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Hello, Dr. Radiology | Mar 25 2021

March 25, 2021

Call me crazy, but I left today’s appointment with Dr. Radiology feeling relieved and a little excited to get started. This is not to say anything about this will be easy. Au contraire, Pierre, much of it will absolutely suck. Here’s some information that gives a general, though detailed, overview on a week-by-week prediction-description. Dr. Radiology agrees that AEs– adverse effects– are generally predictable.

It’s important to note that there is a plan in place to counteract (or at least, address) many of the likely side effects. These include prophylactic anti-fungal medication, proton pump inhibitors, swallow-able lidocaine, prophylactic anti-viral medication, and even more. When she began listing possible pain medications, I stated firmly, NO BENZOS (benzodiazepines) for pain and she wrote it down and said, “No benzodiazepines, OK.” Then she listed the pain options again, leaving off the benzos.

Introducing Dr. Radiology: medium-length blonde hair all tangled in her PPE, short, beat-up sneakers, striped socks, though she is generally not a fan of socks, approximately 12 years old. Answered every single question and waited to hear if we had more. Is going to let me look at the 4D image of the tumor in the lung to see how it moves when I breathe!!!!! How cool is that?!

That viewing will happen tomorrow, when they throw me in a fancy CT machine to pinpoint the exact location of tumor and sickly lymph nodes. They build a model and then every time I go in, they position me exactly and zap those suckers. Treatment will be five days a week, for about 30 days of treatment (every weekday, weekends off). The length of time will vary, depending on the x-ray machine that is used. Insurance providers want a simpler machine– three-dimensional conformal radiation therapy (3D-CRT)–to be used, so she ends up writing an exception report showing why she needs to use some really fancy machine: Intensity modulated radiation therapy (IMRT). That will take about 15 minutes per visit.

Other important stuff: Exercise! Water water water! Side effects worst toward the end of treatment, and in the two weeks following treatment. Burned esophagus so probably lots of soft meals. Possible increase in coughing, more asthma, etc. I may even cough up specks of dead tumor, which she says I might not even see, but I kind of hope I will. The rest of the tumor gets recycled through the immune system, liver, etc.
 
So here are all these really smart, really kind women, rallying around to care for me. Dr. Oncology: woman. Dr. Radiology: woman. Dr. Primary Care: woman. Home team: daughter, mom: women. Husband: honorary woman.
 
And, the intent is to cure. Of course, she said, that’s always the intent, but in my case, she feels there is a reasonable chance of success. (Anybody want to try to quantify “reasonable”?)
 
Today I feel that maybe I will be able to do this. It will not be pretty. I will be miserable and very very uncomfortable. But I think I have what it takes.
 
Mostly I feel hope.
 
Thanks for reading.
 
 
 
 
 

Why I’m not a surgical candidate:

Node 7 is big and in a lousy location. There are a couple of other nodes, which will be zapped.

 

Tumor is is in the middle lobe of the right lung, near where the airway splits, and close to the esophagus.

 
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