2020: The Diagnosis - Chapter 3

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Following my post about the conclusion of our 2019 softball season, several team members had expressed a concern that my breathing sounded 'off', encouraging me to go see my Family Dr. to check it out. After the initial consultation with Dr. Zoudis, he got me to try taking an inhaler regularly for a Month, only to then come back and see him to discuss any changes.

This initial test proved unsuccessful in that no 'notable' change of any kind was observed, so Dr. Zoudis sent me off to try a 2nd Inhaler (perhaps the first one wasn't strong enough) for another 30 days, to then return and discuss again. On completion of this 2nd 30-day experiment, there were yet again, no observable changes. This resulted in my issue being referred to a Pulmonary specialist working out of Sunnybrook. At first glance, Sunnybrook carries an incredible reputation so I figure a Specialist should help in identifying what the source of the breathing challenges is.

Dr. Shukla at Sunnybrook sets me up on a Lung-Volume test to digitally monitor the air inflow and outtakes. This test demonstrated a sizeable gap in the volume of air I was able to 'breathe in' vs. 'breathe out', to the point he questioned whether his machine was not operating correctly. Fast forward a few weeks, and he had referred me to The Royal Victoria Regional Health Centre in Barrie, to re-run these same tests as hey also had similar equipment and were able to book me in within a couple weeks (now end of January 2020). i repeat Dr. Shukla's experiment, with the same result observed. Now knowing of an issue in my trachea resulting in a disparity of my airflow intake and outflow, orders a CT scan to get imaging of that part of my body. Unfortunately, this is right at the beginning of the COVID-19 Global Pandemic, and in an effort by the Canadian + Ontarian Provincial Authorities, my follow up CT had been classified as 'elective' and deprioritized in maintaining hospital capacity for an expected COVID-19 patient onslaught observed in other regions World-Wide.

Mood (Song I listened to repeatedly and/or would sing out loud):

Fast forward to May 2020, and Ontario observes a dip in daily COVID-19 cases reported by Public Health and nowhere near the anticipated Hospitalization projections expected. As a result, testing is now announced that it would begin working through the backlog to help people catch up on other health-related issues. Not shortly after the announcement was made, I received a phone call that my CT scan from February had been rebooked for May 14. I go in to Sunnybrook for the CT and then head home to get on with my day from there. Approximately 2 weeks later, I receive a phone-call at 3:50pm not 10-minutes before I was due to kick-off an internal Media team meeting presentation Klick-wide. The phone-call was from Dr. Shukla letting me know he's just reviewed the imaging results from my CT scan, and that the results are troubling and would require the assistance of a 2nd specialist to properly evaluate from this point onwards. When pressing him for the nature of why he was concerned, the response was "I don't want to alarm you, but the CT scan is showcasing a sizeable tumor measuring approximately 2x2x2 CM. I'll coordinate with the specialist and have his office contact you for follow up".

--Click--

The silence at end of that call was deafening. What had I ever done from a lifestyle perspective that could have resulted in a tumor? A tumor? Are you freaking kidding me?

In the few minutes remaining before my 4pm presentation, I try 'putting down' these thoughts in order to ensure I'm ready to deliver my content. The meeting opens, I'm introduced, and off-we-go for a 10-minute presentation of which to this day, while I hear went well, couldn't recall a single-word I'd said. I wrap up my content, turn off my Zoom camera, and then begin digesting the news that had just been shared with me. At 39 years of age, this is the closest to home I'd ever had to dealing with a tumor of any kind (ie no hereditary gene considerations). I continue listening on with the remainder of the meeting, while starting to run through how I'd form a plan of action from here.

Shortly after 5pm, Janelle walks in beginning to tell me about the events of her day and running directly into things that needed to get done that evening. I interrupted her to let her know of the news from Dr. Shukla's call, to which I could see had frozen her the way it'd frozen me. Her initial reaction on the spot was to begin crying saying "I don't want you to die...", to which I went to comfort her; All while still trying to make sense of this news myself. The one thing however which seemed abundantly clear in my head was the overwhelming sense of peace I had with my spirit. "If this is my time, it's my time" I remember saying to Janelle. "This is all in God's hands anyways, so the best we can do is pray and prepare based on what's in front of us. Worrying about it will do nothing beyond distracting our energy away from fighting this thing, whatever it is."

Time continues marching on over the following days. I connect with the Management at Klick individually, to let them know of the diagnosis and to anticipate that I may soon begin to need additional unannounced time away from work in order to further get to the bottom of this. To my amazement (although given Klick's core values, I'm not sure why), and to a person, they were nothing but supportive. "Do what you need to do", "Let us know how we can help", "Take whatever time you need" were all phrases I'd hear over and over and over again, the more my recent health news was socialized at Klick. This was a welcome revelation as I know prior places of employment would not have been so supportive, in particular during the conditions brought on with COVID-19.

Within a week of receiving Dr. Shukla's news, the weather begins to turn more Humid outside with the increase in temperature and general spring 'dampness' still in the air. I remember vividly, the one night I went to take Bear out for his daily evening walk where I felt myself working a bit harder to breather and to keep the pace we generally kept on our average 5km round-trip hike (he'd walk in the mornings as well approximately the same distance as we take him out twice daily just for reference).

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In socializing my health news within my family, the news reaches my Step-Brother Rick, a specialized Physician working out of the U.S., who decides to give me a call to give me his thoughts. Rick informs me that he reviewed my CT scan notes with his peers at work as though I were an independent patient and asked what they would suggest as next steps. The feedback was to expedite the priority of my case by walking into an Emergency Department and demanding to be treated as there didn't appear to be a lot of margin within my available airway. He tells me to drop everything and go and that this is serious enough to the point I can no longer wait for Hospital Admin to transfer my case between specialists for follow up, in particular due to the COVID-19 pandemic. I tell Janelle about this, hop in my car, and head over to Cambridge Memorial Hospital following Rick's advice.

It was about 10:00 at night when I'd arrived there at which point I was triaged and evaluated for breathing challenges. Follow up tests (Bloodwork, Multiple CT scans & an Ultrasound) were all ordered ASAP and within 10 days, were completed with results available. On review with the attending physician, I learn that my Tumor is actually 2x2x3 cm in length, and that according to the Technicians who managed the scans, that they didn't see "Any identifiable opening in my Airway and were surprised to see me walk in and out of that room under my own power".

The Attending Physician at Cambridge managing my case, lets me know that the results were definitive enough to identify the need for a specialist within their Hospital network, resulting in my case being transferred to St. Joseph's Healthcare out of Hamilton and specifically their ENT + Throacic Surgery departments. Next up, a biopsy to confirm whether the Tumor was Benign or Malignant (Cancer).

Boy how things can change in the span of 2 weeks!! I'd gone from thinking I was just out of shape and needed to push myself harder to catch up for some reason, to learning I have a tumor in my neck that's significantly impeding my ability to breathe. Drawing from my Agency Wars experience 5 years earlier, I knew that despite things looking bad on the surface I had to maintain a calm + collected head space or risk having the entire situation run right over me and spiral out of control. While I am a practicing Christian by Faith (Baptist) and have been since 2012, this situation prompts me to increase my daily prayer and reflection of the Spirit.

Mood (Songs I listened to repeatedly and/or would sing out loud):

Thank God for granting me His peace and overwhelming sense of control over the situation. Things looked bad on the surface, but I know He's ultimately in control and that I need to just continue to 'Soldier On'.

After some back + forth with Dr. Choi & Dr. Agzarian's offices at St. Joseph's, I learn that my medical imaging files from both Sunnybrook and Cambridge had not reached their offices respectively. Having called Medical records at each Hospital, it turns out that despite whatever protocols existed for Specialists to request imaging results from other Hospitals on shared Patient profiles, that there would be a delay of 2-3 weeks (or more) for processing. 2-3 weeks? How is that possible in the day of so much being available digitally? In any case, I contact Sunnybrook requesting access to my own records + imaging and do the same with Cambridge, ultimately picking up the imaging CD from Medical records directly and hand-delivering to Dr. Agzarian's secretary in-person at St. Joseph's. Three weeks after receiving the imaging, I was now booked for the all-important Biopsy on July 22.

July 22 arrives and I remember feeling like I did in the lead up to my fight at Agency Wars, 5 years earlier (you don't forget life events like that). Many people wishing me well, an overwhelming sense of calm, knowing i'd be in for a fight but not getting consumed in the moment. Before I know it, I'm lying on an operating table at the hospital with the procedure about to begin. The operating tools begin being placed down my throat, and all I remember next is my gag reflex triggering before falling asleep. I wake up to hear that they got some sample and will send off to the lab for analysis. "Expect results within 7-10 days and a follow up with the Surgeon's office after that.

Waiting through the August Civic long-weekend, I get a phone call early in August from Dr. Choi letting me know that the biopsy results were 'inconclusive' and that they'd have to try again. Dr. Choi goes on to tell me that the biopsy is key to properly mapping out the surgical path as the results of the biopsy could vary the therapy + treatment quite dramatically. Biopsy #2 is then booked for August 20th, this time as an Open Neck Biopsy. I'm forewarned that depending on the status of my airway, there's a chance that a Tracheostomy Tube may need to be inserted to secure the integrity of that region and my ability to breathe. Dr. Choi goes on to map out for me that he actually recommended proceeding with the tracheostomy tube insertion regardless as it would be under ideal circumstances and carry a lower long-term risk as a result.

I go in for the procedure and recall getting onto the operating table and having Dr. Choi tell me to keep "Very Still" as he begins. Next thing I know I'm waking up in a hospital bed in the ENT Patient recovery ward.

The first 24 hours were definitely the worst. I recall being barely lucid yet in immense pain at the same time. My body temperature was spiking into severe fever territory, blood pressure spikes of over 190/120 for resting heart rate (norm is 125/80) and an indescribable pain repeatedly pulsing itself through me as though part of some rave party with a deep bass. I go through 4 bags of Hydro-morphine IV drip in the 1st 24-hours alone in an attempt to get everything under control which appears to do the trick as my need for pain-medication completely subsides 36 hours after that.

Preparing for living with a Tracheostomy tube isn't something any amount of preparation can set you up to handle. Among the most noticeable is the fact that the air is diverted in + out of a hole in your neck towards your lungs, effectively bi-passing your vocal chords entirely. This makes speaking near impossible and creates a new dependency on written forms of communication instead. When it came to my remaining time in hospital from this surgery, I became reliant on the use of a personal-sized dry-erase board and markers to communicate with those around me:

In the days and nights that would follow, my body began adjusting to living with a Tracheostomy (Trache) tube. I got better at managing my own care from a cleaning and suction POV, despite the inner canula filters getting 'plugged' quite frequently with combinations of blood and mucous:

When that became problematic however is when the trache would plug and I was unable to 'cough it out' or treat via suction with the machines around me. This was emphasized on the following 3 nights whereby I had 3 separate 'coughing attacks' resulting in the Nurses being called for assistance and in one case, the On-Call E.R. Dr. paged for added assistance. For reference, the issue of not being able to clear a plug in this instance (using a Trache as a primary means to get air to your lungs and v.v.) is that it gets 'stuck' and effectively clogs what remaining airway you do have use of, slowly suffocating you in an area you have zero ability to address naturally. There were definitely instances during this coughing attacks where the thought crossed my mind of "Is this how I'm going to go out?". Eventually, these attacks end up coming under control and subside allowing me to finally come home after a 7-day stay in the ENT Ward of the Hospital.

Towards the end of my time in the ENT ward recovering, Dr. Choi comes by to have a conversation with me about the results of my Biopsy:

Praise God for this!!

Sadly, the drama of the week doesn't end on a good note however.

The first Saturday morning I wake up at home in my own bed, I wake up to notice something feels off with my neck. Having become self-sufficient with my care, this definitely was different than anything experienced in the ENT ward of the hospital. Turns out it was my trache tube that had dislodged in my sleep!! Who knew that was even possible? Janelle takes one look and calls 9-1-1 for the local ambulatory care to come and help manage from there. They arrive, assess the situation, then help secure me on a mobile bed taking me to the local hospital for care from there. Not knowing how much margin the Trache tube has before falling out / coming apart entirely, I do my absolute best to keep movement to a minimum while the Ambulance rushes me off. My blood-pressure spiking to 177/112, there were causes for concern that this could be the beginning of something serious again.

All I could do was Pray!!

The same inexplicable 'Calm' came over me and I knew everything would be ok despite the situation around me. Not long after arrival at the hospital, a Respiratory specialist is on-site, reconnecting my Trache Tube and the collar, tightening everything up in the process to prevent future scares. I'm held in Hospital a few hours longer for observation and then am discharged to go home without incident from this leg of the journey again.

Mood (Song I listened to repeatedly and/or would sing out loud):

All things said + done, and I'm still here!! Next up, rest and recovery for a few weeks while my case notes are run through the Surgical review board and a definitive next-step determined..

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