I can deal with them. The increase of swelling in different areas is distressing. Painful. This disease will eventually get me, I guess. Everyone dies from something. I know that my attitude and the faith and prayers of my friends and family will sustain me for however long I'm supposed to be here. Only Heavenly Father knows how many more years of Scouting I am going to see. Or if I'll live to see grandchildren. How many buckets of KFC I will get to buy or the number of worms I'll drown not catching fish.

I have all the confidence anyone can have in my doctor, Dr. Mehdi. A really great, kind man. Eventually, relying on medicine though, is a bit like relying on "the arm of flesh" isn't it? Any thoughts?

I have not been writing much in the past months. I am not in a concise groove of wordy expression yet. I promise to be more brief. I really need to get back to chronicling all the cranky nurses I get to contend with. All these treatments expose me to plenty. Somehow I just bring it out in nurses. Dr. Mehdi put me in the hospital for 5 days the last week of July. The nurses outvoted him and decided I should leave after 4 days. I couldn't have agreed more.

Rex H. McBride

Sunday, Aug. 8, 2004