#Gratitude

If there was a single word to sum up how I'm feeling today, its Gratitude. If you are a user of Twitter, you will understand that using the # symbol, or hashtag is a way to mark key words or topics in a Tweet. I love that it was created organically by Twitter users as a way to categorize messages. Within Twitter, you can search on #Gratitude and see what the multitude of Twitter users across the universe are grateful for. As I look around, I think there's a huge opportunity for everyone to be a little more diligent about identifying what they are grateful for on a daily basis.

As I emerge from these past few trying months, that is one of my new habits. Each day I am writing down at least three things I am grateful for - as well as three positive things I am envisioning for my future. The act of writing it down makes it much more real for me.

Today's list so far? Well, first, I had not one but TWO cups of coffee this morning. For me, this is huge step forward because it symbolizes that food and drink are actually beginning to taste and feel normal. Second, I am grateful to be living in an amazing and beautiful location. It's still February, but today we will flirt with 80 degrees. The sun shines 300+ days a year. Having undergone treatment in January and February, it was such a blessing to be able to travel to the clinic each and every day in 60 or 70 degree temps and beautiful sunshine. I think it did so much to help my attitude!

And finally, I am so grateful for the love, friendship and support of so many people in my life. Doing my morning reading and meditations, I came across this blog and wanted to share it because somehow the people in my life either intuitively knew, or knew from experience, how to do every single thing on this list. You know who you are!

http://www.huffingtonpost.com/suleika-jaouad/cancer-advice_b_1290008.html

If you have a friend or family member with cancer - or even if you've had the good fortune not to face this, I found this to be an incredibly accurate list from a patient's perspective.

The secret of happiness is to count you blessings while others are adding up their troubles

The End of a Chapter, the Start of a New

Last Thursday, I had my final radiation therapy treatment. That made 28 of those treatments, every week day for nearly six weeks. As you can imagine, I got to know my radiation therapists quite well- and I am really grateful for the incredible care they gave me and the compassion they showed each and every day.

Here's me, ringing the bell that says I am done with treatment. Anna and Allison are with me - as they should be! It was a team effort and I thank them - and Andrea and my other therapists who rotated in occasionally - from the bottom of my heart for helping me get through this.

It is my sincere and deep hope that I will not have to endure a regiment such as this ever again. Yet in a way it will be hard to move forward because there seems to be no explanation for why I got cancer. No significant family history. A very healthy lifesytle. Hardly ever been sick a day in the last 10-15 years. And so, without a why, I am left to wonder what I am supposed to do differently, or better. What I am supposed to eat - and not supposed to eat. If there was something in my environment that caused this to occur. So many questions - so few answers.

But here's what I can do. I can choose to focus only on the positive. To think the best of myself and others. To rid my life of those things that no longer hold value, or offer joy and happiness. To spend my time with people who lift me up, and on activities that I am passionate about. I challenge each of you to ask yourself if you are doing these things. You don't need to have had cancer and undergone treatment to make the same choices!!

I know that it will be a slow, but steady climb physically to resume my normal activities. Last week, my blood counts were (hopefully) at rock bottom, causing the nurses and my doctor to marvel that I looked as good as I did. I have to be very careful not to expose myself to illness - I don't have many white blood cells to fight germs. I am to avoid knives - or injuring myself - because I have few platelets to clot my blood. Perhaps most frustrating for me is my lack of hemoglobin - which carries oxygen to my muscles. I get winded walking up a flight of stairs. But these are all temporary and I have to believe if my healthy cells have been this impacted, that the double-whammy of chemo and radiation has completely eradicated any remaining cancer cells in my body.

It's beginning to feel trite to say "thank you" to those of you who continue to lift me up with your cards, emails, texts, prayers, gifts and good wishes. I will say it again: You will never know how much all of your many expressions of love and support have meant to me. I am truly, deeply, completely blessed.

Yes, I am Alive and Well!

I know it has been awhile since I last blogged, but to be honest that last round of chemo really knocked me down, making me even more grateful it was my last session. I am just now, nearly two weeks beyond the treatment, overcoming the nausea and fatigue. And, proof that I no longer take the little things for granted... today was the first time in over a month that I had a morning cup of coffee that tasted and felt normal! Progress!

I have one more week of radiation treatments and then I am done - hopefully forever. This week I will learn more about my follow-up, but what I do know is that I will be seen at least every three months for the next two years and undergo several scans during that period to make sure that nothing else is brewing.

During my most difficult days, so many of you continued to reach out to me - through emails and cards and gifts and texts - and you will never know how much those things meant to me, nor how much they helped me fight the inevitable frustration and impatience with my physical condition. Surrounding myself with people who love and care about me has truly been my lifeline during these last three months. Here's a darling photo of my sweet niece, Kerstin, sent to me during this time:

The other thing I've done is found words to inspire me and keep me going. I thought I would share with all of you a couple of blogs, email feeds and the like that I have discovered and whose words I now crave. Check out:

marcandangel.com
tut.com
tinybuddha.com

Throughout these challenges, perhaps the single most important thing I have learned is the power of hope and positivity. Chasing away negative thoughts, moving away from negative people, focusing on the best of every situation and expecting the most positive outcomes will, I hope, be ingrained in me forever.

Unexpected, Unbelievable Good News!

When my diagnosis first became clear, and I met with a cadre of physicians - gynecological surgeon, radiation oncologist, oncologist - each assessed me from his perspective and then together, they crafted my treatment plan. After surgery and the pathology of my tumor was clear, the radiation oncologist and oncologist took over treatment planning.

So, throughout these past weeks, I've met with my radiation oncologist each week to discuss my progress and side effects. But this past monday, after three rounds of chemo, it was time to meet with my oncologist.

I went into the meeting with some trepidation. At the outset, he told me that he wanted me to complete four cycles of the chemo - six if I could tolerate them. And, he hinted that that might not even be enough - but he wanted to do some more reading, consulting with colleagues and examining the latest literature before making a final call. So, image my complete surprise, delight, relief and overwhelming joy at his news Monday that THIS WOULD BE MY LAST ROUND OF CHEMO!

So yes, if you are keeping track of my calendar, Tuesdays are chemo days and so I am OFFICIALLY DONE!

His decision stemmed from the most current literature on my rather unusual situation. You see, he told me, usually there is no radiation or chemo indicated for Stage 1B1 cervical tumors, BUT in my case, the cancer was a very rare and somewhat aggressive signet ring cell adnocarcinoma - and therefore it was collectively decided that it was very much in my best interest to endure this double whammy of chemo and radiation. In his research, four rounds of Cisplatin is pretty tolerable, but once you go beyond that patients start to experience permanent side effects, like hearing loss and neuropathy. He felt that the risk of continuing would outweigh the diminishing benefits, given four treatments is the standard.

So yesterday afternoon, I made it through my last chemo session, again with the help of some amazing and incredible nurses. Maddie, Amanda, April and others. As they were removing the catheter from my arm, 15 nurses came into my curtain with tambourines, blowing bubbles and cheering for me and presented me with this certificate:

Well... of course I cried. And then the nurses told me their rule - if you cry, you bring brownies. Guess I'd better get baking!!

I do however continue my radiation therapy sessions to completion - 28 total. As of today I have 12 left to complete!

It's Halftime

Living in a household of all boys, I'm pretty comfortable with sports analogies. And so, today I'll use one to declare that for me - it is HALFTIME.

Yesterday at 4 p.m. AZ time, I had my 14th radiation treatment, which marks exactly the halfway point. Earlier in the week (Tuesday) I had my third chemo treatment, also the halfway mark.

All in all, this has been a little better week than week two. In my pre-chemo blood work, we learned that my magnesium levels had dipped really low, and so I'm on oral supplements for that now. My nurses told me that could have contributed to the much more severe fatigue and nausea I felt last week. In any case, I'm trying to take each day as it comes, with no pre-conceived notions about whether its a good day or a bad day until I'm actually living it. And while I'm so excited to be halfway done, I'm also trying not to look too far ahead.

I am grateful for everyone's continued support! The emails, texts, cards, visits, phone calls and packages are so uplifting and so very appreciated. Two special gifts this week: a beautiful book on Paris from my dad, and a special package from a relative of mine who is using my dad's place in Texas. She found a knit blanket/shawl that my mother wore often and sent it to me (with my father's blessing) so that I could wrap myself in it and feel my mother's presence.

Today, I will leave you with this beautiful work by Rumi:

Don't run away from grief, o soul
Look for the remedy inside the pain.
because the rose came from the thorn
and the ruby came from a stone.

And now for the Men

Doing my morning reading today, I was immediately drawn to the headline "Cancer Gender Gap." It seems that word "Cancer" jumps out at me from all over the place these days, when in the past I may not have paid all that much attention to it.

In any case, a new study has found that 32 of the 35 types of the disease are more prevalent in men. I have to say this shocked me a bit because it seems that women's cancers seem so much more publicly discussed, probably because of the huge focus on breast cancer in particular.

The authors of this study suggest that gender differences could be explained in part by different exposures to environmental and behavioral factors such as smoking, occupation and alcohol consumption, but the majority of the gender gap probably results from key biological differences between males and females. "If we could find out what causes the male excess of cancer and somehow eliminate it, we could prevent roughly one-third of all cancer," said Dr. Ellen Chang, the study's senior author. One third!!

So men (and women who love them), you can't shirk your health responsibilities either! I implore you, too, to get your annual check ups, milestone preventative care procedures and - most of all - don't ignore changes in your body or how you feel.

For the Ladies

So, enough about me. Let's make today's post all about you, Ladies. I'm going to explain in more detail my situation as a way of imploring - begging - urging you to dutifully get your preventive care testing LIKE CLOCKWORK.

Some of you may have heard that the old guideline of annual pap smears has changed. Here's the straight scoop on the new guidelines from the National Cancer Institute:

According to the new ACOG guidelines, women aged 21 to 30 years should be screened every 2 years using either the standard Pap test or liquid-based cytology. Women 30 years and older who have had three consecutive negative (i.e., normal) cervical cytology test results may be screened once every 3 years with either screening test. 

So, I had had a string of normal pap smears, the most recent of which was a year and a half before I saw an OB/GYN in my new city in late September. I actually went because in my state you have to have a prescription from a physician to get a mammogram, and of course, being over 40, those are suggested to be conducted annually. It, too, had been a year and a half so I was getting nervous that I should get screened.

My mammogram was great - perfectly normal! But the first week of October I got a call from my OB/GYN's office saying that my pap was abnormal... and not just a little abnormal but VERY abnormal. They set an appointment for me to come back in two weeks later for a more invasive procedure to look at the cervix. A polyp was found, and a biopsy was taken. On October 31, waiting to board an airplane, I received a call from my doctor with the dreaded words "It's definitely cancer."

I had followed all the rules. Lived excessively healthily. No family risk of cancer. Zero symptoms. And yet had I waited the recommended 3 years between Pap Smears, I shudder to think what I might be facing now.

And of course, being the overachiever I am, it was not just a typical cervical cancer. Oh no. It was exceedingly rare. The tumor had the pathology of a digestive cancer - mostly likely colon - called signet ring cell adnocarcenoma. There were no estrogen or progesterone markers at all. And so, physicians began an very invasive hunt through my body to make sure that the cancer had not started somewhere else and already spread. They examined every millimeter of my esophagus, stomach, liver, pancreas, intestines, appendix, gall bladder, ovaries. In the end, thank God, it was a primary tumor in the cervix, Stage IBI, and at the end of this treatment plan I'm told I have a 90% chance I am completely cured.

One other note. cervical cancer can be largely eradicated through the widespread deployment of the HPV vaccine. I implore those of you with daughters to carefully examine the benefits of giving them this vaccine to prevent the most common and widespread risk factors for cervical cancer. For me, it would not have changed anything given the pathology of my tumor (non HPV-related) but anything you can do to help your girls avoid the absolute shock of receiving a cancer diagnosis and subsequently enduring a challenging treatment regimen is something to seriously consider.

So back to making this all about you. Please get your annual screenings. Endure more frequent pap smears if you possibly can. Don't miss a mammogram. Have a colonoscopy when you are 50. And listen to your body. You don't have to wait until these milestones if you are feeling like something isn't right.

As I went through several sedated procedures to get to diagnosis, the nurses preparing me had of course studied my chart and had a million questions. Did you have symptoms? Do you have family history? When did you last have your pap smear?  After told them the answers, every single one of them said to me,  'I'm calling my doctor to schedule an appointment today!!"  PLEASE do me a favor, and do the same!!