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Katie Kramer, RN/Life Coach/Author
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Scans and Labs and Kool-aid, Oh My!

8/13/2019

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I've known about this appointment for three months.

My last post-cancer check-up on May 14th revealed that my LDH level was back to normal at 199, and a follow-up appointment was made for today's CT scan with labs.

I was told that for the first two years post-cancer, I will be monitored every three months, either by a scan of some sort (PET or CT) every 6 months with labs, then with labs and an office visit during the in-between appointments. When I hit year three, monitoring will be cut back to every 6 months, then yearly at the five-year mark. 

Essentially, I will be closely monitored until I hit the "cure zone" of five years, and I've been aware of this all along.

But when faced with the reality of what it all means, it's a different story.

Usually an emotional one. 

I arrived early for labs this morning, then had a CT scan with contrast done.

Yes, I drank the Kool-aid.

But flavored with a raspberry twist, the radioactive poison actually went down easily. I sipped on my 32-ounce drink for an hour (ample time for it to coat my innards) before I was taken back to the scanner. 

I've had a few of these already, and not all of them have been for cancer. It was quick and easy, just as expected. When the technician asked when I would be having my follow-up with my oncologist, I told him "Two o'clock today." 

"No pressure," he said. Something in his voice caught me off-guard. Was it sarcasm? Or a hint of knowing how that appointment would turn out? I couldn't grasp what I'd intuited, but it felt just a smidge off-kilter. 

But I've learned not give into my own paranoia so I went about my day running errands until my scheduled appointment. Soon after I returned to the Cancer Care Center, I was taken much earlier than my alotted time. It pays to arrive early.

When I stepped onto the scale, I was proud to report that my 9-pound weight loss had been intentional. Health professionals become a bit skiddish when they see a weight loss with cancer patients as it's often one of the first signs of there being a problem, but not this time. 

In fact, as a result of cancer, I've tweaked quite a few habits and one of them is my food. I have significantly decreased my sugar intake, switched to gluten-free breads, and cut out coffee and dairy. In just a few months, the pounds melted off of me, even after cheating during my week-long eating binge on a cruise last month. Once I was back on dry land, I resumed my previous eating habits and the 4 pounds I'd gained were gone within a few days. 

Easy peasy. 

After (happily) weighing in, I was taken back to a room where my vital signs registered as normal, but I was already beginning to tear up. Not real tears, like I wasn't ready to sob, but I had to keep wiping my eyes at the corners. 

As usual, I had also walked into that room with a list of questions:

1. Why was a CT done instead of just labs? (Because a scan every 3 months is protocol with my type of cancer and there were a few areas in my body that were "questionable" on my PET scan in February, so this CT was done to monitor those areas); 
2. Why does the CT cover my neck to mid-thigh but not my head? (Because lymphoma normally doesn't metastasize to the brain); And
3. What if...? What happens next if today's information goes south? 

While I was reading over my questions, the PA walked in, breathless, like she'd just ran from upstairs. "I have only part of your CT, so we're still waiting on the other half, but your labs are all normal." 

I wiped the corners of my eyes as I shifted in my seat. Then I got down to business. After all, I am not just a patient, but a Nurse. 

"My LDH level?" 

"178."

Wow, I mused to myself as I kept my eyes on my note pad. That's so much better than 199 in May!

"And the upper half of the CT--your neck--is clear. All clear."


That answered my question about the nagging aches I feel every so often in my neck. It's like waking up with a stitch after a deep sleep; each time I turn my head left, the twinge stops me from rotating all the way around so instead, I often have to rotate my whole upper body. 

My massage therapist has been working on these twinges since long before I finished my treatments and although they've improved, they haven't gone away entirely. I've been passing them off as "radiation aftershocks" and the PA agreed that I could still be experiencing some minor issues post-chemo and radiation. 

No biggie. I've never had to medicate myself for them and I've become used to the aches. As long as it's not cancer returning, I'm good. 

Then she left again in pursuit of the other half of my scan, and returned a few minutes later. 

"Yep, all clear!" she sang as she entered the room. "The areas we were concerned with earlier have improved, too."

I looked down at my pad of paper and casually crossed off "What if...?"

Then I reached for another Kleenex. 

She rambled on about something, but I didn't hear much. I hadn't realized until that moment that I went into my appointment feeling a little bit more than worried. I had been keeping a tally of symptoms that have been feeling out of the norm for three months, worried that it may be a sign of cancer returning. Even though I don't normally think about cancer, a slight variation of some bodily function can jerk me back into "uh-oh." 

It wasn't until I heard the LDH level that my shoulders relaxed, it wasn't until she said "all is clear" that I breathed normally again, and it wasn't until I was walking out to my car that I realized how much I base my life off of these appointments. 

I have been planning a trip to the southwest for this Fall, but I wasn't willing to book a flight until I knew this scan was clear. If the scan was not in my favor, I had already mapped out in my head what my next steps would be--both at work and on the home-front. 

It's like I have a "Yes, Cancer" or "No, Cancer" plan quietly hanging out in the back of my thoughts for when I may need to retrieve either. 

I had cancer last year, a statement that still doesn't make sense, but I am healthy today--very healthy. A friend of mine died of breast cancer the day after my birthday last month, and a gentleman-friend has developed Multiple Myeloma seven years after having leukemia. Two other friends have brain tumors, another has prostate cancer, and one of my favorite residents is dying on Hospice. 

Cancer is all around me, so it is not lost on me how blessed I am that I am well. 

But it doesn't mean that I am beyond the trauma of having had cancer.

I imagine that that worry may quietly hang out in the back-drop of my life, maybe forever. 

I just don't plan on allowing it to stop me from enjoying every last minute of the days I get to be on this planet. 

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    Author

    On May 1st, 2018, my Guru showed himself in the form of a 10.6 x 6 cm tumor deep within my chest cavity (it would soon be revealed through a PET scan that there were actually a dozen small tumors in and around my neck, chest and abdominal cavity).

    ​From the moment he appeared, lessons began to unfold around me, summoning me to listen. Ever the good student, I immediately took note...

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