One Week Down, Five and a Half to Go.........

8/18/13--Sunday-Day 309--So Far Radiation Isn't Bothersome, Just Noticeable.

It's Sunday following my first week of radiation and we are back home on a 48 hour furlough.  Yesterday was the first home game of the Cardinal Football Season so we stayed in Mesa to attend Saturday's game against the Cowboys, which, by the way, WE WON!  We have been season ticket holders for eighteen years now and used to really look forward to our trips to Phoenix as protected time we guaranteed with each other.  This weekend, however, staying in Mesa the extra day only delayed our escape back home.

The first week of radiation has gone well.  On Monday, I had a late afternoon appointment so I worked at the office until noon when Greg, Brooklyn and I headed for Mesa.  The evening before, we loaded the car with everything we figured we needed to set up offices at my Aunt Mary's house for the next six weeks.  Greg and I both had super busy work weeks ahead plus, Brooklyn would be flying out on Wednesday morning, I had my four-month gynecology oncologist exam, and we were starting radiation for real.  It was going to be a challenging week, so I was glad we arrived in Mesa with enough time to unload and settle in before heading to the Cancer Center.

I was not looking forward to going in for radiation as the first two simulation sessions had been challenging.  When we arrived at the Cancer Center, Greg and Brooklyn waited in the waiting area as Robbie, the receptionist, greeted me and pushed the button for the automatic door to open.  I went down the hallway and into the dressing room where I put on my gown and waited.  A young lady came to get me this time, and escorted me into the control room where Kaleb asked me to verify my name and birth date.  The three of us then proceeded into the radiation room.  As I went through the vault door, I realized it really wasn't three feet thick after all, but maybe half that size.  And the machine, it didn't have the large CAT scan ring as I had remembered, nor did it have near as many intimidating arms.  In fact, it already looked familiar and much less ominous.

I climbed onto my body mold on the table hoping the back stretches I had started doing were going to keep me from cramping. With my gown pulled down, both arms stretched above my head in arm cradles, and my back in the body mold, Kaleb and his assistant pushed the table up under the machine then adjusted my body until the marks on my skin lined up perfectly with lights being shot from around the room.  Bright red lights with patterns shined on me from the ceiling on both sides of the room and neon green laser-looking lines helped position my body to the exact spot.   When it was just right, Kaleb and his helper both left the room.

I closed my eyes to keep the bright red light out and to relax hoping to keep the cramps at bay.  I focused on staying calm by picturing myself on the shore of Apache Lake at sunset relaxing.  As machines started to move, I opened my eyes.  Though my head was turned sideways to the left, I could see from the corner of my eye that above me was the round machine with metal plates behind glass.  From my research, I knew this was the multi-leaf collimator which is what is used to deliver the radiation and what the big deal behind IMRT is.  As the radiation is delivered, these metal leaves are programed to change shape directing the radiation so higher doses can be precisely delivered to certain areas while minimizing radiation exposure to healthy areas.  On the sides of me, two large flat panel screens moved in close on each side.  These were silver, but shaped like super large flat screen computer monitors.  "When you're ready, take a deep breath and hold it," Kaleb said through the speakers.  As I held my breath, I heard a quiet buzzing noise for about five seconds while the monitors took the x-ray images. "You can breath now," Kaleb said as the two screens and the large round machine, automatically rotated to the right 90 degrees so one screen was now above me and one beneath.  As I held my deep breath once again, more x-rays were taken.  Then there was a long pause.  The table jerked ever so slightly moving probably a millimeter at a time.  I held my breath several more times as more adjustments were made. Soon the screens rotated to the left moving beyond their starting position and pulled away a bit while the collimator moved in closer.  The collimator was large and round.  Behind a glass were what looks like the edges of a bunch of metal plates.  It reminded me of those metal toys that look like tons of small nails and you put your hand on it and the metal nails form a three dimensional shape around your hand.  The collimator sort of looked like that.  Certain plates were opened creating an odd looking shape.

The collimator was now positioned to my left at a 45 degree angle pointing toward the target, my right breast.  After being instructed, I took a deep breath and the collimator began rotating to the right.  The entire machine slowly rotated around my body approaching its 180 degree point underneath me.  While it was moving, I held my breath as long as I could, then gasped for air.  As I gasped for a breath, the machine stopped immediately, just as Kaleb had told me it would.  Through the speaker, he assured me it was okay, instructed me to catch my breath, and when I was ready, to take a deep breath and hold it again so we could finish.  I did and the final few seconds of the radiation beam continued while the machine found its resting place just underneath my right side now.  After a few minutes, it was time to start again.  I took another deep breath and the machine began its journey back around to the top of me. As the collimator moved around my body, the metal leaves moved creating different shapes directing the radiation to certain parts of my body while protecting other parts.  I closed my eyes trying to focus on keeping my breath.  Though I knew it was okay not to hold my breath for the entire rotation, it was now a challenge.  I pretended I was at Apache Lake swimming and wanted to make it under the boat.  That helped.  It kept my mind busy and just as I was about to lose my breath, the machine stopped back in its starting position and I heard Kaleb say, "You can breath now.  That's it.  Stay still until we come in."  And that was it.  It was over.  My first radiation was completed.

As they pulled me out from under the machine, my right arm was hurting where it is numb from the surgery, but that was it.  I wasn't nearly as exhausted, I had no back cramps, and the treatment seemed much shorter.  Wow, I was pleasantly surprised, encouraged, and optimistic.  "I can do this!" I said to Kaleb.  "This is much easier than it was on Friday!"  He laughed, "Easy peesy, I told you."  The whole process had taken about forty minutes.  That was MUCH BETTER than the hour plus the practice sessions had taken.  I returned to the dressing room, got dressed, and, with a much brighter attitude, headed out to where Greg and Brooklyn were waiting.  Greg asked how it went and I told him my right side seemed warm, and I swear I felt the tingling of the energy which had just been forced inside of me, but all in all, I was encouraged that this whole process from start to finish would be just under an hour.

Tuesday's, Wednesday's, and Thursday's treatments went pretty much the same.  Each day I learned a little more as I came prepared with questions for Kaleb.  He's been great, patiently explaining how things work and providing the answers for all of my questions.

On Wednesday, Preston took Brooklyn to the airport to return to Idaho.  We weren't able to go because we had an appointment with Dr. Matt, my gynecologist oncologist that morning.  My tumor markers were down from 19 to 17, which is great.  Anything under 36 is good, so all looks good on that part.

Thursdays after treatment, we met with Dr. Grade, something we will now do every Thursday throughout the treatment.  I saved my medical questions for her.  One thing that had been bothering me was having multiple x-rays done every single day.  Dentist only x-ray your teeth once a year to minimize your exposure to radiation, yet I was having multiple x-rays each day for 30 days?  Dr. Grade assured me that the x-ray was a much smaller dosage which is also why they didn't cover the other parts of my body with a led apron like they do at the dentist.  She said all of the imaging is taken into account when calculating the total amount of radiation exposure I am receiving.  Just like with chemo, you have to trust that the doctors know what they are doing when they are prescribing treatment.  I had to trust that all of the radiation I was receiving was part of the prescribed plan.

On Friday, I learned it was double imaging day.  Once a week, they take an extra set of images to make sure the positioning of my body and the delivery of the radiation beams are still in line.  After the two x-rays are taken with the screens to my sides and then on top and bottom, for the extra x-ray or imaging, now a screen makes a complete arch circling around me while I hold my breath, sort of like a CAT scan you can see moving.  Kaleb said this is just an extra precaution to make sure everything remains in line with the calculations of the IMRT.

So that's the story of radiation so far.  We have started applying the aloe vera as instructed by Dr. Grade.  The only bad side effect so far is my lymphedema in my right hand and arm has really flared up.  My hand is so swollen you can't see my knuckles and it is really aching, and this morning, my forearm was covered with a rash of light red dots.  We will return to Mesa tomorrow after I work at the office for half the day as our Monday radiation appoints are in the late afternoons.  Tuesdays through Fridays I will have morning appointments starting this week, so that will help us settle better into a routine.  This past week my appointments were all in the afternoons because some of the machines were down for mandatory maintenance and they had to fit everyone in on the remaining machines.  As for the actual treatments, being someone who is very in-tune with energy and energy fields, I truly believe I feel the radiation for quite some time after each treatment.  It's like a crazy, bouncy, excited energy field bouncing around on that side of my body.  But all in all, So Far Radiation Isn't Bothersome, Just Noticeable.