6.3 More Treatment Planning

The good news is I am all caught up, blog-wise that is.  Friday, I had appointment for the radiation simulation.  Basically, simulation maps where the tumors and impacted lymph nodes are, where the good things are like my carotid artery, and sets up the correct dose of radiation – one that will kill the cancer, but impact as little of my healthy tissue as possible.

I wrote the previous sentence prior to actually participating in the simulation.  Not sure why they call it a simulation, since I think of a simulation as something that tries to mimic something real.  Maybe I’m just hoping it didn’t mimic what it will really be like, but it was as unreal as can be. 

It’s the day before Halloween, so lots of the Mayo staff are dressed up in costumes.  There is a woman wearing a clam shell hat and strings of pearls.  We think she’s an oyster, but she says she’s “Happy As A Clam.” She assures us clams have pearls, too — that she googled to make sure.  I don’t need google, since we are at the Mayo Clinic, the place that I am depending upon so save my life… so I assume everything everybody says is the absolute truth.  Anyhow I digress. 

My part of the simulation process takes 3 or 4 hours.  It felt like so much longer.  Suzy is waiting in the waiting room, and it’s great to know she is out there.  I really didn’t know what to expect.  I have read a few things, but it all seemed so abstract.  Now it’s getting real.  Suzy and I go into an exam room, and there’s a person dressed up as nurse.  No wait, she is a nurse (remember it’s the day before Halloween).  I thought we were going to talk to the doctor, but it’s only with the nurse.  We go over some stuff (again, it’s a blur, sir! Get used to that Hamilton reference — I’m sure I’ll say it a lot more in the future).  The part I remember is her putting in an IV so they can inject some stuff into me for the CT scan and an MRI.  For most of my life, blood tests and IVs have been easy.  Now, of course, it’s not.  After missing once on my left arm, then getting a cool-looking light that shows where my veins are, a heating pad to make them pop out, and some digging around, it’s done.  I’m such a whiner, but you all know that.

Next, I’m called into the room to get fitted for the radiation mask and do a CT scan.  Who would have expected a Ninja and a witch would do this?  They position me on the table, and bring out a warm, wet piece of what I think must be Kevlar with holes in it and place it over my shoulders and face.  With two people working, they pat the Kevlar into place, tight on my shoulders, neck, chin, nose, and even my ears. In 6 or 7 minutes, it’s dry and they remove it.  It looks like a bust of me, only with an opening in the back.  They make a mouth guard that takes about five minutes to dry. Glad I’m that over!  But wait, there’s more.  They put in the mouthpiece, put the mask on, lock me in, and slide me into the CT machine.  The mask is really tight and they strap my legs down.  I can only move my hands to push the panic button.  After 5 minutes or so, the CT scan is done.  The mask has diamond shaped holes in it, allowing me to see a poster on the ceiling and the lights of the machine.  I didn’t even use the panic button.  Quite the stud, huh?

Next up is an MRI.  They are going to take 4 pictures, so we should be done in a couple of minutes. Just kidding.  They take about 10 minutes each, so 40 minutes or so.  For some reason, these people are dressed up as lab technicians.  (They explain that they can’t dress up because if something was metallic it would get drawn toward the huge magnet which is basically what the MRI machine is.)  We are waiting for someone or something.  I just want it to get to over with!

While we wait, the guy explains how an MRI works.  I am not strong on science but here’s what I heard.  When the MRI is making noise, that’s the magnet being engaged.  Since our bodies are made up of water, the magnet makes the hydrogen atoms stand on their edge.  When the magnet stops, the hydrogen atoms fall flat.  The atoms stand up at different rates; ones in the bones stand up slow, the ones in soft tissue faster, and tumors at some other rate.  Again, we are at the Mayo so it must be so.  You don’t need to google — they are always right!

The door opens, and it’s the ninja carrying my mask and mouthpiece. I must have looked surprised, so the ninja explained that the purpose of the mask to hold me in the same position for every machine they use so they can position the machines, knowing that I am in the same EXACT spot.  He said it that way – EXACT.  They strap me down, but put some other pad-like thing over the mask so I can’t see out.  In I go, for forty minutes.  First, I imagine being in those red Adirondack chairs in Canada, then sitting on our back porch watching golfers, then relaxing with Suzy.  Then the third picture begins and I thought about those hydrogen atoms standing up and laying down.  I swear I felt them.  When they told me that the last picture was going to start, I had thought myself out, so I just counted the banging noises – there were hundreds! It’s finally over. They removed the mask and I sat there for a few minutes collecting myself.  Only in the times of corona would this be the case: my radiation mask had a surgical mask on it.  They walk me back to the waiting room as a stormtrooper walked by.

One last thought, everybody who is helping me is wearing a mask.  I haven’t seen anyone’s face, shook anyone’s hand, or been comforted physically by a pat on the shoulder.  It’s weird, but you can see there are smiles in their eyes.

I walk out and see Suzy there and know that she will be there for me through this journey.