metastatic cancer

Three Little Bruises

The first time I went to the ER for my bronchitis, the triage nurse did not believe my warnings, which I provided in between violent coughs, about the veins in my left arm.

“You can only use my left arm because I had 5 lymph nodes removed from my right arm in 2010.”

Do they ever listen to me? God no.

The first time he stuck me, he could tell almost immediately that he did not find a vein. The second time he stuck me, this time in the forearm, he said, “I think I got it.”

I coughed (barked?) out, “NO, YOU DON’T GOT IT,” after feeling both him digging around and hot burning in my forearm.

The ER nurse, responsible for the third poke, fetched a Vein Finder before subjecting me to a third unassisted stick in my arm. “Hey, next time you’re in this situation, just ask for a Vein Finder right away. Explain you have difficult veins, and that way, you don’t get repeatedly stuck like this.”

Each poke is like adding an ounce of physical trauma to my body, especially my left arm. Think of how many times I have endured a poke in the arm, cut of the skin, or radiation burn to the skin in the last 16 years. The three pokes may not be significant for a triage nurse to care about in his day-to-day job routine, but every time I experience a degree of physical pain, it’s like adding a grain of sand to a jar.

It accumulates slowly over time.

I associate my left arm with pain, with bruising, with scarring and weird vein discolorations.

When I had my colonoscopy this week, I asked the nurse who was prepping me to use a vein finder, providing the same spiel as a above, including the story of my first trip to the ER.

Did she listen to me? God no.

Luckily, the nurse for the second ER visit did listen to me and spared me from additional grains of sands. So I’m batting 50%. So… yay?

However, as I type here now, I unsurprisingly have three little bruises (compared to the first ER visit) on my left arm. The third and final bruise on my arm came from a medical professional using the (what now) Vein Finder. My patient notes probably make note of the tears I shed after the second failed attempt to insert an IV into my arm.

I wonder if they mistook my tears for anxiety, but they don’t know that it’s more than that. It’s a culmination of 16 years of countless sticks into my arm, and watching the sand in my jar fill up ever so slowly.

I wish I could provide direct feedback to these medical professionals after the fact and say, “Hey, you inflicted needless pain on me when you didn’t have to. You could have just listened to me from the beginning and that way, I’m not walking with three visible bruises on my arm for all to see.”

Translation: You made me walk around with a visible reminder that I am someone who is ill.

If you are someone in the medical professional, please listen to your patients. I didn’t tell the first nurse about my difficult veins in the midst of a violent coughing fit for the sake of hearing myself talk. I was having a hard time just even BREATHING.

Sometimes that “Big pinch” really fucking hurts, okay?

Next time, I won’t suggest that they get a Vein Finder before looking for a vein to insert an IV. I will demand it.

I can’t breathe

Breathe in, breathe out.

In the last 35+ days, I have been to the Emergency Department twice for uncontrollable coughing. I’m talking out-of-control, violent coughing, causing me to actually throw up from the sheer violence and form petechia underneath my eyes.

Breathe in, breathe out.

The second Emergency Department visit was because my cough came back (or never left), and every time I coughed, I felt a sharp pain in my upper left rib, like some invisible monster was pressing their knuckles into my rib.

I can’t breathe. I can’t breathe.

It has been almost 3 years since I last dealt with a respiratory illness that knocked me on my ass. My dog, Boomer, had gotten out Thanksgiving night, and I had gone to the ER earlier that evening because I was sick as, well, a dog. I couldn’t breathe out of either nostril and I had lost my voice. She got out that night and I had to go running in my neighborhood, croaking out her name as I’m running through the neighborhood.

That particular illness lingered for a month, which is to be expected.

This time around, something’s different. Maybe it’s me, and I’m different? I’ve had three years of Ibrance, a CDK inhibitor with known side effect of interstitial lung disease, since that prior illness.

Breathe in, breathe out.

Last Friday, I spoke with my oncologist’s PA about my blood work results and my lingering cough. While I appreciate her attention to detail and compassion for my situation, I felt pretty shaken after the conversation her and I had. She mentioned that she would have no hesitancy whatsoever to sign paperwork for me to go on a medical leave.

Am I at the point in my life where a respiratory illness means I can’t work?

That realization caused a sadness that I had never experienced before. Being able to still work full-time with stage four cancer has allowed me to push certain doomerism thoughts out of my mind. My very serious illness cannot be that serious if I can still work full-time, right? Now you’re telling me that if I get a respiratory illness like this again that I’m not equipped to power through it?

This feels like a Before and After moment in my life, and it makes me sad. It’s been a month and a week since I first got sick, and I can still feel an ache in my lungs. Sometimes it feels like that invisible giant is squeezing my lungs ever so gently.

“We all die someday.” Yeah, but your “someday” isn’t staring you right in the fucking face.

I felt conflicted writing this because I know putting this out there makes it real. My very serious illness is very serious, and not even my dark sense of humor can save me from what’s to come.

“Handling it so well.”

For some unknown reason, I have had loved ones and acquaintances tell me, “Lara, you have been handling your Stage 4 so well.” Every time I have heard this, I’ve been taken aback by this comment. Why would anyone think I’m handling my disease so well?

I have lived alone for the past 6 years, and I’ve been working from home for 2.5 years now. I’m not around any single person for extended periods of time. I stopped running, so I’m not seeing my running friends on a regular basis anymore. This is the most isolated I’ve been in my entire life.

Yet, I get these remarks about my state of mind. One day, I’m going to respond, “Am I handling it so well, or do you only see what I want you to see or hear?”

The weeks leading up to my 3-month scans always do a number on my mental state. I wonder, “Is this going to be the scan that changes everything?” As of right now, my cancer does not appear to be motivated and content to stay put in my sternum. I used to be anxious and scared out of my mind that my cancer was going to come back stage 4, and now that it’s confirmed stage 4, I’m anxious and scared out of my mind that my cancer is going to spread throughout my body.

How is anyone supposed to “handle this well”? I don’t think it’s socially acceptable for me to be periodically shrieking to people, “Do you know how fucking scared I am?” I have to deal with this the best I can because again, I live alone and there’s nobody coming along to “save me” and take care of me when I can no longer take care of myself. You know how terrifying that is?

What’s going to happen to me?

Living with stage 4 cancer is like staring down a mama grizzly bear alone in a forest. It’s not a matter of if but when.

I honestly believe several of the people who have said this to me wanted to convince themselves that I’m okay and totally don’t need any help. That way, they don’t have to ask or actually do anything. Out of sight, out of mind, amirite?

I am so appreciative of my friends and loved ones who have not assumed my state of mind and sincerely ask how I am doing. I am definitely grateful to be able to still work because it ensures a 40-hour reprieve from all things stage 4 cancer. This disease is full of emotional landmines, plus all the side effects that come with treatment (i.e., joint pain, weight gain, stomach problems, sleep issues, etc.).

I am handling this the best I can, but for the love of dog, don’t ever assume you know what’s going on with me. That just infuriates me.

Self-Care

One of the biggest physical issues I have been dealing with since my diagnosis would have to be my stomach. I go through periods where my stomach just outright beats the snot out of me. I’ve cried and been in physical distress, all while trying to keep up the appearance that everything is a-okay.

My stomach has always acted up (or more accurately, acted against me) when I’m stressed. What can be more stressful than stage 4 cancer? (Spoiler: Not a lot.) Juggling working full-time, a social life, and oh yeah, cancer treatment… yeah, it’s stressful.

I’ve been doing whatever I can to reduce my stress and not get myself worked up. First, I hired someone to mow my yard and pick up poop. Good lord, this has to be one of the smartest decisions I have made recently. Every penny spent paying this man to take care of my yard is worth it. Taking that off my plate has been huge for me and my stress level. I am currently looking for someone or a company to come and clean my house on a monthly basis. That’s the other big load that I need to take off my shoulders. Finding a cleaning company is high on my to-do list.

Running has definitely been a big part of my stress relief. The physical exertion is just fantastic for my soul, and I feel stronger overall. I don’t know if it will, but of course I hope this helps with my overall survival rate. Maybe I will be an outlier, a cancer unicorn? I keep running because I can, and during these runs, I can still forget that I’m stage 4, even if it’s just for 30 minutes or an hour.

My other stress relief as of late has been reading, specifically romance novels. I used to be judgmental about romance novels, and I honestly think I was just closed off for whatever hang ups I had. Not anymore, friends. Romance, smut, I do not care. I am about that romance novel life, and I give zero shits if anyone judges me. Life is definitely short. Do what makes you happy.

One of the big stressors lately for me has been certain family relationships. It has been strained for quite some time, and my illness just put a big ole magnifying glass on the trouble that’s been there for years. I had to cut off a family member from my life because they were causing me emotional distress. I am only on the defensive, and if I object to any hate or vitriol my way, I’m the one overreacting. I went nuclear and just did a straight up block, but this didn’t come out of nowhere. This has been happening for the last couple of years. I didn’t want to do this, but I cannot keep having the same fight and conversation. Over and over and over and over again.

I would like to think me just bowing out of this negative back and forth will cause my family member to do some self-reflection. Unfortunately, I don’t think this will happen. They’re going to do what they think is best, and I’m going to do the same. I am going to protect my mental health and in turn, physical health, at all costs. I’m not going to fight anymore, and I am especially not extending myself to anyone (friend or family) who hasn’t reached out to me once since my diagnosis to see how I am.

One thing cancer has taught me – you have to look out for yourself. That’s what I’m going to keep doing. Nobody is entitled to my time or energy, even if you are related to me. I don’t want to keep fighting but the other person has no desire to change, so peace out. I only have room for one cancer in my life.

Mental Health, Metastatic Breast Cancer & a Mother-Freaking Pandemic

A question I get asked a lot, and understandably so, has been: “How are you doing?” I typically respond, “Hanging in there.” It’s an answer that tells you absolutely nothing, but conveys the sentiment that hey, I am still here. I am always touched when a friend or family member checks in on me, and it warms my icy cold heart that anyone has been thinking about me. I’ll let you in on a secret though: I often give the non answer of “hanging in there” because I honestly don’t know how to answer this question. I really don’t. Does anyone really want to know the real answer?

Most of the time, my stress level is probably at a 7 or an 8, and it’s been that way since the beginning of October 2020. I am going to do my best to try and explain what this feels like. To me, sometimes it feels like there’s a killer clown with a 10-inch serrated knife in the room with me. This clown looks like it crawled out from the depths of hell, and it has got murder on its mind. The killer clown has soulless, jet-black eyes, and yellowish fangs. It has a devilish smile, which enjoys mouthing the words, “I am going to kill you.”

The kicker – nobody else can see this killer clown.

“Can’t you see it, too?” I scream at others. They nod their head and shrug at me. Nope, it’s only me. So, I have to pretend to be normal and do my best to not pay attention to the killer clown, but sometimes I slip, look back and see it once again mouthing the words “I am going to kill you,” and then freak out accordingly. I still have to go about my regular day and pretend like I don’t see this clown but I am always aware that it is there..

Living alone during a pandemic was challenging and tough enough, as it was. I often felt lonely and isolated. Like so many, I felt cutoff from my friends and my running community. The big difference, though, was that I could still run and work out. Now, I am lucky if I get 30 minutes of aerobic exercise on the treadmill. I keep gaining weight, and my body is changing so much on me. Soon, it’s going to be even more foreign to me, and I mourn my pre-diagnosis body with all my heart and what I used to be able to do.

I am lucky that I enjoy my job, and really like the people I work with and for. My job allows me to be creative, and I always try to learn something new every day. My job allows me to ignore the killer clown for 40 hours a week, and pretend to be normal, when I feel like anything but. I want to keep working as long as I physically can because it really helps my mental health, too. There are stretches of time where I actually forget I have metastatic breast cancer. Oh my, I am actually tearing up thinking about this. I desperately need these stretches of time where I can forget and feel like Lara again.

I truly believe my mental health will significantly improve when the weather gets warmer, and I can leave my house for physical exercise. I miss being on the trails so much. Don’t get me wrong – I will not be running on the trails ever again (well, unless something is chasing me). During my last brain MRI, I tried to go to my happy place, and I found myself transported back to the trails in North Park. I was climbing up the massive elevation on the purple trail, and then I was trotting along the green trail where I typically spot deer.

Even though I’m exhausted pretty much most of the time and my counts are currently in the toilet, I will hike those trails again. I’ll just have my boyfriend along with me (making sure I don’t trip and fall).

“Do you want to be defined by this?”

This question was asked of me lately, and I have been really giving this question a lot of thought. Do I want to be defined by my illness, by cancer? More importantly, do I… have a say in this matter?

Cancer has been a part of my life since I was 2 or 3 years old, whenever it was my mom first got sick. Cancer for sure set off a crater in my life when she died when I was only 7 years old. Thanks to cancer, I learned at a very young age that life was not fair, and the people you love will leave you, even though they don’t want to.

I always felt weird and out of place going through school, like this major life event marked me as different, a weirdo. I was the girl with the dead mom. Navigating adolescence without your mother is difficult, and I went through many “you’re becoming a woman” milestones with my dad.

Then, cancer once again becomes a part of my life when I was 25 when I started getting yearly mammograms. Five years later, I am told I have stage 1 breast cancer. Now, at the age of 40, I am living with stage 4 breast cancer. This freaking disease has been a part of my life for pretty much the entire life, and it’s going to kill me just like my mom. So yes, I have been very much defined by breast cancer.

Yeah, I have been defined by my cancer, and I plan on fundraising for metastatic breast cancer research as much as I can before I die. However, I will always be more than my disease. I was a runner, and I take bomb ass pictures. I am accident prone, and I love memes. I like my job, and I really like and care for my coworkers.

When the time comes I find out once and for all if heaven is real, I know my loved ones will be talking about funny stories about me, and not giving cancer a second thought.

Good-bye 2020

Like everyone else in this whole wide world, 2020 was a giant dumpster fire of bad news, cancelled plans, and overwhelming feelings of isolation. A couple of weeks ago, I underwent my first ever brain MRI that my oncologist ordered. I had been experiencing more headaches than normal, and I had episodes of complete forgetfulness which worried me.

First of all, MRIs in general are just anxiety-inducing procedures to begin with. During my MRI, I did not have any option to listen to music. As a result, I spent the 35 minutes in the MRI tube trying not to think about the very enclosed space and cage around my face. I did try to go to my happy place, but the sounds of VMMMM VMMM DUM DUM WHIRRRRR, or a combination thereabouts, prevented me from going to my happy place.

Also, similar to that gut feeling I had when I pushed my oncologist to order the CT and bone scan, I honestly felt like something was there. Guess what? I was right. (Yay me.)

I have a 9 mm (approximately a 1/3 inch) tumor in the back of my brain. When my oncologist told me that news, I just broke down. When I thought I was just dealing with a met to my sternum, it was one thing. Oligometastatic, if you’re going to have stage 4 breast cancer, is the diagnosis you want because the good prognosis and life expectancy odds are in your favor.

However, the idea that I could be also dealing with brain mets not only pulled the rug from underneath me, it beat the shit out of me with a bat. I mean, come the fuck on. This is a lot for anyone to deal with. I knew that even if the brain tumor turned out to be benign, the fact that I had metastatic breast cancer, a brain tumor, plus all the bullshit that comes with Cowden’s Syndrome, felt downright unbearable.

ESPECIALLY IN A FREAKING PANDEMIC. It’s not like I can meet up with my friends for support, or travel down to my parents house for Christmas like I had really wanted to. I spent Christmas by myself (well, my dogs are with me). As a result, I lost it. I cried a lot, and both my anxiety and depression took the wheel, while I stayed in the backseat curled up in a fetal position. I wrote in a notebook how I really and truly don’t want to be anyone’s idea of inspiration or strength. Let me be weak and cry, and for the love of pete, do not put me on any pedestal. I hate that shit.

I’m human, and I’m doing the best that I can. I’m not going to put on a brave face to make anyone feel comfortable.

Finally, after consultations with a neurosurgeon and my radiation oncologist, my team of doctors all agreed that this tumor looked like a typical meningioma, and where it was located in my brain further suggested that it’s a benign tumor. However, since this was the first ever MRI of my brain, the neurologist can’t say with 99.9 percent certainty without a second scan. If this tumor doesn’t appear to have grown in between scans, she can say with almost complete certainty that this is benign and let’s just keep watching it.

If I didn’t have Cowden’s Syndrome, she would have re-scanned me in 3 months and then 6 months, and then so on. Since I have stage 4 breast cancer, they are going to scan me in 4 weeks or so (pending insurance approval), and then every 3 months for a period of time. We will only talk surgery if it looks like it’s growing or I’m symptomatic. I am a-okay with this plan because I have zero desire to have brain surgery unless it’s necessary.

Oh look, there have been research into the frequency of meningiomas in patients with Cowden’s Syndrome: Hidden association of Cowden syndrome, PTEN mutation and meningioma frequency (source). Fun, super duper fun.

I’m not surprised that 2020 ended with one last punch to my emotional well being. This year, I was told that my breast cancer is now stage 4. I missed out on my own planned 40th birthday party, my beloved niece’s high school graduation, and a trip to Maine with my best friend. I spent every holiday at home by myself. Why not add a brain tumor to the list?

In an effort to put a horrible year behind me, I will do my best to recap and focus on the good things that happened (or, in my case, the not so terrible news):

  • My brain tumor is certainly benign.
  • My cancer appears to be only in my sternum still, not widespread.
  • I still have my job, and in fact, I got a promotion!
  • Management at work has been so wonderful and supportive to me. My boss, and boss’s boss, have been the epitome of caring toward me. I will honestly work for them as long as I can.
  • Countless friends have helped me and showered me with love in 2020. They sent generous gifts, bought Huffman rules clothes, and sent me money. Because of my loved ones’ generosity, I have been able to save more money and prepare myself for the rainy day that is coming, and it is coming fast.
  • Last, and certainly not least, my boyfriend has stood by my side, and he makes me feel like the luckiest woman alive. (Never thought you’d hear that coming from someone who definitely did not win the genetic lotter, huh?)

Yeah, 2020 sucked royally, and my life will never be as it was. It’s okay. If my only win this year was that I survived, I’ll take it.

Back to Work

Today was my first day back at work, and I beyond excited to be back. Am I ready? Mentally – hell to the yeah. I am someone who loves and appreciates a routine. Recovering from major surgery and dealing with the fact that I have metastatic disease has honestly made these past six weeks feel like six months. All I had to do each day was think about my poor health and catastrophize my fate.

Needless to say, time dragged.

Work will be a welcome reprieve from my worried mind. I can focus on audit, fraud, and whatever else I have been tasked with. Work will allow me to be more than just a cancer patient. I mean, yeah, I’m a cancer patient, but I can put on a different hat for the majority of my week.

Plus, I like working, and I really love the team I am on at work. We are a great, supportive team. I truly enjoy figuring things out, editing, research, and analysis.

Am I ready physically? Maybe. I am tired, friends. My body feels foreign to me now. For the last couple of days, my legs have felt heavy, and I feel winded just walking up stairs. This time last year, I ran a marathon!

The gyn oncologist cleared me for exercise today at my 6-weeks post op appointment, and I am already setting goals for myself. I would love to be able to run a 5K in the spring. Even if I am slow as hell, I am going to keep moving until my body tells me I have to stop.

I swear to GOD, I will crotch punch anyone who cries at the sight of me running and refers to me as inspirational. Never ever ever ever ever make me the subject of any inspiration porn.

I just want to live my life, and I’m going to do whatever I can to have more good days than bad.

5 Stages of Grief

It has only been one month since my oncologist told me that I had metastatic breast cancer, and it’s only been a little over three weeks since my hysterectomy. Honest to dog, it feels like a couple months since all this began, as if I am in a suspended state. Between Covid-19 and my medical leave of absence, I have no concept of time anymore.

During this period of time, I have definitely cycled through the different stages of grief, which I imagine is quite common.

  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance

If you are like me and need a refresher as to what constitutes the 5 Stages of Grief, refer to this article on Psycom.net (link), which discusses the Kubler-Ross Model.

DENIAL – Avoidance, Confusion, Elation, Shock, Fear

I previously believed that denial involved only avoidance, and even thought at one point, “Well, at least I never visited the denial phase.” Boy, I was wrong.

During September, I had both a bone scan and a CT scan of my neck down to my special area. When the bone scan posted to MyChart stated that my sternum presented as potential metastatic disease, I had a delayed mental breakdown. I had an important meeting that morning, which I had to lead. I told myself that I could break down later. When it was safe, I ended up taking a half day from work because I went to a bad place.

Quite simply, I went into shock. 

I swear, I knew that very day I was going to be stage 4 and that my cancer was back. I was already back in the chemo chair in my mind. I rocked back and forth in a corner in my bedroom, whispering, “I can’t do this” over and over again. My face went numb. My arms went numb and eventually, my hands went numb. I couldn’t

My loved ones who knew I was having a panic attack about this told me, “Oh this could be the result of your trip and fall.” I wanted to believe them and go along with their theory, and I eventually agreed it could be a possibility. I never really believed it fully, but I wanted to.

The fear that I felt that day will stay with me for a very long time. It’s the type of fear that consumes you and changes you. It definitely changed me.

ANGER – Frustration, Irritation, Anxiety

Oh, I have visited this stage and camped out here for a spell. Heck, I think I have bought a house in this stage, renovated it, and redecorated. I know this phase so well. I have felt angry, and why not? I’m allowed.

I did everything I was supposed to do to ensure that I didn’t suffer the same fate as my mother. I started getting yearly mammograms at the age of 25, and sometimes, I had to go twice a year. With every mammogram, I had an ultrasound done due to having dense breast tissue (aka fibrocystic breast tissue). I had multiple fiboradenomas, and multiple biopsies.

At the age of 30, doctors found my breast cancer at stage 1b. I “caught it early.” I went through absolute hell and back for almost 2 years – a lumpectomy, chemotherapy (including anaphylactic shock), radiation, double mastectomy, and reconstruction. Still, to this day, I experience legit flashbacks if I ever get lightheaded and dizzy because that’s the sensation I felt before anaphylactic shock.

I. Did. It. All.

My oncologist threw everything but the sink at me, and I came out of that period of my life scarred and shell shocked. I even had my oncologist repeatedly tell me that the odds of it coming back were so small because of the early stage and aggressive treatment. I did everything I could to prevent this, to not end up like my mother, and it still fucking happened. This should make me angry, and it’s okay to be angry. I’m not going to pretend to be someone or something I am not.

BARGAINING – Struggling to Find Meaning, Reaching Out to Others, Telling One’s Story

Man, if I thought I could bargain my way out of this, I absolutely would. For real, if I had something I could offer in order to not have this disease, then I would do it. “Lara, you will no longer have stage 4 cancer anymore if you give up coff-” “DONE.”

In all seriousness, I don’t consider myself all that religious, so I don’t typically hold conversations with God. I didn’t, nor will I ever, ask God why this has happened to me because why not? Me having stage 4 cancer is not some horrible tragedy. It’s genetics.

It might also be that I don’t believe that God gave me cancer, or that I have been set on some journey. (Whenever I read ‘cancer journey,’ I cringe. It’s a disease, not a trek in the woods.)

While I haven’t had any “WHY GOD WHY” conversations with a higher being, I have been struggling to find meaning in all of this. One of the reasons why I love(d) running so much is that it allowed me to be someone other than a cancer patient. I got to be a runner, an athlete. I wanted to test my physical capabilities, especially after my body betrayed and failed me.

Life as a cancer mutant with a rare genetic condition means I live a different life. I have had a black and white view of what this body of mine does, and this diagnosis has me wondering if it just all grey. Maybe my body didn’t fail me? Maybe my body did what it just does, and I just have to navigate these setbacks and accomplishments more graciously?

DEPRESSION – Overwhelmed, Helplessness, Hostility, Flight

According to the American Cancer Society, 1 in 4 people with cancer suffer from major or clinical depression (source). I have made absolutely no secret that I have dealt with depression before. After treatment for my early stage breast cancer ended, I suffered and I struggled with my life. I had to reach out for help when it got really bad for me in my early 30s.

An October 2, 2013 article on MD Anderson’s website provides the following symptoms of depression:

  • Feeling sad most of the time
  • Loss of pleasure and interest in activities you used to enjoy
  • Changes in eating and sleeping habits
  • Nervousness
  • Slow physical and mental responses
  • Unexplained tiredness
  • Feeling worthless
  • Feeling guilt for no reason
  • Decreased concentration ability
  • Thoughts of death or suicide

In addition to medication, MD Anderson recommended the following activities to manage symptoms of depression: psychotherapy exercise, and stick to routine. The article explained, “Following a routine can help you maintain a feeling of accomplishment and a sense of control, both of which can be negatively affected by cancer and depression. A routine can also help push an individual to engage in activities they wouldn’t necessarily be motivated to complete.”

I did end up doing all of those suggestions, and it worked for me! Once I got help, started running and dumped a horrible boyfriend, I got my depression and anxiety under control. I really did climb out of the fog of depression and learned to really enjoy my life.

Now… *waves around* this.

I am struggling with the enormity of this disease, and what it’s taken from me. When I read the symptoms of depression listed above, I can say that I can check off six of those items. What I have feared for so long has come to be. For so long, I have been absolutely frightened that I was going to end up just like my mother, and now that it has happened, I’m just a scared 40 year old who wishes she had her Mom.

Be rest assured that I do have a good network of support to assist me as I come to terms with my new normal. If I can get back to running, even if at a much slower pace, then that will help me manage my depression. I also think being off work right now is playing a part in my mood. I enjoy a schedule and routine, and I also appreciated the ability to not think about cancer for 8 hours a day.   

ACCEPTANCE – Exploring Options, New Plan in Place, Moving On

What does it meant to achieve acceptance with a stage 4 diagnosis? I know and understand that my life is going to regularly consist of doctor’s visits, blood draws, scans, and sometimes surgeries. None of this will be easy, and I likely will regress back to the earlier phases more often than not. I truly believe that this phase will involve layers upon layers of events and truths that I need to accept, until I get to the final layer, the core: inner peace.

I have accepted that I have stage 4 breast cancer. It’s not like I have a choice, and I can somehow opt out of this. If I could, I fucking would. (Way too many people say that “cancer is a gift” and if that was true, I’d keep my receipt and return this.) This is my life now, and I can either fight my circumstances or do whatever I can to accept all of this and adapt. It’s not an act of bravery to accept my stage 4 diagnosis. It’s a necessity.

When I dig deeper, there are some hard truths that require reflection and acceptance. I accept the fact that I will die from this disease. I also accept that there is a possibility that I may not see my 50s or my 60s. I have to accept the fact that I may not even see 45, although I do hope that is not the case. This could all be out of my control.

As noted above, I want to achieve inner peace. This disease has forced me to rethink about what my priorities are and what they should be. I, for sure, want to figure out my new plan. I’m not going to figure it all out now. I can’t plan this out. I just have to let go.

This, I promise

Understandably, I have been thinking a lot about my priorities since my oncologist told me my cancer is Stage 4. What do I want to do with whatever time I have left. Don’t get me wrong – my oncologist at no point has told me to start getting my affairs in order and preparing for death.

However, the thing about metastatic cancer is that you have no way of knowing if you’re going to be one that responds well to treatment or poorly to treatment. Right now, as far as we know, the cancer is only in my bones: confirmed in my sternum and possibly in my spine. Cancer is smarter than all of us, and I have no doubt it’s already thinking of where it wants to go next.

As I recover from my surgery, I have been thinking about what I really want to focus on and try to achieve, and what time-sucking activities should I just let go. I hope and I pray that the side effects from the upcoming endocrine therapy will not be so bad so that I can go back to work.

I want to go back to work, I really do. I thrive in a structured environment, and I enjoy having a purpose and teaching others what I know. I’m an internal auditor, which I get isn’t like making scientific breakthroughs or saving lives. I contend that even in the normal, every day jobs, you can always make a difference in someone’s life by small acts. Maybe my enthusiasm for research and dogged determination to figure out the answer will rub off on a fellow coworker?

I also work for a company and a team that know about my stage 4 diagnosis. I truly believe that this company, if possible, will want to help fight against metastatic disease and the criminal underfunding of metastatic breast cancer research. I still have zero desire to be, what I call, cancer famous. If I have to put myself out there, though, to put a face to metastatic breast cancer and the importance of research, I will do it.

This, I promise, is my solemn vow: I am not going to go quietly. Please don’t mistake this statement as some declaration of mine that I’m going to “fight” cancer and win. Cancer is not a battle or a fight, and I’m not going to “beat it” or “win.” It is a deadly disease that will eventually kill me just like it killed my mother (hmm, maybe I shouldn’t be a motivational speaker, eh?).

Two generations of Metastatic Breast Cancer

I intend to make as much noise as I can for as long as I can about the importance of metastatic cancer research and the insidious PTEN mutation that caused my cancer. When I was considered to be an early stager, I was often described as outspoken or very vocal. Well, guess the fuck what… that’s just a preview of what’s to come. Ideas are brewing.

Metastatic breast cancer killed my mother, and I was told I had stage 4 metastatic breast cancer at the same age she was when she died. I was maybe 3 years old when my mother was first diagnosed, so this disease has been a part of my life for more than 3 decades, almost 4. I’ve never wanted to be defined by cancer, but we don’t always get what we want.

I’m not going to go quietly. I plan to do something about this, and it’s not always going to be positivity and rainbows. If I’m angry, I’ll be angry. Same goes for sad, depressed, happy, or hopeful. I’m going to feel all the feelings, and when the time comes for me to meet my mother again, I hope she knows I gave it my all.