Starting the New Year Right | Jan 12 2023

January 12, 2023

I’m coming to you live from the annual How-quickly-can-you-meet-your-medical-deductible challenge. Since it’s also time for All The Check-ups, I reckon this year’s process will be quick.

Yesterday was MRI #1, to recheck the ole’ brain. Today was Dr. Radiology. God, I love that woman. I always learn so much, and in unexpected ways. Today’s learning was profound, kicked off by one simple phrase: “Since you had such a powerful immune response… .”   Me, not listening to the rest of the sentence, puzzled: “Um, which response would that be?”

She flashed me a look. “Why, the pneumonitis, of course.” Me: “Ohhhhh?” Dr. R.:”Yes, what do you think that was? You had [via immunology treatment] such a strong immune response that your lungs filled up with….” Me, nodding vigorously: “Oh! Oh! I never understood it that way! Well, that’s a really positive way to view extreme pneumonitis.”  She laughed.

But isn’t that cool? That strong immune response is just a way my body went, “Nyah nyah na nyah nyah” at stupid cancer.

So the brain continues to do its brain thing, with shrinkage of the zapped spot. She thinks it will eventually disappear– maybe there was so much inflammation there that the body had to absorb that before tending to the dead cells. She was completely nonchalant when I mentioned the person I’d met last summer who’d had 29 gamma knife procedures: “Oh, yes…”

Two teeny teeny spots, i.e., less than 1 mm., continue to wave at us. For the first time, the radiologist who read the MRI scans called these metastases [note to self: haha– who read the scan?]. That surprised Dr. Radiology, but she consulted with another gamma knife dude who agreed they were probably just vascular blips. “We’ll watch those,” she said. “But we’ve been keeping an eye on them for a while and there hasn’t been a change.” By comparison, it took only three months from first seeing Mr. Metastasis to noticing he was growing and needed to be stopped in his tracks. So they don’t think the two spots are cancerous. The osimertinib may be containing it, she acknowledged, but the docs are not very concerned.

So the other thing I learned was that any brain procedure can speed the development of cataracts by about five years! This factoid emerged in a rundown of symptoms, when I said yes, indeedy, I had recently noticed rapid vision changes. I have an appointment for that later this month– another specialty doc appointment with more than a 6-week wait. (The first being the dermatology appointment to check for wussy basal cell carcinoma, which is still 6 weeks away.)

Then there was the chat about memory. She asked about kinds of changes I’d noticed, which she tried to clarify. It’s not that I don’t remember things occurring, I told her,  it’s just that if my mom asks if I want the other half of a banana for breakfast, and I say yes, then, a little later, when I go to make my breakfast, I’ll see the banana in front of me but completely forget I’d planned to eat it. Events are sometimes like breezes floating through my brain, I told her. I forget to tell her about subtle changes in fishing for words in conversation. — <sigh> hold your comments, please….

We both agreed it would be wonderful to have the clarity and thought-speed of our twenty year-old selves, coupled with the experience, wisdom, and greater confidence we have now. I think the good thing about spring-breeze-memory might be the accompanying shrug and oh-well-who-cares attitude that comes with it. We’ll see what happens.

Remind me if I don’t say anything about this in my checkup report in 3 months.

MRI tip for the day: be sure your lorazepam prescription is up-to-date before your scan. Cancershrink says drugs typically last beyond their 1-year expiration, but this is one to pay special attention to. Also, if you are having memory issues, never take lorazepam– except for infrequent, one-off medical procedures. Plus, lorazepam takes 45-60 minutes to be fully active in your system. If your MRI center says to wait until you get there to take it, talk to them! I took mine 40 minutes before the scheduled start of the test, and before my scheduled check-in. No way was I going into the tube without it.

Tuesday was my first echocardiogram, just to make sure the TKI isn’t messing with my heart rhythms. So cool to watch the heart chambers contract. All is well there, too.

Ain’t it grand to be boring?!

Let’s end with pictures from the department of Life With Stage IV Lung-Cancer:

Thanks for reading. Here’s hoping your January days are boring– and increasingly bright.