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Operation Shake and Bake

My idea of relaxation is certainly not staring at a crooked poster on the ceiling of a hospital room with heavy radiation equipment around me. I don’t think the hole at the center of the poster through which the red laser is peeking can convince me or another patient that they are  looking at a scenic island with clear water and waterfalls. I ponder, if everyone believed in the same God, it could have been possible to have a heavenly image up there and then when a beam comes out of this hole, it would be more believable as a divine intervention and healing. I have no idea what is coming through here. Chemotherapy is something I saw and felt, had side effects to so felt more real. This, I just need to have faith.

Laying on the radiation machine with both hands up and breast exposed is not the most comforting positions. “Hands up” always evokes feeling of fear and unpredictability, and anxiety of what may happen. Our brain is fascinating at making associations and the association of both hands being up is that of being vulnerable. I am here to get radiation treatment with the desire to get any stubborn cancer cells that may have survived the surgeries and chemotherapies.

The ladies at the reception seem familiar with the crowd in the small tightly packed waiting area. They should be since radiation treatment is given five days a week for several weeks. They know patients by their first name and usually their accompanying friend or relative. When I declare, I am here for my shake and bake, they crack up. (My radiation oncologist is Dr. Sheikh). They are not used to chirpy cancer patients, and I notice that the chairs in the waiting room are occupied by humans with very depressed affect and sickly demeanor.

Radiation Oncology is a topic not much discussed in medical school unless you inherently are interested in finding more about it. It is usually a department tucked away in the basement of a medical center or in an area that many don’t pass through. So despite being a physician, I had no idea what goes on in there until I arrived there as a patient. The presence of equipment seems to have had some robotic effect on the staff too. Or is it that the principles of physics that over-arch the principles of empathy that is so prevalent in my world of psychiatric medicine. The appointment begins with changing into a gown…ah the dreaded hospital gown. This will be the routine for another 32 days. Being a sucker for unique products, I have acquired the “radiant wrap” which is a designer radiation gown for breast cancer patients. However that doesn’t really make the ordeal any better. I am neither more radiant nor more covered.

I walk into the radiation room, and its cold and dark. There is soft music from a radio channel that doesn’t add much to the ambiance. There are women in lab coats, i.e the technicians who quickly line you up in the right position. Of course the black marking on my chest with markers help them align the machine. Reminds me of the old embroidery machines that I used to watch with fascination at the street corner as a child. How the craftsman would line up the needle on the careful drawn on design and give the machine a whirl. Well, now facing me is a round disc attached to a huge machine arm emitting rays that intersect right at the spot where the “x” is on my chest. I can see my image in the glass. I also see, the machinery inside opening tiny metal doors with a disturbing screeching sound. I lay still, with my chin up since I don’t want my chin to get the radiation. Then I breathe. After few seconds the machine moves and now its angled to my side and I can see the darn poster again.

I am quite skilled at imagery and have taught it to my patients many times. But now as the radiation equipment moves around me,  I just can’t summon the power to imagine that I am basking in sun light on this island full of water falls. What I have gotten good at though, is believing that the little energy bundles that come out of the machine are hitting my skin and making sure that all rogue DNA is blasted away one by one. 32 more treatments to go, I softly pray, and hope for the healing rays to make me disease free. Then perhaps soon, I will vacation at a real island and won’t have an “x” mark on my chest.

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Chemo Bipolar

Yes Katy , I am having a case of Chemo Bipolar, and I am hot and cold in my noggin’ sans hair. I have treated many with bipolar but now I am getting a visceral understanding of really what having the ups and downs means. Having no control over how you are going to feel for the next few days, actually  miserable is the forecast 3-4 days post chemo, waiting for the cloud to lift so you can have your share of the “manic” week before it starts all over again. It’s hard to believe that a week ago I chose to walk 2 miles just to get a cup of good coffee – only had decaf at home, what kind of life would that be! Today just a trip to the kitchen feels like a hike. That, my friends, is Chemo Bipolar.

I am passing the week in hope for the “bipolar switch” when the metallic taste in the mouth disappears, the “shutdown” in the alimentary cabinet is able to push out a solution, the aching in the muscles (reminding you of what you are going through) disappears, the nerves start to fire some energy beats and the corners of the mouth are able to host a smile. Such are ups and downs of life with chemo.

It’s good they give you a schedule. You start to plan your life in the “good week” – work, kids and activities. The good week is off week – off from hospital, off infusion pumps going “hee-haw, hee-haw” for 8 hours (I hear them as “you will, you will, survive”), off from smell of IV meds, off bandages, off hospital gowns, off being “the patient.” It’s life without caffeine….no buzz, no beat, just existing, waiting for the grand prize at the end, end of treatment. My mind wanders, “What will be my lithium for this bipolar – something to hold on to so I can bear it all?” Thinking like a true psychiatrist, huh?

For me, it is the “manic week” when I am able to bake cookies (OK, I admit not from scratch), go do my Target runs of mostly non-essential items, go see patients and encourage them out of their deepest depression, be silly with the kids so much that I forget it all and live in the moment and cook and taste real food. Life truly becomes a collection of moments rather days, and about having fun while you can.

Then the day before chemo comes, with anxiety and irritability, with apprehension, with hope that it will easier this time, knowing very well that fatigue is a cumulative side effect of chemotherapy, still some hope lingers, until the infusion is done and I puke my guts out – that signal from the pit of the stomach that says “This stuff would be so much better outside my body.” The day of chemo, two hours prior I “marinate” my port (IV access disc surgically placed in my left subclavian vein) with lots of lidocaine (numbing medicine), so the needle won’t hurt (not the worst pain every but totally avoidable with good marinating) and then place Saran Wrap on it. Really, Saran Wrap. Then I put on my smile and my make up, and we go.

I guess it’s all about dulling the pain as much as possible and taking the rest in stride. Especially in October. Happy Breast Cancer Awareness Month! Take care of those breast or you will miss them bad!