Knowing Your Limits

 

Did you know that there is a maximum dose of radiation that has been determined for each human body organ? This is a lifetime limit called the organ tolerance dose because radiation damages the tiny blood vessels inside organs, causing them to progressively narrow and scar — a process called obliterative endarteritis. Over time, normal tissue is replaced by stiff, fibrous scar tissue that has little capacity to function or heal. These changes are largely irreversible (1). So, with few exceptions, radiation therapy is a once-and-done treatment. The image above is of my treatment plan with the different colors representing different levels of radiation being delivered. The red in the center is the highest dose and the blue at the outside the lowest. This means that my scalp received the least amount of radiation, and therefore the lowest side-effects, like skin redness and hair loss. That doesn't mean I didn't experience it at all, but it was limited as much as possible:

 

 The pictures aren't super helpful, but I did get redness above my eyebrows and lost small chunks of hair, primarily on the back of my head near my glasses end. Because the dose was so low, the hair is likely to grow back and the redness is already diminishing. The thing is, the damage to the vascular part of these areas is permanent. What does that mean? I have to be careful about additional radiation to these areas for the rest of my life, and guess what produces a lot of radiation? Yep, the sun. So, from now on, I'm a sunhat girlie. 

 My husband has a few rules when bringing someone hiking with him in the woods. These are critical and he will let you know before departure that breaking the rules will result in you being left behind, on your own, to find your way back. Rule #1? KNOW YOUR LIMITS. This is a healthy boundary he's set in his life, drawing the line between what he is responsible for and what others are. He doesn't want to be responsible for keeping track of you and figuring out if you're ok or not. Do you need to eat? Use the bathroom (or dig a hole in this situation)? Take a break? No, he doesn't want to have to manage that for you. You should be doing it. Do you need something? Speak up! He's happy to oblige and let you lay down on the side of the path and take a nap if needed...

 No one else should be responsible for managing your limits, unless you are in a special circumstance where you are truly unable to. What that means is, you are responsible for it. You cannot expect others to magically know what you need and accommodate you. Staying quiet about what's going on so as not to "complain" doesn't help anyone. If you need to sit down, say so. If you need help finding a seat, ask for it. I spent too many years living in a false understanding of this situation that challenged and compromised so many relationships and never helped me at all. I was taught growing up to "put up and shut up." If you had a problem, that was your problem and you shouldn't bother others with it. The thing is, that's just now how life works! By me keeping my issues to myself I denied others the blessing of helping me. By not sharing my needs, and not having them met, I put myself in a place of lowered capabilities. Things that could have been solved simply became serious issues. Take a very simple example. Say you've got a need for a restroom, but you don't want to "bother" the group by going before you leave. Then, 60 minutes down the road things are getting desperate and now everyone has to detour and find you somewhere to stop. Think how much they would have preferred waiting 5 minutes before leaving - even if they gave you a hard time for it. 

 Just like I need to be aware of my radiation limits, I need to monitor the limits in my daily life. This has become trickier, and more crucial, as I recover from radiation therapy. I find myself being unaware of my limits until I hit that proverbial brick wall. I see the anxiousness in my husband's face each time I do. Have we reached that point? Is he in charge now? No, we're not there yet, but each time I run up against something I didn't see coming steps us just a little closer to that possible eventuality. This week my job was to rest and recover. I was to stay on my steroid dosage from treatment for this one more week and begin to titrate off next week. Somehow, I managed to miss one afternoon dose on Wednesday and Thursday was BAD. Weakness, shaking, pain, disorientation. To say that it makes me nervous for next week when I'm supposed to eliminate this dose every day is an understatement. 

Here's the Thing: My job, my main vocation for the foreseeable future, is knowing my limits. Doing all I can to manage communicating this myself so as not to put the burden of that responsibility on my husband. It seems simple, but to be honest, I'm intimidated by it. Your prayers are appreciated!

(1) BiologyInsights Team. (2025, November 27). Why can’t you have radiation twice? - Biology Insights. Biology Insights. https://biologyinsights.com/why-cant-you-have-radiation-twice/?utm_source=copilot.com