I’m Gonna Puke On This Roller Coaster

Yesterday the HR coordinator of my firm informed me that the partners were “stunned” by the news of my ovarian cancer woes and offered to pay my COBRA through 2009.  I cried like a newborn baby.  Like I’ve said before, I feel like I’ve been kicked while I’ve been down, and for whatever reason, the partners have now decided to pay for my COBRA.

Talking about crying like a newborn baby, this morning I helped my girlfriend Destiny with her 2-week newborn, Soren.  Destiny’s husband (and Soren’s daddy), Sven, landed a pretty big contract filming a video this week for a local software company,  so he has been busy with this project and Destiny and Sven have been in need of help.  Destiny had a C-section that put her on a lifting restriction for six weeks (including lifting Soren), so I volunteered for the early morning shift today to assist — 7:30-11:00 a.m.  I think I’ve mentioned this before — my friends circle the wagons well.  Poor Destiny had been up every hour-and-a-half feeding Soren the night/morning before I arrived.  I came with a bagel, cream cheese, and an Americano for Destiny and lots of energy to assist with Soren.  While Destiny was taking a shower, Soren and I hung out and I quickly found out that he would stop fussing and stare at me if I sung to him.  I have an okay singing voice, so I started singing the songs most familiar to me, which include a bunch of lullabies and Hawaiian songs.  I realized in the moment that beautiful Soren was staring at me in silence as I sung to him “Kanaka Wai Wai,” that I loved connecting with this little person in this way.  I really do want to be a mother at some point in the future.  I’ve questioned that desire in the context of my romantic and health woes — I mean, who can be a mother without a mate and without an ovary and potentially without a uterus?  But seriously, today I really felt fulfilled hanging with this beautiful little boy singing to him.

For frack’s sake, I’m gonna puke on this roller coaster.  Do I want kids?  Can I have kids?  Do I have health insurance to insure I am able to have kids?  More importantly, do I have health insurance and an income to allow me to survive?  There’s that word again — “survive.”  Blessings like Soren keep my faith and strength to survive and endure alive.  Even if I’m unable to have my own biological kids, the thought of being able to give love to a little person unconditionally the way I felt with Soren today keeps my spirits up.  Hopefully, I’ll get to take another shift helping Destiny and Sven with Soren on Friday.

When It Rains, It Fracking Pours

Good news: I do not have the CA 125 tumor marker for ovarian cancer.  Bad news: I was let go by my firm on Thursday.  Given my last blog post, it’s a very eerie.  Talk about foreshadowing.  As you can imagine, I am not doing very well right now.  I was given two weeks severance by my firm, which means my regular paychecks and health insurance will run out as of March 31st.  Technically, two weeks should run through April 2nd, but with my luck lately, I’m just going to prepare for the worst. 

Again, my friends have circled the wagons and I am being very well taken care of in my time of need.  The day I was let go, my friend Steve came to get me and took care of all the logistics of getting the tons of personal crap from my office transported to my storage unit.  A whole posse then came over to my condo to make me cookies and margaritas.  They brought a lot of laughter with them.  A good girlfriend of mine has already scoped out the job scene for me and sent me a ton of referrals for potential work.  Although it’s hard to believe it because I’m still in a period of mourning, I know deep down inside that I will be okay.

Thankfully, my girlfriend, Jae, is visiting me from NYC.  Not knowing about my job issues, she flew into town Thursday evening and is staying with me through this weekend.  Jae was laid off from her job on Tuesday, so we’ve been two peas in a pod.  She’s been an amazing support these last few days, and it’s hard to be sad when she’s around.

I applied for unemployment and plan to spend the next few days working through every financial plan possible to allow me pay for COBRA, pay my bills, and survive.  Survive.  That word has taken on a whole new meaning to me now.  My job loss would mean one thing if I wasn’t in the middle of a breast reconstruction and wasn’t facing the loss of my right ovary and fallopian tube.  It feels overwhelming thinking about having to juggle all these balls in the air without a guarantee that I will be able to continue treating with my doctors.  It’s hard not thinking about the dreaded “D” word.  Death.  It’s a goddamn reality that is much more present in my mind now than ever before.

When I received the news about me not having the CA 125 tumor marker, I was relieved, but that’s not the end of the story.  Dr. Rothblatt explained that if my family history was the only thing we were worried about, he wouldn’t be too concerned about my right ovary at this juncture.  However, because I have already battled breast cancer and I have an inconclusive genetic test result, we need to take these issues with my right ovary more seriously.  That said, I have until the end of the month to menstruate — which would make it much more likely that the mass growing on my right ovary is a cyst and not a tumor — or else I must have my right ovary and fallopian tube taken out.  Later, I told Dr. Rothblatt about the loss of my job and he suggested we schedule the surgery to take place as soon as the month ends so that we can take advantage of my health insurance while I have it.  In the end, I need to figure out a way to pay for COBRA at least through May, when my second breast reconstruction surgery is scheduled.   

It broke my heart to call my Dad on Thursday morning to tell him about my potential ovarian cancer woes.  An hour-and-a-half later I was let go by my firm.  You can’t imagine my fear of having to call my Dad back to tell him the news about my job.  My Dad’s health has been pretty crappy lately (he has heart issues, among a bunch of other problems), so I was fearful that this conversation would put him over the edge.  He’s a “worrier” like me.  My father is a stoic Asian patriarch, so I’ve rarely had the opportunity to see his emotions (other than anger if my sisters or I were disobedient).  Crying in public is an absolute no-no.  Put it this way — I don’t recall seeing him cry at my Mother’s funeral.  But on Thursday evening, as I’m telling him that I lost my job, I could hear his voice crack in a way that made me realize that he was probably crying.  It broke my heart.

Again, although it’s hard to really process now, I know I will be fine.  I just need to get to a mental space that will allow me to shift out of feel-sorry-for-myself mode and into problem-solving mode.  I pray that I will be able to weather this storm they way I’ve weathered every other storm that has hit my shores over the past year.  It’s hard feeling like I’ve been kicked when I was down, and feeling fearful that the next storm will overpower my will and ability to survive.

In my bid to get to a better mental space, I leave you with this for today’s soundtrack: http://www.youtube.com/watch?v=4RDW__oo9JU.

Karla Returns?

This evening, I got the results of my intravaginal ultrasound from my gynecologist, Dr. Rothblatt.  I’m still in a state of shock, so forgive me if I’m not as eloquent as I would like to think I usually am in this blog.  There’s something wrong with my right ovary.  The ovary itself is enlarged and there appears to be a mass growing on it.  Dr. Rothblatt explained that the mass could be one of three things: (1) a  cyst brought on by my ovary coming “back to life” and menstruation right around the corner; (2) a benign tumor; or (3) a malignant tumor.  I am going in tomorrow to have blood drawn to test for the CA 125 marker that will tell Dr. Rothblatt if I have the tumor marker for ovarian cancer.  However, he explained that even if my CA 125 test comes back negative, we still have to deal with the anomalies with my right ovary.

If the mass growing on my ovary is just a cyst brought on by menstruation, then I should have my period within the next two weeks.  However, if that doesn’t happen, Dr. Rothblatt wants to go in for an immediate laparoscopic excision of my right ovary and fallopian tube to test the tissue for cancer.  If the tissue tests negative for cancer, we’re in the clear, but by then I will have lost my right ovary and fallopian tube.  If the tissue tests positive for cancer, I will then have a lot more hoops to jump through (e.g. evaluating if the cancer has spread to my other ovary, uterine lining, lymph nodes, etc.).  I asked Dr. Rothblatt what the worst-case scenario was and he noted that with the information he has thus far, the worst-case scenario would involve taking out everything (i.e. both ovaries, fallopian tubes, uterus, cervix) and having to go through chemotherapy all over again.  Although I kept up a good face with Dr. Rothblatt on the phone, I started to cry inside at the sound of the word “chemotherapy.”  When I actually got off the phone with Dr. Rothblatt, I started bawling.

I know it’s useless to get worked up over something that isn’t concrete yet, but I’m getting a sinking feeling in my stomach about this issue with my right ovary.  I feel like it’s last year all over again and that there’s no use in blindly keeping optimistic about the pathologist report that will ultimately tell me that I have cancer.  I’m also feeling a strong desire to just throw the fucking towel in.  I mean, how long will I be forced to be in survival mode?  When do I get a fucking break?  For the first time since my initial meeting with Dr. Paige, I thought a lot about my mortality.  I am experiencing a ton of anxiety about dying young.  Fuck having my own children — that all seems like a goddamn pipe dream now.  I’m worried about dying in the next few years because of ovarian cancer.  I’m a few months shy of my 33rd birthday and I’m worried about not outliving my 74-year-old father. 

I am feeling even more depressed now than ever, and I can’t even begin to think about the stress I will have to deal with at work if I’m forced to go through chemotherapy all over again.  How stupid, is that?  I have all these health concerns that have come to the forefront of my mind and all I can think about is work.  With all my health woes, my health insurance is worth its weight in gold.  For that reason, I better keep my employer happy to remain gainfully employed in this dire economic climate.

I pray I will be able to sleep tonight.  I have a long day at work tomorrow.

I’m obviously feeling melancholy and somewhat spiritual, given having to face the reality of my own mortality again, so for this evening’s soundtrack I give you this: http://www.youtube.com/watch?v=A25Ww5SRsXQ&feature=related.

Holding My Cards Close

Treating for cancer and now dealing with my reconstruction as a single woman has been an interesting experience.  As I’ve blogged about in the past, as soon as my hair started growing back, I started feeling more comfortable in my own skin, and as a natural result, I started attracting the attention of the opposite sex.  Through these pleasant interactions, I’ve had opportunities to evaluate what a different person I am now compared to before my diagnosis.  More accurately, what a different single person I am now compared to what I was like as a single person before my diagnosis.  In the past, I could casually engage with men without worrying very much about the ramifications.  If things didn’t work out, things didn’t work out — big whup.  But now, I feel like I have a lot more to lose if I invest in someone and things don’t work out.  My physical changes have made me more physically vulnerable, and as a result, more emotionally vulnerable.  My “fragile” state demands a level of trust established by a lot of communication and up-front honesty.  Not that these things weren’t important before, but I feel like I must now be much more diligent about managing my expectations and those of any potential love interests. 

I’ve been so wrapped up and involved in my physical changes that I’m not sure I’ve spent enough time thinking about the effect my physical changes have had on me mentally/emotionally.  It’s one thing to be in therapy, it’s quite another to make it a point to sit down with yourself regularly to take mental/emotional stock of your life.  I’ve had the luxury of not having to worry about the day-to-day stressors of being single because I’ve been distracted by Karla and my reconstruction.  But with my second surgery scheduled and the end of my reconstruction in sight, I’m now confronting what life will be like for me when everything is done and I am “whole” again.  I’m not the same person I was before my diagnosis and I suspect I will be a different person when all is said and done with my reconstruction.  I’m usually a free spirit who often throws caution to the wind to capture and experience life in all its glory.  Karla taught me not to take anything for granted and to live the shit out of the life I have.  So you can imagine the cognitive dissonance I’m experiencing as I struggle with wanting to put myself out there and live it up as a single woman, but also appropriately manage my fear of rejection and the emotional consequences of rejection that I did not have to deal with before Karla entered my world.    I’m not sure how to navigate the waters of singledom with my new body and I have to be honest, I’m scared shitless to try.

I struggled with today’s soundtrack (too many options), but I’ve decided to leave you with this: http://www.youtube.com/watch?v=iKl8bU2LqYs.

Gas Tank Now Full & Inspection of Plumbing Below

Miriam was able to get in the last 50 ccs in each boob with little difficulty.  I’m glad Dawn decided last week to do 50 ccs then and 50 ccs this week.  My body is grateful.  I’m now done with the filling process at 425 ccs in each boob.  Looking down at my chest makes me laugh.  It’s just comical.  I have to literally “hang” with these expanders for a couple months before Dr. Paige switches them out for the actual implants.  My surgery date has been tentatively scheduled for May 15th, but I’m trying to figure out if I can get the surgery date pushed up.  I know I can’t rush things, but the sooner my reconstruction is done, the better for my mental health.  I’m dying inside feeling like I’m in a constant state of being in limbo.  I’m ready to start living my life free of cancer and surgeries and hospital visits every week.

I also had an intra-vaginal ultrasound today to check my uterine lining (remember that the Tamoxifen I’m on puts me at higher risk for uterine cancer), check my ovaries, and track my uterine fibroids.  I have to say, it is one helluva weird process when a technician sticks a dildo-like prod up your vajayjay.  I had an intra-vaginal ultrasound about a year-and-a-half ago right before I had surgery to remove endometriosis and track my uterine fibroids, and I had several intra-vaginal ultrasounds during my fertility preservation efforts.  It’s never something you get used to — it’s always uncomfortable and weird.  I will meet with my gynecologist soon to go over the radiologist’s report and hopefully everything will check out fine.  Keep your fingers crossed.

And for today’s soundtrack, you gotta love Nightmares on Wax: http://www.youtube.com/watch?v=eKy0Uu-s1kM&feature=related

From Prom Queen to Porn Star

Oh my fucking God.  My boobs are huge.  Yesterday was fill up #4 of what was supposed to be 4 fill ups at my plastic surgeon’s office.  You may recall that I was at 325 ccs in each boob prior to today’s fill up.  Nurse Dawn put in another 50 ccs, so now I’m up to 375 ccs in each boob.  I am scheduled to come in next Tuesday for the last fill of 50 ccs.  You read that right — another 50 ccs, which will overfill my expanders to 425 ccs.  Doctor’s orders, which I will explain below.

Dr. Paige examined me before my fill up yesterday and said he was pleased with how things were progressing.  My boobs are pretty symmetrical and I appear to be healing well from the process.  He wanted to know what my final thoughts were on size and I reiterated that I would like to be a full “B” cup if possible.  He asked if I liked the size I was at (which was before Dawn filled me up), and although I did like the size, I told Dr. Paige that it was hard to tell with how high the tissue expanders sit on my chest (they look more like pillows under my skin than boobs).  In the end, Dr. Paige noted that my body is telling us what size I should be, because it’s getting harder and harder to stretch out my skin and tissue, so it looks like I will be about a “B” cup.  I wonder if he thought I wanted to go bigger.  Jesus, I can barely handle the size I’m at now.  I can’t imagine going bigger.

With final thoughts on size squared away for now, Dr. Paige told Dawn to fill me up with another 100 ccs to overfill my expanders.  I didn’t realize they could do that, but I guess my 400 cc expanders actually have more space if they decide to go another 25-50 ccs over the capacity.  Dr. Paige wants to overfill my expanders to make the second surgery — where he switches out the expanders for the actual implants — easier.  So he has to fill me up approximately a cup size bigger than my final cup size.  Just weirdness.  When I laid down to start the fill-up process, Dawn realized how tight my skin was stretched from last week’s fill up.  She commented that we should rethink trying to put in 100 ccs in one session.  So she put in 75 ccs in my right boob and stopped to check how I was feeling.  75 ccs brought on the same pain that I felt the last fill up in my left boob – very distinct pressure that I knew would get worse once I sat up and exponentially worse an hour or two after the fill up.  I told Dawn I could handle the pain if she thought it was best that I walked away with 75 ccs that day.  But in the end, to keep the overfilling option open and to minimize my pain this week, Dawn decided to take out 25 ccs (leaving me with 50 ccs) and scheduled me to come in next Tuesday for the last 50 ccs.  I’m glad we chose to go with only 50 ccs, because I do feel like my body is at max stretching capacity and it’s appreciating a slower pace toward the end of this process.  The sucky thing is that I have to come in next Tuesday for another fill up.  I was hoping to be done with fill ups yesterday.  Oh well, the price I must pay for boobs.

Dawn joked at the beginning of the fill-up process that she warns her patients that they will very quickly go “from prom queen to porn star.”  I didn’t understand the gravity of her joke until now.  I feel like fucking Pamela Anderson.  I’ve always been small-chested, so having what I feel are huge breasts has forced me to reevaluate my spatial reasoning around my chest.  It’s quite comical, but I find myself inadvertently knocking shit off my desk at work because I can’t judge my chest anymore.  I’m also always knocking myself in the boobs with my arms because they get in the way.  When I’ve shared these frustrations with my large-breasted friends, their only response is, “Welcome to my world.”  Oh well, again, the price I must pay for boobs.

I’m noticing that people I interact with are having a hard time keeping eye contact with me.  I’ve never had that problem before and I have to be honest, it’s very irksome.  I’m finding myself dressing a lot more modestly than I would otherwise.  It’s stupid.  All of a sudden I feel self-conscious.  I mean, I should enjoy having these things big while I have them this big, right?  I suspect there are many more body issues I will have to deal with, and  I’m both scared and excited to confront these challenges in the future.  However, I’m getting mentally fatigued with the process itself and I just want it to be over soon.

For today’s soundtrack, I thought I’d find a cheesy 70’s porn guitar riff, but instead, I leave you with this ’cause it’s how I’m feeling today: http://www.youtube.com/watch?v=yEn0UdJfLr0.

Thank God I Never Had Braces

Well, more accurately, I probably needed braces, but my family couldn’t afford them when it was time to make that decision.  But I digress. . . .

It’s Tuesday, which means I had fill up #3 at Dr. Paige’s office.  Before today’s fill up, I had 250 ccs of saline in each tissue expander.  Today’s nurse, Miriam, was supposed to fill me up with another 100 ccs in each boob, bringing me up to 350 ccs.  However, as soon as Miriam started filling my left boob with the first 50 ccs, it became evident that I was not going to be able to handle the full 100 ccs.  I started experiencing significant pain from the pressure.  So, instead, Miriam filled me up with 75 ccs in each boob, bringing me up to 325. 

My appointment was at 8:30 a.m. and Miriam was quick, so I was able to get back into the office at around 9:10 a.m.  However, by 9:45, I started experiencing significant pain in my left breast that would get worse (and sharp) if I took a deep breath in.  I was also experiencing numbness and tingling pain radiating into my left armpit and along the dorsal side of my left arm, all the way to my fingers.  I found myself yawning a lot and feeling a bit light-headed.  Then my body went cold.  

I immediately called the nurse’s hotline at the plastic surgery clinic and left a message.  By the time Miriam called me back, I was no longer freezing, my breathing had returned to a normal, and I wasn’t light headed.  However, the pain in my left arm persisted and I still felt sharp pain in my left boob whenever I took a big, deep breath in.   Miriam said that she thought the pressure of the recently-filled tissue expander was pressing on a nerve, causing me pain.  She suggested I come into the office to have some of the saline drained to alleviate the pressure.  Call me stupid, but I told Miriam I wasn’t ready to give up just yet.  The fact that my symptoms had alleviated a bit from when I first called the nurse’s line made me optimistic that I just had to wait it out. 

I tried working and did get some stuff done, but the pain in my arm was distressing, making it difficult to type.  I also refrained from taking deep breaths to avoid any additional chest pain.  I prayed my allergies remained under control.  The thought of sneezing or coughing hard made me cringe.  I was sure I’d pass out from the pain of such an action.  My increasing anxiety motivated me to self-diagnose my condition online.  The crap I was coming up with was not making me feel better — heart attack, nerve damage,  etc.  Add to my stress that I was dealing with difficult opposing counsel in one of my construction defect cases and facing several upcoming deadlines.  Finally, after two hours of continued pain and less-than-ideal productivity, I called Miriam to find out when I should come in to get drained.

My legal secretary, Lauren, drove me to the hospital, where I was quickly ushered into an examination room with Miriam getting ready to drain me.  Miriam alerted Dr. Paige of my condition so he examined me first.  After discussing my symptoms in great detail with him, he concluded that my chest pain was not heart-related, because it was obviously related to increased pressure in my left tissue expander: more pressure by taking a deep breath in = more pain.  He also told me that the nerves that are of most concern to him are located near/in the armpit and nowhere near where my tissue expanders are situated.  He then told me that although I could definitely have some fluid drained to stop the pain, he thought that I would feel much better tomorrow after my body had a chance to relax from today’s procedure.  I asked Dr. Paige if the symptoms I described to him indicated that my health might be at risk and he said no.  After pausing a moment to consider my options, I told him that I knew what I was signing up for with this process and that I would deal with the pain.

I was really hoping that I wouldn’t experience any more complications from here on out, and obviously that’s just not going to be the case.  As I type this, my symptoms have alleviated more, but I am still in significant pain.  Patty, my paralegal, checked in with me after I returned from my visit with Dr. Paige today.  After listening to me describe my ordeal, she noted that my experience sounds a lot like what it’s like to have one’s braces tightened by the dentist — it hurts like a mutherfucker for the first few days after the tightening, but then gets better with time.  I pray this gets better with time.  I dread the last fill up next Tuesday.

There’s no question this song represents my day: http://www.youtube.com/watch?v=KNthqC2fsVw.  Cheezy, yes, but very fitting.

Getting My Mojo Back

This post may be an overshare, but I think the topic has been so egregiously underaddressed by the medical community that it’s important I share about my own experience.  Today I went to a very interesting workshop at a local store called Babeland.  Here’s the info I received about the workshop:

Babeland Brunch: Great Sex Post-Cancer
Sunday, March 01, 11:00AM, FREE!
Your sex life isn’t the first thing your doctor talks about when you are going through cancer treatment, though most people experience a lot of changes regarding their sexuality during this time. Chemotherapy and radiation can leave you feeling tired and irritable, or you may be experiencing lack of lubrication, changes in your erection, or loss of desire. We’ll share advice and suggestions to get you back to enjoying your body again, with or without a partner. Enjoy complimentary brunch snacks.

My girlfriend, Kristin, received word of the workshop and signed me up with her.  Kristin’s mom has recently battled breast cancer also, so Kristin decided to go to the workshop to take notes for her mom.  This workshop came at the perfect time, given my recent annual exam with Dr. Rothblatt.

I came to some serious revelations about the effect of chemotherapy on my body during my annual exam with Dr. Rothblatt.  I have had an annual exam with a gynecologist every year since I was 18.  The first time was very uncomfortable and weird, but after a while I got used to them.  Therefore, much to my surprise, this last annual exam was one of the most painful things I have endured in a while.  Dr. Rothblatt explained that chemo put my reproductive system down, which then decreased my estrogen levels pretty significantly.  As with women who are going through menopause (which technically, I am too) low estrogen levels lead to issues with – and don’t judge me for using an Oprahism — one’s vajayjay.  I was amazed that no one had had a conversation with me about this topic until now.  Granted, thankfully my cancer care team was more concerned with making sure I got through chemo, surgery, and overall treatment in one piece, but I feel like it is important to address this issue with any single woman going through this process.  Perhaps my cancer care team assumed I was not focused on having sex with anyone because they knew I had broken up with Alex shortly after my diagnosis.  And to be fair, I did not have sex on my mind at all leading up to and immediately after my mastectomies.  However, I can’t tell you how disconcerting it was to realize that attempting to have sex after my mastectomies would have been an extremely painful process.  Bear with me as I continue to overshare, but it’s not just lubrication — it’s overall elasticity too.  The former can be addressed with a trip to the local drugstore.  The latter requires personalized care and coordination with your medical team.

Working with Dr. Rothblatt and Dr. Pinder, I have been able to remedy most of the ”issues” with my vajayjay brought on post-chemo the same way menopausal women deal with these issues.  Other women in my situation, attached or single, need to ask appropriate questions of their medical providers because these issues are seriously underaddressed.  Don’t be afraid to ask.

So back to the workshop I attended.  It was one of the most helpful things I’ve attended since my diagnosis.  As part of a graduate program at the University of Washington, Shannon, the woman who organized and put on the workshop spent the last 12 weeks studying women and their sexuality after breast cancer treatment.  In preparing her presentation for Babeland, she expanded her talk to include men’s sexuality post-cancer.   Shannon had a lot of interesting and helpful suggestions of how to deal with the problems surrounding sex after cancer.  Lots of mental exercises, exercises to strengthen your PC muscles (for women), suggestions that involve hardware, and of course a recommendation to work with your medical providers.  She also shared two amazing book resources I’ll list here:

Intimacy After Cancerby Dr. Sally Kydd and Dana Rowett: http://www.intimacyaftercancer.com/

Better Than I Ever Expected by Joan Price: http://www.joanprice.com/BetterThanExpected.htm

Shannon mentioned that her research and experiences talking to women in my situation have prompted her to write a book on this topic.  I hope she does.  Hopefully, with more information out there, patients and their doctors will be more likely to have comfortable, candid, and honest discussions about sexuality after cancer.

So for today’s soundtrack, I leave you with yet another song about mojo: http://www.youtube.com/watch?v=FhTCYqJsfqs.