Radiation Walkthru

Let’s do radiation!

If you’ve never had the pleasure of having a laser through your head, here is your big chance:

Okay, so the day starts by leaving physical therapy and heading to Northwestern Memorial via Lower Wacker Drive, which is absolutely the greatest street in Chicago. It can be a little scary at times, and I don’t know if I would drive it alone at night, but it is definitely the downtown expressway during the day.

The entire trip to the hospital is spent quantifying exactly how much you don’t want to go to radiation. Everyday. It seems like the dread would pass, but that is not the case. It is just so counterintuitive to purposely subject yourself to something so damn destructive. Everyday. So, no, you never get over it, and you futilely practice circular logic all the way to NMH everyday. I don’t want to go, but I need to, its so bad for my health, but it pays off later, they are going to hurt my head again, but it sure beats having cancer…

Next, you park at the parking garage ($9 a day for six weeks) and head into the hospital.

The ride to the Lower Concourse (Northwestern Memorial Dungeon) is in the absolute nicest elevators ever.

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This is where the the radiation/gamma knife center is. “Gamma Knife” is such a sweet word.

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The wait time is somewhere between 0 minutes and two hours for the radiation room to be available. There are no such thing as medical appointments, there are only “recommended show-up times”.

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The radiation techs, either Josh or Megan, comes out to the waiting room to let you know they are ready for you. Sad to say, but Phil Collins Lover Tech no longer works in radiation room “A”. That was a one day pleasure only.

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Would you enter a room with this sign? :

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Apparently, I lack the common sense to go the other way, because this sign tells me I am in the right place.

You lay down on this machine:

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And then they put the mask over your face and upper body. The mask is so tight that you can feel your heart beat over the whole upper half of yourself. thumpthump. thumpthump.

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You make some attempts at small talk while the techs line up the sighting lasers located directly above you and to your left and right. These lasers are like those little laser pointers. They make sure the machine is aligned properly on the reference points marked on the mask.

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The little red laser is the sighting laser directly overhead. The machine 45 degrees right in this photo.

The techs leave the room (who would want to be in here with all this radiation?) and shut the 6-inch steel door. Josh, per our SOP, presses play on the cd player before he walks out.

Its dark.

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The first notes of Metallica’s “One” play.

The machine starts its intial operation checks and makes some weird noises as it cycles, plotting your downfall with its mechanical clicks and beeps.

Waiting for it…

The buzzer sounds as the laser sends radiation into the space where the eye used to be. The laser pulses on and off, and the buzzer indicates when the radiation is being administered. The time between pulses varies from a half second to several seconds to a minute or so. Its predictable, however, in that it’s the same program every day. By this time, you know the sequence by heart, which is important since breathing has become an obsessive exercise in imaginary self preservation. Meaning, no doctor or technician or website has ever mentioned anything about holding your breath when the radiation is ripping through your head, but it just seems like the thing to do. Not breathing (or any movement) has become pavlovian when the buzzer sounds. If I don’t hold my breath I imagine that I will be blind or brain damaged because of my lack of discipline, which is ridiculous. Thank God the Marine Corps taught me how to “power breathe” in the swim tank. Power breathing is used to keep your lungs inflated to increase buoyancy in a water survival situation. Just imagine a normal in and out respiration in a fraction of the time, with the extra moments spent with full lungs. Back to the walkthrough…

Buzzz….powerbreathe….buzzz….powerbreathe….buzzzz…..powerbreathe…..buzzz….powerbreathe….buzzz….

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The machine directly overhead.

Oh, I forgot to mention the overwhelming taste from the radiation. Sometimes it is the taste of copper, sometimes it is the taste of burnt meat. Its also predictable, however, meaning the same pulses everyday produce the same tastes. By the way, Dr. Mittal claims this is impossible, and that he had one other patient complain of the same thing 15 years ago. He doesn’t believe me or that other person, however, and insists radiation is odorless/tasteless. I am sure he is quite mistaken. Its not a subtle imagined sensation brought on by the sensory depravation of the treatment room, its an overwhelming metallic or carbonic event that drowns out any other scent or taste, and disappears immediately when the buzzer dies. Anyways:

Long pause, the machine talks to you with clicks and whirring gears, instigating a futile curse at the mechanical beast for doing its job. At the same time, you have a moment to swallow, blink, and breathe normally; although you still feel your own heartbeat outside your skin while “One” continues to play.

Thumpthump…thumpthump…thumpthump

Break’s over!

Buzz…powerbreathe….buzzz….powerbreathe….buzzzz…..powerbreathe…..buzzz….powerbreathe….buzzz….powerbreathe….buzzzz…..powerbreathe…..buzzz….powerbreathe….buzzz….powerbreathe….buzzzz…..powerbreathe…..buzzz….powerbreathe

This repeats itself over and over through the first 4 stations of the radiation program. The laser starts at about 45 degrees to the right of center for the first series. After each series of pulses, the machine moves to the next station. The second station is directly overhead, then 15 degrees left, etc. “One” ends during the middle of the third station, and is followed by “Sanitarium”, also by Metallica. I listen to the same two songs everyday, since it has become part of my breathholding, nonblinking, nonsensical OCD radiation routine.

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Each station is the same except for the last two. For some reason, on the first pulse of the last two stations, there is a new sensation. It lasts only moments, but there is a blinding white/blue light that fills the entire field of vision no matter if the eyes are open or closed. Its pretty freaky and never loses its ability to unnerve. Its sickening to think about the fact that the radiation is coming from 90 degrees left, and that this must mean it is passing through the good eye. Dr. Mittal says this is also impossible, and that the same patient 15 years ago complained of the same thing. Awesome.

He was fine by the way.

The final station in the program finishes.

Buzz…powerbreathe….buzzz….powerbreathe….buzzzz…..powerbreathe…..buzzz….powerbreathe….buzzz….powerbreathe….buzzzz…..powerbreathe…..buzzz….powerbreathe….buzzz….powerbreathe….buzzzz…..powerbreathe…..buzzz….powerbreathe

The lights come on, and the techs come over and unscrew the mask, freeing you. The heartbeat is no longer heard and felt.

Its time to go. Time to go plug your nose with Vaseline because its bleeding and break out the special moisture cream that feels oh-so-refreshing on the face because its irritated once again. And today its worse than yesterday, which was worse than the day before and so on.

I swear I’m not complaining. There are other people in the waiting room everyday who have it worse. This is nothing that can’t be handled. Its just therapeutic to share the experience. I don’t know how else to explain why I don’t want to go everyday. That feeling never disappears. It’s the craziest thing to allow this every day. And I’m not losing my mind with all the compulsive habits during treatment. Understand, it’s the only way to participate in the radiation. To have a job to do. Other than holding my breath and not blinking or moving, the rest is being done to me. Those habits prevent focusing on the impulse to rip that plastic shroud off and leave radiation, never to return.

Yeah, I know, “its important for my continued fight to remain cancer free and healthy”, I know. I’ve heard it. I know “its been shown to significantly reduce the percentages and 3 and 5 year survivability increase significantly and words like unlikely and highly unlikely blahblahblah so on and such”.

None of that changes the fact that everyday I stick my head in the microwave and push the “popcorn” button five or six times until it quite literally makes me sick. That doesn’t seem very healthy.

Life goes on though, and that’s the whole point. My woman is still beautiful, motorcycles are still fast, and Jim Beam still makes everything okay (doesn’t it?).

Thanks for reading my way-too-long post.

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One More Week

One more week to go! That’s right, its a full week now. I thought that it was going to be just Monday and Tuesday, but that is not the case. Apparently, 6 weeks to Dr. Mittal means +/- a few days, in this case + 3 days. It would be such a big deal except for the fact that the side effects have defintely taken a turn for the worse over the last 10 days. My nose still bleeds constantly, but now all the way through both sides. The left side of my throat swells up, making it painful to stuff my face with Joy’s food. And the new fun thing is that my left ear has swollen shut, so I can’t hear much on my left side.

All of this should clear up over the next few months, starting Friday when I have my last radiation treatment. All of this just amounts to a pain in the a**, but nothing that can’t be handled. Its just stuff to be endured.

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13 down!

Another week of radiation in the books! Wednesday of this week will be halfway. Right now I have 13 treatments done, with 17 to go. However, I doctors and technicians have warned me that there is normally a drastic increase around the 2000 units of radiation mark, which I just hit the other day. Radiation accumulation is linear, but the body’s ability to deal with is not. Once My only goal is to not have to stop radiation. If damage from the side effects is too severe, I’ll have to take a break from radiation to recover, and then finish my treatment after the break. Between the sleeping, the nutrition, the herbal therapy, and maximum activity, I really can’t be doing any more to stay healthy, so hopefully it will be enough.
At this point, the biggest side effect is the fatigue. When I’m feeling good, I feel great (thanks Dr. Guo). I just tend to crash a few times a day for about 20 minutes to an hour. As soon as that is over, I feel great again. I also have constant nose bleeds, which is an acceptable side effect as well. This is a result of the radiation passing through my nose enroute to the target area and destroying some tissue on the way. The nosebleeds are a new special gift as of the a few days ago (Wednesday). I use a saline spray to try and treat the irritated tissue, and I put Vaseline up my nose before I go to sleep. The nose thing is just something to be managed until radiation is over, its not going to heal until radiation is over. The radiation prevents any affected tissue from healing. Other than those two, the only other thing I’m dealing with is the tissue damage on my face. A quarter of my face is basically irritated and dry all the time. No big deal. I have a special moisture cream to help it, but its not really going to heal until a month or so after this is over.
Maximum is dead, long live Accelerated! As you know, I dumped Maximum Rehabilitation a week ago. I started at Accelerated this past week, and the difference validated that decision entirely. After the MRI, and evaluation by Dr. Nuber (Da Orthopedics Doctor), we have determined that no surgery is necessary. Just lots physical therapy…
Here’s a good story: Dr. Fine was telling me a story about a patient he had when he was in medical school. He told me that the patient had a 1.25” diameter titanium rod fused to their femur to repair a traumatic break. Titanium is one of the strongest metals science can manufacture. It snapped in half. The reason is because titanium, while incredibly strong and resilient, begins to weaken the moment it is created. The human bone, on the other hand, becomes stronger over time, learns to work with the other parts of the body, and heals when it is damaged.

My (unintended) takeaway: The body is the strongest, toughest thing on the planet. It can be abused, it heals, it grows, it doesn’t give up. It’s the mind that’s weak. Something to think about when you feel a little pain…

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