Peter’s Hospital Diary

And it was off to London again this morning, this time for the radiotherapy planning session! I’ll gloss over the difficulties of finding a car parking space near Winchester station at 10 o’clock in the morning – it only took an hour – but eventually I arrived up at St Thomas’s Department of Oncology and Clinical Radiotherapy for the planning session.

I was met by Olivia (Specialist Registrar in Oncology) who explained the procedure and got me to sign the all important consent form. Basically, the plan is to give me a few (!) rays on my neck from both sides to zap the lymphoma cells that are residing there. Side effects will include a sore mouth and throat (a bit like the effects of the chemo) and another assault on my taste buds (with the risk that the changes in my sense of taste could be permanent – although they still haven’t returned to normal after the last lot of GvHd!) There is also the risk of a dry mouth as my salivary glands will be affected, but they should return to normal.

Anyway, after the consenting, I went into the planning. The important thing is to ensure that the right bits are irradiated, so the first stage was to position me on a machine similar to the gamma ray generator, to measure my position and take a general X-Ray of my neck to ensure that I was positioned correctly. The gamma beam itself is very precisely steered, (to within a millimetre) so it is important that I don’t move when I am being irradiated. To ensure this, a face mask is made that clamps over my head and holds it in place under the machine. The mask is made from a thermoplastic mesh, so while I was lying on the ‘bed’ like the one on the gamma machine, this warm mesh was moulded over my face and allowed to harden. Not a very pleasant experience because my head is immobilised, and the mesh tends to shrink slightly as it cools, gripping my head quite tightly.

After the mask was made, I was put in it under a CT scanner so the precise location of the affected lymph nodes could be determined, so that the coordinates can be fed into the computer that controls the gamma ray generator. From a technical and engineering point of view, all very interesting. As a patient….hmmmm!

This all took about 2 and a half hours, so I got away by 4 o’clock to return home, clutching the appointment schedule.

Ah yes, the appointment schedule. I will be having 20 doses of radiation, each session lasting up to an hour. Not that I will be zapped for an hour, but it takes some time to set up the machine, and get me aligned in it. I suspect the actual radiation will be on for 5 minutes or so. However the times are all over the place, and take place on successive days. I haven’t decided if I will travel up daily, or stay in London for the week. I suspect I will feel quite tired (although I hope not too sick – it isn’t zapping my gut or stomach) so maybe staying in London 4 days at a time may be the solution. Anyway, it starts on the 31st October, and ends on 27th November. I don’t think it will be much fun, but then no-one said this would be easy!

Meanwhile I am continuing with the Thalidomide, so lets hope the GvHd starts soon!

The next trip up to Guy’s is on Thursday for the haematology clinic – and a lung function test!

So the show is back on the road – onwards and upwards! I just want to crack on with it now!