I haven't written... In ages... Yes.. I am still alive...
I have decided... To share with you some of my "journal" entries for my final project due at the end of my internship.
... I write one basically every month to say what I have been doing... I'll include them here so you can read what I have been doing for the past 5 months... And how I have been progressing... I feel I should apologize for my lack of posts.. The past... 2-3 months... Has been interesting in too many ways.
_____
Entry 1
This is my first month at Cancer Center in Dallas, Texas. Another student and I started at the same time. Usually they start students on treatment machines, or their nurse rotation. I am in CT simulation. The first week has been getting familiar with setting up patients for their future treatments. You have to know what you’re treating, what the doctor wants in regards to exactrac and be mindful of what the patients are capable of doing.
The second week of my rotation, I went to nurse’s week. It was interesting to sit in on some of the physical exams. Dr. S pointed out the cervix and where exactly the brachytherapy tandem is being placed and where it is treating. It was also interesting to sit in on the doctors with their various patients to tell them it’s going well or not so well and what they can do to manage their side effects differently. It helped me learn what is most likely a radiation side effect versus a chemotherapy side effect. So far, my first month has been going very well.
*****
Entry 2
I finished my CT simulation and nurse week rotation. At this point, I am currently trying to find a patient to do my case study on. Hyperthermia seems interesting since there are not many cancer centers which offer it. All of the patients I have simulated have been supine patients. I was hoping that I would see some prone patients so I could see how the belly board works and how the set ups would be performed. I am sure I will see some prone setups later on when I treat on the IX machine.
I started my treatment machine journey and I am excited! I feel like I am headed on the path of a therapist now with really interacting with patients and getting to see all the work I did in CT come together. I started working with the console on day 2 of being on the EX machine. They mainly treat breast and palliative patients on this machine. It has been a good experience getting to know setups better on this machine. Hopefully it will continue to go well.
*****
Entry 3
I am finishing up my second month on the EX machine. The clinical supervisor told me that I am going to moving machines to the IX soon. They primarily do head and neck, and pelvic cancers. I am going to be sad to leave the EX machine. The therapists J and F have made it relaxing and enjoyable. The patients on this machine are so uplifting and positive it really reaffirms coming to clinic every day and that what I do is worth it.
I have experienced a few patients dying on this machine. It was quite an emotional shock because you find yourself getting attached to patients when you ask about their weekend plans, what they do for work, about their kids etc. and see them decline and have the hope for them that they will get better and somehow pull through for just a little bit longer.
On a happier note, I did a whole patient setup by myself with moving the patient, setting up the SSD, the whole 9 yards. F was very pleased with me. He was dealing with a scheduling conflict and I already called the patient back and she was on the table. Instead of waiting and having the patient uncomfortable, I got the patient setup and right as I was about to have him come check it, he came in. He counted it as my second check. It was very enlightening.
*****
Entry 4
Well I just started the IX machine. I think this is my first week over here. They primarily do head and neck cases, with pelvic and abdomen cancers. I think about half of the cases are head and neck. We do not treat any palliative cases on this machine, that seems reserved solely for the EX machine. We may get a few if the EX is overscheduled.
The one thing I have found difficult about this machine is getting to know the console and this new thing called exactrac. Exactrac takes pictures from two kvp tubes at 45 degree angles and compares them to the DRR from dosimetry to make sure we are treating where we need to be. It overlays the two images and you can shift between the two to see how far you off. The couch will automatically move itself. It is difficult some times to see the difference because the gantry may be in the picture, you can see the tennis racket and because of the oblique angles, it makes it hard to decipher. Hopefully with time it will get better.
I also started cutting blocks. Those darn things like to leak all over the table because the table itself will warp. It is stressful when you are sitting there thinking it will be okay and a few minutes later you can hear it leaking. You have to basically block the leaking cerrobend off so it doesn’t go everywhere and wait for it to ruin the perfect block you just cut and redo it. It’s time consuming and irritating. Hopefully it will go better down the road.
*****
Entry 5 (this month's)
I will be starting my sixth week on the IX machine. I have become much more comfortable using the exactrac and reading the kvp images on the screen. It seems second nature now. All of the head and neck cases use exactrac for their treatment, unless it is a Dr. S patient. Usually, Dr. C gets all the head and neck cases. Dr. S is known to do gynecological cases. I would say 80% of all head and necks get ethyol. No one has ever finished going through their whole treatment with taking it. The side effects are pretty intense for these patients. I don’t envy them.
My case study patient just finished her treatment a few weeks ago. She was a MALT lymphoma case which is a more rare type of cancer. She was a very nice and seems to have a good prognosis. I wish her well. I don’t want to discuss her much here because I will be writing a big case study paper on her soon. I don’t want to give too much away.
My block cutting has gotten much better. They seldom leak. I find it more relaxing in the block room and will use my time there to throw on some music while I cut and make sure my blocks aren’t leaking all over the table. I have not cut one photon block. MLC pretty much takes care of that now. Most of the blocks I cut are for breast boosts and Internal Mammary Chains.
I am looking forward to going to the trilogy hopefully by the end of this week. They get a lot of specialty cases. B was the first student to be allowed to go on the trilogy. I think she opened the door for us. It will be exciting since they do SBRT gated lung, SRS brain and body and TBI cases.
______
That is all I have for you.
116 days and counting.
Recent Comments