How Do You Bandage Your Underarm (and Still Use the Arm Attached To It)?

Last Wednesday (June 13) I had my last radiation treatment before surgery. Phase 1 is officially over, and the resting period before surgery (Phase 2) is upon me. Of course, things were going a bit too smoothly, so Week 5 of the radiation brought its own delights - skin problems. These were expected, they just hadn't manifested through Week 4, so I thought I might miss this part, even though it had been told to me that such a scenario was common.

Basically, the accumulation of high-energy X-rays finally caused the skin under my arm to burn and peel. So I have a kind of sunburned patch under my arm that is raw, which is annoying and sporadically painful. More of an nuisance than really problematic in the pain sense, but needing to be dealt with. The Biafine cream is fine, but the doctor decided to prescribe another cream, one which is used to treat burn victims and helps them grow new skin, as well as some other agents. The new cream is Silver Sulfadiazine.

Before the cream was available from my pharmacy (a 2-day wait), the prescription for my underarm was to put a kind of dressing over the area, called Xeroform, which is a yellow "gauze impregnated [their word, not mine] with 3% Xeroform (Bismuth Tribromophenate) in a petrolatum blend." Translated, this is a sticky yellow gauze that keeps the area moist and clean so that it can heal. Think gauze soaked in Vaseline with an anti-infective agent that's bright yellow. Then I covered the Xeroform with a non-adhesive dressing (called Telfa). Then I used tape to hold that in place while I made a kind of shoulder harness from the tape to go around my shoulder and hold the whole thing in place. I had to use two long strips of tape, one slightly longer than the other, and place the two strips with the sticky sides facing each other except for the ends. This allowed the part that went around my shoulder not to be stuck down on my shoulder, because removing that much tape from skin is not a pleasant experience. The sticky ends were taped to the back of the non-adhesive dressing and held it (mostly) in place. The whole apparatus was mostly a Rube Goldberg contraption, especially as the movement of the shoulder makes placing a bandage to stay put under your arm highly problematic. I did it for two days, and it took about 30 minutes each day to put the thing on. Needless to say, the fit was not overly comfortable.

When the Silver Sulfadiazine arrived, I was instructed to put it on the affected area with one half of a tongue depressor. This white cream is the consistency of cake frosting, so it feels rather like icing a cake a couple of times a day. But it stays in place without a bandage, so I've ditched the Xeroform, non-adhesive dressing and Elliott Ness shoulder holster tape job for just the Silver Sulfadiazine and Biafine creams. I don't wear my best shirts, and it's a lot more comfortable. It also seems to be working, as the Silver Sulfadiazine (an antibiotic that helps burned skin heal and regenerate) and Biafine combination has, over the past 5 days, lessened the annoying pain and begun the healing process of the skin. Also, not receiving radiation helps the process immensely.

All in all, things are going along just swell. I'm busy at work, getting ready to go to a conference for 3 days in DC, and just short of one month before the surgery. Perhaps I'll have fully regenerated skin under my arm before then - who knows. In the long run, the effects of the radiation on the tumor site seem to have done exactly what was hoped for, and now I'm getting my house (figuratively and literally) in order before going on to the next challenge.

No Red, But Skin So Soft

Although I've asked twice, there seems to be a scarcity of red markers in the radiation oncology building, so I'm stuck with turquoise. Not bad, but a little high contrast when wearing an orange or red t-shirt. It really doesn't matter that much, since I'll be done with the radiation in 3 more treatments ending Wednesday, June 13. After that, it's into my resting period until surgery on July 17.

I see my radiation oncologist every Wednesday, just to check in and see how things are going. The technicians take plain X-rays the day before I see her, so that she can see if things are going as planned. So far, I'm doing swimmingly. I haven't had any problems with excessive fatigue (except when I put in 10 busy hours at work disciplining kids, running Cub Scout programs, and dealing with an accident involving the bookmobile, all at the same time), which was one concern the doctors suggested I might have to deal with. I have developed some irritation under my left armpit, largely due to the loss of my armpit hair from the radiation. I've switched to the Biafine cream, and it works well. It is like having a type of sunburn, in that it's tender to the touch. As it's always resting on my side (unless I raise my arm, which I do frequently), it's hard to keep it from rubbing. Put in perspective, it's a minor annoyance.

The radiation oncologist was surprised at how good the rest of my irradiated skin looked. When I told her that I had finished 4 of my 5 weeks of treatment, she seemed surprised and said that in that case my skin looked extremely good. I figure that if I keep up with the cream, the underarm irritation will subside greatly by the time of the surgery.

And so I'm coming down the home stretch of Phase 1, as I've come to think of it. Three more days. Truthfully, I'll miss the people I've met at the treatment center - it's been a pleasant way to start my days. But Phase 2 (rest) looms, and then Phase 3, surgery. Phase 4 is rehabilitation, which will probably be the toughest part of the entire process. Mentally, I feel ready for all the phases - the only way out of them is by going through them, so bring them on and I'll deal with what I have to deal with. It could be kind of fun, and it certainly will be an experience I'll never forget!

Big Arm Birthday!

With 7 treatments left in my radiation therapy, today I'm celebrating my 52nd birthday. A very happy day, all in all. Really, I wouldn't trade in a day of my life to get out of experiencing what I'm experiencing now. You may ask why, given that I get irradiated 5 days a week, have a tricky surgery looming, and don't have the cancer-free body I did a year ago.

The answer is very simple - I view my life as a wonderful and wonder-filled gift. Every day I find myself learning something new, exploring new possibilities, moving ahead. If boulders roll in my way, it just means I have to find a way around them, they are just a part of the grand journey through life. And it is this experience of the grand journey, which is my life, with all its ups and downs, that so enthralls me and fills me with gratitude for being able to experience exactly what I have experienced to this day.

For lots of people, each day may seem to start the same way (waking, bathing, coffee, work, etc.), but if I truly pay attention, I can't help but notice the fluctuations from the seemingly normal routine. Have you noticed (if you're up early enough to hear them) what types of bird songs you hear early each morning - are they always the same? The color of gray or blue of the sky - how are they different every day? The quality of the light coming through you windows - bright, muted, nonexistent? The coolness or mugginess of the air? The state of your mind and your mood upon awakening? The other sounds your house makes as you move about your morning routine (the creaking of steps, the opening of doors, the running water in the bathroom and kitchen)? These and a hundred other things, taken collectively, may at first seem like the same thing, day after day. When looked at more closely, they are never the same two days in a row. The question is - can you hone your ears, your eyes, your sensibilities, to experience them as new every day?

That's what I've worked on for years, learning to pay attention to the people and places of this world as if I had never experienced them before. It's very hard to take for granted something or someone you've never met before. This newness makes you see things with a refreshed perspective. And it's only because of all the experiences in my life, happy and sad, uplifting and depressing, that I have come to this point of being able to work in the world this way. So I am very happy and grateful to have had exactly this life. I look forward to many more birthdays exploring the amazements to be found living life with this kind of awareness. So here's to a very happy birthday as I move, day by amazing day, towards my next birthday.

Do You Have Anything in a Red?

As I come down the home stretch with my radiation treatments, the repetitiveness of the daily process leads me to look for less obvious items of interest. The one I'm particularly amused by these days is the ongoing change of colors used to mark my arm for proper alignment during treatment. These "registration marks" help the technicians to place my arm in exactly the same position repeatably, which is fairly crucial to getting a good result. To that end, when I had my fitting for my mold, the technicians spent a great deal of time making sure all the little details were taken care of, tweaking my position, cradling the mold while the foam inside set to the proper consistency, and taking CT scans to assure all was perfect. This procedure cost over $3000 (at least that's what the bill said - my portion came to a tad over $55, thankfully). They then marked my arm with (supposedly) permanent marker, which they covered with small, clear, plastic adhesive patches, so that when I had my simulation 9 days later the technicians would have no problem getting me in the same position. The color used that day was purple.

Within 4 days, the plastic patches began to "wiggle", as I've taken to calling it. From normal bodily movements and the usual wear and tear (like showering or high heat and humidity), the adhesive begins to get degraded, and the patches start to pucker up, which, of course, moves the position of the lines. In my case, 2 of the patches were in extreme danger of falling off completely the day before I was to take a 4 day trip. The fine folks at Greenspring re-patched me, but when I came in for my simulation on May 8, they began to relabel me - sort of a fine tuning of the previous marks.

Obviously out of purple markers, they redid a couple of my marks in black. Perhaps they were trying to simulate linear bruises, or they were ardent Ravens fans; whatever the reason, the results were two-toned. Over the course of my next 3 plus weeks of treatment, every one of the marks has had to be redrawn or touched up. At first there was consistency, with the purple marks morphing to black, so that about 10 days ago my marks were uniformly black. However, during the last ten days, the color choice has changed again, to turquoise this time. And the lines they've drawn are freehand and longer than before, so that an inch or so of extra turquoise shows beyond the patch-covered areas in some places. Fortunately, what is permanent on paper turns out to be extremely impermanent on my skin. Just part of the fun of the process. I have to say that I am in no way criticizing the performance of the technicians - we joke about the colors and they have not compromised my treatment at all. According to my doctor the setup and results are just fine. I think I might even miss these little marks when I finish my treatment cycle, which is soon (just 8 more radiation visits to reach my 25). But I'll see if I can squeeze in another color or two before I'm done.