Monday, May 5, 2008

when the bizarre begins to be normal

I have had two scans over the last few of days.

On Friday, I had a CT scan and was taken aback (but pleasantly so) when the technician informed me that she had checked and that there was no change from my previous scan and that there is still no evidence of cancer on my liver.

The events leading up to this conversation were a little outside the norm of what one should expect in a professional hospital setting, so I thought I would share them with you (actually, my spouse, when I told him, kept repeating, "You have to blog about this!).

I left for the hospital at around noon on Friday, still a bit woozy from the chemo and light-headed from fasting all day. I dodged construction in order to check in and seat myself in an unfamiliar waiting room. A few minutes later, I was handed two half liter cups with a clear liquid in them and told to drink them over the next hour and a half. "At around 1:30, someone will come and we'll get your iv started."

When, by 1:50, no one had come for me, I approached the front desk, where, once they clarified that I had in fact checked in and consumed my drinks, a man in scrubs (tech? nurse?) was asked about my place in the queue. He looked confused but said that someone would be along shortly, "They haven't forgotten about you."

Less than two minutes later, the same guy came to get me (which does lead me to believe that I had been forgotten). He led me back through the construction to a big room, with a few beds and two chairs in it for drawing blood. My guide gestured to the one empty chair and told me that a tech would be along shortly to set up the iv for the scan.

The two chairs in this room were extremely close together. The woman in the next chair and I were facing the same direction and could have put our arms around each other without stretching.

I had seen her come into the waiting room. She was young (anywhere from teens to twenties), wearing pajamas and an eyepatch. She also seemed quite weak and had been supported by the older (mid-forties? early fifties? I really go out of my way not to stare in these circumstances) man who was with her. Shortly after their arrival in the waiting room, they had been ushered out, around the corner and told that someone would be waiting to speak to them.

I don't know how long she had been sitting in the room where they usually do the blood work before I got there but within seconds of my arrival, a woman (who I later learned was a doctor) came through the door from the scanning room and began to speak to the woman and her companion in Arabic (I'm pretty sure it was Arabic).

They did not acknowledge me and there was nowhere for me to go. The doctor began to speak quickly, with the odd English word thrown in. I understood, "Ear, cancer, vocal chords." I also understood that there was a great deal of emotion in the room. I closed my eyes and turned my head away so that we could all pretend I wasn't there.

Within a few minutes, the door once again burst open and a diminutive red-headed woman called out my name. I was eager to leave but did take the time to say that I didn't have my iv in yet. "I'll do it in here," she barked (I didn't mention that for the last five minutes the fire alarm had been wailing in the background...)

"I brought you in here because there as a very hard conversation going on and I thought she deserved some privacy."

My eyes widened and I nodded vigorously.

"And you, too. It's not nice to be listening to that."

She then took down my particulars, prior to the test. When I told her that I was undergoing chemotherapy for breast cancer that had spread to my liver, she grimaced, "Then that conversation must have been particularly hard for you. My co-worker didn't realize what was going on when he put you there. You shouldn't have had to hear that, especially as a woman."

Bearing in mind that I hadn't understood much of the conversation and had been acutely uncomfortable, I remained mostly silent during this ongoing monologue.

Tech: "Did you have a lumpectomy or a mastectomy?"

Me: "Mastectomy."

Tech: "Good! I used to do mammograms and my fiancé works at (a clinic that women go to for diagnosis of breast cancer). You could say that breasts are our life. Other than the fact that I have two."

Somewhere in the blur that followed she asked and I informed her about my initial diagnosis, the mets and how my liver had originally been "riddled with tumours" but that I had had three clean scans (with no signs of cancer) in the last year.

She was duly impressed.

A few minutes later she asked, "Doesn't breast c.a. usually spread to the brain or the bones?"

Me: "It can also go to the liver and the lungs."

Tech: "Liver, then lungs."

Me: "Liver or lungs." (I didn't have the energy that mets can manifest itself in other ways, too, such as skin cancer.)

By this time she was tapping on my arm, getting ready for the iv injection. "Do you usually have good veins?"

Me: "No." (Veins tend to shrivel up and collapse when you are undergoing chemotherapy. The cost of this has been driven home to me quite graphically)

Tech: "I'll get you the first time. I'm the girl they always go to when they have trouble getting a vein."

Me: "Then you're the girl I want to be doing this."

She trussed me up with two tourniquets and did it in one go. I was impressed.

Me: "That's awesome!"

Tech: "Thanks! It's because I like doing it. I am a sick, sick woman."

Me: "You are sick!"

Tech: "I also like giving barium enemas. No one understands that. But wouldn't you rather have someone who likes doing it give you your enema?"

And with that, she set up the iv, explained the procedure and left the room so that I could be scanned.

When it was done, I heard her voice through the intercom, "You can relax. I'm just going to take a look at your films."

A few minutes later, she came in to unhook me from the iv. While she was doing that, she said, "To make up for what we put you through earlier, I had my fiancé look at your films and there is no change from last time. Isn't that great?"

I thanked her and said that it was. I think she was a little disappointed that I didn't react more effusively but I was too stunned, overwhelmed and light-headed (I had not eaten anything since the night before, nor had I had any caffeine).

She ushered me out a side door and I stumbled outside the hospital to wait for my friend D. to come and pick me up. I also called my spouse to give him the news.

This is the first clean scan that we haven't celebrated. This is due, in part, to the fact that I was still feeling pretty lousy (post-chemo) on Friday and partly to surprise (the import of this news didn't really sink in for me until I was out for a walk on Sunday afternoon).

However, I do think that we might be entering a place where we assume that my scans will be clean and that I am continuing to respond well to treatment. And I don't think that's a bad thing.

This morning I had another kind of scan, to make sure that the Herceptin isn't damaging my heart. I won't have the results for a week or so. I'm not too worried. But I am covered in some spectacular bruises along my right arm and on my hand.

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