Alston's Nth
Where n is not a nice tiny integer, like 5. No, n is considerably larger than that. Large enough for its exact value to be insignificant. The PET scan that I had on Thursday, January 28 was my NINTH. Yes, I was surprised, too.
Comparison was made with the previous PET scan from November, 2009.
Since the previous study, this patient has been treated with chemotherapy with the last dose given apparently on January 15, 2010.
The current study shows multiple intense hypermetabolic foci scattered in the neck with a predominant involvement of the left upper and left lower regions, as well as in the left supraclavicular zones and less obvious hypermetabolic foci in the right upper neck are also noted.
There is also intense focal increased uptake in the right lower neck and at the beginning of the subclavian vascular pedicles. (Pedicles? What a cute medical word!)
There are also hypermetabolic foci in the right mediastinal prevascular regions and in the right internal mammary. (Like breast cancer? Why didn't my oncologist mention this? Probably because it's no different from the 316 other nodes in the area.)
Below the diaphragmatic level, there is extensive heterogeneous lobulated increased radiotracer uptake close to the midline, probably in the region of the previous gastric surgical bed, as well as there are few contiguous smaller hypermetabolic foci including in the upper retroperitoneal regions.
The rest of the scan shows no evidence of other significant (emphasis mine) hypermetabolic abnormalities.
IMPRESSION:
Very extensive and very intense hypermetabolic abnormalities compatible with active metastatic disease. There has been marked deterioration of the overall appearance of the PET scan as compared to November, 2009, as the previously demonstrated hypermetabolic foci are now more intense and/or larger and there is evidence of multiple new hypermetabolic abnormalities.
It's quite bad, yes, but there is much, MUCH more to say here. I am trying to craft a mega entry that will attempt to synthesize certain things that have been happening to me since July; things that I have not really discussed and that I need to act on. I'll just say that coincidences are probably not just coincidences. There may be a new me in the near future.
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