Radiation simulation

Dear Family and Friends,

Simulation for radiation was yesterday. It wasn’t difficult but I didn’t feel well so every thing they asked of me either hurt or was a ‘bother’. Note to others: Save yourself the grief and don’t plan radiation simulation four days post-chemotherapy.

Here is a quick rundown on what happened:

Parking at the hospital: I had to pay for valet parking because I couldn’t find any open parking spots. Anne accompanied me to the appointment in a separate car so the cost for this trip was $10.00.

Registration: I waited until the registrar was off the phone which took several minutes. She hardly looked at me during the registration process and acted a bit like it was a bother to her. Who knows how her day was going? I’ll give her the benefit of the doubt that she was having a difficult day and was preoccupied with her thoughts instead of my gut feeling that her customer service skills are marginal at best. It was a good reminder for me as a clinic administrator that the first person a patient sees when they arrive really sets the stage for a positive or not so positive experience. Things can improve, despite that first encounter, (as you will see they did for me) the deeper into the ‘system’ you get but how simple to ensure a successful visit for all right from the beginning.

Radiation Oncology: We walked down the hall to some glass doors behind which resides the radiation suite. Here, the welcome was completely different and right from the get-go the staff was pleasant and helpful. I don’t think they were different with me because I’m married to a medical oncologist and they’re aware of that relationship - I just think they were nice people. The hospital has a catchy little mission statement that these staff members don’t need to be reminded of – “The Patient is the Center of All We Do.” They live that statement and that is where things began to improve…as much as could be expected anyway given the reason for the appointment.

Here is the sequence of events for this portion of the visit:

• Change into a hospital gown. The women’s changing area is small and most of the chairs were full. I could tell there was a familiarity with the group and they were accustomed to new people showing up for simulation. The look on their faces said, “Yeah, I’ve been there. No problem. If I can do it, you can do it.” No sympathy, just an acknowledgement that they too had walked that walk.
• We got to watch a movie! Actually it was a video showing simulation and radiation treatment. Certainly a picture is worth a thousand words but that video with the breast pictures was difficult to watch. I’m wondering now if I will get that severe burn or sloughing of the skin. Not pleasant to ponder. There will be thirty-three treatments for the entire breast given daily, Monday through Friday. There will possibly be boost treatments and that total remains unclear. One person said five and another said seven.
• First Room – Making the ‘Cradle.’ I don’t know what the individual rooms were called but they took me to two. The first room had what looked like a CT Scanning machine. The ‘bed’ was twisted out from under the scanner. They placed me on it trying to position me on a garbage bag (literally ~ it was a big black garbage bag that held a type of foam material. When they added a particular liquid substance, the bag heated up and conformed to my upper torso and then hardened. How weird was that?). As I looked around the room, I could see at least eight or more of these black ‘cradles’ with patients’ names on them. The whole process took approximately 40 minutes or so – guessing as to the exact amount of time as they made me take my watch off…and my wig because the heat might burn it (that tells you how hot the foam gets. It wasn’t uncomfortable although I did have to hold my arms above my head for a while. Fortunately, I have full range of motion in my left arm; others might not after a full axillary dissection (I had the sentinel node one) and I cannot imagine how uncomfortable this process would be for them). The movement of the table as they twisted it around to go through the CT-Scan made me sick. I don’t think this would have happened under normal circumstances but in my haste to get this portion of my treatment completed as well, I scheduled simulation too soon after the last chemotherapy. Historically, I know I don’t feel well the first week after treatment and in retrospect, simulation should have been delayed at least ten days.
• Second Room – My First Tattoo. As most of you know, I’m a Harley rider. David and I have been riding motorcycles since 1999. Often, friends would kiddingly inquire if I had a tattoo yet. Umm…no. Well, now that’s over. They placed real tattoos on my sides. One on the right and one on the left – just a quick pain as they inserted a needle with black ink. I’ll be honest, I don’t like them. It is just another permanent reminder (as if I need one) that I’ve had cancer and treatment - another insult to my body as it were. In this room, I was put back in the ‘cradle’ so they could align my new tattoos with the cradle to see if it would fit for them to give radiation. Staff here was friendly but at this point I just closed my eyes and tried to keep the nausea at bay.
• Next step is to verify simulation. On June 18^th I will return to verify simulation which I have been told is similar to a trial run.

So, that’s my experience with simulation for radiation.

Love,

Veronica