Friday, March 28, 2008

Next Up - scans!

5:41 AM 3/28/2008

We made it through an entire day with no sickies at home. Wow, what an achievement. I am ecstatic to report that, other than Lynley, everyone seems to be back and working as a fine oiled machine. Everyone was back and everyone was good. To be honest, I kind of missed having someone around. Although I worked pretty solidly while she sat and watched movies on the couch it was nice to have the companionship. Okay, I admit it. I am a little lonely.
It has been a pretty busy week. I haven't had a lot of time to update everyone on my conversation with Dr. Eames. We are in the process of rescheduling scans in the next week or two. We are planning a followup MRI, bone scan, and MIBG. Many of you may be wondering why we are repeating the bone scan so soon after the biopsy that we did a few weeks ago. Won't it be worse? Well, sure, but you are thinking of it the wrong way. We are not trying to prove the area is any better. Remember, we still have not done anything to treat it. In fact, we aren't even going to prove that it is any worse in that spot. We know it probably will be. Essentially we are still trying to ensure that it is not neuroblastoma. So, in this case we are using the bones scan to ensure that (whatever it is) it is not spreading to other bones (like neuroblastoma probably would) It does not mean much if the spot is the same or even worse. We are concerned that it is not spreading to other locations.

Next you may be wondering why we are using MIBG. You may say, she isn't MIBG avid in this spot. You already know that Mark. My answer is this. No we don't. The only thing we know is that it did not show up previously. This could be because it was not neuroblastoma, not avid, or not enough disease to be picked up by the scan. With this scan we are assuming that if it is neuroblastoma it has probably grown enough to be detected by MIBG. We are using this scan to rule in disease not to rule it out. I know it seems a little backwards to the normal way of thinking but we have to work within the limitations of the tests. A negative MIBG does not provide us any real value. However, a positive one would tell us for sure. While we obviously don't want to see that result it is the purpose of the MIBG.

Finally, the MRI is to keep tabs on the bone lesion that was detected by MRI. This also probably won't be definitive for or against neuroblastoma but it might gives us an a better indication of exactly what it is. It will also give us some indication of the growth or lack thereof of the abnormal marrow respons. We are monitoring it closely to ensure that it does not get out of control. Until we know what it is you can expect to see a MRI just about every month or so.
Now, on to happy shiny news. I want to thank everyone for all of their emails and comments that they left on the last set of photos. It seems that we have an understanding with each other. There is a bit of misconception, however. I am not a professional photographer. Not even an amateur one. So, don't expect too much. However, I will try to get them closer up in the future. The Easter pics are here:

Happy purpose hunting!

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