The beginning …….

In the early days of June 2023, Robert was suffering from abdominal pain. The pain in the abdomen was excruciating and caused issues breathing. Robert tried to deal with the pain and difficulty breathing but after approximately two weeks he could not handle the pain anymore. On June 13, 2023, Robert woke up in the early morning hours because he was gasping for air and was having an extremely hard time catching his breath. Knowing this was not normal and he had not felt this way before, Robert decided to go to the emergency room to get checked out. Robert drove himself to the emergency room around 0200 hours. Robert checked in with the administration clerk and waited to be called. The emergency room was pretty much empty at this time, so the wait was brief before he was called back by a nurse to get his vitals and ask what brought him into the emergency room. As the nurse was hooking up the pulse oximeter, blood pressure cuff, and getting the thermometer out he asked Robert what was going on? Robert explained his abdomen pain he had been suffering from the past few weeks and how it was gradually affecting his breathing. The nurse was taking notes as Robert spoke and when he looked at Robert, the nurse asked about a lump on the left side of Robert’s neck. Robert acknowledged that he noticed the lump a few days ago but did not know how long it had been there. The nurse asked if Robert was having any issues with his throat or talking, Robert told the nurse he had not had any issues like that and the lump on his neck did not hurt at all. Robert said he only noticed the lump when he went to scratch his throat the other day and noticed it felt swollen. The nurse continued with his note taking and told Robert his vitals appeared to be fine. The nurse advised his blood pressure was 117/76, his oxygen saturation was 98 percent, and his temperature was 98.4 degrees Fahrenheit. The vitals and information gathering was completed and the nurse walked Robert back to the emergency department to get him in a bed to be seen by a doctor. Robert was handed a gown and a plastic bag to put his clothes in once he donned the gown. Robert put the gown on and laid in the bed to wait for the doctor.

While waiting for the doctor a few nurses came in and out of the room checking on Robert and asking if he needed anything. Robert always stated he was fine as he laid in bed watching Forensic Files on HLN. It was now about 0400 hours when a doctor walked into the room introducing himself. The doctor must have received all the information Robert provided to the nurse because he came in asking about the abdominal pain and the lump on the left side of his neck. Robert was still in pain and told the doctor his abdomen was his concern because that is what was causing all the pain and discomfort. The doctor stated he understood as he put on a pair of gloves and started pressing against my abdomen asking if anything hurt. Robert told him it hurt before he touched it, so it still hurt as he was pressing it. The doctor said the abdominal region felt hard and given the pain complaint he wanted to do an ultrasound to see what was going on. The doctor also said he wanted to do an ultrasound of the lump on Robert’s neck to see what it was as well. A nurse brought in the ultrasound machine along with some gel. The doctor applied the gel to my abdomen and started scanning the area with the probe. As he was scanning the area, he was not saying anything, but Robert could see the screen, but it was difficult to cipher due to the angle he was looking at it. The doctor made a few passes and finally started telling Robert what he saw. The doctor told Robert he had an enlarged spleen which was causing the abdominal pain by pressing against his stomach and the issue breathing was from the spleen pressing against the diaphragm. As the doctor concluded the explanation of the abdomen, he was applying gel to Robert’s neck and starting to scan with the probe. The neck did not take long at all, the doctor said it was definitely a mass, but he was unsure of the type. The doctor expressed concern for the lump because it could be many things and given the location, he wanted to figure it out. The doctor asked Robert if he would be alright with getting a CT scan to determine what the mass was on the left side of his neck. Robert not really knowing what the concern was because he was still feeling the horrible pain from his abdomen agreed to the CT scan because the doctor showed so much concern. The CT was ordered, and Robert was taken to radiology to have the scan done. Once in the room the radiology tech explained the machine and the process. Robert was asked to lay on the table that would move him through the scanner. Prior to starting the scans an IV was inserted to get dye into Robert’s system. This dye made the body feel extremely hot for a few seconds. Robert thought to himself that it was a weird feeling, but he was warned prior to the dye being inserted. The CT was completed, and Robert was returned to his bed in the emergency department.

Robert laid in the bed thinking about what was possibly going on, but he did not have a clue at the seriousness of the situation. Robert kept watching TV and playing on his phone waiting for the doctor to return with the results of the CT and bloodwork. The nurse from the nightshift did a final check on Robert and said she would be leaving in about 15 minutes, which was going to be 0800 hours. Robert said he was fine and thanked her for checking. The morning shift nurse came in and introduced herself and asked Robert if he needed anything. This time Robert asked if she had a phone charger because his phone was dying, and he knew he would have a few more hours at the hospital. The nurse said she was unsure but went to check and she returned with a portable charger. She allowed Robert to use it and made a joke about always having a charger when you have kids. Some time passed and the doctor walked into the room around 1000 hours. It was a tense entrance, and Robert could immediately tell the news was not going to be good, but he had no idea how bad a hurt abdomen and lump on the neck can be. The doctor looked at Robert and told him he was concerned about the mass on his neck along with the enlarged spleen and the bloodwork. Robert was a bit confused and not grasping the entire situation at this point. The doctor stated he was concerned about the mass in the neck being cancerous based on everything. Given this information the doctor told Robert he would like to have a biopsy done on the lump on his neck to confirm the possible diagnosis. Robert thought to himself he literally came to the hospital 12 hours ago for his abdomen and now there was so much going on he didn’t know what to think anymore and his pain was exactly the same as it was when he arrived. Robert agreed to the biopsy and signed the consent form to have the procedure done.

Robert was taken to a procedure room where he met with a fellow who stated he would be doing the procedure under the attending doctor. The fellow explained the procedure step by step. Robert had completed coursework for surgical technology to obtain his associate degree but still has to do his clinicals to take the board, but he knew exactly what instruments would be used and the order of the procedure to get the samples from his neck. Robert was nervous about having punches taken from his neck because it was so close to veins and arteries that are pretty important. The fellow told Robert he was going to try and get seven samples to make sure enough would be sent to pathology to prevent Robert from having to go through the same procedure at a later date if more samples were needed. Robert smiled and said whatever you think, you are the doctor. The fellow walked out to scrub in as a nurse walked in to assist me to the procedure table. Robert was laid on the table and secured in position to allow for the procedure to be done under an ultrasound machine so the punches could be seen in real time. A member from pathology entered the room and said he would check a sample as soon as it was taken to make sure it was a readable sample to save any problems in the future. The fellow entered the room with the attending doctor. The fellow applied some local anesthetic to the left side of Robert’s neck so he would not feel any pain while the biopsy samples were being taken. The fellow warned Robert of a loud snapping sound that would be made by the punch when it is released to gather the sample. Robert shook his head and was just ready to be done. The fellow placed the punch into the lump and fired it to get the sample. The punch was removed, and the sample was passed off to pathology who took a minute to look at it and told the doctor the sample was good. The fellow repeated the sticking the punch into the lump six more times until the procedure was completed. Robert was assisted up from the procedure table to his awaiting wheelchair. Robert spoke with the fellow as he was waiting for the emergency department nurse to come get him to take him back to his room. The fellow was from Texas and was married to a doctor, so he was doing pretty well. After a little small talk, the nurse arrived and returned Robert to the emergency department.

Back lying in bed still not having a clue about the past 20 hours with the same pain Robert was just mentally exhausted. The doctor came in and told Robert it would be a few days before the results came back from pathology to know for sure what the diagnosis could be. Robert asked if it was a guarantee bad result, the doctor said not necessarily. The doctor said a lot of the test and indications pointed towards possible cancer, but it could be a mass that is benign which could be removed if need be. The doctor did not want to make any false statements, but he told Robert all the possible outcomes. Robert chuckled and said thanks, I came with a hurt abdomen, and I leave with a hurt abdomen plus possible cancer. The doctor told Robert he would be notified of the results as soon as the results were received from pathology. Robert thanked the doctor for his time and all the test he ran to try and figure out what was causing his pain. Robert got dressed and was finally discharged from the hospital. As Robert was leaving the nurse told him if he had any pain or issues breathing from the biopsy to call 911 and not to try and drive back to the emergency room. The nurse said a complication of the procedure could swell the throat. Robert thanked her for the advice and made a joke about not being able to afford an ambulance. The nurse smirked and said she was serious. Robert exited the hospital through the same doors he entered approximately 26 hours earlier.