The View Up Here

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Archive for October, 2013

Cautious Optimism

Posted by Tom Benedict on 16/10/2013

Rydra made it through her gamma knife treatment with flying colors.

We flew to Oahu the night before and got to the Gamma Knife Center early Monday morning. They had a couple of steps to do before the gamma knife treatment itself, including an MRI, frame placement, and a CT scan just prior to going into the gamma knife machine. One of the most critical steps, and the one that caused the most “discomfort” was placing the frame on her head. Since the frame provides the coordinate reference to the machine, it was important not to have it shift between the CT scan and the procedure. The frame is secured using four bolts. Here’s the assortment the surgeon had to choose from:

Pointy Things

I’m sure the manual for the frame refers to the screw tightening procedure as something like “applying torque”. At work we have a name for what her surgeon did: “gitcherbutt on the back of that wrench and wail on ’em!” By the time he was done I wasn’t concerned about the frame shifting. But Rydra was careful not to let the frame touch anything once it was on.

After the various scans, the treatment team (neurosurgeon, gamma knife specialist, gamma knife physicist) got together to discuss a treatment plan. Rydra, meanwhile, relaxed.

Chillin'

Well… As much relaxing as she could do with a big chunk of aluminum and titanium bolted to her head. (She did an amazingly good job of relaxing, actually. She was cracking jokes with the nurse and doctors the whole time.)

Once the treatment plan was set, she went down to the machine to be bolted in.

Going In

That’s her physicist on the left, Rydra on the bed (obviously), her nurse (who’s got some of the most amazing bed-side manner I’ve ever seen), and the gamma knife specialist (who also had amazingly good bed-side manner.)

Shortly after I took that picture the physicist ushered us all out of the room and shut the door. I watched on the monitors as the machine opened and Rydra went in.

I got to hang around for the first couple of minutes as the gamma knife specialist described the procedure and showed me the interface to the gamma knife machine. I was really pleased to see that the interface looked a lot like the interface we made for remote operation of our telescope: lots of icons with very obvious meanings, clear labels, and a layout that was easy to read. I figured the people making the machine knew what they were doing. I was just glad to see how close we’d come with our own efforts.

The machine is basically a big computer controlled 3-axis translation stage with a hemispherical set of radioactive sources at one end. Treatment was broken up into a number of targets – five in Rydra’s case. For each target the machine moved her head to the appropriate location, and some or all of the 190+ sources opened for a precise amount of time. Then the shutters on the sources all closed, the machine moved to the next position, and the procedure repeated until all five targets had been irradiated.

Once the procedure was done, her nurse removed the frame and bandaged the four screw points. No shaved hair this time! Rydra took an hour to recover, then we headed out.

Considering everything she went through, I hate to say it but it was driving out through Honolulu traffic that was the roughest experience of the day. Keep in mind neither of us had seen an overpass in years, and one-way streets were distant memories. I got lost. It took us almost three hours to go from the clinic to a place where we could have lunch. By then Rydra was so motion sick she almost couldn’t eat. Thank goodness it only took another hour to get to the airport. We sat and she ate the only fresh fruit we were able to find in the entire airport concourse (thank you, Starbucks, for selling fresh pineapple… go figure…) By the time they called for general boarding she was looking better.

She spent last week recovering, and for the most part she has actually recovered. Last weekend she helped our daughter with her science fair experiment, Rydra has been driving the kids to swim practice all week, and we’ve been hanging out together as much as work and life allows. This is nothing like the recovery from her craniotomy surgery two years ago. This is nothing short of amazing.

We won’t know for another two years whether this treatment got everything, and even then her surgeon wants to keep getting regular MRIs to look for new growth. It’s nice to see someone who takes professional paranoia as seriously as I do. She’s in really good hands.

– Tom

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