Brain fog: the subtle side of scanxiety

Image credit: Microsoft

Image credit: Microsoft

Tomorrow morning I fly out for another Monday PET-CT scan at University of Colorado (CU) in Denver. Tuesday I start cycle 35 of Xalkori on my clinical trial (cycle = 4 weeks). If my Tuesday clinic visit reports a clean scan, I’ll be almost 30 months NED on this targeted therapy.

Because my injured left shoulder is so inflamed, I asked my oncologist if I should have a CT instead of the usual PET-CT this time (inflammation shows up hot on a PET scan), but he says he will just ignore that shoulder. Since I had a detailed MRI of that area a couple of weeks ago when diagnosing my shoulder problem, I’m not concerned a metatasis might be missed. I do wonder how my shoulder will feel after having my arms over my head in the scanner for over 20 minutes, but that’s not a big concern either.

While at University of Colorado, I’ll also be meeting with a CU communications staffer (to discuss cancer center public relations), a molecular pathologist (to discuss ways to explain benefits of genomic testing), and Lung Cancer SPORE members (to discuss a SPORE project). I’m really enjoying my work and friendships with all of them, and love getting to learn about cutting edge science from those who are doing the research. Alas, Dr. Camidge is away on travel, so I won’t get to work on any videos with him this trip.

Interesting projects are definitely worthwhile distractions at scan time. I’ve been so busy with lung cancer advocacy and travel (26 days out of the last two months) that I haven’t had time to feel any conscious scanxiety. However, I still haven’t packed, completed household pre-trip tasks, or written items with impending deadlines, and I’m moving slower than usual. I find myself having difficulty thinking beyond my next cup of coffee. It’s sunny and clear outside, but gray and fuzzy inside my head. So maybe I’m not yet entirely immune to scanxiety’s influence.

Then again, the brain fog could simply be lack of sleep due to Seasonal Affective Disorder (the sun is up 16 hours of the day right now in Seattle), time zone tango, and travel schedules. The source of the fog doesn’t really matter, I suppose, as long as I warn my family of its presence. Otherwise they may wonder why the dirty dishes are in the microwave instead of the dishwasher.

Pavement Diving Is Not My Best Event

On May 28, I blithely strolled the streets of Chicago and stepped in a missing sidewalk square.  My right toe caught the edge as I stepped out, and momentum carried me forward.  I lunged several steps, trying to regain my balance, but my shoulder bag (with my iPad and other weighty items) threw me off balance.  All 230-ish pounds of me crashed in a face-down baseball slide, arms outstretched like Superman, onto the ChiTown pavement.

Credit: Sandro Giordano (Instagram)

Credit: Sandro Giordano (Instagram)

Fortunately my husband was only a step or two behind, and stayed with me as the dizziness of shock dispelled.  Eventually he pulled me to my feet with my left arm (I protect my right arm after radiation damaged its nerves) and he steadied me as we wandered to our hotel, followed by a solicitous street sweeper who insisted the pavement would be repaired immediately.

Heck of a way to end our anniversary celebration, much less start a five-day conference (ASCO) in which I daily log 3-4 miles of walking.

At the hotel, I discovered I’d skinned my bare left elbow as well as my right kneecap (despite being covered by jeans and compression hose), and my shoulder hurt.  I hadn’t noticed any pain before.  I wondered aloud if my neuropathic tootsies perhaps contributed to the fall, then applied bandaids over the raw skin and iced the joints.  The iPad seemed unfazed.

The next morning, my knee was bruised, but supported my weight and allowed me to walk comfortably. However, my shoulder didn’t want to move or be touched.  Putting on a bra became an Olympic challenge, only slightly more difficult than pulling on pants and a t-shirt. I didn’t use the arm much for the rest of the week.

Two days after we returned home from Chicago, I saw my primary care provider. He said the knee was healing, but suspected a rotator cuff tear in my left shoulder.  An orthopedic specialist  ordered an MRI.  

The good news:  the shoulder shows no torn tendons or muscles, just a bad bone bruise, tendon strain, and a ton of inflammation. I came very close to breaking my shoulder (the socket does have a tiny crack), but no surgery is necessary. The shoulder gets four weeks rest in a sling, then physical therapy.

The bad news: since I’m on warfarin, I can’t take anti-inflammatories (NSAIDs), and I can’t have a cortisone shot to reduce the inflammation because the bone won’t heal properly. I can have Tylenol and, if I need it, Vicodin (which, thankfully, my clinical trial allows me to take).

To celebrate, I bought myself a rolling case for my PC, and washed sports bras to wear the next few weeks.

Yet (despite my dramatic retelling) the entire episode seems no more disruptive than a scratch.  I will recover.  Life goes on, with only a temporary adjustments in activities and few hours lost in the clinic.  Compared to cancer, this is a minor bump in the road. Or a dip in the sidewalk.

So what if pavement diving isn’t my best event?  I’m damn awesome at living.

What’s the best part of National Cancer Survivors Day?

To celebrate National Cancer Survivors Day, I’m sharing a recent picture of me with Linnea Olson, a sister metastatic lung cancer patient and one of the bloggers (Outliving Lung Cancer) who inspired me to become a lung cancer blogger and advocate.  She and I are both alive thanks to research and clinical trials.  As Linnea phrased it on Twitter, … read more