December 31, 2010

Radiation Treatment Process Details

These three photos show some of the radiation equipment used to nuke me each day now.  There are two technicians involved in the process. The procedure goes like this:

1.  I have to be there at the Radiation portion of the cancer center at the hospital at 7:15A each week day.  By this time, I have already sedated myself with meds.  I am not in a stupor but significantly relaxed...and about to lose a lot of my memory of the next 2 hours or so.  There is one patient before me.  One of the techs comes to get me as soon as that patient is done with his fun for the morning.
2. I enter the radiation room and go get my special teeth guards and tongue hold-down devices from a storage area and position them in my mouth.  No talking after this...more grunts and growls only.
3. I remove my shirt.  The other patents put on one of those stupid hospital smocks with their butt showing.  I have done all of those I am going to wear since all this started so I have told them to deal with it and let me go without a covering.  Besides, for me with my phobia issues, the cold room helps keep me from imploding during the treatment.
4. They assist me lay down on the movable horizontal portion of the radiation machine.  We have formed a special headrest that was formed to my head shape so that my head does not roll around.  It also slightly elevates my head...a good thing with the phobia issues. Once my head is in position, a pillow is placed under my knees to slightly elevate the legs at that point.
5.  Then the fun begins.  A special tight fitting mask was earlier formed to perfectly fit the outline of my head and upper chest.  The technicians get it now and fit it over me.  It takes a minute for me to move my head around so that it is in the right position so that the mask can be pressed down on me properly.  The mask fits right up against my skin; not with the small air space they suggested might be there when first discussing this nightmare months ago....
6.  Now that I am in the mask properly while it is held down on me by the tech, he or she then uses the numerous locking screw downs that firmly lock the mask to the horizontal surface I am laying on.  As you can see in the photos, I do have openings for my eyes. I can slightly flex the mask by moving my chin if I need to swallow...which at this point is becoming more and more difficult as my throat reacts to the radiation I have already received. The tech now observes if a number of narrow beam lights projecting from the ceiling are hitting special marks made on he mask....sometimes they tattoo the marks on the patient but I "negotiated" that out of my Disney package....
7. The techs leave the room and go to the control room.  The surface holding me is lifted a bit and then it moves me into the radiation machine....we refer to it as the TOMO machine. 
8. A CAT Scan is then made taking about 3 minutes.  Yes, a CAT Scan five days a week for 39 sessions.
9. I am then taken back out of the machine while the technicians use the CAT Scan to make absolutely certain that my head is in exactly the right position to match the radiation beam firing pattern programmed for me.  One tech comes out of the control room stands beside me and reads various readings off the TOMO and casually speaks to me (secretly praying I will not pick this moment to have a panic attack) while the other tech is working to make the final Go or No Go decision.  The time to do this varies each day but rarely tmore than 5 minutes or so elapse...thankfully.
10. Once they decide to go ahead, the tech tells me that decision and leaves the room.  I am then again moved back inside the machine and the radiation begins.  I should mention that there is always a lot of noise inside this room, lots of air conditioning, etc.  While I am inside the TOMO, I also have a lot of different noises going on from virtually all directions going around my body.  The radiation beams are fired from all sorts of angles to hit the many many spots targeted to kill the cancer.  The radiation takes just under 6 minutes while feeling like 15.  I now know to recognize that certain sound that signals me that the radiation is shutting down and the exist is about to occur.  I do keep my eyes closed most of the time in the TOMO but do occasionally open them...probably the craziness in me to see if doing so will make me blow up into a full on panic attack.  So far, no.
11. After I am out, one of the techs rather quickly unscrews my mask and lowers the movable surface to a point where I can ease off.  I then remove my mouth guard, wash all the pieces and put them away ready for the next day.

I have worked out an agreement with the radiation center that makes sure that everyone dealing with me knows about my extraordinarily acute phobia issues.  Also, after a couple of incidents where I was told stuff during treatment that I later had absolutely no memory of, everyone knows that nothing is said to me that is important unless it is written down and pinned to Johnny's shirt for his mommy to read - you get the idea.

We leave the radiation center at this point and go home where I pour a can of "food" into my stomach feed tube. 

Then back into the car and off to Doc Q's office where Nurse Mary weighs me in and then takes me to the infusion room to give me a liter of saline solution and a anti acid through my chest port.  That hydration goes immediately into my blood stream. 

During the weekends when Doc Q's office is closed, I report back to the hospital to receive the hydration.  I get the hydration 7 days a week.  While a lot of trouble, the specialist promise it will make the next many weeks of radiation go easier on me.  That's all I needed to hear to agree to do it each day.