Hello tumor friends. I'm currently sitting in the basement of the Ben and Jerry's Hospital feeling the radioactive tracer goodness percolate through my body. ('Cause, hey, after all of the radiation I've had, a little more can't hurt!) I'm about to have a PET scan, which is not as cute and furry as it sounds. The radioactive tracer is stuck to glucose (sugar), and I haven't had anything to eat since 6am. So, the hungry cells in my body will gobble up the glucose. Cancer cells are the hungriest, so they should take the most. Then, when I go through the scanner, the cells with the most tracer will light up on the scan, and hopefully we will have a better idea of the shape of this tumor (or discover it's really a giant mutant booger).
This use of the technology is relatively new. There is variation even with tumors, and by biopsying the area that is brightest on the PET scanner, they can make sure they have selected the most malignant part. It also shows extent of tumor beyond what may be visible to MRI or the naked I.
So, now for the catching up.
1. Visit with Dr. The Jedi Master.
Dr. The Jedi Master last messed with my head in 2004 when he plucked a meningioma out from under my temporal lobe (I am told he did it while juggling four scalpels and singing the Star-Spangled Banner. This guy is a first-rate neurosurgeon.) He is no longer at Ben and Jerry's Hospital, having moved to a less hectic suburban setting at Outside Hospital.
Last week, he had stated interest in performing my biopsy himself. However, after seeing the other exciting things that have happened to me since our last encounter, he, like Dr. Mr. Rogers, said that I will be best served at Ben and Jerry's Hospital. In addition, he explained, the all-time world champion clivus cleaver, Dr. King Clivus, recently moved to Ben and Jerry's Hospital. His heir apparent, Dr. Prince Clivus (the surgeon selected by my primary care doc) should be fine for the job as long as Dr. King Clivus is around for backup and consultation.
He also went over the films with us. The approach to the Clivus is straight back through the nose. It is much simpler than the surgeries of my right maxilla/orbit or under my left temporal lobe. Things were looking less and less like 'The End of the World' and more like just another malignant tumor. Ho hum.
2. An Audience with Dr. Prince Clivus.
So, finally, yesterday afternoon, we all met Dr. Prince Clivus. He looks about 25, although he is much older than that. Still, for the first time, I will have a surgeon younger than myself. How strange is that? Anyway, he was happy to have Dr. King Clivus come along for ride.
Dr. Prince Clivus also pointed out that if you look closely enough at my MRI from September, 2010, you can see the beginnings of the current tumor. This is a sobering thought. There were radiologists and surgeons from the two best cancer centers in the Northeast pouring over that MRI looking for just such a tumor. It's only clear with 20-20 hindsight.
Dr. Prince Clivus is a champion nose-picker. He will approach the tumor endoscopicly and scoop it out like the giant mutant booger I wish it were. He predicts a 2 day hospital stay. (Then, of course, there will probably some chemo and radiation, but this is all sounding relatively tame compared to my last adventure.)
The next step would be the PET scan.
3. Back to the Present
So now I have discovered, after talking to Dr. Prince Clivus' nurse, that he is booked for the next two weeks. This wouldn't be a problem except for the annoying little issue of the strokes.
I have now had two strokes. Even I have to admit that it's time for me to go on an anticoagulant (blood thinner). I am in serious jeopardy of having a third, and it could be much less fun than the first too. However, they have to identify the tumor first, because it might be the type of tumor that hemorrhages on anticoagulants. That would be very messy and might stain my ties.
Dr. Mr. Rogers and Dr. The Jedi Master both talked about getting the surgery done in the next two to five days so that I can be protected from another stroke as soon as possible. I've asked if he can find a way to squeeze me in sooner. We shall see. Meanwhile, I'm staying up way too late.