Cancer chew toy, that's what I am these days. The cancer started in my colon in 2010, and categorized as Stage 4 as it had spread to my liver. By 2014 it had returned to my colon, and from there spread to my lung. Not satisfied with soft tissue, it began snacking my left tibia. However cancer looks at my body like an all-you-can-eat buffet, and in early 2016, it had spread in earnest: lower left jaw, thoracic and lumbar spine, right hip, right ankle. Unfortunately cancer has a constant dining companion called Pain, and my quality of life went from miserable to despair. Then it got worse.
Despite the drama implied above, the pain and symptoms did not happen overnight. Months prior to my most recent radiation treatment I had noticed a numbness in my chin. Additionally a loose tooth from that same time frame went on to become a 'highly mobile' tooth that required immediate extraction. The extracted tooth would be biopsied and show cancer in my jaw. The extent of the bone cancer showed clearly in a subsequent bone scan. My treatment, as it has been over the past year, is of a palliative nature: control my pain to give me some enjoyment of life. That treatment would take the form of a single large-dose of radiation, and that happened on Tuesday, February 18th, 2016.
Prior to my actual procedure was something called a CT mapping. A special CT scanner determines the extent of the cancer in the bone. Because it would target my lower left jaw, it was imperative that the beam be precisely 'on target'. The easiest way is to immobilize the target so it won't move. Translation: lock my head down. During the CT mapping a plastic mesh mask is created to precisely place my head into the same position for my return visit. Millimeters can make a difference. The mask will prevent me from overtly moving during treatment. It's a bit unnerving as the mask, while mesh, is so very tight. Furthermore, this mask will be bolted to the table during the treatment.
With the mapping over I waited for my appointment for the actual procedure. During this time my lower left jaw was getting worse. Ongoing numbness in my chin made me feel like I had a fat lip. Drinking liquids would sometimes result in dribbles down my chin. Headaches on my left side of my head grew progressively worse. I would find that even at night, laying on my left side, the pillow would put too much pressure on my face. Sleeping was uncomfortable and broken, even with the sleeping pills. By far the worst aspect was the emotional one, as every time I brushed my teeth I would look into my mouth and see the raw effects of cancer directly working on my body. Gums were enlarged, splitting away from the tooth at acute angles. My teeth were being forced out of alignment by the actions of the cancer. A careless slip of my toothbrush would result in a sink full of blood. My despair grew as I waited. A momentary pain, no matter what the source, would cause me to lose control and I would spend the next hour crying. Tylenol-3's were being taken as often as safely recommended, but they were proving inadequate. Finally I received an appointment for my treatment, and it was with a mixture of relief and fear that I brought with me that day.
There were no special requirements on the day of treatment, but I made sure I took a Lorezapam to relax me, and two more Tyelenol-3's to hopefully cope with the pain that would accompany me lying on my back. They almost worked. From previous experience with radiation on my leg, I figured I knew what was going to happen next, and I was mostly right. I would have two treatments this session, one for the jaw, the other for my lower back. The jaw was first, which meant my plastic mesh mask and I would be inseparable for the next few minutes.
Getting comfortable on a flat surface when you have a broken leg, arthritic joints (especially the knees), and soreness in the back is simply on of those things you have to grit your teeth and do. Only with the restraining mask on me, I couldn't even grit my teeth. My face and head were in exactly the same position they were in during the CT mapping process the week before. However this time the mask was secured to the table. As a small comfort, a foam support was put under my knees to help my legs and joints. Finally they were ready to begin.
First part of the treatment is actually an X-ray, to ensure that the area they're treating is indeed the area we want treated. If there are problems at this stage, my treatment would stop. Fortunately everything appeared good to the technicians and the radiation treatment proceeded. They actually position the doses from both the left and right side, in order to evenly distribute the beam across the affected areas. I had a fleeting vision of me with permanently sunburned cheeks. Fortunately this scenario did not occur. Whether due to the combination of meds or my thoughts wandering off into dark outcomes, the treatment seemed to crawl along. In reality it was only tens of minutes. Mask removed, I was allowed to recover somewhat. I needed to sit up, to stretch. My back during this time had become very uncomfortable. Yet I would need to return to that uncomfortable position once again, in order to treat that back pain.
I still need to remain in a fixed position during the treatment, but by now my backache was aggravating me more the longer I remained prone. Similar to the previous treatment for my jaw, I would have a single large dose of radiation administered from above and below. In some cases this might affect bowel or bladder, but my main concern was simply to not move and ignore the pain. Perhaps because the 'hard part' of treatment while wearing the mask was complete, the back procedure seemed to go quicker. In short time I was crutching my way out of the Cancer Clinic, to go home and rest. All I had to do now was wait for the radiation to do its job over the next few weeks. What that meant was I had to endure more pain.
By the time the first weekend rolled around after my radiation therapy, I was experiencing daily headaches that left me morose and miserable, unable to concentrate, and unwilling to do any activities. Evenings or time when I was alone seemed to magnify this effect. A quick spurt of pain would bring tears, and that would magnify the enormity of my despair: real crying jags would be the result. I had no hope within me, and just wanted relief from life. By Monday I had enough, and contacted the Cancer Centre, telling them I was having difficulty managing my pain. Within minutes I received call back: a prescription for Dilaudid to replace my Tylenol-3's was issued.
I would take a pill every 4 hours 'as needed'. By Wednesday I realized that they were not making much, if any, difference. Another call to the Cancer Centre. Another prescription. Basically a 12 hour long-acting version of what I received on Monday was sent to me. This time there was noticeable relief from my various pains. By Friday my headaches were under control. I had an appetite again (sort of). I was drinking a lot more water. And my medicine shelf was stocked with a variety of laxatives and stool softeners. Strong pain medication comes with a price.
Exactly one week after my radiation treatment, I had an appointment with my Dental Surgeon to follow-up with the tooth he had extracted. He was concerned over the size of the growth of the gum tissue. To alleviate a possible infection, I was given an antibiotic, along with an antibacterial mouthwash, and a numbing agent that he believed might bring some temporary relief if applied to my gum on the left side.
Over the next several weeks there would be some relief, due to the drugs and the radiation treatment. But I also experienced side effects: incredibly tired and weak, no appetite and I wanted to do nothing but sleep. Sometimes I would be sick, shaky arms and tears as I held onto the toilet wondering if my life couldn't get any more miserable. My days are filled with mindless entertainment on TV and the internet as I wander from couch to the bed. The nights when I am home alone are the worst.
Three weeks after my radiation treatment I was scheduled for another CT scan. I'm so tired of tests, despite how routine they are by now. But for now the weather is getting warmer, the days are brighter and Spring is on its way. We'll see what the next CT scan brings.
