Post #4: BrachyTherapy

Brachy What? Thats exactly what I said. BrachyTherapy is radiation from the inside focusing on a specific area (in my case, my tumor). This form of treatment can be used to treat a variety of cancers. When I met with the radiologist in Houston at MD Anderson, her treatment plan for brachytherapy was 2 treatments…2 different weekends (I would be hospitalized each time) with a 2 week break in between. My radiologist in Austin used a newer method (so he says) of breaking that up into 5 different treatments lasting a week and a half (so I thought) with no hospitalization.

With a week left to go of radiation I started asking about my next step of treatment, brachytherapy. They said someone would be calling me to help set that up. I asked again on my last treatment (which was a Friday) what was going to happen next and they said the same thing. A week went by and nothing. With the encouragement of a client, I started calling some of the numbers I had to ask questions. I called on a Tuesday and it was after hours so they left a message. No return call on Wednesday. FINALLY on Thursday morning, as I was walking in to train my athlete, I get a call stating that I’m scheduled to have my sleeve put in tomorrow morning at 10am. I frantically called my mom and informed her and bless her heart she dropped everything and drove up to ATX to take care of me.

On Sept. 26th, 2014 a few weeks after my last chemo and external radiation treatment, I went into the hospital to have a “sleeve” put in to help with radiation. This piece was going to be used to hold the instruments during my brachytherapy treatments. Since I was going to have to an anesthesia mom came up to help with driving and to take care of me. I was admitted to the day surgery center early that morning. After lots of questions and waiting and 2 different attempts to get blood (my veins are shot from chemo) I was prepped and ready to go. I had met with nurses, doctors, anesthesiologist, oncologist, the whole 9 yards. I had answered question after question. Then sadly my oncologist came back in the room and said that my WBC (white blood count) was way too low for surgery and I was at risk for infection and I was rescheduled for Monday Sept. 29th. Ugh.

Even though it was common to have a low WBC during chemo, I still needed to move forward with treatment. I gathered my things and got unhooked and went to my oncologist office to see if my insurance would cover a certain shot to help raise my WBC. After about an hour we discovered that the shot would be covered and I was sent to a clinic to teach me how to give myself a shot so over the next few days I could give myself shot of a drug that would help with my white blood count. My original AWESOME chemo nurse was working and she showed me how to make and administer the shot (even though I gave myself shots during IVF). We (Mom and me) left the hospital headed to walgreens to get the shots. When we got there we found out that my insurance DIDN’T cover the shot. I frantically called the nurse back and she arranged it where I would come into the hospital and get the shot. Let me break it down for you. A cancer patient with a low WBC was to admit herself to the ER and tell them what is going on and they would administer the shot. Doesn’t that sound a little off? So Saturday Sept. 27th I admitted myself to the ER, after a lot of paper work (where I found out each shot was $10k) I was ADMITTED TO A ROOM. About an hour after I got in the room, they came in to give me the shot and I was free to go. I did that Saturday AND Sunday.

Mom returned on Sunday evening to help out with me on Monday. We went through the same thing got all hooked up and was ready to go. I was out before I left the room. During this procedure they went in and sewed a “sleeve” to my cervix.

This sleeve would be used in my brachytherapy to hold the instruments during treatments. This procedure lasted a short 30mins. Recovery from the procedure was rough. I have never had anesthesia before. I thought I was going to get up and walk out…wrong. I was wheeled out to the car and in the process I puked.

After getting home I went straight to bed to sleep off everything. CONFESSION, Chief was a little puppy and wanted to be next to me so I allowed him to sleep next to me in the bed. This is the ONLY time Chief will sleep in the bed at my house (Grandma’s house is a different story). He slept with me for a long while. I recovered the next day and headed back to work. 2 weeks later I started treatment.

Let me breakdown the WORST part of my treatment for you.

I asked lots of questions about this part of my treatment and got LOTS of different answers. Some said I could do it without drugs and it was no big deal, others suggested I take the drugs. HOWEVER if you take the drugs, you have to have a driver. Being “Ms. Independent” and super tough I was going to forgo the drugs so I could drive home myself and not have to interfere with other people’s schedule. Mom insisted on going with me to the 1st one and I’m glad she did.

We arrived at the hospital early in the morning. They took me back (mom in the waiting room) to a room. I striped from the waist down, but because it was cold I had on multiple layers up top and 2 pairs of socks. Then the nurses came in took blood and started an IV and put a blood pressure cuff on me. The 1st nurse started a catheter which was REALLY uncomfortable and unpleasant. I thought people got great relief from theses things, me not so much. If that was the worst part I was going to make it, wrong. The radiologist came in to put the instruments in me. These instruments were going to be attached to the sleeve that was attached to my cervix.

No, this is not MY instruments (that would be gross) but this is what it looked like.

He goes to put that in and HOLY HELL did it hurt. I quickly asked for the drugs. They strapped me with oxygen (and sometimes heart monitors) and put in some drugs through my IV and then gave me a pain killer. I later asked why that hurt so bad, “I’m pretty tough why did that hurt so bad?” He said it could be from a number of things (1) my pelvic floor is tight, prob due to lifting/training (2) I’m young (3) I haven’t had kids yet so things were still pretty tight. My KICK ASS (pause: she was awesome! I couldn’t of had a better one. She was very observant of what was going on and attendant to my needs) nurse gave me a drug to knock me out so they could finish inserting the instruments. Once the instruments were in, they transferred me to a gurney and took me back for a CT Scan, then placed me back in my room (where my mom joined me) and then the rough part. The Wait. Here they look at the CT Scan and plan out exactly how they are going to administer the radiation. This wait was anywhere from 2-4hours. This wait was MISERABLE and LOTS of tears were shed over pain; I just couldn’t get relief. I was consciously sedated, but I was aware of what was going on. I couldn’t move from the waist down because there are instruments in me. I had an IV in my arm and was unable to bend my arm. Blood pressure cuff on the other arm. I was also strapped to the bed. I got NO relief from the catheter, so it was like I had to pee but I couldn’t go. I was constantly begging the nurse for drugs to give me relief from the pain. She did all that she could to keep me happy. For a few treatments I had my mom put in my earphones and I turned on a book so incase I did focus it was on the book and not the pain. After the wait was over, mom would go back to the wait room, they would take me back and hook the instruments up to a machine and administer the treatment.

From what I can remember, the machine looked something like this.

The treatment lasted 10-12mins. After the treatment, I was given anti nausea meds and another round of pain meds through my IV, and then headed back into my room where they remove the instruments, catheter and IV.

This is how it went for most of the treatments. I would come in, remove my bottoms, nurses placed a blood pressure cuff on one arm, start an IV on the other, they would take blood, administer drugs via IV, start oxygen, insert catheter, insert instruments, CT Scan. I would wait anywhere from 2-4 painful hours receiving as much pain meds as they could legally give me, 10-12mins of treatment, more drugs, finally removal of catheter and instruments, nurse would escort me to the car and mom would drive home. I would check in at 7am-ish and leave around 2pm-ish. I was prescribed 5 treatments, but honestly it took 7 attempts. There were 2 different times that I didn’t get my treatment due to gas bubbles in my rectum (PS Gas Bubbles are normal and everyone has them, they are not an issue until you have to get treatment).

If you have read my radiation blog then this would sound familiar. They discovered my bubbles AFTER the CT scan, meaning I got knocked out and “set up” only to discovered this wouldn’t happen. On the time it was suppose to be my last treatment I was having gas bubble issues and after a few hours wait in the room, they came in and told me they were going to relieve me of some of the gas….aka rectal coil. I’m not even kidding you. With more pain meds, they put a tube up my rear end and took me back for more CT scan. Let me paint a VERY TMI picture…there was a catheter, instruments for treatment and now rectal coil in me, all at the same time. Apparently the rectal coil is common for prostate cancer patients. They took me back for another CT Scan and realized the coil only relieved 1 of the 3 bubbles. In the CT scan room the radiologist got on one side and my nurse on the other and they started pressing on my abdomen trying to move/relieve the bubbles. They pressed on me for a few mins then ran me through the scanner again and came to the conclusion that it was a huge risk to treat me so they didn’t treat me that day. From this point forward they put me back on stool softeners, gas X and enemas (morning of treatment). No I’m not kidding and yes this was new to me. Since I was having trouble, these were added into the mix. Yea. My last treatment’s set up was normal except they put the rectal coil in from the beginning. It was awful. I cannot imagine being in that position for a full weekend like the original radiologist suggested.

My afternoons following treatments were spent recovering. I always had gatorade and after a few hours of napping I was able to eat food (I couldn’t have anything by mouth after midnight the night prior so I didn’t eat until that afternoon). Since the 1st 3 treatments were on a MWF, Mom stayed that week and then they started getting crazy and were scheduled all over the place, my mother came and went.