Final Steps

The scan was done and the results have arrived. They kindly sent me the radiologist's report so that I could check it out for myself. This is how it begins:

'Previously demonstrated hypermetabolic bilateral cervical and extensive mediastinal adenopathy has resolved morphologically.'

I read this sentence twice, went away to have a cup of tea, and then came back and read it again. Despite the tea, further illumination was not forthcoming. Of the twelve words in the sentence, just six were familiar: 'previously demonstrated', 'and extensive' and 'has resolved'. This half of the sentence seemed to be reassuring, but I remained curious about the meaning of the other half.

The word that troubled me most was 'cervical', which surely meant something related to the cervix. I didn't think I had one. I began to wonder what had been going on when I was in the scanner. It did make some odd noises at times. Or maybe the lymphoma had been having effects people had been too embarrassed to tell me about. Or perhaps I had been suffering from a life-long delusion.

Being one of the unfortunate souls with little Latin and no Greek I turned to google and discovered that in Latin 'cervix' means 'neck'. Not in English today, but in Latin back in the good old days of the Caesars, and that is what matters in the medical world. So when every civilised person spoke Latin everyone, man and woman alike, had a cervix, an admirable - and rare - example of Roman gender equality.

So I had a first clue. It had something to do with my neck. But just in case someone has picked up a bit of Latin and starts cracking its code, the medical profession mixes in some Greek as well, like 'hypermetabolic', 'adenopathy' and 'morphologically' to throw you off the scent.

However, I wanted to know what was going on inside me and I was not going to admit defeat. After some time I came up with this translation:

'The over-active lymph nodes which had been identified in previous scans on each side of the neck and extensively between the lungs have returned to their normal size.'

That might not get me an alpha in finals of Greats but I think it tells me what I wanted to know, which is that treatment has worked. The largest node has reduced in size from 32 to 9 mm and a standard measure of the uptake of glucose, which indicates how active the malignant cells are, has gone down from 17.2 to 2.1. Those measures look pretty decisive to me.

But there was a catch:

'Left lower lobe consolidation looks inflammatory and should be closely monitored. Persistent right pleural effusion.'

That is consistent with my remaining symptoms. I wonder why the good news is conveyed 50% in Latin and Greek and the bad news 90% in English. (I had worked out some time ago that 'pleural effusion' is excess fluid in the lung.) Maybe it's just a coincidence.

They are indeed closely monitoring things and have booked me in for another PET scan this month.

In the meantime I am addressing the coughing and wheezing by doing some breathing exercises under the guidance of a lung physiotherapist at the Marsden and a beathing expert who lives locally.

I wasn't sure that the exercises would work, but in fact there has been slow but steady improvement. It's a bit like working out every day at the gym, but exercising the lungs rather than muscles. The effect is cumulative.

One of the exercises I have been given is called 'box breathing' and is practised by Navy Seals. It enables them to stay relaxed but alert when they are hiding out behind enemy lines or waiting to spring an ambush. I understand they are trained to do other things as well. I've decided to leave that to them. I think box breathing is enough Navy Seal training for me.

My Christmas present from the Marsden is a review with some White Coats. They may decide to do some more treatment to deal with the inflammation or it may turn out to be my last visit to the hospital for some time. I hope Leni will be there to keep an eye on the White Coats. I may need to call on Athena. She knows more than anyone else and speaks to me in English. I am also hoping this will indeed be a wrap up of the treatment.

The owl of Athena flies at dusk.