To combat the holes in my bones from the cancer, I have a new drug regimen.  I’m on Reclast, which I will receive quarterly.  I had my first treatment last week.

It was painful.  Not the infusion itself, but the aftereffects.  I experienced growing pains all over again, writ way large.  Luckily, I had the following day off from work as well.

The process of the infusion itself was interesting.  I was expecting to receive it in the chemo room, but when I got to the hospital, they directed me to a much cushier suite of private rooms on the second floor.  I had a very comfy chair and a TV, as well as a nurse named Ro who was very friendly and professional.

I couldn’t help but remember chemo and the time period around it.  Even smells remind me of the months of chemo treatment.  At the time, we had cherry blossom-scented soap in our bathroom, and whenever Ryan would give me Neulasta shots he’d wash his hands with the soap.  If I smell the scent of cherry blossoms on someone now, I can feel my stubbly scalp in my hands and feel the needle in my belly.

I am also on a new estrogen blocking drug, called anastrozole.  I’ve had a couple of queasy days on it.  My doctor also prescribed an anti-nausea medication.  The nausea wouldn’t be a big issue if I didn’t have to work.  I dread being sick at work.

My biggest fear going into this second round was that it would render me incapable of pulling my weight at my job.  So far, everyone has been supportive.

Sometimes I think about the things that brought me here.

I’ve been introduced recently to someone who is newly diagnosed. She is starting chemotherapy soon. She is getting a drug called adriamycin, as I did. Adriamycin is known in some circles as “red devil.” At the time I was told about my drug regimen, I was unaware of adriamycin’s reputation.

It is so potent and so dangerous that it can only be administered by a nurse wearing a full nasty-stuff getup: mask, apron, gloves. When a patient gets it, he or she must chew on ice chips, lest they break out with nasty mouth sores.

At that time, I was not in a good place, emotionally. I think I might have had post-traumatic stress. So when I heard my new friend’s news, I was briefly brought back to that time. I started to feel anxious, stressed-out. I was wondering if I was headed back down that spiral. I was legitimately afraid.

I snapped out of it, and now, I have to say, I feel pretty grateful. I saw my oncologist again yesterday and the news continues to be good.

I am no longer on Tamoxifen, the side effects of which were a problem the first time around. Instead, I’ve been switched to Anastrazole, which I only have to take once a day.

It’s more powerful and only for patients who are post-menopausal… which, having had my ovaries removed, includes me. I managed to avoid symptoms on Tamoxifen, but I’m starting to get hot flashes after only a day on the new drug.

Because there has probably been damage to my bones, my doctor also wants to start me on an IV osteoporosis drug. I’ll have to go in quarterly for a two-hour-or-so infusion.

I am just so lucky that I’m not facing more chemo. I think of my new friend and hope she makes it through okay.

I suppose I should talk about what went on in between my diagnoses.

I won’t lie; things got really dark around the time I started chemo. Luckily, some kind of switch went off when radiation ended and I made peace with my life in a way I never thought I would. For four years, I was carefree, enjoying my new lease on life.

I had reconstructive surgery in 2013.  That was a messy affair.  In retrospect, I probably had the surgery too early.  The radiation thinned my skin considerably and made the area difficult to heal fully.  I had to see my surgeon for repairs two or three times, but eventually, it was done.  I don’t regret having the surgery, not at all, but it never hurts to wait a bit. That’s one lesson I learned.

At the end of 2013, I got my first job since having a family.  I’m fortunate to be with a company that is involved in several charities, including the American Cancer Society.  I even participated in the Relay for Life when my company organized a team.  This job made me fit–walking around and carrying boxes is great exercise.  I was loving that, but I noticed that every day, it was harder and harder to recover from the day at work.  The constant joint soreness is what lead me to the see the doctor and my second diagnosis.

I feel now that I am better equipped to handle this fight than I was before.  In the last few years, I think I’ve learned to not sweat the small stuff.  And I’m hoping I’ve passed some of my wisdom onto my children.  Recently, I’ve been watching friends renew their own personal battles with cancer.  I know that despite all of the complications, I’m lucky.

As I make this journey, I’m determined to stay close to Katie.  Being a woman in this word is hard enough without having his disease looming over the horizon, as it will since there’s a hereditary consideration.  I’ve worked hard these last few years to teach her how to be herself, with no apologies.  I hope if my children, all of them, learn nothing else from this experience, it’s compassion.

There’s nothing quite like waking up after a procedure and seeing a crowd of people in scrubs around you. It’s frightening and surreal. When I woke up after the procedures, I wondered if I had made it through. I had two procedures that day, but first things first.

Shortly after my CT scan, a nurse called to tell me that alongside a looming oophorectomy, I had three good-sized kidney stones. I made an appointment with a urologist, a Dr. Thibault, and at that consult it was decided that he would zap the kidney stones with a laser on the same day of the oophorectomy. I was in a rush to get it done and was secretly hoping they’d be ready to go right there and then.

I took the week of the operation off from work so that I could go to all of my pre-op appointments. Although my bone pain is mostly gone, fatigue sets in much faster than it used to and I felt I needed the extra time off. It might not have been the right call because it’s taking me a little longer to recover than I’d anticipated. I’m on fairly serious pain medication and that helps, but I feel a little guilty for taking it.

Katie wanted to be home for the weekend and we couldn’t say no. I know it gave her a lot of peace of mind to be here. When I picked her up, we had lunch and did a little shopping and it was like she never left.

I’ve determined that there’s a certain rhythm at play during any kind of operation involving anesthesia. Kind of a hurry-up-and wait feeling, like I’m backstage watching actors getting ready for a play. Once in a while, a nurse pops in and takes vitals, and then there’s more waiting, and then suddenly all the doctors and a thousand nurses are all around and everybody needs to go RIGHT NOW. I’ve gotten used to this rhythm.

The weekend went by too fast. I was enjoying my first free weekend in a while with my family, even though I was still recovering.

Tomorrow I have my second appointment with my oncologist, post-diagnosis. In the meantime, I’ve had a battery of tests, including a bone biopsy (to confirm that this is the same cancer as before) and a brain scan, which is both troubling and fascinating.

Apparently, the full-body bone scan revealed an abnormality on my skull. I’m not a doctor and don’t know if whatever is going on in my skull can make its way into my brain, but I guess that’s one thing we’ll find out tomorrow.

My oncologist has a few things to learn about subtlety.

I like my oncologist; he is honest and forthright and I appreciate that in a doctor. But on our last visit, he prefaced his remarks by saying, “I have been dreading this appointment.” He went on to tell us (mostly) good news, but what can one expect to hear when one’s doctor is dreading a meeting? He then showed us the pictures from the full-body bone scan and again, oddly, stated, “I was hoping I could avoid showing you these.”

The pictures, I admit, were alarming. To my untrained eye, they looked like those of a severely ill old person. Several vertibrae were dark, as was my hip bone, and a chunk of my head, places where there was a lot of bone death and growth, indicating a fierce battle with cancer cells. They went a long way toward explaining why I’d been feeling so lousy. He expressed surprise that I hadn’t been in more pain than I was.

My drug regimen now includes Tamoxifen (again), and I have to say, it’s reduced the pain quite a bit. I hardly need the gigantic bottle of painkiller my oncologist prescribed for me. Some days, I wake up and it takes me a bit to remember that I have this problem. Most of the time, I can just go about my day and not think about it too much.

Days like today, though, when an appointment is imminent, I fall into an emotion that I can’t describe and can’t pull myself out of. Oncology visits bring knowledge and a plan, but they’re also milestones that change everything.

My daughter just started college. She is attending school at a campus about forty-five minutes away from us by plane. Facing this new cancer challenge while she’s away reminded me of something that happened in my life before.

Just after I earned my Associate’s degree, I decided to move here to get a degree in Marine Science. I got into UH-Hilo, the school our daughter is attending now, and was packing my things and making plans when one day my dad came home, walked through the front door, and said, “The xray showed a spot on my lung.”

Coming to Hawaii was suddenly out of the question. There was no way that I could leave. I told my parents that I would take a year off from school and try to find a four-year school closer to home.

They were having none of that.

Dad did not have lung cancer; in fact, he was perfectly healthy and lived another twenty-three years. I moved here, meanwhile, grateful to still have my dad in my life, and never took for granted that one day, he wouldn’t be around anymore.

So it seems like some kind of practical joke that the Big C reared its ugly head just as Katie was about to leave. Life is full of moments like that.

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Tomorrow I get my routine yearly mammogram. My oophorectomy has also been scheduled. When I was on the phone with the nurse yesterday, they told me that I’d need a phone appointment with the anesthesiologist first.

That frightened me a little. The OB made the procedure seem so simple, like they could do it with a minimal amount of medication, but I guess it’s all the way under after all.

The last round of tests have been strange. My periods resumed just after my diagnosis, which worried my oncologist. He referred me to an OB/GYN for some tests as well as my annual exam, which was overdue.

I went into the office thinking I would get a confirmed date for my oophorectomy, but was told instead that they needed a tissue sample, which would be “crampy”.

I think male OB/GYNs are the masters of the understatement. Not being owners of the parts involved, perhaps they are less in tune with the way some things feel. So they basically took some tweezers and pinched off part of my uterus. This, he explained, was to rule out any chance that the cancer has migrated into my uterus. This procedure was the second most painful thing I’ve ever experienced. It almost ruined my day.

On the other hand, I was dreading my bone biopsy, which was accomplished very quickly. I didn’t feel a thing. It was very unlike my breast biopsy in 2012.

Afterward, Ryan and I went to Aiea Bowl. I had my very first oxtail soup. It made up for the uterus nightmare.

I wish I was getting a more accurate picture of what’s going on. I’ve been examined head to toe and inside out, and nobody has told me what they’ve found. I don’t know how much I should be worrying and I’m starting to feel optimistic.

This could be a problem. It’s when I get optimistic that things happen.

When I was diagnosed in 2012, I had been a stay-at-home mother for many years. This time around, I’ve been employed at the same company for almost three years.

My situation is not one I discuss with many people at work. I have a few friends to whom I confide about my health and I am keeping all of my supervisors up to date. I don’t like sharing things like this. This diagnosis, though, has been harder to keep quiet about.

For almost a year, I had been a sales associate, which involves crazy amounts of heavy lifting and walking and climbing. Becoming a sales associate was a physically demanding change, so much so that I knew I couldn’t continue to perform these duties given my recent challenges. I went back to being a cashier. My coworkers have questions about this. I don’t know what to tell them.

I don’t want to be That Lady With Cancer. My reluctance to discuss the change in my job description stems from sheer vanity. I don’t want them to think of me as some sick person. I’m still me. I’m still showing up to work and doing the things I’m supposed to do. I’m embarrassed that I’ve had to ask to be let out of a promotion I begged for. The idea of my coworkers being afraid to talk to me is even more embarrassing.

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The tamoxifen doesn’t seem to have the same side effects I noticed at first. In fact, I feel a little better. I wish I had just stayed with it. I’m not having trouble functioning. With my job, I feel a sense of purpose, I guess, that mitigates the mushy-brain feeling.

Next up, I schedule my oophorectomy.

I heard from a high school friend recently. She wrote to me to tell me that she’d recently been diagnosed with breast cancer.

Shw went on to tell me that she’d been following my cancer blog, which had been sorely neglected. I kept meaning to update. I wanted to make time to write and tell everyone that I had completed treatment and was in good health. My husband urged me to post a small entry, at the very least.

I wrote in an early entry that if my blog helped one person, it would have made me happy. It did help my friend, who was diagnosed after she discovered that her symptoms were similar to mine. I’d saved her life, she said.

I’ve been spending a lot of time this week wondering why this is happening. As a recovering Catholic, I am quite familar with the concepts of guilt and retribution, and as illogical as it sounds, I guess some small part of me still thinks I’d caused this to happen, that I’d brought it on myself.

It turns out that breast cancer metastasizes into bone cancer more often than one might think. It’s not a rare occurrence. I didn’t know this. I didn’t know that cancer like mine can be treated as a chronic condition and controlled. I didn’t know these things, despite the reading and research I’d done. I suppose I thought that I was done with the whole experience. I am not, so I will continue to share what I learn at this particular rodeo. Science is discovering new things about cancer every day.

During the past three weeks, I’ve had an X-ray, CT scan, a bone scan, an MRI, a bone biopsy and an annual pelvic exam that was only slightly less awful than a root canal. Later this month, I will have my ovaries removed. The focus of my treatment at this stage is to completely remove all sources of estrogen from my body. I am told that the ovary removal process is a very simple outpatient procedure. I’ll be in and out of the office in a couple of hours.

While this is happening, my daughter is starting her freshman year of college. This round of the battle, coupled with the ache of missing her, is exhausting me. My faith in her to put her head down and get through her studies is what keeps me going. I am also still working at my part-time job, where they have been wonderful at making concessions for me and trying to help in any way they can.

So many people have been where I am now. I wish I knew how to get through like they have.

I’m a working mother. I’m a cancer survivor.

I was warned by doctors and fellow survivors of a condition called “chemo brain”. More than any other possible side effect — more than hair loss, more than nausea, more than the thought of death itself — loss of my cognitive function scared me. I read that the effects of chemotherapy on the body and the mind can last for years after treatment. Hair grows back, I reasoned. When one’s mind is gone, is it gone forever?, I wondered.

The bad news is that maybe it’s true. Perhaps one does not ever truly recover from the effects of chemo and radiation. Maybe western cancer treatment is hopelessly outdated at best and barbaric at worst. I have good days and I have not-so-good days, three years after treatment ended for me. I have a little less stamina; I’m sometimes not as able to focus as I once was.

The good news is that it doesn’t matter to me.

Cancer was a terrible experience. I would not wish cancer on anybody. As traumatic as it was, however, it taught me a few things. It taught me how to be compassionate; it taught me the meaning of love. It taught me to let go.

At one point, I realized that I’m still alive. I’d beaten the odds. My cancer hadn’t spread past my lymph nodes and I had a very good chance of living to be an old woman. I also realized that life is short and very fragile.

I have spent a very good part of my life worrying. I am a worrier by nature. I used to cope with everyday life by worrying about minor details. I still find myself stressing about things that are beyond my control. I’ve learned to control it, though. I’ve gone to therapy. I’ve learned that after the first degree burn on my chest that I got during radiation, nothing hurts. I’ve learned that I used my intuition and my brain to figure out that something was wrong before it was too late. I’ve learned what love is. All those things combined have brought me to a more peaceful place.

Originally posted on Medium.