Wednesday, June 9, 2010

Day 22

I am always late for radiation. I go every day. And every day it’s the same story. I procrastinate. Try to squeeze in a few more e-mails. Sort through my old magazines so that I can take a pile to donate to the waiting room. Play with Luke after the kids go to school. Water some flowers. Take time for a real oatmeal - the one that takes 30 minutes to cook - not the instant. Chop the walnuts and dates, even though it is almost 9 am. I am supposed to be there, checked in and changed into my gown by 9:15 am. (I put one gown on facing frontwards, the other backwards - for modesty, of which I no longer have any. In fact I could walk into the waiting room without a gown and it would be all the same to me. (Except I wouldn’t want to offend the nice older woman who is always knitting as she waits for her husband who I assume is being treated for prostate cancer.) I show everyone my breasts now because frankly I am as detached from them as if they are an elbow - no more, no less - so there is really very little to be modest about and besides I chose a very immodest cup size). Radiation at Sibley is almost like the drive-through window at McDonald’s. You have a blue i.d. with a barcode that you flash after the automatic sliding doors allow you into the sunny lobby. You might as well be flashing your library card. Then you are supposed to change quickly in a locker room that really feels like it is a changing room at a spa without the Enya. I pride myself on changing in seconds flat once I flash my i.d. I always wear my gym clothes. I never have a bra on. I toss my shirt in a locker. I toss the gowns over my Lululemons. I am seated before they can even round the corner looking for me. They expect me to be late, but not because I am a slow changer.

In the beginning I was late because I always got slowed down at the parking lot. I would always be fumbling for my parking pass and because my arms didn’t lift all that well after the mastectomy and my steering wheel was tight, I’d nearly wipe out the automated post in front of the security gate. I could never get close enough for it to read my parking pass because, again, my arms and pectoral muscles were so sore that I rarely cut the turn into the parking lot just right. The first few times I was too far away and had to get out of the vehicle, which annoyed me. Next time I would try to cut it closer until two of my four wheels rode up on the curb - all that stood between me and the automated scanner that was supposed to make my life easier. I nearly hit that post at least two times a week. Now my arms have a bit more range of motion and I find the whole thing a bit less unwieldy. It all added to my sense that this radiation thing was really annoying and pretty inconvenient after the year I have had. 33 sessions. Daily except the weekends and holidays. It is the reason I am always late. I don’t really want to be there. Anita, the technician in a lab coat who runs my ‘linear accelerator’, said on Monday, “It’s official!” I knew what she was talking about. The fact that I am always late - not too late but about 10 minutes late every day. She repeated, “It’s official.” And then I explained that it really wasn’t anything personal just that I really didn’t want to be there. (People are slotted in pretty tight and you aren’t supposed to be late or you lose your place in line like at a Baskin Robbins.) She said early on they had switched my time to 9:30 am and not told me. She said, “Now don’t you start coming at 9:45 now that you know. Just pretend your appointment is at 9:15.” I got there at 9:25 this morning and declared to Anita that I was ‘early.’ She laughed.

There aren’t a lot of jokes on the linear accelerator, but I keep trying. It’s a little harder now that my right chest wall, breast and underarm are the same color as my skin was that time at the Norfolk Hotel in Nairobi circa 1992 when I didn’t put on sunblock and sat by the pool after a tough stint in Somalia during the famine. My legs that night looked like something out of that Coppertone ad from the 70’s with the dog pulling the little girl’s bikini down and all you could see is burn. I had forgotten about the altitude. That was my last real sunburn. In fact, I really should have had melanoma not breast cancer given my lack of pigmentation and bad relationship to the sun.

I try to make the technicians laugh. I asked them if they could even up my tan this time (the side that they radiate is now a geometric red burn that itches. It is making it hard to wear sundresses and I am ready for the next 10 sessions to come and go. The 99.7 percent aloe vera that my friend Pamela gave me hasn’t really worked. It’s not her fault. It is mine. I didn’t follow the protocol exactly right. Friends and the nurses at Sibley swore by a French product called Biafine and scared me about putting anti-oxidants such as vitamin E and C on the radiated skin. They said Dr. Gage (Sibley’s Irene Gage, the world renowned radiation oncologist that Sibley recruited from Johns Hopkins) wanted to make it burn. They wanted the free radicals from the radiation to break down the walls of any rogue leftover microscopic cancer cells. Who knows? I have used a combination of aloe and Biafine cream, a tube of which is about 18 dollars in Paris. There it can be bought over the counter at a pharmacy. It costs the same here in the U.S. with a prescription IF you have insurance, unless you try to go back to CVS and ask for another tube sooner than the 21 day period that United Healthcare has determined you should make it last. I had been slathering the stuff on and was duly annoyed when I went back on Day 18 and asked for another tube and was told it would be 80 dollars and then the pharmacist asked if I could stretch what I had until Monday. Maybe that is why I am burned. I have run out again and have no idea what day I am on and whether insurance will pay for another tube.

When I lie down on the table, the radiation comes in several bursts. I raise my right arm over my head - in a “fight the power” pose. I couldn’t do that at first so clearly the PT is working, but it still gets stiff. Receiving the radiation feels no different than getting an x-ray. In other words, you can’t feel it. It’s what it does later. Barbara and Anita always mark me with Sharpies once I lie down and pull one arm out of my gown. A few dots over the tattoo. They line up the red laser light lines that look like a sniper rifle’s target and I close my eyes. I am no longer charmed or fooled by the fake trompe l’oeil palm trees or backlit beach scene staring down at me from the ceiling and at the foot of the machine. I don’t have long enough to fall asleep. "Do you snore," General Petraeus asked me recently? I guess he found it relaxing getting radiation, but I don’t have enough time for REM sleep. I usually have just enough time to say the Lord’s Prayer when the first burst of radiation which is accompanied by a small alarm so that you know not to move or breathe. I nearly always make it. “Our father who art in heaven...” On the next burst I usually picture napalm. “Hallowed be thy name. Thy kingdom come. Thy will be done on earth as it is in heaven.” Then I say to myself “all-y-all-y out come free.” I have no idea why we used to say that as kids when we played Foxes and Rabbits in Mr. King’s yard with Gretchen Barbash, Moira Mulroney, Liza Johnson and the other neighborhood kids. That was what whoever was ‘it’ would yell at the end of the game when it was safe to come back to base because the game was over. “Lead us not into temptation...” like the Georgetown Cupcakes that Komen handed out and which I resisted at VP Biden’s house and then on race day only to tell Amelia as I saw the pink boxes in my refrigerator that the girls had left behind that this was my biggest ‘temptation’ to which she replied, ‘Just like in your prayers at night.’ She remembered the word ‘temptation.’ “And deliver us from evil...” And then I start to speed up because the first burst is usually coming to an end. So I slur the ending: “For thine is the kingdom and the power and the glory forever and ever. Amen.” The next two bursts are shorter. Then they turn on the light, the table lowers and returns to the start position, and Barbara, the technician, comes in to tell me that it is ‘ok to put my arm down’. I would if I could but it is frozen in the ‘fight the power’ position and so I slowly will it to lift - slowly - and it crosses over my forehead and over my heart as if I am making the sign of the cross. Then the feeling starts to come back. I put my arm back in my gown and I sit up and I squint from having lain there with my eyes closed and my contacts in. My eyes adjust. I grab my purse and head back to the locker room. I immediately apply the Biafine in the changing room and walk out of the hospital a little more raw and burnt but with my head held high. What’s my choice? Just ten more to go. I feel like the little engine that could.