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Georgetown and Radiation Bombs

Posted by on August 1, 2012 in Medical Procedures and Other Drugs, My Health Updates - 20 Comments

So I finally got into Georgetown.

When I was, well, younger, and working on Capitol Hill, my former graduate adviser came to D.C. to give a presentation on American foreign policy. We got some dinner, and he asked if I was ready to quit fooling around with politics and get back to real work. Those were his actual words, if I remember correctly. And by real work he meant research and writing about politics. American history, anyway. And he was perfectly serious. I admired him quite a bit, and when he suggested I could live in DC, keep a hand in politics and still get my doctorate at Georgetown (of course, he knew some people), I nearly took him up on it. At the time, though, I was too caught up in seeing history unfold in real time. It’s one of those points in your life where you look back and wonder how a different decision would have changed the direction of your life. I guess there are many of those. I’m glad I made the right decision. I don’t know what I’d do without Dena and the kids to help me get through this fight with cancer. And besides, I eventually got into Georgetown anyway.

About a week or so ago I officially applied and was accepted to the Georgetown Department of Radiation Medicine. Admittedly, the circumstances of my enrollment at Georgetown are somewhat different than those I’d considered when I was younger. For one thing, American foreign policy and radiation oncology don’t have as much in common as you might think.  For another thing, I’m going to be on the pointy end of the radiation stick.

Dena and I arrived at GU today for our consult and simulation session. Heath care providers may or may not be aware to what extent the environment of a hospital affects a patient’s confidence. Considering that we were pulling onto the campus of one of the nation’s elite colleges, with a architectural history dating back nearly to the founding of the United States, I was expecting some grand surroundings. Pastel flower arrangements. Towering oaks. Statues of inspiring men on horseback. What we drove into was as a extended carport with shattered concrete and construction barriers everywhere. Even inside, the mood lightened little. The radiation oncology department is located in the basement of GU’s Lombardi Cancer Center, and there is little light or fresh paint in those tight, underground corridors. The waiting rooms were akin to those you’d find at the CarMart, except CarMart has television.

And then we met Dr. Sean Collins and our moods changed. For one thing, Dr. Collins had actually reviewed my CT scans and medical history prior to arriving at the consult. (No, this happens less than you might think.) And clearly, he’d given it quite a bit of thought, as his treatment plan was different from what we expected — more aggressive, which we liked. Most importantly, though, he was funny. Just damn funny — and not in a weird Patch Adams kind of way. In my opinion the most important qualities you want in a doctor are skill and competency, but how much nicer is it when you find such a doctor who also has a good beside manner? We’ve been lucky in this regard; most of our doctors have been skilled and compassionate. Dr. Collins is this, and goes a step further. He seems like the kind of guy who might blast your lungs with radiation and then offer to buy you a beer afterwards — either as a kind of apology for burning through your skin or as an opportunity to relive the glory of it. In fact, I’m going to ask him if I can bring in a sixpack to split tomorrow during our first radiation session. Even if he says no (and Dena and I have to down a quart of bourbon hiding by ourselves in the bathroom as we usually do), my confidence level remains high anyway. And confidence is critical when you find yourself registering with a new medical facility, especially one decorated by the medical examiner.

Brachial Plexus

Now, Dr. Collins did emphasize on more than one occasion that he could hurt me. I am going to assume that this was not meant as a boast but an explanation of why he wants to proceed with his treatment plan more slowly than expected: four weeks rather than two. This gets back to his aggressive treatment plan. Like Dr. Song at Johns Hopkins, Dr. Collins observed that the mets in my subclavicular area threatened my brachial plexus, which is a network of nerves passing from my neck through  my armpit and down my arm. Should the mets continue to get larger it could cause some real damage, besides the nerve pain I’m currently experiencing — such as the loss of the use of my right arm. However, he also noted some alarm about mets pressing against my trachea and bronchial tubes. These could create some obvious respiratory challenges should they expand. The term collapsed lung came up once or twice.

So Dr. Collins proposed that we move forward with a higher dose of radiation than we originally discussed with Dr. Song and that we also go after the lymph nodes in the chest that are threatening my airways. This, he said, would require at least four weeks of treatment, every day. So we’re looking at a solid month of daily radiation treatment (and, who knows, maybe a lot of beer), starting tomorrow at 4:40 p.m.

After our consult with Dr. Collins, I went under the CT machine and simulated a treatment session — meaning that they measured my chest and neck from every angle and marked my body with tattoos (no, really) indicating where the radiation beams will be directed tomorrow. I also got to make a facemask. How cool is that? More on the simulation tomorrow morning. Time to force some kind of foodstuff down my throat.

  • Laura ( cousin)

    I’m so sorry you have to go through all of this Chris. I pray everything goes well.

  • Mike Venable

    Chris and Dena, I appreciate that you’ve got your claws dug in and that you continue to fight with the strength of an army. I am one of the ones cheering you both on and praying that your decisions are perfect and perfectly timed. You know, it is just a damn shame that you’ve proven your nowhere as good at licking cancer as you are at writing. It is beyond time for you to buck up and get better at beating cancer. When you figure that out, please let me know what you’ve learned. It is starting to kick my ass, too!

  • Tracy Hoffman Freeman

    My prayers are with you as you start this treatment.  I pray it will be the last one youi need and the mets will shrink or completely go away.  It’s nice to have a funny doctor who is a human being and not afraid to show it.  My family doctor is like that.  Take care.  We missed all of you at the Boegner family reunion though I must say Krista admirably represented the Plummer daughters.

  • Frankfriedman8311

    My prayers are with you Chris as you go through this month of grueling treatment.  Prof. Frank Friedman,Flint,Mi.

  • Dom Caputo

    My thoughts and prayers are with you and your family as you continue this battle.
    D. Caputo (ACKC)  

  • Shaun

    Hi Chris,
    Sounds like a great plan to me and I have the tatts that give me street cred. I also received very high doses over 5 years ago and those areas have stayed stable. The technicians thought there was a mistake in the orders because I was getting about 30% higher than “normal” bone met radiation. RCC requires some serious blasting. I’ve been affiliated with Harvard since early 2007. Still can’t seem to graduate. I know my major is in RCC oncology, but I continue to dabble in other areas like cardio-oncology, radiology and endocrinology. In fact they even built a beautiful new building since I enrolled, so I guess I’ll stick with it. Plus my doc is really funny. I don’t look forward to seeing the serious side of him some day.

    All the best,
    Shaun T

  • Laneia

    Warm thoughts and well wishes are being sent from Boston. Well Fitchburg to be exact, but close enough. Good luck. We will await your update of how it all went. Best wishes to you and your family. LaNeia

  • Cfegles

    Chris and Dena, our prayers are with you too as you forge ahead in this journey!!!  We have come to grow quiet fond of you both, although you don’t even know us :) )  Chris & Mike from Kidney-ONC group
    (PS  Mike’s back here at OHSU right now for another round of IL-2)

  • Karen Eagleson

    Sending you strength Chris to help you through this next rough spell of treatment – keep that sense of humour (Canadian eh!) and just say ‘yes dear’ and let Dena bring you through it.

    Karen in Ottawa Canada

  • Jplantin

    Thoughts and prayers are sent your way as you continue your journey. For every zap, you earn a beer. Best always.

  • Dianaboyesen

    As always following your journey from afar and sending wishes your way for strength and good news

  • Stephanie Kovats

    Chris, thanks for the update.  Eric and I will continue to pray for you, your family, and your health care providers. 

  • Patricia Alana

    Chris and Dena, my prayers are with you too as you forge ahead in this journey!  I have come to grow quiet fond of you both, although you don’t even know me :) )  Patricia from Kidney-ONC group

  • Katie Tichacek

    well it’s about time that Georgetown contributes something to the world besides cheesy bars…
    hope they go easy on you with the hazing,

  • Mjpattison

    I hope this Dr Collins is not part of the Twilight Saga family!
    Good luck with the treatments, keep that confidence up (and check out his eyes).

  • Sasbearfacts

    Good luck Chris and to you as well Dena, we may not actually be in the machine but we are going through the treatments just the same :)

  • Julie Corrigan

    I’m so glad that the radiology onc has a bedside manner and humor! Makes the process a little easier! Good luck with everything the next few weeks. Hope you and Dena have some relaxation and fun planned for the weekend. Take care.

  • Upwithdogs

    Hopefully the tats have little smiley faces that you can show the girls…  Hoya Saxa!

  • Minnie kriek

    Hi there, in our neck of the woods we have the same Interior designer as you. I think this person has an international contract and the main aim of the design is to discourage return visits. And a little aside, American foreign policy tends to be invasive when there is a mess somewhere so it is similar to radiation! 
    May you be surrounded by competent caring people and much love in this part of your journey. A very special God bless to you too Dena.
    PS And if this is my ubiquitous second post, sorry!!! my computer is a little weird of late. Must be the menopause!

  • Gnuse

    You gotta love the face mask.  Cody had one as well LOL.  

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