the bald and the beautiful

Chemo is one of the most dreaded words. There are no positive associations that immediately leap to mind upon hearing the word, "chemo." The word evokes images of emaciated, wearied cancer patients devoid of hair and exuding a sense of utter exhaustion. Gaunt and pallid, their faces haggard and drawn from sleepless nights and varying stages of malnutrition; dusky semi-circles clinging to the underside of blood-shot eyes.

It's possible I have a tiny flair for the dramatic. I consider it one of my most under-valued of attributes. ;)

As previously discussed, my own associations regarding chemo were probably even less positive than most peoples'. Having stepped into the cancer-treatment fray despite my deep-seated presumptions, I can testify to having developed a greater appreciation for the all the complexities of this mildly-barbaric treatment.

About the time I was beginning chemo, I embarked on a good-sized pity party with all the, "woe is me," you could possibly tolerate. And then a bit more.

Chemo, and its subsequent misery, terrified me. And don't even get me started on the whole hair loss bit.

Losing your hair is traumatic enough, but for a woman it has to be significantly more so.

I remember my chemo nurse, the brilliant Kathy, preparing me for what was to come. Just prior to beginning my first round of chemo, she stood in my room and, propping her hip against the counter, effected a soothing, but direct tone as she listed for me what to expect in the coming days/weeks/months.

Hair loss, as we all know, is a relative inevitability as the chemo that endeavors to kill stray cancer cells also happens to staunch hair growth. You not only don't grow hair, but you lose the hair you already possess.

The hair loss, she explained, typically took place within the first ten days or so, but everyone was different. That meant that my rounds which were spaced at three-week intervals, would see me only attending my very first treatment with any of my own hair.

Big. Fat. Bummer.

I was hoping for a longer transition. Or that maybe somehow having fewer rounds--as I only had four--might mean I could curtail the entire hair loss portion of cancer.

No such luck.

It was sort of an either or thing. Black and white. Yes or no. There was no sliding scale. No grading on a curve. No gray. No maybe.

And it that moment I had to jump on board. I had to leave the ever-ruminating, over-thinking Holl at the door and just dive in. If I hadn't, I probably still would be vacillating on the topic, even eight months later.

Act a little more, think a little less. Not a mantra for everyone, but gospel for me.

So I did.

Kathy educated me on the nuances of chemo hair loss. Here are some of the things she told me to expect:

• Tingling in the days proceeding the most significant loss. I didn't really have this, but it's very common.
• As the hair falls out and in the initial first few weeks of being bald the scalp can be hyper sensitive. This was super mild for me, but I know some people complain of it being unbearable.

• Loss of all body hair. Okay FINALLY a chemo side effect I can get on board with. I didn't have to shave my legs for months! And, most people lose their lashes/brows, but I didn't.

Not that it would have mattered as I have drawn my spartan eyelashes on since the seventh grade and I've worn fake lashes for over twelve years. Ha! Take that, cancer. (Hey, I'll take victories where I can get them! ;))

The hair, when it did begin to come out, really came out. By the handful. My pillow and mattress looked like I had been grooming Wookies in my spare time.

above: Chewbaca, the most famous of wookies.

But the whole chemo/hair loss thing really was an exercise in just-doing-it-ness. You know...lots of biting of bullets and grabbing bulls by horns, etc.

And I did a couple of things that helped me overcome the inevitably frustrating impotence that accompanies cancer, particularly chemo.

• I bought a stunning wig. Wigs aren't for everyone, but mine was a godsend! I made sure to buy it before losing my hair so as to ensure I was as objective and non-emotional as possible. I invested in a really great one. Forget whatever you think you know about wigs, NO ONE knew I was wearing one until I told them. More about that in a later post.
• And I shaved my head. Once it became all patchy and I started to resemble more a junk-yard dog afflicted with mange, I decided to take control and have my mom shave my head for me.
  

The day I shaved my head, my little three-year-old nephew was visiting and he stood in rapt attention attempting to make sense of what I was doing. Upon finishing, he pointed to my head and said, "Caillou!" For those who don't know who Cailllou is, he's an animated character on children's programming who's bald. Like Charlie Brown. I obtained the moniker, Cailllou that day and it was all my nephew insisted on calling me, up until a couple of months ago, anyway.
above: Caillou

good riddance, 2011!

I typically imagine my life--not as a linear strand of events--but rather a complex, landscape of varied terrain.

And inevitably, on my wandering path through said landscape, I find myself encountering one striking vista after another. BUT the Universe is not content to let me view these sights through nothing more than my standard vision--awesome though it may be. But rather I am required to see them through ever- evolving eyes so that each unique experience is observed through a constantly changing perspective.

This year, and its subsequent foray into the world of cancer, required some real trailblazing on my part and I found myself donning a new lens through which to view my life.

2011 was a year characterized by my first--and last--mammogram. Ultrasounds, biopsies, MRI's, three surgeries, multiple rounds of chemo and its subsequent hair loss, tissue expanders, and allergic reactions (all of which I'll get into in a later post.) Not to mention the acquiring of a team of gifted surgeons and clinicians and a whole new title to add to my life's resume:

Breast Cancer Survivor Extraordinaire.

However, this year will also be remembered as the year I gained greater perspective, finally learned patience, developed greater control over my thoughts and attitude, realized the breadth of relationships and discerned my increasing fortitude.

So, while I'm eager to embrace the coming year and brand it with a fresh perspective, I am not unappreciative of the blessings this year has provided.

I will make this clear: like junior high, 2011 was an essential and formative period for me, I just have no desire to repeat it! ;)


*I feel I should note that the aforementioned mammogram is my last only because--having endured a double mastectomy and subsequent reconstruction--my circumstances will require me to have only physical exams and regular MRI's. I am nothing if not an avid proponent of regular mammograms. Consider me an ever-responsible provider of relevant disclaimers! :)

treatment....

Despite my unequivocal trepidation regarding chemo, as I have mentioned more than once, the process was actually surprisingly anti-climactic.

As is often the case with our fears, it was an experience that equated to a fraction of what my expectations hitherto had been.

Hey. No complaints here. Thank God for small favors. :)

I came home from chemo and busied myself. Among the many lessons the years have taught me, distraction as a tool for coping with anxiety was one I had employed on many occasions. It had not disappointed.

Twenty-four hours post chemo I was expected to inject myself with a shot called Neulasta. As I have no aversion to needles, this hardly seems worth mentioning. The fact that at this point there was no notable nausea, however, made that a banner day.

One day fled into the next and with relative speed, accumulated behind me becoming part of the rich fabric of my mortal experience.

It was like the proverbial family road trip with the incessant whining from the children in the crowded backseat of the family station wagon demanding impatiently, 'are we there yet?' Then, as if by magic, after seemingly hundreds of times, they ask and the answer is

yes.

That is what chemo felt like.

I had two calendars: a wall calendar and a small pocket calendar. I relished the daily ritual of crossing each day's square with a giant pink, 'X.' I decided I needed both of them so that I had a large reminder in my room and one to keep with me in my purse. It was a reality check during those times when treatment seemed interminable and allowed me to refocus; taking pride in the accomplishment of enduring another day.

After a short time, I saw a the X's lined up in a row celebrating the completion of my first week of chemo. Then one week evolved into two. Soon the grid was awash in X's and I found myself celebrating the turning of a calendar page as I graduated from May to June.

I put my mantra, 'I can totally do this,' on repeat in my head and utilized the power of distraction whenever things seemed inundate me.

I had demons with which to contend in the form of fatigue, migraines, mild mouth sores, body aches, sore throats, queasiness, and general malaise to name a few. But I just brought my secret weapon out and put it to good use.

What's my secret weapon?

My sheer, unadulterated awesomeness.

The good news? All women have it.

And that is why breast cancer is 99% curable when caught early.

End of story. ;)

XOXO

Chemotherapy

That's a loaded word. One that elicits many emotions:

dread

fear

anxiety

hopelessness

self-pity

(insert virtually any of your own negative adjectives)

Twenty years ago Vera Jane Williams Hoffmann, my paternal grandmother, died after a valiant battle with breast cancer. My highly-impressionable mind and often overly-sensitive nature absorbed the experience as one of incomparable physical pain and discomfort. I watched as her strength dwindled and her spirit waned. I overheard stories of the tortures of cancer treatment—chemotherapy to be specific—and those second-hand tales left me smarting.

I became familiar with the descriptor, 'a treatment worse than the disease.' My mind formed a conclusion that suffering from cancer and living seemed oftentimes to be only marginally better than dying from it.

I was young and it was a formative time for me. I mean, what thirteen-year old girl is rational anyway? I took these morsels of incomplete information and allowed them to mushroom into a profoundly irrational basis for judgment. Chemo became something I equated with the sheerest physical misery a person could endure and this tiny monster of fear in my mind fed on ignorance born of the trauma a young girl experienced watching her grandmother die of a disease she'd later contend with herself.

So, when my oncologist, the illustrious Dr. Elizabeth Prystas, gave me her professional opinion suggesting chemotherapy, I went into a severe state of shock.

It's possible I uttered the words, 'I'd rather die of cancer than go through chemo.'

And it's also possible I didn't so much utter the words as I wailed them.

But, let's not split hairs...

I knew what I had to do. I knew there were too many people who loved me in all my mostly-perfect glory.;) I knew there was a whole wide world of opportunity waiting for me; children to be raised, friends to be made and a soul mate to find.

I don't think there can be a much more compelling case than that.

So I started chemotherapy the following week. Monday May 2, 2011. I went in to said oncologist's office and confronted that monster that had taken up residence in my head two decades ago. It had indubitably grown in size, but I conquered it with impressive veracity. I'm a very strong person, something I've never had the luxury of doubting.

But even I was surprised to know just how strong.

XOXO

hollie

a letter to cancer

Dear Cancer,

I've given you a lot of thought lately; it would really be impossible not to as you have endeavored with great success to encroach upon my life--attempting to rob me of opportunities, peace and time.

Ahhhhh, but you have greatly underestimated me. ;)

I am stubborn. Some might call that a detriment, but I know it for the fortuitous blessing that it is. A lot of traits fall under the umbrella of, "stubborn," chief among them:

brave
resilient
tenacious
driven

and let's not forget one of my favorites: resourceful.

And you might be interested in knowing, I've been through and survived worse than what you've thrown at me.

I am sure it scares you to know that I have all these weapons stashed in my arsenal. I know it's humbling for you--a disease teeming with hubris--to know the strength of my resolve.

I'm aware of the way you ravage lives, deplete resources and separate loved ones from their families. I am not ignorant to your grip on so many lives and the negative effects that lie in the wake of your devastation.

I know that for many people, you are a form of death and fear; that those attributes are your calling cards. I am also aware that not everyone has the blessing of forging a life beyond your arrival.

But I think you underestimate human spirit: the need to not only survive, but to prosper. The aching need in a mother's heart to watch her children age. The subtle desperation with which a husband prays for his wife's recovery while she struggles to gain physical strength in a wearied and weakened body.

I think you have no clue of the great gifts you often leave behind. Your devastation knows a boundless reach and impacts the lives of nearly every individual on this earth in some capacity.

But what might surprise you, is how great a blessing you provide to so many. The family rifts that mend, the strength and courage that is adopted by so many who's hearts had long been ignorant of their true caliber. The poignant awareness that breaks boldly, exposing the genuine scope of a human's soul.

It is because of you I've had a blessed awakening--a restructuring of priorities, dreams and all the aspects of Hollie-ness I hold dear. I have been honed and polished--as cliche as it may be--and have received a glowing glimpse of the woman I'm becoming.

You have been an incomparable impetus in the evolution of my spirit. Thank you for that.

You probably find that appreciation of mine intensely irritating. Another point in my favor. :)

It's not in your nature to enjoy losing, but you should get used to it because I am not the only strong one out there and science is gaining on you.

I hope you've enjoyed having the last laugh for as long as you have, because the tide is turning and your days are numbered.

Consider that your prognosis, Cancer!

to chemo or not to chemo....THAT is the question!

The cytoxin-one of my chemo meds-as it drips from its bag into my line.

All throughout this ordeal of cancer, I have been on proverbial pins and needles:

First-How would my biopsies come back?
Second-How aggressive was my cancer?
Third-How far had my cancer spread?
Fourth-What kind of breast cancer do I have?
Fifth-With these answers, how do I go forward? What is considered to be reasonable and effective treatment for someone in a position similar to mine?

I made so many serious, weighty decisions over the last several months completely on my own with nothing more than all the information I could glean and the good sense and capable mind God gave me.

Don't get me wrong: there is no human way to compute this information and determine treatment specific to you--your longevity, your quality of life, the impact on loved ones--without emotion becoming a real factor. Despite this and despite the fact that I was teeming with hormones and facing perhaps the most critical decision of my life, I was actually able to maintain a great deal of objectivity throughout this. It was no small feat and a miracle for which I will be infinitely grateful throughout the remaining fifty plus years of my earthly stint.

It was a clarity borne of equal parts my innate Hollie-ness, the support of loved ones (especially my parents) and the divine whisperings of a Higher Power.

I cycled rapidly through the five stages of grief at each of the crazy little mile-markers of the cancer journey.

Reaching acceptance was, without a doubt, the most imperative and cathartic step in the grieving cancer.

Saying the words, "I HAVE CANCER," went from some disturbing and statement fraught with outrage to being more: "I have cancer. What of it?" It just sort of evolved into something without the sharp fangs and beady eyes the 'c' word usually tends to elicit.

I had to exercise an impressive amount of patience as final pathologies were completed and specialists were able to examine me and review my case.

The patience paid off; I got my answers. And then some:

First-How would my biopsies come back? Malignant, aka cancerous.
Second-How aggressive was my cancer? Grade One: the slowest-growing form.
Third-How far had my cancer spread? Nowhere. It's stage one and has NOT spread to any lymph nodes
Fourth-What kind of breast cancer do I have? Invasive Ductal Carcinoma. Estrogen receptive= the least aggressive form and exceedingly rare among pre-menopausal women.
Fifth-With these answers, how do I go forward? What is considered to be reasonable and effective treatment for someone in a position similar to mine? Surgery with three options: lumpectomy, single mastectomy or double mastectomy.

We all know which of these I chose. Surgery is known as primary therapy. It's purpose is two-fold: to remove known masses/tumors and to test the sentinel lymph node for cancer in order to see how far the cancer's likely spread.

Once this has been accomplished, the next step is to see an oncologist to guage what, if any, secondary therapy should be pursued. Chemo and Radiation are the most common. They exist to sort of sanitize the cancerous spot; like taking bleach to your kitchen counter tops. It diminishes the likelihood of recurrence by killing any stray cancer cells that might have made it past the ectomy phase and the sentinel nodes.My arm with the intravenous chemo meds.

Consider it a beautifully effective insurance policy; a prophylactic measure to ensure that you did everything in your power to assure that the cancer's growth was halted and that any remnants have been destroyed.

So after most of my mastectomy recovery had passed, I finally received the opportunity to meet with my oncologist. She examined me from tip to toe and gave me glowing reviews of my body's remarkable ability to heal.

Can I get a, "Yay, Holl!?!"

At the end of our pow wow she showed me a graph of statistics.
"Everyone's cancer's different, but based on someone closest to you: some one your age, in your health with comparable tumors, we reach a conclusion regarding your secondary therapy."

The short of it is that all the factors were in my favor for not needing secondary therapy: grade 1, stage 1, estrogen receptor positive. All of these indicated a very low chance of recurrance.

But my age--my youth rather-would be the impediment. I'm 33 1/2. If I'd been 18 months older I'd be in a completely different bracket and secondary therapy would be unnecessary.

But alas, I'm young and somewhat punished for that. I chose to undergo chemo as a means of insurance; ensuring that I'd live for the fifty plus years I stubbornly plan on gracing the planet with my sardonic wisdom.

So, I'm undergoing T/C chemotherapy--four rounds to be exact. And I'm currently halfway through them!

Another "Yay, Holl."

P.S. Did I mention no nausea/vomiting? Take that, cancer! ;)

healing is a team sport!

I've mentioned before that cancer has this ugly, inescapable tendency to isolate you and it does. Inevitably, you face every facet of it's course--from diagnosis to remission--alone.

For some reason finding a proxy to undergo chemo on your behalf, isn't really how it works.

Shocking, I know. ;)

One remarkable thing about cancer, is the opportunity it provides you to make room in your life for the assistance you need. If you're anything like me, then you're charmingly stubborn. I have a problem resisting the urge to keep my problems and suffering to myself. I have an overwhelming urge to stifle any need for help from people.

Why? Because I have a fear. No--a phobia would be a better term. I have a MASSIVE fear of being a burden to people.

I have a surfeit of self esteem, so no problem there. I've just always been pretty competent; very capable. To the extent that I actually irritate myself.

My friend Angie, lovingly volunteered to wash my hair post-mastectomy as some of my arm movement was limited. I even had the opportunity to wear a smock adorned with monsters that is generally the exclusive property of her eight-year old son. :)

But cancer, has not afforded me the luxury of being fully self sufficient. It has forced my hand. It has necessitated in me the need to not only accept help, but to actually ask for it.

Growth in spades. Way to go, Holl!

So this is a big, fat, gargantuan, 'thank you!' to everyone. From you all reading my blog, to the people I'm about to detail whose efforts to improve and simplify my life during this ridiculously harrowing spell are soooooo appreciated!

My daughter and her friend had a lemonade stand to raise money for breast cancer research.

Here's my girl and her pal, whose grandmother also had breast cancer.

I've also received some of the most adorable gifts, cards and yummy meals. Here's one of my faves from my friend, Sarah.

Pink donuts paired to mimic....you guessed it: boobs.

I really could not have gotten through all this without the loving support and encouragement from everyone!

Long live the ladies! ;)