Today is Jan. 25, 2023. After 2020, 2021, and 2022, writing 2023 feels like a fresh start. In 2020 and 2021 I had much striving, deepening professional burnout, personal challenges and personal successes. In 2021, I had a much-needed breakup, started over, moved in with my parents, met Mike in Bozeman, found a home, and also ran the Rut's 28k, which helped me pursue discovering the power I knew was in my mind, soul, and body. All these moments of overextending, facing my fears and pursuing myself first, and seeking stillness to better know my truths all served me with my 2022 cancer diagnosis. In 2018 I got into counseling and I am so grateful I have been able to carry these supported years of growth, curiosity, and increasing gentleness into the white waters of cancer treatment.
This week, I played indoor soccer for the first time since the fall of 2021. I have this amazing indoor team (the mighty Sharks!). In college, I played soccer and was too serious. I battled with feelings of not belonging. I loved the thrill of diving and adrenaline, but I wish I had more joy playing when I was in a moment where I committed so much to the sport. Now, with Helena's adult league, I have met a community that is multi-generational, rich in a diversity of backgrounds, experiences, professions, philosophies... and generally, not too serious. This league is my community.
At this week's game, we had most of the core of the original Sharks (circa 2019) at the game. It feels utter heart raising to walk back to any sort of pitch and see so many people who have shown me that Helena is home. Helena is community. Helena is where we can kick around, lovingly trash talk, see each other try something utterly new with our bodies that have never been older and brilliantly, shockingly dazzle or amazingly, boldly, rebelliously bumble and bust. There is so much freedom as an adult just going to play a sport with friends.
After the game, the team went to the nearby neighborhood, carpeted bar. I'm cutting back alcohol (in the ongoing, ambiguous effort to learn how to avoid a reoccurrence) and was surprised that there were options of alcohol-free beer (the Heineken 0% beer actually tastes like...Heineken, for better or worse)!
I love this group. I adore these people. When my diagnosis started to get known around town, my team reached out. I feel deep elation getting to see and hug them in the gym. We caught up and man, how we've all lived. One person asked how I was doing in that way that means they care beyond a basic response. And then we all shared. One teammate walked with his father through lymphoma. Another's wife survived a gnarly car accident.
Navigating adult friendships in the busyness of life makes the relationships that can stick feel like something sacred. I keep trying to find the right word---sacred feels a bit off-- but it's always remarkable when lives interweave in real ways in face of the potential heaviness that can come.
And behind all this--the reunion, the rising joy of friendship--is the amazing fact that my body can. I can play soccer in this body that has lived so much these past 11 months.
Radiation was much more humbling than I anticipated. It surfaced unrecognized sadness, anger, and was the point of the pain that has been the right side of my chest. On August 15, I had my lumpectomy surgery. On September 5, I ended up with a staph infection and had my axillary (aka armpit) surgery scar lanced open in the ER. With my body's ability to heal slowed and compromised from the prior six months of chemo, I couldn't heal the incision. Radiation has to happen within a window of time to be effective, and with my compromised ability to heal, I got a wound vac through October. I drove to Bozeman twice a week to get the wound vac changed and each day, Mike would repack the deep cut, and, eventually, I healed enough to start radiation.
Radiation was painless, at first. I didn't realize how it would create burns and what that would carry (If you go through radiation, please reach out! I was able to avoid the worst burns likely due to a cream that a Montana friend has made for radiation). I didn't realize how the combo of the lumpectomy and radiation would make my skin feel tighter and limit my range of motion and require me to adjust how I sleep and use my arm to limit pain. I didn't realize that I wouldn't be able to hug or move without pain from August 15 until perhaps this week. My incredible oncology physical therapist has helped me learn to understand the lay of my body that has been radiated. My mom, who is an expert lymphatic massage therapy, has helped me understand the incredible movement of our lymph system (and the need for lymph drainage). The radiation clinic confirmed that for the coming year, my body will continue to heal and tenderness isn't as temporary as I thought it would be.
I think radiation was mentally harder than I anticipated because during radiation, I became acutely aware of how much my body was trying to adapt to pain, how many temporary sacrifices were necessary, and the tab of permanent body alterations that cancer treatment requires.
But after getting through the challenge of radiation, and healing just in time to be able to swim, Mike and I went south for vacation. At the beginning of December, Mike and I went to my friend, Martha's, wedding. She did a destination gathering in Cabo. I haven't taken a week off since before the pandemic began. And navigating chemo has wearied both I and Mike. The chance to enter into new places and experience true freshness was so restorative and refreshing. The wedding had about 40 people, and it was so enlivening getting to know fellow guests. Martha and her now-husband, Mike, are both in medicine and so it seemed that every person they invited was brilliant and grounded. Mike and I were also able to reunite with two couples from undergrad. The whole week, I felt young and free. I had no appointments. I had enough hair growth where only my port gave away my treatment.
Mike and I also spent time with his family member, Tom. Tom, who had his career in the hospitality industry, was the warmest of hosts. He shared his favorite parts of Cabo, and sent us off on adventures. One evening, we drove to see the town of Todos Santos. On the way south to Cabo, we stopped at a beachside town. We ran into the ocean and let the waves crash into us. I swallowed so much salt water laughing. We sat side-by-side to watch the sunset. Again, the feeling of aliveness was so fueling. At the end of our stay, Tom drove us through the dusty desert to a one-mile hike. At the end of the trail, there was a burst of water. The desert gave way to succulent plants and a 40-foot waterfall. The water was crisp and I swam to the base while Tom and Mike jumped in. That evening, we played dominos at a beachside restaurant-shack.
This whole week--the chance to rest, experience, discover, and connect--was so healing. I feel it shifted my mind away from the mindset of enduring and being patient to aliveness and hope.
In December, I also started to see a second physical therapist. Herceptin is a cardio-toxic chemo, and I'm on it every three weeks until March 15, which is my final infusion. I've been anxious and fearful of heart damage. I love what my heart has given me. I have always loved the ways my body moves and has taken me wherever I crave.
With this PT, he assessed my strength and flexibility. It was heartening to know that my body did not totally dissolve with the challenges and inactivity of the year. Each session, I got more confident. I rejoined the gym and am proud of how I am pacing myself. I have no fear that I will overdo it or create harm. Instead, I just thrill that I can feel my lungs and muscles alight again. On Jan. 10, I signed up to run the Rut again. I'm back to making goals!
In addition to PT, I've found a phenomenal counselor in Helena, Tina Stern. She worked in St. Peter's oncology clinic before opening her private practice. I've heard over, and over, that after treatment ends, it can be disorienting and the mental aspect of recovery can be rough. This makes sense---there are no more marching orders and things calm down but life picks up back to pre-cancer speeds. So I've been embracing EMDR (Eye Movement Desensitization and Reprocessing) therapy, which is specific for trauma. "A medically-induced trauma" is what my Bozeman Health social worker said this year has been. And before radiation, I thought I was processing pretty well, but I see now that it's okay, I've more to let settle into my mind and soul and let heal.
I've worked on a return-to-office plan that feels really solid and respectful. My workplace environment will be quite the change from these past months working from home. I'll share a small office with two other colleagues. The lovely, calm isolation of my home will be a contrast to the constant access of an office. I start back at the beginning of February with a slow transition plan. I want to prioritize my healing over work's potential to be hyper productive and busy. In the two years leading up to my diagnosis, I was so unhealthy at work. I never took lunch breaks or walk breaks. I broke every boundary I held myself to and I'd stay however late was necessary to do the job. I feel now how much that excess costs, and I am not going to let work be such a source of fatigue. I can't.
I also have started having neuropathy in my feet. It's not a numbness, but more like quick needle jabs. Apparently, Perjeta can cause neuropathy in about 10% of patients. Last chemo, I iced my feet during my Perjeta infusion and the zingers have softened and aren't quite as frequent. But this new side effect was a good reminder that although my mind is moving forward toward goals, new strengths, and being back in community, I am still healing.
Oddly, too, I have been having reoccurring eye styes, which are a new adult experience. I also developed a doozy of an ingrown toe nail and had to have a bit of the nail removed. (I feel like my age post-diagnosis is now n+10 -15 years). After my January 11 infusion, I was deeply tired. It's tricky to identify what is the source of fatigue. It could be simply because it's the 11th month since my biopsy. It could be anxiety about returning to the office. It could be because Herceptin and Perjeta are still poisons. And it could be radiation-related fatigue. It's impossibly to know the source, and I've always plowed through fatigue, so I am still trying to balance where I am each day with the energy I expend for things beyond myself.
So, here I am. I am counting down the days until March 15. I'll get my port out in April. I am working on getting as rested as I can before I return full-time to the office. And I am also looking to the future. I want to have a better work-life balance. I want to savor all the ways I can know and experience my body again. I want to get back to running trails (Helena is an utter ice sheet at the moment). I want to keep getting out into the community. I want to start each day with a cup of green tea and reading or meditation. And I want to rest and keep finding ways to slow life down. I don't ever want to be as busy as I was before my diagnosis. Sometimes, I feel my mental optimism outpacing my energy, so, I keep learning.
Books I am reading (and recommend):
Breasts: The Owner’s Manual, Dr. Kristi Funk I've got this book highlighted and dog-eared. It was recommended by my Bozeman Health oncology team and has been a great source of information on how I can use nutrition to help recover and do my best to avoid a reoccurrence. I'm switching to more plant-based foods (at least 70-3), limiting dairy, and have almost eliminated alcohol. It's a good read because the author makes the science of nutrition really digestible for a non-clinical reader. It makes nutritional changes not feel like deprivation. I am still surprised how nutrition is not integrated into oncology treatment, and this book feels like a path forward to trust.
How We Live is How We Die, Pema Chodron: I want to fear neither life nor death, and I want to be open to each. I only get through one chapter at a time, because this isn't a book to rush but rather absorb gently. This book is helping me reframe a few things: 1) everything is transient and with that, control isn't that logical or fair of a goal, 2) life flows and I want to go with the flow, come whatever may be. Chodron talks about how we experience countless births (beginnings) and deaths (endings) every day and throughout our life. I want to cultivate presentness to life and this book is a grounding and expansive challenge.
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