Month: August 2020

Radiation therapy is pretty uneventful. The worst part of it continues to be the drive, what with the West Seattle Bridge being closed and the traffic being so unpredictable.

No real side effects. So far the only thing that really seems to be happening is that my skin is getting a little red.

Also I’ve gotten migraines every weekend, but that could be due to the driving as opposed to the actual radiation.

I have a little routine now – I get into “work” first, and check traffic as I do morning work things – read and answer emails, do meeting prep, etc. The plan is to leave an hour before the appointment starts, but I’ll leave even earlier if Google traffic looks bad.

The drive is usually fine until West Marginal Way South. If it starts backing up before the 6500 block I know it could be nasty. but I also know that if i get onto the First Avenue South Bridge by a half hour before the appointment start time I’ll probably make it on time.

Since I hate being late and I always leave so early, I usually end up getting there 15-25 minutes early. If it’s over 15 minutes I find a street parking spot and check my phone until 15 minutes before. Then Ill go to the underground parking garage. If the radiation spots are open I’ll park in one of them. If not I’ll park somewhere else. I’ve only had to park somewhere else two or three times, once I figured out where they were (they are spots B3, B4, B6, B8, and B10). They are right by the pharmacy entrance in the south building. I can just go in there, run down the underground corridor to the main building, and Radiation Oncology is right there.

If I’m early enough I’ll use the restroom first. Then I check in – I have to give htem my date of birth and Kaiser Number each time – and they send me back to the dressing rooms.

i always grab the same locker and the same changing room if I can – one time I accidentally walked in on someone in the changing room because I was so used to going to that one and didn’t expect someone else to be there.

I’ll send Sam a text to let him know I’m there. Then I change into a hospital gown and lock my stuff up in a locker.

Usually they are ready to take me back to the radiation room right away. They also ask my birth date and take my temperature, because of COVID-19. I have passed that test every time so far.

Then I go into the radiation room, which looks like this:

The bed thing is covered with a white sheet, and there’s a thing for your knees so you can bend them and be a little more comfortable. The person in the picture has their arms crossed at their chest and is wearing a gown – I lie down on the bed thing and put my arms up over my head – they have little guides to hold them in place. And of course I have to pull my hospital gown down.

The techs make sure I’m perfectly positioned on the bed thing. There are lasers that help them see exactly where I need to be, and they align those with the tiny dot tattoos on my torso.

Then they leave the room and go to their control room to administer the radiation (they have cameras so they can spy on me in the radiation room).

I get three doses each time. See how the radiation machine thing looks tipped? It actually rotates in a half-circle so it can shoot radiation at you over 180 degrees. So each of my doses comes from a different angle – one from the left, one almost directly overhead, and one from the right.

Here’s a pretty good diagram to show how the angled radiation hits you:

The illustration shows the hospital gown mostly on. I just pull mine all the way to my waist. I have zero shame.

There have been a couple of sessions where they’ve measured the radiation doses – they do this by taping electrode things to me before they start the treatments. And they have taken x-rays at least once.

Every third time I get two of the three treatments through The Bolus, which, as I think I probably mentioned before, alters the way the radiation is delivered. They put the bolus on, make sure it’s placed properly, and leave. I breathe shallowly while getting the bolus treatments because I’m afraid I’m going to dislodge it.

On bolus days they’ll take the bolus off for the last treatment.

Then I’m done! I go back to the dressing rooms, change back into my clothes, toss the hospital gown into the hamper, and leave!

And today I am done with Week 4.

It will be so nice to be done with it. Its a huge errand to have to run every day.

I’m also looking forward to getting my permanent implant because the tissue expander is so strangely shaped, and feels weird where the port is. The target would be 12 weeks from the end of radiation therapy – check-in with the plastic surgeon 6 weeks after I finish radiation therapy, around mid-October, and then surgery six weeks after that – early December.

Radiation therapy seems to be going well so far. Knock on wood.

The simulation appointment was back on July 13. That involved getting into the machine, getting measured, getting scanned, and getting like 4 tiny tattoos. Just dots. To make it easy for them to line me up in the radiation machine. They also made a “bolus” – this is a thin sheet of material that they melt and form over my torso – it is used to moderate the way radiation penetrates my skin. They put it in a microwave oven or something, and it was pretty hot when they put it on me. My skin was flushed afterward.

The simulation appointment took about an hour. The whole time I was lying on my back with my arms stretched overhead. What with the position, and the tattoos, and the bolus, I was pretty sore and tired afterward. Then I had to wait for the radiation onocologist to develop my treatment plan. They called to set up the radiation appointments on Friday the 25th.

Day One, last Monday, was also a longish appointment. I had to get all set up in the radiation machine, and they took a bunch more measurements and more scans, and talked numbers and stuff. There were two radiation techs, and then the radiation oncologist looked at some things and adjusted some things. And then I had my very first radiation treatment, which only took a few minutes.

The other appointments were super fast and easy. The bolus is used about every other treatment – they do a couple of treatments with it and one without. If it’s a no-bolus day you just get all the treatments without. On Wednesday they put some probes on me to measure the exact dose of radiation I am getting.

The worst part of it is the drive. Since the West Seattle Bridge is closed there is a ton of crap traffic to go through. That’s as much as 45 to 50 minutes each way. Last week I got two days of exceptionally horrible traffic and was super stressed out. So I decided I need to leave a whole hour before the appointment starts.

They do have special radiation oncology patient parking in the parking garage, and you get a parking pass to put on your dashboard for those spots. It took me until Friday to actually find them, but they are very convenient.

So I park, and from those spots I can run right in to the South Building without having to take stairs or an elevator, and then run along the underground tunnel to the Radiation Oncology department. Since I am a regular radiation patient, I check in at the front desk and they send me straight back to the changing area. There are lockers, and hospital gowns in the changing rooms. I take off all my top clothes, and put on a hospital gown, tie in the back. Then I go to the waiting area and the radiation techs take me right back into the radiation room to set me up.

There’s a bed you lie on, with a nice support for your knees, and you put your arms up over your head. They make sure you’re positioned just right. Sometimes there’s the bolus, sometimes not. Then they leave the room. You lie very still, and then they do the radiation. And it is really fast. Just a few minutes. Since I can’t take a cell phone and there’s no clock in the room (that I’ve seen, anyway – maybe next time I should look for one), I don’t know exactly how long. Five minutes maybe?

Then I’m done. I get up, I get my hospital gown back, go change back into my regular clothes, and GTFO.

I set up an Excel spreadsheet to track my treatments and and side effects. It’s funny to think that I’ve already got a week done – the time went pretty fast.

I got a prescription cream for my skin. I had thought the radiation was going to be limited to my breast and underarm areas but it’s actually a much bigger field than that. On my first radiation appointment they drew the radiation treatment areas on me, so I would be able to see where it is. It goes all over the right half of my chest, up to the base of my neck, about an inch around the right breast, and the whole underarm area.

I asked on Friday if I should stop shaving my underarm during the radiation treatments. They said yeah, probably.

Putting the cream on – it’s a very dense cream and one of the techs suggested that I mix it with a regular light unscented lotion to make it easier to put on. So that’s what I’ve been doing. It’s kind of a PITA chore to do. Also my skin is kind of numb since the surgery, and the tissue expander is weird, so it just feels weird to do.

I did feel extra tired getting up on Friday morning, so that’s the first inkling of possible fatigue.

My skin feels more or less OK so far. But it’s only been a week! My muscles around my underarm area did feel a little sore by the end of the week, but not much.

I had a migraine on Saturday. Probably because even though this seems to be going well, it’s a huge thing and a new thing and I have to do it every day. But if I have to crash every Saturday during this treatment I think it is ok that I do that, and not feel like I have to be super productive. I have cancer and we’re still in the middle of a pandemic. So I can give myself a break. Or lots of breaks.

I also have talked some to my boss about taking several days off during Radiation Month, and last week I found some proposed days to take, so I will see about getting those approved tomorrow.