I didn’t get a tattoo today

I thought I was going to.  I was supposed to.  I was minutes away from getting one.  I wish I got a tattoo today.

Let me back up.

Last Monday was my last chemotherapy treatment.  I didn’t really celebrate much apart from a few classier-than-normal-dinners, because I was still dealing with the side effects, and, well, I’m not done treating this cancer yet.  In the past week I’ve had to shift gears from the relatively normal routine I was used to with chemo and get used to doctor appointment after doctor appointment to see what state my internals are in and to plan the next step in my treatment: radiation.

I met my radiation oncologist for the first time last Thursday, and he spent a significant amount of time walking through my history, telling me what the next steps will likely look like, and even showing me the details of my PET-CT scans from April and August.  I hadn’t actually seen the images before, and it was enlightening to see the improvement that the chemo had done in that time in killing off the cancer.  Also, the April images were still a little upsetting.  I was basically operating on one lung, and it was beginning to fill with fluid.  And my windpipe was not even close to where it should be.

August PET-CT scan. Still a lot of scar tissue in my chest.
August PET-CT scan. Still a sizable bit of scar tissue in my sternum.

So yesterday morning I got another PET-CT scan.  The nursing staff there are starting to recognize me by face alone.  The results, as expected, were still negative for active cancer activity and showed the scar tissue in my chest was even a little smaller than it was in August.  At my appointment this afternoon with my radiation oncologist, the plan was to get another detailed CT scan of my insides, this time lined up with lasers and marks on my body so that I could be positioned in the radiation machine the same way every time.  Hence the purpose of the tattoos.

I was taken to the scanning room by a student nurse, who, I swear must have quit a previous job as a supermodel because she was an effortless 10, and my immediate instinct was to check to see if she was wearing a ring.  All clear.  I think I could look forward to coming in to receive radiation every day.  Shoot, only a month?  Let’s make it two.

I was laying on the table that gets put through the CT machine with my shirt off, head locked down in a weird webbed cast formed to my face, belt undone and pants/boxers slid down just enough to be able to make some pen marks – where I was due to get tattoos – where the lasers crossed my lower abdomen, when the nurses stepped into the separate room to start the scan, and then my radiation oncologist ran in with jazz hands shouting “STOP EVERYTHING!”

He’d just gotten off the phone with another doctor at Loyola’s hospital in Chicago saying that, yes!, in fact, I would be a perfect candidate for proton therapy.  Not that normal photon and electron radiation wouldn’t work for my tumor, but there would be a risk of some permanent side effect damage to my lungs and heart because of how the radiation beams would have to be shaped to kill any leftover cancer DNA in my tumor/scar tissue.  It’s just how my tumor was shaped.  There’s always a risk of affecting nearby organs when getting radiation treatment, not that it would completely impair them, but apparently at least one other person with Hodgkin’s lymphoma has been treated with proton radiation, and I could be number two (or number 100, I’m not really sure, but it’s not common yet for Hodgkin’s lymphoma because normal radiation treatments are effective enough).

I will add one thing.  I’m very glad for my background and education as a mechanical engineer because all the physics talk of these treatments makes perfect sense to me.  It’s very comforting to know and understand – really understand – what’s going to happen me on the microscopic level.  I’m not usually very talkative in my doctor visits, but that’s because (I think) I have a fairly good grasp of what’s going on and what’s going to be done to me, and well, yeah it makes sense – no questions – let’s get on with it.

Either way, the pros are that I’ll probably have fewer side effects from radiation, and the cons are that I’ll have to move back home to Deerfield and drive to Warrenville every day for a month to get my treatment, as opposed to driving 15 minutes to the center in Holland where I thought I’d be getting all my radiation treatments.  This development came a little out of left field for me, and, well, even though I don’t always give glowing reviews of life in Holland, I definitely still prefer it to Chicago suburbia.

So it goes.

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