Scanxiety and the Human Pin Cushion

29 Oct

Last week Susie had her regularly scheduled cancer follow-up, which happens every four months. Let’s start with the most important detail, which is her scan results show her brain cancer is stable. Stable means no progression of disease, i.e. her cancer is not growing. While a miracle of no disease and regeneration of missing brain is what many fantasize about, we interpret stable scans as good news.

But my intent is not to purely write about Susie’s cancer follow-up appointment. I was thinking more about the overarching experience. I’ve heard many friends talk about “scanxiety”, i.e. anxious feelings a week or so before cancer MRI and doctor appointments. When I look back on my journal notes, I think we experienced these feelings more at the early stage of Susie’s treatment and when follow-ups were every two to three months. I’m not saying we don’t experience heightened stress today, but the intensity seems less.

When Susie experienced adverse events in the past, the fear and concern were obviously higher. On days when her MRI was scheduled ahead of her doctor appointment, I would request a copy of the MRIs. This way I could compare them with past scans and be prepared with any questions with her neuro-oncologist. So my focus was on what I could do/ control rather than the actual scan result. Susie liked this approach too.

Beyond the scans, the other dimension of the MRI/ doctor appointment that added stress related to getting an IV for the MRI gadolinium contrast media injection. People who had lots of IVs in their life, especially associated with chemotherapy, probably can sympathize with Susie. Susie’s veins just don’t cooperate. They may look good, but getting an IV is an art with a lot of luck. They move and burst. After discussing these experiences with nurses, we’ve come up with a few activities to do before each session:

  • Drink two bottles of water thirty minutes before
  • Go for a 15 minute walk before the appointment
  • While walking, pump your arms
  • Set expectations regarding tricky veins
  • Recommend smaller-gauge butterfly needle
  • If can’t establish IV at elbow crease, recommend back of hand or no tourniquet
  • Suggest an infrared vein finder

Last week, Susie decided she wanted to sleep-in before her MRI. Thusly she skipped the first few bullets and became a human pin cushion. She still has bruises on the back of her hands and elbow creases, i.e. “the best laid plans of mice and men often go awry“.