Supposed to start Brachytherapy on Monday amidst covid-19 outbreak in NYS

Go ahead and start.  Just get in your car and don't go anywhere else.   Take hand sanitizer and wash your hands.

I also heard wearing glasses will protect your eyes, should some inconciderate person sneeze near you or cough without covering their mouth. I heard the glass on the eye frames prevents droplets from getting in your eyes, one of the forms of transmission. 

I'm sorry for your current predicament.  Going through cancer treatment is never easy, but the stress added by the coronavirus situation takes things to a whole new level.   

In reviewing all of your prior posts, I saw that there was a discrepancy in the grading of your cancer (grade 2 on D&C, grade 1 on hysterectomy).  If I were in your situation, I would get a second pathology review from another major cancer center to see if another gynecologic pathologist agrees with your present grade 2 designation.  You also mentioned that your tumor arose in the lower uterine segment, which is another risk factor that likely led to the recommendation for your brachytherapy.  My tumor also arose in the lower uterine segment and was grade 2, and I had brachytherapy as well as external beam radiation back in 1999.  Do you know whether there were other reasons for the radiation oncologist's brachytherapy recommendation?

After the second pathology review, if I were in your situation, I would also request a second opinion on your need for radiation.  In the past, I referred someone to MD Anderson in Texas, and she was quite pleased and relieved with MDA's remote second opinion evaluation of her case.   In reading your prior posts, I saw where you stated "starting brachytherapy in March.  I'm scared, but I don't feel like any other choice is the right choice."  Also, you said in another post, "quite confident in the quality of the medical care and the prescribed treatment plan."  Given your above statements, you don't want to have any regrets if you do decide not to get radiation in the coming weeks.  You want your decision, to the extent possible, to be based on information rather than fear.  Therefore, I would seek out whatever additional medical opinions you can to ensure that you make a decision in your best interests. 

From what you stated, you will be entering a separate facility for the brachytherapy, not the hospital itself.  It sounds as though the facility is taking significant precautions to protect your health and safety.  I realize that you have a number of other medical conditions, so I am sure if I were in your situation, I would have similar concerns.  I know when I had a hip replacement, I opted to go to a specialty hospital, where all they did were orthopedic procedures, rather than the main hospital.  I thought that I would be much less likely to come home with an infection in addition to a new hip. The specialty hospital was a great experience and I never regretted the decision.

Best of luck and health to you!

JillAndrea said:

Thank you everyone for your

Thank you everyone for your feedback.  It really was helpful.  

First, for clarity, I had already decided to go forward with the brachy prior to the COVID-19 outbreak. I consulted with my surgical oncologost, the radiation oncologist, and I met the pathologist (in person) who conducted the post-surgery diagnosis and staging.  She showed me my slides and the basis for the diagnosis.  All of them agree that the stage 1a and grade 2 results are accurate, even though they only found grade 1 cells after surgery,  They told me that the prior D&C had likely removed the grade 2 cells and they do often see the two grades merge in cell samples.  The radiation oncologist reviewed the reasons why the reasons to go forward with brachy. I do fall into risk categories for recurrance, and according to their algorithms my chances of reurrance drop from 7% to 3% after five doses of HDR.  

My quandry was having to go out into an "infected world" after 10 days of isolation in order to proceed with the brachy treatments.  I came to terms with it, and am taking extreme measures to protect myself, which I will describe below.  In my county, the outbreak is in early stages.  We have only about 160 confirmed cases of COVID-19, with 600 more people in mandatory quarantine and about 3000 presumed positives from community spread that have either not shown symptoms or cannot get tested.  We now have 100% business and school closures with the exception of essential services.  I do agree that it is only going to get worse, so if I can be done before the outbreak peaks here, then I can go back into isolation and be safe again.

 

EFFORTS TO STAY SAFE

I went for brachy simulation on Monday, and it was our first day out of the house in 10 days.  I had to get blood work at a lab first, and then we proceeded to the cancer center for my appointment. My husband stayed in the car the whole time. I wore the only mask I have, glasses, and carried a paper-bag purse containing only sanitizer, wipes, ID and phone.  i was impressed with the blood lab - all the techs wore masks, had the windows open for airflow, and were actively wiping down the chairs with disinfectant.  I was the only person there when I arrived.  I was in and out in less than 10 minutes and as I left one of the techs advised me to dispense my hand sanitizer in one hand ahead of time and then use the other hand for doorknobs and railings, then when outside wipe my hands for 30 seconds or more.  It was great advice.

When I arrived at the cancer center my husband dropped me off - they screened me at the door and the nurse wanted to take an oral temperature.  I refused to take my mask off so she conceeded and took my forehead temperature, which ended up being fine at 97.7 degrees. Then I had to take the elevator down one floor and did the same thing as before - pre-dipensed the sanitizer in my hand so I could disinfect after touching anything.  I was the only one, but right before the doors closed someone rushed in, and I immediately jumped out of the elevator.  It was an employee, perhaps a nurse or a tech, and when she saw how I reacted, she apologized profusely... but it just goes to show that even medical professionals forget about social distancing protocols.

I approached the reception desk to check in and kept my distance and didn't touch anything. I noticed the waiting room had at least 15 people all sitting close together and chit chatting like it was any other day, which was shocking to say the least.  I mentioned to the receptionist that I did not want to wait there, so she called a nurse to come and get me so I could wait in an empty exam room.  The nurse told me everything had been wiped down before I was brought it and I could see streaks of disinfectant still on the surfaces.  When the doctor came in he sat across the room from me, and the techs kept as much distance as they could. while performing the necessary procedure.  I also used the sink in my exam room at least 3 times to wash my hands with soap and water.

At the end of my appointment, I walked outside where my husband was waiting in the car.  I wiped down everything I own, and I as I wiped each item, I tossed them one by one into the car through the passenger window. Then i dispensed sanitizer in my right hand, threw away my "paper bag purse", and wiped my hands thoroughly before I got in the car.  When we got home, hubby and I stripped out of our clothes in the garage (no jokes please) and took showers immediately including shampooing twice.  I don't think I could have been more careful.  I know it may sound like overkill, but this disease scares me.

 

ABOUT THE BRACHY SIMULATION

Now for the brachy simulation - It was effortless!  After I changed into a gown I was brought into a room with a giant CT scanner.  I laid on the table on my back with my knees bent. They asked me to gently let my knees fall outward to the sides.  there were no stirrups or anything - just me and the table.  The doctor showed me the cylinder - it looked a biy like a popsical but smooth plastic.  It was about 1 inch in diameter and about 8 inches long with a "handle/stick" on one end.  He asked me if it scared me and if I was okay with him inserting and I told him it was fine.  He told me to let him know if it hurt or caused pressure.  It didn't, and they removed it.  Then he asked if I thought I could handle one 1/4" wider in diameter.  I said yes.  This time when they inserted it, it did feel tight and it created a bit of pressure against my bladder so I felt like needed to urinate.  I told him that, he asked if I thought I could handle it for 10 minutes and I said yes.  He told me that what I described was exactly what they wanted - as the slight pressure ensures the cylinder is fitted tightly and delivers the most effective treatment.  Next, they asked me to bring my knees back together and straighten them on the table.  It was a little bit uncomfortable, but very tolerable.  From that position with the cylinder in place, they left the room and took the scans which took about 6 minutes.  Then they came back in and explained that for the actual treatment it would feel exactly the same except with an additional wire attached to the end of the cylinder a little tiny flutter feeliing when the radiation is actually delivered, which would only be 4-6 minutes.  

After I got dressed they gave me a special ID card to scan in when I arrive for my appointments.  They told me that I would only be there for 20-30 minutes in total for each of the five treatment appointments and that as soon as I scan in, they will come and get me right away.  My first treatment is tomorrow morning (Thursday) - I will come back and fill you in on that.  And I will follow the same safety measures I followed on Monday.

I will be completelly done by Aprll 9, and then I can go back into full isolation until this crazy virus passes.

I hope everyone stays well.

 Jill

It will be easier after this. I had brachytherapy last year during the summer. Three treatments; but the simulation and the first treatment were done the same day and I had a catheter inserted and was left in a waiting room while they did calculations for about an hour. The other two treatments only took 20 min.

I was stage 1a, grade 3.

Good luck tomorrow. I work in NYC and live in NJ and haven't left my house for a week and half already. There were positive cases in our offices, although on floors above and on the one below. These are really scary times. Stay safe.

I'm coming back later to read more carefully how you did this "outing." I had a mammography and also a liver scan due in March, but I think I'm going to wait a few weeks.

Hello and good evening My name is June,

Just trying to connect with others like myself. I  had my surgery..  a radical hystorectomy at Highland Hosptial in Rochester January 28th. I live 16 miles outside of Cooperstown NY.In March I had several HDB High does internal brachyradation treaments at Bassett Cancer Center.Basset Medical Center is where I also work. I only recently retured to work on April 6th walking into an invisible disease while trying to deal withthe slient one.My stress level is very high  especially after  being home for two months recovering  and not expose to  anyone or anything,I work on an locked unit in patient psychiatry while pts are being screened tested and isolated quarantine. I am frustrated my doctor did not put me on intermitant leave,I had asked him the response was" business as ususal."

 I do not think you are over doing it at all.I  was upset when I came in wearing a procdure mask due to having a slight cold and allergies and had to ask my team to wear face masks, they treated this like it was no big deal. I am frustrated  in the lack of any supprt other than the American Cancer Society and Cancercare.org  due to living in  a rural community with only the main hospital and the outside regional hospitals.

Please keep doing what you are doing and advocate for yourself to make sure your team is taking all precautions to keep you safe.

June B said:

Endometrial Uterine Cervical Cancer Stage II

Hello and good evening My name is June,

Just trying to connect with others like myself. I  had my surgery..  a radical hystorectomy at Highland Hosptial in Rochester January 28th. I live 16 miles outside of Cooperstown NY.In March I had several HDB High does internal brachyradation treaments at Bassett Cancer Center.Basset Medical Center is where I also work. I only recently retured to work on April 6th walking into an invisible disease while trying to deal withthe slient one.My stress level is very high  especially after  being home for two months recovering  and not expose to  anyone or anything,I work on an locked unit in patient psychiatry while pts are being screened tested and isolated quarantine. I am frustrated my doctor did not put me on intermitant leave,I had asked him the response was" business as ususal."

 I do not think you are over doing it at all.I  was upset when I came in wearing a procdure mask due to having a slight cold and allergies and had to ask my team to wear face masks, they treated this like it was no big deal. I am frustrated  in the lack of any supprt other than the American Cancer Society and Cancercare.org  due to living in  a rural community with only the main hospital and the outside regional hospitals.

Please keep doing what you are doing and advocate for yourself to make sure your team is taking all precautions to keep you safe.

 

I'm hearing more and more stories of friends, and relatives of friends, who ONLY were going to the grocery store once a week, and they caught it.  But this is in the NYC tristate region, and in cape cod, to which a lot of people from affected areas fled.

June, I am afraid that your job is putting you at risk.  I would see if there is any way that you could work from home, or be furloughed with pay and insurance, or be back on disability, or be transferred temporarily to a job that doesn't put you at such high risk.  The problem with inpatient locked psych is that these are people who are very possibly unable to have taken isolation precautions because of their psychiatric disorder.  Someone will bring it into the unit, and it will spread like wildfire, the way it spreads through nursing homes.  Even if you were masked and hand sanitized constantly, once it is in the unit, everyone will get it.