I am at work, as is Frank, Zack is hanging out with his friends and going to see his Aunt Jamey. The "protection" starts. I text Jamey "do you or any of the kids have a cold, have been sick or a runny nose, even if it's allergies" She replies, "no we are all healthy, the house is clean but we do have two cats and a dog", I reply "we are even then, I have Frank".... we get a good laugh in and she writes that she totally understands.
We get a call from the Cancer Center and there is no trace of anything in his chest or abdominal area! This is GREAT news!! This means it has not spread. We make it through another huge hurdle.
I get a call from the surgeons office, the anesthesiologist and the scheduling dept. Zack's surgery will be tomorrow ( Friday) at Noon. We are to be there at 10:45 to prep him. The surgery, as with everything else is at Mission Hospital in Asheville, NC. A big (ok I live in Brevard, people) city just 45 minutes away. They will be installing the port and do a bone marrow biopsy on his hip. This is the FINAL test to show that he does not have any more cancer cells in his body. The port will be inserted into his chest on the left side, this will enable them to connect the tubes for his iv for the chemotherapy. This will stay in him through the course of the treatments. Of course I had to make some joke about charging my cell phone through the port, I did manage to get one chuckle... (Humor is my way of coping).
My wish is to start the chemo on Tuesday next week. I am off work and can be there for a day or two to get him settled in. We are to go and meet with the Doctors after the surgery tomorrow to set up the rest of the treatment schedule.
Glossary: These are all the tests that Zack has had to date.
Cancer is a complex disease and occurs when cells in the body begin to grow chaotically. Normally,
cells grow, divide, and produce more cells to keep the body healthy and functioning properly.
Sometimes, however, the process goes astray; cells keep dividing when new cells are not needed.
Some types of cells are more prone to abnormal growth than others. The mass of extra cells forms
a growth or tumor, which can be benign or malignant.
Magnetic resonance imaging (MRI) is a relatively new and
painless technique that allows doctors to look at the soft tissues of the
body. it is different from regular x-rays like you get in a doctor's office
because it does not expose you to radiation. Instead, a radio frequency
is used to knock your hydrogen atoms out of line. As they move back to
their natural alignment, each hydrogen atom in your cells emits a tiny
electric signal. The MRI scanner has very strong magnets in special coils
to detect the electric signal. A computer uses these signals to create
a detailed image of your soft tissues.
Magnetic resonance imaging allows doctors to see the image
of many structures inside joints that cannot be felt by direct touch with
their fingers. Some of these structures are ligaments (tissues connecting
bones), menisci (tissues absorbing shock in the knee), and tendons (tissues
connecting muscle to bone). The ability to look at these structures inside
an injured joint has greatly improved patient care because, in many instances,
it enables doctors to correctly diagnose and treat the injured structures
Positron Emission Tomography (PET) and Computed Tomography (CT)
imaging have become essential diagnostic tools physicians use to reveal
the presence and severity of cancers. PET/CT imaging helps physicians
detect cancer, evaluate the extent of disease, select the most
appropriate treatments, determine if the therapy is working, and detect
any recurrent tumors.
a PET/CT scan, the patient receives an intravenous injection of
radioactive glucose. Many cancer cells are highly metabolic and rapidly
synthesize the radioactive glucose. Information regarding the location
of abnormal levels of radioactive glucose obtained from the whole-body
PET/CT scan helps physicians effectively pinpoint the source of cancer
and detect whether cancer is isolated to one specific area or has spread
to other organs.
From this information physicians can plan an effective treatment strategy. Treatment options
include surgery, radiation therapy, systemic therapy, or a combination therapy where one or
more of these options are combined.
During the course of treatment, the information from the PET/CT scan allows
physicians to monitor the effectiveness of cancer therapies and provides physicians
with the opportunity to change the treatment strategy if it is not working, avoiding
the cost and discomfort of ineffective therapeutic procedures.
After completing the treatment regimen, a follow-up whole-body PET/CT scan can provide information
to assess if the treatment was successful and if areas that were previously abnormally metabolically
active have responded. Often, scar tissue at the site of surgical resection or radiation treatment may
appear as an abnormality on the CT scan. The PET portion of the PET/CT scan can detect residual disease
within the scar tissue and indicate if the treatment was successful or if the tumor has returned.
A computed tomography (CT) scan uses
X-rays to make detailed pictures of structures inside
of the body.
During the test, you will lie on a table that is
attached to the CT scanner, which is a large doughnut-shaped machine. The CT
scanner sends X-rays through the body area being studied. Each rotation of the
scanner provides a picture of a thin slice of the
organ or area. All of the pictures are saved as a
group on a computer. They also can be printed.
In some cases, a
dye called contrast material may be used. It may be put in a vein (IV) in your
arm, or it may be placed into other parts of your body (such as the
rectum or a joint) to see those areas better. For some
types of CT scans you drink the dye. The dye makes structures and organs easier to see on the CT
A CT scan can be used to study all parts of your
body, such as the chest, belly, pelvis, or an arm or leg. It can take pictures
of body organs, such as the liver,
adrenal glands, lungs, and heart. It also can study
blood vessels, bones, and the spinal cord.
is a special test that is not widely available. It uses a steady beam of X-rays
to look at movement within the body. It allows the doctor to see your organs
move or to guide a
biopsy needle or other instrument into the right place
inside your body.
A bone scan is a
test to help find the cause of your back pain. It can be done to find damage to the bones, find
cancer that has spread to the bones, and watch problems such as infection and trauma to the bones. A bone scan can often
find a problem days to months earlier than a regular
For a bone scan, a
radioactive substance is injected into a vein
in your arm. This substance, called a tracer, travels through your bloodstream and into your bones.
This could take several hours.
A special camera takes pictures of
the tracer in your bones. Areas that absorb little or no amount of tracer appear as dark or "cold"
spots. This could show a lack of blood supply to the bone or certain types of cancer.
Areas of fast bone growth or
repair absorb more tracer and show up as bright or "hot"
spots in the pictures. Hot spots may point to problems such as arthritis, a tumor, a fracture, or an infection.
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