3 of the 4 Gama Knife 'helmets'
i was finally told that dr. chung and his team were ready for me at about 5:30pm. i would be taken down to the gamma knife room on the gurney as i was still not allowed to sit or stand up after the angiography, my allotted 'torture time' had not yet expired. but thank god i had been called! i was starting to lose my mind after five hours of boredom, pain and waiting and i was driving colin and my dad crazy with my whining. one last request before i go, "i need to pee". no, no, no we don't have time now and the gamma knife radio surgery will be quick, says colin. okay, okay, let's go . . . more humiliation to come!
but first, i shouldn't really complain about having to wait for five hours. the doctors and technicians need to be very careful when planning the radio surgery. first, they place the angiography images on top of the MRI images (creating an MRA) so they can get an accurate idea of where the AVM is, how big it is etc. using these 3D images they then plan the treatment. there are 4 'helmets' of differing strength (4, 8, 14 and 18) that can be used in the gamma knife machine and each 'helmet' has lots of carefully calibrated holes through which tiny, accurate beams of radiation can pass. the neurosurgeon and his team decide which strength helmet(s) to use and then plot the various angles at which the radiation should hit the damaged area of the brain, and for how long. in most cases a number of different angles are plotted for differing amounts of time, these are called shots. it is a very precise and complicated science, which i am having difficulty even explaining.
anyway, back to the humiliation . . . we got down to the gamma knife room and spoke to dr. chung. the radio surgery would take about an hour and a half altogether. WHAT?! there was no way i could 'hold it in' that long, i HAD to go. dr. chung was a bit nonplussed, there was nowhere private for me and they didn't even have a bedpan (i couldn't just use the toilets like a normal person). so, the nurse went running to find the 'crazy foreigner' a bedpan and some toilet paper. all the taiwanese males turned around in embarrassment while i pulled down my hospital pyjamas and 'tinkled' into a bedpan in their reception area. leaving the poor nurse to dispose of it. to be honest, i think dr. chung and his team were more embarrassed than i was and there's no way they'll ever forget me now. i'll forever be remembered as that weirdo south african who peed in their reception area ;-D.
Clamped into the Gamma Knife machine
feeling suitably relieved, i was wheeled into a very modern, very white room. there was a forest scene posted on one wall and 'elevator/pan pipe' music playing, obviously to create a calm atmosphere. i was lifted onto the bed of the machine and watched dr. chung and his team input a series of coordinates into a remote control hanging from the ceiling. i was to have two 'sessions' of radiation. the first session would last 40 minutes using the second weakest helmet (8). this would eradicate the nidus (centre) of the AVM. then i would have a break as they changed to the weakest helmet (4). the weakest helmet would be used for 20 minutes just to clean up the veins and capillaries around the edges of the nidus. there was a camera pointing straight at me the whole time and if i felt any discomfort i could tell dr. chung in the control room and they could stop the treatment immediately. i was told that i would feel no pain and that it was actually pretty boring. after the day i had had, boring was exactly what i wanted. only one condition - DON'T MOVE!i was clamped into the gamma knife machine, my head and neck at an incredibly awkward angle, everybody left the room and it was just me and the eerily quiet, alien machine. i heard a beeping sound and the bed moved me inside the machine. the inside of the machine looked like graphite to me, black and rough, shot with silver. i would stay inside the machine for a few minutes and then i would hear a beeping sound, the bed would move me out and my head would be twisted into a different, but equally uncomfortable position and back into the machine i would go. this was repeated many times and i think i had about 12 different 'shots' in the first 40 minute session. the worst part was that i had an incredibly itchy nose for 40 minutes and couldn't move a muscle. this was where 'mind over matter' really counted, i had no nose. if i had had a nose, i would've scratched it and the ghostly machine would've silently and painlessly rendered me brain damaged. i think this is the closest i have ever come to meditation, to finally conquering the body's primitive urges with a strong mind.
Taking a break between 'sessions'
after a millenium of communing with my disembodied mind and the bodiless machine i was allowed a break to acknowledge my body, scratch my nose and sit up while the helmet was changed and new coordinates were set. the last 20 minutes felt like 20 minutes and i only had about 6 'shots'. i still had an itchy nose the whole time, but i was 'enlightened', i was superwoman so i could deal with it. then finally, the ordeal was over and the head frame could be removed, much less painfully then when it was put on. i was FREE! my head felt light, i was ecstatic and immediately burst into tears.
