Wednesday, May 7, 2014

"No Intracranial Metastases" = All Good

CLICK, CLICK, Clank. Whirr. Ka-Chunka, chunka.

Somewhere between when I pushed PUBLISH and when I climbed onto the MRI bed, I lost my Zen perspective. All I could think was, “Last year I came in for a mammogram expecting nothing and ended up with a cancer diagnosis. THIS IS MY BRAIN.”

Ya. So my inside voice was like that. My outside voice was overly talkative as it is wont to be when I’m nervous.

There was not enough leftover brain power to ruminate on climate change, world hunger or even simple algebra. I climbed in the bed. I was very still. I counted down from 1000 by threes.

Whirr. Ka-Chunka, chunka. Clickclickclickclick.

I stalled out a few times and at 221 was pulled out for my shot of contrast and pushed back in. I knew I’d screwed up the whole backwards count thing when I finally arrived at the number zero. There was enough brain function not allocated to anxiety to realize that, since 1000 is not evenly divisible by three, I shouldn’t have ended up at zero.

“C’est la vie,” my inside voice said and I started the process of counting down from 1000 all over again until the test was over.

Distraction is my preferred method of managing anxiety so I futzed around at home until I received email ‘bing’ at 3:03pm from my oncologist’s nurse practitioner:


** HISTORY **:
41 year old woman with breast cancer and headache and periorbital

COMPARISON: None available.

TECHNIQUE: Multiplanar, multisequence images of the brain were
obtained without and with 6 cc of Gadavist intravenous contrast at
1.5 Tesla.

Ventricles and sulci are age-appropriate in size. No suspicious
parenchymal T2 hyperintensities. No restricted diffusion to
indicate acute infarct. No suspicious susceptibility artifact.

No masses, mass effect, or extra-axial collections. No
hydrocephalus or herniation. Intracranial flow-voids are intact.

No suspicious parenchymal, leptomeningeal, or dural enhancement.

Orbits and globes are intact. Paranasal sinuses and mastoid air
cells are clear.

No suspicious scalp or calvarial lesions.


Normal contrast-enhanced brain MRI.

No intracranial metastases.

Clear sinuses.

No intracranial metastases. 

No intracranial metastases. 

No intracranial metastases!

I did a little dance. Walked outside and smelled some of my front yard roses with my completely “normal contrast-enhanced brain’.

(Thanks for all the good vibes texts and emails - they were obviously put to good use!)

Friday, May 2, 2014

Turning Scanxiety Into a Math Problem

Within two hours I’ll be enclosed in a long, lighted tube and lying very, very still.

An occasional “How are you doing, Stacey?” will break through the crazy loud clanks, clicks and whirrs.

"I'm fine," I'll answer. And, after the third or fourth ask, I may respond with an, "I'm great."

And I will mostly mean it despite the fact I dislike noisy, enclosed spaces.

In fact, I will be doing math problems in my head.

If I start to get exceptionally agitated in that tiny confined space, I will revert to counting backwards from 1000 by threes. The backward counting activity is challenging enough to keep my mind off of the extreme enclosed space and yet simple enough to do while putting up with the noise from the MRI machine.

I am having an MRI to rule out any abnormalities with my noggin.

There will be nothing amiss. At least there will be no abnormalities discoverable by MRI.

MRIs don’t pick up anxiety. MRIs don’t pick up frustration. MRIs don’t pick up fear.

Actually, I am surprisingly mellow this time around. I have a coping mechanism (math problems) that works for long runs, long rides and even long scans. And I’m confident that the MRI will simply serve to show that this Type-A personality can lie still for longer than most people think I can.

In the scheduling phone call, the MRI tech asked, “Are you claustrophobic?”

I paused, chuckled and replied, “I KNOW that’s a trick question. But I’ll be fine.”

And I will. 

1000, 997, 994, 991…