Coronavirus, Cancer, & My First Chemotherapy Infusion

2020 just keeps on getting crazier. 

It’s nearly mid-April, and we are in the midst of a national shelter-in-place order as the most virulent coronavirus we’ve seen in years, COVID-19, is ravaging the world over, its unpredictable nature adding to the palpable fear of contracting it. People of all walks of life, of all ages and health, are succumbing by the thousands to the pervasive wrath of the virus, fighting for life on ventilators. Progress is quelled by setbacks, as those who seem to be improving are admitted into intensive care units mere days, or hours, later. 

We are living through a global pandemic on a scale no one alive today has yet had to endure. We are being tested in ways that are obvious, and in subtler, more nuanced ways yet to be realized. As millions of people live in a varying state of lockdown around the world, we are only united in spirit, and the cybersphere, as social distancing mandates keep us mostly walled apart within our four walls. Parents are homeschooling children, adapting to distance learning on computers, missing the camaraderie of their peers. Gone are the moments of spontaneity and tangential inspiration that unfold so readily within the physical classroom, fostered by the shared purpose of students and teachers driven to keep learning, keep asking questions, and keep improving.

We all have a lot more time on our hands now that we are all but confined to our homes aside from essential activities, and exercise. Santa Cruz County has been on a shelter-in-place order since March 14, and the state of California issued a statewide order soon after. The economy is wobbling on a tight-rope, balanced in the tension of a trillion-dollar government aid deal soon to bring some financial relief to Americans and businesses, to the pitfalls of a marketplace with no customers to serve, no clients to meet. Far and wide, businesses deemed non-essential have been ordered to shutter, leaving them with the daunting challenge of keeping afloat when income streams have dried up, but bills are still due. 

The effects on our economy will be felt for years to come, regardless of how the Dow Jones behaves on a daily basis. Volatility is the understatement of the time. We are insecure about everything from our retirement funds, to whether we’ll have food to eat. People are legitimately scared, and are forced apart at a time when most of us would want the comfort of friends and family. Though videochats and social media help bridge this void, nothing can replace the physical presence of flesh and blood, of a laugh heartily shared, a hug warmly shared. 

We find ourselves reexamining our lives – our careers, our relationships, our goals, and our mortality. This pandemic makes everyone think about death, and our health. We wonder how we would respond if we got it; would we end up on a ventilator in the ICU, or be one of those asymptomatic types that barely ekes out a sneeze? What if someone we loved got it, and ended up in the hospital? What if they were to die? No matter how calm, cool, and collected you are, this crisis makes you think about these questions, if only for a moment, but hopefully not all day, everyday.

It’s a lot like being diagnosed with cancer. I’ve heard various interviews on talkshows lately where people talk about how they’re coping with the shelter-in-place orders, and they all might as well have been talking about being diagnosed with cancer. There are a multitude of parallels between the coronavirus pandemic and cancer. 

First and perhaps most obvious, they both make you think about death and your health. Eating habits, exercise, sleep, stress, and other lifestyle factors are meticulously combed through for deficiencies. Your life is put under a giant microscope. All that glistens, and all that cowers in the darkness, is brought to light. You think about your loved ones dying; how you would live without them. You think about all the things you should have done differently in your past, choices that may have led to your fate. You imagine yourself dying; how would it actually feel to take your last breath? Would you even know it when you did? Though I always knew I would die someday, being diagnosed with cancer made me reconsider death in a profoundly deeper, more intimate way. It was no longer something out there on the horizon; it was presenting itself to me in my thirty-ninth year of life, probably having grown slowly for years undetected. 

They also both preoccupy your mind in a way you must learn to control. You are a slave to learning more about them; you just want to understand them, so you can fear them less. I spend hours reading through breast cancer articles, trying to better understand my situation, the NCBI website is one of my most-visited sites; I read blogs, I watch YouTube videos. There’s a lot of mental energy that goes into just trying to figure it all out, and as someone who is passionate about Science as it is, it makes the thirst for knowledge insatiable.

Then, there are all of the COVID-19 stories happening worldwide. They demand your attention, and everyone I know is following the news constantly. It is important to be informed. I read the newspaper daily, and watch the news in short bursts. If one watches the news endlessly right now, fed by a relentless torrent of heartbreaking stories, day after day, it isn’t necessarily good for our mental health. 

It’s the same with cancer: while I invest hours upon hours researching my cancer, I have to know when to take a break. If I spend too long consumed in the tunnel of statistics, prognoses, and web of possible culprits for my cancer, it wipes me out; I’ll feel exhausted, anxious, and discouraged. It took me some time to learn how to regulate that need for learning, to realize that the knowledge wasn’t going away, that I could still find it the next day on the Internet or book I was reading; I’m still working on it. Stepping away and doing something completely different – a distraction – was exactly what was needed, and that’s what I hear a lot of people talking about today. Just trying to stay busy, stay distracted, is what I said often after my mastectomy. Now, I hear people saying the same thing with the shelter-in-place order; they are just trying to stay busy, to keep their mind off the gravity of the situation. Cancer or coronavirus, we all need a break from the constant onslaught of news updates, alerts on our phones, and the state of alert we are all living in. 

Yet another way cancer and coronavirus are similar is how they command you to deepen your gratitude. When I first was diagnosed with breast cancer on February 3, 2020, a roller-coaster of emotions began, but I remember distinctly thinking: I’ve been living my life healthily; I’ve been appreciating everyday, living like it could be the last. Darn it, I haven’t taken my life for granted! I don’t need this lesson!

I knew as soon as I thought it how inane it actually was. Of course I had room to grow more grateful, to appreciate more deeply. Of course I wasn’t done in that regard; there will always be more room to show more grace for my blessings. Now, just barely over two months later, I feel I’ve already stretched my seams in the gratitude realm. I look forward to time with my husband and cat, moseying around the garden; I delight in the sight of birds bathing in the birdbaths. I relish my time in nature, and the amazing creatures I find, from lizards to bobcats to coyotes. I feel incredibly grateful for my loved ones. It helps that I’ve had so much time off work to dive deeper into celebrating the little things in life, being on-leave since February 14, which leads me to another similarity between coronavirus and cancer: the shelter-in-place order. 

We all have more time to ponder our lives, to reflect in ways perhaps not regularly done so. No two people will handle a cancer diagnosis precisely the same, and no two people will handle a COVID-19 diagnosis quite the same way, though there are undoubtedly more similarities than differences. One of the main things we all will do is reflect upon our lives – our happiness, our chosen careers, our life choices. It gives one pause, and suddenly everything is open to scrutiny.

The world on an all but lockdown amid a pandemic? That will make everyone take notice – to not just their own lives, but the state of the planet. I hope everyone will give credence to the drop in pollution levels during this time. The grounding of airplanes, cars not commuting to work, factories shuttered – there is a marked drop in global pollution as a direct result of this pandemic. Stephen Kessler said it best in his editorial, that perhaps this would be the catalyst to really bring change to remedy the climate crisis. It is imperative that we as a society adopt cleaner technologies, and work to restore natural ecosystems; to protect endangered species; to stop using forever chemicals; to realize that overpopulation is a key factor in our problems. We are making some progress on environmental initiatives, but nowhere near as far as we should be by now. It makes me so angry that I learned about the greenhouse effect as an eleven-year old; we learned about the ozone hole, and CFC’s. The message was clear then, as it had been for years before: pollute the Earth, and we will hurt. Now, as a seventh grade-Science teacher, I am teaching my students a similar story, with much worse stakes, much worse outcomes. It is confounding how the profits of corporations and private interests can supersede the health of our planet for so many years. 

While the coronavirus stay-at-home orders will spark self-reflection about that which we are unsettled or unhappy about, it will also be the catalyst for creative self-expression. We reassess our lives, and we also reacquaint ourselves with lost hobbies, passions, and artistic outlets. When you have lots of time on your hands, your truest instincts and desires will surface loud and clear; even if you thought you’ve heard them already, they will roar stoically, echoing across the canyon walls of your psyche. This is a wonderful time for music making, writing, reading, cooking, cleaning, organizing, gardening, and taking good care of yourself. It is an opportunity to dive into our hobbies, even if only in between catching up on the news.

It is also a good time to connect with our most authentic emotions. One of the things I struggled with in my cancer diagnosis was anger. Though I felt sadness, fear, and tinges of hope here and there, I was sidelined by anger for anything I was upset about in my life – the state of the environment, my neighbor’s white smoke spewing toxic pollution, the fact that I had Stage 2 breast cancer. 

I was really angry about that one, especially that I hadn’t found it sooner. I’d done mammograms and ultrasounds for years, checked myself regularly for new lumps, ate well, exercised a lot – you already know the spiel. When I was told at my last appointment, at the end of 2016, that I only had fibroadenomas, and didn’t need to worry; that with no breast cancer history in my family, I could come back at age forty for my next mammogram, unless I felt any changes in the meantime, I let go of the rope. I stopped worrying about the lumps in my breasts. They didn’t change, and for whatever reason, I never felt my cancerous tumor until it was quite sizeable. I remember feeling it, mid-December 2019, and it felt like a peach pit, a few centimeters at most, maybe. By the time it was excised during my mastectomy late February 2020, it was 4.4 cm. It matched the statistics I’d read about doubling size, that tumors could double from every 50 to 200 days, a wide range, but an estimate. It had likely been growing for years, and for whatever reason, I didn’t feel it, or it didn’t show up as an abnormality on my previous scans. 

I wished I’d gone in for an ultrasound over the last three years, instead of trusting that I didn’t need to worry. I wish I’d felt something sooner. I can’t explain how angry it has made me, for how on top of my health I’ve always been; I’ve always taken really good care of myself, and it baffled me that I could let this slip. I had struggled with occasional bouts of fatigue, headache, and nausea over the last couple of years, and seen my doctor about it. I even wrote about it in my journal. Bloodwork was normal, and they thought my sleep apnea was contributing to it. I had already tried a CPAP machine to no avail, and ended up trying a mouthguard, or mandibular advancement device. I couldn’t get used to that either, as it aggravated my jaw painfully. I knew something was off, but I thought it was just not eating well enough and overexerting myself, compounded by a poor night’s sleep from my apnea. 

I go over all of the things I could have done differently; I could have asked for an ultrasound just in case. It makes me so angry. All that energy is wasted, though, since I can do nothing to change it now; moreover, blaming myself isn’t helpful. That’s the mystery of cancer; most people don’t get a clear culprit for their diagnosis. 

I also felt angry that I didn’t feel more self-actualized in my life – that, after all I’d done with my life thus far, after all the happiness and passion, the times I’d felt like I was really stoked on how life was going, I still didn’t feel like I’d made it; that I didn’t feel fully seen or heard, or entirely successful. Part of it was financial. Sure, I’d like to be making more money, but mostly, it was existential; it brought into focus how much more I still wanted to do with my life, how much sharper I wanted to hone my mastery. Now, as millions of people find themselves with the boon, or burden, of too much time on their hands, we all share a unique opportunity for self-reflection, granted, of course, that we are lucky enough not to fall ill with COVID-19.

Another glaring similarity is the loss of control, and the anxiety that accompanies the uncertainty of the time we live in. A cancer diagnosis reminds you that despite your best efforts – healthy diet, exercise, and low-stress – we can’t control life; we can’t protect ourselves from every threat, no matter how hard we try. We are living in anxious times, worrying about our health and that of our loved ones, but we are also worried sick about the future. How many business owners will still have a viable business to return to? How many dreams of investing in a new business will be shelved indefinitely, victims of the slow build-up of the working man’s acquisition of savings, every penny one can spare after feeding and housing oneself? How many will be forced to work in another field altogether, trading a sense of purpose for a sense of sustenance? How many lives will be forever altered? Ultimately, how many lives will be forever changed by the loss of a loved one? How many lives will be lost, last breaths taken in crowded hospital wards, beds soon replaced with the next victim? It is staggering to think about the loss of life. It is also unsettling and worry inducing. 

We are reminded, again, that there are catastrophes whose scopes of damage know no boundaries. We are reminded of our vulnerability. Our economies, our infrastructure, all the structures we depend upon for our lives are on shaky ground. We must adapt to live, at least temporarily, without them. We are pushed to the edge of our comfort zones, no Vanilla Lattes to ease the sour aftertaste of a world gone awry. 

We must learn to be okay, on a certain level, with this loss of control, with this humbling recalibration of humankind. As cancer patients, this loss of control is compounded by changes in our treatment schedules, delays, and the risk of falling ill with a weakened immune system. We are at the mercy of a triage health-care approach, where things are changing on a minute-by-minute basis. Delays and hiccups are the nature of the game at this point, coronavirus, cancer, or both. We walk along with our dream legs, hoping to near a rewarding horizon of relief. The horizon sometimes moves, though, and we have no control over it. We must learn to focus on what we can control – ourselves – instead. It isn’t easy to do, especially when your life depends on it. Our patience is tested in a myriad of ways. 

Spring2020-34

I knew I would have dream legs moving along with my chemotherapy treatment, that my patience would need to adapt. On Monday, March 30, I went in for my first infusion at Kaiser San Jose. My sweet husband Ron drove me, and when I showed up my Dad was waiting in the parking lot! It was such a pleasant surprise to see him, and made me cry happy tears immediately. Though we couldn’t give each other a hug, it meant the world to me to share a few quick words before I continued on for my appointment. The love and sweetness continued when Ron dropped me off at the infusion clinic; he unzipped his sweater to reveal one of my favorite shirts: I Love My Smokin’ Hot Wife. He wears this shirt on occasion, but this time was just perfect. We embraced in a warm hug and off I went.

That’s another similarity between cancer and coronavirus: it brings people together, even if we are physically alone. The amount of love I’ve received from the virtual realm – emails, social media comments and messages, videochats – all help me feel supported and connected. People have sent gifts, money, and cards, all of which made a huge difference for me. The staff and teachers at my school collected a generous sum of money for me, which moved my heart. Though I often talk about what an introvert I am, we are all a blend of extroversion and introversion; few of us are solely one or the other. We are a shade of grey. I love time alone, but I love the people in my life, too! I am so grateful for the love and support I’ve received, it’s almost overwhelming. We all need each other right now; we are all feeling vulnerable amid the coronachaos. It warms my heart how much people are stepping up for each other. Nightly cheers for healthcare workers have been incredible to see, from singing Italians, to pots and pans banging New Yorkers, to our own local Eight O’Clock Howl in the San Lorenzo Valley. We even made the newspaper! It’s been a real treat each night to go out and howl with so many others, our valley echoing our calls in symphonic unison. You can feel the heart in everyone’s voices. 

Walking into my first scheduled chemo infusion, I definitely was feeling the love all around. I was ready. Seeing my dad and Ron before really helped calm me. As I entered the building, there were two COVID-19 screeners at the door. I’d had a hint of a cough over the last couple of days, nothing strong, so I promptly let them know. Though I didn’t feel sick, I wanted to be honest. I could be one of those mildly symptomatic people, after all. 

I donned a mask, and waited for a nurse to come take my temperature, only 98.5, for someone who usually runs about 97.9. After some time, she said they were delaying my infusion in case I was sick. At first, I was selfishly disappointed; I’d been so nervous about the appointment, it had taken a lot out of me. I just wanted to get it over with, and that wasn’t possible anymore. I left the building and started crying as I walked toward the parking lot to meet up with my father. I called my sisters Mary and Bonnie, and vented my frustrations; they kindly comforted me. I was fortunate to spend a half hour talking with my father in the parking lot, from six feet apart, until Ron came to pick me up. Of course it was normal to feel some disappointment, but I understood the severity of the situation, that all precautions must be taken. There was no point in risking nurses’ lives, or other chemo patients’ lives, if I was sick. They sent me back home, and told me to come back in a week on Monday, April 6. 

I quickly got over the let-down of the delay, and took it as a Bonus Week! I had a gift of another week to live my life chemo-free, and more importantly, to recover from my port implant surgery. I’d had the port implanted on Wednesday, March 25, under twilight anesthesia. They implanted a PowerPort into my right chest, connecting a catheter tube to my jugular vein in my neck. It didn’t hurt while it was being put in, but that night, I felt like I might’ve been shot (this coming from someone who has no idea what it feels like to be shot). My entire right chest, neck, and shoulder were just frozen and throbbing at the implant site. I couldn’t even lift my right hand to read a book, or make a cup with my hands under the sink while brushing my teeth. It was worse than the post-mastectomy pain, although I’d had some pain medication to help with that. This time, I didn’t want to take any pain pills; after my withdrawal from the gabapentin, I didn’t want to feel that way again. And, the anesthesia had already damaged my liver and body enough, so I didn’t want to add anything into the mix. It was really tough, though; for a good three days after surgery, it constantly hurt. My mobility was limited, and I could barely turn my head to look right or left. The mastectomy had been a huge hurdle, but I’d gotten over it and was feeling stronger by the day. Then this port comes along and takes me two-steps back, and sucker-punches me with pain worse than the mastectomy. 

I was so grateful to have an extra week to heal up from the port implant, and more importantly, have some fun! We are lucky to live in a beautiful mountain near the beach community, where there are plenty of trails and beaches to spread out upon. We were able to go mountain biking a few times, go to the beach, and only saw a few people quickly in passing. The weather was nice and sunny; I laid out in the backyard, soaking up the relaxing rays of the sun. 

I felt myself truly let go for the first time in weeks. I needed this extra time to heal up; to just get stronger, and feel like myself again. I wasn’t sore from my port implant anymore, and it felt wonderful to get outside and move! My husband and I had a fantastic week together – a Bonus Week – and it really buoyed my spirits. 

Spring2020-22
Happy Rider

The rain came in on Saturday the 4th. An oncology nurse telephoned to ask how I was doing, and whether I still had a cough. I reported that the cough had persisted throughout the week, but never worsened to the point of being productive or constrictive. I had no other symptoms – no runny nose, no signs of fever, no body aches – and added that I felt better as the week went on, just had a mild cough. She said they’d call me Monday morning to let me know if they wanted me to be tested. On Monday, April 6, they called and said I’d have a phone appointment with my doctor later that day. After the phone appointment, I was sent to the Scotts Valley Kaiser drive-up testing site. 

I felt so badly, and so grateful, for the two nurses manning the testing station, wearing face-shields, masks, gloves, aprons, and other PPE I may not have noticed. They were not taking any chances. I waited for them to tell me to roll down my car window, and the nurse said she’d do a throat swab followed by a nasal swab. I pulled down my mask, taking a deep scratch to the back of the throat. The nasal swab that ensued was quite uncomfortable – it felt like a swab had been pushed up into my brain. My eyes immediately started watering, and I felt as if I had water up my nose. I rolled up the window, and pulled away, feeling a bit shocked by how painful the test had been. It was not a pleasant experience! My nose felt like it was being tickled the rest of the day. I was told I’d get my results within a day, and went back home. 

My oncologist had told me they like to start chemo no later than six weeks after surgery; for me, that six-week mark was Wednesday, April 8. I’d hoped to start on March 30, but all precautions must be taken, and I understand the delay. That’s exactly what I’d written about in my last post, so I wasn’t too surprised. I’ve heard stories of other cancer patient’s treatments being delayed, too, and knew it could be worse. 

I got my test result back on Tuesday, April 7, and it was negative – phew! Part of me wished I’d never said anything when they asked if I had a cough, because after all, it wasn’t anything serious, and ended up delaying my treatment, but honesty is always the best policy. 

They suggested Monday, April 13, as my first infusion, but I asked for something sooner. They had Friday, April 10, at 10 a.m.; Good Friday. I took it. Until that needle was in my port, though, I wouldn’t believe it. Too much hype and delay. I enjoyed a beautiful Pink Supermoon on April 8, an apt moon for me. 

The day came, finally. I felt ready; I was calm, even. Ron dropped me off, and off I went. I started with thirty-minutes of wearing my Paxman Cold Cap, which gives me about a 50/50 chance of saving, to some degree, my hair. If it’ll work, I’ll try it! It felt cold, but not uncomfortable. I was in a side-room off of the main infusion room, where there were about fifteen other patients receiving infusions. The chair was comfy, and it was nice to have my own space. 

The nurse gave me three pre-medications: Zofran, steroid pills, and Zyprexa. A pharmacist was there to consult with me about the purpose and side-effects of each; Zofran and Zyprexa were antiemetics, or antinausea, medicines; drowsiness was the main side-effect. I was surprised to learn that Zofran was an antipsychotic, but is prescribed for nausea in chemotherapy patients as well. I’ll take Zofran twice a day for three days following chemo, and Zyprexa once a day, at night. Zyprexa is a serotonin-5-HT3 receptor antagonist, meaning it works to block serotonin from activating my gastrointestinal nerve, which is triggered by the chemotherapy drugs, Adriamycin and Procytox.  I’d also have to give myself a shot in my stomach, Zarxio, once a day, for seven days, starting on Day 3 of chemo (Sunday, for me). It will stimulate white-blood cell production in my bone marrow, bringing a side-effect of bone pain; for whatever reason, Claritin, your basic, over-the-counter antihistamine, is known to help with this. For how much I don’t like to take pills, it’s a lot for me to submit to all of these medications, but if they’ll help me to live a longer, healthier life, I don’t see it so much as a choice, but a necessary step toward healing. May they work effectively!

My oncologist also came in to meet with me, which was comforting. She explained that she had a new idea for my Taxol administration; initially, it was to be a 12-week cycle, given once a week, that was to be given after the first four rounds of Adriamycin and Procytox, given a two-week intervals. She explained that they would try doubling the dose of Taxol, and give it to me at two-week intervals, instead of weekly. This would allow me to finish chemo four weeks sooner, which was good news to me; that’s finishing on Friday, August 1, instead of Friday, August 28, the first Friday of my first week back at school, presuming I’m ready to go back then. It would also mean I’d have to continue doing the shots in my stomach, but I was okay with that as long as my body will tolerate it. We’ll have to wait and see, but hopefully I can finish on this shorter regimen – 16 weeks instead of a 20-week cycle. 

The infusions began next; the fluid was bright red, hence the nickname The Red Devil. It is also called that because red sores are common on the palms and feet, as well as hand-foot syndrome. It is red from the bacteria Streptomyces peucetius, from which the drug is derived. As frightening as some of these drugs are, I can’t fight my curiosity about them; it is interesting to learn about them, to the extent that someone who’s not a doctor can. Science is endlessly fascinating and intriguing. 

Both administrations took about twenty-five minutes, given slowly by the nurse into my chest port. It didn’t hurt having the port accessed, probably thanks to the lidocaine cream I put on an hour before. After the nurse had administered both drugs, I sat about twenty more minutes with a saline injection circulating through my port. I sucked and chewed ice the whole time, in an effort to reduce mouth sores. I didn’t have a strange taste in my mouth, though I’ve heard of it happening. I didn’t feel nauseous either, which was a relief. The nurse removed my port, and congratulated me on finishing my first round. 

First Chemo
First Chemo Infusion – Mask On!

Then, it was ninety more minutes of the cold-cap. I sat there reading my book, The Last Black Unicorn, by Tiffany Haddish. It was a great, fun way to pass the time of my first infusion. She is one of the funniest women!

I was finally done, and took off my cold-cap. Ron picked me up outside, and we went back home. I ate some lunch, and then took a nap for about three hours; I was exhausted. I felt okay, and went to bed around midnight. 

When I woke up the next morning, I was super thirsty and drank a bunch of water; I also took my Zofran pill. I immediately threw everything up. I went back to bed for a few more hours, and awoke around noon. I felt not only better, but energized. It must’ve been the steroids from the day before, because I was charged. I spent the day pruning and gardening, doing laundry, cleaning, and getting a lot done. I’d heard Day 3 was hardest for most people, and for me, that’s tomorrow, Sunday, April 12, Easter Sunday. We’ll see how I feel then, but here on Day 2, things are going okay.

It’s scary starting chemo at a time when you need your immune system at its strongest, when the coronavirus looms as a risk, but I am looking forward to making progress. I feel quite relieved now that chemo has begun, especially that it’ll be a 16-week cycle instead of 20-weeks. 

It’s coming at an apropos time, when we are forced into social distancing; right now, surfing is banned along the entire Santa Cruz County coastline! You’d think it were an April Fool’s joke, but no, it’s true. Beaches are closed, all parks and trails are closed, even the West Cliff Drive footpath is closed. It’s a one-week closure, aimed at deterring tourists from visiting over the usually popular Easter weekend. Though I’m bummed I can’t legally go for a mountain bike ride right now, at least I can go for a run from my house. I live in a beautiful neighborhood, and luckily the streets are still open. 

Like everyone these days, I’m looking forward to life returning to some semblance of normal. I’m looking forward to simple days built on simple things, with a healthy body. I’m looking forward to seeing my family and friends again, to sharing time together in a way that Skype or Facetime could never replace. I’m looking forward to living my life, free of cancer, free of coronavirus, free of the shelter-in-place order that holds us in this limbo of self-reflection and self-expression. 

I wrote about wanting to feel seen and heard when I was first diagnosed, but now, I just want to see my own reflection, to hear my own echo; that’s enough for me. I want to see myself on the other side of breast cancer, healthy and strong, my voice empowered, not defeated, by the vicissitude of cancer. If I can survive this in good health and see myself through, that’s all I need now. I don’t need any accolades, recognition, or compliments of others anymore than I need my appendix; with or without them, life goes on. I only need my good health, and the rest will follow. May I be blessed with such grace in the years ahead, as survival rates are only protracted over the long-term. Much of what I’ve been reading lately has only confirmed that my survival rate is lower than average, and my recurrence rate is higher. There are a multitude of factors that go into determining the virility of a woman’s breast cancer: age at diagnosis, size of tumor, histologic grade of tumor (Nottingham score), whether the tumor is hormone sensitive to estrogen and progesterone, genetic factors such as the BRCA-1 and 2 genes, family history, and whether the cancer has metastasized to other body parts such as the lymph nodes. Young age is typically associated with more aggressive cancers and worse prognosis. The more lymph nodes the cancer has spread to, the worse the long-term outlook. The higher the Nottingham grade score, the worse the prognosis; my tumor was 9/9, with three positive nodes. It’s a complex web of factors, but in my case, everything I keep reading doesn’t give me a lot of hope. 

I feel like I am fighting for more time. Everything I’m doing for treatment now is for the chance to have more time on this Earth. The chemo, the radiation I will undergo, despite my fears of its collateral damage, is part of my attack plan. The goal is to throw everything I can at it now, in the hopes that it’ll quash my cancer, to make whatever leftover cells not excised from my mastectomy and lymphadenectomy dormant. 

Like any other cancer survivor, should I respond well to treatment, I will have to live the rest of my life looking out for collateral damage from my treatment now – the risks of lymphedema, lung-cancer, heart damage, leukemia, and a recurrence of breast cancer that would be a death sentence. Though women are living years with metastatic breast cancer, there remains no cure for it. It is a balance of palliative care and extending life. I fear I will be one of those women whose cancer comes back, who dies at a relatively young age as a result, but none of that worry is helpful right now, so I try to let it go.

Which leads me to yet another similarity between the coronavirus and cancer: it has changed everyone’s lives forever. Nothing will ever be exactly the same after this. We will all look back at this time with heavy reverence. There will be a time when we can look back and remember what it was like when we were at home, or when we had it but persevered; we’ll remember a loved one who fell ill, and either got better, or died. Bless the thousands of lives lost from this virus. I will always live with the risk of a recurrence of cancer, but the world too will live with a risk of recurrence, of a similar pandemic crippling our societies. We will all live with the consequences of this time for years to come. We will live with its shadow for years. We will carry on ahead, lessons learned from the past, but no sense of what the future may hold. Such is the dynamic, changing nature of life. 

It’s extra crazy to have cancer during this coronavirus pandemic, but the magnitude of the pandemic overshadows my individual struggle. The world is suffering, and that pain is greater than my own. It gives me perspective, and makes my challenge not seem so ominous. It reminds me that life is unpredictable – cancer or coronavirus – and nothing is guaranteed.

What’s really helped me cope with everything has been pretty simple: hiking and riding my bike in Nature, reading, enjoying my hobbies, yoga, playing and listening to music, and, most of all, the good grace of a loving husband whom I am eternally grateful for. I really don’t think I’d be doing as well without him; if I were all alone, I think it’d be harder. I know women do it, and do it with strength, but I can’t imagine doing this without my husband, especially now that people can’t come visit me anyway.

I think everyone is appreciating their loved ones, their cherished hobbies, their time to do what they love. There are tons of podcasts, TV shows, and movies to escape into as well. I’ve been playing my guitar a lot, rocking out to Ozzy Osbourne’s No More Tears, one of my anthem songs for breast cancer. I’ve been dancing around the living room to my favorite hip-hop songs. We all need an outlet, especially in challenging times. Distraction is the word of the moment, but it’s more than distraction; it’s adaptation, it’s survival. We must adapt to the reality we are in, and find ways to nurture ourselves through this time. We must keep ourselves as happy as we can be. 

May we all come out stronger on the other side; smarter, sharper, clearer in our convictions. May we all come out alive and healthy. May we all come out to see each other’s smiling faces on the other side. 

In the meantime, may we all make the most of the situation; may we show gratitude and reverence for life’s daily gifts. The world remains beautiful, stoically persisting despite the darkest hours of our lives. May we all find serenity in the simple things, from coffee in the morning, to a shared laugh with a loved one; with the shared bond of sheltering in place amid a global pandemic. Though miles apart, we are united in spirit, and we have so much more in common than our differences.

May we all count our blessings, and stay well. 

 

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