It is more important to know where you are going, than how long it takes to get there.

Tuesday, November 23, 2010

5 Greats...

A little over a week ago I had a post-radiation appointment with my radiation oncologist, Dr. Dad. He took one look at my exposed left chest and underarm and exclaimed, "Great!" pause. "Great, great, great great!" I asked him, "Is that 4 greats or 5 greats?" He responded, "5 greats!" ( I actually feel like 2 okays and 1 good.) He said that my skin is healing beautifully, but that I still had some burning to go. When people ask me how I am feeling, I tell them that "I am smoldering." You know, like how a forest fire smolders for days after it is extinguished. Dr. Dad also told me that if I went swimming in warm ocean water, my skin and scars would heal in two days! I asked if he could write a prescription for this treatment, but he didn't think insurance would cover a trip to a tropical island. If I was a member of congress, I bet I could get an insurance company to pay for this trip!

After the comment about continuous burning, I asked several questions. You may wonder why I didn't ask them earlier. Well, as we all know, hindsight is much more clear than foresight.

1. "Why did you use the bolus during my treatments?" When someone is having a radiation treatment, the radiation kicks in just below the surface of the skin. In my case, the bolus tricked the radiation so that the maximum strength started right at the skin and radiated at max strength all the way to the chest wall. Because I have so much scar tissue on my left breast (Riley said that is looks like the Oakley logo with a tail that extends to my armpit,) he wanted to make sure that the skin gets maximum radiation. As scar tissue heals, the scar area is like fertile soil, both good and bad things grow well, plants and weeds, skin tissue and microscopic cancer cells. He wanted to kill any tiny cancer cells that might be hiding and germinating in the scar tissue. This explains the ugly dead skin that looks like all colors of Playdough mixed together. As of today, I still have some of this nondescript gray skin along the scar line of the oval Oakley O. By the end of this week, the dead skin should be all gone. It has been over two weeks since my last radiation treatment, and the skin is just finishing its long, slow death.

2. "Why does the burning continue weeks after treatment?" (I somewhat knew the answer because just the night before, Riley and I read something about this in her biology text.) It takes many days for the cells to complete their reaction to the radiation. Via a 10th grade biology text, I was reminded that some chemical reactions are instantaneous, and some are very slow. Radiation happens to fall in the slow category. I know, common sense.

3. "Three times during radiation, the tech forgot to tell me to breathe in before she turned on the machine. Should I be worried?" I was concerned about my lungs, but Dr. Dad set me straight by explaining that the large inhale was to protect my heart. Because I was radiated on the left chest area, there is a very slight chance that the heart could be affected by radiation. (All this time, I thought the big inhale was to protect my lungs.) By taking a deep breath, the lungs slightly push the heart out of the radiation path, giving it a little extra protection. He told me not to worry, because in the past, they did not do the breathing to protect the lungs. What?! That's like saying, in the past we didn't have such thorough sterilization procedures for our instruments, so don't worry if the scalpel fell on the floor; I wiped it off on my pants. Anyway, I am not at all worried. I was just surprised by Dr. Dad's uncharacteristically lame statement. I still think he's great. Great, great, great, great. 5 greats!

A few days after seeing my radiation oncologist, I saw my medical oncologist, Dr. Banana Split. I was thinking of calling her Dr. B.S. for short, but it just doesn't fit. We talked about the medications I will be taking for the next five years. For the next 2-3 years, I am taking Tamoxifen. Tamoxifen blocks estrogen that can feed new cancer cells. I take one pill every day. I am so bad at remembering if I took a pill, that I bought a 7 days of the week pill box. Oh my God, am I getting old! My grandmother didn't need one of these pill organizers until she was in her 90's! After the Tamoxifen, I will take something similar for the remainder of the five years. I am also receiving an i.v. of Zometa every 6 months for three years, which sends me back to the infusion clinic - the place where I received my chemotherapy treatments. It will be given to me through my port. Zometa is a bone strengthening drug that is widely used to treat osteoporosis. Dr. Banana Split said that the Tamoxifen can sometimes weaken bones, and that if cancer comes back, it is often in the bones. Strong, healthy bone cells don't allow the nasty cancer cells to move in like unwanted guests, spreading their crap everywhere.

I was scheduled for day surgery last Friday to have my port removed. I was not looking forward to this procedure because I got so sick from the anesthesia when it was put in. Coincidentally, earlier in the week, when I went to have blood drawn, the lab tech had a difficult time finding a good vein. (They do not take blood through a port.) She could not find a vein in the usual place, inside the elbow, so she went for a vein in the middle of my forearm. She kept moving the needle around as she was removing blood to fill three vials. She gave up on this vein half way through the second vial, and went to a vein in my hand to fill the second and third vials. (She threw away the half filled second vial from vein #1.) It didn't feel so great, and I don't recommend getting blood drawn this way. I ended up with a couple of first-rate bruises on my arm. As a result of this lovely episode in the lab, I received a call Thursday late afternoon from MGH, cancelling my day surgery to have my port removed. I have always had difficulties with i.v.'s and veins. When I was in labor with Riley, it took 2 nurses and an I.V. specialist to insert the needle...another reason I could never be a heroin addict.

Today I received a call from Shirley, Laverne's partner, and the case worker in charge of the study I volunteered to be a part of way back before chemotherapy. Shirley often calls me to follow up on "stuff" for Dr. Banana Split. She is the one that called me last Thursday to inform me that my day surgery was cancelled. Today she informed me that my blood work showed a vitamin D deficiency, and that a prescription was called in for a pill with 50,000 units of vitamin D! I am taking this pill once a week - another pill for my box. Ladies, look up vitamin D. It does all kinds of great things for us; it maintains calcium level for our bones, it can help keep bad cells like breast cancer cells from multiplying, it boosts immunity, and it can decrease the risk of high blood pressure. Since vitamin D also comes from the sun. That trip to a warm tropical island is sounding more and more beneficial!

Whacky thought for the day...
"If more than one goose is geese, why isn't more than one moose, meese?" - Mia Cromwell, age 8

Nov 22nd - Happy Birthday Nora!


  1. I am also on a once a week vitamin D. I take it for 8 weeks, then have another blood test to see if I should stay on the prescription vitamin D or can do an over the counter one.

    Winter time in New England, I believe everyone needs extra vitamin D