Scan No. 2

A looong Day in Boston...

My Dad and I left the house around 9:30am for a scan appointment at Dana-Farber for 11am. Plenty of time for a 30 mile drive. That's what you would think... except we hit practically stopped traffic right around the I-95 exits on 93. I was calm, thinking that it would lighten up after we passed 95... but it didn't. I planned on calling radiology to let them know I might be late. We crawled all the way to Storrow Drive. Unfortunately for us, this unusually late-in-the-day morning-commute traffic would set the pace for the rest of the day.

We got lost. Although I have been to the Dana-Farber building before, for my first of many scans to come, nothing is ever as you remember it in Boston. Of course, the first of a few imperative side-streets that we needed to take, Jimmy Fund Way, was closed. Luckily, Dad's eyes aren't as bad as you might think, and he spotted the DETOUR sign hidden behind some landscaped-city-foliage that would lead us to the parking garage.

Ahh, the parking garage. We made it! Not quite. We circled into the bowels of the cement basement. Around and around practically skimming the suspended cieling pipes we drove, down, down, down. There wasn't a single spot. As we started to panic a crew of parking garage gurus flagged us down and created us our own temporary parking spot of orange cones. We jumped out and ran to the elevators.

After stopping at a few different receptionist desks that all looked the same I finally checked in where I was supposed to be... 10 mintes after 11. I was called after about 15 minutes. I left Dad on a couch in the waiting area with his WantAd magazine.

In the room, behind the lead door, the nurse explained the procedure. She injects the green radioactive liquid into my veins, I wait for an hour while I become radioactive, then I go in for my scan. It's probably my favorite procedure since it is so low-key: a tiny needle, no blood work, no blood pressure... just resting in a room with a warm blanket and the TV. Nice.

As I watched her prepare the needles I noticed that the radioactive syringe came from inside a heavy lead safe that she had to lift with two hands. The syringe was also encased in a lead sheath! This procedure was getting cooler by the minute. She wrapped my arm in a flourescent bandage and left. I watched some terrible daytime judge shows for an hour.

I went in for my scan. I asked to keep my arms down since they fell asleep last time and made me extremely uncomfortable. I just laid there sometimes pretending I was in the cabin of a boat on the ocean, sometimes trying to remember song lyrics, and sometimes just staring at the machine and listening to the noises it makes. It was over before I knew it... 21 minutes. I went to the snack room and got some chips for me and Dad.

Dad and I went for lunch in the cafeteria. We had about a half hour before our meeting with Dr. Fisher at 2pm. We got sandwiches in the deli line. Todd showed up right on time. The hematology oncology office was really crowded. I'm surprised we even got 3 seats in a row in the waiting area. We waited about 15 minutes before being called into a room.

Dr. Fisher said my scan looked great. I guess that means the cancer is responding well to the killing-chemicals we call chemo. But not well enough to call it quits. Dr. Fisher prescribed 2 more cycles of chemotherapy (4 treatments = 2 months) and suggested that I speak with his friend Dr. Mauch in radiology. He called him up and asked if he would see me right then. Of course. These Dana-Farber doctors are amazing at immediacy... I've never seen anything like it. So, Todd, my Dad, and I took a hike over to Brigham and Women's. It was about 3:30pm.

We didn't wait long in the waiting room... but in the examination room we waited forever. We couldn't really complain since he agreed to see us on such short notice... but we did a little bit anyway. The flourescent lighting was giving us all headaches and I don't think any of us wanted to deal with the important task of asking relevant questions about a subject we didn't really know anything about. We were already pooped.

Dad and Todd... this is how we wait

Enter a med student doing his residency. He was nice, asked me all kinds of personal questions, and examined me. He asked things like how many cigarettes have you smoked in your entire life and how often do you drink alchohol and what do you do for fun. All of these things I had an extremely hard time answering, probably because I was tired and I'm bad at math and I have chemobrain which makes me sound like an imbecil. Dad and Todd laughed which made me laugh and then I attempted to have a semi-intelligent conversation about literature that ended pretty quickly.

Enter Dr. Mauch. One of the first things he said was that I could never smoke a cigarette ever again. Which I agreed to on the spot. Later, being the insanely nostalgic person I can be I re-lived all the great moments I had smoking Lucky Strikes on the beach in Fuerteventura and the excitement I felt whenever I found an old school cigarette vending machine and the laughs I had ignoring the harsh warnings on the boxes in Scotland. Now, I am just frustrated because I am forced to change my habits and experience a new lifestyle... which is a choice I would have liked to make on my own... but that I probably never would have. So, I have to try and be grateful and creative with my clean slate. But it's not easy.

Anyway, Dr. Mauch talks to us slowly and thoroughly like he has all the time in the world, which was really nice since we waited so long. He reccomends 3 weeks of Monday through Friday radiation in Boston, where the precision experts practice. We tried to look at the alternatives since we know from the research that radiation can cause breast, lung, and thyroid cancer.
















The two options are:

A.) 4 more cycles of chemotherapy (8 treatments = 4 months)
B.) 2 more cycles of chemotherapy (4 treatments = 2 months) and 3 weeks of radiation (M-F)

There are new lymphoma and radiation studies happening as I write this, but all of the results won't be in for years to come. What we know now is that those patients who opted out of radiation have a higher recurrence rate. Dr. Mauch estimates that chemo alone probably produces a 75-80% cure rate with a relapse rate of about 20%. Radiation boosts the cure rate up to 90-92%. Dr. Mauch also estimates that the newer, more precise radiation fields probably produce about half as many secondary cancers as studies done in the past show.

After shaking hands with Dr. Mauch and his resident we hiked into the bowels of the parking garage and went for a bite to eat. We thought that by leaving the city later we would avoid the rush-hour traffic. So we had a few drinks, I had a salmon sandwich. We dropped Todd off at home.


Again, we hit traffic around I-95. I'm not sure what it was... but it was a slow day. We didn't get home with our news (whether you call it good or not is your own discretion) until 8:30pm.

Dad deciphers the parking voucher

Good nite!