The NeverEnding Journey

Biopsies. Check. Chemo. Check. Follow-up appointments. Check. Surgery. Check...You would think that after all of these appointments and procedures (refer back to the timeline post) I would be done with treatment and ready to resume life.  Not...quite...yet.  Despite hoping and praying that I would not need to do radiation, I was informed that the team of 15 radiation oncologists ALL agree that it is in my best interest to complete 25 rounds of radiation.  The doctors told me that radiation would help to prevent recurrence of cancer (if there are any lingering cells in my breast area or lymph nodes after the surgery) but also discussed the risks and side effects of this aggressive treatment.  So...ultimately...the decision was up to me.  I did my research and decided that I want to do everything in my power to kill the whore ( it is also really difficult to say no to a procedure that so many doctors recommend).  Despite feeling exhausted and worn down I am hoping that all of this treatment will pay off in the end and that I will be able to officially bid farewell to the whore who has consumed the past seven months of my life.

Radiation in Los Angeles is almost like having a full time job.  I have to travel from Santa Monica to Hollywood Monday through Friday for each daily treatment.  Right now my treatment time slot is at 4:30pm which is traffic hell in Los Angeles.  Needless to say, I am spending a lot of time in my car and trying to explore parts of Los Angeles that I have avoided due to the commute.  Radiation treatment is fairly painless and quick.  The side effects should be relatively easy compared to chemo.  If all goes well I will be done on July 18!

It has been a month since my surgery and I am feeling pretty good.  I am getting used to my "foob" (the term that breast cancer survivors use to refer to their reconstructed breast after a mastectomy) and have some discomfort but minimal pain.  My hair is growing back and I have been going out sans scarf!  It is nice to have hair again. 

Surgery

My surgery is scheduled for May 16....which is quickly approaching.  I am not going to lie, I am a little nervous about the procedure and recovery process.  While the surgery means that the cancer will be removed from my body, it also means that my body will be changing...forever.  It is a loss and I don't think it will truly hit me until after the surgery. 

On the other hand, surgery means I am one step closer to being done with the treatment phase and officially becoming a member of the cancer survivor club!  This will symbolize a new beginning.

It has been four weeks since my last chemo and I am still waiting for my body to get back to normal again.  Mainly for my hair to start growing back and to stop having hot flashes.  It has been awesome to not have chemo every other week and I am noticing that I have more energy these days. The day of my surgery will be exactly six months from the day I was diagnosed.  Cray! That seems like so long ago and I am realizing that a lot has happened in six months...I can only wonder where I will be once I hit the one year mark!

Here are some pics from my End of Chemo/31st Birthday Party!!!

Decisions. Decisions. Decisions.

As chemo is coming to an end (I will be done April 6!) I am now faced with new decisions to make regarding surgery.  It is exhausting.  I have met with two plastic surgeons, my breast surgeon, and I will be meeting with the radiation oncologist on Thursday.  Although I am beyond excited to end chemo, the thought of surgery is a little scary and I am feeling pretty overwhelmed with all of my options.  There are pros and cons and "what ifs" to all of my choices and I need to make a decision soon since surgery will occur sometime in May.  I wish there were easy answers but that is not the case and I once again have to trust and rely on myself to make the best decision for me.  Will keep you posted when my decision is made! 

Hello March...

So far, March has been a period of highs and lows for me.  The highs have been seeing some great friends (Kristi, Aggie, and Annie) and the lows have involved feeling tired, sore, and 100% OVER chemo.  While it was great to go back to work in mid February, it was also exhausting and overwhelming.  I originally tried to be superwoman and go back to work for 30 hours a week but my body got pissed at me and it was just too much.  I had to surrender.  So I cut my hours down to 20 hours a week and feel very happy about this decision. 

As Miguel says, I have to respect the chemo.  There are times when I want to be back to normal.  When I start feeling better I try to do things just as I used to.  My body is not the same and the things that I used to do with ease take more energy and leave me pretty exhausted.  If I over do it, I end up having weird and unpleasant side effects.  So I have forced myself to slow down.  It is another test of my patience and it is not easy.   I am counting down the days until chemo is over and can't wait for my body to be medicine free...and for my hair to start growing back.  Surprisingly, time is flying by.  Chemo should be done in three weeks!   I have two more rounds of chemo to go and my last treatment is scheduled for April 6...woo woo!!

March 3 2012. Kristi came to visit and we spent the weekend in Santa Barbara!

Cancer is Everywhere

Is it just me or are more and more people being diagnosed with cancer these days.  Young people.  Maybe it is the same phenomenon as when you break up with someone and then hear their name everywhere you go.  It makes me so mad and sad when I hear about cancer...especially when the whore ends up killing someone.  I found out today that a colleague from graduate school recently lost her battle to brain cancer.  I was really sad to hear this news and it is also scary because it reminds me that the whore is strong.  I also found out today that a therapist in my agency was recently diagnosed with Hodgkin's Lymphoma and is in need of some serious support right now.  I gave her my email address and hope that she reaches out.  It is crazy to think that I can offer her some advice and support and that I have already learned so much since being diagnosed.  A sign that I am well into this battle and hopefully approaching survivor status. 

Hearing about newly diagnosed people or those who have lost their battle makes me want to fight harder and to make sure that I destroy the whore.  Speaking of my whore...she is definitely shrinking!  Chemo #5 went fairly well but my body is starting to get tired of chemo and I think I am taking longer to recuperate.  I am trying to not get overwhelmed at work and pace myself which is working well this week. 

Patience...

I went back to work last week and experienced a whirlwind of emotions.  It was nice to be back at the office and to see my co-workers, but it was also really exhasuting.  I think that I initially expected to go to work and resume right where I left.  Boy was I fooled.  There is no getting around the fact that I am battling cancer at the moment and that things in my life have to be a little different.  I can't be exactly the same person I was before the diagnosis...not right now at least.  Time seems to be passing by quickly but I am still having a hard time being patient. 

As a therapist, it is my job to hold others' emotions, be selfless, and attend to people's needs.  I also have to be mindful that my own emotional experience is not interfering with my work.  I often tell parents that it is imperative to take care of themselves in order to properly care for their children.  I need to practice what I preach.  I need to focus on myself and put my needs before others.  This is hard to do but I am learning.  Cancer punched me in the stomach last week but I am recovering. 

L-O-V-E

Roses are red, violets are blue, not sure if it's the chemo or valentines commercials that are making me feel ewwwww!   I swear I'm not bitter, I'm just not a a huge fan of Valentine's Day.  I was sick of the ugly jewelry and proposal commercials the day they started.  Valentine's Day was so much more fun when I was younger.  I loved making cute valentine holders out of shoe boxes and giving candy and cards to my classmates. 

In honor of the Hallmark holiday, I wanted to take time to thank everyone for all of your love and support.  I feel so grateful to have such positive people in my life!  I truly feel loved.  When I tell people the news about my cancer, the first response is usually, "I am here if you need anything."  It is difficult to identify what I need right now.  I have recently realized that what I do need (which everyone is doing) is the positive energy, thoughts, and love that are coming my way.  Seriously, it is powerful stuff knowing that people are thinking about me, praying for me, and hoping for me.  I appreciate you all! Happy V-Day!

Tales from the Chemo Room

I am halfway done with chemo!! Yay! I start a new medication on 2/24 which is a little anxiety provoking but I will have four rounds of that and then be done!  Time is starting to pass quickly and I am very eager to be finish this phase of the journey.   

This is going to sound crazy but the actual chemo procedure is quite an entertaining and pleasant experience.  This is mainly because the chemo nurses are awesome!  Two of them are my age and we end up having good conversations and lots of laughs.  One had breast cancer when she was 24 so it has been really nice talking to her about her experience.  My dad comes to every chemo session and is becoming quite popular with the nurses.  He is always dressed to the nines in a suit.  It cracks me up.  Annie came with me this time around and got to experience the madness.

Thanks to Jihan, Bridget and Brett for my halfway done gifts!

Loss

I miss my cancer-free life.  The naivete that came with not worrying about my health.  The innocence of thinking that my body is invincible.  Not having to constantly worry about my health.   I have just started feeling this recently.  Probably because my treatment is well under way and everything is more real.  This feeling is better than the fear I had when I was first diagnosed and the six agonizing weeks of waiting for test results and deciding about treatment.

Everyone experiences grief and loss at some point in their lives.  Emotional reactions to grief and loss have been well studied in psychology and the Kubler-Ross model describes five stages of grief.  Individuals progress through the stages differently and the process is not linear, but rather, people might skip a stage, return to a stage, or stay in one stage for a long period of time. These stages can be applied to losing a loved one, family transitions, illness, the end of a relationship, infertility, moving, major life changes, etc. 

I thought it would be fun to map my progression through the stages...

• Denial  This is definitely the first thing I felt as I recall thinking everything was a dream.  I also was in denial about how serious the diagnosis is and about my treatment. 
• Anger  I have not felt extremely angry, I feel that others are feeling my anger for me.  I have had passing thoughts such as "why me" and "this is not fair" which are common.  Come to think of it, I was and am pretty pissed off at the timing of the whole thing.  Granted there is no perfect time to have cancer but I am pissed at the bitch for slowing me down right now.  I call her a whore sometimes.  Okay, maybe I do feel a little angry.
• Bargaining/Negotiation  This seems to be happening mostly with treatment and the "I will not do" list that I created when trying to take control of my treatment.  
• Depression  This is where I am right now.  I am missing my old life and feeling sad about things that I cannot do at this moment.  I am worried that cancer will ALWAYS be a part of my life.  
• Acceptance  I have dipped my toes in this stage and cannot wait until my whole body is immersed.  I am slowly starting to embrace my new life and accepting that this is happening to me for a reason.  I am already feeling like a less anxious and more confident person. Blogging helps me stay in this stage! 

Cancer's a Bitch!

A few things I miss since starting chemo...

manicures, happy hour, not being a germ-a-phob, diet coke, having a normal sense of smell, my hair, vanilla lattes, sushi, not being tired all of the time, a normal schedule...

Things that I have gained since starting chemo...

A sense of control over the cancer, knowing that I am doing something to kick cancer's ass, relaxing and napping whenever I please, being able to eat all the pinkberry I want...

I have a feeling that undergoing chemotherapy is a lot like being pregnant.  I have a very sensitive sense of smell, some bouts of nausea, fatigue, and many dietary restrictions.  I should avoid alcohol and caffeine and I can't eat raw foods.

Third round of chemo is going pretty well so far!  I have an appetite and am feeling pretty tired but good.  Three down...five more to go!

Life of a Cat

For the first time in at least seven years I am doing nothing.  I am currently taking a break from work and enjoying the calmness and stress-free nature of having minimal obligations.  I am spending my time catching up on movies, hanging out with my parents, cooking a little more, walking, and doing some yoga.  The days still go by pretty fast.   Sometimes I feel guilty for taking this break or worry that I am not advancing my career.   I feel that my choice does have some healing power as I am handling chemo pretty well (so far I have only had one really sick and miserable day) and able to rest when I feel tired. 

I recently started reading a great book, Crazy Sexy Cancer Tips, written by Kris Carr who is a cancer survivor.  The book is extremely positive and includes bios and experiences of many young, successful, and beautiful female cancer survivors.  It helps me to remember that I am not alone.  There is an entire chapter devoted to using the "Cancer Card".  The book describes the Cancer Card as follows: "It's an I'm-human card, and like it or not you can't do it all; every now and then you need a treat."  Basically, it is a way to soak up the benefits of having cancer.  For me, I think that is taking a well needed break from work and letting myself enjoy doing nothing!

This Shit's Cray!

Usually when I am driving, walking, or letting my mind wander, I think how crazy it is that I have breast cancer.  Statistically, I am an anomoly.  I think there is less than a 5% chance that women in their 30's will develop breast cancer...but it happens.  My life has changed pretty rapidly and it feels like everything right now is cancer related.  I have to adjust my schedule to chemo, focus on the present, and change my priorities.   I am flexible and adjusting to this change pretty well but it is annoying and surreal at times.  It is so interesting how my focus and mindset has changed in a matter of minutes and made me realize what is truly important in life.  I hope know that this is temporary and that I need to be patient...but it's cray!

Chemo-Sabe

1. kemosabe   friend *Definition from Urban Dictionary   Many people refer to chemotherapy as poison or toxic...I prefer a more positive take on the medicine that is aggressively killing my cancer cells.  I am 1/4 done with chemo!  My second round of chemo was pretty similar to the first round.  I was a little tired and out of it and my body felt sore.  It was not too bad and I am hoping that this is how my body will keep responding! As promised, my hair started falling out about 14 days after my first round of chemo.  It was coming out in clumps and something had to be done.  Luckily, Bridget was in town visiting and Miguel is awesome with a razor.  Miguel shaved my head on Saturday evening and he and Bridget were amazing and supportive.  It feels pretty crazy to have no hair.  Overall, the experience was not too traumatic but I do notice that I don't really want to leave the house today.  We had some fun during the buzz...     Here is my new day look... *A pic of my bald head is to follow...

Along for the Ride!

When I first learned that I had breast cancer I created a list of things that I was certain that I did not want to do (chemotherapy was #1 on that list).  I wanted to have some control and the treatment aspect was very scary.  I am starting to realize the importance of not having many expectations and plans about my treatment because things change very rapidly and many times I have to trust what the doctors tell me.  It really feels like I am on a roller coaster...turning, twisting, and tossing...not really knowing where I am going next.  BUT I am strapped in...I am in good hands...and I feel safe.  I trust my doctors and my body and want to be aggressive and efficient at fighting this shit!

Last week was a pretty busy week in cancer treatment land.  On Wednesday, I had my port surgically implanted in my chest so that I do not have to have an IV started every time I do chemo and to protect my veins.  This was my first experience with surgery and it was very scary.  The nurses were really nice though and I was given some Versed (a drug that sort of paralyzes you and erases any anxiety or fear you may have) and the process in itself was actually pretty easy and painless.  My sisters were there so that was also nice and comforting!  Later that day at lunch, I got a phone call about the biopsies I had the week prior.  Got some bad news and good news...the good news is that my right breast is cancer free!  The bad news is that my left breast has two other small cancer tumors in it.  This was a WTF moment and I am glad that my sisters were with me.  I met with my oncologist on Thursday and he reassured me that the chemo is working and that my tumor is shrinking!!! He also told me that my left breast is faulty (I laughed) and that the additional tumors will not effect my prognosis but that I will likely now need a mastectomy to get rid of the faulty boob.  This was another item on the "I do not want to do" list!  Hence the importance of going along for the ride...   

Alternative Medicine

I have never really used meditation or imagery but I have heard about the benefits of these practices and often integrate them into my therapy with adults and teenagers.  I have been known to over think things and worry and I have always wanted to do yoga so that I could have a space to get out of my head and relax.  Lately I have been reading about the benefits of using alternative/unconventional practices to complement my cancer treatment. There is some research on the benefits of meditation and yoga and evidence that these techniques can reduce anxiety and improve physical and mental strength while battling cancer.  

One of the most frustrating aspects of having cancer is how powerless I feel with regards to my medical treatment.  I was able to choose my initial treatment plan but there are many things that I have to do.   I am starting to realize that the one part of treatment that I can control is the mental aspect.  Staying positive, laughing, spending time with my loved ones, and doing things that I enjoy are crucial right now.  I know all too well that stress takes a toll on the body, compromises the immune system, and is linked to many health problems.  My thought is to feel as little stress as possible right now and to focus on fighting winning this battle.  I use positive thoughts and sayings when I am upset or anxious about something or to help me fall asleep at night.  At my first chemo treatment, my younger sister and I took time to visualize the tumor shrinking as the drugs were entering my body and I am going to do this at every chemo session.  I am also trying to do one enjoyable activity every day.  Today I saw some of my college friends at a baby shower.  I am going to go to a yoga class on Monday!

This is something I say to myself often...usually before a scary medical procedure. 


And in my less zen moments...

Leap of Faith

My major dilemma about doing chemo period is the issue of fertility.  Chemotherapy kills many active cells and could stop ovulation during treatment and/or damage eggs.  Thankfully, I am young and my period should return...but it is still an issue I had have to deal with.  After a daunting and exhausting mental debate and tons of research, I decided that right now I want to focus on beating the shit out of cancer.  I feel that doing chemo first is the best way to do this.  Harvesting eggs is an extra procedure I do not want to deal with right now and I really do not need any excess hormones entering my body at the moment as my tumor is fueled by progesterone and estrogen.  I am very happy with my decision.  This is something I wrote before going to my appointment with a fertility specialist.

12.9.11

Will I be infertile?  At thirty, I am prematurely faced with this question...something I think I have subconsciously feared.  Mainly because I have always wanted children.  As a child, I loved playing with dolls and pretending to be a mom.  At age nine, I helped my aunt take care of my younger cousins any chance that I could.  Then I grew up and went to college and graduate school and chose to put nesting on hold so that I could focus on my education and career.  After this long and winding road, parenthood still does not quite fit into my life (with or without a cancer diagnosis) right now and I figured I would be ready to start having children at age thirty-four or thirty-five.   

But now I am forced to think about my fertility and future.  The very first thought I had when I learned about my cancer diagnosis was, "will I ever be able to have a baby?"  It is a question that still bothers me at times.  It is an unknown.  There is a chance that chemotherapy can leave me infertile.  I have the choice to harvest my eggs or an embryo.  I am confused and scared and faced with a new question..."Do I rely on science to save my fertility or do I take a leap of faith?" 

I am drawn towards taking a leap of faith, relying on chance, and hoping that things will work out and that I will one day be able to have my own children.  With this decision, I have to also be willing to accept that I could be infertile.  The bottom line is that I will be more than willing to explore alternative family options if needed.  What I do know for certain is that I will have children one day. 

In a twisted way, I feel like having cancer right now is some type of fate.  Whether that be to change my perspective on life, to adjust my priorities, to be more self confident, to be more present, to be more happy and complete, to be more healthy...I do not know yet.  I do know that it is forcing me to think about what is best for me and to trust myself.  It is changing my priorities.  It is making me realize how incredibly lucky I am to have such amazing friends and family and a wonderful boyfriend.  I have also learned how unbelievably important it is to have support and love in my life and the benefits of worrying less and thinking positive!   

Timeline

Lately I have been calling Kaiser West Los Angeles my second home because it feels like I am there all of the time.  It is pretty insane.  Here is a snap shot of my medical treatment that started in October 2011 and keeps going...and going...and going...

• Beginning of October--I felt a lump in my left breast that felt pretty big and decided to call Kaiser and get it checked out.
• 10.12.11--Met with a breast specialist (surgeon) who was pretty convinced that my lump was due to hormone changes.  She suggested an ultrasound to stay on the safe side.
• 11.4.11--Ultrasound of my left breast.  After the ultrasound a radiologist told me that they found two masses that "look suspicious" and stated that I needed to have a biopsy.  
• 11.14.11--Biopsy of two masses in my left breast.
• 11.17.11--Radiologist calls to tell me that one of the masses is cancer.  States that I have Invasive Ductal Carcinoma (the most common form of breast cancer). 
• 11.23.11--Met with a surgeon who gave me a run down on my diagnosis and the treatment options.  Find out that my tumor is about 4 cm and that it is too big to do a lumpectomy without deforming my boob.  Suggests that I do chemo first to shrink the tumor.  Refers me to an oncologist and orders a bunch of tests.  
• 11.25.11--CT scan of my chest and pelvis to make sure that there are no other masses any where in my body (there weren't...thank god!)
• 11.28.11--Bone scan to make sure that there is no cancer in my bones (that was negative as well!)
• 12.5.11--Appointment with oncologist #1--she was a nightmare and basically looked like she was going to cry the entire appointment due to my young age and pretty hair and did not give me any information.  She recommended that I do a mastectomy and harvest my eggs or an embryo due to the fact that I was concerned about the effects of chemo on my fertility.  This was very confusing and raised a whole lot of questions.  I asked for a second opinion.
• 12.6.11--Took and passed my last licensing exam (had to throw that in there!)
• 12.7.11--Genetic testing to make sure that I do not have the gene for breast cancer (I don't!)
• 12.9.11--Appointment with a fertility specialist--very difficult appointment and I will post about this later.
• 12.12.11--Appointment with the Breast Coordinator to learn about resources, see pictures of mastectomies and lumpectomies, and find out about different options for managing hair loss.
• 12.16.11--Appointment with oncologist #2--he is awesome and at this point I had made up my mind to do chemo first.  He was extremely informative and thorough.  
• 12.21.11--MRI of both breasts...very uncomfortable procedure.
• 12.22.11--Met with a chemo nurse to have "chemo class" where I learned about the medication I would be given and tips for managing side effects...scary...
• 12.22.11--Had an appointment for a Muga scan (basically a heart scan)...I fainted at the appointment due to not eating, feeling overwhelmed, and because the nurse could not find my vein.  Appointment was moved to the next day.
• 12.23.11--Muga scan take two...success!
• 12.28.11--Chemo #1 (of 8)...not too bad...will post more later.  
• 1.5.12--Ultrasound #2 due to some findings from the MRI (Deja-vu)
• 1.6.12--Biopsy #2 (they have to biopsy five different things...WTF?????)  Hopefully they are benign.  The radiologist told me that they look normal but that they want to be thorough and certain.
• 1.11.12--Will have a port surgically placed in my chest for the remainder of my chemotherapy treatments.  It is an outpatient procedure.
• 1.13.12--Chemo #2 
• 1.13.12--Bridget visits!
• 1.21.12--Pauline Visits!
• 1.27.12--Chemo #3
• 2.10.12--Chemo #4
• 2.10.12--Annie Visits!
• 2.14.12--Back to work...
• 2.24.12--Chemo #5
•  3.2.12--Kristi in CA and Santa Barbara weekend getaway!
• 3.9.12--Chemo #6
• 3.23.12--Chemo #7
• 4.6.12--LAST CHEMO!!!!!!!!!!!!
• 5.4.12--Sentinel node biopsy and removal of my port (an outpatient surgery).
• 5.16.12--Mastectomy of my left breast with immediate reconstruction
• 5.31.12--Consult with second radiation oncologist
• 6.5.12 & 6.11.12--Planning sessions for radiation
• 6.13.12-7.18.12--25 rounds of radiation  

Take home message: Do monthly self breast exams. If you feel something or if your boob looks different...get it checked out!!

Why Now?

For the past year or so I have been thinking about starting a blog so that I could have a space to document my thoughts and ideas.  When I turned thirty I had the idea of starting a blog called "Thirty Something" because I liked the name and wanted to chronicle the new decade.  As with most things, I procrastinated.  Then on November 17, 2011, I was diagnosed with breast cancer at the ripe age of thirty.  I figured this would be a good time to start a blog so that I could share my thoughts, feelings, and medical updates with friends and family.  So...here I go...