This summer has officially been the hardest season of my cancer journey. After seven years battling, I thought I had seen it all. I thought I could handle anything thrown at me in that doctor's office with grace and power. I thought I had already dealt with and learned how to overcome disappointment and setbacks. I was wrong.
Cancer has taught me several new lessons this summer. Learning has been painful, isolating, discouraging....heartbreaking.
My niece, Annabelle, was born with a full head of beautiful brown hair, brilliant blue eyes, and charmingly fat cheeks on April 5th. I was there to greet her, which was so special! You won't see pictures of baby Annabelle on this blog as she isn't my baby to share with the world, but I must say, she's the most gorgeous baby I've ever seen. I may be biased though.
On April 6th, I spent the sweetest morning ever in Annabelle's hospital room, smelling baby smells, listening to coos and cries, and meeting this new life that magically appeared and completely changed our family dynamic forever. I left the hospital, checked my cell phone and saw a message from my doctor. Cancer has an unpleasant habit of injecting itself right into the middle of every major life milestone - engagements, weddings, babies, holidays. Scan results were back and my cancer was growing, quickly. Change would be needed. Could I get to the hospital at 7am on Monday. Flights home were moved up, Annabelle visits were cut short. I didn't tell the glowing new parents about this news though. This needed to be their weekend. Cancer might ruin my day, but it sure as hell wasn't going to ruin their's!
The plan on Monday was to enroll in a clinical trial. Unfortunately, no clinical trial seats were available. Dr. P thought a trial might open up at the end of the month. For now, she was putting me on an FDA approved drug, Navelbene, that I had been on before. It had been several years before and I had stopped taking the Navelbene early. We didn't think my cancer had ever grown on it. The cancer hadn't shrunk on Navelebene, but it had stayed stable and the side effects were minimal. This seemed to be a good "place holder" for a month while a clinical trial seat opened up. I wouldn't use up any previously unused FDA approved drugs, we would keep all new drugs in my "arsenal" should we need them in the future, but I wouldn't leave the cancer untreated.
A month went by and no new trial opened up. That was heartbreak number 1.
Everyday I waited by the phone holding my breath, distracted and stressed out and snippy with the husband, hoping beyond hope that this was the day we would get the call. This was the day a trial seat would open. I can only imagine this must be what organ transplant patients go through. I hate it. I never want to experience that kind of long term anticipation and constant disappointment as each day's sun sets again.
Two months go by, a trial seat opens! This trial, however, is not ideal. It is a phase 1 trial of a type of drug called a "protein kinase inhibitor" I had taken a protein kinase inhibitor in a clinical trial setting before and had a very violent reaction. My platelet count fell dangerously low and I was breaking out into bruises all over my body. Just sitting on the couch watching tv, I would stand up and my whole back would be covered in bruises. It was scary. I didn't want those side effects again, but beggars can't be choosers and not all protein kinase inhibitors are created equal, so I jumped in with a smile and both feet!
Enrolling in a clinical trial is harder than getting into Harvard. The patient must first go through a "drying out period." No other chemo drugs for a month. You have to swallow your fear, put all your eggs in this clinical trial basket, and hope your cancer doesn't grow for the next month chemo-free. You then spend the next month going through test after test after test- bone scans, brain scans, lung tests, blood work, blood work, and more blood work. I was at the hospital for days on end getting different tests. Each test was more stressful than the next.
Finally the big day is here. Somehow we've made it to July, I've barely blinked or had time to wrap my head around this, and I'm still not being treated with any drugs! I am sitting in my gorgeous peach hospital gown, freezing cold in the AC, excited to start my new lifesaving clinical trial. The doctor comes in to review the last round of blood work and perform the last exam before that priceless drug can enter my bloodstream. As she is going through the blood work, we get to the last page of like 6 pages of results. She suddenly stops, "hmmmmmm"s, looks at me, looks back at the computer screen, frowns. Turns out, my liver function has dropped over the past month of no chemo because the cancer in my liver has grown. One little liver output - billirubin - that rarely changes and we rarely look at has gone up drastically. My billirubin has disqualified me from the clinical trial.
I struggle not to cry. I struggle not to scream. I struggle not to strangle Dr. P right there in the exam room.
She quickly calls in reinforcements and starts looking through her email and on the clinical trials website for another option. All options require my billirubin to be lower. I am officially a clinical trial reject. I can't enroll in anything. It is back onto drugs that are designed, not to kill, but to (hopefully) keep things stable.
After all this waiting, all this hoping, all this sitting by the phone.
I can't handle it. I shut down. The disappointment is too much. I am sick and tired of being cancer girl. I am paralyzed. Every time I think about my cancer now, I cry. I break down. I am shedding tears on my keyboard now as we speak. I have reached my limit. My Big Girl Pants can only stretch so far. A girl can only handle so much. I can handle no more.
I don't call my friends. I stop my blog. I don't want to talk about how I'm doing. I'm not doing well.
I throw myself into work - where I am anonymous. Where I am judged, not by my liver output, but instead by things that are within my control. I flourish at work. Work makes me calm. Work makes me normal.
I throw myself into caring for my husband, who is struggling perhaps even more than I. He can't make this better. The drugs do not keep things stable. My tumor markers rise from 200 to 500 to 600 to 6,000 to 8,000. Big Man can only watch as I lose my appetite and get skinnier and skinnier. I struggle to catch my breath when I walk the dog because the lesions in my lungs are getting larger. I wake up in the middle of the night with excruciating pain in my side from my enlarged and painful liver. Every day I feel new swollen glands, in my neck, in my belly, in my groin. The cancer is in control. I can't get on a trial, what can I do? I can bake him birthday cake. I can cook him 5 course dinners. We can watch movies together and go out to long silent dinners together and just spend time clinging to one another.
But this life is not good. A life revolving around work and caring for the home is good, but is not enough. We need friends, we need to come out from the shadows and share. We can't keep this news to ourselves forever.
I am starting to call friends. I am keeping engagements. I am trying.
Last week, even though I was getting over a major chemo-induced bout with Thrush, which is a horrible virus I don't recommend any of you contract if you can help it, I insisted upon keeping a long standing Annabelle visit. It was hard traveling when I wasn't 100%. It was also scary to travel when every single person around me seemed to be coughing and sneezing and touching things nearby. I hate traveling with cancer, but I realize now that I can't keep doing what I'm doing or I'm going to keep getting what I've got. I am sad. I cry a lot. I am missing fun summer things. I have to move forward.
I am so glad I traveled. The latest chemo drug we are trying to get my cancer under control is making me lose my hair again. I only have about 3 months worth of hair growth, but it is hard won and has done a lot to boost my self esteem. My hair is starting to fall out again. Hair is everywhere. Taking showers is depressing. The last of my eyelashes fell out on Sunday.
But when you get a spit-filled, toothless grin from your niece at 7am as she greets you in her crib smelling all baby-ish, when she looks at you, and recognizes you, and knows that "this girl is fun! I know you! It's time to have fun today...." That 4 month old grin wipes away all the pain and sadness and hair loss. When you are showered with 4 month old Annabelle smile, you feel like the most gorgeous girl in the world - hair loss be damned.
I want to have more of those lifetime moments. I want to have more moments of belly laughter around a dinner table with friends. I want to have more late nights of card games with my sister in law. I want more Annabelle smiles. Even if I feel sick, there are things I can do and should do. I was able to make that trip home. I want to plan more of them. Even though I'm crying over the keyboard, I am perfectly capable of sharing with all of you, and I know that you will lift me up, and somehow magically make me feel better as you always do with your support and love.
So here I am, this is my coming out party. Things are going well these days. This has been hard. But I am moving forward, and I am insisting on focusing on and planning more wonderful, happy lifetime moments. I am hopeful that this latest drug regimen - Herceptin, Docetaxol, and Perjeta - is THE drug regimen that stops all of these painful cancer-induced side effects. I am hopeful that I will start to feel like myself again, even if I am my bald self. I am hopeful that I will have many more Annabelle visits and that I can watch her start to sit up on her own and crawl, which she is dying to do!
I am going to start living life again.
Thanks for being patient with me as I struggle with this. I care about all of you very much.
Showing posts with label health. Show all posts
Showing posts with label health. Show all posts
Tuesday, August 28, 2012
Friday, November 25, 2011
My Blog of Thanks Giving
Happy Thanksgiving, readers!
I hope you are all snuggled up on the couch, catching up on sleep, reading a book, or enjoying a football game! For me, Thanksgiving took on a whole new importance after my cancer diagnosis. Prior to cancer, Thanksgiving for me was simply the dress rehearsal for Christmas. Now, after cancer, Thanksgiving is my favorite holiday. I so appreciate this one day a year when I can sit back, surrounded by my loved ones who know me and my struggle best, and count my proverbial blessings.
Every year, my family goes around the dinner table and proposes a toast to his or her greatest blessing. Prior to cancer I always came up with something, but it was never anything that truly stirred my heart. Post-cancer, I was giving thanks for just about everything- from my health care insurance, to my co-workers who covered for me on sick days, to the plumber who cleaned a whole head's worth of my hair out of our shower drain. Everything, even the most inconsequential, took on a new importance post-cancer.
This year, for a moment back in October, that happiness, that ability to give thanks and mean it, even for the small stuff, the ability to count my blessings was taken away from me. I had trouble finding things to be thankful for when I was facing constant, aching back pain from my bone metastasis. It was hard to be thankful when my hair was falling out in huge clumps every time I took a shower. It was hard to be thankful when the Taxol started giving me daily nosebleeds. It was really hard to be thankful when, not only was I self conscious about my newly sheared head, but I also started breaking out in a hot red rash all over my face and bald head from the steroids. It was hard to be thankful when I missed a best college friend's wedding because I didn't have enough energy after chemo to make the cross country trip. But most of all, it was hard to give thanks for even the most constant blessing - my family and friends - when I looked around the room, remembered the terrible news my doctor had given, and imagined future Thanksgivings without me at the table.
I was running the risk of becoming jaded. I didn't like jaded Bridget. Jaded Bridget was not in line with my sunny personality. Had cancer finally won on every front? Had it taken away not only my health, my good looks, my physical ability to provide for my family, but even my happy personality?
I didn't know how to deal with this. I was having nightmares about visiting the pearly gates and being denied admission - very vivid dreams where I would be grilled by a scary looking judge about every piece of nasty gossip I had spread and every lie I'd ever told. I was petrified by and obsessed with the thought that we might have a vengeful God on our hands.
One Sunday afternoon, Big Man came home from a weekend away with friends. He asked me what I had done all weekend long in his absence and I did what so many wives would do. I lied. Did I tell him I sat on the couch all weekend and read that trashy chick lit novel I'd been meaning to get to since summer? Did I tell him I let the dog sleep in bed with me because I wanted some company while I ate popcorn and watched "Princess Bride" for the 50th time? No, I told Big Man that I spent the weekend at the grocery store, walking the dog, and "running errands" because Big Man wouldn't even know what errands exactly needed running. That beautiful fall Sunday evening, I fell asleep in our crisply cold room and woke up in a sweat at 4am from that same nightmare. Vengeful God had condemned me to an eternity in hell for lying to my husband about the dog sleeping and the book reading.
October was a tough month for me.
But then, without warning, hope and joy started peeking through in the most unexpected of places when I wasn't even looking for it. Hope found me in the bathroom when I lost my hair.
The first time I went through chemo and lost my hair six years ago, I visited a fancy salon to have my head shaved. They took me into a private back room, and some woman I've never seen before or since shaved me in about 5 minutes. This time around, I was much more matter-of-fact about the whole hair loss. I was prepared. I had done this before.
One morning, I woke up and I couldn't take the itching anymore. (Chemo kills your hair follicles so they itch and the hair shaving actually comes as a bit of a welcome relief.) I woke up Big Man. Without even a word of protest, even though it was only 7am on a Saturday morning, Big Man got up. He and I walked hand-in-hand to Walgreen's. We purchased a pair of clippers, I stuck my head into the sink, and my husband shaved off all my hair. He cried a bit, which made me cry. I thanked him profusely, which made him cry. But in the end, a moment I had dreaded actually gave me hope. I will cherish that memory forever. After seven years together, shaving my head in the bathroom sink was certainly our most intimate moment. We were a scared young couple looking ahead toward an uncertain future, but at least we were doing it together. He had my back. He would take care of me. "In sickness and in health" we had told each other when I still had hair and boobs. Big Man proved he meant those vows when he shaved my head last month, slowly, carefully, and whispering soft words of comfort when I cried.
I also found hope that I was afraid to share with all of you. I'm still so afraid to share this news with you because I'm afraid next week the tide will turn. My heart and hope might be crushed again, and only God knows when. When this good news changes, I will be forced to explain the change to all of you, and then all of you will be crushed right along with me. I'm also so afraid that, by sharing my hope here with all of you, I might be jinxing it! I always prided myself on being factual, logical, grounded.... now I fear cancer is making me all religious and superstitious!
But I can't keep the news to myself any longer. If I jinx myself, so be it!
Taxol gave me hope. The most unexpected drug has given me hope for a future. Taxol was a drug that was given to buy me more time. It was meant to keep the "cancer at bay" and "minimize the pain from my metastasis." After years of enrolling in clinical trials and taking the latest, greatest, best, most touted new medicines, Taxol, first discovered back in 1967, has turned out to be "The Drug" that I was hoping for! At least for now....
When I last got scans back at the beginning of October, my tumor markers were extremely high. The most important tumor marker in my blood that my doctors look at each week is called CA 27-29 and it is a tumor marker that breast cancer cells leave behind in patient's blood. Normally, in a healthy person, CA 27-29 counts range between 0-38. My CA 27-29 count was 965! This critically high tumor marker number is what prompted all the discussion about getting my affairs in order and it's what prompted getting a CT scan earlier than expected, which is what uncovered the tumors in my lungs and bones.
Well ladies and gentlemen, I am happy to tell you that my blood work this past month has been steadily dropping! The first few weeks of Taxol, they didn't take any tumor marker bloodwork. They wanted my body to get used to my new drug before trying to measure its efficacy. November 2nd was the big day. November 2nd, I went in with Big Man and Mom to meet with my doctor to find out the results of my first tumor marker test on Taxol. I was petrified! I was so scared that the Taxol wouldn't have had an effect and we would be one more drug closer to death.
I was prepared to give you all an update on my hair loss and impending doom on November 2nd when, to my surprise, I was told my tumor markers had dropped from 965 to 587. I was shocked, I was thrilled, I was completely unprepared for this foreign thing we call "Good News." However, I was still afraid. I realized then that I was afraid to hope. Cancer had left me jaded and afraid of hope.
Unable to share the news for fear of a jinx, I simply stayed silent. I stayed off the radar. As unused to good news as I had become, I continued planning as if the good news hadn't happened. I still want to schedule a meeting with my priest, but I no longer had nightmares about the pearly gates.
Then, at my appointment on November 16th, my markers fell to 300!
Then, at this week's appointment, my marker fell to 234!
I feel a little bit like I'm watching a Thanksgiving football game, and my team just got a first down. Improbable as it might be, we got another first down, and then another. The TD is now within my sites. I'm allowing myself to dream. I'm allowing myself to set goals. If I could get down below 100... 38 could be attainable. 38 means normal. How I would love to be normal! I'm right there in field goal range of normal. I can taste it.
November has allowed me to hope.
Back in October, my doctor told Big Man and me to go on a trip. We should take a trip so that we could take quality time away together while I was still feeling good, today. My bone pain was manageable with Advil, today. We needed to take advantage of our time together because we were together, today. So we did, we booked a trip to Europe at Christmas and we're so excited! But our excitement was also tinged with sadness. What was this trip? People take honeymoons. People now take "Babymoons." What was this a "Goodbye-moon?"
Now with this good news, that trip has taken on such a more fun and exciting feel. What other good news might we celebrate come Christmas? Maybe we could finally be like other couples and truly leave our worries at home? Maybe in the New Year we could start imagining a new home in our future? A home where we had the room to host more than 6 people for Thanksgiving dinner? A home of our very own, not an 800 sq foot condo? A home that we could decorate as we see fit for the Christmas holiday? A home that we could call our forever home? A home with space for an office AND a nursery? A nursery.
At chemo on November 23rd, instead of blogging as I should have, or answering emails as I should have, I allowed myself to google adoption resources in Massachusetts. I bookmarked the Massachusetts Department of Children and Families. If I get those tumor markers down to 38, down to the normal patient range, I'm going to allow myself to call their 800 number and start asking questions. Then maybe in 2013, when we're in our new forever home, I could actually schedule a home study. Hey, a girl can hope can't she?
I may be bald and covered in acne. I might not recognize myself in the mirror. I may have daily nosebleeds. I may have to sleep 13 hours every night, but at least I have hope. Those are just inconveniences. I wouldn't even elevate them to the level of "side effects." They are a mere nuisance, and they are a small price to pay for hope.
I realize as I'm writing this that I am getting all excited about just one month's worth of results. I know this is a marathon and not a sprint. I know that things can turn on a dime. But this Thanksgiving, I'm so Thankful for hope. I'm so Thankful for just one more day; just one more year. I don't want to get too greedy. I don't want to get ahead of myself. But I do want to take a moment and enjoy that future so many people take for granted. Thanks, God.
I hope you are all snuggled up on the couch, catching up on sleep, reading a book, or enjoying a football game! For me, Thanksgiving took on a whole new importance after my cancer diagnosis. Prior to cancer, Thanksgiving for me was simply the dress rehearsal for Christmas. Now, after cancer, Thanksgiving is my favorite holiday. I so appreciate this one day a year when I can sit back, surrounded by my loved ones who know me and my struggle best, and count my proverbial blessings.
Every year, my family goes around the dinner table and proposes a toast to his or her greatest blessing. Prior to cancer I always came up with something, but it was never anything that truly stirred my heart. Post-cancer, I was giving thanks for just about everything- from my health care insurance, to my co-workers who covered for me on sick days, to the plumber who cleaned a whole head's worth of my hair out of our shower drain. Everything, even the most inconsequential, took on a new importance post-cancer.
This year, for a moment back in October, that happiness, that ability to give thanks and mean it, even for the small stuff, the ability to count my blessings was taken away from me. I had trouble finding things to be thankful for when I was facing constant, aching back pain from my bone metastasis. It was hard to be thankful when my hair was falling out in huge clumps every time I took a shower. It was hard to be thankful when the Taxol started giving me daily nosebleeds. It was really hard to be thankful when, not only was I self conscious about my newly sheared head, but I also started breaking out in a hot red rash all over my face and bald head from the steroids. It was hard to be thankful when I missed a best college friend's wedding because I didn't have enough energy after chemo to make the cross country trip. But most of all, it was hard to give thanks for even the most constant blessing - my family and friends - when I looked around the room, remembered the terrible news my doctor had given, and imagined future Thanksgivings without me at the table.
I was running the risk of becoming jaded. I didn't like jaded Bridget. Jaded Bridget was not in line with my sunny personality. Had cancer finally won on every front? Had it taken away not only my health, my good looks, my physical ability to provide for my family, but even my happy personality?
I didn't know how to deal with this. I was having nightmares about visiting the pearly gates and being denied admission - very vivid dreams where I would be grilled by a scary looking judge about every piece of nasty gossip I had spread and every lie I'd ever told. I was petrified by and obsessed with the thought that we might have a vengeful God on our hands.
One Sunday afternoon, Big Man came home from a weekend away with friends. He asked me what I had done all weekend long in his absence and I did what so many wives would do. I lied. Did I tell him I sat on the couch all weekend and read that trashy chick lit novel I'd been meaning to get to since summer? Did I tell him I let the dog sleep in bed with me because I wanted some company while I ate popcorn and watched "Princess Bride" for the 50th time? No, I told Big Man that I spent the weekend at the grocery store, walking the dog, and "running errands" because Big Man wouldn't even know what errands exactly needed running. That beautiful fall Sunday evening, I fell asleep in our crisply cold room and woke up in a sweat at 4am from that same nightmare. Vengeful God had condemned me to an eternity in hell for lying to my husband about the dog sleeping and the book reading.
October was a tough month for me.
But then, without warning, hope and joy started peeking through in the most unexpected of places when I wasn't even looking for it. Hope found me in the bathroom when I lost my hair.
The first time I went through chemo and lost my hair six years ago, I visited a fancy salon to have my head shaved. They took me into a private back room, and some woman I've never seen before or since shaved me in about 5 minutes. This time around, I was much more matter-of-fact about the whole hair loss. I was prepared. I had done this before.
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| Me in my wig the night after Big Man shaved my hair. That's one good-looking wig & he's one good-looking hubby! |
I also found hope that I was afraid to share with all of you. I'm still so afraid to share this news with you because I'm afraid next week the tide will turn. My heart and hope might be crushed again, and only God knows when. When this good news changes, I will be forced to explain the change to all of you, and then all of you will be crushed right along with me. I'm also so afraid that, by sharing my hope here with all of you, I might be jinxing it! I always prided myself on being factual, logical, grounded.... now I fear cancer is making me all religious and superstitious!
But I can't keep the news to myself any longer. If I jinx myself, so be it!
Taxol gave me hope. The most unexpected drug has given me hope for a future. Taxol was a drug that was given to buy me more time. It was meant to keep the "cancer at bay" and "minimize the pain from my metastasis." After years of enrolling in clinical trials and taking the latest, greatest, best, most touted new medicines, Taxol, first discovered back in 1967, has turned out to be "The Drug" that I was hoping for! At least for now....
When I last got scans back at the beginning of October, my tumor markers were extremely high. The most important tumor marker in my blood that my doctors look at each week is called CA 27-29 and it is a tumor marker that breast cancer cells leave behind in patient's blood. Normally, in a healthy person, CA 27-29 counts range between 0-38. My CA 27-29 count was 965! This critically high tumor marker number is what prompted all the discussion about getting my affairs in order and it's what prompted getting a CT scan earlier than expected, which is what uncovered the tumors in my lungs and bones.
Well ladies and gentlemen, I am happy to tell you that my blood work this past month has been steadily dropping! The first few weeks of Taxol, they didn't take any tumor marker bloodwork. They wanted my body to get used to my new drug before trying to measure its efficacy. November 2nd was the big day. November 2nd, I went in with Big Man and Mom to meet with my doctor to find out the results of my first tumor marker test on Taxol. I was petrified! I was so scared that the Taxol wouldn't have had an effect and we would be one more drug closer to death.
I was prepared to give you all an update on my hair loss and impending doom on November 2nd when, to my surprise, I was told my tumor markers had dropped from 965 to 587. I was shocked, I was thrilled, I was completely unprepared for this foreign thing we call "Good News." However, I was still afraid. I realized then that I was afraid to hope. Cancer had left me jaded and afraid of hope.
Unable to share the news for fear of a jinx, I simply stayed silent. I stayed off the radar. As unused to good news as I had become, I continued planning as if the good news hadn't happened. I still want to schedule a meeting with my priest, but I no longer had nightmares about the pearly gates.
Then, at my appointment on November 16th, my markers fell to 300!
Then, at this week's appointment, my marker fell to 234!
I feel a little bit like I'm watching a Thanksgiving football game, and my team just got a first down. Improbable as it might be, we got another first down, and then another. The TD is now within my sites. I'm allowing myself to dream. I'm allowing myself to set goals. If I could get down below 100... 38 could be attainable. 38 means normal. How I would love to be normal! I'm right there in field goal range of normal. I can taste it.
November has allowed me to hope.
Back in October, my doctor told Big Man and me to go on a trip. We should take a trip so that we could take quality time away together while I was still feeling good, today. My bone pain was manageable with Advil, today. We needed to take advantage of our time together because we were together, today. So we did, we booked a trip to Europe at Christmas and we're so excited! But our excitement was also tinged with sadness. What was this trip? People take honeymoons. People now take "Babymoons." What was this a "Goodbye-moon?"
Now with this good news, that trip has taken on such a more fun and exciting feel. What other good news might we celebrate come Christmas? Maybe we could finally be like other couples and truly leave our worries at home? Maybe in the New Year we could start imagining a new home in our future? A home where we had the room to host more than 6 people for Thanksgiving dinner? A home of our very own, not an 800 sq foot condo? A home that we could decorate as we see fit for the Christmas holiday? A home that we could call our forever home? A home with space for an office AND a nursery? A nursery.
At chemo on November 23rd, instead of blogging as I should have, or answering emails as I should have, I allowed myself to google adoption resources in Massachusetts. I bookmarked the Massachusetts Department of Children and Families. If I get those tumor markers down to 38, down to the normal patient range, I'm going to allow myself to call their 800 number and start asking questions. Then maybe in 2013, when we're in our new forever home, I could actually schedule a home study. Hey, a girl can hope can't she?
I may be bald and covered in acne. I might not recognize myself in the mirror. I may have daily nosebleeds. I may have to sleep 13 hours every night, but at least I have hope. Those are just inconveniences. I wouldn't even elevate them to the level of "side effects." They are a mere nuisance, and they are a small price to pay for hope.
I realize as I'm writing this that I am getting all excited about just one month's worth of results. I know this is a marathon and not a sprint. I know that things can turn on a dime. But this Thanksgiving, I'm so Thankful for hope. I'm so Thankful for just one more day; just one more year. I don't want to get too greedy. I don't want to get ahead of myself. But I do want to take a moment and enjoy that future so many people take for granted. Thanks, God.
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Friday, October 7, 2011
The Importance of October
October is here again and the newspapers are full of opinion pieces about the commercialization of breast cancer. People are arguing, yet again, that we are "pink washed" and that this Breast Cancer Awareness Month takes away from other cancer research.
This couldn't be further from the truth. I have been on dozens of drugs that are actively used to treat a plethora of solid tumor cancers like lung, prostate, pancreatic, GI, and liver. Dollars raised for cancer research - any kind of cancer research- are a good thing, period.
It just so happens that pink is a pretty color. Pink resonates with a large segment of the population. Marketing and PR skills, so often used for bad in our country, are finally dedicated to a noble cause. Everyone needs to stop talking, stop criticizing, stop complaining, and simply take action. Stop wasting your breath throwing stones at what is meant to be a positive effort, get off your soapbox, and start taking action for that cancer or cause that stirs your soul. People are dying while we debate the value of the color pink. People are dying- remember that.
There isn't enough pink in this world. Every time someone dies from this terrible, painful, scary disease, another pink ribbon needs to be born. That is why I re-branded my blog for October. Do you like?
As if I needed a reminder, as if I needed another fire lit under my bottom, October 2011 commenced in the Spence household with a harsh reminder of the urgent need for a cure.
Last week, my routine weekly bloodwork showed a sharp increase in my tumor markers. The Good Doctor was concerned; she ordered CT scans. On October 3rd, 2011, I found myself in my familiar CT tunnel fighting back tears.
Here we go again.
My cancer is getting more and more aggressive. The Good Doctor delivered terrible news this week. Instead of two small tumors in my liver, I am now facing a much greater hurdle. There are now "several more" spots in my liver, and the old existing spots have tripled in size. From 7mm to 26mm and 32mm respectively. They also now see spots in both my lungs, and evidence of cancer in my bones. I have small spots in both hip bones and in my low back.
I am scared.
I am looking forward to going to church this weekend. I need consolation and some advice that only prayer can provide. I don't know how to enter this new chapter gracefully. My doctor tells me we are no longer in control. The cancer is in control. We are now the underdog. We now have to fight to regain control.
Don't get me wrong: I plan to fight. I have been screaming at the ceiling. I am only 28. I have only just begun. I have so many hopes and wishes and plans. I want more time. I'm not ready. At the same time, I also don't want to be brave anymore. I don't want to put on a smile and get on with everyday life when I have to fight so hard for every precious moment. I just want to curl up with my loved ones and be cared for. I am tired and I want to stop fighting.
But I can't. There's too much at stake to stop fighting. If breast cancer takes me down, then I'm going to go down swinging.
This October, I'm going to lose my hair for the second time. My wig has been brought out of storage and visited the hairdresser for an update. It stands at the ready in my walk-in closet. It's scaring the dog. She barks at it.
I'll be celebrating breast cancer awareness month with an electric razor and a mirror. How will you be spending your breast cancer awareness month?
This couldn't be further from the truth. I have been on dozens of drugs that are actively used to treat a plethora of solid tumor cancers like lung, prostate, pancreatic, GI, and liver. Dollars raised for cancer research - any kind of cancer research- are a good thing, period.
It just so happens that pink is a pretty color. Pink resonates with a large segment of the population. Marketing and PR skills, so often used for bad in our country, are finally dedicated to a noble cause. Everyone needs to stop talking, stop criticizing, stop complaining, and simply take action. Stop wasting your breath throwing stones at what is meant to be a positive effort, get off your soapbox, and start taking action for that cancer or cause that stirs your soul. People are dying while we debate the value of the color pink. People are dying- remember that.
There isn't enough pink in this world. Every time someone dies from this terrible, painful, scary disease, another pink ribbon needs to be born. That is why I re-branded my blog for October. Do you like?
As if I needed a reminder, as if I needed another fire lit under my bottom, October 2011 commenced in the Spence household with a harsh reminder of the urgent need for a cure.
Last week, my routine weekly bloodwork showed a sharp increase in my tumor markers. The Good Doctor was concerned; she ordered CT scans. On October 3rd, 2011, I found myself in my familiar CT tunnel fighting back tears.
Here we go again.
My cancer is getting more and more aggressive. The Good Doctor delivered terrible news this week. Instead of two small tumors in my liver, I am now facing a much greater hurdle. There are now "several more" spots in my liver, and the old existing spots have tripled in size. From 7mm to 26mm and 32mm respectively. They also now see spots in both my lungs, and evidence of cancer in my bones. I have small spots in both hip bones and in my low back.
I am scared.
I am looking forward to going to church this weekend. I need consolation and some advice that only prayer can provide. I don't know how to enter this new chapter gracefully. My doctor tells me we are no longer in control. The cancer is in control. We are now the underdog. We now have to fight to regain control.
Don't get me wrong: I plan to fight. I have been screaming at the ceiling. I am only 28. I have only just begun. I have so many hopes and wishes and plans. I want more time. I'm not ready. At the same time, I also don't want to be brave anymore. I don't want to put on a smile and get on with everyday life when I have to fight so hard for every precious moment. I just want to curl up with my loved ones and be cared for. I am tired and I want to stop fighting.
But I can't. There's too much at stake to stop fighting. If breast cancer takes me down, then I'm going to go down swinging.
This October, I'm going to lose my hair for the second time. My wig has been brought out of storage and visited the hairdresser for an update. It stands at the ready in my walk-in closet. It's scaring the dog. She barks at it.
I'll be celebrating breast cancer awareness month with an electric razor and a mirror. How will you be spending your breast cancer awareness month?
Labels:
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Susan G. Komen for the Cure
Friday, August 5, 2011
A Huge Blow
I have to ask for your forgiveness, kind readers. I admit, I have been hiding and I have been procrastinating. Both of these qualities are unusual for me. I am usually very forthright, open, and a take the bull by the horns kinda gal, but, please allow me to explain my silence.
A couple of months ago, I celebrated stable scan results and looked forward to a quiet summer. I promised all of you blog readers that I was going to celebrate my summer of stability by focusing on others and ending the Bridget Show.
The reason I have been hiding is because the Bridget Show has come to the forefront again- way sooner than expected.
I desperately want to be normal, quiet, and not the center of attention or the focus of pity, so I didn't want to share my news with you blog readers until I absolutely had to share it. I wanted to put off this post for as long as necessary. I wanted to put off the questions of "How are you doing" and "what can we do to help?" etc, etc for as long as possible. At the same time, I also couldn't in good conscience lie to all of you. I couldn't write about other people's stories, or cover topics like cancer and fertility or cancer and careers, and pretend my world was quiet and perfect, when in fact my whole world was falling apart. So I chose the middle ground. I didn't lie, but I didn't come clean. I chose silence.
Please accept my apology. Today, I'm coming clean.
The cancer has grown. The Tykerb/Xeloda regimen has failed.
It all started with my stable scan results. At the same time that the doctors look at my CT scan, they also take blood work and keep an eye on my "tumor markers." Tumor markers are like trails of trash that my cancer leaves behind in my bloodstream as it grows and travels. When my tumor markers decline, it is a sign that my therapy is working. When they increase, it is a signal that my treatment is failing. That said, tumor markers are unreliable, so we don't jump to 'all hands on deck' after just one bad blood test. Instead, like playing the stock market, we follow the tumor markers' trends and we make decisions based on trends after looking at weeks and weeks of data points.
So, the same day that my CT scan results showed stability, my blood work showed increased tumor markers. Because we focus on tumor marker trends, my doctors played down the blood work and focused instead on the stability seen on the scan. However, after we saw a second large jump in my tumor markers the next visit, the doctors started preparing me for bad news. After a third jump, the doctors said, let's be safe and scan you early.
After the second appointment, when concerns were first raised, I felt a knot in the pit of my stomach. My doctors had never before focused much on tumor markers. My subconscious was telling me that this was not good. I wanted to hide. I wanted so desperately for my life to be normal and wonderful and perfect. I wanted so badly to enjoy the blissful summer I had planned.
I couldn't bring myself to blog. Sharing the news made it real- I was admitting to something I couldn't yet admit to myself. Like I said before, I took the easy approach and I disappeared- from blogs, from Twitter, from Facebook, from email returning, even from some phone calls. I apologize, friends.
Instead of blogging or emailing with all of you, I threw myself into home and work. I cooked for Big Man like he was a family of 4. I made mango salsas and elaborate skewers of meat and fancy veggies. Like Izzy on Grey's Anatomy, I baked- cookies, and brownies, and cakes- oh my! I walked the dog 4 times a day for long walks through new neighborhoods. I stared at her perfect, cute little face. I stayed up late and stared at the Big Man while he was sleeping (creepy! but also romantic) and I imagined what our kids would look like. I didn't want to fall asleep each night. I stayed awake later and later. I didn't want to go to bed because I didn't want the party to end. Every day that passed was one day closer to the bad news that the butterflies in my stomach knew was coming.
I also threw myself into work. For those who don't know, I am a coach as well as a 5 time walker for the Susan G. Komen 3-Day for the Cure. A few months ago, I moved into a new position at the 3-Day- I no longer worked nationally with every event, I now am the chief cook and bottle washer here in Boston. That really is my title "Boston's chief cook and bottle washer!" I threw myself into the new job working weekends and nights, and loving it! The Boston 3-Day for the Cure was July 22-24th, otherwise known as the hottest weekend in 100 years or something. I relished the busy-ness and the heat and the challenge. I wasn't winning in my own cancer battle, but I sure as hell could work my tail off and save someone else. I also relished the fact that, at work, I knew what was expected of me. I could handle work. I could control work. There were SOPs and checklists and deadlines. There is no SOP for metastatic breast cancer. I couldn't control my tumor markers.
I loved hiding.
So this brings us to a couple weeks ago. On Sunday July 24th, I celebrated with the 1,800 walkers and 350 crew as they crossed the finish line of the 2011 Boston 3-Day. I hugged my survivor friends. I cried with them. I laughed with them. I took pleasure in hearing other people's stories instead of sharing mine. I looked fabulous. I felt fabulous. I was a success. Life was good.
The next day, on July 25th, life got tough. At 7am, I lay alone in the tunnel of a CT scanner, praying because my life depended on it.
This unexpected, early scan showed that in just 2 months my cancer had grown in both my liver and my lymphnodes. In my abdominal lymphnodes, the cancer used to be about 1mm. The cancer was now more than 2cm. In my liver, my tumor previously was 1cm. My liver tumor was now 2.6cm. In just two months, my tumor markers went from 40 to 120.
Allow me to explain those that these tumors, my cancer, is all still very small and very manageable. This is not a "get your affairs in order" situation. I don't want everyone to freak out or misread me. I still plan on celebrating my 30th birthday in two years and throwing the most fabulous Birthday Bash the world has ever seen, but there is also no doubt the cancer is growing. We need to take action and stop it.
There are two things that make me angry about this situation. First of all, the trials and tribulations of Tykerb and Xeloda were all for naught. That regimen never really worked for me. I was on them for only 4 months. I suffered with hives, painful and peeling feet and hands, and acne on my face that made young children run and hide. All of that was for nothing. That said, the Tykerb and Xeloda probably did slow down my cancer's growth. The cancer grew, but it took 4 months for us to notice anything. I guess I'll take that, but I'm not happy about it.
Secondly, I feel like we are getting down to the wire. I just keep taking hit, after hit, after hit, and its getting to me mentally. These past 2 years it seems as though nothing has worked! I've had some victories, but I have had more losses than victories. My "arsenal" of drugs has now dwindled to 4. There are 4 more standard therapies available to me if this cancer keeps growing. That does not make me happy. I need 84 years worth of drugs if I am to grow old with Big Man as I have planned. When I counted the remaining number of drugs with my doctor, I gulped and clutched Mommy's hand desperately. In the past I have felt scared, disappointed and worried, but I've never felt desperation before.
I am starting a new chemo called Gemzar. I am going to take it in combination with my BFF, the drug Herceptin. The big bummer is that Gemzar is given through IV over several hours...every week. No more fantastic trips to Paris or Milan for me. I might have to miss a few friends' weddings. Every single week I have to show up like a good little girl and get my drugs. Cancer will be an even more frequent intruder in m life. I will spend even more time at the hospital instead of out living like every other 28 year old. Unfair!
Gemzar causes flulike symptoms. After my first treatment a few days ago, I ran a fever, and had chills and muscle aches. It's pretty daunting to imagine suffering through a flu every single week for the foreseeable future.
My doctor says in most patients the flulike symptoms diminish over time. I won't run a fever or have chills, I'll just be achy. Let's hope that diminishing happens sooner rather than later. After all, I have a full plate. I have to take over the world and cure cancer, remember?
The realities of entering this next, scarier phase in my fight against breast cancer are particularly daunting. All of the most exciting and talked about supposed "cures," all of the hottest and latest drugs, well, I've taken them. They haven't worked. Now I am on to "standard therapy." I am hoping and praying that Gemzar gives me stability, but after 3 failed regimens in one year, I just don't know if I can say that I am kicking cancer's ass. Cancer seems to be kicking mine these days. On the internet I found a synopsis of the results of clinical trials of this Gemzar and Herceptin regimen, the median time to progression for patients (meaning the median amount of time that these drugs gave patients' the stability that I so desperately want) was 5 months. The median survival time for patients receiving this regimen....10 months. I want more than 10 months! I am not ready to die in this calendar year. I have to assume those statistics will not be mine, but they still are staring me in the face. They still haunt me every night as I try to fall asleep.
My doctor is my biggest fan. It makes me choke up just thinking about her. She's wonderful. She tells me she has seen some patients who were on this drug for several years. She's confident of my future and she scoffs when I mention that I am doubting my hope of a 30th birthday. She says the results of this regimen vary greatly by individual. She also reassured me because I'm in great shape and I'm so very young.
With her confidence in my back pocket, I am entering this new chapter with my Big Girl Pants on tight. She's right, I can handle this. She wouldn't give it to me if she didn't think it would help. So, even though I am scared and worried and disappointed, I have to put on my Big Girl Pants and focus on hope. I suppose that is what faith really is, believing in something when it seems impossible. True faith isn't believing in something when the chances of it happening are good. True faith is continuing to believe even if that seems crazy, especially when it seems crazy. I'm choosing to believe. I am going to continue to believe in my future. I will continue to believe that Big Man and I could one day have babies. I will continue to believe that we will grow old together. I will continue to believe in it, and I can't wait for that to happen!
Today though, I ask you for some favors. I ask you for prayers, but not pity, and I ask you for research dollars, passion, and activism, but not gifts or cards. We need to cure this and I can't do it alone. We need to cure this SOON.
Even though I hoped and prayed and hid from reality for the past two months, I now must admit: the Bridget Show continues. I just hope that this past year of my blogging has opened your eyes to the roller coaster that is Life With Breast Cancer. I hope that my blog has made you understand why the world needs more pink. I hope you realize that, contrary to popular opinion, this battle for a cure is far from over.
Every 69 seconds someone in the world dies from breast cancer.
That needs to end....now. I don't want to add my life to that statistic, but I can't help but wonder, when will my 69 seconds come around?
A couple of months ago, I celebrated stable scan results and looked forward to a quiet summer. I promised all of you blog readers that I was going to celebrate my summer of stability by focusing on others and ending the Bridget Show.
The reason I have been hiding is because the Bridget Show has come to the forefront again- way sooner than expected.
I desperately want to be normal, quiet, and not the center of attention or the focus of pity, so I didn't want to share my news with you blog readers until I absolutely had to share it. I wanted to put off this post for as long as necessary. I wanted to put off the questions of "How are you doing" and "what can we do to help?" etc, etc for as long as possible. At the same time, I also couldn't in good conscience lie to all of you. I couldn't write about other people's stories, or cover topics like cancer and fertility or cancer and careers, and pretend my world was quiet and perfect, when in fact my whole world was falling apart. So I chose the middle ground. I didn't lie, but I didn't come clean. I chose silence.
Please accept my apology. Today, I'm coming clean.
The cancer has grown. The Tykerb/Xeloda regimen has failed.
It all started with my stable scan results. At the same time that the doctors look at my CT scan, they also take blood work and keep an eye on my "tumor markers." Tumor markers are like trails of trash that my cancer leaves behind in my bloodstream as it grows and travels. When my tumor markers decline, it is a sign that my therapy is working. When they increase, it is a signal that my treatment is failing. That said, tumor markers are unreliable, so we don't jump to 'all hands on deck' after just one bad blood test. Instead, like playing the stock market, we follow the tumor markers' trends and we make decisions based on trends after looking at weeks and weeks of data points.
So, the same day that my CT scan results showed stability, my blood work showed increased tumor markers. Because we focus on tumor marker trends, my doctors played down the blood work and focused instead on the stability seen on the scan. However, after we saw a second large jump in my tumor markers the next visit, the doctors started preparing me for bad news. After a third jump, the doctors said, let's be safe and scan you early.
After the second appointment, when concerns were first raised, I felt a knot in the pit of my stomach. My doctors had never before focused much on tumor markers. My subconscious was telling me that this was not good. I wanted to hide. I wanted so desperately for my life to be normal and wonderful and perfect. I wanted so badly to enjoy the blissful summer I had planned.
I couldn't bring myself to blog. Sharing the news made it real- I was admitting to something I couldn't yet admit to myself. Like I said before, I took the easy approach and I disappeared- from blogs, from Twitter, from Facebook, from email returning, even from some phone calls. I apologize, friends.
Instead of blogging or emailing with all of you, I threw myself into home and work. I cooked for Big Man like he was a family of 4. I made mango salsas and elaborate skewers of meat and fancy veggies. Like Izzy on Grey's Anatomy, I baked- cookies, and brownies, and cakes- oh my! I walked the dog 4 times a day for long walks through new neighborhoods. I stared at her perfect, cute little face. I stayed up late and stared at the Big Man while he was sleeping (creepy! but also romantic) and I imagined what our kids would look like. I didn't want to fall asleep each night. I stayed awake later and later. I didn't want to go to bed because I didn't want the party to end. Every day that passed was one day closer to the bad news that the butterflies in my stomach knew was coming.
I also threw myself into work. For those who don't know, I am a coach as well as a 5 time walker for the Susan G. Komen 3-Day for the Cure. A few months ago, I moved into a new position at the 3-Day- I no longer worked nationally with every event, I now am the chief cook and bottle washer here in Boston. That really is my title "Boston's chief cook and bottle washer!" I threw myself into the new job working weekends and nights, and loving it! The Boston 3-Day for the Cure was July 22-24th, otherwise known as the hottest weekend in 100 years or something. I relished the busy-ness and the heat and the challenge. I wasn't winning in my own cancer battle, but I sure as hell could work my tail off and save someone else. I also relished the fact that, at work, I knew what was expected of me. I could handle work. I could control work. There were SOPs and checklists and deadlines. There is no SOP for metastatic breast cancer. I couldn't control my tumor markers.
I loved hiding.
![]() |
| Me as 3-Day coach with my blogger buddy Dusty Showers- Big Man, be afraid, be very afraid! |
The next day, on July 25th, life got tough. At 7am, I lay alone in the tunnel of a CT scanner, praying because my life depended on it.
This unexpected, early scan showed that in just 2 months my cancer had grown in both my liver and my lymphnodes. In my abdominal lymphnodes, the cancer used to be about 1mm. The cancer was now more than 2cm. In my liver, my tumor previously was 1cm. My liver tumor was now 2.6cm. In just two months, my tumor markers went from 40 to 120.
Allow me to explain those that these tumors, my cancer, is all still very small and very manageable. This is not a "get your affairs in order" situation. I don't want everyone to freak out or misread me. I still plan on celebrating my 30th birthday in two years and throwing the most fabulous Birthday Bash the world has ever seen, but there is also no doubt the cancer is growing. We need to take action and stop it.
There are two things that make me angry about this situation. First of all, the trials and tribulations of Tykerb and Xeloda were all for naught. That regimen never really worked for me. I was on them for only 4 months. I suffered with hives, painful and peeling feet and hands, and acne on my face that made young children run and hide. All of that was for nothing. That said, the Tykerb and Xeloda probably did slow down my cancer's growth. The cancer grew, but it took 4 months for us to notice anything. I guess I'll take that, but I'm not happy about it.
Secondly, I feel like we are getting down to the wire. I just keep taking hit, after hit, after hit, and its getting to me mentally. These past 2 years it seems as though nothing has worked! I've had some victories, but I have had more losses than victories. My "arsenal" of drugs has now dwindled to 4. There are 4 more standard therapies available to me if this cancer keeps growing. That does not make me happy. I need 84 years worth of drugs if I am to grow old with Big Man as I have planned. When I counted the remaining number of drugs with my doctor, I gulped and clutched Mommy's hand desperately. In the past I have felt scared, disappointed and worried, but I've never felt desperation before.
I am starting a new chemo called Gemzar. I am going to take it in combination with my BFF, the drug Herceptin. The big bummer is that Gemzar is given through IV over several hours...every week. No more fantastic trips to Paris or Milan for me. I might have to miss a few friends' weddings. Every single week I have to show up like a good little girl and get my drugs. Cancer will be an even more frequent intruder in m life. I will spend even more time at the hospital instead of out living like every other 28 year old. Unfair!
Gemzar causes flulike symptoms. After my first treatment a few days ago, I ran a fever, and had chills and muscle aches. It's pretty daunting to imagine suffering through a flu every single week for the foreseeable future.
My doctor says in most patients the flulike symptoms diminish over time. I won't run a fever or have chills, I'll just be achy. Let's hope that diminishing happens sooner rather than later. After all, I have a full plate. I have to take over the world and cure cancer, remember?
The realities of entering this next, scarier phase in my fight against breast cancer are particularly daunting. All of the most exciting and talked about supposed "cures," all of the hottest and latest drugs, well, I've taken them. They haven't worked. Now I am on to "standard therapy." I am hoping and praying that Gemzar gives me stability, but after 3 failed regimens in one year, I just don't know if I can say that I am kicking cancer's ass. Cancer seems to be kicking mine these days. On the internet I found a synopsis of the results of clinical trials of this Gemzar and Herceptin regimen, the median time to progression for patients (meaning the median amount of time that these drugs gave patients' the stability that I so desperately want) was 5 months. The median survival time for patients receiving this regimen....10 months. I want more than 10 months! I am not ready to die in this calendar year. I have to assume those statistics will not be mine, but they still are staring me in the face. They still haunt me every night as I try to fall asleep.
My doctor is my biggest fan. It makes me choke up just thinking about her. She's wonderful. She tells me she has seen some patients who were on this drug for several years. She's confident of my future and she scoffs when I mention that I am doubting my hope of a 30th birthday. She says the results of this regimen vary greatly by individual. She also reassured me because I'm in great shape and I'm so very young.
![]() |
| My favorite poster from this year's Boston 3-Day This is going to become my mantra! |
Today though, I ask you for some favors. I ask you for prayers, but not pity, and I ask you for research dollars, passion, and activism, but not gifts or cards. We need to cure this and I can't do it alone. We need to cure this SOON.
Even though I hoped and prayed and hid from reality for the past two months, I now must admit: the Bridget Show continues. I just hope that this past year of my blogging has opened your eyes to the roller coaster that is Life With Breast Cancer. I hope that my blog has made you understand why the world needs more pink. I hope you realize that, contrary to popular opinion, this battle for a cure is far from over.
Every 69 seconds someone in the world dies from breast cancer.
That needs to end....now. I don't want to add my life to that statistic, but I can't help but wonder, when will my 69 seconds come around?
Labels:
breast cancer,
chemo,
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coping,
CT Scan,
death,
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metastatic breast cancer,
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recurrence,
results,
scan results,
support,
survivorship
Tuesday, April 13, 2010
Spring Has Sprung!
Last week, I got out of the car in the pouring rain and saw a glorious sight. The tree I parked underneath, which I initially cursed because it was dripping all over my head as I struggled with groceries, instead suddenly became a sign of hope. There, on that bare tree, were thousands of teeny tiny little pink buds. So easy to miss, yet such a glorious symbol. Every year around this time, the world starts getting a little bit louder. I have been hearing birds each morning outside my window, and I can almost hear the sound of the flower buds bursting through the soil in our back garden.
This morning, those very same birds put a little spring in my step as I got out of bed. I opened the blinds and smiled at the sight of my newly planted window boxes with happy little yellow and purple pansies blooming. I admired my newly flowering tulips as I sipped my coffee in the backyard and, then, as I opened my Outlook calendar, the spring in my step turned into a verifiable leap of happiness. Today is my final inflation!
That's right, people, spring has sprung here in Boston....and so have.... my boobs!
The Girls are growing! Just in time for bikini season, the body that was Bridget is back and better than ever. I no longer just need Big Girl pants, I now also need Big Girl Bras! Now I should hold my joy back a bit, there's still a long way to go in this process, but I did want to provide everyone with a boob update.
Probably one of the hardest things about having a double mastectomy, especially at the ripe old age of 26, is that when you tell people you are having "a double mastectomy and reconstruction" they assume that you wake up with new boobs. Far from it, my friends. I've had to work for these here little ladies. It's been slow and hard and painful.
Even though I had been dealing with scars on my breasts for five years before I ever had my double mastectomy, and even though for five years I was taking hormone therapy that took my once C cup boobs and shrunk them down to a generous A, even though I had worked in breast cancer and seen mastectomy scars both in person and online, and while I was on some level afraid of all that my boobs had done to threaten my life, nothing can prepare you for that moment when you see your very own mastectomy scars for the first time.
Granted, my surgeon did an amazing job. Honestly, if there were a Heisman Trophy for mastectomy surgery, my doc would be a shoe in, but the sense of loss was unexpectedly overwhelming. It hit me in the gut...hard. I know in my heart I made the right decision, and since I've had the surgery, I've slept better than I have in years. I know I have done everything that I can do to keep this cancer at bay, but there are certain things with a double mastectomy that you can't prepare for. For example, in addition to the scars across your chest, you lose all feeling from your belly button to your collar bone. That is heartbreaking, and it serves as an everyday reminder of all that you have lost.
The grief I felt was particularly difficult over the past six months when I would try to resume my normal life. Behaving like a normal 26 year old is incredibly important to me. I will leave the chemo chair and go to a birthday party. I vividly remember leaving one of the most difficult appointments of my life where a doctor gave me some bad test results, and heading directly to a cocktail party. I could have canceled, but I figured, I don't know how much time I have left. I most certainly will not spend what precious time remains - be it 5 more nights or 5,000 more nights- in bed feeling sorry for myself.
Manicures, pedicures, shopping for the perfect dress or shoe, getting dressed up and being told you look great even though you just left the hospital, those moments have kept me hopeful and alive. Then, after the mastectomy, I didn't fit into any of my shirts. I felt ugly. I felt ugly, and no amount of make up was going to hide that.
Also, contrary to what the name of the procedure "double mastectomy with reconstruction" implies, I didn't wake up with boobs after my mastectomy. Instead, I woke up with expanders in my chest, empty balloons that will one day create boobs. A lot of my friends didn't understand that, at least not until they saw me.
Over the past six months, I have visited my plastic surgeon once a month and he has slowly stretched my skin and inflated those balloons in my chest. We have slowly recreated boobs. The process has been painfully slow, not physically painful, just mentally painful. I liken it to when you are growing out your hair- you just don't think it will ever happen.
My first inflation, I was scared about pain so when I got home from the plastic surgeon and surveyed the damage in the mirror, I wasn't bothered too too much. I was able to quell my disappointment at the fact that my chest was still just as concave as when I started that morning. But the next month, after the second inflation, when I still left the office feeling like a 12 year old boy, I started getting a little antsy.
I say I felt like a 12 year old boy in all seriousness. It was snowing that day, not fun Christmas snow but slushy, rainy, brown snow. I was wearing a gray newsboy kind of hat with a cute brim on the front. Kind of like what old men in Ireland wear. Except, when I arrived home after visiting my plastic surgeon's office that day, I made the mistake of surveying his handiwork in the mirror whilst wearing that very same cute gray hat. Instead of boobs, I saw pectoral muscles.
Instead of taking a deep breath like a sane person and realizing these are a work in progress, I saw my gray hat wearing, flat-chested body and saw myself as, for real, a 12 year old newsboy. Cue the breakdown.
But that was February. That was snow. Today is April. All of a sudden, out of nowhere, my boobs have bloomed. One day, I looked down as my doctor was slowly inserting the saline in my chest and I started to actually see boobs! Which brings us to my post today. It has happened! The Girls are back and better than ever! Today is a glorious day!
I still have to have two more major surgeries to finish my boobs, but today I just wanted to reflect with all of you:
Even though I should know this by now, life is a journey. Whenever you are having a bad day, take a deep breath and realize that tomorrow will be better. Spring will come. The sun will shine. And some day soon, you will have boobs.
This morning, those very same birds put a little spring in my step as I got out of bed. I opened the blinds and smiled at the sight of my newly planted window boxes with happy little yellow and purple pansies blooming. I admired my newly flowering tulips as I sipped my coffee in the backyard and, then, as I opened my Outlook calendar, the spring in my step turned into a verifiable leap of happiness. Today is my final inflation!
That's right, people, spring has sprung here in Boston....and so have.... my boobs!
The Girls are growing! Just in time for bikini season, the body that was Bridget is back and better than ever. I no longer just need Big Girl pants, I now also need Big Girl Bras! Now I should hold my joy back a bit, there's still a long way to go in this process, but I did want to provide everyone with a boob update.
Probably one of the hardest things about having a double mastectomy, especially at the ripe old age of 26, is that when you tell people you are having "a double mastectomy and reconstruction" they assume that you wake up with new boobs. Far from it, my friends. I've had to work for these here little ladies. It's been slow and hard and painful.
Even though I had been dealing with scars on my breasts for five years before I ever had my double mastectomy, and even though for five years I was taking hormone therapy that took my once C cup boobs and shrunk them down to a generous A, even though I had worked in breast cancer and seen mastectomy scars both in person and online, and while I was on some level afraid of all that my boobs had done to threaten my life, nothing can prepare you for that moment when you see your very own mastectomy scars for the first time.
Granted, my surgeon did an amazing job. Honestly, if there were a Heisman Trophy for mastectomy surgery, my doc would be a shoe in, but the sense of loss was unexpectedly overwhelming. It hit me in the gut...hard. I know in my heart I made the right decision, and since I've had the surgery, I've slept better than I have in years. I know I have done everything that I can do to keep this cancer at bay, but there are certain things with a double mastectomy that you can't prepare for. For example, in addition to the scars across your chest, you lose all feeling from your belly button to your collar bone. That is heartbreaking, and it serves as an everyday reminder of all that you have lost.
The grief I felt was particularly difficult over the past six months when I would try to resume my normal life. Behaving like a normal 26 year old is incredibly important to me. I will leave the chemo chair and go to a birthday party. I vividly remember leaving one of the most difficult appointments of my life where a doctor gave me some bad test results, and heading directly to a cocktail party. I could have canceled, but I figured, I don't know how much time I have left. I most certainly will not spend what precious time remains - be it 5 more nights or 5,000 more nights- in bed feeling sorry for myself.
Manicures, pedicures, shopping for the perfect dress or shoe, getting dressed up and being told you look great even though you just left the hospital, those moments have kept me hopeful and alive. Then, after the mastectomy, I didn't fit into any of my shirts. I felt ugly. I felt ugly, and no amount of make up was going to hide that.
Also, contrary to what the name of the procedure "double mastectomy with reconstruction" implies, I didn't wake up with boobs after my mastectomy. Instead, I woke up with expanders in my chest, empty balloons that will one day create boobs. A lot of my friends didn't understand that, at least not until they saw me.
Over the past six months, I have visited my plastic surgeon once a month and he has slowly stretched my skin and inflated those balloons in my chest. We have slowly recreated boobs. The process has been painfully slow, not physically painful, just mentally painful. I liken it to when you are growing out your hair- you just don't think it will ever happen.
My first inflation, I was scared about pain so when I got home from the plastic surgeon and surveyed the damage in the mirror, I wasn't bothered too too much. I was able to quell my disappointment at the fact that my chest was still just as concave as when I started that morning. But the next month, after the second inflation, when I still left the office feeling like a 12 year old boy, I started getting a little antsy.
I say I felt like a 12 year old boy in all seriousness. It was snowing that day, not fun Christmas snow but slushy, rainy, brown snow. I was wearing a gray newsboy kind of hat with a cute brim on the front. Kind of like what old men in Ireland wear. Except, when I arrived home after visiting my plastic surgeon's office that day, I made the mistake of surveying his handiwork in the mirror whilst wearing that very same cute gray hat. Instead of boobs, I saw pectoral muscles.
Instead of taking a deep breath like a sane person and realizing these are a work in progress, I saw my gray hat wearing, flat-chested body and saw myself as, for real, a 12 year old newsboy. Cue the breakdown.
But that was February. That was snow. Today is April. All of a sudden, out of nowhere, my boobs have bloomed. One day, I looked down as my doctor was slowly inserting the saline in my chest and I started to actually see boobs! Which brings us to my post today. It has happened! The Girls are back and better than ever! Today is a glorious day!
I still have to have two more major surgeries to finish my boobs, but today I just wanted to reflect with all of you:
Even though I should know this by now, life is a journey. Whenever you are having a bad day, take a deep breath and realize that tomorrow will be better. Spring will come. The sun will shine. And some day soon, you will have boobs.
Labels:
breast cancer,
breast reconstruction,
cancer,
celebration,
health,
inspiration,
lessons,
metastatic breast cancer,
motivation,
results,
survivor,
survivorship
Tuesday, March 30, 2010
Celebrations!
Put the big girl pants away for now; they aren't needed this week. Instead, everyone raise a glass and toast my good health! Yesterday I saw my doctor and she told me that my scan results came back. There is no evidence of any new cancer. I have been given a clean bill of health!
I will be getting my next set of scans three months from now, sometime in July, which means I get to party it up and have a fabulous spring and early summer.
I'll talk more in future postings about how I have learned to live a full life in three month increments in between scans, but today is all about celebrating.
I have truly been given a new lease on life! Life is good today.
Tonight I am taking off my big girl pants and putting on my party pants. Momma, the Big Man and I are going out for a celebratory dinner. I invite all of you to join us in celebration. Thank you for your prayers! They worked!
I will be getting my next set of scans three months from now, sometime in July, which means I get to party it up and have a fabulous spring and early summer.
I'll talk more in future postings about how I have learned to live a full life in three month increments in between scans, but today is all about celebrating.
I have truly been given a new lease on life! Life is good today.
Tonight I am taking off my big girl pants and putting on my party pants. Momma, the Big Man and I are going out for a celebratory dinner. I invite all of you to join us in celebration. Thank you for your prayers! They worked!
Labels:
breast cancer,
cancer,
celebration,
CT Scan,
health,
scan results,
survivor,
survivorship
Friday, March 26, 2010
Rainy Friday
This weekend is shaping up to be a Big Girl Pants kind of weekend, and this weekend is one of the reasons I started this blog. Today I will be heading in for my first set of scans since October. Scans are at the heart of the metastatic breast cancer journey. The fact that I need scans every three months is what it means to not have a cure. My doctors do the best that they can. My doctors are the best in this field. As one of my favorites put it, "we carpet bombed you" with chemo. We do the most aggressive surgery. We consider all options. And then, we wait and we watch.
The hardest part of scans is not having my morning coffee. As soon as I get out of that tunnel I make a beeline for Starbucks! I have to starve myself for 4 hours before the scan. The other annoying part is the sheer time I must devote. I have to arrive 90 minutes before my actual appointment time. I've never understood why they don't just schedule the scan for the hour when I have to arrive, but I'm not in health care. There must be some bureaucratic explanation.
When I arrive 90 minutes early, I am given a lovely little cocktail of Crystal Light and Barium. They are so nice as to ask my preference- Iced Tea or Fruit Punch. I've tried Barium with any number of things and unless its a stiff alcoholic drink strong enough to overpower the metallic taste of the medicine, it is no difference. I sit there for 90 minutes and drink three whole bottles of this stuff intended to coat my insides with "contrast". The Barium tastes like a mixture of metal and dirty feet. It's not so offensive as to make you get sick, but there is a gag reflex.
Now you may recall, I was diagnosed as a senior in college. While some may think that is incredibly unfair, I actually see that timing as a gift from God. Why you may ask? Well...I bring my college drinking skills to the table at scan time!
While all the other old ladies are sipping their contrast with straws, I take a deep breath and throw that baby back. The nurses tell me my nauseousness after the scan is over would be better if I sipped, but I'm young enough to still have my eyes on the prize. I'm 26, I'm allowed to throw caution to the wind when it comes to thinking about the end results of my actions. And so I chug. I want to go to Party City one day and find a pink beer bong and bring it with me to my next appointment. I can picture it now, I am going to be going down on one knee in my gorgeous hospital robe holding the beer bong up high and downing that Crystal Light in two seconds. Then I'll teach the rest of the waiting room!
After 90 minutes of waiting, you would expect the actual scan to be a big deal, but it is actually like that roller coaster ride at the amusement park. You wait hours in line and then the experience is way underwhelming and only lasts for .3 seconds. I have timed the CT scan, and it is never more than 10 minutes long.
But then the real waiting begins.
At the beginning of my cancer journey, when I first moved to Boston in 2006 and began going to Dana Farber, I would spend a whole day at the hospital. I had my scan in the morning, break for lunch and then go see the doctor for results in the afternoon. But then one time, the results came back bad. I had probably only been in Boston for 3 months. My hair was just sprouting. I was joyfully cavalier that I had beaten it. This cancer thing was just one year of my life. Just one horrible year. And then, the scans. I came to the results appointment alone. That was the last time I ever spent scan-time alone.
Since my journey has been so unpredictable and outside of the usual realm of cancer patients, my doctors tend to get creative with my treatment plan. Many doctors weigh in on statistics and treatment options and then my doctor and I get together and usually end up with a plan that is some where in the middle of the whole spectrum. I really enjoy being a partner in my care and knowing all of the options and all of the pros and cons. Well that first recurrence back in 2006, they saw the tumor in my liver grow. My doctor had just gotten the results minutes before my appointment and she came in unsure of how we would proceed. She had not had ample time to think about a game plan. It was an all around unpleasant experience because the news was bad enough but leaving without a game plan is enough to send me over a steep cliff. I must always have a game plan. Knowing that I have options keeps me sane.
So now, I get the scans on Friday and get the results on Monday. It makes for a difficult weekend, but my mom flies up to play with me and we fill our time with all sorts of fun things. This weekend, mom is teaching me to garden. We are also going to get the usual mani-pedi action. We have a list of shopping we need to get into on Newbury Street. The Big Man and I will take Mamma to our favorite restaurants. The days with mom fly by and I find that I forget about the impending appointment that could potentially take this beautiful life and throw it all to pieces again.
I don't remember until I'm sitting in the waiting room.
So everyone, enjoy this weekend for me. Get out there and take a brisk walk. Go to a party. Go to a hip restaurant. Dance. Have an amazing weekend. Love Life. Because on Monday, my life could change. I will of course update everyone as soon as I know anything.
The hardest part of scans is not having my morning coffee. As soon as I get out of that tunnel I make a beeline for Starbucks! I have to starve myself for 4 hours before the scan. The other annoying part is the sheer time I must devote. I have to arrive 90 minutes before my actual appointment time. I've never understood why they don't just schedule the scan for the hour when I have to arrive, but I'm not in health care. There must be some bureaucratic explanation.
When I arrive 90 minutes early, I am given a lovely little cocktail of Crystal Light and Barium. They are so nice as to ask my preference- Iced Tea or Fruit Punch. I've tried Barium with any number of things and unless its a stiff alcoholic drink strong enough to overpower the metallic taste of the medicine, it is no difference. I sit there for 90 minutes and drink three whole bottles of this stuff intended to coat my insides with "contrast". The Barium tastes like a mixture of metal and dirty feet. It's not so offensive as to make you get sick, but there is a gag reflex.
Now you may recall, I was diagnosed as a senior in college. While some may think that is incredibly unfair, I actually see that timing as a gift from God. Why you may ask? Well...I bring my college drinking skills to the table at scan time!
While all the other old ladies are sipping their contrast with straws, I take a deep breath and throw that baby back. The nurses tell me my nauseousness after the scan is over would be better if I sipped, but I'm young enough to still have my eyes on the prize. I'm 26, I'm allowed to throw caution to the wind when it comes to thinking about the end results of my actions. And so I chug. I want to go to Party City one day and find a pink beer bong and bring it with me to my next appointment. I can picture it now, I am going to be going down on one knee in my gorgeous hospital robe holding the beer bong up high and downing that Crystal Light in two seconds. Then I'll teach the rest of the waiting room!
After 90 minutes of waiting, you would expect the actual scan to be a big deal, but it is actually like that roller coaster ride at the amusement park. You wait hours in line and then the experience is way underwhelming and only lasts for .3 seconds. I have timed the CT scan, and it is never more than 10 minutes long.
But then the real waiting begins.
At the beginning of my cancer journey, when I first moved to Boston in 2006 and began going to Dana Farber, I would spend a whole day at the hospital. I had my scan in the morning, break for lunch and then go see the doctor for results in the afternoon. But then one time, the results came back bad. I had probably only been in Boston for 3 months. My hair was just sprouting. I was joyfully cavalier that I had beaten it. This cancer thing was just one year of my life. Just one horrible year. And then, the scans. I came to the results appointment alone. That was the last time I ever spent scan-time alone.
Since my journey has been so unpredictable and outside of the usual realm of cancer patients, my doctors tend to get creative with my treatment plan. Many doctors weigh in on statistics and treatment options and then my doctor and I get together and usually end up with a plan that is some where in the middle of the whole spectrum. I really enjoy being a partner in my care and knowing all of the options and all of the pros and cons. Well that first recurrence back in 2006, they saw the tumor in my liver grow. My doctor had just gotten the results minutes before my appointment and she came in unsure of how we would proceed. She had not had ample time to think about a game plan. It was an all around unpleasant experience because the news was bad enough but leaving without a game plan is enough to send me over a steep cliff. I must always have a game plan. Knowing that I have options keeps me sane.
So now, I get the scans on Friday and get the results on Monday. It makes for a difficult weekend, but my mom flies up to play with me and we fill our time with all sorts of fun things. This weekend, mom is teaching me to garden. We are also going to get the usual mani-pedi action. We have a list of shopping we need to get into on Newbury Street. The Big Man and I will take Mamma to our favorite restaurants. The days with mom fly by and I find that I forget about the impending appointment that could potentially take this beautiful life and throw it all to pieces again.
I don't remember until I'm sitting in the waiting room.
So everyone, enjoy this weekend for me. Get out there and take a brisk walk. Go to a party. Go to a hip restaurant. Dance. Have an amazing weekend. Love Life. Because on Monday, my life could change. I will of course update everyone as soon as I know anything.
Labels:
breast cancer,
cancer,
chemo,
CT Scan,
health,
inspiration,
medicine,
survivor,
survivorship,
wellness
Wednesday, March 3, 2010
How Are You Doing?
Think about the phrase "How are you doing?" Everyday, in every city across the globe, hundreds of people are asking that very question. Mothers ask sons over phone calls, girlfriends ask over a glass of wine, long lost friends connect over coffee, doctors ask patients as they give a pat down.
Sometimes, like during high school reunions, people don't really care about the answer. Instead of listening to the answer, the questioner simply prepares for when the same question comes back her way. But every once in a while this simple question is posed in such a way that makes the heart sing.
I notice a lot when people ask me how I am "doing" because I never quite know how to respond. When I answer the, "How are you doing" with the expected, "Fine, thank you and how are you?" I am almost always lying.
Five years ago, on June 3, 2005, I was diagnosed with Stage IV breast cancer. I was 21 years old. It was two weeks after my college graduation. I had no family history of the disease.
Five years ago, some people started to dread asking me 'the question'. Five years ago, some people I have never met and may never meet started asking how I was doing. And five years ago, for the first time ever, I noticed how wonderful and liberating it can be when someone asks, "how are you doing?" and really, truly wants to know.
As my new blog title implies, life with Stage IV breast cancer requires a pair of Big Girl Pants. If you're going to enter my world, you better put on a pair of your prettiest party pants and buckle them up tight, because my answer to "How are you doing?" is always long winded!
My long winded answers are what prompted this blog. For years, I've been filling people in on my latest adventures in cancer over coffee or dinner, at cocktail parties or in mass emails. I bring people up to speed in 500 words or less. Over five years struggling with recurrences, I am slowly realizing that my life will never be normal enough to sum up over dinner. Instead, life with Stage IV cancer means that every day major news is happening. Every month a new hurdle pops up. Every week a new drug is tried. Every evening we pray.
Sharing my story over dinner, over coffee, at weddings, is unfair for my friends and family and it is a disservice to the huge hurdles that I overcome every single day. I plan to use this blog to share those day to day struggles.
I plan to update this blog everyday, or at least once a week, with reflections on where I've been, updates on where I'm headed, and general thoughts about life and about facing down death.
In an ideal world, people will actually read this and share it as well. I am also giving birth to this blog because I want to raise awareness about living life with breast cancer. Not beating it, not surviving it, not closing that door, but truly, happily, sadly, thoroughly and completely living with it.
I joke sometimes about being scary. I really am not joking.
My story scares people, especially fellow cancer patients. I am the worst case scenario.
I was diagnosed way late. By the time someone sent me for a mammogram five years ago, the cancer had traveled from my breast to my liver. One doctor gave me a 16% chance of celebrating my 30th birthday. Over the past five years, I have had three recurrences and 5 surgeries. I have been on nine different types of drugs. My cancer just won't quit. The doctors can sometimes be quite grim about my "prognosis"
But I am living well. I am living fully. I am happy. I am one of the happiest people I know. I just got married in August (best wedding ever!!) and some days I call my husband in the middle of the day to just thank him for the amazing life that we have made together. I created a song that I sing (way off tune!) while cooking dinner about how much I love my little life. I think these facts can help people, even though my situation might scare you.
It is this happiness that keeps me motivated when life isn't very happy. This day to day happiness makes me a fighter.
So let's kick off this journey by sharing one of my most favorite-est pictures ever. This is me with Stage IV cancer.
Do I look sick to you?
Does it look like I might feel sorry for myself?
Now I'm off to a doctor's appointment and will update everyone shortly! I hope there will be someone reading.
Sometimes, like during high school reunions, people don't really care about the answer. Instead of listening to the answer, the questioner simply prepares for when the same question comes back her way. But every once in a while this simple question is posed in such a way that makes the heart sing.
I notice a lot when people ask me how I am "doing" because I never quite know how to respond. When I answer the, "How are you doing" with the expected, "Fine, thank you and how are you?" I am almost always lying.
Five years ago, on June 3, 2005, I was diagnosed with Stage IV breast cancer. I was 21 years old. It was two weeks after my college graduation. I had no family history of the disease.
Five years ago, some people started to dread asking me 'the question'. Five years ago, some people I have never met and may never meet started asking how I was doing. And five years ago, for the first time ever, I noticed how wonderful and liberating it can be when someone asks, "how are you doing?" and really, truly wants to know.
As my new blog title implies, life with Stage IV breast cancer requires a pair of Big Girl Pants. If you're going to enter my world, you better put on a pair of your prettiest party pants and buckle them up tight, because my answer to "How are you doing?" is always long winded!
My long winded answers are what prompted this blog. For years, I've been filling people in on my latest adventures in cancer over coffee or dinner, at cocktail parties or in mass emails. I bring people up to speed in 500 words or less. Over five years struggling with recurrences, I am slowly realizing that my life will never be normal enough to sum up over dinner. Instead, life with Stage IV cancer means that every day major news is happening. Every month a new hurdle pops up. Every week a new drug is tried. Every evening we pray.
Sharing my story over dinner, over coffee, at weddings, is unfair for my friends and family and it is a disservice to the huge hurdles that I overcome every single day. I plan to use this blog to share those day to day struggles.
I plan to update this blog everyday, or at least once a week, with reflections on where I've been, updates on where I'm headed, and general thoughts about life and about facing down death.
In an ideal world, people will actually read this and share it as well. I am also giving birth to this blog because I want to raise awareness about living life with breast cancer. Not beating it, not surviving it, not closing that door, but truly, happily, sadly, thoroughly and completely living with it.
I joke sometimes about being scary. I really am not joking.
My story scares people, especially fellow cancer patients. I am the worst case scenario.
I was diagnosed way late. By the time someone sent me for a mammogram five years ago, the cancer had traveled from my breast to my liver. One doctor gave me a 16% chance of celebrating my 30th birthday. Over the past five years, I have had three recurrences and 5 surgeries. I have been on nine different types of drugs. My cancer just won't quit. The doctors can sometimes be quite grim about my "prognosis"
But I am living well. I am living fully. I am happy. I am one of the happiest people I know. I just got married in August (best wedding ever!!) and some days I call my husband in the middle of the day to just thank him for the amazing life that we have made together. I created a song that I sing (way off tune!) while cooking dinner about how much I love my little life. I think these facts can help people, even though my situation might scare you.
It is this happiness that keeps me motivated when life isn't very happy. This day to day happiness makes me a fighter.
So let's kick off this journey by sharing one of my most favorite-est pictures ever. This is me with Stage IV cancer.
Do I look sick to you?
Does it look like I might feel sorry for myself?
Now I'm off to a doctor's appointment and will update everyone shortly! I hope there will be someone reading.
Labels:
breast cancer,
cancer,
chemo,
health,
inspiration,
medicine,
survivor,
survivorship,
wellness
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