Radiation is Monday to Friday except holidays so there was a nice 4 day break at Easter since Easter Monday is a stat holiday in BC. I am now at the three quarter mark and so far it has been very uneventful. Until today. Today one of my radiation techs tried to cut off my arm. She was horrified, I was glad it happened to me and not to some little old lady or another patient that is stressed out and not coping well.
I have discovered during my radiation treatments that I have been receiving a very customized program. This for a few reasons:
1. I was born with this weird thing called pectus excavatum. Basically this means that I had an indentation in my chest due to an abnormality in the growth of my sternum and some ribs. I had a surgical repair done as a kid but I still ended up with a "funny shaped chest wall". Yes, that is the exact medical description I was given recently. :P
2. I had a small piece of skin at my sternum that had cancer.
3. There were also metastases in my sternum so part of the goal of radiation was to hit those areas.
Normally radiation for breast cancer patients may only slightly touch on the sternum whereas my radiation oncologist wanted to blast away at my whole sternum.
My radiation involves both photon and electron treatment. I believe that many patients do not receive the electron treatment. It is the electron portion that includes a large adaptor that could cut off my arm and it was the cause of the radiation tech freak out today.
The part of the radiation machine that actually emits the radiation is pretty neat. There is a glass plate that is about 1 foot square through which the radiation passes (in the picture the glass plate is not shown). On the inside of the glass there are about 40 narrow metal fingers that stick out from either side. The metal fingers, probably made of lead, since they block radiation, are lined up in a specific pattern so that radiation can only come through the glass in the desired way.
Here's a picture of the fingers before set up:
The machine is set up so that the fingers are in my required pattern and then a light is turned on and lights up on my skin exactly where the radiation will hit. It is the upper portion on the treatment area that is traced out in ink and becomes my radiation artwork. This artwork is used to help line up the electron adaptor to the treatment area.
During the set up there is also a ruler that is displayed with light on my skin. The ruler measures my distance from the radiation source.
I also have 3 radiation tattoos. Two tattoos are used in the very initial set up, I think to ensure that I am in exactly the same position I had been in during my initial CT plan development scan. There are red lights emitted from the ceiling, one that crosses me vertically and the other crosses me horizontally, and they must hit the tattoos. The tattoos are just single needle point pricks so not too big and noticeable.
The third tattoo is used in the electron set up, probably in a similar fashion.
The whole treatment takes about 10 minutes.
Today's little arm cutting off incident occurred after my treatment was complete. The radiation machine looks sort of like this:
only it is an older version and is blue instead of white.
The electron adaptor attaches to the curved metal piece that is sticking out from the radiation emittor. In the first picture showing the metal fingers the holder for attaching the electron adaptor is not attached. The electron adaptor sticks out about a foot from the radiation source and sits very close to my chest and will sometimes actually touch my left arm close to my armpit. Lucky for me I don't feel it as that area is still numb from surgery.
Anyway, while the electron treatment is happening I am essentially sandwiched between the adaptor and the bed so when treatment is complete I can't move until a tech comes in and lowers the bed enough that I can move my arm out from under the adaptor.
Today, the tech raised the bed instead. Oops. And then just to make sure she really freaked herself out she raised the bed a little bit more. In all she probably only raised the bed about half an inch but she was totally horrified.
I understand that. You really never intend to skewer a patient.
I, of course, thought it was hilarious and could not stop laughing. It just felt like the perfect end to a pretty yucky, rainy Friday.
It is just one of those things that happen. No big deal, I wasn't hurt, no bruising or anything. I think it just a part of healthcare, everyone does the best job they can but everyone is still human and occasionally the wrong button gets pushed.
That is why for the really vital stuff there are always several different checks to minimize the human impact on the treatment and prevent errors.
Oh, and as for radiation side effects. So far they have been minimal. My skin is a little red and I may be slightly more fatigued, but I am currently walking about 50 K a week not including trips to the cancer agency or grocery store so probably not. Apparently the fatigue is often partly due to dehydration caused by the radiation so I am trying to stay well hydrated.
So that is pretty much radiation in a nutshell. Have an awesome weekend everyone!
found you tonight. read the whole way through. you truly seem to be my sister. I was 39 at diagnosis - and was working at 3 hospitals as a phlebotomist and medical assistant. Am 8 weeks shy of 59 - and I am a nurse in an oncology practice. But I only had a mastectomy, and 3 nodes
ReplyDeletepositive out of 20. I will so be following your blog and mentally I will be with you all the way. PS - I handled my cancer with the same sense of humor you have -