Cautious Optimism

I've been trying to post this for over a week and finally got the editor to work.  Sorry for the delay.

I was hoping that this report would be where I tell you that I’ve been given a clean bill of health and that things were going to be great from here on out. Not so much.


I went to Brooks Army Medical Center (BAMC) on 12 Aug for my PET scan. I got there approximately 6:45 am I haven’t been there before and wasn’t familiar with the parking or layout of the hospital, so I wanted to be early. I drove through the security checkpoint and could see the hospital off to the right and some parking off to my immediate left. I took a left turn and parked in a dirt parking area. The whole area is a construction zone, BAMC is a new facility, moved from a previous location on Fort Sam Houston in San Antonio, TX. I mistakenly parked in a lot reserved for the members of the construction team. It just made for a longer walk to the hospital but I didn’t mind the walk.

A little after 7:00 am I decided to go into the hospital and find the nuclear medicine clinic. I had a good idea where it was. I had been told to go in the main entrance, turn right and follow the signs for nuclear medicine. Should be easy, right? For a change it was. I found it easily. I checked in and was given a couple of forms to fill out and bring back to the reception desk, the usual pre-treatment questionnaire, medical history stuff. I skipped all the questions concerning pregnancy.

After a short wait a young airman (or maybe airperson – it was a female Air Force Technical Sergeant) came and got me and brought me back to a room to be prept’d for the procedure. She needed to test my blood sugar level and set up an intravenous injection port. She couldn’t use the port in my upper chest; only nurses specially trained could use that location. There are certain precautions they have to abide by to use that port. They have to flush it and use a special attachment. It never looked too complicated to me all of the times it was used in the past, but I guess it’s a union thing. Only certain specially trained individuals can do that procedure. Oh well, it just meant they had to try and find a vein in on of my arms (good luck with that!) She did her best to find a vein, but to no avail and ended up using one on the back of my left hand. She drew some blood, checked my blood sugar level and then left the room to get the radioactive isotope they were going to inject into me. She came back with a metal tube set up to contain the radioactivity so no one is exposed to a dose of radiation. Pretty neat little device. It held a normal syringe sized dose of Fluorodeoxyglucose (18F). FDG, is a radiopharmaceutical used in the medical imaging modality positron emission tomography (PET) scan. I was told that I would be injected and then have to wait 90 minutes before they could perform the PET scan. They actually do a PET scan and a Computed Tomography (CT) scan and then combine the results. It takes 90 minutes for FDG to circulate through the body and start to congregate in places that take up a lot of sugar, like cancer cells.

I was led off to a side waiting room to wait the 90 minutes. They provided a couple of nice recliner chairs much like the ones in the chemo clinic, a TV and a 6 month old copy of the San Antonio Express News newspaper. I brought a book.

About 75 minutes later the Tech Sergeant came in and told me they were just about ready for me and that I should take a drink if I needed one and then empty my bladder. She’d be back to get me in a few minutes. I followed orders, took a drink and had a satisfying pee. Not long after that, she came and got me.

Once in the PET scan room I was met by a male technician and he told me to empty my pockets of anything metal and lay down on the table attached to the PET scan machine. Once I laid down I was told to drop my pants to just past my knees ( so my belt and metal button on my pants wouldn’t show up on the scan). I was maneuvered through the machine so they could hook up the intravenous connection to the other (CT scan) contrast isotope (iodine) they were going to inject me with. My head was strapped down so I couldn’t move it and away we went.

They did the CT scan first. They injected the iodine, which causes a warm flush feeling in a couple of places in your body and then proceeded to run the scan. The CT scan only took 10 minutes or so and then we did the PET scan. That took about 20 minutes. Then I was dismissed and I went back to work.

Once back at work I called both Dr. Eller and Dr. Richard and left messages that I had gotten the PET scan done. I don’t have a direct line to either doctor, no one gets that, so I either have to leave a message or talk to a nurse. It was Friday so I didn’t expect any results until Monday or Tuesday.

Tuesday morning when I got to work I checked my voice mail and found a message from Dr. Eller from late Monday afternoon (after I left work). He said the results were good and he’d talk to me later. I returned his call and of course left a message. I did not get a call back. On Wednesday I stopped after work at Wilford Hall Medical Center and got a copy of my PET scan results. Interesting enough I had a voice message to call Endocrinology to set up an appointment on my home phone. Terry and I looked at each other questioningly. Terry and I spent about an hour on the internet trying to decipher the pathology report. There were lots of medical terms we had to look up to try and make sense of. From what we could tell I was good to go. The primary site of the tumor looked good (no cancer evident), my lymph nodes were good and other than a couple of notes about a inguinal hernia (which I knew about) and a 1.3 cm left renal nodule, meeting CT and PET criteria for lipid-rich adenoma, things looked normal, except for a stable 1.0 cm persistent indeterminate left thyroid nodule nonhypermetabolic (Non-hypermetabolic means that it doesn't show up on the PET scan, doesn't take up radio labeled sugar molecules any more than the background tissue).  The pathologist recommended consideration of an ultrasound guided biopsy if desired. Needless to say that piqued our interest.

Dr. Eller called on Thursday morning and we went over the report line by line. We were both happy with the report concerning my tongue cancer (I’m cancer free). But, the thyroid nodule (what’s the difference between a nodule and a tumor ??) concerned him and he recommended that I get it looked at. I told him the endocrinology clinic had already contacted me and I had an appointment set up for 31 August for an assessment. That assessment could include a Fine Needle Aspiration. That procedure involves a somewhat large syringe with a medium sized needle used to suck up some of the nodule cells that are then tested for cancer. Sounds like fun right?

So here we are again in the dark wondering just what the future holds for me. Dr. Eller told me 6 - 7% of the general population have thyroid nodules and only 6 – 7% of them are positive for cancer. He said the nodule was identified in my original CT scan but it wasn’t taken seriously due to the tumor on my tongue. He also said if it wasn’t for my tongue tumor he wouldn’t be too concerned about the thyroid nodule either, but because of the tongue tumor he wanted it looked at. I guess that makes me feel better, but once cancer has been diagnosed and treated I think all of us cancer survivors are always mindful of a recurrence.

If you check out the above links, I think you’ll be about as informed as I am now. I am cautiously optimistic that nothing is going to come of the thyroid nodule and I’ll be back to recovering from my treatments satisfied I won’t have to worry about cancer in my future. I’m continuing to make progress, it’s still frustratingly slow, but I’m feeling better. I’ve still got issues with my throat, swallowing is still difficult at times, the dry mouth hasn’t improved much and my sense of taste hasn’t improved much either. But I’m getting used to it.

So in a few days or so I should know how things went with the thyroid test and I’ll broadcast that news when I get it.

Y’all take care,
Miller, out