A Year Later

I've been meaning to do a blog update for my family with details such as recent doctor visits for at least 6 months, but it's just the LAST thing I want to talk about so I never get to it. I'm having a moment of strength so I'll go for it and update everyone who's curious but too polite to ask how things are really going. And P.S., thanks to everyone for being too polite.

Since treatment ended I'm supposed to have check-ups with my medical oncologist every three months and every 6 months with the surgeon and radiation oncologist. Lucky me it's been every four months with the medical oncologist due to summer schedules and them meeting my request to wait until the New Year for insurance reasons. The vampires at the medical oncologist take blood each visit and the doctor looks for any changes that could be indicative of things not functioning the same (kidneys, liver, etc). He also pokes around in my abdomen and listens to my heart and lungs. All things are well. The radiation oncologist and the surgeon do physical exams of my breasts and armpits where the lymph nodes drain the breasts. All things are well. Guidelines for mammograms are changing and range from every 6 months to a year. I understand the change from every 6 months to a year is driven by too many false positives and the associated stress. My doctor's are all on board with the plan to have annual 3D mammograms which are supposed to be better for evaluating dense breast tissue. The doctor's are also supportive of annual MRI's as well which can be helpful and there is no added radiation, but no one is forcing me to go this route and I likely will not because of my high-deductible health care plan. Besides, deep down I'm less worried about more breast lumps. I'm more worried about metatasic cancers elsewhere and MRI's of my breasts aren't going to help with that. The last component of my post surgury/chemo/radiation treatment is the hormone blocker Tamoxifen that I'm supposed to take for at least 5 years. After long agonizing about taking this daily pill I've been pleasantly surprised that I haven't really experienced any of the side effects that I was so worried about. As things progress my doctors visits will change to every 6 months, then every year, etc. Medically speaking all is well.

I suppose an update on the hair is in order too just because it is such a topic of converstaion. My hair is coming in well, is getting thicker, is curly (and no, it wasn't curly before) and every month that goes by I'm starting to have a style that looks more intentional. Honestly I like the short hair and I think it works for me. I'll probably keep it somewhere between pixie and a bob. The curls are still there but with every trim they seem to be less curly and I do believe it will progressively start to relax. While I'm flattered by compliments I just can't wait until it isn't a topic of converstaion. Partly because too often the conversation evolves into something that I'm uncomfortable with. The worst was on two separate occasions where an innocent conversation ended with, "my aunt's hair came in curly after chemo, but I don't know if it would have stayed that way because she only lived a couple years after that." A couple weeks after I've recovered from such conversations I can forgive, but not forget, knowing that those same people were hurt by cancer and experienced loss and needed to share their story. Let me just say that cancer-survivors are more aware of their mortality than anyone and hearing about the death of loved ones is one of the least helpful things to hear during the recovery process.

The emotional side of recovery is still evolving and I struggle at times with anxiety. I can't go a day without thinking cancer related thoughts morning, noon and night. The worst of it comes and goes. The last big event happened at the doctor's office during my check-up with the medical and radiation oncologist in September. I went to the appointment thinking I was fine...then after 15 minutes of sitting in the waiting room waiting for the lab to work up my blood I could start to feel the tears welling up in my eyes. I was soon cursing at poor undeserving nurses out of frustration that things were taking too long. By the time I got to the doctor's office I was sobbing uncontrollably. I literally couldn't stop it. So needless to say after I survive the doctor's visits the last thing I want to do is come home and talk about it. I'm sorry especially to my family for the lack of updates, but it's just not there yet. I'll play the doctor card and say "no news is good news."

That day my radiation oncologist (who is an angel) took over an hour to do her check-up but also talk with me about my emotional state. I don't often have anxiety attacks and it's possible the waves of anxiety are fueled by the fact that I can't and don't talk about my cancer. Not ever and not to anyone. My radiation oncologist suggested I talk to the hospitals' social worker so I did. Twice. I hated it and found it hard to focus because my brain was too busy trying to come up with excuses for why I had to leave early or why I couldn't come again next week. The social worker recommended that I meet with a therapist outside of the hospital since I have such anxiety with being at the Cancer Care Center. I haven't done this yet. I just don't know what there is to say?! What I want someone to tell me is that the treatment worked and this won't happen again but no one can tell me that. I think that time is the only thing that is going to heal anything.

The one good thing that came out of the visits with the social worker was the breathing exercises. I realized that I often go through the day holding my breath and taking the time to just sit back and breathe does help with the anxiety. Instead of making an appointment with an outside therapist I joined a yoga studio in October. I can't say enough good things about the yoga. Taking 60-90 minutes to focus on breathing and stretching in a blissful studio overlooking the Boise River is just heaven. I leave there feeling better emotionally and physically. It's also done wonders for my tight muscles and low back where I had weaknesses that I didn't even realize until yoga. My visits to the yoga studio are like little escapes from cancer too because no one that I've met at the yoga studio knows me as a cancer survivor. When they ask me "how are you?" I know that they are simply asking me how my day is going instead of my usual paranoia where I think people are asking me "how is the cancer going?"

I know survivors who celebrate their cancer-free anniversaries or participate in things like Races for the Cure. They seem happy and grateful and are not afraid to say that their early diagnosis and treatments like chemo and Tamoxifen will prevent the disease from reoccuring. I love to see their smiles and they inspire me. I just wish I could figure out how to get to that side of optimism. Instead I have a box of chemo hats and other cancer-related recovery items hidden in a box in my closet for fear that tossing them will somehow jinx me. According to my doctor the greatest chance of a reoccurence is within the first 5 years. I'm doing everything that I can to better those odds and hope that as each year passes so will the anxiety. Indeed good things have come from my diagnosis. I feel like I'm living a more meaningful life and care less about material things. I had a wonderful year of adventures with my family and we're planning a trip to Hawaii hopefully this spring. I'm truly grateful for life and the fact that I am blessed with a family that I love beyond words, but that same gratefulness is the very thing that makes me terrified that it could be ripped away from me. If I didn't have it so good I woudn't be so afraid of losing it.

"So, are you cured?"

No, nobody really asked me this question, but I feel like it's on everyone's mind. That's the million dollar question, right?

Everyone wants to know what is next medically speaking. For now I see the medical oncologist and the radiation oncologist every three months. The medical oncologist reviews my blood work and checks for things like liver and kidney function and listens to my heart. The radiation oncologist does physical exams and pays more attention to the breast area. I also just met with the surgeon for my 6 month follow-up where he did a physical exam of the breast and lymph nodes - poking around for any lumps, bumps or enlarged lymph nodes. I'll see him again in 6 months and then after that every year. I'll get my next mammogram ~3 months after radiation (has yet to be scheduled). They typically wait at least this long since the scar tissue is still forming from the radiation. The real goal of my next mammogram is to re-establish my new "baseline."

For the handful of people who know how long I've been agonizing over whether or not to take Tamoxifen...well, this week I finally decided to give it a go. Partly due to undisputed evidence that it can better my breast cancer odds (despite other risks and side effects) and partly out of fear. I'm not going to go into further detail on that one. My pill cabinet is definitely larger than I want it to be, but I suppose I should just be happy that what I'm taking now is less toxic than what happened last year. Fortunately, Ryan has been proactive with researching and understanding supplements and every week he stocks my little pill box with vitamins and other supplements shown to better my cancer and heart odds and I have him stick that last little pill in there so I can try not to think about it.

I'm 12 weeks post-chemo and 3 weeks post-radiation. So how am I feeling? Physically I feel pretty good. In general I wake up feeling somewhat rejuvenated - as much as anyone who's kids wake them up too early can say. I no longer feel like I need to go take a nap every hour of the day. I've been running ~4 days per week and occasionally go to a barre class at the Y which I like. According to my Garmin device I'm actually a hair faster than I was a year ago. Not bad!

Emotionally I'm OK. I know this is going to take time. A couple women who have been through this have told me that it gets a little better after every good check-up. First every three months, then every 6 months, then every year.... I tend to hold things in because I hate talking about this shit and then every once in awhile something triggers me and I'll have a big cry and then move on. Repeat. Possibly talking to a therapist regularly would help, but you know what, I don't have the time to see a therapist! I have kids and a job and if I have any spare time I prefer to get some exercise which does a lot for my head.

Back to the question on if I'm cured. It's very possible that I'm overly sensitive and when people ask me how I'm feeling they're just genuinely asking how I'm feeling and not prying about the whole being cured question. Or maybe they are dying to ask the question but trying to be polite. It's crossed my mind! It very much sucks that there is no full body cat scan or blood test to tell you 100% whether or not your body is free of any cancer cells. You just have to have faith that the surgeon removed the tumor, that the radiation picked up any stray cells that the surgeon may have missed, and that the chemo took care of microscopic cells that traveled elsewhere. But no one knows, so I have to learn how to go on living without fear.

And now the hair, because I know everyone is curious. My eyebrows and eyelashes came in WAY faster than I expected. My eyelashes look good and I was able to catch them in an eyelash curler weeks ago. Some days I still fill in my brows a little - they're probably a little thinner - but mainly because I think I look better with more make-up these days to help me not look like a boy. Once the hair on my head is longer I doubt I'll fuss with the eyebrows anymore. The hair on my head is growing in well. It's still a buzz-cut but I'm well on my way to pixie. It's too early to tell on texture whether it will be curly or straight but if I had to guess I'd say straight. Unfortunately the color left a lot to be desired. It came back very grey-brown. I'd best describe it as "grey-mouse brown." I'm sure if you toured the hair color aisle at the grocery store you will not find "grey-mouse brown." So yesterday I had an appointment with my stylist and colored it a little darker and richer color. I like brunette pixie's and am looking forward to one of my own.

Finished Radiation - Now What?

Yesterday was my last treatment of radiation. It seems like this shit has been going on for so long and I did get a little emotional lying there the last 2 days as I counted the 22 seconds it takes for my daily dose. It felt strange to walk out that door knowing I didn't have to come back again the next day, and the day after that, and the day after that...

Just like with chemo the finish line isn't exactly a big party, though it did feel good to celebrate New Year's Eve with friends and have a few drinks. Yes, I'm happy this is all over but I'm a little numb too. At times speechless when people ask me if I'm so happy. I don't really have much to say about it as I still feel like I'm holding my breath.

When I first started blogging about this journey I asked for friends and family to share stories of survival with me. I received many and found great strength in each one. The friend of a friend whose mother had BC when he was five shared with me that for a few years after treatment his mother was burdened by a deep depression, which as a small child he was oblivious to. Later in life he learned from her that the depression lifted years later during a family camping trip in northern CA. She had a moment when she finally felt OK again and she smiled everyday for rest of her long life.

While I don't feel depressed, my mental health is still a work in progress as I tackle feelings of denial and fear. I still can't believe this all happened. I'm still trying to answer the question of why this happened - I need to stop trying to answer that question. I'm afraid that any little dysfunction in my body could be a recurrence or a secondary cancer as a result of treatment. I'm scared that I won't be there for my kids as they grow up.

So yes, I'm happy this is all over. But yes, I very much look forward to my special moment in the mountains - or anywhere else - when I learn to release these emotions and gracefully accept the things that are out of my control and simply embrace what is good in life.