A Journey to and through a Tumor.

It was on the 30th of October 2011, my daughter called me up to read a Report of Blood Test carried out on my son-in-law who is 32 years old.

The report had ESR( Erythrocyte Sedimentation rate) at 145 Hemoglobin at 9.(ESR maximum 20,Haemoglobin around 14-15)

‘The erythrocyte sedimentation rate (ESR), also called a sedimentation rate or Biernacki Reaction, is the rate at which red blood cells sediment in a period of 1 hour. It is a common hematology test that is a non-specific measure of inflammation. To perform the test, anticoagulated blood is placed in an upright tube, known as a Westergren tube, and the rate at which the red blood cells fall is measured and reported in mm/h.

Age	20	55	90
Men	12	20	19
Women	18	21	23

http://en.wikipedia.org/wiki/Erythrocyte_sedimentation_rate

Hemoglobin concentration measurement is among the most commonly performed blood tests, usually as part of a complete blood count. For example it is typically tested before or after blood donation. Results are reported in g/L, g/dL or mol/L. 1 g/dL equals about 0.6206  mmol/L.^[56] Normal levels are:

• Men: 13.8 to 18.0 g/dL (138 to 182 g/L, or 8.56 to 11.3 mmol/L)
• Women: 12.1 to 15.1 g/dL (121 to 151 g/L, or 7.51 to 9.37 mmol/L)
• Children: 11 to 16 g/dL (111 to 160 g/L, or 6.83 to 9.93 mmol/L)
• Pregnant women: 11 to 12 g/dL (110 to 120 g/L, or 6.83 to 7.45 mmol/L)

http://en.wikipedia.org/wiki/Hemoglobin#Diagnostic_uses

I had asked my daughter to have the tests redone at another Lab.

She had done so and informed me that Haemoglobin was at 9.6 and ESR  at 98.

All these tests were taken because we noticed that my son-in-law was losing weight for about 3 weeks and on my advice to have it see a doctor and have his Blood tested, he was reluctant to do so saying that I read a lot and get worried over nothing and that he was on Diet to reduce his weight.

He was also getting tired very often, had a persistent light cough and light temperature was noticed.

I stay in a different city,Chennai and my daughter,son-in-law and my grand son(2 years old) paid a visit to us and on her returning to Bangalore i advised her sternly to meet an experienced ,preferably elderly for consultations and avoid surgeons and Multi speciality Hospitals at this stage.

The Doctor recommended the above tests.

As these parameters indicated some serious ailment,ESR High reading indicates inflammation somewhere in the Body and coupled with Low Hemoglobin count it is really a cause for concern, I discussed the case with a leading doctor in Chennai who is a good friend of mine.

These indicators indicated some thing serious , possibly in the Renal area(kidney).

I left for Bangalore on 31.

On the advice of the doctor we had an Ultra sound of the Thoracic region and the Abdomen.

In the mean while we had done a Mantoux  Test to eliminate TB.(the symptoms exhibited in this case apply roughly to about 80 diseases)

It had a reading of 10, bordering on confirming TB.

In the meanwhile Ultra sound report came in.

It found a Lesion of about 10cms, nestling in the gap between the Pancreas, Spleen and the Kidney.

It was pressing down the Kidney and seemed to be pressing the Spleen and the Pancreas.

As this is on the Kidney, we were referred to a Renal Specialist who had advised us to meet a Renal Surgeon.

We met him.

His flippant attitude made us think about having the surgery done by him and we decided to move to a Multi-Specialty Hospital,The Manipal Hospital,Bangalore as the tumor is big  and in a critical area we decided to have the Surgery done by an Oncologist as surgery by an Oncologist will facilitate easy treatment without complications if the  tumor were to turn out to be malignant.

We met, by mistake ,a Clinical Oncologist in Lymphoma who immediately decided that the the Tumor was Lymphoma and scared the wits out of us.

We immediately corrected ourselves and met a Surgical oncologist who told us that the lesion has to be removed by Open Surgery and as the mass was huge Laproscopy was ruled out.

He also wanted us to have a LFT(liver function test) done.

We also on the advice of our relative who is a Doctor, had done EMA test-to know whether the Lesion/Tumor is secreting hormones.

LFT indicated slight mal function of the Liver and EMA indicated non secreting tumor.

Taking all these facts into consideration the Surgeon took a decision to surgically remove the Tumor which now has been christened as non secreting Adrenalin Tumor.

These Tumors of this size tend to be malignant and as such the Doctor informed us that he shall treat it as such until proved otherwise by a Biopsy.

Adrenalin  Tumors ,I am informed, do not respond to Chemotherapy and radiation is the only option after Surgery.

We also had done a Biopsy of the Liver which turned negative for Cancer.

The Operation date was set on 19th November.

Imagine the pressure on a 28-year-old girl,my daughter,and me who is very much attached to my son-in-law,son and daughter and they to me.

I could not express my anguish lest the children may lose heart,though they know the essentials of the case .

But I had the deep conviction that Goddess Abirami will not let me down and left every thing to her.

The Surgery was conducted on the scheduled day and a tumor weighing 375 gm were removed from my son in law’s abdomen.

It has been found to be harmless and not cancer.

It is found out to be Phe0crom Cytoma.

A pheochromocytoma or phaeochromocytoma (PCC) is a neuroendocrine tumor of the medulla of the adrenal glands (originating in the chromaffin cells), or extra-adrenal chromaffin tissue that failed to involute after birth ^[1] and secretes excessive amounts of catecholamines, usually noradrenaline(norepinephrine), and adrenaline (epinephrine) to a lesser extent.^[2] Extra-adrenal paragangliomas (often described as extra-adrenal pheochromocytomas) are closely related, though less common, tumors that originate in the ganglia of the sympathetic nervous system and are named based upon the primary anatomical site of origin.

http://en.wikipedia.org/wiki/Pheochromocytoma

My son-in-law is discharged and he is well.

I have learnt the following lessons from this incident..

Life is Fragile.

People are important for people have been offering good will and help ,especially medically and people are essentially good at heart by nature.

When you face difficulties of grave nature you draw reserves from within you which you never knew you ever had.

Medicine, with all its Technology is final analysis depends on the Human(Doctor) and his instinct.

This blog is intended to inform people

-never take the symptoms lightly, we have been able to be successful because we did not take symptoms lightly.

-have faith in your Doctor.

-discuss the case  with the Doctor rationally .

-have the appropriate tests done .

-select the best multi speciality hospital.

-do not bother about minor administrative problems in the Hospital, what matters most is good medical attention and cure.

Never, ever give up.

He is up there.