Santa left some small, cheap jigsaw puzzles in our stockings. They are flimsy and garishly colored. Last week, we cleared off a coffee table, cut one box open, and spread out the pieces.

Jigsaw puzzles can be huge time sinks, as much as any electronic en­ter­tain­ment. This particular puzzle is of a carousel horse, its colors tinted towards the Fauvism spectrum. It has 660 pieces, over 600 of which look identical to the casual eye. No wonder an hour can go by while I try to find the next piece of the carousel pole on the far left side.

The latest twists and turns of my medical saga bear a strong resemblance to that jigsaw puzzle.

I have been experiencing shortness of breath (dyspnea, if you want to get technical about it) for over a year now. I am not talking about “Gee, I just climbed Pike’s Peak and am having trouble breathing” concerns. I mean I am experiencing shortness of breath walking upstairs to the second floor, a staircase I have climbed thousands of time in eight years, and walking to or from downtown, trips I have made tens of thousands of times in my life.

My myeloma specialist has tried to track down the cause. Amyloids in my heart? Negative. Pulmonary hypertension (suggested by an x-ray when I got my port placed)? Negative. I passed the walking tests; my echocardiograms are immaculate.

Finally he said, “Just because you have cancer doesn’t mean you can’t get another serious illness.”

Like cardiac disease. Like pulmonary disease. Like something else that will seriously hurt me.

As a result, I have spent portions of the last three months undergoing more tests. There was a full cardiac workup, including stress tests. My heart is fine. There was a series of respiratory function tests. I passed them with flying colors. Then came a high resolution CT scan. Piece of cake.

Yes, we eliminated some concerns, but the puzzle is still taunting us.

While working on the jigsaw puzzle, my husband Warren dropped a piece on the floor. It landed print side down; the backside of the piece is gray. Our carpet is gray and brown. We looked and looked but could not find the piece because it blended in so well.

Four days later, sitting down at a different angle to work on the puzzle, I could clearly see the piece against the carpet and restored it to the table.

In looking at old medical notes for another reason, I came across a PET scan done in June 2015. The focus of the scan was multiple myeloma. But buried in the findings is a reference to a possible pulmonary issue.

Like the puzzle piece that blended into the carpet until I was in a different position, the findings could only be seen from a different angle. I copied the report and passed it on the pul­mo­nol­o­gist with whom I am con­sult­ing.

It may be a false lead. I don’t know. Or it may be a missing puzzle piece.

In a few weeks, I have a slate of doctor visits. First my oncologist for my four-week check, then the pul­mo­nol­o­gist for the shortness of breath problem, and finally my personal physician for the ongoing Coumadin (warfarin) battle, which I wrote about in my last column ^[1]. (The latest twist in that adventure is we upped the Coumadin dosage and my INR dropped lower, which is totally contrary to how this is supposed to work.)

There are multiple puzzles in my life right now. There are multiple pieces, some upside down, some mixed in with the pieces for another puzzle, some, I am sure, missing entirely.

It makes the carousel puzzle look easy.