Dear Doctor, thanks for the cake

NOTE: This post was written yesterday, but I couldn't upload it due to Internet problems (see post below).
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Somedays its hard to find interesting stuff to write about, other days "material" comes pretty easily. Today it was served to me like cake on a plate.

This morning, Mathilde and I drove out to the hospital to have a preliminary meeting about the radiation treatment. Up until now, I have been part of the hematological ward, and the doctor who is treating me is a hematologist. I don't totally understand the organizational structure at the hospital, but our meeting today was with a doctor we have never met before, an oncologist (the radiologist will come into the picture in a few weeks).

So today, for the first time, we met the oncologist. Now, I know it probably isn't ideal to be able to crack jokes about your oncologist, but holy shit this lady was wacky! Mathilde and I left feeling like we had witnessed a one woman surrealistic, improvisational theater and we spent the rest of the day laughing at the memory of it.

The introductory, hand shaking stuff went fine, but then we got settled in our chairs and it was time for her to start communicating. The best way I can describe her communication technique is absolutely, completely, totally random. Usually when the doctors or nurses are going to give you information about a treatment, you get the feeling they have done it at least a few times before. They have a certain routine about their presentation which is comforting (We've noticed the nurses have a bit more routine than the doctors). This particular doctor must have left her routine at home, or maybe she is too young to have developed a routine yet.

She started by looking at me sideways, as if she was sizing up a tree she needed to cut down. After a long pause, she says, "Hmm...where should I start?" Another long pause. More looking sideways. "We'll primarily be giving you radiation in the places where you've had cancer."

I write this down, then it occurs to me to ask, "You say 'primarily in the places where I've had cancer'... where else will you be giving me radiation?"

Calm smile from her. "Oh, no where. Only in the places you've had cancer." Okay...

A few minutes later, after a long thinking break, she says, "Your radiation will start 2 weeks after your last chemo treatment."

Mathilde scratches her head and says, "Uhm...the hematologist said radiation will start around FOUR weeks after."

The doctor looks at Mathilde calmly and smiles, "Yes, that is correct. Three to four weeks." Okay...

The meeting progressed in this surrealistic, random kind of way, where she'd pause for a long time, size me up a bit, and then provide some new detail or possible side effect as if she'd just pulled it out of a hat. Initially, we were doubting her qualifications (you know, inconspicuously scanning the walls looking for the framed medical degree). But after a while we relaxed and realized that she actually knew what she was talking - she just sucked at communicating. We also took comfort in the fact that I am not a patient of a single oncologist. That is, she isn't making decisions alone (more senior doctors will be involved in that), she just happened to be the one that we met for the informational meeting.

Anyway, in a random, haphazard, stare-at-Kevin-sideways kind of way, we found out the following things:

- I won't feel any side-effects until about the fifth time
- my lungs will be hit, which could lead to short term and long term side-effects
- my heart will be hit, which could lead to long term side effects
- my (what's the word for food pipe?) will be hit, which could have short term side-effects (loss of appetite, difficulty eating)
- I could have permanent loss of hair in the places where they radiate. I asked if they could possibly radiate in some kind of attractive pattern on my chest, like maybe a heart form. (I hope she knew I was kidding). The cool thing about loosing my chest hair is that it'll lead to a sympathy shave that Rod can participate in too!
- They'll do some heart tests before starting the radiation
- I'll go to a special scanning and then they'll sit down with radiologists and other fancy people in order to determine exactly where to zap
- the radiation will probably start around May 23 (date not set yet) and continue over the next 19 weekdays.
- the first treatment will take about 2 hours, after that I'll be in and out in 15 minutes

Even though she communicated like someone with a mild form of tourette's syndrome (sans curse words), we actually left feeling like we are much more informed about possible radiation side effects than we were about possible chemo side effects.

But she WAS weird. There must have been at least 5 times where I thought she was done and I started packing up, only to find out she still had more. When I REALLY thought she was done and had my notebook closed and I was standing to leave, she announces that she'd like to examen me. So I let her do that, and it went fine. And again I thought we were done. But boy, was I wrong.

As I was getting ready to leave for the second time, she she blurts out, "I'll be right back," as if she got a bright idea. She hurries out of the room and comes back about 2 minutes later with a smiling, six foot tall, red headed nurse.

The nurse introduces herself, handshakes all around, and that's when I see that in her other hand she has a tube of lubricant - with the top off. This alone makes me nervous, but when the nurse slips quietly behind me (with the tube of lubricant) and the doctor rolls her chair right up to mine, I can't help but half shout, half whimper, "whoa! whoa! what what's going on?"

The wacky doctor then explains that because my (what's the word for food pipe?) may be affected, she would like to have a look down there before hand. (I noticed that she never said she did things because she "was required to" she did it all because she "would like to").

Anyway, as she is explaining this, I see, out of the corner of my eye, that her smiling, fullback of a nurse is lubricating this 2 foot long, dangling, rubber rod. The doctor explains, with a happy smile, that she is going to cram the dangling rod into my nose and down my throat. Turns out the dangling rod is a microscopic camera thing-a-ma-jig. "Okay, that's fine," I say, and I look back at the nurse nervously, "But is that thing clean?"

They laugh, as if their thinking, "ho! ho! ho! this guy so funny." The nurse then shows me how she has put my own personal condom on the rod, so I have "nothing to worry about". Nothing to worry about at all.

I finally accept that this is standard procedure, something they HAVE to do not, and not just something they WANT to do. So I straighten up and decide to be a man about it. I am told to sit up straight and stare at a butterfly picture on the far wall. The doctor slides her chair closer (which was quite a task considering my long spider legs kept getting in the way) and starts feeding the tube into my right nostril. I kept expecting the nurse to put me in some kind of head lock, but she just stood beside me with a calm, gentle hand on my shoulder and coached me along.

It was a pretty uncomfortable little procedure. I can tell you that when somebody sticks a long tube in your nose, your urge is to grimace and close your eyes, but that is the wrong thing to do. Apparently, you should just relax and take it. That's what the nurse kept telling me anyway. She actually said I was doing great, "like I had done it 20 times before" (I think the word is out at the hospital that I am a sucker for compliments).

I didn't think that doctor was going to be able to get the tube past my deviated septum, but I should have known that a little crook in the nose wouldn't stop this lady. She got past the bend, and around the corner and I then I could feel the camera scratching down my throat. The tube also seemed to turn my right tear duct into a faucet, and through the whole procedure I had a waterfall of tears cascading down my right cheek.

The doctor had a good look around down there, had me say "ahh" and "ehh and squeal like a pig, and then she announced that everything was fine. As she pulled the final length of tube out of my nose, the nurse kindly gave me a tissue to dry my face. I dried my face and as I grabbed another tissue for my eye, I said, "See how sad you made!"

The nurse was pretty distraught by this and I had to explain to her that I was only making a joke.

Well, after all of that, the doctor was FINALLY done. She left (presumably to take some other patient for a wacky ride) and the nurse stayed to explain a bit more about the radiation facilities. She gave us a bunch of brochures and then we were done.

It seems the different radiation machines have names. I think I'd like the one named "Odin" or maybe "Thor". There were a few with women's names, but after today, I'll try to stay away from those.

UPDATE: Mathilde just read this and suggested the doctor wasn't THAT bad (she's concerned that my parents are going to read this and get all nervous). Mathilde is probably right. As I said, we left feeling fine about the whole situation (and the nurse was actually very, very nice). Anyway, I didn't make anything up, I just sort of told it all in my own way ;-)