Ready for Radiation!

I have had a great couple of weeks. Lots of energy, many great hikes and walks, and time to focus on healing and resting before radiation starts. Things continue to go well with my physical therapy. My scars are looking better, little by little. My mobility is awesome - I can finally do a snow angel! - and when I keep up with my lymphedema massage regimen I don't have any noticeable swelling.

This week was a busy one. I was at the hospital 4 out of 5 days this week. On Monday I had my latest (3rd) heart echo which went smoothly. I haven't seen results for that yet, but we don't expect any changes. On Tuesday I met with my radiation oncologist to find out the plan for radiation treatment. I will be having 20 radiation treatments. 16 will be to my breast and remaining regional lymph nodes. The final 4 are 'boost' treatments that will focus only on the breast. We spoke about side effects from the most obvious to the most obscure. I didn't learn anything completely new but it was really nice to go over these things in person. The doctor did an examination of my surgical sites to make sure my healing was going well. Things look good and he pointed out one small area where there was a small bump resembling a pimple and said it was a stitch abscess. I wasn't surprised by this as I had noticed it and could feel that there was something under the skin that was stitch-like. It was a pretty small pimple, and I wasn't too worried about it. After my appointment I decided to get my bloodwork done for the next day rather than go in 2 hours before my regular medical oncology appointment. I got lots of knitting done while I waited for these appointments! I also got some weaving done this week - not too much but things are ramping up. I haven't shared any weaving in a while so here are some recent projects:

A dish towel made for a friend:

Dish towels for us! Started these in June and finally finished them:

On Wednesday morning after my shower I noticed that there was now some suture material visible where the small pimple had been. It wasn't the end of a suture but a small segment maybe 4 mm in length. This was definitely weirder than the pimple had been! A quick Google search told me that this wasn't uncommon, and that stitches can actually take months to dissolve. Some people find stitch material years after surgeries! Fun fact, right? So, when I saw my medical oncologist a couple of hours later I asked him to take a look. He didn't really know what to make of it or what advice to give as it is definitely not his area of expertise. His advice was to call the surgeon, so when I got home I left a message at her office.

Thursday morning the office called back and they asked if I was able to pull the stitch out. I told them I'd check, and I carefully cleaned my tweezers and changed my glasses so I could see what I was doing. Seeing that a stitch was there was not the same as seeing it well enough to remove it. It was really easy to remove, it turns out. The piece was about 1.5 cm long. I can still feel some more suture under the skin so we'll have to see if anything else crops up in the next little while.

Thursday afternoon I had my immunotherapy infusion which was faster this time. The appointment took about an hour in total and I had a sweet window seat overlooking the garden and street, so it was great for people-watching. After my immunotherapy I had my positioning scan for radiation. This is a CT scan which is used to plan the technical aspects of my radiation treatments. I had learned on Tuesday that my radiation oncologist makes a plan that is reviewed by one of his peers. After that the plan is further developed by a dosimetrist who uses the information from the scan and the doctor's plan to determine the technical details of the radiation treatment. This plan is reviewed and confirmed by a physicist, then returned to the doctor for further review before it is approved. Before my scan my radiation oncologist came in with a sealed package containing special tweezers because he had heard from the medical oncologist about my stitch. (I LOVE how much these people talk about us...makes me feel well looked after.) I think he was almost disappointed that I had taken it out myself, but thanked him for taking the time to check up on me and promised him I'd let him know if I needed help again in the future. 

The people I interacted with during my positioning scan on Thursday were radiation therapists. Their job was to build and measure the exact posture I will use for the treatments, perform the CT scan, and then put tiny tattoos in certain places to help ensure that my position is perfect for all of my zaps to come. In my case, there was a pillow under my knees, a sort of wedge pillow under my neck (the second one they tried was the best one), the table was slightly elevated, my arms were up over my head resting in small cuffs, and my hands were holding on to bars just beyond that. All of the heights and angles were carefully recorded so I can go right back to the same spot every time. I am the proud owner of 5 tiny tattoos: one on my left side, two along my chest midline, and two on my right side. The radiation therapists were efficient and friendly, and pretty good at making tiny tattoos. My radiation will start on Tuesday November 15th, so the last day should be December 12th. It's good to know I'll be finished with daily hospital visits by the time the holiday comes. I know I'll probably still have some discomfort and fatigue, but at least we will be able to travel to St. Catharines like we usually do!

One of the tattoos, this one is on my left side and it's just below the bottom band of my bra.
Hard to get a clear photo, probably because it's sort of dark in here. :)

I wasn't sure after my first Kadcyla immunotherapy/chemotherapy treatment whether I had experienced any side effects from it. At the time I was just a week out from surgery #2 and was feeling a little tired in general. After yesterday's infusion I can say that I am most definitely feeling fatigue in my brain and body due to the treatment. Today we slept in a bit since the kids weren't going to school due to the CUPE strike. I took Martha for a hike in the woods, then joined some of my colleagues during their lunch break to support our striking CUPE and OPSEU co-workers. We walked up and down the line a bit and there were lots of honks of support. I got home around 12:30 after picking up a few groceries and I was SO TIRED. I didn't notice how tired I was until that moment, and the feeling is still with me. I don't feel that I overdid it today but rather that this weird tired feeling is just something that will follow me around for a couple of days. We'll see! Today I was also surprised that my appetite wasn't normal, as I should have been really hungry when I got home but I wasn't and the thought of lunch wasn't exciting at all. I did make and enjoy some lunch because a girl has to eat, but it was a little strange to not want food. We had delicious pizza for supper and, similarly, I wasn't too excited about it but did enjoy it while I was eating. So weird! I'm curious about how long that feeling will last. I'm not surprised that I didn't notice it last time; we were busy packing to go to the cottage and ate dinner really late. This is my only chance to have an immunotherapy treatment separate from surgery and radiation (at least until January!) so that's why I'm trying to pay close attention to how it is affecting me.

Here are some pictures from some of our recent walks. What an amazing autumn it has been! We are doing our best to make the most of it. :)

Is't this puddle of golden leaves lovely? It was one of the recent misty mornings.

Martha on the boardwalk last week. 

It was frosty and she rubbed her face against the boards for several minutes. 

I think she's excited for cooler weather!

Martha on the path this morning. She is becoming a great off-leash walker!