Gamma Rays and Laser Guns!

LaserGun

“Where does the radiation shoot out from? Is it a little cone with rings and a round knob at the end?”

“If the radiation hits you in the wrong spot, it will hurt you, right? Then why don’t we have laser/radiation guns?”

Paul (age 11) and I were brainstorming questions to ask my radiation oncologist, Dr. Loiselle, and my neurosurgeon, Dr. Monteith.

James (age 9) wanted to know what would happen in an earthquake. Or if you need to sneeze.   And why doesn’t the laser hurt you on the way into your brain?  How does it just zap the tumor?

Let’s start with the fun stuff.

There IS such thing as a radiation laser gun. It’s called a cyberknife. Dr. Loiselle showed me a picture.

CyberKnife

The cyberknife works like a gun, pointing radiation where you point the knife.   But creating that laser knife demands that you generate temperatures of about 2,000 degrees Celsius.  Yeah.  HOT!  And it takes a huge room of equipment to cool things back down.

Plus, the weight of the protective casing for the radiation would be huge and hard to carry.

“But they could still create canons, right?”  asks Paul.

Hmmmm… More questions for the next visit.

OK.  On to James’ question.

A Gamma Knife is not a Cyber Knife.  (I’m pretty confused on capitalization here.  Are these brand names or products?  Kleenex or tissue?)

GammaKnife

A gamma knife is actually a kind of half-spherical helmet with 192 pieces of cobalt emitting radiation.  The knife acts on the radiation rays like a magnifying glass would act with the rays of the sun.

(The magnifying glass is Dr. Loiselle’s metaphor.)

Remember using a magnifying glass to burn your initials into leather or kill ants?    If that magnifying glass was too close to the leather or ant, nothing happened.  If it was too far away, nothing happened.  There is a focal point created by how the lense bends the light rays.

The gamma knife works in a similar way.    It works like a lense, moving that focal point to exactly where it is needed.

Then they just zap the tumor, bit by bit, voxel by voxel.

Remember when it was cool for all of us to learn Photoshop because there weren’t really any other good options out there for amateurs?  Remember how we (some of us) could only use it to correct red eye by making the picture so large you could see the pixels and then by changing the color of each pixel, one by one?

Well that’s what they do with the Gamma Knife.  They have a very detailed picture of my brain and they zap the tumor voxel by voxel.  A voxel is a three dimensional pixel.

Anyway, the gamma radiation from the individual rays coming into the helmet are not strong enough to do any damage.  You need those  192 rays all focused together at one point.

Cool, right??!!

The science behind this treatment is really the only thing to talk about because the treatment itself is probably, statistically, the most effective tool ever been used so far on my cancer.  Success rates are in the high 90%.    Because my oncologist, Dr. Wahl, has been so proactive, the scans available allowed the team to identify very small tumors and other possible threats very early.   Therefore, there will be practically NO SIDE EFFECTS.

Cancer treatment without side effects.  How cool is that?

I’m not supposed to put my head between my legs and then swing it upright for a day.  I’m not supposed to lift heavy stuff for a day.

I can’t drive for a day due to sedatives they give.

And I need to take steriods before and after the procedure to help reduce the risk of swelling.

Steriods make me MOODY, so I’ll just warn you all to ignore me for a week.

That’s it.  Boring, right?

Turns out the screws they put in my head to place the helmet don’t even go into my skull.   They just push into the skin a bit.   And the reason they keep you awake for the procedure is that the entire process is so painless and uneventful that it’s simply not needed.  It’s just a long MRI session, but quieter and with a hat.

I *do* have an interesting “spot” in my brain,  though, that I will tell you all about next time.

Gamma Knife day is Thursday, July 7th and I’ll be getting lots of scans the day before.

Oh!  Oh!  Oh!  And the BEST part?  There’s a PHYSICIST on the medical team!!  If your brain’s health depends on the team’s ability to get their math right, it’s really great to have a physicist on board.

Francois (my personal physicist) said I should ask for his grades from graduate school,though, to be sure.

😉

 

 

Advertisements

Send COMFORT FOOD.

"Don't use any big words for a few weeks."
“Don’t use any big words for a few weeks.”

So complain about things getting too hopeful? The cosmos will hit you back with (WHAaa waa WAAAAaaaaa…) BRAIN METASTASES!!

There’s nothing quite so centering as the idea of cancer growing in your brain. Jumping on the trampoline suddenly takes second place behind, oh, you know, SCREWS IN YOUR HEAD.

(I’m really going to milk this, guys. Feel free to send sympathy and shower me with good FOOD. No SALT on my chocolate, though, OK? And I prefer MILK chocolate in times of stress)

Full Disclosure here — The tumors are tiny tiny. There’s four that measure only a few millimeters and one that’s about a centimeter. And there’s something funky that might be hiding behind a vein.

I meet with doctors next week and will have real facts for ya’all. I also plan to take a LOT of pictures of the frame they’re going to SCREW INTO MY SKULL.

And maybe I’ll have someone take some video of me on the sedative I’m going to ask for when they SCREW INTO MY SKULL.

It should all be quite educational and maybe even entertaining. Based on my own research (I have a doctorate in Google Science) it looks like my cancer can managed pretty well with frequent scans and some Gamma knifing when needed.

More cancer is never good news. But it’s not necessarily a game changer.

But have I mentioned they’re going to SCREW A FRAME into my skull? I have to say that freaks me out ALMOST as much as having part of my toenail taken out.

Which went fine. And was painless. And really didn’t make for this impressive photos this whole adventure is going to generate.

And I’m wearing boots to the dog park again.

So the house is full of tired happy puppies.

The Pain of Hope

IMG_2205 (1)

Tumor markers have dropped significantly. Tumor markers dropped from 2805 to 1300. That’s a hopeful sign.

Everytime I get surprisingly good results from lab tests I fall into a fit of tears.

Maybe it’s because I’m coming off of steroids right when those results tend to come in.

Maybe it’s because there’s a relief release, a purging of pent up emotion.

Maybe it’s because hope is fucking hard.

Hope rises up and I suddenly wish I could jump up on that trampoline with my son like I did two years ago. But my burning feet and recovering toe keep me grounded on the patio.

Hope makes me grieve my lost sex life and worry when my husband comes home late from work that he’s found someone to help sooth his losses.

Hope makes me angry that my morning pride in wearing my “big girl panties” ended a mere two hours after my first chemo dose for this cycle. (Try scheduling sex around chronic diarrhea.)

Hope make me cry.

But hope also means I might see my daughter graduate from high school It means my son will have a mom for those first years of middle school.

It means that maybe there’s something more.

But it sure tears me up inside.

Hope is awesome, like a God that bestows both suffering, punishment and salvation.

Hope sucks.

And I am so grateful that I hope.

Eyelashes and Toes (Gross!)

IMG_2202

First of all, it is GREAT to have eyelashes.  Eyelashes aren’t just beautiful, they keep your eyes COMFORTABLE.   So I’m very grateful for my new eyelashes.  Thank you, Xeloda!  (And my hair looks great, too!)

Driving had become a chore.  I kept wanting to close my eyes and take a nap at stoplights.  The light of even cloudy days blinded me.  I wore sunglasses even inside to help control the irritation.

I thought it was the tissue damage caused by Xeloda  (And yes, there are plenty of tender tissues on this body), but my Opthamologist, Dr. Nermeen Hamza (http://www.bellevuevisionclinic.com/) , discovered some of my eyelashes had GROWN IN BACKWARDS and were scratching my CORNEAS!  She plucked them out and then, voila!  I drive, I can go outside without sunglasses, I can go through a day and not feel I need to close my eyes for a nap every 20 minutes.

In this same vein of strange side effects for chemo, I will share the story of my toe.    Because of the Hand and Foot Syndrome (FHS) caused by Xeloda, I have switched shoes to Sketchers GoWalk 3.  They keep my burning, tender soles soothed.
IMG_2198

But they don’t have bumpers.  My boots had bumpers.  So when I slammed my neuropathic feet around, there was little consequence.  With soft shoes, I have soft bumpers.  So a small stubbed toe became an horribly ingrown toenail and spurred my first trip to a podiatrist, Dr. Andrew Lo (http://www.swedish.org/physicians/l/lo-anthony).

IMG_2199

I have to tell you, going to get my ugly toe fixed was more traumatic for me than getting my boobs cut off.  When will I get to go back to the dog park?   How long will this hurt?  …and…Do I have to be AWAKE when you cut out my toenail!!??

Turns out I’m not as tough as I thought I was!

But Dr. Lo and his staff were great.  He talked to me about Hawaii and I stared at the ceiling and wham-bam, it was done.  My toe is healing well and I’ve been to the dog park…in big loose wool socks and flip flops.

 

Self and Centered and Stablish

I feel centered at the dog park.      I come prepared for a big, muddy mess.    I wear snow pants and hiking boots on cool days.  Cropped pant on warm ones.  I really need to invest in some rubber boots, but I’m not averse to just walking into the water with my hiking boots to fetch a drifting ball or interrupt a dog wrestling match that seems to be getting a bit too frenzied.

Most of the people at the dog park are also feeling centered.  There are no cell phones out because we know about the random, the huge, goofy grinned rottweiler armed with a drooling ball, the gaggle of clumsy footed labs run-waddling through.    (Mud and phones don’t mix well.)

Rottweiler

The fences draw clear boundaries wherein the dogs can be dogs. Between eager noses and fetching puppies, there’s hardly time for our minds wander to tasks waiting outside our circle.

We bask in the joy of our dogs.

I’ve been feeling a bit of angst lately, uncentered.   My surface self attributed this to guilt.

Each day, though my computer,  I watch my colleagues work on deeply significant issues of equity and policy decisions that will determine a future culture for higher education.  I see my nearest and dearest friends and mentors heavily involved in fundraising, marches, protests, and peer education, responding actively to political threats and terrorizing attitudes .

And I post videos of my dog.  I blog about my diarrhea.    I chat about my new kitchen and floors.

I argue with myself, reminding myself that I’m incontinent 1 week out of 3.  I require diapers and two hour naps or risk falling asleep at the wheel or pooping my pants while taxi-ing kids after school.   I vomit in random places and spaces if I drink too much water without enough food in my stomach.

So it’s OK to enjoy that dog park, to indulge in those naps, to go out to great restaurants with best friends and visiting aunts and cousins.

To focus on my self.

And I enjoy focusing on myself.

I like eating good food, socializing with great people, hanging out in dog parks, binge watching quality TV series — and talking about MY insights to the world,  MY insight to YOU.

There’s this tipping point where a healthy, healing focus on the self becomes self-centered.

“Stablish”  — I got that term from an amazing breast cancer survivor Mandi, who blogs at http://www.darngoodlemonade.com/.    When your liver is so illulminated with bright spots on the PET scan that it’s easier to measure the dark ones, stablish is AWESOME.  It’s a term she used to describe that state when some tumors grow (meaning, yes, there is cancer there that is not responding to treatment and WILL spread), some tumors recede and some tumors stay the same…but overall, you get MORE TIME.

When that decaying feeling stops and your liver function improves, “stablish” feels like a miracle.  It feels like you could live forever and that you’ve refound a healthy normal.

Francois and I were even talking about my going back to work.  He’s a bit nervous about becoming the sole breadwinner on a teacher’s salary.  I’m feeling a bit guilty for feeling so good.

So I start to try to puzzle it out.  I still wear diapers most days because I’m never sure what my bowels have planned for me.  I have days where I need 14-16 hours of sleep.  I still vomit at odd times and unpredictably.  I have hours of medical appointments to attend.  My body is more fragile.   And stablish could end any minute.  It’s not a good place to put students or colleagues.

But “stablish” feels so good that it feels, well, sinful.

We’ll see where stablish goes.  It could morph into stable.  And then I could contribute to that amazing work my colleagues do.

And I’ll think about ways I can contribute a bit more to something bigger than myself even without stable.