Now Ain’t the Time for Your Tears (Dylan)
So, we rocked along. Known: lung cancer, really early. Known unknowns: had it gone beyond the lungs. Doc Onc1 sent me to the South Texas Radiology (and something with an I) Center [STRIC] for a PetScan…just to see what other evils might lurk in the bodily organs of men. The new scan showed that the cancer had, in fact, spread to a central lymph node close to the pulmonary artery.
I met with Doc Onc1 again for a consultation. He wrote on a yellow legal pad: STAGE 3. “But,” he said, “you’re asymptomatic and the prognosis remains excellent.” Abdomen’s clear, liver’s clear, left kidney’s (if you’ve been reading this blog, you’ll know that I no longer have a right kidney) clear. All that was good. “So,” Doc Onc1 said, “So, now, we just need an MRI of the brain to make sure the cancer hasn’t metastasized to there. That frequently happens; so, we want to be thorough.” Back to STRIC.
A New MRI
When I got to STRIC, downstairs from the START [acronym irrelevant, actually, non-existent] Center where my Docs Onc hang out, I was punctured once more by a nurse…IV needed to shoot crap into my veins. This one was with and without whatever the substance was. The next day? One more consult; one more piece of bad news: yes, two small tumors existed in my brain. That moved me from Stage 3 to Stage 4. Doc Onc1 warned me to stay away from the Internet. The dire warnings about Stage 4 did not, he said, apply to me because I was healthy, asymptomatic, and really early on all stages. There’s some really scary stuff about Stage 4 out there; I suggest you not read it.
What the MRI did do was change the treatment protocols. I would not start chemo immediately; instead, in DocSpeak “we” would take care of the brain cancer first. The procedure would be “effectuated” by Doc Onc2. Doc Onc1 made an appointment for me with Doc Onc2 for that same afternoon. Both docs are part of the START Center, but the radiation therapy Doc Onc(2) floats to and from various locations while he is engaged in his trade. I saw him that afternoon at the START office at Northeast Baptist (just around the corner from Doc Onc1’s office).
Some Really Cool Technology
All of my doctors plus the various centers are able to share data in the way President Obama wants all doctors to be able to do. Each center, each individual doctor, can call up all my medical history and current labs and pics on the computers in their offices. So, Doc Onc2 asked me to sit down and called up my MRI of the brain on his computer. I saw the two small tumors immediately. “Fortunately,” he said, they’re both small. I can take care of them with two cyberknife procedures.”
He explained that a cyberknife was a slight advancement from the gamma knife. It was totally robotic and he had to take a couple of days to program the computer that would ruin the computer. He sent me to STRIC at the main START Center in the Medical Center. They, too, called up my MRI on their computers and turned me over to a couple of techies.
At the Big START Center (I get a neat new mask)
I had no earthly or unearthly idea of what they were doing when the strapped me into a CT platform and sent me sliding backward into the machine. What they did: part of cyberknife involves molding a mask to your face, not unlike the masks used, in some cases, to build death models for some famous people…in past centuries. The CTscan would help map where the cyberknife would attack; the mask would hold my head perfectly still while the cyberknife worked.
NOTE, please: the cyberknife is NOT a knife. It is, instead, a metaphor for a little radiation box held by a robot’s artificial hand and maneuvered around the area of a person’s body that contains cancerous cells for the purpose of zapping them. I had flashbacks, as I learned all this, to Orson Scott Card’s classic science fiction novel, Ender’s Game. In that novel, Ender, a child genius, is taken from his parents to a special military academy for geniuses. There, the kids learn a complex video game and have something very like rigorous military training. Do excuse this digression. Ender is the best of the lot. We do not learn, until the end of the novel [SPOILER alert] that the videogame he and the other kids have been playing is not a game at all, but is weaponry aimed at a hive of enemies called “buggers.” I had that impression early on and thought the START folks should hire a team of kids to operate the cyberknife. But, there is no joystick, just a computer program.
I Get Cyberknifed (twice)
Six weeks ago, I was strapped onto a table in the cyberknife room at the Methodist Cancer Treatment Facility. I would lie on the table, head immobilized for 72 minutes. Around me, a robot wheeled itself, its arm (much like the arm on the now defunct space shuttles) positioned itself around my head, and zapped radiation into my brain at pre-targeted areas. The same thing happened three days later for the other tumor.
Doc Onc2 is confident that the cyberknife and robot did their jobs well (he had programmed them) and that I was now, unofficially back to Stage 3. But we won’t be sure until I have a follow-up MRI of the brain on a couple of weeks.
As I said at the beginning, quoting an old Dylan song, “Now ain’t the time for your tears.” (Bob Dylan, “The Lonseome Death of Hattie Carroll”).
Next: the joys of chemotherapy
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