It’s MUGA Time! (Not to be confused with Miller Time.)

Yesterday I went for a multigated acquisition (MUGA) scan. A MUGA scan creates video images of the heart which show the size of the chambers, the pumping function of the heart, and any abnormalities in the walls of the ventricles and with the movement of blood between the chambers.  The reason I went for a MUGA scan is because one of the drugs I will be receiving during my first 3 cycles of chemotherapy is epirubicin. Epirubicin may cause damage to the heart during cancer treatment, so they check my heart beforehand to establish a baseline and then they will check it again after the 3 cycles to see if my heart function was affected.  Another cancer drug, Herceptin, can also cause heart problems. Herceptin is given to you as part of your drug therapy if you test positive for the protein human epidermal growth factor receptor 2 (HER2). I did not test positive for HER2, but my mother and one of my friends have, so they needed to go for regular MUGA scans to monitor their hearts.

I ended up being a few minutes late for my appointment. Even though they give you a map of where you need to go, when you arrive at the end of a corridor, you are not always sure what direction to turn. You look at the map, then at the signs on the wall, then recall in your head where they said to go, and discover things don’t match up.  It looks really straightforward on the map, but it’s not. When you are standing there trying to figure out where Clinic F or Nuclear Medicine is and not one sign says either, you try and study the map. And if you study the map long enough, when you look back up, you can no longer remember which hallway you actually came out of.  I did make more than one wrong turn and one of those was before I thought to go to information to get a map.

When I finally arrived at Clinic F I was taken into a room with a big chair, where you can be comfortable when they stab you with a needle. Pearl (I am making up names as I go) explained that she was going to give me an injection which is a primer. I would then go and hang around the waiting room for 30 minutes and then Dotty would come and get me, give me another injection of radioactive material, which will bind to the primer, allowing them to get pretty pictures of my heart.

At the same time Pearl is telling me this, Dotty walks in. Pearl points her out and says to me, (this is me paraphrasing Pearl) “We had a lady in getting a MUGA who was young, younger than you. The chemotherapy had put her into menopause and she is having a hot flash during the scan. After it was over, Dotty says to me, “That was funny.” I said, “Funny! Hot flashes are not funny! Hot flashes are anything but funny!” Let’s hope we come back here when she fifty and having hot flashes and then come back 20 years later and she is still having them!” (I like Pearl.) Dotty is grinning over in the corner and I am thinking, “Yeah, I wanna come back when she is fifty and then again in 20 years. It will mean I am still here. Hmmm not sure if I want to come and get MUGA scans, but I definitely want to be here.”

Pearl asked which arm she could give the injection in and I held up my right hand and said “This one.” She then asked what side I had surgery on and I told her the left. She said ok we can do it on the right. By this time, I knew that whatever IVs, injections, or poky things they wanted to stick in me had to be on the opposite side of surgery, but I didn’t know why, so I asked. (More paraphrasing of Pearl) “It does not matter as much now as it did in the old days. Before when you had breast cancer they took your entire breast and pretty much all of your lymph nodes. Ladies used to get this big arm because the lymph system had nowhere to drain, so you had to stay away from that side.” She gestured to her chest and held out her arm as she told me this. I could see a big puffy pink arm in my head.  (I like Pearl.)

Pearl told me she was going to inject me in the hand. Ick! I hate needles in the hand and that was why I asked for a portacath for the chemo instead of getting it by IV. Someone today told me they had a PICC for chemo, I just looked it up and shuddered. I will stick to the port. As Pearl was getting me ready for the injection she asked if I had any reconstructive surgery and I smiled and said, “No. I just had a lumpectomy. I just have a small dent.” She laughed, “Just like a car! A small dent.”  (I like Pearl.)

She stuck me with the needle, started injecting and said, “It puffed up.” Next thing I know she has another needle, “I am going to have to put this one in your arm. I hate to poke people twice, but it wouldn’t go in your hand.” (Its ok, I still like Pearl.)

Off to the waiting room. 30 minutes later, Dotty brings me to a room with a giant machine. I put my stuff on the chair and ask if the machine will kill my phone and she says no. She then asks me if I have any jewelry or breast prosthesis.  I say no, and then think hard about if I have any jewelry on. I know I don’t, but I have seen too many episodes of House with metal ink in tattoos pulling through skin and surgical pins heating up in the MRI. I don’t usually wear jewelry and I wasn’t anywhere near an MRI, but my brain made me double check anyway.

I got to wear my regular clothes for the scan. It is always good when you don’t have to undress and get gowned up. Dotty has me lie on the bed of the machine and gives me an injection in my arm. I have to raise my arm up and down a few times to get the material moving.  Dotty then placed 3 electrodes on my chest and asked if I would put my hands either in my pockets or underneath me so they stay close to my body when she slides the bed into the machine.  I choose to lie on them. She slides the bed in, and then brings the camera, which is big and flat like a computer monitor, in toward me at an angle. She tells me to lie perfectly still for the scan. This meant I could only look around with my eyes, because I couldn’t turn my head. It was really quiet in there. I assume she didn’t talk to me because I she did not want me talking and not being still. I stare at the ceiling and then the sleepies start to attack and I try to fight them off. It is useless, but no sooner did I fall asleep then the machine went “BEEEEEP!” and the first scan is done.

For the next scan, the camera is straight above me and only for five minutes. This time I choose to put my hands in my pockets because they are numb from lying on them. If you are going for a MUGA scan make sure you are wearing pants that have pockets you can put your hands in. For the last scan, the camera is positioned at your side and you put your arms over your head. This scan is five minutes as well.  After it is all over she tells me that it will take a week for my doctor to get the results. I put my jacket on and I ask if I can take a picture of the machine and she says sure.  (I like Dotty even though she wouldn’t talk to me).

Now I wait to hear when chemo is scheduled. Dr. Bob (not his real name either), my oncologist, told me that chemo would start 10 to 14 days after my MUGA scan, so that puts me between the 11^th and 15^th of December and my port insertion is on the 9^th.  I am sure I will have some other things to tell you in the meantime so stay tuned!