For one week in June my blog will be known as the 'Radiation Chronicles' to reflect the treatment I would be receiving. Treatment prescribed for the likely metastasis in my left shin. Because of the chronic pain, I couldn't sleep, I couldn't walk, and I couldn't concentrate. My personal and work life were suffering. Pain was now defining my life. Radiation offered hope to relieve that pain.
I had my initial consult with my Radiation Oncologist on Thursday June 11th. The day after I would undergo a CT simulation which would identify the extent of the radiation treatment. After finishing the approximately one hour mapping process, I was handed a green appointment card. My first treatment would start on Monday.
Sunday night and I'm not sleeping. My left leg is throbbing, the only position that brings any sort of relief is when I'm lying prone on my stomach, left leg stretched straight. I don't care that it's in my bones, I just want to sleep.
I arrive at the Cancer Centre well before my appointment time, going directly to the Radiation Registration desk just as they told me to last Friday. I present my green appointment card. The receptionist smiles and comments that I'm a "treatment newby". As I've never received radiation treatment before, the receptionist guides me to the waiting area for Radiation Therapy. I've never been in this part of the Cancer Centre. It seems empty, quieter than where I received chemo. Another patient arrives. He is older, and we exchange muted greetings. I wasn't up to conversation, but my companion was undeterred. However his one-sided conversation was marked by the anger he had towards his disease and how it changed his life. I could only wonder if I would feel similarly in the future.
My co-patient was soon called in for his treatment. Minutes later, a smiling young tech calls my name and leads me to the treatment room. A second tech joins us, and as this was my first treatment they took great care in making me feel comfortable. Patiently they explained that the procedure would be painless and wouldn't take long. My only job would be to simply lie still during the course of treatment. I could do that I thought. First first step was removing my shoes and the sock on my left foot. I had the forethought to wear shorts, so I didn't have remove my pants. No one needs to see that. Next I had to lie down on the table, and my feet were placed into plastic rests that slightly raised my heels off of the table. I was given a pillow for my head, and somewhat tentatively I asked for a second. I like my head propped up a bit, and the techs obliged my simple request. I was surprised by their next request: would I be more comfortable if they strapped me onto the table? It turns out that part of the process involves the table lifting to a height of approximately five feet!
The finicky part of the process was the alignment of my leg. The dots tattooed on my leg last Friday were used for this part. Satisfied that the stars, or at least my leg, was in alignment, the techs left the room to begin the process. Now the table I'm on is raised. I watch as the Varian radiation therapy machine slowly rotates around my leg. This machine is a large and imposing device, moving with a precision I find reassuring. I understand now why the table is raised: so the machine can deliver it's treatment from any angle. During my treatment there will be X-rays to ensure that the alignment is correct before the radiation is actually delivered. My only feeling during this time is the ache in my knees as I try to keep perfectly still. Perhaps because this is my first experience, the time seemed to pass slowly. Random thoughts: what if I have to sneeze, would they stop the procedure? I would later find out that if I was to sneeze then do so, just don't move, especially your arms. Fortunately during my treatment I never had to put that action to the test.
I realized the treatment was completed when the technicians return. My table was slowly lowered, and I have to be patient not to try to sit up too quickly. I had come through my first treatment without incident. With four more treatments remaining, I wondered how long it would be before I felt any improvement.
The rest of the day, perhaps feeling a confidence that I didn't really have, I walked, or rather, limped, a lot. The efforts I put forth attempting to walk "normally" would prove too much. That night exhaustion caught up with me, despite the pain in my shin. Tomorrow I would receive my second treatment, and interestingly, meet with the Radiation Oncologist for a follow up.
Thursday, July 30, 2015
Monday, July 6, 2015
Lung Biopsy
On June 18th, 2015 I had my first, and likely my last, lung biopsy. The reason for this procedure was to obtain samples of the mass in my lungs and lymph nodes. By having these samples analyzed, it can be determined exactly what type of cancer I have. This means a day surgery procedure, and, more importantly, the joy of experiencing another tube inserted into another orifice.
As a veteran of several day surgery procedures, I know the process well: show up early at the Hospital and register at the Admitting department. Take your paperwork up the Day Surgery floor, and wait for your name to be called . So that's what I did on June 18th, arriving about 40 minutes early for my 1PM appointment. I waited patiently until I was seen by the clerk, discovering only then that I was pre-registered. My paperwork was already waiting at the Day Surgery site on the fourth floor.
Upon arriving on the Day Surgery floor, I confirmed my appointment and was asked to take a seat, being informed that I would be seen shortly. Good thing I had done all that 'practice waiting' earlier today. Soon enough a nurse arrives to bring in me into the preparation room. It's cold and I'm expecting the usual process of having to disrobe entirely and change into a hospital gown. While I would eventually wear the "Johnny Shirt", I would be able to keep everything on but my shoes and shirt. I was thankful for this, as it was cold in the room. My problematic left leg hurt as I'm not comfortable laying on my back. The nurse is looking at my hand, seeking a suitable vein for the IV. I have good hands for that apparently, yet the first shot misses. Second attempt is higher in my arm, near the crook of my elbow. I prefer that anyways. This attempt succeeds. I will wear the usual souvenir bandages and tape when I leave. More waiting, then my nurse is replaced by the anesthesiologist.
The nice anesthesiologist patiently explains the process of what they need to do to me. This consists of numbing my tongue, throat, mouth and voice box. I will receive a 'twilight sedation' via the IV, and will likely be conscious during the procedure. What she didn't tell me is that the administration of the anesthesia is accomplished by dabbing the above-mentioned parts with an anesthesia-soaked swab on the end of a stick. The first part began easily enough, with an Ativan pill placed under my tongue. Once that was dissolved, the anesthesia application began in earnest.
My job is to open my mouth and stick out my tongue. Repeatedly. Initial applications are easy, the mouth and tongue are swabbed, and you are encouraged to swallow, as this will help numb your throat. Things get a bit more challenging the further down your throat, and that's where the gag reflex kicks in. You never actually choke, it's a natural reflex that most of us can't (or won't) override. I was able to test my gag reflex several times during this process. Each time I'd gag, my anesthetist told me what a great job I was doing, and waited for me to regain my composure. I would take another breath, open my mouth and stick out my tongue. We repeated this activity numerous times, and yes, it did get easier, mostly because she stopped doing it.
I don't recall if I felt particular numb, but the doctor and staff were satisfied I was ready. By now I've got numerous EKG monitoring wires stuck on my chest; those will be fun to remove. I was repeatedly asked if I was on blood thinners or aspirin. I was also asked if I had any allergies. Next I was given a bite guard, so I wouldn't chomp down on the scope tube that would be threaded down my throat. Finally my eyes were covered up, and the procedure began.
A sensation of something moving down my throat was my only indication that the tube was being inserted. This feeling only lasted for a few moments however. I wouldn't remember when it was removed, yet I believed I was conscious during most of the procedure. I would hear conversations, the occasional "he needs more...". I can't talk, but I can make hand gestures: thumbs up or down if needed. There wasn't anything requiring my input, and I tried to drift off. Rather, I hoped I'd drift off, I hadn't been sleeping well for a very long time, and was hoping I'd be right out. No such luck. My time sense of course wasn't very accurate, I can't tell how long the procedure lasted. It didn't seem very long. More importantly, I didn't feel a thing.
I'm aware that the procedure is done, and things have gone well. My bed and I are moved back to a recovery room. I feel fine. I'll be observed for about an hour, and then my gag reflex will be tested. They way they do this is have you sip some water. If you can drink without gagging, it's a good thing. Those initial sips were quickly followed by substantially more water; I hadn't had anything to eat or drink in over 12 hours now, and I was thirsty!
Upon discharge I was reminded that there might be some coughed-up blood and a raw feeling in my throat. Fortunately none of these symptoms presented, and over the next few hours I was able to eat and drink without concern. Now all I had to do was wait another 11 days for the results. Of course as I was getting dressed I discovered the leftover EKG sensors stuck on me like leeches. Pulling each sensor off also yanked a fair bit of body hair with it. The most painful process of this whole thing always seems to come down to tape and hair.
My biopsy results would be read to me on the 29th, eleven days from my procedure date. I didn't feel worried about the biopsy results, I know I have cancer. I just wanted to be comfortable. When I saw the Lung doc, it was rather anticlimactic. Our conversation lasted about five minutes, where he confirmed I had cancer and that it was derived from the instance in my colon. Upon leaving his office, the doctor told me he was glad to have met me, and for some reason, that made me feel sad. At home that night I dutifully informed my friends and family about the results. It seems that everyone wants to believe that there's a microscopic chance that the biopsy would show something else. I feel like I'm letting them all down when there's no good news.
It's getting difficult to keep emotions in check, to keep motivated, to want to live my life in my usual fashion. I know that this feeling will eventually fade and I'll adopt a new perspective. It's slowly dawning on me that I don't have to maintain an air of strength for myself or others. I just have to be strong enough to do what I want, when I want. Finding ways to be comfortable and happy are hard enough when you're healthy, so when you're sick, you should simply enjoy those peaceful and happy times as you can.
As a veteran of several day surgery procedures, I know the process well: show up early at the Hospital and register at the Admitting department. Take your paperwork up the Day Surgery floor, and wait for your name to be called . So that's what I did on June 18th, arriving about 40 minutes early for my 1PM appointment. I waited patiently until I was seen by the clerk, discovering only then that I was pre-registered. My paperwork was already waiting at the Day Surgery site on the fourth floor.
Upon arriving on the Day Surgery floor, I confirmed my appointment and was asked to take a seat, being informed that I would be seen shortly. Good thing I had done all that 'practice waiting' earlier today. Soon enough a nurse arrives to bring in me into the preparation room. It's cold and I'm expecting the usual process of having to disrobe entirely and change into a hospital gown. While I would eventually wear the "Johnny Shirt", I would be able to keep everything on but my shoes and shirt. I was thankful for this, as it was cold in the room. My problematic left leg hurt as I'm not comfortable laying on my back. The nurse is looking at my hand, seeking a suitable vein for the IV. I have good hands for that apparently, yet the first shot misses. Second attempt is higher in my arm, near the crook of my elbow. I prefer that anyways. This attempt succeeds. I will wear the usual souvenir bandages and tape when I leave. More waiting, then my nurse is replaced by the anesthesiologist.
The nice anesthesiologist patiently explains the process of what they need to do to me. This consists of numbing my tongue, throat, mouth and voice box. I will receive a 'twilight sedation' via the IV, and will likely be conscious during the procedure. What she didn't tell me is that the administration of the anesthesia is accomplished by dabbing the above-mentioned parts with an anesthesia-soaked swab on the end of a stick. The first part began easily enough, with an Ativan pill placed under my tongue. Once that was dissolved, the anesthesia application began in earnest.
My job is to open my mouth and stick out my tongue. Repeatedly. Initial applications are easy, the mouth and tongue are swabbed, and you are encouraged to swallow, as this will help numb your throat. Things get a bit more challenging the further down your throat, and that's where the gag reflex kicks in. You never actually choke, it's a natural reflex that most of us can't (or won't) override. I was able to test my gag reflex several times during this process. Each time I'd gag, my anesthetist told me what a great job I was doing, and waited for me to regain my composure. I would take another breath, open my mouth and stick out my tongue. We repeated this activity numerous times, and yes, it did get easier, mostly because she stopped doing it.
I don't recall if I felt particular numb, but the doctor and staff were satisfied I was ready. By now I've got numerous EKG monitoring wires stuck on my chest; those will be fun to remove. I was repeatedly asked if I was on blood thinners or aspirin. I was also asked if I had any allergies. Next I was given a bite guard, so I wouldn't chomp down on the scope tube that would be threaded down my throat. Finally my eyes were covered up, and the procedure began.
A sensation of something moving down my throat was my only indication that the tube was being inserted. This feeling only lasted for a few moments however. I wouldn't remember when it was removed, yet I believed I was conscious during most of the procedure. I would hear conversations, the occasional "he needs more...". I can't talk, but I can make hand gestures: thumbs up or down if needed. There wasn't anything requiring my input, and I tried to drift off. Rather, I hoped I'd drift off, I hadn't been sleeping well for a very long time, and was hoping I'd be right out. No such luck. My time sense of course wasn't very accurate, I can't tell how long the procedure lasted. It didn't seem very long. More importantly, I didn't feel a thing.
I'm aware that the procedure is done, and things have gone well. My bed and I are moved back to a recovery room. I feel fine. I'll be observed for about an hour, and then my gag reflex will be tested. They way they do this is have you sip some water. If you can drink without gagging, it's a good thing. Those initial sips were quickly followed by substantially more water; I hadn't had anything to eat or drink in over 12 hours now, and I was thirsty!
Upon discharge I was reminded that there might be some coughed-up blood and a raw feeling in my throat. Fortunately none of these symptoms presented, and over the next few hours I was able to eat and drink without concern. Now all I had to do was wait another 11 days for the results. Of course as I was getting dressed I discovered the leftover EKG sensors stuck on me like leeches. Pulling each sensor off also yanked a fair bit of body hair with it. The most painful process of this whole thing always seems to come down to tape and hair.
My biopsy results would be read to me on the 29th, eleven days from my procedure date. I didn't feel worried about the biopsy results, I know I have cancer. I just wanted to be comfortable. When I saw the Lung doc, it was rather anticlimactic. Our conversation lasted about five minutes, where he confirmed I had cancer and that it was derived from the instance in my colon. Upon leaving his office, the doctor told me he was glad to have met me, and for some reason, that made me feel sad. At home that night I dutifully informed my friends and family about the results. It seems that everyone wants to believe that there's a microscopic chance that the biopsy would show something else. I feel like I'm letting them all down when there's no good news.
It's getting difficult to keep emotions in check, to keep motivated, to want to live my life in my usual fashion. I know that this feeling will eventually fade and I'll adopt a new perspective. It's slowly dawning on me that I don't have to maintain an air of strength for myself or others. I just have to be strong enough to do what I want, when I want. Finding ways to be comfortable and happy are hard enough when you're healthy, so when you're sick, you should simply enjoy those peaceful and happy times as you can.
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