RADIATION

Radiation is barbaric. Chemo is more so, but if I am going to get my flesh toasted, can’t it be a less odious procedure? Doctors told me that my options were to get cooked every weekday for a month or have Brachytherapy, in which a  probe the size of a thumb was inserted and left 24/7 for a week, with twice daily visits for five days to insert radioactive seeds. This would require restricting basic activities like showers and would hurt. This probe resembled an thumb-sized egg beater, with tubes sticking out. Nope. Nope, nope, nope. That thing in my body? How would it even fit? My second thought was can’t they do better?

Reading too many internet articles on radiation side effects had scared me. Flesh blisters, hardened flesh and fatigue sounded terrible. Did I really need to do this?

My medical oncologist suggested a doctor that has a week long/twice per day external beam radiation treatment, with no interior eggbeater probe. This seemed too good to be true, because the surgeon had not thought it an option and the radiation doctor had not offered it. Going twice a day would be pain, but the short time line could minimize side effects of fatigue and possible skin damage.

My first appointment with the radiation oncologist got off to a rocky start because she was late, but she seemed like nice. She apologized for the delay and explained that she had been using this radiation method for twenty years and that the short time period was an advantage. Wanting to get this treatment over quickly, I was sold.

The second appointment, a technician cat-scanned the area to be radiated and made a mold of the body to position it precisely. They also tattooed the point where the machine zaps the flesh.

The first treatment took about twenty minutes.  Ill-timed road construction made me late, which only added to the stress. My body was positioned and I had to lay still the whole time with my arms overhead gripping the hand rest. The machine hummed and whistled, passing to the right, then stopping for what seemed five minutes. Nothing felt hot when the beam moved over me. The round part of its head then rotated and passed back across to the left. The only thing to stare at besides the machine was the green laser light across the ceiling. Too bad a picture wasn’t up there to look at to ease the tedium. When it was done, someone came in the room to help me get up.

The decor of this place was much better than the usual medical institution. The waiting room was round with a tall ceiling, enhanced by organic wood cut outs and a fancy chandelier. The dressing room was decorated with butterflies. Still, I just wanted to get in and out in a hurry. After the radiation, I rubbed cream on the affected body part, which was red and hot, then got the hell out of there.

The after effects were sneaky. They would come and go and sometimes stay. I felt fine driving away the first time, then suddenly felt weak, tired and a little queasy. I continued to my destination, but didn’t feel that good.  I considered going home, but continued on. I felt a little better after a while. 

I got a swim in, then lunch. Exercise kept me sane through this process, even if I was too tired to do it well. It was something under my control that made life seem more normal. In the afternoon, I returned to the place using a different route.

I repeated the pattern. The next day, I ran, then went to the radiation place again. I didn’t feel woozy, but was tired. I got some grocery shopping done afterwards. The yucky feeling came later in the day. The breast was sore and looked a little red, but wasn’t too bad.  

The third day I felt tired and weak in the morning and it continued through the afternoon. I told the doctor, but she didn’t offer much help. It was something to suck up and get on with. A nap  helped. 

The fourth day I ran again, then felt crappy for the first appointment. Then, swimming in the cold weather, which was uncomfortable. The stiff wind blew on my wet arms. It was a struggle to keep going through the fatigue, but I stubbornly persisted.

In the afternoon, a nap beckoned, but had to wait until after the second appointment. The pattern of exhaustion seemed to be worse in the morning, better in the afternoon.

Friday and the last day of radiation! I felt icky again after the morning session. Afterwards, I saw the doctor. My usually low blood pressure was very high again.  My left arm has a lower reading, but they won’t use that one anymore, due to it being on the side of the surgery site. Maybe it was a problem to be looked into, or maybe it was stress. The fatigue after treatment will get worse for a while, then get better. The skin looked a little red, but was otherwise okay. Skin reactions can occur up to ten days after treatment.

Were they Really Gone?

I got to hit the shiny golden metal gong for the last treatment. Was this ordeal really over? The fatigue, the nausea and the stress? I almost felt a sense of guilt not going through as much as other cancer patients. Only a month of treatment with surgery and radiation. A week later, I felt almost normal again. I was lucky to be relatively unscathed. Maybe the ghost cells were still there, but the original Seeds of Death must be gone. In the mushy medical world of prediction, radiation was supposed to prevent re-occurrence, but not with total certainty.

What a relief. Life could move forward again. Or so I thought.

NEXT UP: CHEMO

Surgery

Since I had small, lazy  cancer, either a mastectomy or lumpectomy could be done. My goal was to disrupt my life as little as possible. A mastectomy would mean a 0-5% re-occurrence rate and no radiation, except if the nodes were positive for cancer. It would require 4-6 weeks recovery. The survival rate of a lumpectomy was the same, with a 5-10% re-occurrence rate, but would require radiation. The recovery would take a week. The trauma of removal and a long recovery of loping off a body part was not appealing, especially with a small cancer. I chose lumpectomy.

This recovery from this surgery meant no swimming for two weeks, no running or cycling for a week. This was annoying, but tolerable. Walking was allowed. At least my muscles wouldn’t totally go to hell. Being a Type A triathlete, it’s very hard to let my body go idle.

Transportation to the surgery and back would be a hassle. I hated to ask anyone to help, but had no choice. The schedule was stupid. I had to be at one place at 10:30 a.m. for a needle localization, then go to another place for the surgery and wait around until 3:00 p.m. This was a lot to ask someone. Maybe I could Uber down and have someone pick me up, so they weren’t waiting around forever.

Eight hours prior to surgery, fasting was required and drinking nothing except a cup of sports drink. At least I could get breakfast and coffee before 7:00 a.m. No coffee would be unbearable. Not being able to drink water made me anxious. I was a little light-headed riding down. A friend drove me and stuck around the area the whole time. I felt bad about the inconvenience to her.

The needle location involved compressing the breast in an mamogram machine and inserting a long, thin needle that projected out of the tissue. The imager suggested not looking at it and I had no urge to see an alien projectile emerging from my body. Then, they coiled it up and covered it in a bandaid. The needle insertion hurt, like the last time, even with numbing. At least I got to sit down and it wasn’t as much poking.

They made me take a wheel chair down and my driver took me to the other place. Again, it was the routine of registering, waiting around, and going back to a holding area. My driver took off after the registration. I found out to my surprise that someone was supposed to stay all night with me and that I had to get rid of my debit card and cash. But of course I had to pay their fee. It would have been nice to know this ahead of time.

I laid on a gurney for 1.5 hours until a nurse came and gave me an IV. I got rid of my contacts beforehand. I had been warm waiting, but when the fluid was injected, I got cold and my legs felt shaky. After some more waiting, another nurse asked me a bunch of medical questions. She was a talkative and no nonsense. She complained about the omission by someone of my support socks. My blood pressure soared again with the stressful idea of being cut up.

General anesthesia would be used, with a breathing tube. The anesthesia doctor came in and I mentioned my past experience after surgery that involved a splitting headache and vomiting three times. Hopefully, this wouldn’t happen again.

Reading a book about Alexander Hamilton passed the time in between the various medical personnel. Waiting was boring and stressful.  Finally, it was showtime. Surgery was supposed to last an hour and a half.

My surgeon came in and talked about the surgery and aftercare. The results of the test to see if the margins were clear would come in four days. Rarely, the surgery has to be done again. The results of the test on the nodes would take two weeks to come in. She suggested that my February 10k might be better to pass on because the side effects of the anesthesia last a long time. I was surprised to hear that, blithely thinking that I would feel fine in a short amount of time.

I don’t remember getting a sedative or anesthesia. Waking up, I was really groggy, but not in pain because the surgeon had given me a novocaine block. Wanting to really get the hell out of there,  I tried desperately to force myself out of the mental fog. It was dark outside and the holding area looked empty.

When I was more functional, they put me in a soft chair to get dressed. My driver couldn’t start her car, so she had to call her husband to jumpstart the car. I finally got out of there by six. We stopped by the drugstore to get painkiller pills. She had called my other friend to stay for the night. I wasn’t prepared for this and was stressed, but we adapted.

I ate some applesauce and plain brown rice, because I wasn’t super hungry and didn’t want to risk nausea. I went to bed about 8:30.

I was too tired to get up and take the painkiller at 9:40, but by 11:30, the novocaine had worn off and I hurt, so I took one. Sleep was difficult, especially on my left side. My back also hurt, so I tried laying on a lacross ball to unknot the muscles. The cat complained a few times during the night. All in all, a crappy night’s sleep.

“RECOVERY”

I underestimated how bad my body would feel. Not having had any heavy duty surgery since my daughter was born, I naively thought that normal activity could be resumed right away. Ice and Hydrocodone helped with pain, but not much. Then two days later, the pain lessened and fatigue set in. I walked for a mile the day after surgery, then gradually worked up to three miles running the week after. The jarring of running hurt the surgery site, but the discomfort got better. Cutting out cancer in a lumpectomy made rearranging chest muscles necessary, so they ached with movement.

A week later, I got my bandaids off, which was a relief. It was weird to take showers and feel like the plastic film on my skin was getting water logged. The tissue was still swollen and achy, but the margins were clear. There were two lesions. Two lymph nodes were negative, which was a relief.

TAKEAWAYS FROM THE EXPERIENCE:

1. Sometimes I have to accept help even if I don’t want it.

2. General anesthesia messes up the body for weeks.

3. Discomfort from slicing the body can last for months.

4. I hate being a patient. Recovery is boring and painful.

5. Even when I feel better, I still tire easily.

6. Even when tired, it’s good to force my body to exercise, though not at the same levels pre-surgery.

7. “Recovery” isn’t total recovery, but the fatigue and discomfort subside. Real recovery takes a lot longer.

NEXT: RADIATION