The Treatment

Three down, nine to go in this current chemo regimen, and I am successful most days at taking one day at a time.  Chemotherapy is the third step of this cancer journey with more to come.  In scanning my past blog posts, I realized I had not shared the complete "treatment" picture with you yet... so, for those of you interested, here it goes:


Step 1:  The Diagnosis - 4 words: "get your routine screenings".  It is so important!  And what's a little discomfort for a few seconds to increase your probability of catching cancer early when it's still treatable?  Had it not been for my routine mammogram, my cancer would have quickly spread through my lymphatic system to other organs.  


Step 2:  The Surgery - For some people this is a lumpectomy, a removal of the cancerous tumor and surrounding tissue.  I opted for the double (bi-lateral) mastectomy early on, and later found that based on both the outcome of the surgery and the genetic test results, a double mastectomy was inevitable.  Along with the surgery comes the lymph node removal and biopsy, a critical step in identifying whether the cancer has likely spread, and to what degree.  It's not fail proof, but testing the lymph nodes gives a good indication.  For me, cancer had spread to 1 lymph node, and only in a small way; while not "perfect" this is good news.


Step 3:  The Chemotherapy.  Phase 1 is the administration of 2 drugs (adriamycin and cyctoxan) which work together to kill off any cells that are replicating quickly:  cancer cells, hair follicles, white blood cells.  These are the drugs that give breast cancer chemo it's bad reputation, as the side effects can be severe.  Thank goodness for new anti-nausea drugs.  Phase 2 swaps the 2 drugs for 1 (taxol), which attacks the bone marrow and temporarily shuts down the production of new blood cells in hopes of killing off any cancer cells that may have eluded the 1st round. This is my current phase.     


Step 4:  The PET Scan.  When the chemo is done, a PET scan is done of the body from head to toe to see if any signs of cancer remain.  Breast cancer typically goes from the breast to the brain or the reproductive organs.  A PET scan is what gives us the "all clear".  Limited lymph node involvement gives us reason to be very hopeful as to the outcome of my future PET scan. 


Step 5:  The Prescription.  For women who's cancer feeds off of estrogen pills are prescribed that will block the normal production of hormones.  Different drugs are given based on whether "at risk" reproductive organs will be removed or remain.  Having tested positive for the breast cancer gene, mine will be removed, which takes us to...


Step 6:  The 2nd Surgery.  There are currently no reliable screenings for ovarian or uterine cancer, so removal of these organs is an important step in reducing the risk of cancer reoccurrence with women who test positive for the breast cancer gene. Once the PET scan provides the "all clear", surgery is scheduled for a full hysterectomy.  Chemotherapy typically shuts down the normal reproductive process, essentially throwing you into a chemically induced menopause; the surgery takes care of the rest.  


Step 7: The Reconstruction.  After a period of healing, breast reconstruction can be scheduled.  Reconstruction requires 3 separate surgeries, separated by a period of healing.    Each surgery becomes less invasive and has a shorter healing period.  


Step 8:  The Recheck.  Once cancer free, there are regularly scheduled rechecks scheduled to make sure you remain cancer free.  This is a life-long process.    


And that, in a rather large nutshell, is the treatment.  So we take one day at a time, and try to focus on the process at hand and not what may or may not occur in the future.  


Live for today, learn from the past, have faith in the future.  
















  

Changing my stripes

Over the years I've had multiple signs, one might even say flashing neon signs, that there were things in my life that needed to change.  When I had health issues nearly 10 years ago, I knew I needed to find more balance in my life, and less stress - or at least better ways of coping with the stress.  After a lengthy hospitalization then, I took time to refocus on the things that were really priorities in my life.  I found a job that would give me better balance between work and home.  I began exercising again.  I let more of the little things bounce off me, and I silently pitied those people that were still getting wound up over the traffic jams, lines at the grocery store or normal mistakes that were made in the course of daily life.  At least for a while.


It didn't take long for me to side back into old patterns.  Somethings stayed - the balance between work and home has been pretty consistent, thanks to some amazing people at work who have been incredibly supportive of my goals.  But somethings slid away - and somethings never really changed.  Habits, especially those that define who we are, are really tough to break.  


In my last post I wrote about independence, and I've known for years I needed to learn to be a little less stubbornly independent, and learn to ask for help, or even just accept it when it was offered; but it seemed each time the opportunity presented itself, I just couldn't change my stripes.


I've known for years I needed to start getting daily exercise, for my physical and mental health.  Each minor ailment that came up over the years was like an additional bulb on the flashing neon sign that said "Start Exercising!"  But I didn't.  


Eat healthier - I mean really, how many food allergies can one person get before they get the message.  Here I had no choice, but should my body have had to wage all out war before I got the message?


And the topper of them all - relinquish control.  


Part of being stubbornly independent is trying to maintain control. Intellectually, I know that control is simply a mirage, a figment of my imagination.  But still, I needed to hang on to the notion that somehow, if only I maintained control, I could manage the outcome of the situation I was in.  Control my actions, control my emotions, control the flow of information, and control the plan.  Ah, yes, "the plan".  


A big part of being "in control" is having a plan, a plan for everything and every contingency that might come up.  Some things are serious (what if my Dad gets sick and I can't be there for him?); but many are superfluous (what are all the routes to work, in case I run into traffic).  Analyzing the situation and having a plan for what to do, no matter how serious or how small the situation, somehow fools me into believing I have the maximum level of control on the outcome.  But the reality is all that analyzing and planning is exhausting, and stressful, and doesn't result in any more control over the situation at all.   But it's part of my stripes, and stripes are hard to change.


Our boldest stripes, our best traits, are those that we build to become the people we want to be, but they often become our greatest achilles heals when we over shoot the goal.  In work and personal life, I've leaned heavily on the ability to analyze situations and find solutions.  The challenge for me is learning to identify and hang on to the positive aspects of how these stripes define who I am and who I want to be, while relinquishing the negative behaviors that cause stress, strain relationships and affect my overall well-being.  The goal is not to become someone new, but to become a better, more balanced version of me, the one I was created to be and the one I can hold onto for all the years to come.    


Balancing.


Balancing being an independent and unique individual with being part of a community of people that depend and support each other.


Balancing being an introvert who recharges by "going within" with getting daily exercise.


Balancing the love of a good chocolate souffle with eating healthy.


Balancing the impulse to analyze every situation with letting go and living, not planning, life.


Balancing being true to myself while changing my stripes.

Learning to lean

If you know me well, or maybe even just a little, you know that I am staunchly independent, even, sadly, proudly independent.  I don't like to ask for help, it makes me feel like I am imposing on someone else, and while I know they have the option to decline, I also feel like human nature is such that most people won't decline a flat out request for help from someone they know.  So I try not to ask.  

But you can't fight cancer with a one person army.

From the beginning, my daughter and I were in this together.  I knew every decision made would affect her as profoundly as it would affect me.  So, she was there to hear the options from the doctor, to receive all the information I received and to have a voice in the decisions made.  She turned 18 before my first surgery and with that took over my medical power of attorney; should I be unable to make my own medical decision it became hers to make.  And she has been amazing, through complication after complication she's stayed strong and wise beyond her years.  

But she needed to be at school, and I needed someone with me as I struggled to adjust to the treatment and medications.  So she asked for help, and it came flooding in.  "Guardian Angels"  - friends and family who rotated help when my daughter wasn't able to be there.   

As chemo continued, I took over the task of asking for help.  I put together a schedule and I sent out a request to friends and family.  But with each request, I lost a piece of myself and my confidence in my ability to be independent.  And with each complication that arose, the need for help increased, the fear rose higher, and anxiety kicked in.  I was at home, but needing someone there most days when my daughter wasn't there.  Someone to be there just in case; in case there was another drug reaction, in case there were new side effects from the chemo, in case i had a migraine episode - scary little "seizure-like" events that were coming almost daily.

Then came the hospitalization, 9 days, followed closely by 3 more spent in the hospital.  When it was time to go home we were faced with a decision on whether or not I was ready to be back home by myself.    I wanted so badly to be home, to be independent, to make everything go back to how it was before the complications and hospitalizations, even if I couldn't make it go back to how it was before cancer.  But down deep I knew it wasn't time.

I needed to focus on getting my strength back, on getting strong enough to start my next phase of chemo.  To focus on healing.  

And I was finally was able to accept that I needed help; and that help needed to come from somewhere other than my daughter's shoulders, so she could be my daughter and not my caregiver.   

Funny thing, in acknowledging that I needed help, in accepting that help and in moving forward knowing that it takes more than an army of one to fight cancer, I found that I had the strength of mind and body and spirit to become more independent.   I'm learning to lean on others without letting it diminish my sense of self or independence.  I'm learning that there is a strength in community that increases strength of self.  I'm learning that fear and anxiety might come from within, but can be battled from without, with the help of friends.  

I have a long way to go, but I'm learning, and for once in my life I'm willing to envision a life where I'm not so independent, and it doesn't scare me as much as it used to.

The time will come when it's my turn to be someone someone else can lean on, but for now, I'm learning to lean.