I have now had 24 treatments of Intrathecal Herceptin. A few weeks ago, my friend Karin came and took photos. They were for me (because I can't see my own head) and they helped me a lot to understand the process. It's occurred to me that some of you might like to see them too.
Every week, I am placed in a private room. It's been the same room every time and I have come to think of it as mine. I get the usual "pre-meds" of intravenous Gravol (dramamine) and Demerol (meperidine) that I have had for years with Herceptin to keep from having a reaction.
My oncologist (only doctors are trained to deal with the Ommaya Reservoir), comes in after the meds have kicked in. This is what it looks like before treatment (after my hair is combed out of the way).
Dr. G shaves the Ommaya to sterilize it.
Iodine is the next step in sterilization. Rubbing alcohol comes after. 
We joke around and laugh a lot at the beginning of every appointment. I look forward to that
part. The atmosphere turns very business-like during the actual treatment. I appreciate that, too.
Before treatment, a sterile cover is put on my head, with a convenient hole in it.
The needle is injected in the Ommaya. It doesn't hurt. Really (remember, that's iodine. I am not bleeding).
Before anything can be inserted, brain fluid must be extracted. This, to me, is the really freaky part.
I will be getting 60 mg of Herceptin, which is about 30 ml (about 1 fluid ounce), so that amount of cerebrospinal fluid is what is taken out of my brain. It will be sent for testing, to see if there are detectable cancer cells. It’s a good sign that the fluid is clear and so far the tests have been negative.
Then the Herceptin goes in. As with the extraction of fluid, it's done over several minutes.
I am the first and only person to have this done in Ottawa, so sometimes I am asked if it's OK to have staff in to observe. I always agree to this.
When it's all over, the needle comes out.
And we are done.
The oncologist leaves and there is a 30 minute observation period. The nurses “take my vitals” after 15 minutes and at the end of the half hour. Then I can go home (except every 4th week, when I stay an additional 90 minutes for the intravenous infusion of Herceptin).
Every week, I am placed in a private room. It's been the same room every time and I have come to think of it as mine. I get the usual "pre-meds" of intravenous Gravol (dramamine) and Demerol (meperidine) that I have had for years with Herceptin to keep from having a reaction.
My oncologist (only doctors are trained to deal with the Ommaya Reservoir), comes in after the meds have kicked in. This is what it looks like before treatment (after my hair is combed out of the way).
Dr. G shaves the Ommaya to sterilize it.
Iodine is the next step in sterilization. Rubbing alcohol comes after.
We joke around and laugh a lot at the beginning of every appointment. I look forward to that
part. The atmosphere turns very business-like during the actual treatment. I appreciate that, too.
Before treatment, a sterile cover is put on my head, with a convenient hole in it.
The needle is injected in the Ommaya. It doesn't hurt. Really (remember, that's iodine. I am not bleeding).
Before anything can be inserted, brain fluid must be extracted. This, to me, is the really freaky part.
I will be getting 60 mg of Herceptin, which is about 30 ml (about 1 fluid ounce), so that amount of cerebrospinal fluid is what is taken out of my brain. It will be sent for testing, to see if there are detectable cancer cells. It’s a good sign that the fluid is clear and so far the tests have been negative.
Then the Herceptin goes in. As with the extraction of fluid, it's done over several minutes.
When it's all over, the needle comes out.
And we are done.
The oncologist leaves and there is a 30 minute observation period. The nurses “take my vitals” after 15 minutes and at the end of the half hour. Then I can go home (except every 4th week, when I stay an additional 90 minutes for the intravenous infusion of Herceptin).
This week, I have a spinal MRI and the following week one of my brain.
I hope treatment is working.
(Photo credits: Karin Jordan)
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