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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