Wednesday, January 04, 2006

An Unwanted Journey: Day 0041 - Tattoos & Training


Normally I refuse to make New Year’s Resolutions. But here’s one that works – this year I resolve to be the first person in my immediate nuclear family to get a tattoo. OK, there’s one resolution that’s already implemented.

Today was my radiation planning and simulation at the Grand River Regional Cancer Centre. It began with an orientation session with an oncology nurse who explained what they were going to do, why the procedures were done this way, and what to expect as I entered the room where the radiation oncology CT scan machine is located. She also gave me one of those wonderful contrast solutions to drink similar to those I had to consume for my previous diagnostic CT scan and MRI.

So, for yet another of what will undoubtedly be many more exercises of undressing and putting on those flimsy hospital gowns, I prepared for the procedure. When I entered the room with the CT scan, another technician took my photograph with a digital camera and then asked me to lie face down on the CT scan bed. I had to maintain that position for about 20 minutes or so, not the most comfortable of positions, especially since I couldn’t see anything and had my buttocks exposed to the world. I guess dignity flies out the window during rectal cancer treatment. This isn’t a complaint about the nurses and technicians. They do everything in their power to make the patient feel comfortable, but this isn’t exactly what I had in mind when I’ve fantasized about two women asking me to get undressed.

They had to position me a couple of times on the table to eliminate any twisting of the torso, followed by a pilot scan. After that, they marked the middle of the back of my pelvis and the sides with a marking pen, ran the CT scans, asked me to wait in the face-down position for another 10 minutes while they viewed the photographs, and then proceeded with the tattoo.

The tattoo is really just some small blue dots used to triangulate the location of the tumour and the pelvis where the radiation treatment will be focused. I was a “jumper”. The tattoo on the back was easy, but the one on my left side for some reason caused a nervous twitch. Luckily my “jumping” didn’t require doing the tattoo over again.

Generally, it takes a couple of weeks for the planning of the radiation treatment; this involves the preparation of the blocks and templates used to shield the rest of the body from radiation and to help position the body for the daily treatments. In my case, since the team is moving ahead quickly and because the chemotherapy is to be executed at exactly the same time, the two weeks was reduced to just a few days. Later in the day, I noticed that my radiation treatment schedule was already in place on the GRRCC’s My CARE Source website for patients.

I will be getting about 54.9 Gray (Gy) in 28 fractions for the radiation treatment schedule (The gray is a unit used to measure a quantity called absorbed dose. This relates to the amount of energy actually absorbed in some material, and is used for any type of radiation and any material. One gray is equal to one joule of energy deposited in one kg of a material. The unit gray can be used for any type of radiation, but it does not't describe the biological effects of the different radiations. Absorbed dose is often expressed in terms of hundredths of a gray, or centi-grays. One gray is equivalent to 100 rads.)

A little later in the morning, I had another session with my fitness trainer at Popeye’s Gym. She has me performing a core training regimen that involves lots of stability exercises, abdominal exercises, stretching, squats, push ups, lunges and other assorted exercises. She indicated that it is a fairly advanced routine. I’m progressing reasonably well already, increasing repetitions and the weight for various sets. But by the end of our session, I felt like I’d like to go back to bed. Oh well, just another 12 weeks of this torture before surgery. Maybe when all the treatment and training is finished, I’ll see about connecting those dots and getting myself an interesting tattoo.

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