Friday, February 20, 2009

Fatigue

In the past, I was compared frequently to the Energizer Bunny, but at this point in my life, I can say that I am no longer a stranger to overwhelming mental and physical fatigue.

The emotional toll of your diagnosis is one thing; it takes a huge amount of your energy to marshal all of your remaining wit and courage to put your psyche back together. This is when you find out what you're really made of. You try to maintain your focus, while wondering if everything you're going through will work: will you be one of the "success stories" in those statistics that you turn to, trying to reassure yourself? How will you plan for dying? Should you? Can you confront the possibility that your life may be coming to an end before you ever imagined it would?

Learning that I had to go through surgery a second time, when I had felt some degree of achievement at getting through the first operation, was quite a mental setback. About 40% of lumpectomy patients must undergo a second surgery, because there are still cancer cells on the margins of their surgery site. I wish that I hadn't needed to wait weeks for the site to heal, only to be cut open again. That was pretty terrible to anticipate, but at least the site was "clean" following the revision surgery. The post-operative infection was also something that I would rather have not experienced; I was truly very ill, and frightened.

Radiation left me a shadow of my former self, and even the smallest task seemed like a huge effort. I would walk a couple of blocks to and from my daily treatment, managing to do this only by sheer will. I had been someone who exercised regularly for decades, and now, I could feel myself becoming less physically powerful, which was frightening. Foods tasted different, and things that I could formerly eat with no problems would upset my stomach. Exercising wasn't possible, and napping became a major "activity". I would awake every morning wondering how I was ever going to drag myself through the day.

One month post-radiation, I began taking an aromatase inhibitor (AI) to prevent my estrogen-positive tumor from returning. I have to take this drug for five years, and I have now been on it for 1 year. It prevents your body from producing estrogen, so it really plays havoc with several aspects of your health. The side effects: "Weakness" - check! "Tiredness" - check! "Mental fuzziness" - check! "Frequent Hot Flashes" - check! "Weight gain" - major check!

I now weigh more than I ever have in my entire life, and I have read numerous accounts from patients who have gained significant weight while taking the AI drugs. These women also emphatically say that eating less and exercising does very little to counteract the effects of taking the AI, which is slowing down your metabolism even more in changing your hormone balance to fight the cancer. My physician swears that all of these drugs make you gain weight. It would be the height of irony to have a heart attack or become diabetic from taking a drug to fight your cancer, but this thought has occurred to me...

I am now keeping track of what I eat, and exercising regularly, hoping that I'll be able to kick-start my metabolism again. It's better to be tired from exercising than from inactivity; it's a whole different kind of tired, a "good" tired. I hope that in a few weeks I'll recognize my lower body again, because there's someone I've never seen before looking back at me in the mirror...




Friday, February 6, 2009

Another Birthday

Tomorrow is my Birthday. I never really care to make a big fuss about my Birthday; I was brought up in the tradition that "It's just another day". Dressing up, going out and partying never appeals to me. Now, of course, I'm happy to tack another year onto my current total, because it means that I have survived to have another Birthday, thanks to the wonders of modern medical care.

I don't know a single person who doesn't get older each day, and I would never choose to go back to when I was younger. Move forward, and don't look back. To anyone who doesn't want to "get old": consider the alternative!

Each day that I wake up and look at my wonderful husband's adorable face is the best day of my life. I am loved for exactly who I am, with all of my flaws and scars! Someone knows everything about me, the good and the bad, and that person loves me more each year that we're together. He even swears that I am more beautiful now than the day that we were married. What more could I ever wish for? Just to stay alive, so that we can continue growing old together...

Long before my illness, beginning in my childhood, I had lost so many family members that I already knew how precious and priceless life is. And, I believe that life is all about "the little things" which happen every day, and that many people unfortunately overlook.

My Father sent the following quote in my Birthday card several years ago:
"Every day is a gift; that's why we call it the Present".

My Mother gave me a plaque for my Birthday a long time ago that said: "There's something to love in every day".

I couldn't agree more.

Thursday, February 5, 2009

"Why Me?"

I have never thought that Fate has chosen me to be a cancer "victim", or a cancer "saint". People who get cancer are exactly that; we are just people. There's no reason to treat us any differently. Don't feel sorry for us, or put us on a pedestal; and don't avoid us because we make you uncomfortable about your own mortality. Just be there when we need a laugh, a hug, to talk, or to simply be in your presence without speaking a word. Our society tends to deify cancer patients, and we are human beings who need other human beings to treat us like people.

One thing that's never a good response to any adverse circumstance is the "Why Me" attitude. It's self-defeating, and it won't help you to deal with this life-struggle that you have just unwillingly begun.

You didn't get cancer because the world hates you, or you needed to be taught a lesson - it just happens. There's no cosmic revenge involved. And, if you didn't know it by now, self-pity, no matter what the situation, isn't going to help you one little bit. It also has the effect of alienating others if you're a continual "drama queen" about your life. I know that I find people with this kind of behavior incredibly draining and tiresome.

Reading and educating yourself as much as possible about your cancer is a good way for you to focus, and push away some of your fears. For example, I read "Dr. Susan Love's Breast Book" from cover to cover immediately after my stereotactic biopsy, prior to my diagnosis. I wanted to know my treatment options, learn about possible surgical procedures that I might have to consider, and it was important to get this type of information from a renowned physician in the field. When I got to the part about various reconstructive surgeries, I actually began to feel sick at this possibility, but I kept on reading. Luckily, I didn't need this type of surgery; but it made me realize that there is always someone who is facing far more than you are, and you need to keep this in perspective. Your life is literally in your hands; you must be well-informed about your situation and the decisions you need to make. An educated patient is an effective self-advocate. Your focus should be on using your energy positively, not negatively - don't waste it feeling sorry for yourself. You don't have the "luxury of time". Don't let your diagnosis stun you into a state where you're unable to take action. Harsh advice, but true.



Sunday, February 1, 2009

Alone

I have never minded being alone. Maybe it's because I'm an only child, but I enjoy my solitude, and prefer not to spend time in large groups of people. I'm used to going almost everywhere by myself, and I like it that way.

This being said, I have never felt as alone as I did during certain times during my treatment; to the point where it was completely frightening and overpowering, and I just wanted it to be over.

The six weeks of radiation treatment was one example: You're physically overwhelmed by the equipment, the feeling that you've lost any control of your fate, and something that has the power to kill you is being beamed into your body, in hopes of just killing the "bad" cancer cells. And, unlike the chemo patients whom I would walk by on my way to treatment, no one can hold your hand while you're lying on that table, which makes you feel even more alone. When the techs all leave the room, shut the door, and dim the lights, it's just you and the big, futuristic (yet oddly scary) machine.

The many scans and MRIs were also isolating and fear-laden. Although I'm a small person, I'm extremely claustrophobic, which only made things worse. I knew that having these procedures was to my benefit, but it certainly didn't get any easier.

The brain MRI was primally terrifying on several levels: having to be placed all the way into "the tunnel" of the machine (I now have an enhanced fear of ever being in a hyperbaric oxygen chamber, an iron lung, or using a tanning bed!); wearing a space helmet-like contraption, which increases your sense of being penned in and unable to breathe; strapping down your body at strategic points, so you can't move and ruin the imaging. Worst of all was only being able to see outside of the machine via a mirror positioned directly above your eyes, inside the helmet.

I was utterly panicked that: the building might lose electricity; I'd somehow be trapped forever inside the machine; the staff would forget that I was there, and leave for the day. I have spoken with other cancer patients who also had brain MRIs, and they felt the same level of abject terror during the procedure. If I ever needed to have this done again, I would ask to be medicated beforehand - without question. Sedate me, please!

The treatments, and the heightened sense of isolation during them, served to make me realize that I alone had the power to find my inner core of strength, and to use it in responding to my situation. Others can give you comfort, advice, hugs, but YOU have to find the resolve to get yourself through the bad times - to reach the good times, when you will no longer feel like "a patient" every day. And, that day will come.