Full-body C-Scans: not all they're cracked up to be

I was reading my new issue of Consumer Reports when I came across this very interesting item:

"Your doctor recommends a “whole-body” CT scan

"Those scans are often touted as a way to detect early signs of cancer and heart disease. But most scans—and up to 80 percent in older people—have at least one abnormality that shows up on the exam. Almost all of the abnormalities are harmless, yet about one-third of patients are referred to follow-up imaging, according to a 2013 study. And whole-body CT scans expose you to much more radiation than regular CT scans. One study determined that for every 1,250 45-year-old adults who have the exam, one will die of cancer as a result. Yet it’s unknown how many lives the scans might save."

One 45-year-old person will die of cancer as a result of a whole-body CT scan! That’s shocking -- but not totally surprising. CTs are utilize powerful radiation technology to investigate the tissues of the body layer by layer; whole-body CTs expose the whole body.

I’ve had a lot of x-rays due to a congenital hip condition, so I’m extremely leery of all medical uses of radiation technology; but CTs are prescribed so often, I’ve even had a couple of them. But I haven’t had a full body scan. However, less than a year ago I was told I must have one.

In New Mexico, I went to see a specialist about a small lesion that had begun to distort the vision in my right eye. Dr. Seligson, the opthamologist I had seen in Santa Fe, thought I had TB, but he insisted that I must see Dr. Shelley Lee at the University of New Mexico Eye Clinic in Albuquerque, to confirm his diagnosis. She is a specialist in uveitis, inflammation of the eye.

Dr. Lee was a youthful, slender woman with a narrow intelligent face framed by straight black hair. She worked late and appeared to be very dedicated to her clients. I liked her at once.

In the grey examining room lit only by the glare from a large computer screen, she showed me vastly enlarged images of the choroid of my eyes. (According to the web site of the National Institutes of Health, “the choroid is the layer of blood vessels and connective tissue between the sclera (white of the eye) and retina. It is part of the uvea and supplies nutrients to the inner parts of the eye.”) Both images were green from the dye that had been shot into my veins an hour earlier. Here was the healthy eye. Here was the sick one, covered with brown spots. It looked pretty creepy.

Dr. Lee looked me over carefully, a woman of advanced years, unaccompanied, intelligent, who did not appear to be terrified, and said, "I think you have cancer and it has metastasized to your eye."

Just like that.

In three weeks, I was moving to California. I had great plans for this move, but I was also very anxious. Now I had cancer!  Should I even go? or just curl up and prepare to die?

Dr. Lee ordered several blood tests, an MRI of the head and neck and a whole-body CT scan. She urged me to complete the tests before leaving because there might be delays in California while I established care.

I tried my best, but the two scans were scheduled just a few days before my departure and I was becoming exhausted. I did the MRI, but the night before the CT I was supposed to drink two liters of fluid that I supposed might have something to do with emptying my bowels . . . and I just wasn't up for it. I postponed the test.

Once in Sonoma, I learned that the small local hospital did not have the right machine for the whole-body scan. I could go to another hospital if I wished, but my doctor and the radiologist thought that the three regular scans would be sufficient; the brain scan would not be included but the MRI had been negative. Another study of the brain didn’t seem necessary.

So I was spared. The three CTs took five minutes; the whole-body version would have been an hour long. That is a lot of exposure.

They were all completely normal.

Unless something is lurking in the folds of my stomach lining, or some other equally obscure place, I am still "good to go."

Something might have shown up in the full-body scan, but that can lead to new problems. These powerful diagnostic tools sometimes reveal mysterious abnormalities that may or may not indicate a serious condition; then doctors order another CT "just to make sure."

That can be the beginning of cancer where none existed! According to Consumer Reports, a 2013 Australian study had shown that people who undergo whole-body scans have a 24 percent higher chance of developing cancer.

I’m glad Dr. Lee was wrong, but I’m very concerned about the way she presented her diagnosis. Cancer is greatly influenced by one’s state of mind, and for several days after seeing Dr. Lee, I was already succumbing to it.

Be careful before you have that whole-body CT!

The power goes to the young...

...and the wisdom to the elders!

I went to the elegant senior center here in Sonoma, aptly named, for wine country, Vintage House, to check out the class in Gentle Yoga.

Vintage House does not feel like an institution. It is designed more like a hotel or conference setting. There's a Renaissance style fountain in the middle of the circular driveway, and as you enter the reception area there's a beautiful arched entry that marks the hallway to the classroom area. At the end of the hall, there's a grand all-purpose room called Stone Room, with a lofty vaulted ceiling, hardwood floor and windows all around, which is used for parties, lectures and various exercise classes.

The Gentle Yoga class is huge! There must be a hundred people there, most of them women. They were laying down their mats as I entered the room, chatting with friends, and generally settling in. I went up to the front, obviously designated as the teacher's area, to await Julia Vining, the instructor. For a few minutes I was just standing there looking silly.

Then I noticed a tall, buxom, smiling woman, obviously not a senior, across the room. That must be the one!

Yes, she said, introducing herself.

I asked if I could join the class, and she welcomed me to do so. "I have a few physical limitations," I said. She smiled broadly, "Everyone does," she said, "you just do what you feel comfortable doing." She was radiant with confidence and the power to be understanding, patient, generous.

She went to the closet to take out a mat for me. Here she was, instructing a roomful of grandmothers. She was strong, warm, and also professional. She was in charge, and I was the humble student, here to follow her instructions and advice. All the power of a woman in the full flowering of womanhood was hers, mine a mere dwindling sliver of the girl-I-used-to-be. And that is as it should be.

This reminded me of a couple of conversations I've had recently about relating to our adult children. This topic has loomed large for me lately because I am struggling with my own daughter over how to redefine our relationship to suit her terms and desires. And believe me, the power is hers.

I feel daunted by this challenge from her. I feel, perhaps unnecessarily, that my identity is at stake here. Indeed, both our identities are at stake. She is fighting to retain hers against what apparently is the towering challenge of dealing with her mother, about whom she has very mixed feelings. She wants to arrange our relationship entirely according to her preferences.

That leaves me feeling stripped of all my appurtenances and powers, reduced to a feeble shadow of my former self and grappling helplessly with how to be recognizable to myself while accommodating this young woman's directives -- because I want to have a relationship with her. It's important to me!

I am struck by the ease with which my friend Joanne describes how she responds to the directives of her daughter-in-law. Joanne came down with pneumonia while she was visiting her son's family over Christmas, but once she was provided with the necessary antibiotics, Rosie had plans for her. I can just see Rosie standing in front of graceful 73-year old Joanne, larger than life, declaring what's on the schedule. "Tomorrow night we're having a party and I need you to take the kids out while we prepare and then of course we'll have the Christmas parade through the neighborhood. I've got tickets for all of you for the children's theater on Thursday and..." da-da, da-dee, da doo. Looks like a scenario for a fight, and indeed, it could be.

But Joanne, with no loss of dignity whatsoever, just follows instructions. "I love being with the kids, and you know, my son, he adores his wife, and if I got into conflict with her, I wouldn't stand a chance."

I can see myself in her place, feeling diminished by the situation and tensing into resistance. Joanne is wiser. Her identity is not at stake here, not at all. She'd rather be home at this point, recovering more quietly from her pneumonia, but what the heck. She's here, and she's going to follow the program. Even with pneumonia, Joanne has a lot of energy. But her energy is partly due to lack of resistance. She loves her son and his family and she's happy to be of service.

Another friend, joining me for tea, speaks about her relationship with her son. Mary has been practicing Buddhism for 30 years. It has helped her learn to develop presence, she says, to be with what is happening without the clatter produced by the mind.

She too has learned to enjoy her relationship with her son even though it's much less than what she would wish. "We need them more than they need us," she said. "That's just the way it is."

Somehow our children do not feel obligated to come home for Thanksgiving or to make a regular phone call to check in on us. "The nuclear family," Mary says, waving her hands across her midriff, "has broken down." Is that what it is? Or were we too permissive? A woman in my women's group says, "I just don't understand it. Why are mothers blamed for everything? Why don't children ask themselves what it is to be a good child? We gave birth to them, sometimes in great pain, we raised them. What if it wasn't perfect?"

They owe us something, was the implication, reflecting the old fashioned attitude to the Great Parent-Child Divide. You do what is expected of you, regardless of what you'd like.

Adult children have the energy, the strength, the power that we no longer have. If they don't recognize their responsibility in the way we would like, wise elders accept what they receive with grace. We don't want to be a burden on our kids, and we hope not to become dependent on them in the end. The young are busy, building careers, raising families, both parents working; they are under a lot of pressure. It's a new ballgame, a dynamic where tradition no longer reigns. And it's challenging, not only for us but for society. A great many people are coming to age now, and who will care for them?

For us, shifting from being in charge, as we used to be, to being in gratitude, is a profound shift for aging parents. We do well to discover this wisdom in our new roles, in the surprising context of our longer lives, with grace.