June 22 2017 - Third PET scan

Today I went for my third PET scan.
The diet was followed perfect, and I was looking forward to a clean scan. I packed an egg sandwich to eat after the scan.
I drove to the PET scan place, arriving at 10:00 and did the whole procedure of injections, pills, and drinking peppermint tasting fluid.
I took my prosthetic leg off while there, and just used crutches.

I did the scan, then she said she wanted to re-do a section. So I ended up doing a total of 40 minutes in the tunnel.
Then they told me to go wait in the cool down room because I was too radioactive to be near anybody for an hour or so. Normally they allow me to eat then, but the lady said no food. About 20 minutes later, she said the Doctors wanted another partial scan.
So I went back into the tunnel, but this time it was only for about 10 minutes. They just did my groin area.

Then I went back to the cool down room. They said I could now eat.
After eating, I started to put my leg on, to go home. Then the Lady told me to leave the leg off for a bit longer. After another hour she came in and asked me to follow her on crutches, to the ultrasound room.

There they did an ultra sound probe of the area next to my groin on the stump. The cute ultrasound Lady said the area in question was next to, the groin lymph node.

After 10 minutes she had a pile of picture paper on the floor. She picked them all up and left. About 20 minutes later, she came back with a doctor. He did another 10 minutes of ultrasounding my thigh, and he produced another pile of paper pictures. They both left with the pile of pictures, and told me to go wait in the cool down room.

About 10 minutes later a lady told me I could put my leg back on. They they came and gave me a big sealed envelope and told I could leave now, and me to give the envelope to the Oncologist. They said that it takes 3 or 4 days before the pictures are interpreted and the report will be sent to the Oncologist.

On the way home I felt depressed, so bought a pizza.

At home I looked at the CD. All images are in DICOM (Digital Imaging and Communications in Medicine) format.
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June 23
It was not easy to see the DICOM images. I had to use GIMP (Graphic and Image Manipulation Program) to convert them to png format.
 Here are 2 of the PET scan pictures.

 It is easy to see what the problem is. On the groin muscle is a bright spot on the PET scan photos.
The bright dots above it are my balls, and the big ball above them is my bladder.
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Today I also spoke with my prosthetists. He made a cast of my stump almost 5 weeks ago. I wondered why things are taking so long.
He has been going on courses to learn a new system for prosthetic attachment.
Normally, like with mine, there is a seal, and a one way valve, that allows air out of the bottom of the socket when the stump is forced into the socket. This forms a suction in the very bottom of the socket, and that keeps the prosthesis from falling off.
With this new system, the seal is very high on the stump, and a small vacuum pump keeps the whole stump under a vacuum. This is supposed to keep the volume of the stump the same, and force the sides to be in contact with the socket. This is supposed to give greater feel, and less stump shrinkage through out the day.
Until very recently this system has only been available for below the knee amputees.
The brochure says it is for people that:

need volume management

require improved socket fit and comfort

benefit from increased proprioception and enhanced gait symmetry

need added safety by eliminating/reducing pistoning 

Well, I have need of all of those. As usual, they want the price of my house for the vacuum system.

One company also has a new foot/ankle system that allows walking on uneven ground.

Again big prices. Add to that a good new knee, and the total for a new leg will be +- $155,000 or  R1,900,000

My prosthetists say he is trying to get a loaner vacuum rig so he can practice building a system. He wants to learn on me. He also wants the medical aid to pitch in for most of the cost. I may have to also add some money.
All this is very exciting for me........
But now I have a shining spot on my PET scan pics. :-(
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April 13 2016 - Second PET Scan results

09:00
A slow morning. Nothing planned till my Oncologist appointment at 14:15.

I have looked closely at the PET scan pictures, and it all looks clean from a tumor point of view. Of course, I don't know anything about the subtleties of reading a PET scan.
The area of my stump end shows as bright yellow, which is indicative of inflammation and excessive blood flow, but I would expect that. I'll see what the Oncologist says.

15:30
We are back home from the Oncologist. She says I appear free of any active malignancy.

The conclusions on the reports say:
"There is no scintigraphic evidence of residual metabolically active malignancy on these images."
"No hypermetabolic activity in keeping with an active malignant process."
"No signs of local recurrence or distant metastases."

With respect to the possible damage from the chemo treatments:
"Bone marrow uptake appears fairly homogeneous throughout with no focal FDG avid lesions visualized."

So all is good news. Next time with the Oncologist will be in 3 months when I have another blood test, and see her again.

Here are some of the latest PET pictures. (The previous PET scan pictures can be seen on my Day 40 blog.)

You can see here the inflammation (shown by the yellow) on the end of the stump bone from wearing the prosthetic leg.




















Here is a picture of the legs showing no bad areas except end of the stump, and the ankle area of my right leg. This is caused by the Cymbalta causing cracked, dry skin, and swelling to my extremities.

This picture is cool because it shows the area in my mouth where I bit my tongue that morning. The PET scan interpreter said that the slight increased blood flow to both shoulders was probably caused by the use of crutches that day.
And for all my "friends"...I now have proof that my heart and brain are normal.
Maddie says it shows the absence of a brain, but then she ALSO doesn't know anything about the subtleties of reading a PET scan.

In this one you can see the missing lumbar disc between L4 and L5, and the skinny disc between L5 and L6. Also note the lack of yellow dots indicating tumors.

Because the radioactive chemical is absorbed by the brain, heart, and bladder wall, PET scans are seldom used to diagnose in those areas.
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Maddie's car got a bump (not her fault) and the bodyshop/panel beaters did not reconnect the hoses properly, so the engine overheated. The insurance has now said that the car is totaled, and will payout cash.
Now we are once again again car shopping.
Maddie has fallen in love with a 2006 Mercedes A170. The dealer is bringing it by tomorrow morning so she can drive it all around the neighborhood.
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April 6 2016 - Drive up from George, and PET scan.

14:00
Today is a lazy day. No exercise allowed before the PET scan tomorrow morning.
It turns out I am very good at doing "no exercise".

On Monday the 4th of April, Maddie and I drove from George to my house in Pretoria. 1225 kilometers. (761 Miles).
We left George at 06:30 and arrived home at 21:30. 15 hours. We stopped for fuel 4 times, and had a big lunch.
The night before we left, I had bad PLP and slept little. We were worried I may want to sleep all the way. It turned out that twice I faded, and needed a nap. Maddie drove both times, while I slept. She ended up driving about 1/4 of the way.

We saw a funny shaped dam. It looked like it was made of huge beer cans.

Front of dam wall

Rear of dam wall

Then we saw some cool trees. They are like bonsai trees. The tallest ones had the bottom of the leaves about sheep or goat high. Good sun shields for the sheep and goats.

We stopped and gawked at some yucca plants that were HUGE. The stems grow 5 meters high, and they are about the size of my upper arm at the base. Not good walking sticks, but they might make good telephone poles. The farmers use them as fences for sheep.

Tomorrow is PET scan day.
As before, the pet scan has a long list of what you can and can't do before the scan. Today, I am on a zero carb diet.

April 7 2016
23:00
I had my PET scan today. I got all the pictures and the CD with all the scans. The official results are only going to be available next Monday.
We looked at the pictures. They print out the most relevant ones. The radioactive chemical they inject into me collects in areas of large capillary veins. Usually where tumors are.
My pics show that my brain has good blood flow, as does my dick, and my heart. Some men think with their dicks, and some think with their hearts, and some with their heads. I guess I think with all three.
Maddie and I see nothing that resembles the tumors that were in the last PET scan. But PET scans are very tricky, and there are many false conclusions possible. So we will wait for the expert report.