This Surreal Life

The high school where I work, and where my son attends, had an event last week where all the classes play games against each other to be declared the victor. They are silly games, fun to watch: obstacle courses, dizzy frolics, crab walks, etc. It is the event of the year, and many people from surrounding middle schools bring their families to watch, and then they decide to send their children to our school after watching this raucous display of good sportsmanship and school pride. Rightly so, I should add: I work at the best high school in Sacramento.

I go every year and love the kids' joy at being young and having all life right in front of them, and competing at something that doesn't matter at all yet matters so very much at the time.

I had a shirt with "judge" on it although I wasn't really judging, and I sat in the staff/judges section. I had been asked to save spots for people on the floor so I did - put my purse to the left and my coat to the right. The stands filled up - thousands of kids and families there.

But, my coworkers never came so I was all alone with several feet on each side of me in a sea of people jammed next to each other, screaming, chanting for their class, for their kid. As I watched, isolated, I dissolved out of the picture. I saw the teachers I work with every day, I watched the kids, I heard the screaming but it was all a bit unreal and as if I was in a mist, a sort of out-of-body experience. I was watching but I wasn't there. I knew that next year, this event would go on exactly like it has for 30 years, and the only difference is I may not be alive to see it. Would anybody notice? Would anybody think of me? I saw them blowing whistles, judging events, laughing with each other, and I knew they wouldn't; I am dandilion seeds, blown into the wind. Gone. But, I looked up and there was my son on the highest rise in the back corner with friends, smiling and cheering. He would think of me. Would he be sad? Would he forget me for this one fun moment? Would he be remembering how much I enjoyed this event? I felt sorry for that motherless boy in the corner.

I do this more and more lately. I'll be sitting at my computer at the dining room table, and my son and husband will have a conversation in the other room, and I am not a part of it anyway, but in my thoughts, I'm really not a part. I'm already gone. I imagine them talking like this when I'm dead. Will they be having this desultory conversation about mundane things, exactly as before? Will they feel my loss or will it be normal? It's both a comforting and disturbing thought.

This is what having a terminal illness is like. You now see yourself as two people - the one fully present and enjoying life, at the same time, you are seeing things as if you will be gone. It's almost like having a split personality. You can enjoy the things you are doing, but out of the other eye, you picture the world without you.

Because, you know that life does go on.

It is very strange to be at a place and not there at the same time, but that is what is happening. You begin to feel alienated from other people. It's particularly so for most of us who still appear to be healthy. We are dying, yet we don't need to park in the handicapped zone; we don't look sick, we wait in line, we listen to people talk about their small aches and pains and petty problems, and we are standing behind them with this big huge secret.

Due to medical advancement, those with Stage IV metastatic breast cancer live healthier lives. It used to be that cancer took over and we died quickly. Now, we are able to beat it back for a year, for two, or five if we are lucky. But, there is no cure, and everybody eventually does die. This means this new generation of cancer patients must live in a strange kind of purgatory, our brains split between life and death.

It's an odd feeling to mourn your life while you are still living it.

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Tits-on-a-boar: A male’s thoughts on his own breast cancer (Guest Post)

“Tamoxifen?” the pharmacy clerk asked me when I presented her with the prescription for the first time. “Are you sure? That’s generally used as follow-up for …”

“Yeah, yeah, breast cancer,” I told her. “That’s me." The one guy you’ll regularly see getting refills of this stuff. I guess I’m coming back for the next five years.

Hers was a pretty common reaction. Since my diagnosis last summer, I can pretty much drop others’ responses to news of my breast cancer into three roughly equal categories. The first being those who quite kindly express sympathy and offer support and encouragement; the second being those who express disbelief, laugh or think I’m kidding (I have to admit that I have a rep’) and, my favorite, those who look at me with an air of expertise and solemnly declare that “oh yes, men get breast cancer, too,” as if they are imparting some new nugget of knowledge to a heretofore uninformed audience.

Yeah, no shit, Sherlock. Do you wanna see my mastectomy scars?

When I found the lump “on my chest” (as many of us are more likely to say than “breast”) last summer, I knew there was a problem. This was not my introduction to the concept of male breast cancer. Sadly, my favorite uncle died from metastasized breast cancer the morning of the ultrasound visit at which my wife and I were to learn we were having a son. Now a spectacularly brilliant, 6-foot-3 honor student, about to begin college as a physics major (yeah, I’m braggin’), my son carries that uncle’s name. It’s homage to a kind and gentle giant of a man … and now serves as an unintentional reminder of what caused his death.

Uncle Philip was like many men and didn’t necessarily react when he discovered a lump on his chest. He was well into Stage 4 when he was diagnosed. His story is what caused me to react quickly. It also set off the appropriate alarm bells with the medical professionals with whom I’ve dealt since then.

The general practitioner immediately sent me to the hospital for an ultrasound and what the radiology tech graciously called a “man-o-gram.” The results came packaged in a bright pink folder (gee thanks, Susan G. Komen folks).

When the radiologist himself asked that I come see him before I leave the building, I pretty much knew what was up. Sitting in the dark room with an array of flat-panel screens in front of us, the ugly blob on my chest stood out in sharp contrast. Kinda like Sarah Palin at a MENSA convention, it clearly didn’t belong there.

“Worrisome,” he said. “No, make that extremely worrisome.” And, with those words, I joined the elite ranks of the 1-percenters. Alas, not those who’ve been the focus of the Occupy Wall Street movement. No such luck on my part. No, I am among that small group of breast cancer patients who happen to pee standing up.

Screw the biopsy. I want that thing OUT of me.

Within days, I was in surgery for a lumpectomy. I should have just started with the full trim job. The margins weren’t clean. This time I opted for a bilateral mastectomy. I, a 53-year-old, six-foot-four-inch tall, happily married father of two, was a getting a mastectomy. I grew up the ‘70s. I did my best to be a sensitive, New Age, kinda guy, sympathetic to the plight of women … but who ever thought I had to get frickin’ breast cancer and a mastectomy to prove it??!?!?

There are actually about 1800 of us diagnosed each year. Many of them had been aware of a lump, but concluded – or worse, were told by medical professionals – that it was nothing to worry about, “merely a cyst, or a fat deposit.” Had it not been for my Uncle Philip, odds are good I’d have ignored it, too.

The importance of being open
Probably the most common question I get from others in “the breast cancer community” (community?!?!?!? Man, that’s a shitty place to live and the taxes are way too high), is how I feel about discussing the diagnosis with anyone outside of a close circle of friends and family. A lot of people want to know if there is any embarrassment or concern about whether I would be viewed as being less of a man, having been diagnosed with what is generally regarded as a “woman’s cancer.”

Nope. Not one bit. First off, given that modern cancer treatments usually involve the surgical removal of the offending body part, I’m actually pretty happy I didn’t get a more “manly” cancer. If I had to give up something, middle-aged moobs are the first thing I’d offer on the sacrificial altar.

There is no emotional connection. Very little of our physical, psychological or sexual identity is wrapped up in ours. Reconstruction – if we opt for it – involves a tattoo.

Chemo bald? Hey, for us, it’s not a crisis. These days, it’s just hip.

It’s pretty much tits-on-a-boar cancer for us guys.

Second, I have nothing to be ashamed of. Given the family history, I was diagnosed with the predictable genetic mutation. Had I known, I would have learned years ago that my chances of developing breast cancer rocketed from the 0.05% risk faced by the general population of men to just about seven percent.

I’ve made it something of a mission to be open and honest about the whole thing … perhaps to the discomfort of those who are listening. I’ve written about it, even to an audience usually focused on – of all things – bicycle racing.

I’ve also done several radio interviews, a few newspaper articles and, most recently, spent a morning discussing male breast cancer and a patient’s view of chemo with a nursing class at the local university. I am, by any definition, something of a loudmouth.

If by potentially “embarrassing” myself, I can convince one guy who finds a lump on his chest to take the thing seriously, it’s well worth it. If I can get one nurse to argue with a doctor who might have just uttered “probably a cyst,” I’ve scored a win. I’ve already talked several of my cousins into getting screened to see if they, too, are a member of the “8765delAG club” (an inside joke for all of you geneticists out there).

If I’d have curled up and not spoken up, it would have been fundamentally dishonest. What’s worse, I would dishonor my uncle's memory, whose own experience quite probably saved my life.

This one’s for Philip … both of them.
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Charles Pelkey is a Wyoming attorney, who began a transition into a new career after spending more than 25 years as a journalist, serving as a radio host, newspaper reporter, press secretary to former GOP Senate whip Alan Simpson and as an editor at the cycling magazine VeloNews. He was diagnosed with an invasive ductal carcinoma and underwent a double mastectomy in the summer of 2011. He received chemotherapy for four months, before a relatively rare and unexpected cardiac side-effect from Taxol prompted his oncologist to end treatments about a month early. His heart appears to be none the worse for wear and his hair and eyebrows have finally grown back. Having lost his magazine job on the same day his diagnosis was confirmed, Pelkey is now practicing law on a (more than) full-time basis in Laramie, Wyoming, where he lives with his wife of 25 years, Diana, and their two children, 17-year-old Philip and 12-year-old Annika.

First Abraxane

It's Wednesday - chemo day. On this day I start my fifth chemo, Abraxane. I drive my usual route through the city, park in my favorite area of the hospital parking lot, grab my iPad and purse and make my way to the building entrance. The afternoon light is slightly golden and the day, after a bout of rain, is warm, moist, and spring-like. Hopeful. I see wet blossoms on the small trees struggling to survive in the asphalt meadow of the parking lot, and I realize, as I open the glass doors littered with small drops, that I have been coming here weekly for nearly two and a half years.

By now I'm a pro at this chemo thing. I take the wheezing elevator to the 3rd floor, walk directly to the sign-in sheet, write my name, greet the receptionist, and sit. I have long stopped noticing the mottled gray/blue carpet, the machine carved wood sign that warns about the wait, the hospice and wig brochures, or the yellow and black check pattern of the waiting room chairs. I know one or two have lost their padding, and I avoid those without thought. I pull my iPad out and start my kindle app to read. The wait might be 10 minutes, or it might be 45; by now I'm beaten into submission, or perhaps I've finally learned patience. I no longer care about time. I'm here, I have nowhere else to be.

They'll get to me.

When my name is called, I walk directly to the scale and step on. I wear heavy clothes because I'm always cold and why wouldn't I be? In jacket, sweater, boots and jeans I weigh 95. Losing weight again, but nobody comments. They take my weight, I know, merely to calculate my dose of medicine. I hop off the scale and go back into the infusion room without being told, where the oval ring of recliners sit waiting, like hunched bears.

Sometimes now, I find one that is farthest away from people. I read more than talk these days. The chatter of the rookies about their newly lost hair, their uncertainty, their doctors - it has become tedious. But the room is open and people sit just feet from each other so it's hard not to be drawn in. There are donated paintings on the walls - seascapes and still-lifes, painted in oils by somebody who watched too much Bob Ross on TV. There are homey, 1970s-colored hand-made afghans and quilts on the back of each chair and a pillow with a paper case on each seat; chemo poles aside each one. The shelves on the walls have wigs and ball caps, free for the taking but too ugly to want. The one window shows the sky, the tops of trees, the edge of the parking garage. To the left is the hospital. I've seen budding trees and rain, sunsets and shimmering heat through those windows, season after season.

It's hard to believe this shabby, comfortable infusion room is where I have spent every Wednesday for two and a half years. And, it's likely where I'll spend every Wednesday until I have no more Wednesdays left to spend.

If only days were like coin. If you could save them up, not spend them, gather them to use when you need them. I think of days I wasted. Threw my coins into something foolish, thinking there was an endless supply. I wish I could have them back.

I know the drill. Today's nurse puts in her special needle, and I turn my head to the right automatically, otherwise the blood doesn't flow properly out of my port. Once the flow begins, I watch the bubbly maroon liquid stream into the tube and then ready myself for the metallic taste of the heparin flush. This chemo, Abraxane, requires an IV anti-nausea drug and 10 mgs of decadron. I watch her place the bags on the pole - bags with my name and the time on it and a large syringe taped to one. She will inject that into the bag at a time known only to her. The assistant drops a fluttering sheet with bloodwork results onto my lap. My marrow is doing its job now - next week, I know will be different. I tell my nurse, and really the entire room since no privacy is available, that for the past two days my stomach has been acting up, the pain has gotten much stronger, my bowels are not normal. I'm worried about the return of c-diff. I wonder if I will need something stronger than compezine for nausea. She promises to call a prescription for Zofran in for me if I need it, and turns on the flow.

I know all the nurses: their children's names, their problems, how they feel about their jobs. One once admitted she doesn't want this to be happening to me. I admit that I don't either.

Drip. Drip. How many drips have flowed into my system over the past two and a half years?

I get my chemo, I go dry, I'm unplugged, and I leave, driving through darkened streets to my family. This chemo is no different than any other. I am weaker than I used to be but I tolerate it well. I have some nausea but it's controlled with Ativan and Compezine and is gone in two days. Ominously, my hands and feet tingle and I know l-glutamine may help me with that; I have used it successfully in the past. But, it must be dissolved it in a glass of water and the thought is now repugnant, me with no appetite. I know I can't get that in my stomach this week.

Next week, I will for sure. I promise myself.

My head also has that feeling you get before you are going to lose your hair. It took ten days last time, now the feeling has happened in two. It's as if I've slept on dirty, knotted hair for too long, and ants are crawling on my scalp. I even washed my hair, just to be certain it wasn't actually dirty. Nope, even freshly scrubbed the feeling is there. The follicles are rebelling, gathering reserves and preparing to jump out of my head. I'll be bald soon.

Carboplatin. Taxotere. Taxol. Navelbine. Abraxane. Herceptin and Zometa. Drip. Drip. Drip.

It's Wednesday. It's chemo day.


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Abraxane

I had a visit with my Sacramento oncologist today, and he was able to read my Sacramento scan just fine.

Unfortunately, Sacramento cancer is definitely growing back in the ablated part of my liver.

It is already 2 centimeters, which means the herceptin is not doing much. That means babying my colon is about to end; I have to go back on chemo. Considering that I was up all night last night with mystery nausea and stomach pain, this idea does not excite me. In fact, it makes me very, very nervous. I'm not sure my tender and flighty intestines are ready to be flooded with toxic chemicals.

But, having cancer take over my liver doesn't sound appealing either, so I guess I don't have a choice.

The chemo I will be on is called Abraxane. It is almost the same as Taxol, which I've done before. The difference between Taxol and Abraxane is in how the body metabolizes it, I think - you don't require as many steroids or pre-meds with Abraxane. The plan is to shrink the tumor down for my San Francisco surgeon - I have an appointment in mid-April. Perhaps he can ablate it again, or maybe he has another trick up his sleeve for me.

The good news, and there is some, is that there is no cancer anywhere else. After all this time, that is excellent. If we can take care of this one stubborn area, I can still be in good shape to live a few more years and buy my son some sheets for his college dorm.

So, next Wednesday I will start the Abraxane and go back on the attack. Colon, I'm warning you now - you need to get on board!

Unfortunately, you lose your hair with this chemo, so I will be bald again. Since there is always a positive, that means no bikini wax for the summer. I'm so happy to not have to shave my legs for a while, what a chore that is.

Last time I lost my hair, I bought cheap, adjustable wigs - lots of them in all kinds of fun styles and colors - but couldn't wear them, they were just miserably uncomfortable. Maybe if I splurge and buy a real hair, lace cap wig, it might be more tolerable, and I can keep it on for more than five minutes without my face turning red and demonstrating the urge to rip it off and throw it across the room. I have a special wedding this summer I don't want to be bald at, and as entertaining as wig-ripping might be, I think I'll leave any histrionics to drunk Uncle Frank. It's a special moment for two special people, and it deserves hair.

I'm sure scarves will be my go-to, but I'm really not very cute bald and I've been there/done that with the bald thing. I've answered all possible questions pertaining to my head about a hundred zillion times.

Anonymous, at times, is good. And, that means a decent wig.

For my SacTown readers: Does anybody in Sacramento know where to get a reasonably-priced real hair wig? And, preferably my own hair color, which is now a silver/gray. And, remember, I'm a pin-head, nothing fits me off the rack. Thank you!

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.

Have you ever seen a PET?

Okay, maybe not that kind of pet.  But nobody online can resist a cute kitten photo so I expect my hits to jump exponentially.

It had been a nerve-wracking week, so to ease my anxiety I tried to get a glimpse of my future the best way I knew how - a Chinese meal with a fortune cookie dessert.  Take-out Chinese is a two-fer: I get out of cooking, and I get a hint at what the future holds.   After I finished my Szechuan Chicken, I cracked open the cookie.  The fortune inside read, "Stay close to your inner self. You will benefit in many ways."

Why, it's like that cookie was made for me! I am not only close to my inner self, I get to see it on a regular basis. And, it is your lucky day - I will share the benefits of that inner view with you!

A quick recap: in preparation for my four month follow-up visit with Dr. SuperSurgeon, who did my liver resection, I had to have a CT scan. The CT scan came back showing something suspicious on my liver, so my oncologist recommended a PET scan to see if it's cancer.  They moved the paperwork through the system quickly so I could bring all the information to Dr. SuperSurgeon. The CT was already on a CD, collecting dust and crumbs in my purse, ready to take to San Francisco.  On Monday, I added the PET.

I hadn't looked at the CT because I know I can't interpret it - they kind of look like a film noir murder scene; one gray organ gently blurring into the other.  Besides, I'd read the radiology report which had already scared the crap out of me. But, I was curious to see the PET scan, both to see if I could find cancer and just to see my insides in color.  I loaded it on my computer.

Because I know that every single time you peeps sit down to your computer and load But Doctor, I Hate Pink, you say to yourself, "I sure hope Ann posts a picture of her liver today," I am finally going to grant your wish (you will need to click to see it all):

Interesting, yes?

There is cancer terminology you may not be aware of, and that is the phrase "light up" when referring to something on your PET scan. We all say our scans "lit up like a Christmas tree" when they show a lot of cancer.  Where the correlation between Christmas and cancer comes in, I can't say.  Personally, if I'd invented the simile, I would have said "lit up like a suicide bomber" or "lit up like cigarette lighters at a meth house" or something a little less festive than Christmas trees.  But, I don't make the rules, I just follow them.

So, I am happily sitting down, snacking on pretzels, when I open my PET scan.  The above is a still image but when you see the PET in real life, it is interactive.  The gross little skeleton on the right rotates around like a Russian dancer,  and you can move the green bulls-eye thing to focus in on specific areas - if you can catch it, that is,  the rotation is fast.  There is also a magnifying glass that highlights any interesting spot you desire for close-up view. As I bit into my pretzel, I was horrified to see that in the area of my liver, right where that growth had been seen, was a very bright light.  As you can see, circled above,  it definitely looks like a Christmas bulb or cigarette lighter that somehow got stuck in my liver.

Well, shoot. Cancer really is back, and only a few months after surgery.

I spent the next few days trying not to be disappointed, yet mentally planning my last ever birthday party, telling myself I really should finish at least one scrapbook (but not actually doing it), and eating extra coconut popsicles and Sees candy because - well, why not?  I also felt bad that I could not provide a good statistic for any future women with limited mets who might want surgery.  It's a big burden to know you let down the surgical future of breast cancer treatment.  I was also really upset at the thought that I wouldn't be around to see my son graduate from high school. That kid is a hard worker and I wanted to see him off to college.  I also just know that without me, my husband is going to pick out some hideous dorm decorations for the boy, and will probably forget meaningless stuff, like sheets.

I forgot one teeny little thing:  I am not a radiologist.

CDs in hand, my husband and I drove to San Francisco.  Once in the exam room, I spoke to Dr. SuperSurgeon's doctor-trainees-assistants about my medical history since the surgery, which consisted of my horrifying c-diff tale. That generated a lot of questions, but I also managed to mention that I expected that my cancer had returned.  I handed them the CDs, they left the room,  and my husband and I awaited the confirmation of bad news.

Dr. SuperSurgeon came in, and I prepared myself.   He looked at me and said something disappointing: he was not able to open the CD the PET came on.  Apparently, all that skeleton rotation and magnifying glass stuff is caused by a proprietary program that conflicted with other programs on their computer system, so they couldn't see it.

But then, he said something wonderful. Based on the CT (which he could open) he would never have even ordered the PET.  He saw normal surgical changes and nothing concerning at all.  He also said that sometimes a PET scan can show uptake (doctor-lingo for "Christmas tree lights") after resection and sometimes radiologists didn't recognize normal ablation changes on CTs and PETs.

Of course, to be sure, he, along with a radiologist, will go over the PET, (presumably after they get tech services in there to open it). They will call me when they know for sure.  But for now, they believe I am fine.

I have one concern:  if radiologists are always going to interpret my surgical changes as suspicious growth, then how am I ever going to get accurate news?  I can't run to San Francisco every time I have a scan, and I don't want a PET scan every time I have a CT scan either.   Somebody is going to have to figure out how to read my scans.

Maybe it's time I go to radiology school.

I might even have time.
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Conspicuity

Isn't conspicuity a great word? I had never heard it before, and when I saw it on my latest radiology report, I was intrigued. It's pretty obvious what it means by the sound of it, but just for fun, I looked it up:

The property of being clearly discernible; The state or quality of being clear or bright; brightness; conspicuousness

So, what has conspicuity? My health? My mental state?

Sadly no. It appears that there is a "rounded lesion of low attenuation measuring 1.6 cms near the linear posttherapy defect in the right hepatic lobe with increasing prominence and conspicuity when compared to 12/23/11."

Ladies, don't you want to meet the guy who wrote that sentence? Hawt.

This "prominence" is in the area of my liver that was ablated; the section they couldn't reach with the knife.

Does that mean I have cancer growing there again? Maybe. Maybe not. Probably. I hope not.

What it means for sure is I have to have a PET scan again. A PET, in case you have forgotten, is the most boring medical test in the history of tests, and I'm dreading it. Asking me not to move even a finger for an entire hour is like asking Mitt Romney to say something interesting to a crowd. Not gonna happen.

Because I'm seeing Dr. SuperSurgeon on Wednesday, we had to rush the PET through, and once again, I have lots of people to thank for being on the ball and making this happen. My doctor's secretary, the RAS folks, they treat me good, no doubt. My PET is Monday and I should be able to bring the CD with me to San Francisco on Wednesday.

The rest of the radiology report was good. My intestines are healing and show no obstruction, although there are still boo-boos on them. (Bowel distension and resolving pancolitis which has shown "interval" improvement) Nothing shows abnormally in my heart, lungs, stomach, kidney or bones or any lymph nodes. So, while cancer may be growing back where it once was, it is not yet travelling throughout my body.

I would like Dr. SuperSurgeon to tell me that they can zap this out, assuming it's cancer. Yes, I would face that again. But my intestinal problems and possibility of relapsing c-diff complicate any treatment they may want to give me.

We shall see.

Anyway, one thing I can say with great conspicuity is that this cancer thing.... sucks.



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