The MRI machine and more

In the midst of my third diagnostic test prescribed by my new ocular oncologist, I felt full of eager anticipation for uncovering the mysteries of my left eye. A mere two weeks ago, she set the course for a series of tests aimed at revealing any potential spread of cancer in my body.  

Today it was for an MRI to check my liver, one of the key sites for metastases. It turned out to be another procedure I could navigate with resilience and ease. I was in and out of the hospital in two hours.

Kindness was again the central theme.

In the sick room, ten cents’ worth of human understanding equals ten dollars’ worth of medical science.

Martin Henry Fischer

Once I stripped down and put on the sterile medical gown, the goosebumps on my bare skin revealed I felt chilly. The thoughtful technician promptly handed me a second gown. And as I reclined on the examination bed, she placed a heated blanket on me before inserting the IV and outlining the steps of the process. There were no unpleasant surprises.

As I was gently maneuvered into the confined space, I became aware of an unexpected tension gripping my shoulders. I canvassed my body to make sure each part was relaxed.

The MRI, lasting half an hour, was a symphony of noise. To combat the auditory assault, they had handed me ear plugs and covers, a considerate gesture that muted the machine’s clamor.

Every few minutes, I was asked to inhale and hold my breath briefly. Fortunately, I’m not claustrophobic; I kept my eyes closed throughout and focused on my breathing.

A breeze came in from above my head. At one point, it felt like a hair was tickling my cheek and lips, which I couldn’t remove, but the technician later explained it was a normal reaction to the magnet.

With the hum of the machine fading away, I reflected on the brevity of the experience—so that was that.

The day after I visited the eye clinic, I went to a lab to do the requested blood tests. Two days later, I underwent a CT scan of my abdomen, also an unremarkable procedure. Now I only have a diagnostic mammogram left to do, and that is scheduled for next week. I must say again that it is astonishing I could get all these tests done in three weeks when so many complain about outrageous wait times to get medical appointments.

With every medical condition comes a slew of unfamiliar words. A friend recently asked me what metastasis means. Good question!

I thought today I’d define some terms I’ve had to learn along this cancer journey.

Maybe this can help someone undergoing cancer treatment or supporting a loved one. If you are already familiar with medical terms, skip the rest of this post.

The use of jargon is evidence of a profession out of touch with the public it’s supposed to serve.

Atul Gawande

Having undergone both now, I got curious about the difference between a CT scan and an MRI. Maybe you know already, but I didn’t have a clue.

CT (Computed Tomography) scans use X-rays to create rapid and detailed cross-sectional images of the body, making them particularly effective for visualizing dense structures like bones. They are well-suited for detecting fractures, tumors, and abnormalities in the chest and abdomen. CT scans are faster than MRIs, often used in emergency situations, and are less sensitive to metal implants or objects.

MRIs (Magnetic Resonance Imaging) use strong magnetic fields and radio waves to generate detailed images, providing excellent contrast for soft tissues. They are especially valuable for imaging the brain, spinal cord, joints, and organs like the liver and kidneys. Unlike CT scans, MRIs do not involve ionizing radiation, making them safer in terms of radiation exposure, but they are sensitive to metal in the body and may offer functional information, such as blood flow.

The choice between CT and MRI depends on the specific medical context and the type of information needed for diagnosis. This, of course, I leave up to my doctor, and I trust her.

I submit to these tests without anxiety and know both the CT and MRI are generally considered safe diagnostic imaging tools. Yet I still wonder what harmful effect they may have on my body, especially since I’ve undergone several scans in just the past year.

Then I remember and take to heart Helen Keller’s words:

Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. … Avoiding danger is no safer in the long run than outright exposure. The fearful are caught as often as the bold. Faith alone defends. Life is either a daring adventure or nothing. To keep our faces toward change and behave like free spirits in the presence of fate is strength undefeatable.

I stay in flow. It may be unreasonable, but I remain hopeful to see negative test results and a positive outcome. In the meantime, an exceptionally stunning autumn is keeping me grounded in the present.

Back to my friend’s question. Metastasis refers to the spread of cancer cells from the original (primary) tumor to other parts of the body, forming secondary tumors. In this process, cancer cells break away from the primary tumor, enter the bloodstream or lymphatic system, and travel to other organs or tissues where they can establish new tumors. Metastasis is a critical factor in the progression of cancer and can complicate treatment, as it often involves multiple areas of the body. Detecting and understanding metastasis is crucial for better cancer treatments and patient outcomes.

In my case, the primary site is assumed to be my right breast. The cancer was diagnosed stage 1, and the tumor was removed though lumpectomy. In September 2021, a small portion of my breast was surgically cut out along with a margin of healthy tissue; aka breast-conserving surgery or partial mastectomy.

The surgeon also performed a sentinel lymph node biopsy with frozen section, medical speak for a procedure to check if the cancer had spread to a lymph node. A lymph node is a small, bean-shaped structure that helps filter and fight infections. The sentinel node is the first lymph node that cancer is likely to spread to from the primary tumor, in my case just above the right breast near my armpit.

A biopsy means taking a small sample of tissue for examination. The surgeon removed my entire node; it was immediately frozen, sliced, and checked for cancer cells. Mine had none, so the surgeon could stage my breast cancer as stage 1.

Hope is being able to see that there is light despite all of the darkness.

Desmond Tutu

I’m a couple of months over two years post-lumpectomy. My left eye did not go cloudy until this past December 2022. I’ve covered that and all the treatments I’ve undergone during the intervening months (chemo, radiation, herceptin) earlier in this online journal.

My hair has grown back, silky and quite dark, albeit without the familiar curls—my honey prefers it this way! Hah! And life goes on.

I invite you to share your thoughts and questions in the comments below. If there are any medical terms in my narrative that have left you perplexed, I’m here to offer clarity.

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