Posted by: julia
on Jan 28, 2016
Every year for the last 24 years I have used my birthday as an opportunity to reflect back on an experience that loomed large in my personal biography: my diagnosis with Hodgkin’s Lymphoma on the day of my 23rd birthday. (You can read past blog entries about it here, here, here and here.) It has been a good practice, a cyclically occurring opportunity to ever more deeply appreciate and commit to the hard-won lessons and transformations that that moment birthed for me, and to the person I’ve become. I’ve also used it as an opportunity to enthusiastically remind myself that I am still here, and that no matter how chaotic or tragic life sometimes feels, it beats the alternative. Life is complicated, yes (and it grows ever more so as I age); but it is good and I am glad to be still around to appreciate it.
Ah, but this year is a particularly complicated and emotionally-mixed birthday. I can’t celebrate my “still here, fuck you cancer!” anniversary with the complete, 100% positive feeling of victory that I used to...because here I am again, dealing with cancer (and not even close to done with this phase yet). And it’s a bigger threat this time: the treatments will not be so easy to get through, and the overall narrative feels like it has escalated closer to pessimism (because the second time you have cancer you are in a different story than “I had it once and I beat it”). There is a more urgent sense of existential angst and fear of the unknown that is back again now after having finally been beaten back by decades of watching the cancer experience slowly recede in the rearview mirror. It’s scarier than I remember. In fact I think this is the most consistently anxious and scared I’ve ever been. I'm trying to stay emotionally open and "keep it 100", but it's both difficult and humbling.
In addition, this particular birthday marks a sort of last hurrah or farewell to my “normal” life for a while, since I start chemo treatments tomorrow and that is going to be a tough row to hoe for a while (not to mention the recovery from the double mastectomy to follow). So it was important to me to celebrate as fully and joyfully as possible by doing as many of the things I love as possible. I’m happy to report that I was pretty successful at that celebrating stuff...successful enough to have delayed writing this blog post for close to a week. I ate delicious food with people I adore, I got all dressed up in fabulous outfits (twice!) and played amongst the art with friends at the Edwardian Ball, I saw amazing acrobatics and listened to excellent music, I talked and laughed and processed with my peeps. It was as good as a birthday gets...and possibly even a little more sweet than usual given the knowledge that it represented an ending of sorts.
on Jan 13, 2016
[Well, I meant to get a post up about my New Year’s Intentions last week and then I got clobbered by the news about needing chemo treatments. I’m still reeling about all that, but at least it helped clarify my intentions. Anyway, onward.]
Last year I intended to trust more, and while that was certainly a challenge (one that will always be with me), I think I did do more trusting. I especially practiced that surrender to trust that comes from overwhelm...there were too many times where my usual plan-ahead, multitasking, project manager mode just wasn’t possible so I had to get comfortable with triage and just-in-time problem-solving and with trusting that everything would be okay. And it generally was, so trust was easier.
This year, it felt harder to pick an intention, largely because there was so much chaos and uncertainty swirling around me that it felt somewhat self-defeating (or at least overly optimistic) to set an intention. I did come up with some personal projects I wanted to commit to: blog more, start yoga again, start using Instagram again, and of course that perennial classic, FINISH THE DAMN BOOK. But though I have started several of those projects already (oh hi, Parentheticals!), I am also vividly aware that any and all of these are likely to sink with barely a bubble into the murky swamp of discomfort and depression as things continue to evolve with my cancer saga (not to mention all the other life drama). Yes, the year is still young and there’s plenty of time to start things anew or continue slogging away at things; but I think the only things I can really commit to are being gentle with myself about expectations and settling into whatever pace I can, even if that pace is herky-jerky and wildly inconsistent.
Posted by: julia
on Jan 08, 2016
Today I had a long (2+ hours), informative meeting with a new doctor at UCSF, a medical oncologist named Dr. Majure. Like all the other staff I’ve dealt with at UCSF, she was lovely and smart and compassionate and I liked her a lot (despite the fact that she’s a newly minted doctor in her 30s and thus a little harder for me to take seriously than the ones that are older than me). She double-checked all my overall health and previous Hodgkin’s treatment details, patiently answered my somewhat scattered questions and gave me a bunch more information about Tamoxifen (while the side effects are not as scary as I thought they might be after my internet research binge, she basically shot down Dr. Ewing’s theory about a lifetime of Tamoxifen being any kind of a good idea). Then we talked about some of the details of my recent pathology reports that had previously not been flagged for attention (or at least *my* attention).
Up until this point, all my conversations around pathology had centered around how delightfully small the tumor was (1.1 cm), how good it was that it was so responsive to estrogen and progesterone (because that meant we could treat it with hormone therapy), and how great it was that the lymph nodes were clear of any sign of cancer (so far). So I was starting to feel pretty optimistic that I’d be getting away with “just” surgical treatment followed up by a few years of prophylactic Tamoxifen. But in what seems to be almost a UCSF tradition now, I found out some new information that really changed things—plot twists in the saga, if you will. Dr. Majure pointed out that there were some additional things in the pathology reports that she was concerned about, namely that my tumor was typed as “Grade 3” (e.g. relatively fast growing) and my Ki-67 measurement (please don’t even ask me what that stands for, I’m too afraid to Google it) was over 60% (when ideally you want that number to be somewhere around 3%, I believe). To her, these were signs that the type of breast cancer I have is a fairly aggressive kind, and so unless the oncotype results come back with a different assessment (which she felt was unlikely, but we’ll do it anyway just to make sure), she said she would recommend chemotherapy in addition to hormonal therapy, in order to make sure that any remaining cancer cells would be blasted out of my system wherever they might be hiding before they could make new tumors. And I’d need to start that ASAP.
It will probably come as no surprise to learn that I was greatly disappointed and upset to hear this.