1. Friends who cry for and with me.
2. Husband cleaning with the kids even though he is tired and needs to pack for a business trip.
Sunday, February 27, 2011
Saturday, February 26, 2011
Today's Gratitudes
1. Rolo candy
2. Fruit slice-shaped gumdrops
Husband, Huckle, and Sally gave me candy for my birthday, since the camera I got for Christmas costed two gift-giving holidays' worth of money.
Normally, I'd feel guilty about eating candy for breakfast, especially two days in a row. Double especially when breakfast is followed by a big slice of leftover birthday cake this morning (breakfast dessert, naturally!).
However, it's not like it's going to give me cancer or something.
But seriously, as someone who has always been health conscious (I even consider getting a cavity to be a horrible health crisis), it has been hard to continue to care about a healthy diet and exercise. It sometimes feels as if it didn't do me any good.
I know that's not logical, but it's my own little rebellion.
Friday, February 25, 2011
The Big 4-0
Today is my 40th birthday. Under most circumstances, this would be a big
deal, a time to somberly reflect on my "youth" coming to an end and my
smile and frown wrinkles becoming permanent facial fixtures.
HOWEVER...
1. There's nothing like cancer to make you grateful to be alive. Perhaps I'm not as grateful as I should be: I still struggle with feeling that my diagnosis is somehow unfair, as if I don't deserve it or something irrational like that. We Americans feel entitled to long, satisfactory lives! But then I take a step back and realize that I am blessed that my cancer was discovered early and that I have a good chance of leading a normal, healthy life after this ordeal.
2. Getting cancer at age 39 is a sure way to be told again and again how young you are! Doctors, nurses, friends, acquaintances, cancer survivors -- so many sigh and say, "But you are so young!" :)
But, really, cancer and its treatment feels like a crash course in aging. I mourn that my body is going to be losing parts and losing strength. I mourn that medications will put me prematurely into menopause. In my weakest moments, I feel as if a decade has been ripped from the middle of my life.
But, in my very weakest moments, I remember to meditate on Psalm 46 and again reach peace and a heaven-centered perspective.
1 God is our refuge and strength,
an ever-present help in trouble.
2 Therefore we will not fear, though the earth give way
and the mountains fall into the heart of the sea,
3 though its waters roar and foam
and the mountains quake with their surging.
4 There is a river whose streams make glad the city of God,
the holy place where the Most High dwells.
5 God is within her, she will not fall;
God will help her at break of day.
6 Nations are in uproar, kingdoms fall;
he lifts his voice, the earth melts.
7 The LORD Almighty is with us;
the God of Jacob is our fortress.
8 Come and see what the LORD has done,
the desolations he has brought on the earth.
9 He makes wars cease
to the ends of the earth.
He breaks the bow and shatters the spear;
he burns the shields with fire.
10 He says, “Be still, and know that I am God;
I will be exalted among the nations,
I will be exalted in the earth.”
11 The LORD Almighty is with us;
the God of Jacob is our fortress.
HOWEVER...
1. There's nothing like cancer to make you grateful to be alive. Perhaps I'm not as grateful as I should be: I still struggle with feeling that my diagnosis is somehow unfair, as if I don't deserve it or something irrational like that. We Americans feel entitled to long, satisfactory lives! But then I take a step back and realize that I am blessed that my cancer was discovered early and that I have a good chance of leading a normal, healthy life after this ordeal.
2. Getting cancer at age 39 is a sure way to be told again and again how young you are! Doctors, nurses, friends, acquaintances, cancer survivors -- so many sigh and say, "But you are so young!" :)
But, really, cancer and its treatment feels like a crash course in aging. I mourn that my body is going to be losing parts and losing strength. I mourn that medications will put me prematurely into menopause. In my weakest moments, I feel as if a decade has been ripped from the middle of my life.
But, in my very weakest moments, I remember to meditate on Psalm 46 and again reach peace and a heaven-centered perspective.
1 God is our refuge and strength,
an ever-present help in trouble.
2 Therefore we will not fear, though the earth give way
and the mountains fall into the heart of the sea,
3 though its waters roar and foam
and the mountains quake with their surging.
4 There is a river whose streams make glad the city of God,
the holy place where the Most High dwells.
5 God is within her, she will not fall;
God will help her at break of day.
6 Nations are in uproar, kingdoms fall;
he lifts his voice, the earth melts.
7 The LORD Almighty is with us;
the God of Jacob is our fortress.
8 Come and see what the LORD has done,
the desolations he has brought on the earth.
9 He makes wars cease
to the ends of the earth.
He breaks the bow and shatters the spear;
he burns the shields with fire.
10 He says, “Be still, and know that I am God;
I will be exalted among the nations,
I will be exalted in the earth.”
11 The LORD Almighty is with us;
the God of Jacob is our fortress.
Thursday, February 24, 2011
Wig Party!?
Thanks to Jane, Carolyn, and Donna for wig shopping with me today and kicking-off my 40th birthday celebration with a special lunch treat.
It's a little surreal to shop for wigs on the day before your birthday (or any day, for that matter). It was a like Girls' Day Out with a macabre twist. It reminded me of little girls who have birthday parties at a hair salon: my party had a wig theme. But I'm so grateful that these 3 friends accompanied me and were encouraging and decisive and FUN! This was especially wonderful after all the pre-operative appointments I had earlier this week, in which the surgeons described rare complications, common side effects, recovery time, pain meds, hospital procedures, and other not-so-fun topics (I now own a set of drain pouches!! Ugh, gross). It's been tough emotionally. So I needed a laugh.
In case you need a laugh, here's a photo of us with me sporting flowing blonde tresses glued to a pink baseball cap.
One week until my surgery.
Friday, February 18, 2011
Grateful
I am very grateful for Carolyn, Helen, and Jane: 3 wonderful friends who volunteered to coordinate care for our family during my upcoming treatment. They will be putting everyone who offers help (childcare, rides, meals, clean up) on a schedule.
I am also so grateful for my mother who will be staying with us for almost the entire month of March. She is a breast cancer survivor and is good at mothering and grandmothering us.
We are so blessed by our families, churches, school, and community!
I am also so grateful for my mother who will be staying with us for almost the entire month of March. She is a breast cancer survivor and is good at mothering and grandmothering us.
We are so blessed by our families, churches, school, and community!
Thursday, February 17, 2011
Upcoming Treatments
Surgery: Mastectomy (unilateral) scheduled for March 3
Chemotherapy: Still choosing between two standard regimens; starting date not determined but most likely late March through early June
Radiation: Unknown; need will be determined based on surgery results
Chemotherapy: Still choosing between two standard regimens; starting date not determined but most likely late March through early June
Radiation: Unknown; need will be determined based on surgery results
Cancer Characteristics
For those who are curious, here are the characteristics of my cancer:
ER positive: The tumor has estrogen receptors. This is good news. My cancer will be responsive to tamoxifen, a standard chemotherapeutic regimen for breast cancer that blocks these receptors to halt tumor growth.
PR negative: Neutral news. As long as the tumor is ER positive, it's okay to be progesterone-receptor negative.
HER2 negative: Good news. Herceptin-positive tumors are very aggressive.
BRCA1/2 negative: Certain alternations to the BRCA genes are associated with a high risk of breast cancer and are often seen in younger women diagnosed with breast cancer. These were not found in my biopsy. This is good news for my 4 sisters.
Tumor size 8 mm: This is good news. The small size (less than 1 centimeter) indicates that the cancer was caught early.
Tumor grade 3: This is bad news. The cancer is aggressive.
Tumor stage IA: This is good news. The cancer was caught early.
4 sentinel lymph nodes removed: All were negative for metastasis, indicating that the cancer has not spread. VERY good news!
Oncotype DX: Breast cancer recurrence score of 30, which corresponds to a 20% likelihood of distant recurrence ('distant' means occurring elsewhere in my body). This high risk of recurrence makes me a good candidate for preventative chemotherapy.
ER positive: The tumor has estrogen receptors. This is good news. My cancer will be responsive to tamoxifen, a standard chemotherapeutic regimen for breast cancer that blocks these receptors to halt tumor growth.
PR negative: Neutral news. As long as the tumor is ER positive, it's okay to be progesterone-receptor negative.
HER2 negative: Good news. Herceptin-positive tumors are very aggressive.
BRCA1/2 negative: Certain alternations to the BRCA genes are associated with a high risk of breast cancer and are often seen in younger women diagnosed with breast cancer. These were not found in my biopsy. This is good news for my 4 sisters.
Tumor size 8 mm: This is good news. The small size (less than 1 centimeter) indicates that the cancer was caught early.
Tumor grade 3: This is bad news. The cancer is aggressive.
Tumor stage IA: This is good news. The cancer was caught early.
4 sentinel lymph nodes removed: All were negative for metastasis, indicating that the cancer has not spread. VERY good news!
Oncotype DX: Breast cancer recurrence score of 30, which corresponds to a 20% likelihood of distant recurrence ('distant' means occurring elsewhere in my body). This high risk of recurrence makes me a good candidate for preventative chemotherapy.
Wednesday, February 16, 2011
Progress to Date
November 4, 2010: At my annual ob/gyn appointment, Dr. Petraske discovers a lump. (Thank you, God, for Dr. Petraske and her vigilance and her kindness!) She asks me to schedule a mammogram.
I am 39 years old. The risk of developing breast cancer at my age is 0.43%, corresponding to 1 in 233 women.
November 5: Mammogram does not visualize the lump; however, it is seen via ultrasound. Radiologist deems it potentially of concern and recommends a biopsy.
November 17: Meet with breast surgeon (I hadn't known there was such a specialty!) to discuss imaging results. Dr. Krisher determines that I will need a biopsy.
November 30: Biopsy performed; cancerous cells found, so a lumpectomy or mastectomy is necessary
December 9: MRI shows no additional areas of concern
December 14-22: Consult with various specialists to help decide between lumpectomy and mastectomy. I chose a lumpectomy to preserve as much tissue as possible.
January 4, 2011: Lumpectomy and sentinel lymph node dissection performed. The cancer has not spread to my lymph nodes. However it is grade 3 and has 'dirty margins' (the tumor was surrounded by extensive pre-cancerous cells called DCIS, or ductal carcinoma in situ) that will require either re-excision or a mastectomy.
January 19: I chose a mastectomy, since it may be necessary anyway and since so much tissue will need to be removed in the re-excision. Mastectomy scheduled for March 3.
Feb 2-11: Consult with two oncologists to determine the need for chemotherapy and chose the best regimen. Both agree that my case necessitates chemotherapy.
I am 39 years old. The risk of developing breast cancer at my age is 0.43%, corresponding to 1 in 233 women.
November 5: Mammogram does not visualize the lump; however, it is seen via ultrasound. Radiologist deems it potentially of concern and recommends a biopsy.
November 17: Meet with breast surgeon (I hadn't known there was such a specialty!) to discuss imaging results. Dr. Krisher determines that I will need a biopsy.
November 30: Biopsy performed; cancerous cells found, so a lumpectomy or mastectomy is necessary
December 9: MRI shows no additional areas of concern
December 14-22: Consult with various specialists to help decide between lumpectomy and mastectomy. I chose a lumpectomy to preserve as much tissue as possible.
January 4, 2011: Lumpectomy and sentinel lymph node dissection performed. The cancer has not spread to my lymph nodes. However it is grade 3 and has 'dirty margins' (the tumor was surrounded by extensive pre-cancerous cells called DCIS, or ductal carcinoma in situ) that will require either re-excision or a mastectomy.
January 19: I chose a mastectomy, since it may be necessary anyway and since so much tissue will need to be removed in the re-excision. Mastectomy scheduled for March 3.
Feb 2-11: Consult with two oncologists to determine the need for chemotherapy and chose the best regimen. Both agree that my case necessitates chemotherapy.
Friday, February 11, 2011
Today's Gratitudes
The Psalms. These ancient poems express raw human emotion -- the whole
range -- before God. From anger and frustration and fear, to joy and
peace and gratitude. It's good to be reminded that God invites us to
pour out our hearts to Him and that all these emotions are acceptable to
Him. He desires this sort of honest dialog.
The Psalms often talk about enemies, praying for protection from enemies or the defeat of enemies. For many years, I skimmed over the enemy parts, thinking that I certainly don't have that problem. Besides, some of it sounds bloodthirsty and 'un-Christian', to desire the bloody defeat of your foes. But I've learned as an adult that enemies do not need to be people who hate you or who follow you around trying to kill you. Anxiety and shame can be enemies, as can any other internal battle that impedes your faith. I think of those who struggle with addiction.
My mom reminds me that 'cancer' can be an enemy too. As she sat through chemotherapy, she meditated on the Psalms with that in mind.
Psalm 41 particularly struck me today.
In this Psalm, the enemies can so easily be visualized as cancer. I imagine the enemy (cancer) standing beside the sickbed, just waiting for the author to die. The image of the enemy spreading lies "he goes out and spreads it abroad" -- how malignant!
For me, the "close friend" who betrays the speaker represents my body -- something I've trusted and been (literally) attached to me entire life (can't get much closer than this "friend"!). The friend is described as "sharing my bread" and "lifting up his heel against me" -- interesting that the author uses the body-related imagery of eating and the foot. My body, close and trusted friend that it has been over the course of my healthy life, has betrayed me to my enemies. That my physical body cannot be relied upon for support is a shocking lesson but also a lesson valuable to learn as I age. Cancer is a crash course in the untrustworthiness of the body. And, if I weren't learning it now, I would certainly get the same lesson slowly over the (God willing) post-40 decades of my life that start in 2 weeks!
The Psalms often talk about enemies, praying for protection from enemies or the defeat of enemies. For many years, I skimmed over the enemy parts, thinking that I certainly don't have that problem. Besides, some of it sounds bloodthirsty and 'un-Christian', to desire the bloody defeat of your foes. But I've learned as an adult that enemies do not need to be people who hate you or who follow you around trying to kill you. Anxiety and shame can be enemies, as can any other internal battle that impedes your faith. I think of those who struggle with addiction.
My mom reminds me that 'cancer' can be an enemy too. As she sat through chemotherapy, she meditated on the Psalms with that in mind.
Psalm 41 particularly struck me today.
1 Blessed are those who have regard for the weak;
the LORD delivers them in times of trouble.
2 The LORD protects and preserves them—
they are counted among the blessed in the land—
he does not give them over to the desire of their foes.
3 The LORD sustains them on their sickbed
and restores them from their bed of illness.
4 I said, “Have mercy on me, LORD;
heal me, for I have sinned against you.”
5 My enemies say of me in malice,
“When will he die and his name perish?”
6 When one of them comes to see me,
he speaks falsely, while his heart gathers slander;
then he goes out and spreads it around.
7 All my enemies whisper together against me;
they imagine the worst for me, saying,
8 “A vile disease has afflicted him;
he will never get up from the place where he lies.”
9 Even my close friend,
someone I trusted,
one who shared my bread,
has turned[b] against me.
10 But may you have mercy on me, LORD;
raise me up, that I may repay them.
11 I know that you are pleased with me,
for my enemy does not triumph over me.
12 Because of my integrity you uphold me
and set me in your presence forever.
13 Praise be to the LORD, the God of Israel,
from everlasting to everlasting.
Amen and Amen.
In this Psalm, the enemies can so easily be visualized as cancer. I imagine the enemy (cancer) standing beside the sickbed, just waiting for the author to die. The image of the enemy spreading lies "he goes out and spreads it abroad" -- how malignant!
For me, the "close friend" who betrays the speaker represents my body -- something I've trusted and been (literally) attached to me entire life (can't get much closer than this "friend"!). The friend is described as "sharing my bread" and "lifting up his heel against me" -- interesting that the author uses the body-related imagery of eating and the foot. My body, close and trusted friend that it has been over the course of my healthy life, has betrayed me to my enemies. That my physical body cannot be relied upon for support is a shocking lesson but also a lesson valuable to learn as I age. Cancer is a crash course in the untrustworthiness of the body. And, if I weren't learning it now, I would certainly get the same lesson slowly over the (God willing) post-40 decades of my life that start in 2 weeks!
Thursday, February 10, 2011
Today's Gratitudes
1. A family friend who is also an oncologist talked to me today (on his
day off); our discussion convinced me to use his close-by clinic instead
of traveling >1 hour to a big cancer center for my chemotherapy. I
am greatly relieved, since this will save time and will be less
burdensome to friends and family who will take me to my appointments
2. My mother, who will be staying with us for most of the month of March to care for us during/after my mastectomy. She is also planning to give me her head-coverings and make me some new ones. She is a breast cancer survivor so is also an amazing source of information and understanding
3. Husband who is working on our taxes (I'm so grateful that he's willing to do that miserable tas!) and who is watching the kids this weekend while I attend our church women's retreat
4. That there are some decent-looking wigs out there!
2. My mother, who will be staying with us for most of the month of March to care for us during/after my mastectomy. She is also planning to give me her head-coverings and make me some new ones. She is a breast cancer survivor so is also an amazing source of information and understanding
3. Husband who is working on our taxes (I'm so grateful that he's willing to do that miserable tas!) and who is watching the kids this weekend while I attend our church women's retreat
4. That there are some decent-looking wigs out there!
Wednesday, February 9, 2011
A Vacation in Denial -- I Mean Mexico
We just returned from a 6-day vacation in the Mayan Riviera, the eastern
coast of Mexico. It was beautiful -- sunny and warm and perfect.
Husband and I snorkeled and read and soaked up vitamin D. Huckle and
Sally swam in the pool and "snorkeled" off an innertube and built
sandcastles. It was a wonderful escape from an especially cold winter.
All vacations are bittersweet. They have the highs of anticipation and of leaving regular life behind for relaxation and/or adventure; and they have the lows of returning to reality (work! school! laundry!) afterward and no longer having a vacation to anticipate. When on vacation, we are always aware in the backs of our minds that it will come to an end. That's part of the fun -- that it's something new and different, a break from normal life. The temporariness of vacation heightens the experience.
In the case of our vacation, this one was more bittersweet than ever. The highs were higher and the lows were lower than the typical vacation. The trip was an escape from a reality that has been very hard to accept. It's still a shock to me that I, someone who cares about and vigilantly guards my health, have been diagnosed with cancer. More than ever, I needed a temporary escape from dealing with constant appointments and tough decisions, a break from cancer taking over my life. And so the days on the beach were sweeter than ever before -- more of a break than any other vacation has been. Six whole days without a doctor appointment or even a phone call about doctor appointments!
But the return was also harder. Not just seeing snow falling as the plane landed, but knowing that the following day would be more setting up appointments and smoothing out insurance issues. Despite how healthy I feel and look, it's time to own up to the fact that I am soon to undergo a big surgery and months of chemotherapy that will alter how I feel and look.
Today's gratitudes:
- a safe vacation that met my high expectations for relaxation and sunshine and family time
- 2 phone calls from friends offering help as needed
- a chance to volunteer at the kids' school, something I will not take for granted as my health worsens
- quiet time alone in the house
All vacations are bittersweet. They have the highs of anticipation and of leaving regular life behind for relaxation and/or adventure; and they have the lows of returning to reality (work! school! laundry!) afterward and no longer having a vacation to anticipate. When on vacation, we are always aware in the backs of our minds that it will come to an end. That's part of the fun -- that it's something new and different, a break from normal life. The temporariness of vacation heightens the experience.
In the case of our vacation, this one was more bittersweet than ever. The highs were higher and the lows were lower than the typical vacation. The trip was an escape from a reality that has been very hard to accept. It's still a shock to me that I, someone who cares about and vigilantly guards my health, have been diagnosed with cancer. More than ever, I needed a temporary escape from dealing with constant appointments and tough decisions, a break from cancer taking over my life. And so the days on the beach were sweeter than ever before -- more of a break than any other vacation has been. Six whole days without a doctor appointment or even a phone call about doctor appointments!
But the return was also harder. Not just seeing snow falling as the plane landed, but knowing that the following day would be more setting up appointments and smoothing out insurance issues. Despite how healthy I feel and look, it's time to own up to the fact that I am soon to undergo a big surgery and months of chemotherapy that will alter how I feel and look.
Today's gratitudes:
- a safe vacation that met my high expectations for relaxation and sunshine and family time
- 2 phone calls from friends offering help as needed
- a chance to volunteer at the kids' school, something I will not take for granted as my health worsens
- quiet time alone in the house
Wednesday, February 2, 2011
Update: Now We're Cookin'
After a month of nothing happening, I finally have cancer treatments
lining up. The lumpectomy in early January did not have 'clean margins',
meaning that the next step involves the removal of more tissue.
Meaning, I will have a mastectomy on March 3. Blah. For awhile there, I
thought I would get off easy. (Then again, for awhile there, I was
expecting a call back from my doctor telling me they were wrong: no
cancer. Funny how delusional one can get.)
Today we also met with a medical oncologist at Fox Chase Cancer Center to discuss chemotherapy:
-will I need it?
- if so, what regimen?
Here's what was taken into account:
-what is the tumor size? (smallish)
-did it spread to my lymph nodes? (no)
-positive for cancer-related BRCA mutations? (no)
-what grade of cancer (grade 1/2)
-Oncotype DX results (high end of intermediate risk)
The last one is the sinker. The results of this test of 21 breast cancer related genes, convinced the doctor that I'll need the "big guns": doxorubicin (Adriamycin), and cyclophosphamide (Cytoxan), and paclitaxel (Taxol) or docetaxel (Taxotere). That's ACT in cancer lingo.
Let's cut right to the chase: this means I'll be losing my hair in about 2 months.
Bother.
Oh, and there will likely be nausea and fatigue.
Double bother.
And part of it will happen over the summer when the kids are not in school.
Triple bother.
But, surprisingly, I'm just grateful to finally have information. The waiting and unknown were difficult to handle. This was a case when any news is good news. The next big hurdle is getting past the surgery (and my surgery related anxieties) and then hitting a routine.
I am so very grateful for a group of three friends from church who have decided to undertake the coordination of my care: they are going to help me arrange rides to my treatments, childcare during treatment and recovery, help with errands or meals, and anything else that arises. Again, I did nothing to deserve this. They are in no way indebted to me, and I haven't been some sparklingly selfless friend. These are godly women just being obedient to God's calling and following Christ's example to serve one another in love. I am again humbled and in awe.
Today we also met with a medical oncologist at Fox Chase Cancer Center to discuss chemotherapy:
-will I need it?
- if so, what regimen?
Here's what was taken into account:
-what is the tumor size? (smallish)
-did it spread to my lymph nodes? (no)
-positive for cancer-related BRCA mutations? (no)
-what grade of cancer (grade 1/2)
-Oncotype DX results (high end of intermediate risk)
The last one is the sinker. The results of this test of 21 breast cancer related genes, convinced the doctor that I'll need the "big guns": doxorubicin (Adriamycin), and cyclophosphamide (Cytoxan), and paclitaxel (Taxol) or docetaxel (Taxotere). That's ACT in cancer lingo.
Let's cut right to the chase: this means I'll be losing my hair in about 2 months.
Bother.
Oh, and there will likely be nausea and fatigue.
Double bother.
And part of it will happen over the summer when the kids are not in school.
Triple bother.
But, surprisingly, I'm just grateful to finally have information. The waiting and unknown were difficult to handle. This was a case when any news is good news. The next big hurdle is getting past the surgery (and my surgery related anxieties) and then hitting a routine.
I am so very grateful for a group of three friends from church who have decided to undertake the coordination of my care: they are going to help me arrange rides to my treatments, childcare during treatment and recovery, help with errands or meals, and anything else that arises. Again, I did nothing to deserve this. They are in no way indebted to me, and I haven't been some sparklingly selfless friend. These are godly women just being obedient to God's calling and following Christ's example to serve one another in love. I am again humbled and in awe.
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