I was up early and ready to go this morning. The Proton Center is about 35 minutes from where I am staying, so I had to be out the door at 6:25 a.m. in order to make it on time.
Anyone that knows me, knows that punctuality - being on time - is very important to me. If I tell someone I'll be there at 7:00 a.m., I am there at 7:00 a.m. - not 7:05 a.m. or even 6:55 a.m. I like to be on time as a show of respect for the person I'm visiting. You can set your watch by it.
When Jessica was in high school, she played softball, and karate. When it came time to pick her up from practice, I would always ask her to tell me what time she would be ready to be picked up. That means all of gear is stowed in the bag, she has made all last minute plans with her friends, and the only thing left is to get in the car when I pull up. For karate practice, the time was 8:10 p.m.
One evening as I pulled into the parking lot, Jess and a couple friends were outside waiting. As I pulled closer, they all started to laugh, pointing at me. I rolled down the window and asked what was so funny. Jess said, "Amanda asked what time it was. I looked up and saw you pulling in, so I told her it was 8:10 p.m. She asked how I knew since I don't have a watch. I said, because my dad is here."
I arrived at the Proton Center at 7:00 a.m. There were three other patients already checked in. As it turns out, newbees get the early shift, so if you are there at 7:00 a.m. on a Monday, you are a first timer. The Proton Radiation therapy seems to always go for seven weeks. That means that every Friday, a group finishes their treatment, and every Monday, a new group begins. By week two, other time slots will open and we will have an opportunity to move up.
I threw my I.D. badge lanyard around my neck and entered the main door like it was the back-stage pass to a rock concert. A quick temperature check at the door, mandatory hand sanitizer wash, and I was off to the waiting area.
One by one, the others were called in, until I was the only one left.
"Joseph, come with me", and I was on my way to the treatment room. Our I.D. badges have an RF chip in them that lets everyone know where you are in the building. Yes, you are being tracked. I suppose it's a good idea since there is a particle accelerator somewhere in the building. You wouldn't want someone like me, that likes taking covers off of machines to see how they work, wandering around the building.
As I entered the treatment room, I saw my mask sitting on a chair next to the table. "Up on the table, please", said the young technician.
Note to self: Do not wear a turtleneck to treatment. No matter how cool and James Bond-esque you may look, they will make you take it off and strap you to the table in your tee shirt. (The tech said that by the end of seven weeks, people are wearing sweat pants with big holes in the knees - whatever is comfortable)
Getting positioned on the table was the hard part. They clamp down the mask, then take an x-ray to check alignment. Then they come in and move you the slightest amount, take another x-ray, and repeat the process until you are perfectly lined up with the imaging that is in the computer. I can only imagine that in a couple years, the computer will track and adjust the patient.
The techs were satisfied with the alignment, and left the room. The machine started with a couple of clanks, followed by a whirling sound, that resembled the sound of a weed wacker. With every flash of the blue light, I could see bits of flesh, scalp and hair being ejected through the openings in the mask. There was blood everywhere. My decision to where safety googles proved to be a wise choice. Over the sound of the machine, I could hear the techs in the control room laughing with delight! "How do I get a job like this?", I wondered.
OK, I made that all up.
Actually, the treatment maybe lasted 15 minutes, was completely painless, and relatively quiet.
I had asked Jennifer, my Nurse Navigator, if I could sit with someone that could talk me through my treatment plan. I am a "need to know" kinda guy, and not having a clear image in my mind of what is happening is making me a little crazy. Jennifer arranged that I speak with Sandy, the Medical Dosimetrist.
Sandy's job on the team is to make sure that every single area gets the correct dose of radiation by it's tissue type. She works very closely with the Radiation Oncologist (Dr. Akthar), and the Physicist, to create the best plan possible.
Sandy took the time to show me all of the imaging, and point out every tumor that I have. I'm not going to lie, there is a huge amount of tumor involvement going on in my head. Some are larger, about the size of a peanut, while others are wire-thin as they lace in and out of the different bones of my skull. I can see why they are so excited to take on this case. It will be a miricle - of God, and of modern medicine - if they can pull this off. The entire team is 100% confident that they can do it. You gotta love their enthusiasm.
The way it works is; every day, every tumor will be blasted with radioactive protons. The computer was painstakingly programed by the team, specifically for me. Some tumors will receive more, and some less, depending on their size and tissue type. The dosing will also increase over the next seven weeks until the very last day.
Sandy explained that cancer cells do not have the ability to repair themselves as other cells in our bodies do. This is why it is important that I receive treatment five days in a row, then have two days to heal. During those two days, my normal cells will have a chance to repair while the cancer cells die. I have been warned through this whole process that weeks three, four, and five will be exhausting. That seems to be the point when my body will be working as hard as it can to heal, and might be running low on energy. Fatigue is the only real side effect.
As for the machine, there is one Cyclotron in the building that services four treatment labs. Through a series of magnets, they are able to guide the protons to a specific lab, and to a specific part of the patient. Sounds pretty cool to me. I do need to learn more about this machine.
From this point on, there is going to be changes. No one can predict what these changes will be, since they have never had a patient with this much perineural involvement. My symptoms could get better, or they could get worse. we will just have to wait and see.
One treatment down, thirty four more to go.
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