Tuesday, January 08, 2019

It's Linear Acceleration Time!

The mask was tight, the radiation sensor put a bit of pressure on the eye, and the accelerator also seemed to move the table ever so slightly.  The set up was about 15 minutes, and the intense blue light that followed was not uncomfortable, but it did seem to bring up the image of the "star baby" from 2001 in my mind.  A slight blurriness to the left eye due to the pressure from the sensor.  Seven hours later, a warm sensation to the left side of the face, and a mild sinus headache, but that's not uncommon this time of January, especially on a day whose temperature bounced between 37 and 53 degrees within a 20 mile range.  I am told I can keep the mask once this three week cycle is complete.  Woop.  More notes to follow.  System employed: Truebeam "advanced image-guided radiation therapy" (IGRT)

Mask and fitting in place quickly, about 3 minutes in set up, two runs of blue illumination running about 15-20 seconds each.  It felt warm this time.  Visuals that appeared were primarily reflective of the intense light - white semi-circles along the lower left visual field.  Warmth was slightly pronounced this visit, as if a 200 watt bulb had been moved around that side of the face.  No blurring this time, but a small white pulsing image in the upper right field appeared, synchronized with my heartbeat.  Fourteen runs are currently scheduled, not the original plan of 15, nor a local clinic's plan of 18 before second opinions were obtained.

Another 3 minute set up, with two runs of blue illumination, less intense, and of 20-25 second durations.  No burning sensation at the end of treatment this time.  I suspect the pulsing will be an alternate day thing, with weekends without therapies being bracketed by the more intense treatment.  Nevertheless, at 1.8 Gray units per treatment, the 14 sessions will represent a total of 25.2 Gray units, which is right in the middle of the 20-30 Gray recommendation for this procedure. 

On the way out, an inmate from the local state penitentiary was being escorted in, literally in chains.  I wonder if that counts as lead shielding. 

Longer irradiation (about 40+ seconds this time) at a further distance, with the same 1.8 shades of Gray.  Observed that the left eye had improved reading-distance vision without glasses the night before.  No other effects after this encounter.  Progress report with clinician set for next session.

Two blue scans running about 25 seconds each, no adverse effects, a slight smell of ozone, again as if a 200 watt bulb had been positioned nearby.  Clinician will review progress in another week, suggesting a lifetime bedtime prescription of sterile Vaseline in the affected eye. Follow up oncology and ophthalmic appointments being confirmed with the referring university. The convict preceded me this time.  Chains to the left, unchained maladies to the right....

The most post-procedure redness yet, with two bursts, one about 25 seconds, the other 40 seconds or so.  The journey there and back, amid a mild round of iced rain, was the biggest challenge.  A Time magazine cover in the waiting room had a newborn on its cover with the caption: "The Future of Babies?" - If lucky, old age...

#7 - the halfway point!  Again, quickly processed, some post-procedure warmth and redness requiring a brief ice pack to prevent a state of constant blushing at work.  Two bursts again, one about 13 seconds, the other over 45 seconds.  Perhaps the gap is due to a need to recharge?  Need to research this.   Additional redness around the eye again, but no pain whatsoever.  The 90 mile round-trip journey was only occasionally slippery. 
Another magazine had an article on Chagas disease, clamping the stomach's cardiac sphincter in a condition known as achalasia, caused by the "kissing bug" Trypanosoma cruzi.  I thought it was an interesting discussion on esophageal nerve damage, and then wondered if it would be useful research in GERD treatments, since an open cardiac sphincter seems to be a powerful contributor to the condition. 

I know it's a diversion from a MALT lymphoma posting, but it was nice to see something other than Guns N Macho and Us magazines to look at.  And don't even get me started on that odd dream about a rough landing from a space ride in the middle of a thunderstorm.

And a nice quick drive today, an early arrival despite two semi's enwrapped on the freeway, only to have a pause to the festivities with a slow startup on the linear accelerator.  One blast of 13 seconds, a couple of false starts, a repositioning of my arms, and then a final run of about 20 seconds.  Reports are that Mr. Lymphoma is looking smaller.  Some neural effects being noted - tingling along the left cheek and at the tip of the nose.  The eye is still responding well to bedtime sterile petrolatum.






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