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8/30 Gamma Knife Radiosurgery

Posted Aug 31 2011 12:00am
All went well yesterday; but, it was an incredibly long day. Registered at the outpatient desk at 7:45AM and left the hospital at 8:30PM. Am doing fine. Not quite as handsome as Capt Jean-Luc Picard as BORG on Star - The Next Generation; but that is quite a frame. It was attached using four sharp pins after I got four shots to numb the areas. Each brace in the picture is held at the top by a pin that attaches to my skin but doesn't attach to the skull. The pins are a bit tight. The numbing shots even numbed my lower left lip. These numbing shots are, apparently, the most painful step for many; but, they weren't really too bad for me.

After installing the frame, I was taken for an MRI. They also temporarily attached a large hard plastic bubble with labeled holes and stuck measuring pins to determine "air space" - I assume between the Gamma Knife and my scalp. Two doctors repeated the measurements for accuracy. The MRI and air space measurements would be used to target the lesion locations and compute the Gamma Knife settings. Four doctors (radiation oncology, neurology, neurosurgeon and a physicist) spent around 2 1/2 hours with the MRI data planning the procedure. The best news was that they had decided that they could treat all 13 lesions this time and I will not need to have a second treatment in 3 - 4 weeks.

When they finally finished, I was moved into the Gamma Knife room. The table was similar to an MRI table; but, it had a frame on which my head frame was attached. It felt like two pins on my frame that slid into two slots on the machine frame. All four doctors remained present for the entire treatment. The process of approximately 25 procedures started. The doctors measured the various angles for adjustments. Two doctors set and double-checked each setting - one would use a tool to set the X axis, one would check that setting and both would say it for an RN to confirm what was on the computer list for each procedure.  This was repeated for the Y and Z axis.

The table was then moved into the Gamma Knife. It is similar to going into an MRI tube. It was very quiet until the 2nd or 3rd procedure when the RN had music set up for me to listen to. I could move my feet, hands and I could talk. So...I proceeded to engage in music trivia with the RN. Those who know me know that I was pretty good - particularly on the 70's mix and the James Taylor. This was helpful throughout the process until the last three or four procedures. It had become pretty grueling by that time.

After each procedure, the table was moved back out and the doctors went through the reset process for each new procedure-X, Y, Z, check, double-check. For some, I had to have my chin almost touching my chest. For others, my head was about as far back as possible.  Others were various head positions. My head was moved since the multi-ton machine with 201 beams from cobalt-60 sources doesn't move. The circle of 201 beams are aimed at a very specific target - a lesion or tumor as identified on the MRI. The 201 beams converge to a very small point. Each beam is very low radiation; but, the radiation is stronger treatment level at the targeted location due to all converging at that point.

Some of the procedures were only a few minutes.  Others were 15+ minutes. In total, I received about 3 1/2 hours of this process. Jill went with me and toughed out the entire 13+ hours. It was required that someone drive me home and she drew the short straw. We had left home at 6:45AM and got home a little after 9:30PM. I had one fall at home before I went to bed but didn't hit my head - just landed on my butt! 

Today and tomorrow I have a classy white gauze turban covering four band-aids. I can remove the turban and three of the band-aids tonight. The 4th spot (left front) will heal last because that pin actually penetrated muscle. I will probably need to wear that band-aid for a few extra days.

Can return to minimal activity at home today-depending upon side effects. Thurs Jill will me drive for a CT and to see Dr Einhorn since I must wait 48 hrs before returning to some normal activities. Driving depends if I need to take pain meds.
I return to see Dr Henderson in three months. He will schedule an MRI and determine the status of the lesions. Hopefully, all will be gone or static at that time.
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