First Consultation And Diagnosis With The Surgeons

The Surgeon - The Biopsy Process - The Diagnosis

Upon visiting the ENT (Ear, Nose and Throat) department at Guy's hospital (London) on 20th October 2017, I had a consultation with a junior Surgeon, Mr Aleix Rovira Casas, who began by asking me diagnostic questions similar to that of the neurologist at King's College hospital (London). This in part was because my CT Scan and Chest X-Ray results from King's College hospital were not sent to him (to Guy's hospital) in time for this appointment.

Nevertheless, he still continued to examine my blocked right nostril with his special camera whereby all he found was thick mucus, which meant he could not investigate the blockage further. He did manage to get a biopsy done afterwards though.

In the UK the image of a surgeon is a specialist doctor (surgeon) who performs operations only. However, in reality, behind the scenes a surgeon has the job of ordering blood tests, biopsies and mri scans as well as interpreting their results and deciding which direction to take next; consulting with other specialists along the way. If surgery is not an option for example a surgeon may refer you to an Oncologist (Cancer Specialist).

The Hollow Needle BIOPSY PROCESS

The biopsy process I had was a Hollow Needle Biopsy, which began with the radiologist (doctor) doing an ultrasound scan of my swollen glands and lymphs (lumpy areas). The ultrasound process meant the radiologist (doctor) applied gel on the areas of my skin where my lumps were (and still are) so that a special handheld scanning device placed over the gel could see through my skin and examine the lumps underneath it in more detail; measuring and photographing the lumps if need be.

Once my lumps had been located and measured, samples of them (their tissue) were taken using special Hollow Needles. The radiologist (doctor) basically pin pricked each lump with a separate hollow needle before using those separate hollow needles to scrape lump tissue into them. The scraping feelings can hurt even though each hollow needle is very thin and long with the scraping itself only lasting 10 seconds or so per needle. In my case the radiologist (doctor) hit a nerve which was very painful.

With a tissue sample of each lump taken, the radiologist (doctor) then asked their assistant to examine each amount of tissue sample under the microscope to make sure each sample tissue was enough to develop in the laboratory. If not, more scraping would be required! Luckily, I did not need any more biopsies. If I did though, the radiologist (doctor) told me bigger needles would of been needed to scrape larger tissue amounts and that I would of needed to be unconscious for that procedure.

Second Meeting With THE SURGEON

On my second meeting with the Surgeon (27th October), where his senior Surgeon (Mr Jean-Pierre Jeannon) was also present, his senior Surgeon told me that he suspects either Lymphoma (a common cancer of the lymphatic system) or some other form of serious cancer based on the results of the biopsy so far. He was disappointed not to of had the full results by now. In the meantime though, he had ordered a MRI Scan for the following day (28th October). Five days later (2nd November) I would have a PET Scan.

The MRI SCAN PROCESS

The MRI Scan process is similar to a CT Scan. Mine began by me being injected with a fluid that allows the mri scanning machine to take an image of my entire body. In particular, an image of my nerve system (blood vessels) in order to gather what was going on in and around my head and neck in relation to my lumps and right eye. The whole process was painless and took around 1 Hour.

The PET SCAN PROCESS

The PET Scan process began by me attending Guy's hospital at 9:45am where I had to scan the barcode on my appointment letter at the main entrance of the R village. Unfortunately the computer did not recognise me as a patient, which I thought nothing of and continued to level R2 of the hospital and booked in with the receptionist there.

Surprisingly, while waiting in the coffee area of R2, I got a phone call at 10am asking me if I was at the hospital already (because they could not see my barcode login). I explained the situation and was then sent to the PET Scan waiting area. In hindsight: If their computer system does not recognise you as a patient, make sure you call an assistant to log you into their "I am here!" system. Otherwise they will think you have not arrived yet, even though you see a receptionist later on.

Once in the PET Scan waiting area I was asked certain questions, weighed and measured before being given a fluid "Tracer" injection in the arm whereby I then had to wait 90 Minutes for that fluid to fully enter my body; which is the standard waiting time for all patients. After that, the actual PET scanning time was around 30 Minutes. The PET Scan in my case, which was painless, was done to measure (scan) how deep and wide my cancer (tissue growth / tumor) had already spread.


THE NEUROLOGIST
OFFICIAL DIAGNOSIS
Index
CONTACT JOHN
E-Mail JOHN