My letter to Gabrielle

Gabrielle Ryan (AKA Gabby, Gabs, Gaba-licious, Lishy-Lou, Breeshka, Brielle, Briella-Bear, and every other silly little nickname I have called you over these 10 years),

      Ten! Double-digits! I am really not sure when I blinked and you became a DECADE old! I know you have been waiting for this birthday FOREVER, I on the other hand, have just been hit with the reality that my little Princess, isn't quite so little anymore. There are things I want you to know and things I want you to keep with your forever, no matter where this crazy life takes you. Part of this is being pulled from the "letter" I wrote you when I was sick, the rest is everything in my head right now that is preventing me from sleeping (and yes, I am crying as I write this).

      MAN! What a crazy 10 years this has been! Time really does fly (believe people when they say that to you), I wish I could freeze time right at this moment. October 30, 2006 at 5:42pm, that is the moment you forever changed my life. I had always heard everyone say "oh just wait, when you see your baby girl for the first time, your life will change forever", I had my doubts. I shared my body with you for 9 months, I felt you move and tumble, I worried about you every second you were in there. I was already deeply in love with you. I didn't think I could love you more than I already did. Boy was I wrong! When you decided to come into this world 1 day late and not wanting to take your first breath (for by the way what felt like an eternity, as doctors and nurses were scrambling around grabbing tubes and calling for the NICU to get ready). I knew in my heart, this girl is a force to be reckoned with. Everything everyone said about that "magical" moment, they were spot on. You took my breath away, you made me speechless, you made my heart full, you made me a Mommy. I had no clue what this insane ride we call life was about to throw at us.

     I have carried around guilt and sadness in my heart for you. You had to grew up so much quicker than other kids your age, for that I am sorry. You were only 4 years old when our family was flipped upside down with the cancer diagnosis. One thing you don't know, the only thing that popped in my head when Dr. Pahnke said "Amy, this is cancer" was you and Cole. The only words I could remember were "Gabby and Cole". I didn't cry when he told me it was cancer, I just asked if I was going to die. The only thing I could mange to say was your names. Daddy and I made a decision that evening to NEVER keep anything from you. We told you everything that the doctors told us, we told you every step of what was happening. You were so small. You asked me that night "Mommy, are you going to go to Heaven", that sentence has haunted me for the past 5 years. That was the night you changed overnight. You went to bed 4 years old and you woke up a mini-adult. For one entire year, you took care of me. You were the adult and I was the child. You took care of Cole, you helped Daddy do things around the house. That was the year you stopped playing with toys, that was the year you grew into such a beautifully compassionate person. That was the year I knew in my heart, this girl is going to be something very special with her life. It took me 5 years to realize cancer didn't ruin you, it made you an incredibly strong, compassionate, determined person. Enough about that, lets not dwell on the past right. 

    I was asked to write letters to you and your brother 5 years ago, I never gave them to you. So, here on the day before you turn 10, I am going to finally share with you some of the words I wrote for you. I am going to skip the letter part and just share my hopes for you. These are things that now you are turning 10, I feel are important for you to know and always remember. Keep them with you, when you are scared because lets face it, life is scary. Remember these. When you are sad because, life will be sad. Remember these. When you are frustrated because, I think you know, life will be frustrating. Remember these. Here goes:

1. I WILL NEVER STOP LOVING YOU:

    Not when you make a mess and don't clean it up, or when you roll your eyes. I will always love you enough to teach you, to listen to you, to guide you. I will always be here to wrap my crazy emotional arms around you and tell you how very proud I am of you, even when you are not proud of yourself. I will always be here when you need me. My love for you goes deeper and higher than anything I could ever imagine in this world. You are among 3 other kids that had my love and my heart before I ever saw you. NOTHING you ever do or say, will change the love I have for you. 

2. STOP WORRYING:

    Mommy has wasted a lot time worrying. My worrying started when I was a little girl. I worried about being sick, or not being good enough. Worrying does nothing for you. Instead, think of all the positive things life has to give to you, don't be like me and focus on the negative. Don't waste your years dwelling on the "what if" theory. Live your life, take chances,  do the thing that scares you a little. This world we live in has so much more to offer than this corner of a town we live in. Mommy worries enough for the entire family. Promise me you will do these things, and I in return will promise and try and let you live that life. I am still learning too.

3. DON'T TRY TO PLEASE PEOPLE:

    You cannot and will not be able to make everyone happy. I have learned, you cannot make someone happy when you yourself are not happy. If you don't want to do something, please don't do it because you think it will make someone else happy. Do what makes YOU happy. This is your life, not theirs. 

4. BE KIND, NOT RUDE:

    This one is a bit difficult. Yes, everyone has a personality, no two people are alike. Learn to accept and love people for who they are. Be polite, be respectful, be humble, BE KIND. I ask that you please always choose kindness above everything. Being rude has never gotten anyone anywhere, this is coming from a former mean girl. I know this one all to well. As you are getting older and your trying to fit in and find your place in this world, remember that HUGE caring heart you have. NEVER make anyone feel like they are beneath you, or that they are not beautiful or important, especially to make your friends happy. Choose kindness my sweet girl.

5. DON'T HOLD GRUDGES, FORGIVE AND FORGET:

    No matter how careful you are, how thoughtful you are. There will always be that situation where you get hurt, not in the physical sense. At some point, you will feel hurt from your friends, from us, from Cole, from Ethan and Maddy, Aunt Mandy and Uncle Matt, even Grammy and Grandpop, they will all hurt you at some point (may not be intentional but it may happen). People will let you down at times. Stand up, forgive them, and move on. Life is too short to hold grudges. Whatever it was will not matter in the long run. And same applies to you, when you hurt someone, apologize! Always remember your pride is not more important than the pain you may have caused someone. 

6. RESPECT YOU:

     Respect yourself, please! If you don't respect yourself or appreciate yourself, you cannot expect anyone else to. Don't EVER let anyone tell you you are not good enough, because you are. Don't ever be afraid to walk away. This life will be crazy, people will be crazy, remember who you are and never lose sight of that. 

7. DON'T EVER GIVE UP:

    When you feel like giving up, feel discouraged, have just plain had enough, DO NOT GIVE UP! You have proven time and time again how amazing you are. Your level of thinking at 10 surpasses anything I can even comprehend. The goals you have set for yourself, are goals most adults don't even have. You have dreams of becoming a Pediatric Orthopedic Doctor (you have been saying since you were 5 that you wanted to be a doctor and I believe it. I see it in your future) don't give up on that dream when things get tough. Pick up the phone, call me, call Daddy, Cole, Aunt Mandy, Uncle Matt, Ethan, Maddy, Grammy. Don't be afraid to ask for help reaching your goals. It's very easy to throw the towel in, but trust me kid, pushing through is a lot better than giving up.

Lastly: KNOW YOUR WORTH:

    You're beautiful. You're strong. You're better than me in every way possible. You're something special. You're smart, you're funny, you're talented, you're caring. Please don't ever let anyone tell you or make you think differently! 

So, to end my emotional "letter" to you, I will say one last thing. Gabby, when I first laid eyes on you 10 years ago, I had no idea how lucky I was. Thank you for being the person you are. Thank you for teaching me, for letting me bad a parent parent and not hold it against me, for loving me even when I am finding it difficult to like me. I could not have in a million years guessed that I would be so lucky as to have the incredible daughter that I do. I love you Gabrielle Ryan! 

"Kid, you'll move mountains" - Dr.Seuss

The truth about 5 years

 
  I cannot wrap my around the fact that this month I will hit the five year mark of having been diagnosed with stage III breast cancer. FIVE years!

  I still remember that day in March in 2011 like it was yesterday. I remember seeing a surgeon at 12:00 in the afternoon and being told whatever it was that I was feeling in my chest was nothing. He told me because the ultrasound tech did a bad job on the ultrasound, he was sending me back for a mammogram, just because. I had no family history, I was 31 and healthy. He just wanted to prove a point. After getting the mammogram a lady asked me to please return to Dr. P's office, there I sat in an exam room with my friend Stephanie (Ryan went back to work because we were told this was nothing). I asked Steph to grab the mammogram report off the door so I could see it. All I saw was "CATEGORY 5. HIGHLY SUSPICIOUS OF MALIGNANCY", that's all she wrote. I went numb. I heard him say the words "this is cancer", I just stared straight ahead and all I could manage to say was "Gabrielle and Cole. I cannot die". I remember staring at my phone and not having a single clue as how to use it. I eventually managed to text Ryan "I have cancer". That's all it said, he called me, I couldn't answer. I walked out of the surgeons office that day and into his waiting room where Ryan was coming through the door, I collapsed in his arms and just kept saying "Gabby and Cole, please don't let me die. Why is this happening". Everything from that moment on moved super quick, I went from finding out I had to cancer to starting chemo in a weeks time. God, I remember that first chemo treatment, the nerves, the tears, the uncertainty. Waking up the next day feeling like I was very hungover and feeling like I had the worst flu of my life. I remember the collapsed lung, the chest tube placement, the sleepless nights. I think I cried every night after the kids went to bed for a good year. I remember one day, about 3 chemo treatments in, asking Ryan to come in our bedroom. I asked him to sit on the bed with me and I lost it (more than the usual lost it) I told him I couldn't do this anymore. I was not strong enough, I couldn't take being this sick. I didn't want to have to fight to live. I didn't want to cry every single time I looked at my kids, I didn't understand why this was happening and I just wanted it over. All he did was tell me to think of how those words will affect Gabby and Cole. They were 3 and 4. They needed their Mommy, he needed me. After that day with Ryan, I got angry. Angry because he was right, I was not going to let someone else dance with Cole at his wedding, I was not going to let someone else help Gabby pick out her wedding dress. Anger is what got me through the rest of the treatments. I wasn't going to write a blog post about five years, partly because I am superstitious that since I haven't hit five years talking about it is bad luck. Partly because I thought I was over it. Well, if anyone read this blog, they may recall a post back in 2011 when my therapist (who was also a big reason I was able to continue and fight) he had me write "goodbye letters" to Ryan, Gabby, and Cole. Well, looking through my hope chest the other night, I found them. I wasn't going to open them, I was actually going to just throw them away. However, I did in fact read them.

  I can't help but be stuck in my own head this month. I know the reality that five years is just a number, I know that cancer can return at any point. I know I will forever live with this mental game. I also know that for anyone who has heard those dreaded words "this is cancer". Whether it be you personally, a spouse, a child, a friend, a parent, a sibling, anyone close to you, five years is a significant achievement. It means the chances of it actually coming back are a lot lower, it means you made it to the mental finish line. I cannot wait for March 24, 2016 when I can say it's been officially 5 years. Until that time though, I am having a rough go around. I am worrying about little thing I feel, I am worrying about things out of my control again. Every March my anxiety spikes a tad, this March, my anxiety is off the charts! I know in my heart all is going to be fine, I just wish I could make my head believe the same things!

Cancer, Anxiety, Remission. There's a combination......

Anyone who knows me (or has read my blog) knows this blog is my catharsis. Whenever I am feeling anxious, sad, mad, scared, anything that relates back to my diagnosis, I open my computer, tune the world out and let the words and thoughts flow. This entry is no different. My posts have gotten very few and far between, which is good. I know I "ended" my blog last year, but for me, I cannot walk away from it. It's the one place I don't feel judged, the one place I feel like I can be as open and honest as possible, also it's a lot cheaper than sitting on a couch in an office pretending like I am letting everything out.

Any person who has ever heard the words "you have cancer" or have heard those words spoken to a loved one, understands what an emotional journey this is. A journey that, unfortunately, doesn't stop after the treatments stop. Don't get me wrong, I am beyond blessed and happy that in 4 months I hit the 5 year mark. I know the significance of that milestone in the medical world, I also know the reality, it's just a number. I secretly struggle just about everyday still with the anxiety of having been diagnosed at 31. Maybe it is because I was diagnosed with Stage III cancer and well there is only one more "stage" beyond that. Maybe it is because I am an anxious person to begin with and this certainly doesn't help an anxious mind heal. Maybe it is because I have worked in Oncology for 10 years and I feel a thousand different emotions and see every possible outcome on a daily basis. Maybe it is just the plain fact that once you have walked in these shoes, the fear never goes away.  Or quite possibly it is just because I have an appointment with my oncologist this week and I feel like my luck is running out. I think a person who is diagnosed with early stage cancer and a person who is diagnosed with locally advanced cancer handle anxiety differently (as it would be different for a person with metastatic cancer). I did read an interesting article (that sparked my thoughts on this subject) about how the anxiety of having had cancer increases as the years go on, instead of decreasing like your chances of recurrence do. I also get more anxious around my appointments, I am still seen every 3 months by either my surgeon or my oncologist, I try to not get worked up about these appointments, however I think in my mind I am waiting for that one appointment where I hear that word "recurrence". I fully understand how low my chances are of cancer returning at this point, but that doesn't really ease my mind. I guess, like I said earlier, I feel like at some point my luck is going to run out. All of these increased anxious thoughts and feelings could also be related to early menopause. Thanks chemo!!!

A lot of people have been asking me when my surgery date for the hysterectomy I decided on is. Turns out, after an appointment with my GYN over the summer and some additional soul searching, I decided against the surgery. Well,  apparently I may have made the right choice. I was informed having gotten chemotherapy at a young age puts you at an increased risk for going into menopause early (my body did go through a temporary menopause while I was receiving chemo. That was a fun summer). I have been experiencing quite a few symptoms that I just chalked up to Tamoxifen (it is a tricky little pill) or just my anxiety problem. However, after talking to my doc, turns out some blood work is needed as these symptoms are also indicators of early menopause. I mean hey, why not at this point. I have mixed feelings on this. I also was told Tamoxifen can put you in a menopause like state as well. So there's that too.

I have done some research (my absolute favorite thing) on cancer survivors who had the same diagnosis and treatments that I had, turns out an increased anxiety level a few months before that milestone 5 year mark is the norm. I can justify it in my mind, the day you get your cancer treatment plan in place nothing is looked at past 5 years (at least not 5 years ago, cancer treatments have changed, things may be different now. Tamoxifen is now 10 years instead of 5). I just had my binder of my medical records out the other day and read my first cancer patient office note. It stated if I had no treatment what so ever I had a 65% chance of NOT surviving 5 years. With the adjuvant chemotherapy, radiation, mastectomy and Tamoxifen route I took, I had a 75% chance of being alive and disease free at 5 years. 75% is wonderful and those are odds that I am more than happy to have, but that 25% still lingers in my head. Especially when 5 years is in 4 months. I get no one is promised tomorrow, I think I just struggle with the statistics. In my research, I also read that even though the fear or uncertainty will not fully go away, once you get past the milestone year, the anxiety level starts going down. I really hope there is truth to that, not sure I am going to make it to March with this level of anxiety.

Nana

"Love is the greatest gift that one generation can leave to another"-Richard Garnett

  Anyone who knows me, knows I am not really good at speaking my feelings. I am better at writing down what is in my mind. I find it easier to express emotions through writing.

  On Saturday my husbands family lost their matriarch. Ryan lost his Nana, my mother-in-law, Pam, lost her mom. Gabby and Cole lost their great grandmother and I lost a woman who showed me so much in the 16 years I knew her. Nana was a strong, caring, compassionate, loving, stubborn, and big hearted person. From the very first time I met her, she was Nana. Not Mrs. Ridall, not Ms. Evelyn, but Nana. She welcomed me into her family with open arms, she always made me feel comfortable, she always made me feel as though I was her grandchild my entire life. She had a special quality about her. No matter what she had going on in her life she always made time for you. One thing that always stood out to me was how much she loved her grandchildren and in return, how much her grandchildren loved her. 

 When I received the phone call on Saturday that Nana wasn't doing well, my heart broke. My heart broke because Ryan was 2 hours away at a baseball game he couldn't leave, Pam and DR were 6 hours away trying to get home as quickly as possible. I headed to the hospital (with my sister, because I called her frantic) to sit with Nana. I was not prepared for what I walked into. As I walked into the room and saw Nana it took every single ounce of everything I had in me to keep it together. I stood there for a few minutes looking at her and trying to figure out what the right things to say were or what the right thing to do was. 

 As difficult as it was seeing her like that, I am so very thankful and honored to have gotten to spend the last few hours of her life with her. She asked to hold my hand at one point and I sat on the hospital floor (yes, germ-a-phobic me sat on the hospital floor) and held her hand and rubbed her head while she replayed memories of her life in her mind. She wasn't able to really speak, so instead I just reassured her that everything was going to be ok, that her family loved her so very much. I thanked her for showing me what unconditional love looked like, for raising a fantastic daughter who was an equally as wonderful Grammy. I thanked her for having a hand in raising Ryan and I told her he was the most incredible person I knew. But most importantly for me, I told Nana how much I loved her (again, I am not good at expressing my feelings). I sat on that floor holding her hand and rubbing her head for 2 hours. That is 2 hours of my life that I will forever cherish. 

 When we lose someone we love, we have to find the beauty in the situation. Watching someone take their last breath is not easy, being there the moment they slip away is haunting. However, just like I have always done in my life, I turned to my sister. She told me to think of that last breath as a milestone. Nana took her first breath in hospital room surrounded by people who loved her deeply, she lived an incredible 82 years, and then took her final breath in a hospital room surrounded by those who loved her deeply. Her life came full circle. Her memory, her amazing qualities, her values, and her will forever live on in her children, her grandchildren, her great grandchildren, and anyone who was lucky enough to have her in their life.

"Don't cry because it's over, smile because it happened "-Dr. Seuss

Rest in Peace Nana, I love you.

I have made my decision.....

"Sometimes the questions are complicated and the answers are simple"-Dr. Seuss

Oh, how powerful our brains are! One of my biggest flaws has been (and unfortunately always will be) my need to over think every situation. It's human nature and it's in all of us to make things much more complicated than need be. I have struggled and obsessed over the question of ovarian suppression vs Tamoxifen. What is right for me? What do the books say is the best option? What would? What if? How come? How long? I have thought so much that I wore myself out.

I have talked to friends and family, I have created a folder (anyone who knows me, knows my love of calendars and folders. If I can create a folder on something, I am all about it). I have printed out just about every single article I could find on the benefits of ovarian suppression in ER positive breast cancers, on menopause at 35, on hysterectomies, on oophorectomies (removing just the ovaries), on the recovery, on the surgery. I have read and re-read every line. I have highlighted statistical facts, I have highlighted opinions, I have highlighted information solely because it looked important. I have been consumed with this for over a week. I had a mini break down the other night over this. I am pretty sure I just mentally wore myself out. 

The other night as I was driving home from work, I was thinking about how I make this choice. I started crying in my car and when I got home I held it together during dinner, then I went into our bedroom and I lost it. Ryan came in and asked me what was going on. I broke down and told him everything. Every fear, every reason I did not want to get my ovaries out, every reason I did want to get my ovaries, how I know I am making this bigger than need be, how I wish I was never told about this new option, how I NEEDED him to tell me what the right thing to do was. Ryan just simply said "do what's in your heart Amy".  I felt like saying well, if I knew that I wouldn't be sitting her crying! However, when he said that, something inside me told me, my answer wasn't in research papers, it wasn't in Google's search engine, it wasn't in any of the places I was looking. To some this might be a no brainer, to some this might seem like I am making a mountain out of a molehill. It's just my head, my heart, and my gut are telling me different things. My head says stay on Tamoxifen. My gut says do the surgery. My heart, felt torn between the both. 

I decided I needed to find some clarity. I needed something to help me make the choice that was right for Amy. As I sat and thought about where do I find this? Do I pray (well, honestly I am not religious)? Do I listen to the advice I have gotten from friends and family (after all they do care about me)?  Where does clarity come from? Then sitting on the couch staring at my computer screen, I decided to re-read my blog. Now, I have only re-read this blog one time and honestly after I was done, I felt sad. I logged in and started at the first entry, March 24, 2011. By the time I had gotten to round 3 of chemo, I knew my answer. I think I always have, I just needed to be reminded. Having gone through everything I have, I mentally blocked out all the bad, all the feelings of sadness, all the feelings of fear. By this I mean from a chemo point of view. I still and will always have feelings of sadness and fear related to cancer, but re-reading the beginning of the blog, when things were still new and my feelings were still all over the place, I instantly in my gut felt like it was happening all over again. I remembered very vividly all those feelings and fears. Then I found the post, the blog post where I sat in my oncologists office in the very beginning of chemo and asked if I could have my ovaries removed. After learning my cancer was 65% estrogen positive and estrogen was made in my ovaries, I wanted them gone too. At that point I was told there was no statistical evidence that removing your ovaries was any better than taking Tamoxifen. Well, look now, there IS evidence that this option can be more beneficial. All I needed was to remember that I told myself from the start, I didn't care how drastic or aggressive it was, I wanted to do every single thing that would make my recurrence rate the lowest. 

So, surgery it is. I can handle menopause at 35, I am kind of thinking it will be nice to go through it young and get it out of the way. I already have hot flashes, I know what it is like to go from a comfortable body temp to pins and needles and feeling like a fire is rising from your chest up. I am already moody from Tamoxifen (I hope it cannot get any worse, there are plenty of days I cannot stand myself). I am already over weight from Tamoxifen and poor lifestyle choices I have made since this all started. I can handle this. I am strong, I am stubborn, I am resilient. I have asked how soon this needs to be done, since it's not emergent (I am 4 years out from chemo in July) but should be done sooner rather than later, I have decided this fall is a great time to go under the ol' knife again. I would like to work hard and drop at least 10lbs (I read, shocking right, that if you go into menopause over weight the side effects are worse). 

I feel good about this choice. I know it's the right one for me. I will meet with my Gyn in the next few weeks and discuss which surgery he thinks is best, total hysterectomy or an oophorectomy. And then I will pick my date. Four years ago, I told myself being a victim to cancer was not an option. I was lucky enough to be diagnosed before it had spread, I was lucky enough to be get chemo and surgery and to be put into remission. I was and still am willing to be as aggressive as possible to make sure I stay in remission. I have 2 amazing children who are becoming their own and who continue to amaze me everyday with everything they do. I am not willing to possibly jeopardize not being there for every game, every dance competition, every argument they have. I am not willing to not be around to continue to annoy the crap out of Ryan ;) We have been married for only 12 years this year, he has a lot more of me to deal with!

So, like I said in the beginning of this post, "sometimes the questions are complicated and the answers are simple"- Dr. Seuss. 

Decisions, decisions, decisions

So when I started this blog in 2011, it was a place for me to write down my fears, get out my frustrations, to help me deal with everything I was facing and to chronicle every step of the "cancer journey'". I stopped writing on here last year because, well life was good. No need to chronicle the every day activities of a normal Mom to two little ones. Well, the other day I had an appointment with my oncologist, still good 3 and a half years in remission, but I do have another decision to make. The last major medical decision I had to make was saline vs silicone vs gel implants. I hate when I feel confused and unsure of what to do. I hate when my mind is at a crossroads and I have absolutely no clue which "road to take".

There continue to be amazing advances in medicine, especially with cancer and how to treat the disease. There constantly are studies being done on the treatment of breast cancer. The newest one to come to light (or at least be brought to my attention, because I fall in the criteria) is to put young women in menopause who have/had ER positive breast cancer. Now, let me recap, it has been awhile since I have written on here, I was diagnosed at the age of 31 with stage III locally advanced estrogen positive, HER2 positive, infiltrating ductal breast cancer. I have undergone 6 rounds of chemotherapy, radiation to the right side of my chest, a bilateral mastectomy with reconstruction and now I take a pill everyday for 10 years. I was (and still am) comfortable with this treatment option. However, like I said, medical advances are made everyday. The new "thing" to do, is women who were under 35 at age of diagnosis, whose cancer was aggressive enough to require chemotherapy and who are premenopausal after chemotherapy would be to shut their ovaries down and put them on an aromatase inhibitor. Now, I stated I take a pill everyday for 10 years. I take a pill called Tamoxifen. Its an evil little pill! Since my cancer was estrogen positive (meaning it needs estrogen to grow) the goal would be to block the production of estrogen in my body. Tamoxifen, as I have been explained to, acts like a bonding agent and blocks estrogen. I was told to visualize the cells in my body being little key holes and estrogen being the key to fit all the holes. Tamoxifen goes in and blocks the keyholes so the keys (estrogen) cannot fit and cause problems. I have been on this pill for 3.5 years, I have experienced and lived through the worst of the side effects, so far anyway. I have gained roughly 25 pounds, I have hot flashes, I am moody, etc.. Nothing that is too much to handle, the way I look at it, I can handle all those pesky things if it means keeping cancer at bay. There is also effects of being on this medicine for a lengthy time, the increased risk of uterine or endometrial cancer, blood clots, stroke, however the chances of those incidents occurring are small (I think). Well, now that this new ovarian suppression and switching to a new pill has come to light, I don't know what the right choice for me is.

If I decide to go with ovarian suppression, I am not willing to get a shot every three months to put me into menopause (I don't like taking medicine, I tolerate Tamoxifen because I have no choice). The route for me would be to have my ovaries removed, since I won't need the other parts, I would actually end up getting a total hysterectomy. Another major surgery. I would also be thrown directly into menopause the moment I wake up from surgery. So, instead of my body naturally and gradually going into menopause (like most women) I was told it would like hitting a brick wall at 60mph. I would have all the effects of menopause, and  I would have to start all over on a new pill for 5 years. Doesn't sound bad, right? Until the kicker, the potential side effects of "throwing" me into menopause would be osteoporosis, heart disease, bone pain, diminished quality of life. Joy! I understand women get hysterectomies all the time and they do fine, but they get hysterectomies because of gynecological reasons, so the hysterectomy is beneficial to them and potentially help their quality of life. I however, do not need one for any reason other then to shut my ovaries down and shock the hell out of body again (it can't really be worse than chemo, right). I also understand these are just "potential" side effects, but the thing with me is, I read every warning label, I research everything, I am that person that NEEDS to know what could happen. Even if 1 person out of ten thousand had a simple side effect/reaction I want to know. I like to be prepared for everything, no surprises.

While the study does show a decreased chance of cancer recurrence after ovarian suppression, it doesn't show an overall survival advantage. Basically, the chances of cancer coming back drop (not significantly but it does drop) and the chances of dying from heart disease or some other complication increase (at least that's how I am understanding it). Unfortunately, tamoxifen used to only be taken for 5 years, a new study proved that extending that to 10 decreased cancer recurrence rates. Since the 10 year Tamoxifen trial and this new SOFT trial are fairly new, there is no statistical evidence stating which one is more beneficial. See why I am confused?

I am the type of person who needs black or white, right choice or wrong choice. I am an over thinker, over analyzer, I have been researching this new information, I have made a pros and cons list, I have been consumed with "what if". I felt the most confident when my doctors told me, you WILL get chemo, you WILL get a mastectomy, you WILL get radiation, you WILL take this pill. Being told, this is your call, I can't seem to figure out what the right answer for me is. This isn't a simple question in my mind. Do I stay the course I have been on for 3.5 years (if it isn't broke why fix it) or do I switch to the new standard of care option (advances in medicine are made for a reason). The hardest thing for me is the unknown (which has and will continue to be the hardest part of this journey). My doctor did ask what my goals were, that is simple, to see Gabrielle and Cole grow up, to not ever have to go through that "journey"again, to grow old with Ryan, the same goal every wife/mother has. I was told, if my goal is to continue to be as aggressive as possible (I made that choice the day I was diagnosed) then surgery and switching pills is the best choice from a cancer stand point. Not the best choice from a now healthy 35 year old stand point though. I did tell myself and my doctors from day 1, that I wanted to do and take whatever was going to make my recurrence rate the lowest it could be, but at the same time, I don't want to decrease my quality of life, I don't want to feel like a 70 year old stuck in a 35 year olds body. Don't get me wrong, every day that goes by that cancer does not recur, my chances of it recurring drop. Each year that I go without recurring, I feel more and more confident this is never coming back. If I am 4 years out and doing fine, do I really want to "alter" myself yet again? I am not a big fan of change, I do best in situations where I can plan my life, where I can plan and be prepared for outcomes ( I am so "Type A" it scares me) I don't like the "well......." feeling.

I had such high hopes that when I got the port removed in April 2012, the big steps would be behind me. In the end I am confident I will do what is right for ME. I am confident I will make the decision that is best for my family. I just need to figure out what the hell that decision is and how I make it.

Losing someone is never easy.......

"Don't cry because its over, smile because it happened"- Dr Seuss.

It's funny the friends and relationships you form with other people who are in your boat. Since my diagnosis 3 years ago, I have made numerous friends through cancer. It has been one of the good things, meeting new people, creating new bonds and friendships with people who understand what your going through or went through. I have been fortunate to make several friends, a few have become very good friends. I never imagined I would have to say goodbye to one of them.

In one of my very first blog entries I wrote about a patient at the cancer center who I ran into in the chemo room. This was not just another patient (I don't mean that in any negative way), this patient was a favorite of mine. From the first day I met him, he was special, he was always happy, always positive. Even when he was feeling like crap from his chemo he always wanted to talk about my family, my life, he always told me "it is what it is" or "what am I gonna do, feel sorry for myself". He was the very first patient I told that I had cancer to, he was at the cancer center (by coincidence) the day of my first chemo. He saw me in the chemo room, stopped us and said "what the hell are you doing back here", when I told him he responded with "not you". He then put his arms around me gave me the biggest hug and said "you are going to beat this kid". He shook Ryan's hand and told him whatever we needed he was there for us. We ran into him a bunch of other times during my course of treatment and he always asked about me when he went in for his appointments. Once I returned to work,  he would come in, ask for me, give me a hug and tell me how great I looked (even when I had no hair and knew I looked horrible, he always told me I looked great). He sat down with me once I was in remission and he told me how pissed off he was that it happened to me. I told him cancer doesn't discriminate and he wanted to hear nothing of that, he wanted to know what was being done to make sure I stayed in remission, what needed to be done to help my mental state of mind, whatever I needed he reassured me it was going to be alright. He became more than a patient, he was my buddy, he had a piece of my heart.

Earlier this year, his cancer came back. I was devastated when he came to my desk that day. He sat down looked at me and said "well sweetheart its back, it doesn't look good", I remember telling him "no, you are going to fight and you are going to beat this again, you have to". Every time he came in for treatment from that day on he always came to my desk, called me "sweetheart" or "kid" and never wanted to talk about himself. He only wanted to know that I was fine, that I was still in remission, that I was taking care of myself. He downplayed every aspect of what he was going through. He truly was a selfless man. I mean, he would always bring in cakes or breakfast, but what I always remember is the hug I got after each appointment. He would hug me so tight that some times I was certain he may pop an implant. He came in for an appointment last month, he came to my desk sat down and said "its over kid", I told him no, no it wasn't. I wasn't listening to him, I didn't want to hear that. I told him he still had fight in him and they were going to figure something out. He came in last week for another appointment, at that appointment, it wasn't him. It took everything I had to be strong while he was there, I wanted to cry, I wanted to wrap my arms around him and tell him I was sorry, tell him it wasn't fair. Not him! I couldn't make eye contact with his wife, she was trying to be strong for him. Today, he went to Heaven. Today, he was set free from pain. Today, the world lost an incredible man. Today, a piece of my heart broke.

Mr. Brooks, you will never fully know how much you mean to me. How much encouragement you gave me. I am glad you are free from suffering, I am glad you will finally get to rest. It will be hard to not see you, I will miss your hugs, I will miss your humor. I will hold onto the memories that I have of you.