Mets Day 3 - MRI results

On Thursday, I had nearly two hours of MRI scans.  I had a pelvic scan, with and without contrast, and an abdominal scan, with and without contrast.  As the machine slowly slid me into that tube, my arms above my head, I was thankful that I was not claustrophobic.  After an hour in the tube, I nonetheless began to uncomfortable.  My nose was about an inch from the tube wall, and my elbows had little room for movement.  I thought it interesting how an MRI seemed to distort the time-space continuum.  The technician would say, "the next scan will take three minutes."  Ten minutes later, the scan would end, and the technician would say that the next scan would take 90 seconds.  Fifteen minutes later, it ended.  At times I was instructed to hold my breath as contrast was pumped through the IV and my abdomen was imaged.  I visualized that I was swimming underwater, trying to see how far I could go before I had to surface.  One more stroke, then another, then another, then finally I could exhale.  As I felt the noisy thumping of the machine, like a badly unbalanced washer during a vigorous spin cycle, I sensed the fluid in my cells jostling back and forth, and I felt my pelvis getting uncomfortably warm.  I thought of the scene from Gremlins where one of the evil critters was lured into the microwave, soon followed by a green explosion.  I remembered that the floor and walls of the MRI room was all tile, and that there was a mop and bucket in the corner.  That realization did not comfort me.  MRI, I realized, was an acronym for Microwave Roasted Individual.  

I received the scan results Friday afternoon.  The results were correlated with the CT scan of Wednesday, and the scans generally correlated.  Here is the key paragraph:






One new piece of information in the MRI scan is the "abnormal nodular focal soft tissue thickening and enhancement along the serosal surface of the lateral wall of the bladder."  As I understand it, the serosal surface is the outermost lining of he bladder, and the suggestion that the cancer has gotten into the serosal surface means that it has progressed from muscle-invasive (T2) to penetrating the muscle wall (T3).   If it wasn't for bad news, there would be no news at all. 

After the CT and MRI reports were sent to Dr. Schoenberg at Hopkins, we exchanged emails.   He suggested 


"that we talk on Monday afternoon to determine next step since the lymph node involvement may require additional chemotherapy.  That said, will probably recommend that you move forward with cysto as scheduled."

The cysto is the trans-uretheral examination of the bladder scheduled for this Thursday, not the major surgery to remove the bladder.  Whether that RC surgery will happen depends on the consultations that I will have next week.

On Thursday evening,  after I received the CT results, we had a family council where we talked about the fact that my cancer had spread.  We honestly acknowledged that we did not know all of the details, but that if the cancer had gotten into my spine, I likely had only a few months to live.  We each talked about how we felt, and expressed our love and appreciation for each other.  We drew upon our faith, and belief that mortality is but a small slice of our eternal existence.

The reaction of Garrett (age 14) was interesting.  The first thing that he asked was whether there was any information that we had but were not sharing with us.  I was struck by how kids often perceive when things are being hidden from them.  We assured him that he knew all that we did.  He nodded, then said how he tried to look on the positive side, and not dwell on the things that were painful.

Kirsten (17) had a harder time with the news, and said that we needed some time to process it.  She didn't want to talk about her feelings too much, and after the council went to her best friend's house to talk.

Spencer (21) said that he wanted to spend more time doing things together as a family.  He said that, after a year where he had spent almost every night going to recovery meetings, he had his feet under him and was in a much better place.  He spoke of missing time with his family, since he usually was gone while I was home, and vice-versa.  Jennifer and I smiled, because it was just a few years ago that Spencer was actively fighting against spending time together as a family.  Actual quote from Spencer at age 17:  "Mom, you are too into this family unity crap."  Now, four years later, Spencer was wanting more family unity crap.  Jennifer said she was going to make t-shirts that said "We [heart] family unity crap."

Chelsea (23) talked both on the scientific, medical level, and on the spiritual level.  It was interesting to listen to her balance the practical facts with the deep commitment she has to her religious beliefs.

Josh (27) spoke of how he admired that we were facing this battle with calmness and determination, balanced by an absence of fear of death.   

We ended the family council with a very heart-felt prayer, where we asked for greater acceptance, understanding, love and compassion.  We asked that this experience could strengthen our spiritual depths, and reaffirm our willingness to look at life not from a short-sighted mortal perspective, but from the Lord's long-term view.  It was a very tender and spiritual moment.  It reaffirmed my belief that this journey with cancer is not about the destination, but about how we walk the path.  I do not know how long my feet will continue this walk in mortality, but I am determined to walk it well, to honor my commitments, to be a good example, and to give thanks for each day that I have with those I love.