PET/CT

... scan this morning. It took, as scheduled, about 2 hours from start to finish. The first thing the tech did was to check my blood sugar (95, fasting) to make sure that the radioactive sugar tracer would get picked up by anything hungry. Second was finding a vein (always a joy), and finally going with one on the back of my hand in which to inject said tracer. The tech brought in a little lead-lined box (looking exactly like a fashionable little clutch, if it weren't for the radiation hazard symbols on it), and took from it a lead-encased hypodermic -- for her protection, not mine, since of course she injected me with the stuff. It was a very small amount of material, but I still had that odd, cold-veined feeling from it.

After that? Resting for an hour to let the tracer work its way through my system, while I worked on a vanilla-flavored barium contrast shake. It's a good thing I was fasting, there is no way I could've drunk that shake if I had had anything in my stomach already. As it was, it wasn't easy drinking the whole thing, even though the texture was much improved since the last time I had to drink something like that.

So, tucked up in a warm blanket, I mostly napped in the recliner for that hour, and then I was brought into the scanner. As usual, it features an incredibly narrow plank which slides in and out of the "doughnut" which is the actual scanner. This is where I screwed up, because I didn't relax my arms enough while the tech was adjusting the velcro straps that are supposed to support them during the scan. I think I just wanted to get it over with, and I wasn't really thinking about whether the straps were supporting my arms or I was.

Holding your arms at your sides for 40 minutes isn't fun, and I ended up with a headache because the cradle for my head, while lined with some type of thick fabric, was still really hard underneath. It doesn't help that I'm in a minor flare and everything hurts now anyway.

I cycled through the stages of "wow, this really hurts, and I really need to move my arms" to "relax, relax, don't screw it up or they'll have to start all over" to "OK, I can do this" at least three times, and had come back around to the "don't screw it up" point again when it was finally over.

The tech says my doctor will have results in 24 hours, 48 at the latest, but my appointment with my endocrinologist is set for March 27 and I don't expect to hear anything before then. (sigh)

I was put off today by a couple of people who know about this situation and just brushed it off as if it were nothing. I don't want to be fussed over, but I would like some acknowledgement that this situation -- waiting for test results, not knowing whether I'm coming or going -- wears on a person. Well, it wears on me.

That wraps up day two of a spring break that is full of appointments and deliveries, and will finish up with a speech and debate tournament. This is the kind of vacation that you need a vacation from.

low

We did some shopping over the weekend.

Young Chang Y-131 52" upright, aka "a real piano"

Sounds phenomenal, and plays like a concert grand. It's to be delivered Friday, and we are all very excited for its arrival. The old Reed Music Co. console has been dead for a while, and I just didn't want to admit it. I only realized how bad it was when I started practicing a new piece, and now I feel rather bad about having the kids play on such a wretched piano for so long.

Still, I'm feeling beset from all sides. There are no new catastrophes to deal with, and I'm matter-of-fact about my follow up tests, now. I just don't like how any happy news only "sticks" for a moment or two and then I'm right back down in the pit. I'm not sure what's going to get me out, although a clean PET/CT scan would probably do it.

Retail therapy is usually a lot more effective.

next...

After three rounds of telephone tag, my endocrinologist's nurse/manager finally called me at a time when I could answer my phone. (The messages we were leaving for each other would have been hilarious if they had not been so frustrating.) The conversation was brief; the nurse manager is refreshingly direct. It's all well and good that the biopsy came back negative, but given that my tumor marker is increasing, the endo wants me to have a PET scan.

That is quite a reasonable course of action, and it aligns perfectly with the ATA guidelines for this situation.

I've never had a PET scan, but it doesn't sound much different from other scans I've had. I tend to doze off during whole body scans, since they are silent and take about 45 minutes. I'm quite happy to hear that this scan will not involve the horrible banging and clicking and buzzing of an MRI.

Scheduling this will be interesting. DS1 will be having two different oral surgeries in the next month or so, plus we've got two more debate tournaments, DS2's field hockey tournament, and spring break coming up as well.

DS1's surgery and the State tournament make extended travel that week impossible, but I'd love to get away for just a day or two. I just have to figure out how to do that.

status quo

Finally spoke to the doctor today. The results were good, in that they didn't find any evidence of thyroid cancer in the samples they took. However, as always, the pathologist did that CYA routine where he noted that the conclusion is only valid for the materials that were extracted and that we can't be sure there isn't something going on in all the stuff that was left behind. To be really really sure there's nothing going on, you have to do a surgical excision.

The ENT thinks that's overkill, and I agree, but given my rising tumor marker (Tg), we are leaving it up to my endocrinologist to make the call as to what tests to do next.

So I still don't know what's going on, but I'm so used to it by now it doesn't make a difference.

I stayed late after school today so I could go with the high school science club to the open house at Microchip, part of the Arizona SciTech Festival. It was a great event, and the kids had a fantastic time seeing all of the cool technology and how it's applied.

It was a wonderful tonic for me, too, as I have been struggling so much with my students. So many of them just don't want to be there or put in any effort at all that it is disheartening. It was a joy to be around students this evening who were engaged and interesting and polite and fun to be with.

missed message

I clung to my cellphone all afternoon so I wouldn't miss the doctor's call with my biopsy results. Of course, that's what happened anyway, when I set my phone down at the music studio this evening (kids' piano and voice lessons) and didn't hear it buzzing when he called. I did not expect him to call at 6:24PM.

I can call him back tomorrow after 1:30PM, he said, "to discuss the next steps, given the biopsy results," which of course he did not divulge.

(bangs head against wall)

There are three possible outcomes of any FNA. Positive, they found cancer cells. Negative, they didn't find cancer cells. Indeterminate, they didn't find much of anything and are unwilling to say anything about what they did find.

Pretty much the only difference that would come from one result versus another is the type of tests that are ordered as the next step. If it's negative or indeterminate, it might be OK to put off further testing until the summer. If it's positive, that may be reason enough to try to move things along more quickly.

Tomorrow I'll find out what I should already know by now, but really, one more day isn't going to make that big a difference.

back in the real world...

Yeah, expecting to hear results after a mere 48 hours was a pipe dream. I still haven't heard anything.

On the other hand, I spent all weekend cooking and eating, as DS2 turned 11 and had a sleepover party, necessitating brownies, cupcakes, and fresh-squeezed orange juice, among other things.

My neck hurts less than it did last week, but still isn't "right", and I have a headache most days which Tylenol helps but doesn't eliminate.

I go long stretches without thinking about the cancer situation, mostly because I have that "beating my head against a brick wall" feeling regarding my teaching. The class average for my seventh graders on our last quiz was 8/20, and I fear that my eighth graders will do just as poorly on the quiz they are having this week. In one review session this morning, I said something like, "The last question is something we talked about during the lab last week." One student -- a pretty good student, too -- replied, "But that was on Thursday, I don't remember anything from that far back!" The lack of continuity and opportunities for repetition over time in the block schedule is killing me.

In spite of that, I know I'm a better teacher this year. It's such a shame it won't be reflected in any of my students' standardized test grades.

group

An hour goes by fast when you're talking to, with, and about other people's problems. It went by so quickly today that I didn't get a chance to mention my biopsy, and no one noticed the faint bruising or swelling under my jawline.

I did get a chance to talk to my co-facilitator to let her know what's going on. She has her own distractions to deal with. We left it at keeping each other posted if we hear any news, especially if it means we won't be able to make the group. There's not much else we can do at this point.

that was easy

Well, as easy as could be expected.

I had a very kind and competent ultrasound technician and an equally kind and experienced radiologist for my FNA biopsy today.

As these things go, that was the best so far. The doctor used an absolutely tiny needle to administer the anesthetic, so it burned much less than it has in the past. He made four passes at the lymph node, and the sensations of the needle hitting the node and then drawing out its contents were painful in a way that is hard to describe if you haven't experienced it. It just 1) feels weird and 2) hurts to have someone poking around your innards, no matter that said innards are fairly close to your skin. But today the pain was bearable, maybe because I've been through it before and knew what to expect, or maybe because I have so much residual nerve damage in my neck from previous surgeries that I literally couldn't feel it as much as I have before.

Whatever the resaon, it wasn't nearly as painful or exhausting as it has been in the past. I'm left with a slight bruise but it's in a location that most people are not likely to notice.

The doctor made a point of showing me the node-with-needle image on the ultrasound, so I could see how well he was able to target it (very well). I asked him if I could see how vascularized it was, and he was very obliging, and had the tech image the node and turn on the Doppler, and then freeze the image so I could turn my head to see it. There were 4 tiny red specks around the perimeter, and no signs of calcification. I would have preferred only one tiny red speck, but the 4 tiny specks were not so bad. If there's anything going on in there, it's just getting started.

The tech told me that my ENT would have results "within 48 hours," which approaches miraculous. After that, I have no idea.

habituated

It took a little more than a week for the shock to wear off. Now I can go entire consecutive hours without thinking about the fact that I have a recurrence (of indeterminate size) and that I am having a biopsy tomorrow.

Then I remember.

It's surprising how future-focused day-to-day life is. With school, it's planning the next lesson, and the lessons for the next day and the days after that, all the way out to spring break. With my family, it's figuring out who has to do what, when, and who needs a ride where, and all that.

What we'd like to be doing, what I would be usually doing at this time of year, is planning our spring break activities and starting to look at flights back east for the summer. That's where my mind goes when I forget, and then I remember.

next step

I'm scheduled for a biopsy on Wednesday.

I've said it before and I hope I never have to say it again, but a day that includes the decision to jab needles in my neck is not a good day. There is no way around that.

My ENT assured me, several times, that even though I have a recurrence, it won't kill me. Of course he didn't use those words, since he has both tact and charm, but that's what he meant. Me, I can be as blunt as I want in my blog.

grrrrr

Saw the endo today. My tumor marker is up, and I have small, but persistent, lymph nodes near my right submandibular salivary gland.

More tests coming, and we'll have to see what they find. In reviewing my labs, I see that even my suppressed Tg (that would be the tumor marker) has been slowly creeping up over the past 4 years or so, from undetectable to .1 something to .2 something to now .32, so there's definitely something going on, even if it's not very big.

I'm meeting with my ENT on Thursday and we'll consult on whether it should be a PET scan, a PET/CT, a CT with contrast, or an MRI that could best visualize whatever is going on. The endo's going with the radiologist (who read the ultrasound report),and recommending a PET scan. I don't think I've ever had one. First time for everything, I suppose.

I never ever ever want to go under the knife again, but it's probably somewhere in my future. Perhaps I can push it off a ways...

boom!

Something loud shook the house at about quarter to 11. DD came down asking about it; it shook her loft bed, which is literally bolted to the walls. We went out to look around in the yard and didn't see anything, but it didn't take long for the sirens to start.

Something exploded, a few blocks south of us. We have a view of the smoke and flames from our upstairs window. We think it's one of the small houses in the residential neighborhood there, but we don't know for sure. Lots of speculation: meth lab? gas leak? What else could there be?

@11:15. Now DH is tuned in to the fire department's radio on our new Roku box, and we hear the address. It's a house not a half mile from here, directly south. From the size of the glow, it was not a small fire, and I can hear more sirens coming in now. People died there, surely. Neighbors most likely died, too, if we felt the explosion a half a mile away.

The older two kids are concerned -- what if it's a gas leak? I've already reassured them and sent them back to bed.

It's unsettling, to be sure. It's remarkable how safe you can feel in a place until suddenly, you don't.

follow up

I had my post-thyroid ultrasound on Monday morning, ridiculously early for a day off from work. Today, the message from Dr. O's office was waiting when I got home from school: Your ultrasound results are in. The doctor would like to see you.

This is the part where I spin my wheels trying to remember what I saw and to figure out what it means. I saw a highly vascularized blob of something, but that could have been my carotid or jugular for all I know. Dr. O could just want to see me to make sure the problems I was having in the late fall, mostly due to flaring gastroparesis, have resolved.

I like the sound of that much better than any other reason to be of interest to the doctor.

wolf, hedgehog, raccoon

Linneaus' pet raccoon, Sjupp...

Oddly enough, this weekend feels like we're finally on vacation. Last week was project work week: SLE (lupus), hedgehogs, and Linneaus. We all know a lot more about each of them, now.

...and here are the hedgehogs - European on the left, Four-toed (African) on the right, in their natural habitats

constructive forces

Reddish, rusty cinder cone dislodged from the top of Sunset Crater sometime late in its last eruption.


It's all a matter of perspective. Sometimes tearing down and building up are happening at the same time.

passed

The time is gone when any of my children will spontaneously give me a hug or kiss, so I give them both to make up for it.

instead

Sunset at Little America, Flagstaff

Somehow all of December passed without a word written here, so again, I resort to an omnibus sort of post, trying to cram all sorts of things in just so they aren't forgotten altogether.

School-wise, second semester coasted to a close after the science fair. My students objected vehemently to getting back to "regular" work, but we managed to get back into some sort of rhythm. I'm working on integrating more video into my lessons as I find more ways to use my projector. Now I just have to remember to retrieve my speakers from the colleague who borrowed them for last days before winter break...

My students were particularly aggrieved that I made them take their second benchmark in the days just before break (which explains why I was willing to loan out those speakers). One reason for that timing: I had my Thyrogen trial in the week before Christmas, and I had to drive up to Phoenix four days out of five -- Monday and Tuesday for injections, Wednesday for dosing, and Friday for the scan. Happily, the scan was negative, but I won't find out my blood work results until the end of January.

After taking a year (or more) off, I've run the whole gauntlet of cancer tests again, getting the all-clear from my dermatologist and my GYN. One test result still pending, though: the BT Test, a new blood test from breast cancer.

In the run-up to Christmas, I remembered how medical issues used to dominate my life. I won't really relax until all the tests are in and I'm clear, but obviously I'm happy about the results so far.

Back at the beginning of December, I took off a day of work to travel with DS1's speech and debate team to the Winter Trophy tournament. It was an exhausting and intense experience, but such a joy to spend so much time with this group of amazing students and dedicated staff and parents. We drove out early Friday morning and returned very late Saturday (or early Sunday morning, depending on how you want to look at it.) Trips like this are like vacations from reality. None of my usual responsibilities weighed on me, because I was completely consumed with a new one: judging. I love the mental workouts these tournaments put me through.

After Winter Trophy, things shifted into high gear, as all the kids had their piano recital, the older two had Fine Arts night, and DS2 had a concert. I took DD and a couple of her school friends up to the Wildlife World Zoo to meet one of their hedgehogs. There was a lot of shopping, some baking, and we even managed to do a Christmas card this year.

DD tolerates this process...barely.

Christmas itself seemed uncharacteristically easy. It was lovely having so many days off to prepare before the holiday itself. I spent most of Christmas in the kitchen, simply because I didn't feel like doing all the cooking the day before, and we had no other plans. I brined the turkey the same way, and paid attention to Thanksgiving's lessons, and dinner was terrific. I admit, I still bailed on making my own rolls: Trader Joe's crescent rolls were much better than the store bought rolls from T-day. DD helped me make an apple pie (at DH's request) and our Christmas Tree cake (blueberry, this year).

After days of lounging around, we booked a room in Flagstaff so we could get some sledding in. We checked the forecast and knew it would be warm, but we didn't realize how warm it really would be, nor did we know how that would affect the snow cover. Wing Mountain trucked in tons of snow but simply gets too much sun to keep it on the slopes, and since we were too lazy to get up at a decent hour, all that was left by the time we got there was slush. Still, the kids and I had a a half-dozen runs or so apiece before we bailed: mud and slush and wandering toddlers combined to take the fun out of it.

Still, Flagstaff wasn't a total loss. After dinner we visited Lowell Observatory and looked back into the earliest days of the universe, as well as the moon, the Pleiades, and Jupiter and four of its moons. The next day we visited Sunset Crater and the Wupatki National Monument, and I was in heaven. It was a perfect geek get-away.

Sunset Crater

Lone tree clinging to the cinder-covered slope at Sunset Crater

at Wupatki National Monument (the fill-in flash on my camera was wholly inadequate to the requirements, here)

What did the kids like the best? My guess: playing in the snow at Sunset Crater.

Off-trail entertainment

lessons

Things I learned this week -- from my 2nd science fair, and from Thanksgiving -- that I'm writing down so I won't forget.

Science Fair first, since it was something of a debacle. I had one class hour (20 students) in which only one student turned in a project. I'm still struggling with how much responsibility for that lies with me; this page details the entire process. What usually happens is that the students screw around until the last minute and then come up with something, but with this particular group of students, that did not happen. Astoundingly, only one other group turned in a project on Wednesday. What are the other ones waiting for? The majority of them had their data and their reports drafted -- all they needed to do was type them up and make a display board. I don't get it.

Next time (if there is a next time):
* submit the facility request form (now that I know it exists) for the gym when the schedule is set
* find out the schedule for benchmark testing for language arts and math, since they either take over the computer lab or screw up the schedule, or both
* find out the schedule for standardized testing for high school, because it screws up the schedule for junior high even though no junior high students are testing
* make the all the projects due at the beginning of school on the first day of the science fair so the judges have more time
* review the rubrics with the judges to smooth out the extremes (everything was great! everything was a mess!)

Things that worked well: requiring complete typed rough drafts from the students was very helpful to the groups that did them. Making the students evaluate at least five other student presentations worked well and forced the students to look at other projects in more depth. The timing -- Thanksgiving week -- seems insane but is actually awesome, because the students know it's a short week and don't want to do anything, anyway, and then there's the four day weekend to plow through all the grading.

Wednesday was a full day at school, but even with breaking down the science fair, I still got home around 4PM, which gave me plenty of time to cook.

Thanksgiving was a vastly more pleasant experience.

* Brine for an already-injected frozen, then defrosted turkey: 2/3 cup kosher salt, 2/3 cup sugar, 1 gallon of water; 12-14 hour brining time for a very large bird.

* Cutting up the turkey before brining and roasting it is awesome. I roasted the back (for soup) while the pies were baking on Wednesday. On Thursday, I sliced carrots, celery, and onion very thinly and scattered the pieces over (double, heavy-duty, lots of extra at the edges) foil-lined sheet pans. The whole breast and one wing fit on one pan, the legs, thighs, and other wing on another. I brushed the pieces with melted butter and gave them a little salt, then roasted at 400 for about 2 hours. (These were pieces from a 22-pound bird). I checked them periodically and added chicken stock to the pans if the vegetables where charring. The meat came out perfect, and made excellent drippings for gravy that were easy to handle -- I just picked up the foil and poured off the liquid. Clean up was a snap, too.

* The cranberry apricot pecan relish needs a lot more ginger than I thought it does.

* Gingersnaps make an awesome crust for a pumpkin pie.

* Microwave cooking a full pot of green beans takes longer than microwaving a few servings.

* Store bought rolls may be easy but the home made ones are so much better. I just need to suck it up and make my own.

* Peeling and cubing the squash before cooking it is a lot easier to deal with than cooking the whole squash and trying to get the edible parts separated from the peel.

* The pies won't overcook if you don't overfill them.

* Check and make sure there's still molasses in the cupboard before starting to bake.

* When making meringue, the instructions that say "add sugar gradually" are not kidding.

* Making cranberry sauce on the stove top, and letting it cook for (at least) 10 minutes, as the recipe dictates, works a lot better than using the microwave.

a day off

So many times I would've typed "a day, off" -- but not today.

Today was a day to count blessings, so I did.

no more jack-o-lanterns

This is the first year in all the years we've lived in this house, I think -- 13 years -- that we haven't carved pumpkins. It was always my job to rustle up some candles from somewhere so I could light them and put them in the pumpkins out front. And then I had to remember to go out later, much later than the last trick-or-treaters, to blow out the candles and bring in the pumpkins, before they got smashed in the street. This year no one in the house wanted to do it, so we didn't.

DS1 opted out this year, knowing he'll be able to share his younger siblings' candy. DD and DS2 are wearing sensible footwear (as opposed to the pre-teen in stiletto heels who just left the door) and will probably be out with DH for another hour, hauling back more candy than they will even want to eat.

While at home things seem less stressed than usual, I'm dreading the rest of this week at school. Children on an all-candy diet don't listen or learn well. Best not to think of that, and enjoy watching Alice's excitement with each new group of children at the door.

She's very patient, and only occasionally
tries to fish a lollipop out of the candy bowl.