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Biopsy-Day Timeline Journal Entry

10:00 AM

I’ve avoided writing about Boop and what’s on her agenda this morning, instead scouring the internet for Gluggle Jugs to order and going on Christmas ornament hunts for everyone’s Thanksgiving boxes, but now, I’m going to bite the biopsy, as it were and talk about the Big Scary Bubble on the CT scan that floats in our collective peripheral vision. 

It’s been a strange experience – and we aren’t done yet— though I pray we’re close to shutting the door on this stage 4 scare.  I feel like it’s a Winnie-the-Pooh, “I’m just a little black rain cloud” scenario for us, threatening to ruin the honey sweetness of our lives,

And today, that threat needs tending to. Today, one of Caitlin’s most-trusted colleagues will go in and snag some samples to send to pathology. So, Winnie-the-Pooh and his fuzzy, destructive paw can go fuck himself. 

11:34 AM

Caitlin just received word that the IR specialist, was able to pierce the tumor and withdraw a good sample to send up for rapid analysis in Miami’s on-site pathology lab. She says it’s a solid mass – which means the blip on the radar may be a legitimate threat — but there’s always a chance it’s benign. I pray the biopsy needle punctures this little black raincloud, removes its teeth and claws.

(About this ridiculous Pooh metaphor: You know how horror films use the most innocent, tinkling nursery rhymes and bright, colorful party scenes in blurry slo-mo just before introducing the killer? That’s the scene I keep imagining. I want the calliope music to stop. The hovering raincloud with ill-intent to vanish. For us to return to our enchanted place.)

2:17 PM

Results have come back with no malignant cells detected. A small victory, as the rapid results can give us an idea of what we’re dealing with, but far from an official answer. Still, there’s a possibility that the sample wasn’t actual tumor tissue, but lung tissue surrounding it. So, they collected seven more samples before waking Boop up to send to an off-site lab for official results. That’ll take five to ten days. So, the waiting game continues…  

But we feel cautiously optimistic.  Boop herself says she doesn’t want to think she’s in the clear yet — only to be crushed in another week — and I totally get it. So we wait on the experts to tell us the results. 

Because, as Pooh so cleverly says:

“When you are a Bear of Very Little Brain, and you Think of Things, you find sometimes that a Thing which seemed very Thingish inside you is quite different when it gets out into the open and has other people looking at it.” (A.A. Milne)

So we wait and we pray to God, the biggest expert of all, for “Un-Thingish” results from this Thing occupying our hearts and minds. And we would very much appreciate any and all of you who feel so led to please pray for the same.

PS: Pooh never means any harm and I believe this blip doesn’t, as well. That’s what I have to believe.

Terrifying Atypical Images on my Baby Girl’s CT Scan

I don’t know if I’m reacting the way a typical mother should. I don’t know what the “typical mother” should react like, feel like, process like.  I’m not paralyzed in place. I’m not gnashing my teeth, nor wailing like a banshee. I’m not ready to rip heads off strangers, or the roses in my back yard… or God.

I mean, that would be pretty typical, right? Blasphemous, yes, but typical — to be angry at God, right? And everyone else out there walking around perfectly healthy in His perfect image?  

Instead, I’m still going through the motions of my normal life… considering all the things I need to do for the day, the places and practices where the boys need to be, what I should make for dinner… even proceeding with this two-week trip to the UK. Surely that one is blasphemy, right? That’s definitely not how I should be acting is it? That’s not typical…

But then, what is typical anyway? 

Because my daughter surely isn’t the typical patient for this disease. This clear cell renal carcinoma that appears to have spread to her liver. As in Stage 4.

That diagnosis is typical of an older person… and a male. Bethany is neither old nor a man. She is a thirty-five-years-young mother of three, who was 33 when she first learned she had a tumor on her right kidney. Thirty-three when she had her partial nephrectomy. If they’d taken her whole kidney, would it have made a difference? Is that typically what’s done? 

No, none of this feels typical. So maybe my reactions don’t need to be either?  

Besides, we still don’t know for sure that’s what we’re dealing with. Although our family’s margin for error is much slimmer than for most. A typical patient’s family would only know that an MRI has been recommended to supply additional detailed imaging at this stage. (This stage. The irony of that phrase is not lost on me.) But we have our own staff of surgical oncologists as kith and kin. 

So while a typical patient’s family would have only been notified of the suspicious lesions on the CT scan, our patient’s surgical oncologist sister immediately asks for a cd of the scan, watches it remotely, knows what she sees, shows the images to her most-trusted radiologist and fellow oncology colleagues, along with every other physician friend she trusts and loves from all over the United States, (because it’s her sister, after all, and she really, really wants to have been wrong),  and they all agree the lesions are characteristic of metastasis from renal cell… so much so that the sister-surgical-oncologist  immediately has her sister’s treatment moved to the University of Miami where she practices and where her surg/onc partner is installed as caregiver, who then immediately orders a chest CT to make sure there are no additional mets in the lungs, along with a referral to an interventional radiologist for an immediate biopsy, as well as a timeline for immunotherapy and eventual (hopeful) liver resection.

No, a typical patient’s family doesn’t have all these experts and referrals and scans and biopsies and treatments fast-tracked to near hyper-speed. Most patients don’t have that privilege.

I understand how privileged we are. I am grateful. So grateful. 

But I’m also here to say it doesn’t feel like privilege. It feels like awfully bad fortune. My daughter faces a terrifying fight. And while the storm howls all around us, I’m doing my best to focus on the tasks at hand. The rehearsals and practices, the dinners and laundry, flights and itineraries. Doing my best to move forward. 

Because there is a slight, oh-so-slight chance, that the spots are perfusion abnormalities. That the contrast pooled. Or that they are solid, but not malignant: hepatic adenoma, hemangioma, or follicular nodular hyperplasia… all benign.

And even though 10 out of 10 experts believe that’s most likely not the case, we are praying for and believing in a miracle.

Most patients and their mothers would do the same. At least on that, I’m pretty certain we’re typical.

Miracles aren’t typical. That’s the nature of miracles. If they were, they wouldn’t be miracles. They would be ordinary occurences. As in, typical. But my daughter, her diagnosis, the whole situation, isn’t typical.

The C Word

They come in threes, they say. Bad things come in threes. And sure

enough, bad tidings rode in on their serrated fonts in swirling

impatient portals: an unholy trinity of cyst, malignancy and mass.

One slung sideways, like a fanny pack across a kidney sack, a second,

mortared to wind pipe, spewing ash into places unknown, a third sucking

marrow from mammary glands like a motherfucker. Unsanctified settlers,

all. Mother of all that is Holy, who let in the false prophet, the devil, the

beast to cast rings around x-rays and pockets full of poison, ashen shadows

on MRI scans? All that rot and stink and bile planted like rancid Easter eggs,

tangled spiders’ nests, like hissing snakes in sacred sanctuaries… Such blatant

blasphemy. Such sick sacrilege. But then, while bad things come in threes, so

too, do good. And we believe in the Good — that Triumvirate of Truth: Faith

and Hope and Love. And the greatest of these is Love. Love lends strength and

courage to fight. When we harness for God the energies of love, then love will

help conquer all. Together, we’ll banish the bad for Good.     Even the dirty, rotten C word.

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