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Maggan

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Finally, I am scheduled for radiation therapy or rather: Preparation for radiation. I meet with a technician to get my measurements set in a foam contour.  Actually, it turns out to be  nothing fancier than a plastic bag that she fills with warm liquid. I  then lie  down and my contours are set as the liquid firms up.  When I come for my therapy I will  lie down in exactly the same position every time.

The radiation oncology department has two waiting areas: one  for family or friends who accompany a patient. In this area there is an aquarium and a small reception desk, a few arm chairs.   It is almost empty.

A door with the sign: “Radiology Patients Only”  leads to another small, crowded waiting area. The ceiling is low and covered with acoustic tiles.  The chairs are the same type as in the outside waiting area.The magazines in the basket are out-dated and dog eared. Staff members, mostly women in blue scrubs, mill about, going in and out of side rooms, opening and closing doors, appearing or disappearing from behind curtains,  seemingly without purpose. Back against one wall is a blue drapery and behind it some cupboards above a low bench. That is where I am supposed to change into a cotton gown, property of the hospital, one size fits all — or nobody.

I also have a CAT scan which takes but a few minutes. I lie down on a narrow bed that slides in and out through a dough nut hole. I have no idea that I am receiving 6000 rads of radiation through out my whole my body. It is a  hundred times more radiation than a regular X-ray. Nobody explained the high level of radiation I would receive. Nobody told me why they need to have my cat scan although I recently had an MRI or why the MRI images would not be good enough.

Every day, Monday through Friday, for the next eight weeks, I will receive a prescribed dose of radiation to kill any cancer cells that may have been left. The therapy will cover my whole breast with some extra shock treatments concentrated on the breast area  where the tumor was (the tumor bed.)

A linear accelerator produces the treatment x-rays and this special  therapy to kill cancer cells is known as EBRT – external beam radiation therapy. (Without radiation, 40 percent of lumpectomy patients have a local recurrence of their breast cancer.)

The exact level of radiation will be set by Dr. Alpha and his medical dosimetrist. The actual radiation therapy treatments will be handled by his radiology technicians. I am told that I will be checked by Dr. Alpha, the radiation oncologist, every Monday.

I get to pick my time slot. I choose  2.15 PM Monday through Friday.  (Should I not be able to come one day, I can come twice the next day, as long as it is six hours between the treatments.) Finally, I get a parking pass, a yellow 8 x 11″ piece of paper with the words radiation oncology written in magic marker. It  is valid for the next eight weeks. When put on my dashboard, it allows me to park for free right outside the hospital entrance doors and to  avoid the crowded parking garage.

I am all set for my personal Chernobyl.

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Dr. Guru calls me at work with the pathology report.  “I just got it,” he stresses.

(So he did read my  blistering email after my first surgery. Then I complained about him not sharing the pathology results until two weeks after he himself received them.)

“Everything completely clear, just as we knew it would be. Margin a bit larger than 2 mm.”

“Good job then, “I say.

Dr. Guru asks if I have decided to fore go chemo and when I say yes, he tells me it would have been of  little or no benefit in my case.

“Why add all those toxins to your body?” .

“Why did you not say so right away? I ask. “You knew I was terrified.”

“I wanted you to make up your own mind,” he says. “Some people will agree to chemo for a one percent better chance of survival.”

This is nonsense. How can a patient, a lay person,  “make up her own mind?” Even someone like me, someone who has cruised the interned “ad nauseam” cannot really decide. A lay person will often misread statistics and project wishful thinking into her readings. This is natural. This is why a doctor will see another doctor when she is sick. A lawyer will not represent himself. You need a professional, someone with experience and perspective.  Preferably a professional with no skin in the game.

But I say nothing

Dr. Guru tells me I may start radiation “any time.” “Your choice of hospital is fine,” he assures me. “Alpha is excellent. Many of my patients go to him.”

(Suddenly, he no longer refers to Dr. Alpha as “that radiation oncologist.”

Dr. Guru sounds upbeat. And I am amused. Now that the icy patches between us have been salted and sanded, everything is on the up and up.

That night, I go to bed relaxed and content.  For the first time since I received my breast cancer diagnosis,  I do not wake up in the middle of the night. Not even briefly.

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Re-Excision Day

February 6, 2010

Second time in OR, I feel like a pro, familiar with the routines of the ambulatory surgery unit.  The prep-nurse and I exchange recipes and talk adult children. While we chat,  Dr. Guru flies by the open drapery, grins,  and gives me a half baked wave. He looks a bit like the cat who ate [...]

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Another Duel With My Surgeon Oncologist

January 28, 2010

This is the week Dr. Guru promised to do my re-excision.  But not a word from his office or from his assistant, Joy,  who  supposedly is “arranging the details.” No explanation. No apology. No  follow up.
Meanwhile I am obsessed with my research, trying to figure out the dangers of putting off radiation. Everything I have [...]

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Dr. Guru Agrees to Re-Excision

January 22, 2010

Twenty minutes after Professor Oncology nixes chemo therapy, five minutes after Dr. Alpha, the radiation oncologist, calls to tell me that I need a re-excision to get clear margins (you are supposed to have 2 mm) I am sitting in my friend’s garden sipping tea from her bone china cup. I am “in the moment” [...]

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Re-Excision After All

January 17, 2010

Three distinguished physicians, all cancer specialists,  seem lukewarm – or indifferent – to the merits of chemo therapy, in my case. I feel as light as a swallow, and just as fast, as I leave the Magnolia Cancer Center. I tip the valet $10, but before I can drive away, my cell phone buzzes.
“Charlie [...]

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Oncology: A Second Opinion.

January 10, 2010

The sign “Magnolia Cancer Center” does not look as surreal as it has during my previous visits. After all, I do have breast cancer and this center is for me. Although I do not yet have the hollow eyes, the waxy complexion, the bloated body, or the shuffling gate of so many of the other [...]

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Dr. Alpha Can’t Radiate Me – Yet!

January 6, 2010

Dr. Alpha, my new radiation oncologist, flips back and forth  in my pathology report. He seems annoyed. Not with me, but with the report. He pushes the reading glasses back on top of his head. “I don’t understand this,” he says. His tone bristles, but he looks kindly at me as he stabs his finger [...]

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Visit with Radiation Oncologist

December 20, 2009

I leave Dr. Weary to meander through the bowels of the hospital until I end up in its basement.  “Radiation” reads one arrow pointing down yet another hallway.  Around that corner another door:  “Environmental Services.”
Toxic waste? Then I realize it is only a euphemism for the janitor’s office. Around the next corner from the janitor’s [...]

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Breast Cancer Tends to Sneak Up on You

December 2, 2009

Dr. Weary piles on the good news about his chemo regimen:
“You will not suffer for five months straight. Only for six week-ends. You may have your treatments on Fridays so you can recover over the week-end and be at work by Monday. Maybe by Tuesday.”
“Great.”
“We give you medication to control nausea. You will not feel [...]

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