Adventures in Dining -or- Can You Spell “Ensure”

September 28, 2004

Hi, all!

First, I want to thank all who’ve been sending cards and making calls. I really appreciate them all, as does Sandy!

Both my radiation and chemotherapy treatments commenced on September 14.

The radiation experience was about as expected since I’d gone through a simulation on the 9th. Since they’ve begun I’ve learned that I’m the single longest and most complex radiation treatment on the docket here in Lancaster. The treatment takes about 20-25 minutes. The radiation machine rotates about my head as I lay on my back on the treatment table, head and shoulders cantilevered on my backboard with my head locked in position by “The Mask”. Beginning under/behind me and rotating in nine steps about my head, I receive ten “shots” of radiation. two being aimed from the same angle, directly above/in front of my head. Each shot is for a different duration and each is through a different, complex aperture shape. The whole procedure is computer controlled with technicians monitoring every step along the way.

I’m very impressed with the process that took place to create my treatment routine. It is designed to hit the tumor with enough radiation to kill the tumor while getting very little on my saliva and spine structures. On the other hand, it is also designed to hit the other areas of my neck (mouth height to shoulders) with enough radiation to kill any tiny bits of cancer that may be floating around in that region. The mathematical manipulations required to do so must have been immense!

Bill Under the Beam
Bill Under the Beam

Six to nine months ago a cancer like mine would have been treated with radiation alone. Now, however, radiation with simultaneous chemo is the standard for treatment. The weekly chemo treatment is a very different experience. After a talk with Dr. Gottlieb he reviews my liver functions and white blood cell count and sends me to the treatment room. The room has about ten stations, each with a hospitalized lounge chair, private TV and infusion pump. An IV is installed into my arm and 2-500 cc bags of hydration fluid are pumped into me. Following that, I get a 500 cc bag of a diuretic and then a shot Lacix, another diuretic. By now I’m running back and forth to the john, infusion pump in tow, dutifully measuring my “output”. After a 50 cc bag of an anti-nausea drug I get the main course, a 500 cc bag containing 90 mg of Cisplaten, the actual chemo drug. Finally, I get one more 500 cc bag of hydration fluid to wash it all down. Since it takes about an hour to pump in one 500 cc bag, the whole shebang takes about 4-1/2 hours. I get a lot of reading done!

Chemo was the first to create side effects. The worst side effect of the drug is supposed to be nausea but the drugs administered during treatment and for 48 hours afterward have controlled that completely. The first week, however, I had a few rough days with acid reflux, hiccups and abdominal cramping. The second week, however, I seemed to tolerate the chemo very well. Other common chemo side effects, dry mouth and loss/alteration of taste, began almost at once. Now, beginning the third of seven weeks, the effects of radiation are beginning to show. My mouth and throat are getting sore and the skin on my neck is just beginning to redden and dry out.

The sore throat compounds problems with dry mouth and loss of taste when it comes to eating. Almost nothing tastes good and many things taste really bad. Bread turns into dust in my mouth and swallowing even water hurts. The concern is with maintaining my weight and health. I’ve tried my first bottle of Ensure and the vanilla ain’t all that bad. Soups and chili go ok but the bottom line is that eating has already become work. I lost eight pounds already and got quite a lecture from the doctor.

In spite of the little trials with my mouth and eating, I’m feeling fine otherwise. I’m sleeping well … almost ten hours a day. I still mow the lawn, got two garage doors installed (with Jack Freas’ help) and get what ever exercise I can. I’m still focused on coming out the other side! November 1 is the last scheduled radiation treatment and I can hardly wait. I should be in pretty good shape for Thanksgiving and ready to ski for New Years!

Meanwhile, Sandy’s 40th high school class reunion is this Saturday and I still have to finish the name badges and the booklet that she’ll hand out.

Thanks, again, for your support and prayers. God bless you all!

Bill Stine