Ainyava

Healthcare — Diagnosis and Decision

Healthcare — Diagnosis and Decision

For friends who don’t know what the story is, I will explain. Please read the full text. This is the second part, and you can read this series of writings in this order:

And finally, the experience of radiotherapy which I have not written yet…

I just want to say that the discussion was about “definitely take care of your health,” and if you have read the first part, let’s continue without delay:

Now, I want to share the events that happened to me to inform friends, maybe it will help.

We got to the point where the chest X-ray showed signs of pulmonary pneumonia, and I said that the test results had not come yet.

Well, the blood and urine test results came, and there was nothing special except for the positive CRP, which apparently becomes positive when there is inflammation in the body, and well, it is a sign of the presence of a mass or tumor that needs to be investigated…

The doctor wrote for further examination a CT-Scan (which is done with an injection for higher contrast, you can search for it)

And well, after a week (for scheduling and reporting because they give the picture right away), the result came, which I write that the parts that are Bold indicate the presence of a problem.

Multi Slice Spiral ct scan of chest with & without contrast axial vies, Reveals:

  • Normal size heart and Mediastinum.
  • No mediastinal mass or lymph node enlargement is noted.
  • Diaphragm and bony thorax are unremarkable.
  • Mass like lesion 93*60mm in RT mid- proximal and para mediastinal portion with Air bronchogram is seen.
  • Irregular enhancement at this lesion is seen, Although main DDX is localized pneumonia, So for R/O mass lesion such as carcinoma BX is recommended.
  • Ground glass opacity and infiltration at LT middle lobe is seen.

Considering the specialized nature of this report, I think it’s better if you search for it yourself because I don’t want to provide incorrect information about something that is not my expertise.

However, what is clear is the presence of a 9 by 6 centimeter mass in the chest (which has now swollen to the same size).

Well, I took the CT scan results to the doctor, and they said that it needs a Biopsy (in this method, a part of the tissue mass is removed and observed under a microscope or tested with chemicals, which you can read about in the link) to determine what the disease is, but they confirmed the presence of the mass and said for the biopsy, I have to refer to the medical science hospitals…

So, I checked the hospital websites to see if I could make an appointment online or not, but most hospitals had very few online appointments available, and those were already reserved, and I had to stay in line… But for Rasoul Hospital, I found a near appointment and went to a thoracic specialist (chest) (you can also go to a lung specialist), and after seeing the CT scan, they said that a biopsy must be done, and radiologists do this. That same day at Rasoul Hospital, we tried to do it or get an appointment, but unfortunately, they had an extremely bad order and said that radiology was broken!

Although the doctor also said if you do it outside and in a private place, they give the results faster (since I don’t have insurance, it doesn’t make a difference in terms of cost)

Well, another day we went to the hospitals (it’s worth mentioning that the government hospitals don’t answer their phones at all!! and private clinics are much better in this regard), so we went in person to Imam Khomeini, Shariati, Rasoul Akram, and Social Security Fiayaz Bakhsh hospitals, the first three did it, but I had to stay in line, and it took a long time for scheduling… Also, all the government hospitals said that their own doctor must see it (and well, getting an appointment :|) and they don’t accept prescriptions from elsewhere.

As a result, by contacting one of the imaging centers (which do CT scans, radiology, etc.), they said they would do it, and we brought the documents, and they gave an appointment for the next day, and before that, a blood coagulation test had to be taken

So, 1 hour before the biopsy appointment, we went to the laboratory of the same clinic (where the blood coagulation test results were ready in 1 hour), and after that, I entered the CT scan department, and the biopsy was done under the CT scan machine (which is done by targeting the specific area with a needle, then the sample has to be taken to the pathology laboratory, which they did themselves, and again we had to wait about a week for the result.

Well, the result was as follows:

Clinical Data:

Anterior mediastinal mass needle biopsy.
R/O Lymphoma

Macroscopic:

The specimens received in formalin consist of three fragments, measuring: 2x0.1cm 3/0 100%

Microscopic:

sections show atypical lymphoid infiltration with crush artifact and areas of necrosis in sclerotic stroma.

Diagnosis:

ANTERIOR MEDISTINAL MASS, CT-GUIDED NEEDLE BIOPSY:

Well, this is the biopsy result that you can search each section, but I have linked the two sections related to the disease to Wikipedia.

Remember I said that the biopsy was done by prescription of a thoracic specialist (chest), they wrote a letter to a hematologist that apparently, it was not a pulmonary disease but related to blood.

After visiting the hematologist, they said that I have Lymphoma, which is a group of blood cancers that you better read about yourself. The explanations they gave seemed very interesting to me!!

But for treatment, they said that to prevent faster growth, it’s better to start soon, and I have to procure the prescribed chemotherapy drugs and treatment can be started. Of course, alongside this, a PET scan must be done (which is a new method) to determine if there is a mass elsewhere in the body that might become a story or not, which apparently is only done in three places in Iran due to its heavy cost, instead, you can use the same full-body CT scan that was the case until 2–3 years ago, then the biopsy sample that I previously took has to be taken to the laboratory for secondary examination, and there they also took a sample from the brain and bone after the visit, which of course, these tests are for the future related to the diagnosis of other cases, prevention, disease growth, etc.; and because their results take time, they said that chemotherapy can be started alongside.

Well, now the disease is identified, if needed, I will write the continuation again and about the result of the treatment and…) and finally, experiences separate from treatment such as scheduling, medical services, facilities, and costs (which are also severely heavy) I will write so that apart from the experience and stages of treatment, you will become familiar with that part too.

A point that both the doctor said and I must say and is also important is that this disease at my age (20 years) is much more successfully treated compared to older ages…

After that, I am not a religious person, but I believe in Vibe and morale, which helps a lot, and I am not someone who easily gives up! Now that something has happened and it can’t be reversed, at least I fight with it as much as I can, and if someone else has such a problem, the least is not to let them easily take your hope away. Life is these struggles, and it’s not supposed to be easy.

I think music also has a very good effect on morale, and I recommend these (you introduce too!)

  • Carrie Underwood — The Champion
  • Kelly Clarkson — Stronger
  • Rachel Platten — Fight Song
  • Keith Urban — The Fighter ft. Carrie Underwood
  • Avril Lavigne — Head Above Water

And finally, I thank my sister who has helped me a lot, spent her time for the doctor, and does any help she can, making the journey easier for me, and of course, my father who spends time and bears heavy costs, which makes me very upset, and I don’t like any pressure to come to my family at all.