Wednesday, February 25, 2015
Run/ Walk/ Bike/ Elliptical (Today: 2.5 miles; Running Total: 186.13 miles)
Day 229 of *Another* 100 Days of Good Karma.
Today I went to the radiation simulation appointment.
When they say ‘simulation’ they aren’t kidding. I didn’t realize it would be such a detailed process. I was surprised at how much forethought and planning went into creating a radiation treatment plan (though it makes sense since it is a branch of Oncology). I thought it was just going to be a matter of ‘take your shirt off and lay back while we shoot beams of light at you’.
Obviously this is why I’m not a doctor.
When the nurse called my name I was shown back into the room you see below.
I put on the ugly hospital gown (seriously, can’t these be prettied up a little?) and laid back on the table.
Side thought: The new story of my life can be summed up in two phrases. “Open to the front” and “Everything off from the waist up”.
The nurse positioned me on the foam that would eventually become my radiation cradle (more on that in a minute).
The table slid through the CT scanner and images were taken of my lungs and heart and any other internal organs that might fall in the line of radiation fire. These images help the radiation oncologist make a plan for radiation treatments.
Everyone’s anatomy is slightly different so the doctors have to take into account how close my heart and lungs lay to my chest wall, and how deep the radiation will penetrate my skin. The images from the CT scan help them form a plan customized to my body.
While I was on the table the cradle was made. The radiation cradle is a piece of foam that forms to my body and the position my radiation oncologist wants me to hold during treatments. The cradle helps the radiation oncologist more accurately reproduce the way the radiation hits the area being targeted. That would be difficult to do if I’m moving around, however slightly, from week to week.
Something else they did while I was laying on the table: they analyzed my breathing patterns. A small rectangular box was taped to my stomach so the round black gadget you see at the end of the table could look at the box and track my breathing patterns.
It makes sense that the movement of breathing could affect radiation treatment, but it sure never occurred to me until I was the one on the table. I can hold still for a long time (say twenty minutes), but I sure can’t hold my breath for that long. So the movement of my breathing has to be factored into the plan for radiation.
When my nurse removed the box she marked where it was taped to my stomach with permanent marker. I’m not sure why, but she said during radiation they’d need to know where the box was during the simulation.
Speaking of breathing, several CT scans were done while I was holding my breath.
The nurse said there are several ways of doing radiation treatments, one of which involves me holding my breath (I assume for short periods of time although she didn’t specify).
She explained that when you hold your breath your chest wall is lifted away from your heart creating more internal space. The radiation oncologist may have me hold my breath during radiation depending on how my anatomy lies. My nurse said that if I have to do the hold-my-breath kind of treatments (something the doctors will figure out when they create my treatment plan this week) then I’ll have to do ‘films’ every week.
I assume she doesn’t mean they’re going to film me topless (if so, I better get paid), but I wasn’t clear on whether that meant I’ll get a CT scan every week or just an x-ray.
I probably should have asked for clarification, but at some point my ability to take in new information capped out and I got lost in the medical jargon. So I just nodded my head fully aware that I’d find out the exact process next week, whether I wanted to or not.
Before I got up off the table my nurse drew lines all over my right side in blue and orange permanent marker then covered the marks in tape. I have blue and orange crosses and hash marks and lines all over the damn place, a few of which you can see without me showing you my poor mangled boob (sorry that picture’s never gonna be posted on the web if I can help it).
She said I can take a shower, but not to scrub the lines. She said the marks might need to be touched up between now and next Wednesday when I come back to begin radiation treatments.
During radiation the marks will be maintained every day. I just have to be careful with them up until radiation starts. Since it’s possible for me to sweat them off I have to factor that into my physical activity for the next week.
If the marks come off completely the simulation will have to be re-run and a new plan will have to be formulated.
When I left the nurse handed me a hard copy of a calendar spanning March and April. On the calendar was every single radiation appointment. One more simulation and thirty treatments are scheduled for five days a week starting next Wednesday. Right now the calendar says my last radiation appointment is on April 15th.
I took it and said thank you, but just looking at that calendar exhausted me.
It was a relatively short appointment (only about an hour), but it made the radiation treatment process go from ‘something happening in the distant future’ to ‘this shit is happening now’. When I got home I tried to keep busy by folding clothes and working on a story, but every time I walked past that printed out calendar with all the radiation appointments on it I got all jittery and anxious.
So I did something I’m not proud of: I poured a glass of wine in the middle of the day.
Disclaimer: Yes, I was sober when I picked the kids up.
I’m not in the habit of drinking by myself (or at noon for that matter) so I Skyped my mom. She got a chuckle out of me. I’m pretty funny in that oh-so-brief window between tipsy and sleeping.
Funny or not, drinking at noon does not mark my finest hour. But goddammit I’m sick of cancer treatment.
Feel free to judge me now.
Today’s silver lining: Cancer sucks, but the science behind treating it is pretty cool.
You know what else is cool?
(at a more reasonable hour, of course)
What’s your silver lining today? I love comments!
Don’t want to leave a comment, but have something you want to share? Send me an email at gettingthewordswrong(at)gmail(dot)com.