Shadow has gone away. No tail wagging, eager morning greeting. No one guarding the door. An aloneness I don’t often feel.
The staff has now seen the protocols for aprés the infusion. Three feet away. An intrusion on their youth, cancer treatment. Crystal, one of my favorite caregivers, brought me garbage bags for my waste over the next the next three days. When she left, she said, “Good luck with your treatment today.” My heart blossomed.
Jenny will pick me up at 9 for the 10:30 infusion. I’m at peace with where I am in my life, on my cancer journey. Pluvicto lies near the end. After it, so far there’s nothing but chemo. Which I may not be strong enough for even if I chose to do it.
A point in time laid out when my biopsy came back malignant. May, 2015. A plethora: surgery, radiation, medication, now radioligand treatment. No lack of medical interventions. I’m alive, eleven and a half years later. Grateful.
10/29 And so, the first infusion has ended. No side effects.
Therese, the theranostic* nurse I met during my first infusion-actinium-is pregnant with a due date of November 25th. A Thanksgiving adjacent baby. Surprised me. The sight of her working around radioactive material while obviously pregnant jarred me. So I asked.
“I have a dosimeter and so does my baby.” She touched the one hanging near her waist. “Also, the medical physicist** watches me each day.” I knew it was safe because Therese is a bright, no nonsense professional. Still.
Laura, the other nurse, tried unsuccessfully to start an iv in my very best vein. Ouch. She switched to my hand. Worked. A bit later she opened the lead box containing my first dose of Pluvicto***. Some saline. Then. As Stephen Bernstein once said, “The good stuff.”
They let me rest a moment. “When you can use the bathroom, we can get out you of here.” Ah. After following my hydration protocols, I was ready.
The bathroom has a touch of weirdness. The toilet, all burnished metal, looked less like a toilet and more like a Marcel du Champ found object. It gleamed. When I mentioned it to Therese, she said, “Oh, you liked our prison toilet?” Ah.
She had me standup and held up a device measuring my level of radioactivity. “4. Too high. Rest a bit.” I finally hit 2.2, the upper limit at which they let me go back into the wild.
Back at Elk Run Michelle, head of medical services, saw me. Asked if I was hungry. Yes. I’ll have lunch brought up.
Caregivers greeted me, asked me how it went. Lizzy of the pink highlights brought my lunch, setting it on a stand near the door. I received several texts and emails.
I ate lunch and took a nap.
*Theranostics is a precision medicine approach that combines diagnostics (finding and imaging disease) and therapeutics (treating disease) using a matched pair of targeted molecules. [1, 2]
**Radiation Therapy (Oncology): Design, calibrate, and test linear accelerators, calculate patient radiation dosages, and create safe treatment plans alongside radiation oncologists. [1, 2, 3]
***Pluvicto (generic name: lutetium Lu 177 vipivotide tetraxetan) is a targeted radiopharmaceutical therapy used to treat adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC). It belongs to a class of precision medicine called radioligand therapy (RLT).