One Down

August 15, 2006 - 34 treatments left to go. All in all, I'm no worse for wear. After spending a few hours in the office this morning, I made the 20 or so minute drive to Fairfax for my 11:15am Tomotherapy appointment. I was a little late and Michelle had already arrived ahead of me. Our first meeting was with a social worker who was very nice and wanted to know how we were both coping, who our support was, etc.... After about 20 minutes with her, I was shown to the treatment room while Michelle stayed behind and continued to chat.

I was instructed to lay supine on the platform while my head was positioned properly on the headrest and my mask was fitted. I'm not going to lie, the mask sucks. It truly is uncomfortable, both physically and mentally, moreso than I remembered. Not only does it prevent you from moving your head laterally but it actually constricts your face so you can't really talk or even open your eyes completely. Since it is snapped down to the platform, there is quite a bit of downward pressure applied and the plastic is not very maliable at all. In fact, because it is plastic mesh, the meshing begins to dig into your skin after a few minutes. If you're at all claustrophobic or anxious, I would recommend a valium or something prior to the treatment.

Before the treatment began, the technician had to calibrate my position which is done to the millimeter. It is very precise. Unfortunately, this significantly adds to the time in the mask. During this time, I tried to control my anxiety by concentrating on my breathing. The trick is to focus all attention on the exact spot where air is inhaled and exhaled. Close your eyes and see that spot in your mind, as though you are looking at yourself. Not only does this help control your breathing and, in turn, your anxiety but it forces you to not think about the pain of the mask or whats going on around you.

Finally, the radiation began and I would have to say it didn't take any longer than 5-7 minutes. I kept as still as possible but after almost 30 minutes, that became exceedingly difficult. I couldn't see any radiation beams or where they might have been coming from for that matter but I did hear it. It was like a locomotive chugging in a halo around my head. CHUG chug, CHUG chug, CHUG chug, all the way around my head. I think I felt it also, which I will not even try to describe because I can't. It didn't hurt for what that's worth. When the mask was finally removed, the meshing left quite an imprint on my face and made me look like I had lizard skin. This should not be too much of an issue after the first few treatments since I probably won't be in the machine as long. I dressed and headed straight for my Erbitux treatment.

When I finally arrived at Dr. Dar's office (15 minutes late) for my 1:30 Erbitux appointment, I was still feeling no effects from the radiation. So far so good. The Erbitux injection takes a long time. I was shown to a long room with one wall full of windows overlooking the grounds outside. There was a series of reclining chairs, each with a I.V. infusion machine next to it. Two of the chairs were occupied by miserable looking yet good-natured people. They were both quite elderly and just like at the PET scan, I felt very out of place. A nurse explained the possible short and long term effects of the drug before inserting my I.V. line. They worry about allergic reactions since I'm a first timer so before they start the Erbitux, I'm given a steroid as well as Benadryl. What I wasn't told was that the Benadryl would make me drowsy and after about 15 minutes, I felt completely stoned. Finally, they loaded the Erbitux which was a two hour infusion since it contained both a normal dose and a loading dose. All in all, I was there for about three hours. One interesting thing to note was the conversation I had with Dr. Dar's benefits coordinator before I went in for the treatment. She explained what was going to be billed to my insurance company and the cost of the Erbitux... $9000.... PER TREATMENT! I certainly hope my insurance company doesn't try to bill me for any of this.

By the time I was ready to leave, my buzz had worn off and I was still feeling pretty good. Maybe a little residual drowsiness but I didn't have time for that. I had to pick Mason up from school and get him to football practice by 6:00pm so I could watch him get consistently outrun and overrun by kids twice his size. If he's going to play for Ralph Friedgen in 15 years, he's going to have to work on that a little.

So now, I still feel good. I was able to work out tonight and eat a big dinner. I asked the radiation techs and the social worker how long it would be before I really start to feel bad and they both said probably 3-4 weeks but hopefully not until the 5th or 6th week. I am apparently only the third person to be treated with this Tomotherapy machine and the first is still undergoing treatments so they don't know what type of improvements this machine will have on side effects although they all believe it will be very positive. I'll take some pictures tomorrow of the mask and the procedure and include them in my next post.