It’s A Warm, Sunny Day Here in Coronach

It's a typical late spring day. Sunny and warm. The smell of new buds and sap running.

Thoughts of gardening and barbeque are in the air. Soon the farmers will be on the land. It's a wonderful site to see the fields come green again as a new season starts.

Time for a cup of coffee

Who I Might See On My First Visit

Pasqua Hospital: About Pasqua Hospital

For 90 years, the Pasqua Hospital has served the health care needs of southern Saskatchewan. Formerly called the Grey Nuns Hospital, the Pasqua Hospital continues its tradition of care and community service as an integral part of the Regina Qu'Appelle Health Region. The Pasqua Hospital is recognized for provision of quality health care in several specialized areas. Highly qualified physicians and staff, along with advanced diagnostic equipment, have enabled the Pasqua Hospital to stay in the forefront of many programs, such as opthalmology, orthopedics and cancer services.

During 1997-98 many other programs and service areas at the Pasqua Hospital were enhanced. The arrival of the new Spiral CT Scanner and advanced nuclear medicine equipment were landmark occasions that greatly improved the diagnostic capabilities available for District clients. Renovations to areas such as palliative care, as well as the creation of a new ambulatory care area, are helping the Pasqua Hospital continue to provide a high standard of care and service to clients.

Who you might see on your first visit

A cancer care team is made up of many different people, including doctors, nurses, radiation therapists, social workers, volunteers and dietitians. Here are some of the people you might meet on your first visit:

Receptionist

The first person you meet will be the receptionist. When you arrive, you must register with the receptionist before going to your appointment.

Admitting clerk

When you are done at the reception desk, you will see an admitting clerk. The admitting clerk will ask you some basic questions:

• date of birth

• address

• Saskatchewan Health Services card number

• other health insurance coverage

• person to contact and phone number

• treaty number, if applicable

• health care directive(living will)

• family doctor’s name.

This is to make sure that the information we have about you is complete.

You should arrive 30 minutes before your appointment to answer these questions.

On later visits, please let us know if this information has changed. You should also know that we must enter this information about all cancer patients in the Cancer Registry. All the information is kept confidential.

Oncology nurse

Once finished at Admitting, you will be directed to the waiting room. An oncology nurse will meet you and take you to an examining room. Before you see the doctor, your nurse
will ask you important questions about yourself, your family and what has been happening to you. He or she will help you understand the information you are given. Your nurse will also give you a phone number to call if you need help or information once you leave the
Cancer Centre.

Oncologist

Next, the doctor will meet with you. When you are diagnosed with cancer, you are referred to a cancer specialist called an oncologist (on-CALL-o-jist). There are many kinds of oncologists. All of them work closely together. You may be examined by your oncologist at this time. Your oncologist will spend time explaining your cancer and deciding what treatment would be best for you. Other team members and support

Social workers

Social workers in the Psychosocial Oncology department at the Cancer Centre help you and your family adjust to the stress caused by cancer and its treatment. Every patient is
assigned a social worker. Social workers provide counselling on issues such as the effects of an illness on family relationships, financial difficulties, and home management concerns. Your social worker can also tell you about support services for you and your family.

Pharmacists

Pharmacists at the Cancer Centre will help you with your cancer medicines. They help to review and calculate all doses of cancer medicines that have been prescribed for you.
Pharmacists will talk to you about your cancer medicines and give you written information which will help you understand how your medicines work, how to use and store them properly at home, and how to manage any side effects. They are available to answer any questions you may have about the medicines prescribed by your oncologist. Palliative
care professionals These are skilled and thoughtful people who focus on aspects of treatment other than the cure itself, such as controlling pain.

Your family doctor

The Allan Blair Cancer Centre keeps your family doctor updated on your progress. The Cancer Centre sends, on a regular basis, letters to the family doctor reporting on your test results and your progress. If you are experiencing a health concern which is not cancer related (e.g. an injury), please contact your family doctor in these instances.

Volunteers

The Allan Blair Cancer Centre is fortunate to be supported by many volunteers and groups who provide a variety of help and support to patients. They can help you find your way around the Centre or to the hospital for tests. Patient Education Centre A
patient library is available for your use. The library contains books, lists of appropriate websites, pamphlets, brochures, videos and audiotapes for you to borrow. A volunteer will be able to assist you with finding the information you need. As well, a computer is
available for your use at the volunteer desk located beside the Patient Education Centre.

What might take place on your first visit

Your first visit to the Cancer Centre may take 1-2 hours. When you meet the oncologist, he or she will examine you and discuss your symptoms. You may also have some tests such as blood, urine or X-rays. This visit is a consultation or discussion visit. You will
not receive any treatment on your first visit. We suggest you bring a friend or relative with you. It can help to have someone else there to keep you company. He or she can help you remember things you have been told or hear something you might have missed.

The Allan Blair Cancer Centre is an "outpatient" treatment centre, which means patients do not stay overnight in the Cancer Centre. However, for some treatments, you may be admitted to the Pasqua Hospital.

The waiting is the hardest part

Its been 2 weeks since I had my CT scan and I have no idea what stage I am at. I won't know until I see my Oncologist, which is scheduled for next week.

The only thing I have been told by my personal physician is that the ultrasound that was done showed that I have some swelling on the Aorta and the abdominal cavity. What does this mean?

I have no idea. At this point I can only wait. ( I'm not a patient man

When I see my Oncologist I will be told what stage I am at and we will discuss treatments.

The treatment given to patients with non-Hodgkin's lymphoma is specifically chosen for each individual. This depends on a number of factors, including whether the disease is newly diagnosed or has relapsed, whether the disease is indolent or aggressive, what stage it is at, what type, or 'grade', of non-Hodgkin's lymphoma a patient has, their general health and age, and their needs and wishes.

For many years, the main treatment of non-Hodgkin's lymphoma has been chemotherapy. Today, chemotherapy is frequently combined with monoclonal antibody therapy, which can sometimes also be used on its own.

• There are many types of chemotherapy for non-Hodgkin's lymphoma, which are given in various combinations
• Chemotherapy can be used with monoclonal antibody therapy, radiotherapy or corticosteroids
• It is given in cycles over several months, with breaks between treatments, usually at the outpatient clinic
• Not all patients have side effects; if they do occur, they can be mild and are often easily treatable

So this is what I am waiting for. Knowing is always better than not knowing.

My visit and explanation of what a CT scan is

CT scans (or CAT scan as it is sometimes called) stands for Computerised (Axial) Tomography. This just means a scan that takes pictures from all around your body and uses a computer to put them together.  You can either scroll down the page to read all the information below, or use these links to go directly to a section on

• How a CT scanner works 
• What will happen? 
• Preparation for the scan 
• Abdominal CT scans 
• CT scans of the head 
• CT scans of the chest 
• Pelvic CT scans 
• Spiral CT scans 
• Can a CT scan be dangerous? 
• The results

 

How a CT scanner works?

A CT scanner uses X-rays. Like an X-ray, it is painless. The CT machine takes a lot of pictures of your body from different angles. These pictures are fed into a computer. The computer puts them together to give a series of cross sections or 'slices' through the part of the body being scanned. A very detailed picture of the inside of the body can be built up in this way.

Together these cross sections give a very accurate picture of where a tumour is and how big it is. They also show how close major body organs are to the area that needs to be treated or operated on.

A CT scanning machine is a large machine that is shaped rather like a doughnut. There is a couch that you lie on.  The couch can slide backwards and forwards through the hole of the doughnut. The pictures are taken as you move through the machine.

This is a CT scan of the pelvis marked for radiotherapy treatment.

What will happen

When you arrive, you check in with the receptionist so the radiographers know you are there.  Then you usually take a seat in the waiting room until someone calls you for your scan.

When you are called, you may first go to a cubicle to take off your outer clothing.  You may have to strip down to your underwear and put on a hospital gown.  If you are just having a CT of your head, you may not be asked to undress.  You must take off any jewellery that is in the area to be scanned because metal interferes with the machine.

When you are ready, the radiographer or helper will take you into the scanning room. You will probably have to lie down on the machine couch on your back. Sometimes the scan is done with you on your side or lying on your front. You need to lie as still as you can, but breathe normally.

Once you are in the right position on the couch, the radiographer will leave the room. This is because there will be X-rays in the room and it would be dangerous for the staff to be exposed to these.  They see patients having X-rays and CT scans all day, every day and if they stayed in the room, would be exposed to far more X-rays than any patient.

The radiographer will be able to see you on a TV screen and you can talk to each other through an intercom. The radiographer will control the position of the couch from outside. The couch can move automatically through the CT scanner so that the part of the body to be scanned is in the machine. The radiographer will tell you that he or she is about to start the scan and remind you to keep as still as you can. When the scan is over, the radiographer will come back into the room and help you down from the couch.

Most scans take about half an hour.  A lot of that is for setting up the scan, rather than actually taking it.  Lying still for that long can be uncomfortable.  If you are getting stiff and need to move, tell the radiographers through the intercom.  During the actual scan, you have to try to keep as still as possible, and not cough or swallow, particularly if your head is being scanned.  Mostly, you can breathe quietly but normally throughout the scan.  For some scans, your radiographer may ask you to hold your breath at various times during the scan.  If this is going to happen, they will tell you beforehand.  You should be able to go home as soon as the scan is over.

Before I left the hospital My Doctor came in and gave me the results of my Biopsy that I had done 2 weeks earlier.

This is when I was told I had Non-Hodgins Lymphoma.

Even though I had hoped it wouldn't be cancer, I was half expecting it. I didn't feel particularly worried at that point. I guess because I have been healthy all my life and at the moment I felt fine.

Time to ponder this and like I always do, it was time to do some research.

Getting a Lymph Node Biopsy

 The only way to get a definite diagnosis of the cause of an enlarged lymph node is to remove it and look at it under the microscope.  This is called a lymph node biopsy.  It is a small operation, usually done in hospital under a general anaesthetic. 

When you wake up, you will have a few stitches where the lymph node has been removed.  These will be covered by a dressing.  You will probably be able to go home the same day, as soon as you have recovered from the anaesthetic.  You will probably have to go to your GP surgery to have your stitches removed, about a week to 10 days later.

My biopsy was done with a local anesthetic. The surgeon froze the area around the lymph he was removing.

It's a weird feeling having him cut while you are a wake. A few times I coud feel it and he had to do more freezing.

It was a fairly standard operation and I was out the door in 20 minutes.

I headed for home again to await results. Its a 3 hour bus ride. I preffer the bus to driving.

When I arrived home I had a message from my Doctor telling me he was scheduling a CT scan.

Another trip to the hospital.