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Lymphoma and Pets
Eight Walls and Radioactivity
On Wednesday the 20th of May, I underwent the second PET scan of my cancer patient career. PET's and CT's are going to be necessary and semi-frequent interludes in my life for at least the next few years while the doctors and I watch to see whether remission is a permanent state or just the intermission.
In any case, PET stands for Positron Emission Tomography which, according to my friends at Wikipedia is a "nuclear medicine imaging technique which produces a three-dimensional image or picture of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide (tracer), which is introduced into the body on a biologically active molecule. Images of tracer concentration in 3-dimensional space within the body are then reconstructed by computer analysis."
So, like, they inject you with radioactive stuff, stick you in a metal tube for around an hour--where you are NOT allowed to move--and then look to see if any of your innards are sparkling like a Stephanie Meyer vampire in direct sunlight. Hey, you want medical jargon, go talk to an oncologist. I manage a convenience store.
Anyway, let me back up a little and walk you through the process. About an hour before my scheduled test, I report to Oncology-Radiology. I'm met by a very nice young guy in scrubs who leads me through the catacombs of the basement of UW Hospital (they're under construction) and ushers me into the weirdest shaped room in the history of rooms. More on that later.
In that room is a chair that, against all expectations, reclines, even though it looks nothing like the coveted Big Blue Chair in my living room that the dog and I compete for on a daily basis. [The dog almost invariably gets the chair, but I maintain control of the remote, so it's a wash.] Trading small talk about the weather, life in general and how excrementally microscopic my veins are, the nice technician/nurse (not sure which) manages to stick a needle into my left arm, because the right arm is frankly crap, and methodically pumps a syringe full of radioactive cocktail into ye olde circulatory system.
[As a matter of interest, the literature from the hospital assures me absolutely that the radioactive tracer stuff is completely harmless, no trouble at all, don't give it a second thought, we promise, pinky swear, but please do us a teensy favor and avoid pregnant women and infants for a few hours after the procedure, okie dokie? Thank you so very much.]
After the injection is complete, the nice guy reclines the chair for me, (I'm not allowed to do it myself) offers pillows and blankets for my comfort, then leaves, turning the light down to a nocturnal glimmer as he goes out the door. For the next forty-five minutes or so, my job is to lie very, very still and be mellow. Totally mellow. To encourage this state of mellowness, I am not permitted to read, or to listen to music, or even to have a friend sit with me. In other words, my mission--and I'd better decide to accept it--is to be bored. There is a security camera mounted on the ceiling and aimed directly at me, probably in case I decide to jog a few laps or perform jazz hands or something. That would be bad.
The reason for all this enforced inactivity is as follows. The radioactive tracer is attracted to cellular activity. The more activity, the more the tracer sticks, the more it shows up on the scan. Therefore, fast replicating cancer cells should show up even if they're just getting started. (The better to try to beat them into submission again before they manage to get a foothold, m'dear.) So logically, if you engage your brain in, say, a lively discussion about Creationism versus Evolution, or you start jamming to a really rockin' angry-woman Ani DiFranco song, odds are THAT'S going to glow on the scan like a neon sign and potentially camouflage any cancer cells that might be trying to crop up in the ol' gray matter. Or, at least, that's my assumption.
This in-chair period of mental downtime is not as easy as it ought to be. I'm a writer. I honestly don't know how to stop my brain from churning along at a rapid-fire clip, short of falling asleep, and so I'm not entirely convinced that they wouldn't have been better off to let me read a really boring pamphlet. Before I catch myself, I write a chapter of the book I'm working on in my head while I'm sitting there in the dark. I don't mean to. It just happens. Once I realize what I'm doing, I try to quiet my mind and, y'know, become one with my environment.
(Sadly, if I'd been doing it right, I might not be able to tell you now that the weird shaped room had eight walls of varying dimensions. I spent some time obsessing over why any room should have eight walls. There were two pictures hanging on the walls in front of me--both floral, which I found moderately uninteresting because I'm a landscape person. The flowers in question were purple with a white background. There was a clock to my left. It ticked very loudly in a Chinese water torture sort of way. And of course, the mind can run wild when you're trapped in a strange place under a security camera. A thousand McGyver episodes flashed through my head and wildly improbable escape scenarios began to evolve in my imagination. I already had some radioactive material! All I needed now was a roll of duct tape, a raw egg and a lawn mower engine!)
Anyway, forty-five minutes into some of the most productive brain exercises I've entertained in quite a while, (oops,) the nice tech-nurse-dude comes to fetch me. I am then bade to use the ladies' room, no pressure at all when there's some guy waiting outside the door for you to empty your bladder, then away to the Big Machine we go.
After a check to ensure that I'm wearing no metal on my person--jeans, belts, under-wire brassieres, glasses, watches, belly button piercings, metallic glittery skin lotion, cyborg implants, whatever--I am guided onto the narrow metal bench and subsequently strapped down, re-blanketed, told once again not to move (unless there's an emergency, in which case I should wave my toes meaningfully) and sucked into the maw of the PET Scanner: The Tube.
Never having been in a coffin before, and not in a hurry to do so, that's still the vibe you get when the gently curved top of the Tube is only a scant few inches away from your nose. It doesn't help that you're strapped down in the traditional funeral visitation position. It really doesn't help that you're supposed to remain absolutely still. McGyver, here we go again!
Truthfully, many PET scan patients need to have some sort of sedation because claustrophobia can run rampant. Not being the claustrophobic sort, this is not an issue for me. (I'm slightly embarrassed to admit that after the first ten minutes or so, I took the nap I probably should have taken in the Eight Walled Flower Picture With Security Camera Room.)
Half an hour later, I wake up as the table slides me back out of the Tube like a slightly misshapen loaf of bread. Unstrapped and released by my captors, I put on my glasses and head for the cafeteria where they offer a reasonably priced omelet and some incredibly greasy bacon. The pre-test six hour moratorium on food and beverages is now a thing of the past. Yay! Then it's another hour and a half wait before I see my doctor.
I'm fortunate that I'll get my results before I leave and it's a good report, but I don't mind telling you that the waiting time weighs as heavily on my gut as that bacon. It always does.
The uncertainty factor is probably a good discussion for another day.