Friday, August 5, 2011

Lymphoscintigrams can bite me

PS. This is a continuation of the last several blog posts in August. Start with "Breaking The Ice" and keep reading for the whole saga.

So, several weeks later, I found myself getting a lymphoscintigram. 

A lymphosincti-what?

Yes, it is as awesome as it sounds.

When cancer spreads from my mole site, it would travel through the lymph system (sort of like a sewage system) to a hub, namely a lymph node. The problem is that the doctors aren't sure which lymph node my mole site drains to; could be my neck, under my arms or in the groin area. So this procedure injects a radioactive dye into my body at the mole site and follows the progress of the dye until it reaches the lymph node. Then, the surgeon will take out a piece of this lymph node and check for cancer. For a more thorough explanation, check out this radiology site.

So I found myself in a large lead-padded room with a giant gamma ray camera machine. Seriously, it looked like something from the future. The nurse told me to strip and lay on the table.

Now, I get that there should be warnings on dangerous materials, and I also get that the nurses and doctors get exposed this material 30 times a day, whereas I will only be exposed to it for a few days during my entire life.

But do they really have to make the radiotracer look so deadly? The doctor enters the room carrying a metal canister between his two fingers (as if he is carrying something extremely distasteful or contaminated). Printed on the side of said canister are the words: DANGER: RADIOACTIVE MATERIAL. The doctor and nurse are wearing turtleneck lead aprons with lead gloves. Lead gloves, people.

They've even put a lead apron over me, with a slight opening by my mole. Does it really matter at this point? You're about to inject that INTO MY VEINS.

So I'm already worked up as the doctor and the nurse bring over the canister of death.

The doctor begins to open the canister and says: "I need you to remain absolutely still while I inject the dye. This is going to hurt."

What's wrong with this picture? Isn't the doctor supposed to say something like: "You won't feel a thing" or "It'll be over before you know it" or "This'll be just like a shot; quick and painless". I'm pretty sure the line "This is going to hurt" is not in the "How to Calm Patients Down" handbook.

As if that wasn't enough, suddenly the nurse puts her arms across my shoulder blades and presses her entire weight down on my back, locking me in a death vice between her body and the table. Whatever, this can't be that bad...


I've read that lymphoscintigrams aren't supposed to hurt. I'm typically not bothered by shots, IVs, or mild scalpel work. But maybe I'm just a baby. I'll admit it: I cried. That injection was the single most excrutiating, vibrant, intense pain I have ever experienced. The injection seemed to drag interminably (much longer than a normal shot). I couldn't move. I couldn't breathe. My world narrowed down to the icy fire spreading through my back and I distinctly remember having the thought, completely seriously: the cancer can stay if you stop injecting that into my back.

When they finally finished, I laid in stunned silence for the next hour while the machine of the future whirred around me following the progress of the dye.

Here is a re-creation of the results of my lymphoscintigram with MS Paint goodness:

Looks like tracer is in both armpits to me
The radiologist handed me a copy of his report with the note: "Left side biopsy only". I puzzled over the lymphoscintigram; it seemed pretty obvious to me that both armpits had evidence of radiotracer in them. Shouldn't I be getting biopsied in both under arms? My mom was also stymied. We shrugged; after all, we weren't doctors. I'm sure he knew what he was doing.

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