Zap zooie: midpoint

Today marks the completion of 14 of my 28 planned radiation treatments. I’m half done with this phase of my current learning experience.

(Blue is radiation, and peach is poison peach pills, aka Xeloda. Percentages are for radiation treatments.)

I’ve been meaning to write up the details for the curious; now seems like a good time. And because of the insurance SNAFU, I’ve gotten to experience the two main kinds of radiation therapy.

Both are in the same room with the same equipment, it’s just how the equipment is used that differs. Either way, I drop trou and lie on the table with my legs in a custom-molded cushion to hold them in just the right place. The techs tug on the sheet covering the table to scoot me this way and that, until my tattoo dots are lined up precisely with the laser lines running along and across my body. The techs flee the room, then take a quick image of my innards. The table position is shifted remotely to make absolutely certain I’m in the right place.

The simpler approach, 3D modeling, used the detailed CT scan they took originally to develop a plan. The x-ray head, an enormous thing that can rotate 360 degrees around the table from its mount at the head, is positioned at three different angles, and from each delivers an approximately five-second burst of x-rays. The beams intersect in the tumor, giving it maximum radiation with as little damage as possible to my innards.

The fancy version, IMRT, instead orbits the head around me, zapping all the way, but finger-like projections are constantly moving to adjust the size and shape of the x-ray beam based on an even more complex 3D model. Science is SO COOL!!! A complete circuit takes about 18-20 seconds, and they do two. I don’t know the beam intensities, but the IMRT provides more time of radiation, and I believe more total dosage as well, while spending even less time over any particular bit of healthy tissue. IMRT is the better of the two because it can deliver more radiation with fewer side effects.

And indeed, the side effects have been fairly minimal. I’m queasy starting about two hours after treatment, and lasting 4-5 hours. So I’ve been eating large nutritious breakfasts. I was on an afternoon schedule for a while, which meant I was feeling poorly from late afternoon through bedtime, but I should be on early mornings for the rest of my treatments, meaning I feel lousy at lunchtime (notice me blogging instead of eating?), but have recovered by late afternoon and can eat a normal dinner. There have been changes in bowel function, but not yet serious diarrhea, and I’m also not experiencing the intense fatigue that radiation can cause (yet?).

The Xeloda, though… I haven’t had the predicted skin problems on hands and feet. I’ve been diligent with moisturizers and not washing the dishes much. Instead, I’ve developed tingling and numbness in my fingers and toes (peripheral neuropathy), which is not usually a Xeloda side effect, though obviously it’s possible. This is tremendously annoying, and runs a risk of becoming permanent if it gets too bad, so I’m now taking Xeloda only on days I receive radiation, rather than seven days a week. This weekend was the first I’d tried that, and the numbness receded somewhat by Sunday evening, a good sign. (Also, numb fingers: if there are typos in this post you don’t need to tell me, because I really don’t care.) I can type, walk, etc, but had trouble trying to warp a loom on Saturday.

So, you know, nifty science and not unbearably difficult so far. This young and healthy thing continues to work in my favor.