Tuesday, June 8, 2021

ENT Tumor Board

     Who knew how hard it is to get rid of a piano? We've been trying to get rid of our upright - donate to a charity - for two weeks. Our House, who has picked up stuff from our old house before - is not answering the phone. Habitat said they didn't take pianos. I wandered into the gross room this afternoon complaining. Joe said he had a piano, no one else wanted it. Jessica said that she watches enough HGTV to know people walk into a house and see a piano and say UGH. She said a lot of people buy them and don't use them. I told her my Mom and Dad gave me this one it's really nice and she said yeah, they got rid of it to you. I laughed touch in point. I want a baby grand in this house. Rex said there are some really nice ones that are a fancy version of a player piano. Technology has elevated it so much you can just plug in a playlist at a dinner party and it sounds like you have a personal pianist. I also want to take lessons again. I was really good as a kid, but it is not intuitive for me. S's partner David is getting in touch with a friend from Knights of Columbus who knows a piano teacher that works with underprivileged kids and only works in studios with donated pianos. Hopefully that will pan out. 

    Luckily the open lung was a softball - early DAD pattern (diffuse alveolar damage) but I had Staggs look at it Monday to agree with me and he did. Nothing here to treat, I told Muesse on Sunday. I got a pleural fluid from the patient today - he's still on the vent - and looked in the chart. New theory, according to Cidney, is that it's vaping related. I went to read a ROSE for Cidney today in the bronch lab and he told me it happens, he's read papers. I had no idea. I read about vapes blowing up in people's mouth and causing major trauma but not this. It's not common. I asked Cidney what happens to these patients. He said they usually recover and do well with support. Good news. 

    ENT tumor board this morning was good - I presented three cases. Was so exhausted from call weekend I forgot to edit and migrate my pics from my phone to a jump. Discovered when I woke at 1:40 am I had left my jump at the last tumor board and panicked. Luckily S plugged in and found a new jump and helped. One of the cases was a rare one - adenoid cystic carcinoma. It has a tendency for nerves - likes to travel down them and spread. 

    After I presented it I told them I had another interesting case this week that is probably adenoid cystic of the breast. I've only seen it twice in my career in the breast - super rare. Strange thing is she had a history of multiple cylindromas. I had to google that it's rare too - there is a syndrome I forgot the name but they happen mostly on the temple this lady had them on her temple and her torso. It's a benign tumor, very different from adenoid cystic but the weird thing is that morphologically they look the same and are each other's number one differential. Rex and I were working on that case together. It's gotta be related, he said. But I'd send it out anyway. So I did. Happy Tuesday - much love, Elizabeth

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