Getting through it all

I've decided that cancer doesn’t change who you are, rather it confirms who you are. How I react in a crisis, how I make decisions, who I turn to for support—these are part of the essence of who I am. The core values that were important to me before my diagnosis are what help me deal with it now. Some people are truly changed by the experience, but what if I find that when I resume my life, I just want to celebrate the person I've always been, and still am? Would that be so wrong? After the initial shock, I found myself dealing with breast cancer in the same way I deal with every major challenge in my life. I get through it with a little denial, a lot of humor, and with the confidence to trust that, guided by my medical team, I will make the right decisions. I am still half expecting, based on media portrayals of the experience, that it will reveal an epiphany about my life. But I have yet to have an extreme spiritual makeover. What if the only growth I had was the one removed by my surgeon?

It hasn't been so much about "attitude" as just trying to get through it because there really isn't any other choice. Going through cancer treatment isn't because you have a choice, you do cancer treatments - you live or you take a chance on not living long. To me, it isn't a choice, its a given; you just do it. There are so many days that I have a “bad attitude” about my cancer treatments – chemotherapy does not play nice, and I don’t care what kind of attitude you have, it is no fun, and all the good attitude in the world isn’t going to change it!

So how do I get through this?

• My sense of humor, which I think becomes more twisted as I continue on this journey.
• I let myself have a “bad attitude about chemotherapy.” I've accepted it but I try not to let it rule me. I am A-OK with my bad attitude.
• I've accepted my tears and my pain; unfortunately it comes with territory.
• I try not to judge myself by how others deal with cancer and its treatments. One thing that I have learned when it comes to cancer and its treatments, is that it affects everyone differently… There is no one-size fits all in cancer, so you have to blaze your own trail to follow.
• I've accepted the fact I have to go through cancer treatments, and try not to spend my time asking “why me?” Cancer is an equal opportunist.
• I don’t beat myself up – chemo does a damn fine job on its own and doesn’t need my help.

I have been so lucky to have so many good friends in my life. Each of my friends has made my life so much richer, and I love the magic, the beauty, and the laughter they bring to my life! It has been so hard for me to share with my friends that I had cancer. I had planned to do this cancer journey by myself, but you know what? It has been impossible to do so. I find it so hard to ask for help. Cancer is teaching me to ask for help, and accept it… It still is not easy, and I still want to pull away from everyone, but my friends will not let me, and for that I am grateful. I just may learn that it is ok for me to let others take care of me and ask for help yet.

A special shout out to my friend Dana who made me her famous cinnamon roles and brought them by all because I said chemo causes me to crave "sweets". She barely got out the door before I attacked them! They were utterly delicious! Thanks, Dana!

I want to be happy with just being...

I hate feeling so wiped out because its hard to even think sometimes. But when I do, I go round and round with my thoughts. I have been wondering if other women felt or thought any “different” because of their cancer treatments. I have been thinking about this a lot – about what I really want? Am I different? What are my priorities now? What do I really want? Yes, I think I am different. I am no longer interested in being a workaholic, I am no longer interested in being busy from the time I open my eyes until I close them at night… I am not interested in doing things that don’t make me happy. I am not interested in anything that doesn’t make me smile, nor am I interested in anything that causes pain… Chemotherapy has caused such pain in me that I just don’t want to be around anything that causes pain… I’ve had enough of pain. Chemotherapy has also caused a lot of anger and frustration with my life… Some of this is from the side effects of chemo. Chemo messed with my head. I had cancer treatment, not cancer.

Frustration comes from acting as if everything is ok when its not. Frustrated because many times I don't want to get out of bed. Frustrated because I am so used to being the "strong" one, and chemo makes me weak...but I keep acting like I'm "strong" because I can't seem to show my feelings about my cancer and cancer treatments outside of those especially close to me. There's no one to blame but myself. Being strong has gotten me through many a tough spot, but this is really scary and I just can't seem to share that with anyone. Chemo seems to take your fears, your frustrations and magnifies them.

Chemotherapy has been one of the toughest things that I have ever done in my life, and not one I would even wish upon my worst enemy. I am tough and I will make it. After going through all of this, I know I will do something, I'm just not sure what...I do know that I will not be content in just "surviving". I want to be creative, I want to listen, I want to laugh, I want to enjoy each day, I want to be grateful for what I have. I want to be happy with just being…

I was an inspiration!

I am really fatigued today. I took Hannah to the drugstore, McDonald's (for breakfast) and to school this morning before stopping by the bank. And that was all she wrote! I was exhausted after that. I took a 3 hour nap this afternoon! Chemo hits me faster and harder these days and the low magnesium level certainly doesn't help!

I did have a really neat thing happen yesterday in the waiting room at the clinic. I had my labs and was waiting to see the doctor to be ok'd for chemo. While waiting, another chemo patient came in for her shot. She was an older woman, having a good 20-30 years on me. I didn't catch her name but she came in and sat down in the chair next to me. She took one look at me and pulled her hat off. She had almost as much hair as I do. She said that if I could be comfortable putting it out there so could she! We then discussed our feelings about losing our hair. When it was time for her shot, the nurse exclaimed that she didn't recognize her without her hat. She told the nurse to get used to it as she now plans to remove her hat whenever she comes in. It made me feel really good to have inspired her to be comfortable with her new, albeit temporary, hairdo.

In the case of cancer, patients change drastically during the different phases of diagnosis, treatment and post treatment. Cancer itself often causes little if any pain, especially in the early stages. But treatment can make people dog sick and bone tired; chemotherapy makes some people feel like they have eaten some bad sushi or been KO'd the H1N1 virus. After completing treatment, many patients report feeling heady with freedom and gratitude one day but unable to climb out from between the safety of their sheets the next. Without a doubt, the hardest part of having cancer for me is going through the treatments.

Having cancer is hard enough by itself partly because it's always on your mind. Every time I watch TV or read a magazine or newspaper, there it is -- someone was diagnosed with cancer on a TV show, or there is a new study linking cancer risks with yet another common food or activity, or even worse, the news reports that some famous person has died from cancer. It is EVERYWHERE! Maybe I just didn't pay attention to it before I was diagnosed, but it has gotten to the point that I would actually be surprised to make it through an hour without being reminded of my cancer.

Chemo Round #5

God Bless Christie Clinic's Wi-Fi! I am actually writing this blog as I sit in the La-Z-Boy recliner being infused with the cancer-fighting drugs. I keep getting yelled at by the nurses because every time I move wrong, it causes my infusion machine to malfunction! I stopped counting after 5, which was early on into this infusion! LOL. I just have to be my usual pain-in-the-ass self! Good thing I often bring my homemade caramels to bribe them! I need to say special thanks to Hannah (who got out of her migraine "sick bed") and Bert for bringing me one of my new favorite salads (Pasta & Chicken Caesar) from Fazoli's; Tara for providing me with the G2 powder packs to add to my water; and my friend Camille for stopping up to say "Hi" and visit for a few minutes while she was here in the clinic. Thanks my wonderful women friends (& family).

Sitting here I was reading an interesting article out of Living With Cancer magazine about "Survivorship Medicine". I thought I'd write about it now so I didn't have to steal the magazine but I see more than one so I'll just go ahead and "lift" this one! Don't tell on me now! Survivorship medicine is a new and growing field. It is practiced by healthcare professionals whose job it is to help cancer patients after treatment so that they're prepared to do everything medically necessary to prevent a recurrence and maximize their overall health. Survivorship medicine also concerns itself with emotional and psychological problems survivors can encounter, as well as with their nutrition, exercise, stress and sexual health. After treatment, all cancer patients (call us survivors, please) need survivorship care planning, beginning with a summary of the treatment they have had that spells out what can happen next. What medical risks could you face as a result of your treatment? What special tests will you need to make sure that other aspects of your health haven't been compromised by the treatment you've had? All I can say is "It's about damn time!" Almost everything that I've read from survivors is how abandoned they felt once treatment ended since they no longer had the support of the medical staff or the other chemo patients.

Dr. Michael L. Krychman, MD, who specializes in survivorship medicine at Hoag Memorial Hospital Presbyterian in Newport Beach, California says that the biggest challenge for a survivor is how a cancer diagnosis impacts their relationships and the way they interact with the people close to them. After diagnosis, you are a different person. He notes that eventually you may be able to take control, become stronger and more powerful than you were before (Oh, I like the sound of that! Look out my peons-you just might not like the new "Tami"). LOL, just kidding! He also warns that you still have to cope with the emotional reactions of the other people in your life, such as anger, fear, frustration, depression, and feelings of helplessness. (I say, "Hell, I'm not your counselor!"). You can help them by doing normal things together and help yourself by expressing your feelings of hurt when some friends back away because of their own fears and failings. (You certainly find out who your friends are!). Wow, reading back over this makes me think I must have taken a double-dose of smart-ass pills this morning!

Do Breast Self Exams Save Lives?

For all of you who were looking for an entry last night, I apologize. I got home very late and the internet was down. After spending a 1/2 hour trying to reset it, I gave up and went to bed. Last night the local chapter of the Young Survival Coalition met. To be with such a group of strong, empowering women is inspiring. Some are like me and currently in treatment, some are dealing with a cancer recurrence, while others have passed their 5 year survival mark. We were discussing "anniversary" milestones like the anniversary of diagnosis, anniversary of the end of treatment and the anniversary of being cancer-free. It's important to celebrate such milestones as time is all we really have. So acknowledging the "anniversaries" is the "in your face" that death deserves!

Amazingly, most of these women discovered their cancer through a self-breast exam and most are much younger than the mammography baseline age guideline. Sadly, the validity of performing monthly breast self-exams to find cancerous tumors early enough to improve survival rates is continually brought into question. Two population-based studies compared breast self-exams with no intervention and found that self-exams didn’t reduce a woman’s chance of dying from breast cancer. In fact, says the review, it may do more harm than good by increasing the number of unnecessary biopsies performed and the level of emotional stress women experience when they find benign lumps. To that I say, "BULLSHIT"! Many of those I hang out with at group may very well have succumbed to breast cancer had it not been for them detecting their cancer. Do we not deserve to have every lump checked regardless of how many benign lumps may be discovered? HELL YES!

The American Cancer Society guidelines state that women should understand the benefits and limitations of breast self-exams, and be more aware of how their breasts normally look and feel and consult with their physician if they notice changes. But other medical experts disagree. “Right now, we have the doctor’s examination, mammography, and a woman’s self-exam. I object to abandoning the one that is the most convenient and least costly,” says Marisa Weiss, MD, director of breast radiation oncology at Lankenau Hospital in Wynnewood, Pennsylvania, and founder of Breastcancer.org. “And the other consideration is that many women don’t have access to medical care, to mammography, and about 20 percent of breast cancers are detected by physical exam alone. So if you tell women not to do a breast self-exam then you’re missing the opportunity for them to have the earliest form of detection in their setting.” RIGHT ON, SISTER!

The Good, the Bad and the Ugly

Shortly after my partial mastectomy, I remember reading survivor stories where breast cancer survivors would state, “Breast cancer was the best thing that happened to me.” This statement truly perplexed me. Here I was, 46 years old, having just lost a breast to cancer. For the life of me I could not fathom that the hell I found myself forced into would ever be a good thing. Was I was missing something? What was wrong with me that I couldn't believe this? I was angry at the world, life, and my own body for letting me down. I did not want to believe that anything good could arise from having breast cancer because in doing so meant I accepted it. Life consisted of a fog of powerful emotions ranging from grief and anxiety to terror and rage. I just wanted to go back to my pre-cancer life and pick up where my life left off before I had breast cancer. But I wasn’t the same person, so how could I expect my life to pick up again where it left off? So who was I now? Such questions I still ponder. I now realize that acceptance of breast cancer does not mean I like it or agree with it, but that I have come to terms with the fact that yes, this has happened to me. I need to fit it into my life somehow. I can only hope that good things can come from bad experiences.

I am not about to suggest that cancer or other life-threatening illnesses are gifts, rather I think that they provide opportunities and insights you would not normally have. There are advantages to having blinders for every day life--the fantasy that keeps awareness of our mortality at bay, ripped away by a cancer diagnosis. Everyone goes down life's path toward death. Some arrive there sooner than others. Some live better lives because they recognize the limitations that life brings. Cancer can provide people with the opportunity to reflect on the meaning of their lives, to renew their commitments, to grow in ways never expected and to have time to repair relationships.

I've realized that many of the big things in life are out of my control. I may not be able to prevent my agency from closing in the future or cancer from striking, but I can control my responses to such events. And there are many little things in life I can control: taking time with my loved ones, watching the passing clouds on a warm summer day, or going to my daughter's track meet. I can embrace small pleasures, pace myself and not "sweat the small stuff.” I can find humor wherever possible. No point in living, no matter how long, if I can’t find laughter and joy in every day.

Lifestyle Factors Increase Risk of Second Breast Cancer

As you may know, I'm concerned about the recurrence of breast cancer in my right breast. I've often referred to diet and lifestyle in this blog, wondering if there is a connection to cancer. I did discover information about recurrence and lifestyle. According to results published in the Journal of Clinical Oncology, obesity, alcohol consumption and smoking significantly increase the risk of second breast cancers among breast cancer survivors. Approximately 200,000 women are diagnosed with breast cancer every year in the United States alone. Treatment for the disease has improved, and five-year survival rates are now greater than 90%; however, survivors have a significantly increased risk of developing a second breast cancer in the opposite breast. (I knew they should have removed the other one, too!)

Researchers conducted a study that involved 365 women who were diagnosed with an estrogen receptor-positive (ER-positive) first primary breast cancer and then later diagnosed with a second primary breast cancer. These women were were compared with 726 matched controls who were diagnosed with only an ER-positive primary breast cancer. The researchers reviewed medical records and conducted patient interviews to ascertain data on obesity, alcohol consumption, and smoking. The results indicated that women who were considered obese (body mass index [BMI] over 30 kg/m2) were 50% more likely to develop a second breast cancer than women who had a BMI lower that 25 kg/m2. Furthermore, women who consumed more than 7 drinks per week after their first breast cancer diagnosis had a 70% higher risk of developing a second breast cancer compared with nondrinkers. Finally, women who smoked were more than twice as likely to develop a second breast cancer compared with nonsmokers.

The researchers concluded that lifestyle factors such as obesity, smoking, and drinking could significantly increase the risk of developing a second cancer. Modifying these factors might provide breast cancer survivors with a way to reduce their risk of developing a second cancer. I used to be able to run a 5K and finish it and would like to get back to doing that again someday soon. This research makes me think that one of my goals should be to get back to the gym and get in shape in order to do so again. I don't smoke and I can do without alcohol so perhaps I can avoid that second breast cancer I'm so sure that I'll develop in the future!

Cancer Etiquette Intervention

We are a nation that tries to be sensitive when discussing race and gender -- or even the disabled. We approach these subjects with restraint, choosing our words carefully for fear of insulting others. But when it comes to life-threatening diseases, that reserve seems to go right out the window! Since my diagnosis, a few so-called friends and random acquaintances have said some downright peculiar things to me. They range from the bizarrely sympathetic: "I couldn't bring myself to call you, but I cried like a baby when I found out you were sick," a friend told me. I actually felt bad for upsetting her. To the straight-up indifferent: "We're all going to die". Uh, yeah sure. Although slightly inappropriate, I recognize that such comments are really just people's way of showing they care. And while I appreciate the effort, it's clear that it's time for a cancer etiquette intervention.

THE DO's and DONT's:

1. DON'T say I'm sorry. I know you mean well, but opt for something a bit more uplifting such as, "Let me buy you coffee (or a drink) for your bravery on the battlefield."
2. DON'T send sappy or generic get-well cards. Is there anything more depressing than the Hallmark sympathy section? Ugh. A good sense of humor is crucial to conquering the cancer beast. Send messages filled with sarcasm and humor worthy of my valor.
3. DON'T say it's only hair. I know it will grow back, but being bald with no eyebrows makes even the prettiest woman look like a Cabbage Patch Preemie. Refer to rule number 6 for more guidance here.
4. DON'T talk to me about survival rates. If I had a cash payout every time someone told me they had a friend whose outlook wasn't so bright but went on to live for many years, I could cover my co-pays. People battling cancer want to focus on living, period.
5. DON'T spout trite expressions like, "God won't give you anything you can't handle." Trust me, that's one I've figured out already. When overcome with the urge to utter said cliche, refer to rule number 10.
6. DO tell me how good my GI Jane haircut looks. I'll play along. If at some point I have a bald head, tell me how nicely shaped it is.
7. DO invite me to lunch and foot the bill. It's been a rough journey; sympathy lunches are always welcome (wink, wink).
8. DO expect me to play the "cancer card." It's the only good thing to come out of all this. I reserve the right to use it whenever it gives me an advantage with a cop, a bill collector, a funder...you get the idea.
9. DO throw parties in my honor but only invite people I really like and want to spend time with.
10. DO tell me how fabulous I am. Going from sickly to simply fabulous is a lot of work. Feel free to compliment me regularly.

Everyone can be more sensitive by imagining for a moment that they're the patient. It's a good idea to ask yourself -- "what would I want someone to say to me?" Banish the following words from your vocabulary: terminal, incurable, hopeless and salvage. When you have cancer you learn who your real friends are because they are the ones who don't vanish into the woodwork and don't act like they've lost all their sense!

Live forward, not backward

I'm still thinking about yesterday's entry where I talked about control (or the lack thereof). Most of us go through our lives aware that there are many things over which we have no control. But there's nothing like the words "you have cancer" to leave you reeling with the obvious reality of our lack of control. Following the initial shock, you attempt to harness any semblance of control by gathering information or by talking to those closest to you (or at least I did anyway). Others withdraw, taking time to absorb the shock. Regardless of how I choose to cope with this diagnosis, it still feels like I have been thrown into a foreign land with no map, compass or directions.

One of my first instincts was to try to figure out why. If I know why, then I can control the outcome. So the questions began. Does God really hate me that much? Did I live an unhealthy lifestyle? Did I do something to cause this? But then I realized that this thinking takes up too much precious energy. Time spent looking backward and trying to discover the cause doesn't help the current situation nor does it contribute to healing.

So what can I control? I can control my attitude and live a full life. While a cancer diagnosis is a crisis it isn't necessarily an emergency. It must be dealt with in a timely manner but careful, well-thought-out choices about treatment is important. I am not "just another cancer patient". The diagnosis does not define me - I am a person living with cancer. Cancer will not overshadow my individuality. I am self-aware. I know who I am and what I need.

I've learned that those who care about me barely notice that I have hardly any hair. The best part is that they can still look me in the eye and rarely do I even remember that I look like GI Jane when I'm with them. It's only when I see that pitiful, startled look on the face of a stranger that I remember. There are times that I tire of hearing "stay strong" or "be positive" but I always appreciate that my friends, family and colleagues are sending me good vibes and keeping me in their thoughts.

The cancer diagnosis changed who I am; it is a holistic transformation in that it affects the whole me. The status quo of my life has been radically altered along with multiple aspects of the previous me that existed outside the world of cancer. The myriad of changes that followed the diagnosis altered the way I view the world and my place in it. Nothing is the same as it was before because I am not the same.

Living with cancer is not a linear process. My feelings, moods and needs shift from day-to-day, hour-to-hour and even minute-to-minute. It requires me to check in with myself. I have given myself permission to to throw out previous priorities and embrace new ones as this is an area I can exercise some control. In situations that feel out of control, self-awareness, recognizing my own needs, and self-advocating will make me feel empowered and allow me to "live forward".

What control?

As the next week winds down towards Chemo #5, I was thinking about how little control I have over this. Time is fleeting and I am not in charge. I can only control how I react to it all. It is believed that the freak-out you may experience from a cancer diagnosis probably comes from fears often associated with cancer—and there are many things a rational person could be afraid of following such a diagnosis. Death tops the list for most, but another fear may be that even if treatment works, the cancer will come back. Fear of an unknown future may persist, including what will happen to the people one loves and cares about. Also on the list is fear of alienation—not being treated as normal by other people. Fear associated with cancer is at least partly caused by the fact that we don’t have all the answers as to why some people get cancer, says Julia Rowland, PhD, director of the National Cancer Institute’s Office of Cancer Survivorship. “Cancer is often equated with the other big C: loss of control,” she explains. “It causes anxiety, because if you don’t know what caused you to have cancer, you don’t know what to do to keep it from coming back.”

Certain situations can also increase fear and anxiety. Disease progression or a change in treatment regimen may increase fear of death or fear of the future. Anxiety about recurrence may increase after treatment, as the time approaches for a checkup. Aches, pains or other problems can also trigger fear of recurrence. Taking good care of your body by eating a healthful diet and exercising when you are able is one way to cope. Many people find that knowledge about cancer helps to alleviate the fear. Others deal with cancer in practical ways, such as taking care of wills and other legal issues, and emotional ways, such as talking with loved ones about unresolved problems. Some people use humor to help manage their emotions.

Cancer survivors report a significantly greater unmet need for mental

health services than do people who have never had cancer. Symptoms of fear that may indicate a need for mental health care include anger and irritability, difficulty with concentration and problem solving and physical symptoms, such as muscle tension, dry mouth, trembling, shaking or restlessness. Some people find that medication is appropriate in helping them get through the most stressful period. Every person dealing with cancer is unique, and their beliefs, experiences and factors, such as economic and marital status, can have a profound impact on their experience with cancer. So control is out the window and time flies when you're having cancer!

How can I get magnesium into my system?

I am so sick and tired of this magnesium deficiency. The medication I was on made me feel so crappy and we were unable to regulate it that I have stopped it. I feel better physically, other than being tired. I'm working to get magnesium into my body in other ways, like certain foods and supplements. Eating a variety of whole grains, legumes, and vegetables (especially dark-green, leafy vegetables) every day will help provide recommended intakes of magnesium and maintain normal storage levels of this mineral. Increasing dietary intake of magnesium can often restore mildly depleted magnesium levels. However, increasing dietary intake of magnesium may not be enough to restore very low magnesium levels to normal [Oh Shit!]. Foods like spinach, nuts, oatmeal, peanut butter, potatoes, beans, bananas, yogurt and milk are good sources of magnesium so I'm trying to eat as much of those as possible.

I did some more research into magnesium. The health status of the digestive system and the kidneys significantly influence magnesium status. Magnesium is absorbed in the intestines and then transported through the blood to cells and tissues. Approximately one-third to one-half of dietary magnesium is absorbed into the body. Gastrointestinal disorders that impair absorption (such as Crohn's disease) can limit the body's ability to absorb magnesium. These disorders can deplete the body's stores of magnesium and in extreme cases may result in magnesium deficiency. Chronic or excessive vomiting and diarrhea may also result in magnesium depletion.

Healthy kidneys are able to limit urinary excretion of magnesium to make up for low dietary intake. However, excessive loss of magnesium in urine can be a side effect of some medications and can also occur in cases of poorly-controlled diabetes and alcohol abuse. Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and cramps, seizures (sudden changes in behaviors caused by excessive electrical activity in the brain), personality changes, abnormal heart rhythms, and coronary spasms can occur [Yikes!]. Severe magnesium deficiency can result in low levels of calcium in the blood (hypocalcemia). Magnesium deficiency is also associated with low levels of potassium in the blood (hypokalemia).

When blood levels of magnesium are very low, intravenous (i.e. by IV) magnesium replacement is usually recommended [Sounds like fun, huh?]. Magnesium tablets may also be prescribed, although some forms can cause diarrhea [Ya think?]. I guess we will know if I was successful in elevating my magnesium level next week when I go for Round #5 of chemo!

Fatigue, the cousin of Hungry

I have to say that I'm feeling quite useless at work these days. I'm tired and "foggy" and not feeling on top of my game. It's that damn fatigue coupled with the low magnesium level. "Chemo brain" is a fuzzy feeling, like trying to think through a fog. Throw in a little bit of exhaustion and fatigue, and it doesn't leave you at your cognitive best. It's hard to concentrate. It's hard to focus. It's a little hard to write this blog sometimes and have it make sense. It's a little bit like the feeling you get when you've had one or two or more drinks too many, and you don't want to be drunk. You try to will yourself into clarity, but it doesn't always work. Chemo brain may occur after chemotherapy and can include difficulties with memory, concentration, language, attention, reaction time, organizational skills and other mental functions.

I cannot express how deep and debilitating it can be. I'm wondering if it started now because I finally stopped the frantic pace I was on? In a survey of patients, approximately 12% indicated their fatigue was so significant they would rather be dead than fatigued. That's exactly how I felt last week! Some patients will show symptoms of depression, but it is related more to a lack of energy than true depression. Some have described this fatigue as a heavy feeling, like "moving though mud." While there are no medical tests that can diagnosis this fatigue, it is probably related to the body using all of its spare energy to repair itself from the chemotherapy. Theoretically, therapies that increase energy (exercise) or the "flow" of energy (exercise, acupuncture, specific supplements) might be beneficial.

I have this picture of "Fatigue" in my mind. He's similar to the "Hungry" character on the Weight Watchers commercial (the orange fuzzy guy). Only "Fatigue" is camouflaged because that little bastard seems to hide everywhere and get you when you least expect it! He sure has had my number recently. I used to be able to outrun him but he's either gotten faster or I've really slowed down!

The Alien Baby needs a name!

These past two weeks have been hell. I'm sick of feeling terrible, sick of being tired, sick of not wanting to do anything, sick of not being able to do anything. Luckily, I'm starting to feel almost human again. They say the effects of chemotherapy are cumulative, but I think these recent issues have been because of the new meds. Today I went back to using Reliv because it contains magnesium and easier on my system than the meds. The biggest issue continues to be digestive problems. This is a common side effect caused by chemotherapy. Some of the most common digestive problems associated with cancer include:

• Nausea
• Vomiting
• Diarrhea or constipation
• Abdominal cramps or pain
• Abdominal bloating
• Changes in bladder or bowel habits
• Difficulty swallowing or digesting food
• Heartburn or gastric difficulties

So, try having all of the above at the same time! (Yes, you can have diarrhea one minute and be constipated the next--I've done it many times over the past couple of months) The alien baby has been putting up quite a ruckus lately. Sometimes I swear I can feel him kick. He's been making his presence known very loudly. Actually, I don't remember pregnancy being this bad. So, if he's going to be present, he needs a name. Any suggestions?

Creative Visualization

Since I am always looking for ways to fight this cancer, I have spent some time studying creative visualization. This is a technique used to create a picture or movie of an event or situation you desire to become your reality. This technique can be used to create either wealth, health or even the perfect relationship. But it must be done correctly! Follow the techniques below to get you ready for visualizing:

• Find yourself a quiet place where you won't be disturbed. Five or ten minutes is ideal although the longer you can give it the better.
• Relax, either lying down or sitting in a chair, and close your eyes. Roll your eyes upward as far as they can go without straining them.
• Begin to breathe in deeply through your nose and breathe out through your mouth and let your body relax. Remember to keep your eyes rolled upward. Continue like this for as long as it takes for your body to become completely relaxed. Having your eyes rolled upward like this will bring you into the "alpha state" more quickly.
• Think back to a time, or place, of strong positive emotion. It can be any thought that brings the feeling of happiness, joy or love. It might be recalling the birth of a child, passing an exam or even a family get together or holiday. So long as when you recall the thought you are left with a positive feeling of either happiness, joy or love.
• Recall the emotion you felt. What did you hear? What did you smell? Remember as much as you can, and make that memory and emotion as real and as strong as possible. Make sure it is a positive emotion you recall!

Once you have this memory fixed in your mind and you can feel the happiness, joy or love cursing through your body it is time to connect that emotion to your visualization. So you can now begin to run through your creative visualization. It is particularly important when you use creative visualization that you see it as being real, in the present moment, as if you already have it. Whatever you want in the future you have to visualize enjoying right now. The more you use Creative Visualization the quicker things will happen. It is best to visualize on a daily basis! Twice a day if you can. After all you are directing the movie of your new life so why wouldn't you want to watch this movie as often as possible? But don't make it a chore, this should be something you enjoy doing. So, I will go to my "happy place" each day and see myself as happy, healthy and wise!

A Life Well Lived

Breast cancer is a foreign country I'm learning to live in. When I was first diagnosed, it was as though I had been parachuted into enemy territory, an unwilling draftee. I had to learn the language and customs of this new place quickly, as though my life depended on it - because it does. I am engaged in a war that is going to change me forever. I have no idea how profound that change is going to be or where it will take me. This new country will be my permanent assignment, my new home. I am learning my capacity for courage, acceptance, strength, humor, joy and persistence. I am getting to know and trust myself more than ever. The common thread woven throughout is living with breast cancer, not dying from it.

I appreciate the fact that my body, which rallies and responds to treatment over and over, shows strength and endurance in the face of a persistent enemy. Yet I sometimes feel betrayed by it. I view my scars as evidence of battle, sometimes even as signs of having been ravaged by this disease, but more often as badges of effort and courage. Not that I'm too philosophical about this. I have to pry myself from an attachment to how I wish I still looked and felt physically. But I remind myself of the profound truth I have discovered -- it's how I live my life that matters. I have spent these past few months with cancer looking for its higher purpose. I don’t profess to have some cosmic understanding of that, but every day I see evidence of the opportunities it opens to me.

Sometimes I feel like I'm all dressed up with no where to go. I walk the tightrope between maintaining hope that I will live to a ripe old age and living in the moment. I have every reason to be filled with hope. I am fairly sure that I will be able to face wherever this journey takes me. I hope to be a whole person, one who loves, accepts, serves, rejoices and opens up to others honestly and without hesitation. Then I might be someone worth knowing. That will be a life well-lived.

Restless legs and weird dreams

I sure haven't gotten much done this week. I think, dare I say it, that I'm finally beginning to feel better! Last night was a rough one though. The restless leg syndrome was really acting up and when I did sleep I had very weird dreams. I dreamed that I was at the house in Deland. I was standing in the livingroom, looking out the font door, when I saw this guy ride up on a bicycle and steal my newspaper. Boy was I pissed! He rode off and I chased him on foot. I didn't catch him but saw where he went. I then confronted him and started beating the crap out of him for stealing my newspaper. Seems kind of extreme over a newspaper, huh? So, I ask, what does this dream mean?

To see a house in your dream, represents your own soul and self. To dream that you are in the living room, represents the image that you portray to others and the way which you go about your life. It is representative of your basic beliefs about yourself and who you are. To see a bicycle in your dream, indicates that you need to devote time to leisurely pursuits and recreation. To see or read a newspaper in your dream, signifies that new light and insight is being shed on a waking problem that has been on your mind. You are seeking knowledge and answers to a problem. To dream that you are unable to read the newspaper, indicates that your reputation is being called into question. There is some uncertainty in a situation that you are pursuing. To dream that you are a witness to a theft or a victim of theft, indicates that others are wasting your time and stealing energy and ideas. Perhaps you feel robbed in some way. If you are chasing someone, the dream may highlight your drive and ambition to go after something you want. Or perhaps the dream suggests that you are falling behind and having to catch up with everyone else. To dream that you are beating someone, indicates that you are shoving your own views and opinions on others.

Later I dreamed that I apologized to the thief, only I was then back at the home I lived in during high school, in Pontiac. To dream that you are apologizing to someone, denotes your revolving door of friendships and friends who have come and gone in your life. It is also representative of truth and forgiveness. It is time to let go of past grudges. To dream about high school, refers to the bounds and friendships that you made while you were in high school.

Dream theorist, Alfred Adler (1870 -1937) believed that dreams are an important tool to mastering control over your waking lives. They are problem-solving devices. Dreams need to be brought to the conscious and interpreted so that better understanding can be shed on your problems. It is important to learn from your dreams and incorporate them into your waking life. Adler believes that there is a correlation between your dreams and the problems in your daily life. The more dreams you have, the more problems you are likely to have. Conversely, the less dreams you have, the less problems you have and the more psychologically healthy you are. (So how messed up am I?) Adler believes that it is control, power and motivation that drives your behavior. Furthermore, Adler does not think that an individual's actions and behavior are ruled by the unconscious. He believes that the strive for perfection and need for control are what causes you to do the things you do. In fact, Adler does not believe that the conscious and unconscious function against each other. Instead, they act the same way whether you are awake or sleeping. Adler's views on dreams are that they are an open pathway toward your true thoughts, emotions and actions. In your dreams, you clearly see your aggressive impulses and desires. Dreams are also a way of overcompensating for the shortcomings in your waking life.

I'm beginning to wonder about these aggressive tendencies I'm seeing in my dreams. First I'm burning down houses, now I'm beating people up!

Live Like You Were Dying

I'm feeling very emotionally drained. They tell me that there is emotional work, the “heart work,” to do around my cancer. I can make great medical decisions but do I really need to “feel” what had happened to me? I'd prefer to just go on as if a rather nasty event is happening to me. What does it mean to “feel” what cancer has done to my life? It's hard and painful at times, but do I really have to face the possibility of my own death? Can I now live the rest of my life without that fear? They tell me that dying without having lived is worse than dying itself. That reminds me of Tim McGraw's song Live Like You Were Dying. I've always liked the song but now I really understand it.

Live Like You Were Dying

He said I was in my early 40's,

With a lot of life before me,

And a moment came that stopped me on a dime.

I spent most of the next days, lookin' at the x-rays,

Talkin' 'bout the options and talkin' 'bout sweet time.

Asked him when it sank in, that this might really be the real end.

How's it hit ya, when you get that kind of news.

Man what ya do.

And he says,

[Chorus]

I went sky divin',

I went rocky mountain climbin',

I went 2.7 seconds on a bull name Fumanchu.

And I loved deeper,

And I spoke sweeter,

And I gave forgiveness I've been denying,

And he said someday I hope you get the chance,

To live like you were dyin'.

He said I was finally the husband,

That most the time I wasn't.

And I became a friend a friend would like to have.

And all the sudden goin' fishing,

Wasn't such an imposition.

And I went three times that year I lost my dad.

Well I finally read the good book,

And I took a good long hard look at what I'd do

If I could do it all again.

And then.

[Chorus]

Like tomorrow was a gift and you've got eternity

To think about what you do with it,

What could you do with it, what can

I do with with it, what would I do with it.

[Chorus]

Sky divin',

I went rocky mountain climbin',

I went 2.7 seconds on a bull name Fumanchu.

And I loved deeper,

And I spoke sweeter,

And I watched an eagle as it was flyin'.

And he said someday I hope you get the chance,

To live like you were dyin'.

To live like you were dyin'.

To live like you were dyin'.

To live like you were dyin'.

To live like you were dyin'.

I don't mind experiencing (living) life but I'm not sure I want to "feel" the cancer. I'd prefer to go on not having to think about all the possible consequences. I'd rather believe in my invincibility!

Toxic Woman

I am so pooped! It makes me wonder just how toxic I am? While there's never a good time to get breast cancer, women diagnosed today tend to have less debilitating treatment experiences than women who were diagnosed 10 years ago. While one might assume the change is due to gentler therapies, chemotherapy for breast cancer, for example, has actually gotten more aggressive. Chemotherapy, of all cancer treatment, is most feared for its toxicity, and the most disabling side effect has traditionally been nausea and vomiting. The experience is so ingrained that some women who have undergone chemotherapy recall anticipating nausea or gagging at the sight of the hospital where they received their chemo, or even at the sight of their oncology nurse. (How true! Just walking into the "chemo ward" sets me off!) Today, however, new medications have made such difficult experiences increasingly usual. New serotonin-based anti-nausea drugs have revolutionized oncology making vomiting rare and nausea less common among women being treated for breast cancer.

Chemo-related fatigue is also often better managed today, though women are still likely to be more tired than usual. "Women need to pace themselves and prioritize their time," says Jean M. Lynn, MPH, an oncology-certified nurse and director of the Breast Care Center at George Washington University in Washington, DC. "I always look at breast cancer as a part-time job for six months. You can't continue doing everything else you were doing. If you try to do everything, you'll just crash." Maybe, just maybe, that's what I'm experiencing?

Just as every woman's breast cancer is different, women's treatment experiences will vary. Some women have no side effects, some have one or two, and other women have all of them. I, of course, must experience them all! And some women have them bad and some women have them mild, and you don't know until you've started. While some women will be more affected by treatment than others, it's safe to say that many will be able to continue leading an active life during treatment. I was handling the experience well up until this last round. Perhaps I am now so toxic that it's finally caught up with me? I was so far ahead of the cancer that I was sure if I didn't stop moving, it wouldn't catch me. But now I'm thinking I was wrong! (How I hate being wrong!) I'm trying to decide if I even like the term "toxic". After all, "Toxic Woman" isn't exactly a great super-hero name! Maybe a good starching of my cape would help?

Is there a silver lining?

I am finally feeling better now that I've cut back on the magnesium oxide! God, I really need to get back to work. Feeling so bad made me wonder if a silver lining really exists. According to Cure magazine, many cancer patients say that one does exist. They say that surviving cancer is seldom easy. (Tell me something I don't know!) Treatment can be painful, debilitating, emotionally draining, and financially taxing. And yet, despite it all, a surprising number of cancer survivors report finding a “silver lining” in their cancer experience. This positive perspective, what researchers call “post-traumatic growth,” affects survivors in a variety of ways. From experiencing a spiritual awakening to becoming aware of inner strength, the silver lining often leads to dramatic life changes. Richard G. Tedeschi, PhD, professor of psychology at the University of North Carolina Charlotte, says it is estimated that one-half to two-thirds of cancer survivors who come away from their experience do so with some kind of positive change.

Tedeschi, who has interviewed hundreds of trauma survivors, reports 5 common growth outcomes:

1. A deepened appreciation of life.
2. Enhanced relationships with others.
3. An appreciation for personal strength and endurance.
4. Setting out on new pathways or pursuing new interests and opportunities.
5. Spiritual growth and development.

"It's always better if your suffering has some meaning to it," Tedeschi says. "So if you perceive that it's teaching you something or changing you in some positive way, there is a reason to keep going." Though not everyone will find a silver lining in their cancer experience. For some, it will be the most agonizing experience of their lives and not easily traversed. But Tedeschi says that patients can increase their chances of finding something positive by avoiding fearful thinking. Patricia Mumby, RN, PhD, associate professor in the Department of Psychiatry and Behavioral Neurosciences at Loyola University Chicago and director of Loyola’s Cardinal Bernardin Cancer Center, agrees that cancer can be life-altering. “I think many of us often take life for granted, and a diagnosis, such as cancer, can really make people look at their life and ask, ‘Am I living my life in a way that is most fulfilling to me?’ ” she explains. “They wonder, ‘Are there things I can change or improve?’ ”Cancer patients should never think of the disease’s potential silver lining as an all-or-nothing phenomenon, says Loyola’s Mumby. “People can be feeling the stress of the cancer at the same time that they are able to find something positive,” she says. “It’s often a matter of degree. But I think if people are able, at any point in the experience, to identify even a single positive, that, in and of itself, can be very empowering.”

Maybe I'm just not there yet. I hear other survivors discussing the upcoming breast cancer walks (Avon and Komen 3-day) and how they are planning and training for them but I have yet to find the motivation to do more than think about it! Feeling so horrible really knocked me for a loop. I just want to be normal again.

Magnesium

Apparently I am supposed to feel this bad! The magnesium oxide causes cramps, diarrhea and dizziness. I had one of the Neupogen shots today so I asked about feeling so bad. I was told to "hang in there"! Yeah, easier said then done. I wondered how a lack of magnesium could make me feel so bad. Magnesium is a mineral that is involved in over 300 reactions in the body. It is important for every organ in the body, particularly the heart, muscles, and kidneys. It also contributes to the composition of teeth and bones. Most importantly, it activates enzymes, contributes to energy production, and helps regulate calcium levels as well as copper, zinc, potassium, vitamin D, and other important nutrients in the body. Magnesium is available in many foods. However, most people in the United States probably do not get as much magnesium as they should from their diet. Magnesium is found in whole unprocessed foods in the diet. Despite the fact that dietary levels of magnesium are often low, actual deficiency of this nutrient is rare. Certain medical conditions, however, can upset the body's magnesium balance. For example, intestinal flu with vomiting or diarrhea can cause temporary magnesium deficiencies. Certain stomach and bowel diseases (such as irritable bowel syndrome or IBS and ulcerative colitis), diabetes, pancreatitis, hyperthyroidism (high thyroid hormone levels), kidney malfunction, and use of diuretics can lead to deficiencies. Symptoms of magnesium deficiency may include agitation and anxiety, restless leg syndrome (RLS), sleep disorders, irritability, nausea and vomiting, abnormal heart rhythms, low blood pressure, confusion, muscle spasm and weakness, hyperventilation, insomnia, poor nail growth, and even seizures. Foods rich in magnesium include unrefined grains, nuts and green vegetables. Green leafy vegetables are particularly good sources of magnesium because of their chlorophyll content.

So, the morale of this story is to get your magnesium because you do not want to have to deal with this! Throughout all of the chemo, I have not felt this bad before. It sucks!

If only it was Captain Crunch's fault...

These mouth sores are out of hand! My friend Karen described it best when she asked if it feels like I ate too much Captain Crunch. Exactly! My tongue really hurts and I can feel the sores. Orajel Mouth Rinse helps but only for a while. Mouth sores are one of the most common side effects of chemotherapy or radiation therapy of the head and neck area. Known to doctors as mucositis, they can actually occur anywhere in the mouth or throat and develop when the ultrasensitive tissue that lines the mouth and throat becomes inflamed. A number of risk factors increase the chance that you will have to deal with chemo-related mouth sores while battling cancer. People who smoke or wear dentures are particularly at risk, and those who have a history of susceptibility to cold sores, canker sores, and gum infections tend to have more trouble with mouth sores than those who haven't struggled with these irritations in the past. Because alcohol is an irritant and dries mouth tissues, drinking can exacerbate mouth sores. If you have a low white blood cell count, this can contribute to mouth sores as well. Chemo-related mouth sores tend to be episodic, appearing three to ten days after a chemo treatment. The first sign is a burning sensation in the mouth, and the ulcers appear soon afterward. These types of mouth sores usually clear up within a week or so, unless malnutrition slows recovery.

Mouth sores often form on the lips, gums, inside the cheeks, tongue, floor and roof of the mouth. These painful sores can affect your eating, drinking, speech and ability to swallow. The proper treatment of mouth sores is extremely important because patients receiving chemo are susceptible to infection. Since chemotherapy attacks both healthy and cancerous cells in the body, the mouth, with it's delicate bacterial balance, is often affected. These cankers can bleed and ulcerate, causing considerable pain.

I'm really getting concerned about the cumulative effects of chemo. I've experienced a few mouth sores before but not like this! The following suggestions have been given:

• A combination of mouth rinses and good hygiene is most effective.
• Eat bland foods. Try yogurt, good old macaroni and cheese, and foods with sauces and bland gravies.
• Brush your teeth after every meal and at bedtime, but do it carefully.
• Drink 64 ounces of water a day.
• Rinse with a baking soda rinse.
• Rinse with salt-water.
• If it hurts to drink, try using a straw. Choose softer foods rather than that hoagie sub you’re just dying to munch on. Cut your food into small bites to make chewing easier.
• Suck on ice cubes during chemotherapy treatment.
• Try applying honey to the sores.
• Discuss vitamin supplements such as L-lysine with your doctor.

I am willing to try pretty much anything as this is awful!

Suggestions for managing fatigue

Still feeling puny today. Cure magazine has the following information re: managing cancer-related fatigue. Studies have shown that exercise, such as light- to moderate-intensity walking, reduces fatigue and improves physical energy, appetite, and quality of life. Prioritize daily activities and use time management to save energy for the things you care about most. Do important tasks and activities first thing in the morning, take on lower priorities later in the day, and allow others to help with additional chores. Plan your activities during the times you have the most energy, and try easier or shorter versions of activities you enjoy. Find other ways to conserve energy when possible. Some suggestions from M.D. Anderson Cancer Center on ways to conserve energy include: Do housework sitting down when possible; prepare double portions of food and freeze half; sit down to bathe; let a grocery store employee carry bags to the car; and when bathing or dressing, minimize leaning down or reaching. Plan your day so you have time to take short naps—no longer than 30 minutes—between activities and try to exercise a little each day. Establish a normal sleep pattern and, as much as possible, optimize your activities and medication schedule to allow you to get enough rest. Eat a healthy diet and make sure you are getting proper nutrition, vitamins, and fluids, but limit caffeine and alcohol intake. Because cancer and its treatments affect appetite and tastes, it may help to consult with a registered dietitian about a strategy to get all of the necessary nutrition in your diet. Guess I'll have to try these. I'm actually starting to get hungry...think I'll send Hannah out for some Chinese food!

Rough Day

They aren't kidding when they talk about cancer related fatigue. Expressions like "bone tired", "exhausted", and "against the wall" are descriptions used by people with cancer to depict the overwhelming fatigue experienced. Fatigue continues to be the most prevalent and disruptive symptom of cancer and its treatment regimens often lingering beyond the treatment phase of the disease. Potential causes of fatigue include preexisting conditions, physical and psychological symptoms caused by cancer, and the consequences of treatment. The fatigue experienced from cancer and its treatment differs greatly from acute or chronic fatigue experienced by the general population from a variety of etiologies. Cancer-related fatigue is described as being a more intense, chronic, and disruptive symptom that is unrelieved by rest.

Fatigue is defined as an abnormal condition that occurs on any given day and can persist for more than 2 weeks. Manifestations can include lack of motivation and interest in activities, exhaustion, weakness, sleep disturbances, irritability, and sadness. There appears to be a reduction in energy that is disproportionate to tasks performed, and associated distress due to decreased physical and intellectual performance related to the disease and/or treatment. Adults perceive cancer-related fatigue in a multidimensional manner, including sensory, affective, behavioral, and cognitive dimensions. Sensory elements refer to the mental, physical, and emotional symptoms of fatigue. Examples of sensory elements are feeling lively/listless, strong/weak, or refreshed/tired. Affective elements denote the emotional meaning attributed to fatigue, such as pleasant/unpleasant or positive/negative sensations. Behavioral indicators include elements such as fatigue distress, and intensity and severity of fatigue. Cognitive/mood factors include the ability to concentrate and feelings such as being relaxed or tense. Intensity of fatigue worsens with the cumulative effects of cancer treatment. [Crap!] Greater fatigue was related to more sleep problems, mouth sores, and nausea. Greater fatigue was also related to lower activity levels among women on chemotherapy for breast cancer. Fatigue has been shown to increase at intervals over the course of cancer treatment. Looks like I'm screwed!

The newest side effect

Chemo was a go today. It was rather sparse in the chemo rooms today due to the weather. The doctor informed me that my magnesium level was low, a side effect called Hypomagnesemia. It is an electrolyte imbalance and is indicated by a low level of magnesium in the blood. The normal adult value for magnesium is 1.5-2.5 mEq/L. I am at the very low end. Magnesium is one of many electrolytes in your body and normal levels of magnesium are important for the maintenance of heart and nervous system function. Severely low blood magnesium levels can cause the following symptoms: muscle weakness, confusion, and decreased reflexes. You may also notice "jerky" movements, high blood pressure, and irregular heart rhythms.

So, I was prescribed Magnesium Oxide. This medication is a mineral supplement used to prevent and treat low amounts of magnesium in the blood. Magnesium is very important for the normal functioning of cells, nerves, muscles, bones, and the heart. Usually, a well-balanced diet provides normal blood levels of magnesium. However, certain situations cause your body to lose magnesium faster than you can replace it from your diet (i.e. chemotherapy).

Tonight I'm tired/feeling weak and still a little nauseous even though I've taken all my nausea meds. That's surprising as I got both doses of steroids in today and that usually keeps me hyped up well into the wee hours of the morning! Not tonight. Dinner consisted of saltines and Gatorade. I'm sure I'm headed for an early bedtime, too.

No chemo today

The day started off with the car not starting and the truck with a flat tire! I managed to get the tire inflated and drop Mike off at Circle of Friends but was late to chemo. Then I was told that chemo was postponed as the doctor was not available! I'm scheduled now for tomorrow morning. Probably a good thing because I'm sure my blood pressure was way high and I was over-anxious by that point. I went ahead and got my lab work out of the way while I was at the clinic. I also told the oncology staff that if the doctor isn't local and can't get in because of the storm, I'd be happy to 4-wheel it to get him to work. They laughed. Now, it's not that I want to do chemo but since it causes me so much anxiety, I just want to get it over with! Then I went off to work. Not a bad deal as it let me finish up the CDBG grant that is due Friday. I delivered it to the City this afternoon. That was a big anxiety reliever so the rest of the week should be smooth sailing as I won't have to figure out how to get the grant finished! Now all I'll have to do is "crash" after chemo.

I was wondering what effect the stress of chemo along with work stress might be having on me so, of course, I started researching it. I found this information in Cure magazine: According to the National Cancer Institute, psychological stress combines an individual’s emotional and physiological reactions when confronting a situation where the demands may exceed the person’s ability to cope. Simply put, the body is constantly bombarded by “stressors” of its external environment. It responds by releasing stress hormones, such as epinephrine (adrenaline) and cortisol (hydrocortisone) to help the body react to the stressful situation with speed and strength, while at the same time increasing blood pressure, heart rate, and blood sugar levels. While small amounts of stress are seen as beneficial, studies indicate that chronic high levels of stress could be harmful and increase the risk of obesity, heart disease, and depression, among other illnesses. Stress beyond an individual’s ability to cope may also lead to unhealthy coping behaviors, some of which may affect cancer risk, such as overeating, smoking, or abusing drugs or alcohol. And newer studies indicate stress creates a cascade effect that promotes an inflammatory response in the body, which leads to a friendly environment for cancer. Again, it makes me wonder about the effect Mike's accident had on me.

Emory Winship Cancer Institute's Burke likens dealing with cancer stress to how an oak weathers a storm versus a palm tree. In a hurricane, the rigid oak may snap, but the palm bends with the squall. Learn to adapt, like the palm, to changing conditions to help you continuously manage stress, he says. He recommends reintroducing daily routines, having fun again, being productive at work, volunteering and being involved with family and friends. But most important, he says, give yourself a break and accept help from your support system. So, even though I have a terrible singing voice, I think we need a night out at a Karaoke bar! Who's with me?

Stand

Since it's the day before chemo, the steroids begin again and my anxiety level starts to ramp up. So I was listening to some music and singing along (at the top of my lungs no less) as it helps keep the anxiety down. You should be aware that my singing voice is so atrocious that I was kicked out of the church choir when I was 11 years old. [I'm sure that experience would require many therapy sessions to resolve]. One of the songs that came on was "Stand" by Rascal Flatts. While I've heard it many times before, today I actually listened to it. Then I played it again so I could sing along! The lyrics are as follows:

"Stand"

You feel like a candle in a hurricane

Just like a picture with a broken frame

Alone and helpless

Like you've lost your fight

But you'll be alright, you'll be alright

[Chorus:]

Cause when push comes to shove

You taste what you're made of

You might bend, till you break

Cause its all you can take

On your knees you look up

Decide you've had enough

You get mad you get strong

Wipe your hands shake it off

Then you Stand, Then you stand

Life's like a novel

With the end ripped out

The edge of a canyon

With only one way down

Take what you're given before its gone

Start holding on, keep holding on

[Repeat Chorus]

Everytime you get up

And get back in the race

One more small piece of you

Starts to fall into place

Oh

[Repeat Chorus]

Maybe the song should say cancer's like a novel, with the end ripped out as I don't know the ending. I am holding on and plan to keep holding on. Maybe I am experiencing some form of denial as I don't allow myself to even consider not surviving this ordeal. What doesn't kill you only makes you stronger, right?

T'was the Night Before Chemo

After I wrote about my anxiety on the night before chemo, my friend Eunice sent me this poem. It gave me a good chuckle. Thanks, Eunice!

T’was the night before chemo, when all through the room

Not a patient was stirring, from Ativan I presume

The chemo bags were hung on IV poles with care

In hopes that a cure soon would be there

The patients were nestled all snug in their lounge chairs

Sipping Ensure and hugging Relay teddy bears

And the nurse in her scrubs and I in my wig

Had just settled down for another chemo gig

When out in the parking lot there arose such a clatter

I sprang from my chair to see what was the matter

Away to the window I flew like a flash

Tore open the blinds and threw up on the glass

Soothing my nausea with the fresh cool breeze

The wind took my wig and it flew with such ease

When what to my wondering eyes did I see?

Eight tiny nurses giggling with glee

Leading the pack was an oncologist so sweet

With a mission of cancer that they would beat

To help with side effects from chemo we blame

Was his arsenal of drugs that he shouted by name

“Now Xanax!, now Ativan!, now Zofran! and Compazine!

Let’s offer comfort with bonbons and magazines

On Vicodin!, on Darvocet!, on Tylenol! And morphine!

Let’s make them loopy and make a big scene!”

To the top of Mt. Courage, to the top of Mt. Hope

Now dash away, dash away so we can help cope

With tumors and lesions and lumps it is clear

We must make their cancer finally disappear!

So up to the clinic-top, they flew and flew

With a sleigh full of drugs and the doctor too

Then with a jingling I heard from their purse

Was the prancing and pawing of each little nurse

As I drew in my head and was turning around

In through the vent the doctor came with a bound

His eyes how they twinkled – his dimples so merry

His cheeks were like roses, his nose like a cherry

He was dressed all in white with an ugly plaid tie

He preached to the patients, “Do not ask why”

Have courage, choose hope and just think positive

Live, love and laugh and your life will be lucrative

Never forget that you are heroes in my book

Conquering cancer without a second look

With a wink of his eye and a twist of his head

He soon let me know I had nothing to dread

A bundle of drugs he had flung on his back

He looked like a drug dealer opening his pack

He spoke not a word but went straight to work

Making me feel sick, so I called him a jerk

A human pin cushion, I had become

So multiple pokes, again I succumb

But then I remembered, my life he was saving

So I realized I better start really behaving

“What comes around goes around” I always say

And a bad attitude might haunt me one day

I thanked him for fighting with me side by side

With two against one, cancer cannot hide

Then laying his finger aside of his nose

And giving a nod, up the vent he rose

He sprang to his sleigh, gave the nurses a sign

To travel the world fighting cancer like mine

The sleigh was our hope and he was the driver

Bringing strength and good cheer to every survivor

I heard him exclaim as he flew out of sight

Happy Holidays to all and to all a good night!

~Heather Warrick

(as posted at Caroline’s Breast Cancer Blog)

What makes me anxious

While I spend most of my time in a "positive" state of mind, I have my moments when I sink into a pit of despair. It has been said, by women who have beaten Breast Cancer or are still in the throes of it, that the period between diagnosis and surgery is the most brutal. Nope - I think it is dealing with chemotherapy. Round #4 is scheduled for Wednesday (1/6). How I dread chemo days. I have to go to my "happy place" to keep my anxiety level down and remain calm. I'm still trying to figure out why it's causing me so much anxiety. Each night before chemo, I go through the motions of a normal nighttime routine. I set my alarm clock and crawl (sometimes exhaustedly) under the covers, only to lie there and listen to the endless parade of horrible thoughts that march through my brain. Sleep is not even a factor anymore (the steroids certainly don't help). My stomach churns as if it were the evening before the start of a brand new job.

When the dark surrounds you, the family is sound asleep and the dog is happily snoring next to you, it is imagination that takes over and elicits such intense fear that sleep becomes comical. My imagination tells me that the cancer is growing and I have to argue with myself that it is not. Or that I will end up with some other health issue because of the cancer. You see Herceptin –which I must take because of the HER2 status (positive) of my cancer and which will increase my survival rate by 50% since the HER2 cancers are far more aggressive and far more likely to come back — carries a large risk of heart toxicity. It is the Herceptin and the 5 years of tamoxafin that really shore up my chances of living a long life. The chemo is just extra insurance. But, the good news is that new research has found that taking Herceptin with, as opposed to after, chemotherapy helped more women live longer without a recurrence. 84.2% 0f the patients that took Herceptin with chemotherapy were recurrence-free at five years and only 3% experienced heart toxicity. So, the odds are certainly with me. Now if I could just stop freaking out before chemo, I'll be good!

Chinese Horoscope

My chinese horoscope for today says, "Take a moment to sit back and relax this afternoon. You're most likely moving at a frantic pace, so remember to breath. If you're putting in extra hours at work, make sure you're getting enough sleep at night. Remember to eat well so your mind and body can keep up this pace." Man, does the Universe know me or what? I was born in the Year of the Rabbit. People born under the sign of the rabbit are gentle, sensitive, modest, and merciful and have strong memory. They like to communicate with others in a humorous manner. They cannot bear dull life, so they are good at creating romantic or interesting spice. But they lack meditative abilities and often sink money into ideas that may cause failures in their career.

People born in the Year of the Rabbit are articulate, talented, and ambitious. They are virtuous, reserved, and have excellent taste. Rabbit people are admired, trusted, and are often financially lucky. They are fond of gossip but are tactful and generally kind. Rabbit people seldom lose their temper. They are clever at business and being conscientious, never back out of a contract. They would make good gamblers for they have the uncanny gift of choosing the right thing. However, they seldom gamble, as they are conservative and wise.

So, what does 2010 have in store? A placid year, very much welcomed and needed after the ferocious year of the Tiger. We should go off to some quiet spot to lick our wounds and get some rest after all the battles of the previoous year. Good taste and refinement will shine on everything and people will acknowledge that persuasion is better than force. A congenial time in which diplomacy, international relations and politics will be given a front seat again. We will act with discretion and make reasonable concessions without too much difficulty. A time to watch out that we do not become too indulgent. The influence of the Rabbit tends to spoil those who like too much comfort and thus impair their effectiveness and sense of duty. Law and order will be lax; rules and regulations will not be rigidly enforced. No one seems very inclined to bother with these unpleasant realities. They are busy enjoying themselves, entertaining others or simply taking it easy. The scene is quiet and calm, even deteriorating to the point of somnolence. We will all have a tendency to put off disagreeable taks as long as possible. Money can be made without too much labor. Our lifestyle will be languid and leisurely as we allow ourselves the luxuries we have always craved for. A temperate year with unhurried pace. For once, it may seem possible for us to be carefree and happy without too many annoyances. I can only hope for such an "easy" year!

Is change in the air?

Happy New Year. The universe seems to be telling me it's time for a change! Today's tarot card is The Knight of Swords, which suggests that my power today lies in change. I am quick, sharp, and ready for assertive, revolutionary or affirmative action. I overcome obstacles or resolve conflict by getting right to the point, cutting to the chase or confronting challenges head on -- even if this means going against the grain. My communication, style or expectation is on the cutting edge and relies on reason, design, the latest craze or facts. It is my honor to protect and defend my perception of truth. I measure twice and cut once. I am empowered by expectation or duty and my virtue is commitment to the greater good.

Further, my mini tarot reading: The Is it Working? position describes a current focal point, issue, or level of performance that can help to reinforce or assess expectations or re-direct your attention to a positive plan of action. The Fool in this position suggests that you may have a tendency to go off on your own, never stay in one place for too long, or throw yourself into every "next big or sure thing," and others may not always share your enthusiasm or vision, but this time, support may follow, and the early results from a leap of faith or trying something new, could come in the form of a change in position, production, conditions, market, or status, and may require some risk, or leaving the comforts and safety of the familiar behind for more public, creative, or social exploration "out in the real world."

The Get Back to Basics position can uncover a driving force, sources of

frustration, chaos, waste, strength, motivation, or areas with room to improve. The Knave of Chalices in this position suggests that you may have recently experienced something of this Knave, and there might have been an air of the mystical surrounding you at that time. This Knave was probably working behind the scenes, and may very well been the one who completed that which another started. This Knave seemed gentle, loving, gracious, and sweet, if not a bit naive or immature. For this very reason, however, this Knave wasn't afraid to wear her heart on her sleeve, or take an emotional risk. If you were considering making an emotional decision, this Knave might have been the one who helped you to make it. Also, it could be that she was the one who brought you news of a happy event, promotion, venture, or project, or specifically, the discovery of a chosen path or hidden talents.

So, now I need to figure out what this means!