Onconversations XL

(With a couple of weeks to go before my next follow-up CT scan, I notice a slight swelling at the bottom of my rib cage on the left, and I have continuing pain in the middle of my back–both are sites where the stereotactic body radiation therapy beams were zapped through eight or nine months ago. The swelling is sore. I am on about four Advil/day, so this pain–which is expected and normal (if anything is normal in the cancer world)– is not severe, but the swelling is new, and I don’t like it. It feels like there’s a little cylindrical sponge under there. So I write an email about this development to my thoracic oncologist. He usually responds to emails, and I use this courtesy as sparingly as I can. I realize that it might be better to call my radiology oncologist, but sometimes when I call his number and the lovely-voiced assistant isn’t there to answer, the phone rings four or five times and then this voice comes on the phone and practically shouts out “Radiology!” The first two or maybe even three times I called that number, I thought it was a real if somewhat impatient human being. But it was Radiology’s version of an answering-machine message, and it left me a bit flummoxed. But guess what: My thoracic guy is out of the office, it seems, because I get no reply. So I call the Radiation number.)

PHONE (after four rings): Radiology!

ME: Um, hello? Oh. Yeah. Message. Well this message is for Dr. ________ This is Robert Menaker calling, You know, Dan Menaker. Robert Daniel Menaker. Well, Menaker is all I need to say, probably. Anyway, I have this sore swelling right under my rib cage and I wanted to ask Dr. ________ about it. Maybe he could call me back. (I give phone number.) Thank you.

(Later that afternoon, the thoracic guy’s nurse calls me back.)

TG’S NURSE: This is ________ from Dr. ________’s office. You emailed earlier today?

ME: Yes–thanks for calling back.

TG’S NURSE: Dr. ________ is out of town. Maybe I can help you.

ME: Well, I have this swelling at the bottom of my rib cage, and then there’s the pain in my chest and back, which I understand is normal.

TG’S NURSE: Can you describe the swelling?

ME: Yes, it’s like a little skinny mole or vole under my skin–soft and rounded.

TG’S NURSE: A mole or a what?

ME: Let’s just stick with “mole.”

TG’SNURSE: When did you notice it?

ME: A week or so ago. I finished my radiation treatments about eight months ago, and was told then that there would probably be pain, though it’s a little worse now. But it’s the swelling that’s new.

TG’S NURSE: Eight months ago?

ME: Yes–I think that’s a normal time lapse for the pain part.

TG’S NURSE: Really?

ME: Yes.

TG’S NURSE: Have you thought about calling Radoiology?

ME: Yes, I called and left a message.

TG’S NURSE: Well I know Dr. ________ will want to talk to you when he gets back, but in the meantime, I’m sure Radiology will call you back.

ME: OK, well, I’ll just wait.  I probably shouldn’t have bothered you. It’s just that their answering-machine message is sort of like a drill sergeant–a little daunting.

TG’S NURSE: What?

ME: Nothing. I’ll just wait.

(No more than half an hour later, the Radiation Oncology nurse calls me.)

RO NURSE (briskly): Is this, er, Menaker?

ME: Yes–Robert Menaker. Daniel, you know–

RO NURSE: Date of birth?

(I give it)

RO NURSE: Dr. ________ asked me to call you. What seems to be the problem?

ME: I have this new swelling right at the bottom of my rib cage, and this pain.

RO NURSE: The pain is normal–do you need anything stronger than OTC meds?

ME (tinily but still ludicrously proud of knowing what “OTC” means): No–just taking three or four Advil a day.

RO NURSE: That’s not so bad, considering how close the nodules were to the chest wall.

ME: But the swelling is new–it seems like a little soft roll under–

RO NURSE: Normal also.

ME (relieved): Really?

RRO NURSE: Yes.

ME: This late?

RO NURSE: Perfectly normal.

ME: Well, good. I mean, not good that I have the swelling, but–

RO NURSE: Yes, I know. Your next scan is on November __th.

ME: Right. Thank you.

RO NURSE: So don’t worry, OK?

ME: Easy for you to say.

RO NURSE (laughs): Right.

(The following Monday, the thoracic oncologist calls me.)

TO: So I hear you called about some swelling.

ME: Yes, but Dr. ________’s nurse got back to me and said it wasn’t anything to worry about.

TO: Right.

ME: I probably should have just called that office in the first place. But not to be a wuss or anything, but their answering-machine message is scary. Some autocrat yells out, “Radiology!”

TO (laughs hard): They’re more about protons than personality.

ME: You didn’t need to call back, but thank you.

TO: Don’t worry–I like to know what’s going on.

ME: I don’t want to be one of those patients who– Well, you know.

TO: You’re not. You’re an ideal patient.

ME (pleasantly taken aback): Really?

TO: Yes.

ME: Jeez, I’d like to put that in my blog, but how can I do it modestly?

TO: You can’t.