13 down, 3 to go

I managed to just squeak through treatment number 13. It was the worst treatment since the first, mainly because of severe anticipatory nausea and a terrible attack of acid reflux. And that’s all I am going to say about it.

I thankfully have only three chemo sessions left to go.

And, for those wondering, no, Robert Krick did not mess up my PET scan. Other than a high SUV of 6.2 throughout my skelton, my PET was clean. My chest masses seem to have disappeared. My spleen is still enlarged, although even that is shrinking. Other than the spleen and the high SUV in the marrow which we are near certain is being caused by the marrow being thrown into overdrive by Aransep, Neulasta, and chemo itself, I would be “normal.”

This is all good stuff, I just wish chemo would not be so difficult and that I could get some sort of hold on this crazy anticipatory nausea stuff.

if my PET scan is messed up …

… I am blaming Robert Krick.

This is one of those unusual posts that somehow ends up in both the Hodgkin’s category and the Civil War category. You’re probably wondering how some very high tech nuclear medicine cancer scan relates to the Civil War. Well, I’ll admit, the relationship is tenuous as best. But hey you’ve read this far, so you’re either bored or experiencing insomnia so let me explain further.

As a Civil War whatever (buff? afficanado? amateur historian? webmaster? you pick the term) I am usually reading something about the Civil War. Yesterday, I was at one of those rare points where I am not currently reading anything. Ok, that’s not quite true. I had just finished rereading William Hassler’s biography of A.P. Hill (we won’t go into how many times I have read that). I am still rereading Douglas Southall Freeman’s classic Lee’s Lieutenants (give me a break, it’s three volumes!) but I don’t like to take that one to medical appointments because it attracts stares and inevitably questions. For some reason, people never ask me about what I am reading except when I bring Lee’s Lieutenants. I have concluded it is because the volumes of Lee’s Lieutenants are so fat. I can’t think of any other reason. Anyway. That’s the main reason I am reading two different things at a time. Obviously I spend a lot of time in and out of medical appointments.

Ok, the point of that rather long digression was to say I had to quickly grab something off the shelf to take to the PET scan. Since most of my readers have never had a PET scan or been a cancer patient, let me explain two salient points. First, you never go to outpatient radiology (or that matter any medical appointment) and expect it to be FAST (the exception is if you have something visibly wrong with you: the outpatient radiology department doesn’t want you hurling on their carpet or bleeding everywhere.). If they say 10:15, expect to be called at 12:00. It’s like the Army. Hurry up and wait. Second, a PET scan requires that you sit quietly for at least half an hour while a radioactive glucose tracer circulates in your system. I’ll explain more about that in a minute. The point is if you don’t take something to do, you’ll die of boredom. So I had to find a book and fast.

By the way, the reason I was running late because I couldn’t find my stinking insurance card. I found it, luckily. The lady at the radiology desk knows me by name, (I never thought I’d be known by name by the staff of the radiology department ….) but every time I go, they have to photocopy my insurance card. Medicine is the one profession that likes killing trees, apparently, even more than the judical system.

Anyway, its not hard for me to find something to read; I have quite a little Civil War library. So I had a lot to pick from. I did the shelf scan and for whatever reason my eyes settled on Smoothbore Volley that Doomed the Confederacy. It is a series of essays on the Army of Northern Virginia by, yes, you guessed it, the aforementioned Robert Krick. I figured it was a good choice — essays can easily be interupted if necessary.

(I’ve read it before. I bought this book because it had an essay on one of A.P. Hill’s generals named Maxcy Gregg. But the whole thing is very good.)

At this point I imagine I’ve lost all but my most loyal readers. Either your a loyal reader or you must BE Robert Krick fresh to this blog via the incredible Google search engine and want to know how you messed up some poor girl that you’ve never met’s cancer scan. So let me say if you’re still with me, thanks for being one of my most loyal readers. And if you’re Robert Krick, comment and say hi. I find hearing from real historians really cool. I mean, it wouldn’t be as cool as Grady Sizemore hitting a homerun for me or something, but it is the sort of thing that makes my day. Really.

Now, I really like reading Robert Krick. I don’t always agree with his conclusions, but I like his writing style (I find it easy to read and he has a wonderful, acid wit) . Krick is also one of the leading authorities on the Army of Northern Virginia, which of course is also my big interest (obviously, as an A.P. Hill champion). Even if you don’t like his analysis, he has access to the type of research library (including primary sources) that would make the mouth of anyone interested in the Army of Northern Virginia water excessively. Krick’s stuff is, therefore, filled with fascinating tidbits you probably haven’t heard of or read anywhere else. In terms of research scope and in terms of his “loyalties” think modern day D.S. Freeman.

It wasn’t till I read a study on PET scan today that I realized picking up Krick’s book was a bad choice on my part.

To explain we have to go back to the PET scan for a moment. Basically what happens at a PET scan is the tech injects a small amount of radioactive tracer that is attached to glucose. Then you basically have to sit there quietly while the tracer circulates through the body; how long you sit depends on your body weight and height. Cancer cells are overactive and fast dividing so they love glucose. They eagerly grab onto the glucose — and the tracer. The scan works by showing the areas picking up glucose the fastest — suspected areas of cancer basically “light up” brighter than non-cancerous areas. The actual scan is just like the much more commonly administered CT scan; it just takes longer (again depending on how tall and heavy you are; someone small like me only actually takes 8 minutes to scan).

So you’re now probably completely lost as to how Robert Krick could mess up my PET scan.

The PET scan is incredibly accurate for diagnosing you when you’re negative. It’s big drawback is it is too good. You can get a false positive — a lit area — because of inflammation or a host of other non-maligant conditions. In fact a study on PET scan showed that “any kind of activity, even energetic foot tapping, before a pet scan can alter the results thus making them not so reliable.”

So, I figure if my PET scan lights up in my jaw, it may be because I read Robert Krick’s essay on Robert Rodes beforehand. Here I was supposed to be sitting quietly and I could not help laughing as I read Krick’s characterization of Rodes’ wife as “pyromanical” (she burned all his personal papers). Or Lee’s chief of artillery (a man named William Pendelton) described as “wretchedly inept.” Historians rarely indulge in such language. When they do I find it really entertaining and funny. Particularly when what they are saying is true. Pendelton was woefully incompetent.

But lesson learned. Next time I will pick something duller. Maybe someone’s memoirs. Or I’ll try and think of the most boring Civil War general I have a biography on. (Guess that means I won’t be taking Sickles the Incredible!)

(Fingers crossed please — seriously, a “messed” up PET scan would be expensive, stressful, and probably indicative that something is seriously wrong at this point. Plus, I don’t want to have to explain why it might be wrong to my oncologist. Can you imagine me trying to explain all this to him? Not only is he likely not interested in the least in the Civil War, he’s actually from New Zealand. So he’s really not likely to be interested or to understand any of this!)