Thursday at the Cross was about getting ready for the radiation treatments, with three activities planned; 1. make the mould for the head mask, 2. get a CT Scan done to help with the final stages of the treatment planning, and 3. have a one-on-one with a radiation therapist to discuss any issues. And yes, because of the mould making, I had to shave my beard and mustache off again. There are moments when I find the loss of my beard, a constant companion since I was 16, to be the most difficult part of all the things that I am going through. I’m beginning to understand the trauma that some women feel when they lose their hair to chemo… And I must admit that my own vanity extends to the still-swollen neck… I feel like a bullfrog on occasion.
1. Making the Head Piece: The mould making process was not what we had been led to believe. Where we had been told (via an educational video) that they would do a plaster cast of the head, face and shoulders, from which they would pull a vacuum formed ‘life mask’, what actually happened is that they cut directly to making the mask. There has been a change in the technology used, but the orientation videos haven’t been updated yet.
I was taken into a room by three staff members. One of the staffers talked me through the process, with some visual aids. The final mask is a plastic mesh (1/4 inch diamond shaped holes throughout and the material is about an 1/8 or even 1/16 of an inch thick) that is first soaked in hot water to make it very pliable. The patient lays down on a table with a head support that holds your head, neck and shoulders in position. If you’ve seen that lovely movie about geisha, there is at least one scene where the woman goes to sleep with a shaped wooded brace under her head and neck to protect her hairdo… the support is similar in concept. They do have a small selection of supports, so don’t hesitate to ask to try one that might make you more comfortable. (One of the things that they will not allow you to do is to cross your legs at the ankles, even though this often makes people more comfortable, more relaxed with what is going on. Apparently crossing your legs puts a subtle twist into your pelvis that can be reflected in the position of the neck and shoulders.) Once the patient is positioned, the now warm, damp and pliable mesh is draped carefully over your head, face, neck and shoulders, and, using special little channels already affixed to the mesh, the material is locked into the table. Yours eyes must be closed. Two of the team then work quickly smoothing the mask to fit as tightly as possible. Don’t move! Don’t open your mouth, shift position or do anything else that will force them to start again. They will run their fingers over your eyes, into your ears, and generally everywhere that the mesh material contacts the body. And then you wait… for 6 minutes, while the material sets up. The staff will try to keep you as calm as possible by chatting to you, trying to include you in their conversation. But remember, you are not supposed to move.
I must admit that their chatter prevented me from getting ‘into the groove’ of relaxing using the yoga breathing techniques I’ve been practicing, so I was, by the end of it, feeling a bit anxious.
2. The CT Scan for planning use: Winston and Christine took me through this step in the preparation. These two are very good, supportive, lovely technicians. Essentially what we did was to put me on the CT table, and then fit the mask just made onto my head, and lock it into the table. They made measurements and added reference points to the mask for the future treatments and then followed it up with an actual CT Scan to be used by the targeting computers in the radiation treatment machinery. They, Winston and Christine, tried to keep me occupied, but I did start to feel claustrophobic. My eyes are closed. I am fastened to a table and can not move, and have no idea how to release myself if I need to. Being on the CT table, I am also moved in and out of the machine, in and out of light. So, yes, I did indeed start to get anxious. And I just couldn’t get the breathing rhythms going, again.
After we’d finished, Christine sat on the table with me to discuss the experience. I was lone in the machine for about 5 minutes. The actual radiation session will be about 20 minutes. I’m not going to enjoy this. I am not confident that I can do this easily. I asked her if we could cut out the eyes on the mask, and she told me that would be up to the therapists running the machines. She did make jokes about taking the mask home after all the treatments were complete and cutting it into little, tiny pieces and disposing of it in any sadistic manner I might choose…
They also suggested that, if I do encounter claustrophobic problems, my doctor should be able to prescribe something to help relax me. I noted that I already have a prescription for Atavan… they suggested that I bring it to the first session, and if necessary, stop the process, take a pill and then proceed.
Winston provided us with a phone number to call if our appointments haven’t been set up by the 2nd of January.
3. The Education Component: Susan was the next person we saw. Susan is one of the radiation therapists who is on rotation this week to do education. It sounds like they all have to do this rotation to maintain some level of contact with the patients. Susan gave us some brochures, talked us through part of the process and let us know that we would be using the newer tomography machine for treatment. She seemed a little surprised that no schedule has been set yet; no duration, no dosage. She was even a bit surprised that we hadn’t been told that we would have the newer tomography machine.
As much as possible, they will try to give us the appointments during the time of day that makes the most sense to us. We chose mornings, but we’ll have to wait and see. It was also rather interesting that she left me with the impression that I might be able to drive myself there and back again and not necessarily depend on others for the transport. Of course that won’t be happening if I need to rely on the Atavan to make it through the sessions.