We spoke in depth about different radiation options and about protons specifically. Dr. Shrieve said that in Matt's particular case, he didn't feel like protons offered enough benefit to justify the expense and inconvenience of traveling to Boston to receive therapy there. The part of Matt's brain that will receive the most damage from radiation is his hypothalamus...... which is already completely shot. The side effects that Dr.Shrieve would expect are the ones that we have been dealing with for 3 years - mainly complete hormone replacement therapy (panhypopituitarism) and hypothalamic obesity. He also said that while Protons are wonderful because there is no exit dose of radiation, there is often a higher entrance dose of radiation and his opinion is that because Matt's tumor is so deep, IMRT radiation would be a better choice. I felt a great deal of peace and comfort while talking to Dr. Shrieve about Matt's history and radiation options. I felt like this peace was a direct answer to my prayers about feeling confident that our choice of treatment would be what is best for Matthew.
Sooooo, today we started this big adventure. It was an extremely long day. Warren kept the boys here, and I dropped off Audrey at Carolyn's (Warren's mother) house. Matt and I headed to Huntsman for his 'mask fitting' and positioning CT scan. We had about an hour and a half before his next appointment so he and I went to the zoo and walked around for awhile. It was so fun to go with just him. It's way faster to walk the zoo with just one older boy. We saw practically everything in just an hour! After the zoo we went over to Primary Children's for the longest MRI, EVER!! They did a full MRI of his spine without contrast then a full MRI of his spine with contrast, then a special, more detailed MRI of his brain. For every 'slice' they usually take of his brain, they took 4 'slices', so it was about 4 times more detailed than his usual brain MRI.
Here are some pictures from the mask making. This mask will be used during radiation. They actually fasten the mask to the table on the radiation machine making it virtually impossible to move out of position. They really need those beams to go precisely to the tumor!
|Positioning his head in the cradle|
|Adding the 'mesh' under his head|
|Using lasers and a 'sharpie' marker to make a perfectly straight line down his face.|
|Waiting for the mask to dry and harden.|
|Going into the positioning CT scan.|
|The finished product. Sometimes they decorate the masks. I don't know if Matt requested that his get painted. I guess we will see next Monday when he begins therapy!|