Well folks, We've managed to survive this round of stereotactic radiosurgery. We'll see how well things REALLY went when it's time for the follow-up MRI in three months.
In the meantime, let's just say this was more complicated than anticipated - and certainly not as pleasant an experience as I had had in January 2002. So, what happened this time???
I had undergone a brain MRI on Monday to give the docs a more current basis to work from. Turned there were now more nodules to be dealt with. Whereas the original nodule was 1 cm, the new scan showed as many as four others scattered about. All were very small, on the order of 5mm, and Dr. Feigenberg, the radiation oncologist, was still optimistic he could zap all of them.
We headed for Fox Chase beginning at 6 on Thursday morning. Since Ken has an interview tomorrow morning in King of Prussia, PA, this was a good opportunity for him to get some idea of what early-morning traffic was like in the Philly area. We managed to arrive at the hospital about 15 minutes earlier than our usual 90 minutes. Although we were supposed to be there by 7:30, those 15 minutes turned out to mean little - the staff had yet to arrive. The nurse showed up around 8, and the neurosurgeon finally arrived just after 9. We began to get the idea this day was going to be longer than we thought...
Instead of a regular hospital room, with bed and regular TV, we were placed in an examining room equipped with a video player for the day. We were told to being tapes with us, which we did. And, of course, Ken had his laptop with him; and he got lots of work done.
The IV was finally started, but for some reason my veins didn't feel like cooperating, which made the preparation that much longer. (I had a similar problem on Monday.) Then came the most painful part of the procedure - getting that stereotactic ring screwed into my head. Think of getting more shots of novocain than you'd ever want to experience and multiply it by some large factor. Although this WAS the worst part of the deal (at least up to that point), after about a half-hour or so, the stuff sitting on my head was more tolerable - actually, much less uncomfortable than I had feared.
I finally arrived at the CT scan at 10 a.m. for not only the usual round of pictures, but also some extra prods through the helmet placed on top of the ring while the doctor took measurements that would eventually be fed into the computer to determine how I'd be treated later in the day. It was 11 a.m. by the time this was all over with and I could finally have something to eat. (I couldn't have anything to eat or drink after midnight, and I was really hungry by then.) Like last year, the ring came just close enough to prevent me from fitting a pair of glasses through it; so as I had expected, I spent much of the time watching the tapes we brought.
By about 3 o'clock or so, I was beginning to feel the discomfort I recalled from last year. Since Fox Chase is very cognizant of pain management, I was offered a choice of either an injection of painkiller or percoset. Since I really didn't want another shot (the ones I got when the ring was screwed in were bad enough) and percoset and I got along (or so I thought), I opted for the pill. Eventually, we got some cake from a staff member's going-away party that put a little more food in me before the procedure, which had yet to begin.
About 4:30 or so, I began to feel a slight wave of nausea; but some water and a mint seeed to stave it off. Little did I know the worst was yet to come...
I was finally taken for the actual treatment just before 5 p.m. Like last year's event, it's a very open situation - not the claustrophobic's delight of the MRI or even the donut hole of the CT scan. Ken took pictures of me (for future posting on the web site) wearing the ring, and the plastic "space helmet" that's used for taking measurements. (At first he thought it resembled a colander, I thought it was more like an old-fashioned hair dryer, and the staff referred to it as "the hair dryer.") I laid on a table with the cages on my head while a linear accelerator passed over me several times. At least that's the way it was supposed to be.
Unfortunately, I suffered a big bout of nausea just after the second pass; and it took awhile to get things cleaned up and for me to rest before the treatment could be resumed. The scene was repeated a few hours later, and by 9:30 it was decided that I would be kept in the hospital overnight for observation due to the nausea. I was given the option to stop the treatment and return another time, but who wanted to repeat this again??? I told the staff I just wanted to get this over with, and Ken was sent home with food from the nurses.
The treatment was finally over at 10:45 p.m., punctuated with one more bout of nausea - as if there was anything left to lose. My head was finally freed from the confinements of the day, and I was placed in a real hospital room by about 11:30. Because of the parade of medical personnel coming and going while taking various histories, I didn't get to sleep until after 3 a.m. I woke up at 6 a.m. feeling fairly alert, all things considered. I was eventually given a full liquid breakfast because of the nausea, but what little I had stayed down with no problem. A doctor came later that morning to inform me that if I could keep a regular lunch down, I would be able to go home in the afternoon.
Alas, lunch didn't show up until 12:15 p.m. - another liquid one. It was yet another hour before solid food finally arrived. At least it stayed down with no problem! Ken arrived shortly before noon with my laptop, so I did spend about an hour online while waiting - and waiting - for someone to complete my discharge papers. The papers finally arrived just after 4 (while Ken was at the Radiation Oncology department getting their orders for me), and we finally left just before 4:30 p.m. We finally got home at 6 p.m.
The one difference between this experience and the last one, aside from what you've already read, is that I wasn't given any medication before the procedure - I had begun taking brain surgery medication 5 days before the last one. This time, I was only sent home with a perscription for one of the pills (decadron), to be tapered down in about a week or so. Even better, Fox Chase had my daily medications ready for me for Friday morning; even though we had brought a supply with us (along with toiletries, a nightgown, and underwear "just in case").
In general, aside from being tired from not getting enough sleep since Wednesday, I am doing better this time than last time. Then again, I had no plans to be out of the house this weekend - and given the very humid weather here, it's just as well I stay indoors. However, I do have some local errands to run tomorrow, including getting my weekly shot of Procrit, so we'll see how that goes. But I feel more up to it this time than last year.
So, that's the way it went!