The below passage was written yesterday - my preliminary PET scan report from today was normal (no return of the lymphoma).
It’s been nearly 9 months since my last chemotherapy treatment for Hodgkin’s lymphoma and yet I still live under the umbrella that it could reappear at a moment’s notice. Calling it a “fear” would be misleading as I do not fear the disease nor the possibility of further treatments or even death. It is more like that tiny pebble in your shoe. You feel it’s presence with every step but not enough to stop, in the middle of your run or walk, to remove it. During the throes of a busy day, the thoughts get moved to the background. But, in the silence of the night, as you lay down to sleep, every breath or chest tightness brings with it the prospect of a return of the relentless, reproducing cells longing to take over my body.
Some days my mind still wanders back to those 2 months prior to diagnosis, wondering why I didn’t seek care sooner. Every symptom, the cough, the fevers, the drenching sweats, difficulty with running, there were alternative explanations for every one of them. Being of perimenopausal age, sweats and “hot flashes” are common. Seeing sick people with prolonged coughs, I was sure I contracted the same virus that they had incurred. Certainly, my running tolerance was either from aging or just being so busy and tired that I couldn’t reach the pace or distances that I was used to achieving. Yet, multiple times during that 2 month period of time, the thought of lymphoma arose and I just ignored it. Either my subconscious was more fearful that I would be incorrect in my assessment (an assault to my intellect) or, more likely, it just wasn’t good timing for me to be "sick".
In November 2015, my daughter was studying in Mannheim, Germany. She was busily trying to perform skype/phone interviews to land an accounting internship back here in the states while studying, exploring Europe and feeling quite homesick. Chris and I would skype with her at least twice a week, never really wanting to hang up because we wanted to comfort her as much as we could. The Paris bombings occurred on a weekend when she was traveling to France with a class. She loved visiting as many busy, German Christmas markets as she could, while we feared that one of these would be the next target. The Syrian refugee crisis occurred prior to her return, and shortly after she arrived home, several people were killed at a train depot near Koln, where she traveled frequently. That being said, we worried about her incessantly but didn’t want that known and we certainly didn’t need to add any more concerns at that time. Then, there was the holidays. Thanksgiving and Christmas were busy, happy times with family that didn’t need to be overshadowed by a gloomy diagnosis.
Understanding those factors, I have never felt any regrets about waiting to seek care for two months. The only lingering concern, is that ability to explain away symptoms, and angst that I might delay diagnosis again should symptoms recur. That being said, I started coughing again in mid-February, shortly after seeing a croupy, 18-month old with an ear infection and lots of wheezing. Sure enough, I developed low-grade fevers and a miserable, wheezy cough very similar to the cough I experienced with the lymphoma. After 2 weeks and frequent use of my albuterol inhaler, I started hearing comments from coworkers. “Are you ok?” “I haven’t heard you cough like that for more than year.” In other words, the cough sounded similar to the cough when I was diagnosed with lymphoma. Although I was pretty certain these were a result to an infectious exposure, my low grade fevers (temperature readings in the 99-100 range) persisted more than 2 weeks and as the cough lingered, I finally gathered the courage to call my oncologist and arrange for blood work and a PET scan. Of course, within 2 days of arranging these tests, the cough subsided and energy level started to improve (Murphy’s Law). Along with normal labs, this certainly makes me doubt whether the PET scan is truly necessary, but, alas, I remember having those same doubts the morning I went in to get my chest xray, revealing an impressive number of lymph nodes in my mediastinum.
Now it is Sunday, the day before my PET scan. In order to find rapidly reproducing cancer cells, a PET scan uses radioactively-tagged sugar to locate them. To assure that the cells are “hungry”, you cannot consume any sugar the entire day before the scan and you can’t eat at all on the day of the scan.
PET scans at my imaging center are only performed on Mondays and Thursdays. Since my oncologist ordered the “first available” appointment, this landed on Monday, March 6th. Unfortunately, my schedule was already packed with meetings starting at 7 am, a full day of patients and then ending with a dinner meeting at 5:30 pm. The 7 and 8 am scan times would interfere with my morning meeting which has already been re-scheduled due to snow and is our first collaboration with physicians from both Overlake and Evergreen hospitals that it’s fairly important that I participate in this meeting. The only other time availability on Monday was at 1 pm. Since the test takes about 2.5 hours due to the barium ingestion, lab testing, radioactive contrast administration, and scan time (which is nearly 30 minutes alone), much of this time would be during my lunch hour (since I take a very late lunch). So, although this meant putting off my coffee and fasting for a longer period of time, this time would inconvenience the least amount of people.
While eating bacon, eggs, meat and hard cheeses may sound fantastic to some males that I know, I dread this day more than the fasting and scan itself. I live in the fear that I’ll accidentally mess up and grab a cracker or, in my case, a piece of chocolate and have to reschedule it all over again. Even worse, we have a grandiose birthday party tonight for my 16 year old twin nieces at a great restaurant in Bellevue and I won’t be able to consume any of the fabulous food or beverages. In fact, I will be eating beforehand to avoid even the temptation, as most meats are marinated that I have to stick to the deli meat that I found without any sugar. Even that is a tricky find. It amazes me how many meat packages contain sugar, even the deli meats typically contain 1-2 g of sugar per serving.
In addition, no strenuous activity is allowed on the day before the procedure. Sunday, being the only day that I don’t typically have meetings or work scheduled, is my usual long run day. This has only amounted to 8-10 miles in the past 2 months, due to increasing fatigue, but it’s still something I enjoy. My Sunday run is a spiritual time to reflect on the words spoken at church and my own actions and activities for the week. Which is why I find myself writing. Just as I journaled during my treatment when I couldn’t run, I will perform the same today. It is just a different method of reflection for me, but one that allows me to share my innermost thoughts with others. As a strong believer in God and His guidance in my life, I know that this is His way of re-focusing my energy again to something that may potentially help others, which has always been my purpose on this earth.
No matter the verdict, I endure this small sacrifice, to gain knowledge of my current cancer status. It will all be worth it for the piece of mind that I am either cancer-free or that I detected the cancer changes much earlier than last time. Regardless of the outcome, I live with the understanding that this is part of God’s plan to keep me focused on my role and to avoid worrying about the day-to-day inconveniences of this life. As I continue to give my best and make the most of the talents He has granted me, I must place my faith and trust in Him.
When you realize God’s purpose for your life isn’t just about you, He will use you in a mighty way. ~ Dr. Tony Evans
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| Sample meals for preparing for the PET scan - Egg/cheese/bacon omelet (below) and steak salad with sugar-free Jello (top) |
