Day 353 - Goodbye 2012!

I have never been so glad to kiss a year goodbye. This year has been one of those that I wish to forget. For the most part it was decent... especially the back half, but the first six months sucked a$$.

But before I drop kick it into the past, I want to thank everyone who has been following this blog. Without your support, I don't think I would have made it. Yes, I would have made it to 2013, but not in great spirits that I am in now. Love to my family and friends. There are a few of you... and you know who you are... that without your constant prayers and just kind words of encouragement have lifted my spirits immensely.

I am happy to be alive.

2013 goals - new boobs and maintenance visits to the doctor.

Can't wait for it to start... only 7 hours 45 minutes... and I'll be ringing it in by sleeping. Yes, got to go to work at 4a.

PS Did I mention that I am now potty training Elaina???

Day 333 - So brave

There's really nothing going on in my world. This Thursday I have my two month follow up with Dr. Chui, my oncologist. Still plugging and chugging away. I can't believe that it's been nearly a year since the diagnosis. It's gone by so fast.

On a different note... I learned that Vern's brother's wife has cancer (learned of this last month). However, I found out today what the course of treatment will be. She is choosing to be brave and strong. She has decided to forgo chemo treatments. She has cancer in both her liver and pancreas. Please pray for her and her family - to give them all courage and strength. Love to you guys!

Day 324 - Happy Birthday!

Wowsers, it's been a long, long time since my last post.

Today is my birthday and I am happy that I am celebrating my birthday still alive, healthy and cancer free. I plan to spend a lot more birthdays this way.

Other than that, not much new is happening. I am still taking tamoxifen. I haven't gotten any adverse side effects. I sometimes get hot flashes, but I don't know if that's because of me running around the house, standing too close to the oven or drinking hot beverages. I seem to notice I get them when I am doing one of those activities. So go figure. My next doctor appointment is December 13. That's with Dr. Chui.

I am still doing my arm stretches. My left arm continues to tighten - rather my pectoral muscle. So I am stretching that religiously. I can move my arm straight up and to the side and up, but when it comes to stretching it behind me, that is where I find the most resistence. But am told that if I keep at it like it will get better.

Until next time...

Day 301 - I understand

Sorry for my last post. I was a bit upset and irritated at my situation for the first time since I learned of my diagnosis. I really wanted to get my whole ordeal over and done with this year. First for the sake of chalking off 2012 and starting 2013 fresh and new and second so I don't have to go through a new deductible and out of pocket max for insurance. So when I learned that it wouldn't be until March of 2013, I was a bit pissed. I had high hopes for this year.

So it looks like I will be getting my reconstruction surgery in March or April. I was also upset because my cruise is in March and I was hoping it would all be done and over by then. So now I am wondering if it would be good to get my surgery sometime in February or just wait until I get back. Either way, I'm getting boobs! LOL.

I was also a little irritated because the medical assistant also works with me at Xerox. She doesn't like me... and we had a little kerfluffel. In any case, she said that she won't say anything about my appointment outside of the office. I said "okay". Well, no, she can't say anything. That would be SOO WRONG. In any case, I was ticked that she felt that she had to say something like that. Whatever. I'm over it. And I saw her today. In fact she was sitting right behind me.

On Wednesday I had my follow up with Dr. Marquez, my radiation oncologist. She is the one who shed light on why they are waiting for the next surgery. First off, they want my skin to be normal color. Right now it looks like I have a tan. Next they want to make sure that the elasticity of my skin remains good. They want pliable skin. I understand now. Dr. Marquez said I wouldn't be ready until next year. And since I know what they're looking for, I am okay with it. Really I am. It just took me a night to stew over it. She also suggested that I do the oophorectomy at the same time. I agree.

Dr. Thakar, the plastic surgeon, gave me a prescription for some lotion to rub on my boob and under arm. I took it to the pharmacy. My insurance didn't cover it... $93. I said, no thanks. They finally got it to $30. I said I'll try it for $30. It's 5.4 ounces... and get this... it's a skin bleacher. Ha. I wonder if Michael Jackson used it all over his body.

On an unrelated note... it's open enrollment at work. In order to get a discount for my medical benefits (up to $600/year), I have to have bloodwork done. So yesterday I went in to Quest Diagnostics to get my blood drawn. After three pokes they said that they were unable to get my blood. I told them that I had small veins, pointed to a few places they could poke me... but they never listened. Irritating. So then I called my doctor's office and got an appointment with my physician for today. I went in... and it took two pokes and two different people to get my blood. They told me that instead of using the vacuum syringe thing, it's better for me to just use a regular syringe to extract the blood. The vacuum has such a strong suction that it blows out the vein. Aha! So they got my blood they needed, I got my flu shot and got to see my doctor. It's the first time that I have seen him since January. I've seen his wife more than him. So we chatted a bit. He said that he wished he knew me better because I told him that this year has gone by soo incredibly fast. He said that's good because it's all dependent on attitude. I also got my flu shot! Yay!

Oh yes, and how could I fail to forget... I got to see Dan on Wednesday. He gave me a great big hug and asked how I was doing. He said that we need to go out and have drinks. I told him I want a ride in his boat. He said no problem. In any case... he had to run and work on a patient, so I didn't get too much time to chat with him. He did say he'd be upset if I didn't stop and say hi. :)

Day 297 - 6 month wait

Went to the reconstruction surgeon today. I have to wait until March at the earliest to get my tissue expanders replaced with the real implants. Needless to say I am extremely bummed.

Day 294 - One Year Ago

It's interesting how life throws you a curve ball. Tomorrow will mark one year since I first went into the doctor's office with my suspected lump in my breast. I made the appointment most likely today and had the doctor look at me the very next day. It puts a lump in my throat. To think that I had cancer one year ago and didn't know it. I went in and the doctor thought that it was a clogged milk duct... mastitis. However, deep within me I knew it wasn't. A clogged milk duct would hurt like the dickens. I was also still breast feeding Elaina one year ago. Crazy. One year ago tomorrow, the doctor would have said try the old wives remedy by sticking cabbage leaves on your breast, then call me in a week if the lump doesn't go away. I must admit, I didn't run out and buy cabbage, so by the time I did, another week had elapsed. I also didn't want to go to work smelling like cabbage, so I would put it on my breast when I got home from work. Needless to say, the cabbage didn't work and then I just got busy with the holidays.... and we all know what happened at the beginning of 2012.

But I am a survivor. I survived my initial breast cancer diagnosis. I am cancer free and all my doctors are going to do whatever they can to keep me cancer free. And yes, I am calling myself a survivor. I had meant to post earlier... but after talking with one of my friends from grammar school - who had ovarian cancer in her teens - I switched my thinking. I realized that I was talking about my cancer in the past tense. I had cancer. I had surgery. I had radiation. Thank you, Andi!

Then in the past week, someone told me they were just recently diagnosed with breast cancer. I told her that I was a survivor. It was the first time that I had actually spoke the words "I'm a survivor." It felt weird. Really weird. But it felt good. In my head I knew I was a survivor... but to hear them spill out of my mouth felt surreal... kind of like the first time you hold your baby. I felt almost guilty to say that I am a survivor - almost. Here's another woman who is just starting her battle, and I am relishing in the fact that I am done (for the most part).

My mom made the most beautiful bracelet for me. It's a glass bead bracelet. On the white beads there are pink ribbons. At the clasp, there's an angel and a metal ribbon. It's wonderful and I love wearing it. I wear it with pride.

While I haven't made it to the one year mark of learning of my diagnosis, I don't think I could have made it this far without the loving support of my family and friends. Thank you.

Day 286 - A quick visit

Just hopping on to let you know that I went in for my check up with Dr. Naik. She said everything is looking good and that she'll see me in 6 months. And so begins my bi-annual check ups! Fun times.

I am taking the tamoxifen. Today marks the fifth whole day, but my 6th pill will be taken tonight. So far, I am not seeing any horrible side effects. In fact, none at all. But I may be singing a different tune in another few weeks or so.

I have started working out more. I am working out on my Wii Fit. Feels good to be exercising on a regular basis again. I've been slacking... and I shouldn't be. Anywho, I was told by Dr. Chui that side effects are lessened if I work out. So I am taking his advice.

Day 282 - Phase 4 Hormone Therapy: Tamoxifen

It's been awhile since I last posted. And that I feel is a real good thing. There wasn't anything really to post. So let me catch up.

Following my last radiation treatment, it took about a week and a half for my skin to feel better. My skin was really red and mad. It wasn't so much the skin on the breast itself, but what really hurt was where the blister had formed and then peeled. I was putting silvadene and aquafor on the blister. I was also putting it under my breast as well because that was the next area that hurt. After the first week and a half, things calmed down. My skin started to crisp up and then peel. I was peeling like a snake molting. Some of the uncomfortableness was because the skin was drying up and when I went to stretch, the skin would crack. Think of chapped lips. My skin cracked the most right under the breast. The skin on the breast itself was fine. It just peeled like having a sunburn. The skin under my arm cracked like the skin under the breast. I had a two week check up on Oct. 2 with Dr. Marquez and she said I was looking good. I now have a final check up on my skin on November 7. My skin is feeling good. It no longer feels like paper. It actually feels like healthy skin. I have been spreading Eucerin Intense Dry skin lotion on it. It absorbs really quickly and also has an exfoliant in it. It works really well.

I've been stretching my arm out every day. I was told by my physical therapist that I want to continue to do my stretches every day for a year after my radiation. I can understand why. With my skin being less elastic, it helps to stretch. Plus the radiation also damages the muscle. So my body is repairing everything. But I have great range... I didn't lose any of it.

Work continues to go smoothly. I got the shift I wanted 4a-12.30p Monday through Friday. However, since the shift bid, we have been required to work a mandatory 45 hours a week. I don't think I've ever worked just 40 hours, but to make it mandatory really sucks. Plus you have to do it when they schedule it for you. But hey, at least I have a job. And last month my team did really well, so I will get a really nice bonus. Hooray. Just in time for Christmas and the cruise. Remember, if anyone wants to go on the cruise with us, I'd love it. :)

On Friday, I met with Dr. Steven Chui. He's my new oncologist. He's nice. I like him, but he's no Dr. Luoh. I really miss him. Our appointment was at 2.30p, but we didn't get into the office until 3.40. He apparently had an emergency procedure and that's why he was running late. Oh well, it happens. I did end up getting a little nap in while waiting.

So he was very pleasant. He knows his stuff. He didn't want to insult my intelligence and said so from the beginning because he (apparently) knew that I knew my stuff. He started off talking about studies of tamoxifen. He said that five years is good, but what he's found is that having younger women on tamoxifen may fair better in the long run. He said that hormone positive cancers have a recurrence of coming back later rather than sooner. So for me, he said that studies show that the cancer would come back ten years or more. He cited an example that a woman had breast cancer and 31 years later she has a brain tumor that is estrogen positive and has the same exact characteristics as her original breast cancer. Whoa! And I just want to let you know that I am paraphrasing all the stuff he talked about because he talked A LOT. So he didn't want me to be opposed to being on tamoxifen for more than five years. We also talked about getting the ovaries taken out because I am BRCA positive. He said that while I am eager to get things taken care of... I may want to wait on that because it puts me on instant menopause. In addition, I could get adverse effects of menopause. He suggested that I wait and then he give me a shot to suppress estrogen in my body and see how I do. But then he also flipped the coin and said that since I am BRCA+ it's a little different. To me, I know that I am going to get my ovaries taken out. Whether I do it now or later, the effects are going to be the same. With the shot to suppress estrogen, that's more for the women who can elect to have it taken out.... ones who aren't genetically disposed. In any case, it's something I'll have to discuss more. We also talked about if I do get my ovaries taken out, Dr. Luoh had said that he would put me on a different drug. The drug is for post menopausal women. Dr. Chui said that that drug is far superior [then tamoxifen], but it does cause bone loss. He said that with my age and my race, I am at a higher risk of osteoperosis. Tamoxifen actually helps with bone density. However, I could go on tamoxifen and switch it out with this other drug for a series of years - back and forth. Then I could get benefits of both drugs. All I said was "sign me up." I knew the risks and the benefits. I will trust my doctor because I know that they keep up with the latest and greatest information. I knew I'd have to go on tamoxifen for a couple of years so let's start now! In another few years I can ask about new drugs or switching to another. And Dr. Chui said that they have now started a new study - 31,000 people - to see if the effects of staying on tamoxifen for more than 5 years works. The initial study, which started in the 70s was a double blind study: tamoxifen vs. placebo. That was a year long study. They found that women who took the drug fared better, so they asked them to continue on for another year and another year and so on and so forth. That's how researchers came to the conclusion that 5 years of tamoxifen was good. But as the study went longer, the base size of participants shrunk. So that's why the study isn't very conclusive after the five years. But we shall see in five years. By then there may be a totally new drug out there. Or researchers will have discovered how to repair the DNA fix. Five years is an eternity.

So, yesterday I picked up my tamoxifen prescription and I took it last night before I went to bed. Some side effects: hot flashes, tiredness (goes away), flare reaction, mood changes, nausea, vomiting, blood clots, endometrial cancer, vaginal dryness... the list goes on. Now we wait and see.

Tomorrow I have a follow up appointment with Dr. Naik. See how my boobies are healing. November 5 I have an appointment with Dr. Thakar to see if I can get the tissue expanders out and the implants in. November 7 I have my follow up with Dr. Marquez for post radiation. Then... it's wait and see.

Day 270

Really boring here...
Nothing to report. My skin is almost done peeling. It's looking more and more normal. It still itches. But it's all good! Enjoying life again with very few doctors appointments.

Day 263 - Radiation Check

Wow... today was a busy day. Started off with going to work at 4a. Halfway through my shift, I developed a nasty headache. Who knows why. In any case, I took some ibuprofen and that helped just a little. When I got home at 1240, I knocked down another one. I grabbed Emmy and was off in the car again.

I just made it to my appointment at OHSU radiation. Today was my two week check up. I got there and got all checked in. I didn't even sit down to wait before I heard Dan in the hallway. He saw me and came over to give me a big hug. :) I like Dan. He's great. Then I went and saw Rebecca, Andrea and Linea... who was at lunch. Rebecca is finally without her boot. Yay! Dan was going to take me to see Linea, but then Nicole grabbed me to do my weight and blood pressure. She was accusing Dan of stealing her patient! Love it. Once I was in a room, I waited for about a half hour for Dr. Marquez's new resident to appear (the new three month rotation occured on Oct. 1, and Dr. Siddiqui is now on elective rotation). Dr. I-forget-his-name, but his first name is Joe came in and talked to me and then went to get Dr. Marquez. She finally came in... but I could hear her down the hall. I heard her ask where my room was because she knew that I would be fast. She came in and asked how I was doing. I said I was doing great and my skin was healing really well. I lifted up my shirt and showed her how great it was. Right now my skin is just doing the normal peeling process. I told her that I am slathering Eucerin lotion on me. She said that's great. She looked under my arm where the blisters were. She said that was looking good and then wanted to see me in 4 weeks instead of 6. When that happens she'll release me. So I guess she's happy with the progress and that I am right on schedule. And that means that I'll most likely be able to get my final reconstructive surgery before the year is out! Wahoo! Following the quick check up, I went to say hi/bye to Linea. I gave her a hug. I wanted to schedule my follow up appointment, but Dr. Marquez is all booked up, so I have to call her Beaverton office. After that... I ran back to Linac 1 and said bye to Dan. He said that he'd walk me out, and then he gave me another hug and told me to see him again. Yup. I'll definitely stop by. :) Those guys/gals were great.

So then after my doctor appointment, I ran with Emmy for her doctor appointment. I took her to the vet to get her rabies vaccination. She's 16 pounds and Dr. Berger says she's doing great. Then it was time to fly to pick up the girls. And now I'm home. Yay!

As you can see... it was a full day. My next appointment is with Dr. Chui on Oct. 19. I have a follow up appointment with Dr. Naik on Oct. 22 and then we'll see when I'll get an appointment with Dr. Marquez since she's all booked until Nov. 27. Her scheduler is emailing her to see if she can double book me. Hopefully in early November... er, next month (I like the way that sounds) I'll be able to schedule an appointment with Dr. Thacker for the tissue expander exchange.

Oh, and I got another radiation fact. Fact #29: Radiation boost... that is an extra dose of radiation. It's more for women who get a lumpectomy. What they do is target the area just where the lump was moved... so it's more specific and concentrated. Interesting.

Day 258 - Peel & Heal

Sorry that I haven't posted in awhile. Following my last post, I got busy with trying to get ready for a long weekend trip. Yay!

Last weekend the family went to Nevada for my Dad's wedding. We left for Reno on Thursday... so all the days leading up to it I was busy packing and doing last minute stuff. Then we were gone Thursday, Friday, Saturday (wedding day!), Sunday and then back Monday. Then it was just trying to get back into the swing of things.

So here's what's happened in the last 10 days. First off, my skin is starting to peel and heal from radiation. The part where the blister was under my arm is now nice and pink... like a good healthy pink. Before it was awful pink - like hot pink. Now it's a nice healthy light pink. Each day my crispy skin is peeling. The bits and pieces of skin look like Thanksgiving Day turkey skin - tan and crispy. I'm not too sure about taste, though. Not going there. In addition to the peeling under my arm, the skin right under my boob is also peeling in big crispy chunks. The rest of the breast is doing good. It's turning tan and then peeling like a normal sunburn would. There's no discomfort anymore. I was putting silvadene under my arm last week. But now I am putting lotion all over to keep it moist and not dry. I do believe the worst is over.

Next week (Tuesday) I have my two week check up with Dr. Marquez. I am certainly impressed with the way things are healing and I have a feeling that I will be able to get my tissue expander exchange surgery done this year. I want it all on one deductible. Anywho, I'll let you know how that appointment goes. My arm did get a little stiff because of the peeling under my arm. But I am back to stretching it every day. Doing my finger crawls along the wall and such. I am just happy that I am able to sleep on my left side again.

I finally got an appointment with my replacement oncologist, Dr. Chui. My appointment is October 19. So that will be good. I really want to start Phase 4 of my treatment.

As for work... it's been crazy busy. We just went through shift bids again. I got my same shift. So I work 4a-1230p Monday through Friday. I don't like waking up that early, but hey, it's a weekday shift.

Other than that... not much else to update you all on.

Just Congratulations Dad and Karen. We enjoyed the three hour cruise! Can't wait to cruise again next year!

Day 248 - Radiation #28: Last one!

PHASE 3: COMPLETE!

Hooray, I am happy to report that I just finished my radiation treatment. Today was the final day and I am over the moon happy that I don't have to go in.

So... I now know what it feels like to be the Thanksgiving Day turkey. I feel cooked and ready to be served. My skin is turning a nice toasty tan/brown and feels so crispy. Ha! The thermometer has popped.

Yes, treatment is finally over for phase 3. This phase was pretty easy compared to Phase 1. Nevertheless, I am just happy it's over and this is all behind me. I went in this afternoon bearing goodies for my favs! I printed out the radiation treatment blog entries and my freshly baked cookies for Dan and Linea. I'm so glad that they were both there for my last treatment. They both came in to get me this afternoon and asked if I was ready for my last treatment. I said heck ya. I also told them that I came bearing gifts. They know I don't bake... and I made it a point to say I only bake for people that I like. I really do like them and I will miss them terribly. They made my treatments so bearable... and when I say them, I mean Andrea, Beth and all the other radiation therapists who I came in contact with. They were all so nice, accommodating and fun to be around. They are the type of people that I wouldn't mind hanging around with outside of OHSU. Dan... I'm taking you up on your offer to go out on your boat next year! :)

So Dan noticed that I am taking more time getting my shirt off. I have been wearing two shirts. One shirt is a little more snug fitting and is very soft. Then I put a normal shirt over that. He looked at my side and said that it's looking a lot better than it was last week. It does look better, but the skin feels so chapped and feels like it's going to crackle at any moment. But now that I am done with treatment, I don't really care because I know the my skin isn't going to get the brunt of radiation anymore. So then I got on the table... they shifted me and then Dan applied my aquafor. Before he touched me I said "Ouch!" I love doing that. It's fun to play around with Dan because he's such a good sport. Then it was time to get zapped. Five - zap. Dan came in twice to fix my wedge. Four - zap. Dan and Linea came in to put my bolus on with the tape. Three - zap. The machine moves around to get my tangent field. Two - zap. I hear the MLCs moving. One - zap (5 seconds). I hear the door open and I am done! You read that D.O.N.E.! I bet you can't tell that I am excited!?

I hopped off the machine. I asked Dan what he does with the bolus when a patient is done with it. He said throws it away. (Actually I asked while I was on the machine.) I asked if I could have a piece. He said sure... I could have the whole thing. I told him I just wanted a little piece of it. Then somehow it got to be (I think it was Linea) that he takes the bolus home and hangs it on the wall. How creepy would that be??? I was laughing so hard... and it's hard not to laugh and not keep your body still (reminder, I was still on the table in between zaps). I told him I could sign mine if he wanted. Anywho... back to after the last zap... he came out with scissors and cut me a piece. It feels rubbery and reminds me of balistic gel.

Before I left, I got to see my radiation fields. Pretty cool. I saw how the x-rays are matched up with my plan to make sure they are getting the right areas. It was so cool... and this has been such a learning experience for me. They do say that OHSU is a teaching hospital. And teach it did. Dan, Linea, Dean, Beth, Rebecca, Andrea, Andrea... you were all great teachers and I am so glad that I could be your pupil. I'll be ready to take my boards next year! :) And yes, you do get CE credits from me.

I also got to see Beth before I left for the day. She gave me a big hug... cause I told her it was my last day. Dan and Linea gave me a hug and told me to stop by when I come in for my two week check up.  I told them I would come and see them... most definitely. They thanked me for the treats... sugar cookies (I took into account that chocolate gives Dan headaches) and Dan said he was going to read the blog stuff that I printed out. I told him it wasn't the whole thing... just my time spent in radiation. I'll more than likely print this last entry out for them and give it to them when I see them again.

Then I was gone.... texting my support group... letting them know that I was done with Phase 3. I love all of you for being great cheerleaders and my never ending support group.

And of course... I leave you now with Fact #28: Bolus. I asked Dan if I could take some bolus home. I wanted to know if it was okay because the early founders of x-rays and radiation had complications later in life. They took home radium and other radioactive materials in their pockets or they studied close to the sources. For instance, Marie Curie's papers are contained in a lead box because they are radioactive. I didn't know if taking my bolus I would inadvertently be taking home a radioactive substance. Dan said no. So here I am with my bolus.


My bolus. It's about 1/4" thick and allows the radiation to
be more at the surface. The radiation was getting my skin
rather than penetrating deeper into my body, thus hitting
organs it shouldn't be zapping.

Day 245 - Radiation #27 (one more!)

Today was a good, fast day. It started off with work. If you haven't heard by now, Apple has announced that it will sell the iPhone 5. Honestly, I don't know what all the fuss is about. Apple is making big bucks - funneling jobs out of the U.S. It costs $8 for Apple to assemble the phone. Meanwhile the company sells them for $500-900 a pop. Yea. So today was a busy day because today was the first day for pre-orders. All those people who are trying to keep up with the Joneses. Makes me laugh.

Anyway, so it was back to back calls today. But it was a good day. I was running a contest trying to raise one of my stats. It worked. I saw lots of people vying for the prize... a candy bar. Hey... whatever works, right?

After work, I high tailed it to radiation for my second to last treatment. Nice! I was in and out. Didn't see Dan, but got to work with Andrea and Rebecca. I even saw Linea. I haven't seen her in FOREVER. Whenever I get my treatment, she's been at lunch. My blisters are getting better. Where I ripped off the skin, the new stuff is growing back. One side effect of radiation is the red skin. It's very red - like a bad sunburn red. And now it's getting itchy. Besides being itchy, the skin is getting tighter. So I am stretching my arm a lot. I'm stretching to keep the skin on my chest loose. That's the only thing that's preventing me from having full mobility now. The skin is just so "dry" and tight. The other arm is good.

Following radiation, I picked up Amelia and took her to the doctor. I needed to get her shots that I put off at her four year check up. The doctor didn't feel comfortable giving her the vaccination since I was just coming off of chemo. Amelia got two... DTaP and chicken pox. In another three months we will go back and she will get her MMRV and be all caugh up. They didn't have the MMRV shot. I wanted to spare her of more needles. She did awesome, too! Hardly a tear shed, however she did scream out "ouch ouch ouch!" We got a milkshake afterwards.

That's about it.

Fact #27: To become a radiation therapist, it requires courses in medical terminology, anatomy and physiology (think Gray's Anatomy, not the tv show), physics-radiation physics, patient care, treatment planning and radiation oncology (studying all radiation treatments that go with cancer patients). Rebecca said that when she went through school she had to create a treatment plan for a "patient" from start to finish. I also found out how the radiation oncologist prepares treatment. In my case, Dr. Marquez talks to a dosimetrist and tells them exactly what she wants. The dosimetrist then calculates the best plan for radiation... figuring out the angles and how to get the best results with the least amount of radiation to the other body parts. Once a plan is figured out, Dr. Marquez will look at the plan and either say yay or nay. That plan is then moved over to the radiation therapists who then enter it into the computer and, the rest as you say, is history. A dosimetrist is responsible for the radiation dose distribution and dose calculations.

Only ONE more treatment left!!

Day 244 - Radiation #26: Breast Cancer Treatment

Not much to report today. Only that I have two more treatments. Oh yes, don't mind my ticker to the right. It's off by three days.

So what's your view... I was looking online at my insurance claims. Apparently OHSU billed my insurance for treatment the day that the LINAC machine was down and I didn't have treatment. Think I should say anything to anyone... or just let it ride? Let OHSU suck Cigna for its money? Thoughts? Heh heh heh...

Today's fact is interesting. Rebecca told me that her mother had breast cancer back in 1995. She had a lumpectomy, chemo and radiation. Fact #26: Radiation treatments have not changed in the past 17 years. She said that her mom had radiation on the tangents, which is what I am having. (I am also having supraclavicular radiation, which wasn't part of her treatment.) Our treatment does not differ to much. Interesting. There has not been any significant findings in radiation treatment.

Here are a few pictures of my "twins." I know that you all are probably wondering how big they have gotten. Enjoy! It was taken before radiation.

Day 243 - Radiation #25 (3 more left): Radiation Therapists

The story of my life right now... but not for much longer!

Not much to report today. Regular treatment. Only three more left! The blisters are healing. They aren't as puffy or rather containing much liquid. So it's a definite improvement. The skin that tore off is healing nicely. It's not as pink and is starting to match the color of my non-radiated skin. Even Dan said that it was looking better... as well as Andrea. She put the aquafor on my skin again today. And she remembered to take the bolus off first, before the tape.

I did ask Andrea and Rebecca about what Dr. Siddiqui had said yesterday about the bolus. If the bolus was taken off, the radiation would penetrate deeper into my body, as mentioned in post Day 207. But if they took it off, the dosing would be different. They sometime take it off if the skin gets really bad. I said it's not bad and I don't want to change anything.

Fact #25: How do you become a radiation therapist? Years ago you had to be an x-ray tech or a nurse first. Then you had to go through a certification. Andrea said that she was an x-ray technician and then went through a one year program. After that she had to take a board test and then was certified. Now, it's a four year degree. Rebecca has two bachelors degrees. The first one is for public health and the second one is for radiation. It's a two year specialized program and concludes with your board test. So to be a radiation therapist it is a little harder... and more expensive. Andrea said when she did it, there was no tuition. All they needed to pay was for books and supplies. The very next year the program required students to pay. When Rebecca went through the program, she had to pay about $22k. When she asked new students just graduating, they told her it was about $40k. Holy heavens! There aren't many radiation therapist programs on the west coast. There's one at Bellevue Community College in Washington and then one at OHSU. I'll have to ask what the curriculum is like...

Day 242 - Radiation #24: Madame Curie

Another day, another radiation treatment. Today's treatment consisted of a zap or five and a meet and greet with the doctor. Dan brought me back to the treatment room and asked how my blisters were. I said they were the same as before. He took a look at it and said, "Yep." Then Andrea put the aquafor on my blisters and it was time to go. Five zaps later it was time to take the bolus off. I asked Andrea to take the bolus off before the tape. She obliged and my side didn't hurt.

Then it was off to see the doctor. Nicole came and got me. She asked me how things were. I told her the same as yesterday and that I liked the non-gel pads better. She thought I might like that. So she told me that she would get me more of those pads and then two more of my fashionable netting tube tops! I told Nicole that I am starting to get itchy, but it's under control. She asked if I was in pain from the blisters. I am not.

Next Dr. Faisil Siddiqui came in (Dr. Marquez's resident). We chatted a little bit and he looked at my blister. He said that it was looking pretty good. He thought that some of the blisters were scars, but those were blisters that my body re-absorbed the liquid. We talked about how I am going treat the blisters... with the aquafor. He asked if I knew what the bolus was for. I said yes. Then Dr. S said something that struck me odd. He told me that the bolus gets the radiation more concentrated at the skin/surface and that if we need to change treatment, we can remove the bolus. Hmmm... nah. I am fine with my treatment the way it is. If it helps lessen the change of recurrence, then continue with what we've got going. I only have four more treatments. I think I'll manage. Dr. S said that he thinks my skin will hold up. I hope so. Then we talked about kids. He actually has three... a daughter who's 12 and two boys 9 and 3. I like him. He's cool. I told him that I need to get a picture with him. He said okay, then asked if it was for the blog. I said, "yep." Then he laughed and said, "No." I told him regardless I still wanted a picture of him. He will when I go back for my check up...

Which brings me to post radiation! My last treatment is scheduled for next Monday. I usually Dr. Marquez on Tuesdays. So he told me that what I need to do is schedule a post-radiation check up in two weeks so they can check my skin. So it looks like I'll be seeing Dr. Marquez the first week of October. They want to make sure my skin is healing. Dr. S said that I will continue to see side effects of the radiation treatment for at least a week after the last one. Not a problem. Following the two week treatment, I'll have another one at 6 weeks. Wow! I can't believe it!

Before I could leave, Dr. S said that he had to get an attending physician to see me for a moment. Dr. S is a resident (it's a 4 year program) and he needs to be signed off. So then he left and came back several minutes later with Dr. Holland. He was a hoot. He asked if he could see my blisters. Joking, I told him no. He thought I was serious. I was not and was laughing as well as Dr. S. He said it's looking good. Dr. Holland asked what I was doing for my skin. I told him it's aquafor, calendula and then lotion. He said that there's a thing called silvadene. I said, I am quite familiar with it. Then I said that when I am done with treatment I'll schmeer it on. I told him that I will play the bagel and the silvadene will be my cream cheese! It's the same consistency. Dr. Holland laughed. And that was it. (Dr. Marquez was away speaking someplace fabulous)

Radiation Therapists: Beth and Rebecca (the historian)

Fact #24: Maria Curie... ever heard of her? They made a movie about her life. Anywho, she was a Nobel Prize winner for Physics in 1903 (along with her husband, Pierre Curie and Henri Becquerel). In 1898, she discovered two elements polonium and radium them. Madame Curie named polonium after her native country, Poland. She also received a Nobel Prize in Chemistry in 1911. Curie died in 1934 aplastic anemia associated with the radioactive materials she handled in her lifetime. Another thing I learned... her papers are kept in a lead case because they are so highly radioactive. If anyone wants to read them, then they need to wear protective clothing.

Me and Radiation Therapist, Linea

The Door of Doom & MLCs

Just popping on quickly to show you the "Door of Doom." See how thick it is? No radiation will pass through!

See how thick the door is? Yikes!

And here's a picture of the Multileaf collimators. This was taken when LINAC 1 was down.

The MLCs make the shape of my radiation field.
They often move during my "zap."

Day 241 - Radiation #23: An escape plan

Today was a good day. I felt like a lot was accomplished. I went in to see the doctor today before treatment. I didn't get to see Dr. Marquez. Instead I saw the nurse, Nicole. We went into one of the changing rooms and I showed her my blister and where the skin was stripped off. She said... oooh. I said that I wanted to continue with treatment since we are so close to being done. She understood. I asked if there was something we could put over the area, like gauze. I said it's not the treatment that I am worried about. I am worried that when the bolus comes off, then it's going to rip off the skin on the blister. She went and talked with one of the radiation therapists. Andrea suggested we try using aquafor hoping that will lubricate the area enough that the bolus wouldn't stick. I asked about using the silvadene. She said I don't have to use it. It contains silver in it which you can't have during treatment. In addition, they would have to take it off for treatment. Nicole said that normally Dr. Marquez treats a patient and when they are done, she says use the silvadene. I'm cool with that. She told me that I should use the aquafor in its place. We will watch for any infection. I have to make sure it's only oozing clear liquid and doesn't smell. She said that the clear liquid is fine. We talked about putting something over the blister so my arm doesn't rub against it or my shirt. So now I have this netting that I am using as a tube top. It's working great. If you've had a baby, think of the wonderful "post-partum panties" they give you. It's glorified cotton netting with elastic in it. Nevertheless, I can put a bandage type pad over the area and have it stay in place without using tape. I also have these gel packs I can use as well. So far, so good. Oh yes, the silvadene... some of it falls off, some of it sticks around and some of it is absorbed - just in case you want to know.

Then I had my radiation treatment. I told Dan it was all his fault. He looked at it and said "uh huh." He went and got me some aquafor and I got to apply it with four people watching me. It was quite comical because it's so dim in the room. I had Dan, Andrea, Linea and Trang (I think that was his name... having a chemo moment) watching me. Finally Dan grabbed a flashlight and shined it on my armpit. Then it was lay down and put my arms up. It took a little longer today because they had to reset the MLCs. It was funny because Trang told me what they were... I said, "yes, I know." He had forgotten that I am learning all about radiation. They all joke that by the time I am done, I will be able to take the boards. Ha! I had the first two zaps and then came the bolus. I told Dan to be gentle. He said he's not ever... I wanted to say something else, but I bit my tongue... since I was in such a compromising position. My next three zaps were uneventful. Next came the touchy part - removal of the bolus. Dan started to remove the medical tape he puts on the bolus (straps me to the table and tapes the bolus down around my breast). Things were going well... but then he got to the part that's near my underarm. I told him to take the bolus off and then remove the tape. It works better for me. When he's pulling off the tape on the bolus, he's pulling at my skin, too. But when he removes it first, it works better. So he pulled off the bolus and the aquafor worked. It didn't stick to my skin as much and didn't pull.

So now I am wearing my little tube top and spreading aquafor under my arm.

Here's my fact... Fact #23: Emergency! I asked today what they do if there's an emergency and there's no power. There's a big two foot thick door that separates me from the outside world. If something were to happen, the rad therapist can shut off the machine from the control area. I can shut it off by a button on the wall. I asked what would happen if there's no electricity. How do I get out of the room. Dan reassured me that I would not be stuck in there and there's a hand crank for the door. Phew. I like the escape plan. Crisis diverted.

Day 240 - Silvadene

So it's day 2 of blisters. The blister has not popped, however, last night when I was taking off the dressing on my blister, the tape took off my skin. It's left brand new pink skin open to the air and it's at risk for infection. So last night I called the on-call radiation oncologist again and asked her what to do. The area was seeping some clear liquid and I didn't know what to do. She called in a prescription for silvadene. It's a cream containing silver sulfadiazine. It's used for burn patients. It contains bacteria fighting stuff in it so the risk for infection is lower. So I am applying that to my skin once a day. A word to those going through this... DON'T USE TAPE on your radiated skin. It may take your skin with you! Tomorrow I have to go in and meet with Dr. Marquez. She told me not to use the stuff tomorrow because if I do, and they give me the thumbs up to go ahead with treatment, I won't be able to get it. Maybe they will say it's okay to continue and then the radiation therapists can just put some gauze over the affected area when they put the bolus over me.

So for the rest of today, I am walking around with my left hand on my hip so the creme doesn't come off of the "wound." Brad asked if I was walking the fashion runway. Ha! Far from it. If the blister pops, there's risk of infection and that can get into the blood and cause sepsis. That's what my mother in law has. I don't want to be in the hospital.

Day 239 - Radiation Blisters

Fun times continue... this morning I woke up to blisters. Yes, blisters have formed under my arm in the axilla area. They have not opend, but they are there. So I called the on-call radiation oncologist this morning. I explained the situation. She told me to continue with putting calendula on the blister and aquafor lotion. I asked if I should put gauze on it because the blister is where my arm brushes across the side of my body. She said that would be good... reduce friction. She told me to call if the blisters open. I said I would because I don't want them to get infected. Looks like I will be meeting with Dr. Marquez on Monday. We will see if we need to rest from radiation for a few days to let the blisters heal or to move the radiation treatment so it's not getting that area. Sigh. When things were going so well... this bites.

Day 238 - Radiation #22: Mammosite

TGIF! Here I am sitting outside on the deck in the 90 degree weather watching my kids play in the pool. Today is supposedly the final day of nice summer weather... well, the last 90 degree day we will have of 2012. That's okay with me, because I am eager to get on with 2013 as I am sure many of you are in favor of.

Elaina (front) and Amelia (back) playing in the pool.

Me! Look at the blue sky behind me!

Today was a quick, fast, painless day of radiation. I ran into the other lady I talked to about a week ago. She was just finishing up her treatment for the day. We said hello. She only has 8 treatments left. I told her I have 6 after today (SIX! WOW!). I told her that I have decided to go with Dr. Chui for my next part of cancer treatment. She said that is a good choice and she really likes him. Good. I have confidence now. Well more confidence in picking a doctor to replace Dr. Luoh. Nothing much to report.

Fact #22: (courtesy of Andrea, the fill in from the other machine) There is another form of radiation treatment. It's called Mammosite. It's an internal form of radiation. It's a 5 day, high density form of treatment. There's a catheder that's placed inside the breast. There's a balloon at the end of it and it's expanded. There's a thin tube to where from which the radiation is emitted. The device is then hooked up (external) to the radiation source. From doing just a little bit of research, I think it's more for women who have a lumpectomy.

Day 237 - Radiation #21: Rubber Gloves

Nothing really to report here. Just the same run of the mill radiation treatment. Today the machines were all up and working well. Today they took films of me to make sure they were radiating the right areas. Other than that... boring!

Fact #21: I learned the history of rubber gloves (thanks Rebecca). We can say "thank you" to William Halsted. Thanks to him, he made the wearing of rubber gloves a staple in the medical field. He was the founder of the gloves when his nurse developed a rash after washing with mercuic chloride in the 1890s. He asked Goodyear Rubber company to make thin rubber gloves to protect her hands. The thought of germ control wasn't the goal, but it was found that wearing the gloves did prevent the spread of disease and infection. Dr. Halsted was methodical about sterilizing his medical equipment and later developed surgical hats and gowns. Halsted developed several new types of operations, including the radical mastectomy for breast cancer. He also became addicted to cocaine, but kicked the habit and became a founding professor at John Hopkins Hospital. Also of note, the nurse, Caroline Hampton, became his wife.

Day 236 - Radiation #20: The price of shoes

Today it was a good radiation day. I say that because LINAC 1 was having issues again. I got to OHSU and checked in. Dan was out in the waiting area talking with another person when I got there. I wanted to check out the magazines, as the magazines in the interior/dressing room waiting area were growing stale. Dan came and got me and he told me his machine was down again and the technicians were working on it. So he asked if I wanted to get some lunch. I said sure and he went to his little office area to get a gift card to get lunch in the OHSU cafeteria. While I was there waiting for him, Dorothy was there (the chair of the Radiation Therapists) and said hello to me again. We chatted for moment. I asked what was wrong with the machine again. The MLCs were acting up again. I told Dan that I didn't do it this time! Well, I ended up getting my treatment today. It wasn't acting up that bad, so I got to go through rad. Awesome. While I was waiting for them to get the machine back up, I think I heard the RTs talking about me to Dorothy. I think she was saying I was a good sport and that I roll with the punches. If you guys were talking about me, then I want to say... what can you do? Things happen. It's gonna get done... just not right this second. Enjoy the moment! :)

So I got my radiation and there were no pretty pictures to be had (no x-rays today). I told him that he could skip it today because I thought Dan would be pushing his luck with the machine. Following my session, I went back to wait for Nicole, the nurse. I didn't have to wait long. She just got back from vacation and she said that she opened up her email to see a flood of emails regarding all the machines going down last week. I laughed. She took my vitals and we went to the exam room. We talked about how I was feeling (no fatigue), if I was working (no time off except to come to appointments) and if my skin was hurting. I said that yes, it does in one certain area. That is the area where the tissue expanders end and there's just skin going from the expander to the chest wall. It's near my drain scars. She asked to look at it. She said that I was red and then looked under my boob. She said it's reddest there. I said, "Oh really? I didn't notice." I thought the worst place was under my arm. Apparently it is not. So she told me that I can start putting lotion - Eucerin Aquafor - there before I go to bed. Okay. Will do. When she got done with that, Dr. Marquez came into the room. She wasn't even paged. She was early and there was no waiting for her! Sweet night! She saw my skin and agreed with Nicole. She asked how many treatments I have left... EIGHT! Dr. M said my skin is looking great and I will have no problems. I said that there's a patch of skin that's turning tan! My skin will turn tan after the radiation. Anyway, I asked if many patients get redder. She said that normally by this stage a majority of her patients are a lot redder than I am. Awesome. That's good news. I also asked about seeing a new oncologist. I wanted to ask her opinion of who she thinks will be best for me. Dr. M said you are so easy going that I don't have a personality issue (compliment). She said that I could go with either Dr. Lopez-Chavez or Dr. Chiu. Dr. Chiu specializes in breast cancer. So I think that's who I will go with for the next stage of treatment. Oh gee, I guess there's 5 stages of treatment, not four.

After radiation, I decided to go up to the Breast Center and see if Brooke was there. I love her to death. We just chatted. She said that I look great. We talked about treatment, shared pictures of the girls, talked about Race for the Cure and just nonsense stuff. It was nice. Then I went home. Other than that, nothing really new. I am tired right now from the day. But I always get tired from the day around now. I'll get my second wind momentarily!

So here's Fact #20: History time (courtesy of Rebecca)! Back in the 1920s and all the way up to the 1970s, shoe salesperson would measure patrons feet by using an x-ray fluoroscope. The customer would place their foot in a box. The salesperson would then look inside the box down at the x-ray view of the foot and the shoe. There would be another viewing port so the parent could see the kid wiggle their toes and see the outline of the shoes. In 1949, it was found the device could cause harm and they were phased out in the U.S. They remained in use in the U.K. until the 70s. OMG! Wow... according to wikipedia, the fluoroscope was a gimmick used to sell shoes with "better fit" during the Depression.

Shoe Fluoroscope on display at the National Museum of Health and Medicine, manufactured by Adrian Shoe Fitter, Inc. circa 1938, that was used in a Washington, DC, shoe store.

Day 235 - Radiation #19: kV vs mV

Hello again! Hope you had a good three day weekend. My skin enjoyed three days of rest! Hahaha! Not much new here. Went to session #19 of radiation. I was in and out. I only have 9 more treatments. Wahooo!

Fact #19: The radiation machine, I have told you, has an x-ray machine attached to it. Normally when I get my x-rays, they take the pictures in megavolts(the same strength as I get for treatment). The x-rays are perfect for what the radiation therapists need. However, there's another x-ray machine built into it... and it takes pictures in kilovolts (kV). So what's the difference? The clarity of the images. The x-rays taken in kV are better quality. The ions are better absorbed in the bone. That's why it's better. So if you break your arm, your x-rays will be in kV rather than mV.

Day 231 - Radiation #18 Redux: ion chamber

My poor friends on the 4th floor of Kohler Pavillion. They can't seem to catch a break this week.

I arrived at "4th floor, radiation oncology" this afternoon. After checking in, I found that LINAC 2 went down this morning twice! Hence, my radiation therapists can't seem to catch a break this week. However, my machine was up and running again. I didn't spend too much time there because I had things to do... more on that later. But it was an uneventful radiation treatment. All I know is that I don't have to go back in until Tuesday!! And my make up session is Monday, Sept. 17 at 2.30p.

Fact #18b: I know what happened to the LINAC machine yesterday. Turns out the first issue was something about the keys. That was an easy fix. But right after that, the ionization chamber went kaput and that's a much bigger deal. The chamber calibrates the dosage of radiation. Good thing it malfunctioned. I wouldn't want to get a higher dosage than necessary.

On to what I eluded to above. My mother in law is in the hospital. She had a blister on her foot that got infected and turns out she has septicemia. It's an infection in the blood. In addition, the infection is so bad it has gone right down to the bone. So the doctor is going to do surgery on it to see if he can get all the infection out. If he doesn't, then she may have to lose her foot. In the meantime, she's on antibiotics. Please pray that amputation isn't needed. So after radiation, I was at a different hospital visiting with her.

Day 230 - Radiation #18... not so much

Today was radiation #18. However, when I got there, the machine was broken. So I waited for awhile to see if the machine would be fixed. It got fixed. I got on the bed and was all ready to go and then it was broke again. Sigh. So now my last treatment isn't until September 17. Still 28 sessions, but now it's extended an extra day. But what can you do? Nothing really. I could have waited to use LINAC 3, but that would mean that they would have to squeeze me in at 8p. Um, no thank you. I'm in bed by then. But it was very interesting nevertheless. I got some pictures of the machine. The LINAC was "upside down" and it was in a position I had never seen. It's been in that position, however, I have always been on the bed getting zapped. But it was interesting to see it from a different perspective. I also got pictures of Rebecca, Linea and Beth. So when I'm not too lazy and so interested in watching Caillou, I'll post pictures.

So, I still have a fact for today... Fact #18a: Today I got to see the computer system that is designed for my treatment. It's all computerized... to some degree. On the screen it has the five radiation fields that are designed for me. The just have to click on one and then they computer does the rest... in terms of setting up the field. So Dan picked my clav area and when he clicked on it, it showed the coordinates, dosage and stuff needed to line me up. In addition, there's a little animated box that shows the MLCs and the shape it makes. It animates as the keys are moving. Too cool. So each zap does the same thing... the machine sets up according to the computer.

So as I was waiting the second time... I saw many people going into the radiation room. One of them happened to be, Dorothy, the chair of radiation therapy. That would be Dan, Linea, Rebecca, etc. boss. She stopped and introduced herself to me. She apologized. I said "so what, it happens." I mean, what are you going to do... sit there and seeth? Nope, that isn't going to help any. Beth said that lots of people tend to get upset. But honestly, don't sweat it. That's one thing that I've learned is that it's pointless to get upset over certain things. It's not going to help. But after the second time it was broken, they said that they have to take the machine apart. So then I went home. Just a little bummed I won't be ending treatment on 9/14. But what are you going to do? I'd rather have a working machine that is radiating the appropriate places on my body. Oh yes, Dorothy said that there are checks the system goes through, so if there's one part that isn't functioning well, then it shuts down. Good checks and balances system!

Oh yes, I met a woman in the waiting area. She also had stage 3 breast cancer. She had an aggressive form. She said she went in for a mammogram in August - nothing there. Then in January... I think that's what she said... she went back to the doctor because she found the lump. In any case, she had a lumpectomy, but they found that the lump went all the way to her muscle. Wow! That's crazy. In anycase, she had four lymph nodes involved. So they ended up doing chemo on her after the lumpectomy. She had 6 rounds. Following that, she is in for 38 treatments of radiation. But I think that she's dealing with lymphedema because I saw a compression wrap on her arm. Her hair was growing back really nice. She had a wonderful smile. She works there at OHSU. So we chatted a little about the infusion room on the waterfront and being positive about treatment and beating this awful disease.

Until next time....

Day 229 - Radiation #17: Cathodes

Not much to report today. Beth freaked me out today. She was setting me up on the machine and her hands were like ice cubes. She ran her hand down my arm sending shivers and squealing out loud laughing. At least I am having a good time with radiation.

Got home, took a nap, picked up the girls and took them for a walk in the woods with Emmy. It's a nice day outside. Now we are at home relaxing! :)

Fact #17 - Mom always said not to sit too close to the TV. There was a darn good reason... and it wasn't necessarily because it would ruin your eyes. In old TV sets there are cathode ray tubes, or CRTs. They emitted low doses of x-ray radiation. So prolonged sitting (and at a very close range) in front of the boob tube could be hazardous to your health. These TVs were the ones your parents and grandparents had. The LCD and plasma TVs are better.

Day 228 - Radiation #16: Radium Girls

Phew! I am so happy this day is over. I was tired from the very start. I woke up and I was tired. I went to work and I was tired. I came home and crashed for about 20 minutes on the couch. Now I am drinking a poor man's mocha (hot chocolate and coffee). That's doing the trick. I decided to do a test today. Since I was going in today and meeting with Dr. Marquez, the nurse takes my vitals. The past few times I have had coffee and my blood pressure was 130 over XX. That is high in my opinion... high for at least me. I know that caffeine has an effect on blood pressure. So today I decided I would abstain from coffee and see what happens. Today when I got my blood pressure taken, I was 120 over XX. That's down 10-15 points. Normally I am 116-120. Excellent. It's amazing what caffeine can do to ones body.

So today I got to radiation on time, but they were running late. I am happy that Dan came and told me that they were running late today. Not an issue. I appreciated that he told me waht was up, though. So I finally got in to treatment. Today was x-ray day, so treatment was just a bit longer than normal. No harm, no foul. In any case, I found out that Dan had to work until 10p yesterday because the other LINAC machine was down. So he worked a 13 hour day. I hope that he gets OT! And tonight... he gets to pick eggs from his neighbor's chicken coop! Nice... fresh eggs. Wonder if he's going to make an omlette!

After treatment, it was time to meet with the doctor. I didn't have to wait long to see anyone. Shortly after the nurse left, Dr. Faisil Siddiqui, her resident came in. We chatted a little bit about kids. He has two boys.. 3 and 9. The reason for the 6 year gap... medical school for both he and his wife. Turns out that his son goes to school with Natali Marmion's son, Luke. Natali works at KATU and I used to work with her. It's amazing how small this world is. :) We were talking about T-ball and the like... and how quickly kids grow up. Then the other doctor came in (I don't remember her name) and we started talking about kids. She has two kids. Then Dr. Siddiqui left and went to get Dr. Marquez. Finally she came in and had a big smile on her face. It's always nice to see a smiling doctor. I threw my hands in the air and said that it's a party! She laughed and then got back to business. I had a question about a bump on my breast. It turns out that she thinks it's a wrinkle with the tissue expander and she's not worried about it. She did mention that my skin is looking really good and it's holding up well. I think she was surprised at how well it looked. I told her that I have been spreading calendula on my skin like no tomorrow. I see Dr. Marquez next Wednesday. She said have a great weekend. I said I am looking so forward to it. She said my skin will be happy too, to have three days off without treatment.

Oh, I did sit down with Dr. Siddiqui to talk about my treatment plan. I have a histogram, but the histogram keydidn't have colors to match up with the lines. So we went over the plan on the computer. I will post it later this week or so... Then we talked about radiation to the thyroid. He said that sometimes radiation will affect the thyroid and I may have to take a hormone replacement. He told me that they should check my thyroid in a year. If it's low, then I'll have to go on medication. The thyroid controls metabolism and my energy level. Interesting... but the good news is, it's just a blood test and I can get it done at my primary care. So I don't have to see a specialist for that.

Fact #16: Radium Girls! No, it's not a music group. In the first half of the 1900s factories hired women to paint dials on watches and instruments. The glow-in-the-dark paint contained radium. The women were told the paint was harmless. So they would lick their brushes to create a point, thus ingesting the toxic substance. Some even painted their teeth and nails! Needless to say, later on down the road, the ladies developed radiation poisoning in their mouths. The women began to suffer from anemia and necrosis of the jaw! Crazy! (Thanks Rebecca & Beth!)

Radium dial painters. (Thanks wikipedia!)

Day 227 - Radiation #15: A Backup Plan

I can now say I am more than half way through my radiation treatment! Yippee!

 

Today I didn't get in until 1p. They were running late because the other LINAC machine was out for repairs. I guess it wasn't a "planned" maintenance. Which brings me to Fact #15: There's a back up plan! There are two machines that do the same thing. So, like today, patients who normally have treatment on a different machine can use "my" machine. The two radiation machines are calibrated the same so if one goes down, the other machine can be used. Interesting. I still hope mine doesn't go down! So while I was getting lined up today, I saw the machine do some things that I normally don't see.

 

As promised, I posted a few pictures of the LINAC 1 (sorry for the spots on the lens):



 

LINAC 1 at OHSU's Kohler Pavillion: Radiation Oncology.
The whole unit rotates around. You can see the bed I lay on
in the lower riht hand corner and the handle I hang on to.

There are two of my "regulars" Andrea & Dan(imal).

If you went online today, you may have seen that GMA's Robin Roberts will be going on medical leave. Most likely she will be getting full body radiation to suppress her immune system. Remember the TBI I showed you? She may be getting radiation treatments using that. I don't know for sure, but it's a possibility.

Tomorrow I meet with my Rad Onc, Dr. Marquez and that's about it. Oh yea, I get x-rays taken of my body, then treatment.

Day 224 - Radiation #14: X-ray discovery

Today marks my halfway mark! I am halfway through the radiation process. Only four more treatments to go... or three more weeks! Yipeee! Treatment was same ol' same ol'. My techs du jour... Beth and Rebecca! I like them. If you recall, Beth was the one who was with me for the first CT mapping. I missed Rebecca last week. She was on vacation (lucky!). Dan joined in the festivities after I was all done. He says that he came back from lunch just in time to say hi and bye to me. I also got to see Linea. Next week I'm bringing my camera back in and will be taking a picture of the others... that way you get to see my whole team.

Today's fact is actually a little history lesson... courtesy of Rebecca (and I found it most interesting). Fact #14: Wihelm Rontgen was the person who discovered X-rays in 1895. What's so remarkable about it... is that only 117 years have passed (relatively short period) since the discovery and look where we are now... guiding those beams in a precise area to erradicate nasty diseases and such. But back to the lesson... Rontgen was studying the phenomena of the passage of an electric current through a gas at an extremely low pressure. The rays he was looking at were previously discovered by the works of other scientists (cathode rays), but his continued experimenting led him to x-rays.

Wilhem Conrad Rontgen

This is the cool part: (excerpt from Nobelprize.org)
During subsequent experiments he found that objects of different thicknesses interposed in the path of the rays showed variable transparency to them when recorded on a photographic plate. When he immobilised for some moments the hand of his wife in the path of the rays over a photographic plate, he observed after development of the plate an image of his wife's hand which showed the shadows thrown by the bones of her hand and that of a ring she was wearing, surrounded by the penumbra of the flesh, which was more permeable to the rays and therefore threw a fainter shadow. This was the first "röntgenogram" ever taken. Because their nature was then unknown, he gave them the name X-rays.

Bertha's, Rontgen's wife, hand.

Rontgen won the Nobel Prize in 1901 for his work in Physics. He died in 1923 of intestinal cancer.

Day 223 - Radiation #13: Energy 23x & 6x

Nothing really new to report. Oh, yesterday I stopped in at KATU to see some of my old friends. I wanted to thank some people personally for all the support they have given me throughout this year. Without them, I don't think this journey would be as "enjoyable."

Brought my camera in today for radiation. I snapped a picture of LINAC 1 and of Dan(imal) and Andrea. I'll post later (maybe tomorrow or Sunday). I need to get a picture of Rebecca and Linea. I am in such a rhythm with radiation, it's almost scary. Leave work, drive to OHSU, check in, wait, get on the radiation bed, say good bye and drive home. I feel like a robot!

Fact #13: My treatment consists of 23x and 6x. That means I am being treated at 23 MEGAvolts and 6 MEGAvolts (I'm emphasizing MEGA). That's a lot of power. The higher the number, the deeper it penetrates. Looking at my treatment plan (which I promise to post when I get the scanner on), the first zap (clav node that's about 17 seconds) is 6x. The second zap to the clav (from back to front) is 23x. That's also the zap that uses the wedge. Then I get two zaps to my chest wall at 6x and one zap at 23x. But I don't know which one is which. I'd have to defer to an expert on that. However I think the zap that takes 5 seconds or so is the 23x.

And that concludes today's post. :)

Day 222 - Radiation #12 Walls of lead

Dan - if you're reading this... proof-reader. That's the word we were searching for today! You will be my proof-reader.

Today marks treatment #12 of my radiation therapy. After Friday's treatment, I will officially be at the halfway mark! Wahoo! I won't say this is cake, but I can't believe how fast it's going. Today while I was getting on the table - or was I already on the table - no matter, Dan said I'm starting to pink up. Yep. I can see the radiation field now. It's amazing. And then when I was spreading the calendula on my chest and such, I looked real close and I could see little blood vessels growing over my scar line.  Interesting. It looks like a spider web growing over my boobies. Ha!

Fact #12: Some people get treatment in padded rooms. I get my treatment in a lead room. The radiation room is built out of lead. The ceilings, walls and floor are lead so no radiation escapes and those in adjacent areas will be radiated - unintentionally. The doors to the room are so friggin' thick. I am in a fortress. However, you wouldn't never know the room is made out of lead. There's a nice little drop ceiling and tile/linoleum on the floor. Tomorrow I plan on bringing my camera to take pictures of the room. Dan said I could! :)

So I've got to do a little research... I've got to pick a new oncologist. I don't know who I want to go with... hmmm...

Day 221 - Radiation #11 T.B.I.

Well, I am in week #3! Yea! I am not halfway through (that will be after treatment 14), but I am so close to being there! Today I had my dose of radiation and then met with Dr. Marquez. It was nice because I slid in right before a consultation, so I didn't have to wait long. I didn't spend too long with her because there really wasn't anything to go over or to talk about. She looked at my chest and said that I was pinking up a little. I have no symptoms - sore throat or lymphedema. My fatigue level has remained constant (tired because of the hour at which I work). She is sooo awesome. So happy I went with Dr. Marquez.

Radiation - Dan was back today. He was on a mini-vacation. So I baked him cookies. Linea was there, so I told him that he has to share with her! I must say those two are my favs! Sorry to everyone else I have worked with during treatments. Since today was Tuesday, it was time for my weekly x-rays. They took I think two or three pictures. It's so cool... the top part of the LINAC machine "takes" the x-ray... and then on the bottom of the machine, a piece folds out and forms the "bottom plate" for the x-ray... kind of like in the old days where x-rays were taken on films instead of digital. Anywho, this is done to make sure that I am lining up correctly for my treatments. Then it was zap x 5!

Fact #11 - I learned about T.B.I. or Total Body Irradiation. There's this machine that sits in the corner of the radiation room. It looks like a medievel torture device. But it's the TBI. It's used to radiate the whole body. Linea says they turn the radiation machine on its side and then the person gets into this "device" and they radiate the whole body. It's used a lot with leukemia patients who are about to get a bone marrow treatment. They have to kill or suppress the immune system in a patient's body. There's stuff to block out radiation to the lungs. The contraption is meant to hold the patient as still as possible. There are handles on the side which they can hold on to and a bicycle seat they can sit on. Yea, doesn't look too comfy to me. I'd rather be lying in the supine position on a hard board for 20 minutes.

This is what the contraption looks like.

This is how the LINAC machine is turned for
full body radiation. See how it's on its side?

 I'll have to take a picture of LINAC one... as well as all the techs that I work with... they're all awesome!

Day 220 - Radiation #10: Why not the whole dose of radiation?

Not much to report today. Went and had my radiation appointment. Got there and the boys weren't there, so I got the all girl team. The first two zaps went well, but the third zap got held up. Apparently, the machine went awry. I was all set for the third zap when the tech came in and had to shift the table around. LINAC 1 malfunctioned. So they had to reset it, move the table around and then go again. They did this twice. Finally it was time to get the final three radiation treatments of the day. Hooray

I got home and pooped out on the couch for about an hour. I was sooo tired. Didn't help that I stayed up too late last night watching the Kathi Goertzen memorial service. It was a wonderful tribute. Tomorrow I meet with Dr. Marquez and my radiation appointments begin at 12:40p. Oh yes, got Elaina's cake ordered for her birthday party!

Fact #10: Why can't I have my full dose of radiation at one time? First off... the whole dose could injure me. At first they said it could kill me... but then took it back because I wasn't getting a full body dose of radiation. But they said it would do lots of damage to my skin and make me feel awfully bad. However, there is some science to it. The goal of radiation is to kill any left over malignant cells. Healthy cells are harder to "get rid of." Malignant cells are easier and are more fragile. So what doctors prescribe is to get a dose of radiation, let the healthy cells heal for about 24 hours, and then get zapped again. Do this over and over again and you've got the "outlaws" dead and the good guys still around and healthy. Radiation is cummulative.

Day 221 - Hair

My hair is rapidly growing. Here's a picture of what it looks like now....

This picture was taken about a week ago, so it may be just a smidge longer than what it was in the picture. But you get the jist.

It's coming in thick and straight!

I've gotten tons of compliments on my hair... and especially since we just went through 90+ weather...

Day 217 - Radiation #9 LINAC

It's Friday!!! No radiation for TWO whole days! Yipeee! Actually radiation isn't bad. It's the driving back and forth which is taxing. So not to drive to OHSU is a real treat. Not much is new. Getting my radiation every day. My skin on the left hand side is pinker than the right side. I'm not feeling too much or if any, discomfort. I really can't complain... this is cake compared to chemo!

So my treatments are comprised of five "zaps." Two are for the supraclavicular nodes. The first one is taken from the front... shooting down right on top of me. The second (the wedge is used) is taken from the underside up. The first one I am radiated for about 17 seconds. The second zap is about 10 seconds. Following the first two doses, the bolus is put on top of me and I am radiated from the top, but at an angle. The x-ray beams are being "shot" over my right boob. That's about a 23 second zap. While it's zapping the MLCs are moving into different shapes. Then the machine moves again... around to my left side... a couple of degrees below horizontal (shooting up... sort of on my side/back) and then zaps me for about 20 seconds. Then the MLCs move and I get zapped for 4 seconds. And that concludes my radiation session. :)

Fact #9 - I am using LINAC 1 for radiation at OHSU. LINAC stands for linear accelerator... and the 1 stands for machine #1. Dean gave me my fact of the day... and I digested as much as I could... so here goes. So there are particles in the machine... they get super-charged or "excited" and change into electrons which generate the x-rays... which are then used to kill the harmful cells. There's more... but I forgot some of it and need a refresher from Dean!

Thanks Wikipedia for this image. This is a patient treated with linear acceleration radiation in 1957. The little boy had his eye removed due to cancer and the other one was treated with radiation because there was a tumor in it. He wasn't the first, radiation treatment had been used since 1953. But take a look at that machine! Holy cow... maybe it was good he couldn't see it too well! I'd be scare outta my mind!

Day 216 - Radiation #8 ODI

Fact #8: Today I learned about ODI or Optical Distance Indictor. Basically it reads the SSD or source to skin distance along the central ray of the beam.

Other than that, there really isn't much to report. Sorry to be so lame. :) But I guess being lame is good sometimes.

Day 215 - Radiation #7

Nothing new. I was a little late to my radiation appointment. I blame nasty traffic on I-84. But I got there. Fact #7: When the "tech du jour" is lining me up for radiation, s/he uses a hand pendent. It's a corded remote control that goes to the radiation bed. I even got to move Dan around on it. He said that he lets all little kids have a whirl... so today I felt like I was five. :) Behind me there is a monitor and they have several numbers - they correspond to the collimator (not the little ones I talked about previously), the bed and where the actual machine is (cause it circles around me).

Following radiation, I got home and climbed up into our attic to grab the kiddie pool. I filled it up in the front yard under the maple tree. By the time I got home with the kids, the water was warm and the tree was casting a shadow over the pool. It was so bloody hot. I think it was in the 90s. Pretty darn close to 100. I know that the forecast for tomorrow is 100! Same for Friday. Thank goodness for a/c.

Day 214 - Radiation #6 Matched Fields

Today I had session #6. Following radiation, I had to wait to see my radiation oncologist, Dr. Marquez. As usual, she was running late. I didn't see her until close to 2p. And then when I saw her, she was in and out. Nothing new to report. She looked at the color of my chest to see if it was turning red. It is pink, but she said my whole chest was pink... and I'm not getting radiation on my whole chest. I told her I was discharged from physical therapy and she said "yea!" No peeling or itchiness of my skin either. I told her that I have been applying the calendula. I also got my treatment plan. I'll have to scan it and then I'll share with you what the plan looks like. :)

Oh yes, today my session was just a tad longer. Every week the techs have to take new pictures of me just in case I have lost or gained weight.

Fact #6: Today I learned about matched fields and divergence. In order to get my supraclavicular nodes, my treatment includes matched fields, tangents and divergence. Divergence is important because they want maximum radiation or energy to the area they are treating. In addition, they don't want to radiate more than they have to. Dan explained it this way: think of a flashlight. When you put your hand about a foot in front of it, the light is pretty dense and small. However, if you shine the light 6 feet away on the wall, the light scatters and is less intense. This is divergence. So when they radiate my clav nodes, they don't want the radiation like the flashlight beam 6 feet away... they want the energy to be centered, concentrated and precise. So what they do is line me up on all tangents (x, y and z planes). The MLCs also come into play because they shield out extra radiation so it doesn't hit other organs or other parts of my body. It's kind of complicated... but that is the layman's terms! Hope that's a good fact!

Six treatments down... only 22 to go! Time is flying!

Day 213 - Discharge Papers & Radiation #5: SSD

I open with sad news. I learned today that one of my former co-workers passed away. Kathi Goertzen of KOMO TV in Seattle, WA died today after battling - for many years - benign brain tumors. Just last week, she was admitted into the hospital and today, with her family surrounding her, she passed on to God. I worked with her from 1996-2000. Kathi was an amazing woman and will be missed. If you would like to know more about her, CLICK HERE.



On a lighter note, I got my discharge papers from physical therapy! I forgot to call and cancel my appointment today, so I drove over there right after work and talked with Cassie, my therapist. I told her that I was doing good and she said that she would take measurements and send me off. My final measurements... 170 degrees in abduction and flexion. Remember I started with 85 and 70 degrees... or something small like that. But I can now do about 90% of the things I used to do. I just have to remember to keep stretching for the next year as my skin and muscles could get tight from radiation. She said that after I get my tissue expanders out and the real McCoys put in, I will most likely be right at the 90 degree start off point... oh well. At least I won't have to deal with cording. :)

Radiation was a blast - literally. There's a new guy, Dean. So he was setting me up on the table and making sure I was on my mark. Thank goodness Linea and Dan were there, cause he wasn't hitting the marks that he needed to be at. Which leads me into Fact #5: SSD: That is the Source to Skin Distance. While they are lining me up, they are reading off measurements. They use my tattoos as a jumping off reference point and then move me up/down/side according to what Dr. Marquez has ordered for me. So as they are getting me lined up, they're reading off numbers.

Also got my FMLA papers back from Nicole. And hopefully I will be able to get my course of treatment printed out so I can share with you all!

Day 211 - Phantom Itch

No radiation today. It's the weekend! Hooray! So no fun fact either.

This is something I meant to write about before... the phantom itch. Lately I've been get the urge to itch my breast (before radiation). I'd go to scratch the place where I think the feeling is coming from, scratch it and nothing would happen. There would be no relief... so in order to get the relief I am seeking, I would have to feel all around. Sometimes I would find the place that is actually itchy. Other times I would just leave it alone. For instance, I feel like I have an itch on the top of my breast, but I'd find that I find relief right where my cleavage is. Ha! I was told that this is expected. As my skin and body heals from the mastectomy, the nerves are growing back. However, the nerves may not grow back to the original spot but rather in a distant spot. It's an odd feeling. As for feeling in my boobs, there's feeling around the edges, but as you move further towards the center where my nipples used to be, I don't feel anything. I can feel if you press down, but that's because I feel the tissue expander pushing down on my chest wall. But I won't ever get feeling there. I also have no feeling on the back of my left arm due to the axillary dissection or under my arm. Small price to pay.

Oh yes, last monday when I went in for my physical therapy session, I asked my therapist if I can enjoy hot tubbing. There are mixed reports of what you should do. She suggested that since I do not have lymphedema, but I am at risk, that I can go in as long as I keep my arm out of the water. So we'll see!

P.S. Do you like the facts??? I know my radiation techs are really getting into it! :)