Radiation Has Begun

Yesterday (June 2nd) was my first day of radiation... the next stage of treatment has officially begun!

I actually went in to meet with my radiation oncologist 2 weeks ago to set up a treatment plan so I guess it technically began then; all this stuff just blurs together.  During the meeting Dr. H answered my questions and then I went to the hospital for a scan and my tattoo application.  My chemo brain is kicking in and I have no clue what kind of scanner this is... CT, MRI???  I don't know, but here's what happened: I laid on my back and put my head on that blue pillow.  I held on to the white bars above the pillow and then they formed the pillow around my body and made it into a cast (so I'd be in the same position every time).  Then, they lined me up to some lasers and gave me a tattoo on my breast bone and on each side of my ribs (again, so I'd be in the exact same position).  After I was all lined up, the bed lifted up and went back into the scanner to take pictures of my body.  The techs in radiation use these pics to generate my treatment plan. (More details on that in a minute...)

Can I just say how thoroughly disappointed I am in my tats?!  It's not like I wanted anything funky, but even a different color of ink would've made a difference.  These look just like blackheads and I'm totally tempted to pick the one on my chest every time I look at it.  (Oh, the crazy things I complain about, lol.)

The week before radiation I drank a lot of veggie juices to get my cells nice and ready.  This wasn't suggested by my doctors, it's just something I wanted to do.  I am normally a pretty healthy eater, but I was surprised by how difficult these were to gag down.  The beet ones were especially nasty.  My kids reminded me to plug my nose and it helped!  

Monday afternoon (the day before radiation) I got a letter from my insurance saying that my radiation had been denied.  I am pretty proud of myself for how I held it together emotionally.  I called the insurance and they told me to contact my dr to ask details and see if we could appeal the decision.  By the time I got off the phone with the insurance, it was past 5:00 so I had to wait till the morning.  When I called Dr H's office, they were wonderful to let me know that my radiation IS covered and I should still come in, but that the letter was in reference to a more specialized type of therapy called IMRT and they would explain it to me in detail when I got there.  I met with the Dr. and he said they wanted to get approval to do the IMRT (Intensity Modulated Radiation Therapy) because my case was intense (ha ha, just what you want to hear) but that insurance almost always denies IMRT unless the cancer is on your left breast (in which case radiation has a higher likelihood of hitting your heart).  He said that he would have appealed the decision of the insurance except that when they made my plan on the computer they were able to manipulate the treatment and curve it so that it was just as effective at hitting my target areas and avoiding as much of my heart and lungs as possible.  He walked me back to the room where they designed the treatments so I could see mine on the computer.  It was amazing... there were 3 guys in a room sitting in front of multiple computers with images of bodies they were designing treatment for.  I got to see exactly where my treatment was targeted to and speak with the guy who designed it.  He said it took a few days and was one of the hardest ones he's had to design (ha ha, just what you want to hear... again) but that he's so excited and proud of how great it turned out.  That made me feel really confident with my treatment and the team that is helping me.  I feel like they really want to make sure I'm getting the best possible results and to talk with them and see these super smart people working behind the scenes to help me and everyone else going through treatment was really humbling.

So, this is going to be the routine:  I check in and change into a top-half hospital gown.  I need to make sure I'm not wearing any lotion, deodorant, perfume, etc because that interferes with the radiation.  The techs come get me from the waiting room and take me to the room with tomotherapy machine.  I lay down with my arms above my head and they line up my tattoos with the laser then slide me into the machine.  They do a scan, pull me out to make sure I'm still lined up and then slide me back in for my treatment.  The actual treatment lasts about 8-10 minutes and I need to keep absolutely still.  I scratched my nose today after the initial scan and they had to start all over because I'd moved my arm - oops!  It is SOO hard to try and stay still... my arms fall asleep, I worry that I'm moving or breathing too much (that can move my lungs or heart into the line of radiation), but then I breathe too shallow and start to feel anxious.  It is a total mental exercise to stay calm - maybe I'll become a pro at meditation by the time I'm done!  My treatments are going to be every weekday at 11:20 AM and I'm there till about noon.  So far, this is a lot easier than chemo but it's going to be a pain to go in every day.  I don't have any side effects yet from the radiation but the biggest ones should be tiredness and skin damage.

Oh by the way, tomorrow marks exactly one month since I finished chemo!!  The last two treatments really knocked the wind out of my sails and I had a hard time recovering last month.  I am really struggling with energy and it has been a bit harder to keep my smile.  I'm forcing myself to eat right and exercise hard every day (you know, to keep my cells, heart and bones strong despite all the poison that's been hammering at them the past few months) but sometimes I feel like that's all I can muster and everything else falls by the wayside.  My toes are still tingly from the neuropathy (that may be permanent), I've got a few fingernails that are coming off, and ALL of my eyelashes and most of my eyebrows are now out.  It's funny how I still see side effects occurring even though treatment's over.  It's good though because that means the meds are still hard at work on my cancer cells, yay!  

Here's a picture of my head at 1 month out.  I've got some fuzzies going on but nothing you can see without squinting.  My oncologist said most people start to grow back hair between 6 weeks and 3 months out of chemo - we'll see where I fall on that spectrum...

So now that I'm done writing this rambling post (wow, looking back I realize that I really did spew it all out!), I realize what good therapy it is for me to write all this stuff down.  I was just going to have this be a quick update but it's turned into a brain and emotion dump.  Yay for journaling therapy!

Have a wonderful summer everyone!!