Less than five minutes.

The little skin graft that could? It could and it did. After what felt like the longest 12 weeks of my life, my right side incision was fully closed and healed, and I was cleared to start radiation. Finally! I rejoiced like a one-woman church choir.

Every step of this journey has been so extremely unknown for me that the science of everything has made my head explode about a thousand times. And radiation has been no exception. It's fascinating. I lay on a table while a machine rotates around me and blasts photon particles into my body, zapping any microscopic cancer cells that might still be lingering. The angles and the positioning of my body and the imaging have to be just so for the treatment to be both effective and safe - actually, the machine won't even turn on if for some reason I'm even a half centimeter off from my correct positioning. It is mind blowing how it all works. Note to self to remember the difference between photon and proton treatment having to do with the heaviness of the particles and the speed at which they need to be accelerated in order to enter the body and treat specific areas in specific ways. Cancer has made me appreciate science more than I ever thought possible. Science and the people who dedicate their lives to it. I've put every single shred of trust I have into this team of doctors and their brains, and I am forever grateful for their work. If I ever get asked to do the commencement speech at a university, all I would say is: appreciate science like your life depends on it, because some day that might just be the case. Mic drop.

***

Monday, August 30, 2021 was my radiation planning session. This was about an hour-long appointment mostly to take a ton of images/x-rays and measurements so that my doctor and the radiation therapists could design my treatment plan to my body. The radiation beams would enter my body from multiple angles so everything had to be extremely precise. They also placed a bolus material over my right expander to make a mold that I would wear during every treatment. It's like a super thick mesh that's wet when they place it on you, and molds to the shape of your breast. Since I no longer have any breast tissue, the radiation will treat my outer chest wall; the bolus mold acts as another layer of skin that the photon beams have to cross through to essentially target and treat closer to the surface of my skin.

The last thing they did was place three sticker markers - two on the sides of my ribcage, and one in the middle of my chest. They would need these in place for my first treatment. It would take about a week to design my treatment plan based on the measurements and images they had taken that day, as well as to finish the bolus mold. They called me a few days later with my start date: September 9, 2021. Every week day for five weeks.

***

For the first two and a half weeks, my treatment sessions were at 12:30 every day. With my radiation start date pushed back so much further than we had initially planned, and Joe back to work, we needed coverage for Sadie while I was at radiation. So after 11 months at home with mom and dad, we started drop-in care at the daycare where Sadie will be full time in November. We started her at daycare the same day of my first treatment, so I was already a mess. And, just like losing my hair was harder than chemo, dropping Sadie off for the first time at daycare was harder than radiation. She cried when her teacher took her and when the door closed between us I cried until I was halfway to the hospital.

For my first official treatment, I didn't know what to expect. They took me back through the first door and it felt a little bit like I had entered Area 51 with the control room and monitors. But then I went into the actual treatment room and the space was really nice. Way less scary than I had pictured in my head. They had 80's music playing and there were even lights projected on the ceiling like a planetarium. It was basically a party. That no one wants to go to.

My first session was by far my longest session - about an hour - mostly due to more imaging and measuring, and making sure I was laying in the exact right position. They also finalized my bolus mold and cut some of the extra material off of it so it would fit correctly. I just laid there, arms raised over my head holding on to handlebars, my face turned to the left while the therapists did their work - my treatment position. They confirmed I would need to hold my breath during each radiation blast. It's common for patients to do this when they're getting radiation on the left side of their chest because of the position of the heart, but for the right side, I would need to hold my breath due to the position of my liver. My doctor friends will know why, but I'm blanking on the actual reason -- I think because the liver can sit higher up and holding my breath moves it just enough out of the way for the radiation beams to do what they need to do. I had butterflies the whole time just waiting for the actual treatment to start.

Finally, they placed the mold over my expander and said they were ready to get started. They all left to go back to the control room with all of the monitors and would communicate with me over a speaker. I heard it flip on and the therapist said: ok, you're going to see the machine rotate four times, you'll hear it turn on six times, and we'll be done in less than five minutes."

Everyone kept telling me I'd spend more time getting into the room, getting undressed and getting on the table than I would getting my actual treatment. They were not wrong. In that moment - again, my head exploded a little just thinking about how much work goes into designing these treatment plans...just for a five minute treatment. On a normal treatment day, from the time I'm called back to the time I'm walking back to my car is 15 minutes or less.

After my treatment was done, they were able to remove the sticker markers from my planning session, but told me I would need to keep the marker on the middle of my chest through the rest of radiation. My options were to continue wearing a sticker for the next five weeks, or get a tattoo right where they needed the mark. I opted for the tattoo and waited for one of the Village People to come in with a tattoo gun. Like in my mind, I seriously thought a tattoo artist would come in and do this. Ah no. The therapist just injected the ink with a needle and it was maybe the least badass tattoo in the history of the world. It's literally a dot the size of a freckle. But still a tattoo! My first tattoo for radiation treatment. Maybe it's a little bit badass.

***

As of today, I've officially completed three of my five weeks of treatment. 15 sessions down, 10 to go. I've memorized the rotations of the machine. "When you're ready, take in a breath...hold...you can breathe." I can hear their instructions over the speaker like a meditation, and the buzzing sound the machine makes when it's treating me will forever be engrained in my mind. Four rotations, six breaths, five minutes. My skin is just now starting to look slightly sunburned and I can see a pretty clear outline of my radiation field. Like a big rectangle that extends from the right side of my neck down to about an inch past my right expander. I gob thick, oily lotion on to the treated areas 4x a day to help soothe the skin, which is one of the more annoying parts of the process. My radiation oncologist is wonderful and I get to see her once a week. I just saw her this morning and she is thrilled with how everything's going. Even with a little redness, she thinks my skin is looking great.

In general, everything is going as well as it can. My energy is waning. By 4pm every day it's hard to keep my eyes open, but at three weeks into treatment, the fatigue is manageable. Most days treatment feels exciting. When I forget about why I'm laying on the table in the first place, I'm amazed by the people and the data and all of the research that have allowed me to even get to this point of my journey. I know too many people who haven't been nearly as lucky because well, cancer sucks. And then some days I cry while I'm holding my breath. It's like the heaviness of the past nine months hits me all at once and despite how great my results have been I get so overwhelmed that I feel like I can't do one more day of this shit.

It passes.

With help from Joe and Sadie, I pick myself up and just keep fucking going. Life is so precious, I keep reminding myself how absolutely lucky I am just to be here.

I'm on the downward slope now. Two weeks of radiation to go!