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Radiation 101

1/31/2015

7 Comments

 
     As I've told you before, every weekday (except federal holidays; tumors observe the federal calendar) I undergo chemoradiation.  For the chemo, I take pills 2x/day called Xeloda.  They are converted in the body to a drug called 5-FU.  You're welcome to make any inappropriate jokes at this point.  Moving on, the enzyme needed to convert Xeloda into 5-FU is more prevalent in tumor cells (and other fast growing cells), so they get a higher dose than run of the mill cells.  How cool is that?  This, combined with the radiation acts as a 1 - 2 knock out punch.  Or at least has The LB reeling.
Picture
Meet the Varian Trilogy 2110 that treats me every week day.
At top is the head, which delivers the radiation.  Within the head are several "leaves" which give shape and direction to the beam of radiation, letting them deliver precise doses to precise locations.
The panel on the right side and the instrument on the left are together an X-ray machine that takes images 1x/week to make sure I've not changed too much (losing weight for example) and that I am indeed in the exact same relative position as the week before.

         The second part is the aforementioned radiation.  This amazingly complex machine looks relatively simple, but looks are deceiving.  Taking one of my famously annoying side tracks, I saw this machine it some artwork before I saw it in person.  Yes, there is cancer artwork.  In this particular artwork series, the patient is portrayed as almost a hapless victim of the big machine, which I found totally foreign.  I mean I guess I can kind of see it.  When you are a cancer patient, there is a lot that just happens to you, independent of any action on your part.  In a weird way, your brain is just a passenger on the journey that is primarily your body's, or more accurately, your tumor's.  As an adult, we're so used to making most of the decisions about ourselves on any given day.  Not now.  Consequently, the focus of any interaction can seem like it's on the cancer; not the entire patient per se, which can make the patient feel like a mere observer.  I said "seem" deliberately because that's not how I see it at all.

     First of all, the people here are very much interested in you as a person.  My conversations with my doctors are just that - conversations.  Same with the other staff.  I'm sure it's very deliberately part of the corporate culture.  As someone else pointed out, that very culture probably attracts that type of person too, so that the two are ideally suited to each other.  And secondly, I see each test, blood draw, biopsy, MRI, radiation treatment, etc. as part of MY attack on TLB.  Not things that are happening to me, rather tools I am employing to actively seek and destroy the tumor.  So, the Varian Trilogy 2110 may look intimidating to some, but I see it as my big, strong friend walking down this dark alley with me.  Yeah, I'm glad for my big, strong friend.

     OK, OK.  Back on track.  So, I report to MD Anderson, check in and head down to my usual Waiting Area F.  They like to put you on the same machine with the same crew every day, so the exact same thing happens each and every time.  I take off everything from the waist down and climb up on to the table.  Remember, I'm short, so my climbing is undoubtedly graceful.  Not.  The table is fitted with different attachments for different patients.  Mine is a belly board with a cutout for my belly.  Remember, having my guts falling down and forward is part of their protection, as is the full bladder.  Then they turn off the lights and 2 or 3 people use green laser guides in conjunction with the artwork they've drawn all over my hips and rump to position me down to the millimeter.  They tell you to "lay heavy."  That means don't try to help them as they're moving you around; they're making really fine adjustments and if you help them, you'll over correct and while you don't end up in a ditch, they have to kind of start over.  Once they have you in position, they turn the lights back on, exit the room and shut this lead door that's at least 8" thick.  Then the treatment begins.

    The entirety of treatment takes about 3 minutes.  One stop overhead, one stop on my right side and one stop on my left and I'm done.  Unless my bladder is overly full.  Then you can guarantee that there will be a student trainee in the control room and they're showing them things on the control panel.  You can tell they're teaching because:
  • It takes longer, and
  • the mouse pointer on any one of the 6 big monitoring screens starts to wander around and hover over different things while I lay there mentally exclaiming, "This is not a good time for teaching!  I have to pee!"
The other possibility when the bladder is overly full is that it's X-ray day.  This more than doubles the time I'm hanging out and just goes to prove that God has a sense of humor.  Not funny God, not funny.

     So, I told you I have a few minutes in time-out while the machine does it's thing.  In studying what I can see while simultaneously not moving at all, I've noticed several things over on my left.  I ALWAYS lay with my head looking left.  On that wall is the bank of various screens showing various things during my treatment.  Below that is a countertop with sundry goods, a wash sink and the like.  One day, I was looking at the counter top and noticed a bright red box (NOTICE: the following may not be suitable for all viewers, although by this time you should know that anything can show up on this blog!).  The counter is a bit far for great detail but I thought I could make out the word "Trojan."  I'm squinting and trying to focus better and sure enough, it's an economy size box of Trojan condoms.    
Picture
I hollered, "Don't look, Ethel!" But it was too late. She'd already been incensed. - Jim Stafford
     Of course, I HAD to ask as soon as the big door swung open and they came in to help me execute my dismount (I try to always stick my landing and then throw my hands straight up in the air, which unfortunately causes my towel to drop right to the floor).  While pretty sure the box was present for legit medical purposes, as I said, I had to ask and they enlightened.  I believe one time I said in this very blog, "Is there any cancer more unglamorous than rectal cancer?"  As it turns out, yes.  Yes there is.  I take it all back and apologize to any and all for that.  I will thank my lucky stars that my treatment does not involve a condom, then show uncharacteristic restraint and not tell you how they're used.
     Showing a more characteristic lack of restraint, I am going to share bit of fun I had with the techs last week while my good friend Debbie was here.  (Aside: Debbie, I'm sorry.  She told me this was NOT for public consumption.  She has good judgement.  I do not.)  Her daughter Meghan had bought some glow in the dark temporary tattoos for me.  I gleefully had Debbie apply one and hopped up on the table expecting much fun.  They unfortunately did not lift my shirt high enough.  I had to say, "Is my shirt in your way?  No?  I think it is.  Lift it."  They did and laughter ensued.  We even shut the lights back off so they could see it glow.  They reported that the teeth especially glow quite nicely.  Again I warn you, may not be suitable for all viewers.  But it's funny.
Picture
My glow-in-the-dark skull. Below you can see two of the many taped-over Sharpie drawings that adorn my backside.
     And now I leave you with THAT in your mind.  See you next time.  And at the risk of sounding repetitive, THANK YOU for your continued thoughts, prayers, well wishes, love and support.  It is an invaluable part of my fight!
7 Comments
Leroy Jackson
1/31/2015 10:38:55 am

We used to use condoms to cover the pickup wand on our radiation monitors when I used to teach emergency responders how to use the monitor.

Reply
Jo Beth Rood
1/31/2015 01:51:34 pm

Love your sense of humor and attitude. Thanks for sharing your journey. Prayers for you and yours!

Reply
Bill Miller
2/1/2015 12:07:59 am

Thanks for the update Barb. We're contuing to do our part but it doesn't involve nearly as much "color" as your reports! I love your humor! Stay strong.

Reply
DanS
2/1/2015 04:50:55 am

Definitely looks like an arse (that's British) worthy of saving! ;-)

Reply
Magdalana
2/1/2015 05:00:19 pm

Wow! Thank you for sharing more details, it helps all of us better understand the journey that you are going through. I sure hope that your big strong friend Trilogy is doing his job. I'm so glad that you are quickly coming to the end of this first series of treatments. Hang in there. I know that all the individuals that you interact with daily will miss your smiling face and positive attitude when you head home. We are continuing to keep you in our daily thoughts and prayers. We are so sorry that you are having to go through this. On a positive note, you might want to look into the Ripleys record for mooning people, by the end of your treatments you might be in the running to displace the previous winner.

Reply
Dick Skochdopole
2/11/2015 03:53:31 am

Your expose is great. When I had mine my Dr first put in three gold threads to outline my prostate cancer. They also put one target dot in front and two on the side of me. My radiation was a complete circle around me for the 45 radiations. I found out three months later that it was successful!!!! Here is to your having the same result. My radiation machine looked identical to yours. Oh yes, i laid on my back.

Reply
Sis
2/12/2015 04:36:31 am

I like to think of the Varian Trilogy 2110 as Puff your Magic Dragon who is going to annihilate the LB. The Salisbury clan is praying for you and following your blog religiously.

Reply



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    Barb Downey

    On Dec. 5, 2014, I was diagnosed with rectal cancer. And that's where we start. If you're here for the first time, you'll have to read from the bottom (no pun intended!) up. Go to Dec 2014 and scroll to the bottom of the page...

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Downey Ranch, Inc.
Joe Carpenter & Barb Downey
37929 Wabaunsee Rd.
Wamego, KS  66547

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