59 Things a-happenin'

Tuesday, October 16, 2007

It's October, Breast Cancer Awareness Month, and exciting things have been happening for me lately.

First, my personal story was published on Dr. Susan Love's web site mid-September. That was exciting. I spent a lot of time reading all of the stories of other women when I was in treatment. It gave me encouragement to know that I wasn't alone out there. Now I get to be one of the people giving the encouragement and I'm thrilled.

http://susanlove.com/breastcancer/content.asp?L2=7&L3=3&SID=233&CID=1266&PID=82&CATID=0

Several women have written to me since the Dr. Love posting came out. It never ceases to amaze me how good it feels to have complete strangers reaching out like that. And for the moment I can type "Angela the Pink Tiger" into Google and my blog is the first hit. That's new!

The last weekend of September I participated in the 12th Annual Champagne Brunch and Silent Auction which benefitted the Breast Cancer Resource Center. I was the committee chair of check-ins and checkouts. I had a grand time planning and organizing the details of my committee's participation. With thorough preparation, a great spreadsheet/database setup that produced invoices, and phenomenal volunteers we had the best year ever with respect to smooth checkouts. It was a lot of work and a LOT of fun!

This month, I was fortunate to be one of five women from the Pink Ribbon Cowgirls to receive a free makeover from Bo Salon. The makeover was last Monday. They colored my hair red! I have never dyed my hair in my life so this was quite the interesting experience! And then they put tastefully done makeup on my face. I thought the lipstick was a bit strong but I liked the overall affect with the rest of it. I didn't like it enough to start wearing makeup all the time, but it was fun for the day.

Local TV station KVUE filmed before and after shots of all five of us.

The makeover also included a free manicure for me. Some of the girls chose manicures and at least one of us opted for a body scrub instead. I decided that I didn't care for the nail polish thing. I damaged it almost immediately and chipped it even more doing dishes that night. Painted nails are not for me, but it was fun trying.

We also all got a free appointment with dermatologist Ted Lain of Steiner Ranch Dermatology. I think we all did Botox. One or more of us got a filler, too. Botox lasts for 3-4 months and a fill lasts for 12 months. I didn't do the fill but I'm regretting the Botox. Botox eliminates wrinkles by deadening the muscles that cause the wrinkles. The muscles between my eyebrows are nicely quiescent and smooth these days so the wrinkles are gone, but every time I want to crinkle my brow to express sympathy or frustration I find that it no longer works. It's weird! I'm glad that will wear off in a few months.

Also, I'm going to be on local TV in a few weeks. Saturday, October 27 I have a slot to appear live on KVUE's morning news show between 8:30 a.m. and 9:00 a.m. (That's channel 4 in Austin, Texas.) My fellow Pink Ribbon Cowgirl Donna will be with me. We're both going to be interviewed about the makeovers and our breast cancer experiences. All five of us have appeared or will appear in these staggered newcasts. They want us to spread the word about the importance of self-exams but I'm tempted to plug the importance of voting for Proposition 15 in the upcoming November 2007 election (in Texas). Proposition 15 is a constitutional amendment that would allow state funding of cancer research for $30 billion over the next 10 years. It's also a topic I wish to say a great deal more about so I will save that for a near-future blog entry.

The makeover was truly a wonderful experience. They treated us so well at Bo Salon. I got a new hairstyle that I love. The owner Ron King strikes me as a genuinely nice person. I'm not often starstruck by people with power or who know famous people, but I was suitably impressed when I learned that Mr. King did the makeup of Victoria's Secret models at a recent fashion show. I know that Victoria's Secret is extremely selective with who participates in their shows and only the best of the best are considered.

I am grateful to KVUE, Ron King of Bo Salon, and Dr. Ted Lain to have been one of the recipients of this wonderful opportunity.

My friends with red hair have indicated so far that they love my new hair color. I can't afford to have it colored again anytime soon so I've grown fond of saying, "I only have a few weeks to look this beautiful." I liked my original hair color so I don't mind going back to it, whatever that was. I used to be dark blonde but now I've accepted that my post-chemo hair color was actually light brown with copper highlights. Now I have a style I can take to my usual awesome stylist Diana Vicars and say "make it look like this, please." That reminds me, I need to get my husband to take more pictures of the new 'do' while it still looks good...

One last cool thing coming is my poem "Radiation on a Rainy Day" appearing in the upcoming winter edition of Women & Cancer magazine. I am very excited about that. This marks the first time one of my poems has been published by a nationally distributed magazine.

I've written one or two new poems that might be suitable to share, but finding the time to type them up is another story...

On a sad note, I've learned of two more women peripheral to my circle of friends and acquaintances who have been diagnosed with breast cancer. One woman is the friend of a friend. One is the sister of a consultant I work with. Another one of my Pink Ribbon Cowgirl friends has had her cancer return as Stage IV - metastatic. It saddens me that breast cancer hasn't stopped claiming new victims. I know that statistically it will get around 212,000 of us this year, but the cost of all that human suffering is more poignant when you know more of the players. One of my great uncles was diagnosed recently with lymphoma, so I know yet another person touched by cancer. That's why I feel so strongly about people voting for Proposition 15; it's a chance to make a real difference in the war against cancer.

I still get paranoid whenever I get a headache. I had my checkups in early October, including another mammogram. Things look good so far. Here's to hoping it stays that way.

That reminds me...I thought it would be nice to repeat something the dermatologist asked me. He wanted to know how my cancer experience has affected my life. I gave it some thought before answering. I told him that after my brush with breast cancer I feel more fierce. I thought of my "pink tiger" persona for the blog name and decided I had chosen an apt mascot.

I feel fierce about protecting my son, about protecting my right to spend time with my family (versus piling up overtime at my job), and about doing little things as I can afford the energy to fight cancer. I thought more about his question, though, and gave a second part to my answer. Part of me feels more vulnerable now, I told the doctor. I know from experience that my body can do nasty things on its own like grow cancerous tumors and I may not even be aware of them for quite some time. That's scary stuff.

My adventures with cancer have heightened my appreciation for my life - every day of it. My son is a toddler now and his language skills are exploding. Every week he learns new words. Every day he changes just a little bit. It's exciting to see him growing and healthy and learning so much. It's also frightening how quickly time passes.

Kelric is 19 months old now. I've been a survivor for 19 months. Will I see him grow up? Will I still be here in 5 years, 10 years, longer? I want to hold him and freeze these moments in time so I can savor them slowly. My heart aches with longing to be home with my little boy more often than weeknights and weekends. Life intrudes, though, with pesky financial obligations and flying minutes that pile into lost days. My obligation to myself and my family, I believe, is to be aware of those minutes and to actively love all I can and savor what I can as time goes by.

So that's what I do.

Fierce. Vulnerable. Loving. Savoring. Strong and nuturing. I am Woman. Hear me roar.

Angela

October 27, 2007

Here is the link to the TV interview.

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58 E-mail: Pink Pearls of Wisdom

August 10, 2007

Last weekend Kelric and I had our picture taken for a calendar of breast cancer survivors and their children. The Houston-based photographer Alisa Murray asked calendar participants to bring along a one or two sentence quote for the calendar, a written copy of our cancer stories, and any nuggets of wisdom we would like to pass along to the newly-diagnosed. The last part is something she is thinking about collecting into a booklet to be distributed at M.D. Anderson in Houston and she is toying with the name Pink Pearls of Wisdom. I think that’s a clever name.

Well you know me. Once I got started writing I found it hard to stop. I started with one page and ended up with three.

This evening it hit me that making my contribution to the Pink Pearls of Wisdom available via e-mail and my blog might do other people some good. If you’ve read all my other posts you’ve probably heard all of this stuff before, but the project for the photographer summed things up nicely. Here is what I gave the photographer just in case you learn about someone newly diagnosed and you feel it appropriate to pass this on.

One of the “pearls” mentions the organization Wonders & Worries which is strictly an Austin agency (for now), but pretty much everything else is universal “wisdom.”

I’ll let you know when the calendar becomes available.

Love,
Angela


What does it mean to you to be a mother who survived breast cancer?
I was 36 weeks pregnant when diagnosed so life before breast cancer means life before my son was born; that makes life as a survivor twice as sweet.

My Story
When I was diagnosed in March 2006 I was 34 years old and 36 weeks pregnant. My son arrived 10 days after diagnosis and I started chemo when he was two weeks old. Through 8 rounds of dose dense chemotherapy and 33 days of radiation, my husband and I learned to take one day at a time and to be patient with one another’s exhaustion. Having a baby in the house during treatment made dealing with treatment harder because I rarely got a chance to rest properly. On the other hand, having a baby in the house during treatment made treatment easier because I had a reason to smile every day no matter how awful my body felt. I have entered my second year of survivorship and so far I’m doing great. I am not grateful at all to have had breast cancer, and yet I gained a new love for humankind because people all around me showed how wonderful and kind people can be. I wrote poetry and essays to cope with and to record my experiences. Those are posted at http://angelathepinktiger.blogspot.com. My baby is now a vivacious toddler and my husband is an even closer best friend (and an awesome father).

Pink Pearls of Wisdom for the Newly Diagnosed
Take someone with you to medical appointments. That second person will hear thing you’ll miss or forget or won’t be able to process at the time, and the conversations you’ll share later about what the doctor told you will be comforting and helpful.

Keep a list of questions to ask your doctor during your next appointment. Take this list with you to the appointment.

Ask questions until you feel comfortable with how much you understand. If your doctor already explained something and you didn’t quite get it, then ask to have it explained again. The good doctors don’t mind doing this. Treatment is tough. It goes a little smoother when you understand what is going on and why.

Find the kind of doctor you like. If you want the doctor to make all the treatment decisions for you and just tell you when and where to show up, then there are doctors like that. If you want your doctor to include you in the treatment decisions and to discuss pros and cons of different approaches, then there are doctors like that. If you don’t feel comfortable with the person in charge of your treatment, then it will be hard to be satisfied with whatever treatment you receive.

You deserve to get treatment from compassionate people who treat you with respect. You have a right to switch doctors, switch lab facilities, and/or switch cancer centers if you don’t like the way you have been treated.

It is your responsibility to review your medical bills and ask questions about thing you don’t recognize or understand. The cancer center will bill your insurance with the standard codes they always use and your insurance company will process whatever they receive. Neither party is looking out for your financial best interests so they won’t suggest that you could save money by having lab work done at a different lab or that certain things could be combined under a single co-pay. You can call your insurance company to learn the guidelines and then you can ask your doctors to work with you on where things are done. People will go out of their way to help if you are patient and polite.

Most medical facilities are willing to work out some kind of payment plan with you.

Blogs and e-mail lists are a good way of communicating with all those people who care about how you are doing. It cuts down on the phone calls where you end up explaining the same things over and over.

Ask someone to be your “volunteer coordinator” for the people who offer to help. That takes the stress off of you while organizing the assistance people are willing to provide.

When people offer to help, let them. It makes them happy to feel like they are a part of your support network by providing meals or cleaning your home or mowing your yard. It eases the strain of daily life when someone else does certain things. People often want to help but don’t know what you would value most. Tell them what you want or need. They will become woven into a tapestry of support that will color the treatment days with bright spots if you let them help you.

Some hotels offer discounts for family members who have a loved one in the nearby hospital. Some hospitals like M.D. Anderson have a list online of the hotels that offer discounts. Ask your hotel if it gives a discount.

Special clothes exist to hold the drains that come after a mastectomy.

Occasional pain is normal after your treatment ends.

Depression is normal during and after treatment. Tell your doctor. Some drugs help fight depression. Find and tell your nutritionist. Some supplements help with depression and might work for you instead of prescription medication.

Seeking professional help for depression is part of taking care of yourself. It is part of recovery. If you need a therapist, go see one and don’t feel ashamed about it. Cancer treatments are rough, and they often cause trauma and grieving. Help yourself with this phase of healing if you need the help.

For short term and long term disability, your options are wider than “all or nothing.” You can do part time disability and it is also protected under the Family Medical Leave Act.

Www.quackwatch.org is a good site for dispelling cancer myths.

The American Cancer Society (www.cancer.org) has a booklet and part of its web site dedicated to safe food preparations and eating guidelines during treatment.

Remember that our society doesn’t teach people how to get through grief or how to support someone who is grieving. Be patient with people who care but manage to step all over your feelings during this difficult time. Help them support you by telling them what you need. If you need them to listen without interrupting or soothing you, tell them that. People aren’t taught how to listen. Help them learn.

If children are involved, seek guidance from a group like Wonders & Worries (www.wondersandworries.org) so you know how to talk with them about cancer. Honor the children’s place in your family by including them in the journey towards your recovery.

The Lance Armstrong Foundation (www.livestrong.org) can put you in touch with local resources to help you along your journey through treatment and recovery.

If someone is coming from out of town to help care for you during treatment, prepare maps or instructions for finding common places such as the grocery store before your caretaker arrives. You won’t feel as much up to the stress of thinking through road directions for an out-of-towner once you are fatigued from treatment.

If you are interested in preserving your fertility after treatment, then the time to act is before treatment. Fertile Hope (www.fertilehope.org) is an organization dedicated to this end. Chemotherapy can bring early menopause, prematurely ending your reproductive options. Doctors often forget to discuss this aspect of your future life after cancer while they are focused on saving your life right after diagnosis. Ask questions. Seek answers. Make informed decisions.

You know? I think that last one bears repeating in a line all its own.

Ask questions. Seeks answers. Make informed decisions.

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57 E-mail: lessons, anniversaries, and memories

June 1, 2007 (almost 15 months after my diagnosis)

Listening
I have been rereading the book Kitchen Table Wisdom by Rachel Naomi Remen, M.D. and I find it is as effective a guide for helping me understand the emotions of cancer treatment and survival as Dr. Susan Love’s Breast Book helped me understand the science of breast cancer. Page 64 of Kitchen Table Wisdom contains the following quote.

Cancer had changed his life. He now lived so far beyond the usual, the normal, the ordinary in life, that he often felt alone. Many people did not want to hear about how it was with him, or couldn’t understand things that had never happened to them. Some were so upset by the pain of it all that he felt the need to protect them from it through his silence.

When my friend Brian Goldberg died suddenly the summer before my junior year of college, I coped in part by telling anyone who would listen what a kind and wonderful person he was. My roommate in the spring semester was so moved by my stories that she expressed regret she would never get to meet him. My boyfriend, who had been Brian’s best friend in high school, unkindly shut me down when I talked about Brian to him. He had no patience for my pain. He had too much pain of his own and preferred to bury rather than express it.

My husband, my soul mate, was a rock for me during the days of my cancer treatments. I could tell him in excruciating detail about the trauma and humiliation of what I was currently enduring and he would let me talk until I was done. Then I’d cry, he would hold me, and I would feel much better. Allowing my tearful confessions helped me heal and enabled me to face the next day with renewed courage. Once in a while he would share his own fears and I would feel honored. I didn’t always cry alone.

I think one thing you can do that is very important when someone you care about is coping with tragedy or a serious illness is to listen until they are finished talking about the part they feel ready to share. If they can bear the pain of the experience, and they trust you enough to share those memories, then you should bear the pain of hearing it described. Don’t shut them down with platitudes about how things will be better in the end. Acknowledge what they’re going through right now. Agree that it’s awful and unfair. If you’ve been through the same thing then it is okay to say, “I understand how you feel.” If you haven’t been through the same thing, then it is better to stick with, “I cannot imagine how difficult this must be for you, but know that I’m here for you and I’ll do whatever I can to help.”

Listening to people talk without brushing away their pain is challenging to do, but that action expresses your love and concern more eloquently than any words of comfort.

I learned eventually that not everyone cared to listen to my Brian stories, and I eventually stopped telling them. I applied that lesson of caution when talking about my cancer experiences, trying to balance my need to heal by way of sharing with not wanting to bore my audiences. I scanned people’s faces for the telltale glazed eyes and I quickly wrapped up whatever I was saying if I thought their attention wandered at all. I think I did a good job last year of distinguishing people who asked, “How are you doing?” out of the illusion of politeness from the people who asked it because they really wanted to know.

I suppose that is why support groups and social groups like the Pink Ribbon Cowgirls play an important role. The common thread of battling the same disease makes it interesting to hear one another’s war stories. I experienced this recently at a girls night out gathering of Cowgirls. We sat around a dinner table and shared stories from our treatment days. I told about events I had previously recorded in my writings. I thought that my complications like the blood clots in my arm and my hospital-worthy infections during chemo were standard treatment adventures. I found myself the temporary center of attention of other women who had been through their own unique treatment hell, and yet they were riveted to my stories. I’ve been in the group a year and thought I was old news, but these were new people and I realized none of us knew much about the specifics the others had endured. It healed something in me to have them as interested in my stories as I am in theirs.

While I’ve made it through my first year of survivorship and most people just want to hear how I’m now healthy and doing fine, it is nice to confess to certain people that now and then everything is not fine. Now and then something reminds me that just a scant year ago I was in the middle of something dramatic, painful, difficult, and grossly unfair. I’ll spend a day feeling spooked and then I’m okay again. I think it’s okay to be afraid of recurrence and metastasis as long as I don’t live in deep constant fear.

The various anniversaries I’ve reached this year surprise me each time with the memories they bring up.

Memorial Day
Case in point, my 14-month-old son was sick over Memorial Day weekend this year. We dosed him with Motrin and comforted him in the middle of the night and I reflected how grateful I was to be at home with a sick child and not at South Austin Hospital. A year ago on Memorial Day weekend I spent a night in the hospital because I had caught an infection and with my chemotherapy-depressed immune system my 102 degree fever had become dangerous. I couldn’t stop throwing up and my fever was creeping higher.

I will never forgive the nonchalant attitude of the hospital staff who took their sweet time preparing my room while I waited in the hall, slouched in a wheelchair because I was too weak and nauseous to sit upright. They joked with each other at the nurses’ station and ignored us while my husband worried that I was going to die. The vomit in the tray I held as I sat in that wheelchair was green and smelled nasty. Where does green stuff come from a body that lost the movie popcorn and soda hours ago and hasn’t held anything down since? My oncologist was my champion that day as he came in person to the hospital to check on me. A lazy worker said the room was ready except they were out of clean sheets for the bed. She wanted to wait for Housekeeping to bring fresh sheets before anyone made my bed, but my doctor pressured her to go one floor down and get the sheets herself. Meanwhile I held my tray of nasty green stuff wanting nothing more than to lay down anywhere. The floor would do. It was the beginning of a long night of nobody listening to me or properly caring for me. I was helpless to stand up for myself the way I usually do and once my doctor and husband left I felt vulnerable and frustrated as well as sick.

I remember that experience and inwardly shudder. It’s ancient history now, but it was a traumatic event at the time and it left scars on both me and my husband. He lay awake all night that night grieving the possibility of losing me. We considered later that my being in that hospital on that night was probably a risk to my health. Fortunately for me at the time I didn’t think things were that serious. I was awake much of the night because joint pain and a room set at 80 degrees made it tough to sleep. The fluids from the IV helped to restore what fluid and nutrients I had lost and maybe there were antibiotics involved. Nobody seemed to know anything to give me a straight answer, but by morning I was well enough to go home and I refuse to return there ever again.

Guy’s Birthday
For another memory of last year’s trauma, Guy’s birthday on March 29th last year was Kelric’s original due date. As exciting as it was to have Kelric born on March 13th which is my favorite great aunt’s birthday, we were sad that he had to be delivered early for my sake. Guy had looked forward to sharing a birthday with his son during the whole pregnancy and the last minute change of plans was a loss he spoke of several times to me.

We celebrated his birthday last year with a dinner out. My mom watched Kelric and I ate an entrée with feta cheese. Feta is on the list of foods to avoid for people in treatment because the natural bacteria it contains can challenge a compromised immune system. Guy’s birthday last year was the night before my first chemotherapy infusion so my feta cheese felt like the last meal of the condemned. This year we ate out with Kelric and I was so proud of myself because I realized his screaming “Me! Me!” meant he wanted one of the balloons we passed on the way in. Kelric got a balloon and was happy. I bought Guy a chocolate silk pie and we went home exhausted by our son but happy about the pie.

My Birthday
My birthday on May 9th last year fell two days before another round of chemo. I had lost my hair by then, knew that chemo made me miserably nauseous, and grew more anxious about the next treatment as it got closer. This year I had lunch with my staff and dinner with friends. This year was wonderful. I expressed gratitude to my friends that I had made it to age thirty-six. I grew melancholy when I wondered if I will live to see my son turn ten. Ten! Let’s not stretch for 20 or 30 or 40 yet. One decade at a time here…

That shouldn’t be a fear for any parent whether she will live that long or not, but I’m only one year out from a diagnosis of a disease that kills around 40,000 people in America each year. I still have the first critical five years after diagnosis to get through before I can relax a little. One down; four to go… If I don’t have a recurrence in five years it doesn’t mean I’m cured, but statistically it will mean I’m a lot less likely to battle breast cancer again.

My friends and husband quickly reminded me that treatment and early detection are so good these days that breast cancer is one of the more survivable diseases out there. That made me feel better. The day after my birthday I was no longer melancholy at all. I was back to my busy life and cancer fears were once again pushed to the dark corners where they belong.

Talking to people who listen and who remind you of the good things keeps the mind working towards the direction of healing and away from the depression of stagnation. I suppose that statement applies in broader ways than cancer treatment-based trauma. It seems I’m learning new lessons all the time. Sometimes I listen well enough to remember them.

Angela

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56 POEM: Radiation on a Rainy Day

It drives me nuts how the blog doesn't preserve the formatting of my poetry. Every other line is supposed to be indented to make it easier to read and to separate the images. I have tried inserting spaces to manually create the indentations and the blog software keeps ignoring them. So just pretend it looks pretty, okay? --Angela



Radiation on a Rainy Day


Lazy summer rain kisses pavement
as I walk from car to gantry.
I know where shade on any other day
will have wandered by the time I leave.

Enslaved in the ritual, I brave the rain
to enter a room bathed in shadows.
Soft lights, gentle music, and hard science await
with a table on rails and monstrous equipment.

Today’s technicians position my body carefully,
referencing doctor’s orders.
They retreat behind thick walls. Watching. Listening.
Exposed, I cannot hide. I must lie very, very still.

The gantry responds with alien grace to computer programs
tailored to my body, my shape, my former privacy.
A buzzer warns of piercing rays and I lie very, very still,
imagining the day when I can leave and stay away.

Free at last – until tomorrow – I chuckle at people
hurrying through cold rain to my exit.
Last year I’d have sported an umbrella, knowing full well
hair would wilt despite ample gel and spray.

A smile shines behind my eyes because velvet fuzz
has grown into baby fine softness, half an inch long.
Too short to style, this is a different kind of freedom.
No need to hurry or worry about umbrellas today.

Instead, I slip through the falling sky towards my car,
naked face upturned, defiance and acceptance dancing through my thoughts.
A moment of optimism catches me and with moisture in my eyes
I finally sense a glimpse of sunshine to come.



Written by Angela Patterson
Copyright Angela Patterson 2007


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Previous 55 E-mail: April mammogram

55 E-mail: April mammogram

Sunday, April 29, 2007

I had a mammogram on April 10. April is my annual spot on the calendar from now on to get my digital mammograms. I went back to the facility at St. David’s and once again had a good experience with the sensitivity and kindness of their staff and the effectiveness of their equipment.

There was “nothing suspicious” to spur further investigation, and my radiologist’s written report says “normal” so I can breathe a sigh of relief. I never thought it could feel so good to be normal. I didn’t even know how stressed and worried I was that there would be bad news until I let out the figurative breath I’d been holding.

So for my one-year mammogram after cancer, I appear to still be cancer free. Hooray!

The radiologist recommends I return in six months to take another shot of the breast that had cancer. This is normal and in line with what they did last year.

So the question becomes, how many of you are 40 or older and haven’t gone for your annual mammogram in longer than a year? For you men, how many of your wives or partners have put off getting a mammogram? Yeah it’s inconvenient and uncomfortable, but the discomfort only lasts a few moments per image and it’s less invasive than a pap smear. I know a handful of women who told me during my treatment days that they were inspired by my experience to get their mammograms done. Now I’m the little sister wagging her finger. Take care of your health, loved ones, even if it involves discomfort and inconvenience. It’s worth it.

Love,
Angela

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54 E-mail: one year of survivorship

March 3, 2007


Our son will turn a year old on the 13th. That’s just a week and a half away. Today has been full of errands and cleaning and planning for the upcoming birthday party.

Today is also an anniversary. Exactly one year ago I was diagnosed with breast cancer. One year ago today I became a survivor.

In the handful of down moments throughout this hectic day, I’ve had flashes of memory from events over the last year of treatment and survivorship.
Tears filling my husband’s eyes as he told me, “You’re going to need chemotherapy and radiation.”
Tears filling my own eyes during the first round of chemo when I sat in an infusion chair for the first time and thought, “I don’t want to be here.”
Jumping a little like an excited child as the confetti floated down after my final radiation treatment.
My newborn son, laid upon my belly just moments after birth. Joy so profound it is too deep for words.
Asking to be turned away from the mirror while my hair was shaved off.
Seeing hundreds of tiny hairs on my hand in the shower as the stubble fell out.
Wanting during my first radiation treatment to jump off the table and run away.
Writing e-mails to my friends and family so they would know what was going on.
Crying in the shower.
Feeling isolated as I adjusted to my circumstances.
Attending the annual company party my first week back at work, feeling sick with nausea, and almost crying as I looked at so many women who still had their hair.
Struggling to cope with the realization that I had a life threatening illness that could very well have prevented me from watching my son grow up if we hadn’t caught it when we did.
Suddenly realizing I would lose my hair and Guy saying, “You poor thing. It’s all hitting you at once, isn’t it?” It was.
Alone in the bathroom, staring at my bald head in the mirror. Some days I felt strong and proud. Some days my reflection looked alien and forlorn.
Wanting to cry from a hot flash because it meant my fertility was gone.
My obstetrician sitting on my bed the second morning after I gave birth, telling me about breast feeding, “You need to stop.”
Feeling light-headed all the time from the anti-nausea medication and the steroids given before chemo.
Feeling elated when my cycle returned because I had hated being 35 and in menopause.
Struggling to drive safely when my fingers and toes were numb.
Needing frequent reassurance that I was still attractive to my husband (and getting that reassurance every time).
Needing to talk about my cancer experience – to record and document events as they unfolded.
Joy at going to my port removal surgery.
Joy when I could stop taking Coumadin.
Realizing that I had a right to demand a butterfly needle when blood was drawn for lab work, and sadness that I knew what it was.
Sadness at realizing I knew the shady spots of the cancer center’s parking lot because I had been there so many times.
Crying because I had just purchased nursing pajamas the day before diagnosis and then learned it wouldn’t be safe to nurse my baby.
My hungry baby instinctively turning his head to my breast as I held him and me bursting into tears while I told him, “They don’t work, baby. Mommy can’t feed you that way.”
Gratitude for the kind souls who looked after Kelric so I could sleep or go to medical appointments, or so my husband and I could have “grown up” time.
Getting encouragement from the e-mails loved ones would send and from conversations with other survivors and how it sustained me.
Gaining confidence and strength as I learned to navigate through insurance billing details, negotiate payments plans with hospitals, and see that my short term and long term disability payments were correct.
Watching my son grow and taking life day by day as I coped with cancer treatments with an infant in the house. And loving him all the more as the special gift he is to our family.
Feeling guilty for falling apart around my husband who would always hold me and let me cry it out so I could calm down and feel better.
Learning that we have a responsibility to ourselves to have unusual things going on in our bodies checked out. And being persistent if the first doctor says not to worry but our instincts say otherwise.
Realizing that you must find medical professionals you like or else you won’t trust their judgment or recommendations.
Staying up late when I was tired so that I could finish typing my updates.
A rush of joy when I realized I had helped somebody else by sharing my story or by freely giving advice based personal experience.
Feeling that sense of, “Aw shucks!” when told that I had inspired someone and mentally kicking my toe at the carpet in embarrassment and secret pride.
Feeling special when Parent:Wise Austin put the picture of me and Kelric on the cover of their magazine.
Feeling special when so many people came to my post cancer celebration party last October.
Wanting to do more to reach other people and help them.
Struggling to balance my work with my newfound activism with private time with my husband and our son.
Loving everyone for their many kindnesses.
Feeling inspired to write cancer poetry and feeling grim about the source of inspiration.
Trying not to cultivate a permanent aversion to the intersections and roads around the cancer center.
Appreciating the knowledge and skills of the medical professionals who treated me and continue to look out for me.
Gratitude for having health insurance.
Feeling the shock and disbelief when I was first diagnosed.
Feeling determination to endure the treatments and thrive afterwards.

I guess one memory lead to another here. That was quite a trip!

I’m doing well now. I had my first post-treatment checkup with my oncologist two days ago. It was interesting how strong the old emotional patterns returned. The day before the appointment I became mildly depressed over returning to the cancer center. That always happened the day before chemo. The day of the appointment I was anxious, just like I always felt the morning of chemo. I was surprised at the reluctance I felt to drive into the cancer center parking lot. I parked my car on the side that gets shady in the late afternoon. I walked in the door and a new receptionist sat at the front desk. I asked for a butterfly needle and a compression bandage from the lab tech who drew my blood. I made real progress in the puzzle in the waiting room before I was called to see the doctor. I felt the familiar sadness at having a reason to be in a cancer center.

The checkup went well. I should mention that a couple of weeks before the checkup I called and asked to speak with my oncologist because I felt I had figured out the link between the liver and post treatment depression. He returned the call and I told him about my theory of the liver being damaged from chemo which leads to Vitamin B deficiencies which leads to depression and also possibly contributes to chemobrain. He found that interesting. I took printouts from my research via the web to my checkup so that he could see what I had found about which B vitamins contribute to what symptoms.

I asked about starting a study to formally prove or disprove my theory. He pointed out that getting funding for a study like that will be difficult since a drug company won’t benefit from the results. Boy, that’s life, isn’t it? You get a lead on a good idea that could contribute to improving the quality of life for thousands or millions of people and you can’t get the medical backing that proves it’s a valid theory because it won’t make money for a major pharmaceutical company. Sounds like I have a new challenge to adopt.

I need to correct something I stated in my last communiqué. I said that anger was depression turned inward. I got it backwards. The saying goes that depression is anger turned inward. Thanks to the friend who pointed that out.

So a year ago I had a lumpectomy and a diagnosis. Ten days later I had a baby. Here’s to the next fifty years of having checkups. If I experience a bit of anxiety with the checkups each time, so be it. At least I’m healthy and alive. :-) Hooray!

Angela the Pink Tiger, Survivor

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53 E-mail: Anger and Depression

February 4, 2007

A lot of things have happened that I feel compelled to share. I can only fit so much into one evening’s e-mail message so here is the first of a handful of topics. I’m doing well these days, but I have found that the journey didn’t exactly end with the last dose of radiation.

2006 drew to a close and I found myself reflecting upon the year. As my personal experience with breast cancer so far has been encapsulated within that calendar year, I kind of associated the close of 2006 with the close of the breast cancer book for me. I firmly stepped from Patient to Survivor and finally felt that I deserved the Survivor label.

The chapter may have ended but the book isn’t really finished.

The months go on and slowly I am spending fewer moments looking over my shoulder, but the specter of breast cancer always looms in my memory. I’m still adjusting to Life After Cancer and I’m still struggling to come to terms with it. The biggest emotional surprise in late 2006 was my anger.

Depression is perfectly normal for cancer patients during and after treatment. Looking back over I would describe treatment as a deeply traumatic experience. Post traumatic stress symptoms are normal for cancer survivors and the funny thing about knowing stuff like this up front is that the knowledge doesn’t stop the roller coaster. It just gives you a point of reference as you ride.

So I talked to the therapist I had started seeing to help me cope with life after cancer and the depression would lift for a while.

Let me back up. You know that feeling when you’re really scared, like when somebody manages to sneak up on you and then touches your shoulder and you just about jump out of your skin, and then fear is immediately replaced with anger that you were made afraid? Well that’s something like the anger I experienced during the weeks between chemo and radiation. The diagnosis and chemo had made me afraid. Then I had time to relax and reflect, and suddenly I was angry that cancer had invaded my body and invaded my life. Our lives. I resented that it took away from the joy of having a newborn baby and that I missed so many moments with my son because I was in treatment or recovering from treatment. I don’t know if I did that topic justice when I was writing the blow by blow essays, but the chemotherapy days were grueling in part because they cost me precious Mommy moments. I had to rely so heavily on my husband and other people to take care of Kelric for me so I could rest or go to medical appointments that I felt disconnected from my own child for the longest time. It felt like a major accomplishment on weekends when it was just me, Guy, and Kelric in the house and I would correctly interpret a cry or a wail. It was a euphoric high to comfort Kelric and have him respond.

Guy assures me that the difficulties I experienced, such as feelings of loss when the latest Kelric caregiver would tell me about something new he did that she saw and I did not, are feelings he shared as well. He believes that all fathers who work full time and only get to bond with their babies on nights and weekends are equally at a loss and equally anxious about learning how to care for this new little life without doing something stupid and accidentally causing harm. I suppose then that my cancer experience helped me share yet another perspective I ordinarily would not have known. Lucky me. I still say that cancer was a thief and it robbed me of many things, including time I should have had with my one and only baby. Only now with more time between the present and the days of chemo has the bitterness over that loss begun to lose its sting.

When the radiation period ended I experienced the anger that comes as a normal stage of grieving. It’s that separation phase where you’re learning to let go of something or someone.

That anger morphed into something else.

Just as I would start to think I did not need therapy anymore and I was doing fine, I would find myself horribly depressed one day or extraordinarily angry and I could not understand why. I would talk about it to my therapist, feel better, and then start thinking over the next week that everything was fine and I did not need therapy anymore. It became a new roller coaster and I struggled to understand the cause. It is not like me to feel deeply depressed or to feel even moderately depressed for several days or weeks in a row. It is not like me to feel my temper flare in traffic unless I’m hungry, tired, or both. I found myself extremely annoyed or frustrated or downright mad at people for minor things – and knowing the incidents were minor in no way reduced the anger. It was out of proportion and I felt a little out of control of myself. Since my body’s reactions to chemo were out of my control this push-me-pull-me dance I had begun with depression and anger also scared me. How could I find a way to just be me again?

Then one fortunate Thursday night our friend Diana Vicars called. She’s the best hair stylist I’ve ever known and her friendship, kindness and compassion made a significant contribution to my being able to “hang in there” during treatment. Diana reminded me that the People’s Pharmacy near 38th and Lamar is a good place for cancer survivors to get advice about nutritional supplements during and after treatment.

So Diana calls and I tell her about my experience that afternoon of staring at the stapler on my desk and feeling a strong urge to hurl it at the wall as hard as I could. I was so angry over some trivial incident that hurling an object that could hurt someone seemed like counter pressure to relieve the agony. It’s like when you have a sinus infection and there’s pressure behind your sinus cavities, and if you press your fingers in key areas it actually makes you feel better for just a little bit. The only reason I didn’t act upon my impulse was because I didn’t think I could pass off a stapler-sized hole in the wall as something that could happen from accidentally dropping the stapler.

I’ve confessed that memory to a few other people since then because it was such a strong low point for me. I’m glad I didn’t act upon it, and it’s not like me at all to have violent mental images. Diana gave me advice which I followed and it has made a world of difference.

Take B vitamins.

From Diana’s advice and the research I did afterwards I learned that the liver stored B vitamins. The liver filters poisons out of your bloodstream. Where are chemotherapy drugs dumped? Uh, into the bloodstream. That’s what the port is all about – to help the poisons reach your heart as quickly as possible where they are pumped to your entire system via the blood. So (now we are getting into my personal theory) the liver must go nuts processing a ton of poison it would normally try to filter out. I’ll bet if I ask my oncologist he will confirm that chemotherapy drugs are deliberately dosed to be toxic enough to get past the liver so that it does the most good in terms of killing cancer cells.

B vitamins, for those of your who are like me and can’t spout the uses of most vitamins off the top of your head, are a series of 8 vitamins scientists thought at first were a single vitamins and then realized later were a family of vitamins. They have names like Riboflavin, Niacin, and Folic Acid. They have numbers like B1, B2, B9, and B12. Some of the B vitamins help with little things like depression and anger. Actually, let’s say that a more scientific way. If one’s body has a deficiency of B vitamins, one may experience symptoms such as depression and anger.

Another side step: one friend pointed out that anger is depression turned inward. I suppose I probably felt internal as well as external anger, then. At least my mind was an equal opportunity depressionist.

Other things that can go wrong when your body has insufficient quantities of B vitamins can include heart palpitations and fuzzy thinking. I was really scared by an abundance of heart palpitations at one point. Remember I went to the emergency room over it because I was scared I was having heart problems? They found nothing wrong and sent me home. Memory loss issues and the inability to think clearly also seem to be linked to lack of one of the B vitamins.

Let’s think about this. The liver struggles to cope with excess poisons. The liver stores B vitamins. The liver gets damaged from chemotherapy so it no longer does as good a job as it used to. Depression sets in. Maybe depression is linked to liver damage linked to B vitamin deficiencies?

I started taking a daily B vitamin pill. I looked for something that focused on Bs and no other vitamins. I also started taking Sam-e every day because Sam-e also helps ease depression, increases clarity of thinking, and incidentally it can help repair liver damage.

It was a night and day improvement.

I felt like myself again! Still do, because I’m still taking my supplements. I no longer need therapy. I’m no longer depressed. I’m no longer angry (unless another driver does something really stupid and then I get over it in about 30 seconds).

At one point I ran out of the B vitamins the lead pharmacist recommended I take when I was in chemo. I took the pills for a while, but they were big horse pills and smelled bad. Being half nauseated all the time, I found it too difficult to swallow the nasty pills and not have them come back up so I quit taking them. So in December I took the remaining vitamins each day until the bottle was gone. I purchased a different brand of B vitamin complex and couldn’t remember where I had put the bottle. It took me two days to run across it in the kitchen in the cabinet with all the hot tea bags. Why was it there? Who knows. Maybe a quick clean up because company came over – I don’t know. What I do know is that in those two days I went back to feeling angry and depressed and I could not understand why I felt so rotten again until I realized that I had quit taking my daily dose of Bs. I found the bottle, took my new, smaller (but still stinky) horse pills and felt like myself again. This is not a placebo effect for me. I believe it is a real, chemical difference.

How nice to have found something so effective so quickly! I’m back to joking with people at work. I know not to take every little thing personally, and I only bite my husband’s head off when I’m too tired or too hungry. That’s the way it should be.

Angela

P.S. Never ever put it in writing that you have experienced depression if an insurance company asks. That is a weapon they will club you over the head with about denying you new coverage. Yes this comes from personal experience backed up by the wisdom of an insurance agent and her personal experience. No, it isn’t about my cancer and isn’t affecting my life now.

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