Radioactive Boy

The technicians were kind enough to let me sit with them and learn more about what radiation is actually like for Thomas. He and I report to the department each day, Monday through Friday.

The radiation clinic is in the basement of the Pasqua Hospital. We've read that Radiation Departments are typically housed in hospital basements, to limit the chance of radiation exposure to other people or to the environment. As we understand it, the areas that house the linear accelerators are usually a specially designed concrete bunker, rather than your typical basement construction.

He's been given a schedule of about a week at a time, highlighting his appointment times - which can vary from day to day. He hands in his schedule to the front desk, who alert the folks in the treatment room that he's there. Before he comes in, they get the mold out that they created to help position him, and they lay it on the treatment table. Tom gets himself settled in, and then they come in to help move him as close as they can to the same spot as previous visits. Then they exit the room. Tom has given them a favourite CD to play and help distract him from the noise the radiation machine makes while treatment is in progress. The setup is finished and treatment actually delivered remotely from a kind of command centre. There are several monitors, some watching Tom, and others displaying various critical bits of information.

The treatment table is adjustable (up, down and sideways), and so is the linear accelerator, which delivers the radiation beam. The computer has been programmed with a map of Tom's treatment areas. In days gone by, radiation machines could only deliver radiation in square or rectangular shapes. If a modified treatment area was needed, heavy lead plates had to be designed by the technicians to prevent healthy tissue from receiving radiation. These plates had to be lifted into place on the machine to cover the beam. Today, the machine can be programmed to sheild part of the beam area with 'fingers' that can be moved across the field. Technicians can deliver radiation in almost any shape, and the treatment field is always customized to the patient's needs. The radiation planning involved very careful analysis of all Tom's previous scans in order to ensure they treat all the areas where the cancerous cells were originally found plus a bit of a margin or extra area to ensure better removal of the cancer cells.

This information has all been programmed into the computer system. The machine has side arms that come out and take an image (almost like an x-ray) and project it on the screen in the treatment room. This too is a new advance - they used to have to come in and out of the treatment room to move films into place and take x-rays - and then wait until the next day's treatment to adjust the patient's positioning. Today, things are much more precise.

The technicians get everything setup, but the computer system has been programmed to deliver a specific dosage to each area of the body that requires treatment. If the computer does not agree that the area about to be treated is exactly what is in it's program, it will not allow the technicians to enable the radiation beam. By law, radiation treatment must be delivered by teams of two or more technicians - for Tom, there is typically a team of 3. They backcheck one another's work and calculations. In other words, everything is checked, rechecked and triple checked to ensure that they know exactly where the radiation is going - to the millimetre.

Tom's body receives radiation to the top and bottom: the machine actually swings right around in an 180 degree arc and then is lined up to radiate him from the underside. The treatment table is made of carbon, and the radiation beams actually pass right through it. Tom says the first time the machine's arms moved in close and the machine swung around and under him, it was hard to concentrate on remaining perfectly still! The technicians say that things generally go better if the patient can be as relaxed as possible. His appointment typically takes 40 to 45 minutes, but it can be longer or shorter depending on how long it takes to get him perfectly positioned.

We pick up his schedule printout on the way out, and check it to see if any changes or additional dates have been added. I was very impressed with how personable and kind the staff are, and I thanked them for doing everything they could to put Thomas at ease. One of the gals said, "Well, there aren't too many people here whose lives haven't been touched by cancer. We are all very aware when we work with a patient that they are someone's family. We try to treat them as if they were our son, or brother, or mom, or daughter - we try to treat them like they were our family."

(and I'm getting all verklempt just thinking about it)

This week we are so grateful for:
* the wonderful staff in Radiation (who complement all the other great people we've met so far)
* baked goodies from Nana Patsy (again Tom claimed the cinnamon buns!)
* visits recently from Steph, Austin, Jynelle and a HUGE card from fellow Luther students delivered by Kat and Katja
* the chance to catch up with some of my coworkers at our Christmas banquet (seems a little early, but it was nice to get out for a bit)
* visitors to my mom at the nursing home: Irene, Uncle Stan and Auntie Lottie, and Lottie's sister Betty (yay, the guest book is working!)
* the continued thoughts and prayers of family, friends and well-wishers.

By the way, we learned Monday that cancer patients will now be able to book appointments at the Cancer Clinics in Saskatchewan to receive their H1N1 shot. (that idea is just so crazy it might work!). Tom already got his last week, but definitely this plan will help many others. Laura was also immunized near the end of the week, now there's still Nancy, Mike, Jeanine and I that need our immunizations so that we can help keep Tom protected. I check the health region site every day for updates, so as soon as we can, we will get that taken care of.

Hope all is well with you and yours,
Thomas' Mom