Last Chemo – Two Years Ago Today

Two years ago today I completed my 8th and final chemo treatment for breast cancer. Some days it feels like so long ago. But most days it feels like just yesterday.

My hair has grown back. It’s short, but no longer looks like I’ve been through chemo.

My energy has come back, for the most part.

My chemo brain still lingers, but no where near what it was during active treatment.

I’ve even gotten used to my new breasts. But I have to say, I don’t think I’ll ever get over loosing my natural breasts. Fake breasts just aren’t the same. For so many reasons.

While I’m grateful that I’m a ‘survivor’ (I hate that word, but that’s a blog post for another time), a day doesn’t go by that I don’t think about all I’ve been through in the last two years. It’s hard to move past a breast cancer diagnosis when you’re reminded of it every morning when you get dressed and see the mastectomy scars.

I do feel like I’m acting more like my pre-cancer self – going out with friends, regularly exercising, taking trips, not completely freaking out every time I feel an ache and pain. But as most people feel who have had a cancer diagnosis, the fear of recurrence is always in the back of my mind. You try to live as much of a normal life as possible, but it’s sometimes hard to quiet those dark thoughts in your head.

In the last two years since finishing chemo, I’ve joined a support group through the Young Survival Coalition. This organization focuses on supporting young women – 40 and under at diagnosis – with breast cancer. It’s so helpful to talk with other women who have gone through and are going through similar experiences as you. It makes me feel less alone and more understood.

I’m also trying to pay it forward a bit. There are newly diagnosed women that come to the support group every month. I remember how I felt at that time – scared, worried, nervous, anxious, etc. So I try not to sugar coat it and to tell these young women that breast cancer sucks. But I also tell them that we’ll be here to help her through it. Sitting and listening was the best help for me, so I’m trying to do the same for these women.

As I mark another milestone of one more year past my last chemo treatment, I’ve noticed that I’ve made other changes in my life too. Some are deliberate, some just happen after going through a traumatic event. I find myself spending less time doing things I don’t want to do. More time with people I want to be with. Going to places that have been on my list to visit. I used to be a person that read magazines cover to cover. Now if there’s an article I’m only mildly interested in, I’ll turn the page. No time for that now. Even if I am lucky enough to be alive for 50 more years, that’s a good life lesson, cancer or no cancer. I just wish I didn’t have to be diagnosed with breast cancer to learn it.

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A Change of Perspective

I’m a little behind on my blogging lately. I’ve been busy doing fun things. What a nice change from being tired as a result of cancer treatments and doctors’ appointments.

Last month, I had my first infusion of Zometa. Zometa is a bone strengthening drug, which also has shown to prevent recurrences of breast cancer in some studies. My oncologist wanted me to do this treatment since in July of this year, I was diagnosed with osteoporosis in my spine. Yes, the joys of breast cancer continue.

I was pretty bummed about having osteoporosis, but even more bummed about the treatment, since the drug is administered in the chemo area of the hospital. I never wanted to be back there. Ever.

My oncologist told me I could expect flu-like symptoms the first couple days after the treatment. So I scheduled the infusion for a Friday, giving myself the weekend to recover. It felt like chemo all over again – figuring out when my body would have the worst reactions to treatment and how long it would take to recover.

So I went to the hospital, as early as possible, to get it over with. The sooner I got there, the sooner it would be over. They start infusions at 9 a.m., so that’s what I did.

The nurses were so nice, as usual. I feel very grateful to be so well taken care of. Not everyone has that experience.

The infusion didn’t hurt at all. I barely even noticed the needle going in or out. I guess I’m just used to that by now. They started the infusion, I turned on my iPod, closed by eyes, and 5 songs later, it was over. As my oncologist promised, the infusion only took 20 minutes. The whole thing took about 45 minutes. Couldn’t wait for it to be over.

I went home and laid on my couch. I was pretty exhausted. Of course I didn’t sleep the night before. The first time I do anything, I’m always nervous. So getting rest that night didn’t really happen. The emotional toll was worse than the physical toll for this treatment.

My oncologist told me to drink a TON (her emphasis) of water. Zometa is flushed out through the kidneys. So water gets it out of the system. I spent the day on the couch, in and out of napping. I did get this souvenir from the infusion – a lovely bruise on my arm:

Bruise From Zometa Infusion

The next morning I woke up, feeling pretty tired still but not terrible. No flu-like symptoms yet, but I decided to stay in to rest and keep drinking that water.

Around 8 p.m., I decided to go to bed early to catch up on that sleepless night the night before the treatment. But that’s when the flu-like symptoms showed up. I started to get some chills and feel a bit nauseous. I actually haven’t felt cold in a long time. Hot flashes and overall heat is my normal body temperature these days, thanks to Tamoxifen and my oophorectomy (the removal of my ovaries). So in a weird way, it felt kind of nice to be cold. The nausea though, I could do without that.

The flu-like symptoms only lasted for a couple hours. As I laid in bed eating ginger to help settle my stomach and with a wool hat on my head to try to warm up, I kept telling myself, “You’ve been through worse. This is nothing.” It actually kept me calm and helped me not freak out about what was happening with my body.

Not that I really needed it, but the Zometa infusion and my body’s reaction was a reminder that I’ve been through the ringer in these last 2 years – a double mastectomy, 8 rounds of chemo that lasted 4 months, 1 reconstructive surgery, 32 zaps of radiation over 7 weeks (5 days a week), an oophorectomy, and countless tests and doctors’ appointments. My perspective has changed. A little chill and nausea for a couple hours? No big deal. I can handle that.

So, I snuggled with my dog Murphy for some body warmth and TLC. Then next thing I knew, the chills and nausea were gone and I went to sleep. Another cancer experience that I’m happy to be moving past.

 

And Now … Osteoporosis

I’m 41 years old and have already gone through a double mastectomy, 8 rounds of chemo, 1 reconstructive surgery, 7 weeks of radiation and an oophorectomy (the removal of my ovaries). All because of my breast cancer diagnosis and having the BRCA 2 mutation.

That’s enough for a lifetime, if you ask me.

I went to see my oncologist in May for my 6-month check up. She wanted me to do a bone density test, mainly to get a baseline, she said. Having my ovaries removed and taking tamoxifen, my body is not producing or getting any estrogen, which helps keep bones strong. So I figured I would be at risk for osteoporosis, but not for a while.

Last week I finally did my bone density test, which, by the way, was the easiest test I’ve ever done. No IV, no drugs, no fasting. You lay down, they scan your spine, then they scan one hip. Then you’re done. In and out in 15 minutes. Best. Test. Ever.

Two days later, I got the call from my oncologist. My spine already shows signs of osteoporosis. DAMN IT!

So now she wants me to be given a drug called Zometa. Zometa is a bone strengthening drug, which also has shown to prevent recurrences of breast cancer. Both good things.

Here’s the good news – I will only have to be given Zometa once every 6 months (twice a year). It only takes 15 minutes to administer the drug.

Now the unsettling part – Zometa is given through an IV. That kind of sucks. But the worst part – I have to go to the chemo area of the hospital to get the infusion.

I never wanted (or want) to see that stupid chemo area again. When I said goodbye to those lovely nurses who helped me through chemo two years ago, I said goodbye. Not see you later. Goodbye. Have a good life. I’ll never see you again.

But here I am, being told to get an osteoporosis drug administered in the chemo area of the hospital.

Now, I know I should be grateful that I’m only going there for osteoporosis, and not because I have a recurrence of breast cancer or some other cancer (fingers crossed that’s always the case). And I should be grateful that my oncologist is aggressive and assertive on my behalf with any health issue. But that somehow isn’t making the tears stop flowing when I think about walking into that chemo area. Having to see all those people, who I used to be one of, get chemo – that’s going to be hard. Talk about PTSD.

I guess the other upsetting part is that this is just one more thing I have to do now because of stupid f*$%ing breast cancer.

I see at least 1 doctor every 3 months, I get blood work done every 6 months, I go for scans every year, and now I have to go get this drug pumped into me every 6 moths. It’s just one more thing that I have to do in a hospital with doctors. And that just sucks.

It reinforces the fact that you’re never really done with cancer. There’s always something.

Welcome Back Freedom – So Nice To See You Again

I love fireworks. Always have, always will. They are not only beautiful and inspiring, but they bring back great memories of summers with my family and at camp.

The last three years I haven’t watched fireworks on July 4th. Since my breast cancer diagnosis in 2012, I was either too tired from my mastectomy and chemo, too tired from radiation or it was too hot for me to be outside to watch fireworks.

But this year was different.

I’ve been staying up later these days – actually able to stay awake until 10.30 p.m. That’s a major accomplishment for me. For the first two years after treatment finished, I could barely stay awake until 9 p.m. So 10.30 p.m. is huge! Small victories, right?

This year was also perfect weather to watch fireworks. It was a beautiful night with temperatures in the 70s. Couldn’t ask for better weather in July.

So I took a walk down to the Washington monument, which is about a mile and a half from my home. That’s another thing I couldn’t do in the last three years – walk for three miles at 9 p.m. I used to get tired after about 20 minutes of walking at night. It feels great to have more energy and stamina.

Over the last three years, it has felt like cancer robbed me of so much in my life – my body changed (not in a good way), my mind got slower and foggier (thanks chemobrain), my energy levels dropped, my insecurities about my future went to new heights…the list goes on.

But this July 4th, it felt like I regained some of my freedom. A freedom to live my life how I used to – going where I wanted, when I wanted, how I wanted. It’s amazing to be able to do that again.

And I’m sure there will be other nights where I’m too tired to do anything or its too hot to be outside, but for right now, I’m enjoying this new found freedom. I often wondered if this day would ever come. So nice that it has.

Fireworks Fireworks

How Do You Tell Someone Those Three Words: I Had Cancer

A couple nights ago I went for dinner with a friend from college. She was one of my best friends at the time, but I hadn’t seen her in almost 20 years. We’ve stayed in touch through Facebook, but I don’t share the intimate details of my life on there.

I was excited to see my old friend, but was pretty nervous about sharing with her that I had breast cancer. Sure, I’ve told many people about my diagnosis and treatment. But how do you share this with someone you haven’t seen in 20 years. When she says, “How are you?” Do I automatically say, “Well, I spent 2012 going through treatment for breast cancer.” It’s not really something you just blurt out when someone asks how you are. Or at least I don’t.

And I’m still hesitant to tell people about my breast cancer because I don’t know how they will react. I want to share this personal experience with most people, but I never know what someone will say or do when I tell them I’ve had cancer. I’ve had people start crying, and then I have to tell them that it’s ok. I don’t really want to be taking care of someone else when I’m the one who’s had cancer.

And then there are the people that just give you a blank stare. They never know what to say so they usually say nothing. That’s awkward too.

So, my friend and I started chatting and I quickly got up the courage to tell her about my breast cancer. I shouldn’t be surprised by this, but she immediately told me that her sister-in-law went through the same exact diagnosis and treatment as me, at the exact same time, at the exact same age (39). To say that cancer is an epidemic is an understatement.

While I obviously wasn’t happy to hear about my friend’s sister-in-law, I was so relieved to be able to talk about breast cancer with someone who had seen it first hand. She hasn’t been through it herself, but she certainly learned how to talk about breast cancer in a caring way. My friend was amazingly supportive, without making me feel like she was feeling sorry for me.

We talked all about what I’ve been through physically as well as emotionally. How scary it was. How crappy it was. How I’m doing now. My thoughts on the future.

And most people can’t even muster up the courage to use these words, but the phrase “I’m still here” came up a lot. My friend wasn’t afraid to talk about that with me, while most people can’t even think those words, let alone say them out loud. It was so wonderful to be able to be honest with her about how much cancer sucked and still sucks, without me having to sugar coat it for her. That’s a true friend.

But while I sit here reflecting on how great it was to see my old, dear friend, it reminds me that I’m still trying to figure out how to tell people I’ve had cancer. This goes for strangers as well as friends I haven’t seen in years.

So how do you tell someone that you’ve had cancer?

My Two Year Cancerversary

Today is my cancerversary.

There are different days that people choose as their cancerversary. Some people use the day they’re diagnosed. Others use the day that they are declared cancer free. For me, I choose the day of my mastectomy – when they removed the tumor in my breast and the tumors that spread to my lymph nodes – and they considered me cancer free.

My mastectomy was on April 17, 2012. That’s two years ago today.

I’ve been thinking about this day for weeks. I was really expecting to be celebrating. I’ve been cancer free for two years. That’s kind of a big deal. Actually not kind of. It is a big deal.

And most importantly, I’m still here.

My prognosis at diagnosis was good, but you just never know what will happen. I knew that reality before, but cancer reinforced my belief that life is unpredictable and bad shit happens. Not much you can do about that.

So I figured I would be really happy to be reaching the two year mark. But I woke up this morning to find myself feeling melancholy. That’s actually a nicer word than what I’m really feeling. A more accurate word is just downright sad.

Although I’m physically feeling good after all my body has been through – a mastectomy, chemo and radiation – I seem to find my thinking, “Is this really my life now?”

Survivorship is hard. I know I’m one of the lucky ones. I did survive. But a day doesn’t go by that I don’t think about my cancer coming back or showing up somewhere else. 30% of early stage breast cancer comes back as stage 4. I was stage 2 at diagnosis. Fingers crossed I don’t become stage 4.

Don’t get me wrong, I think I’ve made good progress in the last two years. And I’m proud of myself for that. I’ve been getting back to the things I used to do before cancer – going out with friends, visiting my family, working normal hours, going on trips, swimming, running, yoga. And I have more good days than bad ones.

But I now know that my life will never be like it was before cancer. My body aches like a 90 year old lady sometimes. I’m still getting used to my new body – both how it looks and how it feels. I get tired a lot earlier in the evening than I used to before. I now have a pill box to organize my daily medication, so I don’t forget to take it. I guess that’s what makes me sad today.

Today reminds me that I’ve lost a lot of my carefree tendencies. I take life a lot more seriously. Now I wonder how long I have to do the things that I really want to do. Will I get to have kids? If I do, how long will I be around to be a part of their lives.

I’ve been lucky to have found a great support group through the Young Survival Coalition. These women that I get together with every month make me feel less alone. We can talk about our fears and concerns. And how hard survivorship is. We can even laugh about things like forgetting where we parked our cars because of our chemo brain.

They say that eventually you stop thinking about cancer every day. I hope they’re right. But its hard for me to imagine that day. Right now it feels like two steps forward and one step back. I guess I just continue to do what I’ve done over the last two years – just take it one day at a time.

Birthdays Are Now Bittersweet

Tomorrow is my 41st birthday. It’s also the day before I was diagnosed with breast cancer two years ago.

I used to love my birthday. Since I was a kid, my mom always made a big deal of birthdays. They were fun and special. But that was before cancer came into my life. Now my birthdays are bittersweet with new significance.

Every birthday is now a big fuck you to cancer. Another year I’ve survived. Another year that I’m able to be around to talk about having had cancer. Another year that I’m able to keep dreaming about growing old.

Tomorrow is only my 2nd birthday having survived cancer. So I feel like I’m still figuring out the roller coaster of being a cancer survivor and being able to celebrate my birthday without getting upset that the day after is my diagnosis day. It’s hard to separate the two days.

Two years ago, I felt my lump a week before my birthday. My friends and family wanted to celebrate my birthday, but I knew that a diagnosis was coming. So I didn’t much feel like celebrating. I couldn’t stop crying about what I knew would be a change for the worse in my life. Even though the results weren’t in yet, I just knew I was in for a long treatment for breast cancer.

Last year, I had finished chemo and radiation just two months before my birthday. My hair was starting to come back, which felt great, but I was just beginning to deal with everything I had gone through. It wasn’t until after I was finished with treatment that I could attempt to process what had just happened. So, by the time my birthday came around, I was trying to make sense of what I went through and couldn’t stop crying about it.

But this year, I’m looking forward to celebrating my birthday The usual things will happen, as they have all my life – people will call to tell me happy birthday and how much they love me. I’ll get cards in the mail or emails wishing me a great day. I’ll go out for dinner with people I love, a great reminder of how lucky I am to have amazing people in my life.

And I’m sure I’ll be crying again this year, but this time those tears will be grateful tears. Grateful that I’m here to celebrate another birthday. Grateful that I’m cancer free (fingers crossed that lasts for another 41 years). Grateful that I have so many wonderful people who support me in happy times and tough times.

Another Study Asks If Mammograms Are Helpful or Harmful

In yesterday’s New York Times, there was an article, “Vast Study Casts Doubts on Value of Mammograms.” The writer explains how the study questions whether mammograms save lives or impose unneeded tests and treatment. You can imagine how upsetting this uncertainty is, especially for a breast cancer survivor.

In all cancers, there is a long-standing debate about how worthwhile scans are versus the radiation imposed on the body from these tests and the anxiety induced from such tests versus leaving a tumor in place that wouldn’t harm or kill someone. I understand the arguments on all sides, but I always have a strong reaction when someone says mammograms aren’t worth it.

For me, if one life was saved from an annual mammogram, then it’s worth doing. Especially if that one life is mine or someone I love.

I was diagnosed with breast cancer at the age of 39. I hadn’t yet had a mammogram. Even though I come from a long line of women with breast cancer, none of my doctors suggested I get a mammogram before turning 40. And a few years earlier, a national government panel recommended mammograms be done starting at 50, instead of 40. Even more reason for my doctors to not push for a mammogram.

I often kick myself about not insisting that I get an annual mammogram starting at 35 years old, because of my family history. I found my lump in a routine self-exam, which I did without fail every month since I was in college. If I did get annual mammograms before age 40, would we have found my breast cancer earlier? Would we have found it before it spread to my lymph nodes? Would it have spared me having a mastectomy? Would I not have had to go through chemo and radiation? Of course we don’t know and will never know the answers to these questions. What ifs do little but create guilt. So I try to let that go. But I do admit it creeps into my mind sometimes.

Dr. Susan Love, one of the smartest, most well-known and accomplished surgeons and advocates on breast cancer, was interviewed about this study on KRCW’s Press Play with Madeleine Brand. Dr. Love talks about how there have long been questions about mammograms. And how this study shows that there are many different types of breast cancers and there isn’t a one size fits all approach to breast cancer screening and treatment. Which means we need research and studies to continue.

As Dr. Carol Lee of Memorial Sloan Kettering Cancer Center explains on the PBS NewsHour, this study is an update on a study reported nearly 20 years ago. Her opinion is that this study is just one in a long list of studies about mammograms that actually show a benefit of mammograms. Her opinion is that mammograms do save lives. I tend to agree with her.

I have another problem with this study, which was done with women ages 40-59. Once again, when breast cancer is researched, talked and written about, young women (women 40 and under) and women of color are barely, if at all, discussed.

As the Young Survival Coalition states, it is estimated that more than 250,000 women diagnosed with breast cancer at 40 or younger are living in the U.S. today. More than 13,000 young women will be diagnosed this year.

Mortality rates for breast cancer have been decreasing since 1989, with larger decreases in women under 50. That’s great new. But what about women under 40? The survival rates for young women are not good. Compared to older women, young women generally face more aggressive cancers and lower survival rates. The statistics on women of color aren’t good either. Although the overall lifetime risk of breast cancer is lower for Black women compared with white women, the death rates are higher.

Would annual mammograms save the lives of more young women and women of color?

When we look at the benefits and disadvantages of mammograms, let’s expand the conversation. Let’s look at all types of breast cancers, all ages of women and all ethnicities. Not until there’s a cure for breast cancer or a vaccine, the goal continues to be to save lives. And in my opinion, annual mammograms play a part in that.

To Scan or Not To Scan

Last week I went for my 6-month check up with my breast surgeon. I’m so grateful that I got connected to her. She’s both brilliant and compassionate with a great bedside manner. She gives me all the time I need to ask as many questions as I want and discuss whatever is on my mind. So I run a lot of things past her and ask her opinion on every medical question I have.

During my check up she did a breast exam and found no lumps or areas of concern. I do get a rash on my left breast, which is my breast cancer side, so that always worries me. Rashes are on the list of ‘red flags’ to talk to your doctor about. My breast surgeon said that the rash looks ok and because of the fact that it comes and goes means its nothing to worry about. Tumors don’t come and go. So she said everything looked and felt good.

HOORAY!!! Let’s take a moment to appreciate that.

Hooray

I still do my monthly breast exams, as my doctors recommend, feeling around my implants for any tumors that might pop up if any breast tissue was left during my mastectomy. But now I have to get to know my new boobs, and understand what feels normal and what I should be concerned about. So at every doctor’s appointment, I ask my breast surgeon about everything that feels unusual. Luckily, everything I’ve asked about she says is normal.

I also asked my breast surgeon about doing scans to see if my cancer has returned. There’s a lot of conflicting opinions about scans in the medical and cancer world. Some people and doctors think that scans can give people cancer from the radiation (ironic, huh!). And some people and doctors think that doing scans are good to be able to detect cancer early, which raises the survival rate. Early detection saves lives, right?

I’m really conflicted about this. Scans bring on scanxiety. What are they going to find when they do a scan? Then what do I have to do when that something is found – more surgery, more chemo? Ugh! But for me, not doing scans means the constant worry of something growing inside me that I don’t know about, which will keep growing until I feel it myself or get a symptom on the ‘red flag’ list for cancer recurrence.

What a shitty choice? Is ignorance bliss? Or is ignorance stupidity? Do the risks of radiation from scans outweigh the risk of not finding cancer early? Or is it the other way around?

I’m leaning toward doing scans. I’d like to know that I’m cancer-free every year. Mentally that helps me continue to live my life and make plans for my future. Not knowing how long I’ll be here is unsettling – to say the least. And I know that I can get a scan one day and then 3 months later cancer could return. Nothing is guaranteed. At least a clean scan lets me exhale and breath for a moment.

My breast surgeon originally said that we should do MRIs every year to watch for a recurrence. But when I talked to her about it last week, she said she usually recommends MRIs every 2-3 years. (I can’t do mammograms with breast implants, so MRIs are the way to watch for lumps. One of the few positives out of having breast cancer – no mammograms.)

We decided we’d revisit the scans discussion at my next 6 month appointment. My breast surgeon said that most health insurance companies don’t cover MRIs every year. How messed up is that! I have pretty good insurance, so I have to check on that. I’m going to pissed if she’s right.

I spent every other month in 2013 doing ultrasounds to watch for ovarian cancer. That much screening was quite overwhelming and difficult for me. So doing a scan for breast cancer every 2-3 years sounds really good right now.

So for now I’m left to decide – to scan or not to scan?

When Is My Brain Coming Back?

My brain still isn’t working like it used to. I’m not sure if its chemo brain lingering, or my mind trying to get back to fully functional, or something telling me to take it easy.

BRAIN-AT-WORKWords come to me slowly. In fact, sometimes they don’t come to me at all. And I’m not talking about complicated words. The other day at work, I couldn’t think of the word chair. CHAIR! I had to act it out to my co-worker, like we were playing charades. Could have been funny at a party, but during a work meeting…not so funny. Luckily my co-workers are also friends, so they were quite gracious with me. It was another daily reminder of what I’ve been through from breast cancer and how my brain hasn’t gotten back to normal yet.

Before I started chemo, I talked to many women who had been through what I was about to go through. One of the things they told me was that their mind still hadn’t gotten back to fully functioning. Some of these women were 3-5 years out of treatment. They said they couldn’t multi-task like they used to. And that their concentration wasn’t as good either. I thought they were being dramatic. And I thought, oh, that won’t happen to me. Well…here we are.

I’m trying to be patient. Next month marks my one year anniversary of finishing all my treatments. Everyone reminds me that it takes a while for the body and brain to get back to 100% functionality. I’m hoping that magically a switch is flicked in my brain that makes it work again at the one year mark. Patience with myself is not one of my strengths. Another stupid lesson to learn from this ordeal.

There’s a saying in the cancer community – “the new normal” – how to navigate your life after diagnosis and completing treatment. But I’ve come to see that my new normal is actually more like the new brain.

I’m sure there’s a more sophisticated word to describe how I feel about this new brain, but the only thing that comes to mind is UGH!