Bone Scan Results - Extended Edition

When I think back to the events of last week, it all seems to be a bit of a blur.  My thoughts were almost entirely consumed by the news of these suspicious spots on my spine and what it could mean, but I also had to make room in my brain for pre-surgery testing and my last week of work.  Not to mention that I decided to refinance my mortgage (hey, interest rates are low!) AND got a toothache along with everything else.  I am not making this up, I swear!

My marathon of trips to the hospital (I graced Roosevelt Hospital with my presence no less than 5 times in three days) started on Tuesday.  First, I had a pre-surgery appointment with Dr. Samson, my plastic surgeon.  Dr. Samson's PA (Physician's Assistant) first had me sign several consent forms, then she went over my pre- and post-surgery instructions.  Pre-surgery instructions were mostly just to avoid certain medications (like aspirin) and don't eat anything after midnight the night before surgery.  Easy enough.

After surgery, I will have surgical drains - at least one, maybe two - that I will need to take care of.  I asked to see what they look like.  They are long thin tubes, part of which will be in my body, coming out of my underarm area.  The end looks like a hand grenade, and that is where the fluid collects.  I have to measure my "output" every day since that's how they will decide when it is time to remove them.  But typically, they stay in for about a week.  I think this is going to be a major drag because I'm not allowed to shower when I have the drains in.  No showering for a week???  I think I'll hold all visitors until they are removed!

They also recommend that you either safety pin the drains to your clothing or put them in a fanny pack.  So I will surely be styling after surgery with my G.I. Jane haircut, my button-down shirts and my fanny pack!  I will have to fend off the fashion photographers I'm sure.

After getting all of my instructions, Dr. Samson came in, did an exam and went over the surgery again.  Since I opted for an implant over the TRAM surgery, this means that I will have a temporary tissue expander inserted which will gradually be filled with fluid over a few "expansion" sessions until it reaches the desired size (i.e. until it matches my left side; I am not going to go for the Picasso look with one huge boob and one normal-sized one).  I also asked to see the tissue expander - it basically looks like a deflated implant with a medi-port in it, through which the expansion injections will occur.

Dr. Samson said when I wake up from surgery I will have some semblance of a "breast mound" but it won't be the same as the left.  So I guess I will be rocking the Picasso look for a little while.

Since I will need radiation following surgery, I will not be getting my permanent implant for quite a while.  As Dr. Samson had explained during my initial consultation, there is a risk that the radiation can damage the tissue, and so my "exchange" surgery - when they take out the tissue expander and put in the permanent implant - won't happen until at least 3 months after radiation is complete.  But that is OK as there is no real drawback to the tissue expander (especially once the size of it matches my left side!).

The PA gave my two prescriptions - for a painkiller (Vicodin) and an antibiotic - to have filled before surgery so I'd have them when I needed them, and then I was on my way.

The next stop was Dr. Rosenbaum Smith's office, to get my pre-surgery testing done.  Again, I had to sign a bunch of consent forms.  I was told to arrive at the hospital at 6:15am on the day of surgery and then I was asked if I wanted a private room.  Dr. RS's surgery scheduler, Jancy, produced a brochure that looked exactly like a hotel brochure (I know, since many of my clients are hotels) showing stylish rooms and advertising "south city views".  It all sounds very nice, but for $400 a night (during which I hope to be too drugged up to be able to enjoy any kind of view), I didn't think it was necessary.  I am just going to hope that I either have a quiet roommate or better yet, no roommate at all.  Maybe since it's a popular vacation week there will be a lot of doctors on vacation and so not as many surgeries scheduled?  One can only hope.

After signing all the forms, Jancy sent me on my way to the hospital to have a chest x-ray, EKG and blood drawn.  This all went fine, except the x-ray techician had a little trouble getting me into place for the "side view" chest x-ray.  The first x-ray didn't come out so she had to do it again, and asked me if I had scoliosis.  Actually, I do!  I guess that was causing some problems but they eventually got what they needed.

The next day, Wednesday, I reported back to the hospital at 10am for my bone scan.  I went to Nuclear Medicine on the 4th floor, which is the same place I go to have my MUGA scans.  Here they gave me an injection - I asked what it was and it is very similar to the injection they use for MUGA scans, except that one goes to the heart and this one goes only to the bones.  After the injection, they told me that I needed to wait a couple hours for the injection to go through my system, and to come back at 1pm.  It was nice to be able to leave the hospital!  I headed to work for a couple hours.

At 1pm I reported back to the 4th floor.  After waiting a bit (they had warned me they were a bit short on staff so I might have to wait), I was called in to the scanning room.  I had to lie on the scanning bed and the whole thing was very much like the countless other scans I've had where I just laid there trying to stay still while the machine worked its magic.  After they did a full body scan, they scanned my skull separately with top and side views.  The whole thing took about 45 minutes and then I was on my way again.

Later that day, I got a call on my cell phone from the hospital.  All calls from the hospital show up as the same general number on caller ID, and I've grown to be wary every time one of those calls comes through.  This was no different.  It was from a woman in the Nuclear Medicine department who said the radiologist asked her to call me to come back for more tests at 9am the next morning.  I asked her a few questions about whether it was the same scan I'd already had that needed to be done again, and how long it would take.  She didn't know anything and just asked me to come back the next morning.

I immediately freaked out.  The last time that I was called back for more tests was when I had my mammogram in January, and we know how that turned out.  I tried to tell myself that maybe the doctor hadn't seen anything and he just wanted to be sure, but I was very worried that it was the opposite - that he had seen something and needed to get a better view of it.

That night, I headed home to my parents' house as I had had long-set plans to go see the new Twilight movie with a friend at the IMAX theater there.  It was a nice 2-hour break from all my worries! 

However, that night I had trouble sleeping due to a troublesome tooth.  This tooth had been bothering me for about a week, but this night it started hurting (luckily AFTER the movie!) and would not stop.  I'm not sure if my stress over the bone scan manifested itself into a toothache or what, but it was pretty much the last thing I needed.  The last time I'd had a toothache like this I needed a root canal - and I didn't know how I would go get my tests, get a root canal and then see Dr. Sara for my bone scan results all in the same day.  I even asked my Mom if hospitals have dentists or endodontists on staff who can do emergency root canals. 

But luckily, it didn't come to that.  When I woke up the next morning my tooth was no longer bothering me.  Whew!  I headed to the train to head back to NYC to have these extra tests done.

When I arrived they called me pretty quickly and had me lay down on the scanning bed head first (the day before I was feet first).  This freaked me out because I was thinking they were going to re-scan my head because they'd found something in my skull.  But, this didn't happen - they just did multiple scans of my mid-section (i.e. where my spine is) from every angle.  It took about an hour and then I could leave.

I headed back to the office but I could not concentrate on anything except what the results would be.  I didn't have to wait long, luckily, and I headed back uptown to my appointment with Dr. Sara.  I was ready to just KNOW - good or bad, I wanted to know what the results were because the not knowing was getting a little unbearable.

Dr. Sara came into the exam room where my parents and I waited, said hello, sat down, and then said "Your scans were fine."  I really like how he just cut to the chase and didn't dilly dally!  He said the radiologist is the same one who reviewed my PET/CT scan and that he is "very picky" - that is why he ordered those extra tests - because he wanted to be sure there was nothing there.  So my wishful thinking turned out to be the right scenario, thank goodness.  At this point I said to Dr. Sara, "and you did say he saw nothing, right?"  Dr. Sara nodded and I said, "OK, I just needed to hear it again!" 

My parents and I all breathed a collective sigh of relief and then Dr. Sara went on to explain that we still don't know what those spots are, but most likely, they were tiny cancer spots that have now been healed by the chemo.  But, the bone scan showed that there is no evidence of active cancer in my bones, so it looks like the chemo completely healed it.

However, since it's likely these spots were cancer at one point, we can't just sit back - we have to still treat them aggressively and that means that I will need radiation to each of those two spots.  Last time, Dr. Sara had talked about a new radiation technique that is very precise and targeted, which is important because it will not damage surrounding tissue (and in the spine, you don't want to damage anything that doesn't need to be!).  This is the kind of radiation that I will eventually have, after I've recovered from surgery.

Dr. Sara also reiterated that had these spots been found in January, he may have told me then that I couldn't be cured, since that is typically the diagnosis once breast cancer is found in the bones.  It's scary to think of how close I came to that.  I've also thought a lot about how if Dr. Sara hadn't decided to give me two more rounds of chemo, I may not have had that third PET/CT scan, and the spots may not have been discovered, which could mean one of two things - either they wouldn't have been fully treated (a scary thought) or they would have but we wouldn't have known enough to do the extra radiation.

In any case, my family and I were relieved to say the least after this meeting with Dr. Sara!  A lot of people suggested I go out for drinks that night to celebrate.  I did go out to dinner with my parents, but after that I celebrated by getting my cavity filled.  Ha!  Actually I was glad to have it taken care of before surgery, so now I don't have to worry about toothaches on top of surgery pain.

All of the drama of last week meant that I didn't really have time to stress about my upcoming surgery, which is a good thing.  I am still wary of the unknown, but at this point I am about as ready for surgery as I'll ever be, and I'm looking forward to getting it over with and to getting on with the recovery process.

Since I don't know when I will be able to blog again, I've made my sister Sara a "guest blogger" and so she will do a blog post with the post-surgery update.  Hopefully she will leave out all the crazy things that I might say once I have those pain meds flowing through my system... we'll see!