August 26, 2024
David’s Y90 procedure was scheduled for 11am this morning, so we had to be at Piedmont Fayette at 9am. David was in a good bit of discomfort during the night and was quite restless so neither of us slept very well. We got checked in and it didn’t take long to be called back to the IR suite where we had been two weeks ago for the first part of the Y90 mapping procedure. We were greeted by the same nurses we had previously. It was basically the same process as the mapping but this time with real radioactive materials. After putting on the hospital gown and popping on the party hat, David was hooked up to all of the monitors and we sat to wait until it was time. We heard all of the morning gossip from the nurses’ station and who was having what for lunch and what was done over the weekend. The same NP we spoke with before the mapping came in to explain today’s procedure. He told us that it was basically the same except for the tiny little fact that following the procedure, David would be emitting radioctiveness for the next two weeks. Say what now? So apparently, radioactivity is detected from the patient up to two weeks following Y90. He explained that there are no studies that prove any harm to other people, but they have to make us aware because it can be detected. He cautioned about being closer than 5 feet and having only brief hugs. He said you would not want to sleep in the same bed or have anyone sitting closely next to him for around two weeks. Perhaps they may want to mention these things before the morning of the procedure. Like, you know, maybe I needed to know to bring bungie cords to strap David to the roof on the ride home. NP also said he would feel pain after this procedure (hopefully) as the cancer dies. So, I guess we are hoping for a good bit of pain? I asked if the radiation would pass through him like chemo and he said not in the same way, so we wouldn’t need to keep and wash his towels, sheets, clothes separate like with the chemo. He said the first week was the strongest of course with decreasing amounts each day. You don’t get the full grasp of a procedure until they are discussing your radioactive half-life with you. David could expect to feel some extreme tiredness and some fever was to be expected as his bone marrow will be working overtime to make more white blood cells to fight off infection. We should watch his temp that it doesn’t go beyond 102 in which case we need to call them asap. He also mentioned that David would need to take some steroids following the procedure and he may (and notice the quotation marks) “experience some roid type rage at times”. Um…what? Yes. It seems some patients have reported having rage feelings while on the steroids following Y90. We both had thoughts of another person with a green alter ego who has some tiny rage issues and who also was radioactive. Boy! Don’t these days just get better and better?
Dr. K stopped by next to check in and explain he would treat the left lobe of David’s liver, and, in around 4 weeks time, he would invite him back for another party and treat his right hepatic lobe to another isotopic cocktail. He said doing the entire liver at the same time is just too much for patients and he usually starts with the left to “ease them into the procedure”. He said the right lobe would prove to be a bit more rough recovery wise. Our nurse popped back in to check on things and she told us that Dr. K was the best doctor for this and people were coming from all different states for him to work his interventional radiology magic on them. We really liked Dr. K from the start and we were particularly comforted to hear this. She said he was very efficient and so humble. In our short experience, we found the same to be true. The NP had five prescriptions for David so when they came to get him this time, I decided to go grab lunch and see if I could get them filled in case we didn’t make it back home in time today.
Why. Is. It. So. Difficult. At. Retail. Pharmacies? I found myself at another chain pharmacy, and while not quite as bad as the one I recently dealt with at home, they also did not have everything I needed. I went ahead and dropped off the steroid and antibiotic scripts to be sure we had those to start today and called our regular pharmacy to make sure I could get the other three at home. No problem there so I just had to wait on the two at the retail drug chain. How long? With a dismissive wave, the lady said “oh, an hour and fifteen minutes” I just recently caught an old clip of a stand-up comic, Sebastian Manicalco, talking about the same pharmacy so this was in my head standing there alone with no one else in sight. I was like “it is right there!” I know my pharmacist friends have a different take from their elevated vantage points but this bit was so spot on for my experience with these big retail drugstores.
I grabbed a quick lunch and sat in the parking lot and answered some work emails. Before I got lunch sorted out, the hospital was calling saying David was back. The lady calling said to let the Imaging registration desk know I was out there and someone would come and get me. I ran back to the pharmacy to see if the scripts may possibly be ready (it had been around 55 minutes). They told me they were just finishing them, so I took the compulsory walk around the store. Finally got checked out and headed back to the hospital.
Back at the Imaging desk there was a long line. After waiting, impatiently patient, I relayed the message I was given. She looked at me and said “let me just make a call”. The first person she called said to call another number. The second person said they would be right out to get me. I was told to have a seat and wait. Well, at the 15-minute mark, I decided to get up and remind the desk I was there. Obviously, no one back there had anything else to do except open the door for the wife of the radioactive patient behind curtain #8. About that time, the door opened and one of David’s nurses stepped out to call someone else and let me follow her back inside. David was sitting up and had eaten lunch and was feeling ok. Like the mapping procedure, he was given moderate sedation but was basically alert during the process. He had another TR band and would have air released to check for arterial bleeding a few times before we could leave. The nurse told us she started out her career in heart catheterizations and how they always went through the groin (artery) and how patients would have to lie flat on their back for at least three hours after the procedure. Anywho, David had just come back from the Nuc Med scan which shows where the radiation went and how much shunted to the lungs, etc. These things are all measured in the reports of course. David wanted his iPad, so he scrolled around on it reading dad jokes to me. Some of them got us chuckling and that was a good feeling seeing him laugh. We don’t do that so much anymore. This has been one of the many hard things about this whole unfortunate journey for me. A slowly crumbling foundation of what made us, well…us. A sense of humor, that up until around the time things started going poorly with chemo, we thought was resistant to anything.
They paroled us just shy of 2:30pm, and I went for the car while they brought around the requisite wheeled steed that would relinquish him back to my care. I cargo strapped Dr. Banner to the rooftop like a canoe, and we drove home.
I deposited David at home to radiate on the couch and went into town to secure the rest of the pharmacological treasures and possibly some soup of the eastern Asian variety. No problem at our hometown shop getting what we needed and grabbing David some hot and sour soup. He always goes in to pick up the Chinese food, so I asked him what I needed to say when I went inside. He said just to say the order number and to bow when I say it. Luckily, this isn’t my first bumpy ride on the turnip transportation apparatus. You always bow first. (Disclaimer: no harm is intended by this insensitive mockery of a fine and respectful Asian cultural tradition which tends to be more Japanese in nature. The mockery was more about my own ridiculous social anxieties and what silly things I make up in my head, and, more importantly…how my adoring life mate capitalizes on that). He ate his soup, took his 6 steroid pills for today (yes I said six), and fell asleep pretty quickly.
We are hoping for the best possible outcome for the destruction of the existing tumors and that the cancer will stop spreading and continuing to grow. At the very least, we hope to slow this thing way down and get it managed, so he can have some semblance of quality of life for the time that is left for both of us.
But for this immediate moment, we just want a Geiger counter…
David’s shirt today: EFFORTING (a Dan Patrick shirt)
