In Your Dreams

Damn. There I go, counting my chickens before they hatch, again.

This was the plan:

Do radiation, or not-- the rest of the plan was the main focus anyway. For the next 3-4 months, rebuild my body to resemble former self. I was going to achieve this by mostly strength training with little cardio (I want to have my muscles back but can't lose much fat from my abdomen as it is needed to make a left breast mound in reconstruction), getting back to my high-fiber, high-iron veggieful diet to assist in rebuilding my white blood cell count, and skiing my ass off as I very well should.
I figured that with a little luck, I could be ready for reconstructive surgery by late January (I was planning on recovering levels faster than their projections as has been my usual throughout treatment) and be all healed up and ready for a normal summer job, something that got me back into my passions and had a splash of adventure to it, like going back to guiding, maybe going to Alaska to work for GOAK or doing an internship in Ecuador, or something. I had also been fantasizing for months about being able to kick my own ass going through the Insanity Challenge and become the most fit I've ever been and be in my physical prime at age 25. Then back to school in the fall-- YEAH!!

Oh how I loved that plan. Too bad.

This is the reality:

Radiation is still completely up in the air. Because of my age, my radiologist was reluctant to give a solid suggestion either for or against. There is always a chance of a second, localized occurrence, meaning I would get cancer again in my left breast tissue or the like, underneath my newly reconstructed breast. That could happen at any point in my life and is the reason why I would undergo radiation in the first place, in the hopes of preventing it. I am at higher risk for a second occurrence because I am HER2 positive (most aggressive form of breast cancer I could have), as well as estrogen and progesterone receptor positive, and I had node-positive cancer (even though I was only positive in 2 out of 21 lymph nodes, it stills ups the ante), and one of my nodes had mutated a little bit, changing shape and extending out into the surrounding tissue, which is apparently not a good thing.
Radiation can also cause cancer, thyroid or throat cancer being most likely because of the area they will be radiating, but it could come back as any kind of cancer as the cells gradually mutate over time. Normally, people who develop a second malignancy (radiation induced cancer) develop it 20-30 years down the road. This is why, when it comes to a patient in their 60's or 70's, radiation is much more readily suggested-- in 20-30 years, this person may not care so much about getting cancer again. But for me, that would place me in my 40's-50's, yet again battling cancer.
There is a breast conference of some sort going on for physicians in SLC right now. My radiologist is going to present my case before a board there and gather multiple opinions. This was excellent news! Not only do I get a second opinion, but a third, fourth and so on from some of the leading physicians in the country, all free!! That part, at least, is awesome.

Radiation aside, reconstruction does not quite look like what I thought it would. Dr. Chen thinks I may be ready for reconstruction in late January, provided I don't go through radiation. She also told me that, no, I would not be doing reconstruction in one surgery, but possibly several. First, I would do the tummy-tuck and creation of the left breast mound. This surgery will take 6 hours. It also does not include any work on the right breast. This was news to me. Although it had never been discussed, I assumed that I would get the left breast rebuilt and the right one lifted and reshaped all in one surgery. While this is possible, it's highly dangerous because the right breast work will take a couple of hours and potential complications with circulation are a big deal.
She has to cut through blood vessels on my tummy and sew them into blood vessels in my left breast area. If, for whatever reason, the tissue does not take and receive adequate blood supply after the surgery, the tissue will die. She will cut off all of the work she just did, leaving me flat chested and flat stomached, I'll recover for a few months, and then we'll reformulate a plan from there. Options for reconstructing a breast at that point would include taking a skin flap from the flank of my ass or my back, over one of my latisimus dorsi. All of these quite unpleasant and frightening outcomes are the reason she is reluctant to tack on that extra two hours during the surgery-- it allows that much more time for something to go wrong.

Directly after the surgery, I will stay in the hospital for three days so that she can monitor my circulation, looking for contusion or necrosis (I cannot explain how effing terrifying it is to imagine a half-moon shaped section of skin on my new breast growing grey and dying before my eyes). I will have three drains after this surgery, one out of the side of the breast like before and two out of an area of my selection for the abdominal incision. I can have the drains come out on the sides of the incision on my hips, but that could pucker the ends of my hip-to-hip scar and make them look like little dog ears, or I could have them come out of the pubic mound. She says most women go with the pubic area because you can easily hide the vampire-bite-like scars with pubic hair. Not too sure I'm into that.
The right breast won't come into play until at least 3 months after the first reconstructive surgery, when all of the swelling and settling has finished with the left breast. She will then lift and shape the right to match the left. And, again, I'll have 1-2 more drains coming out of the right side for another 2-6 weeks. Then, when the right side is all healed up (another 3 months), she'll create a nipple for the left side to match where the right has settled. I also have the option of having the created nipple tattooed to match the areola of the right side, but I don't know if I want that yet. Depending on how the left ends up looking, I was just going to cover the whole damn thing with a huge tattoo...so....yeah....we'll see. Btw, this is not the tattoo I want, it's just to give you an idea.


I'm frustrated with myself for making plans that I'm now having a hard time letting go of. It's my own fault, really-- that's what I get for assuming. Oddly, I'm not upset about the prospect of getting another 3 surgeries, making it 7 major surgeries in the span of a year. I'm sad about not being able to get back into shape and prove to myself that I can still be as strong as I ever was, if not stronger.
It's been difficult for me to watch as my body becomes softer and softer, wider and doughier. I know that I'm still stronger than most women who work out regularly. I know that, even if I worked out steadily for 3 weeks, I could still ski, row, climb and hike at almost the capacity I was managing pre-cancer. And yet, I do not feel as strong as I used to. I feel like a patient.
Being a patient brings on feels of obligation, disappointment, uncertainty, anxiety, apathy, frustration and sadness, and I'm slowly becoming tired of it. I miss feeling like me: strong, confident, funny, intelligent, beautiful and, in some ways, unstoppable. I still believe I am all those things (except perhaps unstoppable considering I'm quite thoroughly on pause), but there are some days that I just don't feel it like I used to, you know? That's the worst part about being a patient: losing my sense of identity in the wash of it all.

However, I have gained more than I've lost as far as beliefs about myself go. I am happy with how I've handled diagnosis and treatment, I've tried hard to stay level-headed and objective (as weird as that is) and I think I've done well with that. I'm also happy with what I've been able to do for others just by doing for myself; I'm not sure if people are just being nice when they say that I inspire them, but it seems sincere in most cases and the cases are many. Overall, I think that given what I was given, I've done far more than I could have done with it and I've taken care of my Pilsbury little self and kept quite happy through surrounding myself with friends, continually learning new skills or honing old ones, and exercising when and how I could.

But it doesn't feel like enough. I want to be free.


Blah....I just read over all I have written and I'm somewhat disappointed with myself. I wanted to not complain about my situation, as much as I could muster-- I often don't like when people do that. I only just came back from my doctor's appointment, so it makes sense that I'd be stewing about the insignificant....but it felt more than momentary, that's why I thought it deserved to be written. The truth of it is, I'm still a lucky, happy little duck with so many great things going for me: I'm just readjusting my plans.

On a much, much more inspiring note: it just snowed 8 inches at Alta with another 2-4 expected by Wednesday evening. I also have a Solitude pass, just Tuesdays so far but I have big plans of adding days. I just sold my car to Sean and had originally planned to hack off a huge chunk of a bill, then buy a bicycle so I can still get around. Now I'm thinking, forget the bike til spring and spend that extra on Monday, Wednesday and Thursday at Solitude. I mean, they open on Friday, and I do so love near-instant gratification.... :D

Hope you are all enjoying the weather, if you're lucky enough to have it.
Love.

Sometimes, there's just no way to hold back the river

A somewhat bedraggled, possibly intoxicated woman sat across from me on the bus the other day. She asked me why I was bald. I replied, "I have breast cancer." And she said, "Oh, I'm sorry."

I wanted to say, "Why? It has nothing to do with you," or "Thanks," or "What a strange thing to say." I wanted to say that I see hundreds of people everyday seemingly living their lives numb, rarely seeing each day as the remarkable opportunity it is-- an opportunity to experience life with richness and passion. I wanted to say that since diagnosis, every symptom-free moment I experience is a delight, every day that I can walk or run or laugh or sing is a truly amazing gift that brings light to my eyes. I wanted to tell her how when I go into the mountains now, I see beauty, feel ambition and smell freedom-- I'm overwhelmed by my own fortune. I wanted to say that because of cancer I am happier, fuller, more aware and more alive than I have ever been, and that she can save her sorry for someone who needs it.

Instead, I said, "Don't worry about it," smiled and looked out the window.



My last treatment was as close to fun as chemo can be. Sean had to work so I went in all on my lonesome. I wore a long hot pink wig, a sassy short skirt and 5-inch black heels that resounded confidence from the cold, clean linoleum to the sterile, beige walls. I smiled big and bright to everyone I saw, although that was nothing out of the usual. Even though I was being pumped full of room temperature liquid, I felt warm and happy. When I was done, I sashayed to the end of the rows of chairs, up to the bell and rang it long and triumphant, signaling that this was, in fact, my last treatment. Nurses and patients alike cheered and applauded, waving in my direction as I walked out happy as could be.

Life since has been just as satisfying. I went out that evening to Poplar and Oh Shucks to enjoy a 36 oz schooner or two. Nothing big, just a nice hurrah! with close friends; the pink wig came along for the ride. It's quite enjoyable to watch how people look at you when you wear such an audacious wig: expressions ranged from admiring to annoyed, curious to contemptuous, attracted to apathetic. Funny how such a simple thing can provoke so much judgment.
No other folderol has occurred on by behalf, although that's not to say none will. I would still like to hold a fundraiser at some point, but who really knows? I'm awful at putting such things together for myself, it just seems bizarrely self-promoting and desperate.

I have, however, been getting out and about as much as possible in celebration of my burgeoning health. I attended a wonderful No Pants Party held by my friend Katie to celebrate her moving into her new home. I saw just about every friend from my college days who still lives in SLC and received congratulations from all. It had been a while since I'd been Designated Driver and I thoroughly enjoyed it. I laughed my ass off at Sean's roommate playing Wii Boxing dressed as a Chippendale in naught but boxer briefs and a bowtie, and the numerous keg stands in knickers. It was so good to see everyone again, especially the weekend after kicking chemo to the curb. Couldn't have asked for better timing, really.

We had our first major snow storm of the season on October 24th and 25th. It snowed over 2 feet in 2 days at Alta and had all of the powderhounds going nuts. I wasn't feeling up to hiking up Collins and getting first tracks on Baldy shoulder just yet, but I wasn't about to let a beautiful storm such as this slip by without my noticing. So I decided to take a nice solo hike up Bells Canyon.
I had never been up Bells, just looked into it from the reservoir, and it was the epitome of beauty covered in fresh snow. I started the hike late in the day and only had 3 hours or so to meander around and explore trails to my hearts content, but I feel I saw a lot of the canyon. I got up to the middle tower before the tracks in the snow ahead of me disappeared: it would seem that the person setting the boot pack up until then had chosen that moment to turn around. I continued on for an hour or so, taking my time and lots of pictures, deeply breathing in that crisp mountain air I so cherish. It felt freeing and almost as though I was accomplishing something-- the culmination of all my trials leading to a moment of astounding perfection and power, I suppose. I can't really describe in any way that would give it justice, but suffice it to say that on that day, during that particular hike, I felt the strongest, luckiest and most content with my life than I had in months, and my oh my did it feel good.

The hike reminded me of this quote from The River Why by David James Duncan:

"And so I learned what solitude really was. It was raw material-- awesome, malleable, older than men or worlds or water. And it was merciless-- for it let a man become precisely what he alone made of himself. One needed either wisdom or tree-bark insensitivity to confront such a fearsome freedom. "


I also went up to the Goldminer's Daughter a couple nights and enjoyed the quality company of Carle, TJ and the slow trickle of returning characters. My latest evening there, I had the pleasure of seeing Y'Olde Burns, Carle, Rigoberto, Liz Page, McEwen, Teej, Rex, Trainer and Licorice!! I mean, good God!, could it get any better? Yes it can. They'll all be back soon, all my beloved besties from my days of living at Alta, each one with a special place in my heart.
I really am lucky to have a place (let alone a breathtaking ski lodge located at the base of a world-renowned ski resort) that I can visit and feel right at home. I don't think a lot of people have that and I appreciate every moment of it.
The morning after one of my evenings there, Carle, Burns, TJ, Rex and I went down to Library Square to attend the live broadcasting of the Rally for Sanity And/Or Fear in DC. It was lots of laughs and I had a great time wandering about looking at people's costumes and clever signs. Well, honestly, some of them weren't that clever, but they were a joy anyway.

While at the rally, I got a call from Sean inviting me to go down to the Diamond Fork hot springs with he and Jeff Story, and I gladly accepted. It started to rain as we were driving through Provo, but that didn't really matter to any of us. In my opinion, camping in adverse weather is almost better when it comes to popular sites like the springs; I have more than enough gear for anything short of a hurricane and it tends to weed out folks who I don't want to be sitting naked in a pool with anyway. People who shoot off firecrackers in the middle of the night, break beer bottles against rocks because they think it's funny, litter into the stream or at the campsites, break branches off the trees to use as firewood, or leave your nasty cigarette butts floating in the water. Straight to hell with all of you people.
Anyway, we had a wonderful day/evening there. Because it was the Saturday before Halloween, it wasn't very busy. I'm sure the weather played a factor, but it seemed as though most folks had somewhere else to be, leaving the upper springs to the three of us. We set up our tents before heading up, then relaxed in the pools for a couple hours, enjoying the feel of the cool raindrops splashing off of our heads and running down our necks as we sat in the luxuriously warm water. We went back down to eat dinner, then Story and Sean went up for an evening dip as I turned in early. I'm still quite anemic, my levels being their lowest, and sleep continues to play a leading role in my life.
I love waking up in a tent, it's such a wonderful pastime, especially in my lovely Mountain 25 after living in it for a summer. Every night I've spent in it since has been reminiscent of Alaskan summer evenings, struggling to fall asleep in the 2 AM sunshine inside of my little yellow lantern of a home. Ah, memories...

I find out about radiation this Friday and everything else will fall into place after that, including recovery times, projected time for reconstruction, etc. I can't wait!! For now, I'll keep going in for Herceptin every three weeks and building my cell levels through diet, exercise and rest. Not a bad plan. :)