Tag Archive | radiation

2014 in Review

2014 was a pretty big year for me. Not quite as big as 2013, but quite a bit still happened in my cancer journey. Therefore, I think it’s worth a look back on the year to see what changes occurred.

I started the year recovering from my mastectomy and going through radiation. While radiation wasn’t as hard as chemo, I really didn’t appreciate breaking out in hives at the end of the treatment.

Hives from the radiation treatment

Hives from the radiation treatment

With hindsight being 20/20, I’m wishing now that I didn’t decide to try reconstruction after my mastectomy. It was a pretty close decision, and now it’s looking like I went through all the pain of expansion and living with the expander (never did get anything close to comfortable with it) without the benefit of an implant at the end. It’s not a big deal living without a right breast. When I’m just going to be home, I don’t even wear a bra much.

I did finish up all my active treatments – radiation and Herceptin were the treatments in the beginning of the year. Now I access the port only to flush it.

No more of this!

No more of this!

My hair is still changing as it comes in. It’s much curlier now than it was at the beginning of the year. I think I’m going to keep it short for a while, especially now that I can go four months or so in between hair cuts. Getting a hair cut every two months gets expensive, even at the cheap place I go!

My hair at the beginning of the year

My hair at the beginning of the year

My hair at the end of the year - so curly!

My hair at the end of the year – so curly!

Things to look forward to this year: not as many doctor’s appointments, since I’m not in active treatment. I’ll have another MuGA scan and a mammogram, but I’m not sure what else in terms of tests. I’m down to every six months with Dr. Engel, and I something similar for the oncologist.

My big goal is to get my port out. I’ve finally gotten used to it and hardly ever notice it anymore (it only took about 15 months), but I still will be happier with it out. If nothing else, it will open up my bathing suit and mastectomy bra options.

Let’s see what the year brings, shall we?

 

Graduation day!

Radiation is over!!!

Actually, it’s been over for a couple of days, and I’ve been glorying in being able to sleep until 7am (when the dog invariably wakes me up) and not have to drive anywhere if I don’t want to. StatsGuy is back to warming the car up for himself. Lucky for him, the winter seems to be over.

I even got a graduation present from the radiation staff:

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It’s a cute little apple pin. Definitely something worth wearing about for a while, to celebrate being done.

Look at the present box:

The last present

The last present

So empty. I saved a big one for last.

The last present

The last present

It was a box full of love from my family. So sweet!

At this point, my skin is peeling (including my ears), and there’s one sore spot under my armpit. However, most of the skin has healed, even of the pinkness. Next, I have an appointment with the plastic surgeon to figure out when to finish up with the reconstruction.

Time for a boost

I’ve finished my regular treatments and have started the boost treatments to the area immediately around my mastectomy scar. Even though I’m on the same machine, it’s still a lot of changes to the treatment. For one thing, I’ll be treated with electrons instead of X-rays. To do so, they add an additional piece to the radiation machine.

See the tube extending below the green light?

See the tube extending below the green light? The red laser is reflecting off the base of the extension.

At the base of the tube, a square of lead is clicked in place that has the cut-out of the treatment area.

One side of the treatment area

One side of the treatment area

To get the proper shape, a tech has to draw on a glass plate clicked into the base of the tube and trace the outline of the treatment area that’s been marked on my expander. The trick is, you can’t just look straight down and trace because the machine is in the way. Instead, you have to curve your hand in between the metal arms and draw with the shadow of the pen following the line on my skin. Very tricky.

Because of the curve of my expander, the physicist and radiologist have recommended feathering the treatment area, which just means they break it into two halves and rotate the machine to get the proper angle for each dose.

Rotation for treatment

Rotation for treatment

The whole device gets within inches of my expander. The techs traced the outline of the treatment area onto my skin from a template developed at the beginning of the treatment, and then line up the light projecting through the metal piece with the tracing. Unfortunately, they couldn’t get the cut-out to line up with the marks on my skin. It seems that my expander has shifted slightly, so they needed to recut the metal to match my new contours. It took the two techs, the physicist, and Dr. Figura about 15 minutes to come to that conclusion, with my lying there with my arm in the torture device arm-holder the entire time.

I had three options at that point – I could stick around while they made a new metal piece (nope, sorry, have to be somewhere at 9), I could come back later that afternoon (before 1:30? No? Then sorry, have to pick up my kids from a class), or I could add another treatment day where they just make up the one treatment. Seems like I have to go with option C. That means I’ll be ending next Tuesday instead of Monday. Even if it adds another day, I’m down to counting on one hand the number of days I have left.

Half my doses are done!

I found out yesterday that it was the last day for my second set of radiation doses. I won’t be getting any more treatments to the area around my clavicle. That means I’m down to just two doses a day, both centered around my breast. I’m happy to be done with even part of my treatment.

I will admit the upper part of my expander has been irritated lately. Dr. Figura is pleased with how the skin looks, but even so it’s pink and sore and itchy. I almost wish it was warmer so I could not wear any clothes over the area. The advantage of it being winter is I can wear lots of layers and the size difference between the expander and my breast isn’t as noticeable. The disadvantage is there’s always something rubbing on my skin. I tried something different yesterday and wore a snug-fitting T-shirt under my warm clothes to hopefully decrease the rubbing. It seemed to help. The nurse suggested cortisol cream to help with the itching.

gollieI have been following the recommendation not to wear a bra so as to minimize further irritation to the area. That works as long as I’m not going out in public. Then I wear a bra because the size and height difference between the expander and my other breast is highly noticeable. The downward slant is what bothers me most. StatsGuy came up with nicknames for the pair of them – Bink and Gollie, after the book series by the same name with two friends of completely unequal size.

Someday I’ll get the expander removed. I need to finish radiation first. Soon!

Halfway done!

Yesterday was the half-way point on my radiation treatment. On one hand, I’m excited to be halfway done. On the other, I can’t believe it’s only halfway. Side effects of the radiation are still pretty minimal, although I am noticing more dry skin and pinkness, especially on the expander.

I celebrated with another marking session, this one for the last five days of radiation that will target the area around my mastectomy scar with electron beams instead of X-rays. The techs slid in an additional device on the radiation machine that will bring the pattern specific to my scar closer to my body. They transferred marks from a template onto my skin (Sharpies, once again) and then from my skin to a clear plate in the device. They’ll use the clear plate to develop a mold and pour the lead alloy around it to make my radiation pattern.

Part of the action for the marking session was figuring out the specific angle to irradiate me, which involved spinning both the table I lay on and the radiation generator. This was all directed by an in-house physicist. I want to know how you get that job, but all I was able to get out of her was that she has a Masters in Physics. By the time we were done, I looked like I had a sock monkey mouth drawn on my expander.

General discomfort

It’s three weeks into radiation, which is when side effects often start to appear. I’ve got nothing too bothersome going on, just some minor annoyances. I have one patch of dry skin high up on my chest. The location was really confusing me, since it’s not really even in the radiation area. Dr. Figura cleared up the confusion for me this morning, though, when he asked if it was where I had a sticker. That explains it exactly! It’s even a round patch of dry skin. I am faithfully slathering on moisturizer twice a day to the whole area, so hopefully the dry patch shrinks quickly and nothing else appears.

The other annoyance is the skin and muscle getting irradiated are tightening up. The physical therapist warned me this could happen, so I’ve been stretching the area whenever I think about it. It feel worst first thing in the morning, and I feel it mostly in my armpit.

I have been using my Swell Spot on a weekly basis. I think the radiation encourages the buildup of fluid around the expander and in my armpit. I don’t appreciate stretching my arm out in front of me and feeling the expander rub on the inside of my arm. It gets in the way when I drive as well. As I said, nothing too horrible, but definitely annoying.

Radiation routine

Radiation has quickly moved into a routine. Every day goes something like this:

  • I get to the Cancer Center
  • Scan my card and sit for a minute (I usually don’t even have time to check my email. I’ve stopped bringing my book, they’re so fast getting me in.)
  • Head back to my room
  • Lay on the table, with my arm in the horribly uncomfortable braces, and a pad under my knees. I keep waiting for my shoulder to stop hurting or my fingers to stop going numb. Hasn’t happened yet. On a good note, I have nailed the perfect place for my head.
  • The techs scootch me over a bit here and there so I line up perfectly
  • Four scans – one below, two on top, one farther below. The two from below need a wedge of metal in the X-ray machine to direct the radiation correctly, so the techs have to come in after the first scan and before the last scan
  • I’m out of there within 15 minutes

There are a couple of differences, depending on the day. On Monday, Wednesday, and Friday, I get a bolus of fake skin put over my chest for the first two treatments. This allows the radiation to target closer to the surface of my skin. Once a week I get X-rays to make sure everything’s still lining up. Once a week I see Dr. Figura, just to make sure there are no problems (none so far). I will occasionally get a dosimeter put on to make sure I’m getting the correct dosage.

All in all, a quick process on a daily basis. It just takes forever to be done with the whole treatment to be done.