Friday, January 8, 2010

Tests, oncologists and good news

Yesterday was a medical day for my family. My mom had two appointments and I had two tests. We met for a nice dinner afterwards.

Mom
The news for my mom is pretty good, all things considered. She got a post-surgery clean bill of health from Dr. P (gynaecological oncologist). He doesn't need to see her any more.

During her appointment with Dr. C (urological oncologist) yesterday afternoon, he diagnosed cancer of the ureter as confirmed by her surgery biopsy, and said there may be another type of cancer crawling up her ureter towards her kidney (described as a carpet-like growth). As a result, he recommends surgery to remove both the kidney and the ureter - as soon as possible. Since he's now booking for the end of March, Dr. C is going to have to bump someone else's surgery to get my mom in.

While he has her open, he's going to look around, examine all the lymph nodes he can see, etc. Based on the current information, the surgery is the only treatment she'll need. Unless Dr. C sees something unusual when he has her open, she won't need chemotherapy or radiation treatment. It's the operation and she's done. Yippee!

Now it's not going to be an easy operation and she's expected to be in the hospital for five to seven days. But overall, that's great news! I think every member of my family was extremely relieved after yesterday's appointment.

Me
Since I have the BRCA-1 gene mutation and my risk for developing breast cancer is extremely high (about 45 per cent after my hysterectomy and ovary removal, which cuts the risk in half), I now need regular and complete breast screening. So yesterday I had my first ever breast MRI.

Magnetic resonance imaging (or MRI) is used to create images of the internal structure and function of the body. Very simply put, the machine uses powerful magnetic fields to align the hydrogen atoms in the water in the body to create an image. Sometimes a contrast is used to enhance the appearance of blood vessels, tumours or inflammation. An MRI creates a much greater contrast between the different soft tissues of the body than computer tomography (CT).

As a slightly claustrophobic individual, I expected to be freaked out when sliding into that little tube. But it was better than expected (and I kept my eyes shut). The tube was shorter than I thought it would be and open at both ends - so I didn't feel as though I was being slid into a crypt.

I knew I'd have to stay still and that it would be noisy, so that wasn't a problem, except when a body part would started to itch. But let me walk you through it.

For the first part of the MRI, I had to lie on my back with my head in a cradle and my knees supported by a pillow. The technicans then placed padded restraints around my head, neck and chest (including my arms positioned at my side) so I was completely immobilized. But that portion of the test was only about 10 minutes, so it wasn't too bad. Although, the inside of my left ear started to itch part way through the test.

Then the technicians reconfigured the bed for the second part of the test, which involved me laying on my stomach. My belly rested on a slight incline and my head lay in a pillow similar to ones on massage tables. I had to open my hospital gown at this point (thank God the male technician left the room) and place my breasts into two wells with my breastbone resting on a brace. So my entire upper body weight was supported by my shoulders (with my arms straight down at my sides) and the middle of my chest.

Part way through this scan, a technician injected me with a constrast through an IV in my arm. It felt cool at the injection site, but that's it.

This test took about 20 minutes. While I didn't find it hard to lay still, as time went on, my breastbone started to ache. It felt as though my body was resting on a bare piece of metal, even though the brace itself is padded. I breathed, tried to relax and thought of calming, beautiful images throughout the test (beaches, vacations, nice places I've been, the spa at Port Franks, Cuba, etc.), which really helped.

After the MRI, I felt light headed and dizzy, and Michael said I was pale. My breastbone still feels bruised today. But it's a small price to pay for a comprehensive look at my breasts to ensure there are no lumps.

As for the noises the MRI makes, I have to admit, they make me laugh. I expected one consistent loud noise. Nope. It's a cacophony of sounds. One would start and then one or more would join in (at different paces and pitches). I heard thumps, muahs, dings, bongs and fire alarm bells. I could even feel some in my head and belly. Every once in a while, they'd stop for a few moments and then the discordant sounds would start again.

Now, after yesterday's experience, I have a bone to pick with medical shows like House. None of their patients are strapped onto the MRI bed, the show doesn't indicate the loud sounds made by the machine change and have different rhythms. But then again, I guess that doesn't make for good TV.

After my MRI, I had a mammogram. My breasts were positioned and squished in between plastic plates and images taken. But after the MRI, this was a piece of cake for me.

So, two tests down. I see Dr. B, the breast specialist on Jan. 20 to discuss the results of these tests and go over my options. My CT scan is Jan. 25 and I see Dr. W on Feb. 2. These appointments, along with my mom's upcoming surgery should keep me busy (and possibly out of trouble) for the next little while.

But overall, I feel optimistic about it all. Hopefully these good feelings bode for good results all around.

Tina

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