Wednesday, January 28, 2015

New Construction


I started this post two months ago. I couldn't get it all out at one time. Here is what I ended up with. I'm still not happy with it, but I need the finality of posting it so that I can move on. Also - it's long and I don't care. 

I feel like a broken record. I start and stop journal entries and blogs and updates and posts over and over again because I can’t figure out exactly what it is I need to say. I can’t convince my brain to concentrate for more than five minutes at a time and then when I start a blog/update/post with those same words, “I can’t figure out what I want to say or how I want to say it.” I get frustrated with myself and delete them. Nothing is original anymore and it all just feels like more blaaaah…. Life isn’t blaaaah but my writing sure is. It’s pissing me off. I’ve lost my muse and find it impossible to be smart with my writing anymore.

Sometimes (rarely), I find myself having really brilliant thoughts – but dangit, they’re gone before I even get a chance to realize they’re brilliant. So frustrating. I’m not sure what’s going on with my head or why I seem to be incapable of maintaining any focus. But beyond the inability to focus, the thing that really bothers me is that I feel like I don’t feel as much. I’m not sure if I’m depressed or if I’ve spent so much time trying not to feel out of self-preservation that I’ve become too good at it. Or maybe it’s the meds? What I do know is that I’ve got to get tapped back into that core of myself that used to be capable of expressing raw feelings… It’s part of the essential human experience for me. Life.

Life, right – it’s been interesting the last several months. I guess the reality is that it’s been going on for about 18 months, but I didn’t recognize it that way until I was catapulted out of the forest and had a pretty clear view of it from above without any trees blocking reality.

I wrote and posted about it before, but upon re-reading my post I decided I’d hate myself based on what I wrote there if I didn’t know myself. My goal is to be authentic and truthful without feeling sorry for myself. The reality that I’m learning as I read other blogs is that because we as humans don’t get to walk in each other’s shoes means that sometimes we are going to incorrectly perceive a bit of self-sorrow now and then.  Still, on reflection I found that the post didn’t reflect what I was feeling – so it’s gone-zo.

It’s really hard for me to be this honest and vulnerable because I’ve built my recovery on being positive and generating good energy. I’d prefer to pretend it isn’t happening, that I don’t feel sad or angry or confused, and that I am absolutely finding the “everything happens for a reason-ness” in this. But I’m not a very good faker.  Similar to the day I was diagnosed, I struggle. I don’t want to talk about it. I can barely write about it… I hardly want to admit it to myself, even in the darkest corners of my heart in the darkest nights when nobody is around. And so, I run from things or I chase things or do anything that will prevent me from feeling the feelings that lurk in the darkest corners of my heart in the darkest nights when nobody is around. I guess the upside is that I will be very fit (it is a pretty sweet upside!).

(Also, I've learned that sometimes a bit of self-sorrow is ok… maybe even appropriate.)

The Facts Without {much} Emotion:

I had triple positive breast cancer which, among other things means that my cancer that was fueled by both estrogen and progesterone. Because of that, I have been on a pill (Tamoxifen) that blocks the estrogen from my body. I've been on this pill for 2 years and am supposed to be on it for 10 (or maybe, forever?). Tamoxifen is very effective (imperative, for me) in preventing a recurrence of breast cancer which, because of my age and the stage of my cancer, is high(ish). Tamoxifen also has the propensity to increase my chances of developing uterine cancer (I think I’ve read it doubles or triples the chances, but that might be less because of my age, I’m not sure). Even still, the benefits of taking Tamoxifen far outweigh any risk of uterine cancer.

That being said, my doctors have been monitoring abnormal thickening of my endometrial lining for over a year now. Endometrial hyperplasia (which is what I had) can be a precursor to uterine cancer. In the past year I have had four pelvic ultrasounds, two uterine biopsies, a D&C and an abdominal ultrasound (just to monitor my uterus… this doesn't include other scans to rule out cancer in other places).

When my last ultrasound indicated that my uterine lining had again doubled after the D&C I had last March, my regular Gyn sent me to a Gynecologic Oncologist. After some discussion between her and I, and her and my regular oncologist, and me and my regular oncologist (to be covered in the “Emotion without {many} Facts” section of this update), we all decided it would be best for me to undergo a hysterectomy. I also requested my ovaries be taken since they (theoretically) produce estrogen (cancer fuel) and since I hadn’t had a period in 2.5 years (not functioning anymore, thank you - chemo) and since ovaries too can grow cancer (especially if you’re diagnosed young and have a genetic predisposition to breast cancer).

And so it was, the surgery took place on November 12. It was outpatient (which is as crazy as it sounds) – I came home that evening. As most people who have laparoscopic surgery will tell you, vast majority of the pain comes from the gas they use to pump you up to move around in there. Outside of that, my pain was in the first 8 hours after surgery, in recovery. Once we got the pain under control in the hospital, I hit the ground running.

Literally- 8 days after surgery I was running.

Here I am, almost two weeks out of surgery and I am almost 100%. Running almost full speed and at full distance. I haven’t been on the bike yet, but I am sure with far less impact in cycling, I will be just fine on the bike. All of this is great news seeing as I have some pretty lofty goals for 2015.

The Emotions Without {many} Facts:

Alright, so this was a massive blow to me. I haven’t been able to pull my emotions together enough to figure out exactly why – but of all the treatments and losses I’ve experienced in the cancer journey – this one hurt the most. Maybe it’s because my expectation was that I’d lost what there was to lose (short of life)? Or maybe it’s because I always thought in the waaaay back of my head that I’d be able to have some miracle baby. It’s definitely at least partly because I have always, always known that I would bear children. I (like every other girl growing up) had named them and figured out exactly how I would deliver and nurse and raise them to be strong and independent and vulnerable – of course, realizing that all of it would change when another party (baby-daddy) was added to the mix.
It feels so sudden, processing the fact that I will, for absolute certainty, not be having children – not my own, anyway.

But it’s not sudden. I have wondered for years whether or not I would actually get the privilege of growing a baby inside me. And over the past two and a half years (since I started treatment) my fertility has been a major question mark. I haven’t had a period since my first chemo treatment and definitely went through the gamut of menopausal symptoms in the year following treatment.  But even then, I didn’t allow myself to process the idea that I would not be able to have babies. And, to be fair – my doctors also held out hope that my reproductive system would recover.

As I contemplate it now, I probably didn’t allow myself to think about it then because I was probably unable to even begin to consider the finality of what was happening at the time. It was all too much and I think my subconscious way of dealing with it was to not deal with it. Or, more accurately, to deal with one loss at a time. So I did. First the hair, then the fitness, then the boyfriend, then the health, then the breasts, then the nipples, then the body as I used to know it… I processed my inability to recover like I once had and found a way to accept the edema in my legs and the fact that my hair, no matter what I tried, would not grow in thick enough to cover my head…  Ultimately, all of those things led up to me feeling like I’d lost the things that made me feel feminine.

Comments I've received from people in delivering this news indicate that they struggle seeing me struggle. “There’s always adoption, Stephanie! You can still be a mom.” Yes, it’s true. It’s just that easy… And their comments have forced me to reconcile what it is I’m really mourning. While I do find remarks a little bit (rash and insensitive?) difficult to swallow, they have a place in my emotional recovery. They've helped me to recognize that I am not mourning the loss of my ability to be a mother. Short of dying, my ability to mother was never on the table. There is something very special, intrinsically feminine about being able to grow a baby inside you. For me, it was never about raising my own children – since anyone who knows me is aware that I can love any child. It was about growing a life inside of me… It really pisses me off when people try to minimize that loss.

So it’s crushed me. I don’t feel it all the time. The waves of emotion come over me when I least expect them and I’m trying to find the best ways to deal with them. It’s like intermittent depression (which could be in part, due to the surgical onset of menopause at the age of 36 – which, by the way sucks bad). Just as the waves of brilliant thoughts and emotion roll over me, so do moments of clarity, of understanding why this hurts so much…

Treatment had an end. As far as I knew, I understood where the end of the race was and I understood the outcome: LIFE. Even though I really was very sick during treatment, I had hope for a future, health, life, etc… The outcome of this surgery is so definitive. Permanent. Painful . As much as I persevere and as much as I process any anger or sadness – I will never have the ability to bear children. I was born with the body parts and the potential to grow babies and now the body parts and the potential are gone. Forever.  Reconciling my love of children with the events of 2014 is a tough nugget for me. I’m working my way through it all, finding the good and giving the tough stuff the attention it deserves.

This whole process of surviving (breast) cancer is pretty wild. Poison, then reconstruction. Surgery, then reconstruction. Radiation, then reconstruction... all of it to get back to what I was before. But this feels different. We aren't reconstructing anything; there's no reconstruction of a fully operational reproductive system (and the life events that come with it). Since the goal is not to go back to where I was before, I've decided I'm calling it "new construction," and it's working for me. 

Here’s to hoping for a 2015 full of racing, health, laughter, friendships, and construction of the new normal. 


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