Disease Diary (Part 1)

In May 2013, WineGuy drove to Orlando to attend a medical convention. He returned home with a wealth of knowledge and a large, unsightly growth in his thigh. He put himself on a course of antibiotics and said nothing to me.

Ten days later, WineGuy casually informed me he went to see a surgeon and was having a surgical biopsy at the end of that week. Stunned and incredulous, I drove him to surgery at dawn and waited nervously for some news. The surgeon came out with a grave look on his face and said he removed a large mass of tissue and that he didn’t like the way it looked. While he couldn’t tell me directly, I clearly understood the implication was cancer. The surgeon sent the specimen off to pathology, and we received a preliminary diagnosis a few days later: lymphoma (cancer of the lymph system).

After a small debate about choosing the convenient oncologist (WineGuy’s choice) vs. the superbly trained oncologist (my choice), WineGuy went to see the superbly trained oncologist. After extensive bloodwork and cytological testing, WineGuy was diagnosed with Stage III diffuse large b-cell lymphoma (DLBCL), a non-Hodgkins lymphoma. The bad news was that the cell-type seemed to be very aggressive, and WG needed to start chemotherapy immediately. The good news was that DLBCL is highly treatable and usually responds well to standard therapies. The oncologist was anxious to start chemotherapy as soon as possible and recommended that WG participate in a clinical trial of a new drug targeting DLBCL.

However before the oncologist could proceed, WG needed a thorough physical. WG went to see his new internist who discovered that WG was diabetic, something I had suspected for a very long time; the internist also learned that WG had poor kidney function as a result of improperly self-medicating for several years. These two complications significantly increased the risk of adverse side effects for the planned regimen of chemotherapy. The plan was to administer the first round of chemotherapy and admit WG to the hospital for 48-hour monitoring of kidney function.

We sat down with a 2013 calendar and mapped out the next five months of our lives: six rounds of chemotherapy, once every three weeks. We had every reason to expect that chemo would wipe out the cancer and that life would return to normal by Thanksgiving 2013. WG refused to tell his family what was happening. I decided to tell my mother and brothers because I needed the support; with WG’s consent I also told my BFFL, MB Walker, Belle, and Lena.

Chemo Day One was scheduled for a Friday so that WG could cancel only a few patients and so that he could spend the weekend in the hospital without having to miss more work. Chemo Day One came and went without any problems: WG tolerated the infusions well, had no nausea or other reactions. I took him down to the hospital, and they admitted him. Although he hated the intrusion of being a hospital patient instead of a doctor, WG tolerated the first round of chemo with no problems at all.

WG went back to work the following Monday with no one the wiser. The only people who knew what was happening were me, our children, his nurse, and his doctors. WG did surprisingly well after Round 1, although his internist was having trouble managing WG’s insulin levels because the chemo cocktail included prednisone, known to spike blood sugar.

WG felt pretty good for the next couple of days but could hardly wake up the following Thursday morning. He cancelled his morning patients so he could sleep. He sounded a little foggy and groggy to me, but I didn’t know any better. I took Wild Thing to the doctor and returned home around 11:00 a.m. I checked in on WG, who was still sleeping. He woke briefly to tell me he cancelled all his patients that day. I closed the door to our room and went to work at my desk for the next few hours. As I filed and paid bills, I heard the most painful groaning from WG — deep, gutteral, drawn-out basso moans, like I’ve never heard from him. I went in to check and found him sleeping fitfully. So, I went back to my desk. At 2:00 p.m. that day, the oncology nurse called to remind us that WG had a follow-up appointment with the surgeon that day. I tried to rouse WG, but he wouldn’t wake up. The oncology nurse said, “Get him up, now!” I couldn’t rouse WG at all: I poked and prodded and spoke loudly, but WG did not open his eyes. She said, “Call 911. NOW.” I carefully dialed 911 and explained the situation. Dispatch said the EMTs were on their way. The 911 operator kept me on the phone until the ambulance arrived a few minutes later. It felt like I was on the phone for hours.

In the midst of all this, I had to explain to my already-scared children that Dad was in trouble, that I called 911, and that they needed to behave and stay out of the way until I knew what to do next. Wild Thing impressed me immensely by taking Moose by the hand and sitting with him on the living room couch, the front row to all the action. Wizard, in his need to control everyone and everything, started to speak for me when the EMTs arrived. I turned around and told him to “shut the hell up until I give you further instructions. Go lock up the cats.” For once, he listened.

The EMTs started working on WG and firing questions at me about health history. I had WG’s medicine list already typed up, and I was able to answer all their questions. The EMTs gave WG two large doses of glucose because his blood sugar had dropped precipitously low. When WG finally roused, I heard him speak his name, but he didn’t know much else. I begged the EMTs to bring WG to the downtown hospital, bypassing the closer branch, because WG previously insisted he would rather be with and near his colleagues there. The EMTS hauled my 300-pound+ husband out of our bed and took him out to the ambulance. As I escorted them out the door, I caught a glimpse-of Wild Thing and Moose on the couch, white with fear and staring wild-eyed at me. I locked the front doors and started giving orders. Wild Thing and Moose got all their things together and were ready to leave in no time. I jumped in the car, ready to follow the ambulance downtown, but Wizard was nowhere to be found. He finally ran out to the car, showing me his phone, where he had just taken a photo of every medicine bottle on his dad’s counter. As we raced downtown to the hospital, I urgently called all of WG’s doctors, informing them what happened. Then, I deposited the boys in the ER waiting room and called WG’s nurse.

As I waited next to WG in the ER, I quickly realized we were going to be there for hours. I called Lena and said “I need help.” Lena left work, picked up the boys from the ER, took them to dinner, brought them home and waited with them until I got home. I brought WG home the following day, but it took me weeks to muster the courage to give him hell about what happened. It turns out WG, upon his internist’s instructions, had overdosed on insulin and went into diabetic shock. WG and that internist had increasing conflicts as the summer wore on; they ultimately parted ways a few weeks later. WG chose a new internist, who is also my doctor, and is far happier with her. I no longer refer patients to the guy who overdosed my husband.

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