Graduation!

Here's a nice example of the cheerful care the radiation department takes of their patients. I received this certificate yesterday after finishing my last session. You'll notice how much success I had at getting them to use "Kae."! Actually, they called me Kae, but Karen still printed out on all the paperwork, which is what they looked at to fill out the certificate, I'm sure.

So I'm done with radiation and about to enjoy my month off. I won't know what to do with myself without appearing at their door at 1:30 every weekday!

Actually, my radiation oncologist warned me that I could feel a bit at loose ends after treatment, because I've lost that organizing principle in my life. I rather doubt it, but we'll see. My medical oncologist warned me of the same possible feeling after I'm through with all my treatment in December--that after being focused for so long on organizing and getting through my cancer treatment, my life could feel empty. Some people apparently get a little depressed. Interesting, no? I can see that it could happen. I figure the best antedote is to fill your life up with some happy things to do! And that's what I plan to do.

A Gentle Rollercoaster

The picture is from our hike to Snoqualmie Falls weekend before last (I'm having trouble getting the picture to load so will add it later)

Since my recovery on the BRAT diet, much water has gone under the bridge (only “so to speak,” not literally!) That following Monday, I took another one-day nosedive, after adding just two small changes to my diet—my Chinese herbs and a teaspoon of honey. Since I was terribly unscientific and added two things, I have no idea which thing caused the dive, but I experienced the worse day of diarrhea I’ve had. However with Lomotil and some Imodium, my system finally quieted down about 11 pm, and since then (that’s the rest of week 5 and now most of week 6) I have experienced only a couple of minor episodes. I have also been able to add several things back into my diet, so I’m not quite as constrained in my options. I am actually astonished that I have been able to do so well in this final phase of radiation. I have only one day of radiation to go! Unfortunately, the side effects stick with you for a week or so after you’re through, but I’m looking forward to a gradual lessening of that impact and a return to more normal eating in about a week and a half.

I have also kept up my exercise routine. In addition, on the weekend before last Phil and I went to Snoqualmie Falls and hiked down to the river (and back up from it, more tellingly). I include a picture from that venture. Last weekend we spent visiting our friends Bob Morrow and Judy Morrow, who own a ranch in Goldendale, just north of the Columbia Gorge. They raise an Italian beef called chianina, a tall animal with blond hide and delicious, very lean meat. I was reminded of how wonderful it tastes when we had one of their superb steaks during our visit. They sell all their beef privately, with a minimum purchase of half a cow. Now I really want to find 1 or 2 friends who might join me in purchasing this meat, which is raised much more carefully and healthfully than much of what I can find in the market.

We’re finishing up the plans for our trip back east. We leave on Monday October 6. I’ll probably get one more update posted before we leave. So for now, know that I am doing just great!

Over the Precipice!

As expected, during week 4 of radiation I moved from the potential 10% of people who escape symptoms in radiation to the 90% who do. On Tuesday afternoon, I went over the precipice as the diarrhea struck—not a gradual change but a sudden one. Tuesday, Wednesday and Thursday nights I was up every 2 to 2 ½ hours. Somewhat interestingly, during the day my system would settle down a bit until late afternoon or early evening, then resume the pattern. I swallowed a couple of Lomotil several times each (maximum of eight per day, mind you), with seeming little effect in stemming the tide. I did drink bounteous amounts of liquids and the energy drink, Recharge, keeping in mind my earlier episode of dehydration that landed me in the emergency room. I also managed to keep up my exercise routines, rowing Wednesday morning, yoga and a gym workout Thursday, and my 45 minute walk on Friday. I did, however, slip in a nap on Wednesday and Thursday afternoons.

During my Friday consultation with the nurse practitioner, my focus was on what I could do reverse my nighttime performances, or whether I would simply have to live like this the next three weeks (not a pretty prospect for either me or for Phil, who was a little disturbed by all the traffic during the night). She suggested immediately going on a BRAT diet—a VERY limited fiber diet (bananas, rice, applesauce and toast) to see if we could give my system a break. If that were successful I could then slowly reintroduce other foods to see what I can tolerate without kicking myself over the edge again.

Would you know, it has worked! Since yesterday’s lunch, I have eaten (or drunk) just those foods, along with clear broth. And last night there was no diarrhea. What a relief! Somewhat to my surprise, the relief is so great that I’d be willing to eat this limited diet alone for the next couple weeks—if I can just get enough of it to fill me up. I plan to stay on this basic diet through the weekend, reintroducing first my vitamins and then my Chinese meds, which I also decided to go off. Then I’ll experiment with different foods to see what I can add. This also means I am able to reduce the amount of Lomotil I’m taking to a minimum.

We’ll have to see if I can maintain this as we add more radiation to my body next week. The effect of radiation is cumulative, which is why you experience worse symptoms as you near the end of treatment. So it could get tougher. I have nine sessions to go, plus I understand the symptoms will continue for another week or two after stopping treatment, as my irritated system works to repair itself.

A very interesting lesson in the power of diet!

Halfway There!

Friday I finished up radiation session 14, which puts me both halfway through my radiation, and halfway through my entire treatment plan (since after radiation I’ll be repeating the same number and type of chemotherapy treatments I had before). I’m feeling good about being halfway through radiation and doing well so far. It’s a little discouraging to think about the rest of what’s behind the radiation, so I’m focusing on other things, like a trip back east in October on my break between radiation and resuming chemo, our Christmas plans to be in California with the family in late December, and all the other wonderful travel we’re thinking about next year.

I managed to get through last week with not much impact on my system. I had a couple of days where I took the over-the-counter Imodium after a touch of diarrhea, but in each case it resolved itself by the next day. I treated periodic episodes of gassiness with Gas-X (it works, by the way). Over the weekend, my system seemed a bit more queasy than it’s been, but I still managed to get in all my activities—rowing both Saturday and Sunday mornings, and joining our book group on Sunday evening. Plus a healthy round of yard work on Saturday. So far fatigue has not been an issue—just the somewhat unsettled bowels, and that’s still more a background than a foreground issue. I think the exercise both helps me both to focus on other things and to build reserve energy capacity for my body to deal with the impact of the radiation.

I rather expect the bowels to become more of an issue in the next couple weeks, so we’ll see how it goes. I have one of the radiation staff encouraging me to think that I might be one of the 10% of people who go through radiation without symptoms. However the same person has also encouraged me to be prepared for a sudden lurch of my system. The odds for escaping symptoms don’t seem that great to me, so I’m definitely coming down on the “be prepared” side. My hope is that the “down” time can be minimized, so I’m taking it one day at a time. At this point I am thankful for each day that I can get through without feeling miserable or being held back on what I’d like to do.

Labor Day Weekend

Guy made it up on Friday, coming by himself because Joahnna ended up needing to stay in Santa Clara. Here are a couple of pictures to prove we did it. We show the pilot pulling his Piper Commanche (which we now know was “5-2-Papa” from the way he shorthands it on the radio) out on to the field in Renton. The second shot shows the approach to the airfield at Jefferson County Airport—the airport closest to Port Townsend. Boy did that runway feel skinny as we landed, compared to the one we’d taken off from at Renton. Surprisingly, it felt much wider as we took off the next day.

As always, the flight was superb. Flying around Puget Sound is absolutely fascinating, with the many combinations of water and land. I learned that it is quite difficult to get good shots from the airplane, due to the reflection from the windows (and probably also due to lack of skill on the photographer’s part). But it was fun trying.

I also finished up my second week of radiation doing well, still. I’m experiencing the beginnings of some diarrhea tendencies, but so far am managing with a minimal amount of medication. It’s nice that I had an extra day off for my system to recover before heading into week 3. My change to a low-fiber diet seemed to help me last week, so I got through the week without any medication until Sunday, and am continuing to try to watch what I eat to minimize any symptoms.

Radiation Week One

During this last week I became acquainted with the radiation routine. This is a daily (weekdays) routine, wherein I show up at the desk, am given my admittance sheet, walk down the hall to the radiation room, and climb on to the table to lie face down with my head cradled in a spongy horseshoe open in the middle, much like a massage therapist’s table. Down come the pants to my thighs to bare my backside, then the technicians scrunch me around a bit to line up my tiny tattoo marks with the laser beams, and we’re off. The technicians disappear to the next room to get out of the path of stray beams, while the table elevates me so the radiation machine can deliver four short bursts (ranging from about 5 seconds to 9 seconds long), one each from the front and back (the two short bursts) and one from each side (the two longer bursts). Bingo – session’s over. The table lowers, I pull up my pants and hop off and I’m done for the day. This whole routine takes about 10-15 minutes. Since I live less than 15 minutes from Group Health, the whole round trip takes less than an hour, which is great.

How does that machine get all around me? By circling around me as I lie there elevated, including sending its beams from underneath through a little glass window in the table. It’s pretty amazing – I don’t get to see anything during treatment so have had them show me approximately how it works once I was through. I have now completed 5 out of 28 sessions. Radiation patients count the days, keeping focused on how much is left to go. For those in the know, I am getting 180 centigrays each day, which will add up to 5400 by the time I’m through.

For most people there are no side effects in the first week or two. I did notice an immediate impact on my bowels—not severe but noticeable and progressive over the week. On Friday I checked in with the nurse practitioner, which, after hearing about these bowel symptoms, reminded me of the low fiber diet she had recommended I go on during treatment. I had not bothered to do that, figuring I would control my symptoms with the medicine. However she got through to me when she reminded me that medications have side effects too, and I would be much kinder to my body if I did what I could to control it first with diet. Sigh.

I am now trying to convert to eating all those things we have weaned ourselves from-refined and processed foods. I am trying to avoid fresh vegetables and fruits (the latter is the one thing I’m not giving up at the height of fruit season, but I’m chewing them up really good), beans, nuts, seeds---all the things you normally want to have to help your digestive system. I regretfully drove past all the berry stands as we returned from working on the boat in Anacortes today. I also bought the first loaf of white bread I’ve had in some time—fortunately we do have some good white breads around here.

Otherwise I am feeling quite good. I have enjoyed getting back into my physical routines of rowing, yoga, workouts and walking. Collectively these have had a positive impact on my left leg, which is now nearly normal in size. My energy is good—a bit depleted by getting myself back up to speed on my exercise routines. I want to get them going as good as I can before the radiation fatigue that I’ve been advised will appear actually hits me. My hair is starting to grow longer, but is so sparse that I look like a newborn. Scarves and caps are my daily companions—it will be several weeks before I’ll want my skull to make a public appearance.

So I’m off to week two, with the radiation routine now pretty well known, anxious to see how much my diet change will help me out this week. Now pretty much caught up on things let go during the trip, I’m beginning to cast my eyes about my desk and the house for projects that I’ve been waiting to take on. And looking forward to hopefully having son Guy and his girlfriend Joahnna make another flight north next weekend to Seattle and then take us over to Port Townsend.

Home, Sweet, HOT, Home!

Passing Under the Tacoma Narrows Bridge

Approaching Deception Pass

Passing Under Deception Pass Bridge

We are back in Seattle, having arrived Friday afternoon to a nice hot “in the low 90’s” day. I’ve included pictures of the two notable bridges we went under this summer, the Tacoma Narrows Bridge and Deception Pass Bridge, which connects Whidbey and Fidalgo Islands. Both bridges are quite high above the water, so there’s lots of clearance, but always still a moment of taking in your breath as you pass underneath.

We returned to Anacortes on Thursday about 12:30, and spent the afternoon cleaning the boat, readying it for haulout. At 11am on Friday, Tamarisk was pulled from the water to return to her winter home, high and dry, while Kae and Phil go play elsewhere. We managed to get back to Seattle in time to join our Friday night crowd for drinks and dinner in our local neighborhood. Kind of wishing we were on the boat still, taking advantage of the relative cool one achieves by sitting in a bathtub of cold seawater.

So now it’s time to sort through bills and mail, put in some groceries and get back into the swim of things. We’re just in time to catch a bit of some of the exciting Olympic competition, which we have not seen up til now.

I was able to get out rowing Saturday morning, and managed to hold my own in a double for an hour. The exercise will be good for my left leg, I think. It was talking to me a bit by the end of the row, but actually seemed to be a bit less swollen until we got into the heat of this evening. Strangely enough, I realized while driving that another piece of exercise my left foot gets around Seattle is depressing the clutch on my car. It’s been talking to me a bit while doing that too. We’ll whip it back into shape soon!

I am looking forward to spending the rest of my Sunday enjoying feeling great before starting my radiation on Monday. Except for my leg, most of my system seems to be back to normal. I recovered my taste for wine in the last week—and with it rediscovered how much wine also dehydrates me so I wake up thirsty at night. A sacrifice I will deal with. It is wonderful to know that I will recover it again after the next round of chemo. My hair is starting to fill in a bit—so it will probably recover enough during radiation that I can appear in public without a scarf (just in time to be mowed down again by the final 3 rounds of chemo). My bowels are also beginning to move normally—they’ll likely have a couple of weeks before the radiation impacts them. You can see why a full day of feeling “normal” feels like a treasure.

So now I am “at home” for the next 5-6 weeks, pinned down by daily radiation sessions. I will find out on Monday when during the day my appointment will be. After that my weekends will be my only flexible full days. I will keep you posted on how it goes. I rather expect to make it through the first week or two without too much ado. Then who knows.