Help Wanted: TomoTherapy Repairman

September 3, 2006 - Sorry for the delayed posting. Thanks to Tropical Storm Ernesto, we haven't had Internet connectivity all weekend. As it is, I'm "borrowing" connectivity from someone in my neighborhood who was kind enough to leave his wireless access unsecured.

So this may sound hard to believe (it was for me anyway) but the $5 million state-of-the-art TomoTherapy Machine is on the fritz! Yes, you read that correctly. It had been getting progressively more tempermental by starting then stopping, having to be reset, communication errors, etc., until finally, on Wednesday, it stopped working altogether. I waited an hour in the reception area only to be told that I would not be receiving treatment that day. This is problematic on multiple levels. One, what would missing a day of treatment do to my overall progress, especially since I'll be missing this coming Monday as well for Labor Day? Two, how disconcerting is it to think that the giant microwave that I have to lay in every day may not be working correctly? As for the first issue, Dr. Tonnessen assured my that one day is no big deal but if it were to become three or four days we'd have to come up with a new plan and he admitted that he didn't know what that plan would entail. Regarding the second issue, it was explained to me that TomoTherapy has a staff engineer and a staff physicist on site at all times so they will get it fixed and there is no reason to be concerned about problems occuring while treatments are being administered. To their credit, the machine was working just fine the following day.

Dr. Tonnessen examined me again on Tuesday and this time said that he can no longer feel any tumor. I took this opportunity to ask the question I should have asked last week which was whether or not this degree of progress is to be expected at this point in the treatments. He told me that it is very encouraging and to be this far along after fewer than 1/3 of my treatments puts me "well ahead of the curve." Encouraging indeed!

My encouragement was dampened this week by a call from Dr. Dar's office. Each week, prior to the Erbitux injection, they take blood to measure blood counts and liver function. Last week they called to tell me that my liver functions were slightly elevated and while not a cause for immediate alarm, it is something they would be monitoring. This week they called again to tell me that my liver functions were significantly more elevated. No one wants to speculate as to what this means so, naturally, my first thought is that that the cancer has spread to my liver. I mentioned this to Dr. Tonnessen on Friday and he told me that's impossible. He said it's most likely due to the Erbitux and worst case scenario, we might have to switch to Cisplatin. However, Dr. Dar insists that it is not the Erbitux because, according to him, Erbitux is not metabolized by the liver and there is no case history of liver complications with Erbitux. Instead, he wants to rule out some sort of biliary duct blockage so he has ordered a sonogram which I will have Tuesday morning. I'm concerned. Very concerned. I think I've gotten over my initial fear of liver cancer but something just doesn't add up with all of this. Before I started the Erbitux treatments, my liver functions were just fine. In fact, they tested me a week before starting treatments and they tested me just prior to the first treatment as they do prior to every treatment. It wasn't until after that first dose was administered that my counts started going up. I guess we'll see what the sonogram tell us but I think they're looking for gall stones. If I do, in fact, have gall stones, they will have to be surgically removed.

Now onto my favorite... the weekly bitch session. I now have a collection of ulcers along the left side of my tongue that burn whenever I put something in my mouth. The thought of eating anything anymore has become totally reprehensible to me. Everything tastes the same and that taste is terrible. I can't really describe the taste but I imagine it's something like dirt or burnt tree bark. My throat still feels OK, so thank God for small miracles, right? I've stopped getting on the scale but I know I'm losing weight and am not looking forward to the stern lecture that I will receive this week from Tonnessen's nurse.

As for the rash, it's as bad as ever. I broke down and finally started taking the Doxycycline that Dar prescribed. I guess it's helping a little but it's probably tantamount to using a garden hose to fight a forest fire. The itch is incessant and I've used every topical cream I can think of on my scalp to try to find some relief. Most anti-itch creams last for a couple of hours but I'm still waking up most nights because of it.

Thank GOD college football has started. At least my Terps pulled out a relatively easy, if uninspired win yesterday. Sorry for not posting, Noli, but if you saw me right now, you'd understand why tailgating is out of the question.