Bill Jerman- My Prostate Cancer Journey

My radiotherapy sessions began on July 23^rd.

Prior to this, I had been given a ‘practice run’ where the team at the radiotherapy centre explained the process, what to expect and the importance of the on the day preparation prior to the radiotherapy. Sarah was in this meeting which was important to help all the information to be assimilated and she subsequently came with me to all the sessions.

The process started by self-inserting an enema into my bottom and drinking  2 plastic cupful’s or 300ml of water. After approximately twenty minutes, it was toilet time!

I then had to quickly drink 4 cupful’s or 600ml of water and then waited, 30 minutes before I was taken into the radiotherapy room for the first time. I was scanned and it transpired that my bladder wasn’t full enough, so I went back and drank another 2 cupful’s or 300ml of water and waited for 20 minutes and returned for another scan and this time my bladder was indeed full enough.

This was also the time that I had my first ever tattoo! Three very small dots around my lower stomach area which would be the the three exact spots where the radiotherapy would be targetted.

So, I then had my figures to work with. After the toilet stop following the enema and 300 ml water, I was to drink 900ml water 45 minutes before my radiotherapy time. The radiographers. Also had the precise measurements of where I needed to be on the scanning bed which again was critical in ensuring that the radiotherapy was accurately hitting the prostate.

All of this was to ensure that my bladder and bowels were in as similar state as possible for each of the radiotherapy sessions.

I had twenty sessions over four weeks with the weekends off. I learned very quickly that timing is crucial especially for a man who can need to go for a wee very urgently!

On that first session, I was given the times of each of the twenty sessions. They were nearly all around 11.45am. This was really helpful in planning the days and getting into a routine, which was important. Once I had completed the enema and toilet sequence, I had to scan in with my personal barcode so that the radiographers knew that I was there and that my 45 minutes had begun.

Drama at the start, however. Not being the most flexible of people, I struggled with the enema and overstretched in an awkward position and managed to ‘ping’ my lower back and aggravate a previous injury. So I struggled out of the loo, hobbling back to the waiting area where Sarah was. It was painful and sitting down was a challenge!

So, standing up, I quickly drank my six cupsful of water-which isn’t easy when you know that you have to do it! We then scanned in and went through to the second waiting room nearer to the scanning rooms and I gingerly sat down and waited for my 45 minutes to pass.

This time became very useful. We caught up with some work, read some gardening magazines that we hadn’t done of months and months, created a family quiz for an upcoming celebration of there family birthdays, caught up with things on the news and social media. It was a bonus time.

We tended to see the same people at the same times on each day which was reassuring. People were reading, talking, using phones and ipads (great wifi connection at the centre) and drinking their water.

A board informed you whether the two scanners were running on time or how many minutes late they were. Again, this was important!

On time, one of the radiographers came to get me, introduced themselves and took me down to scanner 1. Shorts and shoes off and very gingerly onto the ‘bed’. They checked my name and date of birth and then adjusted my positioning to get it accurate. They then left me alone with the machine and I lay there waiting as they checked my bladder and bowels on their screen in another room. And then the machine started up and began it’s journey around my body whilst targeting my prostate. There were different sized and shaped parts that went round and it sometimes changed direction. After a few minutes it stopped and a radiographer came in and said that was it-first session completed.

They kindly, helped me off the ‘bed’ and down the step. Shorts and shoes back on, out to the waiting room to Sarah, via the loo and session one was completed!

On the way home we discussed the whole experience and, working in schools, we did a WWW and EBI reflection!

What Went Well:

• The staff were amazing. Caring, understanding, good communications and patient.
• Julie at reception, who was so helpful and clear in explaining the process and had time to answer questions and was reassuring.
• Drinking the right amount of water at the right time for my bladder to be as full as it needed to be.
• The carpark code we were given, worked.
• We made good use of the waiting time which kept my mind focused on something else.
• Getting on and off the ‘bed’-with help!
• Watching the scanner go round and thinking, ‘You are tackling my prostate!’

Even Better If:

• I clearly struggled with self-administering the enema and hobbled out of the centre so needed to do this differently.
• We were at the centre too early and waited a long time before the first part of the process. Therefore, needed to leave home later.
• Drinking 900 ml of water, at pace, from the plastic cups was challenging. Somehow, it made it feel frenetic. Needed to do this differently.

Solutions:

We are fortunate in living within a 15 minute drive from the hospital so we decided to split the process into two parts.

• I asked, and Sarah kindly agreed to administer the enema! Hero! (‘For better, for worse!’) This removed both the physical stress but also the anxiety that I was feeling about doing it myself after the day one debacle.
• I drank the initial 300 ml water at home and took the other 900 ml to the centre in a water bottle. This meant that I was also able to drink flavoured water, which I prefer.
• We left straight after the enema and initial drinking to arrive at the hospital in time to go to the loo, scan in, go to the waiting room and brink the 900ml from the water bottle.
• It worked for us and became the routine for the remainder of the sessions. Of course, there was always a niggling concern of heavy traffic or a traffic incident, but we thought on balance it was a reasonable choice and we knew of alternative routes.