The Scans

Today I'm feeling: Good.
Mostly because I'm about to use the word "heretofore" in my blog, which actually makes me a little giddy.

****************************************

Well, Fred Thompson went and dropped out of the Presidential race, leaving me without a Non-Hodgkins Lymphoma candidate. Huckabee has diabetes, Edwards' wife has breast cancer, Obama is going to smoke himself into emphysema someday....Don't know what I'm going to do on Superduper Tuesday. Someone needs to step up -- as the fastest growing cancer in the country, we NHL folks are an important demographic that has been heretofore ignored by the candidates.

*****************************************

A couple of quick things before I get into the scans I had today:

First, we've heard from a few people who have said, "I was going to call/e-mail, but I didn't want to bother you." It's OK to call. I said the blog was to keep people updated so they wouldn't feel guilty about calling, but I didn't mean that you can't call at all. This blog has been great for me. But Isabel, I sense, doesn't get as much chance to unload. So it's OK to see how she's doing every once in a while.

Second, a few people have said to us, "I told so-and-so about Bob. I hope that was OK." Yes, that's OK. We're not hiding anything. What's more, the hardest part of this has been telling people the news (though that gets easier with practice). We told people who were most directly affected. If there are other friends/co-workers/family members who don't know, it's OK to tell them. The more prayers and positive energy, the better.

***************************************

So I had the scans today, a CT scan and a PET scan. As I've explained before, the CT scan gives a full picture of my torso, and the PET scan shows the "hot spots" (if any) where the lymphoma might have spread. Dr. R isn't sure what will show up; PET scans for NHL are often less effective than for other cancers because it's so slow-growing. They don't quickly use up the sugar that other cancers do, so they don't show up as brightly on the scan.

My appointment was for 8:15 this morning at the Hospital of St. Raphael downtown. It was yet another one of those tests where I wasn't allowed to eat after midnight, so the 8:15 am wasn't so bad (the node biopsy surgery was originally scheduled for 2:00 in the afternoon, moved up to 11:00am, thank goodness. That was killer to not eat all day.). We arrived on time and checked in. Over the last few months, I've accumulated a wristband ID band collection that will soon rival my wet-nap collection, but without the geographical diversity.

I was taken in pretty quickly, and led to a nice comfy chair, where they put an IV line into my arm and poured me a Barium milkshake. It's not really a milkshake, but it has that consistency. It's very sweet, slightly pina-colada tasting, and it helps with the CT scan. The nurse poured me a big cup from a quart jug and told me start drinking. I made a yummy sound, and she said, "Glad you like it, because we need you to drink the whole jug. Should take 4 or 5 cup-fulls." So I sipped my pina colada barium milkshake and answered her questions about my kidneys.

From here, I was given the radioactive sugar solution through the IV line, and told I needed to sit still for an hour. "Can I read?" I asked, pointing to the book I had brought (Christopher Moore's Fluke, in case you're curious). I was told they would prefer I didn't read, that I just sit or lie down and relax. And so I did. They played some soothing music and, because I was currently the only patient in the room, they dimmed the lights. They even put a warmed blanket on me. I decided I was going to take a nap.

Which I would attempt right after I sucked down two more cups of pina colada barium milkshake. And once they stopped banging boxes of whatever supplies they had just delivered on the other side of my curtain. And once they moved the CD player off whatever annoying Enya song was playing. And once the new patient that they brought in stopped talking.

So I didn't nap, but I did keep still for an hour, which was an accomplishment for me.

They then brought me in to the scan room. First, a half hour PET can, then a 5 minute CT scan. No big deal. I've already had a CT and an MRI in the last three months, so I knew what I was in for. The hardest part, for me, is keeping absolutely still. I getting restless easily.

The procedure, they explained, was this: I'd lie on a table, and the table is moved through a large donut-shaped structure. the inner layer of the donut moves around in a circle to take the scan. The PET scan is done in stages, so first my head and chest are in the donut for four minutes. Then the table moves forward about six inches, and the middle of my chest gets scanned for four minutes, then the table moves six more inches, etc. After about a half hour, I'm taken out, readjusted, and the CT scan happens (quickly -- no 4 minute stages, just one slow 2 minute push through). They needed a clear shot of my torso, so I had to put my hands straight out behind/above my head.

So they strapped me on to the table and reminded me that I absolutely can't move, or it would ruin the images. I went through with the first segment, and moved a few inches forward. I tried to distract myself, and what I began to think about was my nifty new collection of wristband ID bracelets. I got one for the CT scan in October, one for the MRI in December, one for the lymph node biopsy, one for the Upper GI endoscopy...Ah, yes, the endoscopy. I have Gastro-Esophogeal Reflux Disorder, GERD, and I'm on Nexium for it. The Nexium helps a lot. It's a Proton Pump Inhibitor, which shuts down some, but not all, of the tiny acid pumps in my stomach so I don't get reflux/heartburn. The only bad side effect I've encountered has been that I can't eat certain foods. It seems like my lack of stomach acid makes it tough to digest certain things, and I get stomach cramps about an hour after I eat them. Mostly high fat foods or foods that are hard to digest. Chicken skin....Steak and onions....

.....and, apparently, pina colada barium milkshakes.....

About 10 minutes into the PET scan, I started getting that familiar stomach cramp. I didn't know what to do. Call for help? Raise my hand? Grin and bear it? If I stopped it, would I have to start all over again? Today? Was the barium time-sensitive, so I'd need to do again another day? I decided to keep my mouth shut and hope it either went away, or didn't get so bad that it would make me flinch, or worse.

Luckily, it passed.

And then I relaxed enough to almost fall asleep. Except that every time I drifted off, the table would buck and move six inches, and it would jolt me awake, and I'd have to quickly recover my senses enough to not move.

After a while, I came to the horrible realization that my shoulders had fallen asleep. My arms had been behind/above my head for all this time. I've never heard of shoulders falling asleep before -- hands, feet, whole arms, but never just shoulders. But there they were. I tried to flex them a little, and I couldn't feel anything. Another decision time -- do I say something? I wasn't counting how many times I'd moved forward, but I figured they had to be close to finished. My head and chest were way out of the other end of the donut, so I was probably on the last segment of the scan, and maybe moving my arms a little wouldn't affect anything. But I couldn't take that chance. If I asked and they said No, I'd keep thinking about it, and it would get worse. So I kept my mouth shut again. Thankfully, they were done about two minutes later.

They brought me back through the donut and let me rest my arms for about 5 minutes while they prepared the CT scan. That one was easy -- 2 minutes and I was out.

Other than the pina-colada-barium-milkshake-induced stomach cramps, and the sleepy shoulders, the whole thing was fairly painless.

So the next step is to meet with Dr. R on Friday. He'll look at the scans, the biopsies, the blood work, and anything else he can think of, and we'll figure out which category and stage I'm at, and what the best course of action will be. I'm guessing we'll get a second opinion next week, but we should get started soon with the treatment.

Incidentally, yesterday Isabel spoke with Dr. M, our kids' pediatrician. He's an incredibly nice man, loves our kids, we love him, and he used to be a pediatric oncologist (which I imagine is the hardest job in the world, which is why he got out of it, from what I'm told). We mostly wanted to ask him about specialists in the area. He told us that he's still plugged in to the pediatric oncology community, though not so much the adult one. He also told us that the second opinion about treatment was a good idea, though to not be surprised if what we hear just confirms the first opinion. Apparently, with more common cancers like this one, there's a sort of standard protocol for treatment based on staging and category. Assuming we don't get any big surprises, we'll probably be told the same thing that Dr. R tells us. So that's something to think about.

*******************************

Tune in tomorrow for the further adventures of Radioactive Boy, and his faithful companion, Sprinkles the Wonder Dog.