From patient to survivor

Survivor (noun): One who continues to live after illness, accident or war. 

 "So when do I go from patient to survivor," I asked my oncologist earlier this month. It's a question that has consumed me since surgery in July. 

Clockwise from top left: Flowers sent to my work from my hubby and boys;
certificate of completion from radiation; bathroom is full of creams and gels;
champagne and balloon from my good pal and neighbor.

"Oh, Wendy, you were a survivor the first day you walked in here," she said. 

Love her optimism. It's one of the reasons I chose her as my oncologist. And of course she's right. There was never any question of survival in my mind. But I wanted to know at what point I refer to myself as a survivor. 

"I'd say as soon as you're done with your radiation," she said. 

Today is that day. Chemo, surgery and radiation are now in my rear-view mirror. I'm far from done with breast cancer. My tumor fed on estrogen. So for the next five years, I'll take a pill daily to block the estrogen and hopefully prevent any recurrence. Reconstruction will be next summer. It takes about six months for the skin to totally heal from radiation. And then we will resume the expansion process to prepare for reconstruction surgery sometime next summer. 

The journey has already been 13 months and I have survived. April and Anne Marie, my radiology techs, told me they had a special song for me today. And as I began my series of deep-breath holds one last time, I heard Elton John sing, "I'm Still Standing." Made me smile. 

Cancer stays with you. The physical reminders are many--mastectomy scars, chemo hair, fragile veins and a burned and blistering armpit from radiation. I'm managing with my assortment of gels and creams and hope to see improvement by the end of this week. 

But even when the physical reminders have healed and reconstruction is complete, cancer will remain a part of my psyche. The challenge is to not let the worry keep me from living. Treatment necessarily requires you to press the pause button on many aspects in life. 

Today,  I'm pushing play.

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.

Time is a precious gift, no matter how you get it

The idea of a sabbatical has always been appealing to me--a paid leave to rest, travel, research, study. Education and religious orders understand the value, but the rest of our society is not so enlightened. Now in week 5 of my medical leave, I am grateful for the mental and technological break from a job that can easily consume.
In the weeks leading up to my leave, which granted is a result of having cancer and needing surgery not because I chose to use up all my PTO for my mental health, I prepped everyone for my need to be undisturbed by the daily stuff of work. And they have been incredibly awesome and respectful of that need. For that I am truly thankful. I'll be all the better for it when I return.

Here's what I've discovered in the intervening weeks.

1. WE have to set expectations and boundaries around our availability even in a 24/7 world.
2. Time to think is one of the most precious of gifts.
3. Nothing clears the head like a brisk walk.
4. People want to help. Let them.
5. It is possible to find time to read for pleasure.
6. The sun is a balm for many maladies.
7. Coffee in a pretty mug does tastes better than in a paper cup.
8. The smell of fresh basil in the garden makes my mouth water.
9. Flip flops > heels.
10. I wake up at 7:30 a.m. without an alarm.

So the trick for me is to remember these things when I no longer have the luxury of time. To remember what recharges my creative battery. Because perhaps the greatest realization is that I need to stay connected to my creative self. It's such an enormous part of my being, that I'm not fully myself if I don't create.

I would never go so far as to call cancer a gift, but what it has given me is perspective. So I've been playing around with ideas for essays, blog posts and, who knows, maybe even a book.

I just need to make sure--as the author Liz Gilbert says--that fear is not in the driver's seat of my creative bus.

The stranger in the mirror

I can't speak for the male cancer experience, but as a woman, when your hair begins to fall out in clumps due to chemo, there's nothing anyone can say that makes that OK. It's traumatic and you look in the mirror wondering who the sickly stranger is reflected back.

Like so many things with cancer treatment (for example, bone pain), it is something to be endured. So be gentle to those who are in the midst. They have lost something (albeit temporarily) that has been part of of their identity all of their lives. No matter what anyone says, it feels like a loss (of beauty, health, identity, etc.).

Big hugs to the cancer sisterhood. You will get through this.