The Radiation Team

Last Thursday we arrived at the Stanford cancer center at 1PM.  We were scheduled for a 4 hour appointment with the radiation team, but we had no idea what it was about or why it was going to take so long.
We were taken to a small room with Pumpkin colored walls and a radiation Fellow began asking us questions.  She was young with dark brown hair and small facial features that gave her a childish look.  She was firing question after question about Willie's medical history and medications he has been prescribed in the past 6 months (which is quite the lengthy list!)
Our answers were short and rebounding as quickly as her questions.  Her hands flew across the keyboard with each response.  She began to read another question from the computer screen when she suddenly stopped and looked up at us.
"Do you have any idea why you are here today?" she asked.
It was as if she had read our minds. 
"Uhhhh, not really." Willie responded "We just know it is supposed to be a 4 hour appointment."
How incredibly disconnected we sounded.
She smiled and turned toward us.
"Today we are going to get you ready for radiation treatments which means meeting with the doctor and radiation team to get measurements taken."
We nodded as if it all made sense, but I was inwardly noting that what I thought I knew about radiation was apparently false because nothing I was aware of included measurements.
"We are already running late which is why I have to rush through these questions before Dr. Million comes in."
She said "Million" with an accent over the "o" in a way that reminded me of fillet Mignon.  It sounded so exotic and ritzy.  I felt under dressed, like we were about to be in the presence of a famous Spanish Dr.
We finished answering her questions and she left the room to get the attending Dr.
"I thought her name was Million like a million dollars.  Did you hear the way she pronounced it?" I asked Willie.
"Yeah," he said "It was fancy."
I had an image in my mind of a sultry Spanish Dr with dark hair and a deep accent so it was a shock when a blond, middle aged, mom-looking woman walked in.
"I'm Dr. Million" she said with no exciting accent.  She pronounced her name without any flair and I found myself feeling a little disappointed.  My vision of her was so much better.
We shook hands and she sat on a stool near Willie.
"We are short on time, but I wanted to go over all the risks and benefits of Radiation treatments and answer any questions you have."
We nodded and she continued on without missing a beat.
"Radiation will kill the cancer which is our main goal, but it comes with side effects.  You will experience nausea as 100% of patients complain of this.  You will lose your hair, but it will come back,  you will be exhausted and may sleep most of the day, you may have problems with cataracts later in life and you may develop another form of cancer later in life...."
I found myself tuning out as she rattled on.  I could see her lips moving, but I felt overwhelmed by the laundry list of side effects.  I felt like we were sitting through a live commercial for a drug in which the benefits are discussed for 5 seconds while the rest of the commercial is filled with warnings and side effects. 
I looked over at Willie as he listened to the Dr. and nodded from time to time.  She spoke directly to him as if he was the only one in the room. 
"You will not be radioactive," she said as I tuned back in "The second you leave the room you will no longer have radiation in you.  It's like going out in the sun and coming inside.  The sun is no longer on you once you go indoors, but the effects can happen later like developing a sunburn."
"Do you have any questions for me?" she asked Willie.
He nodded his head no
"I think you covered my questions."
She smiled and stood up. 
"Ok then, we need to get your downstairs to get your fitted for the machine."
"What does that mean?" I asked.  We had heard the term a few times now and the images that came to mind were from the scene in Star Wars when Harrison Ford got stuck in the metal casing.  That is what I thought of being fitted for a machine.

"The lungs cannot be exposed to radiation so they will be taking measurements and using x-rays and a ct scan to make a special shield for Willie's lungs that will protect him from the radiation."
What a concept!
The nurse took us down the back stairs on a "super secret" route to the radiation department.  They rushed Willie directly into the x-ray room where a man and woman were waiting for him.  They began working on Willie like he was a piece of equipment, positioning him against a wall while taking measurements and noting distances.  A machine projected a giant "X" on his chest and the nurses were moving Will to center the mark over his lungs. 
They worked in silence, the only sound in the room being a low hum from the x-ray equipment.  It was unsettling.  I sat in the corner holding Willie's sweater and hat tightly on my lap. 
Finally, the man nodded to the woman and they turned toward me.
"We all need to leave the room now for the x-ray" the woman said and lead me into the hall.
They took pictures from the front and back then moved Willie next door for a CT Scan.  He was handed off to a new pair of male nurses who were much more personable.  They talked and joked with Willie as they positioned him on the table then ushered us all out of the room.  The scan took about 3 minutes.  When the heavy door opened I laughed when I saw Willie bent over with one of the nurses picking up change from the floor.
"Did he give you a tip?" I asked the nurse.
He laughed and offered a handful of pennies to Willie which were placed back in his pocket.  We walked down the hall to the jingle of pocket change and were placed in yet another examination room.  After a few minutes a female doctor with a heavy Chinese accent entered the room.  She was from a research study group and wanted Willie to participate in a research study.  After the radiation incident in Japan they are working on developing methods of handling an incident like that if it were repeated in the US.  They will take Willie's blood before radiation and during radiation to look at changes in genes and proteins.  The idea is to identify specific changes that occur after a person has been exposed to radiation in order to test people if needed in the future.
Willie agreed to help in the study and she was visibly excited.
"Thank you!" she said "You will be participant number 257."
She had him sign some waivers then left with a bounce in her step.


Not a Sauna!

A nurse poked her head in the room and announced that they were running behind and that there would be an hour wait until the last part of our appointment.  We decided to walk upstairs and spent the hour listening to a woman playing a grand piano in the common area.  It was a relaxing break from an emotionally racking day.
We returned to the radiation department and were taken into a white room with a hard wood sauna in the middle.  It was a simple box made from beautifully stained wood with a glass doors.  We knew this was the radiation treatment room, but I couldn't wrap my brain around what I was seeing.  The nurse motioned toward the sauna looking box
"This is the radiation booth," she said, as if we were site seeing from a tour bus "this is where you will be receiving your treatments."
She invited Willie to get inside the booth and began adjusting levers and taking measurements. She had Willie place his hands on two bars that hit him about mid thigh.
"We are going to trace your body so I'll need you to stand as still as you can for a few minutes."


The machine that delivers the radiation

A second nurse turned off the lights and I watched as the shadow of her hand traced around Willie's limbs.  This took a few minutes then they turned the lights on and began measuring the distance from Will's face, neck and body to the glass door that will be shut in front of him.  It was only a few inches from his nose to the door and I found myself feeling claustrophobic just watching him stand there.
He was so patient with the nurses, but was out of the booth the second they said he was done.
"You'll have to stand there for 8 minutes, three times a day."  The nurse explained.
"I got an itch on my head when I was standing there," Willie said, pointing to his head "I won't be able to scratch it when I'm getting radiation will I?"
The nurse laughed "It never fails that the second you have to stand still, everything will itch!  I hear this from almost everyone.  You are free move back and forth a bit and scrunch you face if needed, but no hand movements.  It's hard, but you can bring your own music if you want to keep you distracted."
That sounded like a good idea. 
The nurses were kind enough to walk us to the lobby and send us on our way.  The next time we see them it will be for radiation,  It's a notion that is scary, at best.
I left with an irrational feeling of fear that I haven't felt in a long time.  I think there is a fine line between being well informed and being told too much.  I felt the info we had received had crossed over into the category of too much information. 
As we talked on the way home we realized it was the same feeling we had before Willie began chemo the first time.  It is fear that is fueled by the unknown.  Willie has responded well to every treatment he has received so far and we have no reason to believe that he wont skate through radiation as easily as he has the chemo. 
 
If we have learned one thing, it is that everybody responds to cancer treatments differently and most of the warnings they provide for treatments don't actually occur.  We have been so blessed that Willie has handled everything well and appreciate all of your thoughts and prayers in our behalf to help us weather the storm.  We are most grateful for our family, friends and faith that carry us through the dark days and into the light. 
We know there is a rough road ahead, but we have faith and trust in a loving God who will see us through this trial and make us better people in the end.
Keep the prayers coming!  We can never have enough!