This is one of several essays from my private cancer journal. It is not intended as anything than a record of my states of mind as I struggled with the disease and the effects of the treatment.
The CAT Scan Cocktail
I called in for my PSA score on Wednesday and got a surprise. It is down from 21 to 15.9. I have no explanation, especially since I was ready to hear it was 40 or 60.
I suppose I should have been elated. I was pleased, definitely pleased, but more surprised. Mostly, I can't figure it out. I know the cancer has spread into tissues, so why has it dropped?
I don't think anyone would understand my attitude. I certainly don't. I'm supposed to be shouting from the rooftops that my PSA dropped. But I'm just pleased, perhaps because I don't believe it. I don't believe the cancer is dissipating.
The day before, I got my pelvic CAT scan. I don't wish that on anyone. The scan wasn't bad. It was the barium that I had to drink, first the night before. It had to be close to a half gallon, two bottles.
I hadn't been told and so when I showed up Monday with a cup of coffee that I was sipping, I was told (1) I wasn't supposed to have anything by mouth that morning and (2) did I drink my barium? What barium, I asked.
So I was given two white plastic bottles of Baro-Cat barium sulfate in a brown paper bag and my scan was rescheduled for the next morning.
"What does it taste like?" I asked.
"Pineapple-banana, I'm told," she said.
I had never tasted barium but the mere concept of it being pineapple-banana flavored was as appetizing as strawberry-tasting motor oil.
She handed me a single sheet of paper with the instructions. I was to drink the two bottles at 9 pm tonight and then have nothing else before my scan at 8:30 the next morning.
"And I hear it helps if you chill it first," she added.
This was getting ridiculous. But when I got home, I put the bottles into the refrigerator. I was not looking forward to this.
About 9:30 that evening, I pulled a bottle out and poured a glass. She was right. I would hate to drink this at room temperature. Yes, it tasted pineapple-banana but hardly natural. I looked at the label, surprised that it said anything. Besides barium sulfate, the 30 ounce bottle contained, ". . .sorbitol, suspending agent, simethicone, postassium sorbate, citric acid, flavoring, artificial sweetener and water."
I got one glass down and refilled. The "pineapple-banana" flavor was quickly getting thin and I was maybe only one-quarter into my first of two bottles. This wasn't my idea of a night-time treat.
I wasn't able to completely finish both of them. There was maybe a half a glass left but I couldn't take it. I was afraid that one more swallow and I would upchuck the three pounds of barium and have to do it all over again.
The nurse had warned me that the drink usually causes diarrhea. "It goes in liquid and comes out liquid," she said with a shrug and a smile. "It may hit you before you get up."
The warning didn't help my whole approach that day but, fortunately, it didn't have that effect on me until I was ready to get up and even then, it wasn't horrible. At least I got a decent night's sleep and could forget about it.
Then morning came and the meaning of the day seeped into my consciousness before I could open my eyes: this is CAT scan day. And I couldn't even have my morning coffee.
At my appointed hour of 8:30 a.m., I stepped into the doorway of the department, gave my name and then took a seat in the hall as requested. After a few minutes, one of the women came out. She was holding a small styrofoam cup in one hand and a now-familiar 30-ounce bottle of Baro-Cat in the other.
"Mr. Young?" she asked as she filled the cup. Yeah, I said, my eyes on the cup. She pushed it at me. "Here," she said. 'Drink this."
I took the cup and then she handed me the bottle. I looked up at her. "The bottle too?" I asked in disbelief. She nodded and then turned and left. I looked at the liquid and nearly barfed. It was the same color as the cup and just as appetizing. I took a deep breath, determined to get it over with as quickly as possible. I swallowed it without stopping, then closed my eyes, trying to catch my breath. I wanted to gag. The cup realistically held only five ounces, which meant I had to drink five more.
As I took a breath, the woman came back out with a piece of paper.
"If you would read and sign this," she said. She handed it to me with a ball-point pen and then went back to the office.
It was a release form but in the middle was a paragraph that I had to read three times to be sure what it said.
"This procedure uses a dye for x-rays given through the veins, which commonly cause nausea, vomiting, hives. Very rarely, severe reactions resulting in kidney failure, heart and respiratory problems, and death, can occur."
Now they tell me.
For a minute, I was of a mind to tell them I didn't want to sign or go through it, that I didn't want to risk it. Instead, I found a piece of paper in my pocket and wrote down that paragraph. I wanted to write about this. It was of no value to anyone if I stepped away.
I poured another cup of the now-foul-tasting liquid and downed it, forcing back the gag reaction as I poured another.
After a few minutes I took the signed paper and the empty carton back to the woman and asked for the nearest bathroom to take a piss.
I no sooner returned than I was called into the CAT Scan room. The machine looked like a giant off-white doughnut standing on edge, more befitting a gawdy pastry shop from the 1940s. A narrow, flat, sheet-covered ramp extended out from the hole.
After ridding myself of the heavy jacket and outer shirt, I stretched out on the ramp. A woman attendant slid a needle into a vein on my left arm. It was attached to a tube with a red-brown liquid that went somewhere out of my line of vision. I closed my eyes and felt the ramp move into the doughnut hole and then back out. I was done in another five minutes.
I walked out into the sub-freezing Cincinnati air, zipped up my jacket and lit a much-needed cigarette. As I headed for the car, I realized how lucky I had been. For one year, the worst that I had endured was my Zoladex shot every three months. I had read the accounts of dozens of men who had endured everything from radiation and rectal bleeding to chemo and vomiting. Since starting my treatment, I had not had to make any real decisions until now and no matter how slight they were, compared to what other men went through, they were a challenge.
It is as if I am being told that my "vacation" is done, that me and the cancer are about to start a new relationship.