Determining My Fate

I met with my oncologist this morning for the first time since all my surgeries were completed and pathology report in. Since they had discovered "fallopian cancer" (although it was precancerous cells, it's still considered cancer), I waited for Dr. Kay to determine whether I had to face another bout of chemo or not. My future was in her hands.

With cancer, your future is always in the oncologist's hands. Period. Not the surgeons. Not the radiologists. Solely, the oncologist. Remember that.

First, I would like to point out that after umpteen times I had to starve myself before tests and surgery, and all the times I went without sustenance following surgery, and all the times I released my food via mouth (if you know what I mean) and all the time I wasn't hungry...I STILL DID NOT LOSE A SINGLE POUND THROUGH THIS ENTIRE ORDEAL!!! You would think that an ovary or two would weigh something...

So, that got me off in a bad mood this morning at the doctor's office. Then, there was over a 2-hour wait...

Finally, when I saw Dr. Kay, I was--as the saying goes--"fit to be tied." However, my frustration over my weight and wait eased substantially when I remembered that this woman, alone, had saved my life. If she had not pushed for BRCA testing, I would have been walking around with fallopian tube cancer developing...and would never have known it. And it would not have had a happy ending. I thanked her for saving my life a 2nd time. She smiled.

She told me that of all her BRCA patients, 100 percent (yes, every single one of us) had cancer developing on the exact spot on our fallopian tubes! I'm sure they will be looking more closely at that phenomenon in the future.

She also said that since I'm still only 7 years out from my breast cancer, I would still need to see her every 6 months for a blood test -- plus, an annual chest x-ray, bone density scan and an MRI for my breasts (since mammogram is no longer necessary) and a blood test for ovarian cancer (for the cells in that area).

I'm still susceptible for cancer developing in my body because of my original cancer -- plus, BRCA carriers are more vulnerable towards other types of cancer besides breast & ovarian, such as pancreatic (oh, goody).

Although this was disheartening news, on the upside, Dr. Kay said my chances of developing breast or ovarian cancer were 5 percent - significantly low.

It's a good news, bad news sort of thing. I've beaten cancer and an early death twice, as I turn 50 this year. At the same time, cancer will always be a phantom hovering over me.

But, I can accept that as my fate. I know I am mortal and I will die of something eventually. And, I'm truly grateful for being able to live this long.

And, for the time being, I don't have to face chemo again. Now, that is reason enough to pop the champagne cork -- except that champagne has calories and now I must concentrate on moving the scales in the opposite direction.

Wine & Whine

About once a month, I meet with a couple of friends, and we vent and rant about what's on our minds. We're a safe outlet to share our fears and frustrations about all that the issues we're facing in midlife. Since we cluster around food & drink and talk nonstop into the night, we thought it was fitting to call our gathering, "Wine & Whine." While some find value in book clubs, we find meaning in whining.

Naturally, all conversations are strictly private, so I won't share any details. However, the one common denominator is how much we've all endured by the time we've reached the age we are now. Our journey has not always led us down a yellow brick road to the Emerald City where all wishes are granted. We are no longer wide-eyed, innocent Dorothy's, who triumph over the Wicked Witch. Life is a little more complicated than that.

I will tell you that since Gary & I have been married (8 years), we have navigated through financial hits, career crises, elderly parents with debilitating illnesses, extended family concerns...and then there's cancer added to the mix. (Not to mention Atlanta traffic, but that's another rant altogether.)

It's all we've been able to do to keep our heads above water.

So, as much as I celebrate the good news of being "cancer free" now, I'm waiting for the next trauma to deal with...you could say my nerves are shot.

They call this Post Traumatic Stress Disorder (PTSD), which, like Wine & Whine, is a perfect descriptor.

After I came home from my second surgery, a friend gave me "In An Instant" by Lee Woodruff. Lee is the wife of ABC news anchor, Bob Woodruff, who suffered a critical brain injury from an explosive device while reporting the war in Iraq.

Her book totally engaged me, as I read with interest and empathy. Although Bob's head injury was severe, Lee had endured many tragedies in adulthood: She had lost a child, uprooted multiple times during her marriage, discovered one of her daughters was deaf, had a sister with a brain tumor and faced the possibility, herself, of having cancer.

She writes: "The more trauma a person has been through, the more they have seen, the worse the PTSD is. The cumulative effect appears to make the person much more susceptible."

She goes on to share how the horrific experience with her husband's slow recovery affected her: "I had morphed from a confident wife and parent into a woman fearful of everything, especially of my kids getting hurt...I saw potential head injuries everywhere. Even driving my car felt scary now. All I ever seemed to say as a mother was, 'Don't do that, stop it, be careful there.' I had become a coiled spring, waiting for the next injury or accident."

She admits, after the crisis was over and her husband was on the road to recovery: "A tiny part of me keeps waiting for a shoe to drop, for something bad to happen. When Bob doesn't answer me from another room after a few beats, I walk in to check on him. When he doesn't return from the store in a reasonable time, I make a call. These are my battle scars."

Amen, Sister! Can I ever relate! When I finished cancer treatment and began resuming a "normal life" again, I worried constantly about those I loved dying. I worried that Gary would have a car wreck on the way to the office, or his plane would crash on a business trip. (I even left his messages on voice-mail until he arrived safely home, in case that was the last time I heard his voice.)

If I had trouble reaching my parents, I imagined they were lying on the floor suffering a heart attack. Death had become a real possibility, and I realized we were all hanging onto life by a thread -- that any of us could be taken out at any moment. I didn't rest.

Although I've calmed down a little bit, I'm still on edge when it comes to my loved ones' safety. And, from time to time, I picture scenarios of potential future problems, so I can devise a plan of action -- just in case.

The one thing that helps calm me is knowing deep down that I can rise to a challenge and all that it entails. I know this because of my experience with cancer and facing my own mortality. I'm stronger than I ever realized.

Lee Woodruff makes a great point in view of her sufferings: "The moments that define us, that strip us down to raw bone and cartilage and build us back up: they are the tough ones. They are the stories of grief or tragedy, stories tinged with sadness and sorrow...I believe how we attack those curve balls is the stuff of life; they count just as much as the good times...

"And so, we have to choose to laugh and to keep smiling. We have to hope that there is always something better around the corner. We doubt our ability to rise to meet hardship, and we do everything in our power to avoid it. We have to dig down, to believe unfailingly in the ability of the human spirit to triumph in ways we didn't think possible. To make the choice to be resilient, ultimately to bounce back, is to make the choice to be grateful, as grateful as possible for the cards you've been dealt."

I might have to invite Lee Woodruff to join our Wine & Whine group.

Caring for Mom

Breast cancer, as you can imagine, isn't just a disease of the victim. It affects everyone who is connected to your life, especially your family.

Of course, my husband was greatly impacted, and obsessively worried about losing me.

But the toll on my parents is what broke my heart. What do you do when your child is sick and you can't make her better? Parents think they're supposed to cure all ills and remove all pain, and when they can't, it's torture. This was the case with my parents as I observed their grief and fear over me.

Right after it was discovered that I carried the BRCA gene, Mom & Dad were over at my house for Christmas Eve dinner. Mom was acting strange, so I pulled her aside and asked to speak to her in private.

She broke down hugged me tightly: "This shouldn't be happening to you...I'm the one who should die first, not you!"

Well, first of all, no one was talking about dying...at least, yet. I was researching surgery options at that point, not caskets and funeral arrangements.

But, I understood what she was saying. She was terrified of losing me...and all mothers take a solemn oath before they deliver their first child that they'll do everything in their power to make sure their children outlive them. That's just the way it should be, according to moms everywhere. Unfortunately, that's not always the way it turns out.

I tried to comfort her, but I knew the only thing that would reassure her would be for me to sail through these surgeries and reduce my chances of getting cancer in the future.

I realized more deeply how much my mom was suffering when she shared with me a heartbreaking email she had sent the prayer group at her church. In her anguish, she wrote:

"Julie stopped over tonight to tell us about her latest report. I can't believe she has been inundated with cancer like she has. Fortunately, the surgery was done in the nick of time since they found pre-cancerous, non-invasive cells in the tissue of the fallopian tubes. She says this was "good news" but they need to remove the uterus in 3 months down the road. I only hope this will protect her from any future cancer but who knows if it will or not?

It is very upsetting to me having brought her into this world, but now the damage has been done."

A beautiful response came from the prayer group leader, who knew the vulnerability of being a mom:

"We are keeping Julie our prayers. God, who began a good work in her, will continue it until the day He comes again! Through her healing, we will all be blessed. Hang in there. God is in control."

To my great relief, I wasn't the only one who had spectacular friends. So did Mom. Amazing, dynamic friends--with years and years of care-taking experience as moms and grandmothers.

One of Mom's best friends drove up from a beach vacation in Florida -- over a 7-hour trip--to make sure she was with Mom during my first surgery. She brought with her homemade soup and muffins. (During my second surgery, the same friend was at the hospital again with freshly baked cookies for my husband. She has earned sainthood, as far as my husband is concerned.)

Mom also received a flood of cards, calls, emails and offers to bring me food. In fact, Mom had more correspondence about my cancer than I did...which was fine with me.

When we heard the good news about my pathology report, Mom received over 50 email responses from friends and well-wishers.

People's generosity carried Mom & Dad through this nightmare than no parent should have to face--and for that, I am indebted to all the people who took time to place a call...or write a note...or say an encouraging word...or give my parents a big hug. These simple acts go a long way in getting us through the tough times in life. And when you think about it, they are actually the mightiest acts of all.

A Minor Setback

It had to happen. I was on the track toward healing when my incision tore. Yikes. Okay, so I admit I might have been overdoing it. After all, they don't want you sitting around all day because of blood clots...so what's a girl supposed to do, I ask?

But there's nothing like a hole in your abdomen to get your attention. You'd think I would have learned after my previous scare when I thought I'd caused a hernia the day after I came home from the hospital. But noooooo. Type A's don't easily grasp the concept of "slowing down to let your body heal"

It typically takes a set-back, like hernias and ripped incisions to make us take a situation seriously.

Although it may not be obvious, the body is wounded internally after such intense surgery and rearranging and requires rest and tender care.

Now if only I could remember that...

A Survivor's Purpose

I recognized her instantly. The pale, delicate complexion. The carefully wrapped headscarf. The vibrant, magenta hat the completed her outfit. She was easily identifiable. A chemo patient.

I was browsing through the bookstore when I spotted her making a purchase. Something about her demeanor tugged at me to go over and say something encouraging, like, "I've been there. You'll get through it."

But I didn't. What if I offended her by being presumptuous? What if she possessed a reserved, guarded personality that didn't freely bear her soul to others? Who was I, a stranger, to approach her and delve into her personal life? Instead, I stood silently in the background, while eavesdropping at the same time.

"How are you today?" asked the saleswoman, as she rung up the purchase and placed it in a bag.

The lady with the magenta hat shook her head forcefully. "Not well," she replied, suppressing a sob. She quickly paid for her item, grabbed her package and bolted from the store. People near the counter looked at each other silently as the door slammed. Their expressions conveyed heartfelt anguish.

I stood there ashamed. Here was an obvious cancer patient, experiencing a bad day--just like the ones that had engulfed me--and I did nothing to help. I resolved then and there, despite any awkwardness on my part, I would reach out to others like her in the future. As a survivor, it was my duty.

How many times during my own battle with cancer did I feel exasperated and discouraged, scared and angry? Days when I was embarrassed to be seen in public. Days when I was fed up with all the shots and the perpetually foul taste in my mouth. Days when treatment seemed like a never-ending process. Days when I wondered if I was going to live.

Despite their compassionate intentions, friends couldn't fully relate. People were either horrified if I made a joke about my condition, or they put me on a pedestal for enduring it all. But, I wasn't a hero; I was a mere mortal with authentic feelings.

My savior came in the form of a woman I knew who was a lung cancer survivor. Since Dee had previously walked in my steps, she knew the treacherous terrain by heart. On our long walks together, we discussed our fears and frustrations associated with cancer. She validated the imperfect thoughts I shared.

Although an impressive support network exists for cancer patients, it was an up-close, personal connection that helped me through the particularly rough spots.

This is true for all the curve balls life throws us. We need those who have already lived through our painful experience. No one else can fully comprehend the questions, fears and anger like another sufferer...whatever the particular situation. It takes one to know one.

My lowest point emotionally during treatment coincided with a dinner invitation from Dee and her husband. That day, I looked and felt horrible, and wanted to cancel. Nothing my precious husband could say convinced me to change my mind. At the last second, though, I decided to go since I would be spending time, after all, with Dee.

She answered the door looking splendid--chic haircut, stylish outfit, enviable figure--compared to me in all my frumpiness and baldness and bloating. As soon as we sat down in her living room, Dee asked matter-of-factly how I was.

"Fine," I replied, masking my misery.

Gary--who never speaks for me--intervened. He told Dee the truth, that I was having a really tough day. I was so grateful for him speaking the words I couldn't voice.

Without a word, Dee got up and left the room. We sat there in silence. A few moments, she returned with a photo album. She squeezed in between Gary and me on the sofa and flipped the album to the first page.

There she was in living color -- bald, pallid skin, grimacing at the camera. Photo after photo documented her experience with cancer. They say a picture is worth a thousand words. By giving me an intimate glimpse of her struggle, I felt understood and restored.

Now, I realize it's my turn to stand in the gap for others in need.

So when I'm approached to provide information or encouragement for someone who has been diagnosed, I realize that hanging out along the sidelines in silence is no longer an option.

Banner Day

This is where the Halleluiah chorus from Handel's "Messiah" comes in. Ready?
HALLELUIAH! HALLELUIAH!
HALLELUIAH...HALLELUIAH...
HALL-EEE-LUIAH!

My pathology report came back "clean." No cancer. Zip. Zero. I left the doctor's examining room and walked into the waiting area, where Gary was sitting. I smiled and told him the news. He got up from his chair, hugged me tightly, and broke down crying in front of everyone.

We walked out to the elevator lobby and hugged and cried some more. The news marked the end of a 7-year odyssey of living with cancer, and then living with the threat of another cancer developing. To end this chapter of my life seems surreal. I've gotten used to all the tests and doctor appointments and anxiety that accompanied it, waiting for the next cancer diagnosis. How do you return to "normal" life after all this? I'm not sure you ever do. Especially when your primary care physicians are oncologists. That's when you know you'll always be in a different category. But that's okay.

The first person I called to tell the good news was my mom, however, the phone conversation ended abruptly since I was crying so hard, I couldn't complete a sentence. With all the stress this disease has wrought on my life and Gary's, I think the people it's hit the hardest have been my parents.

I've heard the one death you never overcome is the death of your child. A parent always thinks they will die first, since that's the natural order of things. They also believe, erroneously, that they have the power to protect their child...no matter what age. I've watched the toll all of this has had on my parents, and it's been painful to watch their pain, their helplessness.

I recall last Christmas, when Mom pulled me aside and begged me, "Don't die before I do. I couldn't live if you did." Tears ran down her face. " This should be happening to me, not you. I've lived a full life, but you're too young." What do you do with that? How do you respond? I wanted to take away her agony and guilt and fear, but I was just as helpless as she was with my BRCA diagnosis. The only thing I knew to do was to take action.

And, that's my biggest advice for women who've had breast cancer or suspect they are a candidate for the BRCA gene. Take action.

Taking action has been the critical element in this entire cancer drama:

* It was because I conducted a breast self-exam that I found my lump. Even 2 mammograms two weeks later did not reveal a mass.

* It was because I forced the issue that I got further testing. And further testing revealed aggressive cancer.

* It was because I took action in selecting the very best healthcare professionals I could that I believe I got the best treatment for breast cancer.

* It was because I pursued BRCA testing last fall -- even when I had been told 7 years previously that my cancer wasn't hereditary -- that I discovered I carried the gene mutation.

* It was because I was so determined to deal with this "sooner than later" and get a double mastectomy and full hysterectomy to decrease my chances of future breast and ovarian cancer that they found pre-cancerous cells in my fallopian tubes as early as they did. Six months later, they told me, would have been a different story altogether.

Why do I tell you this? It's not because I'm such a noble person for taking action. Far from it. My natural inclination is toward procrastination. In fact, it's one of my specialities. And, I'm also not saying that taking action always gives you the perfect fairy tale ending. You may lose the battle with cancer because it's a nasty, hateful, deadly opponent that strikes witout warning, despite your best efforts.

But, your best defense is to do something. NOW. Not tomorrow. I've realized that Now can make the difference between life and death. I hope I can take this advice into other areas of my life. Wouldn't it make such a difference if I took action with all the zillions of other things I need and want to do...one day?

While sitting on the examining table, waiting FOREVER for the doctor to come in and tell me my pathology results, I prayed. I don't pray for "miracle cures" as much as I pray for courage to accept what God is leading me into and grace to walk into the future with love and compassion and gratitude instead of bitterness and self-pity and anger.

I then began praying for all the people who have cared so much and done so much for me during this entire ordeal. All the love, hugs, tears, phone calls, cards, emails, gifts, meals, car rides, doctor appointment buddies...it's so much. I've been placed on countless prayer lists in churches and small groups throughout several states.

My friends and my entire family have given enormously and sacrificially, and I feel greatly indebted. I want to be there for others in the same way people have been there for me during my darkest times. This experience has allowed me to see the power of us ministering to each other in the simple, daily routines of life. Maybe this is the most profound thing I've learned from cancer.

Other than it's nice to not be bald.

Campfire of the Vanities

You would think with a life-threatening diagnosis before me that I would be focused on the higher things in life. But, I must point out as a Southern Belle, shallowness and vanity are part of my birthright.

So while the unknown pathology results loom before me, I realize I can't do anything about staving off cancer and must bravely face the outcome. You learn when you have cancer, you simply must accept what comes your way and rise to the occasion and deal with it. Monday, I will see my surgeon who will deliver the verdict. Yes, I'm nervous to know what my future holds...but meanwhile, I have other things to obsess over.

Such as cellulite. This has been a recent fixation of mine, examining every inch of my body for lumpiness. After breast cancer treatment 7 years ago, my obsession was eyebrows -- or lack thereof. Just so you know, I had beautiful dark eyebrows, which didn't return after chemo.

None of my friends could understand my irritation; however, most of them are blondes. (Which makes me think I should re-examine my choices in friends.) I, on the otherhand, have dark hair and dark eyes, so eyebrows dramatically define your face. Think Brooke Shields.

After much whining and gnashing of teeth, I located an excellent "permanent makeup" (tatoo) artist, who crafted some exquisite brows for me.

With cancer and chemo, it's a full-time job maintaining your appearance. The loss of hair. The scarring from surgery. The lymphedema ballooning your arm at inconvenient periods. What's a girl to do, I ask you?!

Now, I know you're thinking I'm being silly and shallow in light of what's facing me. But, those traits are also what maintain your normalcy throughout a period that is anything but normal. Why can't cancer patients be as trite as everyone else?

Years ago, during my chemo days, a coworker asked how I was doing, and I replied that I was fine except for losing those darn eyebrows.

She looked at me in horror over my admission. She grabbed both my arms: "Be grateful for life!" she lectured.

Now, there's a concept! I wasn't thinking about being grateful. I left this interaction feeling guilty, but irritated that I got slapped down for being honest.

Then, I was walking with my "cancer mentor" and mentioned my anger about my browless condition.

"I know exactly how you feel!" she exclaimed. "I hated that part of chemo, too." Honesty is the best medicine.

So, while people in my situation face the reality of death (instead of some vague concept that may happen in the distant future), it's nice to know I can still take part in the same daily dramas that those without cancer relish in.

After all, Southern Belles are known for our dramatic flair as well.