I read on the Internet last week that one of the treatments for a benign schwannoma is to do nothing but track it to make sure it doesn't turn into something more sinister.
When we saw Dr. Singer on Thursday he confirmed this, explaining that our options were either to just watch the tumor, or to schedule surgery and take it out.
So it didn't surprise us this morning when the neurosurgeon on my case, Dr. Mark Bilsky, started his presentation with a description of the laissez faire approach. We'd heard it before and presumed the doc was just clearing his throat before he got serious about my particular case.
It was several minutes before it dawned on us that he was recommending we actually pick Door #1, the door leading to a summer free of any further medical attention whatsoever.
We had never thought this option was open to us -- and apparently Dr. Singer hadn't either -- because my schwannoma shows up on the CT scans as invading bone and grasping for major nerve conduits and blood vessels in and around the spine.
But for Dr. Bilsky, the single most significant fact of my case is that I have no symptoms whatsoever. No numbness. No loss of strength or function in my lower back, legs or feet. Most important, no pain when going to bed or waking up in the morning.
He reasons that a slow-growing tumor as big as mine which hasn't yet interfered with life as I know it may not do so for years. It's been with me, he said, "forever," meaning at least 20 and maybe as long as 30 years. An old friend.
"It may never have to come out," he said, a sentence I repeated back to him slowly, to make sure I had heard it right.
If I go ahead with surgery now, he said, I will undergo all the risks of the operating room, the pain and discomfort of getting back on my feet, and the inconvenience of months during which I wouldn't be able to do anything remotely strenuous, not even so much as putting Elizabeth in her carseat. At the end of all that, I can count on being less strong or nimble than I am now.
The only reason to accept that grim certainty, he said, is if I think I'm bound to have the surgery anyway and it would be better to have it now while I'm relatively young and strong.
But Dr. Bilsky said the odds of avoiding it entirely are actually pretty good. And even if symptoms appear months, or years, down the road and he has to operate after all, the delay won't cost me much. The spinal repair I'd require would be no greater than it would be today, and any other neurological damage inflicted between now and then can be repaired.
"I'm sorry to have to tell you this," he said. "I love to operate, and I've got kids about to go to college."
Giddy as we were starting to feel, this struck us as a real knee slapper. He wasn't done. When I said I had many well-wishers who might feel a sense of anticlimax when they heard the news, he told me not to worry.
"Oh, we can keep it going," he assure me. "We can milk it. Tell them we said the tumor is inoperable. Tell them you went to Sloan-Kettering and we couldn't take it out."
All levity aside, flying home with nothing to show for the past several weeks of psychodrama but frayed nerves and a prescription for a fresh CAT scan in four months does leave me feeling a little sheepish alongside my deep satisfaction and happiness. I know it shouldn't, but it does.
I'll get over it.
I think my friend Nancy in Albuquerque probably wrote the best epitaph for this whole affair.
"Okay, we've ridden all the rides. That was fun. Now it's time to go home. Whew."