#17 - Positrons are a +

I had an extremely hot date on Wednesday afternoon with a radioactive tracer.  Having been through a PET scan once before, I decided to go it alone.   The process was similar to the first time with some subtle differences.   Scrubs rather than gowns = Plus (+),  hospital rather than Bookmobile style bus = Plus (+),  13 year old Pet scan technician rather than Dude #1 who exuded medical know how = Negative (-). Seriously, it appeared that the Boy Scouts of America may have added the PET Scan merit badge to their list of awards. Apparently I was helping a local 2nd Class scout get his service hours.
I got over it pretty quickly, after all,  what could go wrong?  I had just been injected with a radioisotope which was currently undergoing beta decay, kicking off positrons and in turn, emitting gamma rays to be collected by a machine that by some accounts, turned Han Solo into a brick.  Rumor has it, that it was also operated by a 2nd Class Scout.

The scan went well.  It is amazing how  hard it is to try to hold still for 20 minutes.  Some people freak a little bit over the confined quarters of the PET Scan machine but for me it was keeping my arms above my head for 20 minutes.  I could barely get them back around after it was over.   After the scan, I was turned loose to expose the general public to gamma rays.   A walking dirty bomb on the streets of Houston. 

Angie and I went back to the Hospital early Thursday morning for the results of the scan and for a blood check prior to treatment that same afternoon.  The blood results came back normal, probably better than they have been in a year.  The written interpretation of the PET scan is as follows:

Diagnostic Imaging reviewed personally with attending, agree with radiology impression as follows:
PET/CT 1/23/13: Excellent therapeutic response when compared to the outside PET/CT scan which is suboptimal because there are no fusion images. There is some residual basically eumetabolic abnormality in the territory of the left iliac nodal groups in the left pelvis.

Assessment/Plan: 36 yo man with stage IIB bulky DLBCL, weakly CD30+, tolerating R-CHOP well with excellent response on PET/CT after 3 cycles.
1.                 Lymphoma: proceed with cycle 4 of R-CHOP14
2.                 Neulasta to be administered 24 hours after completion of chemotherapy
3.                 Follow-up: the patient will return weekly for fast track labs. He will follow-up with Dr. Fowler in 2 weeks for consideration prior to cycle 5.

A couple of notes here:

• BSA 2nd Class scouts are awesome!  
• C'mon All Knowing PET Scan Dude #1,  No fusion images?
• I thought I was originally told that each cycle for R-CHOP consists of 2 treatments per cycle = 12 treatments. Apparently I may have been mistaken. It was explained to me that I may only have 2 more treatments followed by Radiation. (keeping excitement in check as this was not my normal Doc)

The verbal assessment as it was delivered to me was that all the small stuff is gone, and that the large mass had reduced by half the original size and had minimal metabolic activity. It really was quite a contrast to the first images. I will post the two here if I can get my hands on them.

I was expecting good results based a few anecdotal things I had noticed but it felt great to see the weight lifted off of Angie's shoulders in those few seconds.  I knew this was a big checkpoint for us both, but didn't realize what it meant to her.  Watching her face as we were given the results was a great moment & a great blessing. The good news was also some much needed re-assurance for our older kids.

Non Lymph Related  (kinda)

I have spent a good portion of the recovery weekend watching the Winter X Games and some college hoops.  The X-Games made me a little home sick for the snowboard and friends, but it has also left me a bit inspired.  They have been advertising the "Go Pro" camera quite a bit. They are pretty amazing devices which can capture some amazing pictures at altitude and are super durable. You can mount them anywhere, and can take video of just about whatever you get into. I am pretty good at justyfying purchases, and decided I should probably purchase one.  I don't think anyone can argue the following points.

• No better way to induce motion sickness with your family and friends than video playback of extreme sports.
•  I can capture all the extreme sports that we (my family) participate in while living in the Houston suburbs of Katy Texas.  

Highlights of my extreme weekend!