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Thursday, May 27, 2010

Stereotactic Radiosurgery -- Everything You Wanted to Know....

Moshe woke me at 6:00 am, Wednesday morning.  I wanted to snag another ten minutes of sleep, but my stomach already demanded attention. (euphemism for: my first round of diarrhea)

Given my already upset stomach, I decided to skip that day's dose of Tykerb (Lapatinib) and that morning's dose of Xeloda (Capecitabine).  I prayed that would be enough to curb the diarrhea and prevent any unpleasantness during the actual procedure.

The instructions were to wear comfortable clothes, so I actually chose my clothes the night before and slept in them!  (you know, like we did for our kids when they were in gan (kindergarten))  I wore the softest black pants and an extra large, bright purple T-shirt, because purple makes me happy.  **TMI Alert** (I even wore purple underpants.)

I remembered to bring almost everything I needed to the hospital.  I even brought my laptop, so I could "live blog" the experience.  OK, that was a little overambitious!  I did not even turn on the computer!

I did forget all about bringing food.  Luckily, my in-laws (Moshe's parents) were planning to join us, and my MIL prepared tuna and egg sandwiches. (She makes such great tuna salad that even I ate half a sandwich!)   When they heard that I wanted candy, they also made sure to stop by the candy store and pick up my favorites:  licorice and gummy bears.   YUMM... 

My friend, AK, had arranged parking passes for us, so we had no difficulty parking right next to Machon Sharret (the Cancer Institute at Hadassah).

We went to room 60, a special room in the radiology ward, for lucky patients like me.  Most of the day, we had the room to ourselves, because the second stereotactic radiosurgery patient did not need a frame and was free to leave the area.

My sister arrived just a few minutes after we did (and managed to find us, despite there being no mobile phone reception!).  She brought cards and crossword puzzles.  She also went to get me ice-coffee, when I was finally ready to eat something. (Even after a dose of steroids, it would be many hours, before I was hungry enough to eat my MIL's delicious tuna.)

Nadia, the nurse, opened my port (had I realized she would be using my port,* I would have put on Emla (a topical anesthetic), but she was quick and precise and it did not hurt too much) and drew some blood, then hooked me up to a saline IV with Zantac (to reduce acid reflux) and Dexomethasone (steroids to prevent swelling).  She sent Moshe to bring the blood tests to the lab.

Just after Moshe left, the neurosurgeon, Dr. Shushan, came into the room to ask and answer questions.  I wished Moshe would have been there, but at least my sister was with me.  Then the doctor and nurse started to prepare for attaching the frame.  I did not want them to do it when Moshe was not there, but they wouldn't let him be in the room anyway, so....

Dr. Shushan injected Lidocaine in the four locations where they would be attaching screws to my skull.  The nurse had already given me an oral sedative (Vaben).   Just before the doctor injected the Lidocaine, she injected an additional sedative into the IV. They said it would not hurt much.  I am sure it did not hurt them. 

I asked for more of the sedative.  They gave me more, but still not enough.  The last Lidocaine injection was especially painful, it burned.  Then they screwed in the frame.  That was also quite uncomfortable, to put it mildly.

Once the frame was in place, I did not see Dr. Shushan again.  From that point on, Dr. Vigoda, the head of radiology, took care of me.

I felt pressure from the frame, but no pain.  At least, not in the beginning. Over the course of the day, when I felt pain, Nadia gave me liquid Optalgin (YUCH!!!) and I took additional Algolysin, from my personal drug store (with permission, of course).

I tried to sleep, but it was difficult to find a comfortable position with the frame.  My sister teased me, calling me "the bride of Frankenstein."  The shape of the frame reminded us all of the helmets in the original Battlestar Galactica

I gave up trying to lie down.  Instead, I sat up and played cards with my sister and mother in law.  My sister kept beating us at Palace (this Israeli card game that she learned from my youngest daughter, who really likes it).  After a million games, I finally won one.  I called it quits and suggested we watch some TV. I tried to relax, but still could not find a comfortable way to lie down.  Finally, with help from Nadia, who strategically arranged the pillows for me, I managed to rest for a bit. 

I expected that by the time I awoke, it would be time for the radiosurgery.  There was something malfunctioning with the machine, so I had several more hours to wait.

My friend from radiology, Tamar, came in to visit/check up on me, several times.  She was really very helpful, and reassuring! 

There was also an English speaking nursing student, Jody, who was very pleasant and helpful.

While we were waiting, we looked for funny programs on TV to help pass the time.  We found some silly shows; they were good for a few laughs.

Another thing I forgot was to bring music for during the radiosurgery.  Tamar brought a CD of musical highlights that she thought I would appreciate -- perfect! 

When they finally called me in for the procedure, I got to listen to all the best songs from West Side Story, Annie, Annie Get Your Gun, Cabaret, etc.

Then, it was over.  They took off the frame -- also not the most pleasant experience, but not too bad.

I was glad it was over.

I wanted to go home right away, but they made me wait.  I felt fine... until I did not.  I had a brief wave of nausea and a headache.  I took more pain killers, ate more candy, and felt better.

I really wanted to pop into my friend's simcha (celebration) -- my friend, MT, married off her final son last night.  But I forgot to bring nice clothes with me!  It was just as well. 

After 13 hours in the hospital (12 within that frame), I was finished.
Overall, the day's events constituted a pretty harrowing experience.
By the time we got home, I crawled into bed. 

My head hurt, and I was exhausted, but I called my mom to tell her I was home and OK.  I knew she would appreciate the call.

Then, I closed my eyes, had a brief conversation with God, and fell fast asleep.

(For more information, see yesterday's brief summary)

Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,

*In Israel, nurses need special certification to be able to open a port.  I did not realize that Nadia was an oncology nurse and would be certified.


Batya said...

You're a trooper.
Refuah Shleimah!

Devorah said...

You are so brave!!

Wishing you a BIG refuah shelaima and thinking and praying for you!

Anonymous said...

You are the most amazing patient! You didn't write about how WONDERFULLY you did!
Have a wonderful shabbat with your beautiful family.
Thanks for the hug yesterday:)

Marion said...

I had to laugh at your assessment of the liquid Optalgin. I've only ever had a single dose...but I agree completely - YUCK! The thought of another dose was enough to make me decide not to mention the afterpains after YM was born...

Sara Layah said...

Sending you a BIG virtual hug and warm thoughts for a Refuah Shleimah!

Shabbat Shalom...

Bernie said...

You are a very strong woman RivkA, may God bless you and I am keeping you in my prayers.....:-)Hugs

mikimi said...

here's hoping all future appointments reveal a good outcome.