You are where you need to be ... just breathe

Radiation treatment has begun and it's the final stage of my cancer treatment. I'm in week two of a six-week course of treatments that last all of five to eight minutes. By October 10th, I'll be done. The countdown to completion is on.

Unlike chemotherapy or surgery, radiation cannot be seen or felt. It's a big ole mystery to me. So I ask questions. Its effects are cumulative, I'm told. Eventually, it will lead to fatigue and skin changes such as sunburn and possible blistering and peeling of skin. Beautiful. Can't wait. Right now, I don't feel much of anything.

Two techs--April and Anne Marie--line me up under the linear accelerator (LINAC for short). Sounds scary, I know, but it looks a little like other scans, only larger. But there's no comfy cushion on the table. I'm on a sheet on the hard table with my head resting in a clear plastic mold. They slide a leg rest under my knees, which helps me to relax. (Side note: I need one of those for home.) I grab onto the handlebars above my head and let my elbows drop to the trays positioned on either side.

In preparation for treatment, the techs tattooed tiny freckles on my chest and sides to ease with the lineup. I lay heavy on the table while they use the sheet to position me perfectly. With the mother of all remotes, they move me up and under the LINAC. "Turn your head slightly to the right." I always forget that part because I'm fascinated with watching the red and green lights. The red creates a target on my chest. The green looks like some kind of measurement device striped down the middle of my chest.

A cross is cut into the ceiling tile above me with red LED lights glowing from within. I asked what it's for and it's simply a center point for alignment. All the lights are cool and distracting. I want to turn my head, but I have to remember to keep it angled.

Because my tumor was on my left breast, the radiation oncologist was concerned about my heart being in the way of the radiation beams. "How long can you hold your breath?" he asked me. "I don't know. Pretty long, I guess. 30 seconds, maybe. Should I practice?" I'm nothing if not a good student.

He explained that when I hold my breath, my heart moves up and to the right away from the radiation beams. So each of the six angles begins with instructions over the intercom to, "Breathe in ... breathe out ... breathe in ... and hold."

An electrical buzzing sounds though I cannot see or feel anything.  I fight my body's urge to twitch while holding my breath. I close my eyes and find my zen. "And breathe." Phheeeewwwww.

The LINAC moves around me with batwing-like trays coming in close, showing red laser lights across my body and then slowly, smoothly flying out again. Each time, it's a different angle targeting the beam on what's called the "tumor bed." The large round accelerator uses a series of "fine, tungsten leaves" to shape the beam to the precise shape of the tumor bed. I can see and hear these leaves being adjusted in the accelerator, almost like the aperture on an SLR camera.

With each position, I hold my breath longer ... 10 seconds, 17 seconds, 22 seconds. And then I'm done. And I'm one step closer to being a cancer survivor instead of a patient.

If You Were Born Today, September 8:

If You Were Born Today, September 8:

You are not only creative, you are able to channel your vision into practical avenues of expression. You are not well-suited to routine work. Your mind is always busy, and if you’re not using it productively, you are given to worrying and overanalyzing. Some worrying is good–you are strong at organizing. Too much, and you fret over the small stuff. Overall, however, you are hopeful and fresh and have an unusual spin on life that intrigues others. You are hard-working, inventive, and talented. Your ideas are gold–you can turn a brainchild into something lucrative. Famous people born today: Pink, Peter Sellers, Patsy Cline, David Arquette, Martin Freeman, Jonathan Taylor Thomas.

Happy Birthday also to Ruby Bridge, Matthew Dellavedova, Bernie Sanders, Sid Caesar, David Carr and the Virgin Mary.

A year of living with cancer

My husband tried to get me to open up. We had a long weekend ahead of us to wait to learn the "official" results of my biopsy. It seemed I was doomed to have all diagnostics on Fridays when the delay in getting results would be excruciating.

I kept telling myself, "You can deal with anything once you know what it is."

But over the Labor Day Weekend in 2015, no amount of self-talk was working on my psyche. I knew I had breast cancer. I didn't yet know what kind or what stage. I knew I was facing surgery, chemotherapy, radiation. Though I did not yet know in what order. Very few people in my life knew what was happening at this point.

When you're inside your head and afraid, you feel utterly alone.

My three sons were away for the weekend. We had no plans and in retrospect, we should have crammed our weekend full of fun stuff. "Let's take a drive," my husband said. We wound up at the Rocky River Marina, watching boats gliding up and down the river. As we sat on a picnic table, I confessed that I felt alone.

While I was at my lowest emotional point, no tears would come.

I just kept cycling through a series of questions. How would the boys handle my weakness? How would my husband? Could I work? What if I couldn't? How would we pay the bills? Will I feel sick? Will I look sick? Will I die? How will my family go on without me?

Speaking the fear always makes it seem less scary.

"You have to tell people," my husband said. "Give them a chance to care for you." Of course he was right. Virgos have a tough time depending on people or even sharing their innermost thoughts. We like to go along as if everything is fine and under control. But I knew I would need the support and love of others to carry me through. So I sent my first email on Labor Day evening 2015:

 I need to share some news. I've been diagnosed with breast cancer.

There. I typed the words. It would become easier the more I said it, but that first time on September 7 was difficult. Everyone asks the obvious:

Did you find it yourself or on mammogram? Found it myself and had been ignoring for long time. I'll write about that another time. 

What kind and what stage is it? I have estrogen positive, ductal carcinoma. My opinion on stage was that I didn't care to know. It would have no bearing on how I would face this. 

What's the prognosis? Really?!!! This is not a question you ask someone who was recently diagnosed with cancer. Because here's my response: I'm gonna fight with everything I've got and I'm going to recover. What other prognosis is there?

 After 3 p.m. on Tuesday after Labor Day I was in my car in a downtown parking garage leaving a meeting. I called the surgeon's office to get the biopsy results.

"Name?"

"Wendy Hoke."

"Birthdate?"

"9.8.67"

"Wow, that's..."

"Today, yeah."

"Happy Birthday. OK, doctor will give you a call back."

The mid-morning sun filters through the trees
to illuminate this statue I see on my daily walks.

As it turned out the results weren't ready until the next day. The lab was delayed because of the Monday holiday. But once I had the official results, I was relieved and then anxious to get started on treatment. I would have a series of scans--bone, heart, PET, CT--all to confirm it had not spread anywhere else and that my heart was healthy enough to get blasted with chemo.

"Wendy, you cannot hold your breath in the scan and hope it doesn't find cancer," my mom, a 17-year survivor of non-Hodgkins Lymphoma advised. "Go into the scanner, close your eyes, give it up to God and let the machines do their job."

So while I would not sleep the night before these tests, I did as my mom so wisely counseled. A good friend had given me bracelets, one with the Virgin Mary and the other a Shamrock. As my hands were clasped above my head, I would hold the charms and recite the Hail Mary. It helped to calm me down and I'm sure it kept my blood pressure normal.

On the morning of Wednesday, September 30th, I got a call from my oncologist saying the cancer had not spread and in a change of plans she wanted to get chemo started that day. I was at work, heading into a management meeting....literally standing in the hallway when I got the call. In retrospect, it was a good thing. I didn't have time to think or worry. I just said, OK.

"Before we begin, I need you to sign this consent to treat form," my oncologist said.

I read it over and the box was checked, "I consent to this treatment to cure my cancer." (bold is mine)
"Cure? We use that word?" I asked. She nodded. "It's an aggressive treatment plan, but yes."

"I'll gladly sign that and I'd like a copy for my records."

It's a year of your life and then it's over or so goes the traditional thinking. But my cancer was stage 3 and nothing about my treatment was traditional. I started with chemo and thought I'd have surgery after. Instead, I was put on Tamoxifen to help further shrink the tumor. I had mastectomy six weeks ago and tomorrow I head back to work AND begin radiation, my final stage of treatment.

We're at the year mark and the active treatment end is in sight. But I'll be on anti-estrogen medication for five years. And the process of reconstruction following mastectomy probably won't happen until next summer. But as my plastic surgeon said the day after surgery:

"Once you finish with radiation, you can start to reclaim your life."

I'm not waiting until after radiation. I reclaimed my life once I realized what was at stake a year ago. I notice things more acutely -- colors, smells, sounds. I smile easily, which is something I've always done. I give hugs freely. And I count every day as a blessing.

Why Lin-Manuel Miranda is my latest crush

The Pulitzer Prize-winning and Tony Award-winning Lin-Manuel Miranda makes me smile whenever I see anything he says or Tweets. That he is wicked talented goes without saying. What I absolutely adore in him is his epic joie de vivre and love for all of humanity. If you doubt what I'm saying, check out the wedding surprise he concocted for his wife. It's apparent that his talent for performance was a gift handed down from father to son.

His treatise on the stories we tell versus the stories we leave out at the University of Pennsylvania was one of the best of all commencement speeches in 2016. 

But it was this that I read in the New York Times By the Book feature back in May that really cemented him in my esteem. 

"I am most in awe of novelists, who move lights, scenery, and act out all of the parts in your mind for you. My kind of writing requires collaboration with others to truly ignite. But I think of Dickens, or Cervantes, or Marquez, or Morrison, and I can describe to you the worlds they paint and inhabit. To engender empathy and create a world using only words is the closest thing we have to magic."