Wednesday, April 10, 2013

Radiation Schedule..pushed back a bit

Because I had my final expansion yesterday, I was able to begin the radiation process this morning.  This morning I had a scheduled CT simulation at my radiation oncologist's office.  From Texas Oncology's website, here is a description of the CT Simulation process:

The CT simulator does not deliver radiation treatment, but instead allows the radiation oncologist and technologists to see the area to be treated. Images are obtained and transferred to the planning system where a virtual 3-dimensional image of the patient is created and the treatment delivery plan is developed.

For the simulation session, temporary marks are made on your skin with magic markers to identify the treatment areas. The room is periodically darkened while the treatment fields are being set. Alignment is critical during simulation and is facilitated by lasers mounted on the wall and ceiling. Special individually constructed immobilization devices may be used to help achieve this alignment. While you may see red lines of light, the low energy lasers are for alignment purposes only and you will not feel burning or anything else from the laser light.

Once the aspects of the treatment fields are set, the technologist will take special simulation x-rays representing the treatment fields. In most centers, the patient is given multiple “tattoos,” which mark the treatment fields and replace the marks previously made with magic markers. These tattoos are not elaborate and consist of no more than pinpricks followed by ink, appearing like a small freckle. Tattoos enable the radiation technologists to set up the treatment fields each day with precision, while allowing you to wash and bathe without worrying about obscuring the marks that indicate where treatment will be delivered.

It was a simple, painless process and didn't even take as long as I expected it to take.  I have marks all over my chest and side.  Unfortunately though, the radiation oncologist said that I need to "deflate" my expander on the right side before we can begin radiation.  The right side will not be radiated, so I can get that expanded following radiation and it won't be an issue.  The right "breast" is apparently in the way of the field for treatment of the internal mammary lymph node in my sternum area.  I currently have a total of 200 cc of fluid in each side (not quite an "A" cup size.)  I woke up from surgery with 110 cc of fluid in each side.  So, I figured when I asked the oncologist how much fluid she wanted removed from my right side, she would give me an answer in the range of 20-50 cc.  But instead, she requested it to be about half of the current size.  I explained that I came out of surgery with over half of the current size.  She said that she would need me to be back to that size. 

Initially, I said "ok, no big deal."  But, on the way home, a little bit of frustration set in.  I thought about how my first expansion was delayed 2 weeks so that my right breast incision could heal.  All of that waiting and then expansion process seemed to be in vain, since I will be going back to where I began anyway on that side.  I could have already begun radiation if I wouldn't have had to wait those two weeks.  But, then I told myself that this is all outside of my control, and it is by God's design.  Things don't always go as we planned.  But, He has a perfect plan.  Again, He has already put the destination in the GPS and I am just following along with the directions. (Jeremiah 29:11 "For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.")

So, here is the new plan. Tomorrow I will head back to my plastic surgeon's office to have some fluid removed from the right side.  I will be lopsided for a while.  On Friday, the radiation oncology office will verify the fields look alright so that all of the appropriate areas can be radiated.  I have an appointment with my MD Anderson oncologist on Monday morning.  Then, I will begin radiation (and oral chemo) here on Tuesday.   Thank you for your continued prayers.

Love, Heather

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