Heavy Mortality Thoughts Today

Today is my dad’s yahrzeit. It’s been 23 years since my dad died from Hodgkin disease. I never know how I’m going to feel during this time each year, but I thought this year I’d be ok. Not really sure why I thought that, but I did. I really did. Then a friend asked what I did last night and I told her I went to shul to remember my dad. That’s when the tears started.

Last year, I had chemo brain during the anniversary of my dad’s death. I was in the middle of my 8 chemo treatments. So I couldn’t really process how his death was affecting me. But today, its hitting me pretty hard.

My dad was a couple weeks shy of his 43rd birthday when he died. He fought 4 bouts of cancer. His body couldn’t handle the toll anymore of 12 years of drugs and damage from treatment. I think he was also tired of the fight. I can’t blame him. I understand the feeling.

Before my diagnosis, the idea of not making it past my 43rd birthday was never a thought that crossed my mind. But now, being in my first year as a breast cancer survivor and being 40 years old, I find myself wondering if I’ll even make it to 43.

I never thought I’d get breast cancer at 39. 65 yes. But not 39. That wasn’t a remote possibility in my mind. But now I know all too well that life is full of surprises – and I’m not talking about the good surprises.

My dad’s yahrzeit and my breast cancer make me think about my mortality a lot these days. How many days or years do I have left? Will my cancer come back like my dad’s did? Will my body give out too like his did? Will I have time to do the things I really want to do?

Obviously I don’t know the answer to any of these questions. And I’m trying to take these overwhelming feelings one day at a time. But what I do know is that this scary stuff.

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It’s Not About The Plane Anymore

Last weekend I flew to visit my family in Michigan. I’ve never liked flying. Whenever I’m on an airplane, I feel that at any moment my life could end. The plane could crash and I would have missed out on so much life. That feeling of being too young to die is always at the forefront of my mind.

Now, when I’m on a plane, the feeling that life is too short takes on a new meaning. And it starts even before I get on the plane, when I put on my compression sleeve.

Since having my mastectomy surgery, I have to wear a compression sleeve whenever I fly to prevent lymphedema.

As I put on the sleeve, I’m reminded of what I’ve been through over the last year. I’m reminded that I’m never done with breast cancer, because every time I fly I have to put on that stupid sleeve. I’m reminded that life is uncertain. I’m reminded that life is fragile. I’m reminded that life is short. Sometimes too short.

Being on a plane now is a symbol for all that I’ve been through, all the I have left to do and all that I might not have time to do.

After my plane lands safely and I take off my compression sleeve, I’m relieved that I’ve survived – both the flight and breast cancer.

Sometimes…Reality Bites

The day of my breast cancer diagnosis, I was tested for the breast cancer gene, BRCA. A week later I found out I have BRCA2. The BRCA name is misleading, because it is also the gene for ovarian cancer.

Since I have BRCA2, I have a higher chance of getting ovarian cancer. So, I have to go for regular check ups with my gynecologist. These check ups include getting an ultrasound and the CA 125 blood test, which is the blood test for ovarian cancer.

These check ups with my gynecologist are always very emotional for me. I have to sit among a lot of pregnant women. I haven’t been pregnant yet and would like to at some point in the near future. My doctor’s advise me not to get pregnant while taking tamoxifen. Tamoxifen is the estrogen suppressant drug woman go on after having breast cancer. It’s supposed to decrease your chances of a recurrence of breast cancer, since breast cancer tumors feed on estrogen.

Like I said, it’s always hard to sit in that waiting room, with those pregnant ladies. They’re all visiting their doctor for a happy reason. Me…not so much.

Don’t get me wrong, I love pregnant ladies. Some of my best friends are pregnant ladies. But do they all have to be sitting in my doctor’s office while I wait to get checked for ovarian cancer?

Last week I went for my regular check up of my ovaries. It was my third check of my ovaries in 6 months, so I thought I was prepared. I brought a mindless magazine and some happy music to distract myself from all the pregnant ladies.

As I sat in the waiting room of my gynecologist’s office, a pregnant woman and her husband came out of the doctor’s office with a sonogram photo. The pregnant woman’s mother was in the waiting room and jumped out of her chair to look at the photo. She started screaming with joy. The three of them talked loudly about how excited they were for their first sonogram photo.

I started crying, uncontrollably. I turned my music up and tried to focus on my magazine. But nothing was calming me down.

These three people were so excited about their future and their great appointment with their doctor. And I was waiting to be checked for ovarian cancer, after having spent the last year fighting breast cancer. The reality of my life hit me like a ton of bricks.

As I sat there crying in the waiting room, I couldn’t help but think about my future – hoping that I would have a future, and a long future. Would I be around long enough to have babies? Would I be able to physically have babies after everything my body endured over the last year? Life felt very cruel at that moment.

Life is uncertain and often times unfair. That’s a tough lesson to keep learning.

The good news is that my ultrasound was normal and my blood test came back normal. So I have 3 months of a break before I have to go for that check up again. Maybe next time it will hurt a little less. 

My Breast Cancer Story

On Tuesday, March 13, 2012, after a long day at work, I went for a run. A normal activity for me on a lovely spring day. After my run, I took a shower. I come from a long line of women who’ve had breast cancer, so I religiously did my self-exams every month. In the shower, I started to do my exam. I knew my breasts pretty well, so as I was feeling around, I knew something was wrong. I came upon what felt like a frozen pea. I always asked my doctors what a tumor feels like, and they say two things: it feels like a frozen pea and you’ll just know what something doesn’t feel right.

Well, they were right.

Shit. I just knew things were about to change.

Getting The Frozen Pea Checked

The next day I called my gynecologist for an appointment. On Thursday, March 15, I went to get her opinion about this frozen pea. She sent me to get a mammogram, which led to a sonogram, which led to an MRI, which led to a biopsy. All of this happened within 5 days. They told me I’d get my results by Friday, March 22.

And so I waited. Often the hardest part.

Thursday, March 21 was my 39th birthday. Everyone wanted to celebrate, but I just couldn’t seem to muster up the energy to be happy about anything. While my friends and family were staying positive about my results, I just couldn’t shake the gut feeling that my results weren’t going to be good news.

The Results

On Friday, March 22, the day after my birthday, I was driving to work and my gynecologist called me. She said she had the results of my biopsy and asked if this was a good time to talk. Those words didn’t calm my fears. I pulled over to the side of the road. I knew I wouldn’t be able to keep driving while hearing this news. She said my biopsy came back positive and I had breast cancer. It’s the word we all are afraid of hearing and hope we never do.

I hung up the phone and burst out in tears. I yelled in my car, so afraid of what would come next.

I pulled myself together enough to drive the 4 miles home and collapsed in my bed. Couldn’t stop crying. My life was about to change and I was so scared.

The Doctors’ Appointment Begin

My gynecologist quickly made an appointment for me to see a breast surgeon. I met with her later that same day. I really lucked out with her. She’s a smart, caring, dedicated surgeon who specializes in young women with breast cancer. I couldn’t have ask for a better doctor and partner in this fight. This doctor, along with her team of a nurse practitioner and nurse navigator, spent 4 hours with me on that first day. They explained everything to me – how breast cancer happens, what our possible options are for treatment, and where we go from here. They were amazing!

Tests, Tests and More Tests

She sent me to do many tests to find out if the cancer had spread anywhere and if I had the breast cancer gene, BRCA. These tests would help determine my surgery options and my course of treatment. Would I need to do a mastectomy or a lumpectomy, chemotherapy or radiation.

She told me we had one month from that day to make all these decisions. One month from that day I would be having surgery. We couldn’t allow the tumor any more time to grow or spread.

All of my tests came back clean. As far as we knew, the cancer was isolated to my left breast. A bit of good news in a cluster of bad.

Then I got a call from the genetics counselor. She said I had BRCA 2, the lesser severe form of the breast cancer gene. I wasn’t surprised by these results, because of my family history and being an Ashkenazi Jew.

I spent the next 2 weeks getting a second opinion from another breast surgeon and meeting with a plastic surgeon. It was very strange being in a plastic surgeon’s office. I’ve always been the one in my group of friends that was adamant about never getting any plastic surgery – ever. How ironic that I would not be the one with fake boobs.

Decision Time

After consulting two doctors and doing a ton of research online, I decided to have a bilateral mastectomy. With my family history and having the BRCA gene, the chances of breast cancer showing up in my right breast was quite high. I thought being aggressive and proactive was the best action to take. Believe it or not, it wasn’t a very hard decision. I knew what I had to do.

First Surgery

On Tuesday, April 17, 2012, I had my bilateral mastectomy. During this surgery, tests would be done to find out if the cancer had spread to my lymph nodes. If they had, I would definitely need to do chemo and radiation. Because all of my tests came back clean before surgery, my breast surgeon told me there was only a 3% chance that the cancer spread to my lymph nodes.

Well…I’ve always strived to be the best at everything I do, so why do anything differently with cancer. In surgery, the tests showed that my cancer had spread to my lymph nodes. I was part of that 3%. So I would, in fact, have to do chemo and radiation.

Besides the cancer spreading to my lymph nodes (minor detail, right?), the surgery went well. Both surgeons were quite pleased. I was pretty nauseous from the anesthesia and had drains in me for a couple weeks, but sure was glad the surgery was over.

Next Steps After Surgery

A week after surgery, I met with my breast surgeon to talk through the pathology report and decide what to do next. She confirmed that I had stage 2 breast cancer, but my tumor was quite aggressive. She was sending me to an oncologist and radiologist, but was pretty sure they’d recommend 8 rounds of chemo and 7 weeks of radiation. My breast surgeon kept saying, “It’s going to be a long year.” I didn’t really get it. I thought 4 months of chemo and 2 months of radiation – that’s only 6 months. What is she talking about? (I was told there’d be no math.)

Well… now I know. I had to have another surgery for my final breast reconstruction. And I had to wait two months after each surgery to start the next treatment.

Making A Treatment Plan

It was quite surreal meeting an oncologist and radiologist at the age of 39. I was one of the few young women in both of these offices. Again, shouldn’t I be 60 years old when I’m doing this?

I was connected to a great oncologist and radiologist. My wonderful team of doctors continued to grow with more amazing women. Both doctors wanted to do the most aggressive treatment possible: 8 rounds of chemo (once every other week for 4 months), and 32 zaps of radiation (5 days a week for 6.5 weeks).

Chemo

I was terrified of chemo. I watched my dad go through chemo and he was sick as a dog. I was pretty lucky through my chemo. I was nauseous a few days of the 4 months, but nothing unbearable. Thanks goodness for those drugs. I was mostly exhausted and slept as much as possible. My brain definitely wasn’t working – confirming the theory of chemo brain.

One of the hardest parts of chemo for me was loosing my hair. They told me this before I started chemo. I didn’t believe them. But they were right. When you have to look at yourself in the mirror and see no hair on your head, no eyelashes, no eyebrows – there’s no way to deny that you’re sick. It’s a harsh reality.

They also tell you that the effects of chemo are cumulative. So, I was often worried about things getting worse as the chemo treatments piled on. The worst part was actually the mental aspect. I grew mentally tired of having to go through treatment as it seemed to be taking forever. And the anxiety of things getting worse as treatments piled on certainly didn’t help my mental state.

Every week during chemo I went to see an acupuncturist, who I’m certain helped mitigate the potential side effects of the chemo. I’m forever grateful for his care – both physical care and mental care. He was a wonderful man who cheered me on every step of this journey.

On September 18, I had my last chemo session. I was so thrilled to be done, but too tired to celebrate. Everyone else was jumping for joy that I was finished with this part, but all I could think about was what’s next? And how much longer?

2nd Surgery

After chemo finished, I had my 2nd surgery. This was my final breast reconstruction surgery. It was a much easier surgery than the first one. It only took a couple hours and I was home by the afternoon. I had to have drains for this surgery also, which was a big bummer. I hated those drains and couldn’t wait to get them out. But the surgery went well and I was one step closer to being done with this journey.

Radiation

On Thursday, November 6, I started radiation. It made me tired, but I didn’t get any of the redness or blistering or rashes that some people suffer through. Going to the hospital every week day for 7 weeks got real old, real fast.

On the first day of my treatment, they gave me a badge that said Cancer Center on it, with my name. I would swipe that badge every day I came in for treatment so they knew I was there. I just couldn’t believe I had a cancer badge with my name on it. It felt like a dream…or a nightmare.

5 days a week for 6.5 weeks I went to the Cancer Center for radiation.

Treatment Finished

On Friday, January 18, 2013, 10 months after feeling my frozen pea, I officially finished my treatment for breast cancer. 2 surgeries. 8 rounds of chemo. 32 zaps of radiation.

Life As A Survivor

Now that I’m done with active treatment, I’m trying to figure out how to live life as a breast cancer survivor. It’s harder than I thought. I’m grateful to have survived, but it sure was a lot to go through.

When you’re going through treatment, you know what you need to do. You put one foot in front of the other. You focus on making it through your first surgery. Then you focus on getting through your first chemo, then the next one, then the next one… Then you focus on getting through your second surgery. Then you focus on getting through your first radiation zap, then the next one, then the next one…

Now I’m left to sort through all these feelings about what I went through, what lies ahead for me and how long I’ll be around. Life is full of uncertainties and getting breast cancer at the age of 39 only reinforces that.

I’m trying now to finding my equilibrium. The roller coast of being a breast cancer survivor is hard. Harder than I expected.

One day at a time.