Still navigating the choppy waters of intimacy after breast cancer

As I have mentioned a few times, I follow a breast cancer message board somewhat regularly. One of the topics that I have found interest in is a thread about sexual intimacy after breast reconstruction. As a single girl dealing with menopausal issues (thanks AGAIN chemotherapy for that gift)… I find myself often in the grips of hormonal surges that would make a teen-age boy blush. I try to maintain my composure during these surges and continue to behave as a lady should but it gets difficult. Really difficult. If I were a dog, I’d probably be humping trees on a regular basis. Luckily, I’m no dog.


That said, I find it very interesting (and helpful) to see other women facing the same doubts and concerns about sexual intimacy and relationship intimacy that I find myself thinking about all the time. And I’ve been learning a lot about ways to navigate these choppy waters. Its all new to most of us. And since so many of us are single in this particular discussion, it has different ramifications (I would guess) than what women who are in marriages or long-term committed relationships face in the aftermath of breast cancer.


I am still quite shy about my body. I never was much of a “porn star” in the bedroom from that perspective (laughs). But now, I find myself making odd adjustments and covering things up this way and that whenever I’m in a position to be intimate with someone. It is odd and a tad frustrating, but its where my comfort is right now so I roll with it.


Side note: I will have a surprise to unveil later on (maybe a few weeks from now) – my way of dealing with this body image issue – and it is my sincere hope that it goes well and helps in the ways that I think that it will.


Beyond the sexual intimacy issue – because it isn’t only about the physical act of making love with someone – there is the issue of just INTIMACY with a man period. I am closed off emotionally and in some ways, it is annoying me to no end. Though I understand why I am the way that I am – and I know that I am not the only woman in the world fighting this emotional battle after fighting the physical one – that knowledge doesn’t make any of this any easier.


I am having a difficult time just relaxing and allowing myself to feel anything too deep with a guy. I have had a few very nice men come my way trying to get to know me better and establish an intimate bond (not just sexual) with me. And I’ve found myself very actively pushing them away.


Does that make any sense at all? I want to be close to someone and yet, I’m doing everything possible to make it impossible to do that. (hanging head in shame)  I’m trying to be better though. In full disclosure, Nicole has always had some difficulty connecting (and maintaining that connection) with guys. No real excuses… I’m like most people afraid of getting hurt if I allow someone to get too close.


One thing that I’ve noticed on the message boards is that several of the women who post somewhat regularly are opting to just take commitment off the table completely. They will date. They will hang out in groups. They may even be sexually intimate with someone. But many of them are just like me – terrified of bringing someone into this world of breast cancer. I’ve had some intense conversations with different men along the way on this journey and many of them have assured me that “a real man” wouldn’t back away from dealing with a woman who was fighting breast cancer (or had beaten it and was dealing with the aftermath). But, there’s real talk and then there’s real life. And sometimes real life leaves you alone and in the cold. Real talk.  


That said, there is someone who is interesting me a bit at the moment. Not sure how long the interest will last or whether things will progress any farther than they have but – sigh – I’m really going to give it a try to be open to just allowing someone inside to get to know me more intimately.


Whew. That hurt just to write that. (sigh) So much work to do. (laughs)


ahhh... the joy of a spring cold

I'm back from my birthday vacation trip. Miami was beautiful and sunny and hot... just like I expected it to be. I had a fantastic time and got a spectacular tan -- using 85 and 100 spf sunblock too. However... I also came home with a bad case of the sniffles.

I'm blaming all the air conditioning... but it could have come from the airplane or anywhere. (shrug) I am miserable. But... one thing I can say is that during the course of my breast cancer treatment, I have accumulated a lot of medical supplies. So... I'm hopeful that I can either kick this cold in the butt OR at least ride it out without feeling totally miserable for the entire course.

*shaking my head*  Only Nicole would go away to one of the hottest cities in the country and come home with a cold. (laughs)

You don't really want to talk to me on the phone right now... I am sure that I sound awful. Will be going to bed early because I go back to work tomorrow.

I'll be back with some good breast cancer topics in a few days. I need to rest and drink some juice.


I am blessed to see another year. Two years ago, I wasn't convinced that I'd see this birthday. But here I am. (smile) And what a journey it has been.

I'm back in Miami celebrating with friends (actually I typed up this blog entry the night before I departed and set it to post on my actual birthday - yep, I cheated) but I wanted to take a moment and give thanks to God and to all of my friends and family members for praying me through these past 2 years.

I am so blessed and very grateful for every prayer that was uttered in my name. I have surely been protected by angels along the way. I have received the best medical care and have been supported by my family in ways that I don't think I will ever be able to repay.

There are things that I have lost during this journey but the fact that I am alive to experience more joy makes up for any losses and any sadness.

Since it is my birthday... I am supposed to get a birthday wish, right? Well... I wish for many, many more birthdays. Many, many more days of laughter. Many, many more opportunities to love (to fall in love and to be loved in return). Many, many more days of worrying about insignificant things like... whether I should buy myself cute leopard print shoes. Many, many more days of smiling and laughing and just being silly.

I wish to continue to be here. Present in this moment and awake to the possibilities of everything the world has to offer me.

That is my birthday wish.

No more port!

That's my port in that cup. It was removed from my chest on Wednesday. Hard to believe that it has been a part of me for nearly two years.

For those who don't know... a port (also known as a mediport) is a small device that is implanted in your chest under the skin with a catheter that feeds directly into one of your main veins. It is used by cancer patients as a way to more comfortably recieve chemotherapy drugs and to have blood drawn from. Although it seems more difficult, it is actually much more pleasant than being constantly "stuck" with a needle directly into your arm.

Chemotherapy drugs are really harsh. And they can do a number on your veins. It is not too uncommon for the drugs to burn some patients at the point of administration (and along the arm) but having a port saves you from that possibility.

In the summer of 2008 (I think it was August) when I received my port, I thought my oncologist was "special" for insisting that I have it. I had no idea how badly chemo could damage your veins or your muscles. But, after sitting in the cancer center watching other patients who did not have ports deal with burning in their arms, collapsing veins, etc. I greatly appreciated his foresight and his insistence.

The interesting thing about a port is getting accustomed to being "stuck" in your chest with a big needle everytime you receive chemotherapy or have bloodwork drawn. When I went to the hospital the other day for my follow-up visit, I had some blood drawn through my port. OUCH! I was out of practice with taking that needle and gained a new appreciation for all the times that I did so with no tears and no wincing.

I was a soldier for all of those months of chemotherapy. A real soldier.

It was previously scheduled to be removed in November but I (pretty much) ignored the surgery date because I was stressing out about my reconstruction surgery which was around the same time.

I really didn't think too much about having it removed this time because chemo seems so long ago. I honestly don't think I really had much choice anyway. A friend made a comment to me the night before the procedure that really made me pause.

She was happy that I was getting my port taken out. And at that moment I realized that I wasn't happy at all about it. I wasn't overly emotional -- one way or the other -- but I realized that having the port removed meant the end of something. And I wasn't sure how I felt about that.

Removing my port means that my oncology team believes that chemo is not in my future. It means that they are confident that I'm cured and can resume a normal life. Because keeping a port requires regular maintenance -- it has to be flushed at least once a month -- when it is deemed that you are in the clear, you are advised to have your port removed.

My port had become a safety net (one of many) for me.  I didn't realize it until it was time for it to go. I know that I am overly fascinated with the notion of returning to "normal" -- probably not unlike most cancer patients. I suppose it is a normal and healthy reaction to going through something so very harrowing. But... as I've shared before, I have a serious fear about recurrence. A part of me has become secure in being "the cancer girl". Having cancer, dealing with it and all its craziness, became normal for me. So the parts of that journey that empowered me, like my port, gave me a strength and a confidence that I really had come to rely upon. Slowly, they are being stripped from me.

I suppose that is a good thing actually. But, I'm realizing just how weak I am without all of these crutches I've been leaning on for the past two years. I hope that my friends and family will bear with me while I get my strength to stand on my own back.

PS. My mother went with me to the hospital -- because I was going to be fully sedated, I could not leave the hospital on my own. She thought I was CRAZY to ask the surgeon to give me my port after the procedure. But besides the fact that I paid for it (laughs)... I needed to see and hold the device that played a part in saving my life. I did not want it to end up in the garbage can because it was such an important piece of the journey for me. Its gross I suppose to keep a talisman like that. But, I needed to see it. To be reminded of all that I've been through.

A part of me is really terrified of forgetting all of this. I have a strong tendency to block out unpleasant things or things that become less important in my life. I mean, completely block out and forget about it. I don't want to minimize any part of this cancer journey though. I don't want to forget too much of it. I don't want to look around and think it was just a blip that I experienced. I want to always be able to connect to the emotions of this time, and keeping the port is a way to remember. (But yes, I know that its a little odd)

Seeing the beauty in the struggle

Last night, I had the privilege of watching a video on facebook. The video was of a sister named Marjory who was recently diagnosed with breast cancer and had just had (what looked like) a bilateral mastectomy. She decided to videotape parts of her journey for her friends and family to bear witness to her struggle.

Marjory is a dancer. She is a friend of a friend of mine. Our shared friend reached out to tell me about Marjory when she learned that she was diagnosed with breast cancer. She asked me to reach out to her and I did. Marjory is well-loved by her friends and family. They hosted a fundraiser event for her and videotaped parts of it. I felt blessed to bear witness to the beautiful outpouring of love and honor and respect for this sister I have never met. And I watched her dance. She moves with a graceful frenetic energy. The joy of movement shines on her face and shoots from her limbs. You can just tell… she was born to move that way. She loves it as much as it loves her.

So I watched her video to her friends and family last night. And I was drawn in to her presence. She was pale and looked tired. She had 4 drains hanging from her body. Two on each side. She wore that same wretched surgical bra that I have had to wear twice now (and soon again for a third time). She looked like a ghost of the woman I had just watched in previous videos dancing and sharing her gift of movement with the world.

But she was there. Even in her weakened state, she was there.

She was there.

She showed how flat-chested she was (her words, not mine). She has expanders in her chest but they haven’t been filled with solution yet. She showed the plastic tubing that was coming from her sides, allowing the fluid that builds up in her body to be released. And as I watched her for those 6 minutes or so… my mind drifted back to January 2009.

While the entire world was focused on Washington, DC because of the inauguration of the first black president… I was looking like Marjory. Pale, weakened, tired. Drains coming out of my sides. Chest flattened where someone had removed a part of my flesh… in order to save my life. I will never forget that time in my life. I only wish I had thought to capture it on film.

I look nothing like Marjory. And she looks nothing like me. But my GOD… my breath was taken away when I looked at that beautiful sister… watching and listening to her hold on to her life with both hands.

I remember so well, the pain and the agony and the fear. But looking at that sister, I could see nothing but the beauty in the moment of her struggle. I only hope that I have radiated that much beauty throughout my struggle.

It is difficult dealing with breast cancer. From diagnosis, through treatment and then beyond… this is hard. And yet, it is the absolute rawness, the pure and almost holy (sacred?) reverence it gives you for life itself that reminds you just how beautiful life is – even in the struggle.

PS. If you want to donate to Marjory's medical costs, follow this link to see more pictures, more videos and to donate as well.

Reason number 6541835... why I hate breast cancer

Sometimes I feel like I'm damned if I do and I'm damned if I don't

Oh my... what a weekend. I am on the move, travelling and whatnot. I had to go to the mid-west for a business meeting for work. But since no flights from my area fly directly to that city, I decided to stop in Atlanta for the weekend (the flight was going to come through Atlanta anyway). I wasn't looking forward to my flight to Atlanta because it was in the wee early morning hour on Saturday (not a great move for me). But I did what I had to do.

Beyond the fact that I was tired when I left my home to go the airport, and tired while I sat at the airport too long... and nearly missed my flight because the airline changed gates and somehow I missed that announcement... outside of all of that... I had hoped that getting on the plane would be relatively easy.

Um. No.

My left arm is wacky. There's no other way to put it. It is, what it is. Since the mastectomy included removing cancerous lymph nodes as well as my breast tissue, my poor arm just isn't the same. I was warned about that. (shaking my head) But I swear I just am sick of breast cancer dogging my life in these little ways.

Breast cancer treatment side effects are real (and annoying)

My arm has been acting up a little bit, over the past few days/weeks. Which is cool. I am learning to deal with the minor issues. But I was a bit worried that flying between home, Atlanta and the mid-west, would aggravate my arm and make life a bit hellish. I had hoped that my worrying was in vain. But... of course it wasn't.

One of the reasons that I am angry (well maybe annoyed is a better word) about being on this side of the breast cancer journey is that people look at you and cannot SEE that you've been through hell. People look at you and just see, a regular ol' person. I suppose that is a good thing but sometimes it is a pain in the butt.

Some of us disguise our sickness very well. It doesn't mean we aren't sick. It means that we just want to fit in. 

Case in point:  I always check my suitcase. I do not like the hassle of dragging around carry-on luggage. I check my luggage and I keep on going. But on this trip, even though I checked my luggage, I still had to lug around my laptop case. Because I ended up being one of the last to board the flight -- instead of one of the first -- I was frustrated squeezing down the aisle of the plane.

(Side note: do the airlines just HATE their passengers or what? Grr... sick of feeling squeezed on planes.)

As I am coming close to my assigned seat, the flight attendant was standing slightly in my way blocking the aisle. Granted, it is very early in the morning and Nicole is not a morning person but I felt that she was a just a tad bit... abrasive for early in the day. Nonetheless, I responded to her bark about where my seat was located with a tight jaw and a smile. After my response seemed to make sense to her, I found myself standing far too close to her as she stood up to get out of my seating area and allow me to sit down.

Now, picture this. I am 5'9" tall and a bit thick (not fat, just not skinny). She is about the same height, also African-American and pretty solid herself. Not fat, just not skinny either. We are standing uber-close -- practically nose to nose because the aisle is just that tight. I am feeling agitated because I was boarding so late and its crowded. I am annoyed because most of the overhead storage space is taken -- the flight was packed -- and the flight attendants kept repeating the same mantra (basically, put your bag where ever you see an opening). So, I'm standing there with this amazonian chick blocking my seat and I look up to notice that there is actually space just above my seat for my laptop bag.

This is what it feels like when someone is rude or unhelpful -- and their job is to be helpful to you

My left arm is tight. The lymphedema has been acting up and I'm already feeling the heaviness. Remember too that I can barely lift my left arm over my head... my range of motion has been shot to hell since the first surgery (aggravated by the reconstruction last fall). In other words, I am dreading the attempt to lift this heavy bag up and over my head to put it in the overhead bin.

When people cannot look at you and immediately see what "your" problem is, they naturally assume that you don't have one. I was standing close enough to this woman to kiss her (if I got down that way) and I said to her...

"Would you please help me with my bag?" She asked me to repeat myself, as though she didn't hear me... so I said again... "would you help me with this?".

Do you know that this woman said "sure" and then proceeded to squeeze herself past me -- moving farther up the aisle from me -- and did NOT offer nor attempt to help me lift my bag into the storage bin.

Sigh. It took a lot of self-talk for me to articulate that simple sentence out loud. Asking for help is not something I do easily or well. But I knew that I would need help and I felt it was okay to ask for it. To be ignored, then to feel the eyes of lots of passengers on me as I struggled to lift my wheeled lap-top bag up from the floor to the top of the seat, and then to struggle to lift it from the top of the chair into the storage bin was really humiliating.

When you don't "look" sick

I know I don't "look" like there's anything wrong with me. I know that people do not have to go out of their way to help me. But I find it particularly repulsive when I ask directly for help and am ignored and stranded. Who does that? Hears a request for help and then just walks on by?

After I get my bag into the storage container and sit down, its all I can do not to become upset and teary. I didn't ask for preferential treatment, just a little assistance. And that was too much to ask, I suppose. Just very annoying. I got through the flight, I pulled my own bag down from the storage bin just as awkwardly as I put it up there. But no pride of accomplishment was there.

Two days later, my arm is still swollen -- it started acting up while I was hanging out today -- and I have to be on a plane in a few hours. And that will only increase my discomfort because flying aggravates the lymphedema. I am dreading getting on that flight, and dreading dealing with that laptop computer. I am worried that when I get off the plane, my arm will really be swollen and crazy looking. Its not looking too great for this arm.

So this is "normal" now? 

I've been so pressed to get back to "normal" that I forgot what its like in the normal world for people who are not at the top of their game. I am generally well-adjusted and cool with my current fate -- however, a little more compassion from people in the world would really help make my life just a tad bit smoother.

Where is the love? Do I have to revert back to my chemo-look? Bald head and sallow skin tone? In order to expect that people will take a few moments to look at and to address whatever problem or assistance I may have/need. I guess that its the way of the world today.

It is a shame that general courtesy is so lacking. And even more of a shame that people in positions of customer service find it to be too much work to actually service the customers. *sigh* Life goes on though. I will adjust and learn how to make my needs known more clearly... and why.

Chemo brain is not a game and its definitely NOT fun

When I started chemotherapy, the nurses used to joke with some of the patients about "chemo brain". Of course, I didn't understand at first and then once it was explained to me, I thought it was a bunch of hooey. (laughs) I really did.

Since being treated for cancer is such a head trip... I figure that anything that you can put a label on to explain why you're trippy, unfocused and generally not sharp isn't a bad thing. It can only help, right? As I've done with every new word, condition, test, and drug that I've been introduced to on this journey... I took to the internet to find more information about chemo brain and what could be done about it.

There's a bit of information out there, but none of it seems definitive and that worries me.

In retrospect, I don't think I really took the notion of chemo brain too seriously. I have a million things on my mind -- just like everybody else. I have a million things I need to do, to plan for, and to prepare for -- just like everybody else. The fact that I have difficult focusing, that I require (and give myself) far too much time to mentally unwind doing bs -- well, I've been chalking that up to a real slacker mentality. (laughs)

But today at work -- as I was berated by a colleague for not finishing a task and not understanding it well enough -- I realized that I might be falling into deep waters, and uncharted territory for Nicole.

I am tired. I say this all the time and I don't necessarily mean a physical fatigue (though that is a part of my problem many times)... I mean a serious mental tiredness that I just can't seem to shake. I feel like no matter how hard I try to keep up, to remember things, to stay on task... I fall short. I forget important details. I get derailed and side-tracked.

Sigh. It is annoying and frustrating. It doesn't help that when I'm at work, I wish I was anywhere but there. Usually, my dreams include a sunny beach and warm ocean water. But really, anywhere other than where I am most of the day is where my mind goes.

Do I have chemo brain? I don't know. I could very well just be a lazy slacker who can't get her head into the game anymore. Or maybe my dissatisfaction with my job is translating into a subconscious refusal to be of good use. (that seems really crazy though) I sort of feel the same fogginess I felt when I struggled with clinical depression some years ago. I don't feel the despair that went with it though.

In reading about other cancer patients who have struggled with chemo brain, I am left feeling a bit distraught. There doesn't seem to be any effective cures out there. And a lot of people who have struggled with this "fogginess" have ended up leaving their jobs. I simply cannot afford to do that. (Unless I hit the powerball this weekend for millions of dollars) I did notice on one website something slightly encouraging -- a few patients have said that they felt better after a few months on anti-depressants. I am not excited about the prospect of taking anti-depressants again (they do a real JOB on your sex drive and I'm digging my sexy swagger these days). But I really do have to do something.

Sigh. Another thing to think about, worry about and wish I could turn back time to escape. Guess its time to call the therapist and work through some stuff. (I'm going to check out the book in the link below -- the cover is up top--maybe they found some answers to this crazy issue)

Your Brain after Chemo: A Practical Guide to Lifting the Fog and Getting Back Your Focus

Sigh. I'm stressed and my body is reacting to it.

I’ve been quietly ignoring my body’s signals that something is wrong. I am not in any pain, other than slight embarrassment and extreme annoyance, but my body is definitely reacting to the way that I am reacting to my environment. In case you were wondering, I feel just fine. I do have, however, a small problem that could escalate into a larger issue if I don’t take preventative steps to handle it.


I am talking about lymphedema. Lymphedema is an occurrence where you experience swelling in an extremity (arms, legs) because the body is incapable of moving the fluid through properly and it collects/pools in those areas. I was told that this could happen after my mastectomy because I was having lymph nodes removed. I sincerely hoped that it wouldn’t happen. My plastic surgeon warned me that my reconstruction surgery would aggravate the condition but I chose to go ahead with it and take the chance that it wouldn’t happen. Or if it did happen, it wouldn’t be horrible.


Well… two things. It’s happening. And it’s really annoying. (Hence the blue annoyed face)


If you’re wondering how you cure it – well, you don’t. What you can do is work to prevent it from occurring too often, and try to keep yourself in a position where it doesn’t get outrageously bad.


It is no secret that I’m a little vain. I think I’m a hottie and I’d like to keep that image of myself intact. But… uh, when one arm is larger than the other, it is not a good look. Ya know? I haven’t been making a big deal of it to myself because the swelling is rather mild and I can still function as well as I have been since these surgeries. But, I am going to be hopping on and off planes quite a bit over the next few weeks and flying aggravates the condition.




I am really annoyed with myself. But, my annoyance did result in one thing: I finally made the call I needed to make to meet with a physical therapist who can help me with it – and hopefully she will be able to help me work on regaining my full range of motion with that arm as well.


I’ve been reading some interesting and conflicting recommendations for women who have gone through mastectomies and reconstruction. When I came out of the hospital after my mastectomy, I was advised not to carry anything heavy with that arm. (I guess they did not get the memo that Nic likes nice bags – big ones too) Not to have any injections or have my blood pressure taken with that arm. To be diligent about trying not to get insect bites on that arm as well. As any and all of these things could cause my arm to swell. I’ve been doing that. However, recently I’ve read a few articles that suggest that weight lifting and or other exercises could be beneficial to women like myself.


Hmph. I wish someone had told me this a year ago. I’ve been wandering around like a crazy woman over-protecting this arm and whatnot and I could have been working out and getting myself together. (sigh)


Ok. I lie. I probably wouldn’t have done that – but at least I would have known that I should. (laughs)


At any rate, after I return from my mini-vacation in May, I head straight to the physical therapist to get this arm straight. It seems that no matter how I try to avoid it, exercise (real exercise too, not that fake kind I’ve been trying to get away with) has to become a part of my life going forward. Ugh.




Somewhere my friend Lisa is smiling…


Pfft… personal trainers, I tell ya.


Fertility concerns with breast cancer

In September 2008 I started chemotherapy treatment for breast cancer. Although my head was swimming from all the information thrown my way, I did remember to discuss my fertility concerns with my oncology team. After stressing that I wanted to have the option of having children after my treatment was done... and after weighing the desire to have kids against the need to begin my cancer treatment right away, I opted to have my ovaries shut down.

As it was explained to me, because I was pre-menopausal, I was a candidate for hormone-suppression of my ovaries. This option was quick and relatively easy to administer. Relatively easy is truly a matter of degrees. That needle I took in my abdomen was extremely long. EXTREMELY LONG. And it wasn't pleasant. But it was tolerable for a good cause.

The hormone suppression had the added benefit of reducing the amount of estrogen in my body which was be a benefit to me since my cancer was estrogen-driven. What I wasn't told -- and I'm not sure that my oncologist knew the answer -- was when or if my ovaries would resurrect and return to full function. Its been a year and a half since that first needle and well... no signs of my cycle yet. I imagine every creak and ache in my body (some days) to be a sign that my "lady curse" is coming back. But nothing so far.

The first surgeon that I met with on this journey was a young asian doctor who was also a breast cancer survivor. Having her on my team helped me immeasurably because I was comforted by the fact that she really knew what my path looked like. She wasn't simply telling me things she learned in a classroom, she was speaking to me from her experience. It made a huge difference. She was open and honest with me every step of the way and I will forever be grateful for her honesty. In hindsight, she set the tone for the way that I write this blog and the way that I speak to others about my journey. Her ability to be open, honest and blunt really was a blessing to me. Her willingness to be available to me at any time by phone was a major blessing as well.

(I remember calling her the weekend after I received confirmation that I did indeed have breast cancer. I called several times and kept reaching her voice mail. She finally called back after a day. And I felt bad because she was on vacation, out of town at her sister's wedding. But I was amazed that she did return my call.)

I remember asking her about fertility concerns in the summer of 2008 (which was just before I started chemotherapy) and she explained to me then that she too had opted to have her ovaries put to sleep. However, when I pried further for an understanding of when I could expect this situation to reverse itself, all she could tell me was that her ovaries had not yet awakened. I believe she was at that time, about 2 years out from her treatment like I am right now. At the time, I hoped that it wouldn't take me as long.

Earlier this evening, I felt a few twinges in my lower back and a familiar nauseating feeling washed over me for a few moments. I actually smiled at the thought that I might be experiencing menstrual cramps. Its been so long that I have forgotten about the misery that comes along with a menstrual cycle. I think my desire for a baby has actually warped my brain into thinking cramps are a good thing.

When you're faced with all of the choices and options you need to consider when mapping out your plan of attack against breast cancer, its easy to become stressed and overwhelmed at the possiblity of making a bad choice. And, if you're a young pre-menopausal woman, fertility may be an issue that you have to deal with sooner or more directly than you wanted. The truth is that you can't make a bad choice. Any choice you make, based upon what you feel most strongly about, what you know in that moment -- is the right choice.

There are lots of ways to try to preserve your fertility -- you can freeze eggs, freeze embryos, shut down your ovaries, opt to use less harsh chemotherapy drugs -- but ultimately, no matter what you choose to do, you are balancing saving your life with bringing a new life into the world. And that is a very difficult choice.

For me, at the time of my diagnosis and the beginning of my treatment I simply did not feel that I had the time or the money to seriously consider cryopreservation options. What's ironic is that prior to my diagnosis of breast cancer, I had researched (a little) cryopreservation options in my area and had pretty much discarded the idea because of the cost. By the time I started thinking about fertility options (before my diagnosis) in a real tangible way, I was in my mid-to-late 30's. A little late to try to preserve eggs or embryos. Considering also, that I lacked a partner to create a child with -- there would have been an added cost of sperm donation to add to the costs of cryopreservation. And if I'm really honest, it just didn't seem like the ideal way to have a family.

I hate to say it this way... but my dream of a husband and then kids just won't let me go. I know that women opt to have children alone all of the time. For many reasons. I know. I know that its possible. I know that I have a good support system with my parents, my relatives and my friends. I know that I would not be alone and that my child(ren) would be loved by many people. But... I have such a hard time convincing myself that I want it by myself. Because I really don't.


So, even though I'm researching fertility options, its really a half-hearted effort.

I don't have the ability to invest thousands and thousands of dollars into the attempt to have a child alone. Now that the urgent treatment is behind me... I'm still faced with the same questions, the same concerns and the same hesitations. After I shared my post yesterday about my baby dreams, one of my best girlfriends posted a scripture reference to help me focus on the fact that none of this is really up to me. And while I know it is true, I still wonder what I am supposed to do at this point. Besides sit and wonder and think. Or make non-heartfelt attempts to do it alone.

I really don't know what to do.

Dreaming of days and lifetimes without breast cancer

My trip to the oncologist last week left me in an emotional tail-spin. It has taken me days to try to get it together.

I am fine. My oncologist seemed pleased that I handled all of the treatments, all of the surgeries seemingly with ease. In hindsight, while there were some bumps along the way -- a little neutropena, delays in healing, and so forth -- things went pretty much as planned. Hard to believe that a year ago, I was finishing up my radiation therapy. With wet blisters, peeling skin and darkened skin from the radiation... I was a puffy, emotional, exhausted mess.

Now, a year later... I am planning another trip to celebrate my birthday and I am travelling around the metropolitan area -- and soon possibly the country -- talking about my experience with breast cancer and encouraging women and men to stop thinking of breasts as an afterthought.

During my oncology visit, my discussion with the current resident fellow... made me stop and really think about fertility. He didn't say anything to me about fertility, he merely asked me about my menstrual cycle. When I said to him that I had not seen my cycle since I started chemotherapy, he wrote down the word "amenorrhea". So of course, I had to ask what that meant -- I mean, I've been through a lot over the past 2 years and slipping unknown words onto my paperwork just isn't going to fly. Not these days.

He told me that amenorrhea simply meant that I did not have a menstrual cycle. From that little bit of conversation, I realized that this menopause thing just might be real, and it might be long-lasting. This could really be IT. The truth is that I am now 40 years old. My fertility has "supposedly" been on the decline since I crossed the 30 threshold. So, even though I found breast cancer at a relatively young age, from a baby-making standpoint, I was late to the game.

If you ever want to see God laugh, tell Him your plans.

In 2008, my plans were to focus on my fertility and to research my options as a single woman who wanted to have children. Now, because of advanced cancer which caused me to need a lot of heavy-duty treatment, I am feeling certain that my fertility is just a by-gone dream. I have been thinking a lot these past few days about being amenorrheic and whether I have the strength to start on the fertility journey.

There are so many things to consider, how will I afford those treatments if they are not covered by insurance, will I use a donor, or will I find someone willing to father and raise a child with me... and so on.

The honest truth is that I don't know. I know that one of the reasons that I keep encouraging women to check their breasts, and to get their mammograms is because IF breast cancer is something that you have to deal with, the sooner it is detected the better the treatment will be. If breast cancer is caught early enough, you may not have to lose your breast, like I did. If breast cancer is caught early enough, you may not have to endure chemotherapy, like I did. Basically, if you find breast cancer when it is small (even microscopic) you can come through the treatment and pick up your life a bit more easily that someone who is diagnosed at a later stage.

You don't have to lose everything about yourself with breast cancer. But in order to do that, you have to know early and you have to act early.

But... even if you're diagnosed at a later stage, like I was... you can bounce back as well. I am planning to find a fertility specialist that I can talk to about my options. Truthfully, I finally realized/accepted that it is very possible that I won't have a baby. And the thought, for once, didn't cause me to cry. I am sad, but I am not defeated by the thought.

I've been dreaming about my life before breast cancer. And dreaming of a world without breast cancer. But, every morning when I wake up, those dreams fade.... and I start my day thinking about how to move beyond this chapter in my life.

Audacity Tees

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