{"id":23754,"date":"2020-11-18T08:28:26","date_gmt":"2020-11-18T13:28:26","guid":{"rendered":"http:\/\/ianchadwick.com\/blog\/?p=23754"},"modified":"2020-11-18T08:28:26","modified_gmt":"2020-11-18T13:28:26","slug":"the-cancer-diaries-part-16","status":"publish","type":"post","link":"https:\/\/ianchadwick.com\/blog\/the-cancer-diaries-part-16\/","title":{"rendered":"The Cancer Diaries, Part 16"},"content":{"rendered":"<div class=\"pvc_clear\"><\/div>\n<p id=\"pvc_stats_23754\" class=\"pvc_stats all  \" data-element-id=\"23754\" style=\"\"><i class=\"pvc-stats-icon medium\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.0\" viewBox=\"0 0 502 315\" preserveAspectRatio=\"xMidYMid meet\"><g transform=\"translate(0,332) scale(0.1,-0.1)\" fill=\"\" stroke=\"none\"><path d=\"M2394 3279 l-29 -30 -3 -207 c-2 -182 0 -211 15 -242 39 -76 157 -76 196 0 15 31 17 60 15 243 l-3 209 -33 29 c-26 23 -41 29 -80 29 -41 0 -53 -5 -78 -31z\"\/><path d=\"M3085 3251 c-45 -19 -58 -50 -96 -229 -47 -217 -49 -260 -13 -295 52 -53 146 -42 177 20 16 31 87 366 87 410 0 70 -86 122 -155 94z\"\/><path d=\"M1751 3234 c-13 -9 -29 -31 -37 -50 -12 -29 -10 -49 21 -204 19 -94 39 -189 45 -210 14 -50 54 -80 110 -80 34 0 48 6 76 34 21 21 34 44 34 59 0 14 -18 113 -40 219 -37 178 -43 195 -70 221 -36 32 -101 37 -139 11z\"\/><path d=\"M1163 3073 c-36 -7 -73 -59 -73 -102 0 -56 133 -378 171 -413 34 -32 83 -37 129 -13 70 36 67 87 -16 290 -86 209 -89 214 -129 231 -35 14 -42 15 -82 7z\"\/><path d=\"M3689 3066 c-15 -9 -33 -30 -42 -48 -48 -103 -147 -355 -147 -375 0 -98 131 -148 192 -74 13 15 57 108 97 206 80 196 84 226 37 273 -30 30 -99 39 -137 18z\"\/><path d=\"M583 2784 c-38 -19 -67 -74 -58 -113 9 -42 211 -354 242 -373 16 -10 45 -18 66 -18 51 0 107 52 107 100 0 39 -1 41 -124 234 -80 126 -108 162 -133 173 -41 17 -61 16 -100 -3z\"\/><path d=\"M4250 2784 c-14 -9 -74 -91 -133 -183 -95 -150 -107 -173 -107 -213 0 -55 33 -94 87 -104 67 -13 90 8 211 198 130 202 137 225 78 284 -27 27 -42 34 -72 34 -22 0 -50 -8 -64 -16z\"\/><path d=\"M2275 2693 c-553 -48 -1095 -270 -1585 -649 -135 -104 -459 -423 -483 -476 -23 -49 -22 -139 2 -186 73 -142 361 -457 571 -626 285 -228 642 -407 990 -497 242 -63 336 -73 660 -74 310 0 370 5 595 52 535 111 1045 392 1455 803 122 121 250 273 275 326 19 41 19 137 0 174 -41 79 -309 363 -465 492 -447 370 -946 591 -1479 653 -113 14 -422 18 -536 8z m395 -428 c171 -34 330 -124 456 -258 112 -119 167 -219 211 -378 27 -96 24 -300 -5 -401 -72 -255 -236 -447 -474 -557 -132 -62 -201 -76 -368 -76 -167 0 -236 14 -368 76 -213 98 -373 271 -451 485 -162 444 86 934 547 1084 153 49 292 57 452 25z m909 -232 c222 -123 408 -262 593 -441 76 -74 138 -139 138 -144 0 -16 -233 -242 -330 -319 -155 -123 -309 -223 -461 -299 l-81 -41 32 46 c18 26 49 83 70 128 143 306 141 649 -6 957 -25 52 -61 116 -79 142 l-34 47 45 -20 c26 -10 76 -36 113 -56z m-2057 25 c-40 -58 -105 -190 -130 -263 -110 -324 -59 -707 132 -981 25 -35 42 -64 37 -64 -19 0 -241 119 -326 174 -188 122 -406 314 -532 468 l-58 71 108 103 c185 178 428 349 672 473 66 33 121 60 123 61 2 0 -10 -19 -26 -42z\"\/><path d=\"M2375 1950 c-198 -44 -350 -190 -395 -379 -18 -76 -8 -221 19 -290 114 -284 457 -406 731 -260 98 52 188 154 231 260 27 69 37 214 19 290 -38 163 -166 304 -326 360 -67 23 -215 33 -279 19z\"\/><\/g><\/svg><\/i> <img loading=\"lazy\" decoding=\"async\" width=\"16\" height=\"16\" alt=\"Loading\" src=\"https:\/\/ianchadwick.com\/blog\/wp-content\/plugins\/page-views-count\/ajax-loader-2x.gif\" border=0 \/><\/p>\n<div class=\"pvc_clear\"><\/div>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright\" src=\"http:\/\/millburnmedicalimaging.com\/od-media\/site\/33\/upload\/imageblock\/j\/dexa_image.jpg\" alt=\"Bone denstiy scan (not mine)\" width=\"300\" height=\"337\">Yesterday, I went for my second bone density scan \u2014 aka bone densitometry or dual-energy x-ray absorptiometry \u2014 the one that had been planned, but scheduled then delayed twice previously. My first bone scan, like my first CT scan, was done in June, before my surgery. This one was ordered by the oncologist prior to my radiation treatment.<\/p>\n<p>Bone density scans are used for many types of diagnoses, including measuring bone loss and osteoporosis, but also to detect the spread of cancer cells. My previous scan showed the cancer had not spread into my bones (a tremendous relief). I hope the second one shows that same result; bone cancer is very nasty. Not that <em>any<\/em> cancer is good; some are simply nastier than others.<\/p>\n<p>I arrived at the hospital \u2014 after my 60 km drive in the first taste of winter snow and wind \u2014 early, as usual, with several books to keep me occupied. I also managed to finally reach someone in the parking kiosk and buy a 30-visit pass for my upcoming radiation treatments. The kiosk sign says it&#8217;s open 8 a.m.-4 p.m., but in reality, they close at 3:45, which proves highly inconvenient for patients like me who have to stay later. I think I&#8217;ve spent more in parking at RVH than in any other aspect of the treatment to date (my usual fee is $15.25 per visit; it would be almost $20 if I wanted in-and-out privileges). I&#8217;ve also found the staff I&#8217;ve spoken to in the hospital seem unaware of, or confused about parking options, costs, or the hours the kiosk is open.<\/p>\n<p>Waiting, as I&#8217;ve said before, is a big part of the process; this one starts with an injection, then a two-three hour wait before the actual scan. Or, if the nuclear medicine department is very busy, it could be even longer (one of the prior schedules for this scan had an almost five-hour wait!). I chose to get a coffee, sit in the open area, and read. I could have gone back to my car and driven somewhere to shop, but it has snowed that morning; not a lot (5-7 cm) but the streets were icy, the traffic slow, and I didn&#8217;t feel like fighting it. besides, what do I need to buy in Barrie? I preferred to read quietly.&nbsp;<\/p>\n<p>(Among the books I brought, I was almost finished re-reading <em>Mexico Set<\/em>, the second of the <a href=\"https:\/\/www.z-machine-matter.com\/2020\/03\/len-deighton-game-set-match.html\" target=\"_blank\" rel=\"noopener noreferrer\">first Len Deighton Cold War spy trilogy<\/a>, and finished it when I got home. As usual, I was working through several other titles I had brought along. My usual calculation is to bring a different book for every 20-30 minutes I have to wait, but to be honest, like yesterday I sometimes get drawn into fewer. Still, it&#8217;s nice to have options available.)<\/p>\n<p>Unlike many processes and scans I&#8217;ve been through since my diagnosis, this one required no preparation and had no limitations on food or drink beforehand. I didn&#8217;t even have to change into the usual hospital coat and gown, nor have a full bladder. For which I was thankful.<\/p>\n<p>The injection takes maybe three to five minutes, mostly in getting into place for it. And the nurse or technician finding a suitable vein, of course; I&#8217;ve had so many injections, blood tests, IVs, and so on this year that my veins are a bit bruised and reluctant to participate in more. The shot contains a small amount of radioactive tracer material. Not enough to make you glow in the dark (that could be fun&#8230;), but enough for the scanner to detect once it settles throughout the body. As the<a href=\"https:\/\/www.mayoclinic.org\/tests-procedures\/bone-scan\/about\/pac-20393136\" target=\"_blank\" rel=\"noopener noreferrer\"> Mayo Clinic<\/a> says,<\/p>\n<blockquote><p>Areas of the body where cells and tissues are repairing themselves most actively take up the largest amounts of tracer. Nuclear images highlight these areas, suggesting the presence of abnormalities associated with disease or injury.<\/p><\/blockquote>\n<p><!--more--><\/p>\n<p>I was led into the nuclear medicine department on time, given my injection (quite painless), then let loose to do as I saw fit for the next two-and-a-half hours. Not that there&#8217;s a lot to do in a hospital. There are a few small eateries in the building (including a Tim Horton&#8217;s in the atrium and a somewhat more upscale coffee shop near the main entrance), and a gift shop that seems geared to women, but sadly no book, newspaper, or magazine outlet (or even a section of a store for it). Just sitting staring at one&#8217;s phone for 150 minutes simply looks sad and lonely.&nbsp; Hence my books.<\/p>\n<p>I was a bit surprised at the number of junk food and pop dispensing machines in a healthcare facility. That struck me as either very hypocritical or simply venal.&nbsp;<\/p>\n<p>One thing I noticed is the dearth of clocks. There&#8217;s a large one above the atrium, and a smaller one in its lower level, but none to be seen in the halls or waiting areas. If you look for them, you can see some in rooms or reception areas, but not waiting areas. Was this a deliberate decision, something to do with the psychology of patient care and waiting? Or just some bizarre oversight in the design? I had to keep checking my phone to be sure I was back in the department on time for the scan.<\/p>\n<p>Back in the department, after only a few minutes of reading, I was led into the scanner room by another of their friendly technicians and nurses. I should take a moment and comment again on how good I&#8217;ve found almost everyone at RVH: supportive, friendly, comforting, all of which matters when you&#8217;re in a stressful health situation like mine. I&#8217;ve only ever had one less-than-friendly contact there in my many visits.<\/p>\n<p>The scanner they use at RVH may be a bit old because I could not find an image online of anything as bulky and mechanical. If it works, I suppose age isn&#8217;t an issue, but at least in online images there are many smaller, less 2001-Space-Odyssey-style scanners in use these days. This one has a long bed you lie on while the bed moves slowly (very slowly when imaging; imagine a snail racing past you) in and out, below the bulky camera suspended above you. When doing a 3D view (as they did of my spine), the camera rotates around your body taking images from many angles; a huge, sluggish machine. You just have to wait for it to do its work.<\/p>\n<p>The camera is placed close to your body. When imaging your head, it is less than a hand&#8217;s breadth above your nose. Not comfortable for people with claustrophobia, but I was okay. And that was the shortest of the imaging segments.<\/p>\n<p>The entire scan takes about 45-60 minutes to get every section (my time was the latter). They did my abdomen first, then my head, then my whole body, and finally my spine (in 3D). Since nothing touches the patient, there&#8217;s no pain or sensation of any sort. The hardest thing is to simply lie still for the duration. The spinal scan is about 15 minutes, the full-body scan about 20 or 25. The rest I had were about five-ten minutes each.<\/p>\n<p>Muscles have a habit of twitching or tensing when you&#8217;re trying to lie still, and I got random itches I wanted to scratch, but couldn&#8217;t. I kept trying to relax, and recall the calming and breathing exercises I learned when I started to learn Buddhist meditation so many decades back. They helped, but my mind kept doing the monkey-wandering thing. It&#8217;s hard to believe I was more focused and controlled when I was in my 20s, but there I was, trying not to twitch and shift. I kept wanting to pick up a book and read&#8230;<\/p>\n<p>It&#8217;s also difficult not to fall asleep while lying motionless for 10-20 minutes. There&#8217;s nothing to distract you, and the soft humming of the HVAC and the machinery is like the susurrus of waves on a shore: conducive to sleep. Not that sleep is bad, and the technician told me many <em>do<\/em> fall asleep during the scans, but I was constantly afraid I&#8217;d twitch or turn if I fell asleep. This would require starting that segment all over and likely get me disapproval from the technician. I have enough people in my life who disapprove of me these days (okay, some are room-temperature-IQ members of our local council, but still&#8230;)<\/p>\n<p>Staying awake and alert was made more difficult this particular day because, several times in the night before, my dog had had an upset gut, and required me to wake up, get dressed, and take her outside a few times to relieve her bowels during the night (with a little flashlight so I could see to pick up after). But I suppose I managed to be still enough no re-takes were required. I was able to re-thread my belt, put my glasses on, and leave for the blustery 60 km drive home.<\/p>\n<p>That&#8217;s it for a week or so. Next up: radiation treatment and whatever effects I have from the hormone therapy I&#8217;ve embarked on.<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"pvc_clear\"><\/div>\n<p id=\"pvc_stats_23754\" class=\"pvc_stats all  \" data-element-id=\"23754\" style=\"\"><i class=\"pvc-stats-icon medium\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.0\" viewBox=\"0 0 502 315\" preserveAspectRatio=\"xMidYMid meet\"><g transform=\"translate(0,332) scale(0.1,-0.1)\" fill=\"\" stroke=\"none\"><path d=\"M2394 3279 l-29 -30 -3 -207 c-2 -182 0 -211 15 -242 39 -76 157 -76 196 0 15 31 17 60 15 243 l-3 209 -33 29 c-26 23 -41 29 -80 29 -41 0 -53 -5 -78 -31z\"\/><path d=\"M3085 3251 c-45 -19 -58 -50 -96 -229 -47 -217 -49 -260 -13 -295 52 -53 146 -42 177 20 16 31 87 366 87 410 0 70 -86 122 -155 94z\"\/><path d=\"M1751 3234 c-13 -9 -29 -31 -37 -50 -12 -29 -10 -49 21 -204 19 -94 39 -189 45 -210 14 -50 54 -80 110 -80 34 0 48 6 76 34 21 21 34 44 34 59 0 14 -18 113 -40 219 -37 178 -43 195 -70 221 -36 32 -101 37 -139 11z\"\/><path d=\"M1163 3073 c-36 -7 -73 -59 -73 -102 0 -56 133 -378 171 -413 34 -32 83 -37 129 -13 70 36 67 87 -16 290 -86 209 -89 214 -129 231 -35 14 -42 15 -82 7z\"\/><path d=\"M3689 3066 c-15 -9 -33 -30 -42 -48 -48 -103 -147 -355 -147 -375 0 -98 131 -148 192 -74 13 15 57 108 97 206 80 196 84 226 37 273 -30 30 -99 39 -137 18z\"\/><path d=\"M583 2784 c-38 -19 -67 -74 -58 -113 9 -42 211 -354 242 -373 16 -10 45 -18 66 -18 51 0 107 52 107 100 0 39 -1 41 -124 234 -80 126 -108 162 -133 173 -41 17 -61 16 -100 -3z\"\/><path d=\"M4250 2784 c-14 -9 -74 -91 -133 -183 -95 -150 -107 -173 -107 -213 0 -55 33 -94 87 -104 67 -13 90 8 211 198 130 202 137 225 78 284 -27 27 -42 34 -72 34 -22 0 -50 -8 -64 -16z\"\/><path d=\"M2275 2693 c-553 -48 -1095 -270 -1585 -649 -135 -104 -459 -423 -483 -476 -23 -49 -22 -139 2 -186 73 -142 361 -457 571 -626 285 -228 642 -407 990 -497 242 -63 336 -73 660 -74 310 0 370 5 595 52 535 111 1045 392 1455 803 122 121 250 273 275 326 19 41 19 137 0 174 -41 79 -309 363 -465 492 -447 370 -946 591 -1479 653 -113 14 -422 18 -536 8z m395 -428 c171 -34 330 -124 456 -258 112 -119 167 -219 211 -378 27 -96 24 -300 -5 -401 -72 -255 -236 -447 -474 -557 -132 -62 -201 -76 -368 -76 -167 0 -236 14 -368 76 -213 98 -373 271 -451 485 -162 444 86 934 547 1084 153 49 292 57 452 25z m909 -232 c222 -123 408 -262 593 -441 76 -74 138 -139 138 -144 0 -16 -233 -242 -330 -319 -155 -123 -309 -223 -461 -299 l-81 -41 32 46 c18 26 49 83 70 128 143 306 141 649 -6 957 -25 52 -61 116 -79 142 l-34 47 45 -20 c26 -10 76 -36 113 -56z m-2057 25 c-40 -58 -105 -190 -130 -263 -110 -324 -59 -707 132 -981 25 -35 42 -64 37 -64 -19 0 -241 119 -326 174 -188 122 -406 314 -532 468 l-58 71 108 103 c185 178 428 349 672 473 66 33 121 60 123 61 2 0 -10 -19 -26 -42z\"\/><path d=\"M2375 1950 c-198 -44 -350 -190 -395 -379 -18 -76 -8 -221 19 -290 114 -284 457 -406 731 -260 98 52 188 154 231 260 27 69 37 214 19 290 -38 163 -166 304 -326 360 -67 23 -215 33 -279 19z\"\/><\/g><\/svg><\/i> <img loading=\"lazy\" decoding=\"async\" width=\"16\" height=\"16\" alt=\"Loading\" src=\"https:\/\/ianchadwick.com\/blog\/wp-content\/plugins\/page-views-count\/ajax-loader-2x.gif\" border=0 \/><\/p>\n<div class=\"pvc_clear\"><\/div>\n<p>Yesterday, I went for my second bone density scan \u2014 aka bone densitometry or dual-energy x-ray absorptiometry \u2014 the one that had been planned, but scheduled then delayed twice previously. My first bone scan, like my first CT scan, was done in June, before my surgery. This one was ordered by the oncologist prior to my radiation treatment. Bone density scans are used for many types of diagnoses, including measuring bone loss and osteoporosis, but also to detect the spread of cancer cells. My previous scan showed the cancer had not spread into my bones (a tremendous relief). I hope \u2026&#8230;&#8230; click below for more \u2193<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[1197,718,761,9],"tags":[1261,961,1263,1264,1110,1262,1265],"class_list":["post-23754","post","type-post","status-publish","format-standard","hentry","category-cancer","category-daily-life","category-musings","category-personal-reminiscences","tag-bone-density","tag-cancer","tag-dexa","tag-dxa","tag-prostate","tag-radioactive","tag-scan"],"a3_pvc":{"activated":true,"total_views":654,"today_views":0},"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_likes_enabled":true,"jetpack-related-posts":[],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/posts\/23754","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/comments?post=23754"}],"version-history":[{"count":12,"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/posts\/23754\/revisions"}],"predecessor-version":[{"id":23768,"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/posts\/23754\/revisions\/23768"}],"wp:attachment":[{"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/media?parent=23754"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/categories?post=23754"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ianchadwick.com\/blog\/wp-json\/wp\/v2\/tags?post=23754"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}