Today was a big day. Our drive downtown was fairly uneventful. The traffic was lighter than usual; I imagine many folks are taking off work for the Christmas holiday weekend, and school is out for the winter break. We valeted the car and got to my appointment about 30 minutes early. This is my first visit to the brain and spine center, but we have been to the main building before. If you have never been downtown Houston to the MDAnderson center, it is like a city all of its own. I remember the first visit here six years ago, when I was going through all the initial staging. I saw a sign to the aquarium, and I thought they had an actual aquarium here. Turns out, that is the name of one of their cafes. (Egg on face.) But, in my defense, it IS a very large place.
As we sat in the waiting room playing games on our iPads and listening to Property Brothers in the background, I asked Tim if he had any questions. He quipped, “will it kill much of the brain? Or better yet, will it restore any of the brain?” Yep, that’s my hubby.
All joking aside, we spent the whole day learning about this next phase of my cancer journey, the Gamma Knife procedure, and what it entails. I did break down and cry at one point as it is a bit overwhelming. But, thankfully, the wave of emotion didn’t last long. The nurse (Tina) was really sweet as she talked about the process and handed me a tissue.
So much for the “one and done” approach we had naively imagined. I should know better. Nothing is quick and easy when you get involved with cancer treatment at MDAnderson, or anywhere for that matter. The main campus is known for even longer waits. Today was no exception. After a thirty minute wait (an hour really, but we were 30 minutes early), Tina escorted us into a room she “stole,” because the others which belonged to my doctor were full. She took my vitals, described the Gamma Knife process, and discussed possible date options. She also informed us of a YouTube video explaining everything MDA does with this treatment. We really liked her. She was down-to-earth and truthful about the wait times as well.
Next, we were visited by the Physicians Assistant. She was also very sweet and knowledgeable. Another explanation and some tests of strength and balance. Tim is my levity as he likened my walk across the room to the DUI test. Not that I would know…fortunately.
Thirdly, we were visited by our very tall radiation oncologist, Dr. McGovern, who will follow me through all of the Gamma Knife procedures, now and later if needed. Most likely there will be more; of course, no one is willing to predict the future. She explained how Gamma Knife actually works. It’s quite interesting, actually. The machine has 192 Cobalt beams that intersect at the exact location of the lesion. By itself, each beam is relatively harmless. But when they intersect, they send a combined large dose of radiation for what I consider an explosion into the lesion which “nukes” them. The table on which I will lay moves me into position so the beams intersect at the exact right location. In this respect, a head frame is imperative (more on that in a minute). The frame prevents me from moving my head even a mm to zap the wrong spot in the brain. Each lesion takes about 15 minutes, so the entire procedure will be about an hour. This is just an estimate until we get the final MRI the day before the procedure.
In addition to a new radiation oncologist, I now have my very own neurosurgeon. “Is there any specialist I have not seen?” I wondered. Apparently, this is also required when you get the Gamma Knife. I was fortunate Dr. Ferguson was available to see me today, so I don’t have to come back another day. Initially they said 3:00, but we came back after lunch and I got a call saying to come on up. That was a real blessing! Lunch, by the way was delicious. We had crepes at Sweet Paris downtown.
Dr. Ferguson is the exact opposite in stature to Dr. McGovern. I believe she said she is West Indian; Tim missed that part of the conversation as he left the room to go find his Diet Pepsi which he left in the waiting room (and I’m the one with brain issues LOL). Funny thing is, he couldn’t remember which room I was in, so he opened the wrong door. Another doctor had to help him out. He opened our office room door and said this gentleman was looking for a good-looking wife, and since I was the best looking in the hallway would I take him. Yeah, I guess so.
Anyway, I digressed.
Dr. Ferguson asked if I wanted to see the pictures from my latest scan, and of course we said yes. The spots are very tiny, but I could see them as well. To do this very precise procedure, one has to wear an aluminum frame, which I mentioned earlier. From hereon, I will dub it my “bedazzling crown.” I may not be a monarch, but I sense this crown will represent victory and triumph, (as it does for the royals), and represents power over this awful disease. Wearing it will enable me to feel victorious. I say it is bedazzling because I prefer to feel like I will be wearing something beautiful over a medical devise, for one. Also, when I think of the radiation beams attacking the lesions, I imagine a big firework display going off inside my head. THAT is bedazzling.
One responsibility of the neurosurgeon is to attach the crown to my head. Basically, they screw it in place. Do you want to hear more? I didn’t…feel free to stop reading. She is also now connected to me in the event I ever need brain surgery. Wow. I know some people who have had brain surgery, but I never thought I would think of that for me.
History. All five professionals seen today took note of my history. It’s amazing how they can summarize six years of treatment in a manner of minutes. Since 2012… Chemotherapy, mastectomy, radiation therapy, continued Herceptin through year one, reconstruction, and Tamoxifen until the MBC reoccurrence in 2016. 2017 started with more chemotherapy, Herceptin and Perjecta every three weeks for maintenance, with daily doses of Arimadex and a shot of Xgeva every month.
In January of this year we discovered two tiny spots in the brain. My medical oncologist sent me for an MRI after Tim astutely noticed I was unbalanced and a bit more fatigued. These have been watched regularly, with no growth until the last scan. They are apparently growing at a snail’s pace, yet now there are three.
Treatment. Mostly what we heard today was good news. It’s easier to treat these lesions when they are small, and there is a less than 5% chance of brain damage to the surrounding areas, much less than treating larger lesions. I also learned that the MRI scans I have been receiving take larger slices than the MRI they will do at MDAnderson. The day before my procedure, I will go in for another MRI, bloodwork, and training by the nurse. They will access my port so I don’t have to get an IV. The thinner slices on the MRI will uncover any other possible lesions, which will all be treated at the same time with the Gamma Knife.
The day of the treatment sounds like an exhausting day. While many people choose to work the day after, I am hoping to get this done over the break. Then I can rest before going back to work. I have to fast after midnight, and arrive early in the morning. They will install my crown, do another MRI, and wait for my treatment time. I’m sure I’m missing some steps, but one thing I remember is that I will sit around and wait with my crown attached to my head until it is my turn for the Gamma Knife. They do three per day, so I could be first, second, or third. There is no specific time frame. They will bring me food, but otherwise I will sit and wait. During the treatment I can listen to music. Afterward, they will watch me for an hour and then I can go home. We are hoping for an appointment on January 2nd, which means all the pre-treatment will be done on December 31st, since they are closed on New Year’s Day. Looks like we will get to see fireworks two days in a row.
We learned a lot — more than I was bargaining for. We are on information overload once again. It was a bit daunting. However, regardless of how we may feel at times, I know it’s going to be okay. God is on my side, and He is watching over me through this whole process. This song by the Piano Guys always gives me a pick-me-up.
A la prochaine…until next time.