At the End of the Tunnel...

There is light at the end of the tunnel. In January when I heard the word “cancer” I couldn’t even imagine this light being there, but now, I’m so close that I can feel its warmth!

As many of you know I finished my last chemo session on 6/25. If you recall from my previous post, I had genetic testing done and I had so many questions about my future. The results came back. I am positive for the BRCA1 mutation. The results also came back indeterminant for BRCA2 and a smaller gene called rad15. Unfortunately, we are not sure what the significance of the indeterminant genes are, but the BRCA1 result sheds light on everything. It explains why I got cancer at such a young age. It explains why so many women on my mom’s side of the family suffered with cancer. But most importantly, it makes my future crystal clear. Having this gene mutation means I have a high chance of breast cancer recurrence, so the decision was easy. I decided to get a double mastectomy as opposed to just a lumpectomy (which I already did in January) and radiation. I will also eventually get my ovaries out because having the BRCA1 gene mutation also increases the risk of ovarian cancer. My first thoughts when I got my genetic results were, “I just need to take EVERYTHING out!” I don’t want to go through this cancer thing again. I need to be around for much longer. I want to be here to see Landon start school, graduate from high school, get married, maybe start a family of his own. I still have so much I want to do. So the answer was clear. I will do everything I can to stick around.

On my 36th birthday I had my double mastectomy. It was a brutal surgery. Don’t get me wrong, everything went great. My breast surgeon said she is confident she got all the breast tissue out so I don’t have to worry about breast cancer recurrence ever again! But it took me a while to recover from the pain. The incisions were quite large on both sides under my breasts. There was a lot of swelling and bruising. For about 10 days I had a terrible pain every time I stood up or walked so I couldn’t do much besides lie in bed. I’m 3 weeks out from my surgery today and I’m finally feeling better. I still have discomfort and limited arm motion but I am no longer in pain! I can finally say, that I am starting to feel myself again and life is approaching normalcy.

I no longer feel short of breath or fatigued with just walking or going up the stairs. 3 days ago I started to use minty toothpaste again.  During chemo my oral mucosa was so sensitive that I couldn’t use minty toothpaste without it being super painful. I can taste everything again! Chemo had blunted my ability to taste certain flavors but that’s no longer an issue. Last week I noticed my eyebrows and eyelashes were growing back. I had lost most of my eyelashes from chemo… let me tell you… you really don’t realize how functional your eyelashes are until you lose them! I had so much eye irritation and itching from stuff getting in my eyes when I lost my lashes. But now, they are growing back and my eyes feel great! New hairs on my scalp are also showing up which is very exciting for me! Despite doing cold cap therapy, I still lost about half of my hair volume. A few days ago I noticed a small grey hair on my head! Mind you, I almost never get grey hairs! I have probably had a total of like 5 grey hairs in my whole life! Usually I pull them out but this time, I couldn’t do it. At this point, any hair on my head is good, even grey hair! Unfortunately, hair in undesirable places are also starting to grow back… For a second, I thought, any hair growth is a good sign! But then vanity quickly took over and I shaved my legs last night for the first time in months. A couple of weeks ago I put in my work schedule requests… I plan on going back to work in the fall! I am so ready to retire as a patient and be a doctor again!

Yes, all of this means I am almost out on the other side of the tunnel. But this doesn’t mean my cancer journey is over. I will still be getting Herceptin infusions every 3 weeks until March of 2020. I still have to get my ovaries surgically removed. I still have a lot to think about when I’m ready to have another child. I have to get my embryos tested for the BRCA gene mutation. I will always be thinking about the chances of recurrence somewhere in my body. I will have to change my lifestyle to be healthier. It turns out that getting cancer once changes you, and the journey really never ends. But for now, I’m past the dark, hard, painful part of it all, and I get to walk in the brighter part of this journey.

THANK YOU!

3 weeks ago I finished my last round of chemo! I never thought I’d get here but I did! It’s definitely not the end of my cancer journey but it’s one step closer. And if there’s anything I learned about fighting cancer, it’s that you have to take it one step at a time, or else it all gets overwhelming. So for the next month, I will celebrate this milestone and be thankful that I got here!

Today, I decide to dwell on the good. When I was diagnosed with cancer I was devastated. I couldn’t think of anything good that would come out of this but there was a silver lining… and that silver lining was YOU!

Since I have been diagnosed, I have received so much support and love from friends and family. It has been amazing to see how so many people care to a point that it brings me to tears. So many of you have been reading my blog entries and have been giving me compliments on it. It means so much to me that you care enough to read this and that you are trying to understand what I'm going through. So thank you!

When I initially opened up and revealed my diagnoses, I was showered with gifts. I received care packages in the mail from friends and family from all over the country. It’s funny because I think there is some notion that people going through chemo should be sitting on a couch with warm socks wrapped in a blanket sipping tea because I have never received so many fuzzy socks, blankets and boxes of tea bags in my life! My dining room table was covered with vases of flowers. I received countless meal deliveries without asking. One day I even had a postmates delivery guy just show up to my place with Randy’s donuts which I hadn’t ordered. It was a surprise delivery! My local LA friends took me out to lunches and of course no one would ever let me pay! I received gift baskets with beautiful cards with messages that I read over and over to help me keep going during the last 5 months. I received countless encouraging text and FB messages. I heard from people from different times of my life. I heard from people I had lost touch with and hadn’t spoke to for years. Many shared their experience with cancer. I didn’t even know some of these people had gone through the cancer journey. Some just texted me funny memes and gifs to make me laugh. 

Of course, I cannot forget the ‘go fund me’ that two of my dear friends set up for me. So many people donated to my fund. People I didn’t even know directly donated because my friends reposted the fund on their FB page. Dan and I were both speechless at how generous people were. We didn’t expect any of this. We were just hoping for a little extra money to offset the cost of my cold cap treatments to help preserve my hair because it’s so expensive to do it. I almost didn’t do it because of the cost but because of this fund, I was able to. Not only did the fund help me pay for ALL of the cold cap treatment, but it also has helped me pay for my co-pays associated with my chemo regimen which, despite having good insurance, is still expensive. 

Of course, the cynical side of me thought that all of this couldn’t last long. I understand that everyone is busy with work, their kids/families. I have cancer, but everyone else’s life will go on as it had been before my diagnosis. I expected to be slowly forgotten… but I was wrong. I continued to get weekly texts, phone calls. I had visitors and lunch meet up with friends every 3 weeks during my “good week” when I wasn’t feeling ill. I still wasn’t allowed to pay for any of the meals! I had two friends from college visit me from out of town. I continued to get packages in the mail with thoughtful gifts. In fact, this past weekend, I got a package with gifts from my high school friends. People continued to come over to help with Landon and to help walk our dogs (especially my brother and sister-in-law). My dining room table still has vases full of flowers. I am still getting cards in the mail. All of this love & support has not stopped. 

I cannot describe how grateful I am, how lucky and blessed I feel. I will never be able to repay everyone for all of this but I know that eventually I will do everything I can to pay it forward. All of THIS… all of YOU have helped me keep my spirits up through this journey. I could not have made it this far without YOU. I need you to know that. THANK YOU! 

Motherhood and Cancer, Part 2

When does motherhood begin?  This is a question that has raised much debate in law, medicine, religion, and spirituality. I don’t know the answer to this question, but to me, motherhood might start even before one knows she is pregnant. When I felt mentally and emotionally ready to try to get pregnant, something inside me changed. I started to think about this potential baby that could change everything, for better or for worse. And since that moment, even before I was pregnant, I started to change my lifestyle, to think ahead, to plan for this potential human being that I hadn’t even met yet. For me, this is when motherhood began.

Most people know that I have always wanted a baby girl. Don’t tell Landon, but when I first found out that Landon was a boy, I cried! Of course now, I can’t imagine my life without him and I love everything about him, but I still have this burning desire to have a little girl. I have a deep, hidden away balloon in my head with images of me and a little girl. I imagine dressing her up in bows and lace. I imagine baking and decorating cookies with her and teaching her how to braid her hair. I imagine getting my nails done with her, picking out her prom dress, her wedding dress. When I found out I had to get chemotherapy I also found out that up to 30% of women go into permanent ovarian failure after completion of treatment. At that moment that balloon hidden away in my mind flew away and popped. I was devastated that I may not be able to have a baby after my treatments.

So began my whirlwind tour in the world of reproductive endocrinology. Leaving my fertility up to chance was not an option for me. I did a bunch of research and eventually found the USC Fertility Clinic. I saw a wonderful female physician who specializes in oncological cases like myself. And for two weeks my life was about preparing for my future baby, not about cancer.

 The two weeks that led up to freezing our embryos were stressful to say the least. I only had time for one round of egg retrieval because I couldn’t delay my chemo much longer. My future hopes for having a baby depended on this one round of retrieval. I had to put all my eggs into this one basket (pun intended)!

So I started with the daily injections to stimulate my ovaries to form follicles. 2 shots everyday at the same time. I was still working during all of this so there were times I had to inject myself at work which was not fun. I had to go into clinic every other day, sometimes everyday to get my blood work checked and to get transvaginal ultrasounds to check of the progress of my follicles. By the end of all of this my arms and belly were covered in bruises from the blood draws and injections. I felt so bloated from my ovaries being the size of baseballs on each side. But the good news was that I was progressing well and had many follicles.

The day of egg retrieval, I went into the procedure center. The whole thing took only about 30 min under conscious sedation. When I woke up I was groggy but received the great new that she was able to retrieve 23 eggs! The rest was a waiting game but I felt good starting with such a high number so I wasn’t too worried.

A week later I found out that of the 23 eggs, 20 were mature enough to fertilize. 14 of the 20 actually got fertilized and in the end, 7 of those 14 developed into the blastocyte stage. Initially I was shocked that I started with 23 eggs and was down to only 7 embryos, but on second thought, 7 embryos seemed like a great number because I sure don’t plan on having 7 more kids!

We decided to get karyotypes/genetic testing on these 7 embryos. The results took about 2-3 weeks. Of the 7, 3 had chromosomal abnormalities that would have led to miscarriages if we used them so those were discarded. We were left with 4 good quality embryos! Thanks to the karyotype, we were able to find out the gender of the embryos. We have 2 boys and 2 girls!! I was so excited to learn this!! And just like that, the balloon with images of me with a daughter that I thought had popped floated back into my mind. 

I can’t believe that this whole process is even possible. I am thankful that I live in a time where science is so advanced that people like me can have the option to have a child after chemo, but I can’t help but think that we are playing God a little bit which seems amazing but dangerous at the same time.

So there you have it, after a crazy stressful 2 weeks, somewhere in a freezer in downtown LA, I have 4 potential kids waiting to be brought into this world. Dan and I will likely only have one more child, and in my mind that child is going to be my daughter. And just like that, in my heart, I have already started being a mother to her, years before she is actually born.

Motherhood and Cancer, Part 1

Two topics that seem completely unrelated… until I became a mother last year and got diagnosed with breast cancer the same month my baby boy turned one. Even though I have been a mother for a much shorter time than I have been a doctor, I identify as a mother now as much as I identify as a doctor. Before the cancer invaded my life, my life was basically doctoring and mothering. So how is this cancer diagnosis affecting my ability to be a mother? Well, January and February were tough because I continued to work full time and on my days off I was at doctors’ appointments, or getting tests/procedures/surgery. So frankly, I didn’t have time to tend to Landon as much as usual. Thankfully, Dan and his parents were home to care of Landon so I doubt he noticed any difference. I have been off work since March and I have to be honest, it’s kinda nice. I get to spend a lot of time with Landon and be there for his milestones. I don’t feel like I’m missing him grow. They change so quickly at this age that when I started working last year I felt like I was missing out on a lot. So in that sense this cancer diagnosis has been a blessing in disguise. But I must say, it is not easy being a mother while having cancer. Usually for about 7-10 days after chemo I feel awful. I have terrible fatigue, nausea, acid reflux, body pain, and I don’t feel like doing anything, including mothering. It’s hard to take care of a screaming toddler (who you can’t reason with) when you feel like crap.

Sometime I feel guilty. I know, it’s not like I can help that I have cancer, but I feel like Landon is missing out on things because of me. I’m immunocompromised from chemo so I have to be extra careful about being around other people who are sick. Everyone knows that toddlers are petri dishes full of who knows what! If Landon gets sick and gives me whatever he has, I could potentially get super sick and may need IV antibiotics and hospital admissions, not to mention I could potentially become septic and die. Needless to say, I am super paranoid because I have seen these cases and it’s bad. I have been trying to keep Landon away from other kids because of this. We used to go to a baby gym but we stopped that. We decided to delay starting daycare so he doesn’t bring home any germs. Landon has missed a few birthday parties and playdates because he could catch something from other kids. I guess I’ll just have to make it up to him in the future. The good thing is that he is too young to remember!

It sucks that I have cancer at such a young age but there is one reason that I am thankful that I got this early. Landon is still young. He is too young to remember any of this. He will never remember me as a cancer patient. He will not remember me looking pale and weak. He will not remember me vomiting and being sick. He will not have to wonder why his mom is not around as much to play with him or hold him. I’m supposed to be his MOM… his rock, his supporter, his cheerleader, his hero. I think for the next few months the roles will actually be reversed, but he will never know that until I tell him when he’s old enough to understand that he saved my soul.