Courage

Wrapping up February also meant wrapping up my time with my first focus word of 2013:

Wrapping up my courageous months felt like a good time to throw a major fear of mine out there into the blogoverse (blogosphere?):

I am scared to death of becoming "the cancer girl"

Yup.  You read that right.

Greg and I have talked this one into the ground, but the fear still lingers in my mind.  I know speaking out about my experiences and circumstances is what I should be doing.  I have a unique position from which to speak to twenty-somethings about their own risks, the importance of their lifestyle choices, the care they need to take in listening to their bodies.  And I have a unique position from which to explain to people why their donations are so important to places like Massey.  After all, the odds are clearly in favor of my being the beneficiary of the work those donations make possible.  And I have a unique experience from which my passion for the subject matter is drawn.  And its a passion that I probably couldnt squelch even if I wanted to.

But as I speak more and more, and as I write more and more, and as I attend more and more events, people around RVA recognize me - and do so specifically in my capacity as "the girl who had cancer" or "the girl raising money for Massey" or "the girl who talks about the Massey Challenge".  Which is awesome.  So awesome.  It means something resonated with them enough that they remember.

But what about the other things that make me me?  Because, after all, part of what I love about Massey is the way its staff didn't allow me to lose those pieces of myself in favor of my cancer diagnosis.  They nurtured them instead - helping me study for the LSAT, reminding me that I would run again one day, discussing the books I was reading during chemo treatments.

So I find myself wondering, from time to time, if people will fail to notice those other parts - ones that I think are quite fabulous - because the word CANCER is obscuring all the rest.  The attorney, the vintage hound, the yogi, the dive bar addict, the flutist - will they all disappear into nothing in favor of my cause? 

I've often asked myself why I have been given the chance to survive when others have not, and I know part of the reason is so that I can spread awareness, create hope, and raise funds for research.  So maybe that means I am supposed to be "the cancer girl".  Maybe thats what its my job here to be.   

*   *   *

Whats up next?  Patience.  A virtue I certainly could stand to have a bit more of.

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In other news - We're just $750 away from reaching 50% on the way to $25,151 - so close!  Want to help make that happen?  Donate now by following the link above.

Calling on Absolutely Everybody

You guys might remember way back here when I told you I had adopted a theme song for this journey to $25,151.  I was leaving Tim's place one day and he thrust a mix CD in my hands for the drive.  And at track 4 I found it.  The song that I knew would keep me going, and hopefully motivate lots of others.

On that drive, I must have listened to the song about 30 times, envisioning the video I knew I had to make.

As Ive said many times before, I am surrounded by people who not only love me - but love my crazy ideas.  So when I told Brian (my amazing videographer friend) that I wanted to do this, he didnt doubt the idea at all, but sent me a slew of tips and thoughts and support.

And then Tim, Lauren, and Becky hopped right on board when I still believed we could shoot the whole thing in about an hour and easily dub the music over.  And Lamone gave us free reign of C Street once again to try to make it happen.

And when that was A LOT more complicated than I thought, Stacey jumped in and saved the day with her photography talent.

And after what I thought would take an hour took 2 months, this resulted:



I've said it before, and Ill say it again - the only way we will find a cure is if absolutely everybody joins the fight.  Hopefully this video can help us remind folks of that.  So please share away!

And as always, thank you for your generosity and support!

Why I Run

Confession time here, folks.  I am not a good cancer survivor.  I'm an even worse BRCA1 carrier.  I couldn't tell you what fruits or vegetables make up the dirty dozen.  I reuse disposable plastic bottles.  I don't sleep enough.  I drink far too much.  I don't do self exams.  Line me up against all the other women in the world who are trying to reduce their cancer risk, and I assure you I'd be woefully inadequate.

(This is something I'm pretty okay with - I'll fill you in on why as the new year approaches). 

I'm headed home for the holidays on Friday and there are three things I can guarantee will happen.  1 - I will locate the hidden stash of Ho Hos in my moms house and go to town.  2 - Paula will order something with "gobs and gobs of molten lava cheese."  3 - Jan will ask me why I run.

Me - I'm going for a run.
Jan - Why?
Me - What do you mean why?
Jan - Why do runners run?  I have never seen a happy looking runner. Stay home with me and eat this cheesecake.

He's right.  I probably dont look happy while I run.  I'm slow.  And the first mile always, ALWAYS, sucks for me.  But after that first mile, I tend to settle in and enjoy lots of things about my runs.  Here's my

All-Time-Top-11 Reasons Why I Run 

(Yes, its 11. Stop picking on my list)

11. I love the view of my neighborhood from my sneakers.  And of all the other old 'hoods I run through both at home and when I travel.  I never fail to notice something I would have missed in the car.

(crazy old sign-post marking the street where I grew up)

10. Because my happiest places are outside.  Running gets me out there when my career keeps me from places like this for too long:

9. I like to think my long runs give me extra stamina when I end up on a stage.  Which happens more often than you might believe.

(Rocking out with the Remnants)

8. Running gives me a space to think through my cases away from my desk.  And if I can get through an oral argument during mile 3, I'm usually confident it'll be cake standing still in a courtroom.

7. Ill admit it - I run because I like to drink beer.

(And someone put an amazeballs brewery essentially in my backyard)

6. And because I like to drink wine.

(Acacia - October 2012)

5. I also run because Tim really likes to cook.  And I really like to eat.  And Tim really likes to use butter.

(Bacon-Wrapped-Turkey?  Yes, please)

4. I am one hell of a sensitive girl, and running helps me to process and let go in ways I probably otherwise wouldnt.

3. I have some crazy- athletic friends.  Running lets me feel like I almost have enough cred to hang out (and sort of keep up) with them

(Although maybe I shouldn't worry about that, since we're all good at acting like idiots)

2. Because for a year, I couldnt.  In the months leading up to my Hodgkin's diagnosis, my endurance was quickly ripped away.  And during chemo and radiation I was lucky to make it through a stroll in the market.  Every time I run today, whether for a mile or a 10K (I swear someday Ill run longer than that!) I remember the time when I couldn't run and I am so.damn.grateful.

1. Because it puts distance between me and cancer.  Its the one thing I know I'm doing to tell cancer to back the fuck off.  In my mind, each mile increases the space between us.  And while I dont generally advocate running way from problems, a second cancer diagnosis is one problem I'm happy to high-tail it away from. 

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Don't forget to make your last minute 2012 donations!  Its easy - just hit that button up there.  Every dollar helps us move even closer to eradicating this crazy disease.

Thankful

Happy Thanksgiving!  I have so much to be thankful for this year, but even so, this holiday always takes me back to the year Hodgkins was such a huge part of my life - likely because my radiation ended just in time for me to celebrate Thanksgiving with family.  I am so thankful to be in remission and that I happened to live so near the Massey Cancer Center.

I'm also thankful for the friends who made that year bearable.  One in particular.  So I'm going to say thanks to her today.

Loren and I met the summer before our senior year of college.  Ill be honest - I didnt like her at first (don't worry - she knows this already!) but we quickly became inseparable.  The following years brought lots of fun together, like annual birthday pictures with the Fells Point Elvis:

Tons of miles logged while hiking:

Her attempts to teach me to ski, perfecting our performance of Ice, Ice, Baby, slumber parties, and establishment of our "designated drinker" regimen, which would allow us to play beer pong while also keeping one sober driver.  She once left me as collateral with a bouncer so she could go inside and use the phone (yeah - before cell phones).  This may or may not have happened because we spent all of our money at quarter bottles night.  And we had more than $5 with us.

We've also had bigger stuff in our friendship - a months long non-speaking fight.  Weddings.  A divorce.  When my dad passed away, Loren didn't bat an eye before calling out from work and driving my brother and I to Connecticut through a snowstorm.  She is THAT kind of friend.

My step-dad once told me that there are very few people in the world like Loren.  Its true.

So it shouldnt be all that surprising that Loren logged a LOT of miles traveling between Baltimore and Richmond while I was sick.  She visited almost every other weekend to hang out with me, even when I couldnt do much.  But one weekend, when Tim was throwing a party on one of my "better" weekends, Tim and Loren decided I should come to Baltimore for a weekend before getting my next round of chemo.  There was really only one problem - I needed daily shots of Neupogen and couldnt give it to myself.

It shouldn't shock you that Loren volunteered to do it.  Even though she had never given anyone a shot before.

Evan loaded up the syringe, packed it in a cooler, and told Loren to call him when it was time for the shot.  One of my funniest memories ever is Loren trying to cradle the phone while holding the syringe listening to Evan tell her what to do.  And she did it. 

Later that night we were off to the party, and our "designated drinker" system came in handy since I wasnt drinking. 

(This isnt from that party, but I felt it was a good representative).

A guy noticed the band-aid over my injection site and kept asking about it.  Over.  And over.  Finally, Loren had enough and yelled at the guy "She has CANCER okay?  Now shut up!"

Tim and I thought our 5'3" friend was about to drop the peoples elbow on the guy.

He was very apologetic.  And probably scared.

It was one of the funnest weekends I had that year.  And I wouldnt have had it without Loren being willing to give me that shot.

Loren - Im so thankful for your friendship.  You're amazing.  And I clearly love you since I willing posted such unflattering pictures here.

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Who are you thankful for this year?  Why not honor someone who helped you through a hard time by making a donation in their name to the VCU Massey Cancer Center?  You can do so here.

Back in Time

I was digging through history tonight, looking for some pictures for a very special post later this week.  I found a journal of sorts I started when I was diagnosed with Hodgkins.  I didnt write in it but I did tape every single card or note I received during that year inside. 

Or I thought I didnt write.  Turns out I had forgotten what I scrawled on the opening page:

Its funny ten years later to stumble upon that quote.  And to think about how I had no idea when I selected that just how glad I would be for the things I cannot change.

Lets All Visit Harry Bear

First things first - yes, I trust my life to a man named Harry Bear.  That is his real name.  And he kicks oncology ass.  I see him every six months and hes on the front line of making sure I stay cancer free.  I decided to take you all on a visit with me last week.

At 9am I roll in to this place to get testing started:

I see all my other doctors Downtown, but I'm happy Dr. Bear is out at Stony Point because the nurses there are super good at putting in IVs and I'm a super hard stick.  So it works out.

First up is a mammogram.  Thats a pretty easy process once you get over the fact that you cant wear deoderant or lotion until the test is over - and have hit the rodeo often enough to remember to bring some with you for after.  See, don't I look so smiley in the changing room?

I am allergic to most pain killers in rotation, so in addition to the normal hospital armband, I get to wear a snazzy extra one with every single allergy I have listed for the nurses and doctors to see:

The mammogram doesnt usually take very long - maybe 30 minutes?  So then I head over to radiology for an MRI.  No matter how often you go, you still have to fill out LOTS of paperwork every.single.time.

 Ill be honest.  This is not my favorite test.  See:

First you have to change into one of those awful hospital gown things.  And then you usually have to wait for a pretty long time.  And its cold.  This is why my hat always comes along.

Then you get an IV.  I do not like IVs.  My chemo was administered through an IV and I still never got used to it.  Now, after so many IVs (I get them for all of my CT Scans too), its nearly impossible to start one in any place that doesnt hurt like a m0*her*#!&er.  Confession - I always cry.

Then, ladies and gentlemen, after you hang out again in the cold with an IV in your arm, you get to finally get the MRI done.  Recall we are dealing with a breast MRI here.  In the interest of narrowly avoiding TMI territory, I will simply tell you that it involves lying on your stomach for 25 minutes in a crazy loud machine without moving and feeling very much like you finally understand how cows feel on the daily. 

Im not much of a complainer, but this is not my idea of a good time.      

After thats done, Im free to get dressed and be on my way.  It usually about 5 hours all said and done.

A week later I come back to hang out with this guy:

We discuss whether my thoughts on surgery have changed - a discussion that has become such old hat that when he asked me this week what I was planning to do I said "go for a run."  He laughed and said "no, about your breasts!"  Duh.  Then he gives me my test results, does a physical exam, and I'm on my way.

This week was another good visit - 6 more months cancer free! 

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I'm hovering around $360 away from reaching the 25% mark on the way to $25,151!  So close!  Push me over that milestone before Thanksgiving by clicking here - and pass my blog onto your friends and family and encourage them to pitch in!  Together we can get to $25,151 - and find a cure for cancer!

An Open Letter To My Hero

Dear Dr. Ginder:

10 years ago today, you told me that I could travel home for Thanksgiving.  I didn't need more radiation.  We could consider my cancer in remission.

In some ways, that day feels very long ago.  In others it feels like just yesterday.

You are someone I never really wanted to meet.  I have never liked needles, or hospitals, or the smell of saline.  Or, frankly, doctors.  But from the moment I walked into your office, I could tell you were different.  You have always listened to my concerns - even if they were ones I found in the far reaches of the Internet that really had no valid medical basis.  You let me throw my temper tantrum when Kevin told me that I needed an extra round of chemotherapy and I.just.didnt.want.it.  You always took my calls - for big things ("the Neupogen is making my bones hurt so badly I cant stand it") and small ones ("is it normal that broccoli makes my tongue hurt now?").  You never once made me feel like your time was more important than me, or that you were more important than me.  And even now, 10 years later, you still never do.

Cancer changed me.  When you met me I only wore flats and I had yet to discover the real fabulousness behind the color pink.  I was so shy I could hardly make eye contact with someone I didnt know well, nevermind talk to them.  I hated my job and thought that maybe law school was something I might be able to do one day.  I was a passive actor in my own life. 

(I think you know thats not true anymore!)   

And having you as my physician, and having the special privilege of knowing you as a researcher, has changed me.  You have taught me how to be compassionate, how to work tirelessly for something you believe in, and how sometimes you have to do the right thing even when you dont like everything that goes along with it (I will always remember how badly you felt after that broccoli incident).  You've taught me that giving someone your time when they need to talk can be the greatest gift ever - even if it throws your plans for the day totally off.  And that none of us is more important than anyone else.  We all have a duty to care for each other - and you do that for your patients and for the researchers who work alongside you with strength, grace, and wisdom.   

There is nothing I could say to adequately thank you for saving my life.  But I hope I use the days you have given me in a way that will make you proud. 

Love,
Kaity

Photo Credit: Doug Buerlein

My Story - Part 3

When I was in high school, my mother was diagnosed with breast cancer.  I was your standard self-centered teen back then and, to be honest, I don't remember much of her diagnosis or treatment.  It didnt seem to have much to do with me.  A few years later, I remember hearing that an aunt on my father's side had received a similar diagnosis.  But aside from a few prayers sent her away, it didnt impact my life at all.

Until the spring of 2010, when my mom decided to be tested for the BRCA gene mutation.

*   *   *

"BRCA" is the acronym for the gene mutuation that casues heredetary breast and ovarian cancer syndrome.  I'm not a scientist, but my understanding is that everyone has two BRCA1 genes and two BRCA2 genes.  If someone has a mutation on one of these genes, their risk for developing certain cancers increases, like this:

BRCA1 mutation	36 percent to 85 percent lifetime risk for breast cancer 40 percent to 60 percent lifetime risk for second breast cancer (not reappearance of first tumor) 20 percent to 60 percent lifetime risk for ovarian cancer Increased risk for other cancer types, such as prostate cancer
BRCA2 mutation	36 percent to 85 percent lifetime risk for breast cancer (in females) 6 percent lifetime risk for breast cancer (in males) Up to 27 percent lifetime risk for ovarian cancer Increased risk for other cancer types, such as pancreatic, prostate, laryngeal, stomach cancer and melanoma

(Those numbers are from here).  Today, physicians can test to see whether an individual carries one of these gene mutations.  If so, that person can elect to take certain preventative measures to reduce their elevated risk of cancer.  That is what my mom wanted to do if she had a positive test result.

I felt strongly that my mom didnt need the test.  It had been so many years since her own diagnosis, and she had been doing well since.  And we really don't have an extensive family history of breast cancer - or any other type of cancer.  And, honestly, I didn't want to know - I had faced cancer once, and had no desire to know if it might be headed my way again. 

I never for a second thought her result would be a positive one.  But it was.  The BRCA1 mutation runs in my family

*   *   *

Even after this result came back, I still didn't want the test for myself.  But I had put my trust in Dr. Ginder for years and years, so when he insisted that I be tested I marched myself over to the genetic counseling team at Massey, where Heather Creswick took a blood sample and sent it on its way.  Honestly - I was still pretty sure my result would be negative. 

Unfortunately, a few weeks later, Heather had different news - I also carry the BRCA1 mutation.

Hearing her tell me this was almost harder than when I received my Hodgkin's diagnosis.  Unlike that time, I understood the diagnosis now.  I asked Heather if this result explained why I had developed Hodgkin's in the first place.  There is still no concrete answer for why otherwise healthy, active, young people develop that particular lymphoma, and I hoped that maybe, if nothing else, in this new diagnosis there would also be an answer to the question that has long plagued my mind with respect to the old one.  But Heather had looked and didn't find any research connecting the two.

Heather finally handed me the papers bearing my diagnosis in black in white and I told her would call Dr. Ginder that afternoon.  As I wound my way through the MCV campus to my car, I wished for the first time in years that it wasn’t quite so full of familiar faces.  The last thing I wanted was for someone I knew to find me in that moment. 

*   *   *

I didn't walk to my car.  Instead, I found myself wandering the streets around MCV trying to make sense of what I had just learned.  It was different from my Hodgkin's diagnosis - when it seemed a given to tell friends what was going on.  This time, it seemed worthless to call anyone - how would they understand?  How could I explain that in many ways this diagnosis rocked me in a much deeper way than when I learned a fight with Hodgkin's was before me?  This time there was no named enemy - just some vague possibility somewhere in the future.

And how could I explain the sudden realization that for many years I had been, apparently, operating under the self-righteous belief that I somehow didn't deserve another unfavorable diagnosis?  That I somehow deserved to escape future illness and pain because I had already paid my dues?  For the first time it occured to me that somewhere deep down I felt like I had already been through the diagnosis.  The staging.  The treatments that didn't work.  The treatments that finally did.  The follow up appointments.  The recurrence scares.  How coudld I explain that part of me felt like I had given cancer my youth, my relationships, and thousands upon thousands of dollars, and that I didn't deserve any more?  That what I really found myself asking was - what more could this disease could possibly ask of me?

It was one of the most frustrating and scary mornings of my life.

*   *   *

But, as he has done so many times for me, Dr. Ginder stepped in to pull me out of that grey place.  As Massey is so good at doing, he quickly expanded my team to include Dr. Harry Bear and Dr. Cecila Boardman.  And they all agreed - combined with the risk for secondary cancers as a result of the treatment I had received for Hodgkin's, the BRCA1 mutation likely made my personal risk of developing breast or ovarian cancer very, very, very high.  But there are still no studies on that particular combination of factors, so we can't be sure exactly how high.  So what to do?

My team recommended an immediate double-mastectomy and a hysterectomy by the time I am 40. 

Every woman (and man - men carry it too!) who receives a BRCA diagnosis has to make the very personal decision of what type of action they want to take.  The gravity of that decision doesnt really sink in until its time to make it.  I adore each of my physicians at Massey.  I trust them implicitly.  And I know I receive the very best care in their hands.  But after months of praying, talking with friends, and research of my own, I just couldn't reconcile in my heart going down the road they were recommending.  A big reason why is because I so deeply believe in the research being done at Massey.  And I believe that if I ever do receive another cancer diagnosis, we will have treatments and cures beyond what I can even imagine today.  I can't with good faith go through those surgeries when monitoring is available.  When progress is still being made.  When we are fighting such a good, hard fight against this disease and making headway every. single. day.

I know I worry my doctors in making that decision.  But I also know the amount of hope and faith I have in the work being done in so many labs will give me the strength to face whatever may come in the future.  And that I will have awesome doctors by my side to help me down that road too.   

So, instead of surgery, I pay lots of visits to Massey.  Each year they give me an MRI, a mammogram, lots of x-rays, an internal ultrasound, a CT scan, more physical exams that I'd care to count, lots of blood work, along with all the normal (really fun) gynecological stuff.  The hope is that if one of them is always in my business, we'll catch anything early - and be able to treat it successfully.  And I have total faith that if that time comes, we'll beat whatever we find.

My Story - Part 2

Its difficult to explain what it feels like to walk out of a hospital with nothing more than a cancer diagnosis and a list of names that mean nothing to you.  To have had your normal 23-year-old world flipped upside down in the matter of an hour.  Where the 24 hours earlier my biggest worries had been where happy hour should be and what cut of jeans was most flattering on me, I was thrust quickly into a world which much bigger worries.

Over the next day or so, called my closest friends and very matter-of-factly explained the diagnosis to them.  While they cried, I didn't.  In many ways, I was relieved.  For months, along with the swollen lymph node, I had been experiencing symptoms that I couldn't make sense of.  I would fall asleep at 7pm, sleeping straight through until 7am and wake feeling like I had pulled an all-nighter.  I went from running 5 miles a day to being unable to make it through just one block.  Night sweats would drench the bed, causing mid-night sheet and pajama changes.  I had never connected these dots until, finally, the diagnosis made them make sense.

*   *   *

My mom loves to tell the story of how I bit my pediatrician when I was young and needed to get a shot.  I have never, ever liked doctors.  But when I met Gordon Ginder, I knew I would like him.

Dr. Ginder's name wasn't on the list I had received from the ENT.  In what I can now describe only as a twist of fate, I happened to know someone who was working in Dr. Ginder's lab when I was diagnosed.  He specializes in lymphoma and is the Director of the Massey Cancer Center.  Even so, I was pretty much brand-new to Richmond, and I am sure I never would never have found Dr. Ginder if not for knowing someone who worked with him.  And I really dont know how my story would have panned out if I hadn't.

*   *   *

Dr. Ginder re-ran my biopsy and came up with the same diagnosis - Hodgkin's Lymphoma.  We then went about the weeks long process of staging my disease - blood work, CT scans, x-rays, and a bone marrow biopsy would teach us that my cancer was stage IIB.  Stage II means that I had more than two lymph node regions involved on one side of my diaphragm.  For me, these were in my head, neck, chest, and abdomen.  B means I had systemic symptoms - like the night sweats and extreme fatigue.  The treatment plan we came up with consisted of 6 rounds of intravenous chemotherapy followed by about 3 months of radiation therapy.

My chemotherapy was administered through an IV in my left arm.  They administer it in a room full of comfy arm chairs and TVs, helping the hours to pass pretty easily.  After the first scary and frustrating dose (the one where they explain all of the things that can go wrong while poison is being pumped into your body, and why you need to take 8 pills just to counteract some of the fastest developing side-effects, and where you are inevitably thinking "oh my goodness how can this possibly go well??"), chemo became a "normal" part of life and the infusion room became something like a second living room.  I grew close to the nurses there, talking about life and plans and their families.  It was a good place to read a book and I took in a lot of daytime TV I had missed while working.  I even studied for the LSAT there.  I ended up needing an extra round of chemo because my cancer didn't respond exactly as planned, but I also didnt lose my hair as expected, so it seemed like a decent trade to my 23-year-old self.

Because of where my cancer was, my radiation therapy involved a mesh mask made to fit my face.  While I was in the radiation phase of my treatment, five days a week they would place the mask over my face, screw my head into the table to immobilize it in exactly the same way, and a large machine would quickly zap me.  Along with the mask, I was given four tattoos that would further help align everything correctly.  Even though I have other tattoos, those four mean the most to me.  Every time I seem one of them, its a reminder of the months spent in that room.  All in all, a radiation appointment would last under 20 minutes.  It was hard to believe something so quick was destroying a killer. 

*   *   *

No one's treatment journey is exactly the same.  And being 23 with cancer changed not just my life, but the lives of my friends as well.  Shopping trips changed from searches for Friday night outfits to searches for scarves to help cover my thinning hair.  My body didnt replenish its white blood cell count between doses, so the same friends that had shared cabs home from bars with me had to learn to give me daily injections of the drug that would help make that happen.  Saturday nights out changed to gatherings in my apartment over movies and cookie baking.  Friends I had once cooked dinner with now picked up meatball subs after chemo for me, because it was the only thing my stomach could handle.  Even after my treatment was over, things didnt just go back to the way they used to be.  The smell of beer and wine made my stomach turn, beach days were limited since I wasnt allowed in the sun, and it took quite awhile for my energy to return back to a "normal" level.  Cancer stole our early 20s from all of us in a lot of ways.  But it bonded us all in a lot of very special ways too.   

*   *   *

After months of chemotherapy, my nurses sent me out of the infusion room a final time amidst a shower of homemade confetti.  And a few months after that, I walked away from radiation oncology for the last time - given permission just days before Thanksgiving to leave the state to celebrate the holiday with my loved ones.  

I was in remission.

My Story - Part I

My Massey story began 10 years ago.  There is a short version that I tell when I speak, or in emails I circulate to fundraise most years.  Theres an even more condensed version I tell those I run into around town or new friends.  But in reality, there is much more to it than what makes it into those brief sketches.  Here is the beginning:

As a little girl, I came down with strep throat all.the.time.  I remember several Halloweens that involved trips to the doctor just before trick-or-treating for a strep culture.  But it had been awhile since my last bout when I came down with a lovely case of strep in July of 2002.  I saw my doctor and was given a course of penicilln - just as I had as a kid.

But this time, things didnt play out as they had in the past.  After taking the first dose of penecilin, I went to bed, only to wake up covered in angry, red hives.  It turns out that I had developed a drug allergy over the years.  I called my doctor who had me stop taking the medicine - he was fairly certain that what I had already gotten into me would be enough to get rid of the strep.  And he was right.  The hives healed and my sickness was gone.

Except for one lymph node on the right side of my neck.  That guy stayed huge.  He didnt hurt.  But when I touched my neck - he was definitely there.

For months I followed up with my doctor.  Literally.  Over the span of seven months we would try various antibiotics, which would reduce the size of the node, only to have it grow again the moment a course was finished.  Over and over - for at least 10 rounds of antibiotics, we played this game.  He was fairly certain it was a colony of strep that had housed itself there.  I had no reason not to agree with him. 

But someone did.  One day my nurse practitioner asked him: "Do you think this could be something else?  Remember we had that one young patient . . ."  Before she could finish, he cut her off with a curt: "Its not that."

I think she knew then what was really going on.  But I had no idea.

*   *   *

February came and I headed west to backpack my way through some of our national parks.  I noticed the climb through the Grand Canyon was harder than I expected, but chalked it up to altitude.  And when making my way through Arches left me fatigued, I figured I hadn't hydrated enough.  So I was sure to keep several full bottles of water with me as I ventured into the back country of Canyonlands National Park.  On day two, one of those bottles fell into a small canyon.  And as my partner climbed down to fetch it, I set the timer on my camera to capture this moment:

As I stood from taking this picture, I reached to scratch my neck.  And I found it wasn't only the one lymph node that was swollen - now there were two.

*   *   *

Fast forward two weeks and I am waiting in my ENT's office for the results of a biopsy.  He had elected to do surgery to remove one of the lymph nodes in my neck in order to get the best sample.  I dont remember the entire conversation.  But I do remember him telling me that the results indicated that "it was malignant".  Demonstrating my complete lack of knowledge about cancer, I smiled and replied, "thats the good one, right?"  The fact that he handed me a list of five oncologists' names told me I was wrong.

I was 23.  And I had cancer.