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Wednesday, April 28, 2010

What Radiation looks like.

Carl is getting 15 days of radiation treatment to the leg, so I thought that it is probably a good time to describe what radiation is and show you what radiation looks like. I'm going to describe radiation with my non-medical understanding. Our non-medical terminology for radiation is 'getting zapped'.

Froedtert Hospital radiation machine 2010
Radiation is a 'local treatment'. This means radiation treatments do not kill miscellaneous cancer cells floating around the body, just cancer cells in the vicinity of the location where the radiation is directed. [The 'local area']. Cancer cells outside of the target area should not be affected. Since radiation can not distinguish between healthy cells and tumor cells, there needs to be caution that the treatment is not killing healthy cells of needed structures.
siemens mevatron radiation machine
Because radiation has to travel through healthy tissue to get to tumor tissue, two intersecting planes of radiation beams are used to concentrate the radiation at the area you want to kill. Unfortunately, the radiation is passing through healthy tissue and can leave some 'collateral damage', (healthy cells harmed). Therefore you have to hope the side effects aren't significant.

The radiation machine has a table that the patient lies on. The table can raise and lower, and move back and forth to align the patient. The table then remains still for the treatment. The machine has large arms that create two planes of radiation beams. These arms can move around the patient. The machine uses complicated mathematical formulas to focus planes of beams of radiation from two directions. The radiation travels through the skin and focuses on the tissue inside to kill (hopefully) tumor cells.

The radiation people carefully map the area of the tumor, and decide what area of the tumor to zap with what power. (The radiation beams are turned on and off, 'contoured' to match the shape and size of the tumor that they are targeting). The map and power information is programmed into the machine.

Radiation therapists build a custom molded form for the patient to align the area to be treated in a precise location. The face mask shown here was created for Carl to stabilize his head and neck for treatment.

For treatment, the radiation therapists strap the person down, align the machine, and leave the room, closing the thick lead door behind them; and then start the radiation treatment. The patient needs to lie still for the procedure, which is relatively fast once the machine is turned on (under 5 minutes) This can be a problem for claustrophobic people, (but not Carl, thankfully.) Wiggling around during treatment would be a big no-no. I wonder how they get children to lay still.

The radiation therapists watch the patient and machine progress closely from monitors in the next room. If you look closely at the top two monitors above, you can see the second arm of the machine extended.

Carl had radiation before, a 10 treatment course spanning 2 weeks December 27, 2009 through January 2010. At that time they were radiating to some cancer cells in Carl's neck. The photos in this blog posting are from that time period, when Carl still had hair. Click on the photos to zoom in and see them larger.

This time Carl is getting 15 radiation treatments to the left leg from April 20th through May 10th, 2010. Carl is getting the radiation treatments with with concurrent chemotherapy. The chemotherapy helps to activate and react with the radiation, which might make the radiation work even better, and the chemo can also treats any systemic (body wide) cancer cells that are lurking about.

The radiation rooms are shielded with lead on all sides. The door to the room housing the radiation machine is made of lead about 12 inches thick.

The technology is amazing, and yet still has a way to go. The Star Trek hand held scanner used by Dr. McCoy seems quite a distance away. But I am praying these big machines get the job done well. Time will tell, but in the meanwhile I appreciate all the prayers that have been sent our way. God Bless.

Leg Radiation Week 2

This week Carl continues outpatient Radiation with concurrent chemotherapy at Froedtert. The Monday infusion of chemotherapy drugs interacts with and stimulates the daily radiation. I hope it annoys the cancer cells!

Last week, on Monday, April 19, 2010, Carl got a dose of Chemotherapy. On Tuesday April 20 - Friday April 23, 2010 Carl got radiation treatments 1 to 4 to his left leg each day.

This week, on Monday, April 26, 2010, Carl got a dose of Chemotherapy and his 5th radiation treatment to his leg. On Tuesday April 27 - Friday April 30, 2010 Carl plans on getting radiation treatments 6 - 9; and on Monday, May 3 - Friday May 7, 2010 Carl should get radiation treatments 10 - 14 each morning. We are getting used to the daily drive to Froedtert Hospital. I am glad Froedtert is so close - others travel from much further to get treated. At least now the route is getting pretty with flowering trees and green grass everywhere.

After radiation on Tuesday through Friday Carl goes to work.

Carl has a good attitude, and he has a fuzzy head of - fuzz. (You can't call him bald at the moment, but you can't really call it hair yet.) I love running my fingers through his hair though. "Touch me head for good luck" Carl says in his best British accent. (or Irish?) He resembles a British Rock star or soccer player (we think), though why the British would mess up the English language like that (touch me head?) I don't know. Nevertheless, the children and I like to touch the soft ducky fuzz that is growing back in.

I hope his treatment keeps going this smoothly. That's all for now!

Thursday, April 22, 2010

Leg Radiation Starts

This week Carl started the next phase of his treatment. This phase will be a dose of outpatient chemotherapy on Monday, pre-radiation. On Tuesday radiation treatments to the leg will start daily for 5 days (but on on weekdays only, not Saturday or Sunday). Then there will be one more infusion of chemotherapy drugs, followed by 10 days of radiation treatments to the leg. So many treats and treatments!

On Monday, April 19, 2010, Carl and I went in to the Froedtert Cancer Center, met with the oncologist, and then Carl checked into the day hospital and was given an infusion of chemotherapy drugs via his port that lasted a little over an hour. We left the Cancer Center before noon. Yeah for outpatient chemotherapy! (Someday I'll add what drugs they were, but not today.)

Carl felt fine, but I had asked him not to go to work and he had agreed, and so we had lunch, ran some errands and got the children from school, etc. Carl even went to the YMCA that evening (and some of the children went swimming). We joined the YMCA over spring break and the children are loving it.

On Tuesday April 20, 2010 Carl and I drove to Froedtert and Carl got his first radiation treatment (of 15) to his leg. (Carl calls it getting zapped.) After that, Carl went to work. Carl said the side effect from this chemotherapy seems to be mostly extreme thirst. He says he can't believe how thirsty he feels, even though he is drinking water until he sloshes.

On Wednesday April 21, 2010 Carl and I drove to Froedtert and Carl got his second radiation treatment to his leg. Radiation is fast - less then 10 minutes of treatment once the receptionist calls you. Then Carl went back to work. He went to the YMCA Wednesday night as well.

On Thursday April 22, 2010 Carl got his 3rd dose of radiation. When he came home from work he laid down for a nap and didn't get up until after 9:00 PM. He says he is amazed at how wiped out he feels. It kind of surprised me too. Now I just want to get him to the weekend so I can regroup my thoughts. I hope this nap is just a one night crash and burn... but fatigue is one of the common side effects of radiation.

When something unexpected happens, I get worried and concerned. (Like cancer isn't enough?).

On Friday April 23, 2010 Carl will get his 4th dose of radiation out of 15, and then he gets to stay home for the weekend. I hope you have a great weekend, I'm planning on enjoying mine relaxing at home. God Bless!

Sunday, April 18, 2010

An overdue update.

It's now the middle of April, and I am long overdue for an update.

Carl last got treatments from March 1-March 5, 2020. At that time he had inpatient chemotherapy. Then the Doctors suggested it might be a "good time for a break". Anthony and Carl had birthdays, on March 19 and 25 respectively. Easter (April 4) and Easter break for the children came and went from April 1th to April 11. Miranda turned 11 on April 11, 2010, and we went to Chicago for the weekend to celebrate her "Golden Birthday". School resumed for the children, and our oldest Tom turned 16 on April 14, 2010. On Friday we celebrated my nieces 16th birthday (She's 16 today, April 18th), and today we celebrated my father's 89th birthday, which is tomorrow, April 19th, 2010. [Deep breath here...]

I have pictures and photos from these events, and while I someday may post them, the idea of keeping this blog "chronological" at this point seems daunting. (I still haven't posted Carl's birthday photo yet, either. I'm not sure it's been down loaded from the camera!) I can't always play catch up, I'll just jump ahead.

Medically, Carl enjoyed a long break from the hospital. So the last month he has been healthy and active, able to eat salads and from salad bars, deli sandwiches and all sorts of other treats forbidden when the white blood cell counts may be low. He has been driving himself to work everyday. He's started to grow fuzzy hair. On April 8 he had to get his port "flushed", a procedure to clean out the port when it hasn't been used for a while so that protein deposits don't build up and block the tubes. On April 12, and April 14th test and procedures started for the next treatment phase, which will be radiation to the leg area for 15 days with concurrent chemotherapy. We have enjoyed a sort of respite from the cancer treatments, which will now start again with a vengeance.

Tomorrow, Monday, April 19, 2010, Carl will get a short chemotherapy dose, and then starting April 20, 2010 and for the next 15 successive weekdays Carl will be getting radiation doses to the leg to attempt to kill the tumor there. The chemotherapy drugs selected will interact with the radiation to maximize the effect of the radiation, as well as treat stray cancer cells. I so hope that Carl's cancer is miraculously sensitive to the radiation, and that the cancer cells die at a rate, and so completely, that the Doctors are astonished. Wouldn't it be great to astonish the Doctors with a miracle? We pray for this.

The Doctors don't rule out miracles. This is a step in a treatment series that will continue throughout 2010.

That idea I find a little exhausting. I find the weekend and day before treatments begin highly stressful. I want everyone to be having a great time, when I am still dealing with 6 personalities and (effectively) 4 teenagers [OK, so the children are 16, 14, 12 and 10. I exaggerate...] I find it a little hard to be happy and sparkly, or even relaxed and enjoying the good moments. I want to celebrate, have the children have friends over, and keep everyone happy, because the treatment weeks get a little rough. And this three week radiation will be another new challenge, slightly different, with different possible side effects and dangers.

Carl, my amazing guy, has a great and remarkable calm as my stress levels start to jump... Good thing I married him!

I am finding it hard to word this blog post elegantly, or even well, so I guess I'll just send it off into blogland and get on to the next task. Thank you so much for your prayers, your thoughts and your support, the meals and treats. I will need them again in the weeks (and months) ahead.

Smile, God Loves You, and Peace.