So, on Tuesday I was scanned.
There were two procedures, a CT scan and an MRI scan. From a purely geeky perspective, the whole process was quite interesting. I’d read up on the technologies in advance, so I knew roughly what the kit would look like, how it worked, and thought I knew what was going to happen. Of course, they still managed to spring a few surprises.
They did the CT scan first. This is basically a series of x-rays, but rather than producing a traditional xray image, they take many slices through you, saving the data into a computer so they can reconstruct various 3D images later. In my case, they were using it to image me from the neck to the thighs, basically looking for secondary cancers. The most likely locations for those would be bladder, liver and kidneys, though it can also show up in the lungs, bones, etc. Anything showing up in any of those would probably be fairly bad news.
To make the best possible image of my digestive tract, I had to drink a litre of what can only be described as “gloop”. Fine from a taste perspective (faint lemon flavour) but the consistency was such that each mouthful provoked a gag reflex. I had an hour to drink it all, and somehow managed it without being sick. Although they never mentioned it, I suspect that it would have been barium sulphate in some sort of suspension. In addition, they put a cannula into my arm to allow them to administer a contrast agent into my bloodstream (iodine solution?) while I was in the machine. This should help them to see any unusual concentrations of blood vessels, which would probably also indicate more tumours. For once I managed not to faint, despite the needle being amongst the biggest I’ve seen so far.
The scanning process itself was trivial: lie on a table, which then rises up, and pulls you through the circular (rotating) x-ray source and sensor array. The operator then controls your position within the scanner, allowing them to image to their hearts content. Oh yes, and they control the pump which flushes the iodine into your blood stream. According to the nurse I “might taste a slight metallic tang, and feel a little flushed” when they did that. In practice, I felt sharp heat at the point of injection, which then flowed through the arm into the heart and all over my body before finally settling (most disconcertingly) as a very hot feeling in my buttocks. All in all, extremely strange, and somewhat unpleasant.
At this point I was glad to have the cannula removed, and move on to the MRI scanner…
Which turns out to need no special preparation, and is another donut shaped device with a motorised bed arrangement. Except this time the tunnel is much longer, but smaller in diameter; there was only just room for me to fit into the tunnel of the scanner – my shoulders were touching both sides of the tunnel. It’s obvious why when you know that magnetic force diminishes according to the inverse square rule; smaller devices will need less power to generate the same field in the center of the tunnel, and presumably cost a lot less to buy and run. Still, I can imagine patients who are in there for a long time would find it very unpleasant. Fortunately since they only wanted to image my pelvis, my head was poking out the far end of the machine, so not as bad for me.
Since these things generate truly amazing levels of magnetic field (the one I was in can go as far as 3 Tesla!) you have to be very careful not to have anything ferrous on or in you – as otherwise it would be dragged around with huge speed and force – think “projectile injuries”. They machines are also very loud – 100+ dB apparently. The noise is from the coils of the electromagnet, which make a lot of noise as they change the polarities, so they give you a set of sound-deadening earphones, through which they can talk to you and play music to keep you amused while they get on with looking at your insides.
In my case, they made a big fuss of asking me what music I’d like to listen to, only for them to not actually have anything that I really fancied. Turns out not to matter much – we settled on some Phil Collins, only for me to discover that I couldn’t even hear it over the buzzing and clacking from the machine anyway!
One thing that I did wonder about during my 20 minutes in the machine was how you got a really big person into it. I’m definitely a bit of a fatty, but nowhere even near the size of some of the people we are starting to see in the UK, who must live on the most dreadful diets to achieve their dimensions. On subsequently asking about this, it turns out that apparently the “super-size me” patients are sent to the local vetinary college where there is an MRI scanner specifically designed for treating horses! If that didn’t provide the impetus to go on a diet I’m not sure what would…
Anyway, the results of the scans and the biopsies they took earlier should all be with the consultants now (they operate as a multidisciplinary team for diagnosis and initial treatment planning) so I expect to be called in after they all meet on Tuesday morning, at which point I’ll know the worst, and what they plan to do about it.
Frankly I’ve passed the point of worrying any more; I’ve had a couple of very bad nights imagining the worst. I’ve come to terms with the fact that beyond being positive there’s very little I can do to affect the outcome, so I just want them to get on with whatever they can do to help me.