Week 36 in Cancer Land = week 2 of radiation, in case you were keeping score. monday was back to radiation oncology, obviously, and also my weekly meeting with dr. d immediately afterwards. that part started off with me, still in my hospital gown, wrapped in a blanket, sitting in a chair, staring at myself in an ipad, which was propped up on an exam chair. eventually dr. d popped up on the screen and we did a little telehealth chatting. we discussed my current side effects (none), probable side effects (radiation sunburns), and anticipatory side effects (nausea, i ask? no, she doesn't expect me to have any. i have my doubts, but i also still have some as needed anti-nausea meds from chemo, so i'm not too worried). then, "ok, great! i'll come in and look at your skin and check it out." i am a little surprised, but i suppose it makes sense to avoid direct contact when you can, and have direct contact only when you need it. she examines me and shows me exactly where i can expect to see changes on my skin from radiation. she is happy with my progress, and i am on my way home.

later in the afternoon, i head back out for physical therapy. arm bike, pulley stretches, resistance band exercises, wall slides/crawls. then it's into the exam room for manual therapy. i've been having trouble extending my arm again, which feels like another cord forming to me, though my PT chalks it up to needing to stretch my bicep/forearm more. i suspect we are both right. no cords released, but my arm always feels better after our sessions. after my appointment, i head to aab india in grandview to "support the local economy" and pick up our order of indian food. truly, we are selfless, more than willing to bear this delicious burden.

tuesday: radiation. i have found that the n95 construction mask sort of presses against my neck during treatment, making me slightly gaggy and uncomfortable. i switch to a cute cloth mask that my mother-in-law has made, only to find that as of friday, they are only allowing n95 or surgical masks to be worn. sad trombone. the hospital bouncer hands me a new surgical mask and i head inside to the dressing room. i noticed the other day that another radiation patient was wearing a robe -- not like the breast health clinic comfy warm white spa robes, but surgical gown material -- and i thought, wait, i can wear one of the robes? in each of the two dressing rooms, there is a cabinet with three shelves: the top shelf has large patient gowns, the bottom shelf has small patient gowns, and the middle shelf has patient robes. the two main differences being that the robes have slightly longer sleeves (irrelevant to me) and they actually, successfully TIE SHUT IN THE FRONT (QUITE RELEVANT TO ME). i, of course, had been told during the dress rehearsal to put on a gown, and i, of course, followed the instructions to the letter. i guess the techs thought i enjoyed trying to keep my gown shut manually? i mean, i suppose they do have better things to worry about.

anyway, radiation days are at least slightly more comfortable now that i'm not worried about flashing anyone on my fifteen yard walk from the dressing room to the radiation area and back.

later that evening is cookie baking time. i had discovered a lonely bag of chocolate chips in the cabinet the week before, and figured quarantine was as good a time as any to destroy the kitchen with a giant mess. i dug out two things: a recipe sent to me in 2006(!) from kate (certain athens friends know what i am talking about), and a stand mixer (certain athens friends know what i am talking about). they did not turn out perfectly, but they did turn out pretty well. we've got cookies for days.

wednesday is another busy wednesday, but not so busy as last wednesday. radiation to mcdonalds to physical therapy, but no stops for computer peripherals or groceries this time. the PT adds more resistance band exercises to my arsenal, there is more manual therapy relief, but no cords released. i have also begun to start feeling slight pain in my hand, on the top, near where my thumb and index finger meet (soft tissue, not joints). it is unclear whether it is from cording or sore muscles or what. at any rate, i feel better as usual after PT, though the tightness and achiness come back later in the evening. sad face.

thursday, another familiar flashback: early morning numbing cream and press and seal. if you guessed a visit to dr. m, you've been paying attention! i get there early for lab work in the infusion room, and andy joins me for the office visit. today begins my monthly injections of zoladex. generally speaking, zoladex reduces the risk of my estrogen-hungry cancer from recurring by telling my pituitary gland to inform my ovaries to knock it off with the estrogen production. side effects include menopause (yes, check), hot flashes (yes, check, familiar already, thanks), and joint pain ("you might feel like an old lady when you get up after sitting for awhile"). dr. m tells me that zoladex is not a normal injection -- it is actually an implant/pellet that dissolves over the course of a month. weird. she also sends a prescription for exemestane, though i won't start that until after radiation is over. only a certain number of variables at a time, so we can figure out what side effects are coming from where! i'll be back in four weeks and eight weeks just for zoladex shots and port flushes, and then in twelve weeks for a zoladex shot, port flush, and office visit. i'll also have some sort of scan before then too, though i can't remember which one. she departs, saying she wishes she could give me a hug, but perhaps in twelve weeks, that will be possible. then it is back to the infusion room for my injection. the nurse explains the implant situation, which will be given with a syringe, and the numbing agent, which is more or less a freezing cold liquid sprayed onto a section of my lower belly to numb the area. she begins spraying and holy cow, it is seriously cold. i don't watch the injection, so i don't know how large the weird pellet syringe is, but i don't feel much at all, so i am totally fine with this method. i get a band-aid and head home; an hour later, i head back out for radiation. i am early and so are they, and i am in and out in well under half an hour.

friday: radiation. throughout the course of the week, i have been trying to figure out the sequence of The Baconator. there are a few days where there are x-rays, or additional imaging, which complicates my calculations, as i can't very well write anything down, or do much of anything aside from breathe while i'm on the table. i have at least figured out that i get seven treatment zaps every day; 0 degrees is me staring straight up at the ceiling:

1 - Baconator rotates about 5 degrees on my right: buzzzzz
2 - Baconator stays at about 5 degrees, parts inside the zapper click and move: buzzzzz
3 - Baconator rotates way to the left, under me, to about 170 degrees: buzzzzz
--- bolus is placed on my chest ---
4 - Baconator rotates back up and over, to about 45 degrees on my right: buzzzzz
5 - Baconator stays at 45 degrees, parts inside the zapper click and move: buzzzzz
6 - Baconator rotates back up and over to the left, under me, to about 135 degrees: buzzzzz
7 - Baconator stays at 135 degrees, parts inside the zapper click and move: buzzzzz

^ edited for accuracy

sometimes the bolus + last four are flip-flopped with the first three, but that is the general idea. some zaps only take a few seconds; others take about ten to fifteen seconds. a common denominator is that my arms start to ache and fall asleep by the fourth zap, and i am ready to get them moving.

by tuesday or wednesday, it was becoming quite clear where exactly i am catching those radiation rays. a big rectangle on my chest, running across from my left side, slightly past my armpit, to the middle of my chest; and from the bottom of my bra line to nearly the top of my armpit. there is also some on the back of my shoulder area, which i was told to expect, though i haven't quite figured out the physics of that. i apply aloe vera once a day; my skin is starting to feel a little tight, but not too bad. the radiation redness doesn't hurt at all (yet). as of this writing, i am one-third of the way through radiation, and no noticeable joint pain from the zoladex. still working on cords and stretching. it's been an enjoyable, relaxing weekend with lovely weather. bring it on, Week 37. let's do this.