“You might experience some digestive issues”, has been the understatement of the month. While I’ve ( so far ) managed to avoid urinary burning and incontinence during my radiation therapy, my rear end has unfortunately taken the brunt of the side effects. How to persevere? Well, poking some fun by drawing comics helps a little. Diet, too, but it’s been a precarious balance between “binding” foods and foods with high fiber. And then there’s the ointments, Sitz Baths, and the timely purchase of an “electronic” toilet seat from Costco. In conclusion? Number two is number one in my mind and I’ll never take it for grated again.
It’s official. I’ve had every single orifice probed this year minus my ears – and the year isn’t even over yet. Today it would be my nose. As part of my radiation therapy I needed to get a COVID swab done. UCSD offered it as a “drive through” service at the clinic near my house. As I pulled into the clinic parking lot I spotted a group of white canopies at the far end. I slowly pulled into the middle of them, stopped at a sign, pulled my face mask over my nose and mouth, and watched as a nurse suited up in a white hazmat suit and face shield.
She walked over and I rolled down my window.
“I’m here to have my brain swabbed”, I joked, grinning.
Earlier in the week I had talked to my mom and aunt, both of whom had the same test and reassured me that the “new” COVID tests just “grazed the nostrils”.
The two eyes behind the face shield, now foggy, squinted.
“Are you having a procedure done? What is your name and birthday?”, a voice emanated from behind the face shield.
“Yes, I start radiation therapy on Thursday. Scott Vandervort. March 1st, 1976.”, I replied.
The nurse walked back to her computer to verify, I assume, my appointment, and came back with a test kit.
“Pull your mask down and try to relax.”, the face shield instructed.
I did as the nurse requested, leaned back into the passenger seat of my car, gently rested my hands on the armrests, and closed my eyes.
I took a deep breath and felt the swab slide into my left nostril.
“Easy peasy”, I thought.
And then the swab kept going up.
As the tip neared my brain the nurse decided to start twisting it around to, I assume, cause as much irritation as possible.
I started gagging and dug my fingers, deep, into the armrests.
“Gaaaaa….Gug…..”, I gurgled, my eyes now wide open and staring at the wooden rod being twisted into my head.
“There!”, said the nurse, withdrawing the swab after what seemed like an eternity.
I started laughing impulsively.
“Holy sh***, that wasn’t cool at all!”, I gasped between laughs.
At least I was done. Through watery eyes I could see that the nurse was busy capturing my swab in a test tube.
“Okay, then. Well, thank you! I’ll, uh, head out now…”, I ventured.
The face shield, still foggy, turned towards me.
“….and now the left nostril”, it said.
A fresh swab had replaced the used one in the nurses’ gloved hand.
“Kaylee! Where are you?”, I bellowed while trudging up the stairs.
“Kaylee, are you in there?”, I asked while carefully opening the bathroom door.
“I’m changing!”, Kaylee screamed.
Okay, dad fail, even for an 8 year old.
“I’m changing!”, Kaylee screamed again.
“I can see that! What’s with the black and gold shirt? What does it say?”, I asked.
“Nothing!”, she screamed back.
Before I could respond the door blasted open and Kaylee zipped out with a towel wrapped around over her clothes. She stared at me, and before I could react, she ran down the stairs.
Shaking my head I followed her.
“What in the hell is going on around here?”, I grumbled loudly, stomping down the stairs.
As I turned towards the kitchen Jodie stopped me.
“The girls and I want to give you something before your first treatment.”, she smiled.
Ashley and Kaylee marched in. Kaylee, dropped the towel she had been hiding behind. Both girls were wearing matching shirts. The shirts read “Dad Daughter Team” in gold lettering. My tears started almost immediately.
Jodie handed me a heavy wrapped bundle.
“Good luck today with your radiation, dad.”, Ashley grinned.
“Open the gift!”, Kaylee urged.
Ripping off the wrapping paper revealed a hardbound copy of “Radioactive Man”, authored by Matt Groening, the creator of The Simpsons. In the TV Show, Radioactive Man is a superhero who gains his superhuman strength through radiation. He is Bart Simpson’s favorite comic book character. Jodie and I had introduced the girls to The Simpsons early on during the COVID lockdown and they love it. We started from the beginning of the series and are watching season 6 now. The gift was perfect.
I gave them all a bear hug, and while doing so, secretly wiped the tears from my eyes.
“Thanks guys. I’m not really sure what to say.”, I said. Then, looking at my watch, ” I, uh, should probably get going to my therapy.”
“Do you think you’ll get superpowers?”, Ashley asked me, joking.
“I guess we’ll have to wait and see….”, I replied, smiling.
Radiation therapy at UCSD is administered out of a couple of squat one-story nondescript buildings on the south end of the medical campus. Upon checking in I was handed a blue card with a bar code by the receptionist.
“Every day, upon your arrival, swipe the card to alert your therapy team that you have arrived.”, the receptionist told me. I was also provided a parking placard which allowed me to park, for free, in front of the facility.
“Uh, should I swipe the card even though my bladder isn’t full yet?”, I asked.
“How much have you drank?”, she replied.
I held up two large water bottles, both empty, and smiled.
“Ah. Why don’t you sit down in the waiting room and wait until you feel full”, she said.
I sat down, pulled out my copy of Radioactive Man, and tried to read, but instead caught myself watching the only other patient, a man slightly younger than me hastily drinking water from a small water cup. While I watched he refilled it two more times before he was ultimately called back for, I assume, therapy for prostate cancer. The water was a dead giveaway.
The good news is that, for once, I wasn’t the youngest person in the room. The bad news was that there was someone younger than me.
Almost on queue, my bladder, now inflated to capacity, screamed at me.
Clenching my legs together I squirmed to the kiosk, swiped my card, and sat back down, crossing my legs. Within minutes a nurse greeted me and led me into the back room.
“Hi, Scott. My name is Mark. I’ll be part of your therapy team.”, the nurse said while guiding me to a smaller waiting room.
“We try not to make the prostate cancer patients wait too long for their therapy.”, he said. “There’s someone using the room now, wait here and I’ll come and get you in a couple of minutes.”
Across from me I could see another room filled with glowing screens, buttons, and knobs. People in scrubs and white coats were busily watching the screens and pressing buttons. Adjacent to that room was a wall plastered with an enormous glossy decal of a relaxing scene of green rolling hills, flowers, and trees.
As I watched the wall it slowly started swinging silently outward. It was then I realized that it wasn’t a wall at all, but an enormous foot thick door. Huge hinges supported its weight. The man who I had seen earlier walked out and within a minute I was ushered in.
“The rolling hills are a nice touch, but I can’t shake the feeling that I’m walking into a bank vault.”, I joked with my nurse.
“Yeah, the doors are to prevent the radiation from escaping.”, Mark said. “Can you tell me your name and date of birth?”
“Scott Vandervort”, I responded, and recited my birth date.
He glanced down at my shirt for a second before continuing.
“And, uh, although it’s obvious from your shirt, what part of your body are you getting therapy for today?”, he smiled.
I quickly glanced down.
“Oh, right!”, I smiled.
I forgot that I had worn my Prostate Cancer t-shirt for the occasion. Jodie had bought it for me during my prostatectomy five months ago. The shirt depicted a blue hand giving the ( not middle ) finger with the words “Give Prostate Cancer the Finger” emblazoned across it. Subtle, it was not.
“Well, I’m getting the area where my prostate used to be irradiated.”, I said.
Nodding Mark led me to a large white behemoth situated in the middle of the room. It looked eerily similar to an oversized washing machine, the front load type, with a large gaping hole where, I assume, I would be in a few minutes. Two other nurses were busily preparing the gurney on which I would be rolled into the contraption. On top of the gurney was the plastic mold that was taken of my legs during a prior appointment.
I was told to lie down on the gurney and the nurses situated my legs into the mold. I was then told to lower my pants a bit so that they could align the equipment using the three tattoos that had been applied during the same appointment that I had the leg mold done.
“Everything looks good”, Mark said, “We’ll be on the other side of that door during the procedure.”
“Uh, this will be quick, right?”, I asked. My bladder was now screaming as it struggled to hold back the 50+ ounces of water that I had pumped into it.
“About 10 minutes.”, he replied.
Mark turned and headed out of the vault.
As the door sealed shut I found myself alone, with a throbbing bladder, in a washing machine, listening to “Proud Mary” by Creedence Clearwater Revival being pumped in through tiny little speakers. I anxiously awaited what would happen next. I didn’t have to wait long.
The clacking of some relays followed by the gurney dropping a fraction of an inch.
A faint whirring noise.
And that was it.
It was anticlimactic and at the same time, absolutely terrifying. I didn’t feel anything. Radiation is scary like that. Unlike my surgery, where the pain and damage was obvious, the effects of radiation are not as perceptible, at least for a while. Instead of physically removing the cancerous cells, radiation blasts away the DNA that allows them to replicate. Whereas surgical pain is immediate, radiation pain builds time as the body struggles to clean up the husks of dead cells and rebuild new ones.
The enormous door slowly opened again on it’s gigantic hinges and Mark and the rest of my team re-appeared from behind it. They helped me to a sitting position, unpeeling my legs from the plastic forms.
“That’s it, huh?”, I asked, a little confused.
“That’s it.”, Mark said. “Remember that after tomorrow’s appointment you have an appointment with your doctor. You’ll meet with him weekly to review how your radiation is going.”
“And the, uh, bathroom?”, I asked.
“Across the hall on your ….”
I rushed past Mark, threw open the bathroom door, and uncorked Niagara Falls in quick succession. The relief was immediate, but short lived.
By the time I had driven home my bladder had completely refilled again. I barely made it through the door and into the bathroom before bursting.
“Day one”, I thought to myself while shuffling to the couch.
And then I crashed, hard, for a couple of hours.
“So, you’re thin. Normally that’s a good thing, but not so much for radiation. You’re probably going to have a little worse diarrhea than my usual patients.”, Dr, Rose explained.
“Awesome.”, I replied, flatly.
I had just finished my second radiation treatment and, after a quick visit to the bathroom, I was meeting with my radiation oncologist in a small exam room.
“So, how are you holding up? Any questions?”, Dr. Rose asked me.
“Aside from having to chug and retain so much water, it’s been pretty uneventful. I’ve been through surgery and have been on hormone therapy for almost a year now. It can’t be any worse, right?”, I ventured.
“…well, except for the diarrhea, but mercifully, hopefully, the onset should take a while as the radiation damage accumulates in my body…”, I continued.
Dr. Rose nodded. Realizing that I wasn’t quite done yet, he waited patiently for me to continue.
“So, that door.”, I asked. “I’m assuming that it’s not just for looks?”
“That’s to protect the technician and doctors from stray radiation…”, he started.
“So, I’m getting secondary radiation in there?”, I interrupted.
“Yes, you are. The radiation bounces around a bit, so you’re getting minute radiation to other parts of your body, too. It’s small so you shouldn’t worry too much about it. The doors are to protect the people working the equipment as, without it, they’d be exposed to it continually.”, he finished.
“And the machine itself?”, I asked, “When I’ve had MRI’s the gurney I laid on was slid in and out of the, uh, glory hole. This time I didn’t move at all. Are you still targetting my entire pelvic area?”
I swept my hand across my groin to my belly button for emphasis.
“Yup! The radiation is applied in a wide band. You’re getting the full treatment.”, he reassured me.
“And, if I hadn’t previously had surgery, would I be getting more treatments?”, I asked.
“The treatment is similar. If you still had your prostate you’d have an additional 4 treatments.”, he replied.
I smiled, satisfied, and then yawned.
“Thanks, Doctor. I’ve been really impressed by how quick and organized everything is.”, I said.
“Your welcome, Scott.”
Not using the bathroom on my way out was my biggest mistake. I was about halfway home before I realized that there was a very good chance that I was going to flood my wife’s car with 40 ounces of irradiated urine. Granted, her car was 15 years old, but neither of us were ready to replace it yet. My foot slowly depressed the accelerator and as my bladder expanded my speed increased.
I pulled into our driveway a little fast.
The front end of my wife’s car dug hard into the lip of the driveway with a crunch, ducked under the still rising garage door, and screeched to a halt. I left the keys in the ignition, swung open the door, raced inside past my dog and youngest daughter, and relieved myself in the bathroom.
“Only 32 more to go … ”, I exhaled, realizing it was going to get a lot worse before it got better.
“… but they wouldn’t put me through all of this if they didn’t think there was a chance that it’d work.”, I finished.
“So how was day two?”, Jodie asked as I exited the bathroom.
“Well, no superpowers yet, although I’m a little curious what superpowers one gets while getting their crotch irradiated.”, I replied.
“Well, it’s Friday, so that means you get a two day break from treatments.”, she smiled.
“Good point!”, I replied.
“You know, the only superpower I’ve managed so far is the ability to take spontaneous naps, anywhere, anytime… ”, I yawned, “… and retain a gallon of water in my bladder.”
“Not too super…”, I shrugged as I walked over to the couch, laid down, and promptly fell asleep.