At first his breathing felt a bit labored which his wife Maria* attributed to his chain smoking habit. But this difficult breathing was in addition to the constant ache in his lower back area. He would sometimes find relief by placing an ice-pack in his lower back. Sometimes the side of his chest hurt too. Joseph thought the worst and imagined himself having a heart attack some time soon. His wife Maria Martinez noticed that Joseph’s voice became hoarse. She was convinced that it was his life-long habit of chain smoking that was taking its final toll. He went to a doctor who diagnosed him with acute asthma and ordered him to quit smoking.
But later on he had great trouble in swallowing his meals and sipping fluids. Some times he would sweat for no reason and come down with regular fever breakouts. His children Carlos*, Fernandez* and Isabel* told him he should take it easy and put all his minor illnesses down to old age and retirement. But he just didn’t feel any better even though he went to see several doctors and consultants. As a last resort he had come to Dr. Carl after numerous references from colleagues and friends.
Pick up your ears
The doctor upon hearing Joseph’s warning signs immediately knew that all his symptoms were not due to smoking but had something to do with asbestos. Dr. Carl asked Joseph details about job and his exposure to asbestos. Joseph told him that he was an auto-mechanic and that too for the past 30 years.
Dr. Carl minced no words and told Joseph that because of his exposure to asbestos dust due to his work as an auto-mechanic he suspected him to have pleural mesothelioma. But in order to be really sure Joseph had to go through some extensive tests. First he had to go in for chest x-rays. His x ray films displayed uneven solidification of the pleura and buildup of fluid in the lungs also known as pleural effusion. Then Joseph had to go through a needle biopsy in which a needle was put into the chest cavity to take out some amount of fluid for sampling. The fluid was then sent to the lab for microscopic and chemical examination to find out whether the mesotheliomic cancer cells were present.
Finally the doctor asked Joseph to go for a CT scan or computed tomography scan so as to be 200 percent sure that he did indeed have pleural mesothelioma. CT scan explained Dr. Carl to Joseph is a radiographic process in which a computer is used to merge multiple x-ray images into a 2 dimensional cross-sectional single x-ray picture. The CT scan device turns around at 180 degrees around the patient’s body, sending out a thin x-ray beam at numerous points. Dr. Carl also added that crystals at the opposite points of the beam pick up and document the absorption rates of varying thickness levels of tissue and bone. The computer turns all this info into detailed pictures. Joseph had to lie on a machine stretcher while the scanning machine went over him. It was a slightly uncomfortable procedure as he had to remain unmoving for the next 30 minutes.
Butchart system
Dr. Carl in Joseph’s case decided to use the Butchart system, one of the oldest staging processes in use, to find out how far his pleural mesothelioma had spread to and attacked other internal organs. Butchart system, Dr. Carl explained to Joseph checks the mesothelioma in four stages. Stage 1 confirms that whether mesothelioma is there in the left or right pleura and if the diaphragm is included on the same side. Stage 2 of Butchart sees if the mesothelioma has spread to the chest wall, the esophagus, heart or pleura on both sides of the lungs. In this stage lymph nodes in the chest may also be diseased. |
