Signed “Final report”

Have you ever read a report from a PET scan or a CT scan? Those things that give people with cancer what’s known as “scanxiety?” I am sharing here the narrative sent to me and my oncologist for discussion. This was the one that led to the decision to radiate my vertebrae when the radiologist found the new (now demolished) tumor on my lumbar 4. Enjoy. I will leave you with the exact document I have to translate on my own prior to my appointment.

Narrative clinical history female metastatic breast cancer. 55 years old. This PET sequence for comparison view and evaluate responses to therapy.

Tracer information into the right mediport. Not the wrong mediport. They take from me in safety they give to me in danger for I am scanned from my head to my toes. Relieve me of the seas of yellow fluid yet my livers not included

Scan algorithms based on a phantom, clear sinuses, no lymph nodes.

Paranasal sinuses: Clear

Thyroid: Not well visualized.

Chest:

Lymph nodes: No FDG-avid or enlarged supraclavicular, mediastinal, hilar, or axillary adenopathy.

Lungs: Scarring in the posterior right upper lobe. No FDG-avid pulmonary lesions. Lung parenchymal evaluation, including for punctate nodules, is limited by low dose CT and non-breathhold technique.

Pleura: Unchanged pleural-based nodule along the periphery of the left lower lobe between the sixth and seventh ribs with minimal uptake above background measuring 1.5 cm with SUV max of 2.6.

Chest Wall: No FDG-avid lesion. Unchanged dense soft tissue within the bilateral breasts without significant focal uptake.

Heart: Atherosclerotic calcification of the coronary arteries is present. No pericardial effusion.

Other Findings: None.

Abdomen/Pelvis:

Liver: No FDG-avid liver lesion.

Gallbladder: Normal.

Spleen: Normal in size and metabolic activity.

Pancreas: No FDG-avid lesion.

Adrenals: No FDG-avid lesion.

Bowel: Physiologic FDG uptake is seen in the bowel. No focally FDG-avid lesion.

Kidneys/Bladder: Normal physiologic excretion of the radiopharmaceutical. No FDG-avid lesions.

Lymph Nodes: No FDG-avid or enlarged abdominal, retroperitoneal or pelvic adenopathy.

Vasculature: Normal abdominal aortic diameter (<3cm).

Other Findings: Diffuse peritoneal thickening is similar in appearance to prior CT, with unchanged more focal nodularity along the right lower pelvis which is additionally unchanged in CT appearance with mild associated uptake with SUV max of 2.4 (212). The latter is newly apparent from more remote PET. Increasing now moderate volume ascites.

Musculoskeletal:

Bones: New focus of uptake within the L4 vertebral body with unchanged underlying sclerotic focus with SUV max measuring 4.8 (172). Unchanged sclerotic appearance of the axial skeleton and ribs, and patchy sclerotic appearance of the proximal appendicular skeleton compatible with diffuse treated osseous metastases. Mild asymmetric linear intercostal uptake along the posterior right chest wall (135) without convincing underlying CT correlate, overall non-specific, but with attention recommended on follow-up.

Other Findings: None.

Impression

1. New moderate focal uptake within the L4 vertebral body concerning for progression of osseous involvement from PET/CT 4/12/2019. Diffuse sclerotic osseous lesions are otherwise not hypermetabolic.

2. Increasing now moderate volume ascites with persistent peritoneal thickening and regions of peritoneal nodularity with mild uptake, remain concerning for malignant involvement. Evaluation on PET is limited due to variable physiologic bowel uptake

I have personally reviewed the images for this examination and agree

with the report transcribed above.

Signed”Final report”

Video: Add a Face to My Words

This is one of the videos I have been asked to do this year to talk about life with metastatic breast cancer. They’re difficult to get out – sometimes by voicing these emotions, I feel like I’m separating the cream from the milk if you know what I mean, and afterwards comes the “clouds in my coffee” – and it’s not vanity but tears that fall. When verbal expressions of deep seated feelings surface the sadness fills up and over the brim of a cup I hold delicately in my hands.

I also thought you might like to see me, although it may send some of you to the unsubscribe button I hold out hope that instead you’ll see more of me and the effects of my disease on my life. Please enjoy and excuse the raw, unedited quality or lack thereof. Just life at the dining room table – no fake news, all fumbles and stutters, without subtitles or captions. The real me.

Quote

Buying Time

Impossible: 
To find the cash
For buying time.
Oranges, sweet crude
Coffee, corn,
Commodities traders
Delisted love and friendship
Health and fathers.
The buying chits line
The exchange floor
Like clothing once
In the bedroom.
Proof money can’t
Buy love.

In department stores
Perfumed and made up
Clerks compartmentalize
Stuffed emotions and
Big wide-eyed bears
Into shopping bags.
Leaving through
A glass revolving door
Tumbling onto the gray
Segments of sidewalk
Blowing like leaves
I chase down sealed
Dented cans of hope.

With one pair of eyes
Inevitably you’ll find yourself in a single view someday.
Walking alone without another Pair, your hands empty
Except for your
Pocketbook and calling cards.
Blistered heels and skinned knees -
No one else to help watch the bumps in the road.
Holding up one hand
Hailing any empty cab while
The sun waits on the horizon
For me to return to
No one in particular
Loneliness casts
A long shadow.

With a single pair of eyes
The myopic make few plans.