Friday, December 31, 2010

Red Shoes, White Snow

Another milestone in Kelly’s treatment passed this week: the start of her radiation and chemo therapies.  This part of her journey will last for six weeks - thirty sessions of the radiation therapy and forty-two doses of the prescribed chemo drug.

The preparations and procedures that Kelly undergoes in her radiation therapy are quite simple and very precise.

Upon entry into the radiation room, Kelly is not required to change into ward garb, but remains in her street clothes; she simply removes any earrings and any other head gear or accessories.  Once prepped, she lies flat on a table-like platform without cushion or cover.  After she has been carefully positioned on the table, an assistant places the head brace on Kelly and its proper fit is confirmed.  The brace itself is then fastened to the table, ensuring that Kelly’s head is in the exact pre-programmed position and ready for radiation.

The apparatus that emits the radiation moves about her head, first directly in front of her head, then to the left side and finally to the right side.  The machine emits a quiet clik-clik-clik sound when emitting its radiation. Otherwise, the procedure is completely non-intrusive.  The total time under radiation is about 10 minutes.  After completion of the radiation cycle, the procedures to release Kelly from the brace and table are reversed and she’s finished for the day!  In total, perhaps 30 minutes pass between entering the radiation room to walking out of the clinic.  Kelly reports no discomfort during therapy or afterwards, though this may change over time as the effects of the radiation accumulate.

The only change in this weekly routine occurs on Tuesdays: a weekly consultation with Dr. Chan’s chief nurse to discuss Kelly’s experiences and the radiation program for the following week.  Kelly has been allowed to pick her appointment times, preferring mid-day appointments for those days that she commutes by train from Mountainville and early morning sessions on those days when she is living in Manhattan.

The day that radiation therapy began Kelly also started chemotherapy.  Thankfully, this therapy is contained in capsule form.  A temozolomide drug, the Temodar capsule is prescribed in 140 mg strength for Kelly.  After dinner and prior to retiring to bed, an anti-nausea pill is taken about ½ hour prior to taking the Temodar capsule.  Kelly has experienced only minor side effects at the start of this routine but those have diminished now.  Whereas the radiation treatments are given 5 days a week, Monday through Friday, the chemotherapy capsule is taken every night.

The scar on Kelly’s head continues to heal very well.  The hair around the long wound is beginning to re-grow – standing straight up like a diagonal mini-Mohawk. Soon she will be able to comb this right back into her natural style.  But not to fall out of current fashion, her radiation treatments will probably result in hair loss at the various points where the radiation is directed; she’ll still retain that “punk” look she has recently acquired.

Mountainville was covered by a thick blanket of snow on the 26th and we continue to enjoy the traditional winter wonderland vistas like those we marveled at in storybooks of yore.  The snow fell light and dry, covering the broken landscape under smooth white drifts that are easily blown about by the wind, reshaping and softening the terrain.  The leafless forest trees and sparse underbrush barely intrude on the white-scape. Making snowballs, snow angels and sledding down the slopes are pleasures of the season; and shoveling snow and scraping ice off windshields are the type of chores that result from the season. Temperatures have remained low enough to preserve most of the snowfall, at least through New Year’s weekend.

Ian and Mary spent Christmas with Mary's extended family in Annapolis and Norfolk.  They joined us on Wednesday and will stay for a few days before returning to their new home in Panama.

Santa and our family and friends were quite thoughtful when choosing gifts to share this year.  Among the gifts to Kelly was a pair of red shoes like those worn by Dorothy to travel to the Land of Oz.  And just like Dorothy, Kelly was advised that she only need to put them on and knock her heels together three time to transport herself off to any land she wishes to visit.  And that land, as you may imagine, lies on the tiny isthmus connecting continents more than a thousand miles to our south.  Home is where the heart is; home is Panama.

The countdown is on...if all goes as planned, this magical journey home will take place in just over 6 weeks!  Indeed, that is music to our ears.

We think of you as we cuddle close to the fireplace, sharing memories of past New Year days and ringing in a New Year as bright and shining as the winter snow that now surrounds us.  And we send you a hearty New Year message: throughout the year, may you enjoy the love and warmth of home, family and friends.

Clan Dillon