Sunday, August 3, 2008

Fine, Fine, Fine, Fine...

I made my latest trek to the National Institutes of Health last week - July 29 and 30 - for another MRI and a visit to the neuro-oncology clinic. This visit came at an interval of about six weeks rather than the usual two months because of an unusual spot that showed up on the previous scan. Without keeping you in suspense, I'm happy to report that all is well in the ole brain bucket.

When I met with Dr. Howard Fine, he brought up my last four MRIs side by each on four fancy-schmancy Kodak digital imaging monitors. Every time he tapped the screen, the image moved deeper into my grey matter. With every tap, he kept saying, "Fine. Fine. Fine. Fine..." I told him that I thought his colleagues in the room were going to think he was just chanting his name over and over. The spot - or "streak" as Dr. Fine called it - that showed up on the last scan was not present on the current scan although it had appeared on the first one.

Since brain tumors don't just come and go, he ruled out anything bad. Although he did not have a definitive explanation, he said that it might be that the contrast dye injections occurring during each MRI could be off by a few miliseconds from one scan to the next.

I came down with my first cold in over a year just before my NIH visit so I had to wear a mask the entire time I was in the clinic. I felt pretty goofy, but I guess that's better than exposing another patient whose immune system is seriously compromised to my cooties.

Dr. Fine's nurse practitioner expressed a bit of concern that my cold came right on the heels of my 10th round of chemotherapy when my white blood count was probably at its nadir. I hadn't even given it a thought, but I guess little infections can turn into big problems if your body isn't up for the fight.

Of course, I overreacted. As soon as I got home, I was at the hospital getting my blood drawn and then I went and camped out at my local doctor's clinic. After waiting more than two hours, he realized I wasn't going to leave so he saw me. My white count turned out to be fine so he prescribed some antibiotics and sent me on my way, probably with a generous amount of eye-rolling. Possessing the strength of 10 men - maybe eight and a third now - I should have known I could not be felled by something as simple as the common cold.

If you're curious about the clinical trial in which I am enrolled at the NIH, you can read about it here. It's called a "natural history" study which, as it was explained to me, is kind of a catch-all for people like me who are on the good end of the survival curve.

I also agreed to participate in another study where they took some blood and a slice of my tumor to check for the "expression" of O6-methylguanine-DNA methyltransferase (MGMT), a gene that actually works against the particular chemotherapy I am taking: temozolomide. Whatever it is, I ain't got it so that's nice.

1 comment:

Guenveur in Kent said...

Well, of course you don't have a bad gene. I mean, really! Hey, I am glad you are doing so well and loved the Fine comment about the doc and his name. He'd better have laughed.