The knocking of my heart

“Why are you knocking at every other door? Go, knock at the door of your own heart.” — Rumi

I debated whether or not to post this entry, because it isn't directly about breast cancer. It is, however, about something that indirectly happened as a result of the radiation treatments, and so I think it deserves mention.

Remember the shortness of breath I mentioned in a previous entry? The Thursday before my last radiation treatment (which was on a Monday), the shortness of breath and heart palpitations worsened. My anxiety about what could possibly be wrong only made the symptoms worse. I thought I was having chest pains, and, afraid I might be having a heart attack, I called 911.

It's an odd thing to call 911. Three little numbers set so much in motion. An ambulance arrived in a few minutes. I was given baby aspirin and nitroglycerin as a precautionary measure, and 10 minutes later I was in a hospital.

My heart rate and blood pressure were high, my heart was beating irregularly, but a blood test quickly showed that I had not had a heart attack. I was mighty relieved by that news.

The doctors kept me overnight for observation. I underwent a number of tests that showed that my heart and lungs are fine. I do have an arrhythmia, which was showing when I was admitted, but the doctors said that it is very normal and not anything to be worried about in the absence of anything structurally wrong with my heart. That's a huge relief.

The only thing they did find was that my electrolyte levels were low, especially sodium. I generally eat a low-sodium diet and drink plenty of water. The radiation made me thirsty, so I was drinking more water than normal. I guess my body became depleted in sodium over the course of the radiation treatments until I was really out of whack. The odd thing is, I never had any of the classic symptoms of low sodium (or hyponatremia): nausea and headache. If I had, perhaps a doctor or friend might have suggested that I drink some electrolytes.

I have follow-up appointments with a cardiologist and an endocrinologist, but I kind of suspect they won't be able to tell me anything different. This may be something I simply need to be aware of and manage: make sure that I get enough sodium, especially when my body is under stress, I'm drinking more water than normal, or I feel heart palpitations. The heart palpitations and shortness of breath were scary, but I'm grateful to have gotten some good information out of it.

In other news, it has been one week since my last radiation treatment, and I'm starting to feel more normal. The fatigue last week was tough; I was possibly more tired than I was the final week of radiation. So far the past two days have been better, though. I'm hoping the trend continues.

Last Day - A Photo Essay

My course of radiation therapy is done! I had my last treatment today -- 32 treatments in all over the past six weeks. To commemorate, here is a photo essay of what the treatments have been like.

Radiation Oncology

First, I arrive at the Radiation Oncology wing of the breast center and sign in.

Waiting Room

Walk around the corner to the small waiting room. Once I change into the gown, I'll put my personal things into one of the lockers and wait to be called for treatment.

Ready For Treatment

I remove all clothing above the waist, then put on one of the provided white gowns. Since I lie on my back to get my treatments, I'm supposed to put the gown on so it is open in the back. If I'm lucky, I get one with long ties so I can wrap the ties around to the front, as in this picture. If I'm not so lucky, I have to awkwardly try and tie the gown in the back. While it was nice to lie on my back for treatments, I kind of envied women who were treated face down, and so got to wear their gowns the right way 'round, open in the front. 

Radiation Machine

This is a photo of the Radiation Machine. The big round beam emitter swivels around to the correct angle for the treatments. My treatment consisted of radiation "hits" from three different angles. I lie on the white sheet-covered bed, with my arms resting in the arm rests along side my ears. The blue thing is a specially molded bean bag sort of thing to help keep my right arm in the correct location. 

Beam Emitter

This is the beam emitter. This is what I see above me as I like on the treatment bed. The treatment lasts no more than a minute. I was usually at the breast center about 20 minutes altogether, unless it was my day to see the doctor.

Bell Ringing Ceremony

The radiation techs do a little ceremony for patients on their last day. I rang the bell three times and received a little pin in the shape of a bell. Hugs all around, and I started getting teary-eyed. 

The plaque on the bell reads:

Ring this bell

Three times well

To celebrate this day

My course is run

My work is done

And I'm on my way

Nearing the end

It is now the eve of my last week of radiation. I have had 27 treatments, with 5 to go. I haven't written in a while because, frankly, I haven't had much energy to spend on blogging. I have been very tired for weeks, and now I'm tired most of the time.

This past week I began experiencing shortness of breath during the 10 minute walk from my car to my office, and back. It was very unexpected. I had a chest x-ray and had my blood hemoglobin checked. Both were fine: my lungs are clear and I don't have anemia. The symptoms--which now occasionally also include lightheadedness and dizziness--seem to be worse when I haven't eaten. So perhaps I'm having a low-blood-sugar reaction?

I can try and eat more, especially more protein, and see if that helps. If I can't get the lightheadedness under control, I'm going to have to stop working even a limited schedule this week. I don't want to run the risk of fainting on the way to my car.

Of course, it is the last week of therapy. I gather many (perhaps most) women don't work at all during radiation. The last week is always the hardest. I had always thought I might have to take the last week off work. If that's what I need to do, so be it.

The shortness of breath has forced me to stop taking my daily half-hour walks. I kept that up through the first four weeks of radiation, but I've had to stop for the last two weeks. I also continued my yoga practice most evenings during those first 4 weeks. I can still do a  bit of yoga, but I've slowed that down, as well.

I know the fatigue is temporary; I'm told I will recover in a couple of weeks after the radiation ends. But the leaves are turning now, and I would love to be out in the woods among them, lengthening my stride and enjoying the Indian summer.