Friday, March 16, 2012

Elite PET Scans

For those who are unfamiliar with California, let me tell you that Sacramento, where I live, is not exactly a small town.   I know when you were in 4th grade and learning the State Capitals, it took several passes with the flash cards to remember that  Sacramento is the capital of California, but that's only because LA and San Francisco steal our thunder.  The Sacramento metropolitan area, in fact, has two and a half million people.

And, it's a nice place to live, with a lot to do, or so I hear. I'm a homebody so I wouldn't really know, but I read in the paper that we have fabulous rivers and professional theater and fantastic restaurants manned by James Beard-nominated chefs.  We have what is considered great weather and, of course, I'm here.  Sacramento is most famous for being easy to get away from - it's only a 2 hour drive to San Francisco and the same distance to Lake Tahoe, and even shorter if you are going to Napa and wine country.  Homes are affordable, by California standards anyway, which means you are going to pay a lot for a two bedroom crapshack compared to Idaho - where I hear they run about ten bucks -  but you won't pay in the millions and still have to sweep a dirt floor, like you would in San Francisco.

We also have more than one well-respected cancer and radiology center and we have doctors who have been trained at Harvard and Baylor and other learned institutions; not all of whom were at the bottom of their classes either.

Why do I defend my city of choice?

As promised, Dr. SuperSurgeon called me back as soon as he and his tech support team were able to crack open the mystery of the PET CD.

Unfortunately, his phone call only generated more mysteries, and it put me right back on the cancer see-saw.

I had hoped to hear, "As expected, your PET looks fine, and it was nice getting to know your slippery liver, enjoy your small town life."

But, what I actually heard was, "We need to get you back to San Francisco and redo your scans."

He said that after reviewing my Sacramento-generated scans with the San Francisco radiologist, they were uncertain about what they were seeing, and the "conservative thing to do" would be to rescan in his facility where the machines are clearer.

Once I got past the idea that anybody in San Francisco would ever consider doing anything that could even remotely be considered conservative,  I agreed.

Who doesn't want monthly radiation?

Then I started wondering about why the scans from my own hometown are blurry.  Are Sacramento radiology techs playing some kind of joke on their big brother San Francisco medical counterparts, and hilariously putting their thumbs in the way of the photos?

"Haha, that'll teach those big city slickers!"

Or, maybe it's just an accident.  I know how easy that is to do; half my iPhone pictures are of my thumb.

(The other half are of my dog.)

I got to thinking that maybe it's not the techs' ability - maybe it's the equipment.  Are Sacramento machines really that bad?  Or, could there be some big city snobbery at play?

Really, it's not like we are in a third-world country or they pull the only CT scanning machine available around on a cart pulled by a team of donkeys.  But, maybe they did stop buying CT machines in 1988 when the price of rent started to climb, and they figure slightly blurry is good enough.  After all, we are only 2 hours away from SF, it's our claim to fame.  If blurry pictures don't cut it, we don't have far to go for clear ones.  And, the State can use the money it takes to cross the bridge.

Not being an expert in medical equipment, I suppose it is possible, even likely, that a famous doctor at a world-renowned medical center does have better scanning machines than are available here in Sacramento.  After all, doctors are just grown up boys, and they all like their special toys.  The bigger you are, the better your toys.  So back I go, sometime in April, to get the elite, clear scan that will actually show if cancer is growing back.  Hopefully, this elite scan comes with a mani/pedi.

All this means, of course, that they are not sure what they saw on my blurry Sacramento PET but that something didn't look quite right, and so my three days of thinking I was cancer-free and the surgery was a success are over.  I'm back to the unknown with the shadow of that noose hanging over my head again and I'm back to worrying my son might have to go to college sheetless.

Honestly, cancer jerks you around more than a 6.9 earthquake.  Which, by the way, is one thing we don't have in  Sacramento.  I guess it's a good trade-off.  San Francisco, you can keep your clear PETs and big city ways, we'll keep our earthquake-free city and big-thumbed radiologists.


  1. Oh, Ann......massive sigh. Sacramento is also, by the way, the place where your car engine might overheat or crap out if you are driving from Lake Tahoe to San Francisco, because it apparently freaks out at the massive change in elevation & atmosphere, and decides that Sacramento is at least level enough to let you add water to the radiator. Don't ask me to explain this any further; it happened to me, twice, so you'll just have to take my word for it. Also, during the first trip, by the time I got to San Francisco, the brakes also crapped out -- infamously hilly SF is so NOT a good place to be without working brakes -- necessitating an emergency brake job on a Saturday. Ka-ching, ka-ching. I ended up not taking that job in Silicon Valley and decided to stay in coastal southern New England, where we don't have earthquakes so much, just hurricanes now & then. I don't know if our radiologists have big thumbs or not, but some of them do have big egos.

    Ann, I'm so sorry to hear this. Limbo is not a soothing place to be. I was really rooting for Dr. SuperSurgeon to be right the first time.

  2. Ann,

    UCSF said the same thing to me about my neurogram, which was, by the way done in Sacramento. But The neurologist checked and found that the MRI with the biggest magnet was in, fact in Sacramento. So I ended up not getting a repeat. Now I know that a CT is not the same as an MRI (apparently my plastic surgeon does not - she thinks you get more radiation from an MRI), but I use this to illustrate that not all machines are the same. some are good and some are really good.

    And then there's the patient. Sometimes she's still and sometimes she's really still.

    And sometimes the docs just want to use their new fancy-shmancy machine...

    All this to say - I hope it's one of these scenarios and not some stupid cancer occurrence!

    I hoping for the best! Hang in there.

    Dianne Duffy

  3. Well, I'm certainly no expert in medical equipment either, but I guess it's a good thing to go where ever they send you in order to get that clear picture, right? Your tongue-in-cheek post actually brings up a very serious healthcare topic, that being the huge disparity in quality of care (equipment included) for various segments of the population, even right here in the USA. I don't mean you personally there in Sacramento, of course. Sorry you have to be in limbo-land for a while longer; you're so right, cancer sure knows how to jerk a person around. Great post, Ann. Thanks for the update. Thinking of you.

  4. Girlfriend, you need a break. Hoping good old San Francisco is the harbinger of good news!

  5. Yes. You totally need a break. And in the middle of all this, you made me laugh out loud.

    Awesome post, Ann.

  6. even though you took that photo for this post in sacramento; on an iphone likely bought in sacramento.....i can clearly tell that its a picture of your dog on a sofa :) ....your onco needs to smarten up. awesome post anne. be well.

    nicola x0

  7. Awful news. I am sorry. I just looked up Pet scans, seems they are VERY sensitive breathing effects them etc. It may be nothing, NOT THAT HELPS...I know. I suffer GAD, OCD and being a hypochondriac. I am sorry Ann, you are my hero in coping...I am not sure if that PC to say to someone w/cancer..I'll have to reread your piece on what to say/not to say..;-)

    Praying for you.

  8. Ann, I go to UCSF for all my breast cancer treatments, but was diagnosed in Redding. UCSF was UNABLE to read my MRI and my digital mammogram, which my local radiologist put on a cd. I can read those darn things on my own computer. I think UCSF just wants to control the scans. I'm hoping that your new scans will be just fine. Been following you since we live close (at least same state!)

  9. Don't ya just feel whiplash from the sudden changes in direction? Hope all turns out well.

  10. I will tell you that when my Dad needed a Pet scan the Dr. here in Reno sent us to Stanford (long drive) not Sacramento (only 2 hours). His reasoning was he wanted a Clear scan and Sac scans came out blurry.

    Hope they find NOTHING on the new scan.


  11. Hey, my car has broken down in Sacramento a bunch of times too! Amazing coincidence! I promise I lie really, really still in those machines. I am such a good girl, I don't want anybody having to do them twice.

    Oh. Ooops.

  12. I don't think we humans were meant to be yo yo's.... I'm sorry you are having to experience being one. This sucks....

  13. I hate those unknowns. Hope that nothing turns up. The waiting is the worst part. XX

  14. Ann--I really wish I had some info on the whole question of scans and the quality of the equipment.

    My hunch (no proof) is that the doctors want the scans done on the machines and with the computer programs that they use most often.

    I simply hate it that you are getting jerked around like this and have to wait longer for answers. My friend Teri (Cheeky Librarian) calls that waiting period "the scan dance."

    A footnote: Having lived in Berkeley for a couple of years (grad school) and then in Chico for a year (teaching at Chico State), I loved your comparison of Sacramento and San Fran.

  15. Ann,

    I'm so sorry that you are going through this. What an emotional roller coaster and you have an amazing attitude. We {Anna & I} will be thinking about you this April and hope for cancer free scans! You post was great and especially for me.. since I live here in Sac and commute to work at UCSF. We are kinda like that unfortunately...but, know that you are in the best of care. I believe that so much.

    Selena & Anna

  16. Ann, I don't comment often, but I come by and see how you're doing often, and you always, always make me laugh. That, my friend, is a rare gift, so thank you.

  17. Hope you get better from this next visit, please pray for me My liver resection is Scheduled for tomorrow at 12:30 central time. He said that it would take about 3 hours.

  18. OMG, I cannot go to bed without wishing you good luck tomorrow with your resection, Dianne. I know it's scary but you'll be fine and you'll feel better in a few days. When they tell you to get up - do, even when it hurts! And, please let post back here or email me as soon as you can, I want to hear how it went and how you are doing.

    And, thanks Dayle, Selena & Anna and everybody - thanks for your kind words.


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