Lincoln County News
April 9, 1998
"LifeLines" My journal about living with cancer
by Sandy Labaree
This journal submission describes my visit to the radiation oncologist and the "mapping" and simulation procedures in preparation for radiation treatment. I never had radiation therapy, so this will be a new experience for me.
March 18, 1998: My journey with cancer is taking a different turn today. I am meeting with Dr. Jeff Young, a radiation oncologist in Bath. During my first bout with cancer, I never received radiation, but I know it has fewer side effects than chemo and the treatments are quick and painless.
June and Frank have offered to drive me to the Coastal Cancer Center in Bath. I had planned to drive myself, but my shortness of breath problems returned several days ago and I have chickened out on driving. Tom called me on Mon. to report that my white count is up to 3400 and the red cell count is 35.3, which shows continued improvement. He thinks my shortness of breath is from the chemo. My Dad suggests that I may have slight damage to a heart muscle, which will eventually heal itself.
June and Frank arrive with a fully prepared dinner of beef stew, rice and homemade apple pie, plus a container of ice cream. How nice to have a thoughtful friend like June who can cook, too! After my two hour appointment today, I will have the luxury of a home-cooked meal with no effort on my part.
June and Frank notice that Lurk is outside on his "cat run", a rope tether arrangement. Now that the weather is warmer, he goes out for a few minutes each day. June offers to unhook Lurk and bring him inside. Lurk always goes completely limp when you pick him up and his 15 lb. weight seems more like a 50 lb. bag of potatoes. June comments on his limpness and tries to entice him to play with his cat toys. His Laziness is not really interested and strolls down the hall to take up his semi-permanent position on my bed.
Frank and June drop me off at the Cancer Center and head to Cooks Corner to shop. Located in a new building off Congress Ave., the Center can handle most radiation treatments, though specialized treatments, mappings and simulations are done at their facility at Maine Medical Center in Portland.
Nurse Julie comes out to greet me and leads me to the consult area. She takes my vital signs and the 25 lbs. of x-rays and reports that I have brought with me. Julie describes the Center's patient support services and mentions that a social worker is available to patients and family members. I notice that many brochures and posters are displayed promoting our Cancer Support Group meetings and I Can Cope, the American Cancer Society cancer education program for patients and families. I have been in many Dr's offices and have never seen this much information so prominently displayed. No one has ever offered me support services, except a very casual reference to such at Dana-Farber. Because of my involvement with the American Cancer Society, I am fully aware of area services and programs for patients. However, many newly diagnosed patients do not know where to turn for help and information on cancer. Dr's offices and treatment centers are the logical places to distribute information and make patients aware of area services. Unfortunately, not all of these places fulfill that role adequately and focus more on the physical care of the patient, rather than information or emotional support.
Jeff comes in to greet me and gives me a hug. I met him several years ago through my American Cancer Society connections. Jeff is probably mid-thirties, with longish brown hair and a short trimmed beard. He is good-looking and friendly. He does not look or act like a real doctor. He looks like a TV doctor, like one you might see on ER. I have seen his credentials, so I know he is not an actor or truck driver. Tom, and possibly Wes, have filled Jeff in on all the details of my case. He even knows I am writing a column for the newspaper, but says he hasn't read it. That's good, he won't know that I have compared him to the actors on ER.
Jeff puts my x-rays up on the light screen. He seems concerned about the rib fracture and like Tom, wants to keep an eye on it. He suggests doing new x-rays of the rib from a better angle, in about two months. We talk briefly about the status of my lymph nodes and cancer. He describes two approaches that could be used in treating me with radiation. The broad approach would cover my neck, clavicle area, underarm and entire chest wall on one side. This radiation field would target any cancer cells lying on the chest wall under the implant. The drawback to this approach is scarring of the lung and the tissue encapsulating the implant. The second and more localized approach would cover a "C" shaped area from my neck, clavicle area, the very upper part of the chest and wrap around under my arm. The only damage would be a slight scarring to the very top of my lung. Jeff favors the localized approach because my original cancer was very confined and small in the chest area, so the likelihood of cancer cells being left behind on the chest wall is minimal. Secondly, he is concerned that my shortness of breath may mean that my lungs have been compromised by the chemo, so avoiding further lung damage is a major consideration.
Jeff suggests a 6 week regimen using the localized approach. It can all be done at the Bath Center and will take about 15-20 minutes a day, Mon.-Fri.. He says I can skip a day if an emergency or other situation should come up. He describes the short term side effects such as sunburn to the area, and a sore throat. Other possible long term effects are swelling of the arm due to lymph channels being destroyed and nerve pain in the neck and arm. He doubts that this will happen and he will do his best to keep any tissue damage to a minimum.
Jeff then asks me all kinds of questions that are not about my cancer. He wants to know about my work, how my family is coping with my illness and my life in general. I give him the Reader's Digest condensed version of my cancer and life since 1994. When I finish, Jeff is smiling and seems amused. I ask him what is so funny and he says that I am so organized, and that I compartmentalize everything. (Hmm, sounds like a psychiatrist). I explain that is how I deal with my illness and add that if he thinks I am organized now, he should have seen me before my chemo. I describe how chemo cured my perfectionism, and to further ensure that I won't worry about unfinished business, the chemo also destroyed my short term memory! I suggest that if Adriamycin wasn't such a toxic drug, it should be prescribed for stressed out perfectionists.
I further describe my current (organized?, compartmentalized?) plan for my life: Taking each day as it comes, planning my cross-country trip, selling my old Corvette, buying a new one that I can't afford, scaling back my work, closing my business and going on full disability. Jeff asks if Ben and I have discussed the future. I don't know what my future is with Ben, so I tell Jeff that Ben will have to deal with selling my new Corvette and any resulting financial disaster after I'm gone. Jeff is now staring at me in amazement. He must think I'm joking or insane.
The chemo and the recurrence of my cancer have caused what I call an "attitude re-adjustment". The Polly philosophy of DONTW8 has taken over my life. Jeff was also Polly's Dr. and he came to know her quite well during her radiation treatments. I informed Jeff today that Polly was one of my closest friends. Jeff was aware of Polly's outrageous sense of humor and daredevil ways. She tried unsuccessfully on several occasions to take Jeff for a ride in her Corvette. Now, it's my turn to try! So, fasten your seat belt, Jeff, it's going to be a bumpy ride!
March 19, 1998: Jeff has asked me to stay by the phone until 9:30 this morning. He may have a cancellation to get me into Maine Medical Center today for my "mapping." Jeff calls at 9:45 am. to say they have a 12:15 pm. opening. It is snowing quite hard when Ben and I leave home, but fortunately the biggest difficulty we encounter is finding a parking place at Maine Medical Center.
The mapping and simulation for radiation is only done at Coastal Cancer Center's main facility in Portland. The procedure takes about 30 minutes. Jeff comes out to greet me and meet Ben. Ben was not with me yesterday so Jeff reviews our discussion and the planned course of treatment. He asks Ben if he has any questions about my proposed treatment. Ben doesn't, but he seems impressed by Jeff's openness and friendliness.
Afterwards, I change into a gown and the mapping procedure begins. I am lying on a very hard table under what looks like a large camera or special x-ray machine. A technician takes several pictures of the area to be radiated. Using a marker pen, she draws a diagram on my upper right chest. After all the pictures are taken, another technician comes in. Actually, she is the "Tattoo Artist". I am getting four tiny blue dots tattooed on my upper chest area. The permanent tattoo marks will be used to precisely line up the radiation treatment every day. I asked Jeff yesterday if they could do tiny Corvettes instead of dots. He said they only do dots. What a missed opportunity! If I have to have a tattoo why not get a rose or butterfly or Corvette? The Tattoo Artist pricks me four times with some type of needle. It only hurts for a second and the procedure is over.
On the way out to the car, I notice a strange metallic taste in my mouth. Half of my face and chest feels flushed, and I am hit with a sudden rush of nausea. I suspect that this may be an allergic reaction to the tattoo dye. Rather than go back to the Center, I take two Benadryl pills. I also have my EPI-Pen with me. I have several drug and food allergies, so I carry the pen (a pre-loaded syringe of Epinephrine) and Benadryl pills with me at all times. Though I am used to self-medicating and handling these emergency situations, Ben wants me to go back to the radiation center. I refuse because they would probably send me over to the ER or give me the same medication I just took. I will tell Jeff about this reaction when I go for my first radiation treatment next Wednesday.
I ride with Ben to Augusta while he makes a few work calls. I sit in the car and try to write in my journal. I feel wretched and can't think straight from the Benadryl and the dye reaction. When we finally arrive home, I am ready for bed. I know I just need to sleep this off. It's too bad that I feel so sick. Otherwise, I would have invited my friends over to see my tattoos tonight.
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