Radiating my eye tumor

TL;DR for family and friends:
Last Thursday I underwent the procedure to insert a radioactive plaque in my left eye. The day was filled with a mix of emotions, a bit of confusion navigating the hospital, and lots of interaction with caring medical staff. Despite a few hiccups like getting lost and dealing with the hospital’s admissions process, the overall experience was positive, thanks to the warm blankets, respectful care, and the efforts to make me feel included and informed every step of the way. I even managed to keep my spirits up with smiles and positive vibes, which I truly believe helped me through. Post-surgery, I was surprised with a private room (because I was radioactive!), and despite a not-so-great dinner, I remained optimistic. The support from everyone, including messages from friends around the globe, has been incredible. I’m now in recovery mode, staying positive about the outcome. More updates to come, but for now, just wanted to let you all know I’m doing well and feeling loved. Thanks for all the support!
🌸🙏💜🙏🌸

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The rest of this post goes into more detail of what happened on the day my ocular oncologist inserted the radioactive plaque in my left eye. I share these details not only as a record for myself but also for anyone who may need to undergo the same procedure.

In the week before I went into the hospital, I had searched the internet for information about brachytherapy, and I did find one blog post that helped me to set reasonable expectations. His blog also had a calming effect on me, as the man writing it over a decade ago was clearly still living a full, productive life. Happy endings are always good.

There is abundant reason to believe that optimism—big, little, and in between—is useful to a person because positive expectations can be self-fulfilling.

Christopher Peterson

Preoperative Experience

My honey drove me to the hospital. We have the good fortune of living less than 10 minutes away and we arrived on time for my scheduled 9:45 am admission.

After presenting my provincial health card and being asked to confirm everything on it—from my name and birth date to our address—the admissions clerk directed me to go to the second floor. As has become the norm in medical settings, we were both wearing face masks and I didn’t clearly hear the name of the place through her mask.

My bad for not asking her to repeat it. I went to the second floor expecting the place to be well-marked and easy to find. Instead, I got lost, and after walking through a loooong hallway devoid of humans, I ended up outside of the closed-door cardiac ICU. There was a phone on the wall to call inside. The woman answering my call had not heard the name of my ocular oncologist. She couldn’t tell me where I should go.

Lesson: the challenge of navigating hospital corridors is a common concern for patients, so always double-check directions.

So I began to walk back through the same empty hallway. After a few minutes, I saw and stopped a woman in medical attire, and she kindly escorted me to the right reception place for my procedure.

Here I repeated the admissions process, which I found puzzling and inefficient. On my wrist they clipped an ID bracelet and a tracking bracelet—in case they lost me, they said. I can only wonder whether that happens often enough to warrant such a high-tech solution.

Once registered, I was instructed to go to the fifth floor to the pre- and post-operative hall. A nurse showed me to one of five beds individually enclosed only with curtains and handed me a cotton hospital gown to change into.

I usually find medical spaces to be quite chilly, so I was relieved when a nurse brought a warmed flannel blanket and asked me if I’d like her to cover me with it. I noticed the ask as something new in hospital care.

Asking for my permission was SOP (standard operating procedure) for everyone who interacted with me as the day wore on. My, how times have changed!

Each time a new medical professional came to me, they introduced themselves by their first name and designation. I suspected that, too, was a fairly recent development in healthcare, and not yet universal. It gave me the impression that there was a concerted effort in this hospital to raise trust and rapport between the care providers and the patient and to make the entire experience less vulnerable for the patient. It certainly aligns well with my insistence that I be included on the team.

I was curious enough to look up the origin of this practice and found that a doctor-turned-patient started it in 2013 with a Twitter challenge #hellomynameis.

In another relevant 2019 article:

[I] was pleasantly surprised to learn just as much about the importance of introducing oneself to a patient and how this might impact both patient care and hospital culture. I would learn that this would be one of many factors that provided ‘psychological safety,’ by implicitly allowed both patients and staff to speak up, as it helped flatten the hierarchy that is typical in hospitals.

Amitha Kalaichandran

I welcome this shift towards more personalized care as a positive change in healthcare. It surely enhances patient comfort and trust.

Back to my preoperative interviews. Nurses with various roles had been assigned to ask me standard questions I’d already been asked a handful of times before in the eye clinic and in different telephone interviews. I intentionally nipped feeling annoyed in the bud.

Lesson: I made a mental note to self to keep going with the flow and to let nothing intrude on my inner peace.  

I expected the long list of general “do you suffer from…?” and “who in your family had…?” type questions. But there were two questions that made me laugh out loud each time. The first was, “should we expect anger or violence?” I wondered aloud whether anyone with anger management issues would admit to it. And the second was, “is there any possibility that you are pregnant?” Really? I’m 68.

Another nurse inserted the IV in my arm, took my blood pressure (well in the normal range but a bit higher than usual for me), and started my medication regime. This regime included three kinds of eye drops: cyclopentolate 1% (to treat uveitis/inflammation), 1% prednisolone acetate ophthalmic suspension (steroid to protect the eye from inflammation), and tobramycin .3% ophthalmic (topical antibiotic). These drops were placed in my left eye every four hours.

One by one, the anesthesiologist, the ophthalmologist intern, and my ocular oncologist (also my surgeon) briefed me on what was about to happen. I liked everyone’s demeanor. I was free to ask questions.

To the anesthesiologist, a young, no-nonsense woman, I conveyed my concern that my legs would cramp while I was under. “Is that why you take magnesium?” she asked. Yes. So she added magnesium, known to be a natural muscle relaxer, to my cocktail of drugs.

When my doctor came into my cubicle, she once again reviewed the procedure for me. She told me her current thinking was leaning more towards the tumor in my eye as a metastasis of the breast cancer; but still not being sure, she was treating it as a melanoma, with the higher dose of radiation.

I merely continued to surrender to the process and to keep the faith everything would turn out well.

Then she asked, “How are you feeling?”

“You can see I’m fine,” I smiled through my face mask. “But more importantly, how are you?”

Her eyes visibly softened, and she took a few steps closer to me. “Thanks for asking, not many do. And I’m great. After you, I have a hard case with a young boy today, so yours will be a cakewalk by comparison.”

I nodded, “I understand, but you will pay attention, won’t you…?” and we both laughed.

It was about 2:30 pm when they rolled me into the operating room, three hours later than scheduled. A previous surgery by another doctor had gone overtime. The hours had gone by quickly.

I was comfortable lying under two flannel blankets and could use my phone to read the many heartening well-wishes from friends around the globe on my Facebook profile and through chats. Their cheering messages made me smile broadly, and, while I was not at all anxious, I’m convinced my body felt better for it.

Research confirms that smiling can have a profound effect on body, mind, and healing. It can:

• trigger the release of certain chemicals in your brain, like endorphins, serotonin, and dopamine, the feel-good hormones
• lead to a lower heart rate in stressful situations like upcoming surgery, making you feel more relaxed
• boost your immune system and aid in recovery
• improve your mood, making you feel more positive, and a positive mindset is beneficial before surgery

Sometimes your joy is the source of your smile, but sometimes your smile can be the source of your joy.

Thich Nhat Hanh

Lesson: Smiling not only helps me, but I believe it also comforts those around me, like the medical staff. It creates a more supportive and positive environment, which is beneficial for everyone involved in the surgical process.

Operating Room Impressions

In the operating room, I had to roll myself over from the bed onto the operating table. The loose and open hospital gown made that a bit more cumbersome than it would normally be, but I managed.

Then seven or eight healthcare staff surrounded the table, facing me. I was introduced to the entire team; one by one, each spoke their name and designation. It was a sweet gesture, but I’m glad there was no naming test afterward!

Soon the anesthesiologist set the oxygen mask on my face and told me to breathe deeply. I’m pretty sure I went under in less than five breaths.

I described the surgical procedure in my previous post.

Postoperative Care

About an hour later, I woke up back in the preoperative room with a hard patch taped over my left eye. I could feel a minor discomfort in my eye, but I can’t call it pain, and, thankfully, no nausea (as some patients have). During the surgery, they had given me a dose of fentanyl (a potent narcotic analgesic), Tylenol 3 (acetaminophen-codeine), and ondansetron (an anti-nausea drug) through the IV.

But I’m a medication minimalist, and when the nurse asked if I wanted more painkiller, I said, “No, let’s just see how well I can tolerate this.”

A few days before going into the hospital, someone had called me make me choose among a private room (for C$195), a semi-private room with two beds (for C$155), or a ward with four beds, which was covered by my provincial health plan. I chose the ward.

So it puzzled me when, after a couple of hours, they moved me from the post-operative hall to a spacious private room with a bathroom on the sixth floor with a view overlooking the North Shore mountains and downtown Vancouver. When I asked about it, the nurse just said I got the private room because of the kind of surgery I had had.

I realized a bit later what she meant was that I was isolated because I was radioactive! There was a sign on the door to my room telling housekeeping to stay out and a red blinking light on my bed to warn others. This detail underscores the careful considerations taken in post-operative care, ensuring not just my well-being but also the safety of hospital staff and other patients.

Positioned above the foot of my bed, there was a small TV. Unlike in Manila hospitals, it wasn’t automatically turned on when I entered the room. Not being a TV watcher, for me, it stayed shut.

It took the staff a few hours to bring me the bags with my belongings, including my mobile phone and Kindle. So for a time, I got to be with just me, myself, and I. I focused on my breathing and did a slow body inventory. All felt well.

About 7 pm, the nurse brought me dinner on a tray. In a word, it was awful. Overcooked and tasteless. Wasn’t even sure what it was, but it included rice and soggy vegetables. Swallowing the food caused me some chest tightening, which may have been a side-effect of anesthesia. I slowed down my chewing, and that helped.

Not having eaten since before midnight the day before, the dinner served was not sufficient to satisfy my hunger. Fortunately, I had breakfast bars in my purse, and I ate those.

Lesson: it was helpful to anticipate my needs during the hospital stay.

Anticipate the difficult by managing the easy.

Lao Tzu

After my bags were delivered, I contacted my honey to say all went well. I was pleased to hear that the hospital had called him to inform him I was okay. I spent the rest of the day on social media and reading business newsletters and a book.

Close to midnight, the nurse came in to ask about my pain level. I still needed no further pain medication.

Being a confirmed night owl, I didn’t fall asleep until about 1:30 am. Uncharacteristically, I woke up around 5 am and stayed awake for about an hour. And yet I still felt fine. I was optimistic that this treatment would end well and that next week, after they remove the plaque, I’d be able to put this saga behind me. I was to learn differently the next day.

That’s enough for today. My next post will be about the day after when I was discharged from the hospital.

I’m happy to receive your comments and questions.

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