***WARNING: This post contains adult language and may not be suitable for youngsters.I had been looking forward to this day for a few weeks now. Maybe "looking forward to" is a bit of an exaggeration. "Dreading" is more accurate. Because today was the day of my first Brachytherapy, the first of five Internal Radiation Therapy sessions.
Dr F had explained Brachytherapy for me by saying "you will be
very uncomfortable," which didn't give me much confidence in the day. Especially since I have been uncomfortable all week with what I like to call Consti-rrhea (or should that be Dia-pation?). The chemo drugs cause one, the radiation causes the other. Logically, this should mean they cancel each other out and leave me in a happy regulated state. But no. It means I'm both. Simultaneously. And they don't make drugs that treat both simultaneously...
And to make matters even more uncomfortable, I found out yesterday that although I wouldn't have to utilize the same bowel prep I had previously used (remember the magnesium citrate?), I would have to partake of some morning-of prep that was... shall we say... quite a jolt up the ass. But we'll get to that in a minute.
As for the Brachy itself, I had an image in my mind. And that image was that bit of plutonium that Homer Simpson accidentally brings home being shoved up my hoo-hah, glowing green for 10 minutes or so. But I couldn't be further from the truth. The truth about Brachy is that the Iridium-192 seed is smaller than a grain of rice. And what is actually
shoved up my hoo-hah are three applicators; intra-va-jay-jay tubes that have receptacle tips to hold the Iridium. And around these tubes is placed yards and yards of packing material.
(Click here to read more)So here's how my day went:
Woke up at 4:30 am to face the ultimate in humiliation. And to make it even more humiliating, I'm including the picture from the instructions that are printed on the
outside of the Fleet
® enema box, so that the guy at the check-out counter at the drug store can visualize what you'll be doing, thereby heightening your embarrassment. Let us bow our heads for a moment and thank the gods of humiliation.
Thank you, gods of humiliation, for letting me cross one more demeaning, shitty task off my list of things I wish to never do. Let's move on.
We arrived, as instructed, at 6:00, and were told that I needed to get labs drawn but the lab didn't open until 6:30. So John & I went over to the lab waiting room to wait. When the time had come, the nurse called me to the window (I was the only customer). Remember, Reader, that port I got installed a few weeks ago? The one I went through hell to get? The one that freaks me out more than a two-headed dog? The point of this port is that as long as it's in me, I will have no reason to get stuck in a vein. Ever. But when I explained this to the nurse in the lab, she explained right back that they don't do that there; they are not
certified to do blood draws through ports. Oh really? Well, you can cross my name off your list, Miss Thing, because I will find someone else who
is certified!
We went up to the second floor and rehashed the whole lab ordeal with the Same Day Surgery Intake Lady who called Nurse D who said that she was more than willing to sort it all out. They called me in, I kissed John goodbye, and my real adventure began.
This was the forth time my port was to be accessed. Generally, this is how it goes.
Bonez: I'm a wuss. Lay me down flat or I might faint. (Head turns in opposite direction) Please don't tell me what you're doing.
Nurse: Ok, deep breath!
stick
Nurse: Good blood return. Now just remember to breathe...
Bonez: Please don't tell me what you're doing. Sniff... Sniff... (tear rolls down cheek)
Nurse: Ok, please breathe!
How it went today was quite different. Nurse D was obviously not well versed in the whole "deep breath" of it all. Instead, she counted "1... 2... 3... " and I had to know to take that breath all on my own. And it kinda hurt. And she kept touching it. And then, even though I asked her not to tell me what she was doing, she kept talking about it with her accomplice Nurse C. And the big issue was: she was trying to get blood for labs, but the blood would not flow. Do you know why? Because when I panic, my blood pressure drops to like 80/30. No blood pressure, no blood flow. I get it. You get it. She didn't seem to get it. She kept trying to move me around: raise my head, raise my arm over my head, sit me up more, etc... In the end, what really worked was getting me talking about Dr T (the a-hole that installed my port in the first place) and my blood pressure rose and rose and the blood, she did a-flow! But I've learned a good lesson - next week, I'll get labs drawn on Tuesday by the ones that do it regularly and know to say "deep breath".
The plan was that I would be anesthetized, Dr M would do an exam under anesthesia, and Dr F would insert the applicator tubes in my sanjaya. I would be woken up and brought to the radiology floor of the ROCk (I learned today that the Regional Oncology Center shares a nickname with Alcatraz. Coincidence? I think not.) Dr S, the anesthetist, explained first that I would get 2 doses of Versed, which I tried to tell him doesn't so much as chill me out as make me talk alot, but once I got them I said "Dude, it worked this time!" I have a vague memory of being brought into the operating room, and once again asking who picked the music. But after that,
nada...
When they woke me up, I had to pee. I don't mean a little tinkle or a nervous piddle, I mean a giant man-sized piss. So I tried to get up, but Nurse W kept telling me "It's ok honey, you have a cath." It was the cath that made me feel like peeing in the first place!
Nurse W was
very good to me with the drugs. Having three test tubes and yards and yards of packing stuffed in your cooch is, as Dr F warned and you might imagine,
UNCOMFORTABLE. It didn't hurt necessarily. But it never stopped being uncomfortable. And to add to the joy of it all, I couldn't move. I had to lay on my back, with my legs slightly askew. So Nurse W made good with the pharmaceuticals: Morphine, Demerol, and Vistaril. The only bad part was that the Vistaril and Demerol had to be injected into a muscle (combined, just one shot), no matter how hard I argued for the port.
After about an hour in recovery, Orderly T came and pushed me through the secret hallways that connect the Professional Center (which houses Same Day Surgery) with the ROCk. When we got there, Nurse K met us in the CT-scan room and I was transferred to the very narrow CT-scan table. Here I was given - you guessed it - a CT-scan. They needed to have a picture of my pooter with the tubes inside with dummy-radioactive material to know exactly where in the reservoir tip to put the Iridium seeds. This is called
planning and apparently, it involves a whole team of experts and takes a few hours. During the planning, I was slid back onto the stretcher and pushed into a dimly lit quiet room where I took a 2-hour nap.
When I woke up, the uncomfortable was pretty much gone. I equate it to the pain of a tattoo - eventually, you just get used to it. What wasn't gone was my irate mental state. I. Wanted. To. Go. Home.
Now.
But I had to wait until after 1:00. They came and got me and brought me to the very high-tech HDR room. HDR=high dose radiation. HDR is one option for Brachy. The other is LDR (low dose radiation) where a low dose is left in for hours at a time. With HDR, the Iridium seeds are only in place for a few minutes. Pneumatic arms are attached to the openings of the tubes, and the Iridium is inserted via remote control. It's left there for 12 minutes, and then it's over.
Then the REAL fun begins! Dr F tried with all his finesse to make this a less painful process, but unpacking several yards of linen from the vag is never pleasant. Whatever lube they used getting the stuff in there had long ago been absorbed, and I was left with
coils of fabric stuck to the inside of my peesh. Dr F and Nurse B pulled quick, like taking off a band-aid, but it was like a clown pulling a scarf out of its mouth. They just kept pulling and pulling and more and more kept coming. Finally, the packing material was out, and it was time to remove the tubes. Which are shaped more like lollipops than test tubes, with the big part all the way to my cervix. I will spare you the gory details, but suffice it to say it was NOT ENJOYABLE!!!
The only thing left was for Nurse B to flush my port and remove the needle. Which had grown accustomed to its accommodations and didn't want to leave. But before long, it was all over, and John was able to take me home. HOORAY!
I've been in bed since. Kinda loopy from the anaesthesia, kinda uncomfortable in the groinal area, definitely glad to cross Brachy 1 off the list :)
For those keeping score:
Oh, and my stitch is still sticking out. ICK!!!!
Thanks again for your continued well-wishes, support, phone calls, emails, cards, care packages, and cheering-up. I am courageous vicariously through you :)