Treatment Countdown: 10, 9, 8, 7, 6, 5, 4, 3…

3 fields of radiation…

So, I thought it would be fun to visit three sunny fields and snap a photo in each for this post. But frankly I’m too tired, so I’m just going to take a nap right here and let you imagine two other fields of your choice. 🙂

“She’s got three fields,” the lead technician says to the others each day as they are positioning me on the table. “Three fields” refers to the fact that I receive three different doses, 1.8 Gray each, at every treatment. Each is directed at a specific part of my anatomy and comes from a different angle as the arms of the machine rotate around my body, and they are delivered sequentially. The first dose comes in from above and to the right, the second from below and on the left, and the last from directly above, targeting a lymph node basin in the super-clavicle area.

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You can see how precise the boundaries of each field are by looking at how clearly defined my “exit dose” is, above, a result of the super-clavicle radiation passing through and out my back.

Three fields, but only two more treatments. Hooray!

And now I am really am gonna go take that nap…

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Treatment Countdown: 10, 9, 8, 7, 6, 5, 4…

4 oils and lotions…

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One of the biggest issues with receiving radiation treatments, especially on sensitive areas like the chest and neck, is radiation dermatitis. To that end, it’s really important to take care of your skin as best you can through the process, and apply oils, creams, or lotions that soothe the skin and ease the burn.

I have what is perhaps a complicated routine. Based in large part on advice offered on MarnieClark.com, as well as some additional research I conducted, I start with a layer of calendula oil (from the marigold plant), followed by aloe vera, then apply organic hemp oil with a few drops of lavender essentail oil mixed in, and end with cortisone cream. I also have some lotion called Radiaguard, made especially for radiation patients, that contains lidocaine for when I get really uncomfortable.

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I’ve been lucky not to need too much lidocaine, but just yesterday I hit a point where the red areas on my skin had become so defined that you can tell exactly where the radiation is being administered. Since I’m getting one dose in the super-clavicle area, I also have an “exit dose” going out my back, so there’s a well-defined red square there I have to treat, too.

Four oils and lotions, sometimes five, every day, three times a day. I could have used something like Aquaphor, but even my non-radiated skin doesn’t respond well to petroleum-based products. At my appointment last week my doc said my skin looked better than a lot of women’s did at that point, so I think natural oils and cortisone were a good choice for me.

I did have to buy a couple cheap underlayers to absorb excess oil and keep it off my clothes, but if I can avoid any serious blistering and keep my skin in shape for the next steps of reconstructive surgery, those couple of throw-away t-shirts will be worth it.

Down to three, and counting…!

Treatment Countdown 10, 9, 8, 7, 6, 5…

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Okay, so I look a little tipsy and my tag is sticking up (I told you they made us wear the capes backwards). Maybe I’m just drunk with happiness to be drawing ever closer to the end of this process.

That’s my spine on the screen there. In addition to my radiation treatments, I also have what’s called “on board imaging” each day, The technicians take two x-rays to be sure my body is precisely positioned to receive those 6 million photons in exactly the right place. Once a week they take an additional set of x-rays as another check. I wasn’t kidding either when I said I feel like I ought to be glowing by now.

The whole process is incredibly high-tech. There are physicists on staff who use preliminary CAT scans to “map” each patient’s dose at the beginning. The delivery is controlled in part by my breathing—I have to watch a screen inside the treatment room and breathe in until I hit a defined target area; only then is the radiation is delivered.

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The five screens above are located outside the actual treatment room, and they are used by the technicians to administer my treatments remotely and monitor the machine and me during the process. The first time I saw the bank of them I was reminded of the control room of a spaceship in a sci-fi flick—until I noticed my name at the top of every monitor. It’s not how I would have preferred to make my screen debut.

Done with #5, and only four left to go!

 

 

Treatment Countdown 10, 9, 8, 7, 6…

6 Million Photons…

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According to my radiation oncologist, my radiation dose consists of 6 million photons.

I think this is a daily dose (as opposed to an overall total), and in fact, since I receive treatments from three angles, I may be receiving 3 x 6 million photons each day.

Guess clarifying that’ll be one more of those one-last-questions I’ll need to ask at my final consult with him. 🙂

Danger, High Radiation: I just might be glowing in anticipation of my treatments nearing an end.

And, yes, those ARE little lightning bolts all over my shirt.

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Just five more: Beam on!

 

Treatment Countdown: 10, 9, 8, 7…

7 More Vogue Poses

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No, I don’t receive my radiation treatments standing out under a tree (how much more pleasant a prospect…), or while listening to pop music from 1990.

I do, however, assume this position for treatment each weekday: arms stretched above my head, the left cocked at a lower, tighter angle due to ongoing mobility issues, my head lifted and turned to the right both to watch the breathing monitor that governs my dosages and to expose the lymph node basin just above my clavicle, all the better to zap it.

Standing up in the position, as I am here, I look like I’m vogue-ing, a la Madonna.

Lying on the table beneath the machine, I feel more like I’m a TV crime show victim awaiting a chalk outline.

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It can feel a little grim there on the table, centered in the red line cross-hairs of the laser positioning beams, listening to the whines and whirs of my radiation being delivered.

“Strike a pose!” Now just six more to go.

Treatment Countdown: 10, 9, …

9 gowns awaiting…

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So here’s what’s kind of funny about these gowns: in the closet where I have to fetch one each day, they are labeled “capes.” Does that make all us irradiated folk each some kind of superhero?

Even if they do make us wear them backwards?

Considering the fact that more than one superhero has gotten their powers in weird laboratory snafus that involve things like (accidental) radiation, well…

I’m gonna put on this cape and fly right on outta here!

10 Treatments and Counting…

Things have been a little crazy lately, between daily radiation, a brief work trip, and a non-blog writing project with a fast-approaching deadline. I am glad to report that, including today, I am down to my last 10 radiation treatments! Inspired by a friend’s comment on Facebook, I thought I’d do something a little different this week, and post a pic each day to mark the countdown. Though I will still have quite a ways to go with reconstruction and full recovery, concluding radiation feels like a significant milestone, as it marks the close of my cancer treatment. After so many months, that feels pretty major.

I’ll soon be back to regular posts (I have a backlog of stories to share, including a more in-depth reflection on radiation, and more books and hats. Always more hats.)

But for now: the countdown is on!

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10 Treatments and Counting!

 

Heartfelt Wishes

Happy Valentine’s Day…

to my husband, who has risen above and beyond again and again;

to my parents, who’ve made multiple visits from Georgia to offer their love and encouragement;

to my sister-in-law and fellow survivor Lisa, who came from Nevada to support me before and after surgery;

to my brother Todd, who shaved his head and told me about Essiac tea, and offered to visit;

to my nephew Ethan, who shaved his head and donated his hair to Locks of Love;

to my stepsons Dusty, who had special pillows made for post-surgery comfort, and Tucker, who has made me laugh (and groan) with many puns;

to all the doctors, surgeons, nurses, and technicians who’ve been tasked with my care and cared for me so well (and answered, answered, answered my endless questions);

to Shannon and everyone who fed us though the Meal Train during chemo;

to Brandy, for the pixie cut to soften the blow of losing my hair;

to my Girls, for shaving my head, for taking me wig-shopping, for taking me to the movies–for always being there, in so many ways;

to my dear ones near and far who sent cards and chocolates and flowers and books and bath salts and bears and so many generous gifts I can’t begin to name them all;

to the friends who “Sandee-sat” when I felt too icky to move, and to those who got me out of the house when I really needed to;

to Sarah, for gentle, restorative yoga and poetry that saw me through some tough days;

to Rita, Mindy, and Pat, whose healing touch has healed me at various points along this path;

to fellow survivor M., whose kind messages and advice have been a bedrock of hope;

to all my many cheerleaders who sent encouraging words via text and Facebook and Messenger;

to all the readers of my blog, who liked and commented and cheered me on;

to the folks who ordered “Be The Tea” shirts for a good cause;

to the Writing Center tutors, for their kind and caring notes (and Jenny, for making it all happen while I’m away);

to my colleagues at RC, for helping me take the time to heal;

to the good people at First Presbyterian, the church of my childhood, who have offered up many prayers;

to all the ladies in my support group, especially our Fearless Leader Catherine;

to Sandra, Mike, and Jolina, for making my pre-surgery photo-shoot beautiful;

to the gentlemen valets who’ve always parked my car with a smile at Blue Ridge Cancer Care;

to the TSA agent at the Atlanta airport who said, “This will not be the end of you, you know that, right?”

and to all those courageous souls who advocate for human and civil rights for all people, including the right to decent health care, because without it, I might not be writing this note–

You are all my Valentines.

With thanks and love, wishing you a beautiful day.

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Past Perfect: The Grammar of Healing

My husband is the math mind in the family; I’m the English nerd. But lately I’ve found myself thinking less about settings and symbolism, and more about symmetry and statistics.

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Mirror, Mirror…

Many years ago, I did an experiment where I held a small mirror up to the center of my face while looking in a second larger mirror, so I could see how I’d appear if my face were perfectly symmetrical. All of us are at least a little asymmetrical, so the trick quickly reveals the differences, large or small, in the two sides of one’s face: the right eye has a little more tilt than the left, maybe, or one cheek is a bit fuller than its counterpart. The altered reflection, for me, almost felt like looking at different person, perhaps a sibling of myself.

notetnc2The process of bilateral breast reconstruction has a tendency to highlight other asymmetries. The first thing my reconstructive surgeon said to me when he looked at my pre-surgery chest was that my left rib cage sat a little more forward, was a tiny bit more prominent, than my right. I’d never noticed this particular (minor) anomaly, but it’s apparently just as common for there to be asymmetry in the rib cage as in the face. The difference in my bone structure became most noticeable immediately after surgery and during my early tissue expander fills; for a while the right expander lagged behind the left, making me look lopsided. I also discovered I have a pocket of fat on my right upper back, unmatched on the left, which appeared only when I didn’t have breasts to pull the skin forward and keep it flattened out.

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Even Olympic athletes’ bodies vary dramatically. (Photo by Schatz and Ornstein)

Studies indicate we equate higher levels of symmetry with perception of beauty, so it’s only too easy to worry over our various anatomical irregularities. But there’s so much about our bodies that’s out of our control: the set of our features; our bone structure; height; the size and shape of breasts, booty, genitals, hands and feet. We can exercise and lift weights to affect our body composition—but the ability to bulk up muscle mass, and the places our fat cells are predisposed to distribute themselves? That’s pre-determined. Significant elements of our health are hardwired too: some suffer multiple allergies from birth, for example, while others are born with immune systems seemingly hewn from impenetrable stone.

Bodies are glitchy and unpredictable in surprising ways, for better and for worse. The fact my body grew a malignant mass is somewhat mysterious: I am, as best we can tell, the first person in my blood family on either side to develop cancer of any kind. My body’s responsiveness to treatment is, to my mind, equally mysterious, and awe-inspiring: I learned this week that only 20 to 30 percent of triple negative breast cancer patients have, as I did, a “complete pathologic response” to chemotherapy. I was thrilled when we got the pathology report stating they’d found no evidence of remaining cancer during surgery, but the news felt weirdly abstracted. Learning the actual statistical probability of achieving that response was sobering. It made me realize just how incredibly fortunate I am. Having a complete response lessens the chance of recurrence dramatically, dropping it from 35+ percent down to 5 percent. As my oncologist said, it’s cancer, so there are no guarantees. But short of never having developed it in the first place, the odds for long-term survival are the best they can be.

davinciI’ve often felt lucky to be in the body I am. Aside from some cranky tonsils, a couple bouts of pneumonia, and one broken bone, I’ve been hale and hearty most of my forty-seven years, and I’ve managed to stay active and maintain a healthy, if not altogether svelte, weight into my middle age without Herculean effort. Excepting the sixth grade, when my legs had a sudden growth spurt separate from the rest of my body that briefly turned me into a sort of hybrid stork-human, my parts are mostly proportional, and my face, while perhaps not symmetrical enough for Hollywood’s standards, is reasonably attractive.

I did nothing (unless you count that bane of puberty, wearing braces) to “earn” any of these features of anatomy. They just are, like my cancer, like my cancer’s responsiveness to treatment. Why did my body grow malignant cells in the first place? I don’t know. Why were those cells especially sensitive to death-by-chemotherapy? I don’t know the answer to that either. I do know I’m extremely lucky and profoundly grateful to be in the relatively small percentage of survivors who have that experience.

survivorship4I’m just vain enough to feel relieved that the obvious asymmetries that appeared in my chest and back are slowly evening out as reconstruction progresses. But I’m far more reassured by a different realization. As I walked into the dining room Tuesday night, preparing to sit down to dinner with my hubby, it suddenly occurred to me: I no longer have cancer. Granted, my treatment isn’t quite done–follow-up radiation is the standard-of-care for triple negative diagnoses, even with a complete response to chemo, and reconstruction will take a while longer. But the chemotherapy worked; the surgery confirmed it. No more need I say, I have cancer.  Now I can say, I had cancer.

My inner English nerd reappeared, rejoicing: the simple past tense has never sounded so beautiful.