How I met Iridium -192: A Savi Story

Radiation is used to kill any stray cancer cells left over after surgery. The traditional whole breast radiation delivers radiation to the whole breast using a machine called a Linear Accelerator. It is outside of the breast .
Breast Brachytherapy is the application of radiation near where the cancer cells were taken out. It is delivered through a device that is placed inside the breast and the radiation is deliver through small small catheters that look like straws. The device was placed in my breast by my surgeon about two weeks after surgery. Part of the device is inside and part sticks out.


My device is called a SAVI. You can see it where it comes out the skin near the bottom of my breast.













This is the CAT scan image of the device inside of me. You can see the device on the left and shadows of my ribs in the middle portion of the image.

The machine that delivers the radiation for brachytherapy is called a High Dose Rate Remote Afterloader or HDR. It has tubes called catheters that hook up to the tubes on the SAVI device and the HDR sends little seeds of Iridium-192 through the device stopping the seeds every 5 mm for a very short time.

HDR Machine as seen by me while hooked up.







Me as seen by the HDR machine while hooked up.








The radiation treatment itself took about 15 minutes but I had a CAT scan to check the placement of the machine before each treatment and the doctor and the physicist checked the device and the HDR before each treatment. I had 5 days of twice daily treatments.

Jenn was one of my radiation therapists. She went to school in Wisconsin at the University of Wisconsin in Lacrosse, I believe and she and her husband are looking for a house.




This is the CAT Scan machine.






I have now completed my radiation and meet for a second time with the oncologist on the 29th.

Thanks Dr. Kuske for helping me with all the radiation lingo and description!

www.armyofwomen.org

I am finished with my radiation, have a terrible headache, and can't wait to get to Redondo, hopefully later in the week. Corey has been more than patient with me this week, Courtney & Ali have kept my spirits up and so have the army of women friends who I have known for years and new friends I have met in the past few months as I have been treated for cancer.

My heart is with my cousin Wendy as she undergoes continuing chemotherapy for breast cancer. Wendy and I are the cousins who are the same age and we were diagnosed with breast cancer within months of each other!

Please send out special energy to my new friend Pam P. Pam has two more radiation treatments to go and then a break before chemotherapy. She is so pretty and calm and I felt such great strength from her as we passed twice daily to receive our treatments!

The army of women site listed recruits healthy women with no history of breast cancer, breast cancer survivors and those at high risk for breast cancer to register through the site to become potential clinical trial participants. Check it out! You may be help even if you do not have breast cancer!

Update

Thanks for all the calls and good wishes. The device for radiation was placed yesterday late afternoon. I spent this morning getting CAT scans and with the radiation oncologist and his group. I will start radiation twice daily tomorrow and will try to report more about the experience later in the week. Right now I feel like a truck ran over me but a small truck.

Peace!

Respite, Redondo and Crumb Cake

The last week has been a respite from cancer. No treatments, only one doctor's appointment and everything healing well, the hematoma in my right breast seems to be resolving. I am working four hours a day from home and enjoying that very much.

I spent the weekend in nice cool Redondo and Corey and I catalogued and organized all the DVD's here. (He has so many we couldn't find anything and they were all over.) We had fun mostly doing nothing.

Looking forward to another peaceful week in which nothing reminds me or anyone else that I have breast cancer and then my family joins us in Redondo beginning Thursday to celebrate the 4th. Until then I am working on my gluten free cake and bread recipes so I can make something special for Courtney. Here is a recipe for a gluten free cinnamon crumb cake that I have nailed (if I do say so myself).

Gluten Free Cinnamon Crumb Cake

Batter:
2/3 cup milk ( room temp)
1 tablespoon yeast
1/4 cup sugar
2 tablespoons butter or margarine
1 egg
1/4 cup canola oil
1/2 cup potato starch
1 cup corn starch
1/4 teaspoon baking soda
2 1/2 teaspoons xantham gum
2 teaspoons baking powder
1/2 teaspoon salt
1 teaspoon vanilla extract

Cinnamon Crumb Topping:
1/2 cup chopped nuts ( walnuts or pecans)
1 teaspoon cinnamon
1/2 cup brown sugar

Icing Ingredients:
1/2 cup powdered sugar
3/4 teaspoon vanilla extract
2 tablespoons milk - enough to make icing easy to drizzle

Batter:
Add yeast to milk - stir until dissolve. Cream butter and sugar together. Pour yeast/milk mixture into sugar and add the rest of the ingredients. Stir together until blended then pour into buttered pan ( about 8 X8 or 9X9). Cover with plastic wrap and let sit at room temperature for about 1 hours.

Mix topping ingredients together and sprinkle over the top of the batter. Bake uncovered for 20 minutes at 375. Cool for 10 minutes. While cake is cooling mix together icing ingredients and after 10 minutes drizzle the icing over the top of the cake.

One More Reason to Eradicate Breast Cancer

In this strange new world the whole family gets to go to the ultrasound of babies. Below is a picture of my grandaughter who will be born in late September. We call her Zebedee right now but I hope her name will change after she is born!

Courtney at 24 weeks!

Courtney ready for the ultrasound!

Cody, Ryan's brother and his girlfriend Sara, Corey & myself watch the ultrasound!

Courtney, Ryan (my son in law) and my sister, Faith, watching Zebedee who would not hold still!

Thanks to Brad for the pics!

On the Job Training

Dr. Kuske gave me a nice compliment the other day about how calm and peaceful I seemed through everything. Over the last few weeks I have come to realize how much I have learned about how to gracefully live with cancer from my patients. Some of the most inspiring people I know have Cystic Fibrosis.

Adults with Cystic Fibrosis lead dual lives. On the one hand, they live with the constant threat of becoming ill even as they practice a regime of medications and airway clearance that is taxing and tiring. On the other hand, it gets old being sick, it gets boring talking about it and it gets irritating to have other people telling you what you should be doing. The worst part is when other people cry for or about you. I am done crying about having breast cancer and am ready to live with the diagnosis and the treatment.

Yet, despite having CF, many of my patients have a calm, brave spirit that does not give into the disease but accepts the reality and navigates through life with this strange companion. They have learned from the experience of having CF but it does not define them. These incredible people inspire me and provide unknowing mentorship for my life with cancer. That is a blessing that I am sure many others with cancer do not have! On the job training is a benefit of employment in a job that I love.


Kim Peet gave me a poetry book with this interesting poem written by a cancer survivor:

ENLIGHTENMENT

by Sylvia Thompson

I prayed to the Heavens

for a great teacher

dignifying, enlightening and steady.

With desperate pleas,

in silent conveyance,

that I, the student, was ready.

And so the Heavens,

obliged to my need,

sent a great teacher

to answer.

When I asked him his name,

he smiled at me warmly,

bowed down to me

and said,

CANCER.

Clear Margins - Yippee! On to Radiation.

The margins around the surgical site were free of cancer. That means on to radiation. I visited the Radiation Oncologist, Dr. Kuske, this morning and we again discussed the, "suspicious lymph node" that showed up on the MRI. It was not the sentinel node. The question of the day is whether to aspirate it before radiation or just wait until after treatment. The chance that there is cancer in that node despite none being noted in the sentinel node is less than 4%. Dr. Kuske and Dr. O'Neill are going to discuss today and get back to me.


There was another radiation oncologist working with Dr. Kuske today named Dr. Chowdry. He came from Alberta, Canada to learn more about partial breast radiation. Both the docs were very impress with my surgical site. Dr. Kuske said, " You don't know how many surgeons hack off 1/3 of the breast to get the same size area. We have seen several concave breasts this morning already with actual cancer sites the same size as yours. " I am really pleased with the results myself - I still think Dr. O'Neill is amazing!


Karise gave Courtney, Ali and I each a pink wish necklace. They are delicate and beautiful. The idea is that you wear the necklace until the string breaks and then your wish will come true. We tried them on and rushed into the mirror to look at them. Here is a picture of the three of us with our wish charms.