Ch. 19 - And Radiation Begins (Sort of)
After a break for a couple of weeks, I had an appointment with Dr. Grace, the radiation oncologist on 1/22/2008. She explained the risks and benefits of radiation in regards to breast cancer s/p lumpectomy as well as what to expect. She informed me of the side effects which include skin dryness, redness, peeling, raw skin, itching, soreness, skin darkening, and fatigue for radiation of the breast area. She also reminded of my recommended treatment regimen of 33 treatments which totals 6 weeks. New to me was that there is a 3 step process in order to begin radiation. First, a CT scan is needed to locate the exact area that needs radiating (they look for the area in the breast that contains the scar tissue remaining from the lumpectomy and the removal of my 2 lymph nodes. Second, from the CT results, x-rays will be performed to determine the right set up for the radiation, i.e. the right angle of the beams in order to minimize radiation exposure to non-affected areas and to maximize the radiation to the focus area. At this time, small blue "dot" tattoos will be made for reference points on the skin in order to ensure the same exact set up each and every time for radiation. And thirdly, the initial radiation visit once step #1 and step #2 are completed. Also at this visit, she prescribed me sween cream to apply to the radiated area daily, every day after treatment to minimize skin dryness. She also reminded me to only wear the non-metalic deoderant on radiation days and to not wear a bra during this time. WHAT!!! NO BRA!! This would not be that big of a problem, but I am one of the nippiest people I know. I have even been known to have to wear bandaids over my nipples just to keep them in check so that I do not have my headlights poking through my bra. But oh well, I guess this will just be one rule (recommendation) that I will try to break, as long as my skin can tolerate the rubbing of the bra. So, we will have to wait and see on that one.
Aside from battling my breast cancer during this time, I also had a follow-up appointment with the dermatologist regarding the skin cancer. On 1/30/2008 I went to this appointment. I was scheduled for a skin check to see if there were any other areas of concern. At this point I did show another "cyst type" place to the left of my nose. He stated that it only looked like a cyst, but I did explain to him that to me it looked the same as the other one did that turned out to be cancer. So, for opening my big mouth he decided to take a biopsy of this one too!! After the biopsy he also looked at a couple of other spots that I showed him. One was a pathy red area on my left thigh that he labeled at eczema. The other was a different looking patchy area on the right lateral thigh, it looked more like ringworm. He stated not to worry, that it was only dermatitis. The tretment for both problems was just to keep the skin hydrated with lotion. He did state that if the problem persisted to inform my primary care physician. As far as the biopsy, I have to wait one week for the results. At this point I have become a waiting professional, not that I enjoy it, just that it seems to come with the diagnosis of cancer.
On Friday, Dr. Grace's office called me to schedule my next radiation visit, the x-ray visit. So on Monday, 2/4/2008, I had my appointment at the cancer center at 11:40 am. This visit was with Dr. Grace and the radiation technologist, Ken. This visit seemed to take forever, 2 hours to be exact. So many x-rays were taken at different angles in order to find the right formula for my radiation treatment. The goal, as it was explained to me was to minimize lung and left breast exposure and to maximize right breast (the area of the excision) as well as the lymph node excision area as well. This was proving to be quite difficult due to the location of my cancer was well as my perky (breast implanted) left breast. Many different ideas were tossed around, taping the left breast out of the way, rolling more onto my side, etc. After they took all the needed x-rays, the radiation technologist then tatooed four reference point on me (one of them was on the outer margin of my nipple...OUCH!!! So with this visit behind me, radiation should begin tomorrow, 2/5/2008.
Well 2/5/2008 rolled around and I was excited to start this chapter. I got dressed in the hospital gown, was escorted to the radiation table, and was set up for "treatment". Dr. Grace was present as well as Ken. They discussed the field problem and then stated "hold still while we take a picture". This happened twice and then Ken told me that I was done for the day. Was that it?? How easy? This simple procedure made me very happy. Radiation was going to be so easy compared to chemotherapy. After leaving I called my husband and my mom to let them know how everything went. When asked how it felt, I simply stated it felt like they took an x-ray, this was the best way I knew to describe it. Everyone was happy and thankful that this part seemed to be like easy street!!
The next day, the same thing, or so I thought. When I arrived Ken showed me my x-rays and explained to me that the beam was it appears on the film stills slightly crosses the left breast and also exposes too much lung. He stated that Dr. Grace want him to take more x-rays in a slightly different set-up to attempt to minimize this exposure. As I was getting on the table, it hit me. So... I questioned Ken on exactly what he was doing. He repeated what he had told me earlier and my return question to him was, so "so far I have not stated radiation yet, only x-rays?". His answer was yes. NO WONDER IT SEEMED SO EASY, LIKE GETTING AN X-RAY!! What a diappointment. Radiation had not begun, I am still on step #2. AAAHHHHHHH! On a positive note, I do want the treatment to be given correctly, but I am also so ready to be finished with the whole process as well. The funny thing is... I had already marked my calender with all 33 treatments which gave me an ending date of March 20, 2008 (written in with a smiley face). I then had to call my husband and mom to let them know the difficult, but also very comical news.
So, back to the cancer center I go on Thursday the 7th scheduled at 12:00 noon for one more attempt.
Today is the 7th and I woke up early this morning, preparing for work and my radiation treatment, hopefully. I put on my non-metalic deoderant and did not apply any sween cream as instructed by Dr. Grace for the mornings of treatment in order to reduce burning. I was all ready, rushing around at work when the doctor called me. She stated that she still did not like the way the films looked and that she needed to cancel today's visit and reschedule for next Tuesday. At this visit she will be present as well as another radiation oncologist, Dr. Mak, and Ken to gather further films and brainstorm about proper positioning for the radiation treatments, one that she would be happy with; so again, I wait.
So while I am waiting, I will fill you in one some of the other aspects of my life. I am currently going through chemotherapy induced menopause. I have not had a period since 12/24/2008. As soon as I was at least a week late with my period, I went to my primary doctor and told her my situation. She stated that she was confident it was from the chemo, but she did order a pregnancy test just to make sure I was not pregnant. I think with the IUD, the chances are less than 2%, but for me this is a big percentage since I cannot get pregnant during this time and would probably be advised to terminate the pregnancy. To my advantage, the pregnancy test was negative... YEAH!!! But, with this news comes the confirmation that my hot flashes are probably not related to the chemo, but more related to the beginning stages of menopause, at 34, YIKES!! And, since my tumor is estrogen receptor positive, I cannot take estrogen replacement therapy to help with the flashes. The only thing she could advise me to do was to eat yams, a natural source of estrogen that will not have any adverse side effects for someone in my condition. So, if I did not like yams before, I do now :-)
Also during this time I received my biopsy results for my face, negative for cancer. YEAH!!!! And, I became a "grandmother". My dog, Scruffy, had 5 puppies on 1/31/2008. I helped with part of the birth which was amazing. She gave birth to 5 healthy puppies, 3 male and 2 female. Here are some photos!!!!
Thanks again for all of your prayers and support. I plan to update you guys again soon after my next radiation visit on Tuesday, the 12th.
