April 25, 2023
My first day of radiation was August 24, 2022. That morning, I bravely got up, took a shower, did full hair and makeup and anxiously went to the bathroom to take my very first dose of 3, capecitabine pills.
Ever since childhood, I have had an extreme fear of vomiting. I am afraid of feeling sick and throwing up and am terrified of other people being sick. The capecitabine pills made me so nervous as I knew that nausea and vomiting could be a side effect, I just didn’t know if it would be mine. I think every nurse and doctor I came into contact with thought I was crazy as I would ask many detailed questions about the possibility of feeling ill. I pushed the point so much that I was written a prescpription for Zofran, just in case.
So I set my IPhone timer and twenty minutes after a breakfast consisting of a smoothie and an English muffin with Sunbutter (just like the directions for capecitabine state) I would strap an anti-nausea bracelet to my left wrist and swallow down my three pills. A half hour later, David and I would head down to Northwestern for my radiation appointment.
The thing that got me over the hump every morning was a very thoughtful gesture that two of my closest friends did for me. They had boxes delivered to my home that contained a total of 28, small gifts, so that I could open one every day that I had radiation. They were my treat that I would open in the morning only after I took my pills and that act of kindness made me feel so supported and wrapped in love every single day.
My doctors chose to administer a low-dose radiation regimen, done over 28 days, Monday-Friday, excluding holidays. This was to avoid severe damage to the other surrounding organs and tissue. I had to take 3 capecitabine tablets in the morning and evening every day I had radiation. Based on the location of my tumor on the left side of my rectum, my radiation would be administered with me laying on my belly.
Several weeks before my radiation started, I had an appointment to create a map of my body and to help determine how this radiated energy would be delivered to the tumor. I laid face down in a CT scanner, while various x-rays and scans were performed - and yes, more of that contrast dye was administered. The contrast dye always makes my entire pubic area feel warm for a few brief moments. Then came the small, tattooed dots on both hips and one right on my tailbone.
These dots would be markers for the radiation technicians to make sure I was always aligned correctly on the radiation table. At this point, I can hardly see those little dots anymore. They are teeny tiny, so don’t worry when the nurse tells you that you are going to get some new ink.
After my plan was created and approved by my radiation oncologist and my insurance company, we were able to get started.
Radiation doesn’t hurt. It is odd to undergo a treatment that has no sensation, but over time, has side effects that sneak up on you. My wonderful team of technicians would welcome me to the dimly lit, fairly sterile radiation room. They would make sure I was aligned properly on the table by instructing me on how I should place my body and then by making slight adjustments to the sheet on which I was laying so that laser beams aligned with the three tattooed dots. They would turn up the country tunes (they always put on exactly what I asked for), step out of the room, and the large radiation machine that was mounted to the wall in front of the table would rotate around me, first taking x-rays, and then administering the radiation. As long as the equipment was functioning properly and the team was running on schedule, the time on the table was quick, maybe 3 songs in length. And by the time I was done with my treatments, I was such an expert at getting on the table that the team barely had to make adjustments to my position, a feat I was very proud of.
Tuesdays were doctor days, where either before or after my radiation, David and I would visit with my doctor to chat about my progress and how I was feeling. I also had to check in with my oncology PA twice over the 28 days to make sure that my side effects from the capecitabine were in check.
Here is a link to information about capecitabine as taken from the Mayo Clinic’s website.
https://www.mayoclinic.org/drugs-supplements/capecitabine-oral-route/side-effects/drg-20062501?p=1
This is a run down of what I experienced during radiation:
The first few weeks of radiation I did very well. I actually looked and felt great as I had stopped drinking (no alcohol with capecitabine), stopped eating red meat, cleaned up my diet, was taking supplements recommended by my naturopath and I was still working out. I actually thought I looked pretty hot as I was still able to work out and do all of my normal things.
Fifteen days into treatment, on September 14th, I had my first dizzy spell. On the short walk from the parking garage to the radiation clinic, my legs began to feel heavy, things started to spin and I felt light headed and short of breath, Thank goodness I was able to get immediate attention from my medical team when I checked into the clinic. All of my vitals checked out, but I was warned that I may need to take it a little easier. So I backed off the heavy duty workouts and opted for gentler movement. I made sure I ate when I was hungry and stayed hydrated.
That was about the time that I became sensitive to food and diarrhea became the new norm instead of the exception. I had to cut out cheese (oh was that hard) and get really bland with lunch and dinner. Pasta, rice, skinless chicken breast, applesauce, apples, and protein shakes dominated my diet.
My weight began to drop. My diet was so limited and I honestly was afraid to eat as I was anxious about the painful trip to the bathroom an hour later. I did learn that Imodium was my new best friend and you should not be afraid to take it.
By the time I had 10 treatments left, my husband had to drop me off and pick me up at the front door of the clinic. I could no longer do the short walk from the parking garage. I was just too tired.
Close to the end I developed itching inside my rectum, a side effect that I was reassured was normal. It was completely tolerable, but odd.
I also had burning with urination those last few days. Not all the time, but sometimes and this lasted into the first week after my sessions finished.
After radiation was done, I was tired and I remained tired for a good week after.
I had a backpack that I took to every radiation appointment, separate from my purse, it housed the following items:
Peppermint essential oil (a gift from a beautiful colleague)
Zofran
Applesauce and spoon
Crackers
Water bottle
Anti-nausea bracelet
Mometasone cream - This medication is used to treat skin conditions such as eczema, psoriasis, allergies, and rash. Mometasone decreases swelling (inflammation), itching, and redness. Mometasone is a medium-strength corticosteroid. This medication is available in several forms including cream, ointment, and lotion (solution). Your doctor will choose the type of product based on the skin condition/area of the body being treated. https://www.webmd.com/drugs/2/drug-5904/mometasone-topical/details
For me, it was important to stick to a routine to make radiation treatments, and even the fact that I had cancer, feel a bit more like a normal thing. I got up every morning, did my breakfast routine, 20 minutes later took my pills, and did a workout of some sort. Everyday I styled my hair, did my makeup, picked out a cute outfit and went on my way. These were things I enjoyed before cancer and it made me feel better when I arrived at the hospital looking nice and feeling good about how I presented myself. Sure, at the beginning I was still waltzing in to treatment in heels and business attire. By the end it was well coordinating lounge outfits and fun tennis shoes, but I always did it. I think it helped my mindset and kept me in a more positive space.
In the evening, we ate dinner at the same time and twenty minutes later, I took my second round of pills. Then wash face, brush teeth, read in bed and asleep by 10pm.
The picture featured with this post is when I completed radiation and I got to ring the gong. I looked at that gong every time I left the radiation room thinking, "watch out, I am coming for you!" I couldn't wait to ring that thing! To Dr. H and my entire team, thank you for making those 28 days as bright and easy as possible.
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