Radiation final run

Turns out, before the radiation treatment begins, there's this "final run" stage. So here I am at Dana Farber in Boston, ready to take on the real deal with the mighty "purple" machine.

First things first, they don't make it a walk in the park to find this place. There are countless radiation oncology departments scattered across Boston buildings, and some are even hidden within a maze of interconnected structures. I felt like a character straight out of the Maze Runner series, starting off in the basement of L2 for oncology radiation, diligently arriving on time, only to be told that I'm in the wrong building. Now, the mission is to ascend to the main floor, hop on another L or M elevator, navigate two internal bridges, undergo Covid screening (because, naturally, one of the buildings in this monstrous complex still requires it), descend yet another bridge/corridor, ride down the P2 elevator, cross the Yakey building connector, and finally reach the promised land. And all they had to say was, "Just ask for the 'purple machine' if you need directions."

Well, as you can imagine, no one had a clue about the purple machine. It took every ounce of my agility and problem-solving skills to conquer the challenge within a mere 15 minutes. I triumphed over the maze!

Now, the actual radiation trial wasn't too different from the measuring day, except for the fact that I had to shield my eyes from the never-ending flashes with a towel. That's right, I became a master at fending off those blinding bursts of light.

Radiation prep

Today was my first encounter with radiation. 

Now, before DF could unleash their proton firing squad, the lab has to meticulously measure and calculate all the angles. I had the pleasure of experiencing this preliminary measurement extravaganza today in the basement of the DF Boston building. I completely forgot how freezing it is in middle earth..

Imagine this scene: you're lying there half-naked on a rolling pulley, while the lab assistant diligently marks your body with sticky notes and markers using a regular high school ruler. And just when you thought it couldn't get any weirder, you glide in and out of a doughnut-like contraption. As if the ruler-wielding assistant and the donut machine weren't enough, they throw in a breath-holding challenge. For a solid 15 seconds, I had to strike the perfect pose, with my ribs held upright and my breath on standby. 

As I went through these peculiar motions, a thought struck me: with 30 sessions under my belt, I might just have what it takes to become the next "naked sushi" sensation. Picture me, effortlessly lying still and holding my breath, all while people enjoy a fine dining experience on my body. 

The beginning 0f a grand adventure in the radiation lab, where freezing temperatures, ruler-wielding assistants, and contortionist-level breath-holding skills are all part of the package. 

I radiation treatments start July 10th

Cancer statistics

Breast cancer is one of the top three cancers in the US, after lung and prostate.

Approximately 13% of women (1 in 8) will be diagnosed with invasive breast cancer, and 3% (1 in 39) will die from the disease in their lifetime.

Breast Cancer Statistics, 2022 - Giaquinto - Wiley Online Library

During out last's week book club, it turned out that out of 8 women around the table, 4 had some form of breast cancer --- mine was the most severe out of the group...but still it is telling how widespread it is. Granted, we are all probably in the right age group to start getting it, but still most of us are under 50 years old.

Post operation

Continuing about my extended Monday at the hospital. 

After the blood draw fiasco at 12 pm, I met with the post operation nurse, who was able to look at my lymph nodes. Both the port and the breast incisions healed well, but the lymph area started to go numb and a seroma formed that was hindering normal movement. This is a lump under the armpit cavity, numb and full of lymphatic fluid.

It turns out that 50 % of the time after surgery, a lymph pool forms at the armpit cavity. The nurse removed it by aspiration, which means inserting a syringe and drawing it out. I didn't look as she was doing it, and she kept asking whether it hurt, and I said it didn't, but I lied!

George held my hand, which was very nice. He says it took 6 large syringes full of red fluid, 90 ml, more than she expected. Another, how to I get this off later, bandages... and I was told that for another week or so there is a 50 % chance that I would get another seroma.

Than, there was half and hour with the radiology specialist to sign my life away, so that they could schedule the preliminary measuring tests and, finally, we headed home

Not that unexpected

Monday was the day I had several appointments scheduled in the hospital:

9 am blood draw

10 am meeting with oncologist

11 am Keytruda infusion

12:30 pm post operation checkup

2 pm preliminary meeting regarding radiology

But everything sort of went side-ways starting with the labs. My port had been removed during the operation (thank God), because I believed it was infected as it never really stopped hurting. It was implanted back on January 5th and after several weeks you are not supposed to feel it. Five months later, even wearing a t-shirt over it was sensitive. 

So now, the labs and the infusion would have to be done via regular IV. For almost two hours several nurses, including the specialist, were unable to find a vein for me, and we finally gave up. My veins are tricky, but this day probably some planet was in retrograde, and even with all the fancy equipment they were not able to draw blood.

And, consequently,  my schedule was in disarray, and at 10:50 am we met with my oncologist. She brought a study graph and explained that even though during chemo Keytruda is key, once the chemo is over, according to protocol there are 5 more infusions, but the efficacy of those is not that obvious. The difference of recurrence without these treatments is less that 2%, but the side-effects are still there.... so, considering that getting an IV for me seems to be in the realm of the impossible, we decided to forgo the left over treatments for now. So we crossed the Keytruda infusion from my schedule.

Grand Slam

Sunday at 7:30 pm I got a happy call from my surgeon -- she got the results from the pathologist, and I have what is called "a complete response": disappearance of any signs of cancer. That in itself doesn't mean that the cancer is cured, only that the chemotherapy killed off whatever cancer cells we knew about.

The cancer cells might still be in the body and might start growing again.... but we don't worry about it now. I still have several Keytruda infusions (4) and over 30 radiology treatments to make sure the cancer stays away, but at least there is a light at the end of the tunnel.

Operation day

Thursday June 1st, on the day of the surgery, Gwen dropped us off at 6 am at Faulkner Hospital. My surgery was scheduled at 7 am.

 After registration they whisked me away to prep for surgery: to hear about all the risks, to sign all the paperwork, to meet the surgery team, and --- most importantly--- to get the IV in. I always have trouble with the last one...

I am fair skinned with lovely blue veins, which are oh so deceptive, but no one was interested in listening to me. The nurse tried to get the IV into my wrist twice, but both times the veins popped leaving me black and blue. Now, I have been down that road so many times and I requested the professional IV people (turns out in MA you can always request one after two unsuccessful tries). The IV nurse was able to finally get the IV in, though painfully searching inside my vein for a while -- I was just grateful it was done at least in only one try.

I devote so much time to describing getting the IV, as it was the most dramatic event of that day. 

Once the IV was in, I was cruising down the corridor counting ceiling lamps... and then I woke up in the post-op station after the operation because George was squeezing my bruised hands. 

13 lymph nodes were removed, a breast lumpectomy, and, finally, the port was removed as well. The tissues were sent to the pathologist to figure out whether I actually still have cancer or not (diagnostically the only almost sure way to know).

We grabbed an Uber and by 12:30 pm we were already home. After wolfing down some leftovers, I crashed and slept for several hours.

So, of course I was super bruised and covered in bandages, but not much more pain beyond that, to the extent that I didn't even eat the painkiller tablets. I thought I would wait till the evening and eat one before going to sleep to hold me over through the night, but it never even got to that point.

Operation

Operation was done this morning at 7:30 am. Alive and back home recovering. 💓 to the millions of messages -- will get back to each and everyone of you once I sleep it all off.