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.





                            Photos of the radiation process

Techs preparing me for radiation....fitting my mask in place



Christmas Eve update

It sure does not seem like Christmas Eve...sigh.  Both Lieska and I have noticed that the day has just arrived and we missed all the usual spirit, music, etc. I do not mean to suggest I am surprised what with all the running around we deal with each day now that I am in radiation.  But, I guess I just did realize how intensely immersed in all this we are.  Normal life stuff just is not in our radar.  Very little else is discussed, etc.  Beating cancer is indeed a full time 24 hour a day job.

Yesterday, I had my first chemo infusion to go with the radiation.  And it was a BIG dose for sure; about 20% more than what I was getting during the chemotherapy cycles. Fortunately, I only received one kind of chemo drug instead of the three received during the chemo cycles.  Unfortunately, it is the one that causes the most sever nausea...sigh They dripped loads of saline solution and anti nausea meds in me also. Now we are waiting with fingers crossed to see how hard it hits me.  I have my marching orders for a full regimen of daily anti nausea meds that will hopefully keep me away from the howling bowl until the the body is used to it in a few days.  I frankly do not know if the radiation stirs up the nausea now that the chemo is in me.  I haven't had any nausea during the radiation period up to this moment.

Finally I have a regular radiation treatment time at 7:30A each week day.  We haven't gotten used to going to bed earlier so that we can do the early wake up but that will come soon I am sure.  I have to get up about 2 hours early so I can start my sedation meds so I start the day in a blur and do not quite come out of that until late afternoon.  After radiation, we drive 15 minutes over to Doc Qs place for a quick health check up and a liter of hydration drip that takes about two hour.  And then back to the house a bit before 11A.  Makes for a long morning...for Lieska.  Remember, I am pretty much in La La land through it. 

Lieska wants to continue doing some work; she finds it helps to get away from all this.  I miss her but there really isn't anything she can do for me after the radiation and hydration and I agree it has to be a good thing for her to get way from thinking about this cancer all of the time. 

We didn't get a chance to do any Christmas shopping for each other so we decided love will do just fine like it did 18 years ago when we didn't have money for presents.  :)

Merry Christmas to all.  Thank you all for the many kind messages and wishes throughout this adventure.

Radiation continues

The two day break from the radiation was a good thing.  I am going to learn to look forward to these weekends; that is clear to me now. 

Today went as planned with radiation around noon at the hospital and then a two hour hydration drip at Doc Q's office.  Tomorrow will be the same. I snoozed through the hydration - remember I am taking that heavy duty sedative.  I take the sedative about 11A and then live in LaLa land until about 6 or 7 that evening. This is some weird existence.  But at least I am able to do what I need to do each day.

Some early side effects have shown up. The first sensations of a sunburn can be felt on my right neck and cheek.  More troublesome is the thickening of my saliva...did not expect this one for a week or two.  By the way, I am now full into my efforts to try and lessen the damage to my mouth, jaw, teeth and saliva glands. I try and rise my mouth each hour I am awake using a brew of water, salt and baking soda.  I occasionally also do a mouth rinse with a medicine that keeps yeast from growing on my tongue. 

My daily hydration is also an important part of making this journey a little easier the doctors say.  So, once a day up to 7 days a week, they pour a liter of water into my IV port located in my upper right chest. It is amazing that they can dump a liter of water directly into a vein going to my heart like this every day.  But, I don't argue because I feel better after every single one of these fill ups; no exceptions.

While I think I am feeling fine emotionally, I notice that holding a conversation for more than 2-3 minutes is almost impossible for me; in person or on the telephone.  I cannot find words to describe it but it worries me because I am concerned old friends are beginning why I sound so blah and so "not me".  Also my short term memory just continues to deteriorate.  I feel like a live in a little moving 24 to 36 window.  Seriously, if someone were to ask me to tell them about my last week, I absolutely could not do - period.  It frightens the hell out of me!  The doctors, nurses and social work tell me its normal and to get used to it.  Well, that isn't gong to happen...this feel so awful.  I think it also plays into this semi anti-social communication thing I am gong through.

The radiation folks have all been awesome dealing with me and my issues.  Each time a treatment is complete, I have this momentary "high" that comes from realizing that we; the techs and me...got through one more without me blowing up into a mind blowing anxiety attack.while inside the machine.  I thank God for each one of those moments of relief.

No crispy pieces

Whew! Three sessions down and I have yet to smell a crispy piece of me or feel a burning sensation inside my body.  The radiation team seems to be everything I could have asked for and more.  They all have been briefed by my terrible phobia issues and working there away around it with me. 

I do not delude myself, though.  I know these are the first...and last...good days of this extremely valuable part of killing of my cancer.  So, I am am absorbing the joy of not having any pain or nausea at this time which frees me to smile a bit and dig out of some depression that has been holding me back.  I am finally able to eat some real food so we are working to stuff as much of that down as we can before mid-next week.  Next week brings back the long day of chem infusion into my body to work with the radiation. So nausea is once again just around the corner.

Somewhere out there in the next week and a half or so will bring new side effects from radiation that I have no experience with.  All the nurses and doctors have gone to great lengths to describe what is coming and what I should do each and every moment of the coming many weeks.  Lieska has received a lot of discussion from them as well knowing that her role will be incredibly essential for me to have a chance at this.

It does feel like I am at arguably some sort of a half way point of all this touch treatment.  Supposedly, the tough half is about to unfold.  I think I will pretend I do not know that :)