When All Else Fails, Read the Instructions

The SCCA contacted me today with the schedule for my PET scan. It's next week. The appointment included directions to the website that contains the instructions for how to get through the scan. 

Yikes!

So here's the basic issue. A PET scan requires the introduction of a radioactive tracer. The default is 2-Deoxy-2-[18F]louro-D-Glucose, or 18 FDG. Unfortunately, diabetics and glucose don't generally get along, though there are ways to work around it.

Sort of.

The scan requires you to fast for 12 hours prior to the scan. Or course, the instructions tell me that the scan "will be early in the morning to reduce the amount of time you need to fast." It should thus come as no surprise that my scanning appointment is scheduled for 1;00 pm. 

Let's work through the details here, based on the constraints documented in the instructions...

Basically I need to stop eating at about 8:00 pm the day before my scan and then not eat the day of the scan until the scan is complete. Oh, and the scan takes an hour and the scanning appointment can take 3-plus hours to be finished. So let's call it an evening and a day without eating. 

But that's not all. As part of the twelve hour fast, they don't want me to take any insulin. Now normally I take my basal insulin in the morning and the evening, and the fast acting with every meal. But per these instructions, the night before the scan I can take my basal and, if I eat early, the dose that would go with dinner, then no food or insulin until the next day at, let's call it, 4:00 pm.

Oh yes, and my blood sugar that morning, and throughout the day of the scan, must stay between 80 and 150 -- without eating and without insulin.

Hmm... Let's see... How can I best characterize my response to these demands? Here, I've got it...

I'm not sure these guys really understand how diabetes works. By way of analogy, imagine being told to keep your house at 74 degrees without turning on the heat, starting a fire in the fireplace or opening a window or door. 

So step 1 is pretty obvious: 

Step 1 --  Reschedule the PET scan to take place first thing in the morning. At least then I'd have a chance. There's pretty much zero chance that I can go 20 hours without insulin or food of any kind and have my blood sugar values stay between 80 and 150 for the last ten of those hours, but I might be able to pull it off for a single overnight.* 

But regardless, it's going to be an interesting week...


* To be honest, in this case I am probably not above deviating slightly from the, uh, definitive truth. Insulin? Nope, never taken insulin in my life, much less in the last twelve hours. Why do you ask?