St Thomas Hospital
The Head Shell Game
I'll be receiving 30 days of RT ( Radiotherapy ). About a hour a day, 5 days a week, for 6 weeks in a row. I'm not looking forward to it.
I'm not looking forward to it at all, frankly it still worries the 'dickens' out me.
The alternative is to live with the knowledge that there might still be rogue cancer cells hiding in my neck just waiting to erupt again. And frankly they can all just fuck off and die. NO ! not "just fuck off and die", we are going to kill every last one of the vicious, mean, little fuckers, dead !, forever!. "Take that, you useless, little, fucking bastards".
Radiotherapy is an exact science. So exact that even the slightest chance in body shape i.e. weight loss or gain, or slightest movement while being eradicated will throw the targeting off.
So as well as the RT bed having footrests, hand grips, chest buffers and shoulder grips I will also be having my head "immobilized" in a "Head Shell".
Before being handed over to the 'Mold Making Team' I have a Pre-Treatment Consultation with Radiographer Sajeesh Raj.
Sajeesh is a lovely chap, very calm, gentle and softly spoken. He explains everything that I can expect to me in a manner that was consummately reassuring. We might even meet again as he is about to start a posting at Guy's Hospital where i'll be receiving my RT. I like him he's another excellent example of the caring-professionals I'm constantly meeting.
Sajeesh takes a couple of photographs of me for my I.D. Card, we don't want anyone else stealing my radiation. He like the first, I like the second, not sure what one will get used.
And 'one other thing', Sajeesh 'pops' out of the room and returns a minute later, Julian the 'Mold Technician' thinks that "yes! if I can trim my beard closer then that would be preferable". However they have no scissors, so I have to 'pop' out and buy some from the local W H Smith's.
The bathrooms/toilets in the Radiography Dept. don't have mirrors (?). What they do have is chrome flush mechanisms for there toilets, the size of paper back books and with large round chrome buttons. So to trim my beard I'm keeling on the bathroom floor with my head over the toilet bowl using the chrome flushing mechanism as a mirror. I forgot to lock the door. Some one opened it, what they must have thought I was doing I can only begin to imagine.
The actual mold making process was to me, fascinating. Victor Lee the Dosimetrist & Julian Chapman the Mold Technician have there own little workshop with an exact copy of the RT bed that i'll be treated on.
They go to great lengths to explain everything to me in as much detail as I can handle. They are both really nice guys ( no surprise there ) polite, charming, well spoken, calm and gentle, they are gentleman. I like them too, I think that they would both be very pleasant men to work with. I tell them about this blog, "Yes I have herd about it" says Julian "from either Dr. Guerrero-Urbano, or possibly on of the other doctors no your team", "don't these people have anything better to do ?"
They seem to have an excellent working relationship, Julian, who is the older of the two and I suspect also the more experienced seemed to be running the operation, but at no point did I ever get the impression that Victor was in any way subservient to him. They worked in tandem with an ease and familiarity that was most reassuring and clearly highly professional and efficient.
After tailoring the bed to my exact measurements which took a few minutes and was aided by laser positioning came the actual molding of the shell to my head.
The raw shell consists of a plastic hoop that 'clicks' into place on the bed. To start with the mesh in the hoop is flat, but becomes pliable then warmed in hot water. The sensation is like having a warm flannel draped over your face. While the mesh still warm Julian and Victor mold it to the contours of your face, paying particular attention to the nose, eye sockets and jaw. It is not an unpleasant sensation at all, more like having a face massage. It takes about 12 minutes for the mesh to cool, harden and set under the fans. Breathing is no problem at all, the holes in the mesh are between pencil and little finger size.
With my bespoke head shell I now have a CT Scan 'shell on' so that the RT Team can calculate & produce my final 3D exposure map, targeting the exact parts of each tumor to be eradicated and avoid sensitive ares like the brain and spine etc.
The CT Scan will be 'with contrast' so i'll be injected with "stuff' again ! As usual while I'm chatting to the nurse I'm telling her how much I don't like needles and I think i've put her off her game. They can't use my PICC Line, the 'stuff' is a bit thick and sticky and could gum up the tube, so it has to be 'old school' a channeler, a needle again.
She's being ever-so careful and considerate, but the first needle goes in 'but' not 'into' the vein, so that one comes out again and goes in the bin. She's ever so sorry and I try to reassure her that it's OK.
Second go, same thing again !, the second needle goes in but not 'into' the vein, so that one comes out and goes in the bin. She decides to go and get someone else who doe's a lot more of this kind of thing, and a lot more than she does.
The doctor arrives, straps the tourniquet around my lower arm, slaps the back of my hand a few times declarers that "this skin is much thiner and, that the veins are bigger and are easier to get to" and in the needle goes "just a 'tad' ouchie" but over an done with, phew!
The CT Scan even in the shell is just like all the other scans I've had, easy. With the head shell my only form of communication is by hand gestures, thumbs up or down or rather from me a divers OK signal.
A small prick with a pin, yes I know you are, but what are you going to do with it ?
Accuracy is curtal and the CT Scan is and RT will also be, laser aligned and as a reference point of a small ball-bearing is stuck to my Sternum. To be able to regain that exact point I now have a tattoo on my chest at 'that exact point'. The tattoo is the size of a single prick with a pin. Jo said "just like how Febe's mum sees her from heaven". I just hope it doesn't get lost I'm my forest of chest hairs, all 19 of them, Snowy the first white one, Snowy Junior my second white one, and there 17 friends.
As soon as I get back home I'm straight off the see the District Nurse for my PICC Line Flush & Clean. It's a different nurse this time, we have the same chat as I keep having re PICC Lines, and she agrees that there is absolutely no reason to 'over dress' the Line, and it really annoys her too.
She's half way through peeling of the old dressing and is about to slip a pair of scissors under it' but a stop her in time. I was quit prepared to shove my finger between the blades of the scissors rather than risk having my PICC Line severed. She was perfectly understanding about my concerns and with a little gentle peeling it was all taken care of, and I actually came away with a very neat and comfortable dressing.
Edited with thanks to Jo W
Reading this blog Stuart has made me feel very humbled. You have an amazing outlook on life and only you could get others to smile while you talk very frankly about Cancer. It's really good news about the tumours reduction/ shrinkage. Keeping you in my thoughts and prayers. We need our Bouncy Tigger back!
ReplyDeleteBest wishes Mary