The Hard Questions

I went out with a friend tonight and was confronted by the impact of my situation.  The vastness of the word CANCER.  The fear.  The sadness.  The inextricable link to death.  Tonight, when I reached out to a friend for comfort unrelated to my illness, I realized that though I've begun to heal my wounds, escaping the impression this disease has left on me and those around me will be much more difficult.  No matter how much I try to ignore it, pretend it didn't happen and move forward, I am bound by the scars this process has left on me and the questions that linger in the air around me, unspoken, like silent veils subtly obscuring the person I really am.  These are the questions that the people who care about me are afraid to ask.  Frankly, these are the questions that we are afraid to ask ourselves.  So here I go.  I'm going to ask them for all of us and get them out of the way.  

Will the cancer come back?  Has it spread?  Will I have children? If I do have children, will I live to see them grow up?  If someone loves me, will they be left lonely?  In a nutshell, will I die?

Well, the truth is, I don't know.  Just like everyone else, there is no way for me to predict the answers to these questions.  All I know is that I've done everything in my power to prevent it from coming back, and that's all that I can do.  But does this mean that now I shouldn't pursue a normal life?  That I should be afraid to love and be loved for fear that I may not be around as long as other people?  Should I stop dreaming and striving and envisioning my future because of the possibility that it may be cut short?

There are no right answers to these questions, but if there is anything this experience has shown me is that I cannot sustain an existence clouded by death.  I have to believe in the possibility of love and life and a future or all my hard work will have been in vain; and if having cancer means that these basic elements of life are no longer available to me then the question no longer is will I die, but when.  

The reality is that the only thing that separates me from everyone else is that now there is a visible threat to my life.  Most people my age get to blissfully ignore how delicate our bodies are, living life with a sense of immortality, which allows us to take the necessary risks to succeed.  My biggest flaw is that I, because of my age, confront people with their mortality, reminding them that if I can die, so can they.  Unfortunately though, that innocence is no longer available to me.  I cannot ignore the fact that my body can and will at some point falter.  So what's the remedy?  What do I do?  I cannot go back and erase what has happened.

The only answer is I have to live, and not just live, but live well.  Otherwise, I'll never be able to lift the veils that have hung themselves over my spirit this past year.  So 2009, here I come, 'cause frankly, I'm freakin' tired of this shit! (I know, I know, really poetic, it's the menopause, I swear).

Thanks as always for reading.

Crawling out of the trenches,

DT

Foobs, Hormones and Me

Well friends. It's official. I'm officially foobilicious, and you'll be happy to know that they are nice and smooshy. Just ask one of my parent's friends who actually reached out and touched one (amazing how many people want to fondle you, especially women, after a boob job). Even my medical team is giving them rave reviews. As for me, I'm just happy that my PS stuck to the plan and held himself back from giving me triple Ds. Now I just need to get some nipples (why do I feel uncomfortable writing that word???), and I'll be good to go (in case you were wondering, this process involves some tattoo artistry, so maybe instead of a nipples I'll just get Betty Boop and Jessica Rabbit, the animated queens of voluptuousness, tattooed on my chest).

So what's next? Well, fortunately, the hard stuff is done! My hair is growing in, my blood count is going up and my scars are starting to heal, so watch out normal life, I think I'm getting my mojo back. Unfortunately, my treatment is not completely over. In order to explain this, we need a little pathology lesson. You see, within every large category of cancer (i.e. lung, breast, etc.), there are different types of cancer, manifesting themselves differently from person to person. This is why, when you start hanging around women in the halls of the Cancer Club, you'll start hearing terms like triple negative, triple positive, high grade, low grade, Stage I, IIA, IIIB, Her2+, ER+, PR+, blah, blah, blah, blah, blah. All of this is enough to make your head spin, so I'll try to break it down as best I can from a lehman's point of view (please visit one of the many cancer sites or your medical professional if you want the accurate professional explanation).

The stage, as many of you know, indicates how advanced your disease is. For instance Stage I cancer is a tumor smaller than 2 cm with no lymph node involvement. The grade indicates how close your cancer cells look like normal cells, so Grade 1 indicates cancer cells that still look somewhat like normal cells, whereas Grade 3 indicates cancer cells that have extreme mutations and have stopped looking like normal cells (i.e. no nucleus, etc.). ER+ means your cancer cells have estrogen receptors, making them sensitive to estrogen levels in your body, and PR+ means your cancer cells have progesterone receptors, making them sensitive to progesterone levels in your body. Finally, if you're Her2+, it means you have an over-expression of the Her2/neu proteins on the surface of your cancer cells. From what I understand, on normal cells, the Her2/neu proteins communicate with the nucleus of the cell to let it know when to divide and regenerate itself. If your cancer cells have an over-expression of these proteins, it essentially makes your cancer more aggressive because these proteins keep telling your cancer cells to divide and grow. So if you're triple negative, it means that your ER-,PR- and Her2-. A triple positive would be ER+, Pr+ and Her2+. Did you catch all that? I think I just went cross-eyed just writing this.

So what am I? I am a Stage IIB, Grade 3, ER+, PR- and Her2+ (how lame is it that I have all this memorized), which means, I had a 2.2cm nasty little tumor that looked very little like normal cells, had some estrogen receptors and an over expression of the Her2/neu proteins. So what does this all mean and why is it important with regard to treatment. Well, here is your answer. You see, if your cancer is triple negative, the only treatment options you have are surgery, chemotherapy and radiation. If you are estrogen and/or progesterone positive, it means that you can add hormonal treatments to your toolbox, and finally, if you're Her2+ you can add this fancy wonder-drug called Herceptin to your arsenal (Herceptin specifically targets the Her2/neu proteins, making it one of the most targeted cancer drugs on the market). So, since I'm ER+ and Her2+, it means, on top of surgery and chemo, I have to continue taking Herceptin and start my hormonal treatment (I didn't have to do radiation, thank goodness).

Now luckily for me, Herceptin, unlike chemo, doesn't have so many side effects. The only real effect I've had is that I get a little tired the day I take it (oh yeah, and I have to check my heart every three months because it can cause heart damage, but we try not to think about that). So like chemo, I have to go in every three weeks to get an infusion of this drug, but other than needing to pass out early that night, it's no big deal. Like I said, wonder-drug!!

So all we have left is the hormonal treatment. Well this is a little trickier. The good thing about hormonal treatment, is that it reduces your chance of recurrence by 50%. This is huge because, let's face it, who wants to go through all of this again. The bad thing is, like any hormonal treatment, there are side effects (ladies, I know you know what I'm talking about). Now usually, pre-menopausal women, like myself, are given Tamoxifen. Unfortunately for me, studies have shown that Her2+ cancer is resistant to Tamoxifen, so I clearly need a different solution. Unfortunately, all the other hormonal breast cancer drugs on the market can only be given to post-menopausal women, so what is a girl like me to do?

Well, drum roll please, PUT THE GIRL INTO MENOPAUSE (cue in marching band and confetti)!!!! Um, wait, excuse me??? Put me into what??? You mean that thing that causes women hot flashes, mood swings and general craziness in their fifties??? That phase that takes you from being a child-bearing dynamo, to um, well, barren?? And I have to do this for five years, and then I may, or may not come out of it, meaning I may or may not be able to have children naturally and I may or may not have to go through MENOPAUSE TWICE!!!!!! Um, EXCUSE ME. I know I joined the cancer club and membership comes with its entrance fee, but I'm pretty sure that this is not what I signed up for. I mean, I thought I just had to get through the surgeries and chemo, and that was it, hasta la vista Big C, welcome back mojo.

Oh well, I guess its worth it so my hypothetical children can have a mom who lives long enough to see them out of the nest, walk down their own aisles and have their own hypothetical children. And I guess it's somewhat a relief to have your biological clock put on pause when you're a single girl in your 30's. Kind of takes the pressure off, but STILL! Just makes you want to stomp your feet, hold your breath and just....aargh. Ok, ok, at least it's not chemo and it's not cancer and there's no knife involved. But honestly, aren't I allowed a temper tantrum? Well I guess being that I'm now officially a mature adult (you get to say that when you're in menopause, you see), that would be unseemly. But just in case I break out into a childish rage, or accidentally snap at you, please be kind, I'm just going through menopause. In the meantime I'll just wait with bated breath for my first hotflash.

Thanks as always for reading.

Straight from the trenches (surrounded by preemptive fans),

DT

New Foobs

So, the time has come.  I'm officially off to get my new boobs tomorrow (often also called Foobs: Fake + Boobs = Foobs, get it?).  Now if you had ever asked me whether I'd ever be choosing between silicon or saline, I would have called you crazy (I chose silicon by the way, they're more smooshy).  But here I am, going in to get a boob job.  Ok, ok, I didn't really choose.  I mean I guess I could have chosen not to do a reconstruction, but is it really a choice?  I mean, I wouldn't have chosen to get a boob job had they not been lopped off in the first place, and now that I've gone through all this stretching... well, it's just the logical thing to do.  Not to mention, what's wrong with wanting to have a perky pair until I'm 85.  So move over Pam Anderson.  I'm joining the ranks, except, well, smaller and with some visible scars, and oh yeah, no breast tissue. But I'll never have to wear a bra again!!! Well, at least not for functional purposes.  Take that suckers!! Maybe this isn't so bad after all.

Alright, alright, now for all of you who are wondering what this surgery is all about, I have to take you back to April 1, 2008 (yes April Fools Day, hilarious, hilarious).  So on April Fools Day 2008, I DT, went in to have my Boobs, not to be mistaken with Foobs, chopped off.  Now I know that sounds morbid, but that's what happened.  One day I had them and the next day, they were gone.  Now here's where the biotechnology gets really cool.  So you would think that once they chop 'em off, you would simply just replace the tissue with implants then and there.  The problem is, to ensure that they get ALL the cancer, they take away some skin along with the breast tissue.  So unfortunately, you're left with less skin, which would make putting implants in very painful, and potentially impossible, since you may not have enough skin to cover them.  So what do they do?  If you're eligible, they put these uninflated implants called tissue expanders in to slowly stretch your skin so that it becomes stretched out enough to fit a regular sized implant in.  These expanders have self-sealing magnets so that the plastic surgeon can inject the expanders with saline every few weeks without puncturing the implant, allowing you to stretch your skin over time.  I'll tell you, going in for a fill has taken on new meaning.  Imagine watching someone stick a syringe in you and watch your breast just blow up in front of your eyes.  Crazy!!!!  

Anyway, you can imagine that having plastic implants with magnets in them doesn't feel, shall we say, natural.  So once you're stretched out to your heart's content, they go in and exchange the expanders for permanent implants.  The permanent implants are either saline or silicon and are contoured to look like a natural breast and are much shmooshier.  I know that in the land of real boobs, smooshy is a bad word, but in the land of Foobs, the smooshier the better.  Don't want people rebounding off of you everytime they get a hug.

So, tomorrow I get my magnet free, smooshy, contoured, silicon Foobs, and how do I feel about it?  Honestly, I'm freaking out.  I mean, they say that this surgery provides almost immediate relief from the discomfort caused by the expanders, but the last three times I was in the hospital, let's just say, those visits didn't inspire confidence.  First there was the time that I sat in a hallway in my hospital gown, with no underwear for 6 hours, waiting for surgery (even the nurse on duty left for the day, and there I was still sitting), causing a nationwide search because my friends thought I'd passed out in my apartment (at least I know my network works).  Next, I had a surgeon try to force me to take my appendix out even though I didn't have appendicitis, causing my Dad to get shingles from all the stress.  Finally, the last time I was in the hospital, it took two nurses, three doctors and an ultrasound machine to find a vein and get an IV in me.  Let's just say, that my faith in hospitals and surgeons, is well, a little shaky.  So even though I know that my plastic surgeon (PS for short) is one of the best in the city, particularly known for his Foobs, I'm well, pretty much thinking of calling the whole thing off.  The only saving grace is that my first surgery, the big one on April Fools, went off without a hitch, and my PS was at that one too, so maybe, just maybe, this visit will be less eventful.  

Anyway, the next time I talk to you, I'll be a new woman.  In the meantime, here's a picture of me from halloween.  I officially have fuzz on my head.   Wish me luck!!

Thanks as always for reading.

Straight from the trenches,

DT

So much to say....

So little time.  I admit, I am a few posts behind.  I got a dog, I started work last week, dressed up for halloween, and tonight I watched history unfold before me as the United States elected an African American president.  What can I say, change is amiss.  So what do I write about amidst all of this activity.  Do I write about myself as the world watches this historic moment?  Seems somewhat insignificant in light of the less palatable changes we've seen over the past weeks.  Do I write about my job, as thousands continue to lose theirs everyday.  All I can say is that I'm thankful for the support my law firm has offered me throughout this chaotic time in my life.  Do I write about politics...well, frankly, there are people much better equipped to write about this subject, and my small words would get lost amidst the largess of this moment, so for now, I'll write about halloween.

To be honest, I wasn't looking forward to halloween this year.  As an adult, halloween is about confronting your inhibitions and facing your fears... and for single girls, its about dressing as sexy as you can, because it's the only occasion that allows ladies to put a mask on and dress like a tart.  Well, for me, this year has been about confronting my fears.  For me, sexuality has been redefined, forcing me to allow other parts of me to shine through, and find comfort in allowing people to see the person, rather than the body, the hair or the face.  So when faced with halloween, it seemed unusually empty and inhibiting.  You see, as everyone put their masks on for the evening, to take on the character of somebody else, I longed to take mine off and finally allow people to see myself.  For months I've been applying my makeup, wearing my wigs and hiding my disease.  Well this halloween, as everyone put on their wigs for the night, I decided to take mine off.  I walked out of my door onto the streets of new york with a fuzzy head and no hair to hide my face, and with every stride, I felt beautiful.  And yes, people asked, and the subject came up as I silently shared my secret.  And none of it mattered.  Because the one night where I could have been anyone else... I chose to be me.  I chose to me.

Now since halloween, I have put on my wig and continued to mask the battle wounds.  But as I said at the start, change is in the air, and for the same reason that the United States elected Barak Obama, even with my wig I feel less burdened.  Eventually, I will permanently shed my masks, but in the meantime, I finally feel hope.

Thanks as always for reading.

Straight from the trenches,

DT

Identity

A few weeks back, when I talked about the exclusive Cancer Club, my prodigious young cousin, "Prodigy", asked me what my identity was among this community.  What nickname would I get from my fellow fighters amidst our common experience.  My flippant response is, "I'm DTintheCity dude!! Haven't you been reading???"  But this is no answer for Prodigy's thought provoking question, so I started to ponder who I really am in light of my recent experience.

The reality is this is a difficult question to answer.  Am I the same person that I was before this happened?  Probably not.  Am I a completely different person than I was before this happened?  Probably not.  Perhaps I am a more saturated version of myself, candidly revealing both my strengths and weaknesses unapologetically.  Perhaps, in an idealistic sense, this experience has brought out the best in me, but anyone who has been around me knows that while I may have had my bright moments over the past few months, the reality is that it's been more of rollercoaster and my character has equally ridden those rails.  So who am I in this process, and more specifically, who am within this community.  

Well, I hate to be a copout, but this is impossible for me to define because just as the nicknames I give to others on this blog represent how I see these individuals, any moniker that might be given to me would be colored by the way the person naming me views me.  Now I could attempt to figure out how people see me, but the closest I would get would be how I hope I'm perceived by others, which would shift, depending on the gaze of the individual naming me.  So all I can do is name myself as I either think people see me, or hope that people see me.  So here it goes, divided by category.

Nicknames reflecting how I think people see me:

*Crybaby

*Control Freak

*PseudoShrink

*Optimistic Pessimist

*Baby (Remember though, "Nobody puts Baby in a corner!")

Nicknames reflecting how I hope people see me:

*Cancer Ninja

*Optimist

*Truthteller

*BadAss

*SuperFriend

*ChemoKiller

*Muscle Mama (metaphorically, not physically)

*Water Roller (i.e. I let things roll off me like water)

*Sexy Sister

*Survivor

Now I have no idea if any of these truly fit, so I invite all of you to cast your votes or potentially even provide nicknames that I haven't thought of.  In the meantime, I'll continue using the name that I think does embody me, both pre, during and post-cancer.... DTintheCity

Thanks as always for reading.

Straight from the trenches,

DT

A New Year, Repentance and Renewal

Hey all.  Sorry for the hiatus.  I guess I just needed a break from the Big C and all it means to you and me (sorry, couldn't help myself, so cheesy).  Anyway, so to catch everyone up, on September 22, 2008, I, DT, had my final chemo treatment, which was appropriately celebrated with an invisible parade dancing through my living room with all the bells and whistles, including confetti.  A week later, my little parade was doused with honey as those of the Jewish persuasion (which includes me) celebrated our new year, otherwise known as Rosh Hashana (in case you didn't know, Jews replace champagne toasts with apples and honey to ring in a sweet new year).  10 days later came Yom Kippur, Judaism's most somber day, during which we repent our sins and promise to do better in the coming year while fasting for roughly 26 hours (even water is off limits).  Two days after Yom Kippur, I was dancing at a wedding, celebrating my friend, "Sexologist's", wedding.  Needless to say, although all of this activity was somewhat exhausting, it's hard to miss the unusual timing and symbolic importance of all of these events amidst my circumstances this year.  In fact, all the major dates related to my journey through cancerland have been somewhat auspicious, verging on the ridiculous.  So let's do a recap.

• Diagnosis - March 11, 2008 (My Birthday)
  
• Bilateral Mastectomy Surgery - April 1, 2008 (otherwise known as April Fools Day)
  
• ER/Hospital Fiasco (which I still need to tell you about) - June 13, 2008 (otherwise known as Friday the 13th)
  
• Last Chemo Treatment - September 22, 2008
• Rosh Hashana - September 29-October 1, 2oo8 (1 week post-treatment)
• Yom Kippur - October 8-9, 2008 (2 weeks post treatment)
• 10th Anniversary of Mother's Passing - October 19, 2008 (exactly 4 weeks after my last treatment)

Now to many of you, this may seem absurd; but the link to life, remorse and renewal is undeniable, even to the most cynical person, including myself.  Accordingly, I spent the Jewish holidays celebrating the end of this difficult treatment and contemplated the experiences I have endured throughout this year.  I have to admit, as trite as this may sound, the apples and honey I ate tasted sweeter this year and, although I didn't fast this year (a ritual which I observe every year religiously), this was the first Yom Kippur that I can remember where I was reduced to tears and actually mourned for the losses I have incurred throughout my life and throughout the past 7 months.  Now admittedly, it is likely that the effects of chemo made me more sensitive when facing themes such as sin, loss, remorse and renewal, but the reality is that I think that this entire experience has simply torn open a sadness and loss that I was previously unwilling to share or embrace.  When your body is weakened, it is difficult to hold up the defenses that usually shield the rest of the world from your inner sensitivities and inner emotions, so after 6 and a half months of accumulated damage to my body, I have been laid bare, exposing my fears and emotional volatility.  So this Yom Kippur, I let go of my facade and allowed my private emotions to fall out of me into the palms of my loved ones, a position which makes me extremely uncomfortable, but is also freeing at the same time.  To allow one's inner soul to be reached by others enables of a level of honesty that relieves you of the strain of navigating the image you think people want to see.  It's a humbling experience for someone like me, but in the end it has made me lighter and more able to embrace the person that I have become throughout this journey.  

So with my lighter self, it is somewhat fitting that two days after Yom Kippur, I headed up to the Colorado mountains to celebrate a wedding, one of the most universal symbols of new beginnings.  Although people treated me with kid gloves, unsure what to say to me and whether to completely ignore the fact that I had cancer or confront this fact and make sure I was feeling ok, in the end, like any other wedding, I ate, I drank (at one point accidently mistaking a shot of tequila for a glass of champagne... quite shocking to get tequila when you're expecting champagne!!!), and even managed to have some young guy who didn't know me or my situation ask me out on the dance floor.  Maybe there is life after the Big C!

Tomorrow marks the 10th Anniversary of my mother's death and to commemorate this day, I am doing a walk in support of the American Cancer Society with my oncologist and some of her other patients.  I was unsure whether I wanted to do this walk, considering how emotionally charged the environment will be, but then I thought, what better way to commemorate and honor both my mom and her sister, and begin the healing process for myself.  So tomorrow, I will not walk in honor of myself, but I will walk in memory of my mother and my aunt as a symbol that old patterns can be broken and life can prevail over cancer.  Admittedly, I still have a long road ahead of me (I still have other non-chemo treatments and surgeries over the next few years), and I'm sure I will have moments where I won't feel as strong.  But the time to fight is over.  It is now time to heal and resume my life as a "Cancer Survivor".

Thanks as always for reading.

Straight from the trenches,

DT

CHEMO...DONE!!!

So today I went to my last and final chemo treatment.  Yes folks, you heard it here first, after a night of impetuous behavior (I blame the steroids... will tell you about this later), I made it through my final chemo cocktail party and celebrated my last round with some cupcakes and good conversation.  So before I get back into the throes of the chemo doldrums, I figured I would share my excitement with all of you.   Yup you guessed it, my invisible parade is marching through my living room again and this time they've come with confetti.  I would pop open some champagne but unfortunately I'm not allowed, so instead I'm toasting with gingerale.  

Have a great night everyone!!

As always, thanks for reading.

Straight from the trenches,

DT