Exercise, again

And again, the NY Times. Today, an article about the benefits of exercise for those undergoing treatment.

Who I was/Who I am

The NY Times, in its ongoing fabulousness, has an article today about coping with identity changes, and I love it.

Two quotes in particular stand out. First,

A critical illness is like a great permission, an authorization or absolving. It’s all right for a threatened man to be romantic, even crazy, if he feels like it. All your life you think you have to hold back your craziness, but when you’re sick you can let it go in all its garish colors.

This is so true. And once the critical illness is over, the permission fades. You were allowed to deviate, given lots of leeway, even permitted to say NO to things and to live your life to maximize health rather than busy-ness. But as time passes, people stop thinking that you are delicate and must be handled with care; they start thinking it's time you stopped whining and started being like everyone else again.

The other quote I loved:

I wanted to be someone, a recognizable personality, a full-blooded, memorable human being, and not just a cancer patient. I had already lost the person I used to be, that healthy, energetic 45-year-old woman. I wasn’t capable of losing more. Other friends had their own spins on claiming individuality in the cancer world.

I alluded to this in an early blog post. At first, I wanted so much to maintain my professional identity, to be the smart, strong person who just happens to be going through cancer treatment. I didn't want to be like those grey, wispy, shadowed people sitting in the waiting room in their headscarfs and their wheelchairs. When I had surgery and couldn't wash my own hair, it was hard to accept help because it just drove home my incapability. When I couldn't walk outside for a full half hour at a time, I felt the loss of my physicality more than I had ever felt its presence.

What the writer doesn't say, and what happened too slowly for me to watch, is that you really can go back to something like your old life, and leave that self-loss behind; but it's almost like a projection of your old life, one rendered in all the same colors and moving in the same patterns, but against a different screen, parallel to the old but never quite touching.

I actually have to fight with myself not to just go the straight denial route, and turn my back on the truth that I had cancer, and ignore anything to do with cancer. Someone close in my social circle just started chemo (her first treatment was on the 2-year anniversary of my last treatment). It is surprisingly hard for me to see her go through this, in part because I just want to deny, deny, deny; and, unexpectedly, her reality becomes a constant undercurrent for me, reminding me of what I experienced and what I am as a result.

Welcome to the club, Christina

None of us asked to join. But we have a new member.

What Not to Say

Wow, this is a great summary of how to interact with people who have cancer--and it was posted on Craigslist, of all places! Craigslist is totally tha bomb.

I found it thanks to the Imagine Bright Futures blog, one I haven't linked to previously--but will.

Sad news

Randy Pausch has died.

Cancer isn't a test. It doesn't separate the good people from the bad, it doesn't spare those who deserve sparing, it doesn't teach benevolent lessons and then release those who learn properly. It just kills people, indiscriminately, hastily, unfairly, too early and too often.

All Clear

The MRI results came back--completely normal. :-)

I go back in 6 months for my regularly-scheduled mammogram, and an ultrasound just for better imaging.

Every time I get news like this it's like I just got my life back again. Which is great. You can find me this weekend, on the beach, playing volleyball. (Or, after dark, analyzing data and writing papers!)

Not quite on topic, but very important

Hi folks--
If you read this blog at all, if you are reading this post, please click over to this other blog, by the family of a 14-year-old girl with a mysterious, undiagnosed, and rapidly degenerative neuromuscular disease. She is running out of time to find a diagnosis and effective treatment--imagine if there were no known treatment for breast cancer, or if we didn't really even know what the problem was! The family is just looking for ANYONE, anywhere, who has experienced similar symptoms--so if you are (or know) a doctor who might have seen such a patient, or if you are (or know) such a patient, please contact them. (The father is a professor in my field at another university.)
Thanks, and this just underscores yet again how randomly cruel life can be.

Needles

One thing I thought cancer might do for me was take away my fear of needles. I always hated them, in any setting. Never worry that I might become a junkie, I always said: the first time I poised that syringe over my delicate inner elbow, I would definitely be scared straight.

I became pretty stoic during the 4 months of chemo (I did not have a port or a pic line--it was a new needle in my left hand, every time; we managed to keep the same vein going for a long time before it threw in the towel and said "find someone else!"), even though I never reached truly blasé. I always asked the lab techs to "stick me" while I wasn't looking; I whimpered a little--no, a lot--when, toward the end of chemo, Lilia had to poke around for a while to find a cooperative vein. But still. I didn't have knots in my stomach beforehand, I wasn't truly freaked out, and it all seemed pretty under control. I figured it was a new era for me, needle-wise.

But it didn't last.

This has been quite the needle week for me. I had to have some fillings repaired by the dentist, and that required numbing my right jaw. I had them give me nitrous oxide while he administered the shots. Of course, I probably could have handled it, but I was a whole lot happier floating several feet away from my body while that needle was probing around my jaw hinge.

And today, I had an MRI. Now, some of you may be thinking that organizing this post around needles is a pretty back-handed way to tell you I had an MRI, so let me be informative. In late spring, I was trying on some clothes when I realized that I had increased a bra cup size on the left (that's the non-cancer side), even though I hadn't really gained any weight. And then I started noticing some aching that didn't seem to correspond with a hormonal cycle. So I called Christy, who said "It's almost certainly nothing," but endorsed the idea of my visiting one of the surgeons out of an abundance of caution.

I saw a new surgeon (Mel has moved on from USC--though I have to admit, I might track him down if I ever need a scalpel wielded again). He did a thorough exam, said it was probably nothing, but felt some lumpiness in the same area where my gynecologist found some lumpiness in December '06. At that time, I had an MRI and ultrasound, and though for a while the medical team thought there might be something to biopsy (again, out of the "abundance of caution"), by the time they went in with a hollow needle, there was no spot looking suspicious anymore.

Well, since it was lumpy again in that area--and I should mention, I am apparently just an extra-lumpy kind of gal--he ordered a new ultrasound. Which was completely, 100% clear and normal. But (always with these abundances of caution) he also ordered an MRI. Which I had today. Which I'll find out about sometime soon. Which I'll let you know about.

And which necessitated another needle--this one in my arm, for an IV push of "contrast dye," which helps illuminate all the booby tissue for better diagnosis. Anyway, this time I was anxious about the needle just like in the old days before chemo. It was like that whole toughening-up experience never happened. Funny. I have been really happy for the "reset" on so many things (getting my hair back, getting my health back, getting my life back). Too bad I also have to get back some things I didn't really miss.

Good eats

Much silence from me lately! This reflects both good news (trip to Europe, getting work done, playing lots of volleyball) and not so good news (I'm feeling resentful about my involuntary association with the world of cancer, partly because of its effect on my own life, and partly because someone very close in my social circle--and younger than me--has just been diagnosed and is being dragged into this world herself).

I break my silence with little to say about my own life. But the NY Times strikes again with another great piece on nutrition. This is just a general "what you should eat" article, but most of these items are on my nutritional oncologist's list of things to eat every day.

Bon appetit!

Living (off topic, but not really)

I am not a traditionally religious person at all, but this story of a street preacher in Oakland just blows me away. One thing that cancer taught me was the importance of living fully and authentically, with courage, following the deepest part of your soul. I also feel that there must be some meaning, some way that we build something that will outlive us--whether through creative works, or academic articles (me), or through the impacts we can have on others. Well, this guy is like the poster child. I just find it very moving.

Then there's this piece from the NY Times, which also moved me on several levels. First, it's an echo of The Wire, my favorite TV show, which depicts the complexities and heartbreaking realities of the life of a modern city. The show and the article both focus on Baltimore, on inner-city kids who don't have much of a future to hope for and about whom most of the world doesn't really care. The article, which is about a lottery for inner-city kids to get into a new prep school, reminded me also of cancer--of that lottery of luck in which your wheel spins agonizingly and stops, the black ball dropping into that slot and a year of surgery and chemo and radiation and weakness and hair loss becoming your prize. Such random fates distinguish the blessed from the forgotten. I got cancer, and lost that particular lottery; generally, in life, I'm quite blessed, and have the kinds of fortune that others might dream about. There's nothing at all fair about any of it, and nothing understandable.

Ted Kennedy = attention to cancer

I was of course very sad to hear about Ted Kennedy's diagnosis of brain cancer. But it is prompting some useful attention to cancer issues. Given that there's been a major oncology conference happening in the past week also, there's been lots of useful cancer news. Here's my favorite one for today:

From CNN, a terrific piece on "what to do when you're diagnosed with cancer." It is a terrific road map for the steps that need to be followed in those first, crazy, terrified days.

Next, be sure to check the comments section from my last post, where a kind reader posted the web address for an article on how vitamin D helps with breast cancer treatment.

In the news

I have certainly been reticent lately. (That's reticent, not reluctant!) The blessing and the curse of being back to "normal life" is that I am mired in the quotidian tasks of work and errands. The good news is, we will be going on vacation in a couple of weeks, to Northern Italy, Slovenia, and Croatia. I am very excited. It'll be a 3-week trip, hitting lots of lovely places (Alps, Venice, seaside Istrian resorts...). And our house and dog won't be lonely, since there will be visitors throughout our time away, enjoying the beach life in our absence.

But I'm here for business, so let me get to it. The other day, NPR had a very interesting story about a new study (published in JAMA if you want to go get the actual study; full paper here, subscription required; the NPR audio is here) regarding diagnostic technologies. Apparently mammography plus ultrasound found 28% more tumors in women with dense breast tissue (like me!) than did mammography alone. That's a rather whopping increase, I think. The procedure was recommended (by the authors) primarily for women at high risk, rather than those undergoing routine screening. As someone who's already had breast cancer, some sources say that I am at high risk, so I will be talking to my doctor before my next annual mammogram!

And a second important story. Now people--does anyone out there really still not get it that we need to exercise? That we really, really need to? That all the rationalizations and justifications in the world do not prevent breast cancer, but that moving our butts even a little bit will start to help, and moving them a lot will really help? (Plus all those other benefits, like fitting into jeans.)

Anyway, now I hope that everyone with a daughter starts to make it a priority to be sure that she does not sit on her own butt, become a couch potato, shun PE (as I did!!), or otherwise grow up without learning that physical activity is a really fantastic part of life. If you can't do this for her enjoyment, then do it for her life. Another new study published this week found that adult breast cancer risk was substantially cut for women who had exercised as girls and teenagers. That's right--it's not enough to turn women loose to discover exercise once they're grown. We need to start them early, so that the next generation can have a better shot at avoiding induction into the Breast Cancer Club.

I hope all my friends, family, and kind readers will take this to heart for the young women-to-be whom they love!

More problems--and one solution!

I'm sure everyone has been following the latest bad news about Nalgene and baby bottles? The regulatory focus has been on baby products, since the chemical in question--bisphenol A--poses risks to development. But the chemical is also implicated in breast cancer (see the end of the article). I'm glad to see that Nalgene is changing its plastic, and that there are tips available to minimize BPA exposure. But as a longtime drinker from Nalgene bottles (and eater of canned foods), I also wish this information had come out earlier.

Now onto the good news. I've been complaining (even more off-blog than on) about the fact that modern corporate farming and food distribution has led to less-nutritious, less-tasty food that poses greater health risks. I've been wishing that I had the time to grow my own food, or that we had a direct line to people who farm organically and could get us fresh produce, not stuff picked a few weeks ago and left to ripen in a dark truck.

Well, it doesn't take much internet sleuthing to find that this is entirely possible. Community-supported agriculture may be a relatively new movement, but it's well organized! I've found 2 potentially good farms in my area. The costs are higher than at the grocery store, I think--and that stinks, because again, healthy food should not be something available only to rich people. But for us, the costs are pretty manageable, and I'll be looking into this more. Just think--peaches and tomatoes that really taste like peaches and tomatoes. Keep you posted!

And more...

I'm sure almost everyone has heard the story that broke last week, about pharmaceuticals in our drinking water. The linked article highlights estrogens as one component commonly polluting our water. Now, my breast cancer was hormone negative, but the vast majority are stimulated by estrogen or progesterone, or both. As women worry about avoiding soy milk, I wonder if they think about the risks in drinking water--risks that can't be avoided, apparently, by switching to bottled waters. (They can be avoided through the right home filters--which is its own challenging issue.)

And I'm feeling just a little bit guilty about flushing my own toxins (e.g., the post-bladder remains of Adriamycin) during chemo...

To fight cancer, we have to fight a lot of other things...

...like our government's refusal to protect our individual lives, in favor of protecting corporate profits.

I know a lot of readers visit this blog looking for support and perspective on dealing with breast cancer, and I don't mean to offend anyone's political sensibilities. But this is germane. I struggle to maintain my survivorship by trying to control whatever I can control: to eat healthy food (not polluted, not full of chemicals, and grown to maximize nutrient value); to exercise a lot; to give my body both motion and rest, challenge and care; and to stay balanced emotionally.

And then, as much as we try to do these things, we live in a world that could either support our efforts, or be a hostile environment against which we have to fight. And when our White House decides it will lean on the agency charged with helping us have a healthy world, urging it away from the strongest and most protective standards (for whatever reason, but especially for the benefit of corporations, which do not get cancer but do make big bucks)--when this happens, I'm really disgusted and angry.