Tuesday 5.20.2008

Radiation Treatment #19

Daniel's alarm went off at 0600. He got up, turned it off, and got back into bed. Huh? What are you doing, I asked. Mind you, I don't sleep well as it is, and I was finally sleeping, and now being awakened for, what? His response--resting before I get up. Hm. I was in that "pulled from a dream" state, and had a hard time shaking the dream, and also getting back to sleep. So, Daniel finally gets out of bed, I doze in and out but don't get back to the really restful sleep until just before my own alarm goes off at 0725. Shoot. The house is quiet, and I think Daniel has left for his golf date. Imagine my surprise when I see him sitting in the living room on the computer. I still don't know why he set his alarm so early. It sure didn't do me any good.

Ok. Find the happy place. Breathe. Praise God for sunshine, birdsong, and being alive. I got myself ready to go to the radiation center.

Once there, I poured a cup of coffee, went back and changed into the gown, and went out into the waiting area. I stood there, looking around. The woman who is usually after me is called, and Ken takes her off to the other side, to a different radiation room. Hm. The other gentleman just before me was sitting there, too. Hm. Lisa had come out and gotten a chart and gone away. Ron came out with a chart, and picked up a different one. Hm. It's 8:50, for my 8:40 appointment time. I sit down at the puzzle table with the wife of one of the patients, and try to focus on the pieces. She and I make small talk; she shares her concerns about her husband, I tried to encourage her, that what she's experiencing is normal. Blah blah. We put a few pieces in. Another gentleman is called back. I freshen my coffee. A few minutes later Ron comes out and calls me, Kathy J he says. I get up--it's 9:10.

What's with the delays today? I ask. You tell me, he says. He said that everything seemed to be going in "hospital minutes" today. Oh, I know what those are....

I get up onto the table, get situated. I ask if my axillary incision is included in the radiation field. Lisa said she thought it was--and got the marker. When they had the lights lined up with the tats, she put dots at the upper margin of the field. Yes, she said, it goes right into the armpit. Great, I thought. Maybe that's why I'm having changes in the fluid in my arm. I thanked her for taking the time to do that. They left the room, the arm moves into position, click, hum, zzzzz, click. The arm moves around to the other side, Lisa comes in and slides the plate in, goes back out. Click, hum, zzzzzz, click. Big breath. I felt a little warmth in the breast tissue (or was it my imagination again) when the machine was zapping. They come back in, moving around like ants on an anthill, moving me, moving my accessories off, getting the next accessories ready, see you tomorrow....

I go back to the waiting area, retrieve my coffee. It's Doctor Day. Mary sees me, stands up and calls me over. To the scales, she says. 146#. WHAT!?!?! How can I have gained a pound and a half in one week???? I exclaim to Mary my surprise. I told her I ran yesterday. I'm feeling mostly good, with some intermittent nausea. She told me now was not the time to be concerned with my weight (why not), I need to focus on the treatment, and staying well. Ok. But I don't need to gain weight doing it. We talked about the axillary incision being included in the radiation field. She said the majority are, and if there were cancerous cells in there, why wouldn't you want to radiate it? You've come this far, why not do the whole thing? I understand her point, but I don't want a blown up arm to deal with on an everyday basis. I'm going to ask Doctor about it.

We finish our conversation, she looks at my skin, yes it's starting to get pink, but looks good for where we are. (fishy words--for where we are) She goes out, and several minutes later, Dr. DeBiose comes in.

He shakes my hand, and we exchange pleasantries. I tell him I want to pick his brain, and ask him why the axillary woundbed is included in the radiation, percentage-wise. He couldn't dig that out of his brain right off like that, but told me that radiation goes in a straight line, and when it's lined up to include the edges or perimeter of the breast tissue, the angle it's lined up at includes the axillary area. In fact, the radiation field includes almost the whole bottom half of my armpit, stopping just posterior to midline. (in the middle of the pit towards my back ). I told him I had understood that we were just going to skim the front corner of the incision, and I explained my concern about the lymph bed and damage being done there.

Doctor said again, that any lymphedema is not caused by radiation, that he gets blamed for it because he's the last one doing treatment in the area. I told him I disagreed, that if the radiation is damaging tissue, why wouldn't it affect the lymph in the area? He countered that he disagreed with me, that it takes 6 months or so for the fibrous changes to occur. (Maybe so, but my breast is swollen now. And I know when Ike is done, it's an amazing difference. I didn't tell him that) He asked if I was going to therapy, I told him yes, that Dr. Richman had ordered it while he was covering for you. Hm, he says.

I asked him about the "boosts", which aren't really increased energy/intensity/gray. It's actually a smaller area of radiation, focused only on the woundbed in the breast. He said there are two ways to define the field: one is to include the nipple, and the other is to go just inside the areola, depending on where the incision is. Evidently, the areolar incision is a common location. His thinking is that since ductal cell carcinoma is in the milk ducts, and milk ducts all lead to the nipple, zap the nipple, too. The problem is that the nipple doesn't hold up well by that point. (Oh?) That makes sense, (but what about my poor nipple...?) So, if the nipple breaks down, or doesn't tolerate it very well, we can redefine the field and exclude the nipple? Sure, he says.

Somehow, I'm not looking forward to this.

Our visit is over, he leaves the room. I had gotten my clothes from the locker after Mary was done with me before Doctor came in, and I got dressed.

It's almost 10:00. We are out of milk and bread at home, and I will need to eat before going to work, so I stop at Meijer. I get everything on my list and am done and in the car by 10:45.

At home, I unload, unpack, put away. Prepare and eat my lunch. Get the dishwasher ready to run and turn it on. Change clothes and head to Jackson, and clock in just before 1:00.

Joyce has had a busy morning, and says she is glad to see me. I get report, Joyce finishes up, and I take over.

Even though it was busy, it was ok, with a good group. I got finished up, stayed until the oncoming shift was out of report, and left the floor about 7:30.

Daniel was home when I got there. We visited a bit, he watched tv, I caught up on some of the emails of the day, he went to bed, I wrote here.

I watched the full moon come up, and I'm hoping to be able to sleep tonight.

Tomorrow is only a radiation appointment. Maybe a nap or two. Maybe a run, too. We'll see.

Thank you for reading, and commenting. The phone calls are great, emails, and hugs. I am blessed to have each of you in my world.