Saturday, September 7, 2013

The Morning After

Nothing like finding out you're pregnant on Thursday and having to immediately shift gears back into cancer-mode on Friday morning. But, this is what my life has become. An endless cycle of enjoying good news for a short while before the reality check smacks me back into perpetual fear.

In other words, Friday was Scan Day.

Every three months for the last two years I've had to have a CT scan of my chest, abdomen and pelvis to check for cancer recurrences. Sometime during the same week, usually two days later, I'll have an appointment with my oncologist to hear the scan results and suffer through a rather painful internal exam. I realize these exams are uncomfortable for all women, but for those of us who've had that area radiated, it's an entirely different level of discomfort, usually followed by a few days of bleeding from the damaged skin inside the vagina being ripped apart as the speculum opens it up enough for the doctor to look inside. Yeah, it's a real party! Anyway, the system for my check-ups changed slightly during the last round because of the back pain I was experiencing. Scans were moved up and extra tests, like an MRI and PET scan, were ordered. After going back and forth for weeks trying to determine the cause of the new pain, I was told I had a small fracture in my pelvic bone caused by radiation damage. But, just to make sure, a follow-up MRI was scheduled ten weeks later, along with my regular CT scan, to make sure what appeared to be a fracture wasn't growing or spreading or multiplying, indicating that it may actually be cancer. Oh, the joy of the unknown! When the office called to schedule all of my tests and appointments I was surprised that they were all being stuffed into one day. "Is it ok to do the CT scan and the MRI back to back?" I asked the scheduler. "They'll need to inject two different dyes into me and I have to be pre-medicated for the MRI because of a previous allergic reaction." I was put on hold for a minute then the voice came back to the line, "I just spoke to the radiologist. It's not a problem to do them back to back. So you're all set for nine-forty on September sixth for your CT scan, followed by your MRI at ten and your appointment with Dr. L at eleven. And don't forget you'll need to be here an hour earlier to drink the oral contrast and get set up with your IV." Yeah, I know. I hung up the phone and groaned audibly. As much as I wanted to shout at the scheduler, "Don't you know I don't do mornings!" I decided to suck it up and deal with the early appointments for one day.

The prep work for my tests started on Thursday night at 9:00. That's when I choked down the first of three doses of Prednisone I'd need to take before my MRI to reduce the risk of anaphylaxis when the dye is injected into my vein. Before I went to sleep that night I set my alarm for 3:00 AM, 7:00 AM and 9:00 AM. The first buzzer jolted me out of a dead sleep to pop my second pill, the second buzzer was my actual wake-up call, though I never really fell back to sleep after the first alarm, and the third buzzer would be a reminder to take my final dose of Prednisone, along with 50 mg of Benadryl.

In order to get to the cancer center in time for my 8:40 check-in time, I needed to leave my house at 7:40. Damn rush hour traffic! I wasn't allowed to eat or drink anything but water before the CT scan, so coffee was not an option. Wanna see me in a really bad mood? Force me to wake up early, don't allow me to eat, deny me a cup of coffee and make me go to the cancer center for scans and an internal exam. I'm surprised I didn't bite the receptionist's head off when I checked in at the radiology desk. She handed me a clipboard with the paperwork I had to fill out each time I'm there and I sat down with my mom, who had met me in the parking lot, and started flipping through the pages. "They told me they were gonna put a note in my file so they wouldn't give me this one again!" I said when I saw the the question that always hurt my heart. "Is there any chance you could be pregnant?" No, morons, there is NO CHANCE I will EVER be pregnant! I don't have a uterus anymore! Look at my chart! Wait! And a mischievous smile crept over my face as I looked at the options below the question. "I am pregnant. I think I am pregnant. I am not pregnant." I texted a picture to Lyndsay and asked, "How do I answer this?" I thought about adding a fourth option "I'm sort of pregnant" but didn't think the staff would enjoy my humor so I checked the box next to "I am not pregnant" and moved on to the MRI questionnaire about whether or not I have any metal in my body. Only one answer had changed since the last time, "Do you have a BB anywhere in your body?" I checked "yes" next to that question and giggled as I remembered the techs finding the pellet my 14 year-old boyfriend had shot into my ass in 1989 that had apparently been there ever since. I returned the completed forms and was handed a large bottle of nasty, red "fruit punch" and I knew I had one hour to drink the oral contrast down to the bottom of the label.

"Suzanne?" It was my turn. I gave my mom a kiss and followed the nurse into the always freezing, tiny room with a chair and a sink where she'd start my IV. It's almost comical how similar the experience is every time. "It's cold in here," I'll announce as the nurse du jour runs out to get me a warm blanket. When she returns I'll spell my name and tell her my date of birth, then she'll ask me which arm she should use for my IV. My answer is always the same, "Whichever you want. I only have one really good vein but it has a lot of scar tissue and I'd rather use another one." Then the faceless nurse will check over my arms, push down in a few locations, realize I'm correct about the overused vein being scarred and look around for another one. Today's nurse decided to change things up a bit. I never look when the IV is going in, but I felt her pushing on my good vein which is actually my bad one. Then I felt the cold of the alcohol wipe cleaning off the area, "Are you using the scarred vein?" I asked her. "Don't worry, I'm going above the spot with the scar tissue," she lied as she took the easy way out and went right into the area I specifically asked her to avoid. What a great way to start the day! And it didn't get better from there. "Hi, I'm Tech S," said the mopey and never pleasant radiology tech I've seen many times before. "I'm here to take you for your CT scan." I tried to keep up as he grabbed my IV bag and basically ran across the hall to the room with the giant machine. "Ok, you're gonna lie here with your head on the pillow and your legs down there," he pointed. Then he covered me with a blanket and instructed, without a hint of empathy, "Pull your pants down to your knees." I tried to break the grump out of him with a smile as I positioned myself on the table, "I know. I'm an old pro at this." He was clearly not amused and my statement, instead of chilling him out, made him seem even moodier because he said nothing at all after that. The only way I knew he had left the room to start the test was because I heard the door close behind him and the motor on the machine start to hum. Soon the table started moving into the giant white circle and I closed my eyed. Here we go! "Breathe in," said the recorded voice. "Hold your breath," it continued. "Breathe," it finished. I followed the instructions twice before the table brought me out of the circle and I knew it was time to be injected with the first dose of dye I'd have that day. Captain Curt came back to tell me we were just waiting for the nurse, which I already knew. It seemed to be taking longer than it normally did and the hum of the motor slowed then shut off completely. Tech S left the room without an explanation and I assumed it was to turn the machine back on. The sound of everything starting up again told me I was correct, but then I heard Tech S taking to someone in the control room and the table began moving back into the machine. That's weird, I thought to myself. "Breathe in," said the recorded voice again. I listened, though I was very confused. Why were they repeating this part of the scan before injecting me with dye? "Hold your breath." What's going on? Did they see something in there and they need another picture of it before the dye? "Breathe." The table moved out after the two additional pictures and the nurse came in to inject me. Back into the spinning circle I went, being told to breathe in, hold my breath and breathe three more times...wait...four. Isn't it usually three times after the injection? Something must be wrong. The table moved back and the machine shut off. Tech S came back just long enough to tell me to pull up my pants, then he handed my IV off to Tech J, the MRI tech who had discovered the BB last time, and I followed her to the next small, freezing room with a chair and a sink.

"You'll have to get undressed for the MRI," said Tech J, who was every bit as sweet as Tech S was sour. "I know it's cold in here but we'll get you some warm blankets as soon as you get into the MRI." She left the room and I changed into a gigantic blue robe, then I followed her to a walk-in metal detector followed by a handheld metal detector and finally into the room with the next giant machine with a moving table that would take me into the scanning coffin. Tech J handed me some ear plugs and helped me onto the table. She put a bolster under my knees, stuck an emergency call ball into my hand and headed out to start the scanner. I immediately noticed that the sound of the MRI machine running sounded like a tweeting bird. Actually, it was more like a bird tweeting on top of a hip hop beat. I closed my eyes as the table started moving, not wanting to make the same mistake as last time when I accidentally opened my eyes too soon and saw how tightly packed I was in the machine. It was like being buried alive. Tech J's voice came over the speaker, "Ok, this first test will take four minutes." And the buzzes and beeps and clicks began. It was like being inside of a video game. "Six minutes for the next one," said Tech J. I listened to the birds chirping and the machine guns shooting and the sledgehammers pounding for what seemed like hours until my body started to relax and I drifted off to...Gasp! I can't breathe! Oh my GOD! I'm having an allergic reaction to the dye! I need to sit up!


I'm breathing. I'm fine! Was I dreaming? They haven't even injected the MRI dye yet. How did I fall asleep with all that noise? Ah, must've been the Benadryl. I'm so glad I didn't actually move or I would've had to repeat the entire 25 minutes I'd already done. "Ok, we're taking you out for your injection now," said Tech J as the table started moving. My heart raced as the nurse started to slowly push the plunger into my arm and I wondered if my dream was actually a premonition. Would the pre-meds work to stop the allergy this time? "You ok?" the nurse asked after the dye had officially made it into my body. I took a few breaths and nodded. "Ok, here we go," said Tech J and the table moved back for the last time. "Four minutes...six minutes...four minutes..." This is taking forever! I thought with each announcement of the length of the next test until the machine finally stopped and the table took me out of my shallow grave. "Sorry it was a little longer than last time. They ordered some additional pictures," Tech J explained. What? "Who ordered them? Why?" I asked, knowing now there had to be a problem. "The radiologist. They just wanted to have a better look." A better look at what?! But I didn't actually ask because I was sure she wouldn't tell me the real answer. I just followed her to the dressing room to change back into my clothes before my appointment with Dr. L, which was kind of pointless since I'd just be getting naked again once I got down there, then I headed to the waiting area to get my mom and Jimmi, who had arrived while I was in the MRI.

Dr. L's waiting room was unusually empty and my second favorite nurse came out to get us immediately. "Congratulations!" she squealed with her huge smile, "I heard the good news!" I knew she was referring to our little bun (buns?) in the oven because I'd called Nurse L, my favorite nurse, the day before to ask a question about my pre-meds and I spilled the beans. Clearly she had done some bean-spilling of her own! "Thank you," I gushed as we all followed her to an exam room where I had the seat of honor, complete with stirrups. "Is he examining you today or just giving you your scan results?" I guess that answered my question but I asked it anyway, "He has the results already?" The nurse nodded. "Then both, I guess." I was glad I didn't have to wait out the weekend, but I instantly started sweating and my heart started pounding. "You need to relax," said the nurse as she read the monitor attached to my finger, "your heart rate is at one-hundred and twenty beats per minute!" I tried to slow my breathing enough to get a normal reading. When she was done she handed me a sheet and instructed me to take off everything from the waist down and put the sheet over my lap.

Dr. L walked in followed by Nurse L, who was smiling. "I'm so excited for you!" she said as I pulled out my phone to show her the picture of Lyndsay's pregnancy test. "Did you tell him?" I asked pointing at Dr. L. "Let me see," he said as he reached for my phone. "You found someone?" he asked, obviously referring to our gestational carrier. I couldn't help myself, "No. I'm pregnant! It's a miracle!" Dr. L's face took on a look of confusion until I let him off the hook, "I'm kidding! Yes, we found someone!" We talked babies for a few minutes until he held up the report from the radiologist and announced, "Your CT was normal. Everything looks good." My mom let out the breath she was holding but I wasn't satisfied, "What about the MRI?" I asked. "I don't have that report yet. It's too soon. But I saw the pictures and they look the same as last time," he tried to soothe me. "Are you sure?" I challenged. "Well," he said, "I'm not a radiologist. But I didn't see anything." Not good enough. "When will you have the report?" I asked. He told me he would definitely call me by the end of the day, but if I didn't hear anything I should call and check in. Then Nurse L helped me get my feet into the stirrups while Dr. L told me to scoot down to the edge of the table. My mom and Jimmi moved to the other side of the curtain before the real fun began. "That's the smallest speculum, right?" I asked as the dreaded instrument made its way from the nurse's hand to the doctor's hand then headed right for my radiation-damaged snoochie. "It's the smallest one we have," he said as the overly-lubed up plastic made its way in and opened up the area so the doctor could take a look and make sure everything was still a healthy pink. I cringed as he moved it up and down and all around then pulled it out only to replace it with a gloved finger. "Are you using the vaginal moisturizer?" he asked as he felt around my love canal. "No," I answered honestly. "Can you tell?" He shrugged, "You should really use it every day to keep the area soft and elastic. And you should use your dilator at least three times a week too," he said, referring to the medically prescribed dildo that sits in my drawer collecting dust. "I keep telling you I hate that thing!" I whined stubbornly. "Look," he said, "the radiation damage never stops. It only gets worse. If you don't moisturize and keep the area open you could have a lot of problems." I had to make another joke, "Can't I just use Jimmi every day?" He managed a small smile, "You can if you want, but you need the moisturizer too. It's not lubrication. It's more like hand lotion to use every day." The words just fell out of my mouth, "If he's using hand lotion every day he won't be able to help me!" I could actually see Jimmi's face turning red behind the curtain. Dr. L removed his gloves and I sat up, "Everything looks and feels normal," he said. "I'll call you with the MRI results and I'll see you again after the holidays."

I wouldn't allow myself to continue my baby excitement until the MRI report was officially read. An hour went by, then two, then three. By 4:30 I couldn't stand it any longer and I called Dr. L's office to ask if the results were in. A message was sent to Nurse L to return my call and an agonizing hour went by before I saw her number on my caller ID. "Hi Suzanne. Sorry it took so long but I wanted Dr. L to read to the report himself before I called you with results," Ok, fine. TELL ME!! "It says, 'there are many micro fractures in the right side of your sacrum. This is not cancer. It is caused by weakened bones due to radiation damage.' So it's nothing bad," she said. I had to have more information, "So there was one fracture a few months ago and now there are a lot of them? Are you sure it's not a lot of little spots of cancer?" Nurse L replied, "This can happen with radiation damage. You have to be really careful how you work out from now on, but he wants you to make sure you do something to keep the bones and muscles strong. You need to find exercises that won't put pressure on that pelvic bone. No running, no bicycles nothing on a mat on your back." Well, that just described my entire workout routine. "Ok," I said, still not totally convinced, "As long as it's not cancer."

I've let the results sink in for a few days and I've decided to trust that my doctors know what they're talking about and allow myself to be excited about the next phase of our lives that is currently growing inside Lyndsay. She'll have her official blood test on Monday, and if it confirms what the home pregnancy tests have told us, she'll have another blood test on Wednesday. As long as her HCG levels double (or more!) in those two days, we'll start counting the weeks until the first and scariest trimester is over. Keep your fingers crossed! Grow baby(ies), grow!!

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