The past six years have largely been a time of upheaval. It all really began around this time in 2007 when I accepted a PhD fellowship 1200 miles from where we were living and working at the time. I was happy in my clinical research position but knew that wouldn’t last forever. Happiness in my job had cleared the way for happiness overall, and 2008 was arguably the healthiest and best year of my adult life. I ran a personal best at every distance, some several times, lost the stubborn weight I’d been holding on to, and wasn’t struggling with depression any longer. Things were looking up.
This all continued into 2009 as I found my space in my doctoral program and new community. Then, in April, I was diagnosed with breast cancer. At 28. It was caught fairly early, at stage 1, but was very aggressive.
Breast cancer cells differ in part by how they respond to the presence the hormones estrogen and progesterone, and production of a protein called HER2/neu. If a tumor is “positive” for any of those factors or a combination of the three, treatment includes blocking the expressed factor(s). “Triple negative” tumors do not respond to any of the three, are more aggressive and harder to treat, and occur more frequently in younger women. Triple negative tumors are also less common and are not understood nearly as well as the other types.
So naturally, my tumor was triple negative.
The time following my diagnosis is still a blur. Given my age and the aggressive nature of my tumor, I chose to have a bilateral mastectomy and undergo four months (8 rounds) of chemotherapy.
I went into surgery and chemo angry and with something to prove. Fortunately I was on a research assistantship and able to work from home, so my progress at school was largely unaffected. I continued to exercise and I’m positive that the fitness I’d built in the years prior helped me tolerate the treatment far better than I had any right to. Importantly, it helped me bounce back when treatment was finally complete and it was time to reclaim my body.
Side effects of chemo forced me to stop running in August 2009 but I continued to walk and bike until after my 7th treatment. Three days later I had to push my bike up an imperceptible hill to campus, crying all the way. A few days later my weekly blood work revealed the reason – my hemoglobin had dropped so low that my body was barely getting the oxygen it needed to remain upright, let alone exercise. So I rested and waited and crossed my fingers that I’d bounce back enough to receive my final treatment on time. When I did, my doctor credited the adaptations from years of regular exercise. My final treatment was on October 23rd and I started running again – in 30 second increments – on November 1st. From that point on I ticked off each anniversary, each milestone with a race. I ran my first marathon.
By all accounts my physical recovery went extremely well. Psychological recovery, on the other hand, is an entirely different matter. I initially decided to hold off on breast reconstruction, honestly unsure whether I would ever do it at all. I waited, and recovered. In October of 2012, right after the marathon, I decided it was time. There are a number of options one can choose for reconstruction. Many of them involve removing tissue – including muscle – from one area of the body and using that tissue to create more natural-looking breast mounds. Removing muscle that had a job, an important job quite frankly, was not an option I was willing to consider. So, I chose implants. Normally when someone gets breast implants they are placed under the breast tissue but on top of the muscle. After a mastectomy this can’t be done – the breast tissue is gone and the skin alone is not strong enough to hold the implant. So, the implant is placed partially under the pectoralis major muscle.
With surgery complete and an actual hairstyle again, I no longer look like a cancer survivor. Of course I’m not likely to forget, and rarely has a day or week gone by that I haven’t thought of it, but it isn’t obvious to others anymore. I finished my PhD in the summer of 2012 and that July we moved even farther away for my first tenure-track position. I was done. Ready to leave PhDState behind me and start over where no one knew.
It was great. I was pregnant when we moved and people treated me like a normal, healthy person. For the better part of a year I thought about cancer less.
There are always moments, though. The moment we found out we were having a daughter and instead of being overcome with joy i was paralyzed with fear for her. And the guilt that followed for wishing my little girl would have been a boy. Wishing my child would be someone other than exactly who she is…I’ve never experienced a worse feeling. The moment when, 10 days postpartum, the OB forgot and asked me if I was nursing. Every single time I hand my baby a bottle of formula.
And skiing this morning, when I tried to put power into my poles and felt my muscles straining against the implants trying to do what they are designed, but unable, to do.
One day, maybe only two years from now, my daughter will ask me why my breasts don’t look normal. She’ll ask what those scars are. I haven’t figured out what I’ll tell her. I hope that I can teach her that she is strong, that I am strong, and that if it ever happens to her she’ll get through it. Just like Mommy.
April 20th will be five years, the big milestone. I find myself looking toward that day, hoping so hard to get there without any bad news, and still knowing it’s not truly a magical hurdle. I’m still afraid, and I’m still angry. My daughter is sleeping upstairs as I write this. She’s helping me move on. Maybe one day I can really put this behind me, but today isn’t that day.