CT/PET Scans

What’s it’s like to have a CT/PET Scan?

I’ve been shoved into one CT/PET box so many times at Memorial North in Colorado Springs I’m thinking about scratching “Leland was here” on the walls.  This combined procedure is par for the course in ongoing cancer care follow ups.  Here are some of my thoughts and experiences on the subject.

First off:

  • C-T (CAT) and PET (Positron Emission Tomography) Scans are often done together
  • Referred to commonly as just CT/PET scans.
  • IT DOESN’T HURT
  • IT’S PRETTY QUICK (15-30 mins)

The worst parts are:

  • Lying still
  • Drinking the contrast
    • You have to pick up a bottle from hospital prior to procedure
    • Drink 16 “ouncer” 2 hours prior to scan
    • Drink other half 16 ounces an hour before the scan
    • Guzzle the remaining half when you get to facility
    • The stuff is nasty, seriously nasty, strong gag worthiness, serious contender for all time greatest barf awards
      • Thick, chalky, steely choke on your choice of pseudo fruity flavor stuff
      • Don’t be fooled by clever names on bottle…”Berry Berry,” ha!

There is an infusion after a few minutes:

  • The infusion always gives me a “pee-pee-in-my-pants-feeling-sensation” (to use a technical description)
    • Of-course the infusion requires getting an IV
      • Seems like every medical procedure – ad infinitum – requires an a @#$$%! IV!!!
      • Can’t underscore the importance of a skilled technician when it comes to poking me with a needle
      • The skill level is really the difference between a relatively mild prick and repeats, new pokes, more bruises, blaming you for your “rubbery veins”, or returning to work and people suspecting – based on the track marks on your arm – you decided to go with heroin for lunch
    • Here I learned, though not perhaps comfortable, it is okay to suggest hopefully in a kind and understanding way, that the technician get someone else to do the stabbing if he or she is having trouble with my rubbery veins
    • The other thing you can do is make sure you are well hydrated before procedure which will help the technicians in getting a good vien

And finally my recurring “40 Year Old Virgin moment

  • That’s because I have hair on my arms, am an ape man/teen wolf
  • When they yank the thick strip of tape holding the IV off my arm, invariably I vow to go 100% Powder (remember that weird little movie from 90s?)
  • Even worse is they do an EKG on the chest hair
    • This is why every nurse/tech should have a razor in toolkit to shave you up
    • I’m starting a movement, “Save the body follicles” campaign
    • We’re gonna crowd fund this baby and change the world!

Additional Notes on C-T/PET Scans:

C-T or CAT scans are essentially a series of X-rays captured in “slices” through the body.

  • This is not quite as terrifying as the book of real human slices at The Museum of Science of Industry in Chicago.
    • That used to seriously weird me out as a kid.
      • A man and woman in the 40’s bodies were frozen solid, power sawed into 1/2 inch sections, and set in sheets of glass.
    • I don’t think they are still exhibited in book format but are “portraits” on wall or something equally capable of giving me nightmares as adult.
  • Alas, I digress…

The digital CT slices are analyzed by software.

  • The resulting images can indicate things like location, shape, and density of tumors
    • But have limitations in finding smaller tumors (less than 2m).
    • So here’s where the combination of PET with CAT make good/is a good idea.
      • PETs detect variations in metabolic and chemical activity in the body using positively charged particles.
      • Areas with increased metabolic activity show up as colored images.
        • Since cancer cells divide more rapidly than the good guys /normal cells, they present with higher metabolic activity.
  • In this way PETs identify small areas (smaller than CTs or even MRIs for that matter).

I hope there is no evidence of disease on your scans.

Gamma Knife Procedures

Gamma Knife is stereotactic radiosurgery or a type of treatment that uses beams of radiation to destroy tumors of the brain, head, and neck. As I’ve “bragged” before I’ve had 99 zaps from the Gamma Knife to treat and, for one particularly stubborn lesion, retreat the 98 melanoma tumors that set up businesses in my brain.

When I talk about the 99 I always want to work in a Jay-Z reference:

  • 99 treatments but a brain ain’t one – huh?
  • 99 treatments but I’m still having fun – true but…
  • 99 treatments but still as dumb – most appropriate.
  • Nothing quite flows…leaves me wanting…

Anyways, despite the cool fact that they don’t have to crack your head open (unlike brain surgery…I have had that too, this is much better)…this hurts and is scary (for me anyways, but I’m sure you can handle it!).

And I have to admit I was surprised when they attached the cage to my head the first time. Dr. Breeze at Univ of Co probably told me but I must have must have done my best to repress it. Okay the cage is actually referred to as a frame (cage sounds more dramatic though don’t you think?).

  • The cage is attached with four screws and the resulting contraption is locked in place
    • A helmet is placed over that
    • This contraption ensures immobilization so that the machine can hit the exact position of the lesions
    • Machine may also adjust the position of your head for this purpose during procedure
    • Beams travel through tiny holes in helmet
  • You lay flat on back, in narrow tube
  • It’s very quiet but you can choose to have music pumped in
    • Recommend you BYO Phone /mp3 player/8-track if you are Starsky or Hutch

They’ll give you a local anesthetic but still hurts (maybe/likely I’m just a wimp)

  • The sessions can be long, depending on how many being treated
  • If you only have a couple you will likely be done in 30 mins
    • Not in my case

I have also “bragged” before about setting the US/EUK record for time in the machine (4.5+ hours)

  • Getting the frame off is welcome relief, that old Tum’s commercial/slogan, How do you spell relief? comes to mind
    • Especially as the anesthetics and whatever else they gave me wears thin by the end of the procedure
  • Have not tried running any marathons or perform strenuous activities for rest of the day…yet
  • Almost always a) hit Chipotle b) Take nap
  • There’s usually swelling where the screws went in
  • There can also be swelling in areas of brain treated
    • I fortunately have not had to deal with that
  • Back to “normal” the next day
    • Dangit!  I keep asking them to make me an accidental savant but Breeze has not complied
      • You know suddenly and inexplicable able to play Mozart with my ten toes while simultaneously speed reading a novel while reciting the birth and death years of every US president …something equally useful and savant-ish like that…

More Notes on GAMMA:

  • Dr. Breeze told me that my 4.5 hours in machine is nothing compared to Japan where I was told they often go for marathon, round the clock sessions
    • The Japanese are supposedly how they know when neurological deficits statistically set in
    • The magic number is 100 or more
    • So I’m still below the cut though you probably can’t tell 0-;
    • Praying we do not have to test those limits further
    • Unfortunately the efficacy of treatment can’t be determined right away…eg how well the procedure worked will be assessed in weeks/months to come.
    • That being said, I wish you and your family tremendous success in this regard!