Tuesday, July 11, 2017

Get out of jail free

My big scan day was much shorter than expected. They were able to eliminate some of the down time, and I was only there from 11 to 3.

Beth the Nuclear Medicine technician takes me back to put in an IV and injects me with weapons-grade plutonium. Then she hands me a small orange piece of paper with something scribbled on it. ``This is your get-out-of-jail-free card,'' she says. If you set off a radiation detector in the next three days and homeland security asks you ``Are you carrying radioactive material?'', you can say, why yes sir I am, in my body, and show them this." I guess I'll be glowing in the dark for a while.

I also had to fill out a form that asked, among other things, whether I'd ever had a bad fall. Well now, back in 1972 I had a rather long one. This led to a pleasant conversation about Yosemite, concussions, and the fact she was formerly on a Search and Rescue Team. When she was a kid in 1969, Beth's parents took her to Yosemite and to Haight-Ashbury. Those were the days. Well, we'll see you back here at 2, says Beth.

Then on to the CT-scan, same-old same-old, except that the IV is already in. Drink the KoolAid. Enter the spinning vortex of the Intergalactic Wormhole Transporter. Hear the voice: Breathe in. Hold your breath. Breathe.

Back for the bone scan at 2. I wasn't worried about the ``lying motionless for one to two hours'', because if I've learned anything in my hospital experience it's that you have to go straight to the source for reliable information. You can't believe the patient information brochure, or a receptionist, or even a radiologist. In this instance, you need to talk to a technician who actually administers the scans. So I called Nuclear Medicine a couple of weeks ago, and talked to in sequence a receptionist, a radiologist and a technician. All were very nice and very helpful, but it's the technician who has the real scoop. Oh, don't worry, she said. There are plenty of opportunities to go the bathroom, and the longest continuous scan is no more than 25 minutes.

Not only that, but Mark, the technician who did my scan, announced at the start that ``we want your bladder as EMPTY as possible''. Can do, sir, can do!

The bone scanner is an impressive, gargantuan device. It has two huge semi-circular arcs behind that rotate two rectangular gamma-ray devices through 360 degrees so as to scan from any desired angle. ``Airport rules,'' says Mark, ``all metal objects in the tray.'' My arms are held to my side with a wide strap and feet held together with a big rubber band. ``The first scan is 20 minutes.Just lie still and breathe normally. Most people take a nap.'' It turns out that the arrangement is very comfortable. I did briefly doze off, and would have been fine with forty minutes. There is a short break and then a five minute head-scan, to see if any brain material is still there I guess. The photos are then sent to the radiologists to see if they're satisfactory. That was about fifteen minutes, still lying comfortably on the ``bed'' (minus straps and bands). In fact I asked Mark if I could stay another hour or so to nap, but that was not deemed an appropriate use of resources.

I'll get the results of both scans tomorrow. Meanwhile, my pembro symptoms have gotten worse. The fatigue has gotten much worse, to the point that I find it intolerable. Numerous naps and lie-downs per day. If I'm lucky I can get two hours of work done.
Going on walks is non-negotiable, but it's gotten a lot harder, with shortness of breath on hills that I was cruising up effortlessly before the treatment. If it keeps up like this, I will seriously consider stopping the treatment regardless of the scan results. I doubt the bone scan will show anything; that clavicle pain went away completely a few days after I talked to the onc. But I am having increasing right-side abdominal pain, which I don't think I can be explained by muscle strain and the like.

Well, enough complaining. To help make it more endurable, I came up with a brilliant idea. According to the Mad Dog Code of Honor, watching television in the morning is strictly prohibited. Well, okay, I make the occasional exception when the Seahawks are playing on the east coast. But it really it is a very poor use of time, especially for a morning person like me. One consequence of the Code is that I have never been able to watch Wimbledon live, except for one time when I happened to be in England.
Then it occured to me: if ever there was a time I could justify it, this is it. If I get up at 6:30, I'm typically having my first nap by 9 and not getting much done anyway. So a little Wimbledon, why not? I have officially given myself permission, and if anyone has a problem with that, we'll have to take it outside.

In conclusion, here's a Kaia story I recently heard from Jessie. Why Kaia was thinking about this in July, I don't know, but she came to Jessie asking whether Santa Claus was real. ``What do you think?'' Jessie replied. ``I think it's you and Daddy.'' At which point Jessie confessed the truth, and was relieved that Kaia was not upset by this. In fact Kaia had decided it's the same with the Easter Bunny and the Tooth Fairy: ``There's a pattern there.'' However, Jessie requested that Kaia not say anything yet to Finley. Kaia was okay with this, but said:

``I'm worried about Finley. What if when he's a Daddy he still doesn't know? He won't know to put the presents under the tree.''

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