PET Scans, and CT scans, and naps! Oh My!

On Saturday we left our boy with his Nana and Papa and headed on down the road to Houston. Sunday Jason, his dad, and I went out to Galveston to Moody Gardens to see the holiday lights, ice sculptures, and other attractions because we obtained some promotional tickets and it was the last day for the holiday displays. If you haven't been there, you should go, even if it's not the holiday season. Year around the aquarium, rain forest, and other attractions are always open and a whole lot of fun! I need to give a shout out to our local NPR station for hooking us up with promotional tickets. We were a bit stressed out because this is a big week for me, so the fish, animals, and holiday festivities were quite soothing.  The next time you write your check to your local NPR station, please keep in mind that stations do a bit more than educational television and radio, they help people in so many ways!

When we woke up on Monday morning, Jason started to get nervous about whether insurance was going to pre-approve the two scans this week, the PET and the MRI, so he called MD Anderson to check on the status. Turns out both approvals had come through, but he asked what the estimate would be if they had not approved and we were paying out of pocket. The answer was $26,000. Take a moment and take that in. A person who has cancer requiring surveillance (which is most cancers) and who does not have insurance, medicare, or medicaid is billed $26,000 for the scans. There is something seriously wrong with healthcare in this country and it's not the ACA. The ACA actually has helped me personally (and probably you too) because it did away with things like preexisting conditions and annual or lifetime caps on claims. In addition, it is no longer the case that unpaid medical bills can be used against a person's credit, which would have previously led to bankruptcy for many individuals and families. I'm very fortunate to have found myself in this situation after these protections were in place, but let's all hope that these provisions are not changed back to how they were before.

After hearing the news that we were going to be covered for these very crucial scans, we decided to go walking for exercise. Five miles later, we got back home and I was ready to eat someone's arm off. I couldn't decide if I wanted to eat my own arm or Jason's, but I was pretty sure I didn't want to just choose any random person on the street.

Knowing that Carnitas were what would satisfy my grumbling tummy, I convinced Jason to take me to my favorite Mexican place in Montrose, El Tiempo Cantina. They take good care of me by replacing the rice and beans with grilled vegetables. There are two inside the loop. I like the one with the upstairs on Westheimer, mostly because I've been able to sit upstairs multiple times and Jason hasn't ever done that. He gets rather vocal and jealous about it. After all, he's from Houston and once lived in Montrose years ago so the idea that I'd get to sit up there so often and he never has, just doesn't sit well with him. So...we went and I asked to sit upstairs. The lady said no problem. That concludes my mission to be the answer to all of Jason's dreams! I've given him the best and funniest wife for 18 awesome years, the most amazing child he could ever wish for, the opportunity to live in Lubbock AND Houston, and now a view of Montrose from the upstairs of El Tiempo. What more could he ask for?!

Once well fed, I had to get home to prepare for today's PET scan. On the schedule, the PET was scheduled for 7:30 AM and 1 PM. When it was first put there weeks ago, I contacted the nurse in the clinic to let them know it was on there twice. Turns out the PET scan is coupled with a CT scan and they do it in two parts. In my neuroscience studies I have read lots about PET, but I'd never had any actual experience with nuclear medicine. All I knew about the actual mechanics of the procedure going in was from the scene in The Exorcist movie, that was probably one of the more disturbing scenes. In that movie, they put the contrast in through the carotid artery in the neck. That was the only visual I had for this procedure and, quite frankly, it scared the hell out of me. I got a call from the technician the afternoon before, telling me to not eat or drink anything after midnight except plain water because they don't want your cells to be metabolizing anything when they put in the fake glucose. They also instructed me to eat low carb the day prior, which isn't a problem since I've been low carb since March, 2016.

When I woke up at 5:30 AM to make it there by 7:30, I was starving and in serious need of coffee. Luckily, no one was seriously injured on the drive to the facility. Because the scan was listed as 2 parts, I was concerned that I wasn't going to be fed until late in the afternoon. Turns out, as we were told after we checked in, I got to eat after part 1. So, already off to a better start than expected. I was taken to a small room where I was prepared with an IV in my arm (and not my neck, as I'd feared) and they tested my blood glucose. I had tested it myself a couple of hours prior and it was 92, which was a bit high for me (I try to stay in the 80's or lower). His measurement straight from the vein was 86, so another success! The technicians then gave me the radioactive contrast and congratulated me on being radioactive for the day. I then was left in the dark room all cuddled up with heated blankets in a recliner. When the technician woke me from my nap 45 minutes later, I had no idea where I was. He said something about being in "power saving mode," which was actually a great description. Next I was put through the CT scan, which uses x-ray to trace the contrast agent flourodeoxyglucose (FDG) and see which cells are using this artificial glucose. The technician said it would be approximately 15-20 minutes and it seemed shorter, but however long it was, it was shorter than the mri usually takes.

When that part was complete, I was set loose to go eat breakfast. I again was schooled on what to eat, since most people apparently don't understand the instruction to eat "low carb." When we got to the car, Jason played the song "Radioactive" for me (he wants to be as funny as I am) and then drove us to breakfast in Rice Village. Best. breakfast. ever. The coffee was pretty helpful too! We had over an hour before we had to be back for PET part 2, so we went home and I got in another quick nap. The recliner nap was just too much of a teaser so I had to try again.

At noon Jason woke me up and (very) annoyingly pestered me to get up and go back. At around 12:15 I was able to get myself going and we went back to discover what the rest of the PET procedure would include. Turns out, not much. The technician explained (which I'm pretty sure I'd already reasoned out) that they give the contrast, wait 45 minutes for it to start being metabolized by the cells, and scan. They then wait a few hours for it to continue metabolizing and scan again. The scans are then compared to discover which cells are metabolizing more, as far as both volume and speed. When they put me into the CT scanner for the second scan, the technician said it would be 20-25 minutes. I don't know how the story kept changing or why, but both scans were approximately the same time period. This made me wonder if they just don't have their stories straight, if they were lying, or if they were checking to see if I would challenge them with something like, "No, I read on the internet..." I didn't challenge them because they were being very generous with those warm blankets. Once that scan was complete, they sent me on my way. So, what's next? Tomorrow I have a blood draw in the morning, followed by an mri. The blood draw is usually to check kidney function, white blood cells, and platelets (at a minimum). At 4 PM I will see the neuro oncologist, Dr. No Naps (no one mention my 2 short naps today), and I hope to get results from both scans. I think this is very likely, as the PET will have been 24 hours prior and the mri is usually read within a few hours on a normal visit. The following day I have a neuroopthamology appointment to check out if my vision has improved and if my fancy glasses are still a good fit. Here's hoping for more successes tomorrow and Thursday! Expect another update in the coming days.