Radiation Therapy Journal – Day 28 – Friday December 7, 2012

Treatment Notes:

– Today is my last day of “regular” radiation therapy, and next Monday begins my “boost” radiation therapy.  Up until now the radiation has been spread over my whole boob, which actual tissue is farther and wider than one might think (the delineated soon-to-be radiation “no fly zone” stretches – measured laying on my back with both arms bent back up over my head – from the center of my sternum all the way around to the center of the left side of my body, and from a point along the outside edge of my boob level with the top of my sternum down to an inch and a half under my inframammary fold.).  Starting Monday, the 1.8 Gy fractionation per treatment spread across the whole boob becomes a 2.0 Gy fractionation per treatment concentrated in the tumor bed only.  Where the whole boob deal was administered from above-and-down-from-the-bottom-right (the machine emitting the radiation was positioned basically above my stomach and pointed just “south” of my armpit) and from below-and-from-the-top-left (the machine is slightly below me angled up from just “south” of my armpit pointing basically toward my stomach) (both of which angles if the depth were miscalculated would harmlessly shoot away from my body into the open air, the boost part will be straight down into my body from above (I’m imaging from somewhere above the left side of my body angled some top-to-bottom, left-to-right way entirely through my body front to back – I’ll know more on Monday when it actually happens), carefully (I sure fucking hope!) calculated to hit the bottom of the tumor bed, but no farther down into my body.

– Oddly enough, with the first blast of down-from-above today, I got some pain where the my ribs connect to the top of my sternum.  Also, as I’m wearing a bra today for the first time in more than a couple days (since the increased pain lately made me wonder if I should be dealing with gravity more deliberately), but I’m finding it generally uncomfortable, slighty cutting into me on the side where I’m more swollen, and then there’s the rubbing on the nipple.  Welcome back to damned-if-I-do, damned-if-I-don’t.

Side Effects:

– Fatigue/lightheadedness – Seems to be a regular deal these days having this hit me while I’m walking from treatment out into the parking lot to go to work.  I’m not sure if it’s one or the other, or both.  I can’t always necessarily separate them (not that I’m trying so hard to do so.)  Thankfully, when I sit down in the car to drive to work, my mind is all there and I’ve not felt like I would be a danger to myself or anyone else (or I’d not drive until I was safe).

– Just plain fatigue – yeah, I’m typing this and it’s only 12:35pm.  Seriously?  That’s it?  Time’s now going backwards, right?

– When I got home and got ready to do my evening gooping, I stopped at the exposing the boob part, since mine had (guess I wasn’t going to get away without it after all) gone full red – like lobster colored.  Fabulous, my last mother-fucking day of full-boob radiation.  Plus…

– more numbness (means more swelling, or more concentrated swelling is now interfering with nerve conduction) and more overt swelling/pain in my axilla

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Radiation Therapy Journal – Day 27 – Thursday December 6, 2012

Treatment Notes:

– Okay, today I got a real zotz when the treatment first started, straight through my nipple, then it went away and didn’t hurt anymore.

[Right, sorry, “zotz.”  Okay, so I tried to find the definition of this word I always thought was Yiddish, but I’m not so much finding an actual definition in a casual web search.  So I’ll define it for you as I’ve always used it and known it to be used, so you know what the hell I’m trying to say.

A “zotz” is a sharp, stabbing or burning pain that comes on instantly and is gone almost before you actually realize it’s there, but leaves an echo behind for a bit.]

Side Effects:

– Tired (come on, you’d wonder what was going on if I didn’t feel the fatigue anymore).

[But of course that’s also not surprising given my 11:00pm actual bedtime last night.  No, 7 hours isn’t enough sleep for me when I’m Not in primary cancer treatment – it’s Definitely not enough now.]

– more pain than I’ve been having the last few days.  Not entirely surprising – I’m extra tired today and that always makes things hurt more, and I got manhandled pretty good yesterday (which was necessary, but still made me hurt more).  So early to bed and maybe tomorrow will better.  At least tomorrow will be Friday, which is Always a good thing!

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Radiation Therapy Journal – Day 26 – Wednesday December 5, 2012

Treatment Notes:

– Again, really nothing to feel during treatment, although once they got me into the position they wanted me in, I felt kinda tweaked.  But we can do anything for 5-10 minutes, right?

Physical Therapy:

– today kinda hurt – I’m having some increased swelling, including some into my arm, but certainly into my axilla and down the side of my body.  She also got rid of some adhesions underneath my nipple scar – breath in, breath out, she’ll stop in a minute.

– PTher is also going to start the process of getting me a sleeve.  You see, one of the fun things about this cancer and its treatments is the risk of lymphedema in the affected arm (for me, that’s left) . . . in hot weather, when ramping up exercise, just being at altitude, or plane travel . . . For The Rest Of My Life.  Woohoo!   So they have these spandex or lycra or something sleeves to add some compression to help the lymph system drain more normally.  Though I haven’t had lymphedema in the arm, I could start, at any time.  Of course, sometimes if I need to wear the sleeve, it’s possible that fluid can get stuck down in my hand and cause my hand to swell – more fun – so I’ll have to be prepared with a glove too.  Dontcha wish you could be me?

– On the plus side, however, when I first started getting PTher, she said a lot of people like to do it at the end of the day, then go home and relax.  It turns out that the lymphatic system is very shallow under the skin.  Therefore, very little pressure is needed to move the lymph fluid through the system.  The result of this information is that lymph drainage feels like a very light swedish massage (over the affected parts of the lymph system) and is very relaxing.  Unfortunately for me, because they start early, their “last appt of the day” is nowhere near late enough to be after I’m done with work.  But today, I’m not going to work (same with two weeks from now), so I can enjoy the relaxation of my PTher (after the pain) and go home to nap (after breffast/brunch of course – see my schedule for this week).

Side Effects:

– Tired (yes, I’m getting as bored typing it as you are reading it) – this time it hit me on my way to the car.

– More pain today, though not entirely unexpected after I’ve been (necessarily and as gently as she can) manhandled.  Of course I don’t want adhesions under my scars, of course I want to minimize the tissue damage my treatments necessarily cause.  So I went home (eventually – after brunch & a quick apple-acquisition stop) and lay down – that always helps the pain.

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Radiation Therapy Journal – Day 25 – Tuesday December 4, 2012

Treatment Notes:

– Same old, same old now (if it’s not films/doctor day).  Marina was kind enough to bring me a warm blanket today without me having to ask – she seems to know which days are cold enough to be automatic-blanket days and which days to ask if I want one.  That girl’s gonna do fine (she’s doing her internship with my regularly-scheduled/licensed guys).

Side Effects:

– tired, again (still?) – I keep throttling back on what I’m doing (on wise advice of Dad, trying Very Hard Not to Overdo when I feel okay), and yet it only takes one long day to really wipe me out at this point – the fatigue slammed me midday when I headed out to pick up lunch.

– some nipple pain today, and me with my lidocaine gel down in the car – the good news is the pain’s not bad enough I hafta run down there ‘n’ fetch the gel.

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Radiation Therapy Journal – Day 24 – Monday December 3, 2012

Treatment Notes:

– They needed to do new films today, and have the doctor come in while I’m positioned on the table because I was swollen and she needed to confirm application of cell-destroying radiation – um, okay.  So my guys could see that on the films (that I was swollen from the treatment – if you’ve been reading me you know it actually happened Treatment Day 1 or 2), and I’m imagining the CT scans taken last week to plan the boost Did Not exactly match the CT scans taken a week before I started treatment because treatment made me swell damn near immediately!  But could she have believed me when I told her this 4 weeks ago?!  Apparently Not – she must be a fan of Dr. House (who gets the reference – 1st section?)!  But other than it taking a bit longer than normal – nothing much to see here, move along.

Doctor’s Visit:

– I’m inclined to believe that my ROnc actually did talk to my RSurg last week as she claims she did, for two reasons:

1) Mom pointed out that she said she did in my medical records and she couldn’t/wouldn’t do that if it weren’t true ‘cuz of this little thing called Medical Ethics.  Count on Mom for reminding me of the logical side of things.  But even more than that, I believe they talked because . . .

2) ROnc did Not try to push me into what she thinks I should do.  She walked into the room with printouts (as I had asked her to do) of the boost plan.  She explained them to me.  She then hands me and explains to me several study abstracts backing up her claim of the benefit the boost will provide to me And shows me the fairly good cosmetic results also covered in the studies.

She then tells me that she’ll do her visit notes with me and when we’re both happy, Then (electronically) sign them and print me a copy (to avoid having to void and reissue the notes as I had her do last week regarding my use of painkillers to get through the pain caused by the swelling (that she actually now believes exists) caused by the treatment itself.

She reads the notes right up until the last sentence, which I happen to see as she’s printing and closing that screen: “Patient will be given discharge instruction on last day of treatment.”  I repeat this to her and ask her to get them to me earlier (I don’t need things like that to be last minute in case I end up having questions, but she says they basically say “Call me if you have any questions or problems.”) and then she says she’ll have them printed and I need to bring them back to her, signed, on Friday, which will be my last day of treatment if I decide not to have the boost.

No further pressure – just giving me the information and letting it be my decision.  This is actually why I quit smoking (98 days CFT, BTW!) – because my RSurg Did NOT tell me to quit – she just told me what would happen to my body if I didn’t and I decided all by myself, just like a big girl who doesn’t have to be told, that my boobs and what I was going through to keep them, were more important to me than smoking.  I have to come around to things in my own time.  Forcing me there does not get me there sooner, it Delays Me Getting There.  Christ Almighty, she could have saved me so much angst if she had figured this out sooner!

Side Effects:

– lightheadedness, again – intermittently throughout the day

– So, interestingly totally normal blood pressure (107/62) this morning during my morning activities & the weekly installment of putting my doctor in her place.  Okay, so I seemed all calm this morning.  I figured I’d go with it.  Then midday I get nauseous and start to hurt, badly.  It’s actually my back that hurts, but I know it’s coming from stomach upset – this is a fairly familiar GERD pain pattern.  So maybe my Monday Morning Stuff manifested this way instead of as higher than normal blood pressure.  Okay, so I take a Zofran for the nausea.  30 minutes later the nausea was gone.  The pain wasn’t.  Took a pain pill.  45 minutes later no nausea And no pain!  Yay!  Time for lunch – soup, just to be on the safe side.  All’s well with the tummy for the rest of the day.

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Schedule: Week of November 26-30, 2012

Monday [Radiation Therapy – Day 19]:

7:10am-7:55am Drive from Home to RTher
8:00am-810am RTher
8:15am-9:00am Appointment with ROnc
9:00am-9:30am Waiting for requested med records to be printed
9:30am-9:45am Making additional acupuncture appointments

[Going from only on non-support-group weeks to weekly, for now, at least while I’m still in radiation therapy, and while Mo is in her clinical rotation (before she graduates and the next class comes in).]

9:45am-10:00am Walked over to lab building across the street (Please see “Seriously, this Woman Knows Her Way Around a Vein – I’m Naming Names Again“) to get my lab results that should have been faxed to me last week.  Yep.
10:00am-10:15am Drive from Disney Family Cancer Center to Work

[With a drive through McDonalds

for junk 740 calorie breakfast (eggs, sausage, hashbrowns, biscuit) – really, there’s only so much one can shoehorn into a morning and still get anywhere near a full-day’s work done.]

10:15am-1:30pm Work
1:30pm-2:00pm Lunch
2:00pm-5:30pm Work
5:30pm-5:45pmpm Drive from Work to Acupuncture
6:00pm-7:00pm Acupuncture
7:00pm-7:55pm Drive from Acupuncture to Home

Tuesday [Radiation Therapy – Day 20]:

7:15am-8:00am Drive from Home to RTher
8:00am-8:20am Wait for RTher
8:20am-8:25am RTher
8:25am-8:35am Slather boob goop/visit with “Dana”

[I had invited “Dana” to join me at Support Group, which is tonight, and then go to breffast tomorrow before going home to rest after we do our crazy crack-of-dawn cancer business, but…

… it seems her blood work yesterday is such that they didn’t do her chemo, and she’s been feeling like something’s going in her body just now, so she’s not really supposed to be around people until her blood counts recover – this all means that her immune system is compromised to a point where she needs to be Extra-Careful ’til things turn back around.

She told me she was disappointed and I am too.  Of course, timing may not have worked out tomorrow anyway with my new CT films, but I hadn’t had a chance to tell her about that.  She said she’d call and I reminded her that we both have the rest of our lives to get to know each other if we want, and we’d keep trying to just find some quiet time for us to hang together some.

Throw up a little prayer for my new friend, if ya feel like it?  Thanks.]

8:35am-9:00am Drive from RTher to Work

[With 1 stop to put gas in the car and buy lottery tickets.  Damn, if there was any time I could go for winning a lottery that would allow me to quit my job, if even just for a while, it’s now!]

9:00am-1:30pm Work
1:30pm-2:00pm Lunch

[Seems I’m back to shorties to make up work time missed for medical appts.]

2:00pm-5:30pm Work
5:30pm-6:30pm Drive from Work to Support Group
7:00pm-8:30pm Support Group
8:30pm-9:15pm Drive from Support Group to Home

[Yeah, sorry, you only get two days of this week.  Even with taking Wed off – this week was my first of 4 consecutive Wednesdays off – I’m getting  pretty tired.

It’s weird, the treatment really doesn’t feel like much – you can’t see it, smell it, or taste it – and yet it can lay you low.]

Additional Tasks Accomplished This Week:

– blogged
– wrote check for housecleaner who came the Monday after Thanksgiving instead of her regularly-scheduled day which landed on the day after Thanksgiving last week
– made it working Monday, Tuesday, Thursday and Friday
– bought lottery tickets for the first time in weeks (months?)

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Radiation Therapy Journal – Day 19 – Monday November 26, 2012

Treatment Notes:

– really nothing to report, except for slipping by one of my guys at the front of the suite on my way back to the machine – being Perfectly on time and having him scramble to catch up with me today – hehehe (well, I’d take credit, but I think we’re maybe headed into that amorphous time of half-holiday-light traffic as we gear up for schools to start letting out for Christmas Break (yeah, I’m Jewish, I celebrate Chanukah, I’ve been known to have a Christmas tree, not a Chanukah Bush, get over the ultra-political-correctness already, will ya?)

Doctor’s Visit:

– Yeah, long story short:

She said she called my RSurg, had a discussion with her, and that my RSurg was okay with a “regular boost,” but was concerned that I was getting a “super boost,” and therefore was comfortable with the boost plan in place for me

. . . which claims, all of them, will be checked out by me, hopefully telephonically, with my RSurg, since I trust her, but do Not trust my ROnc to have the Whole Me in her best interest.  I wish I did, but I don’t.  Oh well.

. . . which boost plan has not been drawn up – What?  Yes, the boost plan (the last week or so of treatment where they take the daily amount of radiation currently spread over the whole boob, and concentrate that amount of radiation in the tumor bed only) has Not Yet been planned.

As I was writing the last sentence, my ROnc called me – she wants to get new CT readings (since I’m having some swelling – or she finally believes I am – she never got to see me before I started rad therapy and I swelled almost immediately) but using my existing tattoos – to make sure the boost plan is completely accurate (since my body has changed with the swelling since beginning this treatment, the CT scans done a week before I began treatment may not be accurate to my anatomy today).  Then she will take Thursday and Friday to do the boost plan.  She will print it out for me (like I asked her to do today with the regular plan) so we can discuss it next Monday at our visit.

Then I’ll have all of next week, still on the original and unchanged first part of the plan to decide if I want to do the boost or not (which, if I do it, will start the following Monday) without getting me into a situation where I don’t have enough time to consider boost or no boost before we’re forced to consider an unintended break in treatment.

So, that’s the plan for the moment, so to speak.]

Side Effects:

– Um, other than blood pressure of 140/75 this morning (WAY high for me – I’m usually – well, BC as in Before Cancer anyways – around 110/60 normally), but since I was planning to follow my “new normal” Monday schedule of 1) get my radiation treatment, 2) put my doctor in her place, 3) go to work – I was okay with that reading (this too shall pass) – the good old “white-coat syndrome” magnified and all that.

Update: This early evening before acupuncture, Mo took my blood pressure again – 110/70.  Not surprising at all.  I was having the Pavlovian relaxation reaction just being there knowing what we were about to do was going to make me feel better, immediately and for days to come.

In fact, when I left I shared the elevator down with another cancer patient I had met at acupuncture and we both had that ever so slightly sleepy, very relaxed ‘I just had acupuncture’ look on both our faces and shared that moment together in the elevator on the way downstairs.

– less pain today.  I’m inside the week that my acupuncture treatment effects seem to last (I managed to get another appt with Mo tonight – yay!), and the past 4 days of not having to wear a bra, and being able to rest and/or sleep Whenever I Want have helped too – a much needed break indeed.

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Schedule: Week of November 19-21, 2012

Monday [Radiation Therapy – Day 16]:

7:10am-8:05am Drive from Home to RTher
8:05am-8:15am Waiting for RTher
8:15am-8:25am RTher
8:25am-8:40am Waiting for appointment with ROnc
8:40am-9:00am Appointment with ROnc
9:00am-10:00am PTher
10:00am-10:10am Post RTher-ablutions [in other words spreading boob goop]

[Yes, you are reading correctly – I had radiation therapy, a doctor’s visit And physical therapy, All Before going to work. :)]

10:10am-10:25am Drive from RTher to Work
10:30am-1:15pm Work
1:15pm-2:15pm Lunch

[I’m pretty sad about this Hostess thing – not only because I’m tired of upper management in companies being greedy, bankrupting their companies in the first place, And Then blaming it on the workers who put all that stolen money in their pockets!  And Then of course, a world without Twinkies and Ding Dongs would make me sad.  Are they healthy to eat?  No.  Is it okay to eat them once in a while?  Yes, I think it is.  Are they a reminder of my childhood I would be sorry to see disappear from the earth?  Yes again.

It has been said (most likely correctly) that another company will buy up the assets of the company (the brands and their accompanying product recipes – at least where the Hostess brand is concerned), so that these bad-for-you but occasionally good-for-your-nostalgic-soul-and-sweet-tooth cakes may indeed survive their original maker’s demise.  Just in case they Don’t get sold and survive, I was going on a hunt for ’em in my local neighborhood – namely my closest (within 5 miles or so of work) Hostess Outlet.

Long unnecessary story shorter than it could be – I came away with two bags of powdered sugar Donettes, but there were no Twinkies or Ding Dongs to be had at all in the outlet (good thing I have a box of each coming from Amazon – let’s not talk price – we definitely achieved the ‘silly’ level, but Did manage to stop short of ‘crazy,’ ‘ridiculous,’ and my personal favorite ‘batshit insane.’)  I’m low on time and energy in general these days (and interest too – a touch of depression anyone?  Yeah, I’m being treated for that – it’s cool.), but I’m thinking that was a lunch hour well-spent.]

2:15pm-5:30pm Work
5:30pm-5:45pm Drive from Work to Acupuncture
5:50pm-6:05pm Get blood drawn for lab work

[Please see “Seriously, this Woman Knows Her Way Around a Vein – I’m Naming Names Again.”]

6:05pm-7:00pm Acupuncture
7:00pm-7:45pm Drive from Acupuncture to Home

[Including a quick drive-through of a pharmacy to drop off the Rx for pain meds I was grudgingly given this morning.]

Tuesday [Radiation Therapy – Day 17]:

Hm, I completely did Not (obviously) keep track of this day, and since this is actually being posted Monday November 26, 2012, I’m gonna let this one go…

Wednesday [Radiation Therapy – Day 18]:

[Otherwise known as (effectively) Friday this week, with Thursday and Friday off from work.  :)]

7:05am-8:00am Drive from Home to RTher
8:05am-8:15am RTher
8:15am-8:20am Post-RTher ablutions
8:20am-8:35am Chatting with “Georgia” at the main lobby reception desk at the RTher facility
8:35am-8:45am Driving from RTher to Work
8:45am-1:00pm Work
1:00pm-1:30pm Lunch

[On days before holiday weekends, my company intends to close early.  To that end we’re asked to take short lunches.]

1:30pm-3:00pm Work

[Yup, we did close.  Yay!  (You see, I work in a fairly small shop, and the policy is ‘we all go or we all stay,’ so work that has be done by any one of a handful of us can scuttle an early day for all of us.  I’ve been both the scuttler and a victim of someone else’s scuttling in the past – but not today!)]

3:00pm-4:15pm Drive from Work to Home

Additional Tasks Accomplished This Week:

– blogged
– RSVP’d to two Thanksgiving Dinner invitations – one yes and one no
– indulged my returning knitting habit by buying more yarn for the stash (yeah, I know but it’s a thing with us crafters)
– that’s about it – it was a short week, ya know?

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Radiation Therapy Journal – Day 17 – Tuesday November 20, 2012

Treatment Notes:

– some odd pain this time during treatment – some at the spot where my ribs in the treatment zone attach to my sternum, and some in the fold of my left armpit – at two separate points in the five minutes it takes me every morning, but still – weird.

Side Effects:

– pain – less of it today.  🙂  I’m crediting Mo (acupuncturist) and Dr. Chu’s acupuncture pattern he calls “WTF,” which I got, with a pain relief “back” as they say in bar lingo.  This is the second time (with Mo in particular, and with Dr. Chu’s WFT with a pain relief back) that I’ve had a better week, both on the energy and pain scales, after having their needles stuck in me for half an hour or so.  I’ve currently been doing this every other week (alternating with Support Group weeks, so I’m doing something other than strictly required medical appoints, but only one, every week – I kinda figured that was all I could handle time- and energy-wise), but I may have to add this into every week (even though it would mean on Support Group weeks, I’d be doing something after work both Monday and Tuesday) if it has the positive effect I’ve now seen twice.

–  more lightheadedness – this time as I was walking back to the elevator after coming back to work after a late lunch break.  I ate a big breakfast and I had some lunch before I ran my errand.  Ah well, how I feel these days is, sometimes, an hour by hour thing.

RTher

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Radiation Therapy Journal – Day 16 – Monday November 19, 2012

Treatment Notes:

– some warmth during the up-from-under portion of today’s program, otherwise not much, kinda in-zap-out

– I laid myself down on the table this morning Without taking my dress down – they had to remind me (and they were so good about it too)!  Oops!

Doctor’s Visit:

– there’s a first time for everything – I’ve never been treated like an addict before.  I finally realized that is the POV that Dr. Sanghani is coming from.  (Yep, naming names.)  I told her that I haven’t had a pain-free day in 14 weeks (since my first surgery).  My intention was to convey the fact that when one’s been in pain that continuously, one’s pain-tolerance may drop.  My dad had a different interpretation – one which never occurred to me: that I’ve been on pain meds every day for the last 14 weeks.  Which I have actually.

What she did not seem to hear and/or take into account is that what pain meds I’ve been taking have changed with my needs over that time.  The highest I was taking was Norco 10 (10 mg hydrocodone/325 mg acetaminophen) right after my 2nd surgery – for about a week or so.  Then something miraculous happened…I stopped taking it because I didn’t need that much pain relief anymore!  :-O  Oh my gosh, I have the ability to self-regulate my intake of pain meds according to actual need – just like a real non-addicted adult!  Can you imagine such a thing?  As it happens, when I first started radiation, I was down to two Aleves twice a day and that was doing the deal.

But let’s be real – the object of my radiation treatment is to destroy cells.  Sorry, well actually I’m not sorry if that makes some people uncomfortable, using those words.  I’ve left my sugar-coating this stuff behind a while ago.  The object of the treatment is to cause damage (a measured amount, more or less, to be sure, but still damage) in my body.  Causing damage to the human body nearly always results in pain.  This treatment causes skin damage – irritated skin can be painful.  This treatment causes swelling in the radiated area.  Swollen tissue presses on nerves – often causing pain.

It is not nearly in the neighborhood of crazy that I should be experiencing pain (increasing pain, as more deliberate and intended damage is done to my body over the course of the treatments), and desire some relief from that pain.  Also, I have recent experience with some pain relievers, and you know that disclaimer they put on narcotic Rx’s: “May cause drowsiness – Take care while driving or operating machinery until you know this medication affects you?”  Guess what, I actually know how these medications affect me, from recent, personal experience!  I actually know I can function, work and drive on 2.5mg hydrocodone.  It’s when I take 5mg that things get a little weirder.

The funny thing is this: I realized that the very fact that she is treating me like an addict (by doling out the bare amount needed to get me through to our next scheduled visit on the amount I’m telling her I’m taking now – not thinking that my pain may increase with more treatments – two more to go this week – and if I have to take more than we planned on, I’ll be stranded right in the middle of a 4-day streak when I can’t easily get to her – nice) – is actually making me act like one!  In order to get my needs met, I’m gonna get my pain meds from another doctor (because I don’t need to have this begging, bullshit conversation every week until the end of my radiation therapy)!  So, because she assumes I’m an addict and therefore is treating me like one, I am actually displaying doctor-jumping drug-seeking behavior…too fucking funny!

Of course, it’s not really funny, because that was one prong of a two-pronged visit wherein Dr. Sanghani completely lost my respect and trust.  She has now given me the strong impression that she really does not care what happens to me after she’s done with me.  And that’s fine, for her.  Not so much for me, since I actually get to live in my body (hopefully for another 40-50 years – yep, not a typo – if this treatment business does its job).  Part of that for me is what the girls look like and how I feel about them specifically, and me generally.

To that end, my RSurg has recommended against me getting a boost because it causes more damage, that she will be having to fix.  But Dr. Sanghani is focused on (and Only on) eradicating the cancer as best she knows how – side effects, temporary and permanent, be damned.  Don’t get me wrong, I want the cancer to be completely gone.  I”m not stupid, and I get what this is about.

And…

I also expect 40 more years of living after this treatment course is over.  I’m currently 46 years old.  That means I expect to live almost as long as I have already been here.  That’s a Long Time to deal with physical defects that could be avoided.  And, if I don’t come out of the other side of this feeling good about myself, healthy And sexy, then really, that’s not a successful outcome – it’s the classic quantity vs. quality of life question.  I want both.  Am I greedy?  Yes.  But wouldn’t you be too in my situation, if you thought you could have both?

So my problem with Dr. Sanghani is that the quality of life issue is not at all important to her.  She doesn’t have the same overall gameplan for my recovery as a complete person that I do.  She’s too focused on the tumor and/or the disease and forgets both of those are attached to an actual human being.

Whereas, my RSurg sees my outcome as a whole person.  She has been involved with this since almost the beginning – certainly before my first surgery.  Her opinion has been dismissed by other saying “of course she cares about how you look when this is done – she’s a plastic surgeon.”  What they don’t know is that that perspective comes from an understanding of breast cancer recovery as a unique blend of mind, body and soul, in a different way than almost any other cancer because of the physical disfigurement attendant to it.

Why do I believe she has my best interests at heart and I don’t trust Dr. Sanghani?  When I met my RSurg, it was the very first time since my diagnosis almost a month before, that I actually felt calm – I could take a deep breath.  I have re-experienced that ‘safe haven’ moment in each of my subsequent visits with her.

I knew also that she had pioneered a one-step mastectomy/implant procedure for breast cancer patients.  She is experienced not just with cosmetic procedures, but with reconstruction after cancer.  She called me (as did my CSurg seprately) to explain why she was not comfortable with and therefore could not do my reconstruction at the same time as my excision surgery – namely that if my CSurg did Not get clean margins the first time and my RSurg had already used my own tissue to do the repair, then my CSurg would have to go in and re-excavate the tumor bed in order to Get clean margins, thereby wasting all of my own adjacent tissue (it would have to be removed along with more edges of the tumor bed) and that tissue would be forever gone for reconstructive purposes.

Why is reconstruction such a big deal for me?  Please see “A Lesson in Volume.”  Let’s take a divet this size out of the front of your body and see what you think, eh?

Anyway, this made sense to me.  I understood it.  Although I would rather have had only one surgery (that would have been ideal, wouldn’t it?), I went into it accepting that I would have two or three (if my CSurg did not get clean margins the first time) and that I couldn’t even Schedule reconstruction until pathology on the tissue confirmed clean margins.  And I accepted it because I Trusted that both my CSurg and my RSurg had my best possible outcome – physically, mentally And emotionally – in mind when charting my treatment.  I trusted (and still trust) this about them because they had instilled this trust in me by how they interact (still) with me.  Dr. Sanghani hasn’t really done this in the same way – my calm last week was (apparently) a temporary reduction of defending myself against doctors who mistakenly think their relationship is about them and not about the patient.  <shakes head>

Side Effects:

– pain – more of it every week.  These days it can hit anywhere from the left side of my sternum where my ribs attach, all the way to past the midline of my body under my arm – and from almost up by my collarbone down to the inframammary fold – including my chest wall under Lefty and Lefty itself being just generally tender.  Lovely.

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