Katie & Briscoe

Katie & Briscoe

Monday, February 28, 2011

☢ Radiation Alert! ☢

I began my radiation therapy today. The first treatment was nothing special. It's very fast, taking no more than five minutes at the absolute most for the actual treatment. I spend more time getting ready for it. I have to change into a gown, then I get on the table. Which, by the way, is absurdly uncomfortable. The nurse laughingly told me the first time I got onto it that if I imagined very hard I could pretend that it was comfortable. Yeah, I have an active and well honed imagination, but even I can't drift that far away from reality.

I had my first experience with the table last week when I went in for my setup. For anyone who might one day have to go through with this, I'm going to lay it out step by step for you.

First off, I want to touch on something that caught me completely by surprise. I had all the typical things done along the way since my diagnosis. First came that day that the Dr. noticed the lump in my breast. Then came a breast ultrasound, followed by a mammogram, which in turn led to an in office needle biopsy. A few days later the official diagnosis came and that sent me on my way to the surgeon and the operating room to have the tumor removed. Then there were pet scans and cat scans and heart scans (called a resting MUGA). And I had another procedure under what they call twilight sedation where they inserted an intravenous port under my skin. Next came the chemo, all 8 of them. And Herceptin, a biological medical treatment came along with the last 4 chemos and will continue for a year.

Through every single step, I've been generally calm. I haven't felt scared or uneasy for the most part. No nerves to speak of. Mostly, I attribute this to my trust in God, and my knowledge that He is in complete control. I've had more than one person ask me if I was scared and the answer has always been no. But last week, for some reason, when I found myself standing there in that hospital gown as I waited for the nurse to tell me what to do next, I felt my stomach twist into a knot. My heart was pounding, and I felt just the slightest bit queasy.

She went over a short list of potential side effects, none of which I hadn't heard about before. The biggest one, she said, would be fatigue. She said those who have the radiation before the chemo usually don't start feeling it until about the third week. For those of us who have already had our chemo, the fatigue strikes sooner. She said I'll feel like I need a nap. I pretty much already feel like that all the time, so hopefully it won't get much worse. She also said that it would take approximately 2 months after I finish the radiation for me to start feeling more normal. I was hoping I could look forward to the fatigue being less of an issue since I was finished with the chemo, but it seems that I'll have to contend with it a while longer.

The second side effect I will have to watch for is a skin reaction. Mostly, this doesn't become a real issue until further into the treatment, but it can be anything from a mild redness similar to a sunburn to actual blisters. I'm sincerely hoping I won't have to deal with the worst case scenario.

So, after pointing out these two most common side effects, we went into the room and she adjusted a part of the bed that sits just below my rear to keep my hips in place. At the head of the table is a U shaped head rest and above that are 4 smaller rests to hold my arms. In all honesty, it isn't horrifically uncomfortable. I've lain on worse.

After getting situated on the table, the nurse folded back the gown to expose my right breast. Then she spent several minutes adjusting the position of the table. It moves pretty much in all directions, fast and slow, in tiny increments until they get it positioned precisely where they want it. There are targeting lasers that come out of the ceiling and wall which are used for positioning. After getting me in position, the nurse started drawing an assortment of things on my chest, from the center of my sternum, around the top and bottom of my breast, and off to the side as well. These marks were made with marker and consisted of lines, dots, and X's.

Following the marking, they applied two pieces of tape that had small pieces of metal in them so they could be seen on x-ray. They took an x-ray, then she came in and used a very thin wire that was laid across my breast to mark the outline. Then they took another x-ray. After all this, she came in and applied some tattoo ink to several of the marker dots. She used a small needle and pushed the ink into my skin, making several very small dots. Then, last of all she took a couple of photos of all the marks. And that was my setup for my radiation treatment.
 One of my tattoos. You can see how tiny they are by comparing them to the pores of my skin. I have six of them altogether. This is the only one that's visible while I'm dressed. It's above my sternum in the center of my chest. When I get my treatments they re-mark them with a marker to make them easier to see.

By the time I was finished with my setup, my nerves had mostly subsided. I don't really know why I felt uneasy at the start. I felt much less anxious today when I got my first actual dose of radiation.

Today I went in and after getting into my gown and getting positioned on the table and then getting the table in position, we took two x-rays. They will take x-rays once every week to make sure their targeting is still good. I will be getting treatments every day, Monday through Friday for a full month. During this time they will be targeting the whole breast. After this treatment is finished I will get a few "burst" treatments that will more precisely target the site where the tumor was located.

I was in the office for about 25 minutes today because they took the x-rays. Regular treatment days will probably take 15 minutes or less. I'll spend more time getting to and from the treatments than in the actual treatments. I keep telling myself that at least it's only for a month.

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