Almost There

I just woke up from a 3+ hour 'nap.' I was sleepy after dinner and headed straight for my bed, and didn't get up until after 10PM. It was a really good sleep and I guess my body needed it.

The side effects of radiation haven't been too bad for me yet. I have completed my 16 treatments and one of my 'boost' treatments, so I've only got three more boost treatments to go. I met with my radiation oncologist on Tuesday and he was very generous with his time. One thing I learned from him is that the protocol for radiation treatment has changed since my treatment started, and 'boost' treatments will no longer be separate but they will instead become part of the initial course of radiation. Had this change happened before my treatment started I would have saved myself four trips to the hospital. I'm glad that the people who come after me can benefit from this change. My doctor explained that, in general, the number of visits required to treat just about every kind of cancer is decreasing. Great news, especially for those who need to travel a long way.

I was also very lucky to have some of my curiosity satisfied regarding my treatment. My doctor showed me my detailed treatment plan on the computer and was able to show me why my healthy breast gets taped down for treatment and how the radiation exposure varies across the treatment area. One area that they are treating are the 'internal mammary chain' lymph nodes. This little group of lymph nodes runs in a line down the centre of the chest. In order for the x-rays to hit these and NOT go straight through the centre of my lung they need to come in at a shallow angle and this means some of my healthy left breast tissue is exposed. By taping my breast down they can reduce this exposure (it's not taped down in the images below).

In these pictures there are coloured lines. They are like isobars on a weather map or lines on a topographic map as they connect areas that get an identical amount of radiation. These lines show the TOTAL radiation from my treatment, including the extra 'boost' x-rays I'm getting for the next couple of days. The greatest level of radiation is directed at the tumour site. My entire underarm, clavicle area, and midline are targeted to make sure all lymph nodes are treated. This means that some of my lung is exposed to x-rays as well as all of the tissue in the treatment area (bone, muscle, skin, etc.).

In this image it is as if you are facing me. You can see that the dark area (my lung) gets some radiation. My heart has very limited exposure since my cancer is on my right side. My ribs and collarbone are getting zapped a bit too. This photo does a good job showing the size of the area being treated. Any spot inside the circled area is exposed to x-rays. The colour of the lines show the intensity.

This image is a slice of me, and it's as if you were standing where my feet should be. This shows the small exposure my left breast gets (since you are looking up from my toes, the left breast is on the right side of this image) so that they can successfully zap my midline without going through too much lung tissue. X-rays travel in a straight line, so this is the best they could do in terms of avoiding important organs. this image also give you a good shot of my lopsided boob situation! :)

So, other than being very sleepy in the evening and having itchy skin, I'm doing OK. My skin doesn't itch all the time, but I am noticing it more often throughout the day. I'm putting on lotion and saline compresses to help. Cortisone cream is here as a backup in case I need something stronger, and my doctor said allergy medicine can also help take out the itch if it gets worse. Even though I only have three treatments left, it has been made clear to me that skin effects don't peak until AFTER treatment is over. This means that a week or two from now my skin will be at its worst. I'm hoping it won't be too bad.

Despite feeling really tired at certain times of day I have still been getting out for walks. Sometimes in the evening it feels a bit more like sleepwalking, but it always feels better to have moved. When I'm out walking I am very aware that my health problems are invisible. I walk at a brisk pace and smile hello to people that I pass. I feel good and strong when I'm out walking and it sort of makes me feel like I have a secret I'm keeping from the world. The world doesn't know that my skin is read and itchy, or that I'm going to have to lie down when I get home, or that I've been to the hospital every day for three weeks, or that I haven't been to work for nearly 9 months.

The location of my house means that if I want to walk by the lake I need to walk down a hill. This means that getting back home form the lake involves climbing a hill. I've got lots of roads, stairs, and paths to choose from when I head home. One of the stairways has this message on it, so I'm adopting it for myself this week. Three more treatments to go, then radiation is done.

In a week I'll have another immunotherapy infusion and I anticipate a discussion about starting hormone-blocking medication. Finishing up radiation seems like a huge victory, but the truth is there are still lots of changes and challenges to come. 

I haven't written much lately which I can blame on being busy with hospital visits, sleepy from treatment, AND the distraction of the World Cup. ;) I've got lots of crafts on the go and a long list of things I want to finish making before the holiday. We'll see how productive I am!

Sunrise from Friday Dec 2nd. The whole world was pink!