This is the tenth entry in a multi-part series. Read the rest here.
It's just supposed to be a half hour consult but it ends up taking all day.
We do the usual tests—weight, blood pressure, temperature—and run through the medications I'm taking. I don't bother telling my new radiation oncologist about all of the supplements my integrative doctor has me on. Spare me the lecture.
The thing about treatment is just when you think you've gotten the hang of something, they throw something entirely new at you. It's like playing a bad video game, but I'm not sure that you ever really win. He runs through the list of potential side effects like he's naming pizza toppings—no big deal: skin problems, fatigue, shortness of breath, swelling, sore throat, lymphedema, pain in the treated area, nerve damage. More cancer. It goes on and on. I sign the consent form anyway.
Next he examines both my breasts, his fingers fluttering gently like a butterfly. The nurse measures the circumference of my arms to make sure I don't have lymphedema. My right arm is just barely bigger around than my left, but that's probably because I'm right-handed. He tells me he likes to start radiation within eight weeks of surgery and walks over to the calendar to check when that would be but I already know. That's right now.
"Oh, great—we'll start next week then."
No, I'm leaving for Cuba Monday.
"Is it flexible?"
No. You've had months to tell me when radiation should begin. If starting within eight weeks of surgery was important, you would have already told me.
I remind him that I'm still on Herceptin, a biological therapy drug I've been on in conjunction with chemotherapy. So I'm still "covered" or something like that.
"In that case, we need to start as soon as you're back," he says.
Okay, what will that entail?
"We need to do a CT scan. It takes a week to plan your treatment, so if you're going to start the day after you're back we need you to do that today. You also have to go to another Kaiser facility for a pregnancy test then come back this afternoon for your scan. We'll know after the CT scan if we'll need to remove fluid from your tissue expander."
I tell him I'm definitely not pregnant and he blushes. Come on: You're a doctor. Get it together.
"I understand, but you have to take a test. Legally we can't move forward with treatment until you do."
He also thinks it would be a good idea to radiate the chain of lymph nodes beneath my sternum because of how advanced my illness is (was?).
What are the risks?
More of my lung will be radiated and potentially my heart—we'll know more after the CT scan. And there's a higher risk of cancer caused by radiation.
If I got cancer again, when would that be most likely to happen and what kind would it be?
"Oh, it wouldn't be for at least five years," he says, like that's some kind of consolation prize. Usually it's another form of breast cancer or sarcoma, a soft tissue cancer.
What are the benefits?
It's mostly preventative.
So you're telling me the risk of not doing it is cancer and the risk of doing it is cancer? Awesome. I'm giving him shit but I already know I'll do what he says. I'm not normally like this, someone who just does what they're told. It's unlike me.
He says it's a balance, but his explanation sounds like bullshit. Then he makes me sign a new consent form because of the increased likelihood of adverse side effects. They take me back to get three tattoos, all tiny blue dots—one on each of my sides and one just left of center between my breasts. The tattoos are so that they can put me in place for radiation. I have to be in the exact same place for all of the treatments (I can't even be a few millimeters off). It really bothers me that it's not centered.
Luckily I have a lot of freckles and it's not that obvious, or that's what I tell myself. They mark my body like it's not a body but a thing.
I leave to drive from South San Francisco, where the radiation facility is located, to Daly City to get my blood drawn. Both towns are so close to San Francisco, where I live, but so far away. I can't help but think of the song Little Boxes.
Little boxes on the hillside,
Little boxes made of ticky tacky,
Little boxes on the hillside,
Little boxes all the same.
There's a green one and a pink on
And a blue one and a yellow one,
And they're all made out of ticky tacky
And they all look just the same.
On the way, I pass through a town called Colma. It's less than eight miles from where I live in the city, but I've never heard of it. Maybe it's because no one lives here—I pass at least four cemeteries and funeral homes. No wonder I've never been: it's where people come to die.
It's sick season—there are 23 people ahead of me just to register and 35 ahead of me to get their lab work done. I'm so impatient that I'm tempted to drive back to one of the Kaisers in the city, but who knows what that would be like. It's probably sick season there too.
This poor Kaiser in shitty fucking Daly City has none of the shiny newness of the SF ones. It takes 20 minutes until it's my turn to check in—"is it always this busy?" I ask and she shrugs that it depends—then I wait another 18 minutes for the blood draw. Only two minutes to draw my blood. You think I'd be used to the pinch of the needle by now, but I'm not.
When I get back to the radiation facility, I meet with a new nurse who walks me through the side effects yet again—my third time today. I get it, thanks. Let's just get this over with. When she gets to the part about how some people feel a stabbing pain, she balls her hand into a fist and makes a stabbing motion with her arm.
I do two types of scans, one breathing normally and one deep inspiration breath. Which sounds like a yoga technique, but it just involves taking and holding a deep breath for 30 seconds. It helps them understand my heart position when my lungs fill with air. It's harder than you would think, holding for thirty seconds. But I pass the test.
Later that day I get a notification that my lab results are back: I'm not pregnant.
Read This Next: Episode 9: My Surgery Bill Was 75K