Mets Day 874 - PET-MRI Scan

Today I went to NIH for a combined PET-MRI scan. I was the first patient of the morning, and arrived at 6:15 am. In advance of the scan, a tech placed an IV in my arm (no nurse was available at the time to access my port), and was injected with 18F-fluoride. That's a type of glucose with a positron-emitting isotope that likes to accumulate in many types of cancer cells. After I was injected, the tech told me that I needed to wait for 45 minutes for the stuff to be absorbed into whatever cancer cells I have in my body. She added that the glucose liked to go into muscles that were used post-injection, so I should relax, close my eyes, and rest. I set aside my biography of C.S. Lewis and reclined my chair, while the tech turned out the light and shut the door.

Exactly 45 minutes later, the tech woke me up, escorted me to the machine, and turned me over to another tech.  He told me that NIH got the machine just  a few months ago, and that there were fewer than 20 in operation throughout the United States. It's a traditional closed MRI design, meaning that the patient lays on a moving table that is slid into a long tube surrounded by large spinning magnets and radiation-spewing beams. I've had both PET and MRI scans before; apparently what makes this machine special is that, instead of conventional photomultiplier tubes used on prior PET machines, this machine has avalanche photodiodes which are not affected by the strong magnetic field of the MRI system, so it can do a PET and MRI at the same time. 

The tech told me that the scan would be a bit over an hour long. After I got on the table, he placed a brace around me neck to limit my head movement, He strapped me onto the table, carefully placing my arms at my sides, then cinched the straps so I could not move. He put a bulb in my hand and told me to squeeze it if I started to feel claustrophobic or otherwise uncomfortable. He then stuffed earplugs into my ears, then put headphones over the earplugs. I remembered my MRI scan in April 2012 (which confirmed that my cancer had metastasized), when I wrote:

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.

 Today's scan was not quite as bad as that one, but it was close. I spent 90 minutes in that metal tube and the machine growled and hummed like a cheesy sci-fi movie. I felt my spine heat up as it was irradiated. An hour into the scan, I had beads of sweat forming on my face. I couldn't wipe my face, and the more I tried to ignore my perspiration, the greater was my desire to squeeze the bulb so I could just mop my brow. I then consciously relaxed, accepted the fact that I was hot and sweaty, and embraced my current state. Calmed, I rode out the scan for the last 30 minutes.

When the tech unstrapped me from the table, he saw how I had sweated through my the front and back of my shirt, and commented how it could get warm inside that tube. I briefly wondered how what percentage of patients have problems in completing their scans, then offered a prayer of gratitude that this scan was made available to me, and that I got through it ok.

I'll get my results in a few days. I have already accepted the results, whatever they may be. I don't control my cancer, and that acceptance gives me strength to embrace my current state: living one day at a time, enjoying one moment at a time, accepting hardship as the pathway to peace.