Thursday, February 25, 2016

Graduation

I'm done with radiation.

All done! Done done done!

And the nice folks who've been with me through the whole thing presented me with this:


Nice touch, right? I thought the "appreciation" part was especially nice. I mean, I appreciate them, but they appreciate me? Really? I guess it's one of those things: "we know you have a choice of where to go when you have cancer, so we're glad you came to us." One of the radiation therapists gave me a nice hug and wished me a good life. It was nice.

Afterward, I had a brief meeting with the doctor for my discharge instructions, which are basically keep doing the skin care routine for two weeks and come back in six weeks for a checkup. She also gave me a summary of my treatment to date, including the surgery, chemo and radiation, along with the standard recommendations for rechecks. I guess it's the standard for the hospital, since a lot of people go through their whole treatment process there, but it felt a little odd for me, given that I've been going to another facility for the bulk of the time. It'll all be fine - I'll make a copy for my medical oncologist - the chemo lady - and discuss it with her at my next appointment. 

Now it's just her, once every three weeks --- and a check in with the surgeon after my yearly mammo in May. 

I felt a mixture of emotions when I left the building. Sure, I was happy and relieved to be finished, but I also felt like crying. It's not as if I made a million friends in radiation, but it was a routine and something I'd gotten used to over the past several weeks. And now the "specialness" and intensity is gone. 

One of the hospital's breast navigators met with me last week to talk about survivorship and mentioned that there's a bit of a let down after all of this. I know it's natural, and there are groups and counselors and other resources to help with it. I even left a message with one of the counselors to get an appointment, but I never got a call back. Perhaps I need to make that call again.


Wednesday, February 24, 2016

That time when your armpit hairs were longer than your scalp hair

Yeah, I just noticed. It's true. Well, at least it looks as if it's true.

And, of course, they're all nice and dark, unlike the salt-ish and pepper on my scalp.

Too bad I can't get them transplanted.

Good times. Good times.

Tuesday, February 23, 2016

Two to go

We're down to two more radiation treatments.

Since Friday, I've been going for the "boost" treatments that focus only on the section of the breast where the original tumor was. That means I have this long oval marked from my nipple down the side of the breast, along with the not-so-fashionable Sharpie markings covered in unattractive transparent stickers. I got those nice little decorations on the first day of this stage, right before they started the treatment. And the skin area within the oval looks as if it got a bit too little sunscreen and a bit too much sun, even though I've been diligently covering it with the prescribed lanolin lotion along with the rest of my breast.

The boost treatments themselves are different from my whole-breast experience. First off, I'm laying on my back instead of my belly, with my left arm extended over my head. For the first time in this whole escapade, I could actually see what the radiation therapists were doing, along with the monitor screen where the treatment plan numbers and so forth are. I don't know what they mean, but, well, there they are. It's like being in a totally different room from the rest of the treatment regimen.

The other difference is in the duration. Instead of getting two 10-15 second zaps with a break in between to change the angle of the machine, I just get one longer zap of about 20 seconds, and they put a frame on the zapper to match my treatment area.

So far, so good, except for that little sunburned bit, but I guess that's to be expected. I see the doctor tomorrow, so we'll see what she has to say.


On another topic: Hair... it's continuing to grow in. My scalp is looking darker; it appears the new hair might actually be black, or dark brunette. Along with the grays, that is. I keep telling myself the gray is because the pigment part of the follicle is still dormant due to the chemo. Yeah, that's it. I can't dye the hair until it's three inches long, so may as well make friends with it, however it looks.

I also noticed more eyebrow hairs coming in. I hadn't mentioned it, but while I didn't lose my eyebrows completely, a lot of the hairs fell out. Now they all seem to be coming in at once, which will ultimately lead to them all falling out at the same time, too. It's not surprising if you consider the way hair usually grows. The growth cycle is usually staggered, but when chemo stops the fallen hairs from regrowing, they all kind of grow in sync once the chemo is out of the picture. Inevitably they all will fall out around the same time since they have similar lifespans. I'll probably see that happen for a couple of cycles until they stop synching. It'll be fine. If anyone asks what's going on I'll tell them my friends shaved them off one night after I passed out drunk.

And my nostril hairs have grown back in. You have no idea how helpful they are until you don't have them... and you get a cold. Trust me, they're useful.



Friday, February 19, 2016

28 down, 5 to go

We're in the homestretch on the radiation. Yesterday I had the last of the 28 full-breast treatments, and today I start the series of five "boost" treatments that focus specifically on the "tumor bed" where the offending mass lived before the surgeon yanked it out last July.

And this morning marked the first time this year that I could take a shower without having to take special care around the nine (count 'em NINE) little stickers placed under my left arm, my left breast and back. Since I'm no longer getting the full-breast treatment, the marks those stickers protected aren't needed anymore. Yay! This afternoon I'll be getting new ones on my breast, I guess.

In other news, the hair continues to grow and my scalp area seems to be darkening. Now it seems to be getting a little patchy. At first I thought the dark spots were bruises from scratching my head, but they're just little sprouts coming in clumps.

I'm also seeing progress in areas other than my scalp. The other day I noticed some growth in my public area all of a sudden (how did I not notice this starting? I don't know!). It's looking like the special effects in the Lon Chaney Jr. werewolf movies, which, oddly enough, is kind of a relief. I was dreading the possibility it would be really itchy, but it's really okay. (TMI?)

Onward and upward!

Friday, February 12, 2016

You can fool some of the people...

Yesterday I went to Shop Rite for the weekly groceries, and as usual, I swiped my shopper card when I got to the checkout. Almost immediately, this popped out of the coupon printer.


Yes, a coupon for Rogaine. I thought the wig was pretty convincing, but apparently it's not fooling the supermarket computers. I'd love to know what the algorithm for that one is. "Uh, she bought Ensure a few months ago. No tampons for a month or two before that, plus lots of bland food? Must have done chemo!"

How's the hair going? Well, it's growing, but not as much as I'd like. A lot of the hairs on the top of my head are getting longer, with some maybe as long as an inch. However, my scalp is still showing through. It'll be a while before I go out without some sort of head covering. I'm taking photos every week, but honestly, they don't show the growth as much as I'd like, either. My SO tells me he can see the difference, so I'll go with that.

Radiation is moving along. As of this morning, I have 10 more treatments (out of 33), and the last five will be a "boost" focused specifically on the area where the tumor was. It's been fairly painless, and I'm getting what can be best described as a bit of a sunburn on my left breast. The worst part has been under my breast, about where a bra cup underwire would sit. My radiation oncologist confirmed that larger-breasted women commonly get a bit of a burn line at that location. She prescribed a burn cream for it and told me I was doing really well, considering where we are in the process.

Everything else? Let's see. Two weeks ago, I was having what I assume were hot flashes. Oh, joy. And toward the end of last week I was getting really, really tired. The SO and I had dinner plans with high school friends of his whom I hadn't yet met, and I was really concerned I wasn't going to be able to stay awake for it. (Chugging coffee at a 7 p.m. dinner is just a little weird, yes?)

Depending on who you consult, the weariness attached to radiation is either unexplainable (or as the docs call it, idiopathic) or a byproduct of the body working extra hard to repair the cells damaged during the treatment. A conversation with the doc confirmed that I just have to manage it, take it easy, etc. Okay... so... this week I've been taking it easy, laying around the house without a bra, drinking a lot of water (and probably too much coffee) and trying to eat better.

So far it seems to be working -- it's Friday and I'm not totally wiped out. Good thing. I have a big week ahead of me next week.




Friday, January 15, 2016

Welcome to the machine...

Yes, the random mechanical noises of the Pink Floyd song were the first things out of my car stereo as I left the hospital parking deck after my initial radiation session. I kid you not.

So, what's radiation like? So far, painless. At the same time every day, I show up at an office in the hospital where I'm promptly escorted to the dressing room by one of the radiation therapists. I trade in my shirt and bra for a lovely hospital gown, and the therapist brings me to a desk that looks kind of like a television producer's console, but with a couple of monitors that show the inside of the therapy room. Two therapists ask me my birth date and compare me against a photo they took of me when I had my CT scan. As if I'd really trade this lovely experience with somebody else. 

Then we go into the treatment room, passing a foot-thick door that reminds me that I am going to get zapped with radioactivity. There's a big machine and a table with a special cradle on it. I lay on my belly, with my face in one of those massage table cradles and the affected breast hanging through a hole. Then the therapists turn down the lights, boost the table up and move me around to line me up for treatment, aligning the marks they made on my chest during the CT scan with laser beams that come from the walls. The first time around, I was tempted to tell them it was the weirdest massage I'd ever gotten, but as nice as these folks are, they don't seem to be very big on humor.

From there, they turn on the lights again and leave the room.    

A few moments later I hear what sounds like a computer printer working, an apt analogy given the registration marks they Sharpied onto my chest and back. Since I'm face down and can't move, I have no idea exactly what's happening when, but some of the noises are the actual radiation and others are the rotation of the big machine. Considering the size of the thing, the printer comparison worries me a little. I mean, what if it gets jammed? Given my past corporate experience with notoriously faulty multi-function printers, I'm a bit wary of a sound that indicates I could get gummed up and mangled like a wayward document. 

I kid, I kid. At no point am I actually inside the machine, let alone being run through a set of platens and rollers.

I haven't asked if I can video the treatments, but I found a great vlog that gives you some indication of what's going on. There's a lot of random stuff in it (this kick-ass woman was prepping for a triathlon during her treatment!) and she's face-up while I'm face-down, but the actual treatment starts around 3:50.

 
The treatments themselves don't take very long. Yesterday was my third one and the first that wasn't special in some way. Tuesday they were doing a bunch of adjustments because it was the first one in the series, plus I had to see the nurse for instruction on skin care for the area they're zapping. Wednesday they took an x-ray for the doctor because that's the day I see the doctor, and that's part of the drill. Anyway, from what I could tell yesterday, I get two big zaps that last about 10-15 seconds apiece, each from a different direction. It literally takes me longer to find a parking space in the deck when I get to the hospital. Come to think of it, finding a parking space is probably more stressful than the treatment.

As for other stuff, I was a bit annoyed the other day when the nurse told me I had to get weekly blood tests because I'd had chemo. I'm all for keeping ahead of potential problems, but it seemed a little excessive, given that my numbers have been improving and I'm checking in with my chemo doc every three weeks along with the Herceptin infusions. I don't like the idea of opening up a vein any more often than I have to, especially since they can't pull from the left arm anymore. Plus, it's a pain in the ass. The less time I have to spend in waiting rooms, the better.

Instead of debating it with the nurse, I asked the radiation doc when I saw her Wednesday. Armed with the lab report from last Monday's infusion, I stated my case, and she agreed we could forego the weeklies in favor of a test halfway through and at the end. 


Thursday, January 7, 2016

Checkups and check ins

Throughout my treatment, I've kept my head by focusing only on the steps directly ahead of me. It's the best way to prevent myself from running away with all of the what-ifs.

Make it through all of the pre-surgical assessments? Biopsies? MRI? EKG? Nuclear stress test? Echocardiogram? Check, check, check, check, check.

Surgery? Check.

Recover from surgery? Check.

Chemo? Check x 6.

Blood tests to check for toxicity? Check x 18.

Recover from the assault of chemo? Working on it, and feeling good about my progress.

It wasn't till this week, though, that I was in the position to think about the long term implications of cancer. I was scheduled for a follow up ultrasound on my right breast. 

You might remember that back in June, my pre-surgical MRI had indicated a potential issue that didn't show up on the mammogram set that had confirmed the mass I'd felt on the other side. A follow-up ultrasound a few days later confirmed the need for a biopsy. To say I wasn't happy is an understatement. In fact, for the first time since my diagnosis, I was downright angry, and scared. I was being such a good camper about the left breast, doing everything I was told to do, keeping a positive outlook, and fate was potentially giving me a double whammy. Intellectually I know that there's no fairness when it comes to matters of health, but... it wasn't fair. I couldn't find a single bit of humor -- not even grim humor -- about this potential for a second cancer, and when I can't find a way to laugh about something, it's pretty bad.

Fortunately, in one of the few examples of really speedy action through this entire escapade, my surgeon was able to fit me in for a biopsy the very next day. Results came back benign a few days later, with a recommendation for a re-scan in six months. I made the appointment and put it out of my mind. Why think (translation: worry) about something so far down the line?

That brings me to this week. Monday I went in for my once-every-three-weeks blood test, Herceptin infusion and chat with the medical onco. All's good, but she scheduled me for one of the recommended periodic echocardiograms to make sure the Herceptin isn't mucking with my heart. Lucky me, I got an appointment scheduled for the next day, also the same morning as the ultrasound. One stop stressing! Unfortunately, my nurse navigator/breast buddy didn't stop by during my infusion - I wanted to ask whether I'd see her if the ultrasound brought good news. Given that my only prior experience there was that I'd need a biopsy, I wanted to be prepared for the sight of her. I personally like her a lot, but, well, there are just certain times when she's the last person I want to see.

Everything was okay until the drive to the medical place on Tuesday morning. That's when I got a bit emotional. I can't even remember what song was playing on the radio, but the lyrics had added meaning. Something about mortality or some equally optimistic topic. I didn't break down in tears, but my eyes got a bit watery.

I wasn't worried about death as much as I didn't want to hear I'd have to go through this crap again. Another lumpectomy I can deal with, but chemo? No fucking way. And how would any potential new malignancy be managed in relation to my current treatment? And if it ended up being a stage 0 ductal carcinoma in situ (DCIS), would the docs want to be aggressive and yank it, or take the more conservative approach of checking back in six months, after I'm past radiation?

Before I could get too crazy, my frustratingly rational inner voice reminded me: nobody was going to be able to tell me anything before I got the ultrasound. Sometimes I really hate the fact that I stop myself before I really get raging.

One advantage of breast cancer: I got what suffices for frequent flyer perks in the imaging office. No forms to fill out, no wait in the cushy girls-only inner waiting room where everyone's wearing the same lovely mauve exam tunic. Right on time, the tech called my name and brought me directly to the exam room, where she gave me a moment to take off my shirt and bra and put on the tunic. 

I usually like to watch the screen during ultrasounds to see what the techs are looking at, but this time I didn't. The images aren't particularly clear, but the last time, I could see something unusual was there, and I got a bit worked up waiting for the news. I wanted none of that, and I didn't want to psych myself out. The tech was really great - after leaving the room for a few minutes to review the pictures, she returned and told me that everything looked okay. I'd get confirmation from my surgeon, but there didn't appear to be anything to worry about.  

Oh, happy day! Next step: the annual mammogram in May.

On my way out the door, I noticed my nurse navigator was in her office, so I stopped to say hi and share my good news. After congratulating me, she reminded me that this is my new normal. Staying healthy means vigilantly appearing at recommended intervals for tests that either confirm I'm cancer free or reveal something small we can nip in the bud. 

And, she observed, there's always the chance that my mind will do a number on me. Something totally unrelated could spawn neuroses that the cancer has returned, taken up residence somewhere else, you name it. It doesn't just happen to survivors; she told me she has moments where she's convinced that one of her own aches or pains is an early symptom of cancer. It's natural to feel that way - our neuroses can protect us as long as we get the issues checked out. I likened it to my experience with bedbugs: even after I'd eradicated them from my home, any little itch or bug bite brought fears they'd returned. 

The breast cancer survivors support group at the practice is a good place to talk about these things, she told me. These are folks who are a year out from diagnosis, and dealing with the aftermath. It sounds as if it might be a good thing for me, even though I've avoided going to the group with patients in active treatment.  

This is going to be a long haul, one that lasts for the rest of my life, hopefully many, many more years. The treatment may be the most intense part of the whole thing, but I'm coming to realize that it's just the first part. I have to get okay with the fact that I'll never be completely done with this.