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.