Two Months of The Unknown

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Nobody wants to tell the doctor, “I found a lump.”

During the last week of September 2012 I noticed something under my skin; it was shaped like a tiny ball, below and to the left of my belly button. The mass was no bigger than a pea, a small thing that felt like a muscle knot. This sort of thing happened before, and since I’m prone to tightness in some of my muscles I didn’t give it much thought. But the obsessive part of me never forgot that it was there. The ball itself never hurt, but it always made itself known. By the following Saturday it had grown larger, and seemed to be planting itself deeper in the tissue. At that point I became concerned.

Of course, being a Saturday, there wasn’t a damned thing I could do until Monday – when the clinic opened.

An afternoon social event that same day – for me anyhow – was overshadowed by what I considered to be a threat to my everyday life. I maintained the smiles and conversations, even getting some great pictures of the stunning Mrs. Clark. But all the while I couldn’t stop thinking about the lump. Every medical scenario went through my head – every good one, every not-so-good one, and every fatal one. The longer the obsessing went on, the more desperate my mind became. I found myself thinking about end-of-life plans, how I could help my family before leaving this world, and how I wanted to be remembered. Red wine did a fine job of helping me relax on the subject, although in the end the problem never completely went away.

By the next day I was a complete and non-responsive wreck.

My brain began obsessing at levels I knew were unreasonable. I couldn’t stop. Overactive kids – tied to the amount of noise they can make – didn’t help matters much. After church that day, one of the youth teachers approached me; “David was disruptive during Sunday School,” she stated plainly, “and interrupted us several times. I asked him to stop but he continued anyway.”

“If he keeps doing this next week I will be sending him to you during the church service.”

As she talked I could see her mouth moving. Through that I heard only enough to know there was a problem, an issue which – at that time – I was emotionally ill-equipped to resolve. I said nothing to her, choosing rather to allow my inner dialogue to hold the conversation silently on my behalf – thereby freeing up the brain to continue obsessing about the lump. “Madam,” I said to myself, “you have absolutely no idea how low a priority your issue is with me today.”

By that afternoon I was nauseous and had no appetite.

My back started to hurt. Near dinner time I could think of nothing but the ball stuck under my skin. To that point I hadn’t shared the situation with anyone, including Sherry; I didn’t want her to worry, unless there was something to worry about. And since I had no clue what it was, there was no reason that she suffer over it like me. It was a struggle I felt was important to endure by myself a while longer – hard as it might be.

Sleep that night was merely a time when I wasn’t thinking about the lump.

After The Clark Boys were school-bound the next day, and after Sherry was on her way to work, the first thing I did was grab the kitchen phone and call the doctor’s office. It was the first time I had verbalized to anyone what I experienced over the previous week. The strain of those days finally broke my spirit; as I talked with the call center nurse employed by the insurance provider, my voice broke down and began to shake over the phone. “You boys,” she said, probably trying to lighten the mood and calm me down.

“Given the nature of this issue,” she also stated, “I want your doctor to see you within the next four hours.”

As I pulled into the clinic parking lot an hour later, my phone buzzed with a text message from Sherry. “Do you want to meet for lunch?” This has become our common Monday activity right now, as I am currently working Tuesday through Saturday. “I think so,” I wrote back. “Let me check back with you in an hour.” I was still holding out on telling her what was going on. As I walked through the door of the clinic, I had gone through a week of thinking about the unknown.

The doctor’s assistant was a poor match for my mood.

She acted wooden, unfeeling, and bureaucratic – something I didn’t need given the circumstances. Her eyes made no contact with mine. Her questions were scripted, and dispensed with the rapid technical accuracy of a player piano. There was no smile to be found. Her demeanor was more appropriate for someone who walked into the clinic with a hangnail, rather than someone struggling with an invasive lump under their skin. It’s quite possible that she had a case of The Mondays – there…I said it – so I was relieved when she finally completed the blood pressure test (slightly high) and left the room.

The doctor himself was far more understanding and warm.

“Have we met before?” he asked while giving me a sideways stare. “You look familiar.” I had not seen this doctor before, so I told him I didn’t think so.

“Ah. You must have one of those faces then.”

He checked over my file, and asked a lot of questions about the lump, my health, any symptoms, and family history. He also gave me a fist bump when he found out I had lost 50 pounds over the last year and a half. I did the customary head turns and coughs for him during the exam. He checked the bump and the area around with great scrutiny. His diagnosis at that point wasn’t certain, but it was comforting. “I don’t know what it is,” he said, “but I’m not worried about it.” When I expressed my concern about cancer, his reply was simple and to the point:

“I hear you. Tumors don’t grow there.”

He suspected that a lymph node had gotten upset or swollen under my skin. “I see you have Folliculitis,” he mentioned, pointing to the red acne-like blemishes I’ve dealt with in waves for many years – an ailment which I always referred to as “Leg Things” because of their location. He surmised that the Folliculitis got out of control and that the lymph nodes had to work overtime to battle them. His prescription: Antibiotics.

I was out of the clinic and able to meet Sherry for Mexican Food that day.

It was then that I finally told her what I’d been dealing with for the past week, now that I was comfortable that whatever was going on wouldn’t be my ticket off this rock. Her first reaction: Wide eyes and “Oh!” Of course she was sympathetic and asked a lot of questions. The next day I began taking the antibiotic, confident that the lump would start going away soon.

A week later it was not only the same size, but I was nauseous – presumably from the medication.

My stomach felt so ill 10 days later that I had to leave work, for fear that I would get sick on a coworker. The first thing I did when I got to my truck was call the clinic to schedule with the first available doctor. Within a couple hours I was talking with another medical assistant, this one far more compassionate than the first one I had seen the previous week. When the doctor entered the room, it was very clear that she had read my file very closely; she knew I had lost weight, that I suffer from an upper respiratory issue every Fall, and that my blood pressure was always a little high. I turned my head and coughed upon request. She checked the lump carefully, and checked everything around it. “Do you feel that?” No, I said. “I’m squeezing it really hard.” It felt like she was simply holding onto a door knob attached to my skin; it didn’t hurt at all.

“I suspect this is a group of lymph nodes that have gathered to fight the Folliculitis,” she commented, “but it is definitely unusual. I want you to have an ultrasound done.”

I couldn’t help it anymore. “The first doctor told me that tumors don’t grow there.”

“Yes,” she replied. “That’s true.” She looked more intently at my face.

I burst out crying.

“You okay bud?” she asked, holding up a tissue box. “Seems that this has been weighing on you for a long time.”

It had been weighing heavily. All I could do for her was nod my head and smile; words couldn’t form as the emotion washed over my face. She looked me straight in the eye. “I am confident that this is nothing dangerous. Tumors don’t grow in this spot, and the likelihood of cancer is extremely low. The ultrasound will tell us more.”

I called Sherry after my visit, and she planned to go with me the next day.

While lying on the ultrasound table 24 hours later, I was smeared with ultra-goo and then pressed on with a wand which ran over my skin – back and forth…back and forth. It was amazing to see what transpired on a screen next to the tech, with the top layer of my skin showing toward the top of the monitor. In the middle of the screen, the wand passed over a mass that was hard to see – as it had the same wood-like “grain” as the space around it. The only way to determine that it was something unique was that the grain looked different, slightly bulged or curved. The tech went over it with the wand many times, and from many angles. She asked me to bear down (sp?), and when I did we could see on the monitor that a vein got each time. The tech indicated this was normal, and a good thing.

“I’m going to have our doctor look at this,” she said before leaving the room.

When they both returned, the doctor looked at the screen, checked the lump physically, and then looked at the screen again. “Well I can’t say exactly what it is,” she said. “But I can tell you it’s not a tumor.”

More good news, even if nobody knew what it was.

The doctor clarified her findings. “If it were something malignant,” she commented, “the mass would show up dark. This one appears to be the same kind of tissue that surrounds it, possibly inflammation or an infection.” I was then scheduled to see a doctor the following Monday, for more inspection and review.

At that point I had gone through four weeks of thinking about the unknown.

“The skin above it looks kind of red,” the doctor said the following Monday. “Does it hurt?”

“Not really,” I replied. “It seems to be getting smaller, but I can’t say for sure.” My brain had been working overtime for three weeks already when it came to the lump, so I was at a point where I didn’t know what in this situation was real or what was imagination. We talked about how it got noticed, what had been done, and how long the lump had been around. I also mentioned the nausea that I had been experiencing concurrently. “Historically speaking,” he said, “those two things would not be related. I want a Urologist to look at this lump, because it is around one of the major veins that goes towards your groin. It is possibly a cyst or growth of some kind. A Urologist would know better.” I was then scheduled for another appointment the following Monday.

By then I had five weeks of thinking about the unknown.

During the week in between doctor visits, I noticed that the lump reduced in size – and moved farther down my torso. Forever a mystery. The nausea was still prevalent; in an effort to pinpoint the cause, I cut my coffee intake considerably – an extremely hard thing to do. It didn’t seem to help. In fact, now the nausea was more on my mind than the lump. The stress and uncertainly of it all reintroduced a love for snack food that I had buried successfully over the last year. It was a long week of wonder before the next appointment.

“Turn your head and cough for me,” the Urologist said. It was something I had gotten used to hearing since first noticing the lump – uttered by both male and female doctors. And – as it had been in the past – all was normal “down there.” The Urologist asked several questions, much like the last doctor had. Once again he confirmed that its origins were unknown, but added something else to the diary.

“I think it’s possibly skin inflammation,” he said, “or an abscess of some kind. If it’s the latter, it will present itself and begin to drain (Ewww – Ed.). Either way, you should leave it alone. Don’t touch it, mess with it, nothing at all. It will probably go away in a week.”

I was then scheduled for a follow-up appointment with the previous doctor, 7-days away – which put me at six weeks of thinking about the unknown.

During the next week the lump did begin to disappear. By the time I met with the doctor it was literally a fraction of the size it had been even a week before. The skin above it was no longer red. It had moved farther down, while getting smaller and smaller. He was pleased. I was pleased. While I was still battling the nausea, that too had reduced in relation to the size of the lump. Even if they weren’t related, they acted like they were. Who knows? It could have been stress in direct correlation to to the lump’s size. If it were, that would show the power of the mind.

After eight weeks of thinking about the unknown, the lump was mostly gone; it became a knot even smaller than when I first noticed, and then eventually disappeared. A year later the experience is easily forgotten. The nausea lingered on for  a while, but not at the levels experienced during the ordeal; it seemed to decrease each week. I never did find out in any certain terms what the lump was. But what I did discover is that the lump made me consider some very important things:

Advocate decency – I was reminded how important it is to be compassionate for those who are suffering. The wooden medical assistant during my first doctor visit hit that one home.

Give in to pure emotion – Over the last two months – for many reasons – the tears have fallen. I never know when those tears will manifest themselves, but I usually feel better afterwards. Thinking about a lump made crying okay.

Know the value of intimacy and openness – While it was hard – but in some ways necessary – to keep Sherry in the dark at first, I appreciated her support, companionship, and love throughout this time. I don’t know where I would be without her by my side.

Maintain faith in God, and trust those guided by His hand – I don’t know why the lump appeared, and apparently neither does any doctor who made me turn my head and cough. But I do know that its two-month residency made me consider what was important in life, especially when confronted by the unlikely notion of finality. And no matter what the outcome, I was reminded to have faith in what happens, and to trust the work done by the people who were helping me.

Bottom Line: I can do without the stress of the last two months. While it’s hard to find the good in being scared for nearly sixty days, it’s possible to find something positive in the experience. Whatever life you have left shouldn’t be squandered, whether it be sixty days or sixty years. There is so much to see and experience in our world, amazing things that will turn your head and present themselves in a whole new way if given a second look. Good can come from bad.

A little unknown lump taught me that.

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