Tuesday 4.29.2008

Radiation Treatment #4

This morning Dan went to the treatment center with me, because we were going to see the doctor, too. I got changed, Ken came out and walked me back, and Lisa (that's her name, not Lynn or Kim) and Ken got me positioned on the table, went behind the wall and zapped me. Just like that, it's done. As I was getting off the table, I made it a point to look around the room.

There was a stainless steel table maybe 8 feet long, with a shelf below it, filled with eerie looking shapes that looked like parts of humans. I looked again, and I asked Lisa if those were "forms". Yes, she said, and picked one up. It was yellow mesh, like a heavy gauge onion bag, and had a tag with a last name on it. She said the product is pretty neat--you just get it wet and lay it on the person, kind of pull it tight, and it forms to the shape. Now, I'll tell you, most of these shapes were of heads. The eyeholes, nostrils, and mouths outside the lipline were cut out, and you could see the shape of the ears. The person lays on the table, the form goes over them, and it is fastened to the board underneath them to immobilize them. Eww, I thought. There were other shapes, too, like neck/shoulder, upper torso, etc. Then I saw a frame like a clothing rack, that had large blue rectangles suspended on it. These pieces were about 3 foot by 4 foot, maybe 4-5 inches thick. They looked like shapes like when you lay on the "memory foam" stuff. She said that was a pretty neat product, too. They come kind of puffy, the patient lays on it, and the staff vacuums the air out of it and it makes the shape. And the best part is that they are reusable.

I looked at the head form that she had in her hand, and told her that I thought it would be pretty difficult to do that kind of treatment day after day. Yes, she said, and often times, the surgeries for the head/neck cancers are disfiguring. Wow, I said, Thank God it's just my breast. I continue to be humbled.

I walked back out to the waiting room with Daniel, and waited for the nurse to come get us. After a few minutes, she did.

She had on a scrub top with matching cap, and a jacket. Hm, she kind of looked familiar... She took us into an exam room, and said her name was Melissa. Melissa, You worked with us at our first appointment. Yes, she said, I did. And you have a cap on?? I said. Yes, she said, she is being treated for breast cancer. Wow. She went on to tell us she found a lump just before Christmas (she's 38 years old) and of course had it checked out. It was a very aggressive cancer, and she's had 2 surgeries, is currently doing chemo, will do radiation, and herceptin, another chemo drug for a year. Wow.

I thanked her for sharing her story. We had walked by the scales, and I was 144# today on their scales, which is the same as I've been at the other office, but looking back, I was 142 on my very first visit to this office.

She did my patient education for skin care--lots of aloe vera gel, she gave me (maybe) 20 small sample size tubes of Aquaphor, and a folder with handouts in it about radiation therapy. She told me to use the aloe vera generously several times a day, and to put a pea-sized amount of Aquaphor on the nipple, and another pea-sized amount on each of my incisions. Also, to wear 100% cotton bras, or no bra at all, to minimize chafing/irritation to the already irritated skin. Or just plain cotton t-shirts, camisoles, tanks, or whatever is comfy. Ok. She looked at my breast and evaluated my skin, with a checklist that we will do each week. She also told me that my total dose of radiation is 60 gray, divided into 30 doses, for 2 gray each dose. (I googled it--a gray is the same as a joule in radiation speak) She also looked at the cord in my armpit, and has seen that before. I told her I've been massaging the axillary wound bed, and some range of motion exercises (thank you Diane), and it did look less noticable this morning. She thought that was a good idea. We've covered everything she was supposed to do, and she went out to get the doctor.

Dr. Jeffrey Richmond came in, and explained that Dr. DiBiose was out sick. Oh. This Dr. Richmond had on a lab coat that was embroidered with a lot of things over his pocket, one of which was the University of Michigan logo.

He was very careful in looking at my chart, then looking at me. He asked about tenderness--yes, about a 2 on the pain scale. He felt my left breast, and I must have done something, because he made a comment that it was pretty tender there. (Yeah, you're pushing over the wound bed...) We talked about the skin, and I showed him my underarm. Yeah, he said, there's something there. He felt the breast again, and asked the nurse if there is a lymphedema clinic here. Yes, she said, a very good one. Ok good, he says, and tells me that he'll send me to the lymphedema clinic for an evaluate and treat. He says that may be fluid accumulating in the breast, as well as localized response to the radiation. I don't think he ever said anything about that cord in my arm. I'm glad for the referral to the clinic.

Dr. Richmond spoke outloud as he was writing his notes, and I liked that. He would look to me for verification as he was going along; that made me feel like I was actually a part of my own care. Thank you Dr. Richmond.

We were done, and I changed back into my clothes and we left. It was about 9:30.

I called the hospital and asked when Joyce wanted me to come in, sooner or later? meaning 1 pm. Whenever I can get there was her reply. Ok.

As I was getting ready to go to Jackson, the Physical Therapy place called Rebound Rehab and Hand Clinic called to set up my appointment. A nice lady named Connie told me about their facility, and scheduled me for May 5 at 1 pm, and will mail me a packet of papers to fill out. Ok, thanks Connie.

With that done, I had a small snack, finished getting my things together, changed my clothes, and headed south.

I found a parking place within one block today, and clocked in about 11:40. Joyce gave me report, she finished up, and left.

I had a pretty good rest of the day with good co-workers. We were busy, but not so that you felt run ragged. The day went on, the night shift arrived. All but one, that is. With the call in, that left them short a person. I offered to stay and get vitals on everyone and chart them before I left. So I did. I ended up leaving the hospital about 8 pm.

Over to WalMart. I looked for the cotton bras--there they are, and several styles. I picked 4 different ones to try on to start with. And I'm glad I did. The ones I thought I' d like best weren't good fits; 2 of them the top of the sides under the arm rested directly on the axillary wound. No good. The one I didn't think would work did. I poked my head out the door and asked the fitting room lady if she would get me a different size in these 2 models, and she did, but they still didn't work. When I was dressed, I went out, and one of the girls showed me the sports bras, thinking they might work. I did end up with 2 sports bras that hook in the front, a regular bra, (all of which are cotton), the aloe vera gel, some "all that" sunglasses to wear over prescription glasses, and a couple more bandanas. Even though it took me a while, I did good.

Home. 10:25 pm. Daniel is tired and sore. He is up, waiting for me to come in. We visit a bit, he watches the end of his show and goes to bed. I write here. It's now 12:30, and I have to be up for my 8:30 standing appointment....

Thank you for reading, for encouraging me. For the hugs and phone calls. You are the best.