Testing me before chemo

Before going back to Montreal for the long weekend I had to run over to PMH to get a CT Scan of my chest and torso area. This required me to consume 900 ml of a chalky white milky orange-y tasting substance called barium sulfate suspension which I had to mix with water. I drank 450 ml of nastiness and then the remaining 450 ml an hour before 8:20am in the morning. I walked into my appointment and was told to remove all clothing from the waist up and to cover myself in a hospital gown and overcoat before walking into the CT Scan room where the tech greeted me with another 100 ml of barium sulfate to “top it off”. I told the tech the drink was vile, he agreed and I was going to ask if anyone ever mixed it with a little rum but did not want to entertain the thought of the barium curdling while chugging it.

Another slim bed slid out of a massive white tube which flashed laser lights from inside the tube. As I laid down the tech started to discuss the contrast dye (Visipaque 320) he would be injecting me with through an IV. I was warned if I had any allergic reaction of hives and such to report it to the phone number on a card he would be giving to me before I left. He started to administer the needle in my hand, I looked away to shut my eyes. When he finished I looked over and grimaced, the tech thought he had jabbed me but I told him, no I just didn’t like needles. He lifted my arms to rest on a cushion above my head and I was told to close my eyes as the bed slid into the spinning tube of laser lights. The tech would do a test run before the actual scan from the adjoining room. The machine started up for 2 minutes before stopping. I heard the door open and the tech ran over and standing above me looking concerned asked, “What’s sitting on top of your chest?!!” I looked at him all perplexed, did they not mention in my file I had a tissue expander inserted where my breast was removed? After I briefly explained to him my situation he asked, “Can you remove it?” Uh-no, I said and he went back into his little room and did the test the best he could. I asked him in the end if it posed a problem having the expander inside my chest. He assured me it was alright he just had to check with the doctor.

By 1pm we had left the city, Montreal bound, and by 2pm my scalp started to itch and along each side of my nose two red lines started to form. I am yet, reacting to another substance on my growing list of allergies!

******

My second meeting with Dr. A. I had to inform him of the course of chemo I would choose. I told him I would do the long course, he seemed pleased, he had hoped I would choose the long course, as discussed, it just covered more cell territory. I asked him to tell me honestly if all my hair would fall out, I was okay with it, but I just wanted to be sure, he answered sincerely,”Yes, I’m sorry, it will.” We went on to discuss whether I needed a port on my chest. A lot of people receiving chemo have a port inserted above their chest to make administering the chemo easier than finding a large vein in their arm. Dr. A. was not for the port insertion because I would not be in chemo for a year’s time like some cancer patients. He thinks the port is a little bit invasive and adds more scars than necessary. I liked his reasoning. We went over my Trillium drug program and he directed me to talk to the right people in order to get all the necessary anti-nausea pills at the pharmacy on the main level of PMH. Joanne, his intern joined our meeting briefly. She asked if, my friend, Carol had gone back to Winnipeg and I told her unfortunately, yes, the fun was over for me. She reminded me I needed to get my blood work done after our appointment to ensure a speedy process with getting the drugs in order for the morning of chemo daycare to go smoothly.

******

The following Friday, I met with Dr. Levin, my radiation oncologist. Lindsay, my paramedic friend, came with me to take notes and record the whole meeting on her iPhone (which is brilliant and I must find the app for my iPad to do this for future appointments). Dr. L asked all the family history questions I was asked by all the other medical specialists, I had before today. How old are you? Do you have a history of breast cancer in your family? When was the first time you had your period? Have you ever been pregnant? After months of research to the precursors of Breast Cancer I always wish I could answer these questions differently than what I know to be the truth. Different answers, from my past, might have saved me from sitting in an oncologist’s office now but this would involve changing my course of history. It is days like these I wished he space-time continuum theory featured on LOST got a little more in depth and had more air time to help me resolve my present predicament.

I was again examined physically but this time I felt liberated being able to do all the stretches necessary, Dr. L asked me to do. I felt I had come a long way from not being able to reach over my head two months ago. Dr. L was even more impressed I could bend my head over my knees while sitting legs stretched out parallel to the floor.

“Oh, very good! Not a lot of people could do that. Do you do yoga?” I told him I used to do it a lot but not much anymore. “It’s a very good exercise to keep up.” he commented.

I got dressed and went back to joining Lindsay behind the curtain of the examination table. I anxiously waited for Dr. L’s prognosis of whether I would need radiation or not. Dr. C had already mentioned, in our last appointment, the chance was slim, we only needed a confirmation the margins were clear enough not to have radiation.

Dr. L delivered his prognosis. He recommended I do radiation therapy after chemo.

But the margins were clear! I was devastated. No, I want this to end.

“You had ductal carcinoma. Cells could jump through your bloodstream.” was Dr. L’s reasoning. He rationalized there was a 30% chance of the cancer returning based on my ductal carcinoma.

THE MARGINS WERE CLEAR! I was told no more breast tissue was left behind, it was in the duct and the duct was removed, there was no more tissue to get. There is no more breast – NOTHING to radiate.

I made it clear to Dr. L, I DON’T WANT RADIATION. The possibility of radiation was always on the table but a very slim chance. I asked him where he would radiate. The whole breast area was his answer. I calmly told him it was only one of the tumours which had a small margin. Which tumour was it? How long would the course of radiation take? Five days a week, for five weeks. Twenty-five days of radiation.

No, eff-ing way.

From the beginning I was warned about what radiation could do to the breast implant. The skin could shrink around the implant and capsular contracture could result but what about all the other side effects. Radiation is territory I barely researched because I, for the most part, thought it was a treatment for those who had a lumpectomies and most literature would indicate so. It is a treatment of killing all microscopic cancer cells around the tissue where carcinoma may have been missed when removed surgically.

He said he would talk with the pathologist again to determine exactly where the tumour in question was and the margin clearings. He thought we should meet again after my chemo. I said, no, I needed an answer sooner than in 4 months, all the better to make an informed decision. He agreed, in the end, we could meet in 6 weeks.

The little crack in my window of doom opened again with the suggestion of radiation. The news was too crushing for Lindsay to think she could comfort me to a better place. All I could think about was that I have 6 weeks to figure out whether radiation is really necessary or how to refuse 5 weeks of radiation treatment.

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About

navigating my way through cancer with laughter, fear, and madness.

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Posted in breast cancer, oncology, radiation
One comment on “Testing me before chemo
  1. natalie says:

    wow pretty tough stuff here.
    amazing ipad gift – but the whole radiation news must have been tough.

    this blog is so good norine.

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