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Sorry for not posting in a while - lots to take in and not feeling very social. Upshot (after about a million doctor visits) is the sputum culture did NOT grow out tuberculosis but rather a less virulent cousin, "atypical mycobacteria". These bugs are not a danger to those with competent immune systems, so Mom and I should be OK, no need for chest xrays or treatment. OTOH, Dad's immune system is suspect b/c of the cancer and the chemo, so COULD be a problem for him. So, off chemo.

The pulmonologist wanted to do a bronchoscopy with trans-bronchial biopsy of that left lower lobe lesion, because a culture grown directly from the infected tissue would be much more sensitive than a sputum culture. I was leery, though, because the lesion was very peripheral, a location that traditionally is not very accessible for a bronch. So we held off until we could see the thoracic surgeon again. Surgeon wasn't enthused about the bronch either, and instead wants to expedite the original plan of surgical staging with mediastinoscopy and wedge resection and/or biopsy of that left lower lobe lesion. That way we kill two birds with one stone - find out what that LLL lesion is, and stage the right upper lobe tumor at the same time. If the LLL lesion is an infection, which we're hoping it is, the bug can be identified and appropriate treatment started.

Whew. Lots up in the air, but at least we have a plan. Dad goes for PFTs and a cardiac stress test next week, to make sure he can tolerate sugery if he turns out to be a surgical candidate. We see the surgeon again week after that. Poor Dad was hoping for no more doctor visits or tests until the new year, but I'm happy that they're moving things along. Mayo definitely likes to take your money, but it's a huge advantage to have everything in one place.

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My dad has been battling myobacterium avium complex (MAC) for several years now. It is a very tough bacterial infection to clear up. He ended up going to National Jewish in Denver for evaluation and treatment. National Jewish is the national research center for these type of lung diseases in the US. I can get you the doctor's name if you end up needing it down the road after things get settled down. Take care and I'm praying for all involved.

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