Yesterday I completed my ninth "dive". The time spent getting ready for and in the chamber over those nine sessions has ranged from relatively light-hearted and positive to a potent reminder of the pain and/or serious medical conditions our diving community represents. But, to back up, I left off describing what a treatment session is like with the end of the "descent".
Once the required forty-five feet of pressure has been reached, it is time for the staff member in the chamber to put on the patients' transparent hoods and begin their 100% oxygen flow. That first day, when it was my turn, Matt shook out my hood from its collapsed storage state, placed it over my head, connected it to my collar, and turned a valve above to start my oxygen. I did not have to be told to breathe.
For the first minutes, I attended to how I was feeling. Was I light-headed? I thought perhaps, for a few seconds, but then no. Was I nauseous? Apparently not. I could see my hood move gently in and out as I inhaled and exhaled. Gradually I relaxed and looked around to assess what would be my home base for almost two hours a day, five days a week, for at least the next four weeks.
The mixed motifs of my surroundings were in some ways so absurd as to make me smile, as long as I separated what I saw from why I was there. Think hospital ward, cum deep sea submersible, occupied by beekeepers with transparent hoods wearing medical scrubs, and throw in two 5 X 7 inch DVD/TV screens held by magnets, one "fore" and one "aft" and you'll get a sense of the overall environment. Today the TVs are tuned to NBC, so the Today Show from Vancouver is on the screen. One can't hear very well encumbered by the hood, but I found that watching a clip of a skater twirling gracefully or a skier racing down a complicated track with incredible skill can be a pleasant distraction. For a while I alternated between closing my eyes and breathing comfortably and glancing up at the miniature athletes dazzling the world with their talent.
I had brought in a book from the waiting area, where reading material was available for all to borrow. I wasn't sure I'd be able to concentrate enough to read, but this seemed a "light" diversion, a mystery, so I gave it a try. I had to hold the book at just the right angle for the print to be well lit and for me to be looking through the central area of my hood, but it was definitely doable. Once again I found that switching back and forth between a distraction and relaxed breathing left me feeling like I was in a good space. Before I knew it, Matt was removing each of our hoods, for our required five minutes off of 100% oxygen after 30 minutes on. We would do two more thirty minute sessions before we were done. So far, so good.
Saturday, February 27, 2010
Sunday, February 21, 2010
Descent
For that first dive, Ryan, the staff "driver" who would stay outside the chamber and handle the compression and decompression, stood at the open hatch with his gloved hand extended to help us up the slightly inclined ramp and in through the opening about five feet in diameter. Inside, bench seating covered with white sheets lined either side of the submersible-like space, pillows and blankets spaced at regular intervals, and multiple metal pipes and control valves lined the sides of the "ceiling". I was directed to a spot on the right, not too far from the entryway. As I sat, I turned my head and was reassured to see the two small porthole-like windows at diagonal angles to me. I didn't think claustrophobia would be a problem.
My fellow divers took their seats, and then Ryan and Matt, maneuvering up and down the narrow center aisle, approached us one by one, stretched the lightweight rubber inside our plastic collars so that they would fit over our heads and gently slipped them on, leaving them resting on our shoulders, the rubber encircling our necks. They commented that mine was cut a little looser than they would have preferred, but they didn't think it would be problem, and I was happy to not feel constricted. Matt put on a headset that would allow him to communicate with Ryan outside and took a post standing close to me. Ryan closed the hatch, and the dive began.
The sound during the descent is hard to describe - perhaps a little like a wind tunnel without the wind; a gradual increase in decibels such that we had each been given a set of OSHA prescribed headphones, should we choose to wear them. But I wanted to focus on whether or not my ears were clearing, and thought the headphones might be a distraction, so I declined. Almost immediately I sensed the need to clear my ears - the same sensation one gets in an airplane - and I swallowed in the way that had been helpful in the air. It seemed to work and I was encouraged. But as the pressure increased, it was clear that I would have to keep responding. I added the technique Matt had suggested - take in some air, close your mouth, hold your nose, and blow. Undignified, but generally effective. Ryan stopped the dive for a minute about a third of the way "down" so that Matt could see if I was okay. So far so good.
Another patient asked for some water, which made me realize that all that swallowing was making my mouth dry. I spoke up too. From a plastic pitcher at the other end of the chamber Matt poured us each a Dixie-cup-full of water, and we continued. Pressure, swallow, blow, sip, swallow. The atmosphere in the chamber warmed significantly in response to the compression. This process continued for the approximately twelve minutes it takes to descend. Then the rushing sound ended. We had arrived and my ear drums were still intact.
My fellow divers took their seats, and then Ryan and Matt, maneuvering up and down the narrow center aisle, approached us one by one, stretched the lightweight rubber inside our plastic collars so that they would fit over our heads and gently slipped them on, leaving them resting on our shoulders, the rubber encircling our necks. They commented that mine was cut a little looser than they would have preferred, but they didn't think it would be problem, and I was happy to not feel constricted. Matt put on a headset that would allow him to communicate with Ryan outside and took a post standing close to me. Ryan closed the hatch, and the dive began.
The sound during the descent is hard to describe - perhaps a little like a wind tunnel without the wind; a gradual increase in decibels such that we had each been given a set of OSHA prescribed headphones, should we choose to wear them. But I wanted to focus on whether or not my ears were clearing, and thought the headphones might be a distraction, so I declined. Almost immediately I sensed the need to clear my ears - the same sensation one gets in an airplane - and I swallowed in the way that had been helpful in the air. It seemed to work and I was encouraged. But as the pressure increased, it was clear that I would have to keep responding. I added the technique Matt had suggested - take in some air, close your mouth, hold your nose, and blow. Undignified, but generally effective. Ryan stopped the dive for a minute about a third of the way "down" so that Matt could see if I was okay. So far so good.
Another patient asked for some water, which made me realize that all that swallowing was making my mouth dry. I spoke up too. From a plastic pitcher at the other end of the chamber Matt poured us each a Dixie-cup-full of water, and we continued. Pressure, swallow, blow, sip, swallow. The atmosphere in the chamber warmed significantly in response to the compression. This process continued for the approximately twelve minutes it takes to descend. Then the rushing sound ended. We had arrived and my ear drums were still intact.
Saturday, February 20, 2010
The Dive
I am now a veteran of four "dives" in UCSD Medical Center's hyperbaric oxygen chamber.
I approached my first day with a paradoxical combination of anxiety and determination to make it a positive experience. Arriving early, already dressed in the required cotton green scrubs, I took a seat in the waiting area with two other patients, similarly attired in our treatment uniform. A staff member, Matt, also in scrubs, sat down next to me to review the "dive" process and explain what I could expect. This was my introduction to the description of each treatment session as if it were, in fact, a dive in the ocean.
First we would "descend," as the ambient air pressure in our chamber was gradually increased. Since it would be my first time, we would descend more slowly than usual, with Matt by my side to watch and make sure I was able to clear my ears continually and showed no signs of distress. "You have to keep ahead of the descent," Matt said, so that pain-causing pressure doesn't build up." Since some people "just can't clear their ears," and the descent is noisy, I was shown the hand sign to communicate "stop," at which point the "driver" of the dive will terminate the descent until either the patient is finally able to equalize pressure in his or her ears, or, in some instances, until it is clear that the patient needs to be brought "back up." Some patients need to have ear tubes inserted, like those children with frequent ear infections receive, before they can "dive." I hoped I wouldn't be one of those.
Once we reached the desired "depth", I was told, each patient would be fitted with a transparent plastic hood, which attached to a collar we would have put over our heads before the dive started. One hose connected to the collar would provide the 100% oxygen we would breathe for three thirty-minute sessions, with five minutes in between, and the other would remove our breathing "exhaust". I was reminded that a staff member was always in the dive with us, and that person was responsible for attaching and disconnecting the hoods and controlling the rate of the oxygen flow. Sometimes patients become nauseous while receiving oxygen, Matt told me. I was shown the hand sign for "Come help me now!" and encouraged to respond early to signs of nauseousness, rather than risk throwing up in the hood. I assured him I would comply.
After I signed a form agreeing that I had been told all of the safety rules for a dive (no cell phones or any electronic devices, nothing remotely flammable, etc.), Matt took my blood pressure and temperature. I was pleasantly surprised to see that my blood pressure was very comfortably in the normal range. Perhaps focusing on breathing in hope was helping to calm my nerves.
It was time to enter the chamber.
I approached my first day with a paradoxical combination of anxiety and determination to make it a positive experience. Arriving early, already dressed in the required cotton green scrubs, I took a seat in the waiting area with two other patients, similarly attired in our treatment uniform. A staff member, Matt, also in scrubs, sat down next to me to review the "dive" process and explain what I could expect. This was my introduction to the description of each treatment session as if it were, in fact, a dive in the ocean.
First we would "descend," as the ambient air pressure in our chamber was gradually increased. Since it would be my first time, we would descend more slowly than usual, with Matt by my side to watch and make sure I was able to clear my ears continually and showed no signs of distress. "You have to keep ahead of the descent," Matt said, so that pain-causing pressure doesn't build up." Since some people "just can't clear their ears," and the descent is noisy, I was shown the hand sign to communicate "stop," at which point the "driver" of the dive will terminate the descent until either the patient is finally able to equalize pressure in his or her ears, or, in some instances, until it is clear that the patient needs to be brought "back up." Some patients need to have ear tubes inserted, like those children with frequent ear infections receive, before they can "dive." I hoped I wouldn't be one of those.
Once we reached the desired "depth", I was told, each patient would be fitted with a transparent plastic hood, which attached to a collar we would have put over our heads before the dive started. One hose connected to the collar would provide the 100% oxygen we would breathe for three thirty-minute sessions, with five minutes in between, and the other would remove our breathing "exhaust". I was reminded that a staff member was always in the dive with us, and that person was responsible for attaching and disconnecting the hoods and controlling the rate of the oxygen flow. Sometimes patients become nauseous while receiving oxygen, Matt told me. I was shown the hand sign for "Come help me now!" and encouraged to respond early to signs of nauseousness, rather than risk throwing up in the hood. I assured him I would comply.
After I signed a form agreeing that I had been told all of the safety rules for a dive (no cell phones or any electronic devices, nothing remotely flammable, etc.), Matt took my blood pressure and temperature. I was pleasantly surprised to see that my blood pressure was very comfortably in the normal range. Perhaps focusing on breathing in hope was helping to calm my nerves.
It was time to enter the chamber.
Monday, February 15, 2010
What does the future hold?
A hard question, that one, at any time. Harder for me now that I know I face a third round of dealing with cancer, made more complicated by post-radiation side effects. Tomorrow I begin a series of hyperbaric oxygen treatments at UCSD Medical Center. Dressed in cotton scrubs I will enter a chamber that resembles a small submersible, don a transparent bee-keeper-like hood through which I will breathe oxygen, and ponder the possibilities of healing.
The treatment is set to last at least four weeks, maybe six, which will provide me lots of time for reflection. At the risk of navel-gazing, this blog will prompt me to record the ups and downs of this time in my life. Whereas with my last two bouts with cancer I was focused on getting to the other side, I sense that this time round I may need to dig a little deeper to stay in a positive frame of mind and I'd like something good to come of that. Whether it may be of value to anyone else, I do not know, but I'd like to believe it might be.
Over the next weeks I will strive to write honestly about the gamut my emotions and experiences will surely run, but for now I will go to bed and visualize breathing in hope.
The treatment is set to last at least four weeks, maybe six, which will provide me lots of time for reflection. At the risk of navel-gazing, this blog will prompt me to record the ups and downs of this time in my life. Whereas with my last two bouts with cancer I was focused on getting to the other side, I sense that this time round I may need to dig a little deeper to stay in a positive frame of mind and I'd like something good to come of that. Whether it may be of value to anyone else, I do not know, but I'd like to believe it might be.
Over the next weeks I will strive to write honestly about the gamut my emotions and experiences will surely run, but for now I will go to bed and visualize breathing in hope.
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