Vein with no name

There was no surgery yesterday after all. I’m rescheduled for April 1. Miscommunication between doctors’ offices resulted in my showing up on one of Dr. V’s clinic days. He had no intention of doing office surgery, as was ordered by my medical oncologist. Chalk up another defeat for patient-focused care.

The snafu didn’t much matter, as it turned out, since Dr. V is concerned about the proximity of a small met in my neck to the innominate vein and wants to do that excision in the hospital surgical suite anyway, where the lighting is better and I can have anesthesia. He’ll also remove at that time the three other mets we know to be present. There are a couple of mystery findings on the PET/CT scans that are unresolved: the masses identified by the radiologist are not palpable and could be false-positives, but Dr. V will review the images to see what he thinks. So while the trip to OHSU wasn’t a total waste of time, I hate having to wait to pass through this latest stretch of whitewater.

I asked Dr. V specifically what he thought about my clinical prospects given the frequent appearance of subcutaneous nodules. Setting aside the future possibility of the melanoma spreading to internal organs, he has seen patients in whom sub-q mets appear sporatically over time and some in whom they simply stop, at least for several months. Their appearance could also accelerate, at which point the option of systemic therapy will again be raised. Surgery is by a huge margin my preferred strategy for now. So far, there have been no side-effects from these minor procedures other than small scars. All things considered, it's not so bad being a human dart board.