Getting Down to Business

by NotDownOrOut

My doctor and I decided that I would undergo six weeks of chemotherapy and radiation simultaneously. This treatment was recommended to kill any cancer cells in my system following my hysterectomy. Radiation is a localized treatment. It will focus on the pelvic area and will strongly affect the bladder and bowel. Chemotherapy attacks rapidly growing cells throughout the body. Cancer cells grow rapidly. Unfortunately, so do many other cells, including those in hair follicles, the mouth, and digestive tract.

Both treatments kill healthy cells as well as cancer cells. You have to hope that the healthy cells will regrow and that the only casualties will be the cancer cells. The truth is that many of the reports I read on the Internet reference long-term conditions that have resulted from treatment, some of them are secondary cancers.

The alternative is to avoid treatment and hope for no recurrence of cancer. I did not want to find myself feeling guilty for having spared myself treatment only to risk my life.

The radiation I was to undergo, as I understood it when I began treatment, was to be entirely external beam radiation. Like undergoing an x-ray, I would have x-rays aimed at specific body parts over a period of time. It has since been explained to me that I will have a final treatment of internal radiation. A catheter (more than one?) will be inserted into my body. I will lie still in a hospital bed and be kept away from people until the treatment is completed. This exposure to radiation will focus on the vaginal area because of the possibility of “cervical involvement.” In fact, the cancer did not reach the cervix and the cervix is gone. Prophylactic treatment is the price you pay for peace of mind. Peace of mind is not what it used to be. The prospect of recurrence weighs more and more heavily on my mind the more I learn about cancer.

I met with a radiology physician who briefly explained to me the procedure. All three radiation physicians have the same last name so my doctor is known by his first initial. I told him that I had watched a simulation on YouTube.com and had done some reading. He stated that he had not much experience with educated patients. This became apparent when he explained that radiation can cause burns in the treated area. He put one hand on his waist and another on his crotch. I was surprised that he did not “use his words.” It was not the last time someone would pantomime.

I had an appointment for preparing me for radiation. I met first with a nurse. She was not the usual nurse for that department. She gave me several handouts and explained the recommended treatment of my skin. Neutral soaps, aloe gel, petroleum jelly–all keys to maintaining skin integrity during treatment. The side-effects sounded uncomfortable but not as daunting as they turned out to be.

On a second appointment I met with a technician who had me disrobe from the waist down and lie on a sheet on a table for a CAT scan that would help the doctors identify the areas to be treated. It was important to have a full bladder for this test. The technician explained that this would push the intestine back, protecting it from some radiation.

I do not like to lie on my back. I am a side sleeper. Just the process of getting onto the table and lying still for a protracted period of time caused discomfort. Looking back, I laugh at the idea that this was discomfort. That was nothing. They asked me to draw up my hospital gown to reveal my body from thighs to just below the chest. A towel was placed over the bottom half of my thighs.

What surprised me was that they placed a styrofoam block between my feet and taped my feet tightly to it. I am spoiled. I have never felt confined before. It was a reminder that radiation was a targeted tool that needed to hit its mark. I had to be very still. Two technicians pushed me from side to side until they had me where they wanted me. I was asked not to try to help them to move me. I understand better now the process, but I felt like a piece of meat being pushed around a griddle.

They exited from the room and proceeded to take images of my pelvis. Every once in a while they would enter the room and move me about. No one spoke to me during the process. By the time they finished, I felt exhausted. They told me to empty my bladder and we would do the whole thing over again. I was nonplussed. The idea of another half hour seemed so draining. Little did I know how easy this stage was.

By the time I returned, the team had decided they had enough images. They took a black pen and made marks on my stomach and hips. These were preliminary markings that would be applied more permanently when I began radiation treatments. It was strange to have strangers write on my body. One technician touched me very intimately to point out what the team would use as a physical landmark for purposes of lining me up. “X” marks the spot. I had gone from a piece of meat to a piece of geography.

I met briefly with a social worker who works for the American Cancer Society. The charity is available to arrange rides to and from treatment. There is a support group. They have little get togethers on Tuesdays when I need to get in and out so I can drive out to Naperville to teach. I have not attended any meetings. There is a selection of wigs on mannequin heads–nothing I would wear. I received a plastic folder filled with information about my cancer. The social worker had copies in several languages. She arranges for people to have their make-up done. Sometimes the group shares a snack to celebrate a holiday. The charity is appreciated by some of the women. Several people gave up their places in the line for radiation on the day before Thanksgiving to join in the festivities. That is saying something because it takes about four hours of waiting to have a twenty to thirty minute radiation session. I would rather go home.

This meeting got me thinking about losing my hair. Truly, it’s not important to my outlook. But bald is bald. I decided I would buy and wear a wig. As I told my friend Michael, “don’t expect me to send any bald photos if I lose my hair. If I don’t choose to wear the short, blonde Farrah Fawcett wig I had to buy the summer I sold wigs at Woodfield Mall, then I’ll wear another one. My last bald Christmas was in 1957 and I have no intention of doing that again!” His answer: “I dig bald chicks!” That made me laugh. I figured I should decide on one early so began looking at wigs online. They have wigs that cost between $500-$1000. I calculated my old commission on wig sales and thought I should have stuck with wigs. But I was looking for something with a shorter shelf life. I focused on a wig in the Raquel Welch line. It doesn’t look anything like me. But isn’t that the point? Nothing is normal anymore. Why not try something different? I ordered one with red hair and gold highlights. Who hasn’t wondered what it would be like to be a “ginger”? Did you know that the English have laws against discrimination against gingers? People don’t like them. I like the idea of being a ginger. Trust my sister-in-law Lisa to ask whether the wig would match the rug down below! No.

Good thing I ordered early because the darn thing still is not here and it’s been about twenty days since I placed my order.

After meeting with the social worker, I was free to go that day, but November 16th we would get down to business. I would begin chemotherapy and radiation.