Thursday, 1 December 2011

The Deep Breath Before the Plunge (from May 8th, 2008)

I have never really been sick. Ever. If I hadn't ended up with a C-section when Indiana was born, I would never have ever spent a night in the hospital. Three times in my life I have gotten a stomach bug and gotten dehydrated really quickly and gone to the emergency room. But that is all. I've never even broken a bone or had stitches. (I had staples for my C-section, which is totally weird, cuz they're actually staples)

And the thing about cancer is... you're not sick. If they hadn't told me I had cancer I wouldn't have known. I think at this point it's kind of hard to grasp the concept that anything is actually wrong. And perhaps the reason I'm handling it so well is because I don't feel like anything is wrong. And maybe all this time, deep down, I have been treating all the tests like they were to confirm the diagnosis, not to determine the extent of the diagnosis. And maybe next Thursday I will stop handling it so well. That is when I will finally have an outward indication that something is really wrong. That is when I go for surgery.

I met with the medical oncologist today. My oncologist. Dr. Attwell. One of two Doctors Attwell in this city, so I have to be very specific about it. I found out that not only is Breast Cancer in women under 35 extremely rare, but it is harder to deal with. The risk of re-occurrence is much higher and it can be more aggressive. For this reason I am getting "lots of chemotherapy." And I am getting it as soon as possible. If Dr. Attwell had his way, I would be getting it first, but I have a baby to think about, and I want the tumor gone. So I will get surgery, then 4 or 5 weeks to heal and then chemotherapy. 6 cycles of chemotherapy, which I have calculated should end right around my 32nd birthday. The chemotherapy drugs I will be receiving will be FEC (somehow appropriate) or Fluorouracil, Epirubicin and Cyclophophamide. Thankfully, alcohol does not interfere with these drugs. Not that I plan on becoming an alcoholic, but I think I'll be needing the occasional beer.

Of coarse this could all change after surgery. If my cancer has either estrogen or progesterone receptors or if it over expresses the gene HER2, then I will get a different therapy.


There are so many things to consider. I had hoped that I would be able to continue breastfeeding Indiana. When I started out on this breastfeeding journey I didn't plan on being one of those long term breastfeeding moms. I didn't want to have a child who could lift up my shirt and help herself. But when the one year mark rolled around I realized I had no desire to actively wean my daughter. I wanted to continue for at least another year, and on the day of my diagnosis, when my surgeon told me I should wean my daughter - I at first agreed, but then I found out that I may not have to. Breastfeeding through chemotherapy requires that you pump and dump your breast milk for 5 times the half life of the chemotherapy drug with the longest half life. During this time, you offer the radiated breast to the child to "comfort nurse" because the radiation kills the cells that make milk, so the child basically gets dry nipple. If you pump effectively the child can then comfort nurse on the unaffected breast and not get any milk because you pumped it all. When 5 times the half life of the chemo drugs is up the child can have milk again. The reason I asked to meet with an oncologist before surgery was to find out what the half lives of chemotherapy drugs are. But it's sort of irrelevant now. I won't get radiation before I get chemo so I'd be trying to pump away the tiny trickle of milk that is left in my right boob, which I probably can't do after surgery. And besides, I'm getting "lots" of chemo. Dr. Attwell said it will make me nauseous. Not it might. It will. It will make me tired. It will make my hair fall out (which doesn't bother me. How many times have I shaved my head?). Do I really want to be nauseous with a breast pump hangin' off my tit? I don't think so. I was hoping that even if I decided wean that I would have at least until the end of the summer, because surgery plus recovery time plus 4 to six weeks of radiation would take me to the middle of August, which gets me almost to 18 months of breastfeeding. But now I have about a month to wean. I don't know who it's going to be harder on, her or me.

Right now I have to focus on getting ready for surgery. I have one week. And I need to make sure I am eating, because I know that when I am stressed or anxious or sad or lonely or worried, I don't eat. And I have to get back in the habit of drinking lots of water because apparently it is very important during chemo to stay really hydrated. And I have to make sure that things stay as normal as possible for Indiana. And ... This has definitely been the hardest day. And I know there are going to be harder days. But I figure, weaker women than me have gotten through this. I'm punk rock. I can handle anything.

Sometimes, someone else’s words say what I am feeling, so much better than anything I could come up with. Music is going to be a major factor in keeping me sane through all this. It is really is true that "Music Save."

Well I Know I miss more than hit

With a face that was launched to sink

An' I seldom feel, the bright relief

It's been the worst day since yesterday

If there's one thing I've said

Is that the dreams I once had now lay in bed

As the four winds blow my wits through the door

It's been the worst day since yesterday

Fallin' down to you sweet ground

Where the flowers they bloom

It's there I'll be found

Hurry back to me, my wild calling

It's been the worst day since yesterday

Though these wounds have seen no wars

Except for the scar I have ignored

And the endless crutch, well it's never enough

It's been the worst day since yesterday

Hell says hello, well it's time I should go

To pastures green, that I've yet to see

Hurry back to me, my wild calling

It's been the worst day since yesterday

- Lyrics by David King, Music By Flogging Molly, from the Album "Swagger"

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