"It is good for me that I have been afflicted, that I may learn your statutes." Psalm 119:71

Thursday, September 30, 2010

Radiation Explanation

Most women who have mastectomys (from what I've read) don't get radiation treatment. But because my surgeon did a skin-sparing mastectomy (which could possibly leave behind some breast tissue), and because my cancer had spread to the lymph nodes, radiation is a plart of my treatment. It's designed to target any free-floating cancer cells.

Monday was my first day. The radiation tech I mentioned before, Chris, is my main contact during the treatment. He's been great and I've gotten to be very comfortable around him. In fact, today there was another man there in addition to Chris and although he was very nice, he was a bit condescending, talking to me like I speak to my children. And it made me appreciate Chris' laid back attitude even more. The new guy kept drawing out the last syllable of every word. "Liiiiiie realllll stilllll, okaaaaaay?" I wanted to tell him that I have cancer, not brain damage!

I have a 10 a.m. appointment every weekday for 33 visits. The first 25 will all be a high amount of radiation, the last eight will be a lower amount. Here's how each visit goes...

After dropping my kids off, I get to the cancer center (above) about 9:45. It's a really friendly office with a puzzle to work on, magazines and Bibles to read, and there are snacks and cookies in every corner of every room (don't worry Dr. Hill- I avoid them all!). Everyone who works there is really pleasant.

From the main waiting room, I'm called into the smaller radiation waiting room. There's a woman's changing room there and that's where I get into my gown. Everything from the waist up is taken off, including my wig. My gown is kept in a bag with my name on it, so I can access it easily every day. I put my clothes into the bag. Then take it with me to the radiation room.
(The shelf of bags for the gowns inside the changing room.)

Here's where I spend the majority of my time.

Can you see the gorgeous floral scene on the ceiling?
It's really very pretty. But since I have to have my head turned to the side during radiation, I don't really get to see it. I'm sure the patients who face up during radiation enjoy it.

When I get to the room, they've already pulled my mold (the light blue thing on the table) from a locker with my name on it and put it on the table. There's also a purple towel on top of the mold. (I'll get to it's purpose in a minute.)

I lie on the table, put the little triangle pillow under my knees, pull the blanket up (it's cold!) and fit myself into the mold. I wait until the last second to put my arms back because my surgery arm gets really sore from the position it's stretched into.

Once my arms are back, they push a button and the table slides underneath the big machine you can see in the picture (the bed ends up above the big white circle on the floor). I forget what the machine is called but it has the ability to do x-rays and give the radiation. There's a monitor on the wall that tells them the "coordinates" of the bed. Each visit my bed has to be in the same place. They can shift the table up, down, left, and right to get me in the perfect place. Next they pull my gown aside and expose the "x" marks they made on me. There are four lasers coming out of each side of the room (and I think some from the machine itself). In the picture below, you'll see a tan panel on the left, on the wall. That's where one laser comes from.

The cross sections of these lasers have to match up with the marks on my body so they know I'm in the perfect place. It's important for my position to be correct so that only the affected areas of my body get radiation. They spend a good amount of time lining me up-- which I'm grateful for since the spot to be radiated is so near my heart!

Here's where the towel comes in. If my body isn't perfectly aligned with some of the marks, they tell me to "lie heavy" and Chris will pull the towel slightly so that my body shifts and lines up in the right place.

I am getting radiation in three areas. My mastectomy area (I'm tired of typing this out, so from now on my mastectomy area will be known to you by the name I gave it back in May: Doobie.) under my arm, and at the base, left-hand side of my neck (the last two spots are to get any cells in the lymph-nodes).

Once I'm in position, Chris leaves the room. The three-armed machine you see above rotates around me and we start first with x-rays. I hold my breath during each x-ray and when they're satisfied with those results, the round arm (the one at the top of the picture) moves into line with whichever area is being radiated. There's a square screen in the circle part and through that screen I watch skinny, long, metal teeth, kind of like screw drivers, shift into place to form my specific radiation field. The metal teeth will block the radiation and allow it to come out only where there are openings. This is what the doctors were working so hard on during the week after simulation-- getting all these patterns perfect.

Chris comes over the loud speaker and tells me to hold my breath. I hear a slight humming for 15 seconds before I can take a breath. Then we repeat the process and I hear a humming for 30 seconds. When I get radiation to Doobie they use something called Bolus. Otherwise known as Superflab. It simulates a thick layer of skin (I think the stuff is quite fascinating) and by draping it over me it allows the area of skin to get the maximum dose of radiation. You can see superflab in the pic below. It's squishy and soft just like you'd expect a layer of... well, flab to be. And mine even lies in a position quite close to this fella's.

We repeat the x-ray and radiation for the other two areas (without superflab) and then they let me up and I'm on my way.

While my simulation last Monday proved to be a bit traumatic, these subsequent visits have been easy-breezy. Chris is very young and new to his job, so he enjoys answering my many (many, many) questions every day. This whole process is really interesting to me. It's all so scientific, specific, and dangerous. If I had any kind of tolerance for science classes, I might consider a career in radiation. Misty, you'll have to keep us all informed of your progress as you go to school for this. (Do you ever get to just sit and play with superflab? That seems dreamy to me. Can you tell I'm quite taken with it's squishiness? It's the same kind of feeling you get from popping those little packing bubbles that come inside packages.)

The first day I was lying on the table I tried to spend some time praying. But more than likely, while I'm lying there, my brain is just wandering. "My arm hurts. When will the surgery heal? ...Hmm, I haven't seen my surgeon in a while. She wears blue eye shadow. I wish I could wear blue eyeshadow... Oh, maybe at that 80's party I'm going to! What's the point of leg warmers anyway? Why not just wear pants? I like these pants. They're comfy. Micah would say "comfty." Man, he's crazy lately. He needs a hair cut. I wish I could get a hair cut. Why does shampoo always smell better at the hair salon that at home? I miss shampoo. "

And around and around goes my brain.

Last night at home we were all busily rushing around and for a second I thought, "Man I wish I was in radiation right now!" Guess my fondness for it comes from getting to lie still with no responsibilities for 15 minutes. (And then there's my love affair with superflab.)

Side effects: It's made me slightly sore so far and I'm a bit more tired. But that could be just because of the crazy pace I've kept up this week. So far I've got no complaints, but I don't want to be overly optimistic because Dr. Morgan keeps reminding me that the pain towards the end will be pretty bad. Oh- and one more note- I've been cleared to wear deodorant! the doc said that they outrule it because it will cause me more skin irritation, not because it will interfere with the radiation. So I can (and will) use it sparingly ("at my own risk," says Dr. Morgan!).


  1. This was a great post. I was so lost in a lot of it, but your fascination with superflab kept me riveted. :) And, I guess maybe it's because I baked a cake today, but when I pulled up the third picture, at first I thought it was a close up of a Kitchenaid mixer. haha! Why that would be in a post about radiation, I don't know.

  2. I'm with Em...I was totally facsinated with your post. Very informative! It's so funny to me that you are obsessed with Superflab. Can't wait to hear your stories in person TONIGHT!

  3. Love the description about how your brain wanders. Our brains can go 100 miles an hour jumping from topic to topic and makes complete sense to us. I have tried to explain my thought patterns to Mark before and he just looks blankly at me. I don't think men's minds are as complex. LOL! Great post!

  4. :) I can indeed play with superflab twice a week. My rotations are T/Thur. The machine is the linear accelerator and those little metal things that move into place are called leafs. I enjoyed this post so much! It helps me appreciate the patient perspective.


Your comments and emails keep me going. So keep 'em coming!