Meeting the radiation oncologist, and a little surprise

So today is the day I finally get to meet with the oncologist and find out my treatment plan. I was a little bit nervous, because this makes it all real now. But I was also just a fraction bit excited (how sadistic is that!) because now I'm going to know exactly what I'm up for.

A few hours before my appointment, I got a phone call from the institute saying they had added an extra appointment to the day - they were going to send me for a planning CT. This is the CT that they use to work out the best pathway to use to zap radiation through my body that will kill off the nasty cancer cells without killing off the good bits that my body will still need (you know, the essential stuff like my bladder and bowels)  I figured this to be good news though - it obviously means that they're planning on getting started with everything.  About bloody time!

So I arrive for my first appointment - off to see the oncologist.  I arrive at the desk, go through the process of saying my name and date of birth, and am then told to go get changed into a gown.  Huh? I thought I was here just for a chat?  Oh no, the doctor will want to examine you too.  Oh yippee.  I can barely wait.  So I got changed into the sexy blue gown (getting sick of this gown) and go back out to the desk.  She has a lovely 3 page questionairre for me.  Oh joy.  The questions started out fine.  Easy stuff like do you have any allergies, no. Are you on any medications, no. blah blah blah.  God I have a boring medical history.  Please write your understanding of why you are here today.  Ummm, because you told me to come here for an appointment? No, wait. That's probably not the answer they're after.  Ummm.....because I need you to cure me? Oh, I know....Because I have CANCER you fools!  Why else would I be here?

I turn the page - the questions get better.  Are you worried about any of the following, yes or no.  Then it lists a long list of 'concerns', like job commitments, financial concerns, family, changes to appearance, changes to sexuality, spiritual concerns, social concerns, treatment etc etc.  So I happily go down the list yes, yes, yes, yes, yes.  Stupid form - of course I have concerns.  Seriously, does anyone get told 'hey, you have cancer' and they go "oh goody, this will be fun, nope, no concerns here, this is going to be a walk in the park".  Then it asks if I want them to place referrals for supports on my behalf.  This amused me somewhat - so if I say yes, I have concerns about changes to sexuality, and then say yes, I want you to put in a referral - just who exactly gets that referral?  Do they have a sex nurse?  I figured I would play it safe and just select no.  No need for referrals here (although meals on wheels might be nice - get out of the cooking for a while!)

No sooner had I finished filling in this form, the nurse came to take me to the exam room.  She told my mother she had to stay behind, the docotor would be examining me, and then she would get called in for the 'talk' part of the consult.  We stop at the scales - apparently I have to get used to this bit, they'll be weighing me constantly.  Great stuff.  What a lovely surprise to see I've lost 10 pounds in the past couple of weeks.  This stress diet is awesome! She also measured me - as I stepped away, she let the scale slide a bit and it went from 156cm to 154cm.  I said hey! It slipped! I'm not that short. She replied I know, I saw that, don't worry, I'll add the cm back.  Right - so now I've lost a cm.  And when you're as short as me, you need every bloody cm you can get!

Then she takes me into the exam room and checks over my form.  Oh, she says.  I see you've answered 'yes' to a lot of concerns.  Are you kidding me?  Who WOULDN'T be concerned about what their life holds over the next few months???  OMG, I really didn't like this nurse and her attitude at all.  How the hell did she get a job in a cancer clinic?  Aren't oncology nurses meant to be kind, caring and compassionate?   She finally leaves the room, saying the doctor will be in in a minute.  And so begins my long wait in a boring little exam room.

The scary exam table - I couldn't help but wonder where the stirrups were.  Maybe it wasn't going to be "that" kind of exam?  Fingers crossed.  So I'm sitting there waiting, waiting....what else can you do when you're bored?  Oh! I know!  How about a lovely selfie in my sexy gown....

Ok, not the most flattering shot, but hey - i'm bored.

Finally the doctor comes in - I'm pretty certain this is her first gig fresh out of medical school, or I'm getting so old that everyone looks like babies.  She is young and perky, and directly to the point.  She says that she will start with examining me, and then discuss what is going to happen from here.  She then starts to give the run down of the scans from yesterday, and before I know it, she's had the entire discussion with me - while my mother is still waiting in the waiting room.  Crap.  Then it's up onto the little table, and oh look!  The stirrups are hidden.  Double crap.  So I assume the position as the doctor has a good feel around of the tumour and how its sitting and feeling and god knows what else.  All I could think of was thank god asians have tiny little fingers.

So here's the plan (the bits I remember of it all).  The scans from the day before confirm that I am Stage 2b.  The tumour doesn't appear to have extended anywhere else, but is pushing against my bladder (yeah, I already kinda figured that) but they can't see any evidence that it has infiltrated the bladder, but that doesn't change the treatment plan anyway.  There was also some evidence on the PET scan that there was some 'minor' activity in a few lymph nodes.  Again, doesn't change anything, but they will keep an eye on it.  She feels its just infectious activity as it didn't show up as active as the cancer cells. I'm just freaking out that my lymph nodes are doing anything at all!

Basically, I have two options - do nothing (yeah, not really an option) or a combined treatment plan of radiation and chemotherapy. Surgery is not an option because the tumour is too big and they can't guarantee clear margins.  So zapping this crap is the only way to go.  What she proposes is a 5 week course of daily external radiation. This will be combined with concurrent chemotherapy over the 5 weeks - I *think* she said weekly chemo, but basically 5 weeks worth of chemo.  After all that is done, I will then get admitted as an inpatient to have an internal rod placed in my uterus (wow, that sounds like a LOT of fun!) and then have 3 days of internal radiation where they basically pump radiation into the rod every hour on the hour.  This means being bed bound for 3 days in an isolated lead lined room, with visitors only able to come in for half an hour at a time.  I can hardly wait.

I cant believe my entire treatment plan is a total of 6 weeks long.  It seems so quick. I can cope with 6 weeks - 6 weeks of crap, a few more weeks of recovery.  Yes, I can totally do this!! (ok, so I'm still a little bit in denial - she did say she strongly recommends at least 3 months off work after treatment to allow my body to heal, but I'll deal with that when I get there....)  The only bit of the whole plan that I wasn't happy about - now that I've agreed to the treatment, the doctor now presents the plan to the ethics board, and I have to wait for them to approve it and to give me a start date. So it will still be 2 or 3 weeks before things get started. This means I will be in the middle of treatment right over christmas.  Merry Christmas to me!

After hearing all this great news, I quickly got changed and headed off to the planning CT appointment.  Once there, its another change into another gown, another form to fill in, another check of my name and date of birth, and it's time to get scanned.  I'm totally freaking out about this - I have heard you get tattood so they can line you up in the machine in the same position every time.  Now I HATE needles.  Really really hate them.  The idea of getting a permanent tattoo on my pale sensitive skin just freaks the crap out of me!  I get positioned on the scanner table, and again they put lovely wedges under my knees to make me comfortable.  Yeah, how comfortable can you be lying there almost naked getting prodded and poked around.  One of the technicians - a guy - is making marks on my skin where they plan to put the tattoos.  I'm doing my usual nervous babbling, and say to him, gee, all this and you didn't get me dinner and a movie first?  He laughed and said maybe next time!  hahaha  Then he tells me they are going to be giving me FOUR tattoos!  WTF??  FOUR???  I'm not prepared for four!  I can barely get my head around 3!!!

I ask him if he's a licensed tattoo artist - I've heard you should always check you're getting marked by a professional.  Turns out yes, he really is.  Great stuff.  I told him I was going to report him to the Better Business Bureau for not asking me for my ID.  And then I had a thought - I said hey, I'm not drunk.  Aren't you meant to be drunk when you get your first tattoo.  Like seriously, I am NOT ready for this!  Then he wiped the area with an alcohol swab - oh great, that's all the alcohol you're going to give me?  Can I suck on one maybe??  He said it would be like a little mosquito bite.  Oh sure - I've lived in Australia man!  They have NASTY mosquitos there!!!!  Then I start to take notice of exactly where he is rubbing the alcohol - the top of each thigh, the centre of my chest (what?  why my chest?) and right in the middle of my hoo-ha.  OMFG!!!!  I'm going to get a pussy tattoo??  Fuuuuuuuuuuuck!!!!!!!

Then zap, zap, zap, zap, all done.  Huh?  Really?  That was it?  It hurts more stabbing myself with a needle when I'm trying to sew on a button!  And now I'm feeling just a little bit ripped off - all that work up and freaking out over nothing?  Really??  And then I see the size of the tattoos - seriously - I have FRECKLES larger than these tattoos. What a bloody let down.

If you look really carefully, you can just make out a black dot near the bottom of the black smudge.  Thats my tattoo!

So now its back to waiting - hopefully they will phone sooner rather than later with my start date so I can get started on getting rid of this crap out of my body and get my life back on track!  Oh, and I got disapproving looks for not having attended the newcomers club yet.  Oh please.  I still have to have an appointment with the chemotherapy oncologist to discuss that part of my treatment, and I get assigned my very own radiation nurse - hope she's a nice one!  So I'm guessing these next few weeks will go quickly.  Now to work on getting my car back from the mechanics - they're hoping by the weekend or monday. Can't believe how slow they are!