I Prefer Not To – Cancer’s Only Rule

One of my many loves in life is math (or as my OZ friends say, maths.)  While I’ve never been particularly great at calculation (speed and place value are not my thing) I love the  logic of math and following the rules and arguments that move you from point a to point b.  Along those lines, I like to decide when I hear opposing viewpoints if they appeal to that logical side of my brain causing me to want to dig and research to determine if the evidence is credible or if they appeal more to my emotions. At the moment, my logical brain and my emotional brain are at war as I am faced with yet another choice less choice.

I am cancer free. For all intents and purposes, the chemotherapy did its job. When I finished chemotherapy not quite a year ago, I was re-scanned, and the cancer was gone.  No trace of it. The months of no energy, no appetite, mouth sores, endless diarrhea and vomiting, brain malfunction, and general exhaustion that is chemotherapy worked. The fight was worth it.

To be on the safe side, just in case that lil-bastard cancer was hanging around on a microscopic level, I scooped out all the tissue around the area that might have been infected by way of mastectomy.  Although my surgeon at the time, told me it would only reduce my risk of re-occurrence by 3-5% and it was not considered a significant enough risk to be mandated as “medically necessary” I opted for a bi-lateral mastectomy. That is, as a matter of extra precaution, I took out both sides, just in case a similar mutation was even thinking about forming, despite having no genetic markers. All of it, scooped out like ice cream. Gone.  Again, the fight was worth it.  The end’s justified the means.

The only thing left was skin.  While not probable, it was possible that a microcosm of cancer was hanging out somewhere in my skin.  Again, not probable just possible.  As another layer of precaution (because we can’t just kill something we have burn it). Despite my beginning to question the medical necessity of this, I did it.  I figured the procedure had been refined enough and enough data had been collected that it was more safe to do radiation than not to.  I mustered up my courage and I enlisted for six weeks of radiation camp.  Every day, I marched in and allowed myself to be burned over and over and over. I endured pains in unmentionable places that would disturb a P.O.W.  But, the battle was worth it.

My doctors recommend that we throw every weapon we had against cancer and I agreed.  I have fought my fight.  There is simply a part of me that thinks if we haven’t got it by now, we aren’t going to.  It’s either there to stay of gone for good.

However, a new weapon has emerged.  As an extra, extra, extra  preventative measure to keep the cancer from coming back, there is this new medication that was recently (as in the last 6 months) approved by the FDA that my oncologist is now encouraging me to take.  Folks, this medication might be the devil.  I say that because all test results indicate that it will cause Linda Blair Exorcist level reactions. It has all of the exciting side effects of chemo, except for losing your hair.  Not only are these side effects possibilities the way they were with chemo, they are now more like probabilities given the research and  everything I know about how my body reacts.  In other words, it’s pretty much a guarantee I’d be putting my body through a war zone all over again… for a year.

I’m not the kind of person that is quick to judge so I pulled up my old friend Google and did a fairly significant amount of reading and research.  Don’t get me wrong,  I don’t want to be mistaken for thinking that I know more than my doctors.  I do however want to have an informed opinion in order to make a decision.  My oncologist shared that the reason she is suggesting it is because studies indicate that the drug might lower my chances of the cancer returning somewhere in the neighborhood of 2-3%.  (It’s interesting to me that while a double mastectomy lowering my chances by 3-5% wasn’t medically necessary taking this heinous medication that might help prevent it’s return by 2-3% somehow is but that’s besides the point.)  According to my oncologist this is one more weapon we have now to help me prevent cancer’s return.  That is her job and I appreciate her for doing it.  That said, it’s my decision to make as to whether or not I want to take it.

After reading all I could about the drug, speaking to as many credible sources as I could find and much careful consideration it seems to me this medication is being prescribed because it can be.  The drug is approved, insurance will pay for, it can be a treatment, therefor it is.

But should it be my treatment?

While trying to make the decision of what to do a friend said to me I would have that “shower moment” where the answer becomes clear.  She was right.  I did have that shower moment it just happened to be in a pool. It dawned on me that while it’s tempting to ask, what would you do? The only thing that matters, is what would I?  Am I the kind of person that is more guided by fear that cancer might come back? Or, am I the kind of person that could decide to stop fighting and be okay with it?

Since day one, I have said there is no wrong way to do cancer.  It is your fight to fight, as fiercely as you need, as bravely as you can, for as long as your body says, “fight it.”

While there is no wrong way to have cancer, the one rule to cancer is, when you’re done fighting, you’re done fighting, and that needs to be okay.  It is by far the hardest decision you will ever have to make.

This decision is the worst because it not only weighs on you but on those who love you the most. It requires an act of the most selfless love to say, “I respect your right to stop fighting.”

What do people with cancer need?  We need you to love us enough that when (and if) the time comes when we tap out, you will let us rest without feeling like we let you down.

The truth is, hanging up our gloves and being done fighting is harder on those who love us than it is for us.  While it’s tempting for those who love us the most to encourage us to keep fighting, sometimes what we really need is for you to tell us it’s okay if we want to stop.

My a-ha moment was realizing that I was defending my right to say,  “I’m done.”  I wish to say thank you, but no thank you. I am done fighting for now. Call me Bartleby the Scrivener but I prefer not to.

It’s the right decision for me at least for now.  As a friend said, “whatever decision you make you just need to be resolute about it.”  She’s right.  While it is not without the possibility of cancer one day returning, I believe that I have taken enough steps to try and prevent it.  I’ve fought my fight and I’ve earned the right to stop for as long as I need to.

I might in a month decide I’m ready to fight again and I want the additional possible prevention.  I might a year from now be forced to come out of cancer retirement and fight again.  Hopefully not, but I’ll make that decision when and if I’m ever faced with it. Other’s aren’t always so lucky, they don’t have as many options.  For some, making the decision to stop fighting has more immediate and permanent consequence.  It’s a decision I’ve seen many time through my journey and it’s the most taboo of all the awful decisions people fighting cancer have to make.

When fighting cancer, when do you earn the right stop?  This is the question we don’t prepare people for and no one is quite comfortable dealing with.

No one’s opinion of what they think they would do when faced with a choice-less choice is more important than the person who actually has to make one. After heavy consideration, I’ve made my choice.  It has to be the right one.  But, I suppose that if I’m wrong, and the worst thing that could happen did, what I’d want more than anything is for those who love me to tell me I didn’t disappoint them by choosing to stop when I needed to.

Be resolute in your decision, and as a friend said, if you’re wrong then you can plan your own fucking-funeral. But when you really think about it, what could be cooler than that?

You Look Radiant

If you ever find yourself with cancer you might get the distinct pleasure of getting to experience radiation as part of your treatment. As it turns out, the decision of whether or not to do radiation is based on your initial pathology. It doesn’t matter how well your body responds to chemotherapy or if the cancer is no longer visible when they cut out the infected tissue.  If radiation was decided in the beginning, radiation is what you get.

Medicine is not an exact science.  Although there is much we know and much we have learned, sometimes the best we can hope for is just statistical guesses, best practices, and the standard of care. Over time, statistics have shown that women with XYZ type of breast cancer have a better statistical chance of it not coming back if they do radiation.  At best, radiation is a balancing act and a bit of a guessing game. As it turns out, studies indicate that the magical number of radiation treatments that the body can endure without getting completely poisoned is about 30, that’s the threshold.  Or, that’s just what insurance will pay for.  You aren’t completely sure.

Radiation is cumulative.  You need to build it up in your system, over time.  The best way to do this is to go every day, Monday through Friday, (not the weekends because everyone could us a little break) for six weeks. But if you wait much more than a couple of days in between sessions, your skin might start to heal, and that’s not what you want.  After all, the point of radiation is to burn you.  The doctors are looking for specific burns on your skin.

In the past they would make a map of where to burn victims patients, by tattooing them, now they use sharpies and stickers. When you first see the radiation map on your skin it looks like that time you got drunk, passed out, and since your friends are assholes you wake up with sharpie all over you. (Except there are no penis’ drawn on you, just a bunch of dots and lines in different colors.)

It’s a treasure map for the pirates of radiation, except instead of digging, that’s where they’re going to burn you.   You of course protect this map with your life. You do everything in your power to keep it from rubbing off, washing off, sweating off, oozing off, and finally peeling off when your skin can’t take it anymore.  Every day you inspect the map, and try to re-stick stickers or re-draw dots and lines that might be fading.

Radiation treatment is a controlled burn. Like firefighters taking to the forest floor before burn season, you are spraying all of the surrounding area with a flame thrower trying to prevent any seeds that may have spread from taking root.  It’s very precise, it has to be because one or two millimeters in the wrong direction and you risk burning your heart, or lungs, or esophagus.  So no matter how much it hurts, or how badly you are in pain, you lie very still on the table and hold your breath when they tell you to.  You let them burn you over and over again, for twenty minutes, every day, for six weeks.

You’re unique cancer journey can be explain like this, cancer is an unwanted tree growing in your backyard, chemotherapy is like putting poison in the ground.  The tree soaks up the poison and hopefully dies. Next, surgeons come in and remove the tree.  They cut it down, and scoop out as much of the roots around it as they can. Then, they remove the places the roots might have spread. Surgery is the cutting down and removal of cancer tree.  After surgery, you are technically “cancer free” as long as they don’t see any more signs of the tree. The final step in your fight is to take flame thrower to any area the wind may have spread a seed.  At the microscopic level, cancer could be hiding in the skin, just waiting to take root and grow again.  The best way to ensure that doesn’t happen, is to burn the skin and the tissue underneath in all the surrounding areas.

It’s funny, at the time of diagnosis everyone dreads chemotherapy. It comes first, and it’s by far the most notable.  It gets all the top billing.  But radiation is like going to a concert where don’t know the opening bands, all you know, is the headliner.  You decide to go early check out some new music.  The opening band comes on and your world is rocked.  You are their newest, biggest fan. You head straight to their merch table and can wait to get your hands on a shirt.  Amazed, you are changed for life.  Then you go on with the show and enjoy the headliner you came to see. It isn’t until after the concert that you realize that while the headliner was good, it was exactly what you expected.  It was the unexpected opening band that really blew your mind because you never saw it coming. Chemotherapy is defiantly the headliner, but radiation is the unexpected opener that kicks your ass in ways you never dreamed possible.  Everyone seems to think if you made it through six months of chemotherapy, and you made it through surgery, radiation is just a drop in the bucket!  Insert Trump GIF Here, “Wrong.”

In the sickest of cruel jokes, you are given about ten weeks to recover from the most horrendous trauma of your life, a double mastectomy.  To be fair, it’s just to let your skin heal, it’s going to take you a lot longer to fully recover.  But your body has about ten weeks to get over it.  The first six are the worst.  Amid heavy pain-killing medications are draining tubes that have to be milked, spit baths, and weekly injections of saline to stretch your skin draped over the expanders that are stitched to your pectoral muscles. But as you move into your seventh week post-surgery, the pain subsides.  The skin has scabbed over where the tubes were removed a couple of weeks ago. You have weaned yourself off of the heavy pain medications and are now only taking Tylenol a couple times a day. You’ve gone back to work and have started to feel somewhat normal again. You’ve survived a war zone and earned two-weeks leave. It’s so amazing after that after a six-month tour, you have this reprieve.  You go out, start to see your friends again, life as you once knew it flows back and you see a flicker of it once was.

You are now eight weeks post-op.  Your skin will not be stretched any more, it’s time to start radiation. You tell yourself, it’s only six weeks. No problem. The doctors say you probably won’t even feel anything for the first couple of weeks.  Derby up, you got this.

The first three weeks of radiation pass by.  You’ve noticed that you have started to get tired again, but this is a different kind of tired than it was before. This isn’t sickly like chemotherapy.  You don’t feel like you have the perpetual flu, it feels more like you go to the gym every night, and people take turns punching you. Radiation doesn’t hurt at the time.  It’s more like an intense workout, about 20 minutes after you’ve finished, you start to feel the burn.  You’re tired after your workout and try to sleep it off.  You hope you’ll feel better in the morning.  And you kind of do.  For the first three weeks, you actually do feel a little better in the morning.  But this has become your existence. Every day you go to work and attempt to live your life, and then every night you go to the gym and let people take turns punching you.  Day in, day out, Monday through Friday, for six weeks.

About three-an-a-half weeks in you start to notice the burn doesn’t fade overnight anymore. It’s red, warm to the touch and a little itchy. You can see the pink building up on your chest and underneath your arm.  By the time you are four weeks into radiation treatment, the areas that were pink are now red, and the Aloe vera doesn’t help the burn for more than a few seconds. You are exhausted from your daily ass-kicking.  (This is no longer a daily workout, this is just a daily ass-kicking.)  By five weeks in, it feels like the pain has gone from linear to exponential growth almost overnight.  It wakes you up in your sleep and there is no way to get comfortable.  By the end of the fifth week you have started to blister and peel in areas where the skin isn’t as thick.  The name of the game becomes prophylactic care and you try to keep as much of your skin as possible from blistering and rubbing off. There is no longer a comfortable way to sit or lay down, and standing is just out of the question.

You begin your sixth week. You’re body has been to hell and back. In the last eight months, you have been poisoned, stabbed, beaten, and burned alive.  You have one more week. Only a crazy person would go back for more.  Who in their right mind would show up?  But Monday is coming.

It has only been with the help of some really good friends and of course your family that you’ve made it this far.  They have held your hand for the last eight months and have journeyed with you to these, the last three weeks which are the hardest, cruelest, most intense and awful piece of this entire experience. You’ve almost made it to the end, but you have nothing left to give.  You have done your best to fight, but you are tired of fighting.  You are tired of hurting, and the pain is like nothing you have ever experienced.

You will never figure out the words to say thank you to the people who are there for you. It blows your mind how in this, the last stretch of this horror-marathon, the people who love you the most step forward, hold you up, and carry you across the finish line. They take the day off work and come stay by your side and cuddle up and watch a movie.  They make you laugh when all you want to do is cry.  The pain your toenails.  They become your own personal lyft and grub hub.  They take you to your appointments and feed you, and they take care of your kids (both two and four legged).  If they can’t be there in person, they message you let you know they are rooting for you every step of the way.  They are the friends who tell you not to worry about anything, to just take care of yourself.  They tell you to stay focused on just getting through it, and they mean it.

You are NOT alone in this war.  You are at the point where you are blistering and peeling and hurting 24 hours a day, but you have back up. You have people in your corner backing you up, dragging you forward, and cheering you on.  They remind you every step of the way that you can do it.  Somehow, with a little help from your friends and family, you will manage to woman up and show up on Monday, for your sixth, and final week of ass kicking. That, is beating cancer.  You’ve gone from three weeks down to one.  You have seven more treatments to go. Barring something horrific (like having to get mapped again because your skin is now so blistery and peeling you can’t keep the map on) you will be done in seven sessions.  You’re down to single digits. 7…..6……5……4….3..…2…..

See you at the finish line.

*Fingers crossed*

 Tuesday, March 13, 2018. 

3:00PM

MD Anderson Cancer Treatment Center in Gilbert. 1^st Floor, Radiation and Oncology.

Fried Shrimp! – Forgiving the Bitches that Betrayed Me

A double mastectomy is an incredible loss. No, it’s not just loss it’s worse than loss, it’s betrayal of the worst kind.  It’s the kind of betrayal that can only come from someone you thought was your friend only to discover you were wrong. The kind of loss that leaves you with questions.  If you were ever my friend, how could you act like this?  How could you put me through this?  The type of loss where you start to question yourself, how did I not see it sooner?

But after all the tears and the anger there comes a day of reckoning. A day when you look at yourself in the mirror and decide to accept the situation as it stands now.  You run your fingers along your wounds and take note or your scares. There’s a sad almost poetic elegance to them. They haven’t cut you too deep.  In fact, in some places you can hardly tell at all.  Of course, you’ll never be the same.  It’s possible that one day you may opt for prosthetics or tattoos, but all the cosmetics in the world can’t erase the past.

The problem with burning bridges is they can’t be unburnt.  There is no possible way you will ever be able to go back to the way you were.  You’re only choice now is to build a new bridge.  It’s the only way you’ll ever be able to move on.  Holding on to anger and hurt keeps you in a painful place, one you have come to realize you no longer have time for. Life is just too short.  Cancer has taught you to respect the fact that at any moment it all can change. It gives you a profound perspective on what is important and more importantly what isn’t.

But how does one forgive the unforgivable?  How do you come to terms with having been wronged and somehow manage to let it go?  It’s so much easier to simply avoid or put on a brave face and act like you don’t notice.  It’s easier to bundle your feelings up and stuff them in a drawer or sweep the under the rug.  After-all, how do you stare down the pain of betrayal and make it okay?

The first conversation after a painful breakup is always awkward.   Starting a conversation after you’ve been hurt is no easy task.   There are some things you just can’t apologize for.  There is nothing that could be said that would make you whole again. There are no right words.

Fried Shrimp!  It’s the only thing to say when you’ve had an awkward break up and don’t know what to say.  Seriously, try it some time.   (Thank you Iliza Shlesinger for that tip!)   Fried Shrimp works wonders. It’s fine that it doesn’t make any sense because the only thing worse than an awkward first conversation, is perpetual sadness.  The first step to forgiving is recognizing it’s time to not be sad anymore.  The worst of it is over.  You don’t want to dwell there anymore, it’s time to move on with your life.  It’s time to let go of your hurt.

Sometimes to truly let things go, you have to embrace them.  Just look them in the eye, smile, walk right up, chest to chest, wrap your arms around them and squeeze. (Hopefully, not too tight because it’s a little painful.) It will never be like it was, that time in your life is over.  As fun as it was, it ultimately grew unhealthy and nearly tragic. You’ve had to accept the fact that removing a part of you was simply doing what needed to be done.

Breath.  The letting go is hard.  Sometimes letting go is harder than hanging on.  But, you have a choice.   The situation is what you make of it, you can continue to let it hurt you or you can choose to feel something else.  Once you’ve had cancer, it’s never very far from you mind. You develop a sense of gratitude for the moments. You become grateful to still be here, to live another day, to tell your story. You are one of the lucky ones.  Not everyone is so very lucky.

Only then do you recognize the awesome power of forgiveness.  Forgiveness, is a personal choice one only you can decide if and when to give.  The beautiful thing about forgiveness is you can give it, even if it isn’t being asked of you.  Sure those bitches betrayed you, but it’s not worth the energy it takes to remind yourself how much they hurt you every time you think of them. It’s time to make peace or at least make civil because thankfully, life goes on.

Cancer has a funny way of putting things in perspective.  It touches too many lives.  It’s a bit ironic that cancer is the ultimate common ground.  No matter how significant the rift is, cancer has a way of reminding us that there’s only one kind of people in this world, people who die. (If you’ve never listened to the song One Kind of People by Amigo the Devil you should seriously look it up on YouTube.)

Finally, you have found humor.  Once you have learned to laugh again you can step back to take in your new form and wonder what the final stage of reconstruction will look like.  Gradually, the fear subsides and you realize it’s going to be okay.  As you stare in the mirror and wonder it hits you, the way they left that one piece of skin… you burst into song, who lives in a pineapple under the sea? SPONGE BOB SQUARE TITS!  There is no greater medicine than the ability to look at yourself and laugh.

You take a moment and just marvel.  The doctors really can do amazing things. Hell, with no nipples you kind of look like a Barbie doll.  WOW, with those expanders in there you kind of feel like a Barbie doll.  Suddenly, the awkward first conversation stops being awkward and becomes acceptance.

Here, feel my boob. No seriously it’s cool, our relationship has changed.  It’s more like a hands-on science experiment and it is genuinely fascinating.  The human body is truly amazing but only half as amazing as the human mind.  Our ability to lose, to grieve, to evolve, to choose what we make of every situation is a gift.

Whether it is Fried Shrimp or Here, feel my boob.  You’ve managed to break the ice.  The relationship is no longer stagnant, it is no longer painful, and it is moving forward.  With every conversation and telling of your story you take a step toward accepting your status as a survivor and forgiving the bitches that betrayed you.

Towanda!

Fried Green Tomatoes is easily in the top 10 of best stories ever told.  If you’ve never read the book or seen the movie, stop reading this blog and add it to your repertoire immediately.

One of my favorite scenes from the movie is when Idgie and Ruth sneak on to the train and toss food out to hungry families. Soon after, Ruth realizes that the problem with sneaking on to a train is that you have to get off.  To her horror, she realizes this means jumping while the train is still in motion.  When her best friend Idgie says, “You’ll never jump.”  She responds with, “don’t you ever say never to me,” and jumps without warning.  Inspired, Idgie yells, “Towanda!” and jumps right behind her.

I have decided that having cancer is much like this scene.  When you are first diagnosed, you find yourself on a train that is leaving the station.  There is little to no warning and you aren’t really sure what you’re doing. You don’t have much time to think about it, or plan your next move.  People tell you things about how you’re going to feel and the horrible side effects that will soon control your life.  They tell you all the crappy things that are going to happen to your body and you can’t help but imagine your impending doom.  I however, have come to believe it really is what you make of it.  When people told me how sick I’d be and how I wouldn’t be able to live my life or do the things I love, I tried to remember Ruth, “Don’t you ever say never to me.”  So with a never say die attitude, the train pushed on full steam ahead.

Throwing out food, is like this blog.  The ride just becomes the new normal, the way life is.  You try to stay positive and attempt to do some good along the way. Maybe sharing the experience is helpful to other people who never realized what having cancer is actually like or were just too unsure how to ask.  I know I’ve learned a lot going through this process, hopefully some of that wisdom is conveyed here and is helpful to others as well.

Six rounds of chemotherapy has taught me a thing or two about things I didn’t know – I didn’t know. It’s opened my eyes to realities I’ve never taken the time to think about or tried to understand. It’s also taught me a lot about the people in my life as well as the things that matter and the things that really don’t.  Facing the realities of your own mortality is no small task, you quickly learn to see and appreciate more of the day-to-day moments of happiness.  You realize how important it is to stop and breathe.  You are so run down and tired most of the time you learn to appreciate just sitting and laughing with a friend in a way you may never have before.  If nothing else, you stop taking those moments for granted because you realize, they are not a guarantee.

Cancer moves at a breakneck pace.  Like roar of the 1920’s, the chemo train rolls on.  The combination of exhaustion and fear steamroll one day into the next.  You don’t even have time to register the stress of medical bills, time off work, and day-to-day chores.  Your head is in a fog, your body aches, and you are heading in one direction.  Survival.  All of your energy is focused on getting through the next round.  Then one day, just as they began, the rounds of chemotherapy come to an end.  It’s time to get off the chemo train.

As relieved as you are to be getting off you realize, much like Ruth, the only way off of a moving train is to jump. The end of your chemotherapy journey is surgery.  As if being on the train in the first place wasn’t scary enough, much to your horror you must now muster up your courage and jump off while it’s still in motion.  Surgery has unpredictable outcomes.  There is no guarantee of safe landing and no easy way to do it.    Whether it’s to prove you can survive it, or simply because you are lifted by the bravery and encouragement of others you close your eyes, take a breath and leap, hoping you don’t die in the process.

Towanda!

One morning you pull up to a hospital, you check yourself in, sign some paperwork, and get yourself into a gown. Eventually, some people come into the room, and dump a cocktail in your veins that make you pass out.  The next thing you know you wake up with a part of you missing.

The landing really is the worst of it.  Much like Idgie you’re in serious pain.  You are alive, but must learn to lean on your friends and family to help you limp the long, unsteady walk back home.  It’s a slow, frustrating, somewhat humiliating, and painstaking process.  Gradually, the steps get easier as you get closer.  Eventually, you realize life really does go on and you will get through it.  You may even come out of this a stronger person than you were when you found yourself on that train.

The only way to know for sure is to just keep walking. Put one foot in front of the other, one step at a time and remember Idgie, Ruth, and Towanda!

The Hardest Dear John Letter Ever Written

Dear Boobs,

How do you say goodbye to a relationship you’ve known for almost 30 years? You are so much a part of me. You are in almost every photo and memory. How do you muster up the courage and the strength to let go after being together for that long?

Perhaps you shouldn’t have tried to kill me. For that, you can never be forgiven. We have reached a point where there is no going back, no fixing what went wrong. There can be no reconciliation. This relationship has grown toxic and so I must end it.

I appreciate the fact that only one of you truly betrayed me. But you are a pair and quite frankly, I don’t trust you anymore. I think it will be better for me in the long-run to make a clean break and leave you both behind.

Not that our time together was all bad. We’ve certainly had our share of good times. Over the years we’ve enjoyed much attention, compliments, and laughs. We’ve shared many experiences I will treasure forever. The things that have landed on us, that we never saw coming, but somehow managed to survive, have taught us some valuable lessons about life, love, and getting stains out of shirts. We have grown up together in every way possible.

We’ve also made plenty of bad decisions along the way. (Sorry about some of the fashion choices I made you suffer through.) We’ve seen our share of tears and broken hearts, and made it out of some sticky situations. We’ve relied on each other for help on more than one occasion, and for the most part, made a pretty good team.

Together, we’ve been through some amazing changes and redefined our relationship when we experienced the miracle of life with the birth of two beautiful children. While I had my doubts in the beginning, you never failed me or them. You served your purpose well in sustaining those lives and nourishing those little bodies for awhile. Although I didn’t always appreciate it at the time, I have never felt true love the way I did in those precious fleeting moments.   Thank you for showing that to me.  I should also thank you for your contribution to getting us into that situation in the first place.  There too, you have served your purpose well many times over.  Function has always been one of your strongest and most admirable characteristics. I will miss that about you.

But none of that seems to matter now. It seems our time together is coming to a cruel and abrupt end. It’s time for me to figure out who I am again and move on without you. Though I may try, I know I’ll never be able to replace you. I will carry the scars from your memory with me for the rest of my life.  I am scared. I can’t imagine what it will feel like to go to sleep and wake up without you. I will miss you. I will miss our day-to-day routines. I will miss the way you made me feel when times were happier. I honestly never thought I’d see this day. I thought we would be together until the end. I guess life really is what happens when you’re busy making other plans.

I will try to honor your memory and the time we had together by turning the scars you leave me into something beautiful.

Love,

The rest of me, the best of me, and the part that breast cancer won’t break.

The Menu of Mastectomies & A Dinner Party from Hell

Coming to terms with losing a breast or two is no easy task. It is my great hope that at some point, possibly within my lifetime, our medical technology will advance to the point where removal of the breasts to treat cancer will come to be considered a barbaric practice that will be eradicated by using some other method that we have not yet discovered.  While we have made tremendous strides in our understanding and treatment of this disease, this is unfortunately not the case in today’s world, and I don’t have time to wait.  While the practice does feel a bit barbaric, I’m a Game of Thrones type of gal, so let talk tits, specifically their removal by blade, a be-titting.

Since this nightmare began I’ve always know this day was coming.  It was definitely a question I’ve been asked quite regularly through the process.  Are you going to whack one or two? (Sounds like a mafia hit.) Everyone seems to have an opinion on the matter.  They seem to know what they think they would do. But, I think breast removal may be slightly more in the category of abortion or performing a mercy killing, you don’t quite know what you would do unless you are actually in the position of having to make a choice-less choice, a position I unfortunately find myself in.

Having to choose is probably the worst part.  Some women don’t have a choice, their cancer and/or their genetic testing is such that “the right thing to do” is clear.  For me, the right thing is a little more ambiguous.   I wish there was a right and simple answer, one that could be deemed the clear winner and better choice.  Like so many things we tend to oversimply complicated situations and go for the extreme, “I’d just slice them off,” when the reality is so much more complex.

One thing I never thought to consider prior to my diagnosis is every woman has a different relationship with her breasts.  I spoke to a friend early on who explained to me that growing up her breasts where never really a part of her self-identity. For her, the decision wouldn’t be as complicated.  To her, her breasts are a mere side-note to who she is.  They are on the smaller side and not a feature that she routinely accentuates when she dresses or even tends to even think about.  They simply aren’t a huge factor in her self-image or sexuality.  On the other hand, I spoke with a different girlfriend who was on the extreme opposite end of the continuum.  She has much larger breast and they are very much a part of who she is as a person and what she considers when she looks in the mirror.  To her, her breasts are central to self-image, as well as her sexuality.  So when considering breast mastectomy surgery and “the right thing to do,” the psychological experience alone is deeply personal and very much unique to every woman who has to do it.  There are many factors to consider that are much more complicated than the decision to simply lob off a breast or two.  The decision is a permanent one that affects so much more than some surface area skin.

Regardless of the close personal relationship each woman has with her breasts, the decision to have surgery is also a complicated one.  Before this happened I didn’t spend much time thinking about the difference between breast enhancement surgery and breast removal surgery.   I have come to realize how very different these are.  Breast enhancement or augmentation surgery (as painful as they may be) are elective and performed for the purpose of looking and/or feeling better.  Plastic surgeons discuss how they can hide the scaring so that you will never know, and what size breast will look and feel the best.

Breast amputation surgery, a.k.a. mastectomies are more like a complicated menu written in a foreign language.  As you attempt to muddy your way through the menu you realize there is absolutely nothing that sounds like a good option.

Psychological effects aside, surgery brings its own risks.  The time spent in surgery and under general anesthesia, the risk of infection post-surgery considering the surface area that needs to be removed and the skin grafting required to replace the affected area. Then there are the joys of dealing with the healing process after having the area removed, including pain, draining tubes, and general self-care, as well as incredible permanent scaring (and a variety of scaring patterns to choose from) written across your body like surviving a slasher film, forever.

Reconstruction is essentially the dessert menu from hell, of which one has to decide if you want to partake in any at all.  This too is another painful and ridiculously difficult decision.  Should you choose to elect for some reconstructive dessert, you must realize this is not a menu of delicious rewarding chocolate porn-tits but rather much more painful options of implants under the muscle to stretch the skin, removal of nipples and permanent loss of sensation in the breasts.  It also begins a battle for attempted symmetry no matter what size and shape you are hoping for, which may or may not be your original size or shape. Should you choose to have only one side completely amputated and then attempt reconstruction, you are guaranteed surgery on the other side to achieve some semblance of symmetry which is likely to fade over time as age and gravity takes its toll.

The reconstruction dessert doesn’t end with expanders placed under the muscle to stretch the muscle tissue.  After that (in a second surgery) you have to determine if you want to use any of your own tissue to reconstruct the breast and if so, what part of your body would you like to hack into?  The preferred method is to use your stomach (and no, it’s not a two-for-one tummy tuck situation) and your back as back-up.  Both procedures of course leave their own set of scaring.   Then you must consider a third surgery (we’re now talking two years down the road) regarding the placement of aesthetic nipples, not to mention any future tattoos you might elect to add in order to color the nipples and/or hide the scars.

I’ve heard of four-course meals lasting an entire evening, breast cancer is the dinner party from hell and it seems you never get to leave.  I for one have had my fill and would like to be done now.  Sadly, chemotherapy was just the appetizer.

Cancer – The Musical

It’s not even Halloween yet and I’ve already accidentally stumbled upon my first Christmas carol, which I find rude and completely absurd.  However, in the twisted way my mind works (and because cancer is unfortunately always on my mind) it did lead me to start thinking about other absurd things.  As this happened to me on my way to the pharmacy to pick up supplies and medications for my ever-growing list of ailments I decided that it would be more fun to think about all of them as a Broadway musical.

In true Monty Python style, picture this opening number, What Fresh New Hell Will Cancer Bring Me Today.  Imagine a bunch of beautifully wrapped packages perhaps under a Christmas tree as the ingénue picks up each bright and shiny package, holds it up to her ear and shakes it in gentle anticipation.

It’s just more fun to share awful information if it’s in the form of a musical.  So, just envision these numbers with bright colorful costumes singing and dancing across a stage.  Without further ado, I’d like to present Cancer-The Musical.  Including some soon to be favorites such as…

• Grey hair doesn’t fall out – wtf?
• I look like a sexy ostrich
• It feels like the atomic bomb went off in my mouth – A new fad diet
• Mouth sores aren’t for wusses
• Butt hurt and other tales of explosive diarrhea
• Neutropenia and flu season, your sniffle could kill me

Somewhere in this musical I also picture a cancer fairy.  Similar to a sugar plum or tooth fairy except she (or in my mind he) delivers hot flashes, night sweats, and premature menopause while the lead is sleeping.

The second act in this delightful musical includes these exciting numbers…

• I can’t remember anything, thank you chemo brain
• Nosebleeds, it’s the only thing I’ve eaten all day
• Cancer made me a hugger
• I laughed so hard I cried and cried so hard I laughed
• Medical marijuana, yes it works
• I might give cancer my boobs but I’d rather give it the finger

I guess my point is this, as terrible as this situation is I’m still finding ways to laugh about it.  The list of awful things that are happening on a daily basis has grown so long I can’t even remember what hurts. They say that cancer is the fight of your life, not because of all of the awful things you have to endure but because you have endure them and knowingly submit yourself for more.

The dark truth of how you get through it is by remembering that it could always be worse.  At least you have the option to fight it.  There is a twisted comfort in knowing that somewhere out there is someone battling a harder, longer, or more unfair battle than you are.  Someone is doing this, and they too are surviving.  So if they can survive it, you can too.

The term survivor recently took on new meaning for me.  I’ve always heard “Cancer Survivor” and taken it to mean, “Cancer didn’t kill me.”  Which is true, but beyond that I didn’t dig much deeper.  Before cancer, I never really understood how people could survive horrible things. How do people go through what some people go through and come out the other side?  How do you survive losing your hair, or cutting off your breasts or other impossible situations?  I get it now.  Being a survivor doesn’t just mean defeating cancer, being a survivor means enduring all that you must go though.  Knowing how awful and unfair the next step is and mustering up enough courage to soldier on and put yourself through it.  It’s realizing whatever you just did to your body, if you aren’t dead yet, you can handle more.  Being a survivor means enduring choice-less choices and living to tell about it.