Sunday, December 12, 2010

Radiation: A Primer December 12, 2010

Happy Holidays Everyone!

I've already had tech problems today.  Wrote a long blog to you all, was making some final adjustments and - boom - it was gone.  No actual sound, but all of a sudden it disappeared!  So frustrating, especially because the auto-save component of this blog immediately saved the empty page!  I can't recover the loss...ugh!

So, I'm going to do this again and maybe I'll get it better this time!  My plan is to do a walk through of a radiation treatment - with pictures.  Hopefully, you won't be too bored.  This routine is how my work-week days have gone for the since November 16 - for a total of 17 completed treatments.

I am scheduled for 8:30 a.m. every morning, which means my day starts before 7 a.m.  Many of you know how much of a morning person I am...not!  I decided to take an early 'slot' because I'd have the rest of my day free.  I'm glad it's this way - I can work, run errands, or nap if that's what seems right with the rest of the day.

When my trusty Camry gets me to the Radiation Oncology Center ((ROC)which is inside the Sutter Cancer Center), there is free valet parking.  A true convenience allowing me to race to my appointment at the last minute - a young person takes care of the car for me and I head into the Center.

The ROC is in the basement.  I used to fantasize that this location was because of the massive size of the equipment (oh, and to contain any errant radiation rays that wanted to fly around).  Turns out that the equipment is big - but not THAT big.  And, I'm certain that the walls, floors and ceilings are heavily lead lined to prevent errant rays flights - if there is any at all!

Must say that the folks running this Center have got the routines well organized.  I walk into the main lobby where non-patients and new patients wait, swipe my bar-coded card under a reader and watch to see my name come up on a computer.  When it does, I head to the private patient waiting room, choose a locker (#12 or #14, no odd numbers...bad), and change clothes.  For my treatment, I relinquish my street clothes (upper only) for one of the oh-so-lovely, open-down-the-back, thin hospital gowns.  You know them, I'm sure.

In the patient lobby area, there are usually four to six of us waiting for our names to be called for treatment.  Because we're scheduled for the same time periods every day, the group is usually the same folks - older adults, mostly men and one or two women.  I think that most of the women are there for breast cancer radiation and that most of us are treated in the same room, sequentially - thus, not so many women at a time in the waiting area.  Our little group has, over my time with them, begun to chat a little each day.  We talk about our non-cancer lives, about our treatments and work on being positive for each person.  It's a mini cheer squad!

There is a very old man who is accompanied by his step-son.  The older man has never said one word and his step-son is unable to speak.  He communicates with us via written messages and is quite outgoing.  He told me that his step-dad is a "pain in the ass!"  Hmm.  His step-dad has bandages on a small part of his face and I think that's where his radiation is directed.

Another member of our radiation cohort is getting chemo concurrently with radiation.  And, twice a week he gets two radiation treatments in one day!  Ugh and double ugh!  There are definitely roads that are much more difficult than mine.

When it's our turn to go to treatment - and usually less than a ten minute wait for me - our names are called over the intercom.  "Susan Strong please come back for your treatment."  Off I go.  Price of admission to the treatment room is my "name, rank and serial number" - my date of birth.  This is one of the safety mechanisms in place to prevent treating the wrong patient with the wrong radiation prescription.  You'd think that the techs would forget this as they get to know each person, but so far not one slip.  Every day, I get asked and they double check the computer to be sure I'm right.  Nice job.  I like a safety first approach.

The picture below is of the room and equipment.  Mr. Magoo is in the main item in the picture (to the right), along with the table and one of my techs, Michael. 



At the head of the table, near Mr. Magoo, is a molded form that was shaped to fit my head with my arms over my head.  When I get on the table, I put my head and arms into the mold and settle into its grooves.  The idea is to try to have me be in the same position every time I get a treatment.

Next in sequence is getting set up for treatment.  This involves aligning the three small tattoos on my chest, some green light strips and various felt pen marks that are applied daily into the exact position prescribed by my radiation oncologist.  The techs will adjust my body, millimeter-by-millimeter, until I'm exactly lined up in the mold and on the table.  I am not allowed to move at all once my arms and head are in the mold - I hold this position for fifteen minutes or more.  When my arms go numb and my shoulders begin to ache, it feels like I've been there for the entire day.  I know, whine, whine, whine. 

This is me, set up in the head/arm mold with Mr. Magoo ready to go for the first treatment segment.  You can see (maybe) a little gold glimmer on the right side of my chest.   This picture was taken on a "bolus" day - the gold metal fabric diffuses and scatters the radiation beam so it doesn't go as deep.  It's designed to be sure that my skin is treated adequately and this is done every other day.



While the set up is going on, the overhead lights are off.  When treatment starts, the overhead lights go on, a red light flashes and Mr. Magoo buzzes.  The treatment sequence goes something like this:

1.  Overhead lights on, techs leave the room.  Buzzing starts, red light flashes for about 6 seconds.
2.  Mr. Magoo stays put, but internal sounds (like a camera starting up) happen.  I've sneaked a peek at the face of Mr. Magoo as this has been happening and it looks like the lens is re-shaping it self to a new beam or treatment area.  Once this adjustment is finished, buzzing and red lights for 19 seconds.

BTW: I count each treatment period every time I'm on the table.  I use the old "one-one thousand" method, so it's probably not that accurate.  But each time I do it, the numbers come out pretty much the same.  Pretty obsessive, I know - a little known secret: I count lots of things and keep it to myself. Not sure why, but I  find the counting calming and reassuring when I'm being radiated.

3.  The overhead lights go off, a tech returns and Mr. Magoo moves over my body to the right side at an oblique angle.  The table is adjusted - the techs call it "kicked" - into position.  Overhead lights go on, the tech leaves and treatment begins.  Red light, buzzing - this time in a 6, 19 and 5 second array of three segments.

4. Overhead lights off, tech adjustments to the table and Mr. Magoo moves to hover directly over my chest and neck area.  I make sure I do not move a muscle - this treatment goes partly onto my neck and it seems a pretty good place to get the radiation location exactly right.  This is the longest direct treatment time - a total of about 30 seconds in two bursts; five and 25 seconds each.

That's it.  Except for the once a week x-rays that are taken for "quality assurance."  I get to take my arms out of the mold, sit up and most days return to the women's locker, change clothes again and am in my car before 9:00 a.m. 

Once a week, I see my radiation oncologist.  She primarily checks my skin to be sure that it isn't breaking down too much.  Actually, my skin has been pretty good - and I now know, on target for the changes that usually happen.  As of Wednesday last week, I have a "sunburn" type rash in various locations on the front and back of my chest.  I'm pretty sure it will get worse through the rest of the treatments - 8 left.  But, then I'll be done and the burn will heal.  In the meantime, aloe vera and hydrocortisone cream help.

All in all, I've adjusted to the routine pretty well.  And, I'm glad that it is a routine - there's very little day-to-day anxiety for me relative to what will happen during treatment.  "No surprises" is a good thing when we're talking about a big machine with super powers!  And, I will say that the ROC staff - from the front desk to the radiation techs, to the nurses and doctors - are all sensitive to the importance and enormity of the work that they are doing every day.  They smile, talk to their patients, answer questions, return phone calls promptly and generally stay on top of what's going on.  I appreciate every piece of the routine - and non-routine - things that they do.

I hope you are not being too crazy-stressed about the season and getting ready for the holidays.  My energy limits the amount of jumping in with both feet that I can do, so I'm feeling unready and calm about it at this point.  Some days, just getting into the car and dealing with the traffic is enough to wear me out...oh yeah, you all know about that too!  With our little rural town as our background for traffic, I'm not sure how you deal every day with the masses of people and metal on the roadways!  Incredible!

In doing the driving between Joy's house and Sacramento or Roseville, Jim and I have discovered what a flyway this area is for migrating birds.  We have spotted several new species - the most amazing of which (so far) is the American Swan.  These are huge, white birds with black beaks who migrate here from the Canadian tundra during the winter.  Their wings spans are in excess of five feet!  And, they are right by the road in big muddy ponds or puddles and in flooded rice paddies as we head to town.  Couldn't resist taking a picture or two, though I hope to get closer next time.



Have a wonderful week.  K.C. - keep getting better!  Love to all!

6 comments:

  1. Thanks for the pictures. Sounds as though you are doing & feeling a little better & grateful to hear that you are. Hope that you keep getting better & enjoy the holidays together.
    Joe & Marie

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  2. To our Dear Sue, (and Jim of course because it is all about him ☺) We love the photo of the Yankie Swan, but really!!!! we can barely see it. Would you like us to come and photograph them for you - REMEMBER the fantastic pelican shots that I took. National Geographic is still hounding me for these photo negatives. So let us know and we will pop over and give you some big pointers in how to take bird photos and of course it will be accompanied by a big bottle of red. We love you both dearly ( Jim not quite as much) but don't worry we still do love you. Annemarie and Paddy xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

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  3. To our Dear Sue, (and Jim of course because it is all about him ☺) We love the photo of the Yankie Swan, but really!!!! we can barely see it. Would you like us to come and photograph them for you - REMEMBER the fantastic pelican shots that I took. National Geographic is still hounding me for these photo negatives. So let us know and we will pop over and give you some big pointers in how to take bird photos and of course it will be accompanied by a big bottle of red. We love you both dearly ( Jim not quite as much) but don't worry we still do love you. Annemarie and Paddy xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

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  4. Annemarie and Paddy - Oh sure, your Pelicans were taken as you shoved the Pelicans into the sea and were standing right under them. Mine were taken from a distance with a newer and better (American) camera, of course! xoxoxoxoxoxoxo S

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  5. Actually, it's a little point and shoot, just like yours! xoxoxo

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  6. and was it bigger as well - as everything is in America - bigger and better - Jim told us it is so. xx

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