August 5, 2022
They say smart people can hold 2 competing thoughts in their brain at the same time. If that’s true, I wonder if the same is true of emotions? I don’t know about thinking, but in terms of feeling, I have walked around this past week feeling simultaneous grief and gratitude. Maybe this makes me an emotional genius, but I don’t care because it’s been weird and uncomfortable. Grief, on the one hand because, well, lung cancer. And gratitude, on the other, because sunshine, birds, flowers, upcoming travel, being on my bike….
Grief is inconvenient, especially because it pops up at inopportune moments. Halfway up a hard hill, for example, is no time to be interrupted by thoughts of one’s mortality. But, there it is. What triggered it this week was the report on Saturday’s MRI, which arrived sometime early in the week of 8/1 ish. It was nothing awful, just not what I wanted. (I feel a bit like a kid at Christmas, having a tantrum under the tree because I got the doll I wanted, but in the wrong color.) Here’s the upshot:
1. Metastatic ring-enhancing lesion in the subcortical posterior right frontal lobe has enlarged slightly, associated with slightly increased edema. The changes favor treatment related change but close imaging surveillance in 3-4 months is recommended.
2. Stable enhancing lesion in the left frontal parietal centrum semiovale, no larger than 3 mm. This is indeterminate for metastasis but similar imaging surveillance is recommended.
I wanted the report to say Everything’s good, no cancer signs, you go girl! (Except in medical lingo.) Instead it said, Jeez, that little spot we zapped has a circle of dark around it. It’s probably nothing, but we should keep an eye on it. Dr. Radiology said today that she thought it was more than likely edema and the dead tumor falling into a little crater. If it weren’t my brain she was talking about, I would be marveling at the overall coolness of that image.
I was marveling at the images today, in her office. You could barely see the brain things. Little blips of white in a field of grey. “I can’t believe you guys even saw them,” I said. “Well, that’s what we radiologists do,” she said wryly. So much for marveling over the intricacies of modern medicine– it’s “what they do”.
What I loved was seeing was what that poor right lung has pulled off. The consolidation of all the floaty white stuff– other wise known as scarring, from pneumonitis and radiology– was notable, even to me. Healing. It’s called healing.
Some factoids about MRIs– there’s no radiation involved. It’s the contrast they inject you with that makes the kidneys suffer. CT scans are actually the radiation bad guys. They used to do CT scans of little kids’ heads, she said, until they discovered that these kids got brain tumors in their 20s. Now they just do MRIs on the kiddos
.
But excuse me, those vital signs? Pulse oxygen levels of almost 100%, insanely excellent blood pressure, a pulse rate that reminded me of the old days. “It’s all the exercise,” the nurse said. (Couch potatoes of the world, are you listening?)
For the future, Dr. Radiology said, we’d be looking to see if Little Blip would start to send out fingers, indicating it had just been playing dead. In that event, we’d just zap it again. In the case of progression in the lungs, we’d do a whole re-staging: PET, MRI, the works, (probably a blood biopsy, too.) We’d have to pay attention to the brain then, for sure. But, she said, in the event of progression in the lung, we’d look at some targeted frying. (Dr. Oncology would probably want in on that game, too.) All in all, a lovely little visit, with someone who spent 11 years in training to be a doctor and a PhD researcher. (I asked her.)
The Deal with Grief
A dear friend whose husband died of shitty brain cancer nodded in complete understanding when I told her about the grief. You go along almost normally, that cancer crap growing ever fainter as the last checkup recedes. When you go in for the next checkup– and there is always another checkup– with the waiting rooms, the tests, the doctors, the waitingwaitingwaiting, everything roars to the surface again. It’s like being clobbered from behind. The word from around the cancer campfires is that it’s also inevitable. So, maybe it’s progress that I could get the report, feel clobbered, and head out on my bike.
We’re headed off for a two week camping extravaganza on Cape Cod in a week. I probably won’t have much to report, except for the insane number of sharks that are being sighted off the coast. This validates my refusal to do swimming of any kind. The lack of electricity means no internet, thus no posting here.
Until our return, in the last week of August, I hope you get some quality time on your bike, in whatever form that takes. Thanks for reading.
