Normal people spent the glorious autumn day outside, enjoying the last days of good weather before winter closes in on us. I spent the afternoon at Strong Hospital enduring an MRI.
No prep for this test, just a ream of paperwork to fill out. Have to make sure there is nothing metal about you! Take off your jewelry, leave you watch in the locker, remove the blouse with the metal beads. Do your shoes have metal inserts? I don't think so.
Surprise! They do! The minute I am strapped into the tray and the weird shaped antennae is belted over my chest, they move me into the tunnel, and it feels like gremlins are grabbing my feet. Out I come, they remove my shoes. My arms are hoisted over my head, they place a bulb in my left hand, in case I need to call for help, and they kindly put a headset over my ears playing the local classical radio station.
"Are you a shallow breather?" Stuart asked me (he was the gentle Asian man running the test). "Well, I am a singer. I generally tend to breathe a bit more deeply." "Take a breath," he instructs. I do. "Take another breath." He seems puzzled. "One more. Ah! You ARE a belly breather. So few people are." He hooks a wire around my belly. "This just lets me know when you are taking a breath. It helps me regulate things."
I am loaded into the canon again, sans metal plated shoes. I panic a bit. The space is very close. The ceiling of the tube less than two inches from your face, the walls are hard, unforgiving. It looks smaller than other machines I have been in, but its the same size. Just the entrance bore makes it look like the space is getting smaller. The test begins. I hear Stuart talking to me. "Breathe in. Hold your breath. Don't breathe." (I make myself count: one one thousand one, one one thousand two, . . . one one thousand fifteen, one one thousand sixteen, . . . one one thousand twenty three) "You can breathe." BREATHE! My lungs collapse in a whoosh of air out, expand in a satisfying air inflation. Stuart says it so casually, as if my lungs were not burning from oxygen deprivation, as if my chest were not screaming 'take a breath NOW!'
Again and again we repeat the pattern, sometimes for 17 seconds, sometimes for 27, sometimes for 12. That was the liver part. Then we move on to the pelvic part. Stuart brings me out and says I can put my arms by my side. He wraps them mummy like with sheets so I won't get a burn if I should accidentally touch the magnet. I can't hold onto any thing. This is a proposition in how long can you hold your arms by your side without resting them on anything. He loads me into the bore.
"No. NO, I can't do this." I yell. Its like being in a coffin. I can't wiggle, I am totally squished. Stuart brings me out. "Hey, I thought you were gonna jump right outta there!" he grins. I position my arms over my head again, he still wraps them in the sheets. Then in I go again.
No holding your breath here, just enduring beeping, buzzing, banging. I am positive there is a jackhammer being used in this tunnel. Or at least an unserviced lawn mower. It goes on and on. At one point, I realized the buzzing is happening in tandem with my breathing. When I exhale, and in the few seconds before I inhale, they buzz. Then I realize I can play games with this one. If I don't inhale as quickly, they can buzz longer. Maybe it will speed things up. And when I need to take a deep breath, they wait patiently until I am done before buzzing again.
We move on to a number of different patterns (Stuart calls them tests). I have been in the blasted tube almost two hours. My shoulders and arms hurt. My muscles are tensing. I consciously make myself relax. I try to "go to my quiet place" but the pain is interfering with my ability to concentrate.
I begin quoting Bible verses. "He has promised never to leave me or forsake me. Yea, though I walk through the valley of the shadow of death, I will fear no evil, for Thou art with me. Thy rod and Thy staff, they comfort me." Even in the heart of a huge magnet. Even after hours of lying still on a hard surface.
I think of that little girl who fell down a pipe in her back yard, and was stuck there for three days. I think her name was Jessica. She was just little - maybe three years old. And scared. And no one could reach her. I am fortunate I am not in some emergency situation, not facing death, not without knowing that within a short time my agony will be over. I am fortunate I can get this test done. I have the resources, the insurance, the doctor. I refuse to complain.
The final step. They pull me out, and the nurse comes to start an IV so they can inject a contrast solution. No, not IVP. Stuart tells me the name of the substance. Something that starts with a g and is an earth element, not related to IVP in any way. I tell her my veins are small, and she looks. "Yup. But this is by power injection, I can't use a smaller needle, I will just have to get a larger vein. She does! First stick. Thank you Lord.
Back in I go. Stuart's voice interrupts Mahler's Third. "Injecting now." My arm feels cold, then my whole body. I am a bit dizzy and feel faint and nauseous. Stuart is telling me to hold my breath. I do, fearful that I am going to pass out. I want to tell him. I wait to see if it will pass. My mouth tastes funny. Kind of tinny. The faintness is passing. After the third round of holding my breath, I am only cold and my mouth still tastes funny.
This round is for both liver and pelvis. But not so many tests. In a matter of twenty minutes, I am done. Stuart helps me out of the machine, helps me lower my cramped arms, unhooks the wires and removes the antennae and the pads. he helps me sit up, chatting about his daughter's interests in singing, how she wants to be on American Idol. We laugh.
I wobble out of the room, buckle on my magnetic shoes, and wander back to the dressing room, stopping first at the bathroom. I wonder vaguely if the radioactivity from the PET scan will interfere with the MRI. Surely they wouldn't have scheduled them 2 days apart if they did. Well, 2 and a half hours after entering, I exit to the parking lot and the sunny day. They have very thoughtfully provided parking validation so I don't have to pay.
Done. Let's not do it again anytime soon. Thanks.
Sunday, September 30, 2007
Saturday, September 29, 2007
The PET scan
No one had given me such a thorough prep instruction as the Imaging Sciences Center sent me for today's PET scan. I had been told before about not participating in any vigorous exercise, not eating or drinking anything for 6 hours before the test.
But these instructions said for the whole day before I was not to have any caffeine, alcohol or carbohydrates. In addition, at the Yale Cancer Clinic, since I am allergic to IVP dye, and since they put their IVP dye in their barium solution, I didn't get any barium solution.
Also at Yale, I had to repeat to every single person I dealt with that I was allergic to IVP dye, and I worried that if I should be unconscious, there would be no one to tell them not to give me IVP dye. Even the oncologist had to be told EVERY time not to schedule tests that require the dye.
Here, the moment I walked through the door, they put a red wrist tag on my arm with an allergy alert on it. AND they confirmed verbally that I had the allergy, and gave me the barium sans IVP. The nurse doing the prep and IV installation told me the reasons why they ask that there be no caffeine, no alcohol, no carbs.
They were very good reasons, and I was beginning to suspect that the tests I had done at Yale had been compromised. Here they also hooked up an IV, something I had not had before. She explained that since the kidneys are always working, as is the heart, they will attract a lot of the radioactive glucose solution. If the ensure that I can expel fluids before the test, it will clear up that area so they can see more clearly. The nurse was attentive when I told her I have very tiny veins - most lab people just grunt and then proceed to have to stick me repeatedly until they can manage to squeeze in a larger needle. Half the time it blows and they need to redo it.
This nurse listened, looked at my arms, then said, "I'm going to get a pediatric needle." She got it easily the first stick. Kudos for thinking that I might know a little something about my own body!
So they tilted back the easy chair, wrapped me head and arms and my legs in warm blankets (which also helps the blood flow and makes the test results better), and tiptoed out. Every ten minutes or so, one of the staff peeked in, checked the IV levels, and left quietly.
I closed my eyes and dozed, my thoughts wandering from children to music to beautiful places I have been. At one point I smiled a little, thinking of that cliche "Go to your quiet place." When I was pregnant and enduring labor pain, the Lamaze coaches taught us to think of a calm beach or a vacation place that we really liked, and visualize being there, experiencing the sensations of that environment (the sound of the waves rolling up on the beach, the sound of the wind in the palm trees, the warmth of the sand beneath you, the warmth of the sun, etc.)
I hadn't thought of that in years, and I cast about in my mind for a place where I wanted to be, someplace carefree and relaxing. I used to think of beaches and mountains and lakes. But now, though I could easily visualize those places, including extraordinary sunrises and sunsets, I found no particular joy and strength in being there.
Instead, I visualized being in my Father's arms, my heavenly Father, cuddled up like a child with my head on His shoulder, feeling His strong arms around me, knowing I was safe. It was the best place for me to be. Too soon the radiologist came to get me, having me stop at the bathroom first.
What a difference their care and attention to details made to my confidence levels! Also, their CT scanner and their PET scanner were 2 separate units, located one behind the other. It was quite clear when they were doing the CT scan and when they were doing the PET part.
As we were finishing, the nurse told me that I would be "somewhat radioactive" for the next several hours. When I use the facilities wherever I am, I need to flush twice and wash my hands very well. And I shouldn't be holding any babies or pets, much less kissing them. Stay a good arms' length for people, and rest assured, it will all go away rapidly.
Well, we shall see if all this additional precaution makes a difference in the test results!
But these instructions said for the whole day before I was not to have any caffeine, alcohol or carbohydrates. In addition, at the Yale Cancer Clinic, since I am allergic to IVP dye, and since they put their IVP dye in their barium solution, I didn't get any barium solution.
Also at Yale, I had to repeat to every single person I dealt with that I was allergic to IVP dye, and I worried that if I should be unconscious, there would be no one to tell them not to give me IVP dye. Even the oncologist had to be told EVERY time not to schedule tests that require the dye.
Here, the moment I walked through the door, they put a red wrist tag on my arm with an allergy alert on it. AND they confirmed verbally that I had the allergy, and gave me the barium sans IVP. The nurse doing the prep and IV installation told me the reasons why they ask that there be no caffeine, no alcohol, no carbs.
They were very good reasons, and I was beginning to suspect that the tests I had done at Yale had been compromised. Here they also hooked up an IV, something I had not had before. She explained that since the kidneys are always working, as is the heart, they will attract a lot of the radioactive glucose solution. If the ensure that I can expel fluids before the test, it will clear up that area so they can see more clearly. The nurse was attentive when I told her I have very tiny veins - most lab people just grunt and then proceed to have to stick me repeatedly until they can manage to squeeze in a larger needle. Half the time it blows and they need to redo it.
This nurse listened, looked at my arms, then said, "I'm going to get a pediatric needle." She got it easily the first stick. Kudos for thinking that I might know a little something about my own body!
So they tilted back the easy chair, wrapped me head and arms and my legs in warm blankets (which also helps the blood flow and makes the test results better), and tiptoed out. Every ten minutes or so, one of the staff peeked in, checked the IV levels, and left quietly.
I closed my eyes and dozed, my thoughts wandering from children to music to beautiful places I have been. At one point I smiled a little, thinking of that cliche "Go to your quiet place." When I was pregnant and enduring labor pain, the Lamaze coaches taught us to think of a calm beach or a vacation place that we really liked, and visualize being there, experiencing the sensations of that environment (the sound of the waves rolling up on the beach, the sound of the wind in the palm trees, the warmth of the sand beneath you, the warmth of the sun, etc.)
I hadn't thought of that in years, and I cast about in my mind for a place where I wanted to be, someplace carefree and relaxing. I used to think of beaches and mountains and lakes. But now, though I could easily visualize those places, including extraordinary sunrises and sunsets, I found no particular joy and strength in being there.
Instead, I visualized being in my Father's arms, my heavenly Father, cuddled up like a child with my head on His shoulder, feeling His strong arms around me, knowing I was safe. It was the best place for me to be. Too soon the radiologist came to get me, having me stop at the bathroom first.
What a difference their care and attention to details made to my confidence levels! Also, their CT scanner and their PET scanner were 2 separate units, located one behind the other. It was quite clear when they were doing the CT scan and when they were doing the PET part.
As we were finishing, the nurse told me that I would be "somewhat radioactive" for the next several hours. When I use the facilities wherever I am, I need to flush twice and wash my hands very well. And I shouldn't be holding any babies or pets, much less kissing them. Stay a good arms' length for people, and rest assured, it will all go away rapidly.
Well, we shall see if all this additional precaution makes a difference in the test results!
Friday, September 28, 2007
Blue Reflections
What is there about PET scans that causes me to reflect on the events of the past few years? I suppose the fact that I have to have these tests because of the cancer, and because every test holds the insinuation that I might discover another episode of cancer has cropped up. Whatever it is, it sets me apart from others who do not have to have tests every few months, don't have to face their own mortality time and again.
I thought back over the chain of events that took me to Illinois, my first direct brush with cancer. I had met Leslie at a Music Library Convention in Las Vegas before I interviewed for the position in her library. She was charming, brimming with love and life, engaging. She and her husband were planning to spend some vacation time after the conference exploring nearby desserts and parks. I liked her immediately.
Before I came for the interview, in a matter of a few short weeks, she had been diagnosed with cancer, had surgery and chemo, and could not participate in the process. I was hired and had worked several months before she was able to return to work, and she was so wanting to be my mentor, to teach me the ropes, to bring me along.
We were headed for a great friendship.
And suddenly, she was back in the hospital, dying. They tried so many medicines, so many interventions. But the cancer had spread to her liver and lungs. Her days were numbered. She elected to stay at home, and we all took turns visiting in the daytime so she wouldn't be alone.
The last time I spent the afternoon with her, we talked and laughed and looked at pictures and celebrated her publication in a newsletter. Finally it was time for me to go back to work. I rose to leave, and she begged me to stay, just for a little longer. I was torn. I was still new on the job, but it was evident that she didn't have much time.
I compromised and stayed a very short time. It was the last time she was coherent. I went several times to administer back rubs and foot massages, but she was so ill she couldn't manage to talk. Her eyes said it all. I kept a constant banter of chatter going about little things at work, and she hungrily drank it in. We both knew time was short.
The next night I stopped over about 7 to give her a massage, but they were bringing in a hospital bed to make her more comfortable. I told Leslie I would come back the next day. She grabbed my hand, her eyes pleading. I knew she was in pain and needed the massage, but I was so in the way that I left anyways.
That night she died. Her husband told me that she became coherent and they talked for several hours, just like the good old days. Her Mom and sister were there. They said their good byes, and she went to sleep. I never saw her again.
When you have cancer, when you are dying, you affect others. I know that quite well. I am concerned about the effect these tests have on Drew. I know he gets anxious about my health - not so much because of what I go through, but because it creates an environment of uncertainty for him.
We have talked often of what would happen to him if I died. He would go to live with my sister Deb, and she would put him in a Christian boarding school. He would hear from his brothers often and spend time with them. But in essence, he would be on his own. I know he would be desperate to know that someone cares about him. Other than God, of course.
Sometimes his behavior tests that hypothesis now. Like this morning. Because my test was scheduled so early, he needed to walk to the pick up place for the carpool himself instead of me driving him there. It meant he had to get himself up and there on time. It meant he had to go to bed early, and indeed, when I got home from choir practice, he was in bed, asleep at 8:45!
In spite of that, he begged to stay home today. Please don't make me go to school. I am tired. I make him go. Much better to be distracted and busy than home sleeping or watching TV. Don't allow the fear to grow. Put your concerns aside. We will not know anything today anyways, even though we expect all the results to be completely positive.
He knows and I know that there is the tiniest little chance that things will go awry. So it throws his mood into grumpiness for a bit until we get the all clear. Sigh. I have to deal with this myself. Hard to also bear in mind that this young man is struggling with big issues too. Go gentle on him. Get something positive to do over the weekend - go see a soccer game, take in a concert (Denver and the Mile High Orchestra). I bought the tickets this afternoon, in between catching up at work since I was rather late getting out of the test, and running to the bathroom from having the test.
Well, tomorrow we shall take a breather.
I thought back over the chain of events that took me to Illinois, my first direct brush with cancer. I had met Leslie at a Music Library Convention in Las Vegas before I interviewed for the position in her library. She was charming, brimming with love and life, engaging. She and her husband were planning to spend some vacation time after the conference exploring nearby desserts and parks. I liked her immediately.
Before I came for the interview, in a matter of a few short weeks, she had been diagnosed with cancer, had surgery and chemo, and could not participate in the process. I was hired and had worked several months before she was able to return to work, and she was so wanting to be my mentor, to teach me the ropes, to bring me along.
We were headed for a great friendship.
And suddenly, she was back in the hospital, dying. They tried so many medicines, so many interventions. But the cancer had spread to her liver and lungs. Her days were numbered. She elected to stay at home, and we all took turns visiting in the daytime so she wouldn't be alone.
The last time I spent the afternoon with her, we talked and laughed and looked at pictures and celebrated her publication in a newsletter. Finally it was time for me to go back to work. I rose to leave, and she begged me to stay, just for a little longer. I was torn. I was still new on the job, but it was evident that she didn't have much time.
I compromised and stayed a very short time. It was the last time she was coherent. I went several times to administer back rubs and foot massages, but she was so ill she couldn't manage to talk. Her eyes said it all. I kept a constant banter of chatter going about little things at work, and she hungrily drank it in. We both knew time was short.
The next night I stopped over about 7 to give her a massage, but they were bringing in a hospital bed to make her more comfortable. I told Leslie I would come back the next day. She grabbed my hand, her eyes pleading. I knew she was in pain and needed the massage, but I was so in the way that I left anyways.
That night she died. Her husband told me that she became coherent and they talked for several hours, just like the good old days. Her Mom and sister were there. They said their good byes, and she went to sleep. I never saw her again.
When you have cancer, when you are dying, you affect others. I know that quite well. I am concerned about the effect these tests have on Drew. I know he gets anxious about my health - not so much because of what I go through, but because it creates an environment of uncertainty for him.
We have talked often of what would happen to him if I died. He would go to live with my sister Deb, and she would put him in a Christian boarding school. He would hear from his brothers often and spend time with them. But in essence, he would be on his own. I know he would be desperate to know that someone cares about him. Other than God, of course.
Sometimes his behavior tests that hypothesis now. Like this morning. Because my test was scheduled so early, he needed to walk to the pick up place for the carpool himself instead of me driving him there. It meant he had to get himself up and there on time. It meant he had to go to bed early, and indeed, when I got home from choir practice, he was in bed, asleep at 8:45!
In spite of that, he begged to stay home today. Please don't make me go to school. I am tired. I make him go. Much better to be distracted and busy than home sleeping or watching TV. Don't allow the fear to grow. Put your concerns aside. We will not know anything today anyways, even though we expect all the results to be completely positive.
He knows and I know that there is the tiniest little chance that things will go awry. So it throws his mood into grumpiness for a bit until we get the all clear. Sigh. I have to deal with this myself. Hard to also bear in mind that this young man is struggling with big issues too. Go gentle on him. Get something positive to do over the weekend - go see a soccer game, take in a concert (Denver and the Mile High Orchestra). I bought the tickets this afternoon, in between catching up at work since I was rather late getting out of the test, and running to the bathroom from having the test.
Well, tomorrow we shall take a breather.
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