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OTV "On Treatment Visit" is when you see the radiation oncologist just after a radiation session. You do it once a week and they're mostly checking your skin for burns and giving you advice on how to manage. I did it 4 times. The conversation always went exactly the same way. "Oh Ms. W, your skin is looking good. What lotion are you using." "Um....." "Ms. W, use lotion." "Um, I mean, yeah I guess I am, maybe once a day." "Ms. W, 3 times a day, use lotion 3 times a day." "Um, yeah, sure." Why is it sometimes sooooooooo hard to comply with the really simple things? Literally, we had the same chat every week. One time, there as a substitute doctor (hey, doctors get to take vacation too... it's July!) he asked me if I had any questions. I told him I was convinced that the cancer (which was already removed) had spread to my leg. He stared at me a bit. I stared at him expectantly. He said, "In my entire career I have never heard of that happening." I nodded my head. "Do you think I'm being ridiculous?" He nodded, "A little bit." Then he went on to explain that when breast cancer spreads across the body it typically follows a 'chain of pearls' pattern. Think of a chain of pearls starting in your armpit and spreading to the center of your chest and then down. Whew... no chain of pearls. Just keep swimming.

Mid-July - I show up for day one of radiation. Well, it's not actually day one yet because day zero is a dry run. They get you on the machine and take x-ray images with all the measurements to confirm they're right, once the Dr. okays the x-rays then you start treatment. I have no idea what to expect when I get there. They show you to a changing room where you can don a gown and robe, or multiple robes, or whatever makes you comfortable. Then you head out to a waiting room with the other radiation patients. There's a massive screen with a bunch of names on it like Infinity and Exclaiber and Excelcius and they all have a wait time status next to it... kinda like Grand Central Station... only for radiation machines not trains. I have a blue card that I scan when I get there... no need to even check in with a nurse or receptionist. So I sit down and wait for Infinity to free up. I notice everyone else is drinking water, but nobody told me to drink water. I see a woman and ask her, "Do you have breast cancer?" "No, cervical cancer." "Oh, do I need to drink water?" "No, that's just for the guys with prostate cancer." "Ah, okay." I wait, kinda wondering if I should be drinking water. A technician comes out and calls my name. We walk back, I scan my card again, we enter a room with a massive door and a huge radiation sign. I lay down on a bed/table thing and put my arms above my head. The technicians do a bunch of measurements, stick a ton of stickers all over me, and then leave the room. A big robotic arm basically rotates around me for 3 x 25 seconds. Then it's done, and I'm free to go. Yup, that's it. I'll come to the hospital every day for 5 weeks to spend 3 x 25 seconds in radiation treatment. What a pain in the ass. Mid-July still - Radiation treatment gets very repetitive very quickly. The only saving grace is how fast it is and the ABC. I don't even know what ABC stands for, but the B is for Breathing. Basically, to move my heart out of the way of the radiation I have something like a snorkel tube in my mouth that I have to breath through. They measure how much air I inhale and thus how inflated my lungs are. The inflated lungs push the heart out the way. So, during my 3x25 seconds under radiation, I have to keep a line above a threshold on a screen which is controlled by my breathing. I concluded this is basically the gamification of radiation treatment and I might as well see if I can beat the game. All the technicians were very impressed at how long I could hold my breath-not that it really matters mind you. I decided I'd rather think about radiation as a videogame then actual radiation, I was going in for my daily ABC and I was definitely going to beat the line. Anything to keep your brain off the actual cancer treatment is a good thing in my book. Still Mid-July - I had lots of time to kill in the radiation oncology waiting room. Sometimes I read a book. Sometimes I checked work email. Sometimes I'd chat with the people around me. I met a lot of people. One very inspiring woman was in her 80s and also had breast cancer. She had gotten a bilateral mastectomy as well and the doctors didn't prescribe any other treatment for her. She found out about radiation and demanded to get radiation treatment, She said, "I told them I was going to do my radiation and that was that." I met another woman in her 30s with cervical cancer. She was doing radiation and chemo at the same time, plus her chemo infusions were 8 hours long. She'd spend 8 hours in a chemo chair to then walk down the hall and go to radiation. She looked exhausted and had already lost 40 lbs. I saw her on her last day of treatment and she gave me a big hug. I was genuinely so happy for her when she was done. Just keep swimming.

Call it late June - I really have no memory for dates anymore, they've all just blurred together. Anyway, the radiation oncologist asked me if I wanted to participate in a clinical trial - one group would do 5 weeks of standard radiation and another group would do 3 weeks of dose dense radiation. The impact on cancer is known to be equivalent, but the trial was to understand cosmetic impact. I said sure, honestly after 5 months of chemo I really didn't care about cometic results at all and both 3 and 5 weeks both seemed wonderfully short compared to 5 months. The research coordinator drew straws and I got 5 weeks... fine. Early July - we manage to sneak in some fun between chemo and radiation. The doctors are okay with me leaving the state and aren't worried about infection anymore. Life is starting to open up. Just keep swimming.

I'm tired, drugged and tattooed.. but mostly I just want to be done with cancer. - me "Last-day-of-chemo" & "Radiation Simulation" - it occurred to me at some point that maybe I should have just said no to simulation, another day.... I'm not good at no. Round 12 - Mom came over late last night so she could wake up here and drive the girls to summer camp. My husband would join me for my last infusion- my partner and source of strength through all of this. We made it out of the house by 6:50, leaving 10 minutes earlier so I could pee in a cup and prove chemically that I'm in-fact infertile. I took 25 ml of Benadryl and put lidocaine on my port for the last time. My stomach is already starting to swirl in the car and all I want to do is go back to bed. K the radiation nurse is at the door waiting for me- at least she's on top of things. We get the pregnancy test out of the way and I go over to medical oncology and check-in for my last treatment. My husband walks down the long hallway with me for the first time and he sees the bell on the wall. N (a nurse who has done 4 of my 16 infusions - including the benadryl drunk/woozy/field study one- is standing by the door. She's filling in as a tech and getting all the patients checked in and taking vital signs. She pointed to me, "Ms. W?" Me, "Yup, I'm hiding in this hat." Her-"I thought it was you." I get checked in and we are sent over to suite 32. N comes too and I tell her it's my last round. She is so happy for me. She looks at me in full honesty and says. "I honestly hope to never see you again." I tell her "I feel the same way. Maybe one day at a coffee shop, that'd be okay." She smiles. We do more vitals, I'm good to go for the infusion. (At this point, nobody is expecting anything less, my oncologist cancelled my last two visits with her as she sees no issues in my blood work, vital signs and I have no symptoms to complain about. She just calls me to check in 'for compliance reasons.' I swung by her office yesterday after blood work and she took one look at me in my running clothes and said, "See, I keep telling everyone you're fine. I'll document this so they're happy.") The infusion goes exactly as expected. J the oncology social worker swings by and says hi. She knows it's my last round and we chat for a while. After the infusion is done a different nurse comes in and asks me to wait for a bit. Then another one comes in and unhooks me and asks me to wait longer. After a bit, today's nurse comes back and asks me to follow him. (He's the first male nurse I've had in 7 months). We follow and 10 or so nurses are standing next to the bell. They give me a certificate for the completion of chemotherapy that they've all signed. I walk over the the bell and ring it, the nurses and my husband all clap. I recognize so many of them, almost every single one had given me an infusion at some point. I'm crying - tears of joy and relief. All I can think to say is "Thank you, so many of you have helped me along the way." I hear someone say, 'Is she crying?" and someone else say, "Yeah, she's crying. She's so sweet." Another voice says, "I really like her." My husband puts his arm around me and we walk out of the infusion center. J is waiting by the door and gives me a big smile. All I can manage is to nod and fight back more tears. We exit the hospital and walk to the car. Done, done with chemo. My husband gives me a hug and we drive across town to our favorite little diner near where we used to live. We sat outside on the patio drinking cappuccino and eating a delicious vegan banana chocolate muffin. He ordered a second and we enjoyed a glorious DC summer morning. Makes you wonder what is really going on in the lives of all those seemingly happy people. Radiation - After an emotionally and physically draining morning, He drives me back to the hospital 2 hours later. This time I check-in at Radiation Oncology. Things work differently here and I am escorted to a 'gowned waiting room' where I find a ladies locker room to put on a hospital gown and put my stuff in a locker. Having learned from surgery- this time I kept my phone. I go into the waiting room and two men are in jovial conversation - like two older men at a coffee shop, only here they're both wearing gowns and clearly don't know one another's names. Nobody in the medical oncology waiting room talks to one another. It takes <10 seconds for me to learn that both men have prostate cancer and both are very displeased with the need to drink copious quantities of water prior to the session. They keep checking the board and cursing that one of the rooms is running 15 minutes behind. Ahhhhh... they both have to pee but can't until after their session. I get it. Another woman walks in, she promptly sits in the chair between the two men and me. There's a whole room of chairs, nobody is worried about social distancing here. She drinks water too and takes her mask off to join the men in conversation. I look over at her. "Do you have breast cancer by chance?" A shot in the dark, it is the most common cancer in women. She says yes. I ask her if we're supposed to drink water. She says she doesn't know, this is her first session but she's doing it because they're doing it. I question her judgement based on obvious components of the human anatomy, but don't say anything. It wouldn't have mattered anyway, she launches into her cancer story. She's 83 years old and had a mastectomy too, they weren't going to give her radiation due to her age. But, she made them tell her all about it and then said she was going to do her radiation and there'd be no discussion about it. She's African-American and told me all about her two sons who both were taking time off work to drive her to and from all her appointments. They have a small family -- too small-- but a tight one. One of the men jumps in. He has prostate cancer, like his brother did. He's 73. He is doing 8 weeks of radiation, but not surgery or chemo or anything else. Same for the other man. He said he'd have done the surgery if he'd known he'd need to pee so badly. My turn.... I explain that today was my last round of chemo and that I'm currently 'really drugged up." I tell them I too had a mastectomy, did 5 months of dose dense chemo, did 21 sessions of PT post surgery and will do 3 or 5 weeks of radiation followed by 10 years of hormone therapy. They stare at me. I tell them that my 10 year survival likelihood is >90%. The 73 year old man says, "We're all in the same boat, only my doctor told me that something else was likely to kill me first." I responded, "The doctors have all told me the same thing - that I'm young and otherwise healthy and that I'll do the most aggressive treatment available because they have a lot of years to protect." They ask me how old I am. I tell them 37. The 83 year old woman tells me her granddaughter is 37 and that her mother died two years ago from colon cancer - she'd missed her screenings and found it too late. I nodded in sympathy. The black older man nodded, he said "It seems like younger people are getting cancer now." I said the statistics say so. He said, I think it's the food we are eating and all this plastic. His mannerisms and facial features remind me of Mayor Williams. I almost ask if they're related, but hesitate. I introduced him to EWG's environmental toxins app and MealLime for healthy eating. He downloads both on the spot and immediately starts playing with them. He says his wife is going to love MealLime and I tell him I can do my weekly meal planning and grocery shopping in 5 minutes. He's quiet for some time looking at his phone. Then he looks up and says, "the roasted salmon looks good." I replied, "It's all delicious." The nurses come and we go our separate ways. The man thanks me for the apps on the way out. Walking into the room, I shoot a note to my husband. We're 45 minutes behind and he's going to be late picking up the girls if he waits. I tell him to come back to the hospital to pick me up once he has the girls. I'll wait. The technician has me lie down on a CT scan with a big bean bag chair added to it. Basically, the plan is she's going to position my arms where she wants them then she's going to suck the air out of the bag until it's like a reusable cast. It takes some fidgeting but she gets me into position and does some scans. Then she does more fidgeting and aligning and more scans. Then she gives me a mouthpiece for measuring my breath. There's a big screen and I have to breathe normally until she tells me to go, then I press a button and fill up my lungs and hold the air in for 30 seconds. There's a big green line at the 1.5 mark that I have to keep another bar inside of by sucking in enough air. She asks if I think I can do it. I say, I'd better! We do it once and she asks how it was. I say fine and that I can go for longer and higher if she wants. She does want.... so now I realize this is an athletic contest and that radiation isn't going to be that bad. She ups the bar to 1.6 and 35 seconds. I hold it and repeat it 6 times. She does the scans while I'm holding my breath. Dr. R had said you can gain up to 5 more mm between the radiation and your heart by holding your breath. We get all the images we need and Dr. R comes to confirm everything. Happy with her measurements the technician comes back. One last step.... I got 3 permanent tattoos on my chest- guide marks for the radiation beam. I'm free to go. Turn to the sun and let the shadows fall behind you - I'm tired, drugged, and tattooed... but mostly, I'm just so done with cancer. A quick tally on My Charts tells me I've had more than 100 cancer related appointments in the past 7 months. I know I told my husband I'd wait for him to come back for me, but sitting in a hospital waiting area for another hour is intolerable. I can't do it, I won't do it. I exit the hospital and look around, it's a gorgeous afternoon - not too hot and no humidity. Perfect running weather. I know this city, I've trained for 10 marathons in this city. I know routes all over the place like the back of my hand... and I ran with the DC Road Runners club, 100s of experienced runners would share their tips on how to connect the best routes and make longer loops with each other... the best ones were passed down like runner lore. That also means that I knew 3 blocks over was the 'Hills of Battery Kimble" route - this is a punch you in the gut hill repeat route that only marathoners running for time do. The idea is basic, sprint up a near 90 degree hill and jog back down, repeat until either your lungs or your quads burn so much you can't stand it. I've run it before and I knew the way you access the route is by a tiny dirt path through a wooded area a few blocks away. It'd be completely invisible to the average passersby - but to a DC RoadRunner it's a widely shared secret. The path drops you down via switchback to Capital Crescent (a 21 mile loop around the whole city) which connects to the C&O. The C&O is like a second home for me, I've gone from 3 miles to 26 miles 10 times on that route. Fuck it. I rip my hospital bracelet off and toss it in the trash as I head down the hill towards the secret path. Cutting down via switchbacks I connect to Capital Crescent and head in the direction of the cut-over to C&O. I started the 13 mile walk home, never once looking back. I hit C&O and relax. Underfoot is a soft pack gravel path and to my right is an anachronistic canal that extends from DC to Ohio covering 184 miles of uninterrupted running, walking and biking space. In summer, trees along the path offer shade and the canal itself fills with algae cut by turtles, water foul and lots and lots of ducks. The silent stillness of the canal on my right is countered by the ever changing Potomac river on my left. At points the towpath offers only 10 or so feet of ground between the two parallel bodies of water - one fast, the other still. Home is west. So I find myself walking slowly but determinedly on a literal and figurative path to recovery. On one side I can see a mamma duck and her ducklings gliding along the still canal. On the other, class 6 rapids angrily beat against solid rock. I keep walking west and the sun starts to set lower in the afternoon sky. My shadow is growing longer and longer behind me. I don't know how long I've been walking but my phone rings and it's my husband. We've been married almost 15 years. I'm aware I can be difficult to be married to, I can be stubborn. I also realized that no normal person would conclude a 13 mile walk after your 16th round of chemo was a good idea. Did I mention I was wearing pointed toe ballet flats? "Where are you?" He's not upset, he knows me. "I'm walking home along the C&O, I just passed mile marker 7." He's quiet and says "Okay. Can you do me one favor, on your phone go to the info section in the last text you sent me. Please turn on "send my location." I do as he asks. I say, "I need water and food." He says, "I love you." I don't know how much longer I walked, maybe 40 more minutes. I look up and there is my husband and two girls skipping behind him as they head towards me on the path. The girls see me and run towards me screaming "Mommy!" He catches up and hands me water and graham crackers. He hugs me and says "we're parked about 20 minutes up the path." Obviously, I can't walk all the way home with a 6 and 3 year old in tow. I ask "How far did I get?" he responds, "About 8 miles." With my family around me, my contemplative walk is over. The girls are singing and making shapes in the sandy gravel. We see a snake and spend a good amount of time debating if it's a baby black snake or a Copperhead. Either way, we give it space to cross the path. The girls are making up songs based on the animal noises they hear around them. They want me to sing along so I give in and sing with them. We reach the parking lot and I find a table to sit down at while the three of them go to check out the river bank. A reporter or the local news is doing a bit on the C&O path users and wants me to do an on-air interview. I'm tired, really tired. I feel compelled to say yes, but I can't muster the energy. I look at him and surprise myself when I say, "I'm sorry. I just completed my last round of chemo therapy today... I can't." He looks at me and my hat. He smiles and says, "As one cancer survivor to another, congratulations. It gets easier." he gives his cameraman a nod and they walk away, leaving me to a quiet moment. When we got home I curled up in a chair and my husband made dinner. Then we read stories and put the girls to bed. Just keep swimming.

June 16th - "Last-day-of-chemo-eve!" - Work has actually been really busy all week. I try to get as much done as I can before heading to the hospital to see E. E is the phlebotomist who has pulled my blood for the last 15 rounds. He's also a cancer survivor. "Hello Ms. W, you look healthy." I tell him tomorrow is my last infusion. He's very happy for me- I've come to realize the phlebotomists and oncology nurses have very little information about the patient other than what they are supposed to do. I think it's so they treat everyone the same way, even those with terminal cancer. He asks me if I'm going to ring the bell. I say, "Absolutely". There's a bell at the entrance way to the infusion center. People ring it when they're done with chemo, it's a celebration and a send-off. Under the bell, the words "Turn to the sun and let the shadows fall behind you" are etched into a stone. Sometimes when getting infusions you can hear others ring the bell and the nurses cheer. My whole life I've been an athlete. Before every big race (rowing or running) I've always followed the same basic ritual, go for a light run to get the kinks out and eat carbs. Somewhere along the way, infusions became very much like races - acts of physical and emotional endurance. In a personal act of early celebration, I drove up to that spot on the C&O near Old Angler's Inn (fit in two conference calls from my car) and then went for my big-race-eve ritual run. (spoiler- that's not me, I didn't have any hair! But... it's hard to take a photo of yourself running!) I listened to Matt Wilpers coach me through a 45 minute run and enjoyed the nostalgia of running in the woods listening to country music. I made it 3 miles before I had to walk the rest, but it didn't matter. I was out there, running, training. I decided on that run that the gift I was going to give myself was to make space for running again. I haven't run a marathon since my oldest daughter was born. Life was just too busy. Now I have to find time to exercise - a recent study showed there is no known limit to the benefits of exercise for the prevention of breast cancer recurrence - literally the more the better. I started to wonder if I hadn't taken a 7 year hiatus from running if I would still have gotten cancer. Shoulda...woulda...coulda...it doesn't matter now. So, exercise will be a priority again... it's my 'happy place'. 14 years ago when I signed up for my very first marathon I could only run 3 miles. Yesterday, when I committed to myself that I would run marathons again, I could only run 3 miles. But, I know if you can run 3 miles you can run 26. You just have to break down the problem into bite size chunks. Every week, for 46 weeks, just go a .5 mile further. In less than a year, you're there. I've done it before and I can do it again. (In fact my weight/rate ratio and my running economy are even better now thanks to having lost 10 lbs during chemo....silver linings). I get home all sweaty and the family heads to the local outdoor pool. My oldest is working on her "Patch Test" which requires swimming a full length of a pool with the lifeguard in order to be able to jump off the diving board. If sheer willpower can propel you the length of a pool, she will figure out how. We head home and eat penne. Just keep swimming.

I met my Radiation Oncologist for the first time. We spend 90 minutes discussing options and looking at diagrams. I realize radiation oncology is totally different then medical oncology. Medical oncologists prescribe systemic chemicals (chemo, hormones, immunicology) and mostly evaluate you by your bloodwork and symptoms- basically they try to poison the cancer without poisoning you too much. Radiation oncologists zap the cancer with either photons or protons. Their job is to review your anatomy and figure out an angle to zap the cancer (or places where patterns say the cancer is more likely to come back) without zapping your heart or other important organs. It's all about angles and anatomy - to my husband's glee she drew lots of diagrams and discussed angles and ways to basically precision instrument me. He spent years at the National Institute for Standards in Technology doing nanotechnology measurement, this is right up his alley. We discussed a plan for my next day of treatment and she scheduled me for a simulation to check the angles using a CT scan while I do something called ABC breathing to move my heart further from my chest wall. The only day she has access to the CT scanner is on Thursdays, the same day as Round 12 (Round 16 overall). She asks if I think I can handle a full day at the hospital. I say sure, why not. She asks me to swing by before my infusion to do a pregnancy test. I remind her I am infertile and have been for 5 months. She says its policy. Apparently it's a medical no-no to zap a pregnant lady with radiation. Just keep swimming.

"I'm happy at 10, but I want 12" - my oncologist Rounds 10 and 11 of Taxol I make it to round 10 of Taxol, not having missed or delayed a single dose (changes to the cycle reduce long-term effectiveness of chemo). The hospital had considered the CDC's new findings and decided patients could now bring 1 guest with them to treatment. I took this as a great sign that the vaccine must be working and that they aren't seeing a lot of patients getting sick. (I got vaccinated while immunocompromised so the efficacy of the vaccine is unknown.) My best friend joins me for my 10th Taxol (14th overall ) infusion. She's a champ and is able to stay in the room for most of the visit- she has a completely irrational fear of needles and needs a sedative to get a shot. There are lots of needles in an infusion center... I moved back home with my family. The standup paddleboards we ordered finally arrived. We take the girls out on the C&O canal (very lake-like) near Old Angler's Inn. The oldest opts to join me on my board and is lying flat on her belly as we start out. The youngest is with my husband on his board. Within 30 seconds of being on the SUP the youngest pops up off her belly and strikes a wonder-woman pose (feet wide and arms straight up in the air- it's the most confident posture for a woman as it is physically the largest we can make ourselves.) She screams "I LOVE IT" - a water baby is born. Maybe 30 minutes later she gets so excited and forgets her surroundings. She screams "I love you!" and runs full speed towards her dad on the back of the board- next thing I see is baby and daddy flipping over into the water. She screams, then squeals in delight. The two girls take turns the rest of the evening swimming between our boards. At night during bedtime now, the littlest one frequently asks when we can go and 'stand on the board and jump in the sea.' I went to a store for the first time in 7 months, it was such a normal thing to do. The whole family heads over to Burke Lake one evening after work. My oldest and I have fond memories of Burke Lake because we like to run the 4.5 mile trail around the lake together. She is the fastest girl in her class (a fact she gleefully tells everyone) and loves to run with me. When we run together it's more a game of tag or 'red-light, green-light" for 4.5 miles than it is a normal run. I classify it as interval training and she always gets to pick the pace and when we run and when we walk. She can already sprint faster than I can.... not to mention she's 6 and can run 4.5 miles... Anyway she's been asking all spring when we can run together again. That night, I just decided it's time and we took off running and screaming through the woods. People stare, but we don't care. My sister and her 6 year old triplet girls arrive home from Hawaii. 10 Taxol down, we throw caution to the wind and see them immediately after getting off the airplane. (She has been so upset that she was stuck in Hawaii due to COVID instead of being with me during treatment.) She joins me for the 11th Taxol (15th overall) infusion. After the infusion we went for a walk at one of my favorite running spots off the C&O canal - right near where we took the girls paddle boarding a week earlier. Then we met our close friend for lunch at a restaurant and sat outside. The next day, I met another friend for lunch at a different restaurant too, I hear all about her new job (she got the communications job at <>!!!- such a hotshot now!) I'm thrilled to hear she likes it and is happy. Just keep swimming.

Rounds 3 to 9 of Taxol - Taxol is the 'mild' chemo I did weekly for 12 rounds. Though definitely less intense on the body than AC, it has the wonderful feature of being highly allergenic and potentially causing lifelong painful neuropathy. So, in addition to the Taxol for each infusion I've been taking precautionary Benadryl and wearing ice on my head, hands and feet for the full hour long infusion. The good(?) news is that having shown no signs of allergic reaction to the Taxol in the first 3 rounds, we cut back from 50ML via IV to 25ML of the over the counter stuff- which I might add is decidedly less intoxicating. The infusions themselves became considerably less eventful and more and more routine. But over the last two months the stress picked up considerably, it was basically 2 months of 'am I going to make it to chemo?' A COVID Scare - I kid in my oldest daughter's class contracted COVID (asymptomatic) along with 8 members of his family. The CDC traced her as a 'close contact' via the school and called to inform us that she was to be quarantined in our house (preferably in her bedroom alone- HA Right! she's 6.) for two weeks. Fortunately, nobody else in the family is considered a close contact and thus need not quarantine unless she develops symptoms and they'd been with her within 2 days of the symptoms developing. Completely freaked out, my husband and I decide it is best I move in with my mom for the foreseeable future. So, my new pattern is living at the farm away from my husband and the girls, driving in on Wednesday to get blood work done, spending the night at my dad's and having him drive me to chemo on Thursday mornings. Without good internet access, I start averaging between 4 and 5 hours a day of conference calls from my iPhone either parked along cow pastures or in the hospital parking lot. A Stupid Gas Shortage - We make it pass the two week quarantine window and all 8 of the kids in her class test negative for COVID. She goes back to school and my husband can start to breathe again after 2 weeks of being a single-dad with a 6 and 3 year old locked in a house for 14 days. The parents of the class feel bad when they heard that I was minimizing risk and continuing to live with my mom, so they started a 'food train' using this new app. A different person dropped off food for them almost every night I was gone. I miss the girls and Felipe a lot. But, I also realized being relegated back to the life of a teenager and being cared for by my mom and dad probably helped with me healing a lot. Then the stupid gas crisis hits and I begin to worry if I'll have enough gas to drive from mom's house to the city and back multiple times a week. Friends - I start having more calls with old friends but it's as hard as it is nice. Their lives are so normal, yet mine is on hold. Everything Else Goes Wrong - things are going well with treatment. Still no side effects, my hair surprised me and started growing back earlier than expected, I got my 6 month melanoma scan and found nothing of concern. Then, the project at mom's house has issues- there is water damage and they can't move forward until it's solved. The roof will need expensive repairs. My husband calls- there's a smell in the house which he thought might be mold but turned out to be rats in the crawl space under the addition. The kid's overflow their bathtub and water starts leaking in the downstairs hallway, the tub needs repair. The repairman suspects mold in the ceiling and needs to rip out drywall on the main floor and basement. The local gas company shows up in the yard, with flags. They're replacing pipes along the whole street and they need to dig up our asphalt to replace ours.... I walk to my car after a blood work appointment at the hospital, the engine light goes on, it only makes a clicking sound and won't start. Sigh. We try to remind ourselves it's just time and money... time and money.... Things start to go a bit better. Projects turn out to be smaller than originally scoped. Work gets completed. Things get resolved. My husband is exhausted. At least the farm in May is beautiful place to be. Just keep swimming.

"You're funny. Thanks for making today a great day." - the infusion nurse April 8th - Round 2 of T - I'm ready to execute my updated plan flawlessly. I had my gloves. I froze the packs for only 3 days, I had music ready to go, and I wasn't going to forget to pee first. The nurse walks in and she starts getting me ready. I've learned from experience that children are a good choice in first topics with a nurse. They love cute stories about little kids. I think it's in the same gene that makes someone want to be a nurse. I start by telling her about my girls and something funny oldest did. She laughs. We start laughing more. She's the type of person that physically acts out the thing you said, but in a muted way probably without noticing. She asks about my allergies. I explain I'm allergic to shellfish... well bivalves specifically. She asked me what happens. I puke for 3 days and lose ten pounds. Hmmmmm. "How'd you figure out what it was?" I said for the longest time I just assumed I was hungover because normally when you eat mussels you also drink wine. After a few rounds of this post mussel weight loss plan I was lying in bed with my hangover when my husband looked at me and said "This is not a hangover. You clearly have an allergy." I said "Huh, you know.... when I have wine without the mussels I don't get hangovers..." The nurse was rolling laughing acting out my dramatic hangover. Then she stopped, looked at me and said, "I would have done the same thing." She opens my charts and looks over everything. "50 cc of Benadryl. Oh that's a lot. You're gonna feel.... woozy." Yeah, I got that memo already. We go through the steps just like with round 1. She's done doing everything and I begin to feel the 'woozy'. She asks if I need anything and offers to bring me a warm blanket. When she comes back, I curl up with my warm blanket (they keep them in a heater), put my earbuds in with Rodrigo y Gabriela Spanish Guitar ready to go, push back the recliner and lift the foot rest. I mean, if I'm going to be 'woozy' for 30 minutes might as well enjoy it. The nurse looks at me as she heads for the doors and says, "Oh, I see you got the spa package." I smile and say "Drugs and a warm blanket... yes please." She leaves. So the thing about my cocktail is it also has steroids. Sooooo, sleeping isn't really in the picture for me. After a few minutes I realize I'm drumming out the Spanish Guitar music with my fingers and generally rocking out. I start to wonder. Is EVERYBODY feeling "woozy" here? I mean, is this the norm for chemo patients? I think about all the old people I see in the infusion center and immediately visualize a white haired petite 80 year old woman feeling 'woozy' in her cardigan and recliner. Well now I just have to know and I'm starting to wonder if laughing is socially acceptable in a chemo infusion center. I mean, what is the etiquette on something like this? FEILD TEST TIME! Okay, in Agile we don't have ideas or opinions, we have hypothesis which must be proven or disproven via testing prior to implementation. Sometimes, we do Gorilla Testing which basically equates to my User Researcher going down to a local bar and offering to buy a table of people drinks if they're willing to give her feedback on something. Quick, effective and cheap. So, when the nurse came back I told her I needed to pee (remember the plan!) and I began my very unscientific field study. So, between my infusion suite and the bathroom and then back via a different route, I determined that no other cancer patients were displaying "woozy' and nobody else was laughing.... hmmm okay so it really is just me. I tell the nurse about my vision of a 80 year old woman, my field study and my conclusion. She burst out laughing. Actually, we both laughed so hard that my blood pressure monitor spiked to a 140 reading and set off an alarm. She said I had to calm down or the alarm would cause the other nurses to come running in... oops so now I'm setting off alarms too. Anyway, it's time to gear up with ice. This time I wear the liners and the ice isn't quite as cold. I have my music and she closes the curtain so I have privacy and can't see the hallway. I have a window overlooking a field and a beautiful sunrise. Did I mention this is all happening at 7:45 am? I mean, is there a 5 o'clock equivalent for 'woozy'? I don't count minutes. I don't have to pee. I'm mildly discomforted but I can deal. I lay back and listen to my Spanish Guitar and remember the last time my husband and I saw Rodrigo y Gabriela in concert. An Immediate Retrospective - The Nurse and I conclude that maybe 50 cc of Benadryl is too much. She puts in a note asking if we should drop to 25 cc next time. On the way out, the nurse said "You're funny. Thanks for making today a great day." I thought you know, I enjoyed this. Happiness score = green. Two down, ten more to go. Just keep swimming.

April 1st was my first "T" session or 'mild chemo'. Basically this means I've shifted into a new phase of treatment. Or, as my oncologist put it in our latest video conference on March 31st, "You're on the recovery side now, you'll start to feel better. The T is just as important for preventing recurrence, but you'll start to feel better soon and get your energy back." April 1st - Round 1 of T - Okay, so here's the things about T it's made from the bark the the Yew tree. (Seriously, don't let your children eat Yew bark.) So, although it is a milder chemo it has some 'features' because it comes from a plant. Now those two 'features' are that some patients are allergic to it and go into shock in the first 10 minutes of getting the infusion. Others, may develop neuropathy in their hands and feet which is awfully painful and may not go away. So, day 1 of T comes with some anxiety as you wait to find out if you're in the allergic camp or not. (I was assured the nurses know what to do it you are. I also noted with interest I was given the infusion suite directly in front of the nurses station.) Anyway, I'm dutifully going through the steps with the nurse to prepare for the T infusion. There are lots of checks and balances built into this process - one which involves a second nurse double checking everything the first nurse did and signing off the infusion can start. So, when the second nurse came into the room for the signoff the first nurse said "Today is her first round of T." Only for the second nurse to go, "Oh....ooooooh, Oh! I'm mean great." Her face did not say great, her face said MONITOR FOR RISK! My read on that was allergic shock is common enough that nurses take it seriously. Also, you can reduce the likelihood and severity of the reaction by taking Benadryl in advance. So, they're setting me up on 50 cc of Benadryl straight into my veins followed by a cocktail of steroids' and nausea meds. The oncologist had said 'you may feel sleepy." The nurse said, "you may feel woozy." I thought woozy, what an interesting word choice. Anyway, the nurse pushes the cocktail into my IV and waits just staring at me. I'm staring at her. Then... WHOA. My stomach turns, my head spins... I get this immediate sensation like I'm sitting in the back of a car that goes over a steep bump in the road too fast... only its over and over and over. The nurse looks at me and says, "yup, woozy." She then walks to the door, says she'll be back in 30 minutes after the meds have settled and that I should just 'ride it out' after that we'll start the T. My mouth must have fell open and all I could think was Are you leaving me here feeling this way for 30 minutes! WTF. I rode it out. She came back 30 minutes later and said, "Alright, gear up it's T time." So, I lean over and open up the cooler where I had my new ice-gloves, ice-socks and ice-hat. Yup, remember that neuropathy that can last the rest of your life, well the prevention is ice. So, I was preparing to sit with my hands, feet, and head in ice for the next hour. Super fun... no not really. It's cold, I have Raynaud's disease so my fingers are white in under 5 minutes and it's painful. I'm uncomfortable, really uncomfortable. I'm counting minutes thinking... there's no way I'm going to make it an hour. I'm shifting in my seat trying to get comfortable. Like a moron, I get caught up in my IV and pull on my port. OOOPS. I press the nurse button, she's in the room in <10 seconds, we're still in that high risk window for shock. "It's not an allergic reaction." I blurt out immediately. She breaths. I tell her about pulling on my port and she checks everything to make sure we're good. The port was fine. (If chemo breaks thought the vein it begins to eat your flesh immediately. So really, breaking the port would have been bad.) She leaves. At this point, we're still only 15 minutes into the 60 minute drip time. I have to pee. I'm staring to do the adult version of the I HAVE TO PEE dance my kids do. I'm looking at the clock, 40 minutes left. I am not calling that poor woman back in here after the port fiasco. I look at the IV drip bag, yup still full and just making me need to pee more. Finally, I push the call button. A different nurse walks in. I feel better. She unplugs the IV tower which is on rollers and told me I'm free to walk around as long as I don't stretch the cord to much. I'm thinking, oh lady you don't who you are talking to. I amble my chemo, my ice socks, hat and gloves and my sorry ass over to the bathroom. Ahhhhhh. I amble back. 30 minutes left, the ice isn't quite so cold anymore. I'm a bit more comfortable. 20 minutes. 10 minutes. An older man and his elderly (90s?) mom walk by they give me a warm smile. 5 minutes. I'm literally watching the bag empty. The buzzer sounds! The nurse comes back and unhooks me. 10 minutes later I'm free to go! FREEDOM. It's like walking out of your last college final. You're so happy to be free and you can't wait to ..... take a nap. 50 cc's Benadryl, right. Expected half life in my body, 4 hours. My husband and the girls pick me up, we drive to the farm. I sleep in the car. I get to my bed and sleep another 2 or so hours, I'm not really sure. Around 2 pm I haul my sorry ass out of bed and get on the Peloton. I bang out a 60 minute ride and feel better. No symptoms since the actual infusion. A Retrospective - I had this boss once who gave me a good piece of advice. He said, 'Your an Agile Product Leader, so manage yourself like a product." So I do. On April 1st when I got home I was pretty dejected. I really kept thinking, "I can't do that again... definitely can't do that another 11 times." I even texted my sister and two close friends a note saying I didn't think it was physically possible to keep your hands in ice of 60 minutes. One of the friends who is another women in tech and former Army officer responded with a link to a video showing a person sitting up to his neck in a bath of ice for 2 hours... a world record. I'm pretty sure the message was "suck it up and keep your hands on the GD ice." Thanks, love you. So I did what any good Agile person does, I did a retrospective, identified a red unhappy face score, and picked a Kaizen. (Set an intention for change) Okay, next time I would wear glove liners to give my skin an extra layer, I'd keep the ice packs in the freezer for 3 days not 2 weeks prior to use, I'd bring music because reading isn't gonna be an option, and I was going to PEE before they start the chemo drip. I have a plan. In Agile we Fail Fast and Fail Often... meaning we identify small failures, fix them and move on. Just keep swimming.

I used to think about the future a lot, but now that makes me scared. So now I try to always live in the moment. Because cancer may take my life, but I will not let it take today. - me March 17th - The Last AC - As advertised, it sucked. If you google 'What's the worst chemo?' The A in AC comes out on top- or at least it did when I did it. And, I got to do a 'dose dense' version of it, where they give you in 2 weeks what most people get in 3. The upshot on this one is that chemo from the prior round is still in your body when you do the next round. So as I progressed from 1 to 4 the amount of the chemo in my body was getting bigger and bigger. It's 30% more effective than normal A and Dr. W described it as the 'hit them while they're down' approach as opposed to the 'let your body process the last round before you do the next one' approach. She told me from the get-go that the 5 or so days after the last round of AC would be the worst of the whole treatment plan. She was right, it really sucked. I felt like swollen water balloon waiting to burst. But now it is over. Spring Break - So, after the really sucky 5 days, I started to feel a bit better and went for lots of hikes with my husband, spent time with the girls at the farm during their spring break, worked out a lot and researched cancer. Oh did I mentioned I finally finished that book I've been reading since Thanksgiving? I used to think about the future a lot, but now that makes me scared. So now I try to always live in the moment. Because cancer may take my life, but I will not let it take today. Just keep swimming.

Clearly I thought it was a good idea to give small children scissors. March 1st - It's haircut day. On AC, normally shortly after the second round is when you hair fully falls out. There are different schools of thought here. Some people try to protect it and coax it into not falling. Others embrace it and cut it all off before it has time to fall. It's a lot less messy that way and you get through with it much faster. We decided to let the girls cut it. We figured they'd think it was fun and would have a memory for why mommy didn't have any hair. Trying to explain cancer to a 5 year old is hard. There are a lot of reasons why I chose to deal with the hair loss this way. It was partially a 'rip the band-aid off' thing, a lot about the kids and how they perceived this, and a lot about me just being tired of waiting for the next shoe to drop. I'm glad I did it this way. I'd tell anyone in a similar situation to do the same. Actually, that's one of the things I hate most when I speak to women newly diagnosed with cancer (and I do if I think my experience can help improve their experience). Often times I hear women worried about their hair, worried about how they'll look and worried about trying to cover up their baldness. This always makes me so angry. Not at them obviously, but at society. Think about it. These women are dealing with a life threatening disease and yet they are still worried about social pressure to be beautiful. How ridiculous is that? Cancer patients have bigger issues to worry about then how their hair looks. In my opinion, just own it. Chemo chic is beautiful. Have fun with it. Use this time to have fun with your loved ones, not to worry about hair. It grows back. Just keep swimming.