What does MRI stand for, anyway? I don’t remember exactly: a side effect of these brain (“bane”) tumors of mine, but it’s either Machine Roars Intensely, Mysteries Revealed Internally or is it Milkshakes Rate Importantly? I forget which one. While PET scans show the cancer in my body from the neck down, the brain doesn’t play by the same rules, so it requires a different test with an MRI.
Since the blood/brain barrier prevents my chemotherapy from reaching my tumors, my treatment options are not the same, either. I am limited to radiation or brain surgery.
I have Stage IV breast cancer metastasized throughout my body, including my lung lining, liver and brain, but it’s totally different from lung, liver or brain cancer. It’s breast cancer, just ravaging other parts. Weird, right? And this is how Clever Cancer kills: It’s a game of Battleship. Try this chemo, improved scan, boom. Or on a scan showing progression, miss, try a new treatment. Cancer spreads via the bloodstream, racing to take over my lungs, liver or brain (Oh, my!): a malignant Wizard of Oz trying to survive and thrive, while inadvertently killing me in the process.
For my brain MRI, I wear regular clothes, but no metal, including zippers, fasteners, jewelry, belts et cetera. The only prep is arranging my ride (thank you to so many of you for that) and the intake questionnaire. No fasting, yay! I’m walked to the rear waiting room until it’s my turn. I put my purse and coat in a locker. This also used to be the part where I got my IV inserted, but now I do it through my chemo port, permanently located under my skin near my neck.
Next, I enter the MRI room with a “love banner”: swatches of material given to me by family and friends attached to ribbons that I can hang nearby during the scan, so I can feel your love surround me. I lie down on my back on the table; they place a pillow under my knees, cover me with cozy blankets and put earplugs in my ears. A plastic cage surrounds my head but doesn’t touch it. I’m given a pump to squeeze if I need to communicate with the staff. At last, the table slides into the machine, which is a hollow tunnel, just like a cannoli, and I’m the filling! I close my eyes and the crazy loud noises begin, as mentioned earlier.
Midway through the scan, it’s Hammer Time – I mean, contrast time. The juice is inserted through the IV, or for me, injected directly into my port with one fast, firm, painful-but-mercifully-brief jab, despite the ointments that I pre-apply to numb the area. My veins are tricky, so after my last IV resulted in painful-yet-gorgeous celestial blue and pink bruised forearms from multiple failed attempts, I just let the staff know ahead of time to use the port. I do the same thing with blood draws now. I love my port.
The contrast is to get clearer images. The chemical used is gadolinium, and point of fact for AC/DC and Metallica fans: It’s a heavy metal! I have not run into issues with gadolinium – most people don’t – but Chuck Norris’ wife sure did, and they are raising awareness about the risk potential.#themoreyouknow. Contrast can taste slightly metallic and feels warm around the groin, giving the false sense of peeing. But it’s just a feeling; you didn’t really wet your pants.
Then it’s back to the scan and its very loud construction noises. This is where the panic about peeing yourself can come in handy as a helpful distraction.
The entire test usually takes around 30 to 40 minutes once I get into the whirring and clicking robot. Eventually, we’re all done, I get a copy of the disk for my records, and I discuss the scan with my doctor at a subsequent appointment.
I always look at my images now while we discuss the results, instead of just relying on his words or a written report. Seeing these tumors with my own eyes and comparing them to my previous scans is empowering. Looking at them gives me a sense of scale, and I am grounded in the gift of knowing I am larger than these tumors, reminding me that I am more than my cancer. It keeps my imagination in check. I understand the details in a shorter amount of time, which leads to better questions.
There is also a beauty to these images. For example, getting this gadolinium glimpse inside my brain shows me that my cerebral edema swirl (brain swelling) looks like a graceful design on my latte. That’s never come up in my reports before!
After my brain MRI, I do something special for myself, like watch a few episodes of Drunk Historyat home or treat myself to a milkshake [whispers: “sometimes both”].
Head On and Heart Strong!
Kids’ Almanac columnist Erica Chase-Salerno was diagnosed with Stage IV breast cancer in the Summer of 2015. To read more about her experience.