If you've followed my blog for a while (no beef if not! 😇) you'll have noticed there was a massive gap where I didn't blog and I didn't mention the part when I had Radiotherapy (Well, I did briefly on social media but yeah 🤷♀️). Very strange coming from a Student Radiographer eyyy🤔. Even I thought this would be the area I'd be smashing blogs out left right and centre about. I just couldn't though. I was knackered - both physically and mentally. Maybe it was because it was the final part of active treatment. Maybe it was because I was going to the hospital everyday. Maybe its because I didn't have the best experience all of the time. Maybe all 3 - who knows 🙃.
One thing I feel I need to iron out VEERRRRY early on, just in case people didn't know is that there are 2 types of Radiographers and they do 2 very different (but equally as awesome) jobs🦸♂️🦸♀️. Each branch of Radiography requires its own degree or more recently apprenticeship to qualify and they aren't typically interchangeable - you'll see why below
Therapeutic Radiographers aka The TRads ☢️☠️
Are called 'Radiation therapists' around Europe and other parts of the world but the protected title is "Therapeutic Radiographer" and this means that this person has completed a degree in Therapeutic Radiography and is registered with the HCPC (Health & Care Professions Council - the regulating body for Health Care Professionals)
What do they do? - plan and deliver radiotherapy for Cancer patients ensuring they receive the correct amount of radiation at each treatment date. They usually see their patients daily (on weekdays) over a course of a few weeks as Radiotherapy is usually given on weekdays for a number of weeks although this can range from anything from 1 day to 8 weeks depending what they are treating you for. This means they will care for this patient over this period of time.
Diagnostic Radiographers aka The DRads ☢️🦴
Sometimes mixed up with Radiologists (who are Dr's that specialise in Radiology) or called button pushers but are actually highly skilled Healthcare Professionals that also have a degree but this time in Diagnostic Radiography.
What do they do? - acquire images (could be X-Ray, CT, MRI, Ultrasound, Mammography) to aid the diagnosis of illnesses and injury. They also work in lots of departments you wouldn't even think of such as theatres, angiography, nuclear medicine and have mobile X-Ray machines.
Why are you both called Radiographers?
We all use radiation! ☢️ But we just use it for different things. The TRads use the high energy of the radiation to kill cancer cells whereas the DRads use radiation at lower energies in combination with technology to produce really useful images.
I could add loads more about the variety and specialisms both types of radiographers do but I get radiography is a niche and I won't bore everyone! But I will pop some links like normal at the bottom if anyone wants to look a bit more into it!
Booby Zapping Stage 1: Planning ✍️
I had my Radiotherapy planning session just before Christmas (about 2/3 weeks after my last chemo). At this appointment I met with a Therapeutic Radiographer who explained what was going to happen during the course of Radiotherapy and that they intended on doing a CT scan that day so they could plan where they needed to fire the beam at my boob when I came in for my treatment. We practiced a technique known a "DIBH" (Deep Inspiration Breath Hold) which is used when having radiation to the chest wall to basically move your heart out of the way of been zapped (there is more to it but just keeping it simple). This involves breathing in and holding your breath.
I then went into the planning room which is totally different to a Radiotherapy treatment room as it has the Radiotherapy bed but instead of the radiotherapy machine (which is also commonly called a Linear Accelerator or LINAC for short but this depends on the type of machine and type of Radiotherapy) there was a CT scanner. This is because the aim of this appointment is to get you positioned on the bed in a way that is both reproduceable (they have to be able to get you in that EXACT position every time you go) and comfy enough that you can hold the position for a few minutes at a time.
I distinctly remember stripping off, gowning up and coming out of the curtain and seeing the machine for the 1st time and thinking "How the f*ck am I going to get into that bloody contraption" because honestly it looks like something out of a 50 Shades of Grey film 😂😳(see photos below). There lots of holders, stirrups and angles and I wasn't sure what was going to go where👀🤪. The Radiographers were fab though and soon had me up on it and laid on my back with my arms above my head - it was actually quite comfy for me. Especially the neck rest. Then came some pushing and pulling as the Radiographers lined me up with their lasers and got me in the position that they needed me - this sometimes does take a while but its because they need to be so precise 🤏. If you've not gathered, at this point you are topless too 🍉🍉 and this is something to get used to during radiotherapy. You will be covered when getting on and off the bed but you are uncovered for the lining up and treatment. So loads of people see your boobs 🙈 - more on that later.
This is the radiotherapy bed set up for breast radiotherapy - the planning room would have a CT scanner instead of the machine above which is the LINAC machine. As you can see, lots of holders and slots - I have been reliably informed this is called a breast board and knee support!
This is also the appointment you get your free NHS tattoos. It's not as scary as it sounds either - the radiographer does it by dipping a needle in some ink and marking the specific points that the need to - they'll then use these at you're radiotherapy appointments to line you up with their lasers and make sure you're in the exact same position you were at the scanning appointment (well, within a tolerance of 2-5mm - Thanks for the info Jo at @RadChat!). When asking my lovely TRad source, I was also informed me there is now technology SGRT (Surface Guided Radiation Therapy) at some hospitals that means they don't have to tattoo marks onto patients.
I have 4 dots - 2 on my chest and 1 on each side near my ribs. The most annoying thing is for me is that the 2 chest ones aren't in the exact middle of my chest, they're slightly to the right and it bugs me! I don't mind them that much at the moment though but eventually I may get them removed or made into something else. I've still got surgery and other bits happening there so no point in doing anything yet. I have seen some gorgeous chest tattoos though! 🤩
These are the tattoo's on my chest - you can see they are small in relation to freckles etc and are quite faint.
It's then time to get scanned and one very important thing to remember at this stage is that this scan is not diagnostic - it is purely for radiotherapy planning (for geekoids like me I have been told its done in thicker slices). I only know this as I had a meltdown 😵💫when the scanner paused when I was under it and I convinced myself that I was there that little bit too long and that the Radiographers had seen something that shouldn't be there. Sounds crazy doesn't it but once you've had a Cancer diagnosis, having imaging suddenly can become very scary - this was my first experience of "Scanxiety". I'd also never had any imaging done after been diagnosed with Breast Cancer other than the Mammogram & Ultrasound that picked up my cancer (as I was classed as Stage 1 and they did a Mastectomy so they didn't see a clinical need) so this has always been a little niggle for me. All I could think about was what if they've not found everything cos they've not scanned me? Most days I do not feel anxious about this anymore and I am able to rationalise. I can't live my life thinking like this and wondering "what if?" all the time but I'm not gonna lie I have worried occasionally. I'm sure most people in my situation have and that doesn't mean I'm not been positive either 🌈.
Anyways I'm digressing and getting off topic (standard Kirsty 👍) - after a normal pass through the scanner and once I'd calmed down and the poor Radiographers had lined me back up again 😬 I had another scan but this time, attempting the DIBH technique. HOWEVER... I had managed to pick up a manky chest infection after chemo and this was no longer as easy as it sounds. I could do it sat up but once I was laid on the bed - no chance! This meant they couldn't get a scan of me holding my breath and after many attempts we had to call it a day. I was reassured they could still plan my treatment, just using other methods to shield my heart - which is absolutely fine according to all the literature I've read and advice from TRads I had as I was a bit worried whether I should go back and have another go. I didn't end up going back in the end, I just got on with the excitement of Christmas and forgot all about it. Then caught Covid 🙉🦠
I will continue my adventure of Radiotherapy in another blog post as this one has been rather long 😴 and although Radiography excites me, I understand it may not excite everyone else as much (losers ha).
As I have spoke quite a bit about Therapeutic Radiography, the lovely Jo from @RadChat (Check them out on Insta) kindly read over my blog today to make sure I'd got my facts right as I am in no way as knowledgeable in that area - Thank you!
All my love and radioactivity,
Kirst xx
Useful links
Info on the different Rads https://www.collegeofradiographers.ac.uk/education/radiography-careers
Info on SGRT - https://ro-journal.biomedcentral.com/articles/10.1186/s13014-020-01629-w