Today marks one year of discovering breast cancer. It is also Olivia’s 6th birthday. Leading up to today I wanted to give the day back to the day of her birth rather than the day I got bad news. But I also felt unsure of whether I’d be a wreck. When I woke up I had the table decorated with Cinco de Mayo Fiesta decorations and Happy Birthday signs for Livie. She had been waiting anxiously for a remote control Monster Truck. Still, a small moment of reflection was needed- to look back at all of the progress I made after the hard diagnosis and emotional drain from learning and processing all the cancer knowledge/talk/treatment/consults/research/clinical trials… it’s never ending. Progress is still happening and all the while running a busy and active family and doing all the volunteer and art work that has given me back a sense of purpose in the community that has supported me so much - through the pandemic, my diagnosis, and recovery.

Life has moved on, almost too quickly. All the kids have several activities and we still go on mountain bike rides a bunch. I volunteer quite a bit for the school PTA. I also volunteered to make art with a well-known school for Autistic kids.  Right now I am working on installing a Mural with the 5th graders of Kirra’s graduating class at Westlake Elementary. Whatever is the word for extremely busy, that is what things are like right now. Not quite ‘drowning’, but a lot going on.

Between my monthly oncology appointments and injections at the Stanford Cancer Center in Los Gatos, I have continued to exercise with an intimate group of friends whose strength and approachability have encouraged me back multiple times a week. We do cardio-CrossFit style exercise, with weights and lots of chit chat too.  I wanted to do more weights to offset the menopause side effects. The monthly ‘Zoladex’ injections suppress the ovaries that cause me to go into a medically induced menopause, so I have been increasingly getting more hot flashes, stiffness in my joints like hips, knees, wrists; almost everything new I feel I find something can trace back to menopause or the absence of estrogen. Another side effect is bone loss, and that’s where the weight bearing exercise comes into play. I recently joined a facility called OsteoStrong in Los Gatos that strengthens bone density and I’m intrigued at the results they have seen in other clients (more on that in another post).

The monthly injection appointment is 30-40 minutes drive along Highway 17, which I usually reserve for a Friday and it takes up about 3 hours of my day- 4 hours if I include a stop for Ramen afterwards. I do bloodwork to show my estrogen levels, and then I meet with my Medical Oncologist. We talk about new symptoms, if I am feeling anything differently (including emotionally), and answer any questions I have been saving up to ask. Sometimes I find out about a clinical trial from others in a Breast Cancer group. For now since my side effects, even though they are happening more frequently, are moderately tolerable so I will stick to the prescription for this ovary  suppressor. If at any point I begin night sweats, or have issues with depression (some of the side effects from Zoladex and estrogen stoppers) then that is when the oncologist will recommend something else. My appointments are usually great, I seem to have a positive demeanor (according to my doctor’s assessment of me), and I am really on top of my regimen and being consistent about nutrition and fitness. Finally I go back to the waiting room for the nurses take me back to the infusion rooms where they administer the injection. It’s a huge/thick needle and they give me an ice pack, which I use to numb my lower abdomen before they poke me. After the poke it’s not painful, and then I leave very hungry and eager to hunt down that Ramen. I used to get emotional walking back to the car, since I have been going alone to these visits.  I am getting used to going but 5 years of this seems like forEVER!

Recently I was contacted by my oncologist about a Nurse Strike at Stanford that was going to affect my treatment plan. My injection happens roughly 4 weeks apart because that’s about how long the slow-release goserelin implant last in my belly, suppressing my ovaries. The nurse strike meant I would not get seen because  the few working nurses were needed for urgent appointments. I was asked (not required) to consider taking an alternative medication until they could see me again. Dr. Said maybe 3 weeks later. Tamoxifen is an estrogen receptor blocker that many estrogen-positive breast cancer patients take for 5-10 years. For me this was not the best prescribed treatment because of my recurrence score, so that’s why they suggested the estrogen stopper- the ovary suppressor (OS) and aromatase inhibitor (AI) combined treatment. When I was asked to just take Tamoxifen, I obliged, even though a lot of time this past week and a lot of my mental space was consumed by whether this was the right decision. I even tracked down the old nurses at the local Santa Cruz PAMF where my cancer was first diagnosed, to see what my options were to get treatment locally again. The outcome was that I’d have to fully transfer care back to the local santa cruz general oncologist - usually doctors wont tag team on one patient. That was a big disappointment but I do like the care at Stanford better so I was willing to wait out the strike. Thankfully I was rescheduled quite quickly (a week later) but I was still stressed about loosening my treatment plan. I go back to get an injection tomorrow, but I only get to see an oncological nurse practitioner via Video Visit. I guess I’ll be doing that from in my car?  By the way, here is the outcome of the Nurse Strike. I hope they all get the raises and staffing they deserve!

So as I set aside some time to reflect on what today meant to me, I solidified it when some sweet friends joined me on a hike at Pogonip after kids were dropped off at school. On Pogonip there was a Rock Garden maybe 2.5 miles in. An array of one Hundred or so stacks of rocks were arranged artistically and chaotically. A shrine and an experience. A place of silence, like walking through aisles of books at the library. The rocks had papers wedged beneath with hand written intentions left by people before. Some were wishes, some were laments. Some were hopes for other loved ones. A mom wishing her daughter would have a great start to a new job. A broken heart missing her partner. Wishing one would be ok to be happy. As I read these I immediately felt the knots and then the tears flowed. And my friend Marie came through with paper and pen for me to place my intention. I was afraid today was going to be a sad day and I was hoping Livie’s birthday and all the mom duties would occupy my mind from getting sad. But then as I allowed myself to be there and feel the prayers and hopes left by others at their various paths in life, I felt it was perfect and just what I needed. It gave me some closure, some permission to move on. 

I’ll still work hard on my treatment, but I am also still working hard on living my best life.

Olivia is now 6, and I give myself permission to give this day back to her, back to remembering the day I became a mom of three.