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....
Thursday, August 30, 2012
Wednesday, August 29, 2012
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.
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.
Tuesday, August 28, 2012
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!)
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!) |
Monday, August 27, 2012
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). |
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.
Friday, August 24, 2012
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.
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.
Rontgen won the Nobel Prize in 1901 for his work in Physics. He died in 1923 of intestinal cancer.
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 |
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. |
Thursday, August 23, 2012
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. :)
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. :)
Wednesday, August 22, 2012
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...
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...
Tuesday, August 21, 2012
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.
I'll have to take a picture of LINAC one... as well as all the techs that I work with... they're all awesome!
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? |
Monday, August 20, 2012
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.
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.
Saturday, August 18, 2012
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.
I've gotten tons of compliments on my hair... and especially since we just went through 90+ weather...
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! |
Friday, August 17, 2012
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!
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!
Thursday, August 16, 2012
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.
Other than that, there really isn't much to report. Sorry to be so lame. :) But I guess being lame is good sometimes.
Wednesday, August 15, 2012
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.
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.
Tuesday, August 14, 2012
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!
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!
Monday, August 13, 2012
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!
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!
Saturday, August 11, 2012
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! :)
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! :)
Friday, August 10, 2012
Day 210 - Radiation #4: Wedge
Had the fourth round of 28 sessions today. Not much to report.
Fact #4 - I learned today that they use a wedge in my treatment plan. The wedge is metal and fits on the radiation machine. The wedge is a beam modifier. Using it creates curves for the radiation. Since my breast is round in shape, the wedge is used to get a curvature so the radiation is evenly distributed. My wedge is really thin... or the angle of the triangle is extremely acute... it looks like the angle is about 15 degrees, so the rise isn't very high.
The first shot of radiation is the whole breast. After the inital "blast" one of the techs comes into the room and inserts the wedge. Then they leave and the blasting continues. I was wondering why they were coming in and then leaving again.
Fact #4 - I learned today that they use a wedge in my treatment plan. The wedge is metal and fits on the radiation machine. The wedge is a beam modifier. Using it creates curves for the radiation. Since my breast is round in shape, the wedge is used to get a curvature so the radiation is evenly distributed. My wedge is really thin... or the angle of the triangle is extremely acute... it looks like the angle is about 15 degrees, so the rise isn't very high.
The first shot of radiation is the whole breast. After the inital "blast" one of the techs comes into the room and inserts the wedge. Then they leave and the blasting continues. I was wondering why they were coming in and then leaving again.
Thursday, August 9, 2012
Day 209 - Radiation #3: Field in Field & a hair cut!
Yes! Did you see the title of my post?? I got a hair cut today. After radiation, I drove over to Moxie and Christine cut my hair. She was the one who cut my hair off back in February. My hair was a little unruly. It was growing over my ears and very scraggly on my neck. So now it looks nice. Now I will take a picture and post it. Yes, I know it's been awhile since my last hair post. But Christine was shocked at how much hair I have and how thick and "colorful" it was already.
So I got to radiation today. Dan and Linea were ready for me for my fun fact... so here goes.
Fact #3: My radiation is Field in Field. So basically the machine gets in place and radiates a portion of my breast. Without moving, the MLCs (Fact #2) change shape, thus changing the field of radiation within the original area. That new area is then radiated. Think of it as a circle within a circle! This technique is used to make sure the dose distribution is more uniform. Click on the link and you'll get a more clinical answer.
Radiation is so quick. I get there, get undressed and wait for a few minutes. Then it's back to the radiation room, get on the table, grab the "oh shit bar" above your head and then get radiated. The longest dose of radiation I get is about 20 seconds worth. The shortest is about 5 seconds... and that's in the supraclavicular area. Yes, I count how long I hear the buzzing.
Other than that, nothing much to report. I like getting these fun facts. I hope you're enjoying it too. It's funny, Dan was asking Linea if they could get CE (continuing education) credit for this. They've also got a list going of what to teach me. This is gonna be good! They told me more stuff, but I promised them I wouldn't share yet! LOL
So I got to radiation today. Dan and Linea were ready for me for my fun fact... so here goes.
Fact #3: My radiation is Field in Field. So basically the machine gets in place and radiates a portion of my breast. Without moving, the MLCs (Fact #2) change shape, thus changing the field of radiation within the original area. That new area is then radiated. Think of it as a circle within a circle! This technique is used to make sure the dose distribution is more uniform. Click on the link and you'll get a more clinical answer.
Radiation is so quick. I get there, get undressed and wait for a few minutes. Then it's back to the radiation room, get on the table, grab the "oh shit bar" above your head and then get radiated. The longest dose of radiation I get is about 20 seconds worth. The shortest is about 5 seconds... and that's in the supraclavicular area. Yes, I count how long I hear the buzzing.
Other than that, nothing much to report. I like getting these fun facts. I hope you're enjoying it too. It's funny, Dan was asking Linea if they could get CE (continuing education) credit for this. They've also got a list going of what to teach me. This is gonna be good! They told me more stuff, but I promised them I wouldn't share yet! LOL
Wednesday, August 8, 2012
Day 208 - Radiation #2: MLCs
Today was a good day for radiation. I got off of work and sped to OHSU for my radiation appointment. I was in and I was out. Each day I am going to teach you a little about the radiation process... care of my radiation technicians.
Fact #2 (Fact #1 was all about my radiation treatment yesterday): Today I learned of the Multileaf Collimator or MLC. They look like keys and they move to form a shape for the radiation field. Tomorrow I will learn more about it. Here is a pictures of what they look like:
Where ever there is open space... as seen in the above picture, that's where the radiation field goes through. It sort of like projects a "shadow" of radiation on my chest.
Today I also learned that they are radiating my interior lymph nodes (the ones in the middle of my chest) by shooting radiation from the underside of my body. I can't remember what kind of radiation it's called... but it's a different type with a different wave length.
Next time I see Dr. Marquez, I am going to ask her to print out a copy of my treatment plan and the histogram that I was writing about on yesterday's post. Treatments are going to be fast and good. I can handle these!
Following my radiation session, I went over to Whole Foods and got the calendula for my skin. I got the lotion, however, I need to return it and get the cream. I forgot that the stuff is not supposed to have alcohol in it. The lotion has alcohol which will dry my skin. However, the cream does not have any alcohol. Hmmm... at least Whole Foods is on my way home! :)
Join me tomorrow for another lesson in radiation.
Fact #2 (Fact #1 was all about my radiation treatment yesterday): Today I learned of the Multileaf Collimator or MLC. They look like keys and they move to form a shape for the radiation field. Tomorrow I will learn more about it. Here is a pictures of what they look like:
Where ever there is open space... as seen in the above picture, that's where the radiation field goes through. It sort of like projects a "shadow" of radiation on my chest.
Today I also learned that they are radiating my interior lymph nodes (the ones in the middle of my chest) by shooting radiation from the underside of my body. I can't remember what kind of radiation it's called... but it's a different type with a different wave length.
Next time I see Dr. Marquez, I am going to ask her to print out a copy of my treatment plan and the histogram that I was writing about on yesterday's post. Treatments are going to be fast and good. I can handle these!
Following my radiation session, I went over to Whole Foods and got the calendula for my skin. I got the lotion, however, I need to return it and get the cream. I forgot that the stuff is not supposed to have alcohol in it. The lotion has alcohol which will dry my skin. However, the cream does not have any alcohol. Hmmm... at least Whole Foods is on my way home! :)
Join me tomorrow for another lesson in radiation.
Tuesday, August 7, 2012
Day 207 - Phase 3: Radiation!
I've made it to Phase 3! Hooray. It's one down and 27 more treatments to go. I had my first round of radiation and boy, was it a doozy.
So last Tuesday, I went to OHSU for my "mapping." That was an easy appointment. I thought it was going to be longer than what it was. The first stage was to get on a table and lie there very still with my hands over my head. It was nice that I actually had a handle to hold. I was worried that I had to put my hands up without any aid. Next, they stuck wedges under my triceps to help keep me comfortable. Once they had me in position, it was time to line me up. There were two laser beams (red) that they centered me on. One beam was going from one side of the room to the other side of the room (horizontal axis). The other beam was coming from the ceiling. Once they had me where they wanted me, Dr. Marquez came into the room and marked me up... the top, bottom and the sides. Next the techs mapped me by pushing me through a CT scanner. Thank goodness they didn't need a dye/contrast. The CT scan is used to map my organs and figure out the best angles for the radiation beams to hit the areas they need to hit and to avoid certain areas (more to come). Following the CT scan, the tech then tattooed me. Three little dots to mark the planes for the laser beams for true radiation. I have one on my upper chest on the left hand side and two on the front of my torso under my breasts. I can't see the ones on the bottom unless I look in the mirror. Ahhh, the trials and tribulations of having such huge knockers! Ha! Following the CT scan, I was done. I was given alcohol wipes to wipe away the permanent Sharpie pen marks. That's a handy thing to have to get those pesky marks off. After that, the resident came in and made me sign a disclosure and we went over the things that could happen from radiation: decreased lung capacity, heart issues, cancer from radiation, skin reddening, loss of hair under the arm, lymphedema... the list goes on. But the benefits far outweight the negatives.
Fast forward today. I got to my appointment at Radiation Oncology shortly after 12. My appointment was at 12.30 with Dr. Marquez's nurse to go over some stuff about what to avoid and what will be good. I didn't get in until about 1.20p! What is it with 12.30 appointments? Nevertheless, we finally got into the door and had a consultation with Nicole, the nurse. We went over what was going to happen today and what to expect in the next few weeks. I am still on track for 28 sessions. So nothing has changed with that... especially after seeing my recent PET scan. The first session will be the longest. We went over how to care for my skin. Apparently there is this herbal supplement/lotion/cream that Dr. Marquez is high on... it's called calendula. It's derived from a species of marigolds. Maybe I should grow some in my backyard and squeeze out the oils and apply it to my skin! Ha! She said that I should put it on the areas where I will be radiated. Apply it twice a day. We went over the fact that I may be fatigued from radiation. And then it was question time. I asked if I would be able to swim during the time that I get radiation. I have been seeing/reading so many different answers. Nicole said that it was okay for me to swim during radiation, as it will help me with keeping the skin and the muscles loose during treatment. She said that many women swim during radiation and then toward the end they stop because their skin is changing and getting more tight. Sweet! I can go swimming in Becky's pool... (here I come Becky!) She said that when I get out of the water to make sure that I apply my lotion and rehydrate the skin. Oh yes, she said that I should use mild soaps and then when I dry myself off, I should pat dry my skin. Reduce any sort of friction that could cause aggravation to the skin. She asked if I wear a bra. She suggested no underwire (I don't, too uncomfy) and that if it starts to irritate me, that I could take a sock and slip it under the band. Nothing like stuffing a bra! I also asked what will my skin look like and when will I start to see changes. She said in about 2-3 weeks, I will start seeing some changes - like a reddening of my skin. The changes will continue up to 4-6 weeks after the last treatment. Radiation is cummulative. Groovy. We'll see what happens. Oh yes, my diet can stay the same... however, I should stay away from antioxidant supplements.
Next up was the actual radiation where I got to sit on the bed and be radiated. So after speaking with Nicole, she showed me to the changing area. There are four changing rooms and each one has two lockers with keys. I changed into my gown. I got to wear my jewlery - all of it except for my necklace (which I wasn't wearing to begin with anyway). Next I was told to wait in the changing room wait area. It didn't take long before Rebecca rolled into the room. She's one of the team of four administering the radiation. She rolled in because she broke something in her foot. So she had a little scooter that she was using. She took me into the electronic room. She wanted to make sure that I knew who I was, when my birthday was and what sort of treatment they were performing today. I gave her all the right answers. I passed the test. Then she told me that the room had satellite radio. Sweet! I got to pick the music. I picked Top 40. It was hard to lie there and not move when all I really wanted to do was to groove and dance to the music. Anyway, I got to see a 3D version of my CT scan... with skin. Looked kind of frightening. It looked like one of those animated bodies you see on the news. Then it was on to the radiation room. There was a chair and a table where I set my purse and my locker key. Next I hopped onto the very hard table. There was a sheet lying over the table. Rebecca and another person, Linea, helped adjust me. They were matching up the three tattoos with the green laser beams. They told me not to move and that they would do all the moving. Finally they got me in the right spot. My arms were over my head and my head was positioned to the right side. The reason for me turning my head... they had to radiate the left side of my neck. They put the wedges under my arms and I continued to hold onto the handle bar. Then they raised the bed up and left the room
The first treatment takes the longest. It was awful. I am not going to lie. The first thing they do is take x-rays and scans of your body. Then they take those "today" scans and overlay them from the CT scan which actually has your internal organs. They want to make sure the computer and whatnot is all set up correctly so they are maximizing the radiation field, but minimizing the radiation to parts they don't want to hit (lung and heart). This was the hardest part because my hands were up in the air and my left hand and arm started to hurt from being in that position for so long. My arm started to get numb. Finally the techs came in and said that they were done doing all the mapping and they would start my first dose of radiation. Dr. Marquez was in the room while they were fine tuning the mapping. They scared the living daylights out of me. I jumped on the table. I asked them if I could move my hand at all. They said I could move my fingers, but not my hand. Dan ended up taping my hand to the handle that way I could relax my arm. It helped... a little, but my arm still hurt. He even said that my arm was ice cold. Um, yep! He started to tape up the right hand, but I said that that one was fine. Then they left and I had 10 minutes of radiation. They started with my supraclavicular area (side effect of radiation, a sore throat because the beams are going to hit my esophagus) and then from there, I don't know. The radiation doesn't take very long... it's all the prep. So after the first round, the techs came in and marked up my skin with permanent pen AGAIN... marking the field of radiation. They marked up my neck, under my arm and down the center of my chest. Once they did that, they put on this thing called a "bolus." It reminds me of ballistic gel. What I found out is that the radiation beams reach their maximum output at a certain depth. By putting the bolus over my body, it acts like a "skin thickener." I need the radiation to hit the skin, not a 1.5cm into my body. If the radiation goes through my normal skin, it will hit anything at maximum input of 1.5cm. Interesting. And the bolus they gave me is MINE. After the last session of radiation which was to the chest itself, the techs came in and took pictures of the markings they made with a camera (as in a little digital one). They have to document the field of radiation. Then I was able to get out of the compromising position they put me in. They promised me that next time it will be much faster.
As for the radiation machine. It's huge. It's open. What they have is me on a table lying flat. By my head is the actual machine that gives me the dosing. It's shaped like a C with me in the middle. The arm then rotates around me, so I never have to move. It looks similar to this.
If you keep your eyes open, you can see there are these little keys inside the plate and they move and I think that's what directs the radiation beams. Interesting, eh?
Next I was told to get dressed and then wait to go and see Dr. Marquez. Every Tuesday I will be meeting with her after radiation. We will discuss how I am feeling and what's going on with my skin. It took awhile for Dr. Marquez to come in, but when she did, she came in with a smile. Made me happy that I decided to go with her. She said that I lined up perfectly. I said that I had been practicing. She said that normally with people they shift a little bit, but I was just perfect. Beautiful... I did something right! ha! She asked me if I had any questions. I asked her if she felt any need for me to get a higher dose of radiation than she planned. She said that I looked fine and that her initial dosages for me was fine. My dosage is 5040 centigray (cGy). That's the total amount of radiation I will get over the course of 28 treatments... so 180 cGy's a day. She pulled up my chart and said that I didn't have any cancer and that this is preventative. Dr. Marquez had mentioned that she would do higher radiation if there was still cancer present in the node in my neck. But since there wasn't there was no need to worry about it. We talked about the PET scan... she said that I had some brown fat which is nothing in my neck. Then we talked about under the arm where I had some uptake, but that's normal after a surgery. Then we went into talking about the very mild uptake in my mid chest (anterior mediastinum). She didn't worry about it. She said that there was no correlation between that and the CT scan that was done at the same time. There's no tumor and there's no concern. Then proceeded to go into what exactly is 'mild' and "very mild"... does that mean cool? So it was all subjective.
The coolest part of the whole day is that she showed me my treatment plan. I got to see the images that were taken of my body. She showed me the quadrants they are radiating: the neck, the breast, under the arm and the area right next to that. Then she showed me the histogram which shows what organs were getting the most radiation. The most was my skin. Dr. Marquez then showed me that they were working really hard to avoid my heart and the aortic valve to my heart. They did a good job with that. However, the lung... they are hitting about 40% of that and when all is said and done, I will have about a 30% decrease in lung capacity. But on the up note, they won't have to do anything to my right lung. I'd rather be alive huffing and puffing than dead. I will most likely start to notice the decrease in capacity about a year from now. So I told her, now's the time to run that marathon. :) She said it's in October. God love her! We discussed the fact that she's radiatiating the nodes in the middle of my chest so I don't come down with inflammatory nodes. That would be a bad breast cancer. Get it all now. Oh yes, during the planning session, she said that she almost had to deflate one of my breasts. She said about 100cc's. I said, "Oh no, I worked so hard for these - all the sweat and tears!" But she talked with Dr. Thaker and they put their heads together so I didn't have to deflate. I didn't realize that the other boob would get in the way of the radiation beams. Goes to show you how much I preplan. So they figured out a way so the rad beams can get where they need to go AND I save my boob. So now I don't see her for another week.
Tomorrow my appointment is at 1p and should last 15-20 minutes. My last appointment is Friday, Sept. 14. Hopefully they will be more on time. I am now on a quest to find calendula. Wish me luck!
P.S. I know that Steve was there with me in that radiation room today.
So last Tuesday, I went to OHSU for my "mapping." That was an easy appointment. I thought it was going to be longer than what it was. The first stage was to get on a table and lie there very still with my hands over my head. It was nice that I actually had a handle to hold. I was worried that I had to put my hands up without any aid. Next, they stuck wedges under my triceps to help keep me comfortable. Once they had me in position, it was time to line me up. There were two laser beams (red) that they centered me on. One beam was going from one side of the room to the other side of the room (horizontal axis). The other beam was coming from the ceiling. Once they had me where they wanted me, Dr. Marquez came into the room and marked me up... the top, bottom and the sides. Next the techs mapped me by pushing me through a CT scanner. Thank goodness they didn't need a dye/contrast. The CT scan is used to map my organs and figure out the best angles for the radiation beams to hit the areas they need to hit and to avoid certain areas (more to come). Following the CT scan, the tech then tattooed me. Three little dots to mark the planes for the laser beams for true radiation. I have one on my upper chest on the left hand side and two on the front of my torso under my breasts. I can't see the ones on the bottom unless I look in the mirror. Ahhh, the trials and tribulations of having such huge knockers! Ha! Following the CT scan, I was done. I was given alcohol wipes to wipe away the permanent Sharpie pen marks. That's a handy thing to have to get those pesky marks off. After that, the resident came in and made me sign a disclosure and we went over the things that could happen from radiation: decreased lung capacity, heart issues, cancer from radiation, skin reddening, loss of hair under the arm, lymphedema... the list goes on. But the benefits far outweight the negatives.
Fast forward today. I got to my appointment at Radiation Oncology shortly after 12. My appointment was at 12.30 with Dr. Marquez's nurse to go over some stuff about what to avoid and what will be good. I didn't get in until about 1.20p! What is it with 12.30 appointments? Nevertheless, we finally got into the door and had a consultation with Nicole, the nurse. We went over what was going to happen today and what to expect in the next few weeks. I am still on track for 28 sessions. So nothing has changed with that... especially after seeing my recent PET scan. The first session will be the longest. We went over how to care for my skin. Apparently there is this herbal supplement/lotion/cream that Dr. Marquez is high on... it's called calendula. It's derived from a species of marigolds. Maybe I should grow some in my backyard and squeeze out the oils and apply it to my skin! Ha! She said that I should put it on the areas where I will be radiated. Apply it twice a day. We went over the fact that I may be fatigued from radiation. And then it was question time. I asked if I would be able to swim during the time that I get radiation. I have been seeing/reading so many different answers. Nicole said that it was okay for me to swim during radiation, as it will help me with keeping the skin and the muscles loose during treatment. She said that many women swim during radiation and then toward the end they stop because their skin is changing and getting more tight. Sweet! I can go swimming in Becky's pool... (here I come Becky!) She said that when I get out of the water to make sure that I apply my lotion and rehydrate the skin. Oh yes, she said that I should use mild soaps and then when I dry myself off, I should pat dry my skin. Reduce any sort of friction that could cause aggravation to the skin. She asked if I wear a bra. She suggested no underwire (I don't, too uncomfy) and that if it starts to irritate me, that I could take a sock and slip it under the band. Nothing like stuffing a bra! I also asked what will my skin look like and when will I start to see changes. She said in about 2-3 weeks, I will start seeing some changes - like a reddening of my skin. The changes will continue up to 4-6 weeks after the last treatment. Radiation is cummulative. Groovy. We'll see what happens. Oh yes, my diet can stay the same... however, I should stay away from antioxidant supplements.
Next up was the actual radiation where I got to sit on the bed and be radiated. So after speaking with Nicole, she showed me to the changing area. There are four changing rooms and each one has two lockers with keys. I changed into my gown. I got to wear my jewlery - all of it except for my necklace (which I wasn't wearing to begin with anyway). Next I was told to wait in the changing room wait area. It didn't take long before Rebecca rolled into the room. She's one of the team of four administering the radiation. She rolled in because she broke something in her foot. So she had a little scooter that she was using. She took me into the electronic room. She wanted to make sure that I knew who I was, when my birthday was and what sort of treatment they were performing today. I gave her all the right answers. I passed the test. Then she told me that the room had satellite radio. Sweet! I got to pick the music. I picked Top 40. It was hard to lie there and not move when all I really wanted to do was to groove and dance to the music. Anyway, I got to see a 3D version of my CT scan... with skin. Looked kind of frightening. It looked like one of those animated bodies you see on the news. Then it was on to the radiation room. There was a chair and a table where I set my purse and my locker key. Next I hopped onto the very hard table. There was a sheet lying over the table. Rebecca and another person, Linea, helped adjust me. They were matching up the three tattoos with the green laser beams. They told me not to move and that they would do all the moving. Finally they got me in the right spot. My arms were over my head and my head was positioned to the right side. The reason for me turning my head... they had to radiate the left side of my neck. They put the wedges under my arms and I continued to hold onto the handle bar. Then they raised the bed up and left the room
The first treatment takes the longest. It was awful. I am not going to lie. The first thing they do is take x-rays and scans of your body. Then they take those "today" scans and overlay them from the CT scan which actually has your internal organs. They want to make sure the computer and whatnot is all set up correctly so they are maximizing the radiation field, but minimizing the radiation to parts they don't want to hit (lung and heart). This was the hardest part because my hands were up in the air and my left hand and arm started to hurt from being in that position for so long. My arm started to get numb. Finally the techs came in and said that they were done doing all the mapping and they would start my first dose of radiation. Dr. Marquez was in the room while they were fine tuning the mapping. They scared the living daylights out of me. I jumped on the table. I asked them if I could move my hand at all. They said I could move my fingers, but not my hand. Dan ended up taping my hand to the handle that way I could relax my arm. It helped... a little, but my arm still hurt. He even said that my arm was ice cold. Um, yep! He started to tape up the right hand, but I said that that one was fine. Then they left and I had 10 minutes of radiation. They started with my supraclavicular area (side effect of radiation, a sore throat because the beams are going to hit my esophagus) and then from there, I don't know. The radiation doesn't take very long... it's all the prep. So after the first round, the techs came in and marked up my skin with permanent pen AGAIN... marking the field of radiation. They marked up my neck, under my arm and down the center of my chest. Once they did that, they put on this thing called a "bolus." It reminds me of ballistic gel. What I found out is that the radiation beams reach their maximum output at a certain depth. By putting the bolus over my body, it acts like a "skin thickener." I need the radiation to hit the skin, not a 1.5cm into my body. If the radiation goes through my normal skin, it will hit anything at maximum input of 1.5cm. Interesting. And the bolus they gave me is MINE. After the last session of radiation which was to the chest itself, the techs came in and took pictures of the markings they made with a camera (as in a little digital one). They have to document the field of radiation. Then I was able to get out of the compromising position they put me in. They promised me that next time it will be much faster.
As for the radiation machine. It's huge. It's open. What they have is me on a table lying flat. By my head is the actual machine that gives me the dosing. It's shaped like a C with me in the middle. The arm then rotates around me, so I never have to move. It looks similar to this.
If you keep your eyes open, you can see there are these little keys inside the plate and they move and I think that's what directs the radiation beams. Interesting, eh?
Next I was told to get dressed and then wait to go and see Dr. Marquez. Every Tuesday I will be meeting with her after radiation. We will discuss how I am feeling and what's going on with my skin. It took awhile for Dr. Marquez to come in, but when she did, she came in with a smile. Made me happy that I decided to go with her. She said that I lined up perfectly. I said that I had been practicing. She said that normally with people they shift a little bit, but I was just perfect. Beautiful... I did something right! ha! She asked me if I had any questions. I asked her if she felt any need for me to get a higher dose of radiation than she planned. She said that I looked fine and that her initial dosages for me was fine. My dosage is 5040 centigray (cGy). That's the total amount of radiation I will get over the course of 28 treatments... so 180 cGy's a day. She pulled up my chart and said that I didn't have any cancer and that this is preventative. Dr. Marquez had mentioned that she would do higher radiation if there was still cancer present in the node in my neck. But since there wasn't there was no need to worry about it. We talked about the PET scan... she said that I had some brown fat which is nothing in my neck. Then we talked about under the arm where I had some uptake, but that's normal after a surgery. Then we went into talking about the very mild uptake in my mid chest (anterior mediastinum). She didn't worry about it. She said that there was no correlation between that and the CT scan that was done at the same time. There's no tumor and there's no concern. Then proceeded to go into what exactly is 'mild' and "very mild"... does that mean cool? So it was all subjective.
The coolest part of the whole day is that she showed me my treatment plan. I got to see the images that were taken of my body. She showed me the quadrants they are radiating: the neck, the breast, under the arm and the area right next to that. Then she showed me the histogram which shows what organs were getting the most radiation. The most was my skin. Dr. Marquez then showed me that they were working really hard to avoid my heart and the aortic valve to my heart. They did a good job with that. However, the lung... they are hitting about 40% of that and when all is said and done, I will have about a 30% decrease in lung capacity. But on the up note, they won't have to do anything to my right lung. I'd rather be alive huffing and puffing than dead. I will most likely start to notice the decrease in capacity about a year from now. So I told her, now's the time to run that marathon. :) She said it's in October. God love her! We discussed the fact that she's radiatiating the nodes in the middle of my chest so I don't come down with inflammatory nodes. That would be a bad breast cancer. Get it all now. Oh yes, during the planning session, she said that she almost had to deflate one of my breasts. She said about 100cc's. I said, "Oh no, I worked so hard for these - all the sweat and tears!" But she talked with Dr. Thaker and they put their heads together so I didn't have to deflate. I didn't realize that the other boob would get in the way of the radiation beams. Goes to show you how much I preplan. So they figured out a way so the rad beams can get where they need to go AND I save my boob. So now I don't see her for another week.
Tomorrow my appointment is at 1p and should last 15-20 minutes. My last appointment is Friday, Sept. 14. Hopefully they will be more on time. I am now on a quest to find calendula. Wish me luck!
P.S. I know that Steve was there with me in that radiation room today.
Monday, August 6, 2012
Day 205 - A little hair & PT
What an awesome day I had! Yes... it was a good day. Today was the first day that I wore no fake hair to work! Yep, I ditched the wig. Last Friday was the last day that I told myself I was going to wear it. It felt so good not putting on the fake hair. Plus, I didn't get hot! I think that's a big part of my hot flashes at work... the darn wig. I mean, it's like having a hat on at work. So, lots of people said I looked really good. A few women said I looked like a model and other said the style was super chic. Even a guy said that he liked my new coif. :) But it felt very liberating coming to work without something on top of my head. Now I just need to get it cut and colored. If you're wondering, it's about an inch long. Some places it's shorter. Other places a little longer. And it's straight. Straight, straight, straight. No curl. And the texture is about the same as my old hair.
On another hair note, I am just getting over a cold... and I have found that when I didn't have nose hairs, the snot got out much easier. Now that I have nose hair, the snot seems to stick in my nose. Most annoying. Yea, it's a little thing. But I'll get over it.
Today at physical therapy for my cording, my range of motion is improving. I can now go to about 170 degrees in either direction/stretch. I will almost be discharged. I find that the finger walking exercises help the most. That's where you stand facing a wall and then walk your fingers up it while keeping your shoulder down. I can get it almost stretched flush with the wall... or the door jamb in my case because my boobies won't squish down. I do the same thing, but do it so I am standing parallel to the wall stretching my arm out to the side. I can now do "carpet" angels. So exciting to do that on the floor with my two girls. The cording is still there, but it's not as huge. Up in my armpit, it's hard to find and definitely can't see it. If you poke around, you can find it in my arm and definitely in the crook of my arm. It's very thin like a piano or a guitar string. But it's not limiting me anymore. I can do most everything. Every so often, it hurts to stretch my arm - but that's mainly when I am stretching to get something on the top shelf of a cupboard.
Tomorrow I start my first of 28 radiation treatments. Sooo excited to start. It's the beginning of the end. I'll have to put a ticker on my blog to show the countdown! Hee hee! Other than that, I will surely post everything about radiation. I plan to tell you what happened at the mapping, too.
On another hair note, I am just getting over a cold... and I have found that when I didn't have nose hairs, the snot got out much easier. Now that I have nose hair, the snot seems to stick in my nose. Most annoying. Yea, it's a little thing. But I'll get over it.
Today at physical therapy for my cording, my range of motion is improving. I can now go to about 170 degrees in either direction/stretch. I will almost be discharged. I find that the finger walking exercises help the most. That's where you stand facing a wall and then walk your fingers up it while keeping your shoulder down. I can get it almost stretched flush with the wall... or the door jamb in my case because my boobies won't squish down. I do the same thing, but do it so I am standing parallel to the wall stretching my arm out to the side. I can now do "carpet" angels. So exciting to do that on the floor with my two girls. The cording is still there, but it's not as huge. Up in my armpit, it's hard to find and definitely can't see it. If you poke around, you can find it in my arm and definitely in the crook of my arm. It's very thin like a piano or a guitar string. But it's not limiting me anymore. I can do most everything. Every so often, it hurts to stretch my arm - but that's mainly when I am stretching to get something on the top shelf of a cupboard.
Tomorrow I start my first of 28 radiation treatments. Sooo excited to start. It's the beginning of the end. I'll have to put a ticker on my blog to show the countdown! Hee hee! Other than that, I will surely post everything about radiation. I plan to tell you what happened at the mapping, too.
Thursday, August 2, 2012
Day 201 - A sad day
I dedicate this post to Steve Jones who just lost his fight against cancer. Steve is my step-dad's close friend. He had been battling cancer for the last year. While I didn't ever meet Steve in person, he was always asking how I was doing in my treatment... and I was always asking about him. My thoughts and prayers go out to Margie, Steve's wife, and the family. Just know that there are many people who wish you the best.
I'll be back tomorrow.
I'll be back tomorrow.
Subscribe to:
Posts (Atom)