Four Years Ago

Yesterday Facebook reminded me it was the anniversary of my last chemotherapy for breast cancer. It's been four years. I still remember the metallic taste of the heparan that was injected to clean out my port. That was the first taste in my mouth and remained along with fuzzy cotton for the next couple of weeks. Actually, if I remember correctly (and I can't be trusted on that these days), I think by this time the fuzzy cotton mouth never left.  I do remember wondering what it will be like to not have a three week cycle, to finally allow time for  my body to fully rebound against the attacks of chemo.  All I had to do was endure one more massive beating. My body was weak, my red blood cell count was pitiful, and I was out of breath, achy and tired all the time.

I would continue to go back weekly for infusions of Herceptin, the miracle drug which helped defeated the aggressiveness of my Her2 positive breast cancer. Then starting in October, I would go back once every three weeks instead of weekly until a year was out. Fortunately my main side effects from this drug were a running nose and insomnia, both easily tolerated.

I remember this day in 2012, hopeful that the chemo did its job, but so tired to think of anything but lasting until bedtime. The kids were all still homeschooling and busy with soccer, church and other activities.  Friends graciously transported them to places because all I could do was sleep. The nausea hadn't set in yet, and the steroids only gave me a bump of energy. That weekend I would miss soccer games and church. Besides not being able to eat or barely drink, I would need to swallow a gigantic potassium pill because now those levels were also low. Walt would bring me back to the clinic for fluids on Monday while friends transported my kids to their co-op classes. We did the best we could. We survived, barely.

It felt like that week would never end, perhaps because it was my last time and I was finished. Done. No more. Finito.  And I couldn't wait to start feeling better.

Once the nausea subsided in about a week, I still felt run down. I tried to eat red meat and spinach and kale to try to boost my iron and combat the anemia. My doctor said it would just take time. I couldn't go on walks during this time, out of breath just walking up the stairs to my bedroom. Even after a few days when I ordinarily would start feeling stronger, I was so weak. I wanted to start walking again, but it needed to be on a flat surface. Hills destroyed me. The track at the high school wouldn't work because of the stairs leading down to it. Everything had to be considered. If I went this far, would I be able to make it back?

Eventually, I caught my breath again. The metally taste and nausea subsided. My stomach was still sensitive so I had to continue to cook my vegetables and avoid anything hard to digest. In a few weeks, I would meet with Dr. Hunter, the radiation oncologist, and learn about radiation. I remember how wonderful it felt three weeks after my last chemo to be going in for just Herceptin. I would continue to improve, not crash again.

I remember back then how going to church, after missing so many Sundays, was magical. Every song, every word, every embrace by friends meant so much. Sitting at the boys' soccer games, soaking up every moment. Looking in the mirror, wondering, will my hair grow back?

Becca singing in church one Sunday during this time--so grateful I could be there

Watching Ben's soccer games

And Nathan's... so thankful to be able to participate in life again

Still wearing my hat and scarf

I am also sensitive, then and now, of those cancer patients whose treatment do not have an end. These are metastatic cancer patients, where the cancer has spread from the initial site. Some people were diagnosed that way from the beginning, and others had a second diagnosis after finishing their first rounds of chemo treatment. When the cancer has spread to other places, mostly the bones, liver or brain for breast cancer patients, you are considered stage 4. There are no further stages. Cancer can be conniving, too, jumping stages with no rhyme or reason. Just because you start at stage 1 or 2, doesn't mean you have a couple of stages to go. This also means that unless the cancer miraculously goes into remission and becomes dormant, the stage 4 cancer patient will be on chemo for the rest of his or her life, either until the drugs stop working or they can't be tolerated anymore.

One other thing to know, just because someone has no breasts, it doesn't mean the cancer won't return or spread. Even the most skilled surgeon cannot remove all breast tissue in a mastectomy. Even after surgery and chemo, cancer cells can lay dormant in someone's body, sometimes for years, and suddenly spring to life.

When I considered between lumpectomy and mastectomy, I elected to take a conservative approach. My surgeon stated that the overall survival between the two is the same. Lumpectomy would require radiation and had a slightly higher recurrence rate than mastectomy. The rate of metastasis was the same. So, we prayed through the decision and felt the less aggressive approach was right for us. The recovery time from the surgery was shorter so we could attack any rogue cancer cells sooner with chemotherapy.

Sometimes this decision between mastectomy and lumpectomy is taken away from the woman because the tumor is too large or there are multiple small ones. Sometimes it's not the invasive tumor that is the concern but DCIS, a type of cancer that is still contained in the ducts and considered stage 0. When this area is extensive, the doctor will often recommend removing the breast.

Each woman will look at the facts, consider whether she wants radiation or not, consider the stress of continued screenings and fear and decide to remove the cancerous breast and sometimes even the healthy one. Each woman will decide what is right for her. I don't regret having a lumpectomy, even though radiation did cause problems in my shoulder. My bi-annual screenings have gradually become less scary. It was the right decision for me.

I also know several women who choose a mastectomy and that was the right decision for each of them. The last thing any woman needs is to be questioned about her very difficult, emotional decision made at markedly one of the most stressful, fearful, emotional times of her life.

As I look at my day today, one spent at the computer writing, anticipating a walk later and then watching Ben at his tennis match, I can't help but feel an overwhelmingly emotion of gratefulness. Four years ago, being bald and weak, seems like a lifetime ago. I'm thankful that God had me walk that journey because of the lessons I learned, but I so appreciate today. Right now. This moment of health and peace. Today, I'm rejoicing in the Lord's mercy.

"It is good to give thanks to the Lord, and to sing praises to Your name... to declare Your lovingkindness in the morning, and Your faithfulness every night." —Psalm 92:1-2