A Weighty Matter

This is sort of an addendum to the last post, but not really. Sorta, kinda.

I've been eating a lot. I've gained 20 pounds, exactly, since last August. And I know exactly why, or at least I do now. I didn't over the last several months.

Worry, stress, all over this medical thing. Do I have cancer, or don't I. What has to be done. Sometimes the tests are more onerous than the surgery. Being poked and prodded, suffering invasions and pain. It took a while for me to report, and now, some three months later, I'm still waiting for the solution.

So I'm eating my way through California. Actually, it's mostly sugar I'm eating. My nemesis, my addiction. This cancer thing isn't exactly eating me alive; rather, it's the other way around.

Still, I have to think of the colonoscopy I just had today (one less thing to worry about, DONE!) to get on the proper weight training track. I just cleansed my system. I hope to take advantage of that.

And if we ever get around to having that uterine- and ovaries-removing procedure, WHAM! I'll instantly lose, what, 10 pounds? At that point, I'm almost even for the year!

A Heavy Shadow

Medical stuff takes a long time. Have you noticed that? Due to my commitments and Dr. Stern's journey to Japan, I can't get with him face-to-face until two weeks from now. However, my regular GP, Dr. Laura Miller of Lifelong in Oakland, called me a couple of times and left messages.

This last time was Friday night, and she said she was seeing a lot of paperwork with my name on it come through with test results. On Monday morning, I promptly called her to see if she had the results of the MRI. I had been waiting weeks and had heard nothing. She did. She hesitated in revealing what was on the report, but she kept repeating that it was a topic of "great concern." Over and over. Rather than leave me there, however, she called Dr. Stern's office and practically insisted that someone in his office, one of his staff, call me and tell me the results instead of just leaving me hanging there. And so they did.

Stephanie called to tell me that the radiologist reported that there was a "mass inside the uterus...suspicious for endometrial cancer," or so it was interpreted by Stephanie when she told me over the phone today. It's too large for a fibroid, she followed.

So, what does that mean. It means.... it's time for another test! This time it's a PET scan, similar to the last MRI I just had, only with radiological material (glucose) instead of contrast material inserted into my veins.

What did we ever do without the internet? According to RadiologyInfo.org, PET stands for Positron Emission Tomography, which is "a type of nuclear medicine imaging."

Small amounts of radioactive material are injected or taken orally or inhaled as a gas, accumulate in the organ or area of the body being examined, and help in diagnosing diseases because they're able to pinpoint molecular activity within the body. Radioactive emissions from the radio tracer are detected by a special camera that produces pictures and detailed molecular information.

The PET scan seems to be quite different in how it works as opposed to the MRI. The CT produces "excellent anatomic information," while the PET scan measures "important body functions, such as blood flow, oxygen use, and sugar (glucose) metabolism, to help doctors evaluate how well organs and tissues are functioning."

Stephanie went on to tell me the PET scan will aid in identifying cancer in the uterus, specifically that mass, and whether it's spread and where.

We are now awaiting clearance from my insurance company, which takes about a week. Megan will then call me with phone numbers, etc., by which to make the appointment. I'm going to make sure this one happens soon. After all, it would be optimal if we could get all the tests done and results in by the time my appointment comes up with Dr. Stern in mid-February.

Modern Dentistry and How It Relates to the Phantom of the Opera

At the end of my dental appointment yesterday, I asked if I had another appointment. Because, I said out loud to the receptionist/scheduler, there's always more work to be done.

I just had a crown put on. The amazing part, to me, was that they have their own lab, and the crown only took about 20 minutes to manufacture. This, after waiting two weeks at my other dentist. Which meant that they had to pound off the well-secured temporary -- double the trouble. So I'm really pleased about that.

The surprising part is that the dentist, Dr. Binh, used dental software to figure out how the crown should be shaped (the photo to the right is actually him and a visualization of my changing tooth). It was an irregular shape, due to the fact that my previous dentist left some real tooth there. So the new tooth would look like the Phantom of the Opera's face: half real face (tooth), half mask (porcelain crown).

I can really get used to this kind of modernization. What I'll never get used to is the time every appointment takes (2.5 hours this time), and, of course, the cost.

P.S. Every time I go into a medical workshop, or whatever medical, they always ask when my last dental appointment was, my last optometrist's appointment, etc. Medical professionals have finally caught on that it's all interrelated. If I have rotten teeth, it's going to figure heavily into my health.

A Picture of My Uterus, Suitable for Framing

I went to the MRI last Wednesday at the Imaging Center on Telegraph in Oakland. it's the same place that sees my breasts every year, so I knew exactly where to go. And going at 8am helped us find parking, although, as usual, the parking lot was still pretty full.

First, we got a runaround. I came in, presented my paperwork, and without looking anything up, the receptionist told me that I was in the wrong place. She told us to go to the Alta Bates Herrick Campus, the same place where the oncologist's office is. However, we turned to go back to her, as Ruth wanted an exact address, and found out that she had been on the phone with them; she subsequently discovered that I had no appointment there. When I asked her if she was sure we didn't have an appointment at her place, she looked and, voila! there was my name. Lesson Here: Don't always trust what they say.

Shortly after that nearly tragic snafu, some tech named Bill came in and told me to take my pants off and put scrubs on. He whispered to me, "Are you wearing a bra?" When I said yes, he whispered back to me to take that off, too, but keep my shirt on.

After sitting there with half of the pajamas on for 10 minutes, Bill finally came and got me. He explained that I will have an injection about half the way through the MRI. I understood that to be the dye for the contrast part of the x-ray.

The automatic roller took me into the tube. I have been in this chamber before. It's rather tight, so I have to pull my elbows in and rest my hands on my chest, but I'm not supposed to rest them on the plastic platform they've placed over my pelvis.

I was amazed at how long I was in there. I couldn't tell time, but the whole process took an hour, so I would guess a good half an hour. I learned what noises represented repositioning and what noises were about the x-ray itself being employed.

So, about half an hour later, they rolled me out. I met another tech, probably a nurse, who gave me an injection -- which I barely felt -- and told me I would have to hold my breath for 20 seconds. 20 seconds seems like an awfully long time. I could hear him through the earphones as he would tell me, in a thick accent, "Okay, hold your breath now!" I had to do this three times, with a minute in between to literally catch my breath. The second time, I couldn't hold it the whole time, which is just ridiculous. I obviously thought it would be easy. But the third time I got it, and he said it was all done.


They handed me a CD on the way out. Bill didn't explain it, but I supposed it was pictures of the MRI images. Yep. Except that the software provided on the disc was a million years old, a 0.3 version instead of the current 3.4 version, and so it wouldn't download.

I hired Neil, my Mac guy, to come out and help me with it. He downloaded the software from the OsiriX website. And then the pictures started coming up. Black and white, hundreds of them. I have reprinted some of them here.

I can't interpret these pictures. i can occasionally pick out intestines, a bone, but don't know what those big, round blotches are. But isn't it fascinating?

More Tests, Always

I went to the oncologist last week, Dr. Jeffrey Stern in Berkeley. Everywhere along the way each person told me that he was the best. I kinda wonder how they would know unless they've been under his knife before. And I doubt that. But it does tell me that Dr. Stern has a great reputation.

Dr. Stern recommended two additional tests, a blood test and an MRI. Each will not tell them definitively if I have cancer in places they haven't biopsied, but they are additional tools to tell them what to expect once they open me up during surgery. As Dr. Poddatoori explained, the biopsies told them pretty much what to expect INSIDE the uterus, but nothing has told them about the outside.

If both tests are negative, I can reasonably expect a small incision during the hysterectomy. And I will go home from the hospital the next morning. If the tests are positive, or when they open me they find cancer, or that it's spread, I can expect a larger incision, more things like lymph nodes taken out, a longer recovery time, and possible side effects later on (like problems with my legs, for example, from the removal of lymph nodes). It's hard to think about that possibility, so for now I'll just do the tests.

I did the blood test the next day. Once that was taken care of, they would schedule the MRI. Only, it turns out, they don't schedule it, I do. I got a phone call from Dr. Stern's office this morning, telling me to schedule the MRI with the imaging center on Telegraph, a place I've practically dated over my many mammograms. After two phone calls, I got someone who told me they hadn't received the fax. So, again, scheduling problems. I'll have to wait a little and try again.