When did you shave your head?

On Tuesday I rode a train from Seattle to Tacoma, and rode another one back. I was counting bicycles on the train, for work.

I had some time to kill in Tacoma, so browsed through the always-seedy Freighthouse Square. I bought an unusual shirt in a used clothing store, and when I went up to the counter to pay, the cashier asked "When did you shave your head?"

That was a new one.

I told her I didn't, and that I had gone through chemo. She replied "Oh. I see quite a few women who shave their head because they like it."

I told her I would never choose to be bald.

She then asked "Is everything alright, then?"

Wow.

What if I had said "No"? I was tempted to say so, just to see what her reaction would be.

"No, I only have until 6 o'clock, and I want to die in this shirt."

*******

When I go in for radiation treatment each morning at 7:45, I am the first patient of the day. I go into a changing cubbyhole, get out of my shirt and bra, and put on a gown. I then put my clothes and satchel in a locker, lock it, and remove the key.

After treatment, I unlock the locker, remove my stuff, go into the cubbyhole, slather aloe gel on my left breast, chest, armpit and shoulder blade, put on my clothes and hightail it back to work.

The last week, when I've come out of treatment, there's been a man changing for his treatment. I have no idea what his ailment is, but it's clear he's suffering. He grunts with discomfort every time he moves. He struggles with the lockers. I've heard him swear in his frustration.

The little bit that I've observed him makes me consider that maybe I ought not to complain so much about my disease and treatment.

Halfway there..... Where?

If you'd like to start at the beginning of this blog, it's here.)

On Friday, I made the half-way mark in my radiation treatment. 

On Monday, the Radiation Techs took x-rays, to ensure the radiation was zapping me where it ought. They do this each Monday. The Radiation Oncologist examined the x-rays, and ordered more because he saw discrepancies. It took a long time to take the images and I was uncomfortable throughout it. When they were done, they continued their game of tic-tac-toe on my chest with a variety of colored pens. Because I was such a good girl, they also gave me a sticker to put over one of their markings. It's still there, securing this very, very important location.

After treatment I met with the Radiation Oncologist, who told me my skin looked good. It should. I've been slathering it frequently throughout the day with aloe vera gel, as directed by his Nurse Practitioner.

He asked about hot flashes, which have been driving me nuts. He recommended increasing some medication I'm on, to see if it alleviates this annoyance. 

My niece is taking "hot yoga" classes. I told her anywhere I take yoga classes, it's hot. No need to go to a special class.

*******

On Wednesday, I rode my bicycle home. I've done that a few times, now. I am dreadfully out of shape. Before getting home, I stopped up on Phinney Ridge for a torturous yoga/pilates class. I was sweating heavily by the time I got there (there are a few hills), and while changing in the bathroom, remembered that I am now mostly bald. I turned on the cold water in the tap and stuck my head under it. Doing this felt great. It was very nice, extremely handy and there was no fallout from having bad hair.

When I ride my bicycle into work now, it takes me very little time to take a shower, dress and get to my desk. When my hair is longer, I'll have to spend more time on it, prettying it. I'm conscious of the time-saving effects of having no hair:

• No hair? No hair products.
• No hair? No shaving armpits and legs.
• No hair? No plucking eyebrows.
• No hair? No hag hairs on my chinny-chin-chin.
• No hair? No need for mascara.
• No hair? No peri-menopausal moustachios.

Jeez, I look like my Papa.

My eyebrows look kind of cool right now. 

They're each the same length, and short, as if they'd been mowed. Plus, they're growing in all over the place. It's a thatch.

******

So, I'm halfway through radiation therapy. Toward the end of this treatment, I'll see both my Oncologist and my Naturopath. The Oncologist will begin prescribing the hormone therapy that is supposed to decrease the chances of the cancer returning. These hormones have a bevy of potential side effects, and the Naturopath and I will discuss what I can do to offset them. When she and I first talked about these meds, she admitted that if she were in my situation, she would be torn as to whether or not to take them, when weighing the possible side effects against the long-term benefits.

I acknowledge that I'll take these meds, and want to be prepared.

*******

I know I'm getting older. I'll be 52 in July. My hands, feet and knees ache. I don't know if this is because of the cancer treatment, or because of age. Frankly, I don't care. I've watched so many of my aging relatives go from limber to creaky that I know it's my fate, also. If the radiation therapy causes arteriosclerosis 20 years from now, so what? If the hormone therapy makes my bones brittle when I'm 80, so what? My fate is to live long and suffer.

*******

My great-nephew and I are both enjoying this socially-sanctioned time of being relatively hair-less.

That was weird...

I was heading into the treatment room for radiation. The tech was reminding me that they were going to do films today, as they do each Monday. As a result of being distracted by her conversation, I approached the treatment table from a different direction.

I couldn't figure out how to get on the table. I was backwards/turned around.

I had to go to the other side to get up on it.

My brain couldn't help me figure out how to do this simple different step.

*******

I asked the tech what people say when they describe their radiation therapy/side effect fatigue.

She said some people say it hits them suddenly, and others say it creeps up on them.

I think I might have had the sudden onset this weekend.

Pavlov's breast cancer patient

It is indeed becoming routine to get radiation therapy. When they tell me it's time, I enter this room, where multiple monitors have all kinds of data and information about me. I bark out my birth date, and they let me proceed into the radiation treatment room.

It's the end of the second week of six weeks of radiation. The last few days, when I'm laying down on the table, I close my eyes keep them closed until treatment's done. I've thoroughly explored the room with my eyes, there's no need for me to do that anymore. I am not interested. I just want this over.

*******

I will be done with radiation treatment about a month from now. I've decided to celebrate in two ways. First, many people at work have been a big help to me as I've gone through the whacky world of cancer treatment. I want to take a break from work and have lunch with them. I suspect that they also want to acknowledge my illness and the completion of treatment.

And I'm going to have an informal gathering at my house for friends and family. The challenge for me will be to not run the party, but to sit back and celebrate with those who care for me.

*****

After treatment on Fridays, I'm seen by the Nurse Practitioner. She looks at my breast and today she said she can see my skin changing. When I told her I didn't, she had me stand in front of the mirror. She pointed to where it's changing, and indeed I could see it. The area where I'm received radiation is becoming slightly discolored. 

She said that my nipple will become very tender.

Great.

*******

I was telling some coworkers this past week that I have no embarrassment about showing virtual strangers my breast. I've become accustomed to showing it whenever a medical professional asks if to see it.

I told them that I'm worried that some not-medical-professional will say the magic words one day and without thinking, I'll pull my shirt over/up/off. I'm like Pavlov's dog, showing my breast when the bell rings.

It's not unusual when treatment's done and I'm sitting up while they're retying my gown, for there to be someone standing there I've never seen before. One time it was a young man who was introduced to me as an intern. I wondered what he thought about seeing the odd-looking breast of a 51 year old woman who's bald and fidgety. 

chemotherapy: 1907, from Ger. Chemotherapie, coined by Ger. biochemist Paul Ehrlich (1854-1915)

 Eyebrows are coming in.

Eyelashes, too.

 It's strange, having stubby eyelashes.

The gray hair on the side of my head is growing quickly.

The dark hair on top of my head is not.

Radiation Therapy finally starts

If you'd like to start at the beginning of this blog, it's here.)

Today will mark one week of radiation therapy, and five more to go.

On Monday, I went in for what they call final treatment planning. 

To me, planning means you sit down with a bunch of people to come up with a game plan for moving forward. 

To them, planning means a jillion x-rays, playing tic-tac-toe on my chest with markers and tattoos, coming in and out of the room to shield themselves from what they're giving me, and ultimately reaching a point where they and the Radiation Oncologist are happy with my position and the machine's measurements.

Tic-Tac-Toe

I just do what I'm told.

I had to change into a gown, lay on a stainless steel "bed" that had a sheet on top of it for my added comfort, raise my left hand over my head and remain motionless (except for breathing) for almost an hour. It was hard to do. My arm both hurt and had its circulation cut off. Wisely, they had told me the one thing that made me not complain or move, "If you move, we have to start all over again."

They removed the gown from the left side of my chest to expose my breast. In order to take the numerous x-rays, they taped my right breast out of the x-ray field. It felt like a jog bra on one breast. More than one of the techs made marks on my chest with markers; various x's and o's. These temporarily complimented the three tiny purple permanent tattoos they'd given me.

The x-rays allow them to map exactly where the radiation should be pointed, and they use the x-rays in conjunction with the CT scan they took a few weeks ago.

This x-ray shows where the machine aims to zap any remaining cancer in the lymph nodes under my arm. I have to confess that my rib cage is much more pear-shaped that I like.

Below are the 3d images taken from CT scans, where the Radiation Oncologist has determined the radiation should be directed and to what degree.

The radiation therapy machine moved around the table I was laying on, and opposite it was an x-ray machine that moved at the opposite end of its arm.

This photo shows the radiation machine lurking over me. Under the table is the x-ray component, and they are always equidistant from each other as they rotate around my body blasting me with x-rays or radiation.

When they were all done with the final treatment planning, they gave me my first treatment. I couldn't feel anything. I did lay there and listen. The machine moved around me, stopping at specific locations and making a noise like a complaining baby Great Blue Heron being throttled.

I was told that the following day's treatment would start with a few x-rays to confirm the measurements they took the day before were accurate. Once that was done, the subsequent treatments would take very little time.

I arrived on Tuesday and asked the friendly reception staff if I could either change the radio station that's always playing in the reception area or turn the damned thing off. The music's annoying and not at all soothing. 

The unfriendly reception staff inserted herself into the conversation and said "No. We can't get any other channel and we're required to have it on." She annoyed me off so much with her aggressiveness that I'm going to plan a passive-aggressive response.

When prompted by the technicians, I started the routine that I assume I'll be able to do in my sleep by the time the six weeks is up.

• Go into changing room
• Take gown out from drawer
• Take shirt and bra off
• Put gown on, tied in back
• Drag satchel and clothes out to lobby
• Remove key from locker
• Open locker and put clothes in
• Lock locker
• Walk a few feet and wait in waiting room
• Text my husband or Facebook or niece or goddaughter
• Follow the tech toward the machine
• Give my birth date so we all know it's me
• Assume the position

They started taking the additional x-rays to compare measurements from the day before. After a few takes, one of the techs who was in the room with me was called back into the room full of monitors and computers and the other technicians. After a few minutes of nothing, another tech came out and said they needed to take some more x-rays because things weren't lining up. She asked if I could wait a bit while they "sneak in" two patients who were waiting, and then they'd be able to give me their full attention for as long as was needed.

Sure, sure. Whatever.

I went back to the waiting room and texted my husband. After a while, the Radiation Oncologist came in and talked to me about the delay, that today's x-rays didn't match those taken the day before, and how important it is to make sure everything's right.

Since I had him to myself, I asked him about a couple of things I'd been told and brooding on. During the first meeting with he and the Nurse Practitioner, I was told that there was no way that the radiation therapy could avoid hitting a small part of my heart and lungs. I wanted to know what this meant, and what the implications were.

He said that the heart itself is very resilient, and if there is an effect there, it will happen to arteries and will only manifest many years after treatment as arteriosclerosis, much the same as the effects of high cholesterol. The chances of this occurring are very slim.

Regarding the lungs, he said that we have more lungs than we need anyway, and that if lungs are affected (again slim chances) , it will manifest as something appearing to be pneumonia, though without the fever. It would be treated with anti-inflammatories.

After a while, I was called back in and they finished the x-rays, gave me my radiation, and sent me on my way.  Before I left, one of the techs reminded me to use the aloe vera multiple times a day, to avoid the inevitable sunburn effect that will manifest in a few weeks. He also confirmed I shouldn't use antiperspirants because the aluminum in them will cause my armpits to explode into sores.

For my third treatment on Wednesday, I arrived a little early. The mean receptionist said with no greeting "We're on hold with the machine back there. Have a seat." After two treatments, I was being "treated" like a nonentity. I'm not going to approach her again, given the chance.

I wandered over to the aquarium and watched this fish, who I could relate to. She'd found her piece of coral and wasn't going to come out unless she had to. The other fish were swimming crazily in circuitous routes within their constrained home, while she stayed safe and mostly hidden. Smart fish.

*******

After work on Wednesday, I rode my bike home for the first time since I started treatment in October of last year. I was nervous and asked my friend Jos to ride with me. She did. We braved all the construction on Dexter by riding on the sidewalk. I made it up both Dexter and Fremont, though in the lowest possible gear. I am horribly out of shape and weigh more than I ever have. But, I made it and look forward to next week's rides.

*******

My eyebrows are growing back. Note the three original remaining eyebrows acting as a placeholder.

Chemo's over, but the fun continues

(If you'd like to start at the beginning of this blog, it's here.)

On Tuesday, I saw my regular doctor. I wanted to talk with her about some post-chemo symptoms that I suspect are a result of the chemo:

• Dry and plugged up nose, and dry mouth.
• Fungal toenail thing, which wasn't complimenting the discolored and cracked appearance of my toenails.

• The surgery site from the removal of the chest port had a stitch working its way out, it looked infected, and had a big lump beneath it.
•  Worst of all, I'm starting to look like Patrick Stewart, with hair growing on the sides of my head and hardly any growing on top.

The few times I've seen my GP during treatment for cancer, it's been normalizing. She's not treating me for cancer. Seeing her reminds me that most of my life the medical treatment I receive will be for mundane things, like arthritis, skin tags, farting in public - all the physical joys that are interesting when middle age begins, and a pain in the ass when it becomes obvious they're not just visiting.

She told me that chemo dries out mucous membranes, thus my dry nose and mouth. She gave me stuff for that.

She confirmed I've managed to pick up a toenail fungus, and gave me stuff for that. 

She looked at the surgery site. I told her that I'd been able to pull part of a stitch out, and I had to trim it so it wasn't hanging outside the wound. It probably became infected then. She agreed the lump of scar tissue under my skin is large, and was going to ask the PA who took out the port about it.

And, she told me that if male pattern baldness runs in my family, I've probably inherited it and the hair on top of my head will grow slower than elsewhere.

Great.

I scared the heck out of myself this morning when I Googled "male pattern baldness" and "breast cancer" and "chemo".

The very white hair that first shot out on my head is being joined by darker hair that's a little shorter.

My eyebrows have continued to fall out, though there are signs they're starting to grow back in. There's some kind of activity going on under the skin where the eyebrows were; it looks dark like hairs are about to break through. I have exactly one original eyebrow remaining on the right and three on the left. And, my eyelashes are beginning to peek out into the world again.

My GP also talked about perfumes, and how they irritate sinuses that are already compromised. She said hand sanitizers are one of the worst offenders; they have to have lots of perfume added to not reek of rubbing alcohol.

*******

I am crocheting myself a new hat out of cotton embroidery thread. As the days warm and the hot flashes continue, I don't want to wear anything too insulating on my head when I'm out in public.

*******

On Monday, I go in to Radiation Oncology for my final treatment planning appointment. I'll be getting my third itty-bitty tattoo. If there's time at the end of the treatment planning, they'll give me my first radiation therapy jolt. And, we'll nail down the time each weekday that I'll be going there for the next six weeks.