All good things seem to come to an end, like vacations from treatment. J has returned to the hospital. Would have been better if he it was tomorrow, The Return of the Fifth.
I worked the second shift today, so I was able to take J into clinic. Our first appointment was the ultrasound. This is where I had my first run-in with the system. We checked in, and the receptionist started asking the important questions for an ultrasound, like "When did you eat last?" I was actually a bit puzzled, because that's something you ask about if you're going to scan the gallbladder, which we had no need to do so. J had eaten breakfast, so I started telling the receptionist that it didn't matter (the receptionist did not know me as one of the radiologists, and was a touch skeptical). They checked with the sonographers, who then checked with me to see if it was OK that he had eaten. It was OK.
The ultrasound was done to follow-up the uncertain finding on the PET scan. There were two parts to the finding on the PET scan. One was a little bit of something that was using sugar (metabolically active, like cancer can be). The second part was a little behind it and looked like a little fluid collection, although it's often hard to know if it's fluid or something solid. The ultrasound was not meant to clarify what these were, but rather to show that nothing was growing bigger. We didn't find anything that looked like a mass had just exploded. Primary end point achieved. We didn't find anything that corresponded with the part on the PET scan that had activity. Another nice feature. We did, however, find the second structure from the PET scan, the part without any activity. It looked kind of like it is solid (not what we want it to be), but there was no blood flow inside it (a little bit better of a finding). It was probably a little smaller than it was on the PET scan. Overall, this was good news, even if we still don't know with certainty what it is.
We then went to clinic. We discovered a problem. No rooms in the children's hospital. Five people needed rooms from the oncology clinic. Before we could address the problem with no rooms being available, the oncologists had to review the ultrasound findings with the interpreting radiologist and feel comfortable with the plan to proceed with treatment. After they felt good about it, we needed to get the port accessed and draw labs. J was a champ and cooperated fully with the nurses accessing the port. Then we had to wait for the labs to come back. When they did, they were odd, but good enough to start chemo. The white blood cells were elevated, kind of in the range when somebody has an infection. His platelets were also really high. It had been a long time since we had given the medication to make more white blood cells, so it was a little odd that everything was so elevated. Since one of the questions the oncologists had was whether this was infection or not, I was worried we may not get to start chemo with these lab results. Happily, they said we were good to go with treatment.
4:30 pm and we finally get to go to a room (the ultrasound was 9:15 am). Kept the fluids running and started the chemotherapy this evening. It's the colorful green stuff.
To celebrate the day, J watched Star Wars The Phantom Menace. Going to see all six Star Wars this week. Can't wait!
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