Saturday, October 29 - Two Weeks of Treatment Under My Belt

I've now finished two weeks of chemoradiation, treated daily on Hopkins' Cancer Center Linear Accelerator #3, an Elekta Infinity, and chemotherapy, receiving carboplatin through an IV drip on Tuesdays.  That schedule will continue through December 5, for a total of 35 radiation treatments.  Thanksgiving week I'll only receive four radiation treatments Sunday through Wednesday, since Hopkins will be closed for the long holiday weekend.  I'm beginning to experience side effects of the treatment, principally dry mouth, soreness in the tissue over the joint of my left jaw, which is more acute when opening my mouth wide, and tenderness on the left side of my tongue.  I expect these are side effects of irradiation of my left tonsil.  I can still taste, but that will probably go soon and not return for a year after treatment.  My daily radiation treatment takes about 15 minutes. 

Taylor and M.E. placing my  mask on the Infinity table

Two therapists fasten the face mask firmly over my head and shoulders to the Infinity's table and leave the room as a radiation shield door closes behind them.  The machine does an initial low-intensity CT scan, which compares my location to the 3-D image from the scan taken weeks ago while I was fastened under the mask for computer simulation that was used by my radiation oncologist to plan my radiation treatment.  The machine makes minute adjustments to its table to precisely align me so that I'm located precisely to target my tumors with lethal radiation and minimize effects to healthy tissue.  After locking down the table, the Infinity's radiation head projects 115 precisely shaped, intensity modulated, radiation fields from nine positions in a 270-degree arc beginning behind my right shoulder around my head and neck to behind my left shoulder.  Lethal radiation doses only occur in target tumors where multiple radiation fields from different positions intersect to give a cumulative high dose that destroys the DNA of the cancer cells, killing them.

There is a therapeutic camaraderie during the daily treatment regimen among the patients and their caregivers who are scheduled before and after me with whom we share the waiting area and chat about all sorts of topics, from kids and grand kids to apple butter preparation to how many weeks of treatment have passed or remain.  Several of them also are staying in Hope Lodge and ride the shuttle with us to and from Hopkins.  Yesterday Damaris and I hung around for another patient of Dr. Quon to ring the gong hung in the treatment area, placed for patients to strike following their final treatment.  I doubt my eyes will be dry when it's my turn on Dec. 5.

Raquel moved us into Hope Lodge on Monday afternoon, Oct. 17 (http://www.cancer.org/Treatment/SupportProgramsServices/HopeLodge/Baltimore/index).  There are 26 rooms, usually occupied by a cancer patient and their caregiver.  The rooms are reasonably spacious, with beds donated by Simmons--essentially everything in Hope Lodge is donated.  A community kitchen has four cooking stoves and microwaves, four refrigerators, four sinks and dishwashers, and many labelled cabinets and drawers with glasses and cups, plates and bowls, pots and pans, utensils, etc. A designated space in a refrigerator and a cupboard for dry food storage is assigned to each room in the community kitchen.  The space is somewhat limiting, but we've learned to make it work.  A couple of times each week a group comes in to cook dinner for all of us.  Last Thursday two couples for Beth El Synagogue cooked lasagna and cauliflower, potato and carrot soup, green salad, coleslaw, garlic bread, and loads of cookies and brownies for dessert.  There's a strong bond among us patients living together and fighting cancer, and I wouldn't be surprised if we keep in touch with some of our fellow residents following treatment.  Some may come visit us in Costa Rica.  Hope Lodge provides housing to cancer patients from all Baltimore Hospitals.  About half are receiving treatment at the University of Maryland Medical Center which is just south of us.  Most of the other half are patients at Hopkins--a Hope Lodge shuttle takes us back and forth for treatment.  At least one resident is a patient at Sinai Hospital.  Our home in Costa Rica is not the farthest--an elderly woman from Sierra Leone resides here with her caregiver granddaughter.  There's also a couple from St. Croix, U.S. Virgin Islands and couples from the Florida Keys and Cincinnati.  Most are from the Chesapeake Bay area and go home on the weekends, so it's very quiet here right now.  We're blessed to be able to stay in this comfortable place for free and find new friends, all who share the common challenge of cancer, during the seven weeks of our treatment.