Door #3.

Remember in my post about the scan that I was writing about how they’re hard to interpret and don’t come with special color coding on abnormal tissue that clearly indicates “radiation scarring” or “cancer?”

You may also recall me writing that I really hoped that we don’t end up with that sort of ambiguous CT scan, and how I really wanted to know something definite today.

Yeah. Well.

The radiologist reading the scan pronounced it “stable”, meaning he didn’t see much change between my latest scan and my pre-treatment one. Dr. Liao, with the benefit of having looked at the actual patient, read it as showing some improvement, particularly on the surface of the tissue inside the mouth. But in the deeper tissue there is something that shows up on the scan, though we can’t know exactly what it is. (My untrained eyes looked at the scan and saw that even that abnormality in the deeper tissue seemed narrower, presumably a change for the better, but I have no idea what I was really looking at.)

Before reviewing the scan results with us, Dr. Liao did a thorough physical exam of my head and neck, and said that he saw clear improvement. The surface seems very smooth and looks good, and when probed with his finger seems soft. The rest of my mouth is healing up well from the radiation, and the skin on my face and neck looks good. He said the small puffy pouch below my jaw on the right was probably lymphedema, and we’ll get some training on how to massage that to help it go away. All in all, the clinical signs look good. Nothing looks worse, and all the stuff he can see and touch seems better.

So what do we do about this inconclusive CT? Well, a PET scan would be able to show us if there was metabolic activity as opposed to just scarring. And we could compare it to the one I had before treatment, on which the tumor is a visible bright spot. (It’s so obvious, even to the untrained eye, that Dr. Liao joked it was like “Oncology for Dummies”.) We’ll get a PET scan!

Only it’s too soon to do a PET scan, since I am still healing, which would also light up on the scan. So I’ll get a PET scan in two months, and meet back with Dr. Liao, and Dr. Futran, who’ll be monitoring my long-term care, at that point.

Oh. Umm…OK.


Since we left the appointment, the “calm, rational adult” part of my brain has been reviewing all the good news. First, there is a clear absence of bad news. No sign whatsoever that I am worse. That’s very good. Second, a highly trained professional has examined me physically, and was very pleased by what he saw. The clinical signs are good. Third, CT scans at this point are often inconclusive. Though we and Dr. Liao were hoping for one with clear interpretation, it wasn’t guaranteed, particularly in a patient with my history. (There has been a bunch of messing about and scarring of tissues in that area already.)

All the actual news we got today was good. There just wasn’t enough of it.

Which is why Kimberly and I both left the building feeling badly. Both of us have been so keyed up about this appointment, and while we are both really happy we didn’t get bad news, what we wanted was unadulterated, complete good news. And this doesn’t feel like that.

For months now I’ve been believing this treatment was going to work, and willing myself to sustain that belief while we really clobbered my body in serious ways. I’m really, really ready to go from believing that it WILL work to getting the proof that it DID work. I want to feel like we’re done (modulo the recuperation and the lasting side effects and the small possibility of recurrence, of course). And despite today’s good news, I don’t feel that.

I guess we’ll know more in two months.

The Wait.

(I am mightily resisting making a bad musical pun right now.)

You know you are a high-mileage patient when you are ecstatic that the IV for your CT scan only took one needle stick. (I can’t remember the last time that happened. Three is average. Seven is not unheard of.) The scan on Friday went quickly and very smoothly. (I’m not reading any meaning into that. No. I am not. Not.)

One way to keep from thinking about Impending Big News is to focus on the mundane. I’ve been keeping busy, with work, and with household tasks. On Saturday I gave the chicken coop the first full cleaning it’s had in months, moving a bunch of well-used bedding into the first stage of our composting process. I’m looking forward to next summer’s supply of rich high-nitrogen compost. It wasn’t much later before I was really feeling my back and shoulder muscles stiffening and tightening up. Still, it’s a ‘good kind of  tired’.

I was eager to get the coop taken care of yesterday because today will be no day for working outside. The seasons are definitely changing here in Seattle, and today storms will be moving through the area. This morning has dawned dim, foggy and damp. There is a black raven perched on the wire outside the window. I hear a mournful foghorn and occassional distant thunder. (I’m not going to be reading any meaning into that, either. No. I am not. Not.)

The sense of impending winter makes me even more satisfied with two other small projects completed yesterday. I replaced a broken light fixture in our basement, and I swapped out a broken switch in my bedside lamp. The shorter days and the return of the rain have me subconsciously seeking the missing light.

Yesterday wrapped up with a good exercise walk just before sunset. As we often do, Kimberly and I walked over to the neighborhood community garden. There Kimberly has a small plot in which she grows things like tomatoes and tomatillos that need the full sun our yard does not provide. Her tomatillo plants have been thriving this year, and branches shoot every-which-way, with dozens of the lantern-shaped husks in which grow the green fruit. I used twine to tie back a few branches that were sticking out into the pathway, and we trimmed off a few more that won’t have time to actually bear fruit this year. We were happy to see some real red on a couple of her slower-to-ripen tomato plants. I had been worried they wouldn’t make it in this season. After a bit of trimming and tying back, Kimberly picked a small harvest of the ripest fruit, and we carried it back home.

After all that exercise, I managed to sleep pretty well. I’m happy that I’m not feeling too wiped out this morning. Today’s plan is for a rest and recovery day – the most physical thing on the schedule is a short drive to see a college friend give a presentation on her recent PhD research. Oh, and I hear tonight’s match for one of our local sports-entertainment corporations should be quite a show, so I’ll be watching that while lounging on the sofa. And, with apologies to Fleetwood Mac, not thinking about tomorrow.

(By the way, if you haven’t guessed what’s the musical pun, based on the title of this post? This is.)

The Scan.

This Friday, I have my first post-treatment CT scan. The appointment with Dr. Liao to go over the results will be Monday morning.

The purpose of the scan is to see what’s currently happening at the tumor site. We’ve had to wait two months since the end of treatment to allow my mouth to heal up enough that the scan wouldn’t just show the tissue damage from the treatment itself. We’re now at a point where what shows up on the scan should be meaningful. This is really our first chance (beyond Dr. Liao’s observations early on) to see whether the treatment worked.

Am I nervous about this?

Hell, yes.

My coping mechanism for dealing with the anxiety mostly involves focusing on other things. I’ve gone back to work, which helps by giving me a big list of complicated things to get wrapped up in. There are all sort of household chores and mini-improvement projects I can throw myself into, and I’ve been doing that with increasing intensity. And I’m still recuperating, so making sure I’m getting enough calories and rest still takes conscious effort, and keeps me from obsessing (much).

At other times, I try to calmly consider how the site feels. There’s some pain when I open my mouth wide, but that’s quite likely due to expected muscle tightness from the radiation. There is some other lingering soreness at the site, but most of the healed tissues in my mouth are still sensitive, and you’d expect that spot to be the worst.

Still, as the date of the scan gets nearer, I find myself feeling increasingly anxious. And this coming weekend, between the scan and hearing the results, will be pretty tense.

What I want to hear, obviously, is that the scan shows no sign of disease, so the treatment definitely worked, and I can go forth to continue recuperating and begin a series of regular monitoring appointments. Yippee!

What I’m afraid of hearing is that the scan shows some sign of disease, so the treatment was not completely successful, and we’ll need to plan the next steps. I haven’t spent much time thinking about where this might lead, because there are too many unknowns, but it keeps popping into my thoughts. Surgery? Probably. Not good stuff? Definitely.

I’m also worried about the third option: ambiguous results. I’ve looked at enough scans to know they are hard to interpret and don’t come with special color coding on abnormal tissue that clearly indicates “radiation scarring” or “cancer.” I really hope that we don’t end up with this. I really want to know something on Monday.

Good wishes, prayers, visualizations, crossed fingers, etc. are hereby shamelessly requested.