A funny thing happened on the way to chemo: Part 2
I start radiation
[Go to Part 1]
Being unable to sleep all night, I was glad Caren brought me some munchies but it wasn't enough. Maybe it was the steroids. By about 4 a.m., between my IVs, I grabbed the wheelchair in my room to go find the fabled vending machines on the first floor. No one told me or recommended that I use a wheelchair but I wasn't in shape to walk the halls of the Vaspa Hotel at 4 a.m. and so I maneuvered awkwardly down the halls, trying to avoid any serious collisions with staff and equipment.
The choices were pretty decent, including some small meals one could microwave, but I settled out on some miked popcorn and cold V8 (vegetable) juice, learning that driving this thing with food on your lap is yet another trick.
Breakfast later was surprisingly good: waffles, bacon, hot cereal, banana, coffee and my appetite was ready again.
Somewhere in there,I got the doctor visits and then the little gurney came to wheel me out to the ambulance and to the MRI center for my 9 a.m. appointment.
THE MRI EXPERIENCE
If you have never had an MRI,
it is an experience. Fortunately, I had one back in December so I knew what to expect.
It is the noise.
One is slid into this tube (not a great place for claustrophobics)and (understatement) told there will be some noise.
The first clicks aren't so bad. It is what follows, which sounds as if one has been put into a metal trash can that is then pounded incessantly by a half-dozen people with metal poles. If this were the sound of one's automobile engine, you would expect parts and oil to be flying and be exiting fast. But it isn't what one thinks. As it was later explained to me, it has to do with the reversing of the magnetic poles in the MRI, to create the 3D picture, which is far as I will take it.
NEXT STOP: RADIATION
When I was done, I was given a large red envelope with my films (the master is in their computer) and taken to the Barrett Cancer Center, about two blocks away.
It is very easy to understand why radiation therapy can scare a person. I went through it back in December, 2000, about 13 months after my diagnosis but further tests showed it wasn't going to be needed. I wrote about that experience. (Link below.)
I can't easily say what has changed in me so I could accept this entire procedure but the fear and apprehension was gone. I was now more interested in the process, than feeling like some helpless victim in a mysterious process that conjures up images of a horror-sci-fi movie. But, then, that's just me. And this is just my record of it, for anyone else who might face this and wonder how it is done. Hopefully, I won't garble it too much.
First, a couple of radiation specialists poured over my MRI results, to get the exact problem and work out their calculations. When that was done, I was shown my MRI film told
the results. There was some compression in the L3 vertebrae, in the lower back. The L3, rather than looking like an H, was sort of squeezed down and out to the lower right (of the photo) but it wasn't so bad that I could immediately see it. The radiologist had to point it out to me and compare it to the others. It reminded me that actual bones are pliable.
Their recommendation was to radiate that area with 10 treatments, to relieve the pressure and the tumor, starting today, and then they would reevaluate.
Let's do it, I said.
First they needed to take a couple of standard x-ray films (called simulation or portal films) of that general area. These are not for treatment or diagnostic but to establish and reestablish (maintain) my exact position on the table and in relation to the equipment, for each treatment.
From there, I was moved to the treatment room and a new table. On my back, I couldn't see each precise step but they were using some red (laser-like) lights
coming down from the equipment and (they said) the simulation film, for my position. Then they did some art work on my abdomen with some felt tipped pens, apparently following the red laser light lines. (They assured me that I could bath between sessions but it would be easier if I didn't use a loofa and the lines could always be retouched.)
After some last checks (including re-measuring the thickness of my abdomen), the apparatus swiveled directly over me, locked and it was time to say cheese. The left the room, the lights dimmed and my first whir of radiation therapy started.
Without being asked to do so, I slowed my breath and listened to the whir, keenly aware that particles waves were entering my body.
It exists around us as sunlight but we don't normally think about it until, perhaps, we hear of atomic weapons or remember as kids how many mutations the science fiction cinema gave us, not to mention watching skin peel in the documentaries of Hiroshima and Nagasaki.
Now I was lying there, hoping it would help.
The whir ended after about 45 seconds. The large metal arch moved to another position and the routine repeated before the lights came back on and the specialists returned.
BACK TO THE VASPA
A few minutes later, I was back at the Vaspa Hotel routine: the endless bags of steroid IVs, TV war news and wheelchairing for munchies in the middle of the night because the steroids were jangling my nerves. Is this what athletes go through when they take this stuff to get buff? When do they sleep?
After a great Saturday morning breakfast, another ride to the Barrett Cancer Center for radiation treatment #2 and then back to the VA. At least this time I knew the routine.
But now it was discharge time. After one last physician visit and examination, I called Caren to pick me up, changed clothes, got a stock of steroid pills and more pain killers and headed out.
No treatment tomorrow (Sunday) but then I have eight more, one per day. I don't know if it is the steroids, staying off my feet for two days or what, but -- other than the lack of sleep -- it definitely feels better.
Mark it up to Climbing Everest.
PS: I later learned more about my condition that I would like to pass on. The technical term is skeletal-related event or SRE. Initial pain from the spinal compression came not from the pressure of bone against nerves but from inflammation of the nerves. Steroids -- like anti-steroidal anti-inflammatories -- relieve the swelling, and thus the pain. Radiation to the area will do the same but any possible reduction of the tumor(s) by radiation won't become apparent until after full treatment. My current treatment consists of 150 grays of radiation from the front and then the back. This is not medical advice and could be in error. Consult your physician about your situation.
My essay on getting a walker (11/05/02)
Essay on Chemotherapy & The Clock (3/19/03)
Definition and illustration of MRI
Essay 12/16/00 on my first threat of radiation
Definition of simulation film
Definition of skeletal-related event