56. What a number. Let me explain...On the evening of December 9th, 2007, Notbillybob (Bobby) kissed his wife goodnight, rolls over to his left side, and plopped down in the bed to go sleep. There was an audible CRACK-ing noise. He jumped up out of bed, screaming-I BROKE MY RIB-I BROKE MY RIB-I BROKE MY RIB!!! Early the next morning they went to the ER , and got and x ray. Nothing. Impression,negative. No broken bone. 10 days passed. The pain was much worse. It's the Friday before Christmas, his primary care doctor says "sometimes a broken bone won't show up until it starts to knit...she sends them to a different ER at a different hospital. The report comes in just as her staff is closing up for the holidays. Bingooo. Broken rib. Positive X ray. Miserable Christmas dinner, but OH so glad that there was now proof he wasn't making it up.
There is nothing worse that complaining to a doctor that you have a pain, and they cannot find a reason. They write in your chart "idiopathic" which is Greek for "unknown". The *other doctors see that and immediately they think Munchhausen!
After the rib healed, Not billybob thought the matter was over... until it broke again.
And again. A n d . . .a g a i n.
Over and over, this rib would break, and worse and worse the pain would get. Some years it would break up to 4 times. Bedridden for a week, then better and better till the next time. You can look down through the posts to see this.
Then one day Notbillybob went to the "U" (Colorado University Hospital) October 2010 for a routine screen for liver cancer .
One of them there Cat scans. One of these every 6 months had become routine. This blog has little radiological symbols all over the place as a result. I think it's because Notbillybob thinks that the Radiology department is his home away from home. Heh heh. Anyhow, this screening report was alarming. Possible small liver tumor, AND a slowly enlarging lytic lesion on the
7th anteriolateral rib (means 7th front-side rib) which was the one which kept on breaking over and over. It was a bone tumor- growing bigger and bigger. Lytic means "destructive". They sent Notbillybob to the Rocky Mountain Cancer Center for a follow up. The doctors there ordered every test in the book. A bone scan. A barium swallow. Chest x ray survey.
Ya da ya da ya da ya da.
November 2012 rolls around and another Cat scan. The
thing has just gotten HUGE.
By now, 5 separate doctors have refused to either do
a biopsy or surgically remove it. Notbillybob wasn't in any shoot-fired hurry to go
the the operating table anyway. Liver doctor had said surgery for cirrhosis patient is extra risky. Risk from anesthesia to the liver, risk of bleeding, etc.
Another Cat scan this past April showed that the lesion is now a huge TUMOR, and has broken through the bone.It's very close to his heart. It cannot stay, because it might be malignant.
The differential diagnoses are almost all carcinomas. (Differential diagnosis is a fancy way of saying "It could be ___") The doctor cannot say for sure, because even though the usual blood markers do not indicate a cancerous presence, the only way to know for sure is a biopsy on the whole thing. Looks like a chicken leg.. or a lightbulb. Notbillybob and Sharon named the thing "Lester Diamond. From the movie "Casino". The surgeon wanted it out ASAP. But Notbillybob wanted to wait till later in the summer. Tuesday July 22nd is the day.
Now for the kicker. Starting a year and a half ago, Notbillybob's platelet count
has been going down. A little at first, then more and more. Supposed to be 150 at
the lowest. Was 151 for years years. Now, it's going down.145... More. 100, 97, 78, 69, 67, he developed a low platelet rash called petichia. Little tiny hemorrages in the skin.
Last week, got some bloodwork done. uh oh.
Bad news. platelet count-----56. Really?
56. (it means 56 thousand). Better if it were 156 thousand. Much much better. But I guess we'll take the fiddysixx and run with it.
Tommorrow morning at 9:00 am Notbillybob goes in for the pre-op.
See you at the "U".