Regular participants of Ancan’s High Risk-Recurrent-Advanced virtual online support group and The Reluctant Brotherhood’s Inner Conversations, may know that I am agoraphobic and claustrophobic. I’m not ashamed to admit it and even find it cathartic at times to talk about it. I’ve lived with this ‘condition’ since I was in my late twenties but it seldom bothers me. It’s usually easy to avoid claustrophobic spaces. I’m perfectly happy to avoid traveling beyond my ‘comfort range’ of a few miles from my home. It bothers some people far more than it does me but that’s their problem, not mine.
I did try psychotherapy years ago until my psychiatrist dropped me like a used condom when I ran out of money. I’ve learned that the term ‘medical care’ – whether psychiatric or medical – is, far too often, a contradiction in terms. I also tried meditation but didn’t find it helpful. Some do and that’s great. To each his own, as the saying goes. I prefer prayer.
Why am I telling you this? So I can segue into a discussion of scans and anxiety; what some people have dubbed ‘scanxiety’. Remember, I’m talking about me here and no one else. But, perhaps, others will find it informative.
Since I was diagnosed with prostate cancer in 2010 (metastatic since 2012), I’ve had a number of tests — as have so many other of my fellow travelers. In my case, beyond the obligatory biopsies, I’ve endured a technetium bone scan, an ‘open’ MRI, several X-rays, several CT scans, a nuclear stress test, and two PET/CT scans. The first was an FDG PET/CT in 2012. That’s how I found out my cancer had metastasized to my bones (Stage 4). FDG is ‘old’ technology in the PET/CT world, still FDA-approved for many cancers but no longer for prostate cancer. There are newer and better radiopharmaceuticals for prostate cancer. As of this date, Axumin (fluciclovine) is the only one approved by the FDA for imaging prostate cancer. There are better ones coming down the pike, especially for PSA levels below 2.0, but for now, Axumin is the only one Medicare and most insurance carriers will pay for. The only way to get the others is via clinical trials.
I had my second PET/CT – Axumin this time – last Thursday. I’ll get the results when I see my oncologist on Monday. Did I tell you I’m claustrophobic and agoraphobic? That’s a rhetorical question because I know I did. Anyway I fretted and worried for weeks about the 12-mile trip to the clinic and, of course, the scan itself. The only restrictions are no vigorous exercise for 24-hours before the scan and no food or drink (except sips of water for medications) for 4-hours. I did miss my coffee!
I want to tell you it wasn’t too bad. I took a prescription Xanax before I got in the car (my wife drove) and another before I got in the ‘tube’. The Axumin arrived right on time, I got my injection, and was zipped right into the scanner. They let my wife sit behind me once the CT part of the scan was complete. The CT does involve radiation so no one is allowed in the room for that portion of it. It was comforting to have her there with me although I couldn’t see her. If the technician talked to me I didn’t hear her. PET/CT is a bit noisy but nowhere near as noisy as MRI with all its banging and clacking. The ‘tube’ is a bit confining but not as much as the MRI, bone scan, or nuclear stress tests were for me. The nice thing about PET/CT is that you can see light at both ends. If I weren’t blind as a bat without my glasses, I might have been able to see more. I kept my eyes closed most of the time but did open them to peek once in a while. I found that praying and saying the Lord’s Prayer was helpful – as were the Xanax and my wife’s presence. Probably the worst part was staying still for thirty minutes or so and keeping my arms above my head. I had a strap to hang on to but my shoulder ached like the dickens the whole time. By the time I got out, I was a little sore but quickly got over it. As a final, much appreciated, touch, they gave me a doggie bag with a drink and a few snacks. The whole process, including waiting for the CD, took less than 45 minutes.
It wasn’t fun but it was doable. If I can do it and live through it, anyone can!
Jake