Prostate Cancer Treatment Diary

 Jim Pickett

 

Monday – 10/25/04

Today was my first experience at the St. Francis Oncology Section.  After checking in I was called back to a room with a CAT scan machine.  I was placed on a table while I was rolled into a large metal and fiberglass donut.  You know it had to be large since I was able to fit into the donut hole.  This machine scanned all my innards in order to get an idea where my prostate was located.  Although they had a pretty good idea, it was necessary to pinpoint the location more closely since they planned to shoot radiation at me and they didn’t want to hit inappropriate parts.  I appreciated their concern for accuracy.

Once I was “mapped” they made 3 small marks on me, one centered from side to side and below my naval, the other two on each hip.  Then the nurse/technician place spots of India Ink on those three locations and taking a small needle (or pin – I couldn’t exactly see at the time), tattooed me.  I don’t come from a generation that was really into tattooing but I had very little choice.  I suspect that the only other option would have been to use a “Sharpie” marker on me and ask me to not bath or shower for a couple of months for fear of removing the marks.  Seeing the options, I suppose the tattooing was the better option.

After this, I was told that the doctors would look over the CAT scans and determine the exact procedure they planned to use and they would call me within the next week to tell me when I should start the treatment.  All of this took less than 30 minutes.

  

Week 1

Monday – 11/08/04

I had my first radiation treatment today.  Appointment time was 11:50 at St. Francis Hospital Oncology section.  I had been instructed to “empty my bladder” about an hour before my appointment and then drink 16 oz. of water.  They wanted to be sure that I had a full bladder during the radiation treatments.  I wondered if that was to help extinguish any fires set during the procedure but I did not ask anyone to verify that. 

I checked in with the bar coded card and within 5 minutes they called my name and asked me to come on back.  A radiation technician/nurse was waiting for me in the larger room and ushered me back to the room where radiation treatment takes place.  I was invited to stand beside the bed/gurney/table or whatever it is named.  The technician held a towel in front of me with the top about even with my waist and she instructed me to remove my pants down enough to expose the prostate area while keeping my more private parts covered with the towel.  Then I lay down on the table on top of another towel (which I later discovered was to allow them to move me about) while I was instructed to move down a bit, then wiggle up toward my head a bit.

By this time she was joined by another female nurse/technician to help with my procedure. She placed some sort of Velcro strap around my feet, supposedly to keep me from moving my legs during the procedure.  Then I was given a loop of something, a cloth-coated plastic or rubber thingie.  The loop was about 8-10 inches in diameter and I was to hold it across my chest with both hands to give me something to do with my arms.

Once I got situated near the right place on the table, she pushed and pulled me sideways and up and/or down until I was lined up correctly, using my “tattooed” marks.  They first performed an ultrasound to better locate my errant prostate and this operation took probably 4-5 minutes. 

It was now time for the actual radiation treatment to begin since they had located all of my “necessary parts.”  The first lady explained to me that I would feel nothing but hear several noises and see the machine (which now hovered over me) move around me.  They would shoot me from one side, then the top, then down to the bottom and end up on the other side.  It was sort of a north-east-south-west operation.   Each “shooting” of radiation lasted for only a few seconds and I truly felt nothing (except a bit of shame for lying there on a table with barely a small covering in the presence of two strange ladies).  I suppose one gets accustomed to this, although I’m certainly not there yet.

After the radiation treatments, they loaded film under my table and also in a mobile rack beside me and took several X-rays.  Also several Polaroid pictures were taken (sure hope those don’t end up on the Internet).

It was finally time to get back up and the larger nurse offered me her shoulder to help lift myself off the table.  After picking up pens and a screwdriver which had fallen from my shirt pocket and getting my dropped hat, I was told that “that’s all for today,” which came as a welcomed blessing.

The whole thing had taken less than 25 minutes and had been painless, except as noted above.  I later discovered that they had drawn a somewhat pear-shaped circle on me where they planned to shoot.

  

Tuesday – 11/09/04

I reported again for my 11:50 appointment by scanning my bar-coded card in the machine.  I barely had time to sit down in the waiting room and pick up a copy of today’s paper and, over the speaker system I heard, “Mr. Pickett.”  I headed back to the Radiation Section and this time I knew exactly where was the room where I was supposed to be. Again, the procedure with the Here’s the towel, drop your drawers and I did so as I had the day before.  I’m still not accustomed to such a procedure and I doubt that I’ll ever become too comfortable with it.

Same as before, they shifted me around on the table until I was lined up.  As they would get me in the right area they would say, “perfect,” then “not perfect” then “perfect” again.

Once lined up, the radiation treatments were performed from top, side, bottom, and other side, each taking only a few seconds and with no feeling.

I did ask one of the nurses if the drawing they made on me yesterday was a true outline of my prostate but she said not particularly but it just gave them an idea where to aim the treatment.  I guess they had not learned to draw a typical target of expanding circles.

More X-Rays were made and perhaps another Polaroid or two, I was not sure.  Once that was completed I got another shoulder to help lift me up and that was it for the day.  One technician told me from then on it would be even quicker since they would not need to take any more X-Rays.

Today’s activity took just about 18 minutes.  I was glad it was over.  Only about 40 plus more treatments to go and I’ll be finished……….. Cured?  Who knows but, for sure, finished?

  

Wednesday – 11/10/04

Well, another day down………. let’s see…… how many to go?  I don’t think I’m quite to the point of counting that yet.  Before I went today I had to go by and fill up the truck’s gasoline tank.  Each daily trip is right at 40 miles round trip so it looks like I’m going to be buying a lot more gasoline in the coming days.  Nice that this problem waited until gasoline prices had climbed to an all-time high.

I got to my appointment about 8 minutes early and checked in, hoping to perhaps get a head start on my treatment and get out of there a little earlier.  Ha, they didn’t call me until 11:59 which was 9 minutes LATER than when my appointment was suppose to start so I got to sit in the waiting room for quite some time and dwell on the fact that I really needed to go to the bathroom but they wanted me to have that full bladder.  Some things in life just ain’t fair.

When I went back to “the room” I did see one of the previous nurse/technicians but she never did come into the room, only the second one whose name, I heard, was Cynthia.  I’m not too interested in getting to know these ladies since I don’t plan to add them to my social list of friends.  She did ask me where I worked, probably because I always carry my ham radio talkie.  I told her I was retired and didn’t go into any more details about my life.  I was just happy that someone thought I might still be employable.

I did notice that there were several color monitors hanging from the ceiling at several locations and with all the information they showed (which I couldn’t read) I did notice that all screens had a small picture of me.  Yeah, like someone would really slip in and try to take my place in this wonderful activity. 

Same song, third verse – drop the drawers and load onto the table.  Get scooted around until I was lined up right and then comes the big machine which hovers over me and has the ability to rotate 360 degrees around me.  One thing I did notice which was different was this time they shot me first from the front or top, then rotated all the way around to the bottom of the table under me, then to the left side and over to the right side.  I started to ask why the variation from previous days but decided my life would not really be enhanced by knowing that information so I remained quiet.  Each shot lasted for 5 seconds since I was doing the “One thousand, two thousand, three thousand, etc.”

No X-Rays so by this time it was over.

I did ask Cynthia what happens if I am unable to make an appointment or to make one at the designated time.  She said that was generally not a problem and if I was to be late they could usually work me in at the different time.  If I happen to be feeling poorly or one of my family was not feeling well and I needed to miss a treatment, that is not a problem for just a day or so.  Also, if the roads were not easily travelable during part of the winter, just call and let them know.  I also asked about treatments which fell on Thanksgiving and Christmas.  She told me I would not be expected to come on those days and if I had gone out of town to visit for Thanksgiving that I could even miss the following Friday without a problem.  I’m glad to see that the treatment days are fairly flexible, although I don’t expect to have to miss any or many days.

I still haven’t had any feeling, one way or the other due to the treatments.  I am somewhat weak but I felt that way even before the treatment began so I just chalk that up to old age.

  

Thursday – 11/11/04

Today was pretty much uneventful.  The day was cold and windy as it started out in the low 50s and by the time I went in for my treatment it was in the mid 40s.  I was running a bit late and checked in right at 11:50, however I still had to wait for 6 or 7 minutes.  When they announced my name in the waiting room I went back but they asked my to sit on a bench in the inner room.  I noticed that there were red and green lights outside of each treatment room and when they had the radiation machine fired up and shooting at someone, the lights would be lighted sort of like an On the Air light outside of a radio broadcast studio.  I also noticed that, according to the lights, the man in the room I am usually in was getting 10 second blasts whereas mine are only 5 seconds.  I’m sure they didn’t have to shoot him longer because he was bigger than me because……….. well…… I’m just sure.  When his treatment was over and he came out I saw that he was about half my size and twice my age……….. well……… perhaps not quite that old but I’m sure he had 20 years on me.

When it was my turn they asked that I remove everything from my shirt and pants pockets since each day before, something had fallen from one of my pockets when I lay down on the table.  Then it was time for the breechcloth and a hop up on the table. Then it’s, “move up a bit, move up a little more, just a bit more, now back down a bit………” They’re just never happy. Each day, once I’m lying on the table one of the nurse/technicians pours some very cold liquid on my lower stomach and presses something down on me.  I suppose I should expect it and be ready each time but, so far, that hasn’t happened.  I assume that the “pressing down device” is an ultrasound unit to relocate my prostate.  Of course, the unfortunate thing about this is, they have instructed me to have a full bladder and when they start pushing down in that area………….. let’s just say that it’s not a pleasant experience and it actually borders on torture.  . 

The sequence today was like yesterday:  above, below, left side, right side.  It was over in a short time and I quickly made my escape.  I was out by 12:10 and got to hear most of Paul Harvey on the truck radio.

  

Friday – 11/12/04

Today I tried something a bit different.  The cancer radiation section of St. Francis Hospital has a valet parking service and I’m told it is the only area of the hospital with this feature.  I haven’t been using the service because I was always able to find a parking place and, truthfully, I considered it just too much trouble.  Today, when I got to the lot it was completely filled so I had to use the service.  I drove the truck right up to the door, gave them my keys and name and was given a card and away I went.  

Once inside the waiting area I saw it was exactly my appointment time, 11:30.  I was just about ready to scan my card when they called my name to come on back.  That was a surprise.

The drill remains the same, drop the drawers but hiding behind the breechcloth, hop up on the table and get pushed and scrunched around until I was, “perfect.”  One new variation followed, before squirting me with the cold goop she said, “cold stuff.”  They then did a bit more of pushing on my (full) bladder.  I commented that I thought it was strange that they wanted my bladder full and then they immediately press on it.  She acknowledged the irony of that series of activities but continued to press down.

The radiation blasts came quickly:  top, bottom, left side, right side and that’s it.  “See you on Monday.”  This was the shortest treatment of all and I was leaving the treatment room at 11:59.  The retrieval of my truck took another 5 or 6 minutes and I got back in the truck in time to hear the beginning of Paul Harvey’s noon broadcast.

I dropped by the What-a-Burger place and helped raise their cash input.  Then I drove over to Gloria’s school and helped her while she worked with her first graders in the computer lab.

One full week down and, so far, I’ve felt no physical pain from the radiation treatments and, as far as I can tell, I don’t glow in the dark…………………… yet.

  

Week 2

Monday – 11/15/04

It was nice to have off a couple of days over the weekend but it’s back to the old grind again.  I got out to the hospital a little early and checked in.  Actually they called me before my appointment time and took me immediately.  Where there were usually two female nurse/technicians, this time there was only one, Cynthia.  Empty the pockets and drop the drawers, then climb up on the table.  Whereas the moving and scotching around usually only took 15-30 seconds, this time it seemed to go well over a minute, perhaps because they usually had a “mover” and a “shaker” and this time there was only a “mover.”  During the middle of the moving, she said, “Just relax.”  I laughed nervously and said, “You’re kidding, aren’t you?”

Before I was attacked by the ‘cold stuff’ on my belly and before she pressed the device into my bladder I heard her say, “gel” or something like that.  Small warning, though it was, it was somewhat sufficient.

In addition to the four radiation shots, she took several more X-Rays; I assume this was to see if their work was being successful.  I didn’t ask, however, and she didn’t say why.  When they lower the table and roll it (and me) out from under the big ‘radiation and X-Ray shooter machine’ I know it’s time to end another day’s work and, hopefully, bring me closer to the day when I’m cancer-free and don’t have to make the long trip for 10 minute’s work.  I’m also looking forward to a day when I can come to the hospital to visit and keep my pants on.

  

Tuesday – 11/16/04

I thought I’d try the valet parking again since it looked a bit like rain.  It’s a nice feature… too bad you have to have cancer to use it.

When I tried to scan in my bar-coded card to let them know I was there, it wouldn’t work, no matter how many times I tried it.  An older lady volunteer came over since she thought she could do it much better.  She had no luck either so she took my card and made me a new one.  After only a week I’m wearing out my equipment……. not a good sign.

A nice lady sat down beside me and introduced herself as being with the American Cancer Society and wanted to know if she could talk to me.  I agreed but told her I would need to go back to the treatment rooms very soon.  She had several booklets and wanted to know if I would like copies.  I took several:  Fatigue………….., Caring at Home,  Nutrition, and (I can’t remember the other title).  I turned down the one on cancer and pain since I hadn’t had any need for that at this time.  She also had a sheet describing some of their services and one included volunteers who will drive me to my treatments if I get to where I don’t feel like doing it myself.  She described their services as being 24/7/365 if they could help or if I had any questions.

About that time my name was called to come back but for the first time, it was a male voice.  When I got back to the rooms, the older familiar nurse/technician was there as was a young man who I had not seen previously.

The old familiar routine, empty the pockets, drop the drawers, climb up on the table.  This guy was in charge of, among other things, squirting the cold stuff on me and pressing something down on my bladder.  Since he was new he was evidently unaware that the nice thing was to warn the person before squirting, freezing, and pressing.

I had not previously mentioned much about the table but it raises up about a foot or two once I’m on it and it also slides horizontally to get me under the radiation, X-Ray machine’s main head.  There is also a narrow beamed but very bright green light in the ceiling which places a thin green line of light across me from foot to head when the machine’s main head does not block it.  I assume that they use it to line up my naval area tattoo mark to get me centered.  They wouldn’t want to shoot me in the wrong place, I guess…… I hope.

Once I was pushed and scooched around I got the four 5-second blasts of radiation.  Then my feet were unbound, the table was lowered and dragged back out and I got an arm up to help me get up off the table.

All that for 20 seconds worth of radiation.  Oh, well…………

  

Wednesday – 11/17/04

Today, because I was running low on gasoline, I left the house early to tank up.  It actually took me less time than I expected so I ended up at the hospital nearly 20 minutes early.  I cleverly thought, by checking in early they should take me early and I can be finished sooner.  Yeah, sure.  I was called into the treatment area at 11:56, six minutes late.  I’ve learned my lesson, no early arrivals for me.

Today’s treatment was no different than previous ones.  I didn’t see or hear anything different from any others so there’s nothing to write about.  Oh Lord……… am I getting accustomed to this?

 

Thursday – 11/18/04

While I was waiting in the waiting room before going back to the treatment rooms, I saw several people bringing in trays of food for the luncheon.  They had previously mentioned that some of the current and past patients met each Thursday at noon for a luncheon and I was invited.   Although it was not yet noon I saw a number of people gathering, but the people I saw were older, and some were much older than me.  About that time they called my name over the speakers so I headed on back to the treatment rooms.

Today, as I prepared to drop the drawers while the older lady nurse/technician held the breechcloth in front of me she said, “How tall are you?”  I answered that I was six – three.  She said, “Seems like I’m always looking up at the patients.”  I didn’t tell her but that’s exactly where I wanted her to look while I was partially disrobing.

One thing new I did notice today in the treatment room was two additional green lights.  I had previously mentioned the one green light overhead which had the extremely bright but narrow light but these other two were on the side walls and both were aimed at each other across the table.  Both were emitting bright green, very narrow, light strips with one line exactly vertical and one exactly horizontal.  In addition, the convergence of the lights on the left shone exactly on the source of the light on the right and vise versa.  I realized that these were the ways they lined me up on the table.  The overhead green line went over my middle belly tattoo and the lights on the sides would line up their crossing at the two tattoos on my hips.

After the treatment was completed and I was re-adjusting my suspenders, I asked the technician what was the official term for the machine that rotated around me and shot me with radiation.  She said it was a linear accelerator made by Varian.  The term was familiar to me so now I know what to call it.

When I went back to the waiting room the luncheon was in full bloom with about a dozen other people already eating.  The lady who seemed to be in charge invited me once again to join them and said this was the weekly meeting of the cancer treatment support group.  I grabbed a paper plate and got some baked chicken, rice, and salad.  It was mighty tasty, too.

Before I could finish my plate the lady in charge started the meeting.  She said they often had guest speakers to come before them and talk about helpful topics concerning radiation therapy, chemotherapy, and living your life after cancer.  Today, however, they had no speaker and she wanted to go around and had people introduce themselves and tell about their treatment stories.  She started at the table where I was sitting and one lady said a few things about her past treatments.  Then the leader called on the other lady and she talked, non-stop for about 20 minutes and told her complete life story with cancer discovery, naming each doctor, hospital and medication she had.

When it was my time I simply gave them my name and said I was in my second week of radiation treatment for prostate cancer.  Someone asked me how I was doing and I answered, “I don’t know, nobody’s told me.”  They asked me if the radiation doctor had talked to me and I told them, only at my initial visit.  One younger lady at the meeting, who I later discovered worked in the radiation treatment department, told me that probably starting next week my doctor (radiation doctor) would meet with me one day each week and discuss the progress of my treatment.  In addition, I would have an opportunity to ask any questions of him.  It sounded like a mighty good idea but seems like they should have tipped me off a bit earlier to let me know what to expect.

One of the men in the group turned out to be the older man who precedes me in the treatment room, the one who gets 10 seconds shots instead of my 5 second ones.  He is a retired dermatology doctor from Bartlesville who drives about 100 miles round trip each day.  I discovered that he was about half way through his treatments.  He mentioned that if the weather got bad before his treatments were finished that he planned to temporarily move down here close to the hospital.  I started to recommend the Ronald McDonald House but thought better of it.

Several other folks told their stories, generally long discourses and much more that I needed to hear.  I don’t feel too much support with their long drawn-out histories when the Reader’s Digest version would have been much better and considerably more useful.  I may, however, try them again, particularly if I find that they’re having a guest speaker.  They do put out a pretty good spread for lunch.  I picked up the truck afterward and I was glad I had tried the valet parking again.  Oh, did I mention that the valet service is free?  They even have signs encouraging patients to use the service and a note that says, “No tipping.”

 

Friday – 11/19/04

Today’s treatment got started right on time.  Only the male technician was here today and once I was loaded on the table I got pushed around again as usual.  I have an idea that most of their patients are shorter since, by the time I am high enough on the table, with my head on a covered block of foam called a pillow, I am often told not to raise my head.  The one time I did, in order to gain a more comfortable position, the pillow fell to the floor.  Too much of it was, by that time, hanging off the top edge with only the press of my head to hold it down.

The ultrasound seemed to take longer and was done three different times.  When it was time for the actual treatments there was a long delay before the first shot.  It was at least 4 minutes that I just lay on the table, uncomfortably waiting for the treatment to begin.  I couldn’t really move since I was lined up with the green lights.  I was basically only able to see the ceiling and I have no idea why the long delay.  Once the treatment started there were still long delays between shots.  Typically, once it begins, with only four 5-seconds shots, it’s over in just around a minute.  This time I suspect just those four shots took about 3-4 minutes.  It was a very uncomfortable time for me.

After I was up I noticed one of the several machines/devices in the room and I noticed, on the screen, what looked liked ultrasounds I had seen in pictures.  I asked about the pictures and he told me it was the ultrasound he had made of me a bit earlier.  Three shadows on the screen were outlined in different colored lines.  He informed me that one was my bladder, one was my prostate, and the other was my rectum.  I was almost sorry I had asked but then, I guess that was the first time in my life that I had ever seen pictures of any of those items.  It’s not a picture I care to store in my memory banks.

Afterward I asked the technician if I was really supposed to get to talk to my doctor next week.  He seemed real confused that I hadn’t talked with him this week.  I told him that nobody had told me that was the plan and I have to hear it from others outside.

He admitted that since my appointment is at 11:50 then the doctor is usually at lunch during that time.  That bit of information didn’t make me feel like they cared too much what I did.  He said next week, on Monday, they’ll put me in a conference room with the doctor before they take me in for my treatment.

Next week will only be four days due to Thanksgiving coming on the next Thursday.  I won’t mind that at all.

   

 

Week 3

Monday – 11/22/04

Well things took an interesting turn.  The Oncology/Radiation folks called to say their machine was down and I should not come in.  I was to call tomorrow to see if it was back up.  I was not disappointed.

  

Tuesday – 11/23/04

I called the hospital this morning to see if I was to come in today.  The lady who answered the phone said the machine was still not working so I should, again, not come in.  She said to call again tomorrow morning.

All this makes me feel like I’m getting a “snow day.”  Most people probably know that around here when it snows so bad that cars and busses are unable to get the kids to school, they declare a snow day where teachers (and kids) don’t have to show up at school but they do have to make up the day or days.  I know I’ll have to make up these missed days but it’s rather nice to have the break from having to drive in to Tulsa.  This does, however, prolong the time I needed to talk with the radiation doctor.  I suppose some day I’ll get to have that visit.

  

Wednesday – 11/24/04

I finally was able to get back on my treatment schedule but not without some difficulty.  Today, Gloria came with me to the hospital since she had had a 7:00 am medical appointment and I got up to take her to that.  We kicked around after her appointment until it was time for mine and we go to the hospital about 20 minutes early, hoping to be able to talk to the radiation doctor.  We were able to talk with him and ask a few questions, which was helpful.  The only problem I had seen since my treatments began was a difficulty in urinating, each time taking much longer and never seeming to completely be able to empty my bladder.  I asked about some medication to “relieve” that problem and even mentioned the name of one I had heard about, FlowMax.  The doctor agreed and immediately wrote me a prescription for that.

Back to the waiting room, which became a real waiting room.  Since the linear accelerator had been inoperative for a couple of days, they seemed to be backed up with people awaiting their turn.  Actually the Oncology/Radiation Department has three linear accelerators so the room was fairly full.  By the time I would normally be taken, 11:50, there were at least 3 people in front of me for the machine on our side.  I learned that they schedule the appointments 20 minutes apart so they were really running behind.  On top of that, one man who went to the other machine went back when he was called, only to return in about 5 minutes to tell his wife that his machine was broken.  They left without receiving his treatment.

I finally got my call to come back at 12:20 which was only 30 minutes later than usual.

While I was waiting in the inner room for my turn, I watched the red and green lights outside the door, which indicated they were radiating a patient inside.  The man who is before me had originally had 4 shots which I determined to be 10 seconds each, twice the length of mine.  This time he actually received 6 shots, which I counted to be about 12 to 13 seconds each.  I was later told that the radiation doctor prescribes how many and how long each shot would be.  The green light indicates that everything is ready and the red light indicates that the beam is actually on and radiating a patient.

I did notice a bit more and saw the two technicians, when ready to do the actual radiation, come out of the room where the patient is lying, close the door which has a big sign which says, “Danger – High Radiation,” and they perform the activities of the treatments from outside the room.  They had a console which includes a large color monitor showing the patient lying on the table.  I assume that is to see if the patient moves before or during the radiation, or perhaps to see if the patient has jumped up and run when they left the room

Once I was on the table, and pushed and shoved to line me up, I got my regular 4 shots of 5 seconds each.  As the machine was rotated around me I could hear something inside the housing, which bumped and rattled around as it moved.  I heard the technicians tell another man who came in while I was being set up that they thought there was a loose screwdriver left inside the case of the machine, which was rattling around.  I assume that the extra guy was one of the repairmen for the hospital and the screwdriver, or whatever it was, was left inside while they had been repairing the machine the day before.

I finally go out of there at 12:35, which put that appointment length at just over an hour.  Judging from what had happened to my machine the days before and the second machine this day, I guess I was lucky to have gotten by with that.

  

Thursday – 11/25/04

There was no treatment today as it was Thanksgiving Day.  I might mention, however, that after starting the medication, FlowMax last night, and although the documentation said it usually takes a week before results are seen, I got wonderful “relief” from this medication………. worth all it cost me.  I guess you take for granted the normal ease in urination until it becomes so much more difficult.  I suppose I could make some comment about not appreciating the water until the well runs dry but I think I’ll pass on that…….. I said PASS on that.

  

Friday – 11/26/04

I was surprised to see an almost empty waiting room when I got there today.  I found out later that one of the other linear accelerators was still down.  The technician said they had been replacing printed circuit cards in that machine and only had one more card to go.  I don’t know what it means if that doesn’t fix it.  Since they have so many people depending on the radiation treatments from St. Francis Hospital I guess they would have to cough up several million dollars to buy a new one.  I see that they are charging me and my insurance company something like $300 a treatment (daily treatment), plus a couple of hundred more when they take X-Rays, so I suppose they can pay off a machine like that fairly quickly.

My treatment was fairly uneventful except for almost everything falling out of both my shirt and my pants pockets, including much of my change.  I discovered that the table I lie on moves, up and down, forward and backward but also it has motors to move it from side to side.  I always know how much change I have in my pockets so later that evening I checked to see if they had found all I had dropped.  I was surprised to find that, not only was it all there but I had an extra penny.  Boy, this disease is making me money…..

I only saw the man who gets treatment just before me and the one who is just after me so the Oncology/Radiation Department might have been shutting down early this day for the Thanksgiving weekend.

Although this was a very short week, with treatments only on Wednesday and Friday, I’m ending my third week with the end nowhere in sight.  I have just realized that I’ll be coming in for treatments all throughout December during the Christmas shopping rush with all the crowds and heavy traffic.  Oh well……..

 

 

Week 4

Monday – 11/29/04

Today, I just made it to the hospital in time for my appointment due to the rain and my truck’s desperate need for gasoline.  I had barely gotten seated after scanning my card when they called my name.  Only the male technician was there today and one of the first things he told me was the ultrasound machine was broken.  Since the pushing around on my (full) bladder area with the ultrasound unit was about the most uncomfortable part of my daily treatments, I told him I was certainly not disappointed.

I asked him if the other linear accelerator was fixed now and he said it was.  I questioned him if the machine breakdowns were a normal thing and he told me that the breakdowns seem to run in cycles.  When they first installed the machines they had lots of problems but then that slacked off.  He did tell me that they had increased the number of patients in treatment and that places more strain on the radiation machines.

While he was pushing me around to get me on the right spot on the table, I asked him if he was lining up the bright green lines on my tattoos and he said, “Yes.”  He told me that, before they had the ultrasound, that’s they way they always lined up their patients.  He said the ultrasound viewing only helped them to locate the bladder more carefully in order to help avoid hitting it.  I started to tell him that I thought they could do a pretty good job of finding my bladder with just their fist in place of the ultrasound device…… I thought better of it, however.

Since they had told me earlier that I would probably meet with my radiation doctor on Monday each week so I asked if that was still on.  The tech said, “He has probably already gone to lunch.”  He checked and, sure enough, the doctor was gone.  Perhaps some day I’ll get to visit with my doctor again like I’m supposed to do.

The treatment time took so little time that the valet parking girl had barely gotten back from parking my truck until it was time to go get it again.  She commented that it didn’t take long and I just said something about one of their machines was broken.

One other thing I’m noticing is that since I began taking the FlowMax medication my daily blood sugar reading is about 50 points higher than what it normally is.  I guess if I ever get to speak with my doctor again, I can check that out.

  

Tuesday – 11/30/04

I arrived about 6 minutes early and saw the guy who precedes me in the treatment schedule in the waiting room.  I asked him if they were running that far behind and he said, “No, I’m already finished.  They’re running ahead.”  He told me the ultrasound machine was still broken but they had the part available to fix it.  I’m wondering if the hospital has to hire more repair people than they do those in the health sciences.  Come to think about it, I guess they don’t have that many repair people since they can’t seem to get things fixed very quickly, even though the parts are available.

I barely had time to sit down when they called my name.  While they were getting me moved around, and since they were running a bit ahead, I told them I really would like to visit with my doctor.  I was assured that was no problem.  Still no ultrasound “pressings” today so the four shots went pretty quickly.  As I was leaving the treatment room they told me to wait in “Room 10” for the doctor.  I told them I’d be right back but I needed to visit the plumbing.  Since they require the full bladder to do the treatment, I always go looking for the restroom as quickly as I can when they finish.

Once back in Room 10, the doctor came in and he asked me if the FlowMax was working.  I assured him that I would be nominating it for the “Wonder drug of the year.”  I asked him, however, about whether the medication was causing my blood sugar to be elevated since from the day I started the FlowMax my blood sugar has been 50 to 60 points higher than normal.  He left the room and spent several minutes looking through the physician’s pharmacy book.  When he returned he said nothing in the book says anything about that drug causing a higher blood sugar so it must be caused by something else.  Actually, I think they just haven’t discovered that “feature” of the medication  That elevation began immediately when the drug treatment began and that’s just too big a coincidence.  I think I must be pioneering something they haven’t discovered yet.  Gosh, I hate to be a “trail blazer.”

  

Wednesday – 12/01/04

When I arrived today, the guy who receives treatment just before me was, again, seated in the waiting room.  I asked him if he was finished already and he said, “Oh no, they are running ‘way behind.”    I finally got my call about 15 minutes later than my regular appointment.  I just can’t get accustomed to the time schedule.

The ultrasound machine was back in operation and they were able to press hard against my full bladder.  I’ve decided it must be a game they play to see how hard they can press before I either rupture or lose the contents.  I plan to really surprise them someday and win the prize.

Only the one lady technician was there today and I asked her if they had left her by herself.  She said, “No, Chris is at lunch.  We just work right through lunch and take turns working and eating.”  OK, now I know his name is Chris.

Each day I seem to notice something new and different about my environment in the treatment room.  Yesterday, for the first time, I noticed that the door they close which isolates the technicians from me while the radiation is taking place was quite thick.  Today I brought my 6” stainless steel rule with me to measure the thickness.  I was surprised that it measured a full 8 inches thick.  That means I am being placed in a room that not only others cannot or will not stay in but also they separate themselves from me with an 8-inch thick door that has a large sign that says, “CAUTION   HIGH RADIATION  AREA.”  Remind me to check tonight after I go to bed with the lights off to see if I’m starting to glow.  I’m sure I’m either there or getting awfully close.

  

Thursday – 12/02/04

I’ve given up on figuring whether to be early or late since they may be behind schedule (often) or ahead of schedule (once).  This time they seemed to be running behind so when I saw the man who is always right before me, I figured I would quickly be next.  Not so, however.  I waited 7 or 8 minutes longer and when my name was called and I went back to the main larger room, the door to the treatment room (the 8 inch thick door) was still closed.  This really confused me but I sat down on the uncomfortable bench seat to wait my turn.  Some of us later called our sitting there, “being on deck.”  I could see that they were still irradiating someone since the red and green lights were on and had seemed to be on for an abnormal amount of time.  After they went off, less than a minute later they came on again.  I did my counting and was amazed that they remained on for 40 seconds, 8 times longer than my shots.  It came on and off several more times and each time the lights remained on from 40 to 32 seconds each.  After this series happened for 5 times by my count, the technicians opened the door, went in for a bit and came back out closing the door again.  This time the lights only flashed on for a second and back off.  They went in again for a bit, came back out closing the door and, again, the lights flashed on for only a second and then off.

Once the door was reopened, and while the patient was putting himself back together, the technician brought out a couple of metal or plastic frames which I guessed might be X-Ray pictures, hence the quick single shots.  The patient who came out was an older gentleman who I had not seen previously.  I guess they are getting more and more people needing radiation treatments and they are “shoe-spooning” them in between existing patients.

I did notice the technician doing something with me, which I had not seen before.  After pressing the ultrasound device into me (painfully) I could hear them talking to each other.  The only word I heard was “longitudinally” and after that discussion one came over and jogged the table on which I lay down several small steps, probably something on the order of a few millimeters.  I’m guessing that the ultrasound picture shows some of my parts in a little different location so they compensated so the beam would hit me just right.  Again, to reiterate, I’ve never felt any pain or temperature change or anything while the radiation beam is being shot at me.  Perhaps the prostate is one of the internal parts that has no nerve endings and can register no pain or sensation of any kind.  Or perhaps the radiation beam causes no feeling by design.

Today, being Thursday, was the weekly support meeting/luncheon that starts just about the time I’m going back for treatment.  Today I had another appointment to meet a friend for lunch so I did not stay for any of it.  The meeting was going on with a person speaking when I passed back through the waiting room heading for my truck.

  

Friday – 12/03/04

Previously, each person scheduled for radiation treatment had appointment times separated by 20 minutes.  The fellow before me was scheduled for 11:30; I was scheduled for 11:50, etc.  Today, they were running behind again and a new gentleman was in the waiting room.  I recognized him as the one who had received treatment just before me yesterday.  He said today was his second day and his appointment was for 11:40 and since it was 15 minutes past then he was concerned that they didn’t know he was in the waiting room.  The two others of us in the waiting room chuckled at that and told him not to worry, they knew he was there, and it was not uncommon for them to be running behind.  I tell this only to say that they have evidently inserted new patients between the current appointments.  Today I was 15 minutes late being called.  There’s no telling what it might be after two or three more weeks pass.

The technicians have now wrapped the 8-inch thick door so that it looks like a gigantic Christmas present but they had carefully removed the big yellow sign with the symbolic circle of 3 segments, which represents ‘radiation’ and says in large letters, “CAUTION  HIGH  RADIATION  AREA.”    It was placed to the side of the doorframe so we could be reminded to what we were being exposed.

It seems to take longer and longer to get me in just the correct position on the table.   I’m not sure why this is but perhaps they don’t pay the technicians very well and the main reward they receive is getting to push, shove, and slide their patients around prior to the beginning of each radiation treatment.  I’m beginning to feel a bit like ‘human silly putty.’

After my treatment was over I asked Chris, one of the technicians how many treatments I was scheduled to have.  The answer was, “43.”

Hmmmmmm…. 43…….  I had just finished number 17 so I’m not even halfway through my treatments and won’t be until the end of next week (assuming no more failures of equipment……. theirs, that is, not mine).  Perhaps I’ll feel a little more enthusiastic after I have passed the halfway point. At this time it still seem like it’s a long way off.

 

 

Week 5

Monday – 12/06/04

Today was pretty much uneventful.  The radiation folks seem to run about 10-15 minutes behind each day now.

After my treatment I asked the technician if the tumor actually showed on the ultrasound.  He said only the outline of the prostate showed with no showing of the actual tumor.  No way to see if things are working or not.

  

Tuesday – 12/07/04

Today started a bit earlier.  This was the day I went in to my urologist’s office to get my second quarterly shot of Lupron.  The first one had been many weeks before my actual radiation treatment began.  Lupron is a drug that suppresses testosterone, which has been part of the cause of the prostate cancer in the first place.  Suppressing testosterone causes the tumor to back off and not grow anymore than it already has grown.  This should bring down my PSA level, which is what originally tipped off the doctor that something might be amiss in my innards. 

After I received the shot it was time to be stuck again.  This time they drew a vial of blood which was to test my current PSA level.  The nurse told me the results should be available in about two days.

Getting back to the Lupron., this drug is also affectionately known as “chemical castration” which makes even the strongest man wince in fear and I was certainly no exception.  I have been assured that once the quarterly shots are no longer necessary (from one to two years) that the dastardly physical effects will subside.  I can’t wait!  The doctor assured me originally that one nice side effect of Lupron. was that my hair would no longer fall out.  I took off my cap to him and said, “Too late.”  The Lupron. shot costs more than a thousand dollars each so I’m forever happy that I have insurance.

After I left this doctor’s office, although he was less than a mile from, where I receive my radiation treatments, I had more than an hour to kill.   Were it not in the midst of the Christmas season with crowds and heavy traffic I would have considered doing some quick Christmas shopping, however, the possibility of getting stranded and unable to make my treatment session (and prolonging the arrival of my final session) caused me to forgo that joy.  I instead went to the shopping center just cattie-cornered from the hospital and sat in my truck.  It gave me time to watch people, the traffic, and sit and consider my own mortality.

The session was, again, late taking me by about 10 minutes and this time I was ushered into a different treatment room on the other side of the larger Radiation Treatment facility.  I asked the technician if the other machine was broken again but she said it was fine but they were behind and trying to catch up a bit.  I assume that means that all the radiation techs were working through their lunchtime.

The new room was laid out differently but had exactly the same size and model linear accelerator and there were the familiar green lights on each side of the table and on the ceiling.  The room also had the same type and size 8-inch thick door.  As I passed by it I rapped on it with my knuckles to see if it was, perchance, partially hollow.  No way, but it was as solid as could be.

They did not do the ultrasound this time but didn’t give me any indication why or why not.  The tech did tell me, as I lay on the table, that this machine was quieter than the other but was accomplishing the same thing.  It did have a much-suppressed buzz while the shots were being made and they were the same length as I received on the other machine. 

Finally it was over again for another day.  Tora, tora, tora.

  

Wednesday – 12/08/04

Today, during the waiting time before I was called back for treatment, I talked a bit with the volunteer who is often in the waiting room to help.   Most, if not all, of the volunteers have already had cancer and have gone through the same thing we are now experiencing.  I mentioned to him about the 8-inch thick doors.  He said he had heard them say those doors weighed either 2000 or 4000 pounds each.  Whatever, the actual amount it is obviously too much to handle by a normal person and they are power-assisted for both opening and closing.  One lady tech had told me that the old doors were solid lead, which led me to believe these new ones were not.  The volunteer told me that he understood they were made of steel but lined with lead.  He did know that when they were installed, they had not been wheeled in through the front door but instead had been lowered through the roof with a crane.

Once my treatment was finished I asked the lady technician how thick the walls were if the door was 8 inches.  She said they were 5 feet thick and were concrete.  Since that much lead would be very expensive it was not cost effective to line the walls with lead but they could get the same protection with concrete, but very thick concrete.  She said the ceiling was also protected but I was afraid to ask whether it was with thick lead or thicker concrete.  The thought of either one over my head while I lie there on that table is certainly not a very comforting thought.

The volunteer had also told me that of the three radiation machines they have, the one I normally use and the one I used yesterday are duplicates and are controlled by the same computer.  That’s why a patient can easily be treated on either machine without having to do major setups.  The other machine, however, is very different (I assume it is older) and to move an existing patient to that machine would take some real doing and re-doing.  I have not seen the third machine nor do I even know in which sub-room it resides.  Perhaps, since it must also have a heavy and thick door I could figure that out by just looking around.  I’ll try that next time I’m in there…………which will be tomorrow. 

 

Thursday – 12/09/04

When I arrived at the hospital the waiting room was filled with people.  Thursdays are typically the day for the support group luncheon.  While I was waiting for my name to be called, they started eating but several people wanted to know if I was going to eat with them.  I told them I probably would but I was currently waiting to go back for my treatment.

When my name was called I went back and was, again, motioned over to the second machine.  While getting ready for the treatments, while lying on the table I asked Chris several questions.  I told him I had seen the 8-inch thick doors and I heard about the 5-foot thick walls but I wondered about the shielding on the ceiling.  He didn’t know what was used but I told him it didn’t give me much comfort to lie on that table knowing there was something very, very heavy hovering directly over me.  He just laughed…… he wasn’t lying on that table.

He did tell me that the technicians wear a badge called a dosimeter on their shirt.  Each month it is collected to verify that during that month they had not been exposed to too much radiation…………….. like I had been.

After the treatment was complete I went back out to the waiting room where I filled a plate with the very special balanced cuisine:  a small piece of broiled chicken, some pasta, a green salad and a roll plus unsweetened tea.  I discovered that all the chairs were filled; all except one, which the lady seated across from it, cautioned me that it belonged to her husband who was in the treatment area.  I could sit there until he came back.  There was no place to put down the paper plate so I had to eat it almost caveman style.  I had a plastic knife but with no table to rest the plate upon, there was no using that knife.  I hope the fine folks there didn’t think me too uncouth by spearing the chicken with a plastic fork and biting off a piece.  Since it was small there weren’t too many bites to be taken.

The program was a slide presentation by a nurse on what to know and what to expect with chemotherapy and some on radiation treatments.  One thing that I hadn’t thought about came to light in this presentation.  I knew chemotherapy caused a large decrease in the white blood cells but the information provided said that radiation also caused this decrease.  We were cautioned to be extra careful so as not expose ourselves to any virus or infection since we had fewer white blood cells to fend off the problem.  I’m washing my hands more that usual now.

 

Friday – 12/10/04

Treatment today was back on the original machine and they were not running too far behind schedule.  It was pretty much a typical day as far as the radiation was concerned.  There was one small discouraging thing I learned while I was talking with a couple of men in the waiting room who were also having treatments for prostate cancer.  We happened to mention the number of treatments we were scheduled to receive.  Both of them were to have only 41 treatments but I have to have 43……….. Bummer!

One new thing that has visited me as I have more radiation and that is diarrhea.  That’s not something I’ve ever had to worry about but it seems to be a near constant companion to me these days.  Like many other things that have changed for the worse, I’m hoping that this too will go away when the radiation treatments cease.  I guess it’s a good thing to have something to strive toward and look forward to and, boy, I’ve got a lot to look forward to.  I keep thinking about the picture that circulated on the Internet several years ago.  It showed a small cat, hanging only by its front claws dug into a branch with the message, “Hang in there, baby.”

 

 

Week 6

Monday – 12/13/04

I was surprised today when I has very little wait before being called in for my treatment.  While waiting, I talked with one of the other patients and the volunteer in the waiting room.  The patient told me he had already been in and the ultrasound machine was broken again.  He was quite concerned because he said the ultrasound sound picture helps to locate exactly where the prostate is and get the aim to within a millimeter if they have that information.  He said otherwise it would be possible for the beam could hit the bladder and cause severe irritation and/or damage.  The volunteer agreed but added that it would take several (day’s) shots hitting the wrong area before any damage was done.  They both agreed that unless the patient had done something like ridden on a tractor or ridden a horse that nothing should have shifted inside.  The patient said they had told him, when he started his treatments, not to ride any horses during this time.  Sure made me feel comfortable since they had not given me any of those warnings.  This was not the first time they have assumed that I have received some information from them when they had not provided it.

When I was called back, and after my treatment, the technician said the doctor would normally talk with me today but he had left earlier so was not available.  I’m fairly sure he had gone on to lunch.  I am concerned because I didn’t pick the time for my treatment, they did, and if that’s a time when the doctor is suppose to eat, so be it but it should not be at the expense of the time they should be spending with me.  I’m beginning to feel a bit like an orphan and I’m not receiving the full, proper, and complete attention and treatment like I should be getting.  This troubles me a bit.

The technician was a new person today.  She said her name was Kim and she had traded positions with Jane who was the older lady I had previously had.  It always takes longer to push me around and set me up correctly on the table when there is only one person.  That person must go from one side of the table around to the other side and back several times.  Otherwise the treatments were as normal as before.

For some reason, both when I went into and came out of the treatment room, the big multi-ton door was only opened half way.  As I left I tried to push it a little to see if it was power assisted, manual or completely powered to open and close.  I pushed as hard as I could and it didn’t budge one inch.  I now know that it is totally powered.  I guess if I wanted to be pessimistic I would think that while I was inside being treated and the hospital lost power I would be trapped inside with no means of escape.  Gee….. it’s always something…………

The only funny thing that happened was when I had used the free valet parking for my truck.  When the young girl brought it up to the door for me, as she got out she told me she was sorry it had taken so long but she had to find a ladder to get up in the cab of the truck.  Hmmmmm…. I do need to get some steps for that tall truck...

  

Tuesday – 12/14/04

I arrived a bit early today so I had some time to just sit.  When I was called in for treatment, the good news is – the ultrasound machine had been repaired….. the bad news is – I was not taken to that treatment room.   I was back in the second room that had no ultrasound.  I have no idea where (on my body) I was treated today.  Since there is no pain or feeling with the radiation I can only hope that the beam is being directed correctly.  When I came into the room there was a strange round device standing beside the table.  It was about 5 inches in diameter and 2 feet high.  It was covered in a vinyl material and had a hand loop on the top.  I asked Chris what it was and he told me it was called a “knee roll.”  It was to be placed under the patient’s knees to make them more comfortable when treating a leg.  He said, “You prostate guys don’t need it since we don’t want you to be that comfortable.”  Of course I knew he was kidding on that part but I asked him if that what he calls us, “…. those prostate guys.”  He told me, “Sure, we call you prostate guys, lung guys, brain guys, etc.”  At least now I know my proper title.

No doctor again, he seemed to be gone……………… big surprise there.

  

Wednesday – 12/15/04

Things were, somewhat, back to normal today and I was treated back in the original room with a machine, which was working, and an ultrasound machine, which was also working.  It reminded me of back in the early days of my treatments.  During the ultrasound, Chris commented to me that my bladder appeared smaller and he wondered if I had drunk my water as I’m supposed to do.  I had.  He seemed to be a little concerned.  I thought to myself that for someone my size, I use to be happy to hear someone say that something about me was smaller.  This time I wasn’t quite so pleased since it seemed to be something not too good.  Then I thought, since I hadn’t been ultrasounded for several days, I wonder if positioning of my pieces might have changed some days earlier and they had been shooting me at the wrong location.

Today, also, was the first time I really felt a more severe feeling of tiredness.  This was the first day I actually felt the need to take an afternoon nap, which I did.  Perhaps it was a case of coming down with something or it might be due to the prolonged radiation.  I’ve been told that things like this seem to visit a person after they had been in radiation treatments of 4 or 5 weeks and I’m currently at that point.  I’ll have to see if I’m feeling a bit better tomorrow or within a few days.  With my granddaughter coming from California within a few days I suspect I’ll find an added supply of strength and energy for her.

 

Thursday – 12/16/04

Today was the cancer support group luncheon and several people in the waiting room asked me to stay and eat with them.  I initially said no but when my treatments came on time and went fairly quickly, I decided to join them.  Instead of a regular program, this meeting was their annual Christmas gift exchange and take-away session.  I told them I wouldn’t participate in that part since I hadn’t brought a gift but they assured me that more than half the people had failed to bring anything and they had brought gifts to cover we who had none.  I ended up with a paperback book called “Christmas Secrets” which I gave to my wife.

Treatment was pretty ordinary, the ultrasound machine worked and the linear accelerator worked.  The radiation technician, Kim, asked me if I could come early tomorrow for my treatment.  Heck, I’ve got nothing else to do except to undress and get shot so I agreed to come 30 minutes early for my Friday appointment.  I wonder if I’ll actually be able to remember?

Afterwards, I got to thinking that I had been getting four 5-second treatments per day for 20 seconds per day.  I will have a total of 43 days of treatments (assuming they don’t have a longer “balloon treatment” like a “balloon payment” at the end).  This means that by the time I have finished my treatments I will have received a total of 14 minutes and 20 seconds of radiation.  Now I know why they didn’t want to do it all at once.  I’ve seen what happens to a marshmallow in a microwave over a much shorter period of time so I guess I’ll just keep coming to those short-blast, daily shootings.

  

Friday – 12/17/04

Well, I did remember.  In fact I got there even earlier than they had asked but I still had to wait for about 25 minutes.  It did give me a chance to talk to a couple of other guys who were receiving the same treatments I was, although I learned some extra things about their treatments where were different than mine.  More about that later.

When I was called in, they put me first in a room to visit with the doctor……………..FINALLY.  The doctor who came in was not the same one I had talked with previously.  After introducing himself I guess I unloaded a bit on him and commenting about how, at the end of my 6th week I was only seeing a doctor for the 3rd time.  I told him there were several cases of pieces of information other patients had been given which I had not been told.  He was very nice and answered some of my questions and told me he understood my situation although since this was the first time he had seen me he couldn’t really speak much to the problems I had been experiencing as to lack of information and being ignored.  I told him I understood that he was not responsible and perhaps my other doctor was not even responsible but they had placed me at an appointment time when that doctor was at lunch.  He did say the my original doctor would be retiring to part time at the end of the year and asked if I would like for him to take me over as a patient.  I quickly agreed.   Hopefully that will alleviate some of my problems and apprehensions.

When I went into the treatment room I, again had two technicians, Chris and Kim, or I think I should really refer to her as “Cold Hands Kim.”  She had earlier apologized for her cold hands while pushing and moving me around but it’s still quite a shock. 

When Chris was using the ultrasound device on me he commented, “Your bladder looks a lot better.”  I told him I really wasn’t sure how to respond to a comment like that, should I say “Thank you,” or should I say, “Yes, I’ve been working on that.”  I didn’t receive a gold star for a “better bladder” so I guess it was just a passing comment. Otherwise, the treatments were the same as before.

When I had earlier been talking to other patients, one man commented that he was shot from seven different directions, or fields as they called it to him.  I asked him how long each shot lasted and he said, “Not as long as a minute….. probably about a half-minute each.”  The other patient said he also received seven different shots of about 30 seconds each, much longer than my 5-second shots.  Both of them, however, are only scheduled for 41 treatments whereas I will get 43.  My guess is that it depends on how far along the cancer might be before it was diagnosed.  I know mine was diagnosed in the very early stages so that made some sense.

They both commented that early in their treatments that they experienced a pretty good amount of the feeling of heat on their backsides.  One fellow said it felt to him like he had sunburn on his butt.  I never did experience any of that so I’m guessing the fewer shots per treatment along with a lesser time for each shot made the difference there.  Both also mentioned that they were told to look for skin irritation but neither had experienced that and neither had I.

Since Christmas and New Year’s Day occur on the following two weeks, the technicians reminded me that there would be no treatments on either of the next two Fridays.

  

 

Week 7

Monday – 12/20/04 – (Treatment 28/43)

 A Christmas miracle has occurred.  I arrived at the hospital about 8 minutes before my appointed time and, lo and behold, I met the man who precedes me in treatments as he was leaving the hospital.  I asked him if I was late and he said they were running ahead of schedule.  A miracle………. ahead of schedule.  When I scanned in my card it was only a couple of minutes before they called me in.  I discovered that what helped them make up time was the fact that the ultrasound machine was down………. again.   I’ll bet those commercial airplanes could take off a LOT sooner if they would just forgo all that time-consuming list of things to check before taking off.  I did ask if that meant they wouldn’t be hitting me in just the right place but they assured me they would hit me OK.  After all the poking and moving me around, as I was awaiting my first shot I looked at my watch and it lacked a minute being just the time for my appointment.

One more day down.

I did have some good news last week that I should mention.  The PSA test is the blood test that tips off the doctors that there might be a problem with the prostate.  PSA stands for something like, “Prostate Specific Aardvark” or something like that.  The good figure seems to vary up and down but I had ordinarily been told that a “4” or under was good but anything above that was not good.  My PSA for several years had been right around 4 but when I was diagnosed this summer. My PSA was up to 5.4.  This led to other tests, which determined that I did actually have a cancerous tumor in my prostate with a Gleason score of 7.  When I had my second injection a couple of weeks ago they did another blood test and ran the PSA test again.

Just last week I received a note from my urologist who had the results and he said my PSA was down to .41 (that's point four one); He was very happy and so was I.

  

Tuesday – 12/21/04 – (Treatment 29/43)

I thought I was in for another Christmas miracle for my treatment appointment today.  But let me explain further.  The treatment went pretty much normally and even Kim’s hands were not as cold as usual.  When I finished, my technician asked me to wait in one of the smaller rooms to talk to my doctor.  Imagine that!  a chance to talk to my doctor.  What a change of pace, in fact, I thought it must have been my Christmas miracle.

I sat in the room for just over a minute but then, the technician came in and told me my doctor had left.  I mentioned to him that we had changed doctors and the newer one said he would be around for my weekly consultation.  Chris only said, “He has left too.”

Was I surprised?  No…. disappointed, yes but not surprised.  After all, I’m the orphan patient.

  

Wednesday – 12/22/04 – (Treatment 30/43)

 The secondary machine that I sometimes use, Unit B, was down today.  The hospital had called the folks who ordinarily receive their treatment on this machine, asking them not to come in for their treatment today.  Unfortunately, they were unable to contact all of those people so several of them had shown up for their session, only to find that the machine was down.  The Radiation Department tried to accommodate as many of them as they could by slipping them in between treatments for those of us who are usually on machine D.  This threw our schedules off by about 30 minutes.  I did see one couple who had a radiation treatment (on machine B) followed by a chemotherapy treatment at another location and the radiation technicians told the lady to go ahead and go to her chemo appointment and then call Radiation to see if the machine was back in business.

I was called in about 30 minutes late and my treatments were about the same as before, except for the timing on each shot, which seemed to be about 4 seconds instead of 5 each.  Afterward, I asked Chris if the shots were shorter than usual and he said, actually they don’t really go on time but on dosage.  I also mentioned that some of the other patients had mentioned their treatments consisted of as many as seven different directions for a good bit longer time than mine.  I wondered if that depended on the severity of the tumor or when it was diagnosed.  He said that had nothing to do with it but the doctor sometimes prescribes the beams to hit a differing angles.

 

Thursday – 12/23/04 – (Treatment 31/43)

 The schedule was pretty tight today as we went as a family over to Sand Springs to have breakfast with Gloria’s folks.  The plan was to finish early enough to drive back home to Owasso, unload most of the passengers and make it back into Tulsa in time for my appointment.  Unfortunately, our time ran so short that we chose to drive directly to the hospital.  We all got to St. Francis in plenty of time and added some variety and extra activity to the Radiation Treatment waiting room with our family gathering.

There was nothing in particular of any difference in the treatments.  I did ask my radiation technician how many Roentgens of radiation I was receiving as part of my treatments each day.  She said they don’t use the Roentgens unit any more but I received 180 centigrams of radiation each day.  I’m not quite sure what I can do with that information but, at least, now I know.  If anyone asks me how much radiation I receive, I’ll be ready for them.

No radiation treatments tomorrow since it is Christmas Eve and all the Radiation Department will be off for the holiday.

 

   Friday – 12/24/04

 Due to this date being Christmas Eve, the Radiation Treatment Department was closed.

 

 

Week 8

Monday – 12/27/04 – (Treatment 32/43)

 Today, before my treatment, I had a chance to talk to my doctor….. at least I think it was my doctor.  Actually, the doctor I got to speak with was the original radiation doctor who they said I had been transferred from… very confusing.  I did, however get a chance to see a doctor and ask a few questions.  I was so surprised that I failed to ask him the question I had wanted to ask and, to tell the truth, I’ve now forgotten what it was since it had been so long.

The treatment was just as ordinary as what most of them have become.  There was nothing different of any note, no conversations of any note and no problems of any note.  It was just a plain, vanilla treatment day.  I’m just about ready now to get a new calendar and start marking the “days until” on it.

 

  

Tuesday – 12/28/04 – (Treatment 33/43)

 Today I guess my timing was a bit off because I try to have a full bladder when I arrive, as they requested, but I was running on over-full when I got there and was uncomfortable.  When they called me in and got me all pushed and shoved around on the table it was time for the ultrasound.  The pressing on me with the ultrasound device made my eyes bug out a bit and I’m sure it you were looking at my eyes you could have seen a water level raising and lowering.  Not only was the ultrasound “torture” longer than normal, shortly after she took the devise away she said something like, “I’m not seeing what I should be seeing,” and she made another run at me with the device.  I wasn’t too surprised when, during the second pressing, she said, “Your bladder is plenty full.”  I told her that this comes as no surprise to me.

When all that torture treatment was finished it was time for the actual radiation treatments.  It may have been the way I was situated on the table or it may have been how my feet were strapped together (which is normally the case) but I had an extreme pain in my thigh and hip, which was terrible.  I wondered if I was going to be able to continue to hold my position on the table until the shots were completed but I guess I somehow made it.

All things taken together, today was the most painful treatment day I had ever experienced and it had nothing to do with the radiation shots at all.

One short conversation did take place between Chris and myself.  When he handed me the ring of plastic and cloth which I hold while lying on the table to give me something to do with my hands, he said, “Here’s your ring.”  I told him that I thought that was the first time I had ever been given a ring by another man.  We both decided that was probably a pretty good thing.

After I came out of the room, Kim (Cold Hands Kim) said, “I know you need to go to the bathroom right now but please come back afterward or remind me tomorrow to talk to you about something.”  I told her I would be back in a few minutes.

What she wanted to ask me was if it would be possible to change my treatment times from 11:50 to 11:00 starting next Monday.  I told her that would work out just fine.  She said they were trying to re-arrange their schedules so they go actually get in their lunch times and also it would allow me a better chance to see my doctor. 

I’ll be making that change at the beginning of next week.

 

 Wednesday – 12/29/04 – (Treatment 34/43)

 Today was a pretty ordinary treatment day.  Gloria went into town again with me today so she got a chance to see who and what I see each day.  The ultrasound views were, again, longer than usual and pressing harder than the poor old bladder would have liked but all in all it was a pretty standard treatment day.

 

Thursday – 12/30/04 – (Treatment 35/43)

 Gloria, again, accompanied me to my treatments.  We got there about six minutes early but the volunteer told me to go ahead and scan my card but to go on back since they had already called my name.  Looks like they were trying to get as much ahead of schedule as they could so they could, perhaps, leave early for the day since they would be closed for tomorrow for New Year’s Eve.

During the ultrasound Chris asked me if I had “had my water.”  I told him I had and asked him if it just hadn’t made it down there yet.  He said it hadn’t. 

The rest of the treatment was just like all the others and as I left they reminded me not to come tomorrow and to come for my earlier time on the next Monday.  I said I would.

 

Week 9

Monday – 1/03/05 – (Treatment 36/43)

 I’ve made it to another week on my treatments and another year on the calendar.  When I arrived for my new time, 11:00 where it use to be 11:50, the waiting room was packed with people.  A few were people I had seen before but many were new.  Most all of the people I see in the waiting room are older than me, however, a few are younger.  Many of the older folks have someone else with them, perhaps a spouse or friend who came along to drive them.  It made me grateful that the radiation had not had enough effect on me that I was unable to bring myself to my treatment sessions.  I didn’t want to cause others any problems, just because of me.

 

Tuesday – 1/04/05 – (Treatment 37/43)

 Today I arrived about 10 minutes early and the waiting room was full of people.  I thought it would be another long wait but they called me about 2 minutes before my appointed time, 11:00.  Treatment went as so many had before so it’s pretty much routine.  After my treatment, they asked me to wait in one of the little examination rooms and the doctor would see me.  What?  Mercy, what a surprise.  When the doctor came in, ah, but which doctor you might ask.  It was the second one assigned to me so it seems to be first A, then B, then back to A, then back to B.  Perhaps they thought, due to my size, that I needed the services of two doctors…………….. once they finally started seeing me.

The doctor reminded me that I only had a few more treatments to go (like I didn’t already know that) and wanted to know if I had any questions.  I asked him several:

  1. How much radiation am I actually receiving?  He checked the chart and said “7700 centigrams.”
  2. I notice that some guys get up to 7 different angle shots whereas I only get 4.  Are my shots more powerful?  His answer was that perhaps they were but it is whatever Dr. Ellis had prescribed for me.
  3. Will urination come easier after the treatments are over and if so, when?  He told me that things will return more to normal but it will probably take a month or so until after the treatments are completed.

It was good to be able to ask some questions and get good straight answers.

 

Wednesday – 1/05/05 – (Treatment 38/43)

 Today the weather was really crummy.  It was cold and raining and the temperature was such that some of it was freezing to the pavement.  I left early and drove more slowly than usual.  I expected the some of the normal crowd in the waiting room would be missing since some of them come from quite some distance, however, it looked about as crowded as normal.  They did call my name about a minute before the appointed time so I was happy with that.

I have probably not mentioned that along with all of the pushing and shoving they do to me on the table, they also have the ability to move the table up and down, side to side, and top to bottom.  Evidently the increments of the table are the coarse tuning and the pushing and shoving is the fine-tuning.  While Chris was moving the table around I asked him if he was lining up the green lines with my tattoos and he said that was exactly what he was doing.

The rest of the treatment was the same as before, except for the fact that I’m one day closer to the end and that makes it special.

 

 Thursday – 1/06/05 – (Treatment 39/43)

 Woooooo today was really cold.  We halfway expected not to be able to make the treatment schedule because of snow and ice but, as it turned out, the only problem was the temperature and that didn’t stop anyone.  Temperature was about 20 degrees when I left the house, heading for the hospital.

Today was another pretty normal day for my treatment.  I’m really looking forward to the end and it’s approaching fast, however, not fast enough for me.

  

Friday – 1/07/05 – (Treatment 40/43)

 This treatment was different than all of the others.  As I was getting ready for the table one of the technicians told me that as I get closer to the end of my treatments they have to be more precise in their aiming.  They would be taking a couple of pictures of me to give to my doctor and be added to my folder.  I assumed that was to be X-rays but actually it turned out to be both X-rays and Polaroid photographs.

The ultrasound torture seemed to take longer than usual.  After they had shot radiation at me from the top, then the bottom, then to my left and at that point they came back into the room.  Something was rolled up to my right, which I suspect was an X-ray film carrier.  The lights were turned off where only the green line lights were on and they went back out and closed the big door.  The X-ray shot was from the same device that shoots the radiation but the shot itself was only for a part of a second.

The technician came back into the room, turned the lights back on and moved the film carrier out of the way.  Coming back to my left side she drew something on my left hip.  Since I had been carefully placed on the table, face up, I couldn’t see what was being drawn but it felt like a somewhat oval-shaped symbol.  Less than a minute later someone took a Polaroid shot of my left side where the figure was drawn.

They came back to my right side and drew the same type of symbol on my right hip, then took a Polaroid picture of that side.  The X-ray film carrier was rolled around to my left side and they exited the room again.  The large machine was rotated around on my right side where it took a short X-ray shot.

Back into the room the technician rolled the film carrier out of the way and exited the room again.  The final of my daily four radiation shots was made on the right side and it was all finally over.

When the tech came back and helped me back off the table she said the marks were only made with Magic Marker and don’t worry about washing them off since that was OK, they had served their purpose.  I think they really just want to see if I really take a shower and to see it they’re still there on Monday.

Finally I’ve come to my last whole week.  Three more sessions and all of this will be past and history……….I can’t wait.

After I got home I was able to look at my drawings to see if there was a smiley face or a Kick Me sign.  Both looked the same and were kidney-shaped symbols about 2 inches or so tall and 3 inches long.  Well now I know what my prostate looks like, although I don’t know what I can do with that information.

I guess I’m lucky, in one way, as I heard on the radio that several years ago, when the TV news was reporting on the news that Alan Greenspan in Washington, D. C. was taken to the hospital with an “oversized prostate,” the closed caption typist made a transcription typing mistake and those reading the captioned news saw that Alan Greenspan was taken to the hospital with an “oversized prostitute.”   I guess I’m optimistic, things could always be worse.

  

 

Week 10

Monday – 1/10/05 – (Treatment 41/43)

 Today, the treatment ritual was about the same as always, except the ultrasound part seemed to take longer than usual. It’s amazing how a person’s attitude changes as they approach the end of their radiation sessions.  I’m not sure what I expected at the end; perhaps down deep I expected the end of the sessions to have the equivalent of a balloon payment at the end of a loan.  Maybe the actual time of radiation would be longer than those earlier or perhaps on the last several sessions, they use a baseball bat on me, I just didn’t know what I should expect.

It looks like, however, that the last few sessions are about the same as the first ones and the middle ones.  I just keep going each day and finally, as I walk out of the room, instead of saying, “We’ll see you tomorrow,” they will say, “That’s it………have a good life.” or something like that.  I’ve got two more times to see what the final sessions actually are like.   I almost can’t wait.

 

Tuesday – 1/11/05 – (Treatment 42/43)

It hit me like a kick in the groin when I was told that I had two more treatments rather than one.  I went back later to check and I still count today as number 42 of the 43, which I was told, I was to receive.

The treatment itself was on time but the ultrasound took an unusual amount of time.  In fact, the technician tried four different times to take the reading.  That’s four times pressing on a full bladder and that was most uncomfortable.  After the third time I asked her if she was having a problem finding “it” and she told me it just wasn’t showing up well.

When the radiation arm is started up it is usually in the 2 o’clock position over me since they move it out of the way to do the ultrasound.  When they left the room and started the treatment, the arm was moved not to the 12 o’clock position as usual but to about 10:00 and stopped, then on to 9:00 where it stopped for several seconds.  Then it was back to 10:00 and stopped and I thought, perhaps they were going to give me some of the shots from a position different from the usual up, down, left, and right as some of the other male patients had received.  After some delay the arm was moved back above me and the four regular, 5-second shots were given normally.

After the treatment I had brought my camera and asked if I could take some pictures of the room and equipment.  After taking the pictures they asked me to wait in one of the smaller consultation rooms for the doctor.  Once the doctor came in I asked about what I should expect next and how would I know for sure that the cancer was gone.  He gave me an appointment to come back in February for a follow-up, which would be a month after the last treatment, and they would see how I was doing then and how I felt.  He said the PSA test would tell whether all was OK.  I told him that my last PSA had been .41 but I had been told that was the result of the injections and I still had two more of them to go.  He agreed that it would really only be after some time passed after that last injection that a PSA test would be very helpful.  He did say the he expected no further problems and everything had gone just like they had planned.  I guess I play the waiting game at this point.

It was then that he told me his records show that I was to receive two days more of the treatments.  That’s quite a disappointment after seeing 3, 2, and then 1 day to go, only to be told that they have moved the tape at the finish line.  I think I shall go back over the diary and write down the actual days I had treatments so I can be absolutely sure.

 Interesting…………  I went back through my diary and wrote down each day that I had received treatments and it still totaled 42. 

Treatment Days

November:  8,9,10,11,12,15,16,17,18,19,24,26,29,30                                   = 14

December:  1,2,3,6,7,8,9,10,13,14,15,16,17,20,21,22,23,27,28,29,30            = 21

January:  3,4,5,6,7,10,11                                                                             =   7

 I called the hospital to speak with the folks and they referred me on to my therapist, Kim.  She said, “No, tomorrow is your last day.”  She said my prescription was written for 43 treatments and that would be my tomorrow treatment.   She said maybe the doctor looked at the chart wrong or perhaps he thought today is Wednesday.  Anyway, the finish line tape has been moved backed to the correct position and maybe………………. just maybe I’m going to make it to the end.

  

Wednesday – 1/12/05 – (Treatment 43/43)

 I made it!  What a wonderful feeling to know that all of this is over.  After my final treatment, as I left the radiation room I was greeted by one of my therapists who gave me a long-stemmed pink carnation, a “graduation certificate” which read –

Hope is …. believing in a brighter tomorrow.

 

 

and a small angel pin.  The pin was attached to a card that read:  Angel on My Shoulder – A Guardian Angel to Watch Over Me. 

 

 

For the first time, nobody said, “We’ll see you tomorrow.”  Truly a wonderful feeling……….

 

 

Pictures at St. Francis Hospital Radiation Oncology Department

 

 Linear Accelerator

 This is the actual radiation machine that does the radiation shooting.  The patient is lying on the table that is rolled back toward the accelerator and then raised.  When the patient is in place, the round unit at the top part is about 6 inches from the body as the large white part of the machine rotates around the patient.  The tabletop is a glass or plastic material with holes in the material under it so the radiation can shoot through the table to the patient’s underside.

The gray unit in the corner is evidently the power unit for the accelerator and when the radiation is actually shooting, it buzzes quite noisily.

There are several color monitors around the room so the therapists can see all of the patient’s information.

 

Patient table

The monitor atop the tall blue table on wheels is the ultrasound machine.   The ultrasound picture is stored and remains on the monitor as long as they want to see it.

   

 Radiation room

 On the wire wall rack you can see the head forms for different patients.  It is important for a patient who needs to receive radiation around the head area that they not move their head while the radiation is on.  The form is a custom fit for each individual patient.

You’ll notice a TV camera at the ceiling in the upper-right.  While a patient is on the table and are the only one in the room, the technicians can see, at their console, what’s going on inside.  I guess they could see if the patient moved or jumped up and tried to escape, although the only way out was though that door which weighs thousands of pounds.

 

 Green line generators

 The two previous pictures show the devices located on each of the room across the table and they generate a very thin line vertically and one thin green line horizontally to help line the table patient up exactly for the radiation.  The lines are barely visible in the pictures but the lines on the left wall are coming from the right side and the right marks from the left side.  When the patient is lined up correctly, the lines cross the patient at the tattoos on their body.

 

 Therapist Kim

 

 Heavy door

This door protects the therapists outside while the patient receives the radiation inside.

 

Radiation room entrance

 Here’s the view from the other side of the extra-thick door.  You’ll notice the Radiation Danger symbol on the door.  The round pieces to the right of the door are used to open it mechanically since it is far too heavy to be opened by hand.  The control console, where the technicians sit while the patient receives radiation inside, is just out of sight to the right of the drawers in the lower right side of the picture.

 

 Control console

 

 

The doctors, nurses, and secretaries are in this inner hub.  The radiation rooms and consultation rooms are entered from the surrounding walls.

 

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