Radiation 101

July 14, 2009

I have been attending regular radiation sessions since July 2^nd. Knowing that I have promised a report in a week, I have been paying close attention and have asked questions when necessary. So here’s the scoop!

The Interview

Before my first trip to the inner sanctum of radiationland, Jennifer, one of the technicians, interviewed me for about 15 minutes. My first instructions included warnings about what to wear (and what not to wear) and what to buy to treat the exposed area.  Essentially, I have to cover up my chest area from the neck downwards to protect myself from sunburn. No décolleté for me! The skin on my chest will be hypersensitive to UV rays because of the treatment. I also have to give up underwire in my bras, and, as much as possible, to give up wearing bras completely. If I were 18, this would be an easy proposition; I was a child of the sixties and loved going braless in my youth, but I have had 40 years of gravity since then, and I need all the support I can get. I was warned that any underwear I had on when I visited the hospital was at risk of being stained by the Sharpie pen marks that I will get every day. More on this later. I was also advised to use very gentle soap when I shower and to avoid shaving my left armpit and using deodorant on the left side. Finally, I was told to get myself some Lubriderm lotion to hydrate the exposed skin several times a day.

So my cancer treatment has fueled my shopping addiction.  I decided to invest in a couple of new bras without underwire. That was a practical consideration that I could easily justify. The purchase of two new golf shirts that zip up to the neck made sense too, but the skirt I bought at the same time was probably not necessary, even though I must say it looks really good on me, and I got it for a bargain price.

The Schedule

I will be in radiation treatment every weekday this month, except the 1^st and the 31^st. I was asked during the planning appointment for my time preference. As a morning person, I was hoping to get the hospital visit over with as soon as possible every day. But the schedule for the first week was all over the place!! In eight visits to Sunnybrook so far, I have had appointments at 5:00 (which I moved to 2:30), 4:00, 3:10, 12:50, 11:10, 10:40, 8:40 and 8:20. I guess flexibility is the key here. Of course, I realize that other patients are worse off than I am, since they have to manage a similar schedule while working, or travelling long distances, neither of which I have to worry about. However, since I have golf dates that I would very much like to keep, I have had a few appointments moved with no difficulty.  In addition to the seemingly random timing of the appointments, is the strong possibility of delays. On the first day, for instance, my 3:10 appointment did not end until nearly 5:00. Fortunately, on that day, I had Jeanette’s company to help me pass the time. I also always make sure that I have a book with me just in case I find myself waiting.

The Routine

Upon arrival, I swipe my health card in a machine and watch the nearby computer monitor indicate that I have been registered into the system.  My next three appointments are also listed to help me plan ahead. Above the check-in area is an electronic message board which indicates if there are any delays with some of the machines. On most days, shortly after I check in, someone comes out and calls my name. I am led to a change room where I strip from the waist up and put on a hospital gown.  My clothes go into a locker nearby. Next, I am led along a curvy hall to the room where PRI2 awaits me. That is my machine.  PRI is short for the company name (Primus) and 2 indicates its number. There is a 1, 3, 4, 5 and 6 as well. On that first day, I was treated on 4 because 2 was running far behind.

I lie on my back on the bed of the machine, my right arm by my side and my left one raised into a rest area above my head, my legs extended. I must lie very still and breathe normally while the technicians position me according to my tattoos, exactly the same every time. They use Sharpie pens and numbers to configure my placement accurately. By the way, so far, I have been coloured in red, blue, green and black. When everything is just right, they leave me alone with the machine which makes machine like noises (clicking, whirring) and travels from my left side in an arc, stopping on my right. The actual radiation takes about 3 minutes, I estimate. On the first four days, I was x-rayed as well, adding an extra 5 minutes to the time I was on the bed. When the process is complete, the technicians return to the room and dismiss me for the day.

The People

I have met six different radiation technicians: Jennifer, Jenny, Christina, Ching, Haq and Emily. Usually, Christina and Ching are my people. There need to be two in the room to set up. Both of them have answered my questions quite readily; last Friday, when Katie arrived for the weekend, they even allowed her to enter the radiation room to witness the set up. I also have a radiation oncologist, Doctor Jean-Philippe Pignol, whom I see every Tuesday after my treatment. He is very French, with a charming manner.

Most often I plan to go alone to these appointments, but, as I already mentioned, Jeanette came with me the first day, Catherine accompanied another day (we had a golf date afterwards), and Katie was with me last Friday.  Today, my husband will come with me, since I have to stay awhile. I have three appointments: radiation, Dr Pignol, and a six-week check-up as a result of the Beatrice study.

This missive is getting very long! I have more to tell you all, but it will keep until the next report.