Bone Scans and Harmony

So this is “scanxiety.” Damn.

All last year, we talked about looking forward to Christmas. By Christmas, I’d be done with the hardest of all my treatments and could fully celebrate my favorite holiday. It did NOT turn out that way. Ho ho ho 🥴

Three days before Christmas, I had my regular check-up with my oncologist and immunotherapy infusion. During my checkup, my onc squints at my bloodwork results and tells me that my Alkaline phosphatase (ALP) levels are high and have been for a bit, which raised concerns. I made a mental note to google what ALP levels are (an enzyme found mostly in the liver, bones, and bile ducts that helps break down proteins and aids in bone mineralization). Then she went and fucked up my holidays.

High ALP levels can be due to the immunotherapy meds or issues with the liver or the bones. Because my bloodwork showed no issues with my liver, she said it could be something in the bones causing this.

“I think it’s best that we test you for bone cancer,” she explained in her calm, sweet voice. It might as well have been blasted from a 50-foot speaker directly into my ear.

Seeing the immediate fear in my face, she assured me it was probably, most likely fine but just to be safe I would need a bone scan. My body tensed. I asked what the bone scan was (a scan of my bones, obviously, but my brain stopped taking in information) and what would happen if it was positive. I don’t actually remember what she said. I was shocked into blank mode.

When I came home, I told Andrew what she told me. He laughed in the way that means are you fucking kidding me and then consoled me as I freaked out. I thought I was done. I thought it was over. It’s not over. It’s never going to be over. I was having brutal scananxiety, a term used by cancer patients to describe the fear that fills you up before a routine scan that can change your life in an extremely shitty way. Exacerbating it all was that my dad’s cancer was found because of pain in his bone, which turned out to be cancer that had spread from his organs. It felt like a terrible sequel.

My bone scan was scheduled for December 26.

Back home in San Diego for Christmas, I felt heavy. I’d imagined the conversations I’d have to have, how I’d have to explain that the cancer was McRibbing (back) in me and I was probably dying. I decided not to say anything at Christmas. There was no point in freaking everyone out until I knew more.

Andrew and I went out to eat at this Mexican spot in Chula Vista the night before Christmas Eve. It was full of older puffer vest Mexican dudes, multiple Tequilas deep singing rock en español. Major divorced energy. Nextels on the belt vibes. Regional specific shit. I sang “Te Sigo Amando” by Juan Gabriel. It’s about someone saying goodbye to their love who they wronged, and they wish them happiness and love and beg for forgiveness. It’s a big belter song. It felt good to sing out my anxiety, filling my chest with air and letting it out loud and :tucks hair behind ear: on key in a tiny bar.

I’m not posting the video because that’s embarrassing.

That night, back in our hotel room, I had a horrible nightmare. I dreamt about getting my results, and telling my friends and family that I had bone cancer and was dying. In the dream, I was resigned. It was over. I fought cancer and thought I had won, but the second I got comfortable it sucker punched me.

I woke up upset, and shook Andrew awake to tell him I had a nightmare. And then I lost it. Sobbing so loud it hit a scream. I begged – to god, to the universe, to the walls of the Hampton Inn Chula Vista Eastlake – to please please let me live. It was such a raw release of emotion I startled myself. I tend to keep that sort of thing locked up, but I broke down, the dam crumbling then exploding under the rush of my fear.

Eventually I calmed down and fell asleep, but the weight carried over into Christmas Eve. My sister mentioned that I looked tired and I said I had a bad dream and didn’t sleep well. She immediately clocked something off, which was probably very obvious, and asked if I had gotten a bad test result or something. I mumbled a lie and walked away. A couple weeks later, when I told her everything, she said “mom already told me, I was pretending not to know.” My mom never lets me break my own news.

At dinner, I gave a small toast to say thanks to my family for being there in different ways during the hardest time of my life, and how grateful I am to be sitting at that table with them. And I thanked Andrew for taking such care of me. We all cried. All I could think was how much it felt like a series finale, but I smiled anyway.

Someone at the hotel took my favorite coat. We called over and over again, and got no help at all. I was favorite coatless, and probably covered in bone cancer. Cancer-free Christmas was ruined.

Back in LA, we arrived at City of Hope for my bone scan. When we approached the check-in line, I asked two women who were standing nearby if they were waiting. One of them turned. It was my surgeon. I was happy to see her, though sadly she was there for her friend who was diagnosed with breast cancer at 39. She asked why I was there, and when I explained she gave me an incredulous look. “What? No, I’m sure it’s totally fine. Let me look,” she said, and pulled up my chart right there on her phone. Really pulling double support duty that day. Thank you, Dr. Schulz-Costello.

She scanned my bloodwork and said she understood why my oncologist was having me tested, but believed it was just my immunotherapy medicine messing with my ALP. “We are really careful here,” she explained. “If anything is even slightly off, we always check it just to be safe. It’s basically City of Hope policy. But I really think you’re fine.”

My butthole unclenched for the first time in days. It was such a wild stroke of serendipity that my surgeon would be there and ease my fears. It was going to be a few days before I got my results because of the holidays (typically, I get results within a day), but having her there to assure me that I would be fine made that waiting period bearable.

The scan required me to lie down flat on a hard table and very slowly be moved into a machine that inspects each and every bone in my body, skull to toes. I could see a little image of my skeleton on a screen on the machine. It looked freaky and horrified. The tech administering the scan got chatty with Andrew, so for 45 minutes straight I had to listen to them talk about Champions League soccer. The tech talked in that excitable way dudes do when they want to flex their authority on a topic and finally have an audience for it. Have I…not suffered enough?

Skeletal reaction to having to listen to footie talk for 45 minutes.

A couple of days later I got the results via City of Hope’s app. Negative. My bones were clear. It was a huge relief to have my surgeon’s assertions confirmed. But it also cemented the realization that this is what life will be like from now on. The cancer boogeyman always lurking, forever creeping around for a way to break into my house, steal all my things, and kill me. People survive cancer sometimes multiple times over, but also sometimes not. And it’s not just a matter of surviving. Treatment fucking sucks. The fear during and after eats you up. The thought of going through it all again scares the shit out of me. I have to learn to live with that, and somehow use it to help me live even more. How though? I have no idea. Watch this space, I guess.