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!