Monday, January 09, 2006

An Unwanted Journey: Day 0046 - First Treatment


I may have to be more careful about what I listen to on the radio while driving to treatment at the Grand River Regional Cancer Centre these days (GRRCC). But it was strangely compelling material that Shelagh Rogers and Syd Birrell were discussing – Ya Can’t Let Cancer Ruin Your Day, a book of emails from Syd about his young son’s battle with a malicious form of cancer called neuroblastoma. I tried to tell my wife about the interview when I met her at the GRRCC, but found that the words caught in my throat and I couldn’t finish – the first of three times during the day when tears caught me unexpectedly.

I will purchase the book, but will have to be judicious about when I read. Today, for instance, despite my eagerness to get treatment underway, I found myself almost suffocated by cancer treatment and the reality of my situation. There were so many appointments, so much information, so little personal control over anything that was being done to my body…everything was just too much.

We started with a blood draw in the chemo suite followed quickly by a teaching session with one of the pharmacists in something euphemistically called a “quiet room”. This was all about 5-FU (fluorouracil), side effects, the kind of Baxter “baby bottle” pump I would be wearing (this was unexpected; I was told earlier that I would have a pump in the shape of a money belt with a keypad protected by a password, something far smaller than the “baby bottle” with a hip pouch which I now have), and the rate of flow by which the 5-FU will enter my blood stream (1.5 ml / hr).

We had time for lunch in the hospital cafeteria and a quick visit to the computer/resource centre (which doesn’t allow for access to My CARE Source, unfortunately, nor for outside access through Remote Desktop, something I need to get into the corporate network where I work most of my days) before on to the 5-FU infusion. The oncology nurse hooked me up very quickly and then presented me with this “baby bottle” which I will have connected to me for the next 6 weeks. She showed me how to care for the bottle and offered suggestions for how to wear it. She also showed me my blood test results from earlier in the day; evidently my liver function and kidney function are both good. My ANC (absolute neutrophil count, calculated by multiplying the total white blood count times the neutrophil count) is well within the appropriate range for chemotherapy.

And then it was on to radiation therapy. Again, I felt my emotions right at the surface – so little control, such a sense of both unreality and super-realism to everything happening around me, and incredulity that all this was being done “to” me. The radiation procedure and machine are impressive and the treatment painless. There were no expected “blocks” on the treatment bed since those are now built in to the machinery itself and controlled through computer software settings. These blocks are about 6 inches thick and made of an alloy that includes the expected lead protection. I get three “blasts” of radiation each day, one to the back of the pelvis and one to either side.

But it wasn’t over. We then moved on to the pharmacy to pick up an anti-emetic to combat nausea if I encounter that side-effect, a “spill” kit for the chemo, some special cream to treat the skin at the location of the radiation fields, and a special pouch to hold my chemo bottle. We picked up more “veterinary” gloves for bathing, collected our literature, hoisted my notebook computer and left for home. In the parking lot, though, we met an acquaintance surprised to see us at the hospital. It was the third such encounter of the day, one of which was another patient in the cancer centre itself, someone who was the crossing guard for our children in kindergarten.

We went home, unpacked all the pharmaceutical products, tried out various ways of securing the chemo bottle, took my temperature with the digital thermometer provided by the GRRCC pharmacy to cancer patients…and then I crashed for a while, sleeping for about forty minutes.

This was a tough day, but my wife was very supportive, helping me bathe in the evening, shopping with me to get appropriate shirts that would work well with the apparatus I have to carry everywhere with me, preparing my supper, and helping me remember everything that happened today. I don’t know how I could handle all this without her.

Tomorrow (Tuesday), it’s merely a physical with my family physician, a consultation with the radiation oncologist, another trip to the pharmacy for my medical supplies, and…oh yeah…more radiation therapy.

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