Wandering Around with a Hole in the Middle of My Face | Part Two
Radiation and the Importance of Physics
If you’ve gone through it, you know. If you’re facing it, I’m going to tell you straight. Radiation is no picnic at the beach. The treatments aren’t the bad part, except for the boredom. It doesn’t hurt. It doesn’t make you sick, at first. And my team of doctors and technicians were magnificent. For me tackling the boredom was the hardest part. Lying still pinned down on a table requires intense submission. I’m not good at that. And then there’s the internal terror. I’m sure there’s no great place on your body to endure radiation, but the idea of lying under a linear accelerator with high-energy proton beams aimed at the center of my face was anxiety inducing.
Before I started radiation my doctors discussed the potential side-effects with me and presented a list to sign. Signing a form confirming that I’d been told I could suffer brain damage, go blind, lose my teeth, go deaf, so many things I can’t remember, is daunting. But the fear of being bored for six weeks was worse. That was immediate and real. The rest were mere possibilities.
45 minutes to an hour and a half, five days a week, for six weeks. That’s a lot of time to stay still on your back with your face held in a what may as well be a vice, your mouth pried open with a brace akin to a large, gag-producing tongue depressor, and a blob of hardened wax stuffed into your nasal cavity.
Not a Great Fashion Look
I used to kid a lot during those months between my cancer diagnosis and the surgery to remove my nose that I was long past my beauty pageant days, so what difference would it make if my face was missing a big feature? But dear god the paraphernalia I had to wear during radiation treatments was U-G-L-Y. First there was the mask that was molded to my face a few days before treatments began. It started as pliable material but hardened to conform to the contours of my head — what was left of them. The back of the mask had latches that attached to the table to hold me still during treatments. It turns out radiation works best when it hits beneath where the beams hits your skin so since I no longer had a nose, my doctors had to shape a wax mold as a “replacement nose” to stuff into the hole in the middle of my face. Finally, being a Boomer, there was the issue of having old tooth fillings made with mercury. It turns out that when radiation hits mercury fillings it bounces around — not a good thing, so I had to wear the lovely mouthguard you see in the photo to keep the protons from bouncing around in my head.
Dealing with the Boredom
I was so afraid to move I found myself holding my breath — which ended up being okay since once I got on a roll with it, I used my time under the accelerator to focus on breathing and meditation. I have a theory that training myself to breath in fluid patterns helped with the cure. They played Spotify for me when I was undergoing treatments. I got to pick my genre so my technique for passing the time without losing my mind was to lose myself in the music. During my first treatment I counted the number of songs it took to get through a session. I couldn’t move my head to see the clock on the wall so from that day on I would hold my hands in fists when the therapy started, then open up my fingers one-by-one as each song ended so I’d know how far along I was into that day’s treatment. I’d imagine myself at an open air concert, singing along with the artist or dancing. And breathe. Just breathe.
Photon Depth-Dose Curves
My surgery and radiation treatments took place at the Stanford University Medical Center, Cancer Institute. I’ve always been grateful that I lived near Stanford during this time, especially after meeting with the Tumor Board there (Stanford puts you through a day long series of examinations by various specialists before designing your treatment plan and assigning your team). These were profoundly smart folks. Even though my cancer was as rare as the chances of winning a Mega Millions lottery, and my doctors admitted more than once over the ensuing months that an answer to one of my questions was a guess based on general data, I felt from the beginning that I was in the best possible hands. But never so much as when I was assigned a physicist.
My first question upon meeting this member of my team, which looking back seems pretty naive, was why a physicist?
The amount of radiation and where to apply it requires a very precise science and complex math. Well of course it does, I just hadn’t thought about that before it became critical to me. My physicist was remarkable. He even took time one day to explain to my son, Michael, who attended every treatment with me, about the calibration of the machine and how it all worked. So, yay, what better place to be than Stanford when you need someone on your team who is brilliant with math and science.
Immediate After Effects
Losing my hair was not one of the items on the list of things I was warned about. In fact, my surgeon Dr. Ha, whom I loved, after telling me I was going to lose my nose alleged that I would not lose my hair. I remember staring at him kinda funny, then asking, “what does it mean exactly that I’m going to lose my nose?” I mean seriously, how many people do you know without noses? After he described the procedure in detail I asked if the hair vs. nose thing was multiple choice because if so, I chose losing my hair.
Be careful what you wish for. By the last week of my radiation treatments the hair on the back of my head, where the radiation had penetrated through my skull, came out in clumps. I also lost all of my facial hair, including eyelashes, most of my eyebrows, and those pesky chin hairs that women either pluck out or have ripped off with hot wax. Losing the fuzzy hair on my face was fine with me. Losing my eyelashes and eyebrows was unexpected and disturbing. The lashes grew back, but my eyebrows will never be the same. Again, just as well. I had grown up being self-conscious about my almost Frida unibrow connecting my thick, thick brows. Now there would be less need for waxing and plucking.
Long Term Prognosis
At the end of my treatments my doctors presented me with another list. This time of all the things that might happen “for the rest of your life” because I’d undergone radiation. For the rest of my life! Okay, whatever. My takeaway? All I heard was FOR THE REST OF YOUR LIFE.
I also earned a certificate of completion. That makes me laugh and I cherish it.
Next: “Wandering Around with a Hole in the Middle of My Face”
- Part Three | Coffee, Wine, Ice Cream and Other Nutritious Tidbits
Prior: “Wandering Around with a Hole in the Middle of My Face”
- Part One | A Sudden Unobstructed View
