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This week the cancer gods have decided

Last week I wrote about receiving an envelop from the cancer gods almost every week. These almost weekly envelopes contain a script or playbook for what's going to happen during the week.  Typically, some new symptom or side effect.

One of the more recurring envelopes I receive is a script centered around my throat and lungs.  The chronic pneumonitis (lung inflammation) seems to have subsided.  But, the persistent cough won't go away and every day I lose my voice in the afternoon.  This is chronic laryngitis so I'm told.  My oncologist called in some heavy guns from the pulmonary practice at Brigham and Women's Hospital.  I met with Dr. Victor Pinto-Plata as specialist physician focusing on pulmonary diseases.  Victor is a forthright professional, very engaging, exceptionally bright and not afraid to have some fun during the visit.  I think physicians willing to smile, have fun, crack a joke exhibit a higher level of confidence perhaps because they are used to being right, used to making good decision, the correct diagnosis.   If you've been making mistakes along the way, you're in no frame of mind to have fun.  But Victor's confident smile was a heads up that he's gonna be good, very good.  

I believe one of the best ways to judge the effectiveness of a physician is to observe how she or he goes about probing, fact finding, data collecting.   This is an important discipline that leads to a correct prognosis and correct path to care.  As expected, I'm scheduled for another bronchoscopy which sounds worse than it is. I've had these before. Really a piece of cake.   Inhale a few times while the physician sprays your throat with some numbing agent.   In a few minutes and before you know what's happening, the physician, typically an ENT specialist gently guides a tube with a fiber optic lens to a remote camera down your throat to take a look around.   Suddenly you realize this thing is down your throat, not bad. You can see what the doctor sees but on a TV monitor.  I like looking around 'in there' wherever "in" may be so I'll often ask the doctor a lot of questions.  Is that my larynx? What's that thing?  How come it looks like that? Hey Doc, is that normal?  

We're looking for the cause of laryngitis which is the swelling and irritation (inflammation) of the voice box which exhibits as a loss of your voice or hoarseness.  This is important for cancer patients because it could be caused by swollen lymph nodes from more cancer activity, or it could come from a virus or respiratory tract infection attributed to your weakened immune system.  If caused by a virus, antibiotics won't help.  Also, it could be something as benign as 'that time of year' allergy for which many suffer.    Don't mess with your lungs, be serious, keep your physician informed especially when getting any kind of chemotherapy some of which are known to cause pulmonary issues.

Now take a deep breath and relax.  This won't hurt a bit, well maybe just a little....

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