Today I once again attended the outpatients clinic for the haemotology and oncology department to discuss recent test results and what to do about any of them. It was pleasant enough to sit in one of their comfy armchairs playing games on my phone and reading facebook. Just as last time, the TV was on. Unlike last time, it appeared to be showing some kind of adult TV rather than CBBC. Presumably this is why they had chosen to turn the volume to zero and discontinue displaying the subtitles. Daytime grown up telly is clearly a bit too radical and dangerous for exposure to hospital patients, so all we had was some people wandering about. There was a graveside scene, so presumably it was some kind of crime or other drama. I didn’t recognise it, in any case.

 Last time I attended I had noticed a ‘beverage preparation area’, with a kettle and mugs and so on. I had presumed this was where the staff went to make tea, so I was shocked when a happy chappy sporting a badge labelling him as a hospital volunteer suddenly turned into the tea boy, not for the staff, but for the patients. Truly, the service levels in haemotology are rising with each and every visit. Kettle on, teabag in mug, tea in my hand. Fantastic effort. I am hopeful that when I go back for my next visit, there might be a biscuit, or perhaps a slice of cake as well.

 In due course, I was called into see (on this occasion) Doctor Alan Williams. For those of you who have been to university and done some kind of science or engineering style of degree, you will be familiar with the sort of lecturer who has been in academia for too long. The hair has a mind of its own, the clothes are a little too shabby and he (usually a he) speaks in a strange language which is full of immense amounts of knowledge trying (and failing) to escape in an intelligible manner. This largely describes Doctor Williams. I understand he does know really a lot about medicine, being the senior haemotologist in the hospital, but sometimes his communication skills fail. I don’t think it helps that he fails to pick up on my own scientific background and ability to understand long words and in his efforts to dumb down what he’s trying to talk about to ‘general not-scientific patientspeak’ his brain implodes and garbage comes out.

So, the result of all my tests to date are as follows:

• Bone marrow – Normal.
• Bloods – Normal. (in particular glad to know I don’t have Hep B, Hep C, or HIV)
• Lymph Nodes in Neck – Basically normal (except the speckledy bits which might be calcifications). Not big enough to remove surgically.

 Conclusion – Probably not lymphoma, but still might be, so we still need to get a lymph node to be sure. In any case, your lymph nodes are enlarged and there’s some cause for that.

 At this point I said… ok, but if it’s not lymphoma, which is good, what about this pain in my shoulder and all the circulation issues and my veins standing out of my arm?

 So the good Doctor and I went through the whole history of “why I am here in the hospital today” from the very beginning. He had my t-shirt off and poked about and gave the whole arm a thorough inspection. He looked at all the test results, even back to 2008 when I first started seeing him[1] and the general conclusion was. “Well … fuck only knows what’s wrong with you to be honest! Could still be lymphoma… maybe it’s sarcoidosis, or a thrombosis or… well… um…”

 So it’s time for a bank of tests. At this point, especially when they start talking stuff like sarcoidosis, I am expecting a grizzled Hugh Laurie to wander in with a cane and start popping pills. Blood tests for the sarcoidosis. Ultrasounds and venograms to look at the circulation and finally, still, we need a lymph node!

 So realistically, the best big node is in my chest, so we now have two alternatives. Number one is a radical new clever treatment which involves ramming a endoscope down my aesophagus, with an ultrasound to see what’s going on and do keyhole surgery from inside my gullet to get samples that way. Alternatively, get a chest cutter to go in from the outside and whip the little bastard out that way. Dr. W is going to talk to the different surgeons and see which are willing to do the job. Either way, this time is probably a stay in St James in Leeds as the first option is radical and new, and BRI has no chest cutters.

 And I must have spent an hour in the consulting room, what with all the tests and of course Dr Lisa wanted to know what was going on as well, so Dr Alan popped in to see her and tell her all about it. It was, in fact, whilst he was going through all my test results that the power went out. It came straight back on as the hospital’s emergency gensets kicked in, ensuring that those poor sods on life support were kept breathing, but it did delay things as his PC had to be booted back up. I note that they are using Windows XP and Netware 4, if anyone cares.

 So it was a good job I was (deliberately so I wasn’t waiting about) one of the last patients in the queue. By this time of course, the vampires had gone home for the day, so I’ll have to pop over to BRI tomorrow for the blood tests.

 So I went home. My house doesn’t have an emergency genset, so it was another half hour or so before I the electricity came back on. I guess I’ll hear about some appointments for ultrasounds and stuff soon and back to see one of my consultants in 4 weeks time.

 [1] I had a lump in the skin on my arm, which turned out to be a plasma cytoma which could have been bad, turned out not to be, but regular annual blood tests “just in case” ever since. Actually, it was bad, as insurance companies hate it and wouldn’t give me income protection insurance.  Getting life insurance was hard enough, I can only imagine how hard it might be after this lymphoma[2] scary business.

[2] Or whatever it turns out to be.[3]

[3] Yes. I do like footnotes, actually.

Last Friday then, I went to hospital to get my ultrasound scan. What Dr Lisa wants is a nice fat lymph node that the lab can chop up and do tests on in order to pin down the exact nature of my complaint. This is important as knowing what the problem is, will (for some reason) be key to deciding upon the correct treatment regime. My previous CT scan came up only to the base of my neck and it did look like there might just be a good one in there, but they needed to scan the rest of my neck for a proper look, or indeed to find any others which might be easy to get at.

 As I’ve mentioned in some status update long since scrolled off your screens, I had to ring the hospital to find out when I was supposed to be attending, as they hadn’t bothered to send me a letter, or it had got lost, or the postman ate it – I’ll let you decide which is most likely. Fortunately, the lovely Natalie, gawd bless ‘er, had said something suitably scathing about BRI’s X-Ray department. This put the doubt into my mind, as to where I was actually supposed to attend, being as all my previous scans had been at St. Lukes. Having rung the hospital a second time, I duly attended at Bradford Royal on this occasion![1]

 As usual the car park at the hospital was completely full to bursting, but I always check as I’m generally bone idle and really can’t be arsed with walking any more than the mandatory minimum. In an ideal world, it would work like a drive-thru. I could wind my seat back and this would serve as a hospital guerney allowing the various professionals the required access to perform procedure du jour, before collecting any followup appointments from the next window along. Yes, I would like fries with that. In the absence of such service however, seasoned veterans of BRI, like myself, will have discovered that there is what they call the “overflow” car park  (in fact a section within the large staff car park) on Smith Lane behind the hospital. This is almost always completely empty and even if not, I’ve never been unable to park there, so as usual I ended up in there, deposited my £2 for 3 hours at the pay and display and headed into the building.

 BRI’s main X-Ray (not emergency X-ray, which is where you go if you shatter your elbow) is situated at the end of a long corridor and whilst the main reception and waiting room is fairly bright and cheery, they sent  me to the ‘Blue Waiting Room’ which appears to be inside some kind of dark and dingy dungeon area, painted lovingingly in institution green (and isn’t blue at all). I really do think that working as a radiographer must have a high depression rate as they seem to be working so often in a subdued light environment. Hospitals are often not the cheeriest of places to begin with, hospitals with mood lighting are either miserable, or downright creepy.

 As normal, the hospital wi-fi barely reached into my assigned waiting room and any it’s “give us your credit card” wi-fi, so I had to put up with slightly dodgy 3G, as I browsed through facebook and waited. Two very attractive young ladies were in the room chattering away in something eastern european, which added to their allure and mystique. This being a hospital waiting room, I felt it would be inappropriate to invite them back for a threesome later. Additionally, I have nowhere near the required chutzpah to make such a suggestion and in any event such behaviour would probably have got me nothing more than a slap in the face for my trouble. Oddly enough I didn’t have to wait very long before getting called in. The girls were still there, with someone apologizing for making them wait. For all I know, they are there still.

 The jolly chappy who showed me into the ultrasound suite kept calling me ‘Sir’. I find this generally disconcerting in medical staff. I realise there has to be a fine line between personal and impersonal between staff and patients, however if someone is going to be involved in prodding me about, I’d rather they dropped enough formality to simply call me ‘Stef’ like anyone else. Even at the age of 41, if someone addresses Mr. Morrell I start looking around for my Dad.

 “You can call me Stef.”

“Thanks sir, it’s force of habit sir.”

*sigh*

 Anyway, he gets me set up on something which approximates a bed, in that it is a flat platform upon which I can lay horizontally, but otherwise shares few features with a comfortable sleeping place. He dims the lights (more!) and so I am waiting, stripped to the waist, with a paper tissue draped over my chest (why the paper, is my chest in some way unsightly?) and awaiting the doctor.

 When the doctor comes (“Call me stef…”) she is clearly confused and another of the care in the community staff that BRI seems to be employing these days. She has a green card upon which is the referral details of why I am here and what we hope to achieve by ultrasounding my neck. At least I presume it has such details, but for all I know it has her weekly shopping list written upon it, for the doctor proceeds to interview me as to what the fuck I am doing in her ultrasound room. So I explain to her all that has transpired up until this point, frankly quite disconcerted that she doesn’t actually know. After some amount of such conversation she gets out the lube and starts probing me[2].

 I’ve seen pictures of my unborn nephews whilst still happily chilling inside my delightful sister. From such pictures it’s pretty easy to see the shapes of heads and feet and bits obviously part of a tiny person. From looking at the monitor whilst I was being scanned, I can see that, in contrast, my insides are one amorphous grey nothingness. The doctor did seem to be finding and marking some of the grey blobs that started to appear within the grey background, so I asked and she confirmed that they were my lymph nodes. This went on for some ten minutes or so, before she asked the following bombshell question…

 “So it’s definately lymphoma, you’ve had the biopsy?”

 In my mind, the words are being screamed like an enraged gorilla on PCP: “Woman I’ve just explained, AT LENGTH, that the reason I am here is so you can find a suitable gland to take out and biopsy. Why don’t you know what you are doing? Why have I got the worlds worst ultrasound doctor?!?”

 What comes out though, with just a carefully measured hint of darkly growing impatience is the explanation about the CT scan… again. She now asks if I had the CT scan there and I inform her it was at St Lukes. She trots off and calls up the results on the nearby computer terminal before informing me that she wants to speak to her consultant and leaving the room.

 And so I am left, on the ‘not a comfy bed’ to contemplate, for a time. Quite a long time as it happens. Long enough to see a box on a shelf labelled ‘trans rectal probe’ and consider that there are some poor bastards less fortunate than I. Long enough, very nearly, to fall asleep for a short nap, despite the lack of basic comforts.

 Just as I am nodding off, the doctor returns, consultant in tow. They are chatting away about (presumably) me and my case. The green card with the shopping list is passed back and forth, and then they peer at my CT scan results again and I hear the original doctor saying “And this is why I’m confused.”

 Yes dear, I think you are.

 So then the consultant comes to talk to me. (“Please call me Stef…”) I am vastly relieved that she seems switched on and with enough of an education in the science of medicine to understand why I am here and what the aims are for my visit. Not confused at all, in fact and discussing with me what she’s finding and that hopefully the ENT[3] people will be able to find something there suitable for easy removal. She also informs me that many of my lymph glands appear speckledy, as though they contain calcifications. Quite what that means in practice I didn’t bother to ask, firstly because she might be completely wrong and secondly because if they are whipping one out anyway, I’ll get better information after they’ve cut it up and checked it out. Anyway, the consultant checks the pictures the first doctor took, does an examination of her own and takes a couple more, then buggers off in an efficient manner.

 I really cannot sufficiently express my relief that the consultant got involved. I was getting to the stage of zero confidence in the first doctor and was becoming extremely worried that the right and required information would not get relayed to the correct departments and personnel. Ultrasound appointments are slow, even fast-track patients like me have to wait over a week to be seen and I did not want the delay of having to come back again for a rematch.

 And so I am left alone with a large tissue (good for wiping up ultrasound lube from necks) and the first doctor. There are two bins, a grey one and a yellow one. The yellow one is for contaminated clinical waste only, the grey one for general waste only. Now, I am unsure if a tissue used to wipe lube from one’s neck counts as contaminated waste or not, so I ask her. She tells me either bin will do. To my mind that does not compute, but I’d about had enough of her anyway. I got dressed and the jolly chappy arrived to show me out.

 “Everything all right, Sir?”

*sigh… again*

 [1] Thanks Nat *hug*

[2] I’m sorry, but the opportunity for lewd and out of place double entendres is just too tempting to pass up.

[3] Ear, Nose & Throat