PET/CT With Oral Contrast

I haven't written here about anything pre-chemotherapy, about the whirlwind of tests, scans, doctors and information that swept me up and spun me around at will in the 16 days between diagnosis and surgery. Those 16 days did not belong to me; I was directed where to go and when to arrive, sometimes with less than a days notice. "What are you doing tomorrow" was a laughable question because, honestly, I could never be sure. It was a fast paced, uncoordinated, back breaking dance that involved a lot of jolts, twists, jumps and dramatic dips.

The imaging scans that I went for included an ultrasound, a mammogram, an MRI and a PET/CT scan.

This last one is the kind that I had on Tuesday as the standard follow-up as well as a diagnostic test. This time, unlike the first time, it was a PET/CT with oral contrast. This is how it went:

I arrived at the PET/CT center behind the Cancer and Blood Disease Center at 10:45am. The nurse brought me to a room right away, asked me a few questions, pricked my finger to check my glucose level and then brought me a HUGE cup full of orange liquid and told me to drink it (barium, perhaps? I forgot to ask). I would have 45 minutes between then and the second cup, so I should take my time. The orange liquid tasted like some kind of powdered citrus flavored kids drink and left a less than desirable taste in my mouth that stuck to my gums. I recommend against this beverage in any normal circumstances.
This was the oral contrast part, and the purpose of the orange stuff was to outline my organs so that they could get a clearer image of my insides when they imposed the CT images over the PET images to create a 3D image of my body.

About 20 minutes later the doctor came in and inserted an IV into my arm. He then went into the RADIOACTIVE MATERIALS room and came back a few minutes later wearing thick, blue protective gloves and carrying a sack of radioactive glucose to be injected directly into my bloodstream. "There's no chance at all that you're pregnant, right?" he asked.
The purpose of this stuff was to infiltrate all of the cells and light up any active cells. Since cancer cells are more active than normal cell, they would light up brighter than other cells. Because all cells use glucose they will all ingest the radioactive glucose and thus allow themselves to be seen. The patient is not allowed to eat six hours prior to the test and is told to only eat a light meal of lean protein, such as eggs, and absolutely NO carbohydrate rich foods the morning of the test if their scan is scheduled for the afternoon.
I saw the images the first time I had the PET/CT scan done and my tumor was definitely the brightest thing in my body, besides my kidneys, which were filtering the the stuff out. The doctor this time said that the radioactive stuff was like "liquid light."

After an hour or so of drinking orange stuff and 40 minutes of letting the radioactive stuff soak into my cells, the doctor brought me into the procedure room. I laid down on the long, thin white table, the doctor put the triangular pillow thing under my knees, I put my arms up over my head, the doctor raised the table to the level of the tube I was to be passed through repeatedly, adjusted my head and then left the room and took cover behind the big, protective glass window of another room.

I was thankful that this room was warm, because the first time I had this scan done was at a different facility, and it was so cold in there that the technician, Todd, put two blankets on me before he left the room. Even then, though, I was still cold by the time I got done.

The table slowly moved into the tube and I could hear the soft swooshing sound of something turning round and round and round inside the plastic shell. A clear glass ring ran around the inside rim of the tube and I could see an off white ring of unknown size with what appeared to be small, flat, black glass rectangular surfaces, possibly lenses of some sort, evenly spaced apart spinning on the inside. I guessed that it was the white thing that was making the noise. The table moved very slowly in and out of the tube, staying completely still for stretches of time while particular parts of my body were scanned for medical data.

When it was all done the doctor came back in and asked if I wanted to see my pictures. I said sure and he showed me the 3D images on his computer in the safe room. I could see my port and the tube leading to my jugular very clearly, and saw the metal clasps and adjusters of my bra on my back and shoulders. I asked him what some spots were on the side of my breast that the lump was found, and he said he didn't know and that he hadn't seen anything too exciting at that point.

Today I went in for my lab post-chemo (which I have gotten every week once a week since I began chemo, more than once a week with the first regiment of chemo) and saw my doctor while I was in the back. She informed me that the PET/CT scan came back clear, but that those scans are not very good at picking stuff up inside the breast and that because the lump she felt was small, I needed additional tests. She wrote me an order for an ultrasound and a mammogram.

On my way out I stopped at the desk and handed Ellen the test orders. She asked which hospital I wanted and then called them. She said that she needed the tests ASAP, and while she was talking to the woman at Citrus Memorial I heard her say, "No, that would absolutely not be suitable," and then while she was on hold she looked up at me, shook her head and said, "April 8th? Yeah right!" I laughed and told her we might as well push it back a couple of weeks. "Who cares?" I said, joking. "I do," Ellen replied firmly. I smiled and felt very lucky to have people like Ellen, Dr. Chiryath and the nurses advocating on my behalf now.