Lilla's Gamma Knife experience

"The MRI showed three tiny spots in the brain." It was with these words that I felt my whole world fall apart.

In time I met with the neurosurgeon and the radiation oncologist.  They both told me that my case was perfect for the Gamma Knife, that it was made for situations like mine.  They assured me that despite the name, no knives were involved. They explained that it was a very high-tech procedure that could radiate the tiny spots with 201 highly focused rays of powerful radiation while leaving the rest of the brain relatively unscathed. The spots wouldn't disappear immediately but over the course of several weeks, the dead cells would then be absorbed into my body.  

Obviously, with such strong doses of radiation, the importance of not moving, even a fraction of an inch, is essential.  In order to attain this perfect immobility, it would be necessary to attach a frame to my head.  This frame, in turn, would be attached to another and then to the table, assuring everyone that my head would remain perfectly still. When they told me that the frame would be secured with metal screws, I nearly fainted.  Still, I knew there was no choice.  The spots had to go and I reminded myself how fortunate I was to have the availability of such a precise way of disintegrating them.

The procedure was set for November 4th, Election Day. I checked into the hospital at 6:00 AM accompanied by my husband and son.  As I sat in the prep room next to another patient, she told me that she had had this procedure many times.  She said the screws were nothing to worry about and that the procedure itself was totally painless.  She is being followed and whenever a new spot materializes, the Gamma Knife takes care of it.  I felt much better having the reassurance of someone who had been through the procedure more than once. 

By 7:10 I had been given a Fentanyl lollipop and a shot of Ativan.  The medication took only moments to take effect and I felt very relaxed and slightly woozy..  The doctor gave me four shots of novocaine, two on my forehead and two at the base of my skull, the points where the screws would go, and injected some fluid into the same four spots to act as buffers.  The 'helmet' which came in two pieces was then attached with only slight discomfort and no pain.

I was told that I would have a further and much more detailed MRI once the helmet was secured. This was to chart the exact location of the spots and to have a better look at them. The procedure requires a team of doctors. A neurosurgeon, a radiation oncologist and a physics oncologist were all in attendance.  I had been warned that under the scrutiny of the more detailed MRI, more spots might be discovered.  I was so relaxed that I slept through most of the MRI. 

I was then taken to a waiting room to rest while the doctors, assisted by a computer, mapped out the plan of action.  The physics oncologist emerged with the computer printout which listed exact measurements and head positioning for each of the spots.  I was then brought into a room and asked to lie on what they called a sofa but looked and felt very much like an examining table.  I remember thinking that I wouldn't want to visit them at home if this was their idea of a sofa! 

Once the headgear had been positioned correctly, I was asked to lie down and the headgear was bolted to the table.  I was pushed into what looked like an old fashioned hair dryer.  It had 201 holes from which the radiation shot out the necessary rays to demolish each spot.  I had my iPod playing in the room as the machine silently did its magic.  There was total silence.   

As predicted, in the more detailed MRI, two more spots had been discovered.  Each of the five spots had to be radiated separately and took about 20 minutes of radiation each, plus time for re-positioning.  All together I was on the table about two and a half hours.  There was absolutely no pain. Any discomfort that I felt came from lying on the table for such a long time, even with occasional breaks.  A felt a strange sensation from having my head resting on the screws in the helmet but it was never painful.

Still, I was delighted when I could get off the 'sofa'.  It had been a long day.  My next MRI was scheduled for six weeks after the Gamma Knife procedure and will hopefully show the spots to be even smaller or non-existent.  In the future we will monitor any further activity with an MRI every three months.  If anything appears, we will be able to radiate the single spot with the Gamma Knife. One of the benefits of this procedure is that it can be repeated whenever necessary. The extremely targeted radiation helps spare the other parts of the brain.   

I felt fine when I was discharged.  My husband and son brought me home, but I insisted on going to the polls.  I'll bet I was the only person in my polling district who had come to vote immediately after brain surgery!  After all, very little keeps us metastatic women down!    

Lilla Romeo