Friday, October 23, 2009

MUGA scan

Today I went for my MUGA scan. (Multi gated acquisition scan) It is a nuclear medicine scan used to evaluate the function of the heart ventricles. I had this test to determine a baseline of my heart function. The reason for this is that the herceptin I will be taking can cause damage to the heart.

When I got there they took me in pretty quickly. The doctor gave me an intravenous injection of tin (stannous ions). I then had to go back to the waiting room and wait half an hour. They then called me back and gave me another intravenous injection of a radioactive substance (technetium-99m-pertechnetate). The technetium labels the red blood cells and the stannous ions keep the technetium from leaking out of the blood cells and dilutes it somewhat. She was actually pretty good at hitting my veins and I would like to bring her along to wherever the next place will be.

Next, I had to lie down on a skinny table and it moved into a cylindrical device which was a gamma camera. It can detect the gamma radiation given off by the technetium. They moved the table up and moved plates down over me at different angles. They came very close. It made me think that it must be how a bug feels just before it is squished by a shoe.

They did three series of pictures, each at a different angle. Each set took about seven minutes and in between she changed the angles of the plates. The hardest part for me was that I had to keep my arms above my head. That was not so bad for a few minutes but it got more painful as time went on.

The test is supposed to give a series of images of the heart, one at each stage of the cardiac cycle. The images show the blood pool in the heart and a computer is used to calculate the ejection fraction of the heart. Ejection fraction is the fraction of blood pumped out of a ventricle with each heartbeat. The normal value is between 50 and 80. If my ejection fraction should decrease during treatment with herceptin it means that it is damaging my heart. The damage sometimes repairs itself when herceptin is discontinued. Of course I did not get any results. They always make you wait. I will need to get these scans a lot of times during the year I get herceptin and at the completion of treatment.

As I was walking out she asked if I got my bone scan yet. I told her I had it and they said it was fine. As I got in my car I started thinking. Why did she ask that? Did she see something on my sternum? Can she even see anything like that on this scan? Is it in my bones now even though it wasn't six weeks ago? I realize I have to chill. I guess when you have this you always worry. I know I will. I don't know when I will stop worrying. I wish I could start the chemo right away. Tonight would work for me. Unfortunately it won't be for a few weeks. I need to know I am doing everything.

So, again I have to flush twice due to radioactivity. Also, my dog Smudge loves toilet water and I have to make sure he can't get near it. He learned that bad habit at my neighbor's house. I don't want him to glow, even if I will soon.

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