Irradiated

I had my first radiotherapy session on Friday. After all the preparation work to get me to this point, the actual event was a bit of a let down. I turned up, went through the usual regime of being asked for name, date of birth and address, and then was laid down on the bed of the linear accelerator. The nurses then went through the same game of “manipulating” me into the right position, before going into the control room to start the process.

The process itself lasted no more than 5 minutes or so, and apparently was a bit longer than normal because they “wanted to take some additional pictures”. It’s quite funny really – I don’t normally like having my photograph taken, and tend to avoid it if possible, so at the moment I suspect the hospital may have more images of my insides than most people have of my outsides. Anyway, the only noticeable sign of the system operating was a faint warning buzzer in the corridor outside, and a big flashing red sign on the wall. No sensation at all of anything actually happening.

The radiographers then ran me though all the side effects I might notice (itching & soreness of the skin, tiredness, lethargy, diarrhea, cystitis and more) before wishing me a good weekend and sending me on my way. So far the only thing I have noticed is that I am incredibly tired. When I got home on Friday afternoon I couldn’t keep my eyes open, and ended up having a couple of hours sleep. The same thing happened yesterday afternoon too. I suspect this isn’t actually anything to do with the radiotherapy, but rather just that after the last couple of months of running on adrenaline, and with the end in sight, it’s all finally started to catch up with me.

Wikipedia have what appears to be quite a good article on radiotherapy, including a picture of someone positioned in a linear accelerator. You can clearly see one of the registration marks on the lady’s hip, lined up with the machine’s laser (the green line running across her). Looking at her smile, I feel the pressing need to run a caption competition. Just what was being said to her as the photo was taken?!

And finally, as far as I can tell, I don’t glow in the dark yet.

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Resimulation

Today I had my radiotherapy resimulation appointment.

This involved introducing me to yet another piece of medical technology; in this case a linear accelerator. This is basically a super-sized microwave, that uses a wave-guide to focus the microwaves against a heavy-metal plate, which then produces x-rays. These are then collected and funnelled into a tight beam which is directed onto the treatment area (the tumour), which kills the cells at the point of focus, causing the tumour to shrink.

Today was the dummy run to make sure that when they’d lined me up in the machine (using the machines lasers, and my tattoos) that the machine would then rotate itself around me, so as to hit the correct areas inside me. And hopefully nothing else. To do this, rather than have the machine send out a powerful x-ray beam, they set the machine up to only take standard x-rays instead. That way, as the machine moves through its programmed sequence, the operators get a series of x-rays of the places that are going to be nuked, and can double-check them against the plan.

In my case, they’re aiming to irradiate an area about 13cm x 7cm; given that they will irradiate the tumour and a margin of healthy tissue around it, that gives me a very rough idea of the size of the tumour. Note to self: just out of interest, when I next see the surgeon I must ask to see the MRI scans they did, which will allow me to actually see the tumour in detail.

Of course, getting the beam to accurately hit just the tumour requires that I be positioned very accurately in the machine in the first place. From talking to the nurses while they were doing this, they try to get you lined up to the exact mm. And this involves a fair amount of manual positioning – ie, they push and pull you around on the table by tiny amounts until everything is lined up. And the end results were fine, so I’m now good to go, and will start the radiotherapy treatment on Friday the 13th, lasting 5 working days, before going into surgery on the 20th.

Meanwhile the antibiotics have kicked in with a vengeance, and given me a thoroughly upset stomach, which given the ulceration in my bowel, is not an ideal situation. But on the flip side of the coin I’ve noticed the lymph nodes in my throat have gone down, the sore throat has vanished, and I’m not coughing so much. So its a small price to pay to knock that infection on the head and ensure I get into surgery according to plan…