PET scan

No matter how hard I try to make sure to prepare myself and do exactly what I'm suppose to do, I always seem to f*ck up my PET scan. Last summer when I had my first PET scan, I took my pills during the time you aren't suppose to eat anything, which includes breath mints or chewing gum. I remember when I was laying on the scan bed and the technician asked me if I was sure I hadn't eaten anything. I was sure I hadn't so I said no, ma'am. Only later did I realized it might have been my pills. I don't know if it actually did cause a problem, but I also remembered that I drank flavored water, which I found out this time around is also not permitted. You are allowed to drink two glasses of water during the fasting period (4 hours) prior to the scan. So, I had no idea that you weren't allowed to drink flavored water. But it wasn't like it was flavored with anything that contained any sugars, which is what they want to make sure you don't have a lot of in your blood for the scan. 24 hours prior you are suppose to limit your intake of carbs and sugars.

So, I think I screwed up last year, but nothing was found on the scan anyway, so it didn't matter. The mistake, if it was one, didn't show up as anything to worry about. That said, this time I wanted to make sure I did everything right so that I knew I was getting a good reading. A PET scan is a slower scan than a CT scan. You lay on the scan bed for half an hour as it scans sections of your body for about five minutes each section until they have a whole body scan.

Getting a PET scan isn't difficult or painful or stressful. It's relatively easy and comfortable. But it is time consuming and a bit tedious. Like I said, 24 hours prior you are suppose to not eat a lot of sugars or carbs, so I had salad for lunch and eggs for dinner. Then four hours before your scan you are suppose to fast, but drink two glasses of water (no flavoring). I drink carbonated water all the time, so I didn't drink that because I wanted to be super sure I was not doing anything that would interfere with the scan. You are suppose to wear comfortable clothes, without metal buttons or buckles, etc. And no jewelry. So, I took off all my jewelry the night before so I wouldn't have to remove it at the center. 

When I got there they took me in pretty quickly. The PET technician was a very nice woman who led me to where they do the PET scan, past my old haunt where they do the radiation treatments. I saw a few familiar faces busy doing their jobs. She took me into the little room where there is just a recliner chair and gave me a warmed blanket to wrap around my shoulders and half of my container of barium drink. She explained that it was no longer coconut flavored but orange cream, and that people liked it enough to claim it tasted like a creamcicle. We laughed at that. I've drank enough of that stuff to know that it wouldn't taste like any creamcicle I'd ever had. Truth was though that it wasn't too bad. She told me to enjoy my nap and turned down the light and said she'd be back soon. About fifteen minutes later she came in to give me my dose of radioactive something or other, which they inject into your veins. She had to go get the drug, which I imagine has to be kept in a radiation containment fridge. It was a small cylinder encased in metal which she used a needle to remove the liquid and inject into my arm (through one of those little tubes they stick in your arm. 

She ten gave me a timer which was set to go off in fifteen minutes, at which time I was suppose to drink the rest of the creamcicle. She said she would be back in forty-five minutes. After I drank the liquid yumminess it was hard not to fall asleep cuz there I was in a recliner, with a warm blanket around me in a dim room, but I managed to stay awake. When she came back she showed me where the bathroom was. You are suppose to empty your bladder of the water you drank earlier, I suppose, and maybe some of the barium. I also had to take off my bra because it had metal fasteners. 

It was a different woman who administered the scan. She asked me, when she brought me into the room, whether the buttons on my shirt were metal. I was wearing a new shirt I'd just gotten. It was a black henley type shirt with five little buttons at the top front. I had decided to wear it when I looked at it a couple days before to see if the buttons on it were metal. I looked at them and was sure they were plastic. I thought that was great because it was the perfect shirt to wear to the scan. So, I told her that the buttons were plastic. I lay down on the scan bed and adjusted my head into the little neck pillow thing and she pulled a big velcro harness thing around my body at my arms so that my arms and hands were held tight to my body and wouldn't move. In a CT scan they usually give you a rubber ring to hold onto and you raise your arms over your head. The big velcro thing is actually a lot more comfortable because you just forget you have arms.

The technician told me when I was halfway finished, and before I knew it I was done. 

So, maybe you are wondering how I f*cked it up again. Well, later in the day I decided to check out those buttons on the henley shirt again just to sort of make sure I was right about them being plastic. I was sure of course. The only problem was, was that I quickly realized how wrong I was. At closer inspection I found they were indeed metal because I clicked it against my teeth and you just know whether something is metal or plastic when you hit it against your teeth. Why hadn't I done that the other day? I'd screwed it up again and I was so upset. I did not want to have to do another one, and waste everyone's time and money again. 

I had to wait all weekend. This morning I called and talked to the PET technician and told her of my button dilemma. She said to wait while she looked at my scan. She must have been right by her computer, and she looked at the scan and told me that it wasn't a problem and not to worry about it. Boy was I relieved, and so glad I called. After I hung up I wondered if I should have asked her what she could see on the scan...

Edited later to add: the PET scan was clear. I had a follow up with my oncologist and he said that the cancer might never come back, which sounded good to me. 

Ah, summer...

Finally it is Summer. Though it is a bit cold yet, at least there is no more snow. At least there are leaves on the trees and grass on the ground. I love it so much.

Last summer began badly. I found a lump on my neck and my father died. I spent the rest of the summer having to do radiation again, and with the added difficulty of wearing a mask. I discovered that I am quite claustrophobic or whatever you might label it when you don't like having something tight around your whole head and it limiting your ability to breath freely. The summer ended with the good news that I wouldn't have to have chemotherapy in addition to the radiation.

This summer is better than last... at least so far. On Friday I have to have a PET scan (before I go to see my oncologist in July). PET scans are easy, but complicated. Lots of rules in preparation, which makes you a little nervous because you don't want to screw it up and have to do it over or get results that are wrong (possible, since I don't know exactly what happens if you do screw it up). You have to fast four hours before the scan, but if you are diabetic (which I am), you are suppose to take your insulin and eat before you start your fast, and you have to drink two glasses of water during your fast prior to the scan, but it can't be any kind of flavored water. You can't eat anything, not even a breath mint.

It was such a long winter, and I am just pleased that I am able to enjoy the beginnings of summer, even though it seems like it's almost over already.

Here is a good article to read:
What to Say to Someone Who Is Sick

June 10, 2011

‘You Look Great’ and Other Lies

By BRUCE FEILER

MY friend sat down and ordered a stiff drink. I didn’t think of her as the stiff-drink kind. An hour later, after our spouses drifted off into conversation, she leaned over the table. “I need your help,” she said. “My sister has a brain tumor. I don’t know what to do.”
Three years ago this month, I learned that I had a seven-inch osteosarcoma in my left femur. Put more directly: I had bone cancer. That diagnosis led me down a dark year that included nine months of chemotherapy and a 15-hour surgery to reconstruct my left leg.
At the time, my wife, Linda, and I were the parents of 3-year-old identical twin girls, and we were often overwhelmed with the everyday challenges of having a sick dad, a working mom and two preschoolers. We survived with help from many people. Our siblings organized an online casserole club, so friends could buy us dinner through a meal service. Grandparents rotated in and out of our basement. My high school classmates made a video at our reunion.
But as my friend’s query suggested, some gestures were more helpful than others, and a few were downright annoying. So at the risk of offending some well-meaning people, here are Six Things You Should Never Say to a Friend (or Relative or Colleague) Who’s Sick. And Four Things You Can Always Say.
First, the Nevers.
1. WHAT CAN I DO TO HELP? Most patients I know grow to hate this ubiquitous, if heartfelt question because it puts the burden back on them. As Doug Ulman, the chief executive of Livestrong and a three-time cancer survivor, explained: “The patient is never going to tell you. They don’t want to feel vulnerable.” Instead, just do something for the patient. And the more mundane the better, because those are the tasks that add up. Want to be really helpful? Clean out my fridge, replace my light bulbs, unpot my dead plants, change my oil.
2. MY THOUGHTS AND PRAYERS ARE WITH YOU. In my experience, some people think about you, which is nice. Others pray for you, which is equally comforting. But the majority of people who say they’re sending “thoughts and prayers” are just falling back on a mindless cliché. It’s time to retire this hackneyed expression to the final resting place of platitudes, alongside “I’m stepping down to spend more time with my family,” or “It’s not you, it’s me.”
3. DID YOU TRY THAT MANGO COLONIC I RECOMMENDED? I was stunned by the number of friends and strangers alike who inundated me with tips for miracle tonics, Chinese herbs or Swedish visualization exercises. At times, my in-box was like a Grand Ole Opry lineup of 1940s Appalachian black-magic potions. “If you put tumeric under your fingernails, and pepper on your neck, and take a grapefruit shower, you’ll feel better. It cured my Uncle Louie.”
Even worse, the recommenders follow up! Jennifer Goodman Linn, a former marketing executive who’s survived seven recurrences of a sarcoma and is compiling a book, “I Know You Mean Well, but ...,” was approached recently at a store.
“You don’t know me, but you’re friends with my wife,” the man said, before asking Ms. Linn why she wasn’t wearing the kabbalah bracelet they bought her in Israel.
4. EVERYTHING WILL BE O.K. Unsure what to say, many well-wishers fall back on chirpy feel-goodisms. But these banalities are more often designed to allay the fears of the caregiver than those of the patient. As one friend who recently had brain surgery complained: “I got a lot of ‘chin ups,’ ‘you’re going to get better.’ I kept thinking: You haven’t seen the scans. That’s not what the doctor is saying.” The simple truth is, unless you’re a medical professional, resist playing Nostradamus.
5. HOW ARE WE TODAY? Every adult patient I know complains about being infantilized. The writer Letty Cottin Pogrebin, who had breast cancer, is working on a book, “How to Be a Friend to a Friend Who’s Sick.” It includes a list of “no-no’s” that treat ailing grown-ups like children. When the adult patient has living parents, as I did, many mothers in particular fall back on old patterns, from overstepping their boundaries to making bologna sandwiches when the patient hasn’t eaten them since childhood. “Just because someone is dealing with a physical illness,” Mr. Ulman said, “doesn’t diminish their mental capacity.”
6. YOU LOOK GREAT. Nice try, but patients can see right through this chestnut. We know we’re gaunt, our hair is falling out in clumps, our colostomy bag needs emptying. The only thing this hollow expression conveys is that you’re focusing on how we appear. “When people comment on my appearance,” Ms. Linn said, “it reminds me that I don’t look good.”
Next time you want to compliment a patient’s appearance, keep this in mind: Vanity is the only part of the human anatomy that is immune to cancer.
So what do patients like to hear? Here are four suggestions.
1. DON’T WRITE ME BACK. All patients get overwhelmed with the burden of keeping everyone informed, coddled and feeling appreciated. Social networking, while offering some relief, often increases the expectation of round-the-clock updates.
To get around this problem, I appointed a “minister of information,” whose job it was to disseminate news, deflect queries and generally be polite when I didn’t have the energy or inclination to be. But you can do your part, too: If you do drop off a fruitcake or take the dog for a walk, insist the patient not write you a thank-you note. Chicken soup is not a wedding gift; it shouldn’t come with added stress.
2. I SHOULD BE GOING NOW. You’ll never go wrong by uttering these five words while visiting someone who’s sick. As Ms. Pogrebin observes of such visits, don’t overstay your welcome. She recommends 20 minutes, even less if the patient is tired or in pain. And while you’re there, wash a few dishes or tidy up the room. And take out the trash when you leave.
3. WOULD YOU LIKE SOME GOSSIP? One surefire tip: a slight change of topic goes a long way. Patients are often sick of talking about their illness. We have to do that with our doctors, nurses and insurance henchmen. By all means, follow the lead of the individual, but sometimes ignoring the elephant in the room is just the right medicine. Even someone recovering from surgery has an opinion about the starlet’s affair, the underdog in the playoffs or the big election around the corner.
4. I LOVE YOU. When all else fails, simple, direct emotion is the most powerful gift you can give a loved one going through pain. It doesn’t need to be ornamented. It just needs to be real. “I’m sorry you have to go through this.” “I hate to see you suffer.” “You mean a lot to me.” The fact that so few of us do this makes it even more meaningful.
Not long ago, I reached out to my friend’s sister, Amy, who had endured three surgeries in the previous six months for a tumor in the thalamus. She was undergoing physical therapy and had just returned to work. What most annoyed her, I wondered?
“I liked having the family around,” she said, referring to her six siblings and their five spouses. “But I had a lot of issues with my room seeming like a party and my not being in a place where I could be down if I wanted.”
The most helpful tip she got? “People reminded me that I had a free ‘No’ clause whenever I needed it. Especially as someone who tends to please, that was helpful.”
So in the end, what would she say to someone like her sister who leaned over and asked for advice?
“Fully embrace the vulnerability of the situation,” she said. “I would never have gotten through it if I hadn’t allowed people in.”
That even included a new boyfriend, who became so intimately involved in her recovery that she allowed him access to her innermost self. The two became engaged in the I.C.U. and plan to marry next year.

Bruce Feiler’s memoir, “The Council of Dads: A Story of Family, Friendship and Learning How to Live,” has just been published in paperback.