Episode 25: Conclusion

"It's happy, scary, and weird all at the same time." - Roxanne

Yes, it is.

Happy Part  Last Thursday, Neil and I met with the oncologist for the second time since January.* We were curious as to whether or not there would be any new information. There was one bit of news. A recent CT scan looking for blood clots in my heart and lungs showed that the cancer had not moved to my heart or lungs. And, thankfully, there are no blood clots anywhere including arms and legs. The really good news, however, was that the doctor stressed the past-tense nature of my condition. She emphasized, "You had cancer." It is in the past. And "You are cancer free. It is highly likely that the surgery got everything." This is what I have been telling people all along but it's nice to hear it from a doctor. I texted my parents and daughters immediately so they could enjoy the good news as well. I knew that they really needed a break from all the worry. A lady (my age) here at the hotel told me that she was 18 when her mother was diagnosed with breast cancer and that it was the scariest thing she'd ever known. My own daughters are 15 & 17 and I know this has been horrible for them. I've always taken my mother for granted (a fault that I can only attribute to her incredible patience) but the thought that a person could lose a mother in their young years brings tears to the eyes. (Oh, stink, where's the tissue?) ...  Quick, back to Happy. Thanks, Pharrell!  I also thought you might find the following link interesting: Due to research, breast cancer survival rates have improved drastically. Now almost 90% of those who experience ‪#‎BreastCancer‬ will survive!  https://www.facebook.com/breastcancersocietyofcanada?fref=nf

Scary Part  Now that I've had a week to digest the following information it's not that scary anymore but I was asked, "If the above is true then why the need for on-going treatment?" That's the wildness of breast cancer. Breast cancer doesn't play by rules. I was diagnosed with two cancers, one of which was aggressive and spreading into my lymph nodes. A modified radical mastectomy removed my left breast which removed the two lumps and the spreading cancer from my left breast. Also, 20 lymph nodes were removed from under my left arm, eight of which were cancerous (don't worry, we have hundreds Number of Lymph Nodes).** We can be fairly certain that everything was caught. But, ultra-sounds and CT scans don't see everything. It is possible for cancer cells to remain very small and escape detection. So at this point, post-surgery, everything becomes a game of statistics. Women in this situation who do not follow through with treatment have a fairly high chance of recurrence: that is the cancer comes back. Women who go through the whole process of surgery, chemotherapy, and radiation substantially drop the risk of recurrence.*** So even though I've been told to claim the status of being Cancer-free, I still do every preventive measure possible. (Perhaps a good comparison would be that even though I've never been hit by a car, I'll still walk on the sidewalk just so I can lower the odds.)

Further, my cancer was identified as Estrogen Receptor positive. This means that my little critters like estrogen. It helps them grow. Everyone produces estrogen until they die and if there are any cancer cells in me escaping detection at this point, they could grow with the help of my own estrogen. However, there is a treatment for that. It's called Tamoxifen and comes in the form of a little pill. Tamoxifen acts like estrogen and leads cancer cells to believe that they are getting an estrogen treat but, instead of helping the cancer cells to grow, the tamoxifen wraps itself around the cell and blocks it from receiving any real estrogen. I will be taking a Tamoxifen pill every day for the next five years. At that time, I will be re-evaluated and likely given another five year term of Tamoxifen. After ten years of Tamoxifen, I might be switched to an aromatase inhibitor but I'll look that up later. Right now, my head is full.

Weird Part It's been almost one year since this adventure started and I have yet to stop and catch my breath. I never ever would have dreamed that I could be in this situation and it's still a bit un-nerving to think about. It's been a whirlwind of learning, thinking, crying, withdrawing, and reaching out (to give and to receive). It's a weird feeling because I have to adjust. I'm not the same person I used to be. That is humbling because I thought I was pretty cool before but I had a lot to learn about myself and being a better person. On the one hand, I'm not as patient as I used to be over lifes minor aches and pains. "You stubbed your toe. Oh, what a shame. i.e. Get over it." But, on the other hand, I have a lot more empathy for the big stuff. For example, the other day I was too weak to walk from my radiation appointment to the pharmacy (both in the hospital) so I asked for a wheelchair and a porter to deliver me. It was kind of fun but also an eye opener. Now, when I see someone in a wheelchair I don't see someone who is weak. I see someone who has a story and probably a humdinger of a story at that. I also have a lot more empathy for old people (oops, the elderly) now. I am definitely younger than almost everybody here by quite a bit but, even still, I understand better the frailty that comes with age. We didn't start out looking like this. It's also weird because I have become an "expert" on an experience that I never asked for. People are asking me if there's "life after chemotherapy". It's a weird but nice feeling to be able to say, "Yes, there is. Don't give up. It does get better. It gets pretty low but you will come back up again."

Dear Reader,

My adventure and this blog have completed their course. I want to sincerely thank you for the time that you have given me. Your support has been such an encouragement through a dark year. Being able to put my thoughts and feelings into read-able explanations has helped me to process this experience. And knowing that my words have been a help or a pleasure for you is extremely gratifying. Thank you.

Bless you,

Dawn

________________________
* For the sake of accuracy, I feel that I must explain that it wasn't actually the oncologist I met but rather his representative, another doctor. Also, it might seem that having only two meetings from January to September isn't good but, in fact, there was a whole team of doctors and nurses looking after me regularly so I feel very well cared for.

** In case you're curious, I do still have pain and discomfort from the surgery, especially under my arm. Sometimes people ask so yes, it's there.

*** I am deliberately leaving out percentages and time frames rather than risk making a mistake. For real figures, please consult a Physician or reputable web-site.

Episode 24: On Being Strong

Hello Dear One,

I'm writing to you from my hotel's computer in the activity room. There is a boisterous game of Euchre going on behind me. Yesterday, the gang showed me how to play. I am now living in London Monday-Friday while I receive daily radiation treatments. I don't know the exact number of treatments yet but it will likely be 33, so three down, thirty to go. The Cancer Clinic has a deal with the hotel so that out-of-town patients can stay here at no charge during the week. I'm just guessing but I would say that there are about 30 people who stay here through the Cancer Clinic program. We are very well treated, including three meals a day at a much-subsidized rate. As cancer patients, we are all at different stages and receiving different treatments so we are a very transient bunch but there is a lot of camaraderie as we all can relate to the trials of living this way and needing to look after each other.

I'm happy to report that the chemo part is over for me. My final treatment was July 28th, a little over a month ago. My hair is about 2" long, although very transparent and, although I'm still achy in the bones and easily winded, I can feel myself getting stronger every day. Yesterday, I used the stationary bicycle for five minutes and went a distance of 1 km burning ten calories. Today, I used the stairs several times from the lobby to the third floor and also back and forth to the second floor.

I want to write today regarding the topic of being called strong. Many times this year I have been complimented by people about how strong I am and that I can "do this". I don't want to offend well-meaning people who are genuinely trying to encourage me but, in truth, this is a compliment that does not sit well with me. It's taken me months of mulling to understand why but I think I have it now.

Just for fun, let's start with some definitions. Strong is:
- someone who comes off as confident; someone who is comfortable in there (sic) own skin; someone who can take on the world; someone who should be very proud of themselves (Urban Dictionary)

- Having passive physical power; having ability to bear or endure; firm; hale; sound; robust; as, a strong constitution; strong health; Solid; tough; not easily broken or injured; able to withstand violence; able to sustain attacks; not easily subdued or taken (www.thinkexist.com)

- not easy to break or damage (Merriam-Webster)

The only definition above that I'll accept for myself is having a strong constitution and being able to sustain attacks. I continue to endure. I think, though, real strength is like courage. It's the ability to do what needs to be done in spite of ones fears when given a choice. I did not have a choice. I had to go through the treatment and I don't deserve the label. Legally, yes it was me who signed the consent form but that's a moot point. There really was no choice or discussion. Knowingly leave my children orphaned: never. Leaving my husband widowed (widowered?), not good. Leaving my parents to bury their child, unthinkable. I will do everything I can to protect my family. You would do the same thing. Don't call me strong.  Also, you don't know how many times I cried on my husband's shoulder, "I can't do this anymore." or how many times Neil brought me meals in bed so I could rest or how many times my children have hugged me to hold me up physically and emotionally, "Mom, you'll be fine. You can do this. You're better than you were yesterday." or how many sleepless nights my parents have had worried about me. Don't call me strong. Watching and carrying on while someone you love suffers is where the real strength lies.

Let me tell you about a lady I spoke with today who could be called strong. Let's call her Betty (because that's her name). She's lovely. She's vivacious, energetic, entertaining, and plays a mean game of Euchre. She's also 75 (looks about 60). She tested positive for the HER2/neu hormone which means that her brand of chemotherapy is especially brutal. Because she's 75, her family of grown children was divided about whether or not she should take the treatment. Her case went before the London Cancer Clinic Review Board. The Board was also divided. The decision became exclusively hers. How do you decide something like that? Choosing or not choosing treatment meant agreeing with some people and disappointing others. That's strength. When she told her family doctor that her decision was to get treated he took her hand and said, "I'm so glad." He explained that when the Review Board looks at a case all they see is a number: 75. When he, as her family doctor, looks at her case he sees her with all her energy, drive and faith. When she told her family about her decision to receive treatment and add a number of years to her life she told them that those who agreed could support her decision and those who didn't agree, if they couldn't encourage her, they should at least not say anything. I was mesmerized by her story and just kept thinking, "Now, that's strength."

Bless you all, my dear ones.