Billy Bob's Wild Ride: Sugarland Express

Monday, July 21, 2014

Sugarland Express

One lump or two?

Bobby's family and and a cousin or two were all jammed into the back of a 67 Plymouth station wagon, at the Evans drive in watching "Sugarland Express", a film by an unknown director name Steven Spielberg in which a young desperate couple kidnap a Texas highway patrolman (based on a true story) to try to get thier baby back from child services. In fact it was this director's first film, and starred a sexy young actress named Goldie Hawn. Unfolding on the big screen, was the biggest car chase ever seen in the movies up until that time, truly America's biggest car chase, if you will.

Then it happened. Bobby was chewing on a handful of Dots gumdrops, just
stuffing his cheeks when sheer TERROR swept over him. There it was right there
in his cheek... A LUMP. He swallowed all the candy...but it was sure still there, plain as day. On the
left side, just below the corner of his mouth. He had been learning about cancer at school from his 6th grade science teacher Bette Davis, whose sister in Galveston was fighting cancer. Her cancer had
started out as a lump on her neck. a salivary gland,maybe. Could this be the same
thing? This lump in his cheek, marble size, just like Mrs Davis' sister?!?!?!?!.

It actually rolled around when pressed.

Sheer Panic!
Was it a tumor? Was it the C word? Maybe it was... it was ...SOAP Poisoning!
Oops. Wrong movie. That's Christmas Story.
So, here we are. This life long fear rearing it's ugly head, a real life monster under the
bed... this "evil nugget" as Kelly calls it.
In the 90's Bobby's Osteopathic doctor surgically removed a lipoma from the back
of his head. (A Lipoma is a fatty tumor. They are not considered dangerous.)
It came back. She named it "Herman". She took out again. Guess
what? It came back yet again and again! The doctor ended up removing Herman
4 times in her back surgery room in her office. The 4th time was a charm. It was
always was benign, but it was a great relief just to be symetrical again. He got the damn thing
in the first place because Donnie Cushman, mess specialist seaman apprentice on
the USS Pluck used to call Chief Wiesen "lumphead". The Chief was Bobby's first
Mess Chief in 1981 when he first reported aboard for duty. He had a lump on his
head, behind his right ear.Right where Herman showed up.
Bobby never scolded or chewed out Donnie for calling
Chief Wiesen "Lumphead"(Bobby out ranked him by 3 steps) . For this, Karma rewarded Bobby with Herman the lipoma from HELL. Damn these lumps. Damn them.
Sharon named this rib lesionn "Lester Diamond" , as in 'leeching lytic lesion' or simply useless, a bum. A parasite...

(Apologies to James Woods, Casino).
Hopefully they will soon be changing his name to Lester the Benign Lesion.

Benign. Benigno. Bene. Buono. Bon. Giorno. Bongiorno.
Bongiorno to the evil nugget. Tomorrow the 22nd. New wing of the Anschutz

inpatient pavillion, AKA the AIP at 7:30 am. Check in is at 5:30. in the AM. Sheesh!
NPO starts at 9:30 this evening. Early bird gets the... lesion.

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Solitary plasmacytoma

Solitary plasmacytoma is a large solitary focus of plasma cell proliferation.

This tumor has a median patient age of approximately 10 years younger than multiple myeloma.

Pain is the most common symptom. However, if the myeloma occurs in the spine, it will usually present with fast developing paraplegia and gibbous deformity due to the vertebral collapse.

Complete Information on this Tumor

Introduction and Definition:

Solitary plasmacytoma is a large solitary focus of plasma cell proliferation. This tumor is extremely rare and is found in the proximal femur, vertebral bodies, and pelvis in order of descending frequency. Solitary plasmacytoma occurs 70% of the time as an osseous lesion, and the rest of the cases are non-osseous lesions usually found in the upper respiratory tract. Approximately 70% of the patients with solitary plasmacytoma develop multiple myeloma.

Incidence and Demographics:

This tumor has a median patient age of approximately 10 years younger than multiple myeloma, and affects men more than women.

Symptoms and Presentation:

Pain is the most common symptom. However, if the myeloma occurs in the spine, it will usually present with fast developing paraplegia and gibbous deformity due to the vertebral collapse.

X-Ray Appearance and Advanced Imaging Findings:

Radiologically, solitary plasmacytoma appears identical to multiple myeloma.

Differential Diagnosis:

Most authors agree on a strict diagnostic criteria for solitary plasmacytoma. There may be no other radiological identifiable lesions, and bone marrow at another site must have no abnormal plasma cells. There may be no serum abnormalities and no Bence-Jones proteins in the urine. Some authors believe that the diagnosis can only be made if no other lesion is found for a period greater than 1 year.

Preferred Biopsy Technique for this Tumor:

Bone marrow biopsy

Histopathology findings:

Microscopically, solitary plasmacytoma appears as well to poorly differentiated sheets of plasma cells. These cells produce the same osteoclast stimulating factors found in multiple myeloma.

Treatment Options for this Tumor:

Treatment of solitary plasmacytoma includes radiation or en-bloc surgical resection. If abnormal serum or urine findings are present then the patient must be treated as if they have multiple myeloma with chemotherapy and bone marrow transplant 2.

Outcomes of Treatment and Prognosis:

Patients with solitary plasmacytoma have a better prognosis than patients with multiple myeloma, but 70% of solitary plasmacytoma patients develop multiple myeloma, and usually die within 5 years.

Graduation Day

LINAC U

You'd think that 25 radiation treatments wouldn't amount to much of anything. It doesn't sound like a lot.

...25 trips to the hospital. We were wrong. We started the week before Thanksgiving after a month long delay because of a bad bad flu like cold I developed. They wanted a commitment, with as few absences as possible, so we waited. The coughing up blood and fevers subsided, then we started, and got our groove. I say WE because Notbillybob's wife, Sharon drove most days. I was just along for the ride. Well, after 10 treatments, the tiredness set in. Especially for her. Like a new part time job. Notbillybob feeling like a roast ham most days. Kind of like a sun burn inside your guts. He made a big mistake in eating jalapenos one night. Ooh, the burn. So, they asked the doc if the stomach was getting radiation. They said "lets pull up your treatment plan... Yes, see here, inside this red line. The treatment plan showed that it was. The innermost red line is the most radiation, the outer one is the least. The green one is in the middle. A good part of the stomach is even inside the blue line.

The pain was accounted for. They told us that they were also concerned with his platelet count. It was going down again. Down to 37! (Low is 150) It has since stabilized at 40. The thing is that the white cells, red cells, hematocrit are all low. Way low. Bilirubin is elevated. INR is elevated. Not billybob began wearing a mask to treatments. Don't need cooties at a time like this.

Then the really cold weather set in. I know, I know- it doesn't really cause colds and "death of pneumonia" like our moms used to say, but when you have cancer of the immune cells, and then your white cell count goes in the toilet as well...

Notbillybob is going to stay a hermit for the foreseeable future.

But SMILE!

New Years eve was treatment number 25. Graduation day! Graduation from LINAC U!

(LINAC is a Linear Accelerator, an IMRT radiation therapy machine)