The PET Scan

Note: The above is NOT my PET scan. It's just for illustrative purposes.

My PET scan was today at 12:30. My friend and co-program advisor, D, was very kind and drove me to the appointment in Olympia. It served a dual purpose as we could discuss work all the way down and all the way back. Major distraction, which I never ever anticipated would be the case with work.

Once there the folks at Group Health were reasonably prompt, although a PET scan takes more time to prepare for than it does to administer.

I had to not eat for 6 hours, in order to lower my blood sugar. More about why later. But this meant I had no food or coffee (the worst) from the time I went to bed until about 3pm. Reminiscent of fast days when I was a Catholic. I don't miss that part at all.

PET scan headquarters was a large shipping container parked in the back parking lot of Group Health. This PET scan is mobile and is driven to a different site--not just Group Health-- in Washington each day. The technician, Tim, told me he travels between 1100 and 1600 miles to administer the tests each week. I asked him if he drove the truck too, and he laughed and said no they had a driver who transported the PET scan to a different location each night. They do it at night because there was less likelihood of the truck having an accident then. Turns out he is from Pittsburgh and a Steelers fan, but I tried not to hold that against him.

Tim drew some blood to test to make sure that my blood sugar was low. It was 113 which is midway between the way low score of 50 and the high score of 200, so I was good to go. He then injected a dose of radioactive sugar along with saline solution to make sure it all got into my bloodstream. I asked if the dose of sugar would help my hunger pangs and stop my stomach from its very loud rumblings. He laughed and said that the amount of sugar in the injection syringe was 1/40 of a treaspoon of sugar so it would take a lot. The body, all of it, needs sugar to perform its functions. I thought of each organ having hands extended out grabbing the sugar molecules as they circulated through my bloodstream. If my blood sugar was high the hands would not be grabbing--there would be no uptake of the radioactive isotopes that showed up on the PET scan--so it was good to be hungry. This radioactive sugar shows up brightly on the PET scan, and the sites where more radioactive sugar has been grabbed, will show up more brightly than those that don't have as many grabby hands. Cancer is fast growing and needs lots of energy, i.e. sugar, so cancer sites are very greedy; they will show up brighter on the PET scan than sites that have not yet been invaded. Cancer is the physiological equivalent of the mercenary troops of the Holy Roman Empire which sacked and looted Rome in 1527 because they had not been paid by their immediate commander, Charles III, Duke of Bourbon. (Completely OT: Hella Haasse wrote a wonderful book about this titled The Scarlet City)

I had to wait 30 minutes to make sure the radioactive sugars were fully circulated in my body before they could do the PET scan so Tim put several blankets over me to keep me warm (they have to keep the unit very cold to make sure the PET scanner does not overheat), and left me with the recliner chair fully extended to relax. As if. I was briefly overcome, contemplating my own mortality, and Tim heard my sniffles over the intercom and came in offering Kleenexes. At that point, I forgave him his misguided football affiliation. (vbg)

Then my waiting was over and I moved to the room with the PET scanner. And here is where some advice to those who have yet to undergo this is in order: Make sure your clothes have no metal on them!!! I had to take off all my jewelry, my bra which had metal hooks and my fancy sweatsuit which had metal in the zipper of the top and metal on the ties to the pants. Two flimsy hospital gowns plus blanket were not much insulation. So that meant really really cold for the scan, which Tim said took 20 minutes and felt like an hour

And of course, when I was in position for the scan, with my arms above my head, I got a cramp in my right shoulder. Figures. I shifted it ever so slightly when the scanner was doing my lower torso and managed to maintain stillness for the majority of the scan. I even dozed off briefly. Finally Tim came into the room and announced that I was done and could get dressed. Which I did and then we waited for another 45 minutes for a copy of the scan to bring to Seattle Cancer Care Alliance, for a second opinion. Group Health offers this service, and I applaud them for it. SCCA is NCI approved and I've always been told that it is good to get a second opinion, no matter the operation/diagnosis. So now there is a copy of my scan in my briefcase, that I have only the faintest desire to open up and put in my computer (if it would take the disk, which it probably would not) to see if I can spot the bright spots. Uh...not so much. I will wait until Thursday when I meet with the medical oncologist for a followup. My daughter will go with me and either way, I know I will cry.


Now to curl up with a good book.