Tuesday, January 27, 2009

Day two at BB's clinic...

...and it was another long one. I've got so many holes in me now I don't know what to do.

First, one thing I neglected to mention from yesterday. The first was a parting comment from the Nurse who said that they were going to run more blood (these were the last two vials taken on Monday) to determine the viscosity of my plasma, and if it was too high, they wanted to perform a plasma exchange. Sounds a lot like a blood transfusion to me.

We got up early and were at the hospital by 7:15 for a 7:30 appointment with, we thought, BB. I thought it was odd as the purpose for the appointment was expressly to discuss pre-op mechanics for the sedation that I was demanding for the bone marrow biopsy. Also on the schedule for the day: social worker and PET scan.

So it turns out BB wasn't the guy there this morning...we met with a resident of his who checked my vitals for the versed I was going to be given for the marrow biopsy. We signed a bunch of forms and went over to the hospital, where I was prepped for surgery. Mind you, last time I did this, I was clothed, in a doctor's office, and it took five minutes. Here, it's a two hour event. Nonetheless, it went smoothly, although my butt is KILLING me right now...they probably took a ton of marrow (7 tablespoons more at least since that's how much the gene array requires) and probably dug deeper than before. On the plus side, the nurse suggested that I keep the IV in place for the day so that they could just inject the radioactive isotope for the PET scan into it that evening. I was all in favor of not needing to stick me AGAIN so I had them leave it in.

I woke up with bandages on both hands and a big one on my backside. Now it was a race, because I'd been prohibited from eating anything all morning, and I had 45 minutes to eat before I had to fast again. I was only allowed to eat protein, so we dashed to the same bar & grill that we'd eaten at a day before and I had a turkey club minus the bread. It was actually pretty darn good.

We then went to the social worker meeting, which was uneventful but served to confirm that I had a good attitude and was not depressed. After this, we met with Lois (who has been through BB's protocol and was down here for a follow-up visit with her husband) and had a nice chat. These are wonderful people. We explained that BB himself was seeing me in the morning and they were surprised. I guess the lobbying has had a good effect! We went back to the hotel and napped for a bit (we got virtually no sleep last night) and then went over to the hospital for the PET scan.

THis is an interesting procedure. The notion is that cancer cells are more voracious consumers of nutrition than regular cells. They deprive your body of nutrients for six hours so all the cells are hungry. Then they take some sugar water and make it radioactive and inject it into your body. The cancer cells gobble it up with greater intensity than the regular cells. They do imaging on you in this state, and it indicates where the cancer cells are in your body.

They injected me and I sat in an isolation room for an hour and called a few people. Then I was brought into the PET scan room where, over another hour or so, I sat on a bench that passed through a tube (like an MRI but not quite as stifling and much quieter). We left and then went to the hotel for dinner (EVERYTHING in this city closes at 9PM and I'm not exaggerating...that left us with the hotel bar, so it was burger and fries for me again).

At the bar, we discussed the four things we are concerned BB will tell me when we meet with him at 8:30 tomorrow:

1. You are high risk.
2. Your markers are very bad and you must start treatment immediately.
3. You have to get your treatment here.
4. We're going to run a ton more tests.

I'm thinking of how to defuse all four of these comments...but we'll discuss that tomorrow once I can report on what he says. I anticipate we'll have the formal results of the X-rays, PET scan, the addtional bloodwork that wasn't completed yesterday, etc. Should be interesting...