17 February 2011

the bright side (an epilogue, of sorts)

i am cautiously hopeful that this will be a story with an ending... and a happy one, at that. while i will continue to update this blog from time to time, i feel compelled to post some sort of conclusion as i close this chapter of my life. although this story may end, in the words of my oncologist, 'cancer is forever'. of course she's alluding to the forever impact it will have on my health and the risks associated with all that my body endured through treatment. however, cancer has impacted me in other ways that i hope will also be with me forever.

cancer has brought many gifts into my life: it has afforded me invaluable quality time with my family. it has brought me closer than ever to my husband. it has reconnected me with old friends. it has made me more mindful of what i put in and on my body and how my actions affect other people. it has caused me to become more involved in my community. it has brought new meaning to the words love, loyalty and hope. it has reinforced my values and reminded me of the words i try to live by:

love. laugh. listen. put family first. be a forever friend. live and let live. be present.
remember that you always have the power to make a good decision, even in a bad situation.
seize opportunities. choose your words wisely. be prepared for the worst, but expect the best. 
express thanks. be true to yourself. get busy living.

i realize there will be challenges associated with the new perspective cancer has afforded me; facing my own mortality only to be catapulted back into a world where some people make big deals out of 'little things' will seem frustrating to me. i will struggle to strike balance between keeping the big picture in mind while juggling the conflicting priorities of day to day life. i will have to bite my tongue every time i see someone smoking a cigarette, not wearing a seat belt, or under-appreciating life. however, these implications are far offset by the blazing bright side.

while cancer hasn't 'changed' me, per se, the characteristics i possessed previously have now been touched with a bolder shade of color. i am a brighter and more vivid degree of appreciative, sentimental, engaged, positive and alive. perhaps the greatest gift cancer has given me is a lens through which i will see the rest of my life.... a lens of gratitude, of beauty and of inspiration. perhaps the rest of my life will be better for this experience. perhaps i should be thanking cancer for blessing me with a gift so early in my life that few people ever have the chance to appreciate.
 
10 doctors, 5 incisions, 50+ leg scars, 8 tattoos and 7 long months later, we're on the other side. we 'beat' this. i surely could not have survived this alone. the words 'thank you' can't even touch the magnitude of my appreciation. i am so fortunate to have each of you in my life, and i am eternally grateful for all you have done to support me over the last several months. here's to the end of a chapter and the beginning of the rest of this amazing life...

15 February 2011

packing it in

i'm thrilled to finally be packing it in and am preparing to head back to 'normal life' (aka, work) on the 28th. i'm cleaning house of all the 'cancer gear' we've accumulated over the past seven months. i was originally excited at the thought of trashing it all, however the looming three year recurrence risk period caused me to opt for packing it up and storing it (for now). so, i've happily collected prescription bottles, wigs, scarfs, hats, surgical masks, a plethora of nausea aids, and a massive three-ring binder containing my 500+ page medical record and packed up a large storage container to reside in my basement... hopefully never to be reopened! on day seven of a vegetable detox, i'm also working on cleaning myself up and putting all this toxicity in my past, even if only mentally drawing a line in the sand.

my last day of radiation was as eventful as it could have been. everything from parking to traffic went terribly wrong. the radiation machine broke, causing us to wait several hours until another dana farber radiation department could fit me in. with a migraine, i curled up on the waiting room couch with my eyes closed until my name was called. on top of not feeling so hot, i found myself to be an emotional wreck that day. as i laid on the radiation table, it seemed as though the past seven months flashed before my eyes. the first day of this crusade felt like ages ago and the thought of really being at the end seemed so surreal. after 15 of 16 radiation radiation fields were complete, the therapist came in to move the heavy, metal plate aligned to zap the lymph node at the base of my heart for the last step of this final treatment. she left the room to return to her monitor saying, 'last one and the rest of your life will be perfect.' talk about a tear-inducing literal and proverbial shot to the heart... and what a promise, huh? :) i came home late that night to flowers and an applauding standing ovation from my husband when i opened the door. from his front row seat, this probably has been quite a show... and one on which i'm elated to see the final curtain fall!

13 February 2011

my two cents for the newly diagnosed

when i was first diagnosed, i certainly appreciated the sage wisdom and words of inspiration that were bestowed upon me by friends, family and perfect strangers. harder to come by, though, were the words of practical advice. early on, a former colleague suggested i drink as much water as i could the day before chemo, advising that 'it will make a big difference'. i clung to those tangible bits of advice that i could actually incorporate along this journey. for those of you heading down a similar path in the coming months, i have tried to capture a few of my own lessons learned (for what they are worth!) from the perspective of the many hats we wear.

admin: with all of the appointments, phone numbers and bills to process, being organized was definitely key for me. i kept a tidy, little cancer notebook that i brought with me to all of my appointments. i tried my best to capture all of the important points the oncologists made, especially the ones i didn't completely understand at the time. i'd take time at the end of the appointment to repeat back what i thought i heard, in my own words, to ensure i absolutely got the message. for those of you who, like me, try to be considerate of other people's time, be selfish. he or she can afford the extra minutes to recap and ensure you understand the information clearly.

interviewer: before each appointment i would sit down and list all of the questions i had for the oncologists. i found that during the appointment so many topics would be covered, it was easy to lose track of that question that seemed so important to me the night before. i asked a lot of questions and certainly felt like the oncologists would have rolled their eyes if that were even remotely appropriate.

student: do your homework... and while you may not have the knowledge to do it yourself (i sure didn't!), ask for help. i was fortunate to have a friend doing a post-doc in the cancer world. he helped me to gather journal articles on some points of treatment that were concerning to me. i wanted to see data and understand my odds. i believe that knowledge is power and felt most comfortable obtaining objective information on the decisions we were making regarding my treatment. 

optimist: during my very first day of chemo i sat across from an older man who spouted lots of negativity and cynicism. i overheard him talking about everything from how miserable he felt with sores in his throat from chemo, to his belief that cancer was going to kill him. talk about an overwhelming orientation on my first day of treatment. while studies provide conflicting conclusions about the relationship between attitude and outcome, block out the haters and expect to win. after all, it can't hurt, right?

nudist: when i chose a career path years ago, i never imagined i'd spend so much time topless in front of groups of young men in my lifetime! welcome to the world of radiation therapy at a teaching hospital. there's no room for modesty in cancer care. the quicker you get over it, the more comfortable you will be.

navigator: in my journey, being prepared for the worst and at the helm meant completing a health care proxy and living will. walking into the hospital the morning of surgery and handing over those documents was sobering, to say the least. in addition to the real planning, i found it important to find little ways to regain control. for me, it was everything from choosing to cut my hair before cancer took it away from me, to finding humor in something that wanted to be so heavy, to exercising during treatment in an effort to feel like i earned that inevitable feeling of fatigue.

patient: my experiences with doctors throughout this ordeal have been polarizing. this journey started in july of 2009 with a missed diagnosis by a radiologist who overlooked what to others (in retrospect) seemed to be a very clear start of lymphoma. perhaps he was low on sleep, or coffee, or motivation to remember that there is a person on the other side of each scan he reads. while the thought alone of being diagnosed with cancer in 2009 just before getting married both stresses and bums me out, my body would certainly have been able to avoid a lot of the long-term damage it has now sustained. the bookend on the other end of my journey is my amazing primary oncologist. she is compassionate, patient, wise, and brings a refreshing perspective and sense of humor to our appointments. the thought of visiting with her every couple months for the next few years is something i may actually look forward to! one of the challenges on this path is trying to strike a very delicate balance between being your own best advocate and trusting your doctors. in a world with so many misdiagnosed conditions and rushed decisions, it seems important to get second opinions, do your own research and ask questions. yet, there comes a time where you need believe that you selected the best doctor and plan of treatment and trust.... trust that you have made good decisions and, more importantly, trust the doctors who are operating on, caring for and advising you.

citizen: ...of the cancer community, that is. i wasn't comfortable with the whole support group idea; it was hard for me to feel comfortable expressing concerns about my own experiences when i think about the possibility of sitting alongside someone with a terminal diagnosis. (boy, did i have it good!) similarly, it's frustrating to hear survivorship glamorized by someone who had a small tumor or freckle removed and was quickly declared cancer-free without enduring any sort of treatment. for me, individual relationships helped tremendously. i became fast-friends with another hodgkin's patient i met in the radiation waiting room; talking about our similar experiences has been incredibly rewarding. i also reconnected with a school-mate of mine who was six months ahead of me on his hodgkin's journey. he quickly became a good source of information on what to expect, along with one of my greatest cheerleaders when i needed a boost of encouragement. the cancer community is one you'd never hope to join, but one in which you will find amazingly helpful and supportive people should you ever find yourself there. this community has tremendous insight to share and has taught me that being strong and vulnerable aren't mutually exclusive.

28 January 2011

(re)mission accomplished!


 

in this case, a picture is definitely worth a thousand words! my imaging whiz of a brother pulled these before and after shots of my chest from PET scans. (in case my cropping makes them hard to follow, those are my raised arms and head at the top.)

26 January 2011

'what kinda gone are we talkin' 'bout here?'




leave it to country music to embed itself in my mind, even on occasions such as these. whenever oncologists talk about these tumors being 'gone', this song jumps into my mind... and sticks around for awhile. but really, what kind of gone are we talking about? i have been very reluctant to throw the r-word around ('remission'....shhh!), understanding how fleeting it can be for lymphoma and, immaturely, not wanting to speak too soon and jinx myself.

i was under the impression that hodgkin's was one of the few cancers that could be 'cured'. so, i very proudly asked my oncologist if i would now be declared 'cured' of this cancer. she responded, 'if i was standing at your funeral confirming that you died of something else, then you'd be considered cured, but not until then.' since i'm not planning to do that anytime soon, i'll have to get more comfortable with my stage of 'complete response'. (it sounds does sound nice though, doesn't it!?)

the recurrence rates for hodgkin's are highest in the three years following treatment, then drop off to almost nothing. so, i'll be looking over my shoulder for the next three years, hoping and praying that this cancer doesn't return. if it does, i'd be going down the stem cell transplant path, and the odds of success there are definitely not comforting. so, i'll be focusing on doing (almost) everything right and keeping my fingers crossed until february 2014!

i'm participating in a study at dana farber cancer institute, piloted on new lymphoma survivors, aimed at instituting survivorship care plans. this plan will not only summarize all of the toxins and abuse my body has been exposed to on one handy sheet that can be shared with health care providers in the future, but it will explain all the risks of treatment and the precautions i should take. the phd-candidate who was working hard to sell participation (in hopes of making me patient 30 of required 30 in the study) explained, 'for instance, if you weren't aware that you can't scuba dive due to the amount of bleomycin you received, that could be lethal'. wait... no scuba diving?! while that wasn't on my to-do list, it also wasn't something that had ever been explained to me. i was well prepared to worry about my heart and lungs forever due to all they have endured during chemo and radiation, but am eager to get my hands on this plan in a couple of weeks to understand guidelines that will help stave off recurrence, secondary cancers and other health problems. i am hopeful that adhering to this plan, being closely monitored and channeling all possible good luck for the next three years will make sure this cancer is gone 'for the rest of my doggone life'!

20 January 2011

like no tanning bed i've ever seen

... although the resulting warm, red burn is pretty much the same. this machine, the 'BW6', and i have spent some quality time together over the last month (radiating 16 fields every day in my neck and chest, to be precise). while I won't exactly miss having my face masking-taped to a table each day, i concur that radiation has been an absolute walk in the park compared to the good ol' days of ABVD!

18 January 2011

this should be the easy part, right?

as i approach the end of treatment, i feel as though this journey has come full circle for me. i'm finding myself feeling as emotional now as i did at the start. perhaps i've been so focused on keeping my head down and in the game, looking to the next treatment, appointment, step, that i am finally now lifting my head back up and taking it all in. is this really almost over? i sure hope so.

while i've always been that friend who tears up upon hearing the first note of processional music at a wedding or during the end of a cheesy movie, i feel as though this experience has aged me emotionally and made me even more of a sap. ('is that even possible?' i know what you're thinking!) ;) i easily shed tears listening to the life story of the new friend i met five minutes earlier in the radiation waiting room, or, most recently, sharing the good news that treatment is almost over with my concerned neighbors at the gym and dry cleaners. this should be happy news, i know, but something about it seems very surreal.

the most frightening part of this journey for me happened right at the beginning. the week between receiving the phone call that changed my life and undergoing surgery, i would wake up in the middle of night consumed with whatever i was dreaming and found myself completely forgetting that my life had changed. i would startle myself with the realization that i'd just been diagnosed with cancer. i'd sit up in bed, look around my bedroom in the dark and think to myself 'is that real? did i dream this? is this really happening?' with no physical manifestation of this diagnosis, no new pain, no scars yet, i had no way to confirm. it would take me minutes to convince myself that, yes, this really was happening. and, for several nights in a row, i would lay awake for hours until i cried myself back to sleep. it was the most devastating feeling i've ever experienced; i was heartbroken for my parents, scared for my husband's future and overwhelmed with the vast unknown that was about to become my life.

the past few nights, i've found myself facing that familiar feeling; i lay awake wondering 'is this nightmare really almost over?' and, although my emotional reaction is the same, the feeling i experience when i realize the answer is 'yes' is a world away from devastated. :)

12 January 2011

the light(s) at the end of the tunnel

now that i'm on the home stretch, i feel as though i can finally see the light at the end of this tunnel. raytheon, i love you, but i cannot allow that light to be your blazing florescent bulbs back in the office! many young survivors i have met talk about how deflating it is to work so hard battling this disease for months only to... return to work?! hmmm. while i will happily return to work at the end of february, i'm focusing on other bright, sparkling lights at the end of this tunnel right now.

i'm snowed in again, camping out by dana farber for a couple of nights. i rode the elevator at the hospital this morning with another patient who came in for treatment on cross-country skis. wow. only the truly determined made it in past the foot of fresh snow today. i've happily spent my down time here planning several upcoming celebrations and purchased three plane tickets in the past 24 hours. i'm looking forward to a long weekend in new york next month celebrating this victory with my dearest college friends, a weekend in siesta key with my girlfriends from grad school, bachelorette parties and weddings for two of my best friends, among others... i've sure got a lot of living to do this year!

first, though, is a long-overdue vacation with peter. we spent much time contemplating what the perfect trip would be at the end of this journey. we weighed the limitations: 'no sunbathing' per my radiation oncologist and 'nothing out of the country' per my cleverly cautious husband, who wants to make sure we're near a comparable hospital in the event that something goes awry post-treatment. we settled on arizona, which will be pleasantly warm (but not a 'sunbathing'-type trip) and is home to my favorite place: sedona. while i lived in scottsdale for a bit when i worked for northrop grumman, peter has never been, and i'm excited to share a place that's so special to me with him.

as i was forewarned, radiation has succeeded in burning the heck out of my throat over the past few weeks. swallowing anything has become a challenge. my old pal lidocaine returned to save the day, numbing my throat enough to make it possible to drink and eat soup. i was cautioned that it will only get worse for the next two weeks, so i'm bracing myself to muscle through to the finish line by focusing on the light at the end of the tunnel... a few short weeks from now my throat will definitely be burning, but hopefully over a celebratory margarita in the shade with my husband. :)

07 January 2011

things i won't miss about cancer, volume 2


1. waiting in exam rooms with my husband ;)
every ounce of patience seems to flee from peter's body the moment we are left in an exam room to wait. this day we could see the doctor standing outside the door casually polishing off a package of twizzlers with perceived disregard for the fact that he was running nearly two hours behind schedule. there wouldn't have been enough candy bars or newspapers in the world to distract my peter's mounting frustration!

2. bizarre hair loss
now that my eyebrows are growing back, i can fully appreciate the cruel joke the universe played on me the day that i texted this picture, along with a desperate plea for help, to my best friend. my left eyebrow wiped off all at once, leaving me to decide what to do with (what was left of) my right eyebrow. after several hours of contemplation (dare i rock one eyebrow?), the decision was made for me when it also wiped off on its own. phew.

3. trays of chemo
of all things that could be delivered to you on a silver platter, huh? :) at least that's what i thought each time i saw this tray approaching. while it has been a little more than a month since i finished chemo, i can clearly remember the feeling of dread associated with the arrival of this pile of syringes and IV bags packaged in their own individual hazmat baggies. (hopefully) this is a feeling i will now only relive through photos!