Implant Radiation Update

Quote of the day, coming from the South Tower of the Methodist Hospital:

• "Dr. Morris is going to cut you open,  and I'm basically going to stick an appliance up yer ying-yang."  - Dr. Duckert, Meighan's Radiologist, talking about her procedure today!

So we are in the south tower of Methodist Hospital tonight and all is good...well...everything minus the spastic bladder that Meighan is currently experiencing.  I've never had a spastic bladder, but I have had a spastic back before.  Judging by Meighan's pained expression, and sudden gasp of breath that occurs every 15 minutes or so, I will do my best to avoid having a spastic bladder.

The procedure went well today and Dr. Duckert was as positive as ever when he came into the room to talk to myself and Meighan's mom, Deb.  It's always a good sign when they enter a room with two big thumbs up.  Anyway, they basically did what they said they were going to do.  Dr. Morris cut her open to help guide and place the radiation device in the correct location, and Dr. Duckert stuck the device up her ying-yang.  While she was open, Dr. Morris did a little exploring of her uterus and cervix and said there were no surprises in terms of the tumor and surrounding tissues.  It is almost non-existent, and the plan is for this implant radiation treatment to be the coup de grace for her tumor and her cancer cells.

Right now she is resting pretty comfortably and I'm sitting in her room trying to get caught up on some school work.  Tomorrow morning she goes into Dr. Duckert's office to have a CAT Scan done.  This is to double check and make sure the device is precisely where they want it.  At that point Dr. Duckert will do some calculations and "figure out the physics" of her treatment to determine how much and how long she will have the device implanted.  He told us it will probably be from 48 to 60 hours, during which time Meighan has to stay in the bed, and she cannot eat...anything...save for a few jolly ranchers and ice chips.  During the next 72-96 hours she cannot have a bowel movement.  If she does they have to take her back down to the O.R. to reset the device.  Oh, and she has to have injections in her abdomen to help prevent blood clots.  Can't forget about those!

At some time Friday afternoon the device will be hooked up to the radiation source and she will have to sit there for a couple of days.  It's a low dosage of radiation--people can visit and the nurses and docs will still come in to check on her--but they will place a protective screen around her to reduce the little amount of radiation that will be coming from her.  Likewise, pregnant women, and people under 18 are not to visit during this time, because there is the slightest bit of risk to them if they are exposed to the radiation.

Well...that's where we stand right now.  We are so very hopeful that this is the last round of treatments and that Dr. Duckert is right when he says that this treatment should get rid of the tumor completely.  Thank you all for your care and concern, and keep Meighan in your thoughts and prayers the next couple of days.  The thought of not eating for 5 days makes me ill, as I'm sitting here lamenting that I haven't eaten anything since noon...what a wuss... 

Thank you, and we will keep you posted!

Now I'm freaking out...

BUT...that still doesn't give anyone else the ok to freak out.  :)  I'm not freaking out because I have cancer, I'm not freaking out because of my upcoming treatment, I'm freaking out because I found out today that I will have to take off more work.  I thought I was going to be able to go back to work after Thanksgiving, but now I will not be able to return back to work until after Christmas.  This is due to the time it will take the incision in my abdomen to heal.  I was really looking forward to getting back to work.  As silly or ridiculous as it may sound, my job is part of what defines me and gives me purpose.  Not that being a mom and wife, don't give me purpose because they, first and foremost, most definitely do.  As much as my job may stress me out at times, I absolutely love it.  I love the kids and my colleagues are an amazing group of people!  But now instead of heading back to work, I will be spending an 6 weeks at home healing.  I know a lot of people at work were concerned about me coming back and how much I'd actually be able to do, so hopefully this extra time will make me that much stronger for when I come back in January. 

Along with finding out today about my recovery time, I did find out a little more about my procedure.  I will be going in this Thursday at 10, and the actual procedure will be at noon.  They will open up my abdomen right along my c-section scar.  The reason for opening up the abdomen is so they are able to place the implant in the right place, but the implant itself will be inserted through the pelvis.  They will place the implant on Thursday and then the rest of the day on Thursday, Dr. Duckert (radiologist) will work on the physics of the implant.  Friday morning then I will go for a CAT scan to make sure it is in the right place, and once that is confirmed, then they will turn on the radiation.  At this time, they will know specifically how many hours I will have to have the implant in for (any where from 40 to 70.)  Once the implant is on, I will not be able to leave my bed.  It will more than likely be pulled out on Sunday or Monday at the latest, and I'm hoping to be dischardged on Monday also.  Visitors are still welcome, but you will have to sign in and sign out stating that you are aware you are entering a room with a low dose radiation.  This is nothing that will harm you, but they take every precaution.  You will also have to stay behind a screen as another precaution.  Apparently, you can see over this screen when you sit in a chair and I can see over it sitting it bed, so I'm assuming it's only a couple feet high.  Other than that info, I don't think I know a whole lot more, but will definitely keep updating you throughout my hospital stay.  The end is in sight, but it could be a long upcoming 6 days!  Thank you for all of your thoughts and prayers!

I'm not freaking out, so you don't get to!

I went in today for my third implant radiation treatment; therefore, I still have anesthesia in my system, so bear with me.  Things didn't go as well as the doctor's would have liked today.  Once they got the implant inserted where they wanted, they took me down for a CAT scan to make sure it was in the right place.  The CAT scan showed that it wasn't where they wanted it, and this was due to my uterine anteversion.  This pretty much means my uterus is tilted and in the way of getting the implant where they want it.  SO...my doctors are discontinuing Tandem and Ring radiation due to this.  They are changing the procedure to Open Syed Template implant.  This type of implant requires an inpatient stay in the hospital for 5 to 6 days.  They will open up my abdomen to help place the implant in the correct position and then the implant will stay inserted for up to 70 hours.  I will have to stay in bed the entire time and can not eat for the entire 5-6 days.  You're probably asking, "well 70 hours is only 3 days, so how does that work?"  Well...Thursday doesn't really count as a day, as I won't even go in for the procedure until around noon, and it will take hours to perform the procedure and place the implant correctly.  From there, it will more than likely be inserted from Thursday evening until Sunday.  They will then take the implant out and I can not eat for another 24 hours after that.  Oh and I also can't eat on Wednesday, 24 hours before the actual procedure, to prep for the surgery.  So this whole going without food for 5-7 days will somewhat be new to me, and I don't think I'm going to enjoy it very much.  Throughout chemo there were maybe 3 days in a row that I would only eat saltines, but I was also feeling so crappy, I didn't really know any different.  As for this time, I should be feeling pretty well throughout this entire procedure, probably just hungry and bored! :)  I also don't imagine this is going to help with my weight loss issue...unless I gain a lot of water weight?! :) 

I would like to stress that this is NOT a set back at all, and has nothing to do with something going wrong.  Things just weren't able to go as planned, but what else is new when it comes to me and this entire ordeal?  Nothing has gone as planned throughout, but I've gotten through it all just fine and it has all been TOTALLY worth it!  My tumor is continuing to shrink and this implant is crucial in curing my cancer.  Therefore, this is what needs to be done and it will be all be fine.  That is what I keep telling my mother and Jerrid, as they seem to be freaking out about it more than I am.  I think they are freaking out for multiple reasons: 
1.  I am the one trying to tell them how this all going to work after just waking up from anesthesia.  Although, hopefully by now Jerrid has talked to Dr. Duckert as Dr. Duckert wanted to be sure to explain this all to him.  After waking up from anesthesia I don't start to remember things until the next morning, so I may not even remember all that I have typed in this blog tomorrow morning.  Dr. Duckert and Jerrid are also becoming best buds, so I think Dr Duckert was looking for an excuse to talk to another science nerd.
2.  It's just another added stress.  Especially for Jerrid, who just started 2 a day basketball tryouts today, so it's just more to add on top of everything else.   
3.  They are also, as to be expected, concerned.  Concerned about all that I've already been put through and all that I still have to go through:  all the prep work I have to go through, the entire process of this thing, and not being able to eat for 5 to 7 days.

I love them for this, but I also told them, I'm not freaking out so they don't get to! :) 

So...I think I'll leave it at that and if Jerrid gets home and decides he needs to add some info after he talked to Dr. Duckert, he will.  Lastly, while I am in the hospital; visitors, movies, magazines, and books are allowed to help prevent boredom! :)  Anyone who is under the age of 18 and pregnant is not allowed, though.  For now I'm going to go stuff my face and not stop until Tuesday at midnight!

"Thank you for the efforts"

Today before I went in for my procedure, Dr. Duckert told me, "Thank you for your efforts in all of this, you are an inspiration."  I found this funny and told my nurse, "Funny how he's thankful for my efforts, shouldn't I be the one thankful for all his efforts?"  She laughed!  I couldn't be more thankful for all of his and Dr. Morris's efforts as I would not have had near the success I have had without their efforts! 

I know I have wrote before about how generous, caring, and amazing everyone at the Estabrook Cancer Center has been, but these people are seriously unbelievable!  Today, when I checked in to the Outpatient Surgery Center, the receptionist knew my name.  Yes, she checked me in on Monday, but still, I'm sure she's checked in hundreds of people since then.  Then, my nurse anesthetist today remembered me from when I had my cone biopsy, way back at the beginning of September.  She not only remembered my name, she remembered where I worked, that I got married in July (sometimes I even forget that in the midst of all that has gone on since), and that we have a 4 year old son.  Not only have these two remembered me, but everyone else I have come into contact with at the Estabrook Cancer Center has remembered me.  This is an uplifting feeling and really makes me feel like I matter (which helps when you're going through what I'm going through.)  So I've decided either all of these people are really good with faces and names, I am so beautiful that I'm hard to forget, or this is just who these people are...the most caring people out there!  I'm positive it's the latter! Either way though, these people have gone above and beyond to provide me with the best care, support, and treatment possible and I will be forever grateful! 

In conclusion, many of you have been asking if I was able to hang out with my friends Bud and Mary last weekend, and you'll be happy to know (or at least I was happy about it) that I did hang out with them, not one, but two nights!  I also am putting in some hours at work this week and next week.  Slowly but surely I'm working my way back.  It feels so good to finally getting back to myself and my old life! 

One Treatment Down...

...and four more to go. 

So today was Meighan's first course of Implant Radiation, and according to her radiologist, "things went exactly as planned." I'm going to keep this one short because I don't exactly know what was going back in the operating room, and Meighan was out so she doesn't know much either.

The highlight of the day was speaking with Dr. Duckert immediately after the procedure.  He came out and let me know that up to this point, things are going better than planned, and that today went exactly as planned.  The quick response of Meighan's cancer cells to radiation has made not only Meighan and I extremely happy, but it has made Dr. Duckert extremely happy.  The small size of her tumor makes it "easier" and less risky for him to perform the implant radiation treatment.  When it was a larger tumor it was pushing up against the bladder, ureters, and colon, which is potentially risky. 

Anyway, Dr. Duckert said three times that he is "very, very happy with how things are going."  Additionally, he let me know that Meighan's tumor is "virtually nonexistent."  Obviously those are things that made me extremely happy.

Meighan here and I too am extremely happy to hear those things.  If you ask Dr. Duckert, it's all him and his radiation plan that has led to my tumor becoming "virtually nonexistent."  If you ask Dr. Morris, it's all him and his chemo plan that has led to my tumor becoming "virtually nonexistent."  (These men really just like to toot their own horns...they know better than to think it was just them.)  In all actuality, it was both of them and their plans along with all of your prayers that has led to my tumor becoming "virtually nonexistent."  This is exactly what we wanted, but we aren't done yet!  I still have four implant treatments to get through to make sure this tumor is nonexistent at the end.  From there, the next 18 months are crucial.  Chances of re-occurrence are highest in the following 18 months.  Therefore, I will have frequent checks every 3 months, and continue to have faith and hope knowing that the best results (meaning the best long term results) happen to those that respond quickest to treatment (and I'm one of those that responded quickly to treatment!)

Little Victories

Well I think I may have figured out what Dr. Morris meant about winning the race.  I have successfully completed chemo and now radiation, two races out of the entire meet.  Next race, implant radiation.  Looking at this entire ordeal like it's a track meet with individual races seems fitting.  I've had many hurdles I've had to jump over (sometimes them feeling like that last hurdle of the 400m hurdles...ugh), I've been physically exhausted after treatments, and I've had to mentally prepare myself for everything from treatments to getting out of bed in the morning.  It's only fitting that Jerrid just accepted the head girls track coach position at Papillion South, as he has been my coach throughout all of this.  Running hills, ab workouts, ect...the guy is a mad man and doesn't stop!  Seriously though, he has held my hand through it all, pushed me to keep fighting, and helped keep me strong!

Today was my last day of radiation; it's almost bittersweet.  It's been a looooooong six weeks, that I wasn't sure was ever going to end.  I couldn't be happier though, as it seems those weeks were totally worth all the hell they were.  My tumor responded very well ("surprisingly well" as Dr. Duckert said today) to the six week course of treatment.  He also said, he's ready to "finish it off" with implant radiation...I'm ready for that too!

So, now what?  Well I'm going to celebrate the end of 6 weeks of treatment!  Not sure how I'm going to celebrate yet, but I'm going to!  I'm feeling better and better each day, and more and more like my old self!  Therefore, I'm hoping to get out and about this weekend, enjoy some friends (maybe even my friends Bloody Mary and Bud Light...we'll see what the taste buds say) that I haven't seen in awhile and celebrate!

Thank you for all of your support throughout these last, not only 6 weeks, but the past 2 months!  We truly have an amazing support system!

Have a great weekend!
Meighan

"You've won the race..."

Well, according to Dr. Morris, Meighan has "won the race."  We're not exactly sure what the race is, and how she won it, but it means that she is done with chemo treatments!  Kathy, Meighan's chemo nurse, just came in and told us after her blood work came back her doctors decided she would not be receiving her 6th round of chemo treatment.  Evidently it's not worth the risk of possibly sending her into the hospital to be hooked up on fluids for 24 hours a day and at this point, the implant radiation is going to be the treatment that finishes off her cancer, not the chemo.  Additionally, as challenging as her implant radiation is going to be, it would be counter-productive to knock her even further on her butt than what she already is.  As I so lovingly told her this morning, "It doesn't look like you've hit a wall, it looks like you've hit ten walls and then were broadsided by a truck..."  She is feeling pretty good in regards to her nausea and discomfort, but she is physically exhausted and barely has the energy to get up the stairs.  I told her the problem isn't her treatments, it's that she is out of shape.  So I've decided we are having a workout session when we get home this afternoon...there is a large hill by our house.  I think six trips up the hill will be a good start followed by some ab work.


With chemo out of the way, we can officially set our sights on the implant radiation treatments, which start on Monday, November 7th.  It will be five rounds of treatment starting on Monday, and continuing Wednesday, Monday, Wednesday, and Monday.  This type of treatment will be a high high dose of radiation delivered for a short time directly to the cancer cells.  As Dr. Duckert explained to us (more so to me, the biology teacher) cancer cells are most susceptible to the radiation at different times of their growth and development.  And all cancer cells aren't in the same phase of development at the same time.  If you would like a more detailed, biological explanation, don't be afraid to ask but I will spare you the "boredom" as Meighan described it.  If the treatment is done only once then you run the risk of targeting cells that aren't susceptible to radiation.  Five treatments  are needed to increase the chances of targeting the susceptible cells.  The actual radiation treatment won't take too much time as she will only be exposed to the radiation for a total of 6-10 minutes on each day.  The problem with the implant radiation is the preparation work that needs to be done by Meighan and by her radiologist.

Meighan will be on a clear liquid diet for the 24 hours before the treatment.  I'm sure this will really bulk up her already small--and getting smaller frame.  The implant radiation is an out-patient procedure, which will require her to be put under a "light" general anesthesia--Michael Jackson's drug of choice, according to her radiologist.  On the day of the treatment she needs to be to the hospital by around 7:00, which will not be easy for her.  Once she is here, they need to do some preparation work before she is put under.  Once she is given the anesthesia , she will remain under for about 4-5 hours!

Why so long?  If she is only receiving the actual radiation treatment for 6-10 minutes, why does she need to be out for 4+ hours?  Well, once she is under they are actually going to wheel her to a different location in the hospital to have a CT Scan performed.  This is necessary for the radiologist to determine the "physics" of the implant radiation.  He needs to determine exactly where to place it, and calculate how much of a radiation dose she is going to receive on that day.  Obviously it is a very complicated procedure but it goes way beyond "sticking a device up there" and turning it on.  Obviously Dr. Duckert was very happy that the tumor is rapidly shrinking for our sake and Meighan's health, but I know he was equally happy for his own sake.  With a smaller tumor he isn't going to need to place the implant radiation so incredibly close to her bladder, ureters, and sigmoid colon, which was a very real concern a couple of weeks ago.  That's great news to all parties concerned because the implant radiation can cause some serious problems to those areas and have long-term side effects.

Meighan here to wrap things up.  I've never been much of a runner, so I think this is the first race I've won (well besides some 7 flight hurdle races in junior high.)  I definitely don't feel like I've won a race, but rather ran a really long race and have nothing left in me.  They keep pumping me full of fluids, and I'm also drinking lots of fluids to hopefully gain a little more energy.  I told my nurse yesterday, "I feel my best (pretty good actually) when I'm laying down."  She said, "Yeah, that's not good."  I thought it was good that I actually felt good at some point?  As Jerrid said, I don't have any nausea or discomfort (this is good) just zero energy.  The littlest tasks take it all out of me and I'm down for the count again, so hopefully this issue starts to look up soon before implant radiation starts on Monday. 

Yesterday, after four hours of fluids I went down for radiation.  This weeks radiation is a little different than it has been.  They have narrowed the field they are treating since my tumor is responding so well.  My mom and Aunt Nancy were with me and they got to talk to Dr. Duckert.  He told them that my tumor doesn't like radiation, is "melting away", and has "drastically reduced."  It never really gets old hearing these sorts of things!

Even though I'm not getting my last chemo treatment today, I am enjoying spending some quality with my husband.  Through all of this you'd think we'd get a lot of time together as I really haven't left the house much, but that isn't the case.  He is always so busy caring for me, caring for Brayden, caring for Mogi, doing laundry, picking up the house, trying to catch a mouse (don't even get me started), coaching, planning, grading, teaching, and the list goes on while I am so busy laying in bed.  Our schedules just really aren't matching up, so today is nice and a great way to end chemo treatments!