Despite nearly being stuck at O’Hare airport in Chicago due to thunderstorms, my flight managed to depart for Reagan Washington National. For anyone looking for a hotel near the NIH, I’m staying at the Hyatt Regency Bethesda until I’m admitted on Sunday. The Hyatt is very conveniently located right atop a metro station. One transfer between the airport and hotel, very handy.
My next day started at 8AM. The NIH was one stop away on the metro. After checking in through security, I walked to the main building, #10. Registration was relatively quick, with fewer forms than a typical office visit. The nurse who had been corresponding with me via email (Celene) then met me to show me where I’d be going throughout the day. My next stop was at the lab for blood and urine samples. Then to radiology for a chest X-ray. Then to have an EKG. Everything was very efficient, so much so that I finished over an hour earlier than scheduled and had time to take in a light breakfast. The staff has also been very professional all around.
My 3T MRI with spectroscopy was delayed a little, but went without a hitch. It was quite an extensive scan, taking about 1 hour and 10 minutes in the tube. Even with earplugs and headphones, it was fairly noisy. I also had the displeasure to experience the “Endorectal Coil” used to enhance the images. Getting it into place wasn’t very pleasant, but it was tolerable for the rest of the exam. Another set of enhancement coils was set on top of me. Near the end of the scan, they injected me with gadolinium to enhance the last set of images. They also took additional images at without the coils before I was finished.
All in all, it wasn’t too bad. Certainly worth the price (free!) if it helps to define any areas for a targeted biopsy. After the scan, I went to the urology clinic to meet with Dr. Peter Pinto. His associate did another DRE and took my history. Then Dr. Pinto came in to discuss everything with me. I also told them about my ultrasound experience and gave him copies of the 5 images I had plus the report.
As I was waiting for my files to go to my next stop, Dr. Pinto actually contacted Dr. Bard regarding my ultrasound. I was very impressed. I only heard bits and pieces of the conversation, but Dr. Pinto talked to me afterward. He re-assured me that the ultrasound equipment used was legitimate for the application. He wasn’t quite as re-assuring about the recommendations I was given at the time… Still, I was happy to have some closure and he thought the images I did receive might be of some use when they reviewed their own images from the MRI and again with their standard ultrasound on Monday.
My last stop of the day was a pre-anesthesia consultation. I was told I’d essentially be one degree above unconscious for the procedure on Monday. I gather I will be barely awake but won’t remember anything until I’m in the recovery room. Most biopsies are done under local anesthesia in an office and take maybe 15 minutes. This one is a bit more involved due to the equipment that “fuses” the MRI images from Friday with the real-time ultrasound images during the biopsy. I am told it takes about 45 minutes or so. They take a standard 12 core sampling that is typical with a prostate biopsy. Then they take an additional 2 samples for each area they have identified as suspicious from the MRI results. The fusion of the images allows them to roughly locate and target these areas on the spot.
It’s not perfect, but it makes a lot more sense to me than a completely random biopsy based on no certain information that a tumor even exists. There’s a chance I will have no irregularities and be sent home early, but I’m told most patients should expect to have the biopsy. So, more to come on Monday if I’m in the mood to make another entry. Until then, I have a couple days of sight seeing, as my friend from New York (who also accompanied me on my visit for the ultrasound) is driving here to visit.