Friday, October 09, 2009
Unlike the Scarecrow of Oz
It appears that I have a brain. At least that is what the brain MRI I underwent today showed. It also showed no metastases. So a big Yay for Friday night.
An MRI is an interesting thing. Once again I couldn't have any metal on my body, so the sweatshirt with the grommets had to go, though I was given a heated light weight blanket to stay warm. I was packed onto a plastic platform connected to the MRI machine and my chest and arms encased by a wide cloth velcro seatbelt, and an open mask type of restraint for my head. The nurse gave me earplugs, placed disposable pillows between my ears and the cold plastic restraint, and put an iv into my right arm, so she could inject contrast dye into me for the last two MRI sequences. However, the first 20 minutes consisted of a series of MRIs that ran for varying periods, from 11 seconds to 4 minutes. Each MRI had its own distinctive resonance, some being deeper in tone than others, with most being a steady burst of noise and I actually fell asleep during most of the procedure (heck I was the mother of 3--I used to fall asleep at the neighborhood pool where there were loads of kids making far more noise than this machine). From time to time the bed pulled me out from under the MRI machine and then reinserted me, probably at a different stopping point each time so all areas of the brain could be mapped.
Before the last two MRI sequences, I was pulled out from the machine and the contrast dye injected. No noticeable effect like during the CT scan. Once again I fell asleep trying to remember some aspect of my days as a camp counselor at a camp named Camp Ladyglen in the early '70's in Grand Rapids, OH. Worthy of several posts on its own, but for me today, a wonderful soporific.
I was done and out the door and had to pass 2 hours before coming back for the next consultation with Dr. N, my medical oncologist who would read the MRI and tell me results. Took my dear friend and driver for the day, A out to lunch and we picked up the charm bracelet that was a group gift from my women attorney friends online at Delphi forums, and then was passed an enjoyable time visiting the Japanese garden in the Arboretum. Truly a pleasant afternoon, if you don't count the stress of waiting for the results.
Back to the meeting with Dr. N and he informed that I did have a brain and that it was clear of all metastases. Then we got down to business.
In response to my question about the New England Journal of Medicine article that I cited in my previous post, Dr. N explained that this study was done of palliative care and the cohort was Asian women. So there was some relevance for me, but not so much. In response to my question about why the recommended treatment now more closely resembled what he had initially proposed for the possibility of stage 4 lung cancer, he explained that my original radiation oncologist, Dr. C, was out of the office when the PET scan results came back, so he consulted with Dr. H and Dr. H was of the opinion that the treatments should run sequentially not concurrently. Dr. N said that once Dr. C was back in the office, he would consult again with him and once again the course of treatment could change. It could also change once I've obtained the second opinion from Dr. M at the Seattle Cancer Care Alliance. He stressed that he would be working collaboratively with everyone involved in my care and that it is and will be a fluid situation depending on outcomes. He recommends a ct scan after 6 weeks of treatment to determine whether there is shrinkage but he is not averse to doing it after 3 weeks, just doesn't think it will tell him much.
So, it looks like October 19 is D Day for beginning chemotherapy. I am also now scheduled for a procedure Oct 20 to install a port in my chest to facilitate the chemotherapy injections in the future. And there is a lung function test coming up plus some blood work, again as well. As I wrap up and turn over my cases to my attorney colleagues in my office, it seems that my dance card is not emptying out, but rather filling up with new sorts of appointments and deadlines.
The immersion is beginning. Let's hope that I can learn the steps required.