Jim Carson One of these things is not like the other

Jim Carson
That’s no moon…

During last month’s Stone Concert, the CT scan showed two unexpected somethings.

Dramatic reenactment: The noisy TIE fighter? It is the least of your worries.

I went into my primary care physician ask what, if anything, I should do about them.  Because I’m generally feeling fine, the gallstone can be ignored. (Update: Until next year.) I will probably have to cut back on the butter fried bacon twinkies smothered in bacon, wrapped between a pair of glazed donuts, sprinkled with Oreo bits, and surrounded by a moat of heavy whipped cream. (I really have never had such a thing, nor would I really want one. I have my bacon-limits.)

The second unexpected thing is a mass on my adrenal gland, technically known as an “incidentaloma,” because it’s found while looking for other things… like Alderan. Though I didn’t have any obvious symptoms associated with The Bad Kind of these masses — excessively high blood pressure, thinning of the skin, hypoglycemia, balding (okay, one out of four) — it’s big enough that the doctor recommended checking various hormone levels before forwarding me to a specialist. He did caution that it’d likely need to come out.

I was a little antsy.  The specialist does a day a week at the nearby office, but was booked through December. The scheduler found a mid-day slot at the main hospital in Seattle. Done.

After running up the stairs to the seventh floor, I emerged in a lobby of visibly sick and worse off people roaming the halls. Mercy! Suddenly I didn’t feel so bad.  The specialist gave me a pretty nice explanation of these, later supplemented by online resources. He drew a makeshift lower human endocrine system on the paper covering the exam table, explaining that the size means it would need to come out. Before doing so, he wanted to get a contrast MRI to better determine its composition. Upon hearing I traveled all the way to The 206, he had his scheduler set me up with the portable MRI machine in Issaquah.

It looks exactly like this:

Oh, boy, breakfast tacos! .... wha?

On the inside, it felt like any medical facility I’ve ever been in, sans the smell of alcohol. One end has a dressing room, the middle is the technician’s “pit”, and the other end is the actual magic donut itself. While in the dressing room, I was asked a series of questions to identify any potential metallic materials in or on me that would cause problems: pacemakers, cochlear implants, shrapnel, prison tats, piercings, stainless steel rapper teeth, and so on. An MRI is a giant frickin electromagnet, where “frickin” is 1.5 Tesla, or about 35000x more powerful than the than the earth’s magnetic field. Metallic objects become projectiles, credit cards are cheerfully erased, and hard drives are reformatted.

Han. Fired. First. (Photo: Photo By Bonnie Burton -- Starwars.com)

They strapped on imaging coils above my abdomen and sent me into the chute. As soon as my head was fully in, a really awful claustrophobia set in.  Luckily, the machine was open-ended and my head was close enough to the edge.  They advised me to look straight up.  Seeing various distant office furniture eased up the tension, after which I just kept my eyes shut and pretended I was on a tropical island somewhere.

Source: How Stuff Works.com

The general procedure was I’d do a couple of deep breaths, then hold (and remain still) for up to a minute and a half while the machine did its thing. Even with the Ye Old Timey airplane-style headset, it’s pretty frickin noisy inside. There’s a low, rhythmic percussion sound that my feet wanted to interpretively dance to. When the machine was actively scanning, I heard four types of jack-hammery sounds. Here’s one of the noises.

The adrenal gland sits on top of your kidney, ready to rock out on a moment

They ran a bunch of scans: in phase, out of phase, wash, rinse, spin.  At some point the radiologist came in and wanted an additional set of contrast images. The lady running things did the IV and she was top-notch.  It didn’t hurt at all.  The contrast agent was a gadolinium chelate that’s given intravenously.  Before injecting it, they did a quick blood test of kidney (creatine) function to rule out any renal problems.

So, bottom line: that’s no moon…

This is the view as if you were looking at my belly: my left is your right.

And looking down from my man boobs:

Yeesh.

If the blobby thing were under 4cm, they’d just keep an eye on it. However, it’s big enough that they’ll remove it. The reasoning is the larger it becomes, the more likely it’ll turn to the Dark Side.

So far, signs point to having it removed (Warning: NSFL = Not safe for lunch) laparoscopically in January.    Each time I watch this, I alternate between fascination at the technology and creeped-outness that we are self-aware meat sacks.  If they have to take the more invasive route that Ted underwent with his kidney, there will be … a much longer recovery period.

As I write this, it’s penciled in for mid-January.  It’s like bullseyeing womp-rats in beggar’s canyon, or something.

6 Responses to That’s no moon…

  1. Tamara Timmons says:

    Hey Jim, very interesting post. I think you have a gift for explaining things very well – I could use a little of that talent! It sounds like what you have is a benign adenoma? (I love the term incidentaloma, one that is actually used in med school) :) Luckily, from what I understand, these are relatively easy to remove – compared to the more invasive malignant forms. I hope the surgery goes well!

  2. Kiri says:

    Wow, fascinating (and scary?). Your MRI experience is similar to mine when I had my knee scanned to determine the ACL damage. Like everyone else, I was surprised at the volume of the noise. I also started feeling like the skin on my legs was tingling very faintly. I kept telling myself I had to be imagining it, unless maybe the magnetic fields could induce the leg hairs to move just a tiny bit. Did you feel anything like that?

    I love it that you got your data and posted your pictures (of course). I still haven’t gotten around to doing that with my knee pictures. Psychological block, no doubt :)

    Best of luck with the surgery. I am certain that it will go well, but that doesn’t make one less apprehensive. Keep me posted!

  3. jim says:

    @Tamara – thank you for the note. Any sign of malignancy is usually an automatic “open” operation similar to Ted’s. Longer time to recover + more potential for complications.

    @Kiri – I felt a faint tingling when the contrast agent went in, but it may have been just a temperature difference. MRI technology is pretty neat, though.

  4. jim says:

    (Private note that I thought would be worth sharing):

    My curiosity outweighed the aversion to the details. I was surprised how easy it was to get copies of the imagery – they’ll even produce a CD the same day. I also requested doctor notes and raw test results via a completely separate process and … am having second thoughts about reading those. The information is presented in a form that, as a layperson, I don’t know how to properly filter. For example, if my Mac wouldn’t boot, the an electrician testing the battery might write up “Battery is uncharged; however, computer viruses, melted motherboard, and hard disk crash must also be considered.” Since I’m well-versed in computers, I would stop at “Battery is uncharged” and shake my head at the rest. When it comes to endocrinology, I know nearly nothing. I must remind myself not to read too much into the data.

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