Before I start chemotherapy, I have a couple more tests that need to be run. This morning I had my first MUGA (Multi Gated Acquisition) scan to see if my heart is strong enough for chemo. For whatever reason this is the test I did not thoroughly research before reporting to the Nuclear Medicine section of the hospital. My understanding was that it would be similar to an echocardiogram. To my surprise, the first thing the technician told me is she would be drawing blood. At this point, I should just roll up my sleeve as soon as I enter a hospital, clinic or doctor's office because that is the first thing they all want these days. I can't say that I enjoy this but I am lucky enough to not have any extreme needle aversions to contend with and I am that weirdo who prefers to watch what is being done to me.
When I seemed startled at the suggestion of a blood draw, the technician asked if this was my first MUGA - um, yes, does it show? She kindly explained the entire process, including giving me a timeline and commenting that it was a good thing I brought a book.
I will pause here to give a brief promo for the book I'm reading - Tina Fey's Bossypants. It is hilarious. At one point I was sitting in the waiting room of the Nuclear Medicine section of the hospital shaking with suppressed laughter to the point that I felt I was making a spectacle of myself and yes, I had tears streaming down my face. I am now convinced funny books are the key to enduring long wait times.
So the technician explained that she would draw some blood, take it back to a lab for about 30 minutes (the time where I was back in the waiting room trying not to cackle too loudly at my book), mix it up with some radioactive pharmaceuticals and then reinject it into me in preparation for the scan. Fun times.
According to Wikipedia (I know, but it is the simplest explanation available), "the MUGA test involves the introduction of a radioactive marker into the bloodstream of the patient. The patient is subsequently scanned to determine the circulation dynamics of the marker, and hence the blood. . . . The patient is placed under a gamma camera, which detects the low-level 140keV gamma radiation being given off by technetium-99m. As the gamma camera images are acquired, the patient's heart beat is used to 'gate' the acquisition. The final result is a series of images of the heart (usually sixteen), one at each stage of the cardiac cycle." I found the whole thing pretty fascinating and was a little surprised that at one point Wikipedia calls it "antiquated" since it all felt pretty high tech from my perspective.
I found it interesting that the tech wanted to draw my blood from the opposite arm from where the cancer is located. One of the nurses at my oncologist told me this a couple of weeks ago after I had a ridiculously low blood pressure and when she switched the cuff to my right arm it was within normal range. I asked the tech why this is an issue and she said she doesn't really know, they are just advised not to take blood from that arm. Another question for my list.
At the end of the scan, the technician handed me a "Security Personnel and Law Enforcement Notification" that states I have "undergone a nuclear medicine procedure involving a small quantity of short-lived radioactive materials. The residual radiation may be detected externally." The expiration date is May 26th - just in time for chemotherapy! I think I will avoid the subway, airports and crowded places to be on the safe side.
Of course, tomorrow's test is the one I'm annoyed about today. To prepare I have been instructed to follow a low carb/no sugar diet. Turns out most of my diet revolves around carbs so this is a challenge. But only one day. Tomorrow I will not be going to the office or really anywhere after the test since my preparation sheet advises "Stay AWAY from CHILDREN FOR 24 HOURS". I was also told to avoid pregnant women. I think my radioactivity level will rise signfiicantly so I will do everyone a favor and stay home. That way I can read Tina Fey's hilarious book in the confines of my own home and not have to supress my laughter. I'll just be the crazy radioactive woman with the banshee laugh (a term bestowed upon me by my 11th grade AP history teacher when she kicked me out of class for laughing too much).