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#417 – Last Call for Radioactive Girl, or Achy-Breaky Therapy
For Jo Anne, the 5 weeks of radiation therapy at the conclusion of her treatment for breast cancer were sold to us as a vacation compared with 5 months of chemotherapy. Radiation therapy has generally been much easier for her to handle than chemo but it’s still been inconvenient and intimidating. It’s like we’re almost done with cancer but there still has to be something to remind us how awful it is to be part of your life.
At 7 AM each day, Jo Anne is led into a room where she undresses and is assisted into a very specific and very uncomfortable position, laying on a table. Once in place, all the nurses and technicians in the room – as many as 4 – race out as if they just heard the fire alarm. The lights go off, the huge machine looming above her hums loudly, and a red light goes on.
James Bond, secured to the table, struggles against the restraints. The giant laser hums ominously and shoots a scalding red beam at the foot of the table, slowly burning a path toward Bond.
“Dhjew expect me to talk, Goldfinger?”
“No, Mistah Bond,” Goldfinger says as he walks away. “I expect you to die.”
At this point, Jo Anne closes her eyes, so she doesn’t know what the machine does after that, but it moves around and the red light moves locations. Then staff rushes back into the room, repositions her in another uncomfortable pose, and they rush out again.
This process takes place 4 times per treatment, 5 days a week, for 5 weeks. Jo Anne is now in week 3. She will complete the final week – and we expect the treatment phase of her breast cancer – while I am in Las Vegas for the first week of the World Series of Poker. Her final day as Radioactive Girl will be her birthday, June 6.
But she has been spared this scary but largely painless routine this week. It has been replaced by something far scarier and very painful.
It’s called brachytherapy, pronounced “breaky therapy”. It may be responsible for saving her life and health but we’re not in the mood to be appreciative right now.
Brachytherapy involves pinpointing and intensifying the radiation in the area of the tumor (or, in Jo Anne’s case, the place were the tumor was removed). The Greek root “brachy” means close, and brachytherapy is accomplished by a radioactive seed traveling inside the body right up against the area for treatment. Jo Anne’s tumor was deep, bordering on the muscle tissue, making her a good candidate.
So how does the seed get there? It travels through a very narrow tube.
How does the tube get there? That’s what we were doing on Monday.
They make an incision, run a tube inside Jo Anne’s body, and run it out through another incision in her side or back. They cover the entrance and exit with a button, which I swear looks like a small collar button or like the studs you’d receive with a rental tuxedo.
But they just don’t implant one tube, with two incisions and two buttons. They have to be thorough, so they told her brachytherapy involves implanting a bunch of tubes and buttons.
Early on Monday morning, Jo Anne had to wrap one of her breasts in Saran Wrap.
You read that right. This incredibly high-tech procedure – lasers, seeds, surgery, even how radiation freakin’ works as a cancer treatment is beyond the understanding of most people – starts with Saran Wrap.
I think there was an urban legend when I was a teenager about horny housewives greeting their husbands at the door wearing nothing but Saran Wrap. As easy as it is for me to get in the mood around Jo Anne, this was strangely unerotic, especially because she wrapped up just one breast, and that was after putting on some smelly numbing creme.
After we drove to the oncologist’s office, I sat with Jo Anne while they did an ultrasound. (They had already done numerous scans and computerized analyses of my wife’s hooters.) Jo Anne had been briefed about the procedure but many parts of the explanation had been very general. “Just take some percocet and valium the morning you come in, and leave the rest to us.”
She asked the ultrasound nurse how many tubes they usually implant.
“About 20,” she explained, “but yours could be a lot less because it was removed so long ago.”
With that, they led Jo Anne to the room where they would perform the surgery and I picked her up 2 1/2 hours later.
27 tubes. 54 buttons, 54 incisions.
You know, they don’t use a general anethetic for this surgery either. In addition to the percocet, they gave her some shots to numb the areas around the incisions, but she was awake for the whole thing and told me it was awful, the worst of the 4 surgeries she has undergone in the last year.
She had to lay very still on this table in a very cold room for 2 1/2 hours in a contorted position, with one arm underneath her and the other above and behind her head. The pain in her arms became overwhelming along with the feeling of immobility. They were able to pull out and massage the arm under her body, but they couldn’t do anything to relieve the pain of the other twisted arm.
All she could think about was this arm, the pain growing endlessly, moment by moment. On top of the pain and immobility was intense claustraphobia. There was a bunch of heavy machinery suspended just above her and partitions kept her from seeing anyone or anything else.
“I understand why they tell you to take valium but they must not have told me to take enough. I thought I was going to have to call off the procedure, and I consider myself a very strong person.”
Jo Anne has had to miss 3 days of teaching this week – right before exams – for this treatment so she planned on working Tuesday (with brachytherapy taking place on Wednesday and Thursday, along with removal of the implants). She was advised to continue taking percocet so I’d have to drive her, but when she woke up at 5 AM in tremendous pain, she had to take Tuesday off. Who would have thought 54 incisions and having half the Nordstrom formalwear department rattling around inside her would hurt the next day?
I still had to take her for a CT scan on Tuesday and the oncologist was in great spirits, even if the patient was miserable. “In a year,” he assured her, “you won’t even see anything from this.”
Great, Jo Anne thought, so I’ll be staring at 27 scars on my chest for a year.
But – we think (we hope?) – this is the last indignity. She went twice today (Wednesday) and goes twice on Thursday, then all this junk comes out. That part, we are assured, is quick and painless.
If I’m cynical about that prospect, let’s just say it’s not because I was born that way.
