In this post I will share my experiences and insights about preparing for the start of treatment.  The period just before cancer treatment begins can be a time of stress and worry, but it doesn’t have to be.  I was determined to make the week ahead of my first treatment a time to refresh, encourage and enjoy myself.   Starting treatment with a positive mental attitude and peace of mind definitely helped me to more effectively deal with the challenges that come with radiation treatment and chemotherapy.

As I shared in my last post, I went through a period of second-guessing before committing to the treatment regime.  (My apologies for the “version control” errors in that last post.  Moving too fast on Memorial Day weekend.)  But once I had resolved my doubts, I was ready to get on with it.

There are lot of things that need to happen ahead of radiation and chemotherapy.  Multiple medical tests and evaluations are conducted to provide a baseline for assessing the side effects of treatment.  In addition to the battery of blood tests, there are dental and hearing exams.  Radiation can wreak havoc on your teeth and chemo can degrade your hearing, so the doctors need to understand your starting point.

The preparations for the radiation treatment itself were extensive.  There was a detailed MRI scan to provide data for the technicians to develop trajectories and energy levels for the radiation treatment.  Then there was the creation of a mask that would be used to hold my head firmly in place during actual treatment.  The process of making the mask on my face was fascinating and reminiscent of being part of special effects make-up.  It was not particularly pleasant. I would learn to strongly dislike that mask before my treatment concluded.

The start of treatment was scheduled for Tuesday, March 21, 2017.  That was the day for first chemo treatment and first radiation treatment. The last preparatory activity was a full simulation of radiation treatment, just without actual radiation.  This would confirm that everything was set, especially the computer program that would control the trajectory and energy levels of the radiation.  This dress rehearsal would occur on Monday, March 20, 2017.

A week ahead of time, I made a plan for my personal preparations.  I would have a great workout on Tuesday.  On Wednesday, I would travel to and work with my client.  On Thursday, I would teach a class for a group of graduate students at the University of Pennsylvania (Private Sector Perspectives on Regulatory Risk).  After class, I would take Debra to a fine dinner at Butcher and Singer Steakhouse in Philadelphia.  (Deb loves a great steak!)  Then we would spend the evening at the Ritz Carlton.

It was a great week. But the thought of just hanging out on the weekend, and thinking about the upcoming treatment, was not endearing to me.  And so, the next day, I flew to Colorado for a few days of skiing with some good friends.  The trip had been planned for some time, but I wasn’t sure I would be able to go.  My friends were committed and I had not confirmed whether or not I would make it.  Debra and my doctors encouraged me to go, saying there was no physical reason for me not to ski. That was all I needed.  It was the best thing I could have done. The skiing, the beauty of the Rocky Mountains, and the company of good friends was a wonderful recipe for my final preparations.  In my Caring Bridge post on March 19, 2017, I wrote:

“The skiing has been great, though the air temperature soared to into the 60s!   We skied nearly 30,000 vertical feet before my legs told me they were done… We topped off an excellent day with dinner ay my favorite restaurant, Splendidos.  The Colorado lamb and a side of roasted Brussels sprouts met my ketogenic needs, as well as delighted my taste buds…

… I feel great. The only symptoms that remind me that something is amiss are fullness in my throat and the raspiness of my voice.  This Weekend in Beaver Creek is an important part of my mental, emotional and physical preparation for my treatment.”

I posted the above just 50 hours ahead of my first chemo treatment.  That evening I began a two-day fast.  The intent was to minimize nausea and other potential side effects, and also weaken the cancer cells so they would be more likely to succumb to the effects of both the chemo and radiation treatments.

I flew back to Philadelphia on Monday, March 20, and I took the local train directly to the Abramson Cancer Center at Penn Medicine.  I arrived in plenty of time for the last prerequisite to starting treatment: the simulation ahead of the actual radiation treatment. This would be my first experience with the mask that would be used to keep my head and neck firmly in place during treatment.  I came to appreciate that this dress rehearsal was as much for me as it was for the technicians.  The routine I learned during the simulation would be part of my life for five days a week for the next seven weeks.  The simulation was completed without any issues.  All systems were ready.  And I was ready too.

I think back on that week with very positive memories and with clear recognition that my choices helped me to be fully prepared for the start of treatment.  What did I do?  First, I continued with activities that were part of normal routine. I kept commitments that I had made earlier: physical exercise, working with my consulting client, teaching my class at Penn.  I continued life with a sense of normalcy, living in the present moment.  Then I did some special things, celebrating life and filling myself with positive energy.   A special dinner with Debra, a night at the Ritz Carlton, skiing in Beaver Creek and an uplifting time with good friends: these combined to increase my inner peace and my confidence that I was doing everything necessary to beat the cancer.

I believe my experience offers a valuable lesson for anyone going through similar medical challenges.  Do whatever it takes to create a positive sense of self and to remind yourself that you have much to be thankful for and, even more so, much to live for.  Do not allow the circumstances to paralyze you. Recognize and really believe that the cancer or other illness does not define you or who you are.  I’ll leave you here with some excerpts from my 5 Minute Journal on March 20, 2017:

“I am grateful for my sense of inner peace and my focus on fully recovering…

My PMA [positive medical attitude], support group and excellent medical team will get me through this.

I am strong and getting stronger

I see the time when this battle will be a past story which I draw upon to help myself and others”


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