chemo

My Chemo-versary v4.0

I tasked my students in my Body in American Culture course with examining their thoughts about the body, beauty ideals and body image. The basic guidelines for this Body Genogram are as follows:

Connect your early life experiences with your current understanding of your body and beauty in general. How do they or do they not impact you today? Throughout the paper, ask yourself, “How did my culture, religion, socioeconomic background, race, ethnicity, friends and family affect my own views? How do these factors impact my current attitudes about my body and beauty ideals? What role, if any, did television, magazines, advertisements and social media play in influencing my views?” Your genogram will be graded on a pass/fail basis.

It’s ironic that I’m reading my students’ genograms today of all days. On September 21, 2010, I walked into my oncologist’s office. I was scheduled to begin treatment for breast cancer with a “lighter” form of chemotherapy and only had a 15% of losing my hair.

Once inside my doctor’s office, though, I learned that was no longer the plan. I needed a stronger chemotherapy cocktail because I had an aggressive strain of HER2 positive breast cancer. My hair would likely be all gone by mid-October.

I knew that losing my hair would change me, but I wasn’t prepared for just how much. I also had no way of knowing then how poorly my body would react to chemotherapy. Steroids caused me to gain 23 pounds and develop insomnia and an eye twitch. I forgot conversations and plans. My migraines increased to three times a week. And, after hemorrhaging following my second round of chemo, I was thrown into menopause.

Four years later, my hair has grown back, and although my weight isn’t what I would like, it’s in a healthy range. I’m also proud of all that my body has done from the minute (being able to walk three miles a day) to the miraculous (getting pregnant and giving birth to Roya despite being post-menopausal).

Nonetheless, I’m not the same woman that I was four years ago. I was diagnosed with breast cancer at a time in my life when my body looked its best. My metabolism was stable, and the age of 37, I was able to eat what I wanted, rarely exercise beyond walking and physical therapy, and not worry about the scale moving. (After suffering from an eating disorder in my late teens-early 20s, I was in a much-improved place emotionally and physically.) I looked in the mirror and felt attractive. My priorities at the time were my blog, increasing my experience as a sex educator, charity and social events, and boys. I also was considering taking a local modeling agent up on her offer to book me and had met with an adoption agency to begin the lengthy process to adopt a little girl.

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Shoot with Patrick Onofre February 2010

I had waited to submit my adoption application and to schedule the meeting with the agent until after I had my mammogram. The mammogram led to biopsies which in turn led to a diagnosis. My plans to adopt and my chance to do some local modeling were put on hold. Four years later, I doubt that I’ll adopt now and I objectively wouldn’t have a shot at modeling. I look at the photograph above, and I’m no longer that girl anymore.

Most days, I relish the roles I now play and the directions that my life took. I love being a professor, an advocate, and a partner. And, I don’t doubt for a second that God had a plan for me to be Roya’s mom. Cancer forced me to reprioritize my life, my views on women’s bodies in general and my body in particular, and my relationships. That was all meant to happen.

However, there are times like today when I can’t help but wonder, “What if?” Where would my life have taken me if I hadn’t gotten cancer? How would I feel about my body, if I had never gone through chemotherapy and a double mastectomy? What would it be like to watch a movie or read a magazine and not be so uncomfortable with how women are portrayed, and their bodies sexualized and commodified? Will there be a September 21st in the future when I don’t question these things?

I’m left with more questions than answers, but that’s my reality. I’m beyond thankful to be cancer free, but my life isn’t free of cancer.

What factor or experience has played an influential role in your views about your body and beauty ideals? 

Roya’s 1st Shoot with Uncle Moshe

I first heard about Moshe Zusman in 2010 from friends who were amateur photographers in DC.  They espoused the virtues of his talents, which are easily apparent when you see his work.

I met Moshe several weeks later at Fashion for Paws. I was surprised at how amiable he was. That was reaffirmed when he casually and humbly gave one of my friends advice while she took a photograph at the event. (He didn’t even tell her who he was or that he did this professionally!)

After I was diagnosed with breast cancer, Moshe and I went to lunch. We had an instant rapport with each other, but I have a feeling that I’m not the only one of his friends to say that! He offered to take photographs of me during chemo, which he did later that month. (If you haven’t seen those photographs, click here.)

Moshe managed to make me feel beautiful in the chemotherapy room, which was no easy feat! More importantly, he brought joy into my life at a time when I truly needed that. I fondly remember laughing so hard with Moshe and two of my best girlfriends during one round of chemo that we almost got in trouble with the nurses!

Even after Moshe put his camera down, he continued to be there for me…on my last day of chemo…after my double mastectomy…when I told him that I was expecting…and many days in between. There are those moments after giving birth that I’ll never forget and tearing up with Moshe when he saw me with Roya is among them. We've come a long way since the chemotherapy room!

Moshe took our first formal photographs of Roya when she was six weeks old. I hope that you love them as much as we do!

Thank you, Moshe, for these beautiful photographs! Far more importantly, though, thank you for treating me like I’m one of your family and for being Roya’s Uncle. We love you! 

Six Weeks and Six Days

Wednesday, October 17, 2012 – Thursday, October 18, 2012

I woke up the morning after finding out that I was pregnant to call my gynecologist. When the receptionist answered, I introduced myself and asked if she could relay a message to my doctor.

“What’s the message?” the receptionist inquired.

“Would you mind telling her that ‘I’m no longer in chemo menopause because I’m pregnant?’”

The receptionist was silent for several seconds so I interjected before it became uncomfortable.

“I bet you’ve never typed that message down before!”

We both laughed awkwardly before she replied, “No…I haven’t.”

When my gynecologist returned the call 30 minutes later, she expressed her shock and then said, “To be honest, no doctor is going to be able to tell you that you can or can’t carry safely to term. There’s not enough research about pregnancy and one of your health conditions, let alone any research that looks at pregnancy and all of your conditions.”

“I know. No one unfortunately has a crystal ball,” I responded.

“If you decide you’ll try to carry, you need to stop your migraine medicine immediately. That drug is highly toxic to a fetus.”

I knew that, but it was easier said than done. I’ve suffered from migraines since I was a teenager. The medicine I’ve taken since 2003 has been the only medicine that has worked and kept my migraines at a manageable two a week.

The rest of the day was spent preparing for my Health Activism and Social Media class that evening. The topic for the two-and-a-half hour class? Abortion.

I broke down several times as I worked on my Power Point for the lecture. During the class itself, I had to fight back the urge to tear up. There was a video that I showed from an anti-choice organization that included a sonogram photograph of an embryo at six weeks and six days. I was exactly six weeks and six days pregnant.

The following day, I headed to my gynecologist’s office for an ultrasound. I knew the technician because I had gone there the previous month for a sonogram because of menopausal pelvic pain. (Oh, the irony!)

As one would hope, the technician was extremely compassionate during the ultrasound. At that stage of development, the embryo just looked like a tadpole on the monitor. I exhaled when she informed me that the size looked good so far, but I started sobbing when I heard a noise and she commented, “Strong heartbeat.”

I looked up toward the ceiling and silently prayed. I didn’t think there was a chance that my doctors would let me try to carry to term, but I wondered what message God was trying to tell me.

To be continued…

After treatment

A friend recently asked me a question about what happens after a cancer patient is done with treatment.

“My cousin finished radiation in the spring and is in remission, but she’s been having a tough time. Most of the family doesn’t want to talk about her cancer anymore; they’re just ready for things to go back to normal. Why do you think that 'The After' is so difficult?” she inquired.

 There are several reasons why it can be tough for patients once treatment is over.

1. Being diagnosed with cancer causes you to experience a range of emotions from numbness to denial to anger. Once surgery and treatment start, you will need to focus all of your physical and emotional energy on getting through the journey. There’s rarely the luxury of time or strength to process all that is happening. It’s difficult enough to handle your essential responsibilities – in and out of the hospital. Once treatment is done, there are less loved ones around, fewer medical appointments, and a lot of time with your thoughts. The intense emotional reflection thus tends to happen once you're in remission.

2. Doctors won’t always inform you that you might not feel better once you’re done with treatment. Chemotherapy and radiation take a toll on your blood counts in a cumulative manner. By the time you’re finished, your counts may be the lowest that they’ve been, thereby causing increased fatigue, iron deficiency and risk of infection.

3. There’s the misperception that life can just go back to normal once you're done with treatment and in remission. That’s rarely the case.  Physical side effects from treatment can linger for several years and make it difficult to return to your pre-cancer routine. There are constant reminders of what you endured. You have scars, your hair is gone, and you have the immune system of a newborn. Emotionally, you may feel confused, fearful of a recurrence, and depressed at how much your life, appearance and health have changed. You'll need time to adjust to several new normals in a short time period.

4. Your medical team will do its best to ensure that you cross the finish line into remission. But, once you’re cancer free and done with treatment, you'll go from having frequent contact with health care professionals and regular exams to sporadic visits and tests. You may feel as though you’ve lost your safety net when you’re told that you don’t need to see your doctor for months.

5. Following a cancer diagnosis, there’s an outpouring of support. The overwhelming majority of your loved ones will recognize that you will have to focus on yourself and your health. Likewise, those who are in a position to care for you will give of their own time and talents to do so. When you’re done with treatment, though, the people in your life will want everything to go back to normal. There will be the erroneous expectation that you’ll be able to handle all of your old responsibilities at the same pace and with the same stamina as before. Few will understand that you are still experiencing side effects that may include pain, sleep disturbances, digestive problems, menopause, chemo brain, fatigue, and nerve and muscle weakness. Well-intentioned comments, disinterest in hearing about your health, and unrealistic expectations might make you feel overwhelmed, misunderstood, weak or depressed.

6. There are many resources for patients during treatment, but there aren’t the same outlets for after treatment is done. Research reveals that 30% of breast cancer survivors experience depression after treatment and 20% experience body image issues. Talk to your doctor about options for counseling, medication, yoga, meditation, physical therapy and support groups before you finish treatment. Even if you don’t avail yourself of any of those resources, it’s worth having the referrals if and when you need them.

What are your thoughts on how to make post-treatment easier for survivors and loved ones?

The Change

It happens to 50% of breast cancer patients under the age of 35 who require chemotherapy.

For those breast cancer patients who need chemo and are 35-40, the statistics go up to 80%.

If you are over 45, have breast cancer and receive chemotherapy, it’s almost guaranteed to happen to you!

“What are you talking about, City Girl?” you might be wondering.

The Big M. The Change. Menopause.

How does chemotherapy-induced menopause differ from traditional menopause? Dr. Melody Cobleigh of BreastCancer.org describes it as follows:

“Natural menopause is a fender bender, whereas medical or surgical menopause is like hitting a brick wall at sixty miles an hour.”

That analogy resonated with me. In October 2010, one month after I received my first round of chemotherapy, I began to hemorrhage. By November, I stopped bleeding entirely, and the hot flashes started. Night sweats, sleep problems, and irritability soon became part of my daily routine. And, then, there was the dryness down there. Yes…there!

Think about it. Back then, I was the 37-year-old sex blogger with an active dating life. Once menopause hit, I couldn’t get wet even when I was turned on. If I wasn’t a woman who prioritized sex during treatment, it would have been very easy to just forgo the act entirely. I had to consistently remind myself that this was important to me since my body wasn’t cooperating.

During chemo-induced menopause, traditional sex was painful at times, and I always needed a lot of lubrication. It took me much longer to reach orgasm. Cuddling for more than a few minutes would cause me to get such intense hot flashes that the entire bed would be wet from my perspiration. And, the lack of natural moisture made my pelvic muscles tighten up so much that I felt like I often had a UTI, even though I didn’t.

I didn’t write tons about this all during treatment because I needed to channel my energy in a positive direction. Medical menopause isn’t sexy. It's not easy to talk about. And, it made a tough time in my life even tougher.

Once I finished chemotherapy and stopped estrogen blockers, my menopause side effects subsided. I wasn’t surprised when my period returned in August 2011. However, when my cycle resumed, it was quarterly, not monthly. I wasn’t in full menopause anymore, but I wasn’t back to normal either. I called it, “The Pause.”

Something inside my body finally decided to press the “Play” button, though. I'm pausing no more. My 30-day cycle returned. Menopause is over, although the doctors believe that given my age and chemotherapy, my eggs are no longer viable. I'm hoping that the next time I experience menopause will just be in the words of Dr. Cobleigh, "a fender bender."

What are my tips for female breast cancer patients under the age of 45 who might have to worry about early menopause?

1. Talk to your doctor, nurse or case manager before you start treatment about the possibility of medical menopause. What should you watch out for? What's the protocol if you start hemorrhaging? Will you need to take an estrogen-blocking medication after chemo that could prolong or induce menopause?

2. Think about the long term before you deal with the day-to-day of treatment. Do you want to have biological children? If so, should you meet with a fertility specialist to discuss freezing your eggs before you begin chemotherapy? Err on the side of keeping all of your options open.

3. Be informed! Read as much as you can from reliable medical sources, check out nonprofits such as Fertile Action, and talk to survivors who have been through it before.

4. Make healthy choices for your body. Approximately ¾ of breast cancers feed on estrogen. Many toiletries, including lubricants and vaginal moisturizers, contain parabens, which weakly mimic the action of estrogen in a woman’s body. Select products that are paraben-free.

Did you know that chemotherapy could cause medical menopause? If you are a patient or survivor, what was your experience?

Wanting Your Old Life Back

I’ve written a lot about not feeling like myself since I began treatment for breast cancer. Deep down, I know that I’m more than the sum of my parts, but there are moments when that doesn’t provide solace.

At a recent charity event, an acquaintance complimented my short hair. Without missing a beat, I cringed and told her that I'm not a fan. She responded:

You should feel lucky that you’re alive!

I looked at her with a confused expression on my face and said:

I do. But why does my sadness at the after effects of chemo need to be mutually exclusive from my ability to count my blessings?

It’s not easy figuring out who you are after you’ve experienced a major life event such as being diagnosed with cancer. The rest of the world continues as normal, but your life can never go back to the way it was before. I felt that way after I started to go paralyzed in 1994, after my mom died in 1997, and when I was diagnosed with cancer in 2010.

What’s my advice for a breast cancer patient who just wants to go back to her old life? Check out my video for Breast Cancer Answers.

And, for those of you who are wondering, yes, there are still times when I need to remind myself to take my own advice! xoxo

2011 in Haiku

Twenty Eleven
Started year in chemo haze
In my bed? Best Boy.

He said he loves me
But does that mean he’s in love?
Neither of us know.

Winter beach weekend
With close friend, ex Philly Matt
My Teddy Ruxpin!

Well, not anymore.
“Tsunami” ensues as beach.
Friendship is over.

Mr. Agency
Reappears. Then disappears.
Lather. Rinse. Repeat.

By April, he’s gone.
We are over now for good.
Yet become friends. Huh.

I date other guys.
But keep them all at arm’s length
Don’t feel any spark.

I let you all pick.
The choices rather lame, tho.
Drama-free dating.

Not much time for boys
(At least, new boys in my life.)
So happy. So busy.

Is heart spoken for?
Honestly? Maybe it is.
By Best Boy. For now.

No epic love tale
But we care for each other
Still makes me smile

Sometimes it does work
At other times, it doesn’t
Don't want the same things

So, I play the hand
I’m not yet ready to fold
Am I, “The Gambler?”

What will next year bring?
Hoping for more of the same
Without more cancer!

Third Blogiversary Thanks!

Today is the third anniversary of my blog.

In December of 2008, I was getting over Lawyer Boy, working on my thesis, and battling the side effects of repeated concussions. It seemed like the perfect time to finally write down my crazy dating and steamy sex stories. I blogged anonymously since I had planned to return to legal policy work. Back then, the majority of my readers were friends in real life.

In December of 2009, I recognized that I could turn heartbreak into blog gold by writing about the relationship debacle that was my time with "Buckeyes" Boy. Within six months, my readership had increased 10-fold, and I started realizing that my blog had turned into a brand. Could I write about sex and relationships and conduct workshops for a living?

In December of 2010, I had finished my fifth round of chemotherapy. I hadn't slept well in three months. I was on way too many medications, including steroids, and was in chemo-induced menopause. There wasn't much in my life at that time that was joyful, but I (somewhat thankfully) was too sick and out of it to care. I just wanted to get through treatment and wanted my life back. I did find moments of happiness when I used my experience to help educate others and when I received attention from either Mr. Agency or Best Boy.

This December, my blog is so much different than it was because I'm so much different than I was. This blog has changed me for the better. Cancer has changed me, too, and with respect to relationships, those changes are also for the better.

Have I made my share of mistakes over the past three years? Sure. But, I'm proud of myself for realizing that life provides enough drama for me all on its own. I don't need my relationships to provide anymore drama. My blog hits aren't as high as they were a year ago, and I'm 100% okay with that. My love life isn't a train wreck, and I don't make questionable choices anymore. A reader who enjoys going online to critcize others will be bored by my site now. A person who just visits this blog for entertainment purposes and doesn't want to hear about cancer or health advocacy will be similarly disillusioned.

I was talking to a group recently about my first book in the sex and relationships arena. I have enough posts to compile a book about my own dating adventures, but I don't know that I see myself going back. Do I really want to go to bookstores or college campuses and speak about my relationship mistakes or give added energy to guys who wronged me years prior? I won't say that will never happen, but it's just not my priority now.

I care about educating others. I care about talking about those topics that people don't often talk about — from anal to cancer to first orgasms to prioritizing our health to spicing up a stale relationship. I care about putting a face to cancer and letting people know that it's okay to date and have sex during a health crisis.

In the next month or two, my site will be redesigned to reflect the new direction. If you're still reading now, there will be more of the same, but the site will be easier to navigate. I'll also be linking my name to my brand more since I'm no longer anonymous. Stef Woods and City Girl Blogs are now one and the same.

For those of you who have read my blog faithfully, I thank you for standing by me after the train wreck has been cleaned up. I'm appreciative that so many of you out in the blogosphere have become my friends. You stuck by me through the highs and lows, and for that, I'll always be grateful. A special shout-out to Abby, Erika, Intrigue Me, Jean, Jo, Kat, Simone and Teacher Girl. I look forward to thanking you all in person some day soon!

With much appreciation from the bottom of my heart, a huge virtual hug, and best wishes for the happiest of holidays,

Stef

Summer Session

I picked when I’m teaching next summer based upon when I might need to get a double mastectomy.

That’s one of those sentences that I never imagined typing.

Getting over cancer isn’t like getting over a cold. It’s unfortunately not that simple.

I pride myself on my ability to keep stress about “What ifs?” to a minimum. Life is filled with unknowns, and I’m not about to limit what makes me happy in the present because of a distant possibility in the future.

My health situation doesn’t fit neatly in that box, though.

The nurses suggested that I keep my medi-port in for at least a year.

My breast surgeon said that I’m a strong candidate for a double mastectomy given my health history, my mother’s health history and the fact that I can’t tolerate hormonal therapy. Getting a preventative mastectomy in the non-cancerous left breast would reduce my risk of breast cancer to 5%. Getting a mastectomy in the right breast where there was cancer would reduce my risk in half to somewhere between 10-15% of recurrence within five years.

From a cosmetic perspective, the breast surgeon noted that my breast were saggy. (Hey, big naturals aren't known for being perky.)

The breast surgeon recommended that we talk about mastectomies next year.

The subtext of the surgeon and nurses’ comments:

Let’s wait a year to see if your cancer returns or not.

I don’t like to assume what people are saying without asking them directly. When I inquired with my breast surgeon if that was where she was coming from, she nodded.

Me: You realize that you and the oncologist's office are on the same page, but everyone is assuming that I would do chemo again if this returns. I can't say that definitively. [My surgeon looks at me with wide eyes.] We'll cross that bridge if — God forbid — we need to.

I’m not about to approach my life any differently than I have in the past. (Well, at least with respect to my health…) Aside from my biopsy in July, I don't allow myself to give much energy to the thought that my cancer will return.

However, I do need to be cognizant of the fact that there is a strong chance that I’ll need several surgeries next year. I’d rather teach my class early in the summer and then have the flexibility to deal with this issue in July and August.

There’s a fine line between not stressing about “What ifs?” and being prepared for the “What is likely to be.” I’m straddling that line like it is a pommel horse. I try to allow myself a few minutes to feel angry, sad and confused, and then I let it go until the next time those feelings hit.

The next time you meet someone who has beat cancer, you might consider asking how he or she is really doing. Until that person has reached the five-year cancer free mark, the answer might surprise you.

Are you making any plans now for 2012? What things do you expect to occur in the coming year?

Great is all relative

A month from now, I’ll be done with cancer treatment. I’m sure I’ll celebrate with close friends after I recover from the mediport removal, and I plan to hold a larger party to benefit Pink Jams in early October. But, celebrations seem bittersweet right now.

I’m beyond lucky and blessed that this aggressive strain of cancer was caught early. And, I’m thankful that I’m almost done with treatment. I also appreciate that my life has been enriched and my relationship clarified because of my diagnosis.

“Then why is this bittersweet, City Girl?” you might be wondering.

The short answer is that I still don’t feel like myself. I was the girl who would receive compliments from strangers about her hair on a daily basis. I was the woman who could get a guy to notice her just by a flip of her long, red locks. I was the 36-year-old who was approached by a modeling agent because of her height, weight and hair.

Then, I was the girl who got attention for being bald. I might have felt ill and frustrated by the weight I had gained from the steroids, but I could justify that. I was a walking advocacy opportunity.

Now, with my short hair that curls at the end thanks to chemotherapy and the inability to lose those last ten pounds, I look like I’m auditioning for a middle-aged woman who can blend in the crowd. And, suffice it to say, I hate blending in a crowd.

Are all of these concerns vain? Completely.
Are all of these feelings valid? Yes.

I keep asking people not to talk about my hair, and I just smile and say thanks when people say that I look great.

It seems nicer than saying: Yes, it’s great that I’m not still in chemo and that you feel more comfortable because I now have hair.

“But, your hair will grow back!” I’ve heard.

Yes, it will — in approximately three years! You don’t tell someone who’s starting law school that they’re almost done, right?

I have been doing more over the past two weeks, and for that, I am thankful. But, I’m still getting sick almost every day from the non-chemotherapy cancer medication that I took for only five days last month!

This, too, shall pass, I realize. And, I fully appreciate that this could be so, so, so much worse. But, please, let me be vain and angry and not have to roll my eyes with all the well-intentioned comments about how beautiful I look and how short hair flatters me.

If you have a couple of minutes, this scene with Maura Tierney from Rescue Me (at about 4:30-5:30) captures what I want to do anytime people say how great I look or how wonderful it must feel for this to be almost over.