Zap!

My treatment plan consists of four phases. I’ve been through surgery and chemo, so now it’s radiation time. The purpose of the radiation is to get any of the teeny tiny cancer cells that were left behind after surgery, and ones that chemo can’t “get”. My whole body is not being radiated, (thank goodness), just the left chest wall and axillary area, as those were the places where cancer was known to reside. Many people have said that radiation is easy. I’ve heard that it’s better than chemo. I’ve heard that it goes by fast. Well, I’m here to tell you that radiation sucks rocks. Big, giant, acid-dipped, spine-covered rocks! Frankly, I think I’d rather go through four more rounds of chemo than endure radiation. Nope, that’s not hyperbole, it’s the honest-to-goodness truth. Let me tell you about radiation.

Patients who are undergoing radiation therapy are being zapped with high energy particles, like x-rays and electron beams. By doing so, any cancer cells left behind are damaged. This damage doesn’t come about in one zapping, though. It takes a long series of the exact same dose to do the damage. In my case, x-rays are being used and there are 33 treatments planned. That’s every. single. day, M-F for 6 1/2 weeks! Every. single. day.

In order for the treatment to be maximally effective, it needs to be delivered to the exact same locations every time. How do they go about doing that? For starters, I have five tattoos to help line up the laser beams. Then they measure exactly where I need to be on the table, what angle my arms are at, how high my legs are, whether or not my torso is twisted . . .everything is measured every day, down to the millimeter. (This was all set up when they initially took lots of xrays and measurements several weeks ago. After studying all of that, they came up with a plan of how much radiation would be delivered to which areas and where I would need to be in relation to the machine. This is especially important in my case because I’m receiving radiation on my left side, which is where my heart is located. Zapping the heart = BAD!)

Anyway, so every day, I go in and get set up on the table. There is a little ridge right under my butt so that I don’t slide down on the table. My arms are over my head (my fingers can touch) and rest in little arm cradles. My legs are on a leg cradle with a pillow stacked on top and they put a ring around my feet so that they don’t move.
My head rests in this cradle thing, which is comfortable at first, but by the end of the longer sessions (45 minutes), it has ceased to be comfortable and it becomes the cause of pain at the base of my head. In fact, one day it was so bad that I walked out of there with the right side of the back of my head completely numb! (In all fairness, that only happened once, and they are getting faster, so I generally am only there for 20-30 minutes. But it’s still not comfortable!)

So now I’m laying down, and they start to adjust and fine tune to make sure all is nicely lined up. Then they say, “Okay, don’t move! Let’s get started.” At that precise moment, it never fails that my nose starts to itch, or a piece of fuzz lands on my face, and I’m left desperately trying to not think about it. Yeah, you can imagine how well that works!

They leave the room and via a little speaker system, I’m instructed to take deep breaths, as they are using the breath hold method of radiation delivery. (This is actually a big bonus. The radiation is only delivered when I’m holding my breath, so I know just when it’s being delivered and there are no surprises. Prior to starting, I had all sorts of visions of me accidentally twitching just before they delivered the dose, and then I’d get zapped in the wrong place. Poof! There goes my heart! Okay, so here I am exaggerating a bit. But really, it’s pretty nerve-racking to be laying there, feeling like “If I move at all, I’ll get zapped in the wrong place!”) So I’m breathing deeply, and then I’m instructed to exhale and hold the next breath. They take an x-ray with a machine, then the radiation machine is moved directly over me, and they take an x-ray with that machine as well. (In between, I can breath normally.) At this point, they make sure that the x-ray of the day lines up with the x-ray from the inital setup. If things don’t line up exactly, they move the table remotely. Imagine, laying there, peacefully, and suddenly the table jerks to one side. Startles me almost every time!

And now, the fun begins: the delivery of the radiation. I get radiated in six different fields: one from above, one from below, two at a diagonal from above and two at a diagonal from below. Each field gets radiated at a different dosage and a different intensity. The machine is round (at least the part that I can see) and there is a piece of glass that is divided into quarters. Behind that glass are these little tungsten leaves that control the intensity of the radiation that is delivered. Each leaf can move independently from the other leaves, and they create shapes. Here’s my amazing rendering 😀

The first field, delivered from above, looks like a rectangle and triangle sitting next to each other. The pulse lasts about 16 seconds and it’s one of the longest pulses. The second field, delivered from below, is a totally randomly-looking shape with the pulse lasting maybe four seconds.

Another masterful rendering 😉

The third and fourth fields are delivered diagonally from the top right. It starts out looking like a meandering stream. As the pulse if being delivered, the leaves move up to the top. When they reach the top, the pulse is over. These two pulses are about 10 seconds. The only real difference I’ve been able to discern between the two pulses is the pitch the machine makes. The first pulse is maybe an F above middle C while the second is an octave lower. (The first field is the lower sound and the second field is the higher sound.) I’ll have to ask tomorrow why the pitch is different and if that signifies anything important.

The final rendering.

The fifth and sixth fields are delivered diagonally from the bottom left, and I have no idea what shape the tungsten leaves take as the machine is out of my eyesight by the time the leaves are in place. I could turn my head, but then they’d have to redo the xrays and make sure everything was still lined up. Far be it from me to make this last any longer than absolutely necessary!

So that’s it, unless it’s a bolus day. Yeah, there’s more! Every third day, I get a bolus dose. For fields 3-6, they place this squishy pad on my chest which serves the purpose of concentrating the dose closer to the skin. They also add a 7th field, which is delivered from diagonally from the top left. So bolus day takes a bit longer, and is even less fun because the squishy pad smells bad, which wouldn’t be a problem if I wasn’t spending the entire time breathing in deeply through my nose! Yuck!

Anyway, for me, radiation is totally tortuous and I’ve only made it through 10 treatments. I’m not even halfway there! Fortunately, there aren’t any major side effects, aside from tiredness, so that is good. The other good thing, in my case, is that I don’t actually have breasts. I think it would be REALLY awkward to be laying in that position, completely exposed with the girls just hanging out. So, uh, hooray for a double mastectomy, I guess!

(Hmmmm . . .maybe the radiation is getting to my brain!)

The only other good thing I can think of about the radiation is that I have the opportunity to leave the house and drive my fun car everyday. Sometimes I stop at the coffee shop right after treatment and get a treat, other times I run a quick errand, and other times I just drive home slowly, enjoying the solitude. I’m not sure that makes up for the inconvenience and torture brought on by having to lie still in an awkward position, but I guess I’ll take what I can get!

10 down. 23 to go!