The Big "C"

Tuesday, February 20, 2007

Something to think about

I have always believed everything happens for a reason. It's a mantra my mom raised me up on. And yes, I do believe I had cancer for a reason. I also believe all the other events in my life also happen for their own reasons.

Medicine has made my life possible. I am glad I am part of this time period, I know that if I had been born any earlier, I probably would not have survived. Even before I was born, there were complications. During her pregnancy with me, my mom's gallbladder gave out. She basically was nauseous and vomitting the whole time with me. She couldn't eat and was admitted to the hospital several times for dehydration. The doctors wanted to do surgery, but she told them no because she would risk losing me. Thanks mom! :) Then, a few months after I was born, I got pneumonia and was admitted to the hospital. My temp was 104.5 degrees. I was lucky I survived that too. Growing up I was pretty healthy, although I usually came down with the stomach flu every year, and one year I got mono. Then in 9th grade I joined cross country, which I owe to helping me find a few things wrong that I would have otherwise not noticed. During the season of my 10th grade year I noticed I couldn't run like I used to. I would get a sharp stabbing pain in my side a couple miles into a run. It would take my breath away and I would have to stop, and usually I could barely run anymore. After a few doctors visits, turned out I had an ovarian cyst the size of a grapefruit! The doctor said it was a good thing we found it when we did otherwise it would have twisted and I would have lost blood flow to my reproductive organs. So I had a laparoscopy to drain that. Then a year later I began having leg pains when running. I credited to being out of shape and a pulled muscle. So I ran more and incorporated more stretching exercises into my routine. The pain didn't subside and I started to get pretty poor times running, even though I had done fine in track two seasons before. The school trainer said I should have the doctor look at it. We had a visiting doctor come to the school every couple of weeks, and he actually served as the doctor to the US women's gymnastics team. He came and I had my leg evaluated. He pushed and pulled my leg this way and that, and then he found the spot of pain and I nearly jumped off the table. He suspected something was wrong with my femur, like a growth on it or irregularity and suggested I get an x-ray. So I got an x-ray, and didn't think much of it. It ended up being a tumor in the upper part of my femur. As it grew, it turned my bone into soft tissue. I literally had been standing and running on a little bit of bone width, and had I continued I would have broke my leg! The surgery for that ended up being an implantation of a titanium rod the entire length of the femur, along with a nail and a screw. Pathology said the tumor was an aneurysmal bone cyst. Yay for me and cysts!

Consequently, when I started having breast problems back in 2004, the doctor's diagnosis of a cyst did not surprise me. I recently met a friend for lunch who asked me how this all started, and I realized I never put that in here, so here it is! During the summer of 2004, I was 21 at the time, I was busy studying for the MCAT. After I finished studying one day I noticed that I had a brown spot on my shirt, and I thought, oh great, stained a nice shirt while I was eating. But later on I realized that the spot went through my bra too. Now at this time I was having hormonal problems, with polycystic ovary syndrome, and figured this had to do with that. That is what the doctors thought too. Physicians felt me up many times and took my blood to show I had high prolactin levels and probably a cyst in the breast. They referred me to a breast surgeon to double check. She said I probably had a papilloma that burst. She did several examinations on me, and I figured she felt the thickened area of my breast, so I never mentioned that part. Looking back I should have mentioned it, and then she would have taken some cells from it. Everyone was more concerned with the drainage that continued from both breasts, this time clear. It took awhile to get my prolactin levels back to normal, and I moved on and never thought twice about it all. Looking back, that's probably when all this started. There are a lot of shoulda, woulda, coulda's, but hindsight is always 20/20.

So, getting back to everything happens for a reason. I believe I didn't get into medical school right away for a reason. Granted there are all the admissions factors, but I feel there was something more. It was as if God wanted to let me get this cancer thing under control before I started. Because I know that if I was in medical school, I probably would have missed my yearly exam, or not bothered to get the issue reevaluated until after the school year was done. By then it might have been too late. And I also believe that is why I have such an interest in medicine. It has saved my life several times, and I owe it. I will enjoy giving back to the medical community, and hoping to save others' lives in the process. I really do feel it is my purpose in life. I will use my cancer experience to hopefully make me a better doctor. Although, I thought I would have made a fine doctor without the experience! :P

Now time for the philosophical part. You might ask, why am I not mad at God, how could he let me suffer with cancer? Well, I feel there are things that God can control, and things he cannot. For example, I was probably destined to get cancer at some point or another--God didn't give it to me. What he did was allow me to find it, and helped me out so that it was diagnosed at pretty much the best time it could have been, if there really is a good time to get diagnosed. Granted I had to postpone a lot of awesome things, but at least I had the option to do that. I am thankful that I didn't find this out a few years down the road when I might be pregnant and finishing up medical school. I can only imagine how disasterous that could have turned out.

If you ever get a chance, please read Kitchen Table Wisdom. It is one of my favorite books and I think a must for anyone going into medicine. The book teaches you about the wonders of life and death, and how human power can only go so far. Love for yourself, others and life is taught through many little stories. It really opens up your mind to the spirit of living and dying and how connected they are. I think it makes for a more passionate doctor. Kitchen Table Wisdom is really my outline for medical practice and I am going to use it as a I guide when I am a doctor someday. Please, please read it if you have the time, you won't regret it!

Wednesday, February 07, 2007

One year down, many more to go!

Exactly one year ago today (2/7/06) my fears came true, I was diagnosed with invasive ductal carcinoma. I lost one year to cancer, and I vow to make it no more! I am very lucky to have come this far, against many odds and bad stats. Aggressive chemo, radiation and lots of drugs for the next five years should hopefully beat this beast into submission!

Ever hear of the Nottingham Prognostic Index? Well my score for it is 5.84, but I am not going to let it bother me. All the treatments I've had have changed it for the better, and things are good now. The true test is to make it through the next year with no problems, then the next milestone is five years, then ten...I just have to knock each year down, one by one :)

I love my life, and I'm going to get back to being busy living it! I'm still waiting for the final okay on insurance, and then I'll be scheduling plane rides and hotel stays for New Orleans! It's funny, originally I wanted to have long hair when I get married, but now my wish is to have two breasts! Being uni-boobed is not as fun as it sounds. Prosthetics are great disguises, but you always have to wear them. It's annoying to exercise with them, as they tend to migrate in a sports bra--not fun adjusting that in the gym, let me tell you. Also wearing bathing suits is tricky business, I have to find the right style to make it less obvious that there is uneven-ness going on. But this summer is going to rock--yay for getting a new boob! I cannot wait to be able to wear just a regular bra and not one of the lovely medical ones for prosthetics (can we say ugly?). Plus, it will be nice just to feel whole again :)

Also, my hair is growing back pretty well! I love having hair again, and now it's long enough that it doesn't look like I've been sick either (ie. doesn't look like I'm growing new hair). The hair on my head has come back thicker and is brown! So if you see me, you might not recognize me! I'm also sporting new eyelashes and eyebrows! Unfortunately my eyelashes are no where near as long as they used to be, and probably will never be where they used to be (after talking to many ladies who've been in the same position as me). My eyebrows also grew back dark, but now they're slowly lightening and I've even got some blond hairs growing in them now. Plus, it's nice when I work out to not have to wear a bandanna at the gym, and the sweat doesn't run into my eyes anymore. Ahh, the little things in life :)

Recently I got another Zoladex shot and I'm hoping it works this time! This was the once a month dose (3.6mg I think?) and I'm praying my labs show the correct values a month from now. I'm supposed to be in menopause, but we shall see if that happens this time around. I know it worked for a time, with lovely hotflashes and joint pain that made it hard to sleep. But then they suddenly went away and now I feel fine. So I'm not sure if my Tamoxifen is working or not. I called the onc to see if I could get a genetic test to see if I am a 'good' metabolizer of Tamoxifen. Hopefully they'll get back with me later today.

Lastly, I just want to thank everyone for their support and well wishes. This past year has been crazy, but all of your thoughts and prayers have really helped me come through! Someday I'll be able to 'pay it forward' to my future patients.

Speaking of pay...did a little book work and I have been pretty high maintenance this past year:

Chemotherapy: $80,092.61
Drugs: $63,600
Mastectomy: $9,613.63
Port Surgery: $4,627.92
Radiation: $37,815
PET Scan: $4,000
Genetic Testing: $3,000
Estimated Reconstruction: $84,000

And these costs do NOT include labs, prescription drugs, and cost of doctor's appointments...

THANK GOODNESS for insurance!