Does Sitting in the Sun Count Towards Radiation?

I sure wish it did!  It has been so sunny in Vancouver and I have spent lots of time enjoying it.  Especially since radiation was delayed.
I was scheduled to start radiation Friday afternoon.  At 0830 I got a call saying radiation had to be delayed until Tuesday because there was a problem with my plan so my radiation oncologist did not sign it off and changes were required.

Friday afternoon while sitting out in the sun after my Herceptin treatment I received another call from the radiation department.  Would it be possible for me to come in Monday morning for a clearance check?  They didn't want to cut my arm off.
Hmmmm, I didn't think I had signed up for losing my arm during treatment so Monday morning I trundled off to the radiation department for my clearance check.

Everyone was ecstatic............5 mm of clearance.

As long as I don't gain any weight I get to keep my arm.

And I gained some interesting body art on the radiation area to help with future setting up of the machine.

To interrupt all of this radiation fun.  My darling dog was sick, again.  It has been off and on for the last 2 - 3 weeks.  We finally decided it was time to take him to the vet and find out what was going on.  I went out for a walk while Ian took Jasper to the vet.  this is what I found when I got home:

Ah, yes.  The Cone of Shame.  Gotta love it.

Turns out my darling dog managed to pick up Giardia.  Probably from eating one of his favourite seawall snacks, goose poo or mussel shells.  Yippee.
The cone is required so that he does reinfect himself by licking his butt before his treatment is done.  Truly, a Cone of Shame.

So, once that  excitement was done it was over it was back to dealing with radiation.

Tuesday afternoon I met the same radiation techs I had the day before so we all sort of knew what was going on.  I got some more body art in green this time instead of black.  The whole process took about half an hour.
And for part of the treatment I have this jelly like sheet stuck to me.  The jelly is supposed to replicate skin so that the radiation is brought closer to the actual surface of my skin.

The radiation machine itself kind of reminds me of the bone scan machine.  There is a machine with a bed sticking out from it.  And there are these plate like things that also stick out and can rotate around the bed.
When the radiation happens I can hear a buzzing sound but I don't feel anything.

Afterwards the area felt a little warm, and by the end of the day I felt like I had spent the day in the sun.  I did go out for a walk, visit Costco, and do some grocery shopping so I did spend part of the day in  the sun but I felt a little more tired than that.

To protect my skin I am supposed to put on a water based lotion twice a day.  I picked up one of the recommended brands on my way home and slathered it on.  When I went to bed most of my body art had disappeared.  Oops.  I don't think my techs are going to be very happy with me today.
Actually, I'm not really happy with me either.  During radiation I have to lie without moving with my hands holding a couple of handles behind my head.  By the end of the day yesterday my left arm was totally numb.  With no body art, today will take at least as long as yesterday if not longer.

Oh well, I'm a radiation newbie.  Now I know to be more careful.  And maybe I should have read the information sheet more closely that said to be careful of the art work.  But I did test the lotion on the ink and it seemed to be okay.  But, I guess not.
Maybe that means I shouldn't follow the directions.  It is so confusing.

At least radiation has begun.  My completion day is April 18th and I can't wait.

Path Report

Now that chemo brain is gone it has been really difficult to stay inside and do nothing so I have been out and about lots and totally avoiding my computer.  As a result I am totally behind in the adventures in cancerland.

I did have a fun day in Whistler

And an uneventful trip up and down the Sea to Sky

(Wow, I really need to clean my phone camera lens.)

I saw my surgeon.........I think, a week ago?  Maybe longer.  No, it must have been a week, last Thursday the 8th.  How ever long ago that was.  What day is today?   Wednesday? No, Thursday, the Canuckleheads play today.  Thank goodness they finally won last game, I thought the band wagon was going to crash.

Anyway, I saw my surgeon last week, the 8th.  Great.  Now I'm getting so loopy I'm repeating myself, I really need to go back to work.  All of the pathology is back.  I have cancer.

Oh wait, we already knew that.

There were 23 lymph nodes removed (no wonder my armpit feels so funny!!!) and one node had isolated tumour cells.  That is as close to being negative for cancer cells as you can get without actually being negative.  My radiation oncologist classifies it as negative.  That is fine with me.

The most important thing regarding the tumour - all margins clear.  Yay!!
The only downside is that there was only a 1 mm margin at the chest wall and 2mm is preferred, but radiation will cover that.
All in all, my surgeon did an excellent job of hacking the cancer out of me.

With the pathology report now available, the next step was the radiation planning session.  That started with a meeting with a radiation resident who asked me if I knew the results of my pathology report and understood what it had said.  Then we covered the basics around what happens during the planning session and then he answered my questions.
My most important question was whether a person can have radiation multiple times at the same site.  This is a potential issue for metastatic cancer patients as radiation is used to control pain of bone metastases.
It turns out that one area can be irradiated more than once but it depends on how much radiation that area has already received and when it was done.  If a lot of radiation was given to a spot, a repeat could not be done within a year or two.  If, however, that spot needed to be done 5 years later, that would probably be okay.

So, now that you have all this new radiation knowledge plus the path results, I tell you that I will be getting 16 treatments, which is a pretty standard course of treatment, instead of the originally planned 10 treatments.  Can anyone guess what that means, remember at the same time about those other keys phrases, "due to my age" and "how well the tumour responded to treatment"?
Pretty much that means we are back to the "we're gonna try and cure you even though we can't really cure you" method of thinking.  The original plan of 10 treatments was apparently decided based on the thought that in the not to distant future the tumour would be involved in my chest wall and then I would have to be hammered with radiation to get it under control.  Now the path report combined with my PET scan makes me a perfect candidate for radiation and they are going to treat me like a plain old breast cancer patient with cure in mind rather than the metastatic patient I really am.
I think that falls in the good news category.

The remainder of the planning session involved getting a CT scan done, once breathing normally and once holding my breath.  I hold my breath for one scan so that my lungs are full of air (obviously) which causes my heart to be pushed down and thus further from the radiation.  Not all patients actually have to hold their breath during the radiation treatments but sometimes it is necessary to protect the heart. Fortunately each radiation zap would be for 30 seconds or less so the chances of me passing out are relatively slim.

My radiation oncologist reviews that scans and decides exactly how the radiation machine has to be angled to hit all of the required area with hitting things like my heart.  Once that plan is made I will get a call from the Cancer Agency telling me when radiation starts.
I hope that call comes soon.  I really want to get  on with the rest of my life.

The Cancer Alphabet

The things I do to entertain myself.

Here it is, The Cancer Alphabet!

A is for Adriamycin.            The red chemo drug.  It causes nausea and hair loss.

B is for Bone Scan.              I haven't been squished by a faulty Siemens sensor yet! This scan is used
                                             to monitor the status of bone metastases.

C is for Ciprofloxacin.         The first antibiotic I have ever been prescribed.  Figures I needed it for a
                                             chemo induced fever.

D is for Dexamethasone.      Yay. A steroid.  Used as a part of the anti-nausea regimen but still
                                              annoying. Causes Insomnia and ridiculous carbohydrate cravings.

E is for Emend.                     Oh anti-nauseant drug........you are my hero.

F is for Family and Friends.  Bet you thought I was going to say Fluevog:-)  This road has been so
                                              much easier to travel with all the support of my Family and Friends!

G is for Gemzar.                   A chemotherapy drug for down the road.  I hope it's a very long road, my
                                              hair is finally growing in.

H is for Herceptin.                May you work for a really long time.

H is for Healthcare.              Our healthcare system is pretty amazing.  It really makes this experience
                                             less stressful when I don't have to deal with an insurance company or
                                             worry about co-pays and deductibles.  It is stressful enough just hearing
                                             about my American friends.

H is for Home Care.            Thank you for not making me change my own bandages.  Yuck.

H is a very popular letter.  All 3 were so important that I couldn't pick just 1.

I is for Ian.                           You are my rock.

J is for John.                        Fluevog of course.  Did you really think I would not mention shoes?

K is for Kleenex.                 Especially the ones with lotion.

L is for Lymphedema.         Really hope I don't get it.

M is for Mastectomy.          It actually was easier to handle than chemo.

N is for Nose hairs.             For such a small body part who knew they were so important!

O is for Optimism.              Not really any point of getting out of bed every day if you don't have
                                            optimism, and a little bit of hope......H is already kinda a full though.

P is for Pancakes.                Yum!

Q is for Quinoa.                   I just threw that in to make me sound healthy.  I really couldn't think up  
                                             anything good for Q.

R is for Rum.                       Needed for mojitos.  I wish it was summer.  Then my mint would be
                                            growing and I could make one.  I could have also selected radiation, but
                                            right now I'd rather have a mojito.

S is for Sebastian.                Hi little nephew, I can't wait to meet you!

T is for TDM-1.                  Newly approved by the FDA.  Also works against the Her-2 gene.
                                            Another down the road drug.  Will also probably cause hair loss:-(

U is for Umbrella.                I definitely need one today.  We are having a pineapple express only it is  
                                             coming from Japan instead of Hawaii........I guess that makes it a sushi
                                             express.

V is for Vinorelbine.           Also known as Navelbine but that wouldn't be helpful for my alphabet.
                                            This is yet another chemo drug.

W is for Walking.               Thank goodness my feet have recovered.  Walking is the only real exercise
                                            I can do these days other than shoulder stretches.  And the shoulder
                                            stretches are getting boring!

X is for Xoleda.                  Here we go again, another future chemo drug.  On the upside it doesn't
                                            always cause hair loss AND it comes in pill form.

Y is for Yoga.                     I am thinking of taking this up once I can move my are more.  It should be
                                            fun, the breathing techniques are practically the opposite of Pilates.  That
                                            should help keep me on my toes.

Z is for Zoladex.                  A drug to prevent estrogen production.  But the real highlight is the 15
                                            gauge needle used to inject the time release pellet under the skin.

My Pill Bottle Pyramid

Recovery is getting more boring.  I can't walk Jasper, I can't lift anything over 10 pounds........actually I can't really lift anything since it feels like I will rip myself open, I can't do yoga or pilates, so instead I built a pyramid:

How exciting.

The pyramid includes everything I took to make it through chemo.  I am missing a few things.  The Emend card at the back was only for one round of chemo.  I had 4 sets of those cards but I threw the others out, I had not thought of taking this picture for posterity when I first started chemo.

I have one unused prescription for a wig.  I have another unfilled prescription for a pain killer but that was for surgery not chemo so I am not including that.

Yea, so, I am kinda bored.  And I have been discharged by my home care nurse so I don't even have her visits to look forward to.  Oh well, at least not seeing her means I am healing nicely.

If you need some entertainment here is a YouTube link (thanks Grace!) http://www.youtube.com/watch?v=iJ4T9CQA0UM

I see my oncologist in another week.  And my surgeon.  By then someone should have some pathology reports for me.  I am waiting to hear how many lymph nodes still had tumour cells.  I am hoping for zero.

And at some point I have to see my radiation oncologist to get everything sorted to begin radiation.  Likely that won't be for a couple more weeks.  I have more healing to do first.

And now, the rain has stopped so I shall go do one of the fews things I can do, walk.

Have a lovely Monday;-)

Recovery is Getting Bor-ring

Thank you to everyone who has gone for a walk or coffee with me during the past week!
Without you I think I would be ripping out what little hair that I have while attempting to not go bonkers while recovering.

I still have the annoying drain so all the exercise I can do is neck stretches and walking.  I know, up until now all I could do was walk so really there should be no problem, but I am SO ready to start expanding my exercise program.
It is possible that in 5 more weeks I can back to Pilates and soon after that I can start going to the gym. And then I will  feel as though I can finally start gearing myself up to get back to work.  It is about time!!!

My hair continues to grow......I might even have to break down and use shampoo for the first time since  July some time in the next few weeks.  That would be so exciting.

Right, the whole recovering from surgery thing.  I stopped taking the Tylenol a couple of days ago.  I woke up one night and realized I had forgotten to take my last dose so instead of getting up and taking it I just stopped taking it.  That seemed a lot easier.
And I still have the stupid drain.  I might get it taken out today.  Otherwise it will definitely go either Saturday or Sunday.  Yay!  Then I won't live in constant fear that I will snag it on something and rip it out.  Ugh.  What a nasty thought.

The flexibility of my arm doesn't seem too bad at this point.  Any limitations in my movement are driven more by the drain than anything else.

Ok, all the above stuff was written at 1 in the morning while I could sleep because of the drain. I am happy to report that the drain came out this morning!!!
It feels like a 50 pound weight has been lifted off my chest. I have to spend the weekend acting like I still have the drain so I don't go overboard and cause any damage but on Monday I can start doing real stretches.

Have a lovely weekend:-)

Post Surgery, at Home and Recovering

I think my surgeon is a superstar.  So far I have taken a total of 12 regular strength Tylenol to control my "pain".
The biggest pain is in my right wrist where the IV tip rubbed against the vein.

Wednesday was surgery day.  I was at MSJ at 0630 to check in.  I met with a surgical day care nurse to go over my medical history and then I got into one of the fabulous surgery gowns with snaps everywhere so they are easy to put on and take off.  Then I met with one of my OR nurses, then I met with a doctor who was assisting with the surgery, then I met my anaesthesiologist, then I met with my surgeon, then I met my other OR nurse.....I didn't actually have to meet the second nurse but she had heard that I was a lab tech and wanted to meet me.

Just after 0830 I was sent off to the OR.  I had a short discussion with my anaethesiologist about the best place for my IV.  Sometimes the vein in my right hand collapses if I am dehydrated but the vein was apparently too big and juicy to resist.  Fortunately the attempt was successful......having to dig around in the vein never seems like a good way to start the day.

And then it was about 1210 and I was in recovery.  I got a shot of gravol for nausea and I was transferred up to 4 West a little before 1400.  Lucky me I got a semi-private room and my roommate didn't show up for another hour or so.

My nurse was great and I had a visit with the Clinical Nurse Leader that I had dealt with quite a bit during my Point of Care days.  It is always fun to hear a little bit about how things are going on the wards that I used to know so much about.

I actually managed to get some sleep Wednesday night in-between visits from my night nurse.

Thursday morning I had the same nurse that had been there the day before.  I had a visit with the physiotherapist about the exercises to be done during my recovery.  I also met with the liaison for home care as a nurse will come out periodically to check my dressing and drain.

Last I had a student nurse come in and check on me.  When she came in she told me that she was excited to meet as she had heard that I had been a lab tech and I was really popular with all the other nurses (the other 2 that I had seen on the ward isn't really all the nurses, but it was nice to hear anyway!).
I offered to let her practice her glucose meter skills on me but she wasn't sure she could do that since I was diabetic.
I did have her check my drain and empty it.  And I had her show Ian how to empty the drain as well.

And then it was time to go home.

It is now Friday.  I am still puffy from the saline but it is getting better.  I am sure my chemo nurse will be thrilled to have to put in an IV this afternoon for my Herceptin.

I had a visit from my home care nurse and everything looks good apparently.  I am a wuss so I won't look at the surgery site.  And there is no swelling so I can really feel the drain and it is kind of gross and uncomfortable feeling but still no pain.
Hopefully the drain can come out on Tuesday.

Ahhhh.......Sushi

Yay!  Thanks to the St. Paul's gang for accompanying me to my first sushi meal since last July.
I don't normally take pictures of my food but this is something I had to commemorate.

Volcano Roll!!!!!!

And tomorrow is surgery.  I'm not exactly thrilled, but I am having the surgery because I had good results.  That is so much better than not having surgery because I had bad results!
I will be in only overnight so home on Thursday.  It seems a little hard to believe that the stay is so short, but the shorter the stay the lower the risk of catching something else so I suppose that is a positive.

There are a few good things from the past week:

I became an aunt for the first time on Saturday, January 26th.  Now I need to recover quickly to make it out to Toronto for a visit.

Next, my chemo brain is almost gone!!  This is wonderful.
The only downside is that after being home for 2 days without chemo brain I had such a bad case of cabin fever I was tempted to teach myself to juggle knives.  I can only hope I get cleared to go back to work soon.  I am aiming for July but I am dreaming about May.

Lastly........my hair has started to grow back!!!! And my eye lashes!!!!! I'm not 100% about my nose hairs since I can't see them, but I don't think I'm blowing my nose quite so often.
Hopefully soon my cancer patient look will start to disappear and then I can wear hats because I want to and not because my head is cold.

I will be out of commission for a few days due to surgery.  Ian will send out a text from my phone after he sees me post-surgery tomorrow but there likely will not be any action on my blog for a few days.