Downhill or Uphill?

I am happy to report that I have now finished 10 of my 17 radiation treatments, a bit over halfway in case you need help with fractions. So in that respect you might think I am on the downhill slope now. However, the side effects are now starting to ramp up and are expected to last at least a week after my last treatment. In that sense I have an uphill stretch ahead of me.

Towards the end of last week I could tell my esophagus was beginning to feel the effects of radiation. It hasn't been painful yet but when I swallow it feels like something is stuck. The doctor said this was the first sign of fun things to come. So maybe he didn't use the word fun but he told me I could start taking ibuprofen to help with the inflammation. He also prescribed another type of mouthwash in case the type I already have doesn't work for me. The mouthwash I got during chemotherapy has lidocaine in it to numb things up before eating. This new prescription has hydrocortisone and tetracycline in it instead. Both mouthwashes have common ingredients of maalox, nystatin, and benadryl. Not sure why you need to know that but if you're interested feel free to do the research online yourself. After all, this is about me and how I am feeling.

Sunday afternoon I started to feel like I was getting sick with a normal sore throat but I haven't noticed any other symptoms with sinus issues or fever so the doctor thinks it could all be due to radiation. We'll see but I had a student come make up a test Friday in my office and she wasn't better yet - she kept hacking away, spreading germs in the air I am sure. I any case I have been very tired the last few days and suspect it is the fatigue that I was told to expect. I face this all with optimism because I know that in about 3 weeks I will be in the clear. Luckily this is not as bad as chemotherapy and I have been spared the nausea they said was possible. I'll keep you posted but we're getting closer to the end.

Hot Zone

Tuesday I entered a bomb shelter to continue my treatment regimen. The metal door was over a foot wide and is magnetically sealed after the techs leave the room. The process does not take very long and I do not feel a thing. I lay down on a slightly skinny table. They made a mold of my arm position a few weeks ago so I lay down on my personal pillow with my arms above my head while they strap my ankles together. The the table slides me under a radiation apparatus about the size of a truck tire that is secured by a C-arm above me. They use lasers from the ceiling and walls to line my tattoos up with my original positioning. Then, if that wasn't enough they take a standard x-ray of me to make sure I am properly aligned. Two arms are mechanically opened on either side to take the x-ray. After I am in the proper position the computer takes over an radiates me for 5 minutes. There are 9 angles in my treatment so the machine rotates almost 360 degrees by the time we are done. I get shot twice from each angle. There is a buzzing sound for 7-8 seconds and then it repeats. There are metal leaves that shape the radiation rays so sometimes the beam is curved and at different angles. I guess I could have just said at the beginning that it is all highly technical and precise. The radiation goes right where it needs to go and at a pretty low dosage.

They tell me that it will take 2 weeks for the side effects to peak at which time I can expect a sore esophagus and fatigue. It will probably last a week or two after my treatments end. I am slated to go 17 consecutive business days, meaning I'll have my last one on my birthday. What a happy day that will be! They thought I might get nauseous because the radiation gets the top of my stomach but so far so good. I have really enjoyed the past several weeks of feeling good but this will be nothing compared to chemo. Almost to the end!

Life's Too Short - Get a Tattoo

The last week or so has been the best for a very long while. I have felt so much better physically and it has also been a boost to get back to work. Today was a reminder that things are not quite finished. I went to see the radiology oncologist to find out more of the plan for radiation therapy. I talked with the nurse and then the doctor about side effects and long-term concerns. It was much of the same as we talked about back in April. Then they took me to the "Simulation Room."

Essentially they did a dry run of the treatment. They scanned me with a CT machine that had an infrared camera as well to make it a 4D scan. They used the camera to monitor the rise and fall of my chest from breathing. It was all very high tech. The walls and ceiling had laser shining out from them. They used a memory foam device to hold my arms above my head and then took a picture of it so we remember how I held my arms. After the doctor looked at the scan, they made some permanent markings on me so they can line me up the same way each time. So basically I got 3 tattoos, though they are minuscule dots. They put ink over my skin and then poked me with a needle. I have a spot on my breastbone and under each arm. The whole process is very technical and precise which allows them to use less radiation. The doctor will consult with a physicist (basically an applied mathematician) and plan the treatment in detail. I will then go for 17 consecutive business days for the course of treatment.

I don't have an exact start date yet but expect it to be the week of the 12th sometime. Each treatment should take about 20 minutes from walking in and out of the door. And luckily the clinic is only 5 minutes from home. The main side effects will be an inflamed esophagus and fatigue. I don't think it will be as bad as chemo was to deal with. I'll keep you posted but for now I am just enjoying feeling great!