After a magnificent lunch at Boulettes Larder – oh my goodness. Hold on. The lunch. Can I just stop for a minute and tell you about this lunch? I had the arugula and burrata salad. The arugula arrived about 2 hours before I ate it, after having been picked this morning. And the cheese? Good gracious. It was a divine experience. All of this outside. On a beautiful, sunny day.
After the incredible lunch, I headed over to the UCSF Comprehensive Cancer Center for my radiation preparation appointment. As I walked in, I had that all too familiar feeling of shock that announces, “WTF are you doing HERE? You were just supposed to go for a check-up.” Sometimes the feeling gives me chills. Other times, it gives me a hot flash. Either way, I’m thrown off. (Better than throwing up! Silver Lining).
Very quickly, however, my chills were warmed and my hot flash cooled thanks to the UCSF staff. Every person I met was nicer than the last. More patient than the last.
Whenever I get nervous, I tend to speak very quickly and my voice goes up a couple of octaves. And nerves tend to bring on a hot flash. All of which happened today. Not attractive. At all. Especially with Irish skin.
Staff patience and warmth persisted which was a huge Silver Lining!
The reason that I had to have this preparation, otherwise known as a simulation appointment is because before radiation therapy can begin, a radiation oncologist must prescribe the dose of required radiation.
The way to determine said prescription is to do an X-ray and CT scan to determine the exact boundaries of the treatment area.
I had to lay in the worst imaginable position during these tests. See the blue appendages in this photo? Well, my arms had to “rest” in this absurd torture apparatus.
I went to the rodeo last summer in Santa Barbara (my first and last time). The device I was in today made me feel like those poor little calves who race out in the middle of a ring and have their hooves (all of them…or the majority of them!) tied down so that they are immobile. That’s what I thought about when I was “tied” to this device. Thankfully, my feet were not restrained (though I was told not to move or cross them!).
By the time I could no longer feel my arms, I seriously thought: “A person doesn’t really need arms. I get it because I now longer have any sensation in mine. Though, how am I going to hail a cab when I get out of here (without arms)? Maybe someone could call a cab for me. How am I going to eat dinner (without arms)?” …& so on…
This was seriously my line of thinking as I was laying on a hard table. In a room. By myself.
Why by myself, you ask? Well, because the emissions from the X-ray and CT scan are so toxic that no one can be in the room when I received them. The technicians would come in from time to time to check in on me or to change my position.
Here’s the dialogue when they came in (which tried every last bit of my patience):
Don’t move. We will move you. Don’t hold your breath. Breathe normally, but not too deeply. Don’t talk. This scarf won’t do. Wait…don’t move. I think we have it. Breathe. Normally. Not too deeply.
Now, you should no longer wonder why I had those bizarro thoughts.
Anyway, by the time I was done, the area to be radiated was tattooed on my skin. Can you imagine? I went to Catholic school for an innumerable period of time without a tattoo…and now, thanks to FBC, a tattoo is mandated. Comedy of the absurd – again!
These tattoos will stay on my skin throughout the entire treatment period because they show exactly where the radiation will be delivered.
After the tattoos were on, I was told it was time for my “bolus”. WTF? This caught me completely off guard. My learning curve never ceases.
Though I’ve never had a cast, this was the closest thing I could imagine to having a body cast. The technicians warned me “this will be warm” before they put the plastic material over my lady lumps. It felt good, actually. Like a warm blanket.
WTF is a bolus, you ask? Well, so did I!
A bolus is a flabby, rubbery material that is used to ‘fool’ the radiation beam so it will deposit the maximum dose on the skin surface instead of a fraction of an inch deeper, as it would otherwise. The net-net is that the bolus ensures that the radiation goes exactly where it should go (near the surface of the skin) and not anywhere else.
In addition to a bolus, the delivery of radiation requires a team effort.
The radiation oncologist works with physicists, technicians and a medical dosimetrist (dosimetrists are responsible for calculating and devising the dose of radiation to best destroy a tumor/tumors while sparing normal tissues). It takes at least 3 days to determine a radiation dose.
Radiation therapy treatments take a few minutes each day (please don’t put the word “only” before “a few minutes). This will take place everyday (Monday through Friday).
The radiation dose is usually is delivered from several different angles so that healthy tissue is exposed to a lower total dose of radiation and to give a more uniform dose to the treatment area.
Next week, I will have a “dry run” (as it says on my appointment card) of radiation. My official first dose will begin on Tuesday.
After my appointment, I walked to the Ferry Building and had myself a little sweet treat.
Patience: A minor form of despair disguised as a virtue.