Sylvia's Journal

Last week I completed my radiation treatments. The last four were called ‘boosts.’ It means the radiation beam is focused sharply on the place where the cancer cells had congregated before they were scooped out. And so now, after a month, I am done with the mid-daily routine of driving to the shopping center where the clinic is located.

To enter the clinic one has to make one’s way through a tangle of wheelchairs filled with sick and handicapped people, and their attendants – and a coming and going of special vans or cars for people who can no longer travel on their own. If you want to get a glimpse of how corporate America has made us sick, this is the place to see the consequences of greed, loose oversight and the power of lobbying.

Once past the wheelchair tangle I turn left to the cancer center which celebrates the person who paid for it in large letters. I walk by the first front desk which is for the people who are here for chemo. The ladies by the second front desk knew me after week one. They probably put a check mark next to my name. I turn right twice and select a johnny from a a small armoire next to two bathrooms, remove everything above the waist and put my clothes in a locker, one of the two with a key. The others don’t even have a door. With my blue johnny loosely tied around my waist I sit down in the tiny waiting room with a large in-your-face TV on the wall that is hard to ignore and blaring loud. There is a remote but I don’t use it because other people who are here for their treatments seem to like it. On a small side table sits a 500 piece puzzle of lobster buoys. Only the edges are done. I love such a challenging puzzle but my wait time is usually short – they run a tight ship here – and I get to find a only few matches. When I am back the next day the puzzle is often in disarray, and my progress wiped out, edges are broken up and pieces scattered again. It is a never ending puzzle, just like the cancers that are being treated here.

One of the radiation nurse/technicians calls me in with a big smile. The staff are lovely. Now I have my own routine: I turn on my audio book which comes in through my hearing devices. I take my johnny off – there is no place for modesty here – and, bare-breasted – climb on the table which is set up with molded foam forms so that I am just in the right position. Green cross hairs on either side of me makes sure the beam is focused precisely. There is some tugging and pushing until I am in place. The nurses disappear into an adjacent room to monitor the procedure. I cannot see much of what happens next since I am lying tilted to my left side, the affected breast dangling below the table and the other smooched out of the way. I can see part of the mechanics as they move in and out of my field of vision, and hear the sounds of their beaming and moving as background to my book. It takes about 15 minutes except that one time that the system crashed and they had to reboot and I ended up with a crick in my neck after 30 minutes, but I made good progress with the audiobook.

On my last visit a woman of about my age was struggling to figure out the routine. Somehow she had not been taught the steps: find your johnny, opening in the front, put your clothes away, wait to be called. She emerged from the bathroom with the wrong johnny, the opening in the back exposing her skinny backside. I helped her and we started to talk. It was her first treatment – also breast cancer. She was only allowed 5 treatments by the insurance company. I suspect that too can be chalked up to the same causes that creates the wheelchair tangle.

After the last treatment is done one is allowed to ring the large bronze ship’s bell. A nurse checked me out, reminded me that the effects of the treatments may continue for several weeks and that I should continue to moisturize my now sunburned left breast. After that she accompanied me to the bell and took a picture.

The next step starts tomorrow with a visit to the medical oncologist about which pills to take for the next 5 years to minimize the chance of recurrence (it is already in the low single digits): tamoxifen or one of the aromatase inhibitors which are, confusingly these days, called AI. I asked the other AI (claude.ai) for advice on what to ask the doctor and what he (it) thought about the pros and cons of the two different types of medicines that starve cancer cells from the estrogen that encourages their growth. Although I won’t know for sure until the next mammogram whether I am now cancer free, I assume I am.