Moving Forward Without Fear

Before every chemo round I either meet with my oncologist or a nurse practitioner—they trade off. I secretly think they trade off because I am too much to handle, but perhaps it is standard practice. This meet and greet before chemo is designed for the medical professional of the day to see how my body and I are dealing with the chemo treatment—to discuss what side effects I am having, is it better or worse than last time, am I taking my B vitamins, how is the pain management going, etc. My mother and I have begun to treat this time as a question and answer period that will last until we are completely exhausted of any questions we may have. Before my seventh round of chemo, (which I just completed thank you very much), my mom and I were in full-on interrogation mode. Our motto that day was to leave no stone unturned. It was a nurse practitioner week, which signaled to us that we had all the time in the world to probe this poor woman with questions about my cancer, treatment, and pretty much anything else our inquisitive minds could come up with.

First, we spoke with her about my upcoming radiation because, as if four months of chemo aren’t enough, I am facing seven weeks or so of daily radiation. I know what you are thinking, parrrtayy!! I have spoken with a few survivors that equate radiation’s effects to a sunburn, but as I consistently point out, that sunburn comes without the beach or the good time. Lovely. The nurse practitioner mentioned the weeks I have between chemo and radiation. For me, it is going to be like a summer vacation. I don’t have to go to chemo, I don’t have to see doctors, I can just be me for a second and brace myself for the radiation. Plans start forming in my head. Can I take a quick jaunt to Rome or London? Perhaps a cruise to the Bahamas? I have a friend there I want to see. I text one of my best friends asking if a road trip to Florida is a possibility? I just want to get out of here! No offense, Ohio, but I just want to be a young woman, in her twenties, who isn’t concerned about the location of her giant pill bag, or the condition of her wig, or hot flashes in public when sweat starts streaming down her face, or where her granny bra is located at that particular moment. Basically, I want to feel less than ninety-five years old. Anything younger would be an improvement.

The nurse explained to me that the period between chemo and radiation is generally just to rest up and get your “exchange” on. What is an exchange you ask? An exchange, my friends, is going to be one of the best days of my life. An exchange is when my plastic surgeon is going to take out these horrid expanders that have been in my chest since last October, and replace them with implants. Silicone implants thanks for asking. For those of you who have not kept abreast (abreast, get it?!) on breast reconstruction lingo, I will give you a brief lesson. I had simultaneous reconstruction with my double mastectomy. I had a choice. I could have had reconstruction with the original mastectomy surgery or I could have waited and had reconstruction when all the treatment was said and done. This would have left me completely bare-chested for about a year. I figured that waking up without my boobs would be traumatizing enough, but to wake up with absolutely nothing would send me over some sort of I-feel-like-I-just-had-a-sex-change-operation-edge. So, with my simultaneous reconstruction, after my general surgeon was done with me in the OR, my plastic surgeon tagged in (I picture them high-fiving) and slipped an expander in on both sides to prepare for my implants. For the record, expanders suck. You can feel them, they are hard as rocks, and oh, ya, did I mention you can feel them??? So, when my nurse told me I am going to be able to swap those bad boys out for implants before radiation I was like, hello Real Housewives of Beverly Hills here I come!! We scheduled a tentative date for the exchange surgery—a week before my 29th birthday. The exchange is scheduled sixth months to the day from when I was first diagnosed. Hold the gift cards, people, I am getting implants for my birthday. This could all work out quite nicely.

Last week I went in for my final appointment with my plastic surgeon to see if I had been “pumped up” enough. With the expanders you have to keep pumping them up to expand them and prepare the skin for the implant, hence the term “expanders.” Or as I like to call them, “Air Jordans,” or “Puberty Take Two.” I have been pumped up probably five times, and at this point I really feel like there are my boobs first and foremost, and I am just hanging off of them. They are enormous! They literally get in the way of my daily tasks. Due to the fact that my boobs are taking over my body I figured I was finished being pumped up, and sure enough my plastic surgeon agreed that I was. When I started all of this last fall I had grand aspirations of getting a bigger cup size—of coming out of all of this with a little extra something just because I felt as though I deserved it. As I was telling my plastic surgeon this originally, with that hungry look in my eye for giant boobs, he leaned over and promised my mother, “I won’t make her look like a porn star.” Darn, but ok. My mom looked relieved. So after all is said and done I am going to end up around the same size I was to begin with. Isn’t that something? It was a long, hard road to end up back in the same place, but at the same time I am worlds away from where I began. These boobs will never drop, and these boobs are cancer free. Cheers to that!

I asked my plastic surgeon how painful the exchange surgery would be, my wheels churning, thinking back to my mastectomy and how difficult a recovery that was. He assured me that the exchange was a walk in the park compared to my mastectomy and then turned toward the nurse in the room and said to her, “Well you can tell her from first-hand experience.” The nurse explained to me that she had a double mastectomy a few years back. Hers, however, was a preemptive mastectomy. I had heard of these infamous surgeries. Those surgeries not plagued with cancer being a part, no, the part, of the equation. She had a full-blown mastectomy before she even had cancer. She explained that breast cancer ran rampant through both sides of her family, and one day she decided that if there was something she could do to not have to go through all this, then she would. I couldn’t agree more. If I could have had a mastectomy earlier on, and avoided chemo and radiation, you could bet your bottom I would have done it with enthusiasm. She explained to me that it is, of course, a very personal decision, and not one that everyone would make. And then she said to my absolute surprise, “Wanna see them??” I couldn’t even really wrap my mind around what she was asking before her shirt was up and her boobs were out. It was like Girls Gone Wild up in my plastic surgeon’s office. There I stood with this lady I had known for all of forty-five seconds just staring at her boobs like it was no big thing. And they looked great! Hooray for modern medicine and gifted plastic surgeons. They looked like boobs. Wait, no…they looked like perky boobs! I can do this.

After we had discussed my “summer break” and my exchange surgery, and before she directed me back to the chemo room for round seven, the nurse practitioner asked me if I had any other questions. I did have just one more. As my chemo treatment portion of this fun-filled all-you-can-eat cancer buffet draws to a close, I have these glimpses of life after cancer. In a nutshell, after chemo, after radiation, after the implants, after everything, how do I live without the fear of the cancer returning? How do I go forth after this huge, forced intermission in my life without looking over my shoulder every single moment? I felt as though I was asking this woman what the meaning of life was because, I feared, there is no real answer. I have made it to this point without seeking professional help. Whoooaah, wait, correction: without seeking the help of a mental health professional. I have seen dozens of doctors since I was diagnosed, but no one to really help me not go crazy. Perhaps I need to speak to someone from this field, because after being on the front line I just don’t know how I am going to cope when I get sent home and stop fighting cancer every single moment of every single day.

The nurse spoke with me about seeing a nutritionist, seeing a therapist, going to a support group, etc. None of this really helped because none of it was really what I wanted to hear. What I wanted her to say was, “You will never have cancer again, go live your long life in peace and prosperity.” And then I would just pick up my yoga mat and be on my way. But that isn’t going to happen. That isn’t going to happen to any of us. Before all of this, that realization that there are no guarantees in life really would not have scared me. Now, after going through cancer it petrifies me. Not just for me but for my family and friends. My parents were eating Doritos with dinner last night (which I have not seen them do in probably fifteen years, but they were treating themselves) and I started hyperventilating and sobbing, begging them to stop eating the Doritos because I am scared of junk food, processed food, pretty much all food. I don’t know why I got cancer, so anything and everything is a suspect. If seeing loved ones eating Doritos sends me into tears, I only see an uphill battle from here. How do I deal??

A friend of mine from high school was diagnosed with breast cancer around the same time I was. For her privacy I will call her Sunny because that is her general disposition so it suits her well. I had my mastectomy months before hers so I was able to answer lots of questions she had before she went in for her surgery which was a little over a week ago (and she is doing great by the way!!). Helping her through this has been one of the most positive experiences throughout this entire nightmare. It helps me feel useful. It helps me feel as though this journey has a purpose. Sunny expressed to me all of her emotions, the same ones that I felt time and time again after I had been diagnosed, and she asked me how in the world I got through it. How did I not just lose my mind? Well, I explained, first and foremost I did lose my mind. The first week or so was an absolute nightmare. I cried for seven days straight. Literally. But then, I told her, there was this moment of clarity for me. This moment where I realized that this was the hand I was dealt, and this was the way my story is going, and there was nothing I could do to change what had happened. I have cancer and I can wallow and pity myself or I can stay strong and fight it. My breast cancer is real, it is happening, and those are my options. It is really as simple as that. So, after emptying my tear ducts semi-permanently, I vividly remember the moment where my world kind of stopped. A few days before my surgery, I was in the bathroom after I had taken a shower, and I looked myself in the mirror and stared at my naked body and my old breasts and said goodbye. I had been struggling internally all morning with the emotional heaviness of my situation. After much turmoil I said aloud to myself in a surprisingly stern voice, “Abby, you don’t have a freaking choice, so just do this.” That was my version of a pep talk but it worked. Fast-forward to today, approximately five months later, when I have new fears, those fears of life after cancer. There are new and equally scary unknowns that accompany that phase, with the cancer cloud trying to follow me wherever I go. When that cloud does follow me and plague me with new fears and doubts I am going to look up at that cancer cloud and tell it what I told myself in the mirror about five months ago—that I have been given this one life and I have no freaking choice, so I gotta just do this. And then, I believe, the cancer clouds will part and the sun will come out.

Bring It, Chemo

The evenings before I go in for a chemo treatment are often extremely tough for me. I am not going to lie. People often compliment me on my strength throughout all of this. I tell them they should stop by the night before a chemo session and perhaps I would change their view. It seems as though time has this way of slowing down as if to taunt me—dangling the imminent chemo in my face. My mind goes through the motions that the morning is sure to bring. First, I will wake up early enough to place my numbing cream on my port so it doesn’t hurt when the nurses stick me. Then, there will be the agonizing time spent sitting in the waiting room with other chemo patients who demonstrate various stages of the journey. It is inevitable that the patients and I will take hurried glances at each other wondering how are they doing? Are they going to live? How bad is it? Is that their real hair? Then, being called to the back where I first will head to a room to speak with my oncologist about how the last round went for me coupled with the inevitable blood draw to make sure my blood counts are in good shape to go ahead with the treatment. Next, I will be escorted into the chemo room where I will be told to pick my seat, pick my poison. I will look for a friendly face and sit and pray for strength.

Time stands still the night before chemo as I rehearse the coming day’s events in my mind. I can’t help it. There will be a moment, it happens every time, where I sob. Where you can find me just begging whoever is closest to me to please, please don’t make me go back in there again. I will have my moment of sheer terror followed by a brief, almost childlike, tantrum caused by the pure and utter fear of what the next few days will bring me and my body this time. Praying God gives me the strength to hold steady in that chair and pretend the drugs they are pumping through my veins aren’t harming my body so much that it has taken away my hair, it makes my fingers and toes tingle, it makes my bones ache so bad sometimes I have to just curl up and count the moments till it passes. These are the dark hours when I forget I am strong, I forget I am blessed to be in the stage that I am, I forget that so many people have it so much harder. No, the night before chemo I forget that this diagnosis I was presented with is luckily something I have the chance to fight when so many others do not.

Without giving too much detail because my symptoms were quite awful, last week was the worst week so far for me during my entire chemo experience. I had some unexpected side effects from the new chemo drug they switched me to. I went in last time scared but hopeful that the new chemo drug would be the answer to all my prayers. I went in hoping it would allow me to fall back a bit to my old ways. Allow me to have more energy. To be more active. To experience just a few more good days and a few less bad ones. The day after my last chemo I felt good. Perhaps my prayers were coming true!?? The nausea was GONE. The nausea that I had lived with every minute of every hour of every day for the past two months was gone. When I realized this—when I realized that the nausea was gone for good—I was driving in the car with my mother and I just started sobbing uncontrollably and I looked at my mom and I said through tears streaming down my face, “Mom, I made it.” We just cried and cried and looked at each other like we had just won the Gold Medal in the Cancer Olympics and that day was a very good day. I went to the gym and we went out to eat and we had a good old-fashioned girls day and it felt great.

The following day things were not quite so sunny. I started to experience aches in my body that made me sad. I was so stoked that the day after chemo I felt well enough to go to the gym that I didn’t want to revert back to feeling sick. But I was. I could feel it. I was slipping back into something chemo-induced and there was nothing I could do about it. I was faced with another feeling of helplessness when I couldn’t think my way out of it as much as I tried to. I was feeling intense aches in my bones and I couldn’t do anything about it. The following days were filled with more aches. My oncologist warned me of this. He told me this new drug, which is known far and wide as being a cake walk compared to the Red Devil, causes aches in your body similar to arthritis and for about a week or so you feel as though you have arthritis shooting through your entire body. And yes, of course, I was one of those lucky ones that experienced all those aches and more. I could feel every bone in my body. It was as if my bones and I were being reacquainted on a much more personal level.

That, unfortunately, was not as bad as it got. That Sunday I had some rather severe intestinal issues and I was unable to eat, sleep, or move for three days. The pain was so severe that there were times when I didn’t think I was going to live through the night. Last Monday night was the worst night of my life. I was in so much pain I was scared that I wasn’t going to die of cancer—the chemo was going to kill me first. I went to the doctor on Tuesday and he helped me through a lot of what I was experiencing. He gave me some drugs that must have dropped straight from heaven above because it helped drastically and by the weekend I was feeling good. No, I was feeling better than good because there is no nausea now and I thank God daily for that.

So, I am sitting here allowing all these thoughts to race through my head the night before I go in for my next round of chemo. I have three rounds left and I couldn’t be more ready to be done. I allow these chemo tragedies to haunt me because I have no other choice. I can’t block them out with the most sophisticated of mind tricks because the pain is all too real, it has all happened too recently, and blocking it out is not an option. I feel all alone on this night regardless of the people with me. I just feel that unfortunately I am the one who has to go in and get this stuff poured into my veins, and as wonderful as my family is they aren’t the ones in the seat so I have a sense of loneliness there—like no one quite understands. But I don’t want them to understand. I do not want anyone to go through this. But that doesn’t change the inescapable feeling of loneliness that comes the evening before chemo. This has become a typical night before ritual for me. I get so scared, sad, and then by the end of the night I feel my strength coming back. The closer the time comes, the stronger I get until the morning before where I begin saying things like “Bring it” to the chemo like the chemo and I are about to get in a girl fight but I have the upper hand because I have that added priceless Latina flavor that makes a girl a little more scrappy in a fight. So, I say my prayers and tell chemo it can just step off because the time has come to own it once again, which I do.

These dark moments last a few hours and I am actually thankful for them. I often tell people I am not thankful I got cancer (obviously) but I do feel oddly blessed by the experience. If I didn’t have these dark days I fear I would not appreciate the brighter ones quite so much. I have always been a happy person but perhaps not quite as genuinely happy as I am now after living this whole experience. When I feel a ray of sunshine on my face, when I reconnect with an old friend, when I see a blond Labrador puppy, I get ecstatic. Every small glimpse of hope, happiness, strength or perseverance that I experience takes me to a whole other level—one I had never experienced before. I feel so blessed to have this life and to experience even the smallest things. I took a walk today in the beautiful weather with the sun warming my body and I stopped at Starbucks and hung out with my mother there. It was a perfect, lazy, happy day. A day I would have taken for granted six months ago. Today, I silently thanked God and smiled to myself because I had the ability to do what I did today.

The night before chemo, I remind myself of this. I remind myself of good friends, laughter, my precious niece and nephew, the beach which I plan on going to immediately after I am all finished with treatment, a January that felt like a March, beauty that can be found in every human soul, a connection you can feel with someone that is so unbreakable that no matter how long you are apart it will always be there. I remind myself that there is boundless beauty in this world and I get to experience it. I have to fight for it, but I get to experience it. And doesn’t it feel a bit sweeter after a good fair fight? Chemo, and my treatment in more general terms, is my ticket to experiencing this one very precious life I get and all the wonder it brings for longer. Hopefully much longer. Chemo also gives me time to fight this fight against breast cancer on a larger scale by joining with other survivors and organizations and really change the nature of this disease. Breast cancer hits one out of three or four women, and to me that is unacceptable. Chemo will allow me to do something about changing that. Chemo is my ticket out of here so to speak. Now I am tired, my eyes are heavy, but my heart is light. It has been a tough mind battle with chemo this evening but I win because at the end of the day I am smiling. I have no wig or hat on but instead my bald head is proudly out for all to see. I will be wearing my pink wig to chemo tomorrow, however, because a man pulled my mom aside at my last treatment demanding to know where the pink wig had gone. I have to remember my fans. I aim to please! I’ve got some good jams on, I am dancing around my house in a giant t-shirt, my bald head is energetically bopping to the beat, and I have a water bottle in hand serving as my microphone. I am singing my heart out and dancing as hard as I can because I feel good and DARN IT I am going to dance while I can. Bring it, chemo.