Nuclear Medicine

It's been a while since I had enough going on to make two posts in under a week! Things are really picking up pace, and the official date of my stem cell transplant will be confirmed very soon.

The reason the date's not yet official is that all of the variables have to be right. I've successfully passed the 'harvesting' stage, and next is to ensure my vital organs are strong enough for the upcoming procedures.

This leads me to the department of Nuclear Medicine. Ominous sounding, don't you think?
Truth be told, there wasn't a single one of these notices in the department.
By definition, Nuclear Medicine is the branch of medicine which deals with the use of radioactive substances in research, diagnosis and treatment.

For those who don't know my background, I have a Masters in Chemistry. Every time I am referred to the Nuclear Medicine department, I have a little geek moment and demand to chat technical with the nurses and radiographers.
I don't have a single photo from labs... Enjoy chemistry drinks from 2011 instead.
My referral was for kidney and heart function tests. For obvious reasons, they both need to be healthy enough to process the chemotherapy drugs otherwise there could be fatal consequences. I can't currently tell you the outcome of these yet, as I simply don't know the results. Don't be afraid though, I'm not expecting any negative news.

The idea of radioactivity doesn't make me nervous. The actual radiation dose is very small and the active products have very short half-lives. My least favourite thing is that my PICC line cannot be used. This is in case the radioactive substances adhere to the tube linings. Instead, another cannula was inserted. My arms are covered in bruises.
A beautiful, deep purple. I might get it colour matched at Homebase.
To probe the kidney function, you must undergo an analysis to calculate the GFR - Glomerular Filtration Rate, or the rate that the kidneys are capable of cleaning. This is carried out using a radioactive tracer (51Cr-EDTA) and detected by taking blood samples. Three blood samples are required in total - the first after two hours, and then every hour thereafter. I was allowed to leave the hospital between the blood tests, allowing me a little freedom and avoiding complete boredom. In fact, I even visited the Grant Museum of Zoology, next door. Definitely worth a look to any of you that come to visit me when the time comes round.
51Cr-EDTA. This is for the curious amongst you.
Immediately after the end of the GFR analysis, I was sent for a heart function scan. The official name is a MUGA - MUltiple-Gated Acquisition scan. I don't know who named these procedures, but they seem purposefully pretentious. In preparation for the MUGA, I was injected twice. The first contained Tin Chloride, which sticks to the red blood cells. 20 minutes later, the radioactive tracer (Tc-99m) was added. The tin stops the radioactive component from attaching to the red blood cells, which keeps it in the bloodstream.
Example pictures obtained in a MUGA scan.
I was immediately moved to a scanning room, which contained a small bed and a gamma camera. At the same time, ECG electrodes were placed on my chest to capture my heartbeat. The two devices work in harmony to take a range of cardiac 'snapshots'. The ECG electrodes trigger the gamma camera based on the rhythm. The process takes around ten minutes.
Check this out, MUGAf*****!
All in all, it took six hours in the Nuclear Medicine department. Done.

My next appointment in on Thursday 19th March, where I will be signing my consent forms for the stem cell transplant, and an official date will be announced. Wish me luck!

Joshua Lerner

Hi! I’m the 'star' of Livin' With Lymphoma. The blog was founded on the 31st October 2013, on the day I was diagnosed with Stage 4B Hodgkin's lymphoma. I hope you find it funny and informative.

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  1. Did you know physicists work in Nuclear Medicine departments too? As it happens, I'm training to be a nuc med physicist and reading your post was interesting, seeing the sorts of things I do from the other perspective.

    I guarantee there will be hidden cupboards and doors plastered with trefoils. One of the things we have to do in Nuclear Medicine is abide by anti-terrorism laws and that means not making it obvious to the public where the 'hot' stuff is!

    MUGA is actually a very descriptive name that differentiates itself from other scans that may be captured dynamically, statically, singular gated etc, and also from a very similar type of scan called a MPS (myocardial perfusion scan). How did you feel going through this scan? It always looks like the camera heads are uncomfortably close!

    The importance of the GFR is to measure not rate at which blood flows through the kidney but the volumetric clearance (cleaning) rate the kidneys are capable of.

    Anyway, best of luck! If you have any questions about nuclear medicine, feel free to ask :)

    1. Hi Mo!

      Thanks for reading through that and helping me to understand the Nuclear Medicine department a little better.

      After seeing your post, I've made a couple of edits, so thanks again for that.

      I've been to the Nuclear Medicine department again this week for my 12th PET/CT. Which hospital are you training at?

      I really appreciate your support, so keep checking back for more updates and I'll be sure to get in touch if I think of something.