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Many people have asked about the chronology of this whole thing so here you go.  I have made it a reference page so you can easily get back to it.  Day Zero (7/26/12) is the day I had a confirmed diagnosis but this page contains the chronology leading up to that date.

Fall 2011: My face

I was diagnosed with actinic keratosis in the fall of 2011.  This is basically sun damaged skin.  The diagnosis was made on a routine trip to a dermatologist (different one that I saw in March) where two biopsies were performed. A chemo-agent cream called Fluorouracil was prescribed.  I used it for three weeks late in 2011 under the care of the new dermatologist, a local guy I really liked.  It melted the skin off my forehead across my nose and upper cheeks.  It was not pleasant and I looked like a freak.  My current driver’s license picture was taken at the tail end of that treatment.

3/30/12:  First clue

Actinic keratosis does not turn into melanoma, even if left untreated.  The first clue in my disease was a spot on my scalp that was itchy sometimes.  I could feel something up there and could pick at it with a fingertip.  Sometimes, a piece would flake off.  We are not talking Goldmember type of flaking off (go ahead and google that), just something itchy.  At my next dermatologist appointment, which was a follow up to the aforementioned Fluorouracil treatment, I pointed this out to the doctor.  He froze this off and sent me on my way.

5/26/12:  Trip to Vancouver, Sinus Infection

My cousin was married in Vancouver the week-end of 5/26/12.  I came back from that quick trip not feeling all that great and ended up with a sinus infection, something that is not very uncommon for me.  I took care of it by keeping my sinuses clear and it went away mostly on its own.  One thing that was different about this particular bout was that my left ear was clogged.  The ear thing is unusual but not extraordinary.  BTW, it was great to see my cousin get married and spend time with my fantastic father and sister!

Early June 12:  Swollen glands

Sometime after feeling sick, the glands on the left side of my neck were a little swollen.  This is the same side of my neck that my ear felt weird and the same side I was having problems with my sinuses.  I know that glands get swollen when you are sick, so I didn’t think anything of it.  I have never had swollen glands but there is always a first time, right?  My ear was still feeling clogged and rang a bit.

6/25/12:  Internist

On 6/25, I saw my internist.  It had been 2.5 years since I last saw him… I think that is good news because I don’t need to see him very often.  He felt the glands, noted the coincidence and said to wait 4 weeks to see what happened.  If they hadn’t gone down by then, I should see him again.

7/9/12:  Resignation

I had not been particularly happy at work for some time and made the decision to resign while the CEO was off on maternity leave and various family activities.  The first day I was able to see him face-to-face was Monday, 7/9/12.  My transition plan was now in his hands but in the interim, I had been and planned to continue working hard trying to get the product ready for upcoming client launches.

7/11/12:  ENT

I am not particularly patient and therefore couldn’t wait a full 4 weeks.  I used the internet to find an ENT and got an appointment scheduled for 7/11/12.  At this point, my ear still really wasn’t feeling quite right so I really wanted was someone to take a closer look.  In my mind, I had an ear infection which would explain the feeling in the ear and the glands.  The doctor used an endoscope to look in my nose, sinuses and throat.  If you have never had this done, it is not fun and don’t watch on the TV monitor.  He checked my ears carefully and felt my neck (remind me to tell you how many people have felt my neck and how many different ways they do it).  The nose, sinus and ear were healthy.  The glands were rubbery.  Not a good sign.  His diagnosis; probable lymphoma.  BAM, punch in the stomach.  He prescribed 1 week of antibiotic to rule out infection and to come back and see him if they didn’t shrink during that week.  That was a rough week.

7/18/12:  Dr. Angel

I had called Dr. Angel during the events leading up to the ENT visit and we agreed to meet after 1 week of the antibiotic.  I visited him at his office in the afternoon and he felt my glands for the first time.  He called his connection at UPenn while I was there because he didn’t like what he felt.  The guy he called was awesome, supportive and calming.  He was going to get me into the right hands quickly.

7/19/12:  Head/Neck Surgeon Call

I receive a phone call from the UPenn doctor the “connection” identified.  We speak for about 20 mins and he wants to see me.  The problem is that he was headed on vacation (Toronto if you must know) that afternoon for a week and had a waiting room of people.  One week was not going to make a difference in my case he assured me.

7/24/12:  Mother-in-Law Falls

My mother-in-law falls and breaks her hip during a routine dialysis visit.  My wife immediately heads out to the Jersey shore to support the situation.  She is gone for the next 6 days.

7/26/12:  Head/Neck Visit

This is day zero.  The PA took a detailed history.  The doctor felt my neck.  He also scoped my nose, sinuses and throat.  After all that, a team of pathologists performed an FNA (Fine Needle Aspiration) of the glands.  Within 5 minutes I had a cancer confirmation and my world substantially changed.  My mother-in-law was in surgery to repair her hip at almost exactly same time.