The tyranny of the routine health screen
I have some feelings about my recent CT scan
I knew when I signed up for cancer treatments in June 2022 there would be no guarantees. Yet, successive clear scans over a year and a half lulled me into a sense of false security. When my recent CT scan from last month showed a small but suspicious mass in my right lung, I was unprepared for my reaction: disappointment, sadness, anger.
The email alerting me to the new test results arrived in my Inbox late on a weekend night. I navigated to the portal immediately and quickly scanned the report. This under FINDINGS jumped out at me first:
LUNGS: Previously seen scarring/atelectasis involving the lingula appears slightly more rounded in morphology, 8 x 7 mm.
There is a developing 6 mm solid nodule at the posterior right lung apex.
Stable granuloma/scarring at the left apex.
And under IMPRESSIONS, which summarizes the scan:
Developing small nodules in the right lung apex and possibly also the lingula. The right apical nodule in particular is considered suspicious.
By comparison, the previous CT scan from September 30, 2023 read:
LUNGS: The lung parenchyma is clear without mass or infiltrate. Stable 4 mm pulmonary nodule posterior right lung.
IMPRESSIONS:
… no CT evidence of definite distant metastatic disease in the chest, abdomen, or pelvis.
The most recent scan from March 2024 is not clear or pristine, as my oncologist characterized the September 2023 scan. The size of the nodule, however, is small, so I knew I didn’t need to engage in a full-blown freak out. We met with the doc the following week and were reassured. The CT scan cannot show activity, often indicative of cancer, so comparison to a previous scan is one method by which the radiologist makes an assessment. Another diagnostic tool — the PET scan — can show activity, but at 6mm, the suspicious nodule is too small for a PET scan to detect.
This means that I am on the wait-and-see plan with a follow-up CT on my calendar for June. So many IFs: if the June CT shows growth of the nodule, the doctor would order a PET scan. If the PET shows activity limited to the right lung, I would likely have it surgically removed. If the PET shows activity in areas outside the lung, … It’s at this point I understand I have gone too far in conjecturing and need to stop thinking.
For today, since all other actions are dependent on the results of the next CT scan, I need only focus on that next calendar event in June.
Memories of my mother
Everyone who lives with a health condition is familiar with routine diagnostic tests. And we all have one or another version of diagnostic test results — even if not attached to a revealed illness. Our doctors routinely measure our weight and blood pressure and heart rate. They order blood work. They examine suspicious skin lesions and discuss with us our aches and pains. Over the years, I would spin myself up waiting for test results. And then sigh with relief when mammograms, skin biopsies, Pap smears all came back clear.
My mom was diagnosed with breast cancer when I was twelve. She underwent a radical mastectomy, the standard treatment in the 1970s. Her prognosis at the time was not good, something I didn’t learn until I was much older. I remember my twelve-year-old self confident that she was going to bounce back — even as I cleaned her sizeable wound and changed her bandage daily. My mind had no space for the idea that she might die from this disease.
As the years went by, I remember her saying each year after her annual cancer check: “Well, that’s done, until next year.”
I thought it was a stray comment. Mom being Mom. I think I understand the gravity of her words today, 50 years later.
Freedom for a few minutes
This latest cancer development, along with my ailing knee, stubborn leg wound, and persistent colitis, all have me a bit frantic. I’m burned out and trapped by this illness odyssey. I’d love to take a vacation from it all.
Taking a vacation from my body — as appealing as that sounds — is not possible. A sliver of relief I uncovered is a simple meditation that I try to practice every morning.
Before Wordle or Spelling Bee, before eating breakfast, before catching up on the news … I play As We Gather Together by Essie Jain and incorporate this meditation by Thic Naht Hanh from his Mindfulness Essentials:
Freedom Is A Practice
If you want to be free, just concentrate on your in-breath and your out-breath. Breathe in and out for three minutes, and in those three minutes you are free.
The poppies have moved on
Remember the glory of the poppies a month ago?
Here they are three weeks later.
Fleeting. I’m glad I didn’t look away.
Thinking of you, getting sad, getting frustrated, rarrrr. I hate all this medical barbed wire!
Your strong spirit, sense of humor, sense of beauty and love for fuzzy rabbits remains intact. Love, healing and happiness to you. Many more beautiful moments on the way.
Beautifully written with all the elements of an unrelenting ordeal that demands anger, sadness, perseverance, and grace. Reading these posts and following your meditation practice are helpful beyond words.