Beverly Dubrin email@example.com
Copyright © 1998, Beverly Dubrin. All rights reserved.
Last Modified: April 28, 2003
July 16, 1998
In January 1998, when I wrote From a Beginning Breast Cancer Survivor I was feeling very much the novice at living with cancer. While there are still times when I find it hard to believe that I am really a "survivor," or that cancer is an integral part of my life, I am becoming more accustomed to living with the "new" me who is somewhat different from and yet very much the same as the "old" me.
THE LAST CHEMO
I left off on the eve of my last chemotherapy treatment. Looking back on chemo, I really hated it. I hated the thought of "poisoning" my body, I hated being "spaced out" for a day and a half, I hated being fatigued, I hated having a compromised immune system. I felt helpless and extremely fragile through the whole process. The week before that last infusion I was terribly tense; my white blood count had dropped to an all-time low the week before and I feared it would not be high enough for the final treatment on the scheduled day. To my joy, it bounced back up that week and then the only problem was that the nurse needed three tries to find a good vein.
For whatever reason, I bounced back faster from my last chemo than I had from the earlier treatments. By "bounced back" I only mean that I felt like taking walks and eating at least a day sooner. What lasted longer was the feeling of nausea, especially in the mornings, and food had little or no taste for more than a week.
One day I ordered a tuna salad in a restaurant and it was served with a bowl of dressing on the side. In the course of the lunch, I used the entire bowl of dressing because I thought the tuna and vegetables were so bland. It was not until I was driving home that I realized that there was probably nothing at all wrong with that salad, it was my taste that was totally off! A few days later I was saturating the bread of a Reuben sandwich with mustard...it didnÃt taste either.
Throughout my course of chemo, I craved salty foods because they had a taste. Other favorites were fresh fruit, especially mango. My oncologist said that I could keep having my glass of wine with dinner, but for much of the time, it burned as I swallowed and for the rest of the time my "off" taste buds made it impossible for me to distinguish one wine from another; fruit juice proved to be a better bet.
Two weeks after my last chemo, I started a series of 29 radiation treatments. Other than the nuisance of having to go for a treatment every week day, the radiation didnÃt bother me a bit. My radiation oncologist and his staff were always upbeat, attentive, and considerate. I made friends with the other patients who had treatments before and after me. It was not until the last week or so that I had any sort of skin reaction from the radiation and that caused little discomfort. My energy level stayed high throughout and I didnÃt need the daily naps that I took while I was having chemo.
THE HAIR COMES BACK
My hair loss gradually annoyed me more and more. I wore my wig for about two months and then got fed up with it...it was hot, it itched, when I walked outdoors in the wind I feared it would take flight, when it rained I feared I would look like the head of a mop. My next "head gear" transition was to hats and scarves. These made me happier because I treated them like accessories and matched them up to my clothes. I have never liked to wear hats and, yet, here I was with a wardrobe of chapeaux. With no hair, my head got cold, even in the house, and I started keeping a baseball cap with me wherever I went, just in case.
Naively, I expected a new head of hair to sprout within days of completing chemo, but that was not to be. In fact, just about the time I was starting radiation, the few wisps of hair that had remained, fell out. The "peach fuzz" on my face disappeared, giving me very smooth soft skin, a perfect complexion, and the hair on my arms disappeared, too. My eye brows thinned and most of my lashes disappeared. Each day I would carefully apply mascara to the four (yes, I counted them) remaining lashes on my right eye. Looking back on this final "shedding" I am guessing that new hair was starting to grow and it pushed out all the old.
When I rode my bike during my hairless period I discovered that eye lashes serve a purpose other than being something to bat at attractive men; they keep out dust and dirt. Bike riding was almost impossible because my eyes would tear continuously from particles that I picked up on the road, even when I wore sun glasses.
About two months after my last chemo, at the end of March, I felt some fuzz on my head. My husband swore that he saw nothing, but, at my insistence, took out a flashlight and magnifying glass to examine my head. Whether there really was hair or he was just humoring me, I will never know, but he confirmed that hair was growing. Yea!
By this time California Spring was upon us and I started going around bareheaded. Yes, I got a few looks now and then, but, knowing that I was growing hair, I had the courage and determination to show it off. Day by day more hair grew and in a short time I had a chic "look" that had people stopping me on the street to compliment me on my hair style. I learned to restrain myself and just smile and say "thank you," knowing that the last thing they would want to hear was my cancer story.
My hair was curly before I lost it and it seems to be curly, or at least wavy, this time around as well. The color is a bit darker and there is more gray than blond, but the sun and chlorine from the pool are lightening it. IÃve had two haircuts to shape it up and like the ultra-short look enough to keep it this way for awhile, at least until total strangers stop telling me how attractive it looks.
Through all my treatments I had not felt the need of a formal support group. In fact, I was so busy going to medical appointments that I felt I had enough cancer-related things in my life. I kept working through this all which contributed to my sanity and gave me a sense of purpose.
But, I did, in fact, have an informal support group which was made up of a few close friends and my swim buddies. I swim on a U.S. Masters Team and attend three or four workouts each week. Each day when I walked into the locker room and tossed my wig or hat into my bag, I got encouragement, praise, and lots of support from my companions. Curiously, while many of them have known people with cancer, few have shared the daily details of going through treatment and coping and recovering. I was only too glad to show my scars and share the details of my treatment. We were all learning and going through this together.
Soon after my last radiation, I made a big party for my personal support group. It was a time to celebrate and that we did.
I CAN COPE
As I was finishing up my radiation, it occurred to me that for more than six months I had been intensely occupied with treating my cancer. Now that was about to wind down and I was to return to my "normal" routine.
Just as I was wondering, how I would handle the transition, my radiation oncologist was handing out flyers advertising an up-and-coming "I Can Cope" program in which he was participating. I signed up.
"I Can Cope" is an eight-session American Cancer Society program which is conducted, at no charge, for cancer patients, survivors, and their families and friends. One of my friends whose mother had just been diagnosed with stomach cancer came with me. Each week we covered a different topic. The class was led by a social worker and an oncology nurse from my hospital. Our speakers included a medical oncologist, my radiation oncologist, a psychiatrist, and representatives from local support groups. This was my first real association with other people whose lives had been touched by cancer and it opened my eyes to what others live with and go through. As members of this group we came to care about one another. We worried when someone was absent and rejoiced when someone had some good news.
A WORK IN PROGRESS
A month after I completed radiation, my radiation oncologist said that my skin had recovered and that I could have my nipple reconstructed.
This was an outpatient procedure that took about an hour and a half. My abdominal scar from the TRAM Flap reconstruction had little bunchy areas on either end. My plastic surgeon revised this scar and removed these "dog ears" and used the skin from one to make a nipple. He sent me home bandaged up with puffy bandages that were so big that I kept bumping into things for the week that I wore them! It is amazing that when you change your bodyÃs dimensions, how you have to make other adjustments.
A week later, when the bandages came off, I got my first look at the nipple. Although my surgeon had told me he was making it about three times larger than the other one because it would shrink as it healed, I was unprepared to look down and see what looked like a Greek Olive sticking out of my breast. It took a few weeks for the "olive" to shrink to raisin size and it continues to look more like its prototype on my original other breast every day.
The next step, once the nipple is completely healed, will be to have an areola tattooed around the nipple. I continue to be amazed and delighted at the wonders of plastic surgery. I feel like a work of art.
SURVIVING AND THRIVING
Last week I had my second three-month checkup with my oncologist and my blood tests indicate that all is going well. Before each checkup I have a few tense days because I know that despite my good prognosis for "cure," there is no real cure for cancer and that it could pop up again at any point in time. This is part of living with and surviving cancer.
I also celebrated my 57th birthday and realized that I worked very hard to get to this birthday. IÃve always loved birthdays and have never been bothered about getting older, but now each birthday will carry with it an added blessing.
It feels great to be a survivor and I am thriving on my survival.
Jan 31, 2013 - Early palliative care clinic visits, integrated with standard oncologic care for patients with metastatic lung cancer, emphasize symptom management, coping, and psychosocial aspects of illness, according to research published online Jan. 28 in JAMA Internal Medicine.