Chapter 2: Its all fun and games until someone loses an eye.

I was one of only a couple of patients there when I arrived, as it was high noon and most of the staff was gone to lunch. The waiting room was standard fare. Dozens of not very uncomfortable chairs lined the waiting room dotted with fake plants and side tables filled with magazines that were at least a few years old. I left David there to peruse the historical journals.

I was taken back to a room with what is probably a bazillion dollar’s worth of equipment. A technician was going to do an ultrasound of my eye.

The technician’s name was Matt. He was young, with straight dirty blonde hair pulled back very professionally, in a ponytail. He was tall and gangly and not a day over 25. I can’t be sure because I wasn’t seeing so well with my eyes dilated, but I think he still had some acne which made me think him younger than he probably was. He wore blue scrubs embroidered with the logo of the office. According to their website, that I had scoured on the way there, they housed about a half a dozen retina specialists.

He covered my eyelid with gel and explained that it would not be painful at all. He was right of course, but I barely registered anything he was saying. Cancer was echoing in my brain. He was looking at the screen as he ran the probe over my eye for a minute or so.

“Man, That’s huge.” He said as he ran the probe over my left eye.

Ok, Now I am listening. “Did he really just say that? “ I am about to have an attack of the vapors. As I have mentioned I am not prone to histrionics but…

“What’s huge?” I asked. I knew he had found the same mound that had so concerned Dr. Lee.

“Just for future reference,” I said, “You might not want to say that to patients because they might just freak out. Lucky for you I am not a freaker outer .”

He apologized profusely as he immediately realized that what he probably thought he was saying to himself, had actually come out of his mouth. I am pretty sure that is why my blood pressure was “a little on the high side” when I was taken to the next office.

I was greeted by Dr. Reid. He is young by my standards, probably mid-thirties, or early forties. Dark wavy hair, cut short with just a dash of salt in the pepper. He was all business. His initial greeting held what I call the conciliatory tone.

“So nice to meet you. I’m sorry it has to be under these circumstances.”

Wait a minute, I thought, that is the tone I use when I am telling someone their loved one didn’t make it. That is my, someone very close to you just died, voice he is using.

He thoroughly examined both eyes but spent a lot longer looking into the left eye.

He pushed himself back on the stool on wheels and swung it around to face the computer screen. He waved toward it and invited me to move closer to the computer screens where the images from my ultrasound were displayed.

“This area that appears to be elevated is fluid that has built up beneath the retina and is causing your vision to be distorted and fuzzy. The area of the tumor is quite large. It is an ocular melanoma.”

He paused to let that sink in. “This is a very rare disease that affects only about 2000 people a year in the US. It is a very serious condition. What I am going to tell you is tough, but I am just going to say it. We may be able to save your life, but we won’t be able to save the eye.”

My mouth said, “What do you mean?” In my head I was saying, “What the F%$^are you talking about?” This is as close as I will get to losing my shit. I rarely if ever drop the “F” bomb so even doing so in my head felt crazy. I was quite pleased it hadn’t come out of my mouth.

Dr. Reid explained to me that this particular cancer usually requires removal of the eye, or enucleation as it is called in polite society. He said that my options were limited due to the fact that I didn’t have insurance.

“Whoa, back up the truck. I have insurance. I most certainly do have insurance! I am the nursing supervisor at the Hospital. I work full time. I HAVE insurance!”

He looked a bit puzzled and said, “I’m sorry, when we called to verify the insurance it said you were no longer employed.”

“I don’t know why they would say that unless they just fired me and haven’t told me yet. I am most assuredly employed. I have no intention of having my eye removed if there is any other option. This is crazy! I feel like I am in the twilight zone.”

When he looked at me rather quizzically, I explained, “It’s an old TV show. Never mind.”

He said, “I can try to get you into see Dr. Fulton in Dallas. He is an Ocular Oncologist and works with this type of cancer. There may be another option with radiation but I am afraid the tumor may be too large.”

“I will work on getting the insurance issue taken care of if you can get me an appointment.”

“OK. There is something else you need to know that makes this a bit more complex.”

What else could possibly be more complex than the thoughts that were swirling around in my head right now? I couldn’t imagine anything that could make this worse until he explained.

“You need to get with your PCP (primary care provider) and have labs and scans of everything head to toe. This cancer has at least a 50% chance of metastasis to the liver, bone and lungs. It usually goes to the liver first. You need to get that done as soon as possible so you will have a baseline.”

I was so shocked, completely taken aback! I thought, Cancer in my eye… Take it out, not my eye, just the cancer. This should be an easy fix. Why would cancer in my eye go to my liver? The eye bone is not connected to the liver bone or however that old rhyme goes. I cannot possibly be here right now. This is some kind of bad dream, a hallucination or something. It’s not real, it’s not real, it’s not!

Did he just say 50%?

I opened my eyes. I was still sitting in that office looking at pictures of the inside of my eye. So, Okay! It is real but it is not going to metastasize to my liver, or bone, or anywhere else. Not gonna happen!

Dr. Reid left the room to give me some time to “process” but not before handing me a box of tissues which I suddenly realized I needed.

I pulled out my phone and called my PCP, Amber. She is a longtime friend and a Nurse Practitioner who I helped raise from a baby nurse many years ago in the ER at General Hospital. I told her my story and she was just as shocked as I was. She had never heard of an ocular melanoma either. We both had some internet searching to do. I told her I would get a list of the tests I needed and bring them to her office.

Dr. Reid returned with his card and put his personal phone number on the back. He had arranged an appointment for me with Dr. Fulton in Dallas for the 30th of March. He would be forwarding all the imaging to him and he wanted me to let him know if I had any problems or changes in my vision before that appointment.

I told him I would take care of the insurance issue. He looked at me and shook his head, with a look that said, “Good luck with that.”

As I left his office the girl at the checkout desk offered me a large discount for payment in full and I promptly wrote her a check.