With my final radiation treatment on December 30, a new era of living with cancer has begun. This new era—cancer treatment recovery and prevention, is one where I am the active participant in my health care. The medical professionals who managed my treatment these past several months have completed their roles to treat cancer. It’s now my turn.
I’m told that being successful in a new endeavor relies on having a concrete goal to strive for. I can’t think of a better goal to achieve than to have a healthy body to help prevent a cancer recurrence.
Somewhere in my readings, I learned that it takes three weeks to develop a new habit. My physiotherapist once told me that it also only takes three weeks to lose fitness levels if one becomes inactive. Cancer treatments placed me in many months of inactivity. So, getting healthy this year will involve a series of cumulative baby steps over the next few months.
I have started to live an even healthier lifestyle than in the past through daily exercise, weight loss, improved diet, and more rest. On January 1, I began daily walks, which are now up to an hour. My lower body muscles are strengthening, and my cardio function is improving. I am far from the fitness level I was at last April prior to my mastectomy, but it will return in a few weeks. By early February, my radiated skin should be sufficiently healed enabling me to take aquafit classes, my preferred exercise for over 20 years.
Medical literature on cancer survival and prevention says that an hour of daily exercise and a cancer diet help to ward off the disease. Women with a breast cancer history are additionally encouraged to lower fat levels in their bodies, as elevated fat levels increase estrogen production, which contributes to breast cancer.
For me, this means losing the weight I put on with cancer treatments and inactivity. Additionally, I will lose more weight to achieve low fat levels in my body. My deadline to lose the weight is the beginning of May, concurrent with the next six-month check-up with my oncologist. The weight loss will be come with a diet that promotes cancer prevention using fresh fruit and vegetables, whole grains, nuts, olive oil, and occasionally fish.
Tomorrow, I will meet with one of my Y aquafit instructors to set up a strengthening and conditioning program to rebuild my body in the gym, and then in the pool one month later. We will create a fitness program that will use weights and machines to develop strength and range of motion in my arms, shoulders, and torso.
Today is Day 10 of the “healthier me” program. Each morning I wake up and am grateful for a second chance of life. I will get healthier in the same way that I endured months of cancer treatment - with Strength, Courage, and Determination.
Yesterday, the final phase of active cancer treatment ended with my last radiation appointment. It was supposed to be on January 3, but selected cancer patients were asked to come in on the December 27 statutory holiday so that their last radiation treatment could conclude before the end of the year.
I can now say that the active part of my cancer treatment, which started last February is over. Today marks the first time in over five months that I won’t have some form of daily treatment.
The passive treatment that remains is minor in comparison to what I’ve been through with surgery, celllulitis, chemo, blood thinners and boosters, a malfunctioning chemo port, fever infections and thrush, and radiation. Taking a daily cancer fighting medication starting on the 2nd will be the simplest part of my cancer treatment.
In the next few months, I will undergo periodic tests and scans to monitor treatment efficacy and to rule out other potential cancer concerns that were identified in a CT scan from last summer. I will also have periodic medical check-ups with various doctors throughout the next year and thereafter, to closely monitor my body for potential cancer recurrence. I am hopeful that in the next few months, I will be declared cancer free and in remission.
In reflecting on 2010, I am inclined to say it was a year that I would like to forget. Unfortunately, it will be one that I will remember for the rest of my life. As with all life-changing experiences, this last year dealt out good and bad moments. In the end, what I have been left with the gift of a second life.
On the eve of 2011, I am happy to start the New Year with a fresh start that does not include living in the world of aggressive cancer treatments. Tomorrow, I will renew my membership at the local Y. I am looking forward to developing a new daily exercise routine that includes rebuilding and strengthening my body to recover from the treatments, and to help prevent a cancer recurrence. In February, I will be able to return to the pool once my skin has healed.
More than anything, I look forward to returning to a “modified” new normal life once again. Spending more quality time with family and friends who have become more precious to me because of my cancer diagnosis will also be a priority.
To all those who have journeyed with me this past year, thank you for “being there”. May you be abundantly blessed with the gifts of love, life, health, friendship, and prosperity in 2011.
Next year is a new beginning for me. I will mark its beginning with Strength, Courage, and Determination.
There are countless Christmas gifts I have been given throughout this year that I can’t possibly wrap.
How can I wrap up my gratefulness for a second gift of life? How can I wrap up the gifts of family and friends who have been steadfast in their loving support of me during my 2010 cancer journey? Wrapping of these gifts are impossible tasks.
The only thing I can do is to be aware of the gifts of my renewed life and of the people in it. I don’t know where to begin to express my heartfelt thanks to all of the people in my life. No words can ever express my gratitude to those who have been on the cancer journey with me this past year.
I feel so small in comparison to the enormity of kindness that has surrounded me for so many months. To all of the people who have journeyed with me during this cancer diagnosis and treatment, a simple thank you just isn’t enough, but a million thank you-s can’t come close to the appreciation I feel.
The gifts of love and support from family and friends that I have received throughout this year could not be bought. They are greater than any Christmas present I could ever receive. The givers of these offered the gift of themselves freely to me. They are priceless and deeply cherished.
Christmas 2010 will be a very special one. It will be low on commercialism and high on time with family and friends. Love and joy will take on new meaning this Christmas. We will celebrate the season as it was meant to be, not with things, but with each other.
To all who have been there for me in body and spirit this year, I wish you a joyous and blessed Christmas filled with abundant love. My wish for you is that you treasure the people in your life, for they are priceless gifts.
Christmas this year gives me a whole new appreciation for living in the present. I will celebrate the gifts of those who give me Strength, Courage, and Determination.
I am so relieved that chemo is completed, and the most dangerous and toxic part of my treatment is behind me.
Daily radiation is now the last active part of my cancer treatments. As of this past Friday, I am half way through the 16 radiation treatments that will end on January 3.
In Manitoba, there are currently eight radiation treatment rooms for the entire province, with another radiation treatment facility opening in Brandon in the near future. Most appointments are scheduled at 15-minute intervals. Every room is busy each day treating patients of all ages from across the province.
In comparison to chemotherapy, radiation is much easier to tolerate. It is not at all what I expected it would be. Each day, I undergo two treatments of radiation that are administered on the affected side of my chest and underarm. Each treatment dosage lasts about 30-40 seconds. The radiation is painless and fast.
Medical staff has told me that I can expect to feel fatigue by the third week of treatment, which takes me to the Christmas and New Year’s holidays and ¾ through my treatment cycle. This is also when I may start to see some treatment side effects with my skin.
Staggering Numbers of Medical Caregivers
This second chance that I have been given for life has come because of a big circle of medical caregivers who have walked along side me since last March. All have been patient, kind, and encouraging in this cancer journey.
To date, there have been over 120 medically associated people who have played a role in treating me and cheering me on in the fight against cancer. The medical caregivers include 19 specialists and ER doctors, 37 hospital, chemo and oncology nurses, 35 x-ray and lab technicians, 13 Canadian Cancer Society volunteer drivers (for treatments), several treatment schedulers, six chemotherapy “coffee and cookie” volunteers, a social worker, a dietitian, an art therapist, and a yoga instructor.
The various treatments also have some staggering numbers. By January, there will have been 149 daily injections of blood thinners, 45 injections of blood boosters, 18 radiation treatments, 15 blood work tests, six chemotherapy sessions, surgery, and a central line port installation and removal. Add to this, an array of tests and scans including a mammogram, tissue biopsy, CT scan, Muga scan, MRI, and various x-rays. No part of my body has been left unexplored.
Walking in The World of Cancer
In all of these months I have walked in two worlds of cancer, one of hope and one of sadness. At 51, many times in chemo and radiation wards, I have been the youngest cancer patient as the majority of cancer patients I have been amongst are seniors.
In this journey, I was told that the radiation treatments would bring the world of cancer into a sad reality. It is true. I have come to realize that despite my cancer diagnosis, there are other lives with cancer which are much sadder.
There are so many images of cancer one sees as a patient.
Tuesdays and Thursdays are treatment days for children at the cancer facility. I have seen a worried young mother tenderly hold her bald, jaundiced infant (about 15-18 months old) following treatment, as they waited in the patient transportation lounge for their ride home.
Another child, a girl--perhaps about three years old, was carried over her father’s shoulder as they exited the facility after treatment. A big, strong man, the dad literally and figuratively was carrying the weight of cancer on his shoulders.
A pretty teenage girl, with a patch on her treated eye, was waiting for her ride home while texting on her cell phone with her good eye.
A young, 20 something, wigged female, fresh from chemotherapy treatments, was waiting for radiation at the same time as me. Totally oblivious to the number of people who have been rallying around her to make her well from cancer, she was seen a few minutes later smoking a cigarette outside the treatment facility.
Ongoing Treatments
On Tuesday, I will be grateful to be having my last daily blood thinner injection. I am looking forward to no longer contending with a swollen and welt-filled abdomen. Hopefully this will allow me a few more clothing choices. On Wednesday, I will have my troublesome chemo port removed. It will be a relief to no longer feel the port’s gentle tug on my jugular vein that I have lived with for the past six months. I no longer need sleeping pills, painkillers, and antacid medication as the potency of chemo and related side effects have left my body. Slowly, my body is “resetting” to its new normal.
The active treatment for my cancer will end in just over two weeks. There will be ongoing passive treatments that await me the next few months, along with regular appointments with my oncologist, surgeon, and family doctor. In early January, I will start taking daily hormone blocker medication to help prevent a cancer recurrence.
I am scheduled for another mammogram, and various follow up tests and scans post chemo and to further explore some medical concerns that were raised with my initial CT scan last July. There will be ongoing blood work, another CT scan, another MRI scan, a colonoscopy, an endoscopy, and a dental follow up, which will all take place early in the first part of the new year.
On the recommendation of my oncologist, I will also be pursuing genetic testing to see if I have inherited a breast cancer gene and am a carrier of it in my family. I have chosen to do so to benefit my mother, sister, and children. Fortunately, none of them have had cancer, but could be affected if my genetic testing indicates a family source for my cancer.
Each day, the weight of living with cancer is getting lighter as I journey to complete the last active phase of treatment. Each day, I make a pledge to continue to fight cancer with Strength, Courage, and Determination
Last Wednesday, I had my final chemo treatment follow up with my oncologist. It could be aptly described as a “weight taken off my shoulders” visit.
After six weeks of house isolation without visitors, I was cleared to leave the house and have company.
I can now drink coffee again. Following the appointment, we headed straight to a coffee shop for my first java in six months. It kept me buzzed for several hours--long enough to squeeze in Christmas shopping before post-chemo fatigue set in.
My first radiation treatment starts tomorrow with daily treatments until January 3. My chemo port gets removed on Dec. 22. On January 2nd, I will start a hormone inhibiting cancer drug, which I will take for a minimum of two years.
Early next year, I will have another series of scans to follow up on chemo treatments and some minor medical concerns that arose with my first CT scan last July. The smallest abnormalities that come up with scans are not left to chance once one has had a cancer history.
My new medical routine will involve regular follow up appointments throughout the year that will include my surgeon, oncologist, radiation oncologist, and family doctor. As time passes, and if I stay in remission, some of these appointments will lessen. There will always be oncologist follow-up visits as long as I live. After active treatment ends in early January, general health care will be under my family doctor.
Yesterday, I was finally able to have this year’s flu shot following two earlier postponements due to low white blood cell counts. It was a chance to brief my phenomenal family doctor about my treatments as I have not seen her since she suspected breast cancer last February.
She reiterated that my lifetime of excellent health, exercise, and self-care were beneficial as I went through surgery, chemo treatments, and infection battles. She noted that the positive outcomes could have been otherwise if I hadn’t been very healthy prior to treatments.
In consultation with the oncologist, my family doctor advised that she would determine when I am able to return to work, likely, sometime this coming summer. She ended the appointment with a big hug, and told me that I was “one tough woman” for enduring the cancer treatment experiences.
I am starting to build my “new normal” life in living with a cancer diagnosis post treatment. This is a new chapter of my life that is being written on a blank page.
I will need to exercise at least half an hour a day for the rest of my life as one way of warding off a cancer recurrence. There will be changes in my diet. I will eat even healthier than I have in the past. Food choices now need to be made with more lowered fats, limiting animal proteins, adding more vegetable proteins, reducing/eliminating sugar, increasing whole grains, lots of fruits and vegetables, and little/no alcohol consumption. (Alcohol and sugar can feed cancer cell growth).
I am still dealing with some physical side effects of surgery and chemo. Throughout this odyssey many emotions have surfaced, and more will come as I complete the last treatment phase and create a new life that includes a cancer history. Getting my mind, memory, and word finding to pre-cancer levels would be welcomed.
Many personal relationships have been affected in this journey. I will continue reconnecting with others as part of rebuilding my life. As summer arrives, there will be return to work considerations.
As I move into the final phase of active treatment for cancer tomorrow, a concurrent new phase of post-cancer life is being built. I bravely continue on this journey with Strength, Courage, and Determination.
There is a Buddhist proverb that says: “When the student is ready, the teacher will appear.”
The student (me) wasn’t ready, but the teacher (cancer), appeared anyway.
These past few months have afforded me an opportunity to learn many of life’s lessons since being diagnosed with breast cancer late last winter. I have been a student in life’s classroom with cancer as my teacher. I was not ready for the many lessons cancer has taught me, and continues to teach me.
In the face of potential death, I am learning about life from this life-threatening disease. As with many of life’s lessons, I do not realize that I have been taught something until I look back to where I was at the start of the lesson.
What are some of the lessons cancer has taught me?
Life is sacred.
Each day, I wake up and realize the gift of life I have been given and how I took this for granted until cancer came.
The lives of those who have surrounded me in this cancer journey are gifts to me that I cannot buy, but are freely given out of love. These are the most powerful, most healing gifts one will ever experience in living.
A cancer patient cannot get through dealing with the devastation of this disease without the support of family, friends, and their medical team. My oncology social worker, cancer nurses, and doctors have been the calm in this cancer storm by keeping me focused on getting through each stage of treatment, one step at a time.
Good health is taken for granted. I’d been the model of excellent health until my cancer diagnosis. Years of regular exercise, proper nutrition and a positive outlook got me through the most difficult time of my life with surgery, chemotherapy, and a multitude of complications. Radiation is still to come, starting next week.
Getting through chemotherapy is a lot harder than healing from a mastectomy. Enduring six rounds of chemotherapy elevated my patience and perseverance to a level previously unknown to me. I had no control over how my body would respond to treatments. It didn’t like the chemo invasion.
Early in my treatments, I learned the absolute necessity of being an active partner in co-managing all details of my cancer care, monitoring symptoms, and quickly acting on suspicions. I learned that chemo infection symptoms can be subtle and deadly dangerous.
Chemo’s side effects taught me to trust my intuition more than in the past. On more than one occasion, my intuitive hunches ended up with diagnoses of febrile neutropenia infections. Thankfully, with chemo treatments ended, my risk for infection dives dramatically.
I learned that the will to live is a strong, positive force in my life that carried me through chemo’s challenges. The positive spirit of other cancer patients, and their will to live are inspirational. As sick as I was with chemotherapy, there were other cancer patients around me who were even sicker.
Lastly, living with cancer has taught me is that it’s OK to cry. There have been tears of being overwhelmed, tears of frustration, tears of fear, tears of sadness, tears of pain, tears of regret, tears of relief, and tears of joy. All of these tears in their own way, made the cancer journey easier to bear.
I keep moving forward in this cancer journey with gratitude for my life. Each day, I am stronger than the day before. Each day, I choose to live with Strength, Courage, and Determination.
Eight Long Months of Treatments
Since my breast cancer diagnosis in early March of this year, these past eight months have at times felt like a woman’s worst nightmare coming true. At other times, I felt like I was in denial: “How could I get breast cancer? I don’t have any of the predisposing factors. I feel fine and am not overweight. I never smoked, exercised regularly, and had no prior health problems.”
Yet, it is true. With all I have been through, there is no denying that this cancer diagnosis is real. It has been a long and frightful time in my life.
Once you have a cancer diagnosis, there is a whirlwind of medical appointments you attend with an array of medical caregivers from various disciplines. The appointments can keep you quite busy and preoccupied during the treatment period. Coupled with resting, recuperating, and managing fatigue, one’s thoughts can be pushed aside for extended periods of time. You do what you need to do to get through each day.
Upon the conclusion of chemotherapy, I now have some time to think about my new life in living with a cancer diagnosis. Getting through my last chemo treatment, and owning up to the fact that I now live with a cancer history has been difficult to accept. This reality of cancer, this certainty of cancer, hit with force on Tuesday night.
I was nearing the end of the run of “crappy days,” when chemo makes you feel dreadfully awful for several days after the infusion. It was not a good day. I could feel my Taxotere and chemo fatigue headache making me fade around 9:00 p.m., and decided that the best therapy was to go to bed and get some sleep.
As I lay in bed, I recounted everything I have been through in the last few months. Suddenly—like a gale force wind, a wave of soul wrenching sobs arose from the core of my being.
It seemed that my body had made a pact with me. It had carried me through all of the treatments and complications thus far, but it did not express the sorrow that was stored inside it over the last few months. It seemed that my body waited for the completion of the last chemo treatment, and gave itself the permission it needed to the express emotions it had suppressed for so long.
I believe that our bodies are very wise, far wiser than we give them credit for. They have an innate sense of how to protect us, and when they must do so. They know when to hold back emotions, and when it is timely to release them.
I get through life by “compartmentalizing” details and projects, handling them one at a time. My body appreciates this approach and handles it well. With growing wisdom, I have learned to only focus on the immediate task at hand, otherwise it is too overwhelming. This is how I got through my mastectomy and its complications, and how I got through my 6 chemo treatments and their complications. It will be how I will get through my radiation—one appointment at a time.
Intuitively, I feel that Tuesday evening’s meltdown was my body’s way of releasing and healing itself. The experience sent me a big signal that I had been ignoring--that it was OK to cry about having cancer, and it was OK to grieve for what I am going through. My body was doing what it needed to do to be well emotionally. My emotions had called their “timeout”, after patiently waiting on the sidelines of treatment all of these months.
The Severity of Chemo Infections
Tuesday was a big “reality check” day for me. The experience of having survived four chemo infections with fever since the end of September, and knowing how deadly dangerous these can be had settled in. I am extremely fortunate that each infection did not evolve into a more serious condition.
My sister Jen holds a Bachelor of Nursing degree. She has been not only a loving sister, but also a medical gift to me in this cancer journey.
A few weeks ago, while “watching” me during one of my chemo fever moments, she explained the gravity of being immune compromised as a cancer patient in regard to infections and fevers.
The biggest concern with people receiving chemotherapy is that they are at risk of developing a life-threatening infection called sepsis, which can evolve very rapidly in immune compromised patients. Sepsis is a severe bodily infection that travels via the blood stream, and eventually can become fatal if not treated quickly with broad-spectrum antibiotics.
My sister has seen the symptoms of sepsis in patients she has nursed, and is able to recognize when they are potentially emerging. Her goal of watching over me during one of the early fever and infection incidents was to detect potential sepsis symptoms, and to coach me on appropriate treatment to be taken if I landed at an emergency ward.
If a patient is being treated with chemotherapy or radiation, they need to be especially vigilant regarding possible sepsis symptoms. If they are developing sepsis, they will often have a fever (applied to me). They may also have chills (check this off for me), and severe shaking (check this off for me in one incident), and may develop pain in their joints (check this off for me).
The most common causes of sepsis are bacteria (I had this as a source in one case of infection and fever); viruses (I had this in another case of infection and fever); and fungi (I had this with Thrush infections). Infections in organs, including kidneys [urinary tract infections--I had this with one infection]; and skin [cellulitis--I had this post mastectomy] can also lead to sepsis.
Infections, fevers, and sepsis are seriously scary stuff to a chemo patient.
On Tuesday night, I realized how close I could have come to dying during two of my recent emergency visits with chemo infections and fever. This realization formed the gale force winds that unraveled my emotions. The tears of relief were released knowing that I have survived some very serious situations during my course of cancer treatment.
The Enormity of it All
The enormity of what I have been through is not something I had reflected on until this week. I have been told it has been a lot; an “unusual number of complications” decried my chemo nurses and social worker. Their collective experiences indicated that they have not seen any chemo patients with as many problems as I have had going through treatment. Perhaps it is so.
There was the mastectomy, and its related cellulitis complication. There was day surgery to insert a chemo port, which caused a blood clot and required me to go on daily injections of blood thinner. There have been low blood counts since July, and the requirement to go on blood boosters after each chemo treatment. There have been six chemotherapy infusions.
There have been Thrush infections, and four episodes of chemo infections with fever. My chemo port worked sporadically. It stopped working after my fifth infusion, resulting in using my arm for blood tests and the final infusion. Then there have been the anxious experiences of waiting for hours, several times, in the chaotic world of after hour’s medical care in emergency wards.
As I look back on making it through all of this, I now can accept that I am a gritty gal. I know that I can get through the difficult times in this cancer battle. It has never been easy, and will never be easy. I prefer to call these tough moments “character building” experiences. This character is now comfortable in officially calling herself a “Cancer Fighter.”
Daily, I think about how truly lucky I am to be alive despite all of the treatment side complications I have had. Somewhere, Angels and a Higher Power were working overtime to watch over me.
It is my hope that radiation will be easier and complication free. I am cautiously optimistic that this will be so, but will not be at ease until the treatments are done because of my complications history. I am also aware that I need to still be careful while in radiation treatment, as I will remain immune compromised.
In a few weeks, most of my cancer treatment will be behind me. I look forward to the day when I can be referred to as a Cancer Survivor. I continue to fight to get well with Strength, Courage, and Determination.