thanks for all the warm birthday wishes. they were on par, because paired with radiation, i’m getting hot. but my birthday was wonderful.

i’m about to enter week 3 of 5 weeks of daily radiation, and like all my treatments, i’ll be so happy when it’s done. everyone told me it would be no big deal, that going in every day would be the biggest annoyance but that physically, i wouldn’t notice anything until week 3 if i noticed anything at all. so i prepared for that.

i’ll go back to the beginning of it before coming back to now. radiation therapy is a local, targeted therapy that works by damaging the DNA of cancerous cells. although in my case the doctors are unsure if it will make a difference, they want to be cautious and aggressive because of my age and type of cancer.

the week before radiation was to begin, i had a 2-hour appointment with the radiation oncologist (different from my primary oncologist) and all the technicians.  most of it was me topless laying on various tables with my arms elevated above my head. i got 7 tattoos all across my chest so that lasers know where to line up for each treatment. i also got a cast or bolus made of my chest. and a CT to see where my heart and lungs are to try and avoid them.

unfortunately the tattoos are nothing to write home about and look more like blue freckles. and the bolus, well i just had to share a picture of me wearing it on the radiation table. yes, i get to keep it after treatment is over. and no, this is not me at my finest but if you can’t share your bolus photos, what can you share?

anyway, the rad. oncologist takes all this info into a computer to calculate the radiation field and my daily dose of radiation.  meaning, where and how much. my field is from the center of my chest to my armpit and slightly up my neck. this is because of the lymph nodes that lit up with cancer on my PET/CT in august, some near my sternum and the rest in my armpit. the how much question is something i don’t understand, except that the daily does of radiation to my heart and lungs is ~137 grays (a fancy unit of measurement). apparently a chest x-ray is several thousand grays to your heart and lungs, and flying in an airplane gives a whole body low level of radiation. so my doctor coaxed me to believe these ‘therapeutic doses’ are going to be safe for life. ugh.  she showed me a lot of fancy images on a computer screen too, which gave an air of certainty and legitimacy. that and she’s a walking encyclopedia of statistics.  but still, all of these treatments carry risks (radiation therapy can cause my expander to fail, give me a broken rib, or a second cancer or sarcoma in 20 years too, among other pleasantries).

a few days later, i went in for my dry run (dukies, as an aside, i kept thinking of our dry run to the duke/yale career fair in dC, and it’s all i could do to keep myself from giggling on the radiation table). they made sure everything was lined up and the dosage was appropriate. i do appreciate all the redundancy and double-checking in their system, especially around something so technical. my rad. onc said they are ucsf’s only department to do this, because it’s so expensive. yikes. i started radiation that day, april 22. i go every day at the same time, and treatment lasts about 15 minutes.
every other day, i wear the bolus to target my skin. or they tape it to me, to the table. with a mastectomy, the breast cancer can reoccur locally in the chest wall or skin. so during radiation, the skin is actually a major target. if i had a lumpectomy, the radiation would target the breast tissue instead.  i don’t have any tissue left, just a thin layer of fat and skin. so here we are.

back to now. unfortunately, radiation hasn’t been no big deal. day 1: pins and needles and shooting pain. how is that possible when the surgery took out all my nerve endings??? the rad. oncologist said she rarely sees this and was surprised given that the dosage hadn’t added up to much yet. ever since then, i have shooting pain up my armpit and into my chest. there’s that, and the sunburn started late the first week, rather than the third. the doctor has given me various creams to apply morning and night, and my acupuncturist has added some in as well. this week because of a rash across my chest, they added a topical antibiotic too. i alternate between crying and laughing about it. i don’t want to be special or have uncommon side effects. really. flo, the radiation nurse, and i have gotten pretty close.

i also took a few evening naps last week and am noticing the radiation fatigue catching up already. it is true that so many residual side effects from chemo and the past 9 months linger on, largely unnoticed until really noticed.

i had a nightmare last week, that the team of doctors told me i’d have to radiate my whole body instead with a lot of needles. i was strapped onto the table and screamed, “you have to kill me to save my life!” so many undercurrents here.

i guess i’m sharing all this with you to be clear on the reality. most of my days and moments are generally happy and pleasant. i’m upbeat. but there is a lot festering below the surface that is easier to write about, with the journal as my outlet. some of the posts can come across as melancholy, but it’s the reality. for me being continuously positive isn’t genuine or helpful. my humor, and husband, are still in check though.
may 28 is my final radiation treatment.  the burn peaks a week afterwards, and the other side effects are cumulative for awhile longer too, so the doctor monitoring will continue.

life goes on. you’re busy. i’m busy. spring has sprung a lot of babies to welcome to the world.  cailyn to ashley and harper, sam to anne and mark, soloman to jocelyn and mike, dave to emily and dave. happy mothers day!!!

as my grandpa pop just said in a letter to us: “hi to all the shigs at sea.” i have no idea what it means, but i like it. [update: we got clarity from pop, and it was during WWII each morning on a ship in the aleutians and south pacific, the captain would say, “good morning sailors and all the ships at sea.” shigs, ships. same difference.] 

xom