Coronavirus, Cancer, & Chemotherapy

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, 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. 

Second, they 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. 

The third 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.

The fifth 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. 

 

The Adaptive Nature of Patience During Breast Cancer

Tom Petty sang it best: The waiting is the hardest part.

I’m a pretty patient person, generally speaking. I once spent ten hours perched high up in a Douglas Fir tree for a college assignment; I spent the night on a mountain bike trail in Downieville without water; I waited nine years to marry my husband Ron. I know I have no control over time, or other’s schedules, and am happy to let life’s timeline unfold at its own pace. We all grow more adapted to being patient as life throws unexpected challenges at us over the years, more accepting of that which we cannot control.

Some things test your patience more than others, though. Cancer is one of those things.

It’s been over a month since my life changed forever. At thirty-nine years old, I was diagnosed with breast cancer. That initial coping period was quite intense, but it quickly showed me how crucial patience would be throughout this whole process. It also reminded me how quickly human beings adapt: we accept the news, we feel all kinds of emotions about it, and then we move ahead as best we can.

Waiting for my surgery date, for example, was a test of patience. I did not know when my big day would be, only that it was super important, and intimidating. I let my breast care coordinator know I was ready to schedule my appointment, and was told I would be contacted by the scheduler for my appointment sometime during the week. I went about my life as best I could. The weather was nice, so I rode my bike everyday, went to the beach for sunset, and enjoyed that time with my husband. I was okay with waiting a few more days for surgery, until Saturday evening 2/22, when I suddenly felt anxious knowing I had this tumor in me with no end in sight, no scheduled surgery date on the calendar. I sent a message to my doctors to make myself feel better, reiterating that I was getting a little bit antsy to get in for surgery. I’ve never experienced such anxiety before, but my good old bike proved therapeutic once again. The minute my two wheels rotated, I felt immediate relief. Nature is powerful medicine, and so is mountain biking.

A few days later, on Tuesday, I was contacted by the scheduler; she wanted to know how much notice I needed, and could I be ready tomorrow, even. I said yes, and she said she’d call me back later that day. About an hour later, she called back and said I was scheduled for the next day.

I’d read books, blogs, and articles; I’d watched other women’s YouTube videos about mastectomies, and looked at pictures online. I felt as ready as I could be for the surgery. In fact, I was oddly looking forward to it. I was getting on the path to treatment, and was ready to board that train. I’d had enough time to become inured to my new reality, and the gravity of what lay ahead. Two books in particular really helped me prepare: Dr. Susan Love’s Breast Book, and Anticancer: A New Way of Life, by David Servan-Schreiber. Thank you to my older sister Bonnie for the Susan Love book, and my Auntie Christie for Anticancer. Both books were instrumental in helping me prepare, and I learned so much from them.

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Two of my Favorite Books

The eve of any sort of big event usually evokes strong emotions and poignance; the day before you get a double-mastectomy evokes an unusual sense of meaning. This was my last day with my breasts. I went for my last ride with my real breasts, the boobs I’d known since adolescence. Ron and I had a great day together, an excellent dinner at our favorite restaurant in Santa Cruz, Chocolate, and finished off the evening with a magnificent hot tub. I felt as ready as I could be.

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Bush Poppy, Santa Cruz Mountains

I awoke the next morning on Wednesday, February 26 – Ash Wednesday, coincidentally. I’m not religious, but I did find the timing amusing. Ron and I left the house at 5:15 a.m. for Kaiser San Jose. We got checked in, and within minutes I was led back to the pre-operating room. I changed into my gown, and laid down on a rather comfortable hospital bed, complete with a hot-air fan that warmed me up like a fireplace. I felt cozy; I was also tired, having stayed up until 2 a.m. the night before.

The three surgeons came in to see me before surgery, which was comforting. Though I’d met them before, there was something calming about seeing them before being in the operating room. The anesthesiologist checked in with me, too, and the nurses were caring and attentive. I felt like I was in good hands.

By about 7 a.m. I was wheeled into the operating room, which was freezing cold. I understand why, but it was such a change from my hot-air blanket in the pre-op room! The surgeons and nurses began doing their security checks, as the anesthesiologist explained to me, which is where they state who they are, who the patient is, and exactly what they will be doing. Of course, this has been reviewed many times before surgery, but it’s the final clearance; the final check of the airplane before take-off, so to speak. As I lay there listening to my surgeon take her turn, stating her name, my name, and that she would be performing a bilateral mastectomy, the anesthesiologist gently said:

I’m going to give you something to send you off to Hawaii now, okay?

Within seconds, I was out.

The next thing I remember, I was in the recovery room. I scanned the room and knew I was out of the OR; surgery was done. The anesthesia? Not so much. I was really sedated, and quickly fell back asleep for awhile. The nurses checked on me a few times, and said I would be able to go home that day. The doctors had told me I’d be spending at least one night in the hospital, so this was music to my ears. I got to go home and sleep in my own bed, see my cat Beau, and be in the comfort of my own home – and avoid Coronavirus exposure at the hospital, perhaps. This was a great way to wake up from surgery!

Next, I awoke to a beautiful sound – Ron softly crying, sitting next to me, his hand on my forearm since the IV was in the back of my hand. He said he was so happy to see me; that surgery was over, and everything went well. I’d been under about five hours. I lay there another forty-five minutes or so, sleeping peacefully, before I asked to get up and use the restroom.

They had warned me my urine would be blue from the dye they injected. The plastic surgeon who specializes in this technique explained it would help him trace the lymphatic fluid after they removed my lymph nodes, possibly divert that flow, and may reduce my odds of developing lymphedema after surgery. Lymphedema is a life-long condition involving swelling, heaviness, and tingling; once you get it, you’ll have to manage its symptoms for life. There are many stretches I learned in the lymphedema clinic I went to before surgery, but with my axillary lymph nodes removed on my left armpit, my risk of developing it increases.

I peed blue, as expected, but what shocked me next was my body temperature. I was feverishly hot all of the sudden – sweaty, feeling as if I were in a sauna. Exiting the restroom, I told the nurse, who promptly sat me in a wheelchair. That hot-air fan used to warm me up before surgery was now directed at my face, but switched to air-conditioning. It felt amazing. She put an ice-pack on my head and back of my neck, and within a few minutes I was cooling off. I guess it’s a precursor to the hot flashes I’ll likely develop from Tamoxifen, which I’ll have to take for at least five years after chemotherapy.

Ron’s father, Ron Sr., and his wife Cindy came up to the hospital to see me, which was really nice of them. Ron drove me back home, and I pretty much slept the rest of the day, waking up for a short dinner before returning to bed.

The next morning, I felt hungover from the anesthesia. I threw up, which was awful. I felt terrible – headache, nauseous, sore, and like my chest was going to explode. I had immediate reconstruction with expanders put in, and they were certainly doing their intended purpose, stretching me out like a balloon. The reward for that was keeping my nipples, which made me cry. I didn’t realize just how much they meant to me until I saw they were still there. The plastic surgeon had explained that they weren’t sure they could save them, but hallelujah, they were still there. I felt more like myself; I still looked like myself, sort of. The expanders were filled with air, so I even looked like I had boobs, or foobs, even though they were awkward-looking and had clearly been through the ringer. While I knew they were no longer my real breasts, it definitely helped with the transition to see something there when I looked down! The nipples were the icing on the cake, even though they could still have to be removed down the road.

The drains take some getting used to, though. One on each side, a plastic tube drains fluid into a silicone bulb that you must empty and clean daily. You can’t take a full shower or get your bandages wet at all. You have to milk them to clear clogs. I had read about them and how annoying they were; how women couldn’t wait for the day they got them out. Looking down on these new drains attached to my body, I realized I would be in a sort of Body Jail for the bulk of the next two weeks, tied to them like a leash. I could be bummed about it, grossed out, and claustrophobic that these things were married to me day and night. Or, I could distract myself by focusing outward on the amazing world going on all around me. Though I knew I had a long journey ahead, I resolved that I would keep myself busy so as not to focus on the drains too much.

First, I had to get over the anesthesia. I spent the day mostly sleeping and fighting nausea; Ron’s dad and Cindy came over for a short visit after picking up my post-mastectomy camisoles from Nordstrom in San Jose. Family is so awesome! I wasn’t in too much pain; I just felt hungover. There was persistent tightness and pressure in my chest, though.

The second day after surgery, Friday, February 28, I woke up early. I was charged and ready to go; lying around for two days straight had me feeling over-rested. My dad came down to visit me, and I decided I needed to go outside for a walk. We walked up the lane behind my house, a quiet street lined with redwood trees, and a slope that stretches the calves like a gravity-stretch. We were rewarded with an expansive mountain view at the top, and it felt so good to be moving again. My breasts were gone, but my two feet were still propelling me forward; my body was still working! I felt inspired.

I had a great day with my dad, and then my wonderful mom came down to cook me dinner. She stayed the night and brought a whole bunch of goodies with her. While there may be many people who nurture us in life, there is simply nothing quite like the tender loving care of your parents. I am so grateful for the love of family and friends right now.

That weekend, I increased my walking each day. I went for a magical hike in the redwood forest by my house in the Santa Cruz Mountains; I relished the warm sunshine of a nascent Spring, enjoying the early bursts of wildflowers that blanketed the hillside. It was beautiful outside, and my surgery hadn’t changed that.

I’ve always looked to nature for an escape, a playground, a quasi-church, as therapy. It is so healing to be outside, whether in my garden, or on a trail. Knowing I was limited in what I could do, I committed to hiking as much as I could each day. I kept my lymphedema exercises and stretches going, too; I elevated my left arm after long walks. I did light yoga, and plenty of namaste, a perfect pose for my arms right now. I didn’t want to push myself too hard, but I also knew exercise was good for me. I’ve spent my life exercising pretty much daily, so sitting around inside wasn’t going to do it for me, although I surely enjoyed my evenings relaxing with a good book, or a good TV show for levity. I needed to go outside, whether reading a book on the chaise-lounge in my garden, or walking on the trail.

Each day felt a little bit easier. The more I did, the less I dwelled on the situation; the more inspired I got, really. The world goes on with or without me, and it was comforting to have so many different things to focus on besides myself. Yes, the drains were a pain, but my camisole had little pockets for them, and once I was hiking, I didn’t notice them. I put on make-up; I washed my hair over the kitchen sink. I took showers with a detachable showerhead, careful not to get my chest wet, and sponge bathed my armpits, which was super strange; my left armpit is still pretty numb, so I can’t really feel how hard I’m scrubbing with the cloth. I also had to avoid getting my gauze wet.

I took the Gabapentin (Neurontin) once a day for seven days, as directed, and took one Norco each evening for the first five nights. I must say, they really helped with the pain. Although I was uncomfortable, I wasn’t in extreme pain, and felt better not taking them. The next night after stopping the Gabapentin, however, I had my worst bout of insomnia – up until sunrise, just could not sleep. I looked up withdrawal symptoms from Gabapentin and Norco, and sure enough, insomnia was one of them. I had no other conclusion to draw except I was having mild withdrawal symptoms; just one pill a day for several days, and it was enough to trigger that response. I never wanted to feel like that again, and decided I was done with those pills, regardless of the pain.

The next evening I slept normally, which was a relief, but the stabbing pain began. I’d heard about this nerve pain before, but it shocked the heck out of me when it first happened. It literally felt like someone was stabbing me in the chest with a knife repeatedly, for several seconds; then, it would just stop. Next, a burning branding pain would ensue, followed by a tingling, electric shock feeling. It was pretty intense, about a seven on a pain scale. I consider myself pretty strong and have a good pain tolerance, but this was a bit much. It happened several times throughout the day for a couple of days before subsiding; it’s only happened a couple of days since, and none the last couple of days. I’ve read it can last for weeks, months, or years, so we’ll just have to see how my body responds. At least I know what to expect now.

During this entire process, I’ve been reminded of the old adage, We fear what we don’t know. Everything that has felt scary has been something I needed to learn more about, just like this nerve pain. I’m adapting, patiently, to my new reality on a daily basis.
I have a positive attitude by nature, but that doesn’t mean recovery has been easy. It sucks, yes; I have breast cancer. Radiation and chemotherapy lie ahead. The will to carry on, however, supersedes self-pity. We are resilient beings, and everyday I am reminded of this.

I continued each day after surgery trying to stay as busy as I could. The less I thought about my situation, and the more I dove whole-heartedly into life around me, the better I felt. I read, I watched women’s videoblogs who’d gone through breast cancer, and kept my daily newspaper and crossword puzzle habit going. I had some amazing conversations. I relished beautiful sunsets over the ocean that made me so grateful to live where I live.

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Glorious Santa Cruz Beaches

I saw a bobcat sleeping right next to a hiking trail; I saw snakes, newts, and birds-a-plenty. I’ve always been a naturalist, and have honed my observation skills over the years through experience, but lately I’ve been a real animal whisperer. I had to walk slowly in the beginning, before graduating to my standard power-walk (I’m known for walking really fast!). There is an art to wildlife observation, and I’ve built it over the years; I’m still growing. These post-mastectomy hikes have presented a great opportunity to see more wildlife I probably wouldn’t have seen were I flying downhill on my bike – something I miss dearly.

I’m used to riding my bike almost everyday, and I cannot wait to feel the flow of two wheels under me again. This has been the longest break since my last concussion years ago. I got on my bike twelve days out from surgery, just to see what sitting on it would feel like. Just the pressure on my wrists and forearms was enough to feel uncomfortable. I couldn’t believe how something as seemingly small as holding the handlebars was. I’d never thought too much about my arms; just hold the bars and off you go. I realize it will be at least a couple of more weeks before I’ll be on my bike again – and that’s optimistic. It will be a test of patience staying off of my bike, but my body needs to heal first.

I am human, however, and there are times I’ve felt claustrophobic from having these drains attached to me; I just want my normal body back. I will get them out this Friday, March 13, five years to the date that I received title and keys for our first home in Ben Lomond. Ron and I also got engaged on a Friday the thirteenth, February 13, 2015. I’m not superstitious, but it’s an auspicious date.

Thirteen days out from surgery was one of my harder days of recovery. I had gone in on day twelve, Monday, for my appointment; I thought I’d be getting them out. My surgeon went over my updated pathology report with me, which noted a 44mm tumor, a few fibroadenomas, including the two I’d already known about for years, and extremely dense breast tissue. My Nottingham Histologic score went up to a 9/9, the worst grade.

And I wasn’t getting my drains out. My doctor was worried about infection from early removal, and proceeded to elucidate what she’d seen over the years. They used to take them out earlier, but this correlated with an increase of infections at the drainage site, which sometimes spread to the breast cavity, ultimately necessitating the removal of expanders and implants. I trusted her experience, of course, but I was disappointed to not get them out. I did get my bandages and tape off, though, which was a welcome relief. My sister came with me to the appointment and spent a couple of nights hanging out with me, which helped ease my deflated hopes (there’s a lot of puns I could run with here!). Bonus? I could finally take a full shower, which felt heavenly. I set the drains on my shower rack, and enjoyed the sweet relief of hot water flowing down my entire body. Hot water always feels wonderful, but this was exceptional. I shaved my armpits as best as I could, which felt so weird because my left one is almost entirely numb still. After almost two weeks without a full shower, I was so grateful.

I spent the next few days hiking and going to the beach for sunset, and saw one of the most spectacular sunsets I’ve seen in months. It inspired me to keep the big picture in mind, to keep my eye on the horizon. The world goes on with or without me, we all die someday, and it’s all okay. Do I want to die now? Of course not, but it’s possible. It’s surprising how quickly your mind adapts to that new reality. Granted, it didn’t come easily, but I do feel more at peace with the prospect of death than I did before this cancer diagnosis, hands down.

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Ocean Therapy

I feel more patient, although I have a lot more growth to do, surely. Once chemotherapy starts, that will elicit a new sort of patience. I am amazed at how natural it is for patience to evolve in the face of adversity. Yes, I think attitude has a lot to do with it, but we’re innately hardwired to do so already. Once you choose it consciously, the pieces fall into place. Sometimes, you have no choice in the matter; it’s a matter of taking care of yourself – survival, almost – of living in a place of anxiety and fear, or living in a place of peace and openness. When I was first diagnosed, I’ll never forget what a friend and colleague said to me at work. She explained that her friend had gone through breast cancer, too; what helped her most, she said, was learning to control her mind. It made perfect sense when she said it; I was in that shell-shocked, terrified first few days after diagnosis, and my mind was cycling through all kinds of sad scenarios. Riding my bike was major therapy during that time, luckily, but it wasn’t enough to eschew my fears altogether. Her advice was timely, and appreciated; I took it to heart. I’ve meditated many times before, and consider forest bathing and time outside in nature to be a meditation, of sorts. There are many shades of meditation, but her words – control your mind – really resonated with me. It’s become one of my mantras throughout this whole process. Thank you, Elizabeth, for this gem of wisdom.

Today is Thursday, March 12, 2020, and I’m on Day 15 with the drains. Tomorrow, I’ll get them out. I’ll also meet with my oncologist to go over the plan for chemotherapy and possible radiation. I can’t wait to wear a normal camisole without the drain pockets; to put on a cute outfit again. I want to exercise more than just a brisk walk and yoga. I miss riding my bike so much it makes me cry. I miss the endorphin rush of intense cardiovascular activity that I’ve become so accustomed to over the years. I miss feeling like my full self, and I’m only at the start. 

I worry I will never get back to my full self. I worry that I’ll never ride like I used to. I worry that I won’t be the wife I was. I worry that I will die young, which always seems to make sense to me for some reason. I’ve lived my life pretty enthusiastically, keenly aware of its brevity and sanctity, living by the old cliches of Carpe diem and Live like you might die tomorrow. I have a fire lit under me most of the time to get after it, whatever it is. I know I can still grow more grateful, more passionate for life, but I feel like I’ve already been living like that for a long time. Was this vigor and lust for life enough to keep me from getting cancer? No.

Finding out you might die soon makes everything come into clear focus – that which you are happy for, and, on the contrary, that which bothers you. That includes everything from environmental problems to unsolicited medical advice. Cliches that oversimplify the situation don’t help. At the end of the day, I appreciate any and all positivity, and am grateful for anyone who authentically cares about me. My sensitivity is heightened, though, and I find myself having a shorter temper than usual. It makes a casual comment, like, Your cancer isn’t that bad; you’re going to be fine, meant with good intention, surely, sting a bit. No, the cancer is pretty bad, and no, I don’t know that I’m going to be fine; I don’t know that it won’t come back to kill me. There’s the Someone I know had it way worse than you story, intended to make you feel better, but it just makes you feel guilty for feeling sad about your situation. If someone else went through something so much harder, then surely my experience can’t be so bad, right? No; of course not, but it can evoke such thoughts.

I’ve been reading like crazy, and I listen to what doctors are saying; what years of clinical trials and research have proven. I’ve pretty much already been eating the healthy diet they recommend for years; no, I’m not perfect, but I can honestly say I’ve eaten well in my life – pescatarian for twelve years, no alcohol for seven, I drink a lot of water everyday. Did it count? Did it protect me? Apparently not. I am always open to improving, learning, and growing, but when it comes to medical advice, I’ll listen to the experts. I am not opposed to advice, but I don’t like being pressured into something that doesn’t work for me. I will try something on, but if it doesn’t fit, I’m not wearing it. I don’t like being told what I should do or not do, especially when it comes to cancer. I don’t need to hear what I should be eating, what I should be doing, or how I should be feeling. My friend Tracey and I once joked that we hate when people should on us. Don’t should on me! we laughed. Just do you.

Arrogance is one of my biggest pet peeves – that, and lack of awareness. I don’t appreciate it when someone acts like they know it all and aren’t even paying full attention; they don’t see the writing on the wall. Sometimes, I want to say, Humble down. Take a humble pill. When I say people, I’m not implying specific people; rather, a general form of the word, from people on the comments section on blogs and social media, to a few people in my own life, too. I’m a pretty open and honest communicator, and will tell someone as directly yet gently as I can if I’m feeling unsettled about something. Again, I mean people in the general sense of the word, so please don’t read too much into it if you know me personally; trust me, I would tell you if something bothered me.

We are never done learning; there is always something more to learn, more depth to explore, more questions to ask. While I’ve read a few informative books and a myriad of articles online, I wouldn’t pretend to speak of cancer with any degree of expertise. Arrogance is the last thing I need here. I am very much a student in all of this, trying to stay as open to the experience as I can so as to saturate myself with the essence of this disease, only to squeeze myself dry of it like a desiccated sponge should I make it out alive. I don’t joke when I say make it out alive; I really don’t have full faith or evidence that I will. That’s why I am more sensitive to what others say right now. Forgive me while I vent; this is part of the process of anger. Like I said, everything is magnified right now, and I can’t help but notice. I feel like a wounded animal. I just want to curl up alone and hide; to lick my wounds in solitude. Bless anyone who tries to help. However, there are times in life where it’s best to admit you don’t have all the answers, you’re not an expert on breast cancer, and just listen; that goes for myself, too.

Lately, I find myself wanting more of that – listening. The patient, I’m just going to sit with you and listen while you talk kind of help. My family has done a stoic job of this, from the early days of diagnosis, to the early days of post-surgery recovery. I’ve had some incredibly inspiring conversations with them that have buoyed my spirits in that way only family can. Talking and messaging with friends has been really comforting as well, and every card I’ve received in the mail has warmed my heart.

My husband has been a professional-grade therapist, letting me jump from happy to serious without missing a beat. He’s ridden the roller coaster of emotions with me, cried with me, laughed with me to ease my nerves. He knows there’s nothing he can say to fix the situation, and he has grown to be an even deeper listener. He sits with me and empathizes, but doesn’t offer platitudes, or oversimplify my struggle with an order to just keep my head up.

He listens like my paternal grandmother, Sheila Prentice Craig, did. She passed away last year, and her absence left a hole in our family that no one can fill quite like her. Sheila was one of the best listeners in our family; she was one of the few people from an early age who really just seemed to lean in to others when they talked. She gave her full attention; she reacted honestly and genuinely, leading a graceful dance of a conversation that would bounce from topic to topic. I would talk with her about everything, from our shared love of birds, to our shared love of the environment. I felt like she saw me for who I was.

I’ve been really wanting to talk to her lately about all of this. I told Ron the other day, and he asked me what she would say to comfort me. I paused, and replied:

Nothing. She wouldn’t say anything in particular; she would just listen and look at me in a way that I knew she understood me. She wouldn’t judge me or try to fix me. She would sit with me and hold my hand, but offer no sympathy; she didn’t care for that. Just pure, true empathy.

I miss her so much, but I realize how much she taught me about compassion, about being a good listener; about not being self-centered. We had a lot in common, and I’ve been told I’m a really good listener myself. I especially appreciate a good, patient listener these days. Patience: a golden virtue.

Patience is adaptive; it is constantly responding to life in ways we aren’t even aware of. When we think we can’t handle it, or can’t wait any longer, we prove ourselves wrong by persevering. When we’re overwhelmed, patience sits with us until we’re out of the woods. When we’re waiting to get surgical drains out so we can take a nice, hot shower, patience is paramount. I am amazed not at myself, but by how our minds are so well-adapted to adapting – we are meant to grow accustomed to life’s changes. Natural selection has shaped us for these challenges, and I am really feeling the effects of its power right now. It’s in my genes to get used to this.

I’ve also been reminded of how important it is to not judge ourselves, or others. I have to forgive myself when I get angry, when I feel despondent, and I have to allow myself to laugh and feel happy without feeling like I’m lessening the severity of the situation. Though one in eight women will get breast cancer in the United States, people deal with it in different ways; there is no right or wrong. I read so many people’s stories before surgery, and was in awe of the variety of stories; it helped me so much, and motivated me to share my story, too. Everyone’s journey is unique to them. What works for one woman may not work well for another, and that includes pain medication. I don’t judge anyone who takes pain medication, let alone after a major surgery, and I also don’t judge those who didn’t take any pain medication. To each their own. I hope that anyone who reads this understands this is merely my experience, and I don’t presume to speak for anyone else.

I surprisingly enjoyed some of this down-time. I am on a leave-of-absence from work, so each day has presented me with the gift of time. While I’d rather be on a real vacation, it’s still nice to have this time off, especially now. I’m a positive person by nature, but healing hasn’t been a cakewalk, either. What helped me cope most was hiking, being outside, and reading. When I would get sad, I’d try to make a conscious effort to dive into something interesting; to put my energy outward, learn something new, get outside of my own head. The important thing is to listen to my body, and take good care of it; that’s really what matters.

A cancer diagnosis befalls you like a rain-soaked cloud, obstinately sitting on your shoulders, but it doesn’t keep you from seeing the beautiful world that remains in front of you. As long as I’m able, I’ll keep going outside, keep appreciating the natural world, and keep getting outside of myself. I may have this shadow following me around now, but so far, I can still see the rainbows and light in front of me. I realize how much more good there still is in the world, whether or not you are sick, and that will always be the case. Even when I die, the world is still full of more good than bad, more beauty than decay, more love than hate, more humility than arrogance. Life isn’t all rainbows and butterflies, as they say, but they’re out there – and that’s enough for me right now. 

Here’s a video I made on March 12, 2020, about my journey so far.

That Chapter Is Done

That chapter is done

That time of my life behind me

Young, carefree, all about me

Sexy, hot little Thang

Using my chest as an asset when I needed,

A burden when I just wanted to be free

That chapter is done

Stage 2, we don’t know how bad 

It really is yet

Poked, prodded, analyzed 

To determine my odds of life or death

I want to crawl into a warm blanket and disappear

December, 2019

I know myself really well; I should, after all, at thirty-nine years old. That includes knowing my body’s idiosyncrasies, like the fibroadenomas I had diagnosed in each breast twenty years ago. I know exactly how they feel, their size, and check them often. Ultrasounds and mammograms over the years confirmed I had dense breast tissue, and fibroadenomas to monitor for changes as time went on. I wasn’t too concerned about them; breast cancer doesn’t run on either side of my family as far back as anyone can recollect. I’m active, eat healthy, and live a low-stress lifestyle. There wasn’t a big cause for alarm, just awareness. I remained aware of those lumps, checking them multiple times a month, almost like a fidget. I would find myself watching television and touching one of them. I knew all the curves of them by heart. For years, they didn’t change, and no one worried. I had my last mammogram and breast ultrasound in 2018, about two years ago, and was told I was good for two more years.

Fast-forward to the holiday season in December 2019. Winter hadn’t even arrived, and California had already been blessed with an abundance of early-season snow. Ron and I had been snowboarding at Kirkwood a few times already, and were stoked about the upcoming season. At some point while fidgeting with the almond-size lump on my upper left breast, I noticed it felt significantly larger – and harder. The texture of it was not the same as the slippery little almond that used to be there. It was irregular, about the size of a chestnut maybe, and was a little bit tender to the touch. This was something different. 

I told my husband Ron about it, and he immediately replied that he’d noticed it a few days earlier; you could even see sticking out a little bit from under my skin. 

Always tell me when you notice something like that! I quickly told him. 

It was the start of Winter vacation now, and the Winter Solstice, December 21. I had two weeks off, and with the epic amount of snow, we had a lot of snowboarding planned. I opted for a January 13, 2020 appointment to get the lump checked out, and had an awesome Winter vacation. Ron and I got in nine days at Kirkwood and it was still early season. We had a White Christmas, like I’d never had. It was a magical time of year, and we soaked up vacation heartily. We kicked off the new year strong, mountain biking everyday we weren’t snowboarding. 

January 13, 2020

When my appointment to get my breast examined began, my doctor was with the mother of one of my former students. I was surprised to see her, but also comforted by her kind, familiar presence. It’s another example of what a small town we live in.
She examined me and felt the lump. There was a silence, how pronounced or perceived I’m not sure, before she said,

Yeah, I’m going to refer you over the hill for this one to get checked out.

I didn’t think anything serious of it, other than, Darn it, I’ll probably have to get this thing biopsied, finally. My appointment was scheduled for a couple of weeks later, and off I went.

We had a vacation planned for Canada from January 17-22. It was a trip of a lifetime, and is best summarized in my most recent post. I am so happy we went on that trip when we did! Kicking Horse was the best mountain I’ve ever snowboarded – yet. 

Wednesday, January 29, 2020 

My ultrasound and mammogram were at Kaiser San Jose, about a forty-five minute drive from my home in Ben Lomond; we call it over the hill. I wasn’t too nervous about the appointment, and was eager to get to the bottom of it. I started with an ultrasound, and then continued for a mammogram. 

Almost right away after the mammogram, I was told there was something suspicious in my left breast, and axillary lymph node in my armpit, that they wanted to take a closer look at; essentially, they wanted to perform a biopsy. We continued into a different room where some sort of care coordinator was suddenly present to hold my hand and just provide moral support during the procedure. While the nurses and doctor prepared for the biopsy with intimidating core-sampling needles, the woman was trying to connect with me – make small talk, answer questions, put my mind at ease, presumably. Once the local anesthetic was administered, and the biopsy began on my left breast and lymph node in my armpit, she held my hand for comfort. Although she was there to calm me, in retrospect, I almost resent that she was there; not resent her, but why she was there. She was probably only there because they knew it was bad. 

After the biopsy, I went home and was told I would get my results within two weeks. Ron and I went up to Kirkwood for snowboarding over Super Bowl weekend, February 1-2. We had an amazing time, as usual. I knew there was nothing I could do until I got the results, and based upon everything I’d heard over the years – You have lumpy, bumpy, dense breast tissue, but no breast cancer in your family so your risk is low – I didn’t worry about it at all.

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Monday, February 3, 2020

After work, I had a voicemail from a doctor. Her tone was somber. I called her back once I got home, about 4:15 p.m., and she asked if I was at home and in a good place to talk. I knew she was about to drop a bomb on me. 

We got the results of your biopsy, Katrin, and unfortunately, all samples tested positive for breast cancer. 

She paused long enough to make sure I’d heard her, before continuing on about the details they had. 

There’s a mass in the upper left breast, and a smaller mass in your axillary lymph nodes. I’m so sorry.

Shocked beyond belief would be an understatement. I asked her questions: what stage, what kind, what next. I told her to give me all of the information she could.

It’s early-stage, but we need to do more tests to really understand what’s going on. Translation: we don’t know how bad it really is yet. She scheduled an appointment for Friday of that week, four days later, to meet with my team of doctors. I had a copy of my pathology report, which confirmed Estrogen-Receptor positive cells in 90% of my breast, and 70% of lymph node tested. It was HER-2 negative, something I was only just beginning to understand. 

I had Invasive Ductal Carcinoma. Translation: my life as I knew it was over. That chapter was done.

What followed next was deep fear and sadness, but I was mostly consumed with shock. Ron was out, so I called my sister Mary. Crying and slightly panicked, I texted her that I had some pretty awful news and to please call when she had a second.

Immediately, my phone rang. I asked if she was in a good place to talk, just like my doctor had asked me. I told her the devastating news, breaking down into sobs as I said the words out loud to another human being for the first time. This was getting realer by the second. She listened empathetically, crying with me, shocked with me, just right there with me. After a few minutes of talking to her and sharing what information I knew, I saw Ron’s van pulling up in the driveway. 

I felt guilty for what I was about to tell him. I felt sorry that I was about to dump this on him as I got off the phone with my sister. In the door he came, and I gave him a tearful hug right away. 

I’m okay, but I’m not okay, Baby, I began. I got the results of my biopsy. They found cancer, I sobbed. 

He hugged me tightly and let me cry like a baby before I shared with him what information I knew. He was shocked, cried, and then affirmed that we would fight this and get through this. The best way to describe how we were both feeling was simply blindsided.

We all deal with grief in different ways. This was no different; I had received news that was causing both of us to suddenly grieve the old me – the pre-cancer me, the pre-fight-of-my-life me. And we didn’t even know how bad it was yet. 

That first night was like getting on a roller coaster through anxiety, sadness, anger, and mostly, shock. We couldn’t believe it. Up until midnight, I knew I wouldn’t be able to go to work the next day, so I scheduled a substitute. I was researching the Internet like crazy, reading all kinds of stories, studies, and statistics about breast cancer, and it quickly became overwhelming.

Tuesday, February 4, 2020

The day began with more shock. It was indeed happening. There was nothing I could do until Friday, however. I was also no different from the day before; only now, I knew some more information. I took it as a sign to go out and celebrate the day. 

Ron and I went on a beautiful mountain bike ride at one of our favorite spots in the Santa Cruz Mountains. We spotted unique fungi, birds, and signs of Spring. The weather was sunny and cold, no sign of the Winter storms that should be slamming the California coast during this time of year. 

Where is Winter? We both pondered. It had started off so strong in December.

We went to Bonny Doon Beach afterwards, and saw one of the most beautiful sunsets. Sitting atop the cliffs, it was starting to get darker. 

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Let’s go, Ron said. He seemed a bit impatient.

I kept stopping to take pictures of the sunset as we started meandering back to the car, and Ron seemed increasingly insistent about leaving.

Come on, let’s go right now, he nearly demanded.

Is everything okay? I asked. He mumbled yes and hied along, hurrying back to the car. 

FebruarySunset

FebruarySunsets2

When we got back to the car, he broke down crying. 

This is not the last sunset we are spending together! We are not just going to sit there and wait for the sky to get dark; I had to get out of there, he said through tears. It’s like a movie, where it’s like They had their last normal sunset together before everything changed; I can’t do it, Baby. I can’t just sit there and think about that! 

I realized then that even though he didn’t have cancer, this was happening to him, too. He was every bit as scared as I was, if not more. After all, if I die, he’s the one who has to mourn me. 

We comforted each other in the car for a few minutes before heading into Santa Cruz for dinner at our favorite restaurant, Chocolate. 

I went next door to Bookshop Santa Cruz and thought I’d give the Cancer section a quick scan. Almost right away I noticed one book shining from the shelf – Running for My Life: My Marathon With Breast Cancer by Michelle Anne Stewart. The Michelle Stewart who works at the District Office in my small school-district; the cool, nice Michelle who was principal at the elementary school, and a teacher for years, whom I taught Summer School with back in 2008. I picked it up, read a few pages, and proceeded to the check-out line to buy it. I’m not superstitious or religious, but I did take it as a sign to read her book. I would end up reading it by the next evening, and it comforted me like a warm blanket during those anxious first couple of days. She is someone I look up to for inspiration!

I went to work the next day on Wednesday. I let my school principal, site secretary, and attendance clerk – all wonderful, caring women – know about my early diagnosis, and that I was still finding out more; that I would be absent again this Thursday for a Breast MRI, and Friday for a bigger diagnostic appointment. They reminded me compassionately to make work my last priority, and that they hoped for a good prognosis. 

I realized I needed to let my kids know something about why I’d been absent so much, and thinking about all of the time I’d need to take off in the future. I didn’t want to tell them I had cancer and scare them, but I also didn’t want to just abandon them with no explanation. I decided I would start by telling them simply that I was going through a personal issue that was very important, and I was okay, but would be missing quite a bit of school over the next month or so. I held it together, emphasizing that I was okay, but that there would be some substitutes over the next couple of months until I dealt with my issue. I would be out tomorrow and Friday, but back on Monday of next week. 

Seventh graders are astute for being kids, still. I could sense their concern, as if they knew I was facing something serious. I didn’t want to panic them, but I knew it was a matter of time before they would find out. I teach in a small community. My primary doctor is the mother of one of my current students; as noted earlier, my OBGYN is the mother of a former student. Word would get out sooner or later, but I wasn’t ready to go public yet. 

Thursday, February 6, 2020

I made it through Wednesday, and when Thursday came, Ron drove me over the hill for my breast MRI. There was a bad traffic jam on Highway 17, the main artery, so we took a back road, Bear Creek Road, to bypass it (catch the medical joke in there?). As we were driving through the mountain road, I saw a squirrel get run over by the car in front of us – not just run over, but every little second of it. I could swear I saw the horror on its face after the wheel went over it. 

I freaked out and lost it. 

It’s an omen – a bad sign! I’m going to die! I wailed like a child. I sobbed uncontrollably, feeling like I’d just seen a foreshadow of my breast cancer battle. 

Ron had been doing a great job of just letting me be all over the place emotionally, but suddenly his tone changed. 

Baby, you need to stop that, okay. I really need you to not think like that and put your game face on for me right now, okay? I could tell he was holding on by a thread fighting back tears. He couldn’t stomach me talking about dying anymore. 

We drove on in relative silence for awhile, him putting his hand in mine to comfort me. No words were needed. This whole situation sucked and there was no sugar-coating it. 

I took an Ativan before the MRI, since I’m really claustrophobic. Luckily, it was an MRI in the prone position, so I was face down, like a massage-table, not supine on my back, where the ceiling of the tube is mere inches above you. I also felt the sedative kick in. I laid there peacefully, earplugs muffling the odd sounds of magnetic resonance imaging. I was doing something to help with my diagnosis, and I felt a mild sense of relief. 

After the appointment, I was completely drowsy from the medication. Ron drove me home and I slept like a baby for four hours. I stayed up late that Thursday night, until almost 2 a.m. I was so wound up about the next day’s appointment. I was to get more information about my diagnosis and prognosis, and although I was worried, I was looking forward to getting an antidote to fear: more information.

Ron’s grandmother, Blanche Deetz, passed away in November 2019. There was an interment ceremony planned in Riverside at a military cemetery, months in advance, for Friday, February 7, 2020, the day of my big appointment. He wanted to be there for me, but I really didn’t want him to miss it. He didn’t want to miss it either, but he was consumed with worry about me. He drove down early Friday morning for the service, and I drove myself over the hill. 

My mother, Kristin, and stepfather, Al, insisted on supporting me that day at my doctor’s appointment. I told them it would be hours, but my mom didn’t let that stop her. We’re coming down to support you! She lovingly insisted.

Friday, February 7, 10:00 a.m. 

I met my breast care coordinator first, a Nurse Practitioner. She was compassionate and patient with me, but also looked at me like I was dying. The sad look in her face as she put her hand on mine and said I’m so sorry seemed like she knew it wasn’t good. I didn’t like it. They’d found signs of cancer in my right breast on the MRI; she described it as a sort of ropy, long mass extending into my armpit. The tumor on the left side was actually bigger than shown on the ultrasound; it was about three by two centimeters in size. They’d need to do a biopsy of my right breast and axillary lymph node that day. As she comforted me, I appreciated the sentiment, but it just made me more nervous. 

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In the few days I had before Friday’s appointments to process the news, I’d considered all kinds of scenarios. Mostly, I’d been concerned that it was worse than they thought. That instinct was now being substantiated. How much worse is it? I wondered.

I met my surgeon next. She explained my options for lumpectomy with breast conservation surgery versus double-mastectomy. We didn’t have all of the information yet to really weigh our best option, but either way, surgery would be needed. 

I met my oncologist next, who explained I would need anywhere from two to six months of chemotherapy, followed by five to ten years of hormone blocking therapy, like Tamoxifen. This would trick my body into some form of menopause, and there was no guarantee I’d get my period back once I stopped it, presumably at age forty-four at the earliest. It would prematurely age me. This made me really angry; now it wasn’t just my life in jeopardy, but my mojo, too? I was becoming overwhelmed. 

I am a sharp cookie. My memory is meticulously detailed and vivid. I soak up information like a sponge. I didn’t need to take notes on what they were telling me; I was taking in every word. I felt myself getting mentally exhausted for a moment, feeling less sharp than usual. I was tired. This was a lot to take in. My mother was wonderfully supportive of me as I sat quietly, sobered by the news I was getting.

Around noon we got coffee and a snack, enjoying a reprieve from the onslaught of information. We waited around until nearly four o’clock for a biopsy on my right breast and lymph node. This one hurt worse than the last. My node under my armpit was so swollen and tender, the ultrasound wand alone was enough to make me wince in pain. The technicians kindly did their jobs, but there was no avoiding how sensitive it was. The needles for local anesthesia came next, and I let out a whimper like a puppy. 

If this hurts, how’s treatment going to feel? I quickly thought to myself. 

They extracted core-samples from two locations efficiently, considering what was being done. By the time I was finished, it was 5:15 p.m. I’d just spent my first full day of work at my new unpaid, mandatory job. This was just the tip of the iceberg. 

Saturday, February 8, 2020

I’ve known for only five days now, and it’s been an intense roller coaster I wish I could get off. My father Laird came down to visit today, and we had a magical hike on the Zayante Trail in Henry Cowell Redwoods State Park, one of my favorite places in the world. We stopped off on a beach on Zayante Creek to take in the view and tranquility. We talked and talked, and walked and walked. There were as many empathetic messages communicated subconsciously between us as there were spoken. My father grounds me, and I know he is right there with me through all of this. I am exceptionally grateful for all of my family right now – my sisters Bonnie and Mary, my mother Kristin and stepfather Al; Ron’s family; relatives. I feel the love from so many directions, and that’s comforting. I haven’t shared the news with everyone yet, as I’m waiting to understand my diagnosis more. 

My cat Beau even knows. When Ron and I cry and talk together about it, he interrupts us with persistent mews, demanding our attention. He keeps looking at me like he’s seen a ghost – perplexed, concerned, and a bit scared. He knows something is up. Perhaps he’s one of those pets that can sense it; maybe he’s just picking up on our stress. Either way, he has been demanding cuddles on the couch, all the while looking up at me with a forlorn look on his face. Right now as I type, sitting on the couch, he is on the footstool next to me in guarding position – paws tucked under his chest, looking out for intruders. 

Beau came into our lives nearly ten years ago on June 20, 2010. Ron and I don’t have children, but Beau has been the closest thing to it. We love this cat whole-heartedly. I’m 99% sure he knows I’m not well. He keeps looking at me with a terribly worried look on his face, and it’s making me a little unsettled. 

How am I doing?

I am a melting pot of emotion, but the shock has definitely gone down. While I have a lot of information, I don’t have a complete picture until I get my biopsy results next week, likely Wednesday. Then everyone will have a clearer picture of the next steps. However, it could also mean more testing is needed; that they don’t have a clear picture yet. Perhaps it is a lot worse than they thought and has metastasized to other areas in my body besides the lymph nodes. Perhaps, perhaps, perhaps.

I love people, but I’m an introvert by nature. I’m kind of a loner; I am really good at spending time alone. There are so many interesting things to do and learn about! I enjoy the company of others, but really need my time alone. 

I recently took the Myers-Briggs Personality Test as part of one of my student’s Science Fair projects. I tested as the rarest kind, apparently: the INFJ, or Turbulent Advocate. Though the subtitle Turbulent raised some hackles when I heard it as I always thought of myself as pretty easy-going, I strongly identified with the descriptions when I read them. It gave me more confirmation of why I am the way I am. 

When I’m going through a hard time, I tend to retreat and withdraw, going inward to deal with the problem. I don’t want to talk about it with many people; I need to sort it out for myself first. Though I am researching like crazy online, I am feeling like a wounded animal, retreating to its den for protection. I am scared to be so vulnerable and weak in front of others, let alone the general public. 

The thought of people fawning over me and helping me makes me nervous; I don’t want to accept help from my loved ones. I fear the stares of strangers; the shock of students at my school. I want to be the strong, independent woman I am. I don’t want people to see me like this. I don’t have a lot of friends, anyway. This isn’t a complaint or a pity-me hook; it’s merely the truth. Sure, I keep in touch with people via social media, but on a weekly basis, I don’t physically hang out with many friends. I know few people give two cents about what I’m up to anyway; this blog post will probably go ignored like most others I share. 

I realize how overlooked and dismissed I feel in my life in general. I’ll never forget the final Oprah Winfrey episode where she articulated three key questions we all really want to know from others in life: 

Do you see me? Do you hear me? Does what I say mean anything to you?

I do not always feel this way, I realize. 

I know I can put up walls, but if I die tomorrow, I don’t know that I’ve felt seen, heard, and significant. Though I mostly feel that way about Ron, family, and close friends, there are times I just feel dismissed, underestimated, and flat out overlooked. I’ll go to gatherings where no one even asks how I am, what I’m up to, or cares to hear about my latest mountain bike races or adventures in the mountains; or, they listen with a placating Um hum… before moving onto a more presumably interesting topic. I’ve literally sat through so many social gatherings just feeling invisible, like I could just disappear and no one would notice. The last thing I want is sympathy from people who think less of me.

I love talking with others, but again, I’m introverted. I don’t want to make myself the center of attention, so I won’t just start sharing stories about my life unless someone shows interest. Over the last couple of years, I’ve felt more and more lonely. I admit I can act reserved, or may not seem too open at times, with people I don’t know very well. I know I’ve contributed to this feeling of loneliness; that my actions help build those walls. Although I love my alone time, I need love and connection, too. I feel like many people just don’t care about getting to know me. Some people are just not very good listeners, of course, and you can’t be everyone’s cup of tea; I try not to take it personally, but obviously, I can. We all want to belong. 

Then there are some holier-than-thou people who dismiss me because I don’t have children; some women legitimately look down on me, or anyone like me, for not doing so. No matter your confidence level, it doesn’t feel good to be criticized. I’ve dealt with passive-aggressive barbs, judgments, and intrusive questions throughout my reproductive years, and there are some people who just can’t stomach that I wouldn’t want to have kids. Now that I’m no spring chicken, I feel written off by some people as boring or unaccomplished. Chemotherapy will all but destroy my eggs and any future chances of having children, unless I freeze my eggs now, which I don’t plan to do given my hormone-receptive tumor. Though Ron and I are all but certain we don’t want children of our own, we’d rather not have the door slammed in our face prematurely, and it does sting a bit. 

Did I mention I am feeling a little defensive? Suddenly I want to fight the world. 

I want to care less about whether others see me, hear me, or care about what I say. I want to get that in perspective, because caring about what others think of me should be the least of my concerns, especially right now. 

I am mad at my cancer, but suddenly, every little thing I’m angry about in life is coming into clear focus. 

I am angry at the mean memes about me on Instagram that a few students made, circulating them among abetting kids who liked, commented, and followed along in cyberbullying. Kids are kids, but this was different. I’m mad my name was trashed, at least among some people, in our small town. Thirteen years at this school, and the last two have been somewhat of a roller coaster. There’s a lot more to that story.

I wish I were immune to people’s actions, but I’m human, too. I’m angry I’m giving that nonsense any energy at all during this time, but I truly wonder if all of the stress from that time contributed to my cancer. I’m angry at myself for the times I lost focus on all of the other good kids in my classes who need and deserve my attention. After all, for all the thirteen years I’ve taught at my school, the majority have been wonderful. That’s what I should focus on, of course.

I realize every and all area of my life I feel wronged. I can’t help but point it all out.

Now that I have cancer, yeah, part of me feels like rubbing it in any potential hater’s face: Are you happy now that I have cancer

Maybe one of my biggest lessons will be to learn to truly not give a darn anymore; to not give a darn that I can’t please everyone; that not everyone will like me. To not give a darn what others think about me at all.

I want to keep enjoying the world; I don’t want to sour in bitterness. I’ve always had a bright spirit. I’ll always remember trail running at DeLaVeaga years ago, when a passing hiker paused and looked at me with a somewhat astonished look on his face.

Is everything okay? I asked him.

Yes; I’m so sorry, I didn’t mean to scare you. It’s just, you have this sort of glow about you. It’s really strong and just, beautiful. I hope you don’t mind me saying so.

I was instantly flattered, and thanked him for his sweet observation. I ran off, and yes, I felt like I had a glow about me. 

Another guy in high school, Rhett, once told me, You have good color, like your overall tone and everything is just really pretty. It was one of the nicest compliments I ever got.

Right now? That glow feels dimmed.

This flame wants to flicker alone.

I want to be alone; then, maybe, no one will notice at all. I can just fade into the background.

Deep down I’m terrified I’m going to die; I fear I might actually die. I fear the battles of surgery, radiation, and chemo that will lie ahead. I fear being a bald near-skeleton in front of my husband. Mostly, I fear I will die young. I don’t have a good feeling about any of this. 

I try to leave these thoughts pretty soon after I accept them. I allow them to enter, and then I try to escort them out the door. I realize a lot of this is out of my control, so worrying about it right now won’t help. I try to let it go and distract myself with something – cleaning the house, writing, singing, riding my bike, listening to really loud music, going somewhere beautiful outside – and for awhile, it really helps. But there is undoubtedly a shadow following me around, and I don’t know how dark or foreboding it is yet. It could be a tornado cell, or a blizzard. I know it’s going to be the hardest thing I’ve ever done, regardless. 

The plastic surgeon said something that really stuck out to me: You’re about to go into a tunnel, but there’s a light at the end of that tunnel, and you will get there.

I feel like I’m preparing for battle. I feel good, physically, but I am overwhelmed and exhausted. I am reflecting on all of the things I’ve done in my life that could have contributed to this. During my appointment on Friday, I shared those concerns with the doctors, prefacing it with the obvious dilemma of patients trying to understand why. Why did I get cancer? What did I do to deserve this?

She patiently listened as I rattled off hypotheses, from drinking milk all my life, to not wearing good enough sports bras, before warmly stopping me. 

I’m sorry, but that’s the mystery of cancer. We’ll probably never understand why, so there’s no value in blaming yourself for every little thing you didn’t do perfectly in your life, she interjected kindly

She added that it was rare for someone of my age and family history to get cancer, and that they’d be doing genetic testing to see if I carried any mutations for aggressive breast cancer, but otherwise, there wasn’t much they could do to determine the exact cause. I knew this before the meeting, but somehow thought she might concur that, Yes! That’s what might have done it

This is probably the hardest part about accepting my diagnosis – I will never fully understand why this is happening to me. Worse? If I beat it, it may come back someday to haunt me again. If I beat this, I’ll have to live in fear of it for the rest of my life. 

My life will never be the same again. No matter what, I will never be the same girl I was. 

That chapter is done.

I will never be the Energizer-bunny, go-getter, thirty-something Katrin again. That chapter is done. Those memories lived, those paths trodden, I am walking in a new direction.

Should I recover from this, I will turn forty on October 10, 2020, starting a new decade of my life. I hope I get to start that new chapter, but I fear who I will become. Will I still be able to do the things I love now, to live the lifestyle I so cherish? I’ll have menopause, aging, and a shadow following me around for the rest of my life should I beat this. Not exactly inspiring things to look forward to, but it beats being dead, I suppose. 

My last post, The Gravity of the Hill, mused about whether aging is harder for athletes, like myself, since we have built our identities so strongly around the sports we love. Will I lose myself even further than my breasts and physicality? Will I lose that sense of belonging to those sports I love so dearly? Will I ever be competitive again? It’s never been about winning a race, but darn it, it felt good when I did. 

There’s one thing I’m feeling pretty proud of right now, at least: I’ve lived my life with a carpe diem spirit for years, appreciating it pretty darn fully. I haven’t taken my life for granted too much, as far as I can tell. My life has been incredibly rich so far – full of experiences, fun, and beautiful, loving relationships that have shaped me. I am so lucky for all I’ve been able to experience so far, and ought to be grateful I am still here after all this time. Others who’ve died younger than I didn’t get that privilege. I feel guilty thinking about people who’ve had it worse than I have.

It is a privilege to be alive. Life is a real gift; I find its sanctity in everything from insects to giant old-growth Redwood trees. 

But this changes everything. No matter what, my life will never be exactly the same again. 

Being grateful for what you have doesn’t protect you from getting cancer. I’ve read many sentiments along the lines of, Getting cancer made me stop and realize how much I needed to appreciate life more, and while I know there is always more room for gratitude, I feel like I don’t really need that wake-up call. I’m sure I will grow more grateful in ways I don’t even know are possible, but for now, I am proud that I have lived thus far with such a deep reverence for life. 

I hope I come out the other side a survivor. I hope I still am a sexy little Miss Thang, not just for my husband, but for my own self-esteem. While I may not seem like a make-up and heels kind of girl, I take pride in my image, like any woman. I’ve always believed you can be naturally beautiful, even as a tomboy, which I was often called all my childhood. I may not dress up in fancy outfits and full make-up very often, but I still appreciate being beautiful and sexy, even if it’s in a t-shirt and jeans, or riding my bike.

I hope I am still a badass mountain biker. I hope Ron and I can still spend our Winters snowboarding together. I hope I can simply go for a walk with my husband.

Mostly, I just want to live – not just survive, but live to get old. While I care immensely about the five-year and ten-year survival rates of breast cancer, I care most about the forty and fifty-year survival rates. I want to live to see one hundred, or at least eighty. I fear it will come back and kill me later in life. 

I fear so much, but none of it is helpful. 

This is a true lesson in patience. I must wait for more information, more clarity. Then, I think things will start happening quickly. I will enter the Tunnel. And life willing, I will emerge out the other side healthy.

Sunday, February 9, 2020

It feels different already, Ron said, tears in his eyes. It feels different between us already. It wasn’t a complaint, a judgment, or a plea, just an authentic observation.

I feel guilty. I feel like I’m going to be such a burden. I honestly think this might be harder on you than me, because you’re going to basically watch your wife die – or maybe, actually die. Then hopefully I’ll come back to life again, but I’ll never be just like I was now, I offered. 

I sometimes think it is harder for him to grieve the loss of his old wife, all the while uncertain about how much of the old wife is going to come out the other side, if at all, after all of this. 

We were in the thick of a sad, reality bites conversation, sitting on the kitchen floor in front of the heater. 

I can sense you withdrawing. I understand you need to process things yourself, but Baby, I’m on your team. We’re in this together; don’t shut me out, okay? I know you want to just curl up and retreat, but I want you to fight that. I need you to let me fight this with you, my loving husband said earnestly. 

I felt genuinely guilty that there were times over the next several months or so that I wouldn’t be there for him – emotionally, physically. I felt sorry for him. 

He noted how I was cowering like an embarrassed child, and told me not to feel guilty, not to hang my head low. Look me in the eye, Baby. I love you. 

A few minutes later, he showed me something he’d found online about the difference between guilt and shame. He read me some of it, and it resonated like a bell. I was feeling guilty, yes, but mostly, I was feeling shame. I am pretty in touch with my emotions, and usually can express them clearly and timely. As soon as he said the word shame, though, it clicked. I couldn’t put my finger on exactly how I’d been feeling since I found out about my diagnosis, but shame was underlying all of it. 

Once the emotion was identified, I felt relieved. Ron added that although I’m entitled to feel whatever I need to feel, there is nothing for me to be ashamed of throughout this whole process; to not shut him out and withdraw.

I was blown away by how much of a revelation it was. It was an example of how teamwork and love change your life; how I wouldn’t have come to that realization, at least not as soon, without my husband’s love. I felt so grateful for him. It was such a powerful moment between us: I needed to let him in, worst self and all, and trust him to love me through it. There was nothing to be ashamed of. I was not a failure.

Emotions are like rocks, at least to a Science teacher who loves geology. I’ve been allowing myself to feel whatever I feel, visualizing each emotion as a rock.

Some are light pebbles, soft and polished from years of wisdom, and nearly bounce off me like wedding rice being thrown on a bride. Some are jagged stones, rough and fractured. Some are heavy like boulders, needing heavy lifting to maneuver. 

I’ve been letting myself sit with each rock, each emotion, taking it in for what it’s worth, before gently setting it down. I am trying not to carry any of them around, although there is a constant circulation of samples inside me. 

This emotion – shame – was a boulder I could not move out from under on my own. I needed the help of a loved one to set it down. I needed my amazing husband to show me what I could not see for myself. 

First, I needed to feel all of that shame – that I am thirty-nine years old and got cancer; that I am losing my younger self. 

What did I do so wrong to get this? 

I’m ashamed that it wasn’t caught earlier, if that were even possible. I’ve been a mild hypochondriac all of my life. I used to look up illnesses in the PDR all the time when I was a child. I have always been super on top of my doctor appointments, screenings, and know my body well. 

Over the last couple of years, there have been a couple of changes I noticed: increased fatigue, which I attributed to sleep apnea and aging, and I started getting a day-long flu every couple of months or so. Some would say it was kind of like an exercise-induced migraine headache. I experienced two mountain bike races in this state of nausea, tension like a mammoth vice grip on the back of the neck, and total exhaustion. I suffered through teaching, and some days, I couldn’t make it through sixth period, having to go home early. The best solution was to go to sleep, and not just for a short nap, but at least a few hours, if not longer. 

I wrote off entire days from these experiences. I investigated all sorts of causes, from dirty water bottle mold, lack of proper nutrition while overexerting myself, to my sleep apnea; I thought of so many different things. I went to the doctor and got bloodwork; I was healthy on paper, and in the flesh, seemingly. I still don’t know exactly what the culprit was for this onset of sickness at somewhat often intervals, but now I think it was related to my cancer. 

I’m ashamed at the thought of looking like a dying skeleton while I’m going through treatment. I don’t want my kids to see me in such a bad state. I don’t want to scare the hell out of them, and I also don’t want to feel completely embarrassed – ashamed – by my haggard presence. 

I’m ashamed that my body is failing me at such a young age. I’ve always considered myself to be in prime physical shape, an athlete. I’ve been pescatarian for twelve years, and haven’t drunk alcohol in seven. I try to avoid pesticides, and the multitude of chemicals that we’re exposed to in this day and age. I’ve long thought about living to be 100, but now, I know my odds are decreased. No matter the outcome, this shadow will follow me around for the rest of my life. 

I am mostly ashamed that I am failing my husband as his wife. We met when I was twenty-four years old, waiting tables together at Shogun sushi restaurant in Santa Cruz, before getting together when I was twenty-five. He’s only known me as a young, pretty thing, and that’s how I want him to always think of me. I felt like that version of myself was about to die. 

He reminded me of a time I had foot surgery at twenty-three years old. Though we didn’t know each other then, he knew I was off my feet for eight weeks, and that it was a full year before I felt fully strong again. It was a big challenge for someone so used to being active, and the first time in my life my mobility was legitimately limited. He analogized cancer to that recovery time: yes, the gravity of the situation was much worse, but there was nothing wrong with me as a person. I was just injured and would need to heal with a lot of downtime, but there was nothing to be ashamed of. 

I wasn’t failing him as a wife by having breast cancer. Yes, things were going to be different between us on many levels, but we would face those obstacles as they come. It was going to be terribly difficult, full of peaks and valleys, crests and troughs, but we needed to fight.

That began with fighting the shame; fighting the feeling that I had failed as a person. 

Next, we would be in for the fight of our lives – or the fight of my life, specifically. That’s what we needed to focus on.

Monday, February 10, 2020

Anger. Just anger. I am so freaking pissed off at everything. I went to work today, and realized how much I need to not be there. I need to focus on my health, not my job. 

After work, Ron and I were going for a bikeride, and he forgot his helmet at home; I just about lost it. 

The world is conspiring against me! Nothing is working out! I cried. 

We had time to go back home, get the helmet, and go for a much needed, stress-reducing ride together, fortunately. MTB Therapy. But I am so mad today at everything today. Screw cancer.

Tuesday, February 11, 2020

I feel fragile. The gravity of the situation is getting quite heavy. Work was really hard. I feel sober in the truest sense of the word. I have started letting some close friends and relatives know.

Wednesday, February 12, 2020

I took today off work for my genetic testing appointment. Ron and I were able to go for a fun bikeride together which temporarily lifted my spirits. More MTB Therapy. Realizing my rides are numbered as I approach treatment, I feel somber. 

I finally got my right breast biopsy results today; some positive news, finally. The biopsy was negative for cancer; all samples were benign. I celebrate this sliver of good news and celebrate the rest of the day.

Thursday, February 13, 2020

It’s been five years to the day that Ron proposed to me at Indicator’s break in Santa Cruz, tandem surfing together. I cannot believe it’s been that long. 

I had my last day at work today before my medical leave of absence starts next week. I couldn’t bear to tell the kids since I felt like I’d just start balling in front of them; I didn’t want to scare them or make them sad. I’m going to miss them, though; their levity, humor, and energy keep me going! It felt too real once the bell rang for my last class. I was done. I didn’t need to come back until August for the new schoolyear, but this wasn’t a happy leave. I fought tears until my car, crying all the way home. I emailed all of the parents that evening to let them know I was taking a medical leave of absence to fight breast cancer, and how much I’d enjoyed teaching their students this year. 

Friday, February 14, 2020

Ron and I have never been big Valentine’s Day people. We slept in, and went for a beautiful bikeride together. I am cherishing each and every ride. I don’t know how long it will be until I can ride again like normal, whatever that will become, but I do know how therapeutic it is for me. It is a true anti-depressant. 

Later, my amazing sister Mary came up from San Diego to visit. We talked and talked and talked, and laughed over a ridiculously expensive shopping trip to the local health-food store.

Saturday, February 15, 2020

It’s been almost two weeks since I was diagnosed, but it might as well have been two months. I am already in a different place with the news, and I realize my emotions will keep evolving. Ron has been an absolute hero for me – listening, talking, comforting me every moment I need him. 

My family has rallied around me and surrounded me with love, with phone calls, emails, and visits. Today, my mom came down and took Mary and me out to lunch at Rocky’s Cafe down the road. I always feel good being with my family. We got one-hour foot massages afterward, which was a lovely respite from everything. We had a wonderful time together, and although there were somber moments, I was grateful for all of the laughs we were able to share. That’s one thing our family has going for us: we’re all pretty positive people. Even if we’re realists, we tend to keep a good attitude. 

Mama'sOrchids
Orchids Grown by My Mother

That evening, my dad came down for dinner with Mary, Ron, and me, at one of our favorite restaurants in Felton, Cowboy Grill. We had a rich, satisfying dinner, followed by a special treat after dinner: looking through old photo albums from my father’s family. I always love looking at old family pictures. He even brought down a priceless family Bible, signed over the generations with people born into the family. It was a sentimental end to a pleasant evening.

My oldest sister Bonnie has gone above-and-beyond to reach out to me from across the pond in London, and I can feel her warm presence although we’re thousands of miles apart. Skype calls, emails, phone calls, all lovingly and thoughtfully sent; questions to consider, cool blog posts she found, words of encouragement, and sweet friends of hers to connect with who’d survived breast cancer themselves. She’s already planning trips out here to come visit, too. The biggest gift of all has been feeling her empathy, but she gave me another huge gift: Dr. Susan Love’s Breast Book. I am nearly through reading it, and it has informed me beyond my expectations about cancer, my treatment, and what I can expect should I beat it. Knowledge quells fear, and reading this tome has really quieted some nerves for me. For example, I was surprised to read that fibroadenomas don’t typically turn cancerous. Whatever this new tumor was, I could find some comfort knowing it was a different beast.

Sunday, February 16, 2020

I am really feeling the love from Ron and my family right now, and am extremely grateful for them. I look forward to building more fun, light-hearted memories with them in the future; to traveling; to sharing inspiring moments out in nature. 

Soon, into the tunnel I must go. May I emerge into the light as a healthy woman. It is nearing go-time. Time to face reality and start treatment, with surgery first. This is getting real. I’m terrified, but remind myself it could be worse.

Whatever happens in these next several months, I know one thing for sure: I won’t ever be quite the same again. Though my spirit is strong, my life has already changed.

My youth fading into the background, that chapter is done. 

Here’s to writing the next one.