“We rarely get to prepare ourselves in meadows or on graveled walks; we do it on short notice in places without windows, hospital corridors, rooms like this lounge with its cracked plastic sofa and Cinzano ashtrays, where the cafe curtains cover blank concrete. In rooms like this, with so little time, we prepare our gestures, get them by heart so we can do them when we’re frightened in the face of Doom.”  Silence of the Lambs.

It was time, once again.  I was wheeled from my pre-op room around the hospital hallways down to the gamma knife room.  What I remember most about the gamma knife room was that it was very cold and bright.  It was a large room but without many objects.  In fact, there wasn’t much at all – just the machine where treatment occurs.  The nurse and oncologist had me lay down on the cold metal slab.  While this was nothing new, the disturbing part was when they screwed my head down to the table so that it could not and would not move during the treatment.  Much to my chagrin, the bolting down occurred and not before long,  my head was affixed to the table –  as in it was bolted to the table.  Crazy thoughts like “what if I sneeze during the procedure?” ran through my mind.

Once I was guided into the machine, I closed my eyes and let the games begin.  Yes, the games.  I envisioned the procedure something similar to a game of Star Wars.  I could not see what was happening behind my head, but I knew beams of radiation were streaming into the tumor and simultaneously destroying its growth.  In actuality, this machine administers radiation in a hemispherical array and hones in on the specific target.  Hence, the mapping that I discussed in part one of this post.  The rest of the brain tissue is left untouched.  The entire procedure lasted about one hour but felt like eternity.

I was guided out of the machine and aided to sit up where the mask was removed from my face.  The oncologist grabbed his trusty drill and began to remove the screws that held the frame in place.  Forget the fact that I could not feel the pins coming out of my skull or feeling the blood that dripped out, the sounds of the drill so close to my ears still haunts me to this day.  The pin sites were all cleaned and my head was wrapped in gauze.  Alas, the procedure was over and I was wheeled back to where my family was waiting during the treatment. I could not be happier to be going home – but who am I kidding, I’m pretty sure that anyone who is released from a hospital stay, no matter how long or how short, is happy to be told they’re going home.

It didn’t matter to me that I felt nauseous, hot and then cold,  extremely groggy and tired from the procedure.  After all, this was all “to be expected.”  I do my best recovering at home.  Comfy chairs, good food and the best nurses.  Not sure if they would agree though…

Up to today, I have felt great and have no reason to believe that there is any further growth.  Yet, I cannot be certain and will always have my doubts.  I prepare for the worst because then, any sort of good news makes me feel like I’m on top of the world.  Yea, I deserve that.  Hopefully good news comes my way next month when I go back for my MRI.

At the time that I began writing this blog, I had just experienced my latest obstacle in my life as a brain tumor survivor:  Gamma knife surgery.

As a reminder, at my MRI last October, it was discovered that there was a small regrowth of the tumor.  But so quickly?  Yes, this was the unfortunate truth.  I knew what I needed to do: I remained resilient despite the news; I had to continue battling and fighting on.

I was presented with three options –

(1) we could take the “wait and see” approach and re-scan in three months to ensure that there was no further growth;

(2) daily radiation for six weeks to destroy the growth of the tumor cells and radiation to the rest of the brain if other cells were discovered; or

(3)I could undergo gamma knife surgery.

I tried to rationalize and understand the benefit to each.  Each option had its pros and cons in my mind but I just could not reason with myself why I should wait and allow the monster in my head to continue to grow and possibly affect my life as it had five years ago, nor could I envision myself going in for treatment every day for six weeks if it was possible to have it done in one day.   I had already made my mind up, but wanted to hear the thoughts of my medical team.

Each of the options were presented, again all having pros and cons and different possible outcomes that could affect my livelihood, but  at the close of my consultation with the radio-oncologist, he indicated that gamma knife surgery would likely be the most effective course of treatment.  Relieved to hear this, I expressed that this was my preference.  Yet, before a treatment plan could be established, a consultation with the “brain tumor board” was necessary.

A few days later, I got the phone call that gamma knife surgery was the chosen course of treatment and I would be on the schedule before the end of the year.  Time to get my game face on yet again and prepared for battle.

I knew very little about gamma knife surgery; let alone what it even meant.  However, I soon read up on the procedure and educated myself on it.  I’ll do my best to describe the pre-procedure steps below and then in my next post, I’ll tell you about the treatment itself.

Upon arriving for my treatment, I was brought in to put on my bracelet and hospital gown. This entire routine has become all too normal for me. The nurses gave me a finger prick, followed by putting in an IV port to administer medication and contrast for the MRI.  However, this is where this procedure differs from being given anesthesia and waking up hours later.  On gamma knife day, the neurosurgeon and nurses applied a local anesthetic on my forehead where the head frame was to be placed.  Using a drill.

The head frame was made of a heavy metal and was extremely tight-fitting to my face.   When I was looking at it sitting on the table, I didn’t connect the dots that this slab of metal would soon be placed onto my face and head.  I was unable to appreciate and fully comprehend that that was the frame to be put onto my face.  While the nurse held it in place, my neurosurgeon got his drill and proceeded to drill pins into my forehead and skull to hold it in place.  Not even the localized anesthesia was not enough to prevent the pain.  But alas, the frame had been affixed to my head.  I don’t know what a vice feels like, but this sure as hell felt like what I would imagine.

Next step: picture a colander.  Something very similar looking to that was then placed on my head.  I wish I could have seen what was taking place at the time because it sounded like a great game of battleship was taking place…”B52”…”E13.”   Joking aside, the letters and numbers were the doctors’ method of mapping where to administer the radiation.

Upon completion of the mapping, it was time for the MRI.  I was wheeled around the hospital in a wheelchair with this metal vise on my face – if I could have known what the visitors to the hospital who had seen me were thinking.  I have been in for numerous MRI’s, but never one with a metal frame on my face.  The radiologist had to add another piece to the frame and this made my head feel that much heavier.  Luckily, this MRI was only 35 minutes, compared to the usual 50, but the frame and contrast combined to make it one of the most unpleasant MRI’s I’ve had to date.

With all of the “pre-procedure” work over, it was time for lunch… with the frame still on my face.  I thought to myself “how the hell am I supposed to eat lunch with this thing on?”  I wasn’t given a choice – either I was going to eat my lunch or fast some more until dinner.  So in came my gourmet lunch and drink (luckily, they gave me a straw).   I heard an occasional snicker from Ashley and my parents as I wrestled with the food to get it around the frame and into my mouth but I managed to eat and drink without spilling on myself.  This is a perfect example of a simple task too often taken for granted.

All the while, and what nobody knew at that moment was the angst and restlessness that I was experiencing.  Outside, I was smiling and content.  On the inside, it was a completely different story.  My mind was racing and I began thinking of the worst possible outcome.  But then, like I had done on previous occasions, I took a deep breath, composed myself and prepared to walk down the hall toward the gamma knife room.  A red-haired nurse greeted me.  I wondered if her name was Clarice…