Erasmus Medical Center

Erasmus Medical Center is hard to miss, since it’s a very tall building. Just look up – from anywhere in Rotterdam - for a big white tall building with Erasmus across the top. It’s about a 10-12 minute walk from Hotel Van Walsum. As you walk there you’ll note that there are actually several Erasmus sites, identified by their locations. Erasmus MC is Hoofdingang. You’ll know you’re there when you see a picture/painting of a woman covering the entire wall of the building next to the entrance.

To get to Erasmus from Hotel Van Walsum, you’ll exit the lobby and turn left onto Mathenesserlaan. Go straight through the intersection with Nieuwe Binnenweg and continue until your reach the intersection with Rochussenstraat. Cross the street and turn right. Walk until Gravendijkwal (not well marked, but a major intersection), and turn left. Walk straight and you’ll pass the building size picture of the woman and a whole lot of parked bicycles before coming to the entrance to Erasmus MC.

Treatment

Treatment is usually given on Thursdays, but the day before (Wed) you’ll go to the hospital at the time given to you in your confirmation letter, to the Nuclear Dept., where you’ll meet Dianna or another nurse.

To get there, go into the Erasmus entrance and walk straight back, turn left. You’ll pass a Starbucks on the left and go through some glass doors. Turn left and then to the right and you’ll see some small elevators (just for people) called personlifts. Go to the 2nd floor and turn left into the V dept. Walk back until you come to double doors ( push the button on the right wall) , and you’ll find yourself in the waiting room where Dianna will come out and call you. She’ll draw your blood, get your urine specimen, and take your weight and vitals. Dianna is fun and upbeat, and will put you at ease.  On your first treatment, you’ll next meet with one of the doctors to discuss the treatment, and ask any questions you have. After this, you’ll go downstairs to the Billing Dept. (next to the Starbucks) and ask for Gino. He’ll work with you to pay for your treatment. He’s really nice too. Plan on spending about a half day that first time at the hospital doing all this. There’s a cafeteria there, as well as the Starbucks, if you want to get something to eat or drink. This is also a good time to walk downstairs to the SV nuclear ward, which you’ll be reporting to the next morning for treatment.

On Thursday, you’ll arrive at the hospital at the time they’ve told you to, and go straight to the SV Nuclear ward, in the basement. Dianna or someone else will give you a tour and show you your room, where you can put your things away and get comfortable. You may have a single room, or you may share one with a roommate. There are usually 8 patients in the ward. If you have a companion with you they can stay there with you until the doctors begin to administer the Lutetium (sometime around noon). The treatment itself takes 4-5 hours, and is not painful, but you will need to keep your arm with the IV in it still to keep the infusion flowing. You can read or nap, or watch television, and the doctors and nurses will be in and out, tending to you. At this time you are officially radioactive, so they will be there for you, but no more than necessary.

On Friday morning you will go – in two different groups – to have a lutetium scan done. It takes about 20 minutes, and is painless. When you get back to your room that’s a good time to begin packing your things for your discharge. Your last activities there all happen pretty quickly, and it’s good to have your packing done. Late morning through lunchtime, you will have an interview with one of the doctors to review your blood tests, lutetium scan, and how you’re feeling. He’ll give you nausea meds if needed. After this, you’ll each have your radioactivity measured, and letters will be written for your transportation home. If you’re flying, know before this how many flights you’ll have, and how many hours each will be. This information will be calculated with your radioactivity in the letters they give you. After this, you’ll be allowed to leave the hospital. Remember you are radioactive, and do your best to maintain at least a meter’s distance from anyone under 60 yrs., and especially children under 10 and pregnant women, for the number of days they stipulate.

Recovery

Each patient’s response to the treatment, and their recovery is different, which is why the doctor asks you to stay in town over the weekend after your first treatment. In talking with other patients, and in my own experience, I learned that the two weeks afterward are when you are most likely to have some symptoms. I had great fatigue the first several days after each treatment, and then it would come and go. I recommend keeping your activities and plans light, and rest a lot. Many of the Dutch patients go back to work after the first few days, but I wouldn’t want to. I also had nausea each time, for 4-5 days afterwards, but most of my fellow patients didn’t. The medication the doctors gave me was very helpful.

Your appetite may be different for a while after treatment, and you’ll want to be gentle with yourself. Fresh fruit, and plain foods like unbuttered toast and oatmeal and tea worked well for me, and then I eased gradually back into my normal eating pattern.

Health Notes

Drink lots of water, beginning on your first day of travel. Take every drink they offer you on your flights. I found that my usual chronic diarrhea became constipation in Europe, although the doctors told me diarrhea is a more common reaction to the lutetium. Since you won’t know until you’re there, I recommend taking a stool softener with you (Senokot S is especially good), in case you need it. It’s also advisable to take pain meds with you, just in case you need them.

You’ll need to take your Octreotide subcutaneous shots with you on your trip, and I found it easiest to load the syringes from home, and take them in a hard case in my carry on (I used a hard eyeglass case). As soon as I checked into the hotel, I put them in the refrigerator, and stored my used needles in there as well until I could safely dispose of them.

Be sure you stop the octreotide subq shots 24 hours before your treatment at Erasmus begins.

You’ll resume your subcutaneous octreotide injections the evening of your discharge day, and the doctors will advise you to continue using them until a week after you get your Sandostatin LAR injection back home.

The doctors will want you to get your Sandostatin LAR injection as quickly after your treatment as possible, so as soon as the Erasmus doctors confirm each treatment, contact your oncologist and make arrangements to get the Sando upon your return.