be a long post ... get ready ...
We said, well we know what kind of lymphoma, for medical care is important to know that even when the lymphoma has spread. The examinations are crucial to know three: computed tomography, PET and bone biopsy.
CT scan (Computerized Axial Tomography) is the main test to see how it's done lymphoma: where, how big. It will be the exam that you do most often, during and after therapy, to be sure that the lymphoma is shrinking and, after recovery, to ensure that not even think about resurface again. To see well lymphomas ACT must be made with contrast medium: a cannulina will put you in a vein and inject the contrast immediately before starting to "take pictures". If the contrast is injected into a vein in small (and after a while 'you will not have many veins cicciose ...) can burn a little bit: warning (enough to speak, the staff will hear from speakers), but do not move while the CT scan is running Otherwise, the examination has to be redone! However, generally the first CT scan that does not happen because the veins are still nice and full, and often during therapy have permanent venous access (which tell you later) and then the contrast is not a problem.
PET (Positronic Emission Tomografy - Positron emission tomography), although it is very similar to ACT, only longer, it is actually a different question. It works like this (forgive me radiologists and specialists for any inaccuracies ...): take the glucose and the "mark" so that it releases positrons, which are particles that normally do not release our atoms. This "marking" is complex, requires a particle accelerator, which covers nuclear physics stuff so to speak ... This glucose "marked" is the contrast medium. Is injected and mixed in with all the glucose in the body that we have, going to do his job: that goes to the cells, which do not realize for sure that is marked and use it like any other molecule of glucose.
But cancer cells are particularly greedy. Want to grow, grow, grow ... The result: "pick up", that you eat, the more glucose than the others.
PET goes to see this: Where does the glucose that was injected. In the lymphomas there will be an abnormal accumulation. It is a very sensitive test, can see even small knots that might escape the TAC or not seen. It is an examination which is often, first because it is very expensive and so do not do it if you do not need, and secondly because in some periods (eg. after a few treatments) can give results very specific and less accurate. It should be done at the right time.
In practice, when you are going to make yourself comfortable and bring PET to read, MP3 player, crochet or knitted ... because it is a LONG review!
first goal should be fasting. Fasting true, not "I only took the coffee: you must not swallow more glucose in any way! Not worth the sweets and sugar-free gum! Nothing at all! Put your soul in peace and think of the carbonara which will reward you the way home.
When you call for the examination, the first thing you'll have a conversation with a doctor who will ask for information about the disease (all of us, especially the TAC) and information they need to examine, and make you sign the various consents.
Then you will measure your blood sugar (making a small hole on the finger and taking a drop of blood), because if you have your blood glucose too high the test will fail: you must be sure that glucose is low.
Then you inject into a vein in the arm labeled glucose. After the injection you have to wait an hour before taking the exam. That's why I said take it slow ... And this time you should try to be calm as possible, drink a pint of water that will give you ... and can do more than pee in the bath prepared, which is especially nice because it is metal, shielded with drain, since we end up with urine glucose positron emitting! ^___^
After having said one last time to pee, you will finally do the test! You will see that it is just like doing a CAT scan, but it lasts more than twenty minutes! Council for a nap ... if you can with cold and with the noise of air conditioners. Speaking of cold, to make the PET (and ACT, and for that matter any X-ray) do not need to undress completely, just do not have metal objects. You have to remove the bra, but you can always keep a tank top or a shirt. Where I did the PET, then, offered elegant shroud of blue-and-use disposable, and I covered the legs with a cover.
brings us to the bone biopsy. "Biopsy" means going to take a small piece of something, in this case bone. Why? Why is the inside bone marrow, which is the "factory" of blood cells. In advanced stages, the lymphoma can invade the bone marrow, and need to be sure that this did not happen.
Normally the sample is taken from the iliac crest. In practice, there are holes in the highest part of the seating on the edge of the back, lumbar height. Lie on your side, is the first done under local anesthesia and intravenous drug a few times to help calm down and maybe "Pisolo 'a bit, then you enter (you will not see anything, it's all behind you) like a large needle is inserted in the tip 'bone, taking a "carrot" very small but adequate for histological examination. If upon examination you find a bell'ematoma is normal.
They say that the bone biopsy sometimes do a little 'bad. I can not tell you, having to do node biopsy under general anesthesia, we held that they should make the same site also bone biopsy. So I slept ...
addition to these, it can be that doctors make you do even more tests, perhaps to investigate other health problems other than lymphoma to be taken into account.
Good. Once you have done all these tests, doctors may your staging lymphoma, that is what progress has arrived. There are 4 stages (I, II, III, IV), with the addition of a letter (A or B) depending on whether or not there are characteristic symptoms such as night sweats or weight loss, which is seen be related to a slightly less good prognosis (mean going in a bit less good ... but just in a bit! Remember that even in stage IV Hodgkin's have full chances of recovery by 80%!).
For example, my lymphoma was IIB bulky:
stage II: because it included more than one lymph node (stage I), but was released only on one side of the diaphragm and not from both (stage III) and bone biopsy was negative, so he had no invaded the bone marrow (stage IV).
B: because I had night sweats (the itch was once considered a "symptom B, then took off because the itching alone does not change the prognosis)
Bulky: because it was particularly" ciccioso " (bulky in English means "massive, massive, bulky")
These acronyms and numbers for a patient may not want to say anything, but as I said to the hematologist change the type of therapy to do, so they are important.
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