Fear of falling

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About a week ago I had “five miles of rolling hills” on my running schedule.  I hate this workout.  Now, no one in their right mind actually enjoys running uphill, but I’d run uphill all day long if it meant I never had to run down one.  The whole time I run downhill, I have to tell myself “don’t shorten your stride, don’t brake, don’t brake, let the hill carry you.”  See, I’m really, really, scared of falling.

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There is no way I would run down this.

So last week as I was running down the hills I added additional self-talk.  “If you fall, just tuck and roll. You won’t necessarily hurt yourself again.”  And out of nowhere I hear my brain respond, “I’m not scared of hurting myself.”  I mean, what’s falling going to do, give me cancer?  So I mulled that over for a minute.  “Well if you’re not scared of hurting yourself, what are you scared of?”  Silence.  Then a few minutes later, “I’m not scared of LANDING.”

Right.  Of course.  I’m not scared of landing, I’m scared of falling.  I’m scared of not knowing what’s going to happen in between the time I lose control in mid-air and the time I regain control lying on the ground.  It always comes back to that with me, doesn’t it?

I’ve been struggling a lot lately.  I’ve been having a lot of anxiety, not related to cancer or illness, but just related to random life and work stuff.  I’ve been having panic attacks somewhat more regularly than I’m comfortable with.  So I called and got a prescription from my doctor and a referral to someone to talk to about it, and we’ll see if that helps.  Because ever since I was diagnosed, I feel like I’m on the precipice of falling, that I’m teetering and could lose control at any minute and that I won’t know what to do next.

I don’t know what’s going to happen with that. But once again recognizing the problem helps to solve it.  Sunday I ran the Rock n Roll Dallas half-marathon 5 minutes slower than I did 2 years ago, which I was really bummed about.  It’s a really hilly course (I know – Dallas – but seriously, it’s more hilly  than the half I ran in Seattle).  My time may not have been what I wanted, but I have to tell you, when I got to those downhills, I flew.

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Car talk

Yesterday a post popped up in my Facebook feed informing me that 8 years ago I had purchased a 2 year old Saab.  I got a really good deal on it and I loved that car.  I don’t drive very much, so it only had about 60,000 miles on it at the end of last year.

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Nonetheless, I had started to think about getting a new car in the fall of 2016.  It was starting to have small problems, and fixing an 8 year old Saab was getting pretty expensive since they no longer made parts for it.  Then I was diagnosed with cancer.  Car buying was the last thing on my mind until I got in an accident on the way home from my first meeting with my surgical oncologist.  I was sure it was totaled (remember, 8 year old Saab – no replacement parts).  To my surprise, my insurance company disagreed and thanks to my friend who owns Twisted Wrench, the car was fixed and looked better than the day I bought it.

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Seriously, like the day you find out your cancer is stage 3 and aggressive and you need a mastectomy isn’t bad enough.

Honestly, although I think my insurance company paid more than the car was worth to fix it (but thanks, USAA!  You’re the best!), I was so happy I didn’t have to buy a new car in the middle of everything else that was going on at the time.  Dealing with the repairs around the time of my surgery was bad enough.  And since it looked like new I was totally happy to keep driving it for another year.  But after my final two surgeries in December, I was once again faced with the reality that I was driving a (now) ten year old Saab and if something big went wrong with it, it would be very expensive to fix.

Why am I telling you all of this?  I guess because I was surprised how scared I was to buy a car.  In the past, I wanted or needed a new car and I went to the dealership and bought one. I didn’t even really haggle all that much.  This time I spent a solid month getting offers on the Saab and looking for EXACTLY the car I wanted and refusing to pay for a navigation system or LED headlights.

But even before I got to that point, I worried about getting the car I really wanted.  Wouldn’t it make more sense to buy a basic Ford or a Chevy or a Honda?  Or a used car?  Or to pay cash for it?  (As is, I put a ton down on it so my payments would be low enough to make me comfortable.)  It’s not that I can’t afford the car.  It’s not that I have any reason to think my job is in jeopardy or that I couldn’t get another job if I wanted or needed to.

No, I finally realized what my problem was the night I asked my husband, “but what if my cancer comes back? What if I can’t work any more and have to go on social security?”  He looked at me blankly.  “Why would you think that would happen?  And if it did happen wouldn’t your car payment be the least of our worries?”  Well, yeah.  Once I said the fear out loud, it dissipated in the light of day.  I have to remember that.  When I’m scared, or sad, or having a pity party – what’s the cause of it?  And who can I talk to about it to make it go away?  (Or, can I journal about it on my blog?)

I’m glad to say that my worries about the car did indeed go away and I am now the very happy owner of a 2018 Cadillac XT5.  Take that, cancer.26056142_10211269269507049_1137633804363924647_n

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An ode to lists

I’m a list person.  I still keep a handwritten calendar with a list of things to do on it that I either check off or put an X next to if I don’t get them done that day (I know, I’m very, very cool.)

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My husband says “wow, you do a lot every day.”  Truth:  I include things like “fold laundry” and “email so and so about that thing.”  

Similarly, when we are getting ready to go on a vacation, I make a packing list. I’ve probably been doing this for 20 years, at least, and I have a folder full of old handwritten packing lists in a folder in the filing cabinet (you know, in case we go to that place again on another vacation).  Now I’ve slightly modernized this system by keeping packing lists in Word – I have a master packing list but still save all my old ones by location.

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Yes, like I said, I’m very, very cool.

So when we were getting ready to go to Banff, I pulled up the list from the last week-long ski vacation we went on (Breckenridge with my sister’s family 2 years ago).  We drove that time, so I took off most of the liquor and food on that list, but there was still something wrong with it.  It took me the better part of the day to realize what it was.

That packing list was pre-cancer.  See, there’s a whole bunch of stuff I have to take on trips now that I didn’t before.  The compression sleeve and glove I’m supposed to wear on the plane to help prevent lymphedema in the arm where most of my lymph nodes were removed (I actually forgot that.  Oops.)  I need to be extra sure to carry my health insurance card, of course. I also need to carry the card about my clinical trial and the warranty on my breast implants.  Just for good measure I tucked in the handwritten list I finally created (after the 18th time I was asked last year) of all the medicines and supplements I take and of every surgery I’ve ever had.

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(Not mine. I don’t have pretty pictures.)

And no more getting on the plane with just my purse and a kindle – I need a decent sized tote bag to carry my medicines. The clinical trial drug has to be in its original container (a bottle inside a box inside a bag), and then I have to carry every prescription in its original bottle to show that I do indeed have scrips for valium, ativan, hydrocodone, percoset….I rarely take any of these, but I never know when I’ll need them.  So it’s kind of like how I used to take Advil, Sudafed, and Immodium “just in case.”  Now I take all of those plus about 8 prescriptions.

Once I added all of this “cancer stuff,” my packing list was done. And I quite honestly was a little bit exhausted.

I don’t know what the point of this post is, except that even when you least expect it, life has a way of whacking you in the head and reminding you that your life has changed after cancer.  It’s not necessarily bad or good — it’s just different. (I know, “the new normal.” I still hate that phrase and am looking for a different one.)

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MRI

During treatment last year, I had a couple of really bad headaches — high fevers, vomiting, and pain behind my eyes so bad I couldn’t bear to look at anything.  While my oncologist and I both figured that these were a side effect of treatment and of me overdoing things, she recommended we get a brain MRI just to be sure and to have a baseline in case of any future issues (I also have a history of headaches, and in fact had an MRI four years ago which was all clear).  The only problem was that as of this summer, I still had tissue expanders that contained metal, and an MRI would have pulled them right out of my body.  I figured neither my plastic surgeon nor I would appreciate that, so we delayed the MRI.  I could have gotten a CT scan, but I’m allergic to CT contrast and so getting one of those requires steroids and Benadryl in advance.  Not worth it.

One reason we didn’t think anything was going on in my brain and there was no rush to scan me is that my headaches come and go.  If there’s a tumor or anything else in your brain, apparently the headache is going to be constant at best and more likely worsen over time.  Still, because I had maxed out my co-payments on insurance this year, we decided to do the MRI after my exchange surgery  in mid-December just to be sure.

I fully expected the call to say “your MRI came back all clear,” and it ALMOST did, but then they said “there is a 2 mm nodule that we don’t think much of.”  Of course I needed to know why they didn’t think much of it, so I made an appointment with my oncologist to review the scans and the report.  The “nodule” is in an area where a solitary tumor would be unlikely to develop, and it’s so small that neither of us could even see what the radiologist saw.  Then again, that’s why he’s the radiologist and we’re not.  So, the plan is to do a follow-up MRI in 12 weeks just to be sure it hasn’t grown or anything like that.  Otherwise, it’s not something we need to worry about.  The nodule is also too small to be causing my headaches so it’s just one of those random things.

Interestingly (to me),  treatment for my type of breast cancer no longer calls for these kind of scans as a regular follow-up once your active treatment is over.  My doctor says it’s because it causes patients unnecessary anxiety and that any return of the cancer would cause symptoms as soon as they could see it on a scan anyway.  While I suspect that insurance companies have something to do with this change in “standard protocol,” I suppose I can see the wisdom in it.  My oncologist said she will get a scan approved any time I think I want one, so we’ll see.  I’m still slightly uncomfortable not getting completely checked out every year, but I’m glad they’re keeping an eye on my brain for now.

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Badass no more?

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When I was diagnosed with stage 3 breast cancer and decided to announce that on Facebook, I also started using the hashtag “team badass.” One of the terrible things about my diagnosis was knowing that other people would worry about me.  The knowledge of that broke my heart.  I didn’t want people to worry about me, and I could only imagine their fear.  My husband.  My mom and my dad.  My sister.  My friends who had gone through cancer.  My friends who had known Angi.  I remembered how that felt, and so I reminded you all how tough I was by deciding on the moniker “team badass.”

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Me and Wonder Woman, badasses. Right?

And I also wanted to remind myself who I was.  A year of treatment?  Fine.  I was going to put my head down and badass my way through it.  Surgery.  Chemo.  Radiation.  Two more surgeries?  Extra biopsies and scans?  Bring it on.  I was going to keep working full time and being tough on opposing counsel and, you know what, I was going to train for a marathon too.  And I did.  And now all of the treatment and surgeries are over, and so I figured I’d go right back to being my normal badass self.

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I had no idea how round my face was from the steroids.  But still wearing my badass head protector!

I mean, I had heard about “the new normal.”  And I even understood at some level that physically I wouldn’t be 100% right away, and that mentally I might still be a little foggy.

But here’s what I didn’t understand:  I’m emotionally raw.  I’m aware of my vulnerability in a way I wasn’t before.  For the past year, I’ve been given so much grace and so much love and at some level I’m afraid that all of that is going to be taken away.  That people are tired of me and my “cancer journey.”  That my co-workers are sick of me being out of the office or being too fatigued to stay late.  That my friends and family are tired of doing things for me.  And more, that my wanting those things — wanting love and grace and people to take care of me — means I’m not such a badass after all.

But you know, I didn’t use the hashtag “badass” on that first Facebook post, or on my subsequent posts about cancer.  It’s always been “team badass.”  I don’t know why I did that, but maybe there’s a lesson in it for me. Maybe it’s okay to need other people, to lean on my family, to allow my friends to support me, and even to ask opposing counsel for an extension of time when I need one.  Maybe keeping my team around me is in fact the most badass choice of all. #teambadass

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The “last” surgery – boobs!

I put last in quotations because I don’t want to jinx it — at this point, who knows?  But 360 days after my first cancer related surgery, the sentinel lymph node biopsy, it was time for my last one:  reconstruction of my breasts.  From most people’s perspective, this should have been a fun surgery.  I don’t want to even tell you how many comments I got about a “free boob job” or to “make sure I picked good ones.” (Let’s put aside that surgery is never “fun.”)

Luckily, I also had friends who had been through this before and let me know that it doesn’t work like that:  you most likely don’t get porn star boobs after cancer.  Reconstructive surgery is totally different than augmentation — with augmentation, you have something there, you’re just adding to it.  In my case, I don’t even have nipples, let alone breast tissue.  You might also recall that there was a lot of worry about my skin and how thin it was – it could only stretch so far.  We did make the decision at the beginning of the process to put the implants over the pectoral muscle – my plastic surgeon, Dr K, said most of his patients who are active, like me, are unhappy with the movement of the implants when they go under the muscle.  He said they would shift around every time I lifted weights, and I definitely didn’t want that.

So there were still a bunch of options though – round versus teardrop versus saline versus silicone versus smooth versus textured, and that’s not even mentioning size.  But again, a lot of this was out of my hands because we had to deal with the skin I had and how much it was able to stretch, as well as my somewhat unlucky combination of a wide ribcage and a short torso. My plastic surgeon, Dr. K, told me he was going to take in two different implants and see which one worked the best.  A Christmas surprise!

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Textured round on the left, smooth on the right.

Well, he ended up taking and trying FOUR different implants before settling on what are called “gummy bear” implants:  teardrop shaped, textured, silicone.  He said the round ones he tried were up to my collarbone, so while they would have given me better projection (read: a bigger rack), they would have made me look heavy and dumpy and the skin distortion would have been visible under a v-necked shirt.  I ended up with 690cc in each implant, and they come with a ten year warranty which for some reason makes me laugh.

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These are the kind I ended up with.  I don’t know if life is more beautiful, but hopefully I am?

The surgery itself wasn’t terrible, but it was still surgery.  A week out I’m still pretty sore and nowhere near ready to start running again (Dr K said a week to a week and a half, so maybe I’m just a wimp). I have been able to walk a bit and I’m almost off pain pills, but not entirely.  The incisions are tender and the implants are kind of achy.  I also had my port out at the same time, which is another incision but not really bothering me. I do have a little extra soreness on my left (cancer) side, where Dr. K said he broke up some scar tissue probably from the lymph node dissection.

So how do they look?  Well, I don’t know.  I hated them at first, and now I think they look okay.  You really aren’t supposed to judge for at least three months, so I’ll see what Dr. K has to say at my follow up.  I’m disinclined to make any changes for at least a year anyway — I want to lose some more weight, they need to settle and the swelling needs to go down, and I need to just get used to them.  It’s pretty common for people to be unhappy with their appearance immediately after cosmetic or reconstructive surgery — after my breast reduction and lift, I actually cried the first time I looked in the mirror.  It’s just weird to see yourself looking totally different than you are used to.  This time, I guess I kind of understand “you get what you get.”  I still have 100% confidence in Dr. K and that however these end up will be the best he could do in the circumstances.

And with that, I’m done with the planned “year o’ cancer.”  Although, it turns out that it’s not that easy to jump back into your previous life.  More on that in my next post!

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Ovaries schmovaries

(Don’t worry, this will be a picture-free post.)

When my oncologist agreed with my Google-assisted suggestion that the hormone suppressing medicine they give post-menopausal women works better than the medicine  they give pre-menopausal women for my particular brand of breast cancer, the obvious question was the best way to either put or keep me in menopause.  Chemo had put me into what they call “chemo-pause,” but a lot of women’s ovaries start up again after chemo is over.  I suggested that surely at my age (48) I had to at least be really close, but she said based on family history and medical background she would guess I had at least seven more years left before I would have naturally gone into menopause.  The medicine they give post-menopausal women, which are called aromatase inhibitors, flat don’t work in pre-menopausal women whose ovaries are working.  So we needed to be sure mine were turned off.

The first option was to have a shot to suppress my ovaries.  This wasn’t a good choice in my mind for two reasons:  one, my doctor said they still couldn’t be sure it would work and even if it did we would never know when I entered menopause naturally (so we wouldn’t know when we could stop the shots) and two, the shot would require me to go see my oncologist every month for the next 7-10 years.  I like my oncologist, but I spend enough time there.

The other option was to have a bilateral salpingo oophorectomy, which is a pretty fancy sounding way to say they would surgically remove my ovaries and my Fallopian tubes.  Clearly, at my age, I’m not using them anyway, so I chose that option immediately.  Also, even though they don’t think there’s a link between ovarian cancer and breast cancer in the absence of the BRCA gene, it does remove the possibility that I’ll ever get ovarian cancer.  My oncologist told me there was no real rush, but she wanted me to do it this year. (Me too, for insurance reasons.)  I had to wait until treatment was over, and due to down time wanted to wait until after the marathon and the half-marathon I had already planned.  But I needed to fit it in before the exchange surgery I also wanted to do this year.

So, two weeks after Wine and Dine, we checked in for a day surgery at the same hospital where I’ve had all of my treatment so far.  I’ve had the same gynecologist since moving back to Dallas, but she hadn’t seen Tony since the last time she performed surgery on me almost 15 years ago, so we caught up over a little chit-chat. Then she told us what would happen and left while they prepped me for the OR.  Luckily everything ran on time and we were able to start at 12:30 as scheduled.

Afterwards, she told me I was a “model patient” and that everything looked great.  There was a small cyst on one of my Fallopian tubes, but she said that was normal.  I found out today that the pathology report came back clear for all of the removed parts, so while I wasn’t really worried, that was good news.  There was one issue with the surgery from my perspective though: I woke up from anesthesia wide awake, not groggy, still in the OR, freezing cold and in a ton of pain. My doctor had warned me that I would probably wake up with a severe hot flash, so I was glad that didn’t happen, but wow that really hurt.  The anesthesiologist even told me “sorry about the pain, but you woke up a lot faster than I thought you would!”  They gave me demerol and morphine until the pain eased up.  Still, that was weird and I will be discussing it with my next anesthesiologist.

Compared to everything else that’s happened, for anyone who might be facing this surgery, it was really pretty minor.  Three tiny incisions that are healed over already.  I was cleared to run up to a mile today, two weeks after surgery, and I could have been back to work within a week to 10 days if not for Thanksgiving and the medical appointments I’ve had all this week.  The hardest thing has been that I have been very, very moody.  Part of that is probably coming off of pain pills and part of it is not being able to work out, but some of it is the change in hormones.  My doctor says it should even out within a few weeks — whether or not that means I even out to being a jerk all the time remains to be seen!

Next up — the surgery I hope finishes my breast cancer treatment!

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