In which we describe what it means to get radiation treatment for my condition, and an introduction to Carina.
The morning was quite eventful. The first order of business was to prepare for chemo.
A PICC line is required to deliver the chemo. This is a line, that goes into a major vessel similar to an IV. The length of the tube inserted is the real difference; it extends from the entry point on my inner-upper left arm, up under my shoulder, and back down to just above an inlet valve to my heart.
It was explained that this allows the most immediate spread of the chemo throughout my body — the chemo is injected into my heart chambers and is, on the next heartbeat, delivered out to the body. And they are not kidding when they say this is immediate delivery. Every day I will have to clean the PICC line (did I mention there are two inlets to the line, with extension, and lots of do-hickies attached) not in use every day. This entails injecting a syringe of saline through the line. The saline tastes kind of metallic, and I get that taste within one second of beginning the saline injection.
So what are we to do with this PICC line? That will come later. The next thing on the agenda today was my first radiation treatment. This treatment is a form of externally directed beam therapy. In English, a beam of radiation is directed on the tumor in order to kill it. My treatments are to take place over 25 days (every business day — weekends off :-).
Below is a link to a site with a short explanatory video about the machine and the various treatment methods. I believe the machine I am using is a variant of this; I was not allowed to get any picture of myself in the machine.
A normal radiation treatment takes longer to prep for than do. After laying down on the metal platform (there is a cushion for the head) in my lower body form, the room is cleared and a HUGE and THICK door is shut to protect everyone but me from possible radiation leaks. The machine makes one complete rotation, taking the equivalent of a 3D x-ray image used to fine tune positioning during treatment. Then the machine makes 2 complete rotations around my body, one clockwise and then one counter-clockwise. During this time the radiation is being generated and directed at the target tumor.
It takes about one minute to do the image scan, and one and a half minutes to do the treatment. Including time to verify my identity, remove and put my shoes back on, get onto and off of the table before and after the treatment, and a few pleasantries such as good morning and how are you doing are asked and answered, the entire treatment takes five minutes. Any longer is because of a delay between the image and treatment, as a doctor always reviews the imaging and targeting data before the treatment begins.
And now the final bit. Back at the RV, at 9 pm Cody showed up at the stoop to teach us about the care and feeding of chemo infusion pumps. My chemo regimen is a continuous slow feed of the poison in very small amounts. What we learn is I must self administer the treatment. As is typical, the treatment has been outsourced to a public company, and the cheapest method is to pay an RN to teach you how to do 90% of what needs to be done, give you the materials needed for the treatment (you, of course, are paying for the materials), and provide you with a few phone numbers if you have questions or problems. We now know much more about chemotherapy than we ever really wanted to know.
Administration of the treatments is pretty easy and common sense — just need to make sure one always follows the procedures step-by-step. They give you a convenient carry bag for the pump so you can get out-and-about since you are attached to the pump 24-7 for the 5 days of radiation treatment. Each Saturday, the pump lets you know when this weeks treatment is done, and I remove it. On Monday, I receive delivery of that week’s dose and hook it all back up to the PICC line.
Just so you know, I don’t like shots and needles — at all! This is a challenge for me.
The poison of choice for the next five weeks is 5FU. Julie was able to sit and chat with a customer about my situation and learned he was doing a similar regimen with a self-administered pump. As a suggestion of his, Julie and I are not going to curse and talk bad about the pump; it is, after all, working to heal me. So from the beginning, we are treating the pump system with respect and we named it “Carina” (we both love that movie (Carina Carina)). The folks at the radiation clinic got a kick out of this.
The last learning curve, a bit of annoyance, and welcome necessity is the shuttle from the Vancouver VA center to the Portland VA center. Depending upon the time of day, and therefore the traffic, the shuttle can take anywhere from 20 minutes to 55 minutes to travel one way. Gotta (NOT) love Portland traffic. But taking the shuttle means Julie or I not driving in the chaos, so we are both thankful for that.
The Shuttle Schedule
Well, that was a busy day and this post was way longer than I wanted to be.
Below are a couple more videos. I apologize for the poor quality of the videos, but they were done with phones and at the moment. You will need to turn the volume way up to hear anything.