The wonderful world of survivorship

I had two visits to Women and Infant’s hospital last week. Neither were check ups although, in the words of Eli Dunn, one could be considered a “check up from the neck up”.

On Tuesday morning I met with Jessica, the genetic counselor. As you may remember from a previous entry my first round of genetic testing came back negative. Results for the second test came in and they were also negative! This basically covers about 96 % of the genes that we would be potentially worried about in terms of mutations that increase the chance of developing other cancers.

In non-medical terms, the genetic counselor basically told me that since I am negative for the BRCA mutations my chances of developing breast cancer are about the same as the general population. This is great news! The genetic counselor went on to say that there is a final test called the Ovanext test that tests for mutations in 21 other genes. The downside is that this test is fairly new in medical science, within the last 3 years. Depending on the gene mutation present we do not necessarily know the risks and implications of the mutation .

I am mulling over the decision to do the test. It will ultimately be dependent on the out of pocket cost. Unlike the BRCA testing, insurance does not necessarily cover the cost of a test like this because there is not enough data to support its findings.

To me, it really doesn’t matter what the results of the Ovanext test are because it likely would not tell me much more than I already know. The only exception would be if there was a mutation in one of the five genes that are connected to Lynch Syndrome. If there was a mutation in one of those genes, the lifetime increased risk for colon/uterine/stomach cancers are greater than the general population. Lucky for me I ditched my uterus months ago so we can cross that one off the list. If there was a mutation we would know to take preventative action by having an annual colonoscopy and endoscopy that would look for polyps before they got out of control.

As I have said before, based on the BRCA testing and my (lack of) family history, my genetic counselor and I are inclined to believe that a genetic mutation is unlikely; however, it is encouraged to pursue this line of testing due to the rare nature of this illness at a young age.

Once I hear from my insurance company I will make a decision. Another factor to consider in pursuing this testing is not what it will do for me, but what it will do for the future of medical research. In medical science, there will always be a guinea pig of sorts. Even if the OvaNext testing does not yield practical information for my own treatment, my DNA sample can contribute to the overall data pool. Eventually, enough data will be collected that trends can be found and my hope is whether it is five or fifty years from now, another young person will have better preventative care because of that. It will ultimately come down to out of pocket cost but I hope that I can make this minor contribution for the sake of science.

Switching gears-

I returned to Women & Infants later that evening for my first night in the “Transition into Survivorship” group. This will go on for five weeks and is meant to provide tools to assist in the transition into “the new normal”. We have a really wonderful group of women there. Mostly breast cancer survivors but there is one older woman that had ovarian. I believe that I am the youngest in the group, but there is a great person in the group closer in age to me. I actually met her during chemo although I do not fully remember (I was probably in my Benedryl haze). I feel connected to her on a level that I haven’t figured out yet. When I was speaking, I could see in her eyes that she not only heard what I was saying but also felt it. I look forward to getting to know her better.

I felt really comfortable with this group of women and when I was asked “what do you want to get out of this group?” the first response I had was “camaraderie”. I can see that need being met with this group of warm and strong women. In the first meeting alone we laughed and cried together. I see it being a beneficial few weeks.

One point that I want to highlight is that despite the trauma that each woman has endured, we all had nothing but wonderful comments about our treatment at W&I. Nothing about the stories everyone was telling screamed “poor me”. It was all about how lucky we were to have such great care within the family that is Women and Infants. That feeling was reinforced personally, when I walked into the room and spotted Allison and Diane, two social workers that I have grown close to. We were mutually excited to see each other. Had we been in any other setting outside of a hospital you would have thought that we were old friends that just happened to run into each other.

Hearing everyone’s story is so powerful. I find myself getting lost in their stories as I can picture it in such vivid detail. I feel the paralyzing fear associated with those haunting words “you have cancer”. I feel the anger. I even feel the needle pricks of an accessed central line. I feel the strength and the courage, and most importantly the determination of not letting cancer win. This group means a lot to me because I know that people are in the same “place” as I am, and probably feeling similarly. You never want anyone else to go through this but you find odd comfort in knowing that someone else feels your experience so deeply.

On a personal level, the facilitating social worker said something the resonated with me. My second response to “what are you looking to get out of this group?” I shared a life challenge that essentially has no immediate impact on my life, having children. Despite it impacting me more in the future, it has wounded me so deeply. I am only 25 and I am certainly in NO hurry to be a parent but goddamn it I wanted the option for later on. I shared with the group that I felt like something was taken from me. The social worker framed my disclosure by saying “You are mourning the loss of the future you thought you had”. Nothing was really taken from me but my own expectations. If I had been conditioned all of my life to believe that I wouldn’t have children of my own this wouldn’t be an issue. This ties back into developing my “new normal”. My old normal may have included having my own children but my new normal will involve being a mother by other means. I will eventually get there but I think this group will ultimately help me to cope with the anger and resentment I have surrounding this perceived loss.

Now that I’ve brought down the mood I want to end on a warmer note. I am so glad that I decided to do this and I look forward to the weeks to come.

Finally,

HAPPY BIRTHDAY ADAM SULTAIRE!!!! I hope my big brother has an incredible birthday! For everyone reading out in San Jose, limit him to TWO swirls.

“I’m a tortoise Bro”-anonymous CMR runner

Let’s get facts straight. I am no perfect portrait of health and fitness. I try to work out a few times a week and a I try to make healthy food choices as often as I can. But I am certainly no dedicated paleo-eating/ marathon-running/calorie-counting/work-out-at-5am kinda girl. I just don’t have the kind of discipline and patience required for that (but I commend others that do!) I do my best to live a healthy lifestyle. Over the past few years I have been more active than I ever was and learned to actually like running. It makes me feel accomplished and athletic (when I was certainly not before). Let’s just say I didn’t need Lucy to pull away the football to look like Charlie Brown when attempting anything athletic.

When I got sick last year, even before I knew that I had the big ‘C’, I struggled to maintain the level of physical fitness that I had achieved post-college. This was due to the several liters of tumor fluid sloshing around in my tum tum (yeah, I said tum tum!). Through the hysterectomy and chemotherapy it felt like more of a pipe dream to be running again. On December 4, 2012 I couldn’t walk more than three steps without nurses holding me up. On September 28th, 2013 I ran 3.1 MILES at the Color Me Rad 2013 5k. 297 days after extensive abdominal surgery that resulted in the loss of muscle function in my left leg, I was able to gain back the strength to run 3.1 miles. I wasn’t the fastest runner there by any means, but I did it.

I do not think I would have accomplished this goal without the help of two people specifically: Meredith, my occupational therapist in Torrington, CT and Matt Weese, my personal trainer. These people never once gave me the impression that I was too damaged to reach my goals and for that I am so grateful for their support, encouragement, and patience in rehabilitating my leg and strengthening my body (and spirit!).

Here are some highlights (and shout out to Sarah Breen for being an awesome running buddy that day!):

CPVD13_10_01776_L CPVD13_03_02057_L CPVD13_10_02111_L

 

I am looking forward to doing my third Color Me Rad next year and hopefully move on to an intermediate race such as a 10k or another physical challenge like a Spartan obstacle type course (NOT Tough Mudder. Forget. That. NOISE).

I would also like to acknowledge my buddy Tony for getting back on his bike after battling Leukemia for far too long! Little by little, we’re getting there Tony!!!

I hope everyone is enjoying this crisp autumn season and staying well!

W&I Social Work for the win

Consistently, Women and Infant’s hospital in Providence, RI always knows what I need before I need it. I have been a bit disconnected from the hospital lately being that I only need to go in once every 3 months. I think that I have transitioned well into survivorship but there are definitely times where I feel that I still find an identity in cancer. No one makes me feel like that other than myself. It can be part of me but it cannot be my identity.

On October 8th I am going to try out a new group at W&I called Transition into Survivorship. It is an educational/support group for people transitioning from active to post treatment. It is run by my social worker Allison so I am looking forward to what her and her colleague have planned. I hope to report only good news about my experience.

(p.s. this is my 50TH blog post!!!!)

Genetic Testing- The results are in!

This is news that should have been delivered last week. My apologies again as I have been a busy little lady (not that it’s a bad problem to have!)

Last month my family and I met with the genetic counselor to discuss genetic testing. Though I have very little family history of cancer on my Dad’s side and none on my Mom’s side, the likelihood that the cause of my cancer is genetic is very slim. Regardless, it is something that we can rule out.  To do so I provided a DNA sample to send out to a lab out west for the BRCA 1 and BRCA 2 test.

Why these genes? BRCA genes basically produce proteins that repairs damaged DNA. They have been described to me as “tumor suppressors”. If you have a BRCA 1 or BRCA 2 mutation, your body may not produce that specific protein or enough of it to protect the cell.

My BRCA testing came back negative for any mutations. Although the BRCA 1/2 tests are pretty comprehensive, it doesn’t account for all mutations therefore further testing is possible. Since this test came back negative, my insurance company will cover the BRCAnalysis Rearrangement Test, otherwise known as BART. This tests for genes that the BRCA 1/2 does not. My genetic counselor and I tend to think that it will also come back negative. There are tests out there beyond the BART that could look for other mutations but they are so new that they could only speculate what those mutations would mean. That being said, if the BART comes back negative I think I am going to pump the breaks on the testing.

Since (as far as we know) there are no BRCA mutations, the likelihood that my cancer was genetic is again slim. This means that my chances of developing breast cancer are not quite as high as they would be if I carried this genetic mutation. This is very good news.

So who knows why I developed cancer but at least we can cross one reason off the list.

In lighter news, I am running my first 5k since getting sick! I’ll be doing my second Color Me Rad race this coming Saturday in Seekonk. I may or may not have purchased pink sequined shorts and knee socks for the event. Though my endurance is pretty terrible after all of those months of ick, I know mentally that my body is capable of running 3.1 miles. Believing you can is half the battle.

Pictures to come!

L’shana Tova

I love this blog. It has become such an extension of myself but lately I feel as if I have been neglecting it the more normal my life becomes. I talked to my mom a bit about this yesterday and she said “you’re not ignoring your writing, you’re living life”. That put a nice spin on the situation. Although I have been super busy living life, I think I can spare a few to jot down some thoughts.

I cannot believe that my one year cancer diagnosis-aversary is just around the corner! Thanksgiving will be here before I know it. Apparently people all across the United States are cooking turkeys and mashed potatoes in my honor! Oh what’s that? It’s actually an established holiday? That’s okay too. I know that I have a lot to be thankful for.

This past weekend my family and I celebrated one of the most important holidays on the Jewish calendar, Yom Kippur. For those of you Goyim out there, Yom Kippur is the one day a year that our faith asks us to reflect on our wrongdoing from the year before and make an effort to do better the next year. It’s very simple. I would call myself a spiritual person more than a religious person. Although a day of repentance sounds like a huge downer I think it serves a great opportunity to look inward and think about how you can be a slightly better person than you were yesterday.

The rabbi’s sermon involved a story about a woman and a man that did not know each other but attended the same temple. The woman prayed and believed that God had told her to make 12 loaves of challah and leave them in the ark of the synagogue (the ark is more or less a cabinet where the Torah, our “bible” is kept). In an effort to feel more connected to her faith and region she baked 12 loaves of challah as an offering to God and left them in the ark. A man that worked at the synagogue cleaning up after everyone had left was very poor and could not feed his family and prayed to God for a miracle to keep his children’s belly’s full. After praying he opened the ark and found the 12 loaves of bread. The man thought it was a miracle and a sign that God had heard his plea. When the woman returned and saw that the bread was gone she also thought a miracle had occurred. She believed that God took her offering. For years she would bake bread and the man would take the bread. Again, they both thought that God was performing a miracle. Finally, the rabbi realized what was happening and exposed the whole operation to both parties. Both the man and woman were crushed as they realized that it was not actually a miracle. The rabbi then pointed out that although it wasn’t a magic act of God, it was an ongoing act of selfless kindness between two people and that in itself was a miracle.

This story resonated with me on a human level more than a religious level. Over the past year a miracle happened, I was dying and I got better. Advancements in medical science healed my body but it was the collective kindness of others that healed my spirit (which is more than half the battle). I don’t think it was a huge act of God that made me better. It was a community coming together in a multitude of ways to inspire and facilitate healing.

For me personally, I owe the world a great deal of kindness in return for all of the love I have received in my time of need and beyond. In the upcoming year I will try to be more cognizant of the opportunities I have to spread support and love to others. Like any normal human being, I am a flawed person and I will not always say or do the right thing but I will try to pay more attention to the smaller but more significant acts, my “loaf of challah”.

Ovarian Cancer Awareness

2013 statistics about ovarian cancer

Ovarian Cancer research is sadly underfunded despite being the number one cause of gynecological cancer deaths. In the future I hope to see the day when research can bring about modes of early detection. There is a serious need for better ways to screen for this disease as reliable preventative measures are lacking. Think of the fatalities that could be avoided if OC was caught in stage 1 versus the more common stage 3 or 4.

This month is Ovarian Cancer Awareness month. I am proud to say that some of my friends have joined the TEAL walk/run tomorrow in NYC to raise money for Ovarian Cancer research. Please visit their page and if you are able to, please make a small donation. If you are unable to donate, no worries! Support this team by leaving a comment on my blog post to cheer these ladies on!  Thank you again Jac, Lisa, Ali and everyone else involved!

http://www.tealwalk.kintera.org/faf/search/searchTeamPart.asp?ievent=1068154&lis=1&kntae1068154=DACA71E01CF24AC6AC4B6CA2EFDF4200&supId=0&team=5589234&cj=YOn

Good News!

I saw Dr. Robison this morning for my check up. She was pleased to see that my CA125 had stayed the same since last time. This is pretty telling considering that this is the longest stretch of time we have gone between blood tests. What we are doing is working! Since the outcome of this check up was so positive we have decided to space check-ups out to every three months. I will also have a CT scan in 6 months.

 

It feels great to be healthy 🙂

 

Making up for lost time

Here we are during the last week of summer. I went from having the worst year of my life to one of the best summers of my 25 years. Here is a recap almost entirely in photographs:

  • I visited my big brother Adam in California

photo-45

  • I reunited with my Torrington girls in NYChome
  • My hair grew long enough to go wigless for the last half of the summer!

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  • I went to Katie Brady Dalton’s lake house in Wisconsin for five days for a study abroad reunion with some of the Americans and Australians I lived with in Aus. during my time there. The Australians couldn’t get enough of the spectacle that is Walmart hence, our “People of Walmart” party seen below:

walmart

  • Two of my favorite couples from college got married one week apart

carlsonsolari

Which means that I had an awesome excuse to dress up and be surrounded by my tons of my  favorites two weekends in a row! (especially Major, my friend’s parent’s dog that happens to be the love of my life and the apple of my eye)

Carlson 2 major

Looking back on the summer I am just so grateful to be in good health and in good company!

My take home message is short and sweet:

There is life after cancer ❤ 

 

I LOVE love.

“The plan as of now is to do 6 cycles of chemo. I will go once every 3 weeks for about 5 hours each session. If I start when I plan to start I could possibly be finished by May and hopefully have hair starting to grow back for the summer. This is timed out well because I know two beautiful couples that expect me to be shaking my tail feather at their weddings in August. I intend to do that just that :)  (Katie/Bobby/Molly/Josh- when it’s time for the bouquet toss I make NO promises that I won’t throw my wig into the crowd of bachelorettes just to mix things up). That’s all I have for now. Thank you again for all of the love, positivity and prayer. Keep it coming.”

 

I wrote the portion above on December 11th of this past year. It was on the last day of my hospital stay at Yale for my first surgery. I was anxious and afraid of what was to come. Nonetheless, I had a glimmer of optimism. Four of my loveliest friends were getting married this summer and I would be damned if I wasn’t there to witness two beautiful days.

 

I am so proud to say that I did in fact “shake my tail feather” extensively last weekend at Molly and Josh’s wedding. CONGRATS MR. AND MRS. SOLARI!!!!!!!!!!

I am also pleased to share that tonight I will have the honor of attending Katie and Bobby’s rehearsal dinner and tomorrow their wedding.  I cannot wait for another beautiful day with two of the greatest friends a girl could have.

Pictures to come!!!!

 

(p.s. there was ultimately no wig tossing as my hair is coming in fierce)

Health Update: 9 Months Later

This past Friday I had an appointment with a genetic counselor at W&I Hospital at the recommendation of my oncologist and the insistence of my mother. A genetic counselor’s job is essentially to help identify genetic disorders and provide guidance to families based on the presence of a genetic disorder.

In my case, we are looking for the presence of the BRCA1 and BRCA2 gene mutations. If I test positive the likelihood of developing other types of cancers are increased. My understanding is that if you are diagnosed with ovarian cancer and carry a harmful gene mutation the chances of developing breast cancer is much higher, about 87%. Carrying the gene has implications for both myself and members of my family.

If I were to test positive, they would then encourage one of my parents to test. Let’s say for example that my mom then tested and tested negative. We would then know that the gene mutation came from my dad. We would then encourage my brother to test for the gene as it could potentially negatively impact him or his future children (particularly if he were to have a daughter). BRCA genes do not skip generations. Although you may carry the gene it does not mean that you will develop cancer. It just leaves you at a higher risk of developing cancer.

When speaking with the genetic counselor my parents and I went through our entire family history to the best of our knowledge. We focused on grandparents, aunts, uncles, cousins etc. We were able to identify two types of cancers on Dad’s side of the family. Only one of the two was a women’s cancer and neither was Ovarian. We are not very close with Dad’s family so I honestly had no idea about any of this history. My parents were kind enough to call a distant relative that they have been estranged from for information. Luckily, this relative was very warm and forthcoming with information.

Even with the small presence of cancer on Dad’s side of the family there were no established patterns. There is also no evidence of breast cancer on either side which is promising. Based on our family history, the genetic counselor is inclined to believe that I do not carry the gene and the cause is not genetic. I did a quick saliva test to be sure. We will know for sure once the test results come back in about five weeks.

I feel very indifferent about the test results. On one hand if I carry the gene that will help to explain the mystery of why I developed cancer. On the other hand it could potentially have implications for my family members. If I do not carry the gene there are other genetic tests that we can do but some of what they are testing for is relatively new in medical science and they do not have enough samples or background to draw conclusions about the “why”. I’m not necessarily anxious about the results. I am happy to test to ensure that we can take preventative measures for my family’s wellbeing.

Bottom line, at this point I have little interest in finding out why I got sick. I knew that I was such a medical enigma that I don’t think I ever really truly worried that much because it was made out to be so rare and complicated. If I test positive for BRCA we will take it form there. If I test negative I am going to keep moving along with my new happy healthy second chance at life.