Total body radiation

Total body radiation (also known as total body irradiation, or TBI) is sometimes given prior to bone marrow transplantation. There are numerous protocols, each with a different treatment schedule. Two examples are: 200 cGy given twice a day for three days, or 120 cGy given three times a day for four days. The treatments are usually five to six hours apart. Prior to treatment, the child will be measured by the radiation therapist using tape measures and calipers. The therapist will give the family a tour and will show the two cobalt machines on either side of the stretcher in the middle of the room.

On the first day of treatment, the child will be brought to the room (at some institutions, small children ride a tricycle or are pulled in a wagon) and may choose to watch TV or a movie, or listen to a tape or radio. He will lie on the stretcher between two cobalt machines, and the therapist will position him on his side or on his back. These positions will alternate each treatment, once on the back, then on the side. It doesn't matter which side, so if a child has a sore left side, he can always lie on his right. The child can move a bit to scratch his nose or cross his ankles, but he cannot get off the stretcher.

The therapist will remove all metal from the child or his clothing—watches, rings, zippers, clamps. Anything with tight elastic—diapers or tight socks—will be loosened or removed. Treatment time lasts from 18 to 35 minutes, depending on the size of the child.

Antinausea drugs are given to prevent vomiting, and these often make the child drowsy enough to doze through the treatment. Some small or extremely active children are sedated.

The radiation was easy. When I wasn't sleeping, I watched TV or listened to the radio. I threw up once, but they gave me Benadryl and I never was sick again from the radiation. The room was neat; it was painted lots of bright colors and had two big blue machines, one on each side of me.

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