Welcome back to my medical journey.  Last I Left you with the results of the sentinel lymph node biopsy being negative.  Fantastic news!  That meant that my breast cancer was a Stage 1 – very good prognosis and so lucky to have caught it early on the 3-D mammogram with tomosynthesis done in January.

After consultation with the Radiation oncologist, she recommended that I undergo 4 weeks of external breast radiation targeted to the area where tumor was removed.  Some of you have asked me why I would need radiation if the tumor had already been removed. I decided to pursue short-term radiation therapy because it would reduce the risk of recurrence in my left breast to approximately 1%/year over the next 5 years and destroy any undetectable cancer cells in the area.

Now mind you, my left breast wasn’t all that game for this plan, but I believed that the benefits were worth the risks/logistics, etc.  Luckily there wasn’t much poking or prodding.  Just some initial measurements and stickers placed on me before scheduling the actual therapy.   I asked the technician, “Why aren’t I getting a tatoo to mark the sites?” “Well, the technology has changed.  We don’t do those anymore.” He responded.  I did tell him that the stickers on my left breast wouldn’t last very long because I was going on vacation the next week. “No problem.  Enjoy your vacation!”, he said with a smile.

Yes, those stickers came off the first day of my vacation.  This was a long-awaited respite.  I sighed as I stepped into the crystal clear, turquoise waters of Cozumel.  I removed the stickers before plunging into the warm, comforting sea.  My dear friend, Kim, had invited me for a “girl’s trip” to an all-inclusive beautiful resort on the beach of Cozumel.  How could I resist?   Not only did I let myself rest, but I indulged in three (or more!) delicious meals a day with unlimited poolside cocktails. Everyone thought we were sisters.   After explaining it multiple times to the hotel guest, we decided to go with it.  Yes, we were sisters – much easier than explaining that she was a nurse and we had worked together at the hospital.

I must say that that vacation was one of the best I’ve ever had.   Mental note to self – consider doing this at least once a year to relax and replenish my energy reserves. Luckily, I had lost a few pounds before the trip to help balance the scales when I returned home.   Now I’m back to my exercise regimen and stricter nutritional intake.

Back to reality.  I’m in the radiation oncology entry area and instructed to change into a hospital gown and wait to be called.  Then, I’m escorted into the spacious treatment center where a table lay in the middle, with huge machines with long arms surrounding it-  somewhat of an alien creature with a round, rotatable arm.  Red laser and green lights shone on me from above.

I was instructed to lie down on the middle of the table.  The friendly technicians then adjusted my position, bent my knees and placed my arms overhead in straps.  Flashbacks of the stereotactic biopsy rushed into my brain.  “Thank God, I’m not in that vice”, I thought.   Here’s a video of how the machine works.

“Take a deep breath”, the technician said.  After a few deep breaths, she said, “Breathe a little deeper.”  I thought I was breathing quite deeply but obviously not deep enough. I needed to think of something that would make me inhale to the fullest.   My fall off a kayak in the middle fork of the Salmon river came to mind.  Please read this blog is you have a chance — this experience was also another eye opener for me.  Here’s the link for that  Blog: The Ultimate Letting go

The thought of releasing my hand from the cold, moss-covered rock and enter into the rapids with only my helmet and life-vest flashed back to me.   “Well, this is a lot easier than that was.  I can do this.” I reassured myself. Then I inhaled as deeply as possible, expanding my rib cage until it was fully distended.  This was needed to decrease the amount of radiation that might get to my heart and left lung-  one of the potential side effects of the radiation.  After about 15 seconds, I heard the technician on the intercom instruct me to exhale. “Whew”, I thought – I needed that breath.  This was repeated one more time.  “Ok, all done”, the technician gently said to me on the intercom.

Back to the dressing room to change back into my clothes before heading up to visit with the radiation oncology nurse.  She got my weight and Blood Pressure and said, “Is your blood pressure always that high?”.  It was 140/90 – the answer was “No.”  Normally, it ranges about 120-130/70-80.  She suggested that I keep track of it at home.  I thought this a bit odd – of course, my blood pressure would be slightly elevated – I just underwent my first radiation treatment in a dark room, with red and green laser lights glaring at me with a machine with alien arms emitting strong radioactive waves to my left breast.  My body was probably still in a bit of shock.  I knew that my adrenals had released quite a bit of adrenaline into my bloodstream during this unfamiliar experience which caused my blood pressure to rise.  I thought of sharing this hypothesis with her, but then changed my mind. “Maybe it was getting up and down with the elevator”, she said.  I just let it go from there – yes, medical professionals, especially doctors are definitely the most difficult patients!

She then gave me a sheet of paper explaining all of the possible side effects of the radiation treatment, including skin itching, redness, pigmentation, swelling, pain and fatigue.  “Ok, if I’ve made it this far, I can get through this”, I thought.

I left with my radiation schedule in hand with my appointments for the next 4 weeks.  Every week day at 8 am before heading to work, I would need to visit the radiation oncology center and get my radiation treatments.

I’ve now received a week’s worth of treatments and am becoming quite a pro at the whole process.  I scan my orange ID card to the machine at the reception desk, get beeped into the radiation department, disrobe, put on hospital gown, and walk down the ramp to the treatment room.  The technicians are incredibly friendly, supportive and comforting which I am so thankful for.  My deep breaths are getting easier and I’m not as fearful of the entire process.

By July 3, I will have completed my 4- weeks of preventative radiation therapy.  So far, I’ve felt just a little fatigue and slight left breast pain.  Overall, I’m doing very well!

Thank all of you for your continued support and prayers during this challenging experience.  I definitely must admit that I have a lot more empathy for my patients after seeing the different phases of this process, from diagnosis to treatment and beyond.  I appreciate each and every one of you!

In health and happiness,

Dr. Diana