Sunday, May 31, 2009

My New Radiation Oncologist

I had a consultations with Dr. S before I started chemo. She was very nice and gave me a break down of what was going to happen. Approximately 9 minutes a day for 6 weeks. 25 sessions on my entire breast and then 5 sessions called a "boost" that went directly to the spot of my tumor. When I got the bill for my copay, I called their billing office and asked to pay by credit card. The person told me that they don't accept credit cards, it must be check or cash. What?? After calling the office, I confirmed that they wouldn't accept any credit cards. That would be $600.00? From my checking account? Hell I don't have that!

So between that and the inconvenience of driving over 20 minutes every day for 6 weeks, I was now in search of a new Radiation Oncologist.

Dr. K (my medical oncologist) suggested another Dr. S (a different one). The new Dr. S was only 1.5 miles from my work. I made an appointment for the next week.

Chris chose to come to the appointment with me, I was glad. After waiting about an hour we were finally able to meet Dr. S (the new one). She spent a little bit of time going over all of my reports from Dr. K and Dr. A (my surgeon). Once she was done, she asked me a lot of questions. Same ones, how was it found, about the biopsies, how was chemo going, when was a finishing.

Dr. S started with saying that due to the severity of my cancer, she would want to start me two weeks after my last chemo treatment. I would have 35 sessions (seven weeks), each treatment would be about 20 minutes each. This was different than what we had been told by the other radiation oncologist that we saw. She explained that every day that didn't have radiation, that was on more day that the cancer could return in the original location. The first drug I had for chemo was the AC, this drug has been known to damage the heart during treatment, radiation of course doesn't help. But since I had my AC treatments first, my heart has since healed enough to proceed with radiation just two weeks after my last chemo cycle.

Dr. S said that she would have to use 4 or 5 rays. That would depend on the CT exams that would be done, you see you have 3 levels of lymph nodes. All of my axillary lymph nodes (my first and second levels) were removed, but there are still some that cannot be surgically removed (under the scapula, down the front of the chest). I will need a CT scan to confirm where these lymph nodes are in my body and then my Dr. will decide whether or not I will need one or two types of radiation.

There is protons and electrons. Protons is what she would like to use, this is radiation that goes straight through the body, but it passes the skin before it gets to intense, so it is more skin saving. Dr. S can manipulate the rays so that they rays won't deflect into other body parts. Electron radiation is different, the Doctor can dictate how far into the body it will go. This sounds better, but it is full strength throughout the entire ray, so your skin gets hit hard. Do to the shape of the chest wall, you cannot stop a sliver of lung to be hit by the rays. So the less amount of lung the better. Dr. S. said that after reading my CT she would be able to tell how much lung would be affected and make her plan of what types of radiation she will use.

She said that there is no pain while radiation is being done, but my skin will get very dry and it will feel and look like a sunburn. Dr. S said that there is a skin regiment that she strongly suggests, it will help with the burn. She said that worst part is that towards the end, I will start to peel. She suggested that during my entire radiation procedure, I should not wear a bra. What?? Not where a bra?? She said nope, already being heavily endowed will be an issue from friction alone, but once I start peeling it is really horrible pain.

Great... So guess who is shopping for camisoles and REALLY loose fitting shirts??

Then came my questions...
1. Can I still get my port taken out even during radiation? Yes
2. Can I get an IUD inserted while radiation? Yes
3. I have an appointment with a plastic surgeon on June 8, will that be an issue? She laughed and said, "You can go ahead and have an appointment, he can talk to you all he wants, but he WILL NOT put one finger on you!" .... Okay..... "Don't get me wrong, my husband is a plastic surgeon. I totally respect the profession, but we need to put a little perspective on this. Your life is my priority. He can do what ever he wants after radiation, but your life is my hands." I knew at that moment that this was a good doctor for me.

I will have my first simulation on Monday morning. They will do my CT and makes some marks on my body to align to the machine. A few days before I start radiation, I will have a validation appointment, where Dr. S will check my marks with the radiation machine, and if her plan matches my body, I will get my official blue freckle tattoos (there will be about 5-7) and I will start radiation a day or two later.

PS. I came back and cancelled my appointment with the plastic surgeon. To be honest, I don't want to get anything done until the girls are older and testing time is over (about 5 years).

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