18 January 2012

PET Scan

Chemotherapy Round #9: Wednesday, 28th December 2011 - Tuesday, 17th January 2012

Everything can change in an instant.

Well, not really, it just feels that way. Like when I was diagnosed back in June... the doc's best guess was that the cancer had started a year earlier, so it wasn't actually overnight... it just felt like it.

After my CT Scan in early December, when it was thought that my cancer was stable & Herceptin would hold it that way, my life started to slowly change. I started to get my strength back without the chemo knocking me down every three weeks, I planned to go back to work when my office reopened January 3rd, and I spent a lovely Christmas with my siblings. Then in January, actually going back to work was a bigger change, but one I was coping with. And then I finally got the PET scan that Dr. Katakkar had referred me for booked, for Monday 16th January.

Then, the Thursday afternoon 12th January, there was a message on the machine: they were cancelling the PET scan. Had to rebook for the next day, Tuesday 17th January. It cost nearly as much as the original airline ticket to reschedule, but I managed. Then Tuesday morning, after dropping me off at the airport, Sterling came home to another message: they wanted to cancel that day's appointment! Fortunately when they couldn't get a hold of anyone at my house, they called the local cancer agency, who read them the riot act & told them I was already on my way, and they'd better find a way to keep my appointment.

I got to Vancouver fine. My Dad flew in from Calgary to come with me to the appointment. We met up in the airport, took a stretch limo downtown (Dad was spoiling me) to get Dad checked in to his hotel (he stayed over to take a number of business meetings the next day, while I was flying home that evening). From there we took a cab to the BC Cancer Agency in Vancouver. I filled out the prescan questionnaire & signed the six page consent form for the contrast injection. My appointment was at 1:15PM and about that time they called me to come back - Dad wasn't allowed to come with me, so we said goodbye in the waiting room & he said he'd be back in 2 hours or so, when the scan was supposed to be over.

Unfortunately, the technician & I hit a small snag. While going over my forms, we had a discussion about the "Are you menopausal?" question. At 33 that should be a firm no, but one of the less-publicized side effects of chemo is that it puts you into menopause - I've had one single surprise-period in the last six months. However, given that one period, there was a teensy-tiny-highly-unlikely possibility that I could be pregnant (instead of menopausal). So the technician went to discuss with the doctor, and came back to tell me they had decided I had to have a pregnancy test to rule out that tiny possibility before they could inject me with the contrast. Up to the 3rd floor we went, where I was introduced to a student-mind-if-I-try-to-draw-your-blood? Being the nice little guinea pig I am, I consented. She managed to get the blood out of my left arm, but I have a serious bruise there - her technique still needs a little work.

Once my blood was drawn, I went back downstairs to wait for the results (not available until 2:30PM). Glad I left oodles of time when booking my flight! Around 2:30PM I noticed a bit of commotion, and lots of whispering. Eventually the doctor came in to explain. The pregnancy test came back slightly elevated, causing the stir. The doctor explained that because of the type of cancer I have, and the fact that the test was only slightly elevated/borderline, he was pretty sure that it was the cancer causing a false positive, and so he was comfortable going ahead with the scan. Thank goodness - if he'd told me I'd come all that way for nothing, I would have been pissed! To his credit, he did apologize for the delay & for making me take a test that turned out to not really give them any useful information.

At this point they let Dad (& his friend Jane who'd come to meet me) come back to keep me company for the ten minutes or so before they could inject the contrast. It was good to be able to update Dad on what was going on - the technician said he'd been pacing back & forth wearing out the floor in the waiting room. We had a nice little chat, before they had to leave, before the radioactive contrast was brought in. OMG it looked like a doomsday device! A giant lead contraption enclosing a little vial. The injection went quickly, then I had to lay quietly for an hour while it circulated throughout my body. Once that was done I changed into a hospital gown & was taken for the actual PET scan. It takes about 18 minutes to be run through the machine, scanned from mid thigh to neck, and you have to lay perfectly still with your arms over your head. It's amazing how twitchy you feel as soon as you're told you mustn't move. I was also a little claustrophobic - like a CT, the machine is a giant doughnut, but a much thicker one, I felt much more encased than with the CT.

Once the scan was over, I was given a letter for the airport, because I was still radioactive & might set off their scanners (as it turns out, I didn't, which doesn't fill me with confidence in the screening procedures). I changed and Dad I took a cab to the airport. We had dinner in the White Spot there (I wasn't allowed to eat all day before the scan, so was pretty hungry, it was 5:30PM - although Dad was thoughtful enough to pick me up a rice krispie square for right after the scan, which I'd devoured at first opportunity - it really hit the spot). Then it was hugs goodbye, I cleared security (without setting off the alarms) and went to catch my flight... which ended up being delayed 2 hours. Grrr! Didn't get home till 10:30PM.

Today (Wednesday) I was scheduled for bloodwork at 8AM because I was scheduled for my third Herceptin-only treatment tomorrow. The nurses managed to reschedule my 10:15 doc appointment to be in the afternoon when the PET scan report would be ready. I went to work for the morning, and tried to distract myself. Sterling came to pick me up for lunch, after which we went for my doc appointment. Waiting in that little room, we were very anxious. When you've waited weeks already, why do the last few minutes feel so long?

Finally Dr. Katakkar came in. You know it's not good news when your oncologist sits down on the bed next to you and puts his arm around you. He'd been hoping that the scan would show that my cancer was now operable, but it's not. In order to be operable, active cancer has to be restricted to just the omentum and the stomach itself, both of which they can remove. Instead, the PET scan showed I still have active cancer at multiple other sites throughout my abdomen: on the outside of my bowels, and on a ligament that runs between the stomach and the liver, for example. This is very disappointing for everyone. I have to go back on full chemo. Another three rounds, we'll do another PET scan, which will hopefully show improvement over this one. We're not going to bother doing the CT scans anymore, because they obviously don't show enough detail. Dr. Katakkar is very sweet, tells me to keep my spirits up: it is still his goal to get me into remission.

Driving home, Sterling & I talk. We are both more OK with this news then we would have expected. The truth is, I've had pains in my abdomen for about a month now. I did report them to the other doctor, at my last appointment, but at the time she thought it was highly unlikely they were cancer related. So many things can cause gut pain, and I'd just had a stable CT scan less than a month earlier. I tried to talk myself out of the pain, tell myself I was being a hypochondriac. But the pain has gotten worse in the three weeks since that doctor's appointment - it hasn't reached anywhere near what I was having when I was diagnosed, this can still be handled by a couple Tylenol or Advil. I think part of why I'm not more upset about this news today is that part of me is glad to know it wasn't just paranoia. Turns out I know my own body a little better than I thought. Some part of me knew something was wrong, that the Herceptin alone wasn't getting the job done. So Sterling & I were both bracing ourselves for even worse news today: that the cancer had spread to my bones, or somewhere else that would equal "no hope". Hope, even a small one, is important, and we still have it.

After dropping Sterling off at home, I had to start sharing the news. I went back to work to tell them & try to tie things up as best I could. I felt so bad - barely back two weeks & now I have to leave again! I was just starting to find my stride again. Sigh. But they were all wonderfully supportive, as they have been throughout this whole ordeal. Tonight I spent on the phone, calling family & friends. Again, I am overwhelmed by everyone's love & support. I am so blessed that way. I tells ya, if love could cure cancer, I would be cured a hundred times over by now. Thank you all.

Chemo Round #10 starts tomorrow. Tomorrow night at this time I will once again have a baby bottle full of poison dangling around my neck. It's discouraging, but what can you do? Soldier on. And hope. Always hope.