Timing Is Everything

The Proton Therapy Institute treats about 100 people per day. The cyclotron produces a steady stream of protons that are divided sequentially among the three gantries. The Therapists in each gantry are positioning their patients while the beam is being sent to the other gantries. It all works like clockwork…except when it doesn’t. A patient may show up a little late, or it may take longer than expected to do the positioning, or a particular patient may require a longer or shorter treatment, or any one of many other problems could crop up. The therapists expect (on the average) a certain amount of unplanned delay, which they build into the projected appointment times that they assign to each patient on the previous day. Knowing that stuff happens, they keep track of the time lag or lead for each gantry. That info is shown in real time on a monitor in the waiting room, and posted on their web site. I routinely check my iPhone to see how my appointment time that day is affected. I’ve see gantries up to 30 minutes early or up to 45 minutes late. Typically, one gantry is 5 minutes early, one is 10 minutes late, and one is 15 minutes late.

Today my treatment appointment was for 11:00, but I saw on the web site while eating breakfast that all three gantries were an hour behind. An hour later, all were two hours behind. This was pushing my beam time into conflict with a 1:30 appointment to get my second (and last!) ADT injection. I managed to reschedule the injection to 9:30, and while nearby I dropped into the PTI building to do the daily blood draw for the research project. I still had plenty of time before the adjusted appointment time for my treatment, so I went back to Third and Main for lunch.

After the delay passed three hours, I got a call from one of the Therapists: Turns out the cyclotron techs were having trouble getting the proton beam right. Soon thereafter I got another call: things were straightened out, but the delay was so long they decided it was getting confusing…so they moved some appointments around, reset the gantry time adjustments to zero, and gave everyone new (and later) appointment times. My new beam time: 2:30. There still were some adjustments to the gantry schedule, both up and down, but I finally got into the treatment room, and got out again before 3:00.

As it was yesterday, the actual treatment was relatively fast and easy. Not quite as comfortable, as I was eager to get to the bathroom as soon as possible afterwards. I’m trying to fine-tune the timing for when I drink liquids in the hours before I empty my bladder and then drink the 4 cups of water--which has to be done 60 minutes before I expect the treatment to actually occur. Latest lesson: don’t have a big helping of watermelon for lunch less than two hours before downing the 4 cups.