A Hole in the Head

Welcome Home, Calin!

This morning, less than 48 hours after returning from a robustly fish-themed first-ever trip to Japan, I went in for my much-awaited Gamma Knife Procedure. It's true, the Gamma Knife was much awaited. From the beginning almost two years ago of this latest episode of cancer (which episode has helped me realize, I think, that it is not actually a fourth beginning but, instead, the fourth upswing in a single long episode of cancer that I have learned to call "one aspect" of my life path) I was interested in the focused radiation part—the "knife"—itself, and the more I heard about it, the more I was also interested in the the somewhat gruesomely barbaric preparation necessary to be able to hold my head still enough for the "knife" to do its remarkable focused radiating.

As you know, a routine MRI uncovered a tiny new spot in the left ventricle of my brain less than 48 hours after returning from my last overseas trip, to Cabo Verde and Portugal and England, and my "surgery" today was the direct outcome of that and the ensuing several more scans that I had in the three weeks before Japan. I've read recently that the shift in earth energies is causing more and more people to experience major things more and more often, in an attempt to help us learn to live in the moment—there simply isn't enough time to stew before the next major thing—and I have to say, in the past 3 months this has certainly been true for me.

Anyway, this morning at 6:00am we headed off to Harborview Medical Center and its Gamma Knife Center (one of 4 in the city, I believe, from research Ian was doing while waiting for things to happen—maybe I'll ask him to write up a quick post about Gamma Knife itself . . .). I checked in at 6:30, was first on the schedule of 4, and arrived back home close to 2pm.. It was supposed to be closer to noon, but the process is slightly different for every patient, and what was expected for me—that I would get in, get one spot done over a period of about 20 minutes, and get out, turned out to not be reality.

The first thing that happens is you get a metal cage screwed into your head by a neurosurgeon, one of three major players in the Gamma Knife experience. Even the cage itself doesn't go on the same way every time, because it has to be in a position that is out of the way of where the radiation is going. Most parts of the brain are accessible no matter where the cage is placed, but not all parts in any one placement. So the neurosurgeon comes in and says "I understand we're putting you in position to get treated for a lesion on the right side."

"No," I said, "I thought it was the left side."

"I'm pretty sure it was on the right side that Jason showed me," said Dr Bob.

"It says here the left side," said one of the nurses helping with the prep.

"Well, I'll be right back," said Dr Bob, and left the room. "Just as I said," he informed us as he returned, "the lesion we're aiming for is on the left side. In the left ventricle."

The placing of the cage was, in fact, the most difficult part of the day. Four shots of lidocaine were pushed searingly into my skull, then the screwing (by hand) began.

"Um, that really stings still," I said, and Dr Bob immediately pushed in another syringe of the numbing agent (my scalp has only recently started regaining feeling), in three of the four screw sites. The numbing hurt, a LOT, but it was the pressure of screwing the plate into my skull that really made me woozy. "I think I'm going to throw up," I informed my nurses, who started pumping saline into my IV and told me to take deep breaths, in the nose and out the mouth. The wooziness passed, to the gratitude of all.

Once the cage was installed, I was wheeled on a gurney up to MRI and had a picture taken of my brain including the coordinates of the cage, so that I could be placed perfectly in the Gamma Knife machine to hit only the spot we were focusing on.

I was then sent somewhere to rest and eat breakfast (Ian had been given $5 to spend on me at the hospital cafeteria) while Dr Jason reviewed the MRI to make sure he could perfectly identify the coordinates of the spot. Except that it turned out there were two additional new spots, both on the right, one, in fact, in a place where it almost couldn't be treated because of the placement of the cage.

The other two new spots were also very, very small—treating them in addition to the first one was not much of an issue since I was already there and prepped, provided the one under the cage could somehow be reached (and it was). And, in and of themselves, they, too, did not offer any serious risks at this time, either in size or in the locations where they were.

What they represent is a new surge of activity, presumably from the body, and delivered to the brain through the blood stream, because the original lesions in the brain are non-reactive at this point.

What this means is that maybe I don't, in fact, have time to try my own thing, even for three months. I'm going to sleep on it, though, a whole night tonight (jet lag allowing), and for the weekend read over the options Dr Specht has suggested to me, as well as continue my own research, and decide where I want to go from here.

I feel so healthy and fit and well for the most part, that I don't expect to see anything at all in my scans anymore, ever. I was surprised by the spot when I first found out about it in February, and I was surprised it was still there today. I mean, it was small—why couldn't my body, my supplements, my Herceptin and Letrozole, my general good health, my love, love of my life and all the richness that is in it, why aren't those things enough? And I felt bludgeoned in the face by the two new lesions.

I know that this is my path. And I know that today's experiences are all part of the richness. And I know that I am lucky to be alive, to be who I am, to have this wealth in its endless variety.

But sometimes, for just a little while, it SUCKS SHIT. No poetic language here.