Day 83, Friday, April 19th, 2013

On Thursday, at ten am, I had another CT scan. You aren't allowed solid foods for four hours prior to the procedure.

On Wednesday, at one pm, I had another bone marrow biopsy. You aren't allowed solid foods for six hours prior to the procedure.

Couple these with Ativan withdrawal, and, well, I have not enjoyed the last few mornings.

The biopsy itself went swimmingly; it was a single biopsy, and by far the least painful or uncomfortable one to date. The CT went at least as well, and I think I convinced one of my techs to move to Canada, for reasons of tolerance, sanity, and health care.

The Ativan withdrawal is simple in nature: I can't sleep. I've been on 0.5mg lorazepam (Ativan), as needed for nausea, for roughly the last month. When I was inpatient at UWMC, they gave it to me intravenously, which was marvelous; as an outpatient, I've been taking tablets, which are less marvelous, but still entirely functional and/or adequate to handle the rumblies in my tumblies. Over the last several days, I've found that my nausea has decreased significantly, and, as such, I have been weaning myself off of the Ativan. This, typically, causes many things to happen, the most significant of which is rebound insomnia, which manifests as a profoundly dissatisfying nighttime experience. Other common side effects include a panoply of mood effects, likely lost in the noise of the not eating/conscious sedation/drink-this-giant-vat-of-oral-contrast-and-lie-still business of the last two days; and headaches, also half-lost in said noise. I say half-lost because I've definitely had a headache for the last couple of days, but I've also had another chunk taken out of my back and had to physiologically sort out a number of non-standard substances, given directly into my bloodstream. I suppose what I'm clawing at is that I'd have had a headache regardless, so who the hell knows if I've gotten one from stopping the Ativan?

The pros are that after a week of weaning and two full days without Ativan, I am beginning to sleep again and my brain feels less mushy. Of course, I'll be back on the stuff in about two weeks because of the second transplant, but the respite is important. I take a lot of pills, and that is not going to go away anytime soon. Whenever I get to stop taking a medication, it feels like a little victory, and it reduces my overall stress levels.

I don't believe that I've talked in detail about getting a CT scan before, and that is because as far as diagnostic medical imaging goes, they're relatively common. That being said, coming off of the Ativan has freed up a remarkable amount of cognitive capacity, which has me feeling wordy, so let's shall, shall we?

When getting a computed tomography/CT/"cat-scan", they start you off by sticking an IV into you. This is important for later. Then, they give you one and a half litres of water, with an Oral Contrast Agent dissolved into it, typically barium sulfate. You are given an hour to consume this volume of liquid; it allows the imaging of your GI tract. Once the hour is up, you are called into a large, very cold, room. In this room is a giant x-ray donut and a motorized medical cot. You lay on the cot, several pads are put in place to help keep you still, your IV is connected to a pump that administers IV Contrast, typically a form of iodine, and then the techs all leave the donut room for the safety of a control room outside of the magnetic field generated by the aforementioned giant magnetic donut.

If you were good during this set up, you will have been offered a blanket. If you were bad, you will spend the next fifteen-to-twenty minutes with gooseflesh and erect nipples because it is chilly by the apparatus; it has to be for operational reasons. Depending on the areas to be scanned, you may or may not be asked to drop your pants. Possibly (likely) you will have been asked to wear clothing with no metal in it (this is becauseit will interfere with the scan). If you have failed to arrive wearing metal-free clothing, you will be temporarily issued hospital pants, which vary greatly in terms of stylishness and comfort, and they want them back.

You are then elevated and passed through the donut while being given instructions over an intercom, mostly involving when and how to breathe. Then, once the techs have satisfied themselves with the pictures they've acquired, they give you the IV Contrast. As it hits your veins, you feel a surge of warmth. It starts in the back of your throat. Boom. Warm. Next, your genitals. Yup. It goes warm throat followed by, "have I wet myself?" Once you have satisfied yourself that you have not in fact, gone tinkle in your metal-free pants, you have the time the notice that the rest of your torso feels quite warm, and you even notice a bit of heat in your extremities. They take a few more pictures, and then they send you back out to the nursing area, where you are fed blessed, blessed snacks, and that's it.

"I met God once.  He sneezed. I didn't know what to say." - George Carlin