Liz’s Story

Site created on March 20, 2020

It's amazing how quickly things can change. On Sunday, I was a doctor, taking care of our neurology patients on the floor and bracing for the impending COVID disaster. By Wednesday, I was a cancer patient.

Let's back up a little. As some of you may know, my maternal grandmother was diagnosed with first breast and then ovarian cancer which she sadly passed away from before I was born. I always knew that cancer "ran in my family," particularly breast and ovarian cancer. But it wasn't until medical school that I learned what that really meant. We were in a genetics class learning about mutations associated with increased risk of cancer when the professor started talking about BRCA - the gene that dramatically increases the risk of breast and ovarian cancer, especially amongst those with Ashkenazi Jewish ancestry. While the blonde hair and blue eyes I inherited from my dad might throw you off, I am of Ashkenazi decent on my mom's side and things clicked immediately. Our family must carry the BRCA mutation. I suggested this to my mom, who said this was interesting and she'd think about it. My mom is a self-proclaimed (but certainly not board-certified) doctor and can rattle off hundreds of medical "statistics" followed by "yes, I definitely read something like that somewhere, I think maybe on Mother Jones." I brought it up a few times that she should get tested until finally one day she called me. "You know sweetie, Angelina Jolie just wrote this whole article about BRCA and I think we should get tested!" Great, my mother taking her medical advice from a celebrity instead of her medical student daughter. Just kidding mom, I love you :) 

As you can imagine, my mom tested positive, prompting my own testing, which was, of course, positive as well. We decided to take things head on. My mom underwent prophylactic mastectomy and prophylactic oopherectomy within the next year. I was 25 at the time, but I convinced my physicians that I understood the risks and benefits. I wanted what BRCA "previvivors" refer to as the "ticking time bombs" gone ASAP. So, after finishing Step 1, while my classmates all went on celebratory vacations, I go to celebrate with some propofol and oxycodone and underwent my prophlylactic mastectomy followed by reconstruction later that year. Then it was smooth sailing for a while - my plastic surgeon did a great job, I got some fantastic nipple tattoos and it felt like this was all behind me. 

Fast forward to 2020, which I will hereby be referring to as the shit year. Coronavirus began devastating the world and all my co-residents and fellow hospital employees started bracing for the storm. Meanwhile, NYC and the rest of the country finally caught on and began shutting down. I turned 30 on March 15th and had the unique pleasure of having to cancel my upcoming vacation to Sri Lanka with Merrill, cancel my birthday plans with my friends and family, and go to work on my birthday. I was feeling an appropriate level of self pity so it seemed only fair that my luck was about to turn around....wrong! 

While showering that night I felt a lump near my left implant. Happy birthday to me! I immediately feared the worst and started frantically texting my oncology fellow friend, my breast surgeon, my plastic surgeon and my OBGYN. As if feeling a lump in a BRCA1 patient isn’t scary enough, our hospital was rapidly shutting down all clinics and ORs to prepare for COVID and I knew things needed to move quickly. Thanks to some incredible advocacy from my friends, doctors and colleagues, I got an expedited work-up. Well I should first mention that I was temporarily on COVID quarantine and desperately refreshing my patient's chart praying to god (well not god, we all know I'm an atheist, but like the four-leaf clover next to the the pot of gold at the end of the rainbow not near any black cats) that it would be negative and I would not need 14 day quarantine. And finally, some good luck, she was negative. 

Once cleared to return to the hospital, I saw my surgeon on Tuesday, who walked me across the hall for an ultrasound which showed a suspicious mass. The interventional radiologist came in and immediately biopsied it. By that night, I had an appointment with an oncologist specializing in BRCA patients. By the next day, pathology was back - definitely cancer. And as we would soon find out, not the kind you want (but the kind you expect with BRCA) - Triple Negative Breast Cancer.
*Just to add to the joy of the current situation, the lifetime risk of developing breast cancer after a prophylactic mastectomy is ~0.5%. So I'm definitely overdue for some good luck moving forward!*

Ok, I think we're all caught up now. After a whirlwind of tests, here I am on Wednesday as a cancer patient. And sadly placed on immediate medical leave from work :( For those of you who don't know, I really love my job and my colleagues and one of the worst things about this whole situation is not being able to be there with them. But unfortunately, nothing I can do about it right now. 

The plan is surgery ASAP,  then hopefully retreating to my childhood home in the middle of the woods away from the NYC COVID epicenter, then in a few weeks chemo which will last ~20 weeks and then probably radiation and the rest is TBD. As my oncologist pointed out several times, we are being aggressive upfront with a goal of CURE. 

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I have had such an amazing outpouring of support and I want to keep everyone updated. But its a bit challenging juggling group chats and emails and phone calls, so I am going to try to post updates to this website instead. I still would love to hear from people but just understand if I'm not responding, its hard to keep up with.  I love you all! 


Oh and p.s. I have already informed my family, but I will be expecting an epic 31st birthday - minimum a week-long, preferably with many separate parties and including a trip to Sri Lanka that doesn't get cancelled this time :) 

Newest Update

November 7, 2020

Journal entry by Liz Matthews —

I am long overdue for an update!! 


 


When I last wrote in August, I had just finished my last cycle of chemo. Things got a little busy after that, hence why I temporarily went MIA. 


Merrill and I moved back to NYC right after Labor Day and I started going back to work on site. While there are definitely some appealing aspects of WFH, being back at the hospital felt so normal. And so good. Mostly because I finally got to see all my residents - who are adorable and cleaned and decorated my whole office and threw me a welcome back party :) Works has remained busy as ever, which in general has been such a blessing to distract me from this cancer crap. Though I have to say, I'm starting to look forward to the holidays and taking a few days off. Because unlike residency, I have learned that chief year really does not come with weekends or nights off. Luckily, I love it so it doesn't feel like work most of the time, but I am looking forward to sleeping in a few days. 


After we got back to NYC, I jumped into lots of doctor's appointments. I saw a radiation oncologist, who laid out my treatment plan - 21 total cycles of radiation, which would take place daily M-F starting 10/19. I mentioned this one tiny detail that I had to take my neurology  board exam on 10/21 (results should come out soon so fingers crossed I passed!!). Given that *minor* conflict, we decided to start radiation first thing 10/22. Merrill is an angel and drove me to the hospital each morning by 7am, they put me on the schedule as the first case of the morning, and unlike many areas of medicine these days - the radiation oncology division is an insanely efficient, well-oiled machine. Most of my appointments took under 15 minutes (including the 5 full minutes of treatment). For anyone who is curious, radiation is basically like getting an x-ray except instead of a quick "buzz" and it's over, the buzz going on for 5 minutes or so. To prevent skin damage, or "radiation dermatitis," I was told to put on special vaseline-like lotion 3-4 times  day and fortunately, my skin reaction was pretty mild. It turned pink and about a week after I finished treatment I got one little area that blistered and peeled and now I just have a nice tan. Well not exactly "nice" - I have a square of tan and the rest of me is winter/COVID-level pale so I look bizarre. But really not bad, and doesn't hurt at all anymore.


Merrill and I celebrated finishing radiation (and cancer treatment all together!) by going out to a socially-distanced, insane NYC dinner splurge. We went to Masa and ate the most amazing  25ish-course sushi dinner. I really cannot thank my incredible co-residents enough who surprised us with the most delicious bottle of sake I have ever tasted and the sweetest note. And Merrill's incredibly generous friend for covering a huge part of our tab. We are so lucky to have such amazing amazing people in our life. <3


After radiation came lots of follow-up appointments - with my oncologist who I will now see every 3 months to check in. She also referred me to dermatology and a BRCA specialist in the gynecology-oncology division. Turns out melanoma is associated with BRCA1 so I will be getting regular skin checks and regular appointments/ultrasounds/blood work with the gyn-onc team given my risk of ovarian cancer. I also saw my plastic surgeon and finally got to say goodbye to my annoying port. It was done as an office procedure and I have to say - I am not squeamish but wow this was no joke. Lots of blood and cutting and sutures but totally painless thanks to the miracle that is lidocaine. Finally, I saw my plastic surgeon and together with my radiation oncologist, they've given me lots of recommendations to decrease the chance that the radiation ruins my implant or that I get frozen shoulder. Basically lots of yoga. I found a great app that has a specific shoulder flexibility yoga sequences, that I've been doing 3-4 times a week. We also joined the COVID cult and got a peloton. So most of my mornings have been starting with a 5am peloton ride or yoga session. The waking up part is no fun, but having a rush of endorphins even before I drink my coffee is a pretty great way to start the day. 


At this point, it is now watch and wait. And hope. If I make it to year 3 without a recurrence, my risk of recurrence drops off a lot and if I make it to 5 years, it drops off so dramatically that I could essentially consider myself cured. So here's to hoping that I don't have any more major updates here ever again :) 


Oh also, JOE BIDEN WON AND WE ARE DONE WITH THIS SOCIOPATHIC FOOL. THANK THE LORD (again not religious but I won't lie, I did pray to every moon and rainbow and mother earth spirit I could think of and it seems like they listened). 2020, I think we finally hit your deep, dark rock bottom and are on the up!!!!  

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