Breast Cancer

The Evil Cancer Med – Part II

In late May, I started an oral medication, tamoxifen, to block the estrogen in my body in the hopes of preventing my cancer from returning. (Research has shown that tamoxifen is as helpful as chemotherapy in that regard.)

On one full dose and four half doses over the course of five days, my body expressed much displeasure! I couldn’t concentrate much or sleep well. I was nauseous, vomiting and dizzy. I had an almost constant headache and intense hot flashes.

I had plans to attend a charity event on a Friday evening in late May, but I cancelled them because I felt so nauseous and tired. An hour later, as I was watching some guilty pleasure television, I had a dark thought. Correction, a really dark thought.

That’s not my personality so I had a confused expression on my face. (Imagine me looking at myself oddly, if that’s possible.) I decided to just keep focusing on my show. An hour later, another really dark thought entered my head.

I thankfully know myself very well. I’m not one who gets that stressed or depressed about health issues. I’ve also never questioned whether I would survive treatment or whether I wanted to survive. (Of course, I would and I do!)

I knew that tamoxifen had caused me to have these thoughts. I picked up the telephone and called one of my best friends. After talking to her for 15 minutes, I called my oncologist on his cell phone. I apologized for bothering him on a Friday evening, but acknowledged that I didn’t think this should wait until Monday. He agreed, saying:

This isn’t you. This is the medication. This side effect is a very rare one, but I know that it has happened to some of my patients over the years. Stop the tamoxifen immediately. It will take time for the drug to get out of your system. Try to be patient, and we’ll figure out another drug for you to take when I see you next.

My normal thoughts and sex drive returned within 36 hours. I started sleeping better and concentrating with greater ease within a week. But, the headaches, vomiting and intense hot flashes persisted for another three weeks.

When I saw my oncologist next, he commented that one in 20 patients has this reaction.

"5%?" I inquired, as he nodded. "That's not a very rare side effect!"

I’m not one who believes that the pharmaceutical industry is one big conspiracy or that the health care field is trying to take all our money. But, the more I read about tamoxifen, the more concerned I am about why this drug is oncologists’ first resort.

EHealthMe recently analyzed 49 FDA reports and surveyed patients about their reactions to tamoxifen. The study determined that 49 people out of 6,123 patients reported suicidal thoughts while taking the drug. That’s 8% of patients, and this is NOT listed as a possible side effect of the medication!

It worries me that patients and oncologists aren’t talking about the potential risk before starting treatment, especially given how many women are taking tamoxifen. The drug has also been linked to increasing risks of uterine and liver cancers, estrogen receptor negative breast cancer, and blood clots.

If you have breast cancer, tamoxifen might be the right choice for your treatment plan. I know several women who are taking the drug and have tolerated it well. There also are other drugs out there with similar purposes and less known side effects.

Research supports that the benefits of tamoxifen or similar estrogen blocking medications outweigh the risks. Nonetheless, I'm not exactly looking forward to starting a new medication in July.

Have you or a loved one taken tamoxifen? If so, how was the drug tolerated?

What would you do if you had an alarming reaction to a medication?

How do you deal with a medical problem that happens after typical office hours?

The Evil Cancer Med

If a person is diagnosed with breast cancer, a doctor runs tests on the cancer cells to determine if they are:

1. Estrogen receptor positive;
2. Progesterone receptor positive; and
3. HER2/neu positive.

What does that even mean?

Well, for the first two, do estrogen and progesterone (hormones that naturally occur in the body) cause the cancer cells to grow? Approximately 75% of breast cancer patients test positive for estrogen receptors, and 66% of patients for progesterone receptors. Hormone receptor positive cancer grows slower than cancer that isn't hormone receptor positive.

The latter category, HER2/neu, occurs when there's a gene mutation and the cancer tests positive for an excess of proteins on the cells. These proteins cause the cancer to be aggressive and fast growing. Only 20% of patients test positive for HER2/neu.

I had triple-positive breast cancer since I tested positive for the hormone and protein receptors. My aggressive strain of cancer was thankfully caught early, and I can benefit from the use of drugs that help prevent a recurrence and lower the amount of estrogen and progesterone in my body.

Once every three weeks for a year, I receive an IV of Herceptin to kill the protein receptors on my cancer cells and reduce the change of this returning. (Thanks to chemotherapy, radiation and Herceptin, my rate of a Stage 4 (metastatic) recurrence within 10 years went from a minimum of 60% to 15%!)

Compared to chemotherapy, receiving an IV of Herceptin is a breeze! The side effects are mild, and the IV takes only 30-40 minutes out of my day. Once I finish receiving Herceptin in late September, I should be done with visits to the Chemo Room!

If you meet someone who says that she has triple negative breast cancer, she has the most aggressive type of breast cancer. Aside from surgery, chemotherapy and radiation, there’s nothing yet available to help prevent the cancer from recurring. I hope and pray that research will advance in the very near future to change that.

For those of us who are hormone receptor positive, the most commonly prescribed oral medication to block estrogen in our system in the hopes of preventing a recurrence is tamoxifen.

I prefer to call the drug: The Evil Cancer Med.

Tamoxifen is taken once a day for five years. When I read about the potential side effects, I was concerned. I talked to my oncologist about the fact that tamoxifen causes a lot of the side effects (nausea, vomiting, dizziness, headaches and fevers) that I already have from my other health conditions. By early May, I was finally starting to feel more like myself, and I honestly didn’t want to be sick again.

My doctor assured me that the majority of patients tolerate tamoxifen well. Tamoxifen has been used for over 30 years, and it's as essential to preventing a recurrence as chemotherapy.

“Okay,” I thought to myself. “This is important.”

I said a prayer before I took the first dose. That evening, I started to feel nauseous and then vomited. Several hours later, I got a very bad migraine. I took my strong migraine medicine, but the pain and vomiting lasted through the morning.

I called the oncologist’s office, and they suggested that I switch to a half dose of the medication. As the week progressed, the side effects – even on a half of a dose – increased. I was still nauseous with a dull headache. I felt dizzy, I had trouble sleeping, and I would cry for no reason. It took me an entire afternoon to edit a few pages that I wrote. And, sapping my body of estrogen sent my sex drive from 100mph to 0mph. (Did I still have sex? Of course. But, I had a really hard time reaching orgasm.)

I’ve had hot flashes since early November when I started to have chemo-induced menopause. But, the tamoxifen quadrupled them.

This is City Girl.

This is City Girl having a hot flash.

Notice how my face matched the color of my hair and dress!

I wondered how my body would handle the full dose of tamoxifen – everyday for FIVE years! But, then, something happened that made my doctor stop my use of the drug immediately.

To be continued…

A Cancer-versary Thank You

A year ago today, I was sitting in my stylist’s chair at my hair salon, when my cell phone vibrated in my lap. I saw that it was Sibley Hospital and excused myself to answer the call. As I remember how I felt when I heard the news from my doctor that I had cancer, I have tears in my eyes and goose bumps on my arms.

I think of the moments in my life that helped shape me into the person I am today, and being diagnosed with cancer at 37 years of age is definitely high on that list. I wouldn’t wish the past year on my worst enemy, but in the midst of the lows of treatment, I’m grateful for all my blessings.

I’m thankful for:

1. Knowing My Body. I've been vigilant about conducting self exams and contacting my breast surgeon, whenever I found a lump;

2. Early Detection. I had an aggressive strain of cancer that was caught early during my annual mammogram. Health technology isn’t perfect, but getting mammograms every year is the best thing that women can do for their breast health;

3. A Great Medical Team. At Sibley Hospital, I've worked with doctors who are experts in the field because they deal with breasts exclusively;

4. Health Insurance. Every step of this process is expensive, and a recent study discussed how many people with cancer are forced to declare bankruptcy. I appreciate that in the midst of such a difficult year, I didn’t have to worry about medical coverage;

5. My Other Health Problems. Treatment and the side effects were horrid, but I'm glad that I never became clinically depressed or questioned whether I was going to make it. I know far too many women who were not that lucky – either because they were diagnosed after the cancer had spread or they hadn’t ever emotionally processed major health issues before. I was as prepared as I could have been for surgery and treatment, and am fortunate enough not to be among the 30% of women who suffer from anxiety or depression after beating cancer;

6. This Blog. I had a forum through which I could express myself. With every post that I wrote, I was able to process my emotions and let go;

7. The Cause. Early on, I vowed to make this about more than just me. In the past year, I’ve volunteered, advocated and raised money for breast cancer awareness, prevention and research. Through helping others, I found a sense of peace as to why I was diagnosed with breast cancer. And, on the advocacy front, I know I'm just getting started;

8. The Wisdom to Know the Difference. There were loved ones who had a difficult time processing my cancer. They either couldn't help me out at all during treatment or had to make it all about them. There were acquaintances that clearly were uncomfortable with the fact that I didn't wear a wig. There were a few people who thought that I used my diagnosis to get attention. There were those who assumed treatment was easy because it was caught at Stage 1 or they would see me in public with a smile on my face. There were those who told me that I must be feeling fine when they saw that my hair was growing back.

I could go on and on, but everyone else’s thoughts and feelings were just that – everyone else’s! I couldn't take other people's comments or actions personally, and I knew better than to try to own their feelings about my illness;

9. Mr. Exec for letting me go without a fight;

10. Philly Matt for convincing me to continue with my treatment plan, even though the doctor had changed my protocol at the eleventh hour;

11. Mr. Agency for reminding me that I was sexy no matter how I felt or looked;

12. Best Boy for being there. When the going got rough, he stayed and helped;

13. My Cancer Crew. (I can't type this part without sobbing.) AB, AF, LF, TL, NP, LV – I honestly don’t know what I did in a past life to deserve friends as giving and wonderful as you. I can’t imagine those people who have to go through treatment alone, and because of you all, I never had to. Thank you will never, ever seem sufficient. I love you all with all my heart;

14. My Friends. Every note, every virtual comment, every care package and every visit meant so much to me. The compassion, support and love you’ve shown me helped get me through the many days in which treatment got the best of me. There’s a reason why friends are the family we choose for ourselves, and I’m very blessed to have such an amazing support system; and

15. YOU! Yes, YOU! The overwhelming kindness of my readers and online friends was humbling, motivating and so very appreciated. I hope that there will be a day in the future when I can give you a hug in person. Your emails, comments, gifts and tweets always brightened my day and my spirits.

In one year, I’ve grown more than I have in the past decade. Thank you for joining me for this portion of my journey and for being so supportive. I hope you’ll continue to come along for the ride. xoxo

The lumps that aren’t so lovely

I know boobs. I love tits. And, I'm all over breast health. In fact, since I was diagnosed with breast cancer last June, it seems that I’m all about the tatas.

With the disclaimer that I’m not a doctor nor do I play one on TV, here are some responses to questions that I’ve received about the boobies:

Question: I found a lump, and I’m freaking out. What do I do?

Answer: The first time you find a lump is definitely scary. Breathe, do something that helps you relax, and try to remind yourself that you don’t have enough information yet to truly lose it. Breast tissue changes throughout the month because of hormones, and those changes are completely normal.

Wait until after your next period is finished, and do another self-exam. If the lump is still there, then it’s worth making an appointment with your gynecologist or a breast surgeon. (If you're a guy, I would also wait about a month and then make an appointment with your internist.)

Question: You had breast cancer, City Girl! Since I found a lump, I’m worried that I have it, too.

Answer: My health history and my family health history put me at a much greater risk for breast cancer. Please remember, though, that my story is far from the average young woman’s story. The average age for a breast cancer diagnosis in the United States is 61 years.

Over your lifetime, you have a one in eight chance of being diagnosed with breast cancer. But, in your 30s, only one in 233 women receives a positive diagnosis. The odds are slim that a lump that you find in your 20s, 30s, or 40s is cancerous.

I don’t write and talk about breast cancer as a scare tactic, but rather to make young men and women more aware and empowered. It’s important to:

1. Know your body, including your boobs;
2. Work with knowledgeable health care professionals and obtain online information from reliable medical sources;
3. Take control of your health from an early age (and not just so you can look great in a swim suit);
4. Reach out to others who have health problems with compassion; and
5. Talk about health, sex and other medical issues without fear or embarrassment.

Question: I’m worried because I have a lump in my breast that’s painful.

Answer: Pain is never fun or easy to tolerate. However, most painful lumps are benign (non-cancerous). If the lump doesn’t decrease in size and remains consistently painful, you can always schedule a minor surgery to get it removed.

Painful lumps are also common for women with fibrocystic breasts. More than 50% of women deal with this at some point in their lives, and these lumps are completely benign.

Question: I waited until after my next period, and the lump is still there. Should I call the gynecologist?

Answer: That depends. If you’ve never worked with a breast surgeon or had a mammogram before, then yes. I would call your gynecologist to make an appointment for a Clinical Breast Exam. If the gynecologist feels the lump, too, he or she may suggest that you return in six months for a follow-up. Depending on your insurance coverage, I’d ask: 1) for the name and number of a breast surgeon; 2) for the name and number of a breast radiologist; and 3) if you can return in three months.

A breast surgeon’s Clinical Breast Exam will last two or three times longer than the exam that your gynecologist performs. Why is that? The breast surgeon deals with just breasts, while the gynecologist is trained more in issues involving your gynecological and reproductive health. There are general surgeons who perform breast exams and surgeries, but I prefer going to a surgeon who deals with the breast exclusively.

If the gynecologist recommends that you receive a breast ultrasound or mammogram, then make sure that the facility you go to uses digital mammography and has at least one breast radiologist who deals with breasts exclusively.

If you don’t care to wait six months for a follow-up, you don’t need to. You know your body better than anyone. (Check with your insurance provider about coverage for these appointments. Also remember that you can ask any medical provider if you can pay your balance in installments. If you don’t have sufficient coverage, inquire if there’s a clinic in the area. If you’re in the DC area, it’s worth the trip to Sibley Hospital if you have insurance, and the Capital Breast Care Center if you don’t.)

Question: I’ve never felt any lumps. Are there other things that I should be looking out for?

Answer: Yes! Make an appointment with your doctor if:

1. There’s pain under your armpits;
2. There’s discharge from your nipples, or a change in your nipples' color or size;
3. Your breast changes in size or shape;
4. The skin on your breast looks different;
5. You are a man and feel pain in your chest or notice abnormalities in the appearance of your nipples or pectoral area; and/or
6. Anything doesn’t sit well with you. Trust your instincts!

What happens if the doctor wants you to get a sonogram, mammogram or biopsy? What if you or a loved one receives a breast cancer diagnosis? I'll tackle those in future posts. Comment on here or Formspring, Tweet or email me at citygirlblogs (at) gmail with any other questions.

PS If you’re interested in joining my Komen Global Race for the Cure team or making a donation, click here. You can join the team under the “sleep in” option even if you don’t live in DC or are unable to participate in the 5K. There's a promotion code through May 31st to save $5 off the registration fee. Enter HIGH5 in the code box.

Take that!

A year ago this week, I found a lump in my right breast, as I was trying on clothes for the Fashion For Paws runway show to benefit the Washington Humane Society. That same weekend, I noticed that my very shy rescue dog, Flake, began sleeping as close as she could to my right side. A year ago this week, I also decided to hold off on submitting the initial paperwork to start the adoption process because I had a feeling.

My intuition and my dog’s sense of smell turned out to be correct, and I was diagnosed with breast cancer on June 22, 2010. (I later read articles about medical studies regarding dogs’ ability to sense the presence of breast cancer with 88% accuracy.)

Since finishing chemotherapy and radiation a month ago, I’ve been fielding a lot of comments like:

Wow! Your hair is growing! You must be feeling better!

You’re done with treatment! So, everything’s good now, right?

Unfortunately, though, being cancer-free hasn’t felt freeing. Yes, I’m done with treatment, but I’m still not feeling well. The low blood counts, muscle weakness, exhaustion, and forgetfulness continue. I dyed my buzz cut back to red in the hopes that I would feel more like myself, but that didn’t do the trick. I want my long hair back, and I want my body to look like it did before all the steroids. I realize that everything is a process, but patience has never been one of my virtues.

Something happened over this weekend, though, at this year’s Fashion For Paws. I was finally able to let go of the bitterness and sadness that I’d been feeling over the fact that I haven’t rebounded as quickly as I – or the doctors – would have liked.

I let it all go with the toss of a wig.

“The toss of a wig? What does that mean?” you might be wondering.

Well, when I found out that I would be wearing a Betsey Johnson outfit for the fashion show, I had an idea. I suggested to Jane, the manager of the Betsey Johnson store in Tysons Galleria, that I wear a wig down the runway and toss it into the crowd.

Me: That’s probably too crazy for Fashion For Paws, though.

Jane: I love it! It’s like Betsey’s last show. Do you have a minute to watch a video?

I nodded my head, while Jane switched the DVD on the television screen in the store. The finale of Betsey Johnson’s Fall 2011 show in New York City featured Betsey’s store managers walking with Betsey-inspired makeup and blond wigs. The last manager fiercely took his wig off, roared and tossed it into the crowd.

Jane pitched the idea to the team from Fashion For Paws Executive Director and The Aba Agency, and I was told that I should go for it! The wig toss turned into the “Wig Finish,” when I learned that I would be closing the show. My excitement grew, as did my nerves, at the thought of pulling this all off in front on a crowd of 1,800 people.

Adrenaline kicked in, and I was instructed to take my wig off in an exaggerated way.

Lolly from Betsey Johnson Georgetown: It needs to be really, really big! Don’t just pull your wig off. Tear it off! Rip it off your head.

Me: Okay. Should I roar like the manager in the show in New York did?

Lolly: Yes! And make it exaggerated so that everyone knows what you’re doing.

So, I went for it. I really went for it.

And, when I tossed that wig into the crowd, I tossed with it all of the negative emotions that I’ve been struggling to process for the last month. Over the past year, cancer has won more than its share of battles against me. Through one toss, I was able to remind myself that I have won the war!

Take that, Sergeant Aggressive Strain! I’m getting IVs every three weeks to make sure you don’t come back.

Take that, Colonel Cancerous Tumor! I do self-exams so I found you!

Take that, Admiral Abnormal Calcifications! I get annual mammograms so my radiologist saw you sneaking in.

Oh, and Captain 15% Chance of a Stage Four Recurrence, I’ll bet against your victory any day! You are not coming back here anymore! I’m taking hormones every day for the next five years to ensure that!

My body may not be up for celebrating yet, but my mind finally is.

That that!

Owning It

In a recent conversation with my father, I told him that I write about “my relationships and sex and stuff” without providing him a link or using the word, “blog.” I then explained my business plan and my advocacy goals for the next two years. I could tell from his pauses and tone that he was thoroughly confused. (Who wouldn’t be? I think most people are confused at first when they hear me talk about advocating for breast cancer awareness and body-friendly sex toys in the same sentence.)

City Dad: So…are you telling me this because you don’t want me to be embarrassed?

Me [pausing]: I guess so.

City Dad: Is there anything you think would embarrass me?

Me [pausing]: I hope not.

City Dad: Is there anything that embarrasses you?

Me [without hesitating]: No.

City Dad: Well, I’m glad that you told me so I didn’t find out another way. And, it’s not like I thought you were a saint! [We laugh.]

After hanging up the telephone, I thought about what I had said. Nothing in here embarrasses me. Nothing. This blog details my life and my choices. I’ve made some good decisions (often professionally) and some bad decisions (often with respect to my relationships with men). But, I don’t regret any of the experiences I’ve had. They’ve made me who I am today, and I love the person that I’ve become. If I was embarrassed about anything in here, I’d be embarrassed about who I am. That’s not me.

One of my dear friends is a life coach, and she always reminds me of how much I “own it.” I smile when she uses that expression because I do own my life and my choices.

When people write rude comments on my blog, I laugh and take their words with a grain of salt. (And, I don’t like salt.) How can I let the thoughts of someone that I don’t call a friend affect me? By having a blog and putting my life out there, I invite comments and criticism. There are many readers who I don’t know in real life that manage to respectfully disagree with my choices and actions. If someone comments in a way that’s disrespectful, I let it roll off of me. I own it.

I was the girl with the long, beautiful red hair, and now I’m bald. I miss my hair, but I know that I’m just where I’m meant to be in life right now. Wearing a wig doesn’t change the fact that I’m in treatment for cancer and doesn’t make me feel comfortable. It’s not authentic to my experience. I’ve done photo shoots and interviews bald. I walk around town bald. I host events bald. I’ve flirted shamelessly and had amazing sex bald. I own it.

I’m a liberal and a Christian. I used to practice law, but now I’m a blogger and advocate. I’m a woman, and I think about sex more than the average teenage boy. From my perspective, none of these things are mutually exclusive. Labels and identifiers are just words. I may be a writer, but I let my actions speak for themselves. As an attorney, I ruffled a few feathers by addressing issues that made partners and nonprofit directors uncomfortable. I do much of the same with my blog. I’ve made mistakes, and I’ve accomplished things of which I’m proud. But, through it all, I own it.

How do you own it, or how do you want to own it?

Once Upon A Time

Once upon a time, there was a Little City Girl. Her parents raised her with love, support and opportunities. They let her know that she could be anything that she wanted to be when she was older.

At 14, Little City Girl told her father that she wanted to go to Wellesley College and become a lawyer.

“Why do you want to be a lawyer?” he inquired.

“Because I like to write, debate and help people,” Little City Girl replied.

When she went to Wellesley several years later, the professors also impressed upon her and her classmates that they could be and do anything.

A college internship brought City Girl to Washington, DC, in 1993, and she fell in love with the nation’s capital. After her internship ended, she stayed in DC and got a job as a legal assistant. She went on to law school, and when she finally started to work as an attorney, she was thankful that an instinct that she had 12 years prior was the right one.

In her first job, she noticed that wearing a short skirt or a fitted sweater to work prompted inappropriate comments from her bosses. With each subsequent position, she sported more pants suits and felt more comfortable informing male colleagues that their behavior was unacceptable.

She also learned that although her dating stories were entertaining, she had to be selective about what she shared with co-workers. One partner only knew that she was dating an NFL player – without any specifics – and thought it funny to walk into a meeting after a football game, saying:

Your boyfriend can’t handle his balls.

In theory, she could do anything professionally that she wanted. But, unfortunately, that didn’t mean that her age, gender, appearance or sexuality wouldn’t be topics of conversation or affect other people’s perceptions of her around the office.

When City Girl left firm life for a nonprofit, she began doing some legal policy work. She always relied on facts and the law, rather than emotions, when speaking about a polarizing issue, but that didn’t stop a few very conservative people from sending her office hate mail. Her former boss approached her about doing policy work exclusively. She was flattered, but she worried that she would miss working directly with the clients if she chose that path.

In 2008, she decided to take a sabbatical from the law to focus on health issues and finish her master’s program. As she prepared to write her thesis, she thought it would be fun to start blogging about her dating adventures. She chose to blog anonymously so that if she reentered the policy arena, her sexuality wouldn’t be used against her. (If she had received several pieces of hate mail and comments about her appearance or significant others without provocation, she knew that her sex life and dating mishaps would become ammunition for those who disagreed with her politics.)

As her blog readership grew, she began attending events as City Girl. Quite a few people in DC knew both her real name and blog link, but they kindly respected her privacy. Local online publications were also understanding, taking her picture with her name or quoting her as City Girl without using her name or face. She managed with the help of others to remain anonymous from the legal policy world.

In 2010, City Girl wondered if it was worth taking another year away from the law to see where her blog could go and start teaching sexual health workshops. She joined the American Association of Sex Educators, Counselors and Therapists and attended their annual conference. She also found a platform, as she wrote about the use of toxic ingredients in sex toys and the need for self-regulation. Lotus Blooms and Fascinations at Fun Love approached her about writing for their sites and reviewing body-friendly products for them. She began to ponder how she could advocate for safe sex toys on a larger scale.

When she was diagnosed with breast cancer in June of 2010, she decided to use her experience to try to raise awareness and help others. Her friends and doctors knew that she was willing to talk about what she was going through, and opportunities to do just that followed. The more that she talked about her experience and let others in, the more she wanted to continue to do so.

She finished chemotherapy and realized that she is stronger than she thought that she was. She also realized that there’s much more for her to do as an advocate and that it’s time to come out from behind her laptop. If she can help one more person through her blog, her photographs or her interviews, it’s worth it. She accepts that she may never work again in the legal policy arena, although she wishes that there wasn’t a double standard with respect to female sexuality in the workplace.

Once upon a time, there was a City Girl with long, red hair named Stef Woods.

Photo Credit: Kristina Hopper Photography

She’s bald now, but she still feels sexy.

Photo Credit: Moshe Zusman Photography

Although she’s not exactly sure what will happen next, she trusts that she will live happily ever after.

Chemo Room Musings

I spent 26 days in the Chemotherapy Room over a period of three and a half months. In that time, I observed a lot and learned a lot. Here are some of my musings:

1. A female always accompanied male patients to the chemotherapy room, whether as a daughter, wife, girlfriend or mother. By contrast, female patients were rarely accompanied by a male friend or loved one. Women battling cancer surrounded themselves with the females in their lives.

That observation made me think about stereotypical gender roles with respect to caretaking. Do women choose to be around other women at a difficult time because many women instinctively know how to care for others? Or, is it related to how men and women perceive the value of men’s work outside of the home versus women’s work outside of the home?

Women comprised my support system during my treatment. These females just did what needed to be done without me asking for it. Or, they would offer to help in specific ways and be available to me at specific times. (Some of these women worked outside of the home with traditional hours, while others weren't working or had a more flexible work schedule.)

The men in my life had to be told how they could help me, and none of the men I’ve written about in this blog ever accompanied me to get IVs. Several friends and readers commented that they wish I had a man who would be by my side through every part of this experience, but I didn’t. I think of how the majority of my friends’ significant others deal with care giving, child rearing, and health issues, and I’d much prefer to have someone by my side who knows what needs to be done and just does it.

2. I was the only bald woman in the Chemotherapy Room 24 out of 26 days. Think about that for a minute. A woman is going to receive chemotherapy, and that’s typically the only activity that she will be doing that day outside of her home. She will be in a room with her doctor, nurses and other cancer patients who are going through similar experiences. As she dresses, she puts on a wig, hat, scarf, or some combination of all three. What does that say about how she views herself and conventional standards of beauty and femininity?

The wigmaker for the Washington Opera Company kindly offered to help me pick out a wig that was similar to my natural hair color and length. I love the wig that we chose, but it doesn’t always look good on me. (Wigs made of human hair need to be washed and styled. When they aren’t well-maintained, they look rather funky.)

I had a great head of hair. Now, I’m bald because of chemotherapy. Why should I feel less sexy, beautiful or feminine because of that? Why should I care about making others feel more comfortable about my experience? Why shouldn’t I make people think about cancer while they’re out shopping at Whole Foods or grabbing a drink at L2?

In the Chemotherapy Room, other female patients would come up to me, saying how brave I was to go bald. And, at least one person approaches me when I’m out in public, saying how beautiful I look or sharing a story about how cancer has affected them. Last month, I put my wig in the corner of my closet and decided that’s where it should stay. I’m the girl, walking around town with a bald head. I've realized that feeling comfortable with my baldness and talking about my experience with breast cancer can help to educate others. That's important to me. I view my baldness like a badge of honor because I earned it.

3. The experience was tougher than I thought it would be, but I’m stronger than I thought I was. I knew that chemotherapy wouldn’t be easy, and I knew that it would hit me harder than most given my other medical conditions. But, I didn’t expect to require 20 additional days of IVs than the average person. It wasn’t easy, and I wasn’t always the most chipper person to be around. (My friends, especially Autumn and Tricia, deserve a medal for putting up with me.) But, I relied on my faith, counted my blessings that this was caught early, and reminded myself that this is part of God’s plan for me.

4. I came away from the Chemotherapy Room with a few epiphanies about my life and the direction that I want it to take. I’ve realized with a sense of calm and certainty that it’s time.

“Time for what?” you might be wondering.

That, my friends, is for another post. In the meantime, I’d love to hear your thoughts about stereotypical gender roles when it comes to caretaking and how you’ve reacted to seeing someone who has lost her hair from chemotherapy. xoxo

Graduation Day

She dresses in layers on a bitterly cold morning in January, as she heads for the doctor’s office for her last round of chemotherapy. Her eye twitches from three months without enough sleep. Her pale face turns beat red with every hot flash. She’s crabby from all the steroids. Her taste buds are almost completely gone, replaced with a constant taste of dull metal in her mouth. And, she’s still nauseous and throwing up from the last round of chemotherapy three weeks ago.

“You look kind of glum,” her doctor commented with a note of surprise.

“I’m so over this,” she replies. “I don’t want anymore.”

“Given how you’ve been feeling, you have to expect that this round will be the worst. The effects are cumulative. You probably won’t feel better from this round for six weeks.”

“Six weeks?!?” she exclaims.

She goes in the bathroom and cries. The average person recoups from a round of chemotherapy in a week to 10 days. The average person just needs one day of IVs per round, and that’s it.

For her, six rounds of chemotherapy translated into 26 days of IVs. (Her body really didn’t respond well to chemotherapy so she needed more drugs and fluids to alleviate the side effects.) She knows that there is a light at the end of the tunnel, but she doesn’t want six more weeks of feeling this poorly.

She takes a night to process that the next six weeks will be rough and then decides to focus on the positive. As the week progresses, she feels worse physically, but better emotionally. By mid-February, the effects of chemotherapy will be a thing of the past. This was caught early. She is lucky. And, she has faith that she will fall within the 85% of people whose cancer doesn’t return in five years.

She thinks of all the many blessings in her life. She has the best health insurance and medical care available. She has never had to go to the chemotherapy room alone. Her friends were by her side at each and every visit – all 26 of them.

As the week draws to a close, she returns for her last day of chemo-related IVs. She sees a 32-year-old woman getting her first round of chemotherapy. The young woman looks like a deer in headlights.

“I’m sure this seems surreal. I was there, too. You’ll get through it, though, and if you need anything, just call me,” she tells her.

A few hours later, the last drops of fluid drip from her IV bag. She and her friend watch, holding hands with tears in their eyes and smiles on their faces. The nurse comes over with tears in her eyes to announce to the room that she has graduated. She knows that she will remember that feeling for the rest of her life.

She did it.

She’ll begin 30 sessions of radiation later this month. And, because her aggressive type of breast cancer is HER2+, she’ll need to receive an IV of a drug called Herceptin once every three weeks through September.

The light at the end of the tunnel almost blinds her from its brightness. She wipes tears of pride, joy and gratitude from her cheeks and smiles.

She’s done.

She prays that she will never have to go through that again. And, she vows to continue doing what she can to raise awareness and funds for breast cancer prevention and research.

We all need to have a plan after graduation, don't we?

The Bald Truth

She looks in the mirror and doesn’t recognize her own reflection. She’s bald. The bags under her eyes display how little sleep she has gotten over the past few months. She undresses and sees her curves. Since her diagnosis, she’s gained 15 pounds, which is unfortunately the norm for her type of cancer. Much like the sky on a gray day in winter, there is no beauty to be found here.

Once a week or so, she logs onto Facebook to look through her old photographs. She smiles at first, feeling nostalgic, before the tears begin to stream down her face. There was a time when she was the girl with the striking red hair. There was a time when she could see her godson whenever she wanted without risking an infection that could delay her treatment. There was a time when the majority of her social life didn’t consist of regular visits to the Chemotherapy Room. There was a time when she wasn’t:

Cancer Girl.

She’s prided herself on being able to process her emotions and then move past them, but that’s become tougher. The fatigue, the steroids, the pain, early menopause and how much her life has changed have taken their toll. She wants her hair back, her body back and her old life back.

People ask her if treatment is working, and that’s a question that she won’t be able to answer anytime soon. See, she has an aggressive type of cancer that was caught at the earliest possible stage. With this type of cancer, there’s a high risk of a metastatic recurrence (also known as stage four cancer or the party is probably over) within five to ten years. She’s following the protocol that has been shown to drastically reduce her risk of recurrence, but only time will tell whether treatment has been successful.

She confesses that she has had a few pity parties since she started chemotherapy. But, then, the clouds part, and the sun returns.

She receives a call from a friend who has found a breast lump and wants to know what to do.

She puts on some lingerie before her man arrives and reminds herself that she doesn’t need to feel sexy to be sexy.

An old family friend writes her that she’s getting her first mammogram in over 20 years.

A man opens up to her about how breast cancer has affected him.

She gets involved in a project to raise awareness and funds for breast cancer prevention, research and education.

People – with and without cancer — approach her on the street and thank her for being brave enough to go out in public bald.

She realizes that she will be a stronger advocate against the use of carcinogens in sex toys because she has had cancer.

Strangers send her messages that they’ve started doing breast self-exams or scheduled their first mammograms after reading her blog.

If her experience can be about more than just her, then how can she cry for that long? This is part of God’s plan. She silently repeats Joyce Meyer’s quote:

The opposite of fear is faith.

She dries the few tears that have fallen down her cheeks and prepares to go for a short walk. There will be bad days until she’s done with treatment in March, but today is a good day. And, she trusts that there will be many, many more good days in her future.

For that, she is grateful.