2019 B.C.

I have long been fascinated with the idea of donating oneself to scientific research.  Back when I first moved to D.C., I made extra money by participating in blood pressure studies and the like and there was just something so riveting about being a medical "guinea pig."  Ever since I became a cancer patient, it's been a dream of mine to one day give back to the scientific community by participating in a clinical trial.  Typically, when one hears the words "clinical trial," the image that comes to mind is someone with active and/or advanced disease who's exhausted all available options and is undergoing an experimental treatment, often in an attempt to prolong their own life. So, as someone who was diagnosed with early-stage disease that responded very well to conventional treatment and carried a low risk of recurrence, I was hard-pressed to think of ways in which I could contribute.

Before I go any further, I should probably talk about something first: One aspect of breast cancer that doesn't get a lot of attention is its effect on a woman's fertility.  Not only can chemotherapy ravage the reproductive organs (provided they aren't surgically removed first due to BRCA or other cancer-causing gene mutations), but the long-term treatment for hormone receptor-positive breast cancer is endocrine suppression in order to "starve" the tumor of its primary food source.  Because my cancer was nearly 100% hormone-fed, estrogen suppression was an essential tool for staving off a recurrence.  For young, pre-menopausal women who wish to retain their fertility post-treatment, Tamoxifen is the gold standard and it's usually prescribed for at least 5-10 years.  Pregnancy is strictly contraindicated while undergoing endocrine suppression due to the risk of severe birth defects, which forces many women to postpone if not completely abandon their plans for starting or expanding their families.  For this reason, it is often encouraged to see a fertility specialist before beginning treatment in order to discuss your options should you think there's any possibility you'll want children in the future.  I didn't touch on this subject in my original post mainly because there simply wasn't time to get into absolutely  everything that happened post-diagnosis, but also because it's a very personal thing that I wasn't entirely ready to share, plus it just didn't seem terribly relevant at the time.

Having children hadn't exactly been a priority for me.  I'd spent many years going back and forth between "Absolutely never!" and "Maybe someday, if I meet the right person" before finally landing on "I'm not going to let it be a deal breaker either way."  Cancer, however, left me with not nearly as much say in the matter.  Facing infertility in addition to cancer is definitely a life-altering thing that makes you reevaluate a lot your priorities.  During that process, I decided that if I never procreated, I didn't want it to be because cancer made that decision for me.  So, on the advice of my breast surgeon, I met with a reproductive endocrinologist shortly after my initial surgical consultation.  If I opted to do cryopreservation (a.k.a. "egg freezing"), it would be an expensive, laborious process that would delay the onset of chemo and/or radiation therapy by several months and require specially-timed injections in order to harvest enough eggs for freezing in the hopes that at least one would be viable.  Of course, none of this was covered by my insurance.  Even though I was eligible for financial assistance via the LiveStrong Foundation, it was still a significant chunk of money at a time when I was saving up to buy my first home (not to mention the $500 yearly storage fee for the frozen eggs that I may or may not ever use).  So I decided that I would only proceed with cryopreservation if my Oncotype test came back saying I needed chemo as that would leave me with a roughly 50% chance of never regaining ovarian function.  Once the threat of chemo-induced menopause was eliminated thanks to my low Oncotype score, my only real risk factor left was my age and I was OK with leaving that part up to fate.  I could always use LiveStrong's assistance in the future if I were to change my mind or need IVF, etc.

One positive thing about 5-10 years of Tamoxifen is that, if I did happen to get hit with baby fever before I was finished with it, I was told I could potentially take a break from it in order to try for a pregnancy. (They call that a "Tamoxifen holiday" in the breast cancer community.)  I needed a minimum of 2 years on it before this would be allowed, though, as the first 2 years after diagnosis carry the highest risk of recurrence, which meant I would be 40 before starting a family would even be an option.  Again, I was OK with rolling the dice that way so I elected to cross that bridge if and when I came to it.

Fast-forward to June 5, 2019.  I was having my regular biannual follow-up with my breast surgeon when she brought up the subject of Tamoxifen and babies (as she is wont to do during these appointments).  I was barely 2 months into a new relationship at the time so, needless to say, it wasn't exactly on my radar.  When I told her this, she mentioned a national clinical trial currently recruiting patients at specific research hospitals across the U.S. and around the world (the closest being in Georgetown) which she thought I might be a good candidate for.  My ears quickly perked up at the words "clinical trial."  She said it was called the "POSITIVE" trial, a.k.a. Pregnancy Outcome and Safety of Interrupting Therapy for Women With Endocrine Responsive Breast Cancer.  Its main objective is to investigate whether a temporary interruption of endocrine therapy with the goal to permit pregnancy is associated with a higher risk of breast cancer recurrence.

While many young breast cancer survivors do opt to temporarily interrupt endocrine suppression for the purpose of achieving pregnancy, there's not a lot of data available on whether that puts them at an increased risk of recurrence down the road.  While the current data suggest that a post-cancer pregnancy after treatment is finished poses no increased risk, less is known about a temporary interruption in hormone therapy before resuming after delivery.  This study is looking to evaluate that more deeply.  The basic criteria for enrollment was fairly specific: you had to be between 18 and 42 years of age at the time of enrollment, able to bear children at the time of your original diagnosis, have a history of hormone-positive, early stage invasive breast cancer, and have undergone at least 18 but no more than 30 months of endocrine suppression therapy.  And of course, you had to be willing to get pregnant.  While having children wasn't necessarily paramount for me, the idea of doing it as part of a clinical trial was quite appealing.  I fit the bill for everything they were looking for in a participant.  The main issue was timing.  In June of 2019, I was nearing the end of my 22nd month on Tamoxifen.  If I had to stop taking it after no more than 30 months in order to be eligible for the study, then that put February 2020 as the latest I could enroll.  But (as I soon learned) the trial was only open to 500 participants worldwide and would likely fill up before then.  Sure, I could always take a break later and try on my own.  But I knew that if I were to go down that road at all, this was the way I wanted to do it.  Because not only would I be monitored extra closely by the research team all throughout pregnancy and for 10 years beyond, but I would be contributing to science!  That itself was a pretty strong selling point.  My only worry was: could we really do this?  My relationship was too new to seriously consider such a life-changing step.

I told my surgeon I would think about it and talk it over with my partner.  I also didn't want to do anything without first discussing it with my oncologist since he was the one in charge of my Tamoxifen regimen.  Meanwhile, I contacted the research coordinator at Georgetown just to inquire about what all the study would entail.  She said the first step would be to bring me in for a consultation.  So I set that up, figuring I could just see what it's all about but with no obligation to enroll.  My partner (Brian) and I discussed it later that night. Even though we both agreed it was crazy soon to even be talking about it, it couldn't hurt to have the consultation, and he said he fully supported whatever I ended up deciding.  He even offered to take the afternoon off work to go to the appointment with me.  (Yes, this man was actually entertaining the idea of having a child with me despite only dating me for 2 months and already having 3 teenage children of his own.  That's just how awesome he is!)

Two weeks later, we were in Georgetown meeting with the research coordinator and oncologist in charge of the study there.  I learned that, in order to enroll in the trial, I would have to stop taking Tamoxifen anywhere from 1 day up to 1 month before enrolling.  Then I would have to wait 3-5 months for the "wash-out" period before the drugs were completely cleared out of my system and it would be considered safe to start trying.  At that point, I would have a 2-year window to get pregnant, deliver, and get back on hormone suppression (obviously the sooner the better).  Participation would require regular visits to Georgetown for blood work and exams from the time of enrollment all throughout pregnancy and for several years after delivery in order to monitor my progress.  The study was extremely intriguing but there were quite a few logistics to figure out if we were serious about doing it.  They anticipated the trial filling up in early 2020, which still gave me 6 months of leeway.  A lot could happen in that amount of time but I felt reassured knowing it wasn't a now-or-never ultimatum.  I told them I was definitely interested but I wanted to meet with my oncologist before making a final decision, which I had an appointment to do in mid-August.  So I said I would get back with them after discussing it with him then.

Two months later, on August 14, I had my biannual appointment with my oncologist.  When I told him I was considering doing this study, he was on board to say the least.  In fact, his words were: "Not only are you an ideal candidate but I think you definitely should do it!"  By his reasoning, it would accomplish two things: it would get me off Tamoxifen for a while (the side effects of which were becoming more and more unbearable and I was so ready for a break!), and it would allow me the chance to try to have a baby.  The fact that I'd be doing it in the name of science made it a triple whammy!  His giving me the green light made me feel much more confident about participating, however it was still way too soon and way too much needed to happen first.  I had about 2 weeks left of my current 90-day Tamoxifen supply.  I decided I would refill it one more time, which would put my last day on it as December 14.  One month later, I would officially enroll, wait out the 3-5 month wash-out period, then just kind of see what happens.  Knowing it could be nearly a year before we even started trying made it seem much less daunting.  I even called my mom to get her opinion on the matter.  She agreed this was not the ideal timeline or chronology of events, but loved the idea of me doing a clinical trial--in addition to giving her and Dad their first grandchild!--and they were both very excited about the whole concept.

Tragedy struck, however, exactly two weeks later on August 28, 2019.  My dad was rushed to the hospital that evening where he suddenly and unexpectedly passed away, leaving my whole family shocked and devastated with grief.  He'd been dealing with several illnesses for the last few years and had spent more time in the hospital than out since March of that year, but he always managed to pull through and we all figured this time was no exception.  He and Mom had just flown down to D.C. less than 3 weeks earlier to see me perform in an opera at Wolf Trap and he'd seemed sickly but nowhere near the end, so it was a devastating blow to everyone.  Dealing with his passing left very little bandwidth for much else, but it also gave me a newfound purpose.  My mom was so completely shattered that I wondered if I would ever see her smile or feel the slightest twinge of joy ever again.  She said horrifying things like she wished she could die so she could be with Dad, and that the only thing that made her happy was thinking about dying.  I longed desperately for something that would give her a reason to live and bring her some semblance of happiness in a world where half of her heart was now gone forever.  She'd told me once that she only ever had 2 real dreams in life: to be a mother and to be a grandmother.  I'm pretty sure she and Dad had abandoned all hope of attaining the latter many years ago since my brothers and I were never terribly motivated in that area.  The thought of seeing her holding her grandbaby and finally crying tears of joy instead of sorrow was the final straw that made me determined to see this study through to the very end.

My plan had been to enroll in the trial in January 2020 but, once the dust started to settle after Dad's funeral and I finally got around to following up with the research team, I learned that it was filling up a lot more quickly than expected.  They thought it would be better to enroll me sooner, like mid-December, since it would likely close by the end of the year.  So my appointment was scheduled for Monday, December 16, which meant I could still finish out my current Tamoxifen supply before enrolling.  However, I got another call from them two months later on November 13 stating that the trial was now projected to fill up by the end of that same month, so I needed to be seen as soon as possible.  So my appointment was moved up again to the following Monday, November 18 at 8:30 a.m.  Interestingly enough, I had originally been scheduled for my next biannual follow-up with my breast surgeon at that exact same time that same morning, but her office had called a few days before and moved my appointment to Tuesday the 19th instead.  It was like the path forward was paving itself!

On Sunday, November 17, I took my last Tamoxifen.  The next morning, Brian and I got in his car and headed up to Georgetown.  I was both apprehensive and eager.  Despite looking forward to relief from the side effects, being off hormone suppression made me feel extremely vulnerable, like I was walking a tightrope without a safety net.  Brian expressed concern over how quickly this was happening, but I reassured him (and myself) that it would be at least 3 more months before the wash-out period would be over, and even then we had up to 2 years.  Besides, I trusted the process and had faith that everything would happen exactly when--and if--it was supposed to happen. 

The appointment was mostly for me to sign a bunch of consent forms (including giving them permission to store my blood and tissue samples at a special facility in Milan!), have an exam with the doctor, and get some basic blood work.  I was told I would need to come back a few weeks later for more blood work since they couldn't do it all that same day.  They explained this was because it would be drawn at a special research lab in the facility, so they had to officially enroll me and give me a participant number before they could take my blood for the study, which would take a couple of days.  And because it was a special research lab, it would be paid for by grant funds rather than billed to my insurance, so I would never see the results of that or any other blood work that was drawn there.  I would also have to come back every three months for periodic blood draws, with possible additional visits in between depending on my pregnancy status and how it was progressing.  I had to provide them copies of my breast surgery and pathology reports, my radiation treatment summary, and fill out several psychological questionnaires.  I also had to start keeping a menstrual diary so they could gather as much data about my cycles as possible.  It was going to be a lot of extra work and I was committing to it for at least the next 10 years.  But something inside me just felt unequivocally that this was meant to be part of my path in life.  And if that wasn't enough, I found out the following week that the study had actually filled up literally the same day I was enrolled.  It had been open to 500 participants worldwide.  I was number 500.  It was all the proof I needed that fate's hands were at work.

Once I was officially enrolled, the waiting game began and, as I've mentioned before, patience was never my strong suit.  On one hand, it was nice knowing there was no rush.  But on the other hand, I found myself growing more and more anxious to "just see what happens."  I'd never been pregnant or even tried to get pregnant before.  In fact, I'd spent my entire life avoiding it!  So the whole thing was completely uncharted territory to me.  I'd always expected that if I ever got to a point in my life where I felt children were a possibility, then my partner and I would simply stop using birth control and leave the rest up to fate.  Unfortunately, I no longer had the luxury of being casual about it.  Because of the risks of getting pregnant while on Tamoxifen and the risk of my cancer coming back while off, I either had to be deliberately trying or deliberately NOT trying.  Well, I quickly learned that to be deliberately trying was a completely different animal from just seeing what happened.  So I joined a couple of Facebook groups for women of "advanced maternal age" who were TTC ("Trying To Conceive") and one called Babies After Breast Cancer where I connected with several other women who were also enrolled in the POSITIVE trial.  These groups ended up being tremendous resources for me as someone who was brand new to the TTC community.  I'd essentially had to learn a whole new vocabulary once I became a cancer patient.  The same can be said of TTC.  The acronyms they used were numerous and ranged from purely technical (LH = "Leutenizing Hormone" and DPO = "Days Post-Ovulation") to downright humorous (AF = "Aunt Flo" and BD = "Baby Dance," i.e. sex).

I figured, at my age and with only a 2-year window, I had little time to waste.  So in early January, just before the 2-month mark of the wash-out period, I made 2 phone calls: one to my reproductive endocrinologist to ask if there were any specific vitamins or supplements I should be taking to increase my chances, and one to my OB/GYN for some blood work and family planning counseling.  My endocrinologist recommended some preconception supplements that were specially formulated for older women (and rather pricey at $140 for a 3-month supply), which I started on right away.  My OB/GYN recommended some labs to be taken on day 3 of my next cycle to check my hormone levels, ovarian reserve, etc.  She also gave me an order for a procedure I could have done called an HSG (Hysterosalpingography) which would check my uterus and fallopian tubes for any abnormalities plus clear them of any blockages if found.  Typically they wait to do those until at least 6-12 months of trying without success but, since I was about to turn 41 and had a 2-year time limit, she figured I should probably be a bit more aggressive.

The next 2 months were a flurry of activity.  On February 1, I began a 6-week class at George Mason University to earn my paralegal certificate, something I'd been thinking about doing for several years but always put off for various reasons.  I figured, with everything going on, it was now or never.  I originally registered for the 12-week course at the Loudoun campus but 2 days before the first class, they emailed to inform me that the course had been cancelled due to low enrollment.  They offered me either a full refund, a transfer to the online course already in progress, or a transfer to the 6-week course at the Arlington campus.  I chose to do the 6-week course in Arlington since I needed to get this done ASAP and knew I would do better with live classroom instruction.  But I was freaking out about how I would ever juggle a full-time job Monday through Friday, all-day lectures on Saturday and Sunday, plus studying and completing 5 major writing assignments for 6 full weeks.  I got it done, though, and even finished with the highest grade in the class!  In retrospect, I'm extremely glad it happened that way because I finished in half the time, and the 12-week class likely would have been cancelled halfway through anyway since that's when COVID-19 was declared a pandemic and social distancing measures were being put into place.  It's funny how fate works sometimes, isn't it?

Not everything that happened during those 2 months was good, though.  I had my Day 3 labs drawn on February 11 and the following week, a nurse called me with the results.  Without giving me the specific numbers, she told me they indicated "increased difficulty conceiving" and their recommendation was to follow up with a fertility specialist to discuss IVF.  I was crushed.  Had all of this been for nothing?  I doubted Brian would agree to such aggressive measures and I wasn't sure how I felt about it, either.  I'd told myself that if it didn't happen naturally then I would just accept that it wasn't meant to be, but suddenly I was wondering if I could really accept that so easily.  I scheduled an appointment with my OB/GYN to discuss the results more in-depth and, in the meantime, tried to come to terms with the disappointment that this might not happen for us after all.

When my appointment came, I told my doctor that I wasn't interested in hearing the odds or percentages of my chances to conceive naturally.  I just wanted to know what all I needed to do to maximize them.  Then, I learned that my lab results weren't quite the kiss of death the nurse had made them out to be.  My AMH (Anti-Müllerian Hormone) was low, indicating diminished ovarian reserve, but it was on par for my age.  And my FSH (Follicle Stimulating Hormone) was high, indicating my body has to work harder to get me to ovulate, but it was just barely over the threshold and also typical for women my age.  Everything else was normal.  My doctor explained that at my age, with those numbers, and a confirmed history of endometriosis, my quickest window to pregnancy would be IVF.  However, she reassured me that I was taking all the right steps to maximize my chances of natural conception.  Obviously my odds of that happening at 41 were decidedly less than they were in my 20s, but that wasn't to say it was impossible, and I was doing everything right to increase those odds.  The primary concern at my age is egg quality, and I was already taking doctor-recommended supplements to help improve that, in addition to maintaining a healthy weight through diet and regular exercise, being physically active, plus avoiding tobacco and recreational drugs, all of which can help turn back the hands of time.  When I read my labs to my mom later, she said they honestly sounded fine to her.  Then she reminded me that her office had just delivered a 44-year-old patient that week who had conceived naturally.  I posted my results in some of my TTC groups and received several responses from women who said their numbers were way worse yet they still conceived on their own and carried to term.  So it appeared that the rumors of my ovarian demise had been greatly exaggerated.  (Mark Twain reference - look it up!)  Besides, regardless how few good eggs I had left, all I needed was one.  With that in mind, I decided to be as proactive as possible for the next 6 months, then reevaluate from there.

The oncologist at Georgetown had given me the business card for an acupuncturist in Dupont who specializes in both cancer and fertility patients, so I made an appointment with her for late March.  I bought a bulk supply of ovulation predictor kits and downloaded the accompanying fertility tracker app where I could upload the results, track my cycles, and calculate my optimal days for conception.  I added some probiotics and Omega-3 supplements to my daily regimen, all of which were on the list of recommendations for older women who were TTC.  I also decided I would schedule the HSG sometime in April or May, once my paralegal class was over and I had some time to relax and get back into my normal routine.  On February 18, I hit the 3-month mark of the wash-out period, which meant it was now safe to start trying.  But, as the saying goes, it was out of the frying pan and into the fire.

My class concluded on March 15, just days after coronavirus was declared a global pandemic and life ground to a halt.  My acupuncture appointment was canceled since the office had to close indefinitely.  And although I still went in to work every day since my firm was considered an essential service, they had to furlough a few people in order to cut costs, which made it nearly impossible for me to be out of the office for any reason, especially an elective procedure (i.e. the HSG).  Further, my 41st birthday present from Brian was a trip to New York City the weekend of April 3 (our first anniversary) which of course had to be postponed to a date as yet unknown.  I did my best to deal with the disappointment of all of this while maintaining as much normalcy as possible, and prayed for no more setbacks or disruptions.

On Saturday, March 28, I woke up experiencing mild cramping, which I chalked up to my cycle getting ready to start even though it wasn't due for 5 more days.  That was actually quite discouraging because my ovulation predictor kit had shown a surge on the 18th, meaning I likely ovulated 12-24 hours later, which made me only 9 or 10 days post-ovulation.  If my cycle started too early, it could mean I had a short luteal phase, which would make it even more difficult to conceive.  Treating a luteal phase defect is fairly easy but usually requires progesterone supplements, which I wasn't certain would be safe for me to take since it was one of the hormones that had fueled my cancer.  I'd been told after my diagnosis that I would never again be permitted to use any medications containing additional hormones, no matter how minuscule the dosage.  The clinical trial had given us permission to get pregnant "using whatever means necessary" but I'm sure my oncologist would have an opinion on it, too.  When I brought this up with Brian, he very firmly stated that me being off Tamoxifen for a short while was the farthest he was willing to go for this to happen.  He said, "You're too important to me to do anything else that could put you in danger.  The last thing I want is for you to end up with cancer all over your body."  So I crossed my fingers and prayed that "Aunt Flo" would hold off a few more days so it wouldn't come to that.

The following night (Sunday, March 29), quarantine boredom and a couple glasses of wine convinced me that it would be fun to take a pregnancy test since I had so many of them stashed up and they were so inexpensive.  So I did.  The control line appeared right away but I didn't see a second line.  When I looked closely, there appeared to be a faint indentation (also called an evaporation or "evap" line) where the second line was supposed to be.  I'd seen many women in the TTC groups on Facebook post pictures of similar results asking "Do you see it?" and people would reply, "I see it! Congrats!" while others would say, "I see nothing."  I remember in that moment thinking that I now understood how easy it was to confuse an evap line with a faint positive and why it caused so many women to get their hopes up.  So I chucked the test aside and thought, "Oh, well.  Try again next month."  On Tuesday morning (March 31), the cramps were still ongoing but my cycle still hadn't started.  I decided to test again right after I woke up since that's the best time of day for the most accurate result.  Again, it was more or less just for fun since AF still wasn't due for another 2 days.  I mainly just wanted to see if I could expect it to start soon so the cramps would finally go away.  Immediately, the first line appeared on the strip.  Then the second one.

"Holy f**k!" I gasped.  Was I seeing this correctly?  Although a false negative early on is possible, there's no such thing as a false positive.  And this was very clearly a Big Fat Positive.  I fished out Sunday's test to compare.  Suddenly, that little evap line looked like it may have been a very, very faint positive after all.  "No freaking way!" I thought.  To say I was shocked was an understatement.  But even more than shocked, I was freaked out.  I hadn't expected it to happen so quickly, especially without some sort of medical intervention.  Plus, I always thought I'd be one of those people who could tell the minute she became pregnant, but I felt absolutely no different except for the cramping.  Then I began to wonder if those were implantation cramps, or an indication of early miscarriage.  I called my doctor as soon as their office opened.  They said they usually don't see OB patients until 8 or 9 weeks, but advised me to make an appointment ASAP because of the cramping.  So I went the next day over my lunch hour.  Brian picked me up at work and drove me even though it was right down the street.  But because of the pandemic, he wasn't allowed in the exam room with me or even in the waiting area.  He had to wait outside by the elevators.

When I'd made the appointment, I learned that due to scheduling changes caused by the pandemic, my usual doctor was only seeing patients at their other location for the time being, so I had to see someone new.  Fortunately, I liked her a lot (and in a quirk of fate, she was 8 months pregnant herself!).  She did a quick exam and said everything seemed normal, then drew some blood to check my progesterone and HCG levels.  I expressed my concern to her about being a high-risk pregnancy due to being 41, the fact that this was my first pregnancy ever, and my history of hormone-positive breast cancer, endometriosis, type II diabetes, and hypertension.  My blood pressure had actually gotten so high while I was on the pill that I had to stop and switch to a progesterone-only birth control method.  And since I was about to have more estrogen coursing through my body than ever before, obviously my biggest fear was pre-eclampsia.  The anxiety of that was fresh on my mind since my cousin's girlfriend had just had an emergency c-section 2 weeks earlier after developing that, and a friend of mine had died from it a few years ago at age 34.  I felt that, with all my risk factors, it was practically a given and I didn't want to even think about how that would affect my mom.  While my cousin's girlfriend was in the hospital trying to get her blood pressure to come down, Mom was pacing the floor and saying that she wouldn't be able to relax until she knew the baby was out.  In her words, she's "seen and knows too much."  Imagine how much worse it would be if it were her own daughter.  If anything happened to me the same year she lost Dad, it would almost certainly kill her, too.

My OB assured me I did the right thing by coming in when I did.  She said it was too early to do an ultrasound but they would let me know the results of my blood work and based on that, likely have me come back in 2 weeks for some imaging.  She also advised me to schedule an appointment with my primary doctor to discuss blood pressure meds that were pregnancy-friendly as neither of the ones I'd been prescribed were recommended, and to monitor my BP twice a day and keep a log of it.  Although my BP was fine at the time, the increased estrogen would likely change that once those levels started to climb, but she said there were some preventative measures I could take which we would deal with once I was a little further along.  Then she gave me a written pregnancy confirmation to send to the research team at Georgetown since they required proof for the study.  Seeing my own name next to the words "currently pregnant" was the most surreal thing ever.  It felt like I was watching it in a movie.  My due date was calculated as December 9th based on the date of my last period, which meant, assuming all went as planned, I'd already had my last childless Christmas.  (Talk about your mind being blown!)

Still, I wanted to stay cautiously optimistic since my age carried a higher risk of early miscarriage.  I wanted so badly to tell my mom because not only would she be overjoyed but her expertise would help me with any questions or concerns I didn't want to bother my doctor with.  I'd asked her a few months earlier if she would want to know the second I got a positive pregnancy test or if I should wait until I was out of the danger zone.  She said I could tell her right away since, after 40 years in the industry, she understood how these things can go, so she could handle the disappointment if it didn't stick.  But I didn't want to get her hopes up only for it not to stick and just compound her existing grief.  Plus I felt a text message telling her she was going to be a grandma was so inherently wrong, all things considered.  I asked Brian his opinion and he felt we should hold off telling her for a while for those exact reasons.  I knew it would be extremely hard to wait and I'd have to be very careful not to let it slip, but this way I could tell her on Mother's Day, hopefully in person if the shelter-in-place order is lifted by then and I can travel to Ohio.  But Mother's Day was 6 weeks away and I was already bursting with the news.

With that, I will conclude 2019 B.C. (Before Conception).  Stay tuned for 2020 A.D. (After Delivery)!

2017 Post-Apocalypse: This Is My Life Now

It hasn't quite been 6 months since my last post but I feel like I've aged 30 years. Around this time last June, I was preparing to begin 6 weeks of daily radiation treatments in the wake of my lumpectomy and sentinel lymph node biopsy.  Radiation was surprisingly easy.  The main side effects are skin changes (redness, itching, swelling, etc.) and fatigue.  Because my rad onc opted to give me a lower dose over a longer period of time, my skin held up surprisingly well.  I noticed a slight pinkness after the first 2 treatments so I was bracing myself for the worst sunburn of my life as treatment progressed, but it kind of leveled off after the halfway point.  It was itchy and uncomfortable but nothing I couldn't tolerate.  I did my best to combat the fatigue by staying as active as possible.  I walked to work every morning, walked from work to the hospital for my treatment at noon, walked back to work after, and then walked back home. Plus I continued my thrice-weekly workout regimen.  I never felt a dip in my energy during the day, although I did notice I was falling asleep an hour or 2 earlier at night.  The treatments usually took about 20 minutes each (as long as the machines were functioning properly, which wasn't always the case) and all I had to do was lie on a table with my arm up in a holder while the rads team positioned the machine around me, then they stepped out of the room and pressed a button.  The machine buzzed for about 20 seconds, rotated around to the other side and did the same thing, and that was it.  There was nothing painful about it at all, save having to lie on a table topless in a room full of strangers.  It's amazing how normal that becomes after a while and how much shame you lose in the process.  (This is my life now!)

My last treatment was August 17, after which I had a happy hour to celebrate.  The following weekend was the annual beach camping trip.  I was under strict instructions not to expose the radiated area to the sun for at least the rest of that year, so I had to be very careful about keeping it covered, but it didn't hinder my ability to enjoy my weekend with my friends. The Monday after my last treatment (August 21), I met with my medical oncologist and we discussed the next phase of my journey: the hormone suppression phase.  For pre-menopausal women with hormone receptor-positive cancer, Tamoxifen is the drug of choice and it's not without its side effects.  The most common of these are hot flashes and mood changes (i.e. depression/anxiety), and the others range from as minor as joint/muscle aches to as serious as blood clots and even uterine cancer.  (Yes, I could actually develop cancer in my effort to prevent...cancer.)  My oncologist assured me, though, that he's treated around 1,000 women with Tamoxifen in his lifetime and has seen blood clots happen in only 2 or 3 (all of whom already had other risk factors) but had yet to see any of his patients develop uterine cancer.  All in all, though, I was more worried about the mood changes.  I'm a pretty happy person in general and didn't like the idea of that being messed with.  Well, I've been on it for nearly 4 months now and I can definitely tell a difference, but it's hard to say whether that's from the Tamoxifen or from outside influences.  (I've been under an inordinate amount of stress since the end of September so I may never know the true culprit.)  The hot flashes are very real and frequent, usually at night.  I've woken up in the middle of the night feeling like my skin is on fire.  Some nights, I'm boiling hot and freezing cold at the exact same time.  It's the most otherwordly sensation ever.  Between the hot flashes, random shooting pains, the increased moodiness, and my hair falling out at twice the rate as before, I feel like some little old crazy lady.  I already can't wait until I can stop taking this stuff.  This is my life now.

Cancer taught me many life lessons.  The most jarring one is that, no matter what stage you were diagnosed or how successful your treatment was, it's always going to play a part in your life.  Right before my diagnosis, I was endeavoring to become a homeowner and had put offers on a couple of different properties that I ultimately lost out on.  But I know that was for the best since I don't think I could've handled having surgery and radiation while worrying about going to closing, then packing and moving.  After active treatment ended and the dust was starting to settle, I figured I would start looking again after the first of the year, once I've had my annual merit raise and year-end bonus.  Unexpectedly, I got a call on November 2 from my boss telling me they were so pleased with my performance, especially in light of everything I'd just gone through while continuing to work full-time, they were giving me my raise 2 months early and it would be effective retroactively as of November 1!  You know how they say timing is everything?  Well, this news opened up the doors for me to resume my house hunt ahead of schedule.  At my realtor's urging, I put an offer on a place that following Monday, November 6.  It was accepted!  After a year and a half of looking, I was finally about to become a homeowner!

However, the Monday after that (November 13), was my 6-month post-op unilateral mammogram.  I went in, as usual, expecting to be out in 30 minutes. As usual, the universe had other plans.  I was barely 6 months out from surgery and 3 months out from radiation so they couldn't possibly find any new abnormalities, right?  Wrong.  The radiologist on duty that day informed me that I had a brand new cluster of microcalcifications on that side, near the same spot as last time.  He was recommending a stereotactic biopsy.  I thought maybe he was kidding at first.  I can't even tell you how much my heart broke hearing this news.  I never wanted to repeat the hell of a stereotactic biopsy, especially so soon after the last one.  And what if it came back positive for cancer again?  How was I going to move forward with buying and moving into my soon-to-be new home while recovering from more surgery and/or going through more radiation??  Those little words he spoke carried with them the potential to derail everything I'd been working towards for the past 18 months.  I was so distraught, I couldn't even see straight.  I met with both my surgeon and med onc the following Wednesday for my periodic follow-up appointments.   Neither of them seemed too concerned about this new abnormality (although that was every physician's stance last time).  In the words of my med onc, these things "tend to happen" after radiation and "more often than not" they're benign.  Again, the same scenario as last time so small comfort.

The biopsy was scheduled for Monday, November 20.  I was somewhat glad about that because Victoria would be in town that week for Thanksgiving and staying with me, so I'd have someone around in case anything were to go wrong.  But I was also not so happy about that because, with my doctor's office being closed for the holiday on Thursday and Friday, I probably wouldn't learn the results until the following Monday, which meant 2 full weeks of stressing and not knowing if I'd be able to move forward with my home purchase.  Remember when I said waiting patiently has never been my forte?  Well, that's probably the one thing in my life that cancer hasn't changed.

If there's anything positive I can say about having to go through another stereotactic biopsy merely 7 months after the first one, it's that it didn't hurt nearly as bad the second time around.  (Nothing like radiation beams to toughen your skin up like leather!)  Also, the results came back much sooner than I was anticipating.  I had the procedure done Monday afternoon.  On Wednesday morning, I got a call from my surgeon's office informing me that everything had come back benign.  It was kind of surreal hearing those words when I was so used to hearing differently, but I'll take it!  Now I could close on my house without the additional stress of a new cancer diagnosis and treatment looming ahead of me!  I spent Black Friday weekend at Burke's beach house in Rehoboth, just like I'd done the weekend after my previous biopsy.  Only this time with much less depressing news.

However, it simply isn't in my nature to not challenge myself or push myself to the limit.  In addition to dealing with this new abnormality, preparing for closing, finding a sublettor to finish out my current lease, traveling out of state for the holidays, then packing and moving, plus my existing workload at my full-time job, I also agreed to perform in a Christmas concert at the Slovenian embassy the day after my closing date.  And not just as a chorister but as one of the featured soloists!  So on top of everything else, I was now tasked with learning music and juggling a rehearsal schedule. So this is what the last couple weeks of my most transformative year to-date will look like: Dress rehearsal (and Kirby's 13th birthday!) today, closing tomorrow followed by a small celebratory happy hour, concert on Saturday, annual Christmas party/gift exchange at Rob and Christina's house on Sunday, begin packing on Monday, move small things on Saturday, fly to Ohio on Sunday, fly back to Virginia on Wednesday, finish moving furniture and big items on Thursday, clean my old place on Friday (including having the carpets professionally cleaned, as per the terms of my lease) and do a final walk-through at some point, then possibly travel somewhere for New Year's weekend Friday or Saturday.  Just these next 4 days are more action-packed than some people's entire months!  At this rate, I won't even be unpacked and settled into my new place until mid-January, if that soon!  I'm hoping to have a housewarming party sometime before my birthday, but who even knows.

As I stated earlier, one thing I've learned this year (and over the past month especially) is that cancer will always play a part in your life.  Whether it's dealing with the long-term side effects of treatment, the fear of recurrence, or the anxiety of what could be lurking below the surface at every yearly screening, you're never completely free from it.  I went in for my 6-month scans thinking the whole ordeal was behind me only to find out differently.  I've realized that you should never talk about cancer in the past tense because it's never in the past.  In a way, being diagnosed is like being reaped for The Hunger Games in the post-apocalyptic world of Panem: There are victors, but there are no real winners.  You may best the other tributes, but you never get off that victory train.  And someday, when you least expect it, you could get pulled right back into that arena to fight all over again. 

Today, on the eve of my becoming a homeowner, I'm feeling both excitement and dread.  After having to move 4 times in 12 1/2 months a few years ago, it still feels too soon to be boxing up my entire life and doing it again.  Once that's behind me, hopefully I can relax a little and enjoy no longer being a renter.  But who knows what 2018 will have in store for me?  It boggles my mind to think about everything that's transpired in just the last 8 months.  I always said I like to keep busy, but this is an awful lot of busy-ness, even for me.  Despite all I have or soon will accomplish, I will never look back on 2017 as having been a "good" year.  Momentous, yes, but the bad and the good carry equal weight, in my opinion.  However, I'm happy to at least be ending it on a high note.  And how many other people can say they beat cancer and bought their first home in the same year?  Not too many, I'd wager.  In the words of John Locke on "Lost": "Don't ever tell me what I can't do!"  Facing challenges and rising above them: this is my life now.

2017 B.C. and A.D.

Friday, April 28, 2017 is a date that will remain etched in my memory because it's the day my life changed forever.  It was the day my "probably nothing" became a huge "something."  It was the day I knew I could never go back to being the person I was so used to being up until that point.  It was the first time I'd heard those dreaded words spoken to me instead of to someone else.  It was the day I joined the greatest sisterhood I never wanted to be a part of.  It was the day of my cancer diagnosis.

2017 B.C. (Before Cancer)

It was the evening of April 5, 2017 when I found The Lump.  I remember the exact date because the first thing I did was text my mother, so the date is not only fixed firmly in my own memory but is also eternally time stamped in the Cloud.  I also remember it because it was a mere 6 days after my annual physical, where my primary care physician had dutifully performed all standard examinations yet felt nothing amiss.  I don't quite remember how I found it, though.  I was sitting in front of my television watching "Jeopardy!" (oh, the irony!) and just happened to have my hand in the right place at the right time.  I wasn't performing a self-exam or anything laudable like that.  I believe I was mindlessly scratching an itch or something.  It was small (just slightly larger than a pea) but palpable and non-painful.  It's the kind of thing you always train your brain to be on the lookout for, but don't expect to actually find.  Regardless, I was more curious than alarmed.  It was located just distal to my underarm, near my axillary lymph nodes, so I figured it was probably just a swollen node.  My text to my mom was to that effect as well.  She assured me there are plenty of things in that area that can get blocked or swollen and, with more than 30 years of nursing experience under her belt, I had no reason to doubt her.  I was also busy rehearsing for an opera performance coming up that weekend, so rather than calling my doctor, I waited a few days to see if it would go away on its own.  Needless to say, it didn't.

The following Monday (April 10) was when I finally called my doctor and not even to schedule an appointment but to find out if she had made any notes in my chart at my last visit that might explain what the lump was or where it came from.  She hadn't, so her medical assistant advised me to make an appointment to come in and have it checked, which I scheduled for the next morning.  I still wasn't concerned at that point.  I was mainly just tired of wondering what it could be and interested in finding out what it was.  When my doctor felt it, she didn't seem worried either.  She said it was "probably nothing" but gave me an order for a breast ultrasound just to be sure.  When I called to schedule the ultrasound, they offered me a time the next day but I was reluctant to take time off work 2 days in a row, so I selected an early morning appointment for the following week on Wednesday, April 19.

I thought I'd be in and out of that appointment in 30 minutes.  Instead, the tech was hesitant to do the ultrasound before doing a mammogram first, which I didn't have an order for.  She explained that mammograms often pick up things an ultrasound does not, so they attempted to call my doctor's office to obtain an order for one but were unable to reach her directly.  I sat in the waiting area for two hours while they continued to try to reach her.  I was draped in a drab, sterile hospital gown and surrounded by dozens of anxious women (most of them many years my senior) and growing more and more annoyed by the delay.  Eventually, they decided to just proceed with the ultrasound while they waited.  The mammogram order came in via fax while I was on the table having the ultrasound done, so I went straight from there into the mammogram room.  

At 38 years old, I'd never had a mammogram before and was extremely apprehensive since I'd heard so many horror stories about how painful they are.  Well, those fears turned out to be completely unfounded because there was nothing painful about the procedure at all.  However, the images revealed an additional abnormality: a cluster of microcalcifications near the palpable lump.  They ended up calling me back in to take additional images with higher magnification and some in 3D.  The radiologist on duty didn't seem to like what he saw, but didn't mention the "C" word just yet.  He just said they weren't sure what it was but there were things about it that concerned them, so he recommended I have both areas biopsied "sooner rather than later."  The lump would be an ultrasound-guided biopsy, and the calcifications would be a stereotactic-guided biopsy.  (Stereotactic = a mammogram done by lying face-down on a special table with your womanhood hanging down through a hole and squished between 2 paddles with X-ray vision.)  Those were scheduled for the following Monday, April 24, and would necessitate taking an entire afternoon off work.  A couple business days after the mammogram, I received my first ever BIRADS categorization via the report uploaded on my online patient portal.  It was Category 4: "Suspicious abnormality."  I'd spent 4 years working in an OB/GYN office.  I'd seen reports like that many times, most of which came back fine.  Statistically, a category 4 only comes back positive for malignancy 30% of the time.  The report was unsettling, but the odds were still very much in my favor.

Biopsies are never pleasant but a stereotactic-guided one is the closest to hell on earth I've ever been.  For the ultrasound-guided one, the area was numbed first with lidocaine so I didn't feel the spring-loaded needle going in, but I felt the impact of it punching through my skin and hitting my rib cage.  I also felt it every time they took a piece of tissue (4 or 5 in all) and it was like someone punching me in the side hard enough to knock the air out of my lungs.  The radiologist immediately looked at the tissue samples under a microscope.  He was hoping they would also contain bits of the microcalcifications and therefore eliminate the need for the stereotactic biopsy, but they didn't.  Again, the area was numbed with plenty of lidocaine, but lying on that special table was excruciating.  The hard plastic edges of the hole kept digging into my clavicle and sternum and there was so much pressure on my chest wall, it was hard to breathe.  But I couldn't move even a little bit or they would lose sight of the area being biopsied.  I used my left thumb to press down on the table just enough to take some of the pressure off my bones, but it did very little to alleviate my discomfort.  I felt the pinch of that needle going in, too, even through all the lidocaine.  After taking a few samples, they checked them under a microscope to verify they contained parts of the calcifications while I continued to lie on the table with a needle hanging out of my chest, "Pulp Fiction"-style.  The entire appointment lasted more than 2 hours, after which I felt like I'd been pushed to the ground and kicked repeatedly.  The radiologist said the results should be in by the end of the week and he'd call me with them as soon as they came in.

The morning of Friday, April 28, I got a call, but not from the radiologist.  It was from my primary care doctor's office and it was her medical assistant on the other end.  She informed me my doctor wanted me to come in to discuss the results of the biopsies "sometime today."  That was the first time I felt any fear or trepidation.  Having worked in the medical field, I know how these things are done and I knew this was not good.  I said that out loud, too, but the M.A. played it off, claiming she didn't know (which is what I used to say to people and the truth was: I knew but I wasn't authorized to give results over the phone).  I started freaking out and called my mom as soon as I hung up the phone.  She agreed this was probably not good, but didn't feel like I should panic just yet.  She did suggest I have someone go to the appointment with me, so I called Heather.  She graciously agreed to accompany me and even drive me to it.  My appointment was at 12:30 so I left for lunch at noon, stopped home to let Kirby out and meet Heather, then we continued straight to my doctor's office.  I can still remember my heart pounding inside my chest the whole time.  I remember the nurse taking my vitals and me getting a glimpse of her laptop sitting on the counter with my chart open and the words "Abnormal Lab Results" leaping off the screen at me as the reason for that day's visit.  I remember the moment my doctor walked into the room with a large manila envelope in her hand bearing my name in crude but ominous black sharpie ink.  Most of all, I remember her bracing me for the results and the utter disbelief I felt upon hearing her say, "Unfortunately, both biopsies came back positive for cancer."

I've studied 6 foreign languages in my life.  I'm fairly proficient in 4 of them, minored in one, and know at least a basic phrase in over twenty more.  Yet, in that moment, I could only think of one word.  One word in all forms of discourse that adequately summed up my shock, horror, disbelief, and plain disgust upon hearing this news: "Fuck!"  My doctor seemed optimistic, though.  She said she'd already scheduled me a consultation with a breast surgeon for the following Wednesday and that I would most likely have a lumpectomy followed by radiation, and assured me that my cancer was the most common and treatable kind of breast cancer.  Even so, I knew I wouldn't be able to go back to work that day.  Heather invited me back to her and Jesse's house so we could spend the rest of the afternoon sipping wine and decompressing, so that's what we did.  Sneha joined us later.  Once there, I jumped on my phone and started reaching out to people I knew who had gone through this, asking for advice or any kind of heads-up they could give me on what was to come.  Between their encouraging words and being surrounded by such an awesome and supportive group of friends, I knew right then that I would not be going through this alone.  But the worst part wasn't knowing I had cancer.  It wasn't wondering if I could beat it.  I knew I could beat it.  The worst part was not knowing what I would have to go through to do just that.  I had very few answers at that point and could do nothing but wait to find out.  Waiting patiently has never been my forte.  Well, I was about to discover new reserves of strength beyond anything I ever realized I was capable of.

2017 A.D. (After Diagnosis)

Cancer patients often divide their lives into pre- and post-cancer eras.  Once you've been diagnosed, you understand why.  Nothing is ever the way it was before hearing those words.  Not everything is worse, but everything is definitely different.  They even refer to it as "The New Normal."  You start to think differently.  You question every decision you've ever made, wondering if it played a part, and you second guess every new decision you make for the same reason.  You feel differently, too.  You exercise the utmost self-care.  Minor aches and pains are suddenly a huge threat and a sign of recurrence or metastases.  You also become very, very busy.  You're physically and emotionally drained because of just how busy you are and how much time and attention your diagnosis commands.  It's a very high-maintenance disease and it takes over your life (and mind) completely.  And there's also the anxiety of knowing your very own body has turned against you.  I used to think not feeling safe in my own home was the worst feeling imaginable.  I never even considered not feeling safe in my own skin.

My first few days after diagnosis were actually pretty pleasant.  I spent them at the beach with Burke and we busied ourselves with painting the back deck of his beach house and sipping wine on the shore.  The weather was perfect and the salty aroma of the Atlantic ocean rolling up onto the sand was both soothing and purifying.  I almost forgot all about that thing growing inside my body.  The knot in my stomach returned immediately after starting the drive home and got tighter and tighter the closer we got to D.C.  I was dreading everything that was waiting for me back there, especially having to face the people at work who were probably wondering why I didn't return after leaving for lunch on Friday.  I used to feel "icky" talking about health issues with anyone other than close friends or family.  I didn't know yet if I wanted to "come out" with this or not.  I wasn't sure if I wanted to share the worst news I've ever gotten with people I didn't know all that well, or how open I wanted to be about it.  It's an extremely personal thing and posting anything about it to the public felt akin to reading my diary out loud on national television.

Wednesday, May 3 was my first appointment with my surgical oncologist.  I'd had 5 days to absorb the initial shock, now it was time to start learning.  One thing that comes with a diagnosis of cancer is a bit of a crash-course in medicine.  Luckily, I already had a head start having worked in the field and taken correspondence courses in pathology and medical terminology, so I put those skills to good use in the days leading up to my appointment and studied everything on my report closely, looking up anything I didn't understand right away.  At my appointment, I learned not only what everything on that report meant, but how it would affect my treatment plan going forward.  

There were 2 diagnoses on my report: Ductal Carcinoma In Situ (DCIS) and moderately-differentiated Invasive Ductal Carcinoma (IDC).  The calcifications that had appeared on my mammogram were the DCIS.  Basically, at some point in time, abnormal cells had begun growing inside one of my milk ducts.  The lump I'd felt was the IDC and it was from those cells breaking out of the duct and infiltrating the surrounding tissue.  The moderately-differentiated part meant it was grade 2, not the most aggressive or fastest growing cells (grade 3) but also not the least (grade 1).  The tumor was just under a centimeter in diameter when it was biopsied.  My lymph nodes had appeared normal in all my diagnostic scans so there was no suspected lymph involvement at the time.  That and the tumor's small size gave me a preliminary staging of Stage 1.  The pathology lab had tested the tumor for hormone receptors and found it was >90% positive for both estrogen and progesterone receptors, meaning my own hormones were heavily feeding the tumor.  That, however, is actually a good thing because it means hormone suppression therapy will be very effective at preventing recurrence.  And the high percentage of those receptors was a good indicator that this was very early stage because receptors often start to die off the longer a tumor stays in your body.  They also tested it for a protein called HER2 which aids the tumor's growth and found it was negative, which is another very good thing.  So far, everything was very promising.  My surgeon explained that the first thing on my To-Do list was an MRI to rule out any other abnormalities lurking below the surface.  Assuming everything came back normal, we would do a lumpectomy to remove the cancerous tissue and also a sentinel node biopsy to check for any lymph node involvement.  The surgery itself would be wire-guided and those wires would be inserted stereotactically, which meant lying on that godforsaken table once again and reliving the hell of the stereo-guided biopsy.  About 4 weeks after surgery, I would most likely begin radiation therapy which would be done every day for 3 1/2 to 6 weeks, the total length of time depending on whether there was any lymph node involvement at the time of surgery or not.  Once radiation was complete, I'd start taking a pill every day called Tamoxifen to shut down the estrogen receptors in my breast tissue in order to prevent a recurrence.  That would be the longest part of my treatment plan because I would be on it for at least 5 but most likely 10 years.  I also would need to visit my OB/GYN as soon as possible to have my Nexplanon implant removed from my arm.  Because my tumor was hormone receptor-positive, I will never again be able to use any birth control containing hormones.  That was a slap in the face after working so long and hard to find a birth control method that gave me the results I wanted without debilitating side effects, but I had bigger problems now.

The whole plan sounded very doable.  I was mainly just relieved she didn't mention chemo.  The only possible hiccup was the results of my genetic testing, which she was sending me to a genetic counselor to do.  If my tests came back showing I'm a carrier of any of the BRCA or other known cancer-causing gene mutations, the stakes would be significantly raised and she would probably recommend a mastectomy rather than a lumpectomy.  It wasn't until my pre-op appointment on 12th that I learned chemo was in fact very much on the table.  There's a relatively new (roughly 10 years old) test performed only on early stage, hormone receptor-positive, HER2-negative breast cancer called the Oncotype Dx wherein they test the tumor for 21 different genetic markers (note: these are the tumor's genes, not my own) and assign it a score of 1-100 based on how likely it is to recur.  A low score is 1-18, 19-30 is in the middle, and 31+ is high.  A low score meant my treatment would consist of radiation and Tamoxifen only.  A high score would mean chemotherapy and then radiation and Tamoxifen.  A middle score would depend which end of the spectrum it fell on.  Even a smack-dab-in-the-middle score would likely mean chemotherapy since, she explained, I'm still young and have many years left for this to come back, so they will want to treat it as aggressively as possible.  So, I'd gone from thinking I was only having a lumpectomy and radiation to realizing I could possibly be facing a mastectomy and/or chemotherapy, too.  Again, the waiting and the unknowns were the most taxing and excruciating part.

They scheduled all of my necessary appointments for me at my initial surgical consultation, so I had that much less to worry about.  The first thing I did was the MRI, which came back showing only the previously-known abnormalities.  Then I had the Nexplanon removed, which meant going back to dealing with all the issues I'd had pre-birth control, but it is what it is.  I then met with the genetic counselor and was tested for the entire spectrum of known gene mutations, all of which came back negative.  Mastectomy was officially off the table!  I'd pressed for a surgery date as soon as possible and it had been scheduled during my surgical consultation for Thursday, May 18, a mere 20 days after my diagnosis.  My doctor cautioned me that operating that quickly could end up resulting in a second surgery if my genetic testing came back afterward showing a mutation.  I elected to take that gamble and, luckily, it paid off.  The day before surgery, my parents drove down from Ohio to stay with me and help me during recovery.  My dad had just completed 8 weeks of radiation for prostate cancer back in February and was still dealing with all the side effects, which is enough to give pause to anyone staring down that road.  It was like watching a horror movie right before going to bed.

The day of the surgery was very long.  The operation itself was at 3 pm and would only take 60-90 minutes, but the hard part was everything leading up to it.  Not only did I have to lie on that ungodly uncomfortable table again so they could insert the wires to guide the surgery, but they had to inject me with a special radioactive dye in order to find which lymph nodes lit up first (a.k.a. the sentinel nodes, the ones the cancer would most likely spread to first).  I had to put on a special lidocaine cream an hour before my 10:30 a.m. arrival time and cover it in saran wrap.  Then I had to go to the imaging center so they could do the wire placement.  Not only was that even more painful than the biopsy but it took 3 times as long because they had an extremely difficult time finding the right area on the paddles.  And I was in so much discomfort at one point, I shifted just a bit too much trying to alleviate it and they had to start all over.  Once they finally got the wires in, they taped them down to my skin so I wouldn't have to walk over to the surgery center with them poking out of my shirt like broken guitar strings.  Then they did another mammogram (my 2nd one ever in less than a month) to make sure the wires had been correctly placed by the area to be excised.  Then I got shuttled over to the surgery center where my nurse navigator met me at the entrance.  She led me down to Nuclear Medicine, where they would inject the radioactive dye into me.  I'm still not sure why I really needed to apply all that cream because they wiped it all off and sprayed me with an ice-cold numbing spray for 30 seconds before inserting each of the needles containing the dye (3 times total).  Then they rolled me under a fancy machine, waited 5-10 minutes as they watched the sentinel nodes light up on the screen one by one, then took me to my pre-op room and instructed me to change into my surgery gown.  By this time, it was after 2 pm, I hadn't been able to eat or drink anything all day, and I was starving and dying of thirst.  I felt a little better once they put an IV in my arm and got some fluids in me, but I still just wanted them to knock me out already so I could wake up and finally eat something.  All day long, no less than 5 different people with 5 different roles in the surgery walked into the room and asked me the same questions they are required to ask every surgery patient multiple times: What's your name?  What's your date of birth?  What's your diagnosis?  Which breast are we doing?  A couple of them even initialed the side being operated on with a marker, like they were branding me.  They said it's a way to be absolutely sure of the correct side.  I wondered how many times they'd gotten it wrong before adopting that protocol.

Surgery got started slightly earlier than scheduled.  I remember up until the moment they said: "OK, we're turning the gas on now."  Next thing I knew, they woke me up in the OR and said everything was done and it had gone very well.  My parents met me in my recovery room with some flowers and chocolate that had been sent down by my friend and former roommate Giselle, who was working just upstairs in IMAR.  A nurse came in and fed me a Percocet even though I didn't feel any pain at that point, then they removed my IV, let me change back into my pajamas, put me in a wheelchair and rolled me outside to patient discharge and sent me home.  Burke and Heather both came over later that night to visit and/or bring flowers and even more people sent flowers and gifts the day after.  The first few days post-op were relatively peaceful and only mildly painful.  The one-week mark was the worst, when my pain and swelling were at peak levels.  I almost went to the emergency room Wednesday night since I figured there was no way this much pain this many days out could be normal.  My surgeon and her Nurse Practitioner both assured me that everything was healing normally, though.

Four days after surgery, my surgical pathology report was uploaded to my patient portal.  My heart pounded with anticipation as I read through it.  But my anxiety quickly turned into great relief when I reached the part saying all tumor margins were uninvolved (i.e. clear), no lymphovascular invasion had been identified, and all 4 sentinel nodes biopsied were negative for carcinoma.  It was some of the best news I'd read to-date.

However, at my first post-op appointment, I found out I would need to have yet another mammogram.  At the time of my original biopsies, the radiologist had left 2 extremely tiny wire clips in the biopsied areas.  I was told this was to mark them so that any future images would automatically denote those abnormalities as having already been checked (this was before they knew it was cancer, obviously).  Only one of those 2 clips had been located in the tissue excised during my surgery so they wanted to check to see if the other one was still in there.  Even though the previous two mammograms hadn't been painful, I was now extremely swollen and tender from the surgery and couldn't stand the thought of being touched near my incision, let alone squished.  My surgeon said she'd give me another week to heal before making me do it, but the idea still brought tears to my eyes.  So much so that I decided to take the whole day off work and take a Percocet the morning of the appointment.  Well, either the Percocet worked really well or they were extra gentle with me that day because it wasn't nearly as painful as I was expecting.  Uncomfortable, but not searing.  They didn't find the clip in there either, so they concluded it must have been suctioned out at some point during surgery.  I happened to catch sight of the images, though, and noticed 2 new additions appearing as white rod shapes.  I later learned those were "rads markers" (little rods inserted by my surgeon so the radiation oncologist would know where to aim the beams) and they would be in there for the rest of my life.

I had my 2-week post-op appointment later that afternoon.  I thought I'd learn the results of the Oncotype Dx at that time, but was told the test still wasn't back yet.  I was assured the wait had nothing to do with the results being good or bad, it was just a test that takes several weeks to complete.  My surgeon's office then scheduled my first consultation appointments with the 2 newest members of my oncology team: my radiation oncologist who would be overseeing all my rads treatments, and my medical oncologist who would basically be taking over my care from that point on, including any chemotherapy if needed.  The trouble was, without the Onco Dx score, we weren't sure yet which doctor I would be dealing with first.  I was so tired of not knowing the plan at that point, I was almost too mentally drained to even care anymore.

Wednesday, June 7 (less than 3 weeks after surgery), I met with my medical oncologist.  We talked more in depth about what the next 10 years or so of my life would look like and also how chemo would play out.  He was recommending a kind called TC, which is less aggressive and better tolerated than its counterpart AC.  If needed, I would have one treatment every 3 weeks, 4 in total.  There was another even less aggressive but old-school option called CMF that we discussed.  The side effects were even milder but since it was 2-3% less effective in the long-term, he would only recommend it if my Oncotype score was in the low 20's.  Anything higher than 22 or 23, he wouldn't feel comfortable going that route and would recommend TC.  My window for escaping chemo was getting narrower and narrower.  I asked if there was any sort of guess he could hazard on what the Oncotype results might be.  I was told there really is no way to predict it, but he did say he'd be surprised if my score was 31 or higher, although not surprised if it was in the mid-20's.

The next day, I met with my radiation oncologist.  It was mostly a talk visit.  I learned, however, I'd be doing radiation for a full 6 weeks.  I'd been under the impression it would only be 3 1/2 weeks since there was no node involvement, but he informed me it would be given in lower doses over a longer period of time to help lessen the side effects.  Thinking back to all the side effects my dad was still dealing with, I was actually grateful for that.  My visit ended with him saying, "Give us a call as soon as you know when you're going to be starting treatment."

Five days later (Tuesday, June 13), I finally got my answer.  I was expecting my surgeon to be the one to call me since she'd said she would at my last post-op appointment, but it was my medical oncologist.  I quickly flashed back to the last time I was waiting for results and the physician I was expecting to call me with them didn't (i.e. my biopsy) so my heart sank, expecting to hear the worst.  Why else would my medical oncologist be calling me except to schedule my first chemo infusion?  I even said to him, "You're going to give me bad news, aren't you?"  To my amazement, he replied, "No, actually I'm going to give you good news!"  My score was 10!!!  So not only was it low, but it was a solid low, not even a grey area!  Chemo was completely off the table!  I nearly burst into tears, I was so relieved!  I was still at work but couldn't help jumping up and down in my office and it took a couple hours for my hands to even stop shaking.  We ended the call with him instructing me to call my rads team and get back in touch with him once I'm finished with treatments.

I called my rads team the next morning and they scheduled me for my simulation (sort of like a dress rehearsal) for the following Thursday, June 22.  I don't think the staff had ever seen anyone as excited as I was to begin radiation, but I was still riding the high of having dodged the chemo bullet.  For the simulation, I basically just lied down on what looked similar to an MRI or a CT scan machine with my arm draped lazily above my head in a special holder while they took images and gauged where the beams would be aimed at the area being treated.  I didn't meet with the oncologist that day, just the radiation therapist.  She took the images and placed X's on my body with a black marker.  She then informed me those X's would be tattooed over (permanently) with little blue dots to ensure they wouldn't wash off during treatment.  I was stunned.  I have 2 tattoos, but they were both carefully thought out and obtained by choice.  I had just acquired a new surgical scar, not to mention additional rads markers below the surface that would be in there for life.  I wasn't wild about having any more permanent marks on me that I didn't ask for, especially ones that would be visible every time I wore a V-neck.  She offered to use the temporary marks instead and cover them with a strong adhesive, but advised that if they came off, we'd have to repeat the whole process of simulating and marking me all over again.  I made her a little deal: "Let's do temp ones first.  If they come off, then you can tattoo me."  So that's what we did.  (So far, so good!)

As soon as that was done, we scheduled my entire treatment course.  I would start one week from that day: Thursday, June 29.  I wouldn't have any treatments on July 3 or 4 since the center is closed for the holiday, but I would have 33 total through August 16.  I was happy with that since the annual beach camping trip was the weekend of August 25 and I wanted at least a week to heal.  The next day, however, I booked a flight home for my 20-year High School reunion on August 11 so I had to call to cancel that day's treatment and schedule a make-up on the 17th.

Today is my first session.  My appointments are all scheduled for roughly the same time over the noon hour, so I can go during lunch and come back to work after.  Since the hospital is just down the street from my office, it'll be a minimal disruption to my day.  The only issue is having to let Kirby out at lunch, but my parents had been looking for an opportunity to take her to Ohio with them for a while, so now they have the perfect excuse.  They plan to come down on July 9 and stay for a couple days then take her home with them until they come back down on Labor Day weekend, so I'll only have 5 treatments I'll need to rush to after stopping home to let her out.  I only started feeling slightly nervous yesterday morning, but remembering that I could have been preparing for chemo instead wipes that out pretty quickly.

It's been a busy 2 months.  Another 2 months or so of busy-ness then hopefully my old routine can resume, insofar as possible.  It hasn't been an easy road by a long shot, but a part of me feels like I got off with a slap on the wrist, having dodged every major obstacle I could have hit.  I'm not completely out of the woods, though, and, in fact, never will be as the threat of recurrence or metastases is ever-present no matter what stage you were diagnosed.  Life as I knew it is over.  But I will slowly adjust to my New Normal just as soon as I figure out what exactly that is.

To The Man Who Promised So Much And Delivered So Little

I'll never be able to reconcile the person I thought you were with the person you turned out to be.  You came to me right when I needed you the most, then turned your back on me when I needed you the worst.  You magically stitched together the huge gaping wound in my heart, only to tear open a huge gaping wound in my soul.  You completely transformed my life, only to permanently depart from it.  You showed me everything I ever wanted, then made it everything I could never have.  You taught me that I could love again, then denied me the person I wanted to share that love with.

I was completely broken when I met you.  You made me feel whole again.  You filled in all the missing pieces to myself.  As imperfect as you were, your imperfections fit perfectly with mine.  You made me feel part of something amazing.  You made me feel like I was finally part of something real.

Except it wasn't.

None of what you purported yourself to be was real.  Your magical healing power that stitched together all my broken pieces was merely a temporary fix--a band-aid, not a cure--and when you took it away, it all fell apart again.  I was forced to face how ill-prepared I was to stand on my own.  I was forced to fix me.

In a weird way, I have you to thank.  You denying me your love helped me discover how surrounded by love I truly am.  Your failures made me see how much I've succeeded in spite of losing you.

Because you are a lie.

I see now that the person I grieved for never really existed.  (When that's the case, can it even be considered a loss?)  Because of your falsities, I've learned what the truth is.  I've learned that the persona you portray is as weak and as fallible as I was when I met you.

You built me up like a house on the sand, and then you laid bare my foundation.  Because of your destruction, I was forced to sift through the rubble for all the pieces I'd been missing, until I emerged--rebuilt and reborn.  Because of you, I have achieved completion.  Because of you, I lost everything.  And found myself.

The End of the Long, Winding Road

Kia passed away last May.  (Cinco de Mayo, to be exact.)  She did so well for so long.  Her appetite began slowing down towards the end of February but she still appeared healthy.  She and Kirby went back to Ohio to stay with my parents for a bit while I spent my birthday weekend in Seattle, and I had yet another roommate change the following Friday, so I thought she might just be stressed.  But on Easter weekend, I went down to North Carolina with my boyfriend and came home to an entirely different cat.  She looked gaunt, weak, and her eyes were extremely sunken in and fogged over.  It was shocking.  I took her to the vet on Monday and they upped her chemo treatments back to 3 times a week, but their best prognosis was that the lymphoma was probably catching up to her and it was only a matter of time at this point.  I spent the last 2 weeks of her life feeding her extremely mushy food through a dropper.  It was a long, tedious, and painstaking process.

The night before she died, I cleaned off all the dried up food from her paws and face, then put her on a warm pad, covered her up with one of my sweaters, held her paw, and listened to serene gospel music with her.  While I was doing that, the song "I Surrender All" began playing.  I suddenly remembered my grandmother's final moments in the nursing home as her cancer was taking over and her entire body began shutting down: She had barely moved in several days and didn't even appear to be with us anymore.  Then that song started playing on the TV in her room and she sat up in her bed, raised her hand and began singing along to it.  Then she laid back down, went to sleep and never sat up again.

I held Kia's paw and told her that I was surrendering her.  If she was ready to go, then she had my blessing to surrender as well.  I came home from work the next day and found her lying on the floor of my room, in the sunbeam of the window next to my bed.  As heartbreaking as it was, I was so relieved that she went on her own, peacefully.  I've never been comfortable with the idea of ending another being's life using a syringe full of poison and I knew it was a decision I would never be able to make for any of my babies, so I'm glad it happened naturally.  I miss her so incredibly much but I'm happy that she's free now and that she went on her own terms.  I decided to have her cremated.  Her ashes are on a little shelf in the corner of my room next to a framed copy of the Rainbow Bridge poem.  I take comfort in knowing that a part of her is still physically present.

Although my life has stabilized in the 400 or so days since my last post, it's still not been without its shakeups.  Losing Kia was the worst part.  Besides that, I got rear-ended in January and, although the damage wasn't terrible, the insurance company declared my car a total loss since the cost to repair it exceeded the car's blue book value.  It looked like I was going to have to say goodbye to the beloved Mustang I had spent several years searching for and fought like hell to keep throughout all those periods of unemployment and roommateless-ness.  But, she's still plugging away and getting me where I need to go, just not looking quite as pretty as before.  Clearly a 15-year-old car is not going to last forever, but I will hang on as long as I can.  I also had to find a new roommate in February (since, apparently, living in the same place with the same person for more than one year is completely unattainable in DC).  Fortunately, this roommate and I signed a 14-month lease, so we're locked in until April 30, 2015.  That means I can at least get through my next birthday without spending it stressing out about finding someone and coordinating the change-over.  There's been a lot of changes at work, too: one of the attorneys passed away suddenly just before Thanksgiving, then 3 of my co-workers left this past spring/summer, and another one of the attorneys is leaving at the end of this month.

On the plus side, I've done a lot of traveling this year: Seattle for my birthday, North Carolina with JP for Easter, the annual beach camping trip in June, Napa Valley for JP's birthday in August, now he and I are preparing for a return trip to NC next weekend, and a visit to Ohio 2 weekends after that for my parents' anniversary.  I still can't seriously plan more than a month ahead, though.  Halloween is about the cut-off point right now, and even that's a little fuzzy.  Currently, I am looking forward to drinking wine and watching football with JP today and the rest of this weekend up through Monday night (Pats v. Chiefs!).  Other than that, this duck continues to float on the water along with the current.  Fortunately, I've found a current I like and will continue to ride it out for however long it takes to reach the other side.  I have no time frame for doing so nor am I in a huge hurry to finish.  If anyone else wants to join me on the journey, it's completely up to them.  All in all, life's going pretty well right now.  So, here's to not rocking that boat!

The Last 700 Days...

I haven't posted in almost 2 years.  I knew starting a new blog was a leap of faith in my ability to keep it up and I knew I probably wouldn't follow through.  Blogging about the situation with Kia was mostly for therapeutic reasons rather than informative purposes.  If anyone is still following or curious about that, I can tell you she's still alive and well.  She's never displayed any symptoms of lymphoma at any time, yet I continue to treat her with chemotherapy pills for 2 reasons: the phenotype test that came back positive for it is usually pretty accurate, and I don't want to gamble with my kitty's life.  We've actually reduced her treatments to twice a week rather than three times.  She's never completely gained back all the muscle mass she lost during her illness, but she continues to eat her mushy food and keep it down daily without showing the slightest signs of distress, which is all I can really ask for.  Most people don't get to keep their cats for this long after being diagnosed with what she has.  I could still have several more good years with her, or she could turn a corner and start declining at any minute.  I simply don't know how much longer she has on this earth, but I'm thankful for the 13+ years I've had with her so far and consider each extra day a blessing.

Aside from Kia continuing to stay well, absolutely nothing in my life is the same as it was the last time I posted.  For starters, one week after her diagnosis, I lost my job.  They began laying people off in droves and I was in the very first group.  It felt like I'd just been handed a death sentence. I'd barely been able to make ends meet and now was faced with the additional cost of Kia's care and suddenly was without any income whatsoever (except for unemployment pay, at a whopping $300 a week).  Not only was I devastated by the financial implications, I was grief-stricken by the loss of the first job I'd ever had that I truly loved.  My salary was barely enough to live on, but I never wanted to leave there because I loved what I did and I enjoyed going to work each day.  After many, many years of loathing my own existence every time I set foot into my place of employment, I was so grateful to finally have a job that seemed tailor-made for me and my strengths.  It didn't make any sense that I was laid off when there were so many other people there who didn't like their jobs and complained about it every day.  So why me and not them?  I couldn't understand why it happened and I grieved like I'd lost a member of my own family.  I had literally lost something I loved and it was a tremendous void.

I didn't have a whole lot of time to process the shock of it all, though, because I had to concentrate on getting myself employed again.  I found a side job singing in a church choir up in southeast DC.  It didn't pay all the bills, but it was good side money, plus it was so nice to be able to sing again AND get paid for it!  The only downside was waking up at 5:30 on Sunday mornings and driving 40 minutes into DC for a 7:30 call for an 8:00 am mass.  There were 2 masses on Sunday: 8:00 and 11:00.  So, I'd usually get home around 2:00 pm.  Oftentimes, I'd only get a couple hours of sleep the night before (Saturday nights, y'know...) so I'd be pretty exhausted and would sleep through most of the Sunday afternoon football games.  But I made it work.  After 40 days of unemployment, I found a temp-to-hire job as an admin assistant at a data center for an internationally known Fortune 500 company.  It was vastly different from my job at the law firm.  I felt lost.  I felt like I had no idea what I was doing and that none of my skills were of any use to them there.  The pay was pretty good, though.  So between that and my part-time gig, I was finally making enough money to live comfortably.  I no longer had to pinch every penny I could scrounge up.  I could put gas in my car when needed.  I could go out on weekends and actually buy drinks instead of having to rely on other people's charity.  Also, things began to improve in other areas of my life that I had long awaited improvement in but had all but given up hope that they ever would.  For the first time in 32 years, I was experiencing true, unadulterated happiness.  I had an awesome living situation with my roommate Victoria and her dog, I was making enough money to survive AND put a little back for a rainy day, I was surrounded by people I loved and who loved me, my animals were both alive and well, and for the first time I could remember, I wasn't overly stressed out about anything.  The sun had finally shone through the clouds and I was feeling reborn.  For the first time, I knew what happiness was.  Life couldn't possibly get much better.  December 2011 and January 2012 were the best 2 months of my life.

Then things started to unravel.  Victoria announced that she was moving out.  My temp-to-perm job ended without becoming permanent, and a couple days after that, I lost my part-time job as well due to cuts to their music program.  The good news was, I was only unemployed for a week.  I found a new job at a law firm in Fairfax, an industry I had desperately missed since being laid off from my old job.  It was nice feeling like I was "home" again at work.  However, I still had the issue of my living situation to deal with.  My lease was ending on March 1.  I couldn't afford both halves of the rent so I had to either find someone to renew it with me, or I would be forced to vacate and find somewhere completely new to live.  I tried to find a new roommate but, as usual, ended up frustrated and angry with people who would express interest then not show up to come look at it, or come see it then never get back in touch with me again.  So, with time quickly running out, I made a fairly drastic and desperate decision: I moved to an entirely new apartment.  I responded to an ad on craigslist looking for a roommate in Fairfax and moved in on St. Patrick's Day.  The place was just down the street from my new job so I could go back to having a 2-mile commute (which is something else I desperately missed since losing my old job).  It seemed like just the fresh start I needed.  New job, new apartment, new city, no pressure on me to keep finding a new person to live with every 6-12 months.  Problem solved, right?

Notsomuch.  I was miserable.  I felt homesick the very first night.  I knew I'd made a big mistake.  I missed Reston and everything about it.  I missed all my old stomping grounds, I missed all the paved pedestrian paths where I could walk Kirby every day, I missed the town center, I missed my old grocery store loop, I missed getting off the beltway onto Rte 7 and taking that straight home.  I missed my old apartment and my old community.  I missed having a place that was more than just a room I was renting from someone.  Not only did I not feel at home, but my living situation soon became absolute hell.  I hated having to live on someone else's terms or suffer the consequences.  My animals were miserable there, too.  My roommate's dog was very aggressive towards them and my roommate didn't treat them very well, either.  I began to fear for their safety, and then mine.  It was such a slap in the face to be that miserable after having the best 2 months of my life.  I knew I had to get out of there.  I'd started looking at other places within a couple weeks of moving there, but then decided to stay and try to make it work.  But, after yet another threat to my dog's safety, I could no longer suffer through any more.  I sent Kirby to stay with my parents until I could get out of there, and gave my roommate my 30-day move out notice.  I'd been looking in many different cities, but I knew my heart was in Reston.  I was so happy to find a place back there.  My commute was a bit longer, but it was a small price to pay for feeling like I was back where I belong.  I moved out on Memorial Day weekend.  My stint in Fairfax had lasted exactly 71 days.

Finally, I was back in Reston.  But, my living situation unraveled pretty quickly there, too.  My new roommate had been through a lot of trauma over the past couple of years and was extremely emotionally unstable as a result.  She changed the terms on me the day I started bringing my stuff over by adding a third person to the mix who would be living in the basement.  I'm not a fan of group homes.  That wasn't what I thought I was signing up for and I wasn't comfortable sharing one bathroom with more than one person, especially if one of them was a middle-aged man.  Then, in June, I went away for a weekend on the annual beach camping trip.  My roommate had agreed to watch my pets for me while I was gone.  Well, Kirby must have been very stressed by my being gone because she got sick that first night and had diarrhea on the floor.  My roommate left me a hysterical voicemail that night telling me I had 60 days to move out.  I hadn't even lived there a full month yet!!  I had already done a ridiculous amount of moving since mid-March and it was only the end of June!  Not just that, but my previous roommate had decided not to pay me my security deposit back, so I'd recently taken advantage of the free legal counsel I was receiving at work to file a Warrant In Debt against her.  We had a court date coming up, which was stressing me out to the max already.  Now I was faced with the additional stress of moving for the third time in less than 4 months.  

Well, my current roommate had a change of heart 3 days later and told me I could stay after all.  I kept looking, though, because I knew that situation was not going to work for me for very long.  Then she suddenly demanded I raise my agreed upon rent by $250/mo.  I refused, so she kicked me out again.  Then she had a change of heart and we compromised on $100 extra.  Then, in mid-October, I suffered the worst emotional devastation ever, which I simply could not face head on and resorted to going out constantly just to keep my mind busy and get away from everything at home.  Shortly after that, my roommate announced her new boyfriend would be moving in with us, so there would soon be 4 people living in a 2-bedroom, 1-bathroom townhouse.  I was reaching my breaking point.  I had lost a job I loved, a roommate I loved, an apartment I loved, and a man I loved all in one year.  But things were about to get even worse.

On December 14, I came home from work and found a "Pay or Quit" notice posted to the door.  Apparently, my roommate had failed to pay the rent that month and was now facing eviction if she didn't square up.  I showed her the notice and she shrugged it off and said, "No, it's OK.  I already paid."  I could tell by the tears welling up in her eyes that she was lying, so I called the property management company.  They couldn't tell me much since my name wasn't listed on the lease, but the person I spoke with quietly confirmed my suspicions and said they would be taking legal action against her.  So now I was being forced to move again or get evicted along with the rest of the house.  But, as it turned out, it didn't even matter.  My roommate kicked me out a third time by telling me her cousin was moving here from Italy in February so she needed my bedroom back for her.  I decided I was done and didn't want to wait until then.  Victoria had offered me the spare bedroom in her townhouse, which was located in Reston near our old place.  I took it, but with the caveat that her lease was ending in May, at which time she would be moving across the country to California.  So I had until the end of April to find a permanent place to live, which would bring my grand total of moves in one single year to FOUR.  And on top of everything else, my ex-ex-roommate (who'd failed to show up for our court date, resulting in me getting my judgment against her) had filed a motion to reopen our case for that following Friday, the 21st.  So here's my timeline for the last 2 weeks of 2012: Dec. 14 - receive pay or quit notice.  Dec. 15 - get kicked out for the third time and decide to crash with Victoria.  Dec. 20 - start packing my stuff up.  Dec. 21 - go to court again (which my ex-ex-roommate didn't show up for, either) and finish packing.  Dec. 22 - move my stuff into Victoria's house.  Dec. 23 - drive home to Ohio for Christmas.  Dec. 26 - drive back from Ohio, right into a blizzard and crash my car into the median on the PA turnpike.  Dec. 28 - go back to court for the garnishment of my ex-ex-roommate's wages (which she, of course, did not show up for either).  Dec. 30 - Kirby gets attacked by another dog, gets badly injured and appears to have been killed right in front of my eyes.

OK, more on that: Kirby got bit on the neck by a large German Shepherd mix.  Immediately, her body turned stiff and she fell to the side, her eyes glassed over and blood began pouring out of her mouth.  I thought her neck had been snapped and she was dead.  I called 911 but they refused to do anything other than send animal control over.  So I sped her down to the closest 24-hour vet, praying she would come back to life.  By the time I got there, she was conscious again but in shock and displaying neurological deficits.  She couldn't stand or move her legs on her right side.  She would just fall over.  X-rays were negative as well as the exam for any external injuries.  So, we didn't know where the blood was coming from.  But, clearly something in her spinal cord was damaged.  She spent the night in the ICU.  During that night, I woke up every hour on the hour and cried out in heartbreak for my baby girl.  I couldn't bear the thought of her not being there in bed with me, or not feeding her breakfast the next morning.  My soul was completely and totally crushed.  I spent a large portion of the day on New Year's Eve at the vet's just holding her in my arms while they continued to observe her progress.  She finally got discharged at 9:00 pm that evening.  There was a New Year's Eve party going on in our house, which I had dressed up for.  But in the end, I stayed upstairs in my room with my animals and slept on the hardwood floor next to Kirby to make sure she felt safe. The vet had said the best thing I could do for her was to just spend as much down time with her as possible.  So that's what I did.  The vet bill was $1300.  Fortunately, since the attack happened on the rental property and an injured pet is considered "property damage," it was covered by renter's insurance.  But I still had to pay the deductible from my car insurance claim to fix the damage to my car.  And, of course, every day was closer and closer to the end of Victoria's lease and, while I'd had luck finding potential roommates, I'd had very little luck in finding a place to live.

Here's the thing with that: I'd just been through hell with my living situation.  I was not going to make this next decision lightly.  I needed to find a place and a roommate that completely worked for me, and where I felt truly at home.  I knew exactly what I was looking for.  I was just having a lot of trouble finding it.  Meanwhile, my roommate plans kept falling through.  There were 4 people I met with between January and March who agreed to look for a place with me, but had to back out for one reason or another.  Then I found out Victoria's parents were coming to stay with her for the last month of her lease to help prepare her for her move to Cali.  So I actually needed to be out of the guest room at the beginning of April, not the end, as I'd previously thought.  I'd just gone from thinking I had 6 weeks to move to having just 2.  And I had yet to find a suitable living space!  I really, REALLY didn't want to go back to just renting a room again, but I started exploring that option anyway and checking out other people's listings.  Then my friend Pete (who had just signed some paperwork for an apartment in Reston) found out his plans had fallen through as well and he was back to looking again.  I suggested we try to look for a place together and he agreed.  The very next day, the perfect place appeared on craigslist: 2 bedroom, 2 bath, affordable, pet-friendly, across the street from the town center, and everything I had been holding out hope to find in my next place.  The timing was just impeccable!  We snatched that up right away and I began to pack and get ready to move again.

The Wednesday before the move, I came home from work to find Kirby straining to urinate.  She'd developed a bladder infection in February, which we treated (or so I thought) but she continued to have problems holding it through the night.  I thought she was just angry with me for all the moving or still traumatized by her attack.  But now it became clear she was having serious problems.  I rushed her to the emergency vet that night and spent 4 hours there, getting X-rays and exams and lab work.  As it turned out, she had bladder stones and one had gotten lodged in her urethra and was preventing urine from passing through.  They sedated her and pushed it back up into her bladder but it was a short-term solution.  She needed surgery to remove them.  They quoted me $2700 to have it done there.  All of a sudden, I was back in those days when Kia was sick: feeling helpless and at a complete loss for what to do.  I called the HSFC the next day to ask if there was any way I could get help from them again.  They said that, while they could give me a loan, they couldn't just foot the bill entirely.  I would have to pay it back eventually.  The emergency vet had mentioned a clinic down in Richmond that could perform the surgery for $700.  It would mean taking a day off of work to drive down there and put her through surgery, and there was the chance her bladder could re-obstruct and possibly burst before I could get down there.  I called the clinic on Thursday anyway.  They said they could fit her in the next day (Good Friday).  I asked to take a last-minute vacation day from work (even though I was already taking Monday off to move), then I applied for a Care Credit card and, much to my surprise, was approved!  I called Victoria to see if she wanted to take a day trip to Richmond with me tomorrow and she said yes.  We left at 7:00 am and drove down to the clinic, dropped Kirby off at 9:00, then spent the day going to museums, beatnik coffee shops, and other touristy places.  I was coming down with a nasty virus, however, and had to pop aspirin every couple of hours just to keep the body aches at bay.  Kirby made it through surgery just fine, and we picked her up at 3:00 and drove back up to Reston (hitting all the Good Friday rush hour traffic on the way up).  I had one day to rest, then I spent Easter Sunday lying on the bare floor of my new apartment and feeling close to death while the Verizon guy installed the cable.

The move did not go smoothly.  The moving company got a flat tire on their way here and ended up arriving several hours late.  It was long past my bedtime by the time I even put my bed back together, and I had to wake up at 6:00 and go to work the next day.  I barely made it through the day due to exhaustion and residual sickness.  I used a day of sick leave the next day and the office manager was all too happy to give it to me.  Meanwhile, little things continued to go wrong with the new place, which required a lot of extra time and patience to resolve.  Luckily, it eventually did and I am so happy to be living here!

My latest incident/drama/setback was last month when I was heading back from a weekend in Ocean City and accidentally ran over a concrete barrier at a gas station that had been hidden from my view, busting my oil pan.  I had to tow my car to a service station in Delaware, but because it was Sunday, there was nobody who could do any work on it that day and no place I could get a rental to drive back.  I had to catch a ride back to VA from my friends the next day, which resulted in another unexpected day off work and another $100 in pet sitting charges, since Pete was traveling that whole month.  I didn't get my car back for 2 1/2 weeks due to so many delays in getting the insurance claim processed and the replacement parts ordered.  Then, I had to take yet another vacation day to drive back to DE to pick it up and turn my rental car in (which was a bit of a GPS nightmare in and of itself).  Thankfully, that's over and hopefully things will calm down for a while.  In summary, I've had 2 moves, 2 car accidents, and 2 veterinary emergencies in the last 8 months alone.

These last 2 years have been one of the most tumultuous periods of my life.  My emotions have run the gamut of being exuberantly happy to absolutely down in the dumps with no light at the end of the tunnel whatsoever.  I've learned that nothing stays the same for very long.  As someone who hates change, that's very tough to swallow.  I'm no longer planning more than a month into the future because I simply do not know where I'm going to be at that point.  I can't count on anything to be stable.  Pete could decide he wants to move out, my landlords could decide to kick us out for some reason or another, one of my pets could fall ill suddenly, I could lose my job, I could damage my car, I could get my heart shattered, or I could experience any number of setbacks (emotional or financial).  There are just no guarantees.

Someone asked me a few months back where I saw myself in 10 years.  I couldn't answer.  Ten years ago, I never would've seen myself where I am now.  In fact, I didn't see myself where I am now 5 or even one year ago.  As such, I am a duck on the water, floating through time and waiting to see where the current takes me.  There is no plan for the future, except to wait and watch it unfold and to just keep on living in the meantime.  I will live each day just as I have lived the last 700 days: one at a time.