How Far the Cancer Has Spread

I had the PET CT Scan this morning. As Ruth suggested, the PET could've stood for Pretty Easy Test. It was much easier than the MRI.

First I met Pat, the nurse, who did a good job of explaining what would happen and what she needed from me. She stuck me and attached a gadget to control the flow, and started an IV; the water coming in would tell her whether the flow from my arm was good. She took some of the blood in the tube after the IV was established to test my blood glucose level. She said that, if it was 200 or over, we would say goodbye right then and there. Fortunately, it was 128.

Then she brought out the radioactive isotope (glucose), and put that into the IV tube. The only thing I had felt so far was the prick of the needle to start the IV. Then she left me for an hour, covering me with a heated blanket. "Don't talk on the phone," she told me, "but you can play games on your phone, anything like that." She then chatted with me about how she had gotten hooked on Angry Birds. During this long period of time left alone, I could've taken a nap, but she came back before I realized the time had gone by, and moved me to another room. I was urged to clear my bladder before I went in.

In the other room with the big, long MRI tube taking up most of it, I was told to partially undress (bra off, top still on, pants off, socks on) and slip into a gown. I then lay on the narrow plank, with my head on the pillow. She then placed a foam rubber pillow over my forehead, to keep it in place, I would guess.

"Your job," instructed Pat, "is to stay perfectly still. Don't hold your breath; breathe normally. This will take 21 minutes." This seemed easy enough until she placed my arms above my head, a most awkward way to relax.

And so I lay there as the machine moved me back and forth through one end and out the other, and back again. I noticed the whirring mechanism at one end, and so I assumed it was the business end.

This is the machine, the test, which will tell the doctors how much the cancer has spread. Whether it's reached the lymph nodes or not. Pretty important test. The insurance paper said the order was for "Pet Image with CT, Skull - Thigh." That's a pretty long scan.

20 minutes went by fairly quickly. I got out with her help, got dressed, saw the receptionist who offered me cookies. I don't turn down cookies, even for breakfast. Come to think of it, the radioactive isotope was breakfast. Helluva way to treat a diabetic, either way.

Telling the Relatives

I have dreaded making three phone calls. Two to nephews, one to my brother.

I talked with Ricky yesterday. Rick and I have always been close, although not as close in the last couple of years. He lives in Coronado, the beautiful island where I grew up. (I'd say "idyllic," except that the island population tends to go Republican.)

Rick took it well. He did say "oh, no" when I started the conversation. I think if I keep him informed, he'll be just fine.

Scott is a totally different nephew. The guy should have been a doctor. He knows so much about medicine. And I don't think it's "fake" knowledge, but some real knowledge there. He himself is flirting with lung cancer, as there's a tumor in one lung, but nothing more has developed about that. It looks like surgery at some point. If Scott had his way, he'd wield the scalpel himself.

So Scott was very understanding, very soothing. We talked a bit about medical procedures during the pre-Oscar festivities last night, and he seemed to think I was at an early stage (a diagnosis confirmed by my GYN this morning). I texted him this morning and he called me (he prefers the phone, which I do not), but I was having lunch with Jamie at that point.

I haven't worked myself up to calling my brother yet. I'm not quite sure how to predict what will happen there. When you're in a conversation with him, it's hard to get a word in. He will tell me where to go, what to do, I think. He's had some experience with cancer treatments, although I really don't think he ever had cancer. He was suddenly "cured" a couple of years ago, but that didn't save him from MRSA, the bacterial infection, from which he's still recovering.

It's sort of like Judaism. You can't be Jewish all by yourself. When you have cancer, you have to include everyone with whom you're close.

Good News about Cancer, If There Is Such a Thing

Dr. Poddatoori called me this morning. My gynecologist is back from vacation.

She doesn't seem to have access to all the medical records from the oncologist, but she did repeat that surgery is March 9th, and that she will be there for that.

She had some really good news for me. Mind you, this is before the results of the PET CT scan are in, and before the pathologist in Alta Bates takes a look at the uterus and lymph nodes he or she is handed. She said that an uncomplicated hysterectomy will mean that I will only be in the hospital for two or three days. Can you imagine that? So that's what we'll hope for.

If there's extraordinary bleeding, or, of course, more is found by the pathologist, the stay will be longer. She did state that it will take 6 to 8 weeks to recover.

She believes me to be in Stage 1B right now from uterine cancer, which means that recurrence is very low. Again, that's without knowing the whole story, which they will discover at the other end of the scalpel.

What wonderful, informative doctors I have. I couldn't wish for a better scenario.

Rabbinical Blessings

Two rabbis this weekend (not counting my sweetie) wished me well this weekend. Rabbi Straus, with whom I've had maybe two words so far, took me aside during Saturday's oneg to ask me how I was doing. We both had a bitter laugh over the fact that I feel just fine and that I'm going into the hospital to "feel shitty" (to use his words). He told me that he was going to offer me an aliyah today, but when he saw my name on the Mi Sheibarach list, he declined. I'm so glad he did not do that -- I would have panicked! But it's nice that he now knows who I am and said some wonderful words.

Rabbi Chester called me on the phone today to talk about my illness and the Oakland A's. Okay, both the A's and I have an illness. When I said, "But we now have Manny Ramirez!" he laughed, which is what most baseball fans are doing right about now. Manny can play on May 30th. I'm hoping I can play sooner than that. It was so nice for Rabbi Chester to call, even though he's in retirement. I guess you're still a mensch, if you are, even in retirement.

I'm mentally putting together a bag for Ruth to take to the hospital a couple of days after my surgery. My G-Slate tablet will be in it, plus my phone. I've talked to three people about smuggling in cupcakes; they're the perfect food, don't you think? I'm not much of a book reader (especially on morphine), but I think I will want that new book I just ordered about the teenaged Jewish photographer in World War II (A Partisan's Memoir: Woman of the Holocaust, written by Faye Schulman). Don't you think that the publisher added that second title?

I have to go now and prepare to watch the Oscars. It's not much preparation: just sit down in the chair with my bowl of popcorn and turn it on. But I have to watch the pre-Oscars stuff first, you know, where they dis the gowns, etc. My prediction for the winners are: George, Viola, Chris, and Octavia. As a non-paid semiprofessional movie reviewer, I'm on a first-name basis with them, you know.

Date for Surgery

I finally have a date for surgery: March 9th.

It's the day before Ruth's birthday, but neither of us feels like celebrating, early or otherwise. Funny how that works. But it's a good day as far as her schedule goes, and it's good to finally have it on the calendar.

In the meantime, my GP, Dr. Laura Miller wants to me to come in to discuss things. I'm not sure why. In fact, I will have 3 medical appointments before the surgery: my PET CT scan, which is still going on as planned on Tuesday, the meeting with Dr. Miller, and my pre-op appointment with Alta Bates.

I have to go now. We're having dinner at an ice cream parlor. Because, I guess, life is too precious to waste on real food.

Waiting...but Planning

As I wait for the PET scan, I am making things happen. I have arranged for a dog walker, who started yesterday, and a cleaning service, which starts next week. I am finishing the taxes (can't hurry those K-1's along, though), and am mailing two out to the CPA today.

I have relaxed a little bit. Last week I was 50-50 that I was gonna die. Now it's only at 20%. My friend George says I should have a positive outlook, that that will help. I will have to talk myself into that.

Claustrophobia Would Be Very, Very Bad

The oncologist's office called this morning to say that the insurance (finally) approved the PET CT scan, and asked me to schedule it. So the surgery is delayed until the results come back from the PET CT.

So the PET CT is scheduled for next Tuesday morning. It will take approximately 2 hours. From what I've read online and from what others have told me, they will inject me with radioactive material, let me sit there for an hour, and then send me through the MRI tube.

As usual, the scheduler asked me if I had claustrophobia. I told her I had just been through the MRI two weeks (more information than she wanted, I'm sure), and that it was a good thing I wasn't claustrophobic. I could see how that would be quite frightening. I have a friend of a friend who just went through one and she's claustrophobic; thankfully, her friend (my friend) sat with her and held her hand during the entire open-air MRI. Now, that's a good friend.

The oncologist, Dr. Stern, should have the results by the next day. And, I imagine, that's when Shirley will be asked to schedule the surgery.

It looks to me like we're looking at mid to late March for the procedure.

In the meantime, I'm cleaning up around home, making lists of things, trying to get the tax prep all done before that date. And when I get the date, I'll start telling people.

I told one friend today, George, and since his wife has had multiple cancers, he had some good advice (he always has advice) and some kind words. We're working on our retiree newsletter together, and this one will be the last issue for quite awhile.

Devastating News

We met with Dr. Jeffrey Stern, the oncologist today. When I mentioned that the insurance company still had not okayed the PET CT, he said he wasn't surprised; they didn't have definitive proof that it was cancer. However, Dr. Stern is convinced (as is that radiologist, somewhere).

He didn't tell me much that I didn't know. But the way he said it, his demeanor, gave me all the info I needed. It's terrible news, and I'm facing invasive surgery. They'll take out more than just the uterus and ovaries. There is muscle mass plus several locations of lymph nodes in the abdomen and legs to be removed.

Here are Ruth's notes, taken during the meeting with Dr. Stern:

Dr. Stern says that the MRI shows a cancer invading the uterine wall. He recommends a hysterectomy plus removal of any affected lymph nodes in the pelvis and higher if need be. The cancer is uterine cancer.

This surgery will require two surgeons, four hands. Incision will be to the belly button.

They will send the uterus to the pathologist during the surgery, and they will tell us the depth of invasion. Should it be necessary the surgeons will use fatty tissue to rearrange things in the pelvis to make the best arrangement for effective radiation therapy. We won't know about that until they get in there.

Post op radiation therapy will be necessary only if the lymph nodes are positive or if there is cancer close to the margins. He said that this cancer, if it is confined to the uterus, is mostly cured by surgery.

His office will contact Dr. Laura Miller and she will coordinate.

We received pre-op and post-op instructions. He said to bring them to the hospital with us.

One piece of good news: the blood test was OK, which points to a likelihood that the cancer is not pervasive.

The delay on the PET scan is probably due to the fact that before the MRI the cancer diagnosis was somewhat unclear. Now the insurance co's approval should come through shortly.

Shirley, in Dr. Stern's office, will schedule the surgery and notify us by this coming Wednesday.

I signed all the papers. Surgery will be around March 1st. No date yet, but I'll find out when Shirlee is able to match everyone up. I can think about little else.

The Diagnosis Is Getting Clearer

I've sat on the news for a full day now. I find it quite unsettling.

The truth seems to be that, not only do I have uterine cancer, the cancer has spread to the muscle beyond that. I don't know much more than that.

If the insurance company ever gets off its you-know-what and approves the next step, the PET CT scan, we'll find out how much it's spread.

And if that news wasn't devastating enough, the incision across my abdomen will be large and my recovery slow. I have stopped planning things for the future, you know, like trips where I have to leave town. Who knows when I'll be able to take a journey again?

Mass Hysteria

Dr. Poddatoori called me this morning. It's Sunday morning, for heaven's sake! I have the most fabulous gynecologist.

She had been out of town with a family emergency, and hadn't kept up with what was going on with me. Dr. Stern's office had just sent her the MRI results. And she basically interpreted that for me, saying that the cancer had gone into the muscle mass. And that surgery will probably be removing muscle as well as the uterus and perhaps lymph nodes.

The PET CT will tell us, she said, whether the lymph nodes are enlarged or not, and whether it's spread. But, as I reported to Dr. P, the insurance has yet to approve the PET scan. And it's been two weeks already, when usually it takes a week.

I will be seeing Dr. Stern, the oncologist, this Thursday. I promised to call Dr. P that afternoon to tell her what was discussed. I don't believe we'll have the results of the PET CT, however, so I kind of wonder whether this is one meeting short of a full decision.

We wait on, but it sure doesn't look good.