82 years man with a lucky chronic cough..

Nurse: Your turn Sir...

A sad and almost hopeless elderly man walked in my room.. sat down and started our conversation with a big sigh.

Not a real patient

Patient : Doc, they sent here to do the bronchoscopy, as doctor uptown suspect I have a lung cancer. They said it is a " big cavity in my left lung ". Well, I don't smoke, nor there is any history of cancer in my family. But I m coughing alot, for a few months.

Me: Ok then, let me review your reports and let see what options we have for you.

Patient: It's OK , no need to review anything Doc. I have made up my mind. Moreover, I am 82, it's more than I have expected to live.

Me: Well, i suggest you give it a trial. You might get lucky. I will recommend a test, if it's negative .. we will have to proceed for further tests , if you are willing to. BUT if its positive .. You might get lucky!

Patient: ( smiling and laughing alil) What's the lucky part ? I don't think there is any lucky part here.

Me : Well, Not all cavity is cancer. From looking at your X ray , Tuberculosis may be a possibility. I have seen various " unique" tuberculosis cases that mimics cancer. I suggest get your sputum test using a more advanced technique ( PCR technique)

Left Upper Lung Huge Cavity Mass

After convincing him for half an hour , he finally agreed. 4 days Later, the report came back " Positive for Tuberculosis". Both of us decided to start an anti-TB medication and close followup for the cavity resolution.

After 2 month of intensive treatment he returned...

Patient: ( looking to gain some weight) Hello Doc !! ( with a strong voice). I think i just got lucky!!

Me: Well, you look energetic ! let me review your X ray and let pray you are lucky.

Fortunately, the cavity resolve almost 80%, in addition to his clinical improvement, cancer was least likely ( though further followup was needed). We end up thanking each other for giving each other a chance.

Me: So, now what next.. you still have another decade to live ..?

Patient : haha, yes yes .. that's what i have been thinking .

I think i am gonna live everyday as if it's my last day. Coz, it's a bonus waking up every morning... I just got lucky doc !!!

His follow up continued for another 2 years. X ray showed 100 % resolution and no recurrence after treatment cessation.

Moral of the story: Age should not prohibit you from pursuing your diagnosis. And lastly, don't trust your judgement when you are hitting rock bottom... get a consultant.. trust them ..it's their business.

#casefiles #lifejourney #lungcavity #tuberculosis