Friday, February 15, 2013

Nasopharyngoscopy and PETSCAN

Today I had my appointment with the Ear Nose Throat doctor (ENT, or otolaryngologist) to rule out vocal fold involvement of my cancer. This was a follow-up appointment from my Positron Emission Tomography report (PETSCAN) of January 12, 2013.  Per statistics it would be rare to have a breast and throat cancer at the same time but it was still important to rule out due to the area in my throat -- the vocal folds -- that was noted of concern on my PETSCAN report. The PETSCAN was originally ordered by my family doctor. The follow-up ENT appointment was set a while ago (this being the earliest date; actually yesterday was the earliest date but my ENT broke his leg, cancelled that appointment earlier in the week, then squeezed me in today due to upcoming surgery).

A note about the PETSCAN and its timing: 
The PETSCAN was done the day after I learned that I have an invasive and aggressive cancer. The scan would determine if there was metastasis to other regions of the body since the tissue sample for the biopsy was taken from my right breast. During the test, they injected radioactive material into my skin. Then I sat in an isolated, windowless, 10x10 foot room for one hour for the material to become active. There was a button in case I needed help. At the end of the hour, I was brought into a room that had a machine that looked like a CATSCAN. On this machine they did both the PETSCAN and CATSCAN. The CATSCAN is the second in my lifetime (the first happened when I was hospitalized with sepsis three years ago). A CATSCAN is the equivalent of 500 x-rays per most experts; some say 1,000. I just learned from an Oprah interview with Dr. Oz that many of these tests may not be the choice test. MRI, which doesn't use radiation, would be one of those choices. I did learn from my cancer doctor that she would not have originally ordered one; she prefers the MRI in my particular case.

Here is the link to the Dr. Oz interview:
http://www.oprah.com/health/Are-X-Rays-and-CT-Scans-Safe-Radiation-Risks-Dr-Oz

During the PETSCAN appointment one hour wait time of the radiation injection and then the following one hour of testing, I cried. I tried not to, but I had just learned about my cancer the day before. AND, the day before I just either cried like a baby, cried like a warrior on a mission, or cried silently with tears rolling down my cheeks. I slept maybe a couple of hours that night, falling asleep from crying only to wake up with crazy thoughts at which I then decided to call my sister on the east coast (midnight west coast time) and we both cried for hours.

When I cry this hard, my throat gets involved. I feel this tightness that especially gets even worse when it's an emotional cry (like at a funeral -- or for me, when I missed my dad as a little girl. I saw him once a month and always cried silently on the way back home to my moms). Even back then I remember thinking how much my throat hurts when I cry -- I even wrote about it in a journal I kept back then. I remember writing that it was like pulling a vibrating guitar string in your throat as hard as you could until it felt like snapping physically, emotionally, and spiritually. To this day if my son cries hard, say at a doctors office or during an emotional event, and he says his throat hurts  -- I totally get it.

In any case, I remember asking my cancer doctor -- "... is it possible the PETSCAN highlighted the vocal folds due to my crying?" She said she never heard of this, but originally she said that -- as she read my report, she wondered if  I was a professional singer (to this I responded my son thinks I am)  so my idea wasn't crazy.

It turns out my idea was a good explanation.  Even the ENT had not heard of such an explanation but said he could see how that would be possible. The ENT performed a nasopharyngscopy.  For this he  sprayed numbing meds down my nostrils. He waited for the numbing to kick in then inserted a flexible wire down these nostrils. The wire end has a tiny camera on it which lets the doctor see the live image of my vocal folds on his computer. He asked me to produce 'mmm', 'kkkk', and 'eeee' sounds. And that was it. Fast. Not painful. Uncomfortable spray process, but it's over quickly. In a geeky way I was interested to learn about this process since, among my few hats, I'm in speech language pathology and I've been on the report reading and studies side. Having this first hand experience definitely gives me an understanding and empathy for patients undergoing scope procedures. It definitely feels good to know my throat is ok.

Recommendation for further investigation has finally come to a close. The chances of having cancer in both vocal folds and breasts are still slim and thankfully I'm not that one incident. My vocal folds are free of pathology and I feel like celebrating!


Note about Post PETSCAN:
At the very minimum per the technician at the time of the scan, he said the amount of radiation stays in your system for about 6 hours; he said he would stay away from kids for at least this long and that I should not be sitting on the same sofa next to adults. It made me think of all the people who get scans, x-rays, walk through airport security -- and then mix with the masses. This can't be good.

I asked the technician if it would be ok to go to a restaurant or cafe and sit alone in a booth afterwards in order to stay distant from people -- he said this was fine. So, afterwards I went to a local Starbucks, ordered a chamomile tea, sat with a book outside and stared into space with a lots of thoughts running through my head.

The following link is the one I first used to learn what the PETSCAN was -- I think I would add to not only stay still, which I did, but don't cry (and see if there is a better first choice test like an MRI).


No comments:

Post a Comment