Wednesday, February 25, 2009

A Break From Reality... And Back Again...

Every time I get the chance to go skiing, I totally relish it. It's such a welcome break from my "cancereality" as we may call it. It feels great to do something physical, and being outside in the snow is truly therapeutic for me.

Anyway, Monday and Tuesday I went up skiing in Winter Park and stayed with some great friends, Mike and Beth. I've worked with both of them in restaurants back when I lived in WP, which feels like eons ago. Mike was actually one of the first people I met. Anyway, they're both amazing cooks, so you can imagine I was spoiled by the food they made me. I thoroughly enjoyed some lasagna and breakfast burritos, plus they got a case of Bud Light for me and took care of my drinks. It was great!

The skiing was really fantastic on Monday. I took some of the best turns I've taken all season, plus I got to ski with my buddy Marty for the first time. Turns out, he likes to ski moguls too, and we had a great, albeit short, time! Then on Tuesday I skied terribly. We'd gotten a bunch of new snow, but it was about 39 degrees out, so it was wet and heavy. I gave up and went to visit some friends and have a Hurricane or two, as it was Mardi Gras and all.

In the midst of it all, I got a call from my oncologist's office. That was scary because it was after 5:00 and I had no idea why they'd be calling me. I was worried that they had rechecked my brain MRI and found something. In the end, though, it was to discuss radiation to my supraclav. My oncologist, unlike my surgeon, was all for it, and had discussed it with another radiation oncologist at the office I go to. My normal rads onc was out of town on a personal emergency, so she had talked with his associate. It turned out though that I'd be meeting with a "substitute doctor." So my medical oncologist agreed to talk to the sub as well.

We went back to M&B's place to change clothes, and then went out to celebrate! I had a great time dancing and seeing friends. Wahoo!

I had to head home on Wednesday morning because I had an appointment with the substitute rads onc, Dr. A. Dr. A. is a retired rads onc who was also a professor at the University of Oklahoma. He had a fantastic bedside manner and truly took the time to help me try to make a decision. The difficult thing about the decision of whether or not to radiate my supraclav is this: the risks are small but severe, and the benefits are not guaranteed. The risk is that the radiation could damage a nerve bundle in my shoulder causing my entire right arm to go permanently numb. There's also an increased risk of lymphedema. And there will be increased damage to my lung, but they tell me that it won't be noticeable or make a change in my lifestyle. The risk of losing feeling in my arm is very small; it's been approximated from anywhere between .5-5%. According to Dr. A., he had never seen it happen to any of his patients in his 38 years of experience. And as with anything, there is no guarantee of any benefit.

Having the control and freedom to decide on this makes me feel like I DO have control over my treatment. But as I am not a doctor, it is very difficult to try to make a medical decision for myself. I'm leaning towards doing it though. The rads oncs seem torn, but because I am so young, it seems like a good idea. I want to give myself every chance I can, and I don't want to regret NOT doing something that might help. There's also the idea that if cancer were to grow in my supraclavicular lymph nodes, a tumor could damage that nerve bundle, also causing my arm to go numb. Damned if you do, damned if you don't.

"Where are we going? And what am I doing in this handbasket?"

The reason there is such a debate over whether or not to radiate my supraclav is that they usually do it if there are three or more lymph nodes "involved," meaning containing cancer. For less than three, they do not radiate this region. But, in my case, because I'm always special about things, the tumor in my node had broken through the lymph node capsule, which is... sorta scary. And like I said, I am a youngster, so we want to give me the best chance possible.

In the end, Dr. A. and I agreed that I should take some extra time to think about it, and in the meantime, have myself mapped out as if I'm going to do it. Then if I decide against it, it won't change anything. Which leads me to the next thing...

I got mapped for radiation finally. To do this, they stick you on an uncomfortable table and slide you in and out of a CT machine. This is purely for mapping and not diagnostic, so I didn't have to drink anything gross or be injected by anything. Then afterwards, I got my very first tattoos.

Now, before anyone gets too excited, these tattoos are TINY and are used to match my body up with the machines. A laser light will need to be matched to these black dots every session to make sure my body is in the perfect position. You don't want radiation going just anywhere! I was against them at first, but in the end, they truly are tiny and they didn't really hurt. The gal who did them told me she was famous for making them REALLY tiny. It was true; the two on my sides turned out so tiny that she had to redo them.

I was scared thinking she'd have a big tattoo gun, but in the end they just put a dot of ink on my skin and then stuck a needle in. No biggie.

I guess now they're working on my treatment plan and will call me to tell me when I can start. I think though, I'll end up telling them when I want to start because Big Brother #2 is coming to town to ski with me, and I don't want to worry about radiation until we're done skiing.

Yeah, I have a one-track mind. Skiing is my passion, what can I say?

I leave tomorrow for Dallas for the Young Women Affected by Breast Cancer conference. I get to meet all these women who have comprised my online support group. I'm really looking forward to it! Because of my age, a normal support group had very little appeal to me. I lost myself to this network of women closer to my age, and we all support each other. It's been incredible to have a life-line of people who know what I'm going through, and how hard it is do it at this age. Hopefully I'll learn a lot and have a fantastic time! I'm headed to Denver tonight to stay with Amber so I don't have to wake up so early tomorrow!

Saturday, February 21, 2009

What a Week!

Hello again! I'm sorry that I keep slacking off with the upkeep of my blog. I think because I'm feeling better, I blog less. I think back to my days of chemotherapy treatment and remember how this blog served as a lifeline for my mental health. I hope it means I'm mentally stronger now because I feel the need to blog less. And admittedly, the further along and the closer to the finish line I get, the more I dislike talking about cancer. I used to obsessively check the message boards at the Young Survivor Coalition, blog about my cancer adventure, and talk about cancer all the time. I finally feel like my thoughts about cancer are no longer constant.

Anyway, I'll fill you in on what felt like a long, crummy week of doctor's appointments.

On Monday, I had two appointments. The first was with my medical oncologist, Dr. M. This was the first time I'd seen her since surgery, so we were going to talk about my pathology results and prognosis. She seemed disappointed that the pathology report found a lymph node positive for cancer. That means that while her original staging was based on a guess, the chemotherapy did not downstage me. She used a computer program called Adjuvant Online to assess my prognosis for cure. The program isn't really the most accurate picture of my prognosis because I did chemo before surgery, but apparently it's the best and only tool we have. So according to the program, I have a 70% chance of making it another 5 years, disease-free.

As you can imagine, I was kind of down after hearing that. It was the number I had in my head approximately, but hearing it officially was a tad depressing. Yes, 70% is better than anything below 69%. But it still isn't as good as 80%, or 100%. Feeling that three times out of ten I'm dead meat was scary and disheartening. But I have to remember that I am not just a statistic and be happy for the 70%.

It really made me realize how little we still know about cancer. When I was asking questions about this 70% and wondering what was going to happen, my oncologist literally crossed both her fingers and said "we hope." Moving forward from a superstitious finger-crossing and a 70% chance of being alive at 31 makes a girl feel a little uncertain.

I also mentioned an issue I'd had a few weeks before with my peripheral vision. I went out and partied a little in Denver with some friends from high school, and the next day I realized there was a chunk of my vision missing in the periphery. It was freaky! But it came back after I ate and rehydrated. The doctor wanted to be on the safe side and ordered an MRI of my brain. She said it was very, very, very unlikely that anything was wrong, but given the whole cancer thing, we're playing it safe. The brain MRI was scheduled for Wednesday. Scary stuff, but I tried not to worry.

Anyway, I didn't have much time to be glum about it because there was more cancer business to attend to. I had my first consultation with my radiation oncologist on Monday too. This doctor, also a Dr. S., was very nice and very informative. I'd heard so many women complain about their radiation (we call it "rads" for short) oncologist, so I was worried mine would be a brusque jerk too. Instead he was a very friendly, informative and flexible doctor. For the first time in treatment, I felt like I really had control over my treatment and had lots of choices.

We discussed some different options for radiation, but we came to the conclusion that standard external beam radiation would be the best option for me. We talked about the side effects, which primarily are fatigue (what's new?) and skin irritations. We're also talking about radiating my supraclavicular region because apparently the cancerous lymph node had cancer that broke through the capsule. I scheduled a mapping CT for this coming Wednesday, and rads will probably start sometime in the first weeks of March. I hope to be totally finished with active treatment by then end of April.

I had my brain MRI on Wednesday, and by Thursday I got the results. The woman on the phone said, "Your brain looks completely normal." No one has ever said that to me about my brain! That was a nice relief.

Also on Thursday I met with a physical therapist to become educated on lymphedema, or LE. I learned that developing LE is a lifelong risk. I also learned that I shouldn't allow it to run my life. For those of you who don't know what lymphedema is, it's a condition caused by the lymph fluid getting trapped in parts of the body, in my case my right arm, and not being moved out because I have had 9 lymph nodes removed. Any injury, or nothing at all, could cause LE to happen. Essentially, I need to reduce my risk factors, be vigilant in my watch for any swelling, and should something occur, be prompt at treating it.

On Friday, I went to Denver for my follow-up appointment with my surgeon. It was a very brief appointment, and I finally got the bandages taken off my re-excision wound. The wound looked great, and Dr. S. was really please with the progress. I asked her about radiating my supraclavicular region, and she said I shouldn't do it. Dr. S. always has a brighter view on my future, so it's nice to see her after I see Dr. M.

So that was my week. It's such a drag to have to go to all these appointments, especially after having such a long break from them. But... this is my life, and as the Serenity Prayer commands, I must learn to accept the things I cannot change.

Side note: I started writing this a long time ago, and now it's about a week and a half later. But to keep my posts approximately in the time frame of actual life, I'm going to post it as February 21 and write another update.

Sunday, February 15, 2009

Sorry I've Been Slacking! And No More Surgery!

Hey everyone! I really have to apologize for slacking on my blog. I keep meaning to update everyone, but it got put off. Sorry sorry sorry!

So first off, let me tell you all that my second surgery was a success. I had a re-excision on Monday, and on Wednesday (I think?) I got the good news that the margins were clean and clear. The medical assistant said, "You won't have to have any more surgeries, unless you need your appendix out!" Let's hope she's right!

Tuesday was a little painful because I didn't want to take any more percocet. I just really hate the way painkillers make me feel! How people get addicted to them I'll never know. Anyway, the pain has been very minimal, and I've resumed my physical therapy exercises. Things are feeling really good right now, so that's great.

For whatever reason, my breast looks a lot better this time around. You'd think it would be flatter from taking out more tissue, but it looks... bigger! I hope that lasts!

I really need to get Susan to take my picture again because my hair is pretty noticeable now. It's not long, and it's not thick... but it's THERE!

Tomorrow is sort of a big day. I'm definitely not looking forward to it. I have an appointment in the morning with Dr. M., my oncologist. We'll probably go over the meaning of my pathology report. I'm thinking she's going to give me an official prognosis, meaning the statistics regarding my likelihood of 5 year survival. Icky. And in the afternoon, I meet with my radiation oncologist for the first time. I wonder what that will be like. I'll be glad to have it out of the way and to know more about what's going to be happening. So think good thoughts for me tomorrow because I'm sick of going to the doctor now. Which I think is pretty fair, since I've been doing it for 7 months. Tomorrow marks 7 months since diagnosis.

Today is actually a special day. You see, 26 years ago today, a little baby arrived in Denver, all the way from Seoul, South Korea. And when she landed, she met her new family and she started a new life in the United States. That lucky little baby was me. Today is what has come to be called "Carrie Day," a day celebrating the anniversary of my adoption. So Happy Carrie Day to you all! Hope you treated yourselves nicely!

Now that we have the updates out of the way, we can move on to the reflection part of the blog. I've been thinking a lot about the transition from "cancer girl" to Carrie. It's so crazy that things happened to fast and so unexpectedly. In 8 months, my life changed A LOT.

On the YSC message boards, we talk about the "new normal" a lot. We talk about how we'll never go back to being the women we were before cancer, but that we find a new normal, a balance that takes into account everything we've been through. I will never have breasts without scars, and I will probably never again feel like I'll live forever. I'll never be young and invincible. And my surgeon mentioned that she thought I might have to do stretches every day for the rest of my life because the radiation might mess up my muscles in my arm. All of this is will certainly contribute to my new normal, which doesn't sound very normal at all.

But slowly, ever so slowly, the evidence of this difficult time is disappearing. When I think about it, I get this visual of a Jolly Roger drawn in the sand by the sea. And with each wave that laps against the sand, the picture washes away just a little bit more. My hair is coming back slowly, and the darkness in my nails is fading. Eventually the fact that I did a tango with cancer will not be visible, and the people I meet will have no idea what I've been through. I will look normal. But we've yet to find out if I'll feel normal.

I've noticed, though, that I find myself thinking, worrying and obsessing about cancer a lot less these days. I didn't think it would be this fast. I feel so ready to move on with my life. Actually, I should clarify that statement. I have no idea what I want to do with my life. But I am absolutely ready to move away from this part of my life. When I'm through with treatment, which, mind you, will still be another two months probably, I want to move back to Winter Park. I feel like my time there was cut short. I feel like I need to go back so that when I decide to leave, it's on my terms. And of course, I want to ski another season because cancer stole this one from me.

What scares me is the creeping thought that I'll get back to the life I had pre-cancer and not be happy. I do feel very different and very changed. And if skiing doesn't make me happy like it used to, then... who am I? I feel like I don't know myself very well anymore because I've changed.

I feel conflicted in how to proceed. When doctors tell me negative things, and I read negative things on the YSC message boards, I just want to be the exception. I want to believe that these various bad things will not happen to me. I want to prove everyone wrong. At the same time, I hate to set myself up for disappointment. I don't want to believe I can go back to being normal and then have to deal with all the stupid effects of cancer and its treatment. I guess what I'm trying to say is that I don't want to live in denial of the after-effects of treatment, and I don't want to have unrealistic expectations. But I DO want to try my best to go back to being a normal 26 year old.

Part of that is getting my body back in shape. I have gotten really flabby and tired, and now I'm ready to tone up my muscles, gain some strength back, and get in shape so that when I finally hit the snow, I'm ready to rip! The only problem is that I have to keep healing from surgery and am not allowed to do any "strenuous physical activity" for another week. But this has become a major goal for me. And I finally signed up for the free 6-month gym membership I got because of cancer. And paid for three 1-hour sessions of physical training. So as soon as I get the go-ahead, I'm going to go ahead!

I'm tired! I'm going to bed. I hope I said everything I wanted to. I have no idea.

Oh wait, two more things!

1) Thanks so much to Nancy! I got your wonderful card! It was a great surprise on a pretty boring day. And thanks for dinner in Dallas! I'll make sure to eat something REALLY good!

2) I'm going to Dallas in only 11 days! I'm going to meet all these wonderful women who have been a special support group in these hard times. I'm excited!

Tuesday, February 10, 2009

Here Comes Another Song About Mexico...

So Christmas was a REALLY long time ago, I know, but I finally loaded up all my pictures from my family's trip to Mexico. We all had a great time, and it was nice to look back on the fun times we had.
I took my camera with me only a few times, so the pictures I have aren't exactly representative of everything we did. Maybe if I get some pictures from other family members, I'll post them.
But without further ado, here are some photos from Playa del Carmen, Mexico!
Here's Mom getting searched by airport security. When she
wears her sunglasses inside, she looks like a movie star!




Here's Mom, Dad, Susan and me eating breakfast
at the airport before we depart. Yum!


The next photos are from a dinner at Yaxche, a Mayan restaurant. There's a beautiful patio in the back where you can eat outside. But it's very dark. You can see Mom and Dad using flashlights to read their menus.

David, Cristi and Michael are deciding what's for dinner.
Actually, David is smiling for the camera!


Here's Dad being a goofball, his typical self.




And me, drinking a delicious mixture of juices. Just juices, I swear!




Mom and Susan, smiling pretty!



And here's all of us, except Dad, who's taking the picture,
and Cristi, who got covered by Michael.



Here's a spotlight on my sister-in-law, since she got
covered by my brother in the last shot.


Here's me being silly. I was trying to imitate this really bizarre
statue across from our favorite restaurant.



And here's Susan being silly, kissing a statue near our house.

Susan and Carrie enjoying strawberry margaritas at Babe's.
This restaurant specializes in Thai food AND Swedish Meatballs.
Go figure.

And Dad and Michael enjoying their mango margs...


Mom enjoying a fine bottled water, and Dad with his margarita!



With our last remaining pesos, Susan and I bought these cool
handmade wool turtles. They're cool!


Here's out kitchen, with the housekeeper Marcela washing dishes.


The living room...

The room Susan and I shared...

Susan took this photo from inside, looking out our magnificent deck!


She also took this one. Hello Caribbean!

The patio, with Cristi, Dad, Mom and Susan...

The palapa covering the entrance to our house! (De nada, Palapa!)
A side view of the house...

Another view, to show you how close we were to the sea!



The front of the house...

This photo shows my sister-in-law Cristi, as well as the house we stayed
in the last time we were in Playa del Carmen.
The palm trees between our house and the beach.





Well, I hope everyone enjoyed a quick trip to Mexico. Remember the sun; it will be back again!

Sunday, February 8, 2009

'Twas the Other Night Before Surgery

Guess who? YES! It's Carrie! And she hates Hates HATES cancer!

Here we are again, the night before surgery. Last surgery I was all jittery and nervous. I was scared of the anesthetic and scared for the pain. I was scared for the outcome, too. But tonight, I look at my upcoming surgery as an annoyance. I wish I didn't have to have it, but I know I do. So... I'm gonna suck it up and blast through it. I just hope there won't be any ridiculous complications like last time. Five wire localizations, three attempts at an IV... not fun.

I have only 12 more minutes of water drinking and eating. Then I have to fast. I hate fasting for these stupid things.

I've been trying to be better about doing my dumb physical therapy exercises. I'm supposed to do them five times a day. And given that I don't really have anything else to do, this should be easy. But they're REALLY boring. Happily, though, they don't really hurt anymore. I feel a lot less of a stretch now. For a bit, my progress wasn't improving and I was getting pretty grouchy about that. But we seem to be heading in the direction of normalcy once again. I really hope that this next surgery won't interfere with the rehabilitation of my right arm. Because this bitch has some skiing to do! (Whenever Madame La Surgeon says it's OK, of course.) I hope to make it out again in March, but we'll see what the doc says.

I finally took my bandages off a couple of days ago. Things are looking pretty good. I was really scared to look at my breast at first, in the days immediately following surgery. But now things have settled, and though I will probably never be symmetrical again, it's not too awful. From straight on, you wouldn't really notice the unevenness (unless you were looking for it). The scar will certainly give away the fact that I have had surgery. But so what? I have had surgery. My profile leaves something to be desired, but it's not that awful either. It's not like they were perfect before, anyway.

I find I still haven't regained the energy I once had. I know it hasn't been that long since I finished chemo, and recovery is a long road. But I'm becoming more and more impatient with how slowly everything moves. I want to be strong and I want to be able to run around, but I still feel so week. I've been too sedentary in the past few weeks, I think, but then again, who can blame me? Anyway, I went for walks two days in a row, and on the third day my legs and feet were aching like crazy. I'm starting to feel that "26 year old trapped in a 90 year old's body" thing. And I don't like it. I signed up for a free 6-month membership at the gym, so I hope to be getting stronger and healthier soon. Wouldn't it be amazing to come out of treatment with a better body than I had before? Dare to dream Carrie.


In other news, I finally booked my flights for the Annual Conference for Young Women Affected by Breast Cancer in Dallas, Texas. I was going to go to Austin afterwards, but truly, funds are limited. And I'm saving up to go to Circus Mexicus! Anyway, I'm really looking forward to going to this conference and meeting so many of the women who have been my online support group. Plus, it's about time I got out of town again. I also have a Roger Clyne solo show to look forward to in about two weeks.

So tomorrow is another day in this whole cancer process. Let's all hope together that we get it all this time. It helps to know that I'm not going to be alone in my suffering... my darling online friends Catherine and Jen will be doing their own treatment things tomorrow too. It's terrible to think there are more 20-somethings out there with breast cancer, but there are. I am not alone. And their support and emails have been really wonderful in the past months.

Let's try to check another thing off the list tomorrow. Surgery, check. Next stop, healing. And after that radiation. And then...?

And then, get a life.

Monday, February 2, 2009

Late Night Update

So it's 3:00 a.m. and I'm finally ready to go to bed. What am I doing up so late?

I am trying to do some writing therapy. When I have problems, it usually helps me to write them down. Otherwise thoughts just ping around in my head, bouncing around and making me feel nuts.

My problem tonight is that there are two people who really let me down through all of this. And sometimes I'm really angry about it. I am especially angry at one person specifically. And I don't like to be angry. I want to just let it go. But it's very difficult. I think I find it hard because neither of these people seem to think they've done anything wrong, and it's hard to forgive someone who hasn't really apologized.

(Just so we're clear, it's not anyone in my family. I'm pretty sure these two people know who they are, and I honestly doubt they read this blog anymore. They don't care.)

Anyway, I just spent the last long time writing two separate posts, which will probably never be published, addressing what these people did and why it hurt me. I hope this will help me feel better about things. Otherwise I may need a counselor. Or a bat. Just kidding.

On a lighter note, I wanted everyone to know that I'm feeling much better these days. I have come to terms with the additional surgery. Things happen and if you can't change them, don't fight them. Save your energy for the fights you can change. This is my outlook, or at least the outlook I strive to live by. It's kind of like the Serenity Prayer:

"God grant me the serenity to accept the things I cannot change; courage to change the things I can;and wisdom to know the difference. " --Reinhold Niebuhr

Anyway, I'm moving forward with life. Or I'm trying to.

Yesterday I went down to Boulder to meet up with a group of other young survivors. We ranged from 26 to 40-something. We had some dinner together and talked. It was really nice to meet some other people who have been in shoes quite similar to my own. Everyone was cool. I wore my blue wig so they'd recognize me from my online signature pictures. It ended up being a great time, and we closed down the restaurant! Hopefully we meet again.

Here's a picture one of the girls took (I hope this is OK)...

I'm the blue haired one.



I also have the Young Women Affected by Breast Cancer conference coming up at the end of the month. It's in Dallas. I may go visit Austin afterwards, or I might just come back home and get ready for radiation. Having something like this to look forward to really helps me push through the weeks upon weeks of treatment. I think the conference will be a blast, and it will be so fun to finally put some personalities and faces to the screen names I've gotten so much support from.

OK, I'm exhausted. I'm going to do my physical therapy exercises once more (only got to 4 times today... rats) and hit the hay. I just wanted everyone to know that things are looking up.

I'll get to that finish line someday.