Last week I meticulously shared the details of what I thought was a whole-body bone scan. My doctor had ordered me the bone scan to rule out my cancer spreading to my bones. The anxiety leading up to this test most certainly kept me up at night. I have had tremendous lower back and hip pain and I had convinced myself that this pain was the warning sign of something sinister. When the test results came in, Kenia from Dr. Laracuente’s office texted me two words - ALL CLEAR!
I shared this joyous news with all who would listen. Leaving work, I called Sonja and told her to get the champagne out; we had cause for celebration. As I was pulling into my driveway, Kenia called me again - this time to say Dr. Laracuente had reviewed my results. Whilst they were all clear, the test was for my anatomy (lungs, liver, spleen, kidneys) only. These are all important organs, but the test was not what he had ordered. Sonja was literally pulling my celebratory champagne out the fridge, as I walked in the house, wagging my finger at her to stop! I do not know what was more disappointing, putting the champagne back on ice, or having to go through another wait for this bone scan.
When diagnostic centers get a script from the doctor, the scheduling and billing department submit the medical order with a code for insurance approval. Turns out the diagnostic center used the wrong procedure code, so I ended up with a Whole-Body PET / CT and not in fact the [long-awaited] bone scan.
Raquel (Dr. Laracuente’s wife) is a tenacious advocate for me. As I have previously said, they fight harder for me than I am able to fight for myself. Even though there was a wait time of nearly a month for a bone scan, she managed to fight hard to get me another appointment in less than a week.
While I waited yet again on the bone scan, the week was filled by the tests my chemotherapy specialist had ordered. He advised me last week that the chemotherapy drugs I will be given are harsh on the body and can result in damage to the heart and bones. Because of this, he needed me to have these tests to establish a baseline. Both the echocardiogram and the DEXA tests will be done monthly when I start my chemotherapy regime, so that my specialist can adjust my treatment if damage appears to be developing.
The echocardiogram was about 30 minutes. This is a test that uses ultrasound to show how your heart muscle and valves are working. The sound waves make moving pictures of your heart, so a doctor can get a good look at its size and shape. My heart is in good shape, which is wonderful news!
The second test was a DEXA (Dual-Energy X-ray Absorptiometry) In this test, you lay on your back and the machine passes over your body, measuring bone mineral density with spectral imaging. Two X-ray beams, with different energy levels, were aimed at my bones. When soft tissue absorption is subtracted out, the bone mineral density can be determined from the absorption of each beam by the bone. My bone density is good.
Two test and two positive results I was hoping for a trifecta with my looming bone scan.
2020 has affected the world profoundly the challenges we have all been presented with this year are momentous. My cancer journey keeps highlighting the importance of giving. Every day I see the elderly and sick unable to be out, for fear of contracting COVID-19. I see uninsured patients waiting for life-saving treatments, mental illness statistics rising daily and food insecurity evident all around us. Nonprofits have been impacted so dramatically by this pandemic. Boca Helping Hands is providing more food assistance than ever before with less volunteers than ever before. Cancer patients reliant on private funding to get live saving treatment are waiting because COVID-19 has stopped gatherings and fundraisers that raise urgently needed funds to help patients in need. Urgently needed funding to develop cures to stop cancer is at an all-time low and now, more than ever, we need to give.
AND give you have done! To date we have raised $12,000 for American Cancer Society, and I want to thank you all for your generous donations. I am so touched and proud to call you my friends. THANK you, and please do not stop giving. It may not be monetary support you can give, but give back in some way. Collect groceries for an elderly neighbor; volunteer at Boca Helping Hands, or help raise funds. Either way, do what you can to help those less fortunate than ourselves.
And finally, the end of the week brought with it my final procedure. A Bone scan and SPECT (single photon emission computed tomography) which are nuclear imaging techniques typically used together when viewing the spine. Bone scan with SPECT is particularly useful in detecting metabolic abnormalities, such as small changes in hard-to-see bones, tumors, or blood flow patterns.
I arrived at 9am and a radioactive substance (called a tracer or radionuclide) was intravenously injected. This tracer is absorbed by the bones and emits gamma radiation. I had to wait two hours for the substance to be absorbed by my bones, so I headed back to work (there is no point in wasting precious time)!
After the two hours, I returned to complete the test.
The machine is like the PET / CT. I laid down on my back with my arms above my head. The bone scan was performed using a special scanner, called a gamma camera, that detects gamma radiation to create a planar image of the bones and other tissues. The SPECT scan was performed using a gamma camera that rotated around my body. The SPECT scan has its imaging data sent to a computer and turned into cross-section images. This test is a nuclear medicine study and my body was radioactive and was transmitting to the camera. The test was 55 minutes, and this included some close-up images of my breasts and surrounding lymph nodes. Areas that have more gamma radiation detection on the images are known as hot spots, whereas areas with less activity are cold spots. The camera does get very close at times and can make you feel claustrophobic, but I have learned that closed eyes get you through anything!
Not long after my day ended Kenia, Raquel, and Dr. Laracuente delivered the joyous news that my bones were all clear. The pain I experience is the result of arthritis in the spine and hips. The champagne was finally taken off ice and enjoyed with a sense of relief, and in Raquel’s words, when you send the praise up, the blessings come down.
My tests are now all officially complete - 24 visits to Sylvester Comprehensive Cancer Center, 5 visits to Dr. Ronald Laracuente’s office, 7 visits to Diagnostics Center of America, 1 visit to my OBGYN Dr. Schey and 1 random visit to my dermatologist to remove a subcutaneous hypermetabolic nodule that the PET/CT found on my left shoulder. That is 38 medical appointments in six weeks, which happens to be more medical appointments than I have had in my entire life. Next, Dr. Eli Avisar will schedule my surgery to make me better again!