Déjà vu

If you have ever seen the movie Groundhog Day with Bill Murray and Andie MacDowell, you will have a sense of how I’ve been feeling about the past 5½ weeks.  Since I started radiation therapy on April 14th, my life has become a series of days that resemble each other unremarkably in their sameness.

I get out of bed each weekday morning at about 7:20 and catch up on e-mail, eat a light breakfast, putter for a little bit and then suddenly look up at the clock, astonished to see that it is quickly nearing the time I should be leaving the house to go to the treatment center. I throw on clothes, sometimes without the time to iron them first, pull together a lunch, if I’m going to work that day, and bolt out the door for the 25 minute drive to treatment. I have gotten on the road in such a hurry several times that I have questioned whether, in my haste I locked the cat in a bedroom, or turned down the heat, and then I fret about it and try to decide whether to return home between radiation and work to check on things.  I have left my lunch behind on at least one occasion. Invariably, I just make it on time.  I scan my ID card, which lets the technicians know I have arrived, let myself into the treatment area, and zip into the women’s changing room, where I change my top for 2 hospital gowns: one open in the back, and the other one over it like a robe.  Then I wait in the lovely little sitting area, and turn the television channel to MSNBC (yes, one is allowed access to the remote in this semi-private waiting area.)  I catch up on some of the headlines and usually within short order one of the technicians comes to get me for my treatment.

The women's private waiting area

There is one cavernous radiation therapy room, staffed by five warm and wonderful technicians. The room, however, is not warm. It is kept chilly to compensate for the heat put out by running the very large linear accelerator, the machine that provides the doses of radiation. One of the technicians finds it so cold that she wears long underwear all year long! Despite the chill in the air, the hospital has gone to some effort to make the room relaxing, with music in the background, low lights, and a set of tropical beach lightshade panels over the table you lie on during treatment. The dim light also helps the staff as they use green laser beams that emanate from the ceiling and the walls to line patients up correctly with the accelerator. They also provide warmed sheets to cover you, but these tend to lose their heat very quickly. 

The treatment room with the linear accelerator

Every day, I enter the room, shed the outer robe, and climb onto the table. 

The treatment table

I slip my arms out of the other gown so the two technicians working with me that day can access my tattoos, which they use to line me up precisely with the machine. My arms go above my head into armrests so they are out of the way.  It’s not a position I’d care to assume for long.  The techs nearly always have to remind me to turn my head to the left, to move it as far from the radiation beams as possible. And, except for breathing I am not to move while being treated.

In position and ready for lift off

The view above me

Once I am properly situated, the technicians leave the room and the arm of the machine moves from above me to my left side, where it delivers a short burst of radiation. Then the arm moves up and over me to the right side, where it targets the tissue from a different angle.  It’s short and relatively simple.

For the first three weeks, there was not much change that I noticed.  Then one day, my treated skin turned a mottled pink.  A day or two later it was solidly pink, the color of a medium rare steak.  It has remained that color ever since, and is slightly tender, like my skin when it is sunburned.  Every night, I dutifully apply the steroid ointment the doctor prescribed and then the moisturizer they gave me. Every morning, I use a cotton ball like a mini powder puff to pat cornstarch on the affected skin to minimize friction.  

On Wednesdays, after treatment I have a brief meeting with my wonderful doctor, who comes in, shakes my hand, takes a look and tells me that everything looks great. Last Wednesday he also told me that my treatment would change for the last five sessions.  Instead of targeting the whole breast, the final treatments would focus on the area around where the tumor was.  That was a relief, as it meant that the reddest of the red part of the breast would be spared further radiation. 

So that sense of routine – of waking up every morning and marching forward steadily through the treatments and through the day every weekday for the past 5 weeks and 2 days has helped move the process along more quickly than I imagined it could. Now here I am, in the third week of May with only three more rounds of radiation left. Come Wednesday by noon, I will have another part of this marathon behind me.  I think another round of champagne will be in order!   

That Natural Glow

Last week on yet another gray Monday morning, I made my way downtown to my treatment center for my tri-weekly herceptin infusion. This process feels so routine now that the full blown chemotherapy has ended.

In some regards, a lot happened during the three weeks between infusions – and, in fact, during the time since I finished chemotherapy on March 7th.  After a few weeks break, I met with my radiation oncologist on April 6th at my cancer center’s satellite site in the western suburbs, to do a mock-up of my radiation therapy. As always, I went armed with a list of questions – some gleaned from the American Cancer Society web site, others from information friends sent my way.  My friend, Joan came over the day before my appointment to give me a preview.  She was diagnosed a month before I was and was fortunate to be able to forgo chemotherapy.  She did undergo the 6 weeks of radiation therapy under the care of the same doctor I am seeing, Dr. Z, whom she liked very much.  It was great to visit with someone who has recently gone through much of what I was preparing to experience.

At my pre-radiation appointment I became a coloring book for the doctors and the technicians.  I was drawn on with markers by several hands as they outlined the area to be targeted.  I received numerous pen tip sized tattoos to help them line me up with the device that delivers my daily dose of radiation, five days a week for six weeks.  Ouch!  They even took photographs of my decorated chest for help in calibrating the treatment area.  

Abstract art marks the spot!

Since then, I have taken my own photographs to share what the treatment area looks like.

The Linear Accelerator, which delivers radiation treatment

The treatments are flying by with no major ill effects. I have had 17 treatments, with 13 left to go, and my skin is only marginally pinker than before.  I slather my chest each night with a prescription steroid ointment and moisturizing cream that the doctor provided.  The only downside of that is putting on my nightshirt afterwards – it sticks to my slightly gunky skin.  In the mornings I apply cornstarch to the treated area to reduce friction, and then I’m good to go. I do get tired a little more easily, but it’s not the major fatigue many radiation patients experience.  I’m not sure why I’ve been so lucky, but I certainly won’t spend much time worry about the whys on this one.  I just thank my lucky stars and feel very fortunate -- and grateful for whatever it is about me that has made this easier than it could have been!