Decisions, Decisions, Decisions

Sean and I are standing on the edge of a precipice.  And we have three options: we can step back and walk away; we can jump and crash and burn; or we can jump and hope and maybe–just maybe–take flight.

What I am referring to, of course, is the very complicated decision to try to have a family.  Or to not.

Our situation is common among young couples; our circumstances and actual options are not at all common.  Our decision has to be carefully determined and planned.  It could never just happen accidentally or on a whim.  Whatever we decide will be fraught with heartache.  And we are OK with all of that.

Let me explain why.

Let me also say at this point that if you choose to read further–and especially if you are new!–there are things you will learn about me that you can’t unlearn.  There is a strong possibility you will see me in a different way.  I am me in my most open form here.  This may not be what you are used to depending on the way in which you interact with me.  I am a rather protected person and I rock a good poker face (probably except, oddly, during actual poker).  And this is mostly because this is where I feel most confident and comfortable expressing myself; not because I can hide behind a computer screen.  I just write better than I talk.  The shit I write here is never anything I can stuff away nor walk away from; I live it every day.

I also swear a lot.  Like, a lot.

So if you’re easily offended then now’s the time to stop reading.

No, really, you can stop.

Are you sure?

This might be a psychology experiment.

Can’t put it down, huh?

Okay, you’re committed…

I also want to express that what I believe and feel and what Sean believes and feels are not at all viewpoints towards how others live their lives.  These are decisions and viewpoints we have made for ourselves for a variety of reasons, some I can explain and some I cannot.  So if you find yourself getting to a point where you’re thinking, “Ugh, so close minded” or “but my situation…” then, well, you’re reading for the wrong reasons.  All I can tell you is my story, our story.  Take it with a grain of salt.  I have yet to find the manual on life or the manual on cancer (can I borrow your copy?  What?!  You didn’t get one either?!  Shiiiit).  Life seems to be more like a Choose Your Own Adventure story.  We’re all just wingin’ it.

To catch you up on a long story: I had breast cancer in 2012.  Surgery, surgery, surgery, chemotherapy, radiation treatment, “adjuvant therapy” (fucking Doctor terminology: this means drugs, meds, scrips, and probably BS and feeling shitty for an unknown outcome).  As a science nerd, I have quickly learned that Doctors haven’t got it figured out–and, yeah, it’s not fair for us to think they do but when you get sick with something shitty like cancer, you just want all questions answered and the path to be clear and obvious (do I really need to think about decisions and weigh them all?  Life.  I just choose that so do what you need to for that to stay happening).  So they don’t exactly know what to do with me.  Maybe I was cancer-free with surgery.  But they weren’t sure.  So I had all that additional stuff, chemo and radiation and the drugs.  It all sucked.  And every day I got to think about death.  And guess what?  Even though it’s all pretty much over and it started 3 years ago, I still get to think about death every day!  It’s “gone” but since it’s cancer it can always come “back,” (or it’s currently cold chillin’ in my body waiting for the right environment to start up again.  Like the shittiest house guest you can imagine!).  So, yeah, there’s that.

And I’m OK with all of that.  I know it sounds like I’m not but I’m as OK with it as possible!  The thing that really crushes me is my Doctors’ responses.  Some of them are cool but a whole lot of them are quite the negative nancies!  Shit, dude, I have/had CANCER, tell me something good for once.  They are very doom and gloom.  Do NOT get your hopes up.  Sometimes I think they need smile therapy.  Or new jobs.  And this is where I am going to be really specific: they are rather AGAINST any possibility of Sean and I having a baby (the kind of baby that involves me getting pregnant).

Woah, Serena, did we just go there?

Yeah, we did and there’s more.

Seat belts on, team.

I think you need to know something important.  I am a biologist.  That means that I know–believe? whatever, leave your opinions at the door–that the majority of living things need three things for their species to continue: food, shelter and progeny (that means babies, you don’t have to google it).  Ah, ruminate on that.

For me, that means I want to have kids.  And even that desire in me is complicated.  I never imagined I would have to decide at this age (I will be 32 in a few days); I really thought, naively, that I would have time to think about it and one day, poof!  I would just get pregnant when I felt the mommy urge.  HA!  I always thought I would have kids.  It was just a given, something I didn’t think too deeply on.  I’m good with kids.  I have been baby-sitting since I was 11, teaching since I was 21.  Yeah, I get burnt out on kids sometimes, especially when I see kids being shitty.  But I know on some level I’d like to give it a whirl.  I don’t have the undeniable urgent need now but I know I don’t want to not have the option to have kids (negatives can kind of cancel each other out there); I don’t want to miss my opportunity.

And I definitely don’t want anyone telling me no!  OH HELL NO!  You tell me no?  I want it more.  Like when I was a freshman in college and this great professor said to the class, “well, if you are having a hard time with chemistry or physics, you might want to reconsider being a marine biology major.”  Um, excuse me?  I hate chemistry and physics but I ain’t leaving.  And by the way, even though I have to take those sucky classes, I’m here for marine BIOLOGY.  Fuck you.  I’ll take a C here and there to get through those shitty necessary classes.  And then I will take my fucking degree in marine biology, THANK YOU VERY MUCH.  Clown.  Great teacher.  He might have even taught me reverse psychology there.  But I really think he just wanted to slim down the competitive major and field so all the hard core marine science nerds could find jobs later!  (It didn’t work).

So when I told the doctors, after all the shitty treatments and such, what does this mean about having kids?  They said, wellllllllll…….  You should wait.  You shouldn’t have kids.  It might not happen.  You might not get your cycle back (I did, step one).  And then the crusher…

Well, you don’t want to make your husband a single dad raising a kid by himself.  You want to be around for that child.

FUUUUUUUCK YOUUUUUU!!!!!!  (Ah the cursing, I know, I know).

I have been told that by 2 doctors, one recently.  I want to fucking scream at them (I don’t, I’m usually blind sided and stunned.  I curse up a storm in my head later).  Worst fucking thing you can say to me; worst load of crap you could pull on me!

Back to that science thing, for a moment, about all living things needing 3 things to continue existing.  I am not going to live forever, why can’t I want to create the next generation to, biologically, pass on genetics?  Yeah, Sean and I are not the only creators of the next generation but why when I ask about this part do my [scientifically-minded, biology-based] doctors look at me like this is a novel and wild idea?!  It’s not the sole reason to have a kid and it’s not even the strongest reason to have a kid but for crap SAKES!  BE A SCIENTIST for 5 seconds and understand where I am coming from.  Yeah, I’ve thought about it: if I died and left a kid behind that would SUCK but it would be the greatest thing I could do with my life.  And I married my husband because I know without a doubt he would be a great father.

Also, I could walk out of the office and get hit by a bus and NOT DIE FROM CANCER.  Stop being doom and gloom!  You told me my cancer was gone!  But now when I want to move on from it, they’re all well, um, yeah, well, death, no, maybe, um, no, death.  I can’t fucking win with them.

Most importantly, IT’S OUR DECISION!  Thank you for informing me, but ultimately Sean and I will decide to try to have a kid or not.  Doom and gloom won’t work on me.  I’ve heard it enough these last few years.  Research is limited and they just don’t know what will happen to me with the cancer coming back or not.  No one knows so why can’t we err on the side of me living my life?  I can do it cautiously to a point but if you crush my hopes and dreams then you are not the right doctor for me.

I’ve gotten my rant and the gist of it out and now I can tell you the reality of where we are at.

I’ve been going to a fertility specialist.  Wait wait wait.  It’s not what you think.

You’re thinking shots and all that.

Thankfully, I can’t do that.  Taking hormone shots would be like giving an addict free drugs: my cancer type loves that shit!  It could “flare up” (I thought that sounded nice and manageable; it sounds better than “return as a giant hostile tumor in any body organ or all of them”).  Yeah, shots are never a possibility.  And I say thankful because… that’s just not for us.  If we can have a kid, I’d like to just conceive naturally or not at all.  I know it’s rough for you to imagine that I can be so all or nothing about it but I am and we are.  I just don’t want to force something that isn’t meant to be.  It would be too hard and stressful.  I’ve had enough of that these last few years.  Conceiving a baby needs to something that is fun and easy and if it happens, great; if not, it’s OK.  I’m OK with that.

So, in review, our options: 1) walk away; 2) try to conceive and fail; 3) try to conceive and succeed.

I think I can be OK with two of those.

And if you know me at all, it is NOT to walk away!

We’ve done some testing with the specialist.  I have the egg supply of a 41 year old: not great but not impossible.  We’ll face countless challenges and heartache going forward but we are prepared for that.  Sean and I have a plan that we will discuss with the doctors in the coming weeks and we will see where it takes us.  It’s not radical; it’s responsible; it might run the course of many years.  And it’s very us in many ways; in a few ways, it goes against our nature but it a wonderful way that we are learning more about ourselves and what we can handle.

But the most important thing is we have each other.  And we’ll figure it out.  We have made peace with our options and potential decisions and outcomes (even if we can’t prepare for all of them) and we are ready to move on and move forward.  As we learn more, things will inevitably change.  Like, maybe, better doctors that can be more open-minded.  And maybe a few other hiccups on the way.  We had this shitty thing happen to us; but that’s ok, let’s move forward.

All I know for sure is: you don’t tell me not to try; you don’t tell me not to dream big, even if it’s too big; you don’t knock me down and expect me to stay there.  I am happy to be humbled–and Lord knows I have been these last few years–but I don’t give up!

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Cancer, You’re Being An A$$hole!

Warning: Not intended for small children learning to read.  Despite following the songstress, Ke$ha’s, ruling that “S” letters can be swapped out for clever symbols to disguise bad words from children while still allowing intelligent adults to see the true lettering, I fear that some children of this era are too smart and will not be fooled.  Keep this blog away from your tiny geniuses!

I have a slew of Doctors visits to clarify with you, a grand decision that has been made and a gift to self but first I’d like to give a shout out to cancer being an asshole in the most strange of ways, a way I have alluded to before.

“I’m start chemotherapy in June.”

“Oh, what for?  Do you have cancer?”

“I have breast cancer.  Er, well, I had breast cancer.  Actually, well I might still have breast cancer?  Really, what I’m saying is… That, well… Ok, here it is, you know the short version.  I had a lump in my breast that was cancer.  And they removed it.  And they said that one lymph node had cancer.  So they removed that.  Which would mean I don’t have cancer anymore.  But then since it was in the first node but not any others, I might still have cancer.  Think like Star Wars and that my cancer cells maybe went stealth and snuck by the first node and now they have an invisible force field around them so that no Doctor can tell me I have cancer but we all have to err on the side that maybe I do still have cancer, when maybe I don’t, and I have to have chemo.”

“So, you have cancer?”

“I don’t know.”

Fuckin cancer!  If I say I have it I feel like I might be lying but the short answer is, yeah, sure, I have cancer.  Or on a good day: NOPE, NO CANCER but I’m having chemo for fun, just in case, just for the experience and curiosity!  Or on a bad pessimistic conspiracy theory day: yup, tons of minute microscopic little cells float around within me ready to land and harvest another of my organs, gotta watch my back, gotta put some chemical warfare on these punks, no more peaceful protests from this hippie chick.

Man, I sure have an active–healthy?–imagination!  Don’t worry, I haven’t gotten to the talking to myself in the grocery store stage yet, though I bet some busy women do this simply because our to-do lists are so long and never-ending.  I haven’t gotten to the crazy lady shit yet.  These are just the thoughts I have right before I fall asleep, when women are known to do their best–and maybe wackiest–thinking.  Then we fall asleep and forget it all.  But sometimes is stays in the brain until I can release it into the blog world.  And now this crazy talk is in your brain.  Welcome to my world!

A short stint into words…

Chemotherapy shall be mainly referred to as chemo, because therapy sounds peaceful and so far, chemo–with its baldness and its mouth sores–does not.

The word blog is a weird word of my generation and I wonder how it was thought up.  Some “writer” was probably thinking, “Man I’d like to write something, maybe a book?  No, too long.  An article?  Too much research.  BLAAAHHHH..gggggggg!  EUREKA! That’s it!  I will create a new genre of writing word vomit with facts, if I so choose, and interesting bits of life’s quirks and maybe it will have a purpose.  And I will write it when I want.  Or not at all.  I will write it when I am not Tweeting and I will Tweet about it so that I will have free advertising.  And I shall call it… a BLOG!”

The nitty gritty is that I had that second opinion with that lady Doctor and I was sorely disappointed.  Not because she basically gave the same treatment plan with a different suggestion on specific chemo drugs (ones better for my heart; will discuss with original Dr).  And not because she put a hard emphasis on the hormonal therapy, the drugs that I need to take for five years and thus would really put me out there with my age and the baby plan (there isn’t a “plan” per se but for the sake of argument, let’s just imagine I wanted to start having kids at 30-32; now I have to wait 1.5 years for chemo, 5 years for hormones and 2 more years “just to be safe,” though this last part is not research-based.  I’m 28.  You do the math.  We did also discuss “the risk I would have to decide to take” if I wanted to take the hormones for 2-2.5 years and then have baby time.  Studies show that 2 years is good, 5 years is optimal and 10 years didn’t show much difference.  I do believe Giuliana Rancic is on this one, tamoxifen).

What really pissed me off the most was her complete disregard for what I wanted.  To a point of dumping on my wishes.  Ah, hi, I’m paying out of pocket to be here.  Please, stop talking and start listening, hone your sensitivity for me and my needs.  I told her my main concern was infertility from chemo.  What I wanted to hear was reassurance.  I wanted to hear about studies in which women had children after chemo, maybe that chemo affects a certain age group’s reproductivity more or less, or that there were other options to chemo or within chemo to lessen this risk.  Or they had invented an invisible shield to protect my womb!  Ok, maybe not that.  But you know what I mean.  This was the Pacific CANCER INSTITUTE.  I wanted to hear the cutting edge research about my age group with breast cancer and future offspring.  That’s all.  Pretty simple.

Did she tell me anything like that?  You know the answer: no, not really.  She suggested egg preservation (which I had already heard about from my gynecologist and had an appointment for after this one).  She gave me a paper about drugs to be used in association with the hormones that would be injected in me should I harvest huevos (eggs in Spanish, we’re bilingual today).  And she went on to say that I should really consider egg preservation and surrogacy.  I told her that I was thinking about it but that my concern was that if it were to come down to it, I would much rather have my own child, that I’m really not into the surrogacy thing.  I want the bonding and the experience of pregnancy.  You know what she said?  Moms out there, you’re gonna shit your pants, she said the bonding thing wasn’t really that great, pregnancy isn’t all that great and that surrogacy would let me keep my figure.  UM, HI?  WTF?  I am not the kind of woman that wants to hear that shit, oh, heeeeeeeeeell no.  If she was saying it to make me feel better about my fertility options, she actually further encouraged what had already occurred to me: that maybe frozen eggs aren’t for me.

But let’s go to the fertility specialist before we make any decisions.

The dog just farted; it smells disgusting.  I want you to be able to experience everything with me.  It must have been the bacon Sean and I snuck him this morning.  Or the six gallons of ocean water he drank yesterday.  Damn it, it’s lingering.  He’s asleep on the couch and didn’t even wake up for it.

The fertility specialist’s assistant had called the day before to try to move the appointment later.  I had said no since I had one more appointment after and didn’t want to be driving like a maniac to it.  She said not a problem, we can keep it as is.  I got there at 2pm and had to wait 45 minutes anyway to see the Dr!  Again, me = paying out of pocket moula for this.  I SAID NO TO COMING IN LATER!  Was there a miscommunication?  Anyway, when I did see him it went well (and he said no charge).  He said, yes, you would be injected with hormones as part of the process but then I would have chemo right away so any problems with hormones, theoretically, would be taken care of.  But then we talked about the cost (which, honestly is not a huge concern for me, I could make it work and there are a few non-profits that help out financially), and that the eggs that are harvested may not even have a viable baby within them, some would be damaged, there’s a monthly charge for storage (can you imagine a chilled three inch petri dish storage unit at $50 a month?  I pay $89 for a ten by ten in Cali, though not chilled), surrogacy, timing…

The more I nodded the more it dawned on me… I don’t want this.

Cause here’s the thing everyone, and maybe it’s just my thing but it’s still a thing: for me, the major allure of being able to create a human life that is in part me is the beautiful mystery of it all.  That’s it.  That’s what I am interested in.

When we’re talking about hormones and uterus size and egg numbers and test tubes and freezing and re-implantation and surrogacy, all that mystery is diminished with each step in the process.  Sure, genetically the child would be mine but I don’t just want the genetics (and even those are still questionable as we await my BRCA test).  I want the natural experience of having a child.  Or I’m OK with a very different, modern, helpful option: that might be lots of dogs and/or adoption of small humans… both cases are about someone that really needs a home, nurturing and a lot of love.

Egg freezing and surrogacy may be for some people, but I can’t do it.  As much of a proponent for modern science as I am, I am also still old fashioned in some respects.  This being a prime example.

The next year and five months will be a long, drawn out version of russian roulette and on the winning end of it, I will hopefully still have my fertility.  85% is my goal number.  85% of women are still fertile after chemo.

It’s also very close to some other important numbers, numbers that are the reason why I have to be OK with chemo: “89% of those treated for breast cancer will survive 5 years, and 82% will survive 10 years.”  I was always more of a B student so I will take it as a good sign and run with it!

My last appointment was easiest and with those I have grown to appreciate and truly trust, my home team: the Kaiser surgical staff.  Ol’ righty looks pretty good, she’s settling in nicely with lefty showing her the way.  My mastectomy scar will heal over many months and then be used to squish in and create a new nipple (ah, modern medicine).  Three rounds of tattooing later and I will have what will resemble a pretty believable new boob.  It feels good to be mostly complete with that aspect.

I cried at my first appointment, but then I just got frustrated, angry and gave up cause the tears weren’t worth it.  I almost cried at my second appointment but held it together.  By my third appointment, I was so emotionally wrecked that I just cried it all out, all it took was, “how have things been?”  And I don’t cry in the peaceful, Demi Moore in Ghost single tear from one eye way; it’s both eyes full buckets, runny nose (my nose cries too) and not able to speak a word then ragged breathing to shudder-talk.  It kind of has to pass before I can get back to a coherent conversation.  But the surgery center is good section to cry in because they actually are on my team.  This next year is gonna suck, she said, you got dealt a shitty card but it will go away.

I know what you’re all wondering–even if you forgot what you were wondering since you got sucked into this episode of Serena’s boob drama–what gift did you get yourself?!

Serena, you’ve won.. A. NEW. CAR!!!!!

Don’t worry, even though I am allowed to have a mid-life crisis or a 1/3-life crisis or whatever, this is not it.  I bought myself the car I’ve wanted since college because life is short and I’m tired of waiting for the right time or the right star to align with a half full moon on the 23rd of August.  Plus, I needed something higher up, more reliable, sportier and with tinted windows and AC.  It’s a Craigslist find, gently used, great condition 2000 Honda CRV-LX.  That’s right, a Cancer Resistant Vehicle-Lets Xtinguishthisshit!  That’s the name right?  It was on Kelly Blue Book like that… Maybe not but it sure would make a great boat name…

A couple of things coming up that you can help with:

1) I have a haircut on Thursday.  My hair is long and chemo might take all or some of it (and hey, maybe it will leave it all).  But to pretend I have some control and to not be totally freaked out when long pieces fall out, I am seeking a mid-length cut, shorter than I’ve had in years and I am looking for suggestions and ideas.  Celeb photos accepted.  I have stick straight hair and I use a blow dryer twice a month, oh and I live and a sub-tropical climate.  That is your challenge should you choose to accept it.

2) Friday I have a third opinion with Kaiser on Oahu and then I have probably the most difficult part (other than mastectomy pain) of this whole ordeal: I get a port installed in my chest.  Look, cancer/chemo combo, it’s not enough that our hair falls out, we puke our guts up and we’re tired for a year and a half, but you make us get an unsightly medical device installed in our chests for all the world to see and murmur about?  Real cool, real cool, ya jerk.  No matter how you dress that up, I’m not going to be happy about it; though my arm veins will thank me as will my nurses who hate poking me for an IV.  So, basically, pray for me and if you’re going to stare at it or want to stare at it once I get it, at least have the decency to ask about it and/or make a joke about it.  If you try to treat me like a leper I will slap you with my port tubes!

3) We’re moving to Kihei at the end of March so if anyone wants to help us move, let me know!  I will be closer to my Doctors and work as I plan to switch my job responsibilities over a bit.

4) Go outside and let the sun kiss your face (with SPF 30+)!  And plant some flowers.  Or tomatoes.  Or both!