CHAPTER 13: SUNSHINE IN THE MIDST OF CLOUDS

You raise me up, so I can stand on mountains

You raise me up to walk on stormy seas

I am strong when I am on your shoulders

You raise me up to more than I can be

“You raise me up” by: Selah

I was long due for good news and it finally came on 9/10/09. I had a CT scan the previous day, and in the morning I woke up to a call from Dr. Scotty. I held my breath when my caller ID showed “MC” and did not exhale until Dr. Scotty said the words “so good news” pheeeeeeeew! Finally!!!!!!!!!!!!!!!!

I had spent the months of July-September in and out of the hospital. The salvage chemotherapy that I was now receiving was much stronger than the previous chemotherapy I had received; it was also delivered over a course of 4-5 consecutive days rather than in just one day as before. Plus, I lived 30-40 minutes away from MC and hated more than anything to be in a car post-chemo sessions because it would cause me to get carsick and thus more nauseous. So, for all those reasons I chose to receive my salvage chemotherapies as inpatient. My stay in the hospital to receive the chemo got shorter though with each one as the pancreatitis was put under control with the tumor shrinkage. At first, I was given this regiment of chemo in July called R-ESHAP, but nine days after my discharge I was hospitalized again for a pancreatitis recurrence. A CT scan at the time showed that the kidneys and lung tumors had shrunk some but not the pancreas tumor. Yeah I figured since I was lying in a hospital bed with abdominal pain again. Because of that, the doctors decided to switch my chemo regiment to another called R-ICE; they were quickly realizing that I did not want to finish this fun experience without getting a taste of all the chemotherapy regiments available out there-give me more, give me more! We had better luck with R-ICE it seemed. I was discharged from the hospital a week later and 2 ½ weeks had passed without incident. On my follow-up appointment with Dr. Scotty he had scheduled my CT scan and told me he would call me with the results as soon as he found out; he also instructed me that I should relax some and not think too much about it-pssshtt yea as if that was possible.

On 9/9/09 I went in for another CT scan and waited anxiously for the call. I was still in bed the next morning when my cell phone rang and I heard Dr. Scotty’s voice on the other line. He informed me that ALL the tumors have shrunk further this time, and the pancreas one was almost gone. This meant that I was chemo-sensitive to this regiment which was really good news. Dr. Scotty finished telling me about the plan- that we will continue with R-ICE treatment and try to shrink the tumors as much as possible before the stem cell transplant. Then he said to me:

“You don’t sound too happy”

I guess I forgot to show some excitement in my voice. I told him that I was happy and thanked him for calling me so quick. The truth is that I was thankful for this little light in the midst of all the darkness lately, but I still could not get myself too excited about the news. If I learned anything from this experience, it is to always be on the lookout for the worst; I did not want to set myself up for disappointment in case things went south again. So I made myself be thankful and happy about the news but very cautiously…

In Him was life,

and the life was the Light of men.

The Light shines in the darkness,

and the darkness did not comprehend it.

John 1:4-5

CHAPTER 12: FRIENDS-THE WIND BENEATH MY WINGS

When you're down and troubled

and you need a helping hand

and nothing whoa nothing is going right

Close your eyes and think of me

and soon I will be there to brighten up even your darkest nights

You just call out my name

and you know wherever I am

I'll come running oh yeah baby to see you again

Winter, spring, summer, or fall

all you have to do is call

and I'll be there yeah

You've got a friend
“You’ve Got a Friend” by James Taylor

During hard times it becomes apparent which relationships in a person’s life are worthwhile and which ones are just a waste of time. Sometimes it may take something life-changing to truly start appreciating some friendships or start re-evaluating others. I have always been so lucky to be surrounded by people who love me, whether they are family or friends, and I have always appreciated the good relationships in my life. However, this experience with cancer still brought with it a few surprises and still taught me a few lessons. There were the good surprises of getting support from unexpected people; people who were merely acquaintances became close friends during this challenging period in my life. At the same time, there were people whom I thought of as dear friends who ended up disappointing me in a major way. I would like to say that it is ok because I had a big support system and I did not need them. Yet, the truth is, when you care about certain people, even when you don’t need them it still hurts when it turns out that the friendship meant more to you than to them. However, I cannot complain at all because thankfully those “friends” were very few and I was blessed to be showered with support from so many people around me. In fact, even though a big physical distance separated me from almost all my friends, the emotional distance between us was never an issue. They made me feel like they were always there, just a phone call, a text message, or an email away.

During the past year, my closest friends have stayed by my side. I could count on them to meet any of my needs. I came to realize and value the unique abilities of each one of them. There is the friend who never fails to make me laugh no matter how stressed or sad I may be. There is the friend who is always there patiently listening to me vent and complain about how horrible my life has become. There is the friend who oozes endless optimism and encouragement no matter how horrible the news or circumstances may be. There is the friend who sends little cards and presents in the mail all the time, making me feel so important, even though I know first-hand how hectic and busy her life is as a medical student. There is the friend who spends money that is not readily available to fly across the country to come visit me and spend a few days being physically there. I have friends who call all the time even when I continuously fail to answer my phone, leaving me messages telling me they just wanted to hear my voice. I have friends who text-message me almost every day when I am sick or in the hospital to ask how I am doing. I have friends who email/facebook/chat with me regularly because they do not want to burden me by calling. Yes, I am a person who is truly blessed to have experienced the meaning of rare genuine friendship to its fullest. In fact, I am so lucky as to be surrounded by not just one such friend but by many assortments of friends all of whom are thoughtful, caring, and wonderful in their own special ways.

My 25th birthday was only two months after my initial diagnosis with Lymphoma. I was in no mood to celebrate it, especially since I was in the middle of my chemotherapy and nowhere near any of my friends. Little did I know though that my sister, who also happens to be one of my best friends, was secretly planning all kinds of surprises for my birthday. She had contacted my closest friends asking them for their help in making my birthday “special”. The evening of my birthday consisted of eating pizza and a delicious ice-cream cake with my family. Then, I was overwhelmed when I discovered all the wonderful cards and presents my friends had sent that my sister had been hiding from me until that night. Among those, I received the most beautiful hand-made quilt in my favorite colors: pink and purple. Imprinted on it were pictures of me and my best friends with all of their names embroidered around the sides of it. It is seriously by far the best present I have ever received and the closest to my heart. Thanks to my fabulous friends, my 25th birthday turned out to be a very memorable one!

Because of such friends, I try not to think of the few people who failed me during this time in my life. Recently, I read an excellent book titled “Everything Changes: the insider’s guide to cancer in your 20s and 30s” by Kairol Rosenthal. Rosenthal says:

In seven years of living with cancer, I have begun to accept that some people simply do not respond to my experiences in a way that brings me comfort. I’m tired of making psychoanalytic assumptions about why they cannot handle my illness. Instead, when it comes to baring my soul about the crap that cancer is, I have learned through Sheila’s example to rely on the small handful of people in my life who really get me.

This is so true. I could beat myself up trying to think of reasons why certain people were not there for me at such a critical time in my life but what is the point? I am not lacking in support, and thoughts like these will not get me anywhere. Plus, I am facing the biggest battle of my life, and only those who are able to handle standing by me and supporting me are welcome in my world. It may sound selfish that I am not willing to try to understand why certain “friends” did not rise up and fulfill their friendship roles, but I need to think of me right now- I need to be selfish some in order to emotionally make it through this time.

Also, when I had first learned of my cancer diagnosis back in November 2008, I chose to only email a few close friends and share the news with them. A close friend of mine recently inquired about why I wanted to keep things quite for so long when so many people would have wanted to be there and show their support for me. I explained to her my position. I wanted her to understand that people deal with such life-changing news in different ways. It has almost been a year now since my diagnosis, and at this point, I am comfortable and strong enough to share the news with people. Cancer has unfortunately become part of my life-like an uninvited and unwelcomed guest. However, at the time, the news was all too fresh for me. I was distraught and trying to wrap my brain around all the changes taking place in my life. I only wanted support from people whom I knew truly cared about me, and were not just going to offer their support out of pity. I did not need nor want pity from anyone. What I did need were people I knew I could truly count on—to listen, to offer encouragement, and to believe in me even when I did not believe in myself. Personally, I did not want people to offer me their support or friendship just because I was really sick. One young adult cancer patient in Rosenthal’s “Everything Changes” book describes it best when she says:

With all the races, rallies, and walks people assume you want to be celebrated for having survived cancer. No! The last thing I want is people cheering me on because I had a disease that I didn’t want, was miserable getting through, and wish I never had. That should not be my moment of fame.

So, my reasons for keeping my Lymphoma diagnosis quite for so long were not to offend anyone. I just do not want to walk around “celebrating” cancer when it is the last thing on earth that deserves celebration, nor do I want to be remembered for this small chapter in my life. I am the same person now as I was before cancer-I have the same personality, the same outlook on life, and the same habits. There have been some minor changes and I have tweaked some areas in my life, but nothing significant enough that would make people want to be my friends any more or less than they did before the cancer invaded my existence!

A friend loves at all times,
And a brother is born for adversity
Proverbs 17:17

CHAPTER 11: ANGER GIVING WAY TO FORGIVENESS

Will you think that you’re all alone
When no one’s there to hold your hand?
when all you know seems so far away
And everything is temporary, rest your head
I’m permanent
“Permanent” by David Cook

I struggled for quite some time as feelings of doubt and uncertainty set in. I had asked Dr. Scotty if he could send my pathology slides to the main MC center located in another state to get a 2nd reading on them. He readily did that for me, and the readings came back to confirm that what I had now was non-Hodgkin; but they further added that the original mediastinal mass was also non-Hodgkin’s lymphoma unlike the lymph node which was still read as Hodgkin’s lymphoma. This meant that I had both components of Hodgkin’s and non-Hodgkin’s lymphoma from the beginning. When I asked Dr. Scotty which chemo would I have received had this piece of information been known from the beginning, he said that they would have given me the R-CHOP (used to treat non-Hodgkin) rather than the ABVD regiment that I received. Hmmm, anger and frustration were definitely not easy to get rid of at this point. It did not help when people close to me were upset too about the delayed diagnosis of the non-Hodgkin’s part of my lymphoma. A part of me wanted to be angry forever, and wanted to escape to another center for care with new doctors who were infallible and error-free. But the more rational part of me knew how ridiculous that was; pathologists are humans prone to error like any other; they did not maliciously single out my biopsy slides that day and decide that they were not going to read them fully. Plus, I could tell how frustrated Dr. Scotty was upon getting the new readings; he was doing everything he could to treat me fully to ensure that I was not only treated temporarily but cured indefinitely.

My dad, being the wise man that he is and having the ability of knowing what to say to turn any situation around, sent me an email upon hearing this news titled “can we forgive?” In it he told me how what happened is in the past, and that we as a family should focus our energy now on deciding what the next steps should be. He said forgiving and moving forward will help keep our spirits high and our minds clear so that we can make the right decisions. It was his email that reaffirmed my thoughts about, eh maybe not forgiving quite yet, but definitely trying not to think about what could have been, and concentrating on what should be done.

On the top of my list of what should be done was seeking other opinions. Dr. Scotty was very open to me getting 2nd opinions, and in fact encouraged me to do so. I wanted to travel to another renowned cancer center in Texas to meet oncologists there and get their opinion on what the next steps should be in a case like mine. Dr. Scotty informed me that he could contact an oncologist there and get me an appointment. My main reasoning was to see if their treatment plan matched the plan Dr. Scotty and the other oncologists had for me, and to come back to MC for treatment.

Unfortunately, my body had other plans for me as usual. I had left the hospital on a Monday after the pancreatitis episode, but by Thursday I was back in the hospital again for a recurrence of my pancreatitis. This time, Dr. Scotty really did not want to wait anymore before giving me the salvage chemotherapy. Their plan was to do salvage chemo regiment for two-four rounds, and then go on to a stem cell transplant (which is done to reduce recurrences and increase the chance of a cure.) He convinced me to start the chemotherapy, and said that I could always go to Texas after the first chemotherapy. I was wiped-out after that chemotherapy (salvage treatments are delivered at a higher dose than the initial chemotherapy), and I knew I was too tired to go to Texas. Plus, I was slowly losing interest in going somewhere else; I felt comfortable receiving my care at MC, and I was scared that going somewhere else may end up confusing me further. I was slowly getting my faith back in the plan they had for me…I mean my main concern was always the pathology readings which I already got a second opinion on.

Like a bullet-proof vest, this cancer experience is making me immune to reacting to bad news…the more bad news I receive, the less and less I react to it. Tears have pretty much dried up, and when they do come they are in the form of a major breakdown once in a while. Plus, when you’re sick and nauseous for more than half the hours of the day, you don’t want to waste the rest of the hours crying. Instead, I spent the rest of the time when I wasn’t nauseous either sleeping (because of the beautiful powers of the antiemetic lorazepam) or thinking how awesome it felt to be nausea-free! But, along the way the bullet-free vest allowed some bitterness to leak into my soul, and take residence there for some time. The bitterness was not directed at anyone in particular, it was mostly irritation at this little thing called: my life!

During this time I also went on strike on praying and “connecting” with God. As I told a friend, I was not exactly angry at God. I just felt that maybe what I have been praying for was not God’s plan for me. What if maybe God’s plan for my life was not cure from this disease? Most of the time believers speak of how they don’t always know what God’s plan is, or that His plan may not coincide with their plans. Well, why should it be different in my case? I just got tired of asking for something that may be the wrong thing. But, I wasn’t even praying for strength and peace of mind that I had been praying for before. I just felt numb for a while. And I felt drained. My strike lasted a few weeks until one night I was finally home in my bed about to go to sleep. I was alone, and I found myself having a one-sided teary conversation with God. I asked him to strengthen my faith whatever the outcome of this battle may be. Slowly, I hope that I would be back to asking God again for strength and peace of mind. In the meantime, I am letting those around me take charge of praying for my healing. That is what sitting at home for many months being useless does to a person, it makes one lazy…

Let all bitterness and wrath and anger
and clamor and slander be put away from you,
along with all malice.
Be kind to one another, tender-hearted,
forgiving each other, just as God in Christ also has forgiven you.
Ephesians 4:31-32

CHAPTER 10: UNEXPECTED SURPRISES

How could this happen to me

I've made my mistakes

got nowhere to run

The night goes on as I’m fading away

I'm sick of this life

I just wanna scream

How could this happen to me
“How Could This Happen to Me” by Simple Plan

I watched as the crimson B+ fluid inched its way slowly through the tube to disappear into my veins. Greeeeeat! Now I had to get a blood transfusion because my hemoglobin was low. Was there anything that I was going to skip in this ordeal?! Again, being a med student I always picture the worst case scenario, and in this case it was me getting a severe reaction to the foreign blood I was being given. Ok, so that did not happen, I was fine and my hemoglobin numbers went up, but still I was angry that I needed blood in the first place.

It seemed like lately anger has been the emotion of choice for me…and damn it, I had plenty of reasons to be angry about!

I had finished treatment-eight grueling rounds of chemotherapy followed by 20 days of radiation, and waited 8 weeks to have my body scanned again to see if we had defeated the cancer. The PET/CT scans came back with unfortunate results that I was so not expecting. See, the whole time while waiting for scan results everyone around me was being super-positive, telling me that the scans will come back clean, that I will be cured and live happily ever after. I, however, was definitely not as optimistic; I had doubts that it was all going to be this “easy.” I also wanted to prepare myself mentally for bad news; I couldn’t just keep myself too positive only to be crushed by unpleasant news, I had to keep open the possibility that I could receive bad news that my cancer was still there. Apparently I did not prepare myself adequately, because my imagination did not stretch far enough to hear Dr. Scotty, my oncologist, telling me that the scans came back showing newly lit spots, which meant there were new tumors in my body. His good news for me? The original mediastinal mass had shrunk considerably to almost a negligible size, and the supraclavicular node was not involved anymore. Wow, awesome! I should go celebrate! WTH! My cancer had spread during treatment?! How is that possible? I now had tumors in my right lung, both kidneys, pancreas, and GI lining! I was in shock, so much for preparing myself well. Dr. Scotty, the ever-positive soul, said that these were too many new spots that appeared in such a short period of time, and thus could just be that I have some sort of infection. I informed him that I had no signs or symptoms of infection, but he said some common Arizona fungal infections can be symptomless. Ok, so I could have an infection. For some reason, I just did not buy that this is what I had; in the back of my mind I knew it was still cancer. However, I had to go through the motions of getting blood work done. Also, I got scheduled for a kidney biopsy to determine what these new masses were.

As I was leaving Dr. Scotty’s office I asked him: “if this is cancer, could it be Non-Hodgkin’s Lymphoma since Hodgkin’s Lymphoma does not normally spread in such a manner?”

He replied: “anything is possible, but it is highly unlikely because this is very uncommon.”

I thought to myself ‘I am used to having rare things happen to me’ and left the office feeling numb and…praying big time for an unlikely infection!

I underwent the kidney biopsy on a Friday. A day later I went to the ER with severe abdominal pain. First thing they did was put my pain under control by giving me the wonderful drug Dilaudid-which the inept ER nurse decided to just push it really fast into my IV putting me in a panic for a few seconds as the drug sent my heart racing and made my entire body heavy, but after I got over the initial shock (or “high” as some people call it I guess) I was in bliss-land, pain-free and in a sleepy/loopy state. Then, they did the usual blood work and a CT scan and came back to tell me I had pancreatitis (inflammation of the pancreas). Ok, seriously? Where did that come from? I thought for a second about my Vegas escapade ten days before with my best friend K (since I know as a med student the 2 most common causes of pancreatitis are alcohol and gallstones), but I was no alcoholic damn it! Thankfully, the doctors agreed and quickly ruled out this possibility as well.

Anyways, I ended up being hospitalized for my pancreatitis. The doctors could only guess at what caused it, and the most likely culprit was the tumor sitting there on my pancreas. The only positive experience of that hospitalization was that now I was being seen by the Internal Medicine team as well as the oncology team. The IM team had interns and residents. The interns and residents who came to see me were all nice, cute and obviously smart guys! Yeah, I can enjoy that even when I’m lying in a hospital bed sick; plus they all were conversational when they knew I was a med student (which I don’t tell anyone but apparently it’s written in my chart in the doctors’ notes.)

The kidney biopsy report came back a couple of days later. I had Diffuse Large B-Cell Lymphoma (a very aggressive and fast-growing type of NON-Hodgkin’s Lymphoma). What happened to the Hodgkin’s they told me I had initially back in Nov.? I was being treated at one of the top most-renowned clinics in the world and I get misdiagnosed/not fully diagnosed?

My anger could just no longer be contained…I was ANGRRRRRRRRRRRRRRY!

NOTE: I have not been able to continue writing my story for a while. when I write my chapters I like to profread them and make sure they are well-written, not just vent and be angry. Recent developments have shown that I am not in remission, I will be continuing the misery of going through futher worse treatment. Because I have so much I want to write about of what is happening to me NOW, I am thinking I may skip a few chapters from the past few months and just instead start writing about what is happening now. I do intend to fill in those missing chapters of course, but that will be when I am feeling inspired to write beautifully again. For now, I just want to keep people in the loop of what is going on with me. And my current mood is "damn pissed off!" details will follow as soon as I get over this latest chemo side-effects and I have enough strength to blog again. Thanks for the continued support!

Nancy...

CHAPTER 9: HAIRLESS & DEALING WITH IT

Breast Cancer and Chemotherapy

Took away her crown and glory

She promised God if she was to survive

She would enjoy everyday of her life

On national television

Her diamond eyes are sparkling

Bald headed like a full moon shining

Singing out to the whole wide world like HEY...
I am not my hair

I am not this skin

I am not your expectations no no

I am a soul that lives within

"I am not my hair" by: INDIA.ARIE

“You are going to lose your hair”…these are very difficult words to fathom. It is not like I have not seen pictures or movies of bald cancer patients before, but this was MY hair we were talking about, and my brain did not want to register the fact that it would soon be gone. Plus, I kept trying to convince myself that this should be the least of my worries; that I should not be so superficial and turn my hair loss into major drama. However, I felt like my hair was part of my identity, part of who I was, and that by losing it I would be losing part of myself. It did not help that I thought of my hair as my best physical characteristic-I was going to lose my long thick beautiful hair. I used to always joke about how thick my hair was; I would tell my friends who had thin hair that I could donate some to them since I had enough hair for four people. It seemed that now I was not going to even have enough to cover my own scalp. Life is so weird sometimes.

I was told that the hair loss would start 2 weeks to a month after my first chemotherapy session. I heard of people who shaved their hair so they would not go through the emotions of losing it little by little, and thereby they felt like they still had some control over the situation. I could not do that, I wanted to savor every strand of hair I had left until the very end. What I did do though was cut my mid-back length hair to chin level. I have always been afraid of getting a short haircut, and I thought this was the best time to experiment and try the new bob haircut that was in style. I mean the worst that could happen was that I was going to hate it, which would be easy to fix since I was due to lose the rest of it in a couple of weeks anyways!

I got the haircut, and of course to make matters more difficult, I fell in love with it. A couple of days later, clumps of hair started making their way into my hands, my brush, and ultimately the wastebasket in my sister’s room. Everyone talks about their first shower when the hair starts to go- it really is not fun seeing large amounts of hair coming off your scalp as you shampoo. I did not want to wash my hair anymore, and when I did I would go into my sister’s room alone, shut the door, sit in front of the mirror looking at my reflection, and just cry as more clumps of hair came out. My hair was being found everywhere around the house but the one place where it should be-on top of my head! I would wake up in the mornings with my pillow covered and covered with too many strands of hair; I eventually got tired of cleaning the pillow and just left the hairs alone. The living room rug was littered with strands of blonde-highlights. It seemed like there was no end to my thick hair. I kept my hopes that maybe because it was so thick I would not lose all of it-if I could only hold on to that thin layer left of it I could handle it. I stopped brushing my hair, and tried to not run my fingers through it. By the fourth chemo session, I was left with a very fine layer of hair that exposed various parts of my white scalp, but I still had those strands that I could touch and reassure myself that I was not a bald chick yet. I would wear baseball caps and still look like a normal person with very thin hair (taking the cap off though would show a different story.) Since it was this late into my chemo treatment and those strands of hair that I had left were still fighting and clinging to my scalp with all their might, I just figured this was the end of the hair loss. However, even though it had slowed down a lot-probably because increasingly there was less and less hair to lose, the hair loss had not stopped yet. Creeping up on me slowly, by chemo #8 (the last session) it seemed that that hair strands I had left could be counted on one hand. It was not till then that I held up the scissors and told my sister to cut the chin-level strands to make them short, because now they were only annoying reminders of the long beautiful hair I used to have. Yes, I did not have the courage to shave my head, but sometimes I think maybe these people had it right; maybe things would have been easier if I had not made myself go through that tormenting experience. I know when we think about it, we think it is only hair; but that was one of the most emotional experiences of my life. It was so emotional that even writing about it now (over 3 months after my last chemo session, and after I already have gotten back a good amount of thick short hair) I cannot help but cry and feel depressed.

I was given some wig stores’ information at the hospital before I left. So, I wanted to get that wig as soon as possible thinking I would be wearing it at all times. My sister came with me as we made the trip to a small wig store at the local mall. We knew nothing about wigs, all I knew was that they had ones made of real hair which were more expensive than the synthetic ones, but supposedly better. We walked into the store that was filled with wigs of all kinds, and we wanted to have some fun. However, the lady working there stopped all the fun in 2 minutes, as my sister reached her hand to touch one wig, she half-yelled at her with a thick accent “no touching.” I looked at my sister and we both almost broke out in laughter as we noticed the sign right in front of that particular wig reading “do not touch the wigs.” Then, we asked her for the price range of the wigs and our hopes of having fun were further squashed as she told us that the cheapest wig cost $199. WHAT?!!! No one told me it was going to cost that much money to get a stupid wig! My sis and I saw the perfect wig; it was a little longer than shoulder length, wavy, and light brown-it looked so much like my real hair. As we were admiring it from afar, we asked the “nice” store lady for the price of that one, and she replied “that’s too expensive for you, that one is $400.” ‘God please give me the willpower not to punch this lady in the face!’ I thought to myself. I mean, she was not being insulting because we had told her what we could afford. Yet, this was not a purchase I had ever imagined myself making, and her tone and snippy attitude was not helping. She finally pointed us to the short wigs that were in our price range. I saw one that was medium brown with reddish tones, and a style that looked cute. I asked her if I could try it on. As the lady helped me put it on, my sister fell in love with it immediately. I just felt weird. The wig was nice, it framed my face well, and the color was great. But, what the hell! I was getting a wig?! I was trying on a wig next to an old Asian man who was looking for something to cover his balding head. I was trying on a wig at one of those mall stores with big glass windows where everyone walking by can see in, and I just suddenly felt so self-conscious. I wanted to get that wig and get out of there pronto. The store lady made sure to inform me that all purchases were final, but as she was giving me the receipt she mentioned that some health insurance companies reimburse for at least part of the cost of the wig if it is for medical purposes. Hmmm, at least she was nice enough to tell me that.

I later learned on my own and with experience, that I probably should have not purchased that wig. Yes, it was one of the best that I owned, and it looked natural when I wore it. However, I soon realized that wigs are itchy and uncomfortable. Especially when worn on top of a bald scalp. I was having headaches from the chemo and all the drugs I was on, and having a tight elastic band wrapped around my head was not helping. So I ended up wearing a wig only when I went out in public to places other than the clinic, which was very rare. During the 4 months of chemo, I avoided people, other than my family, like the plague. Not only because I did not want to see anyone in the state I was in, and because my friends were nowhere close to Arizona anyways, but also because of my low white blood cell counts. You see, white blood counts go down tremendously as a side-effect of chemo treatments, sometimes reaching zero. White blood cells fight infections, and I had very few of those around, so any contact with people’s germs or sickness could put me at a risk of a serious infection. In fact, I developed a fever the week after my first chemo session because I did not take this germs thing seriously and ended up being put in the hospital for another five days. They could not find any source of infection to be causing my fever (it was probably viral), but they would not take any chances and they started flooding me with broad-spectrum antibiotics for those days that I was in the hospital. This, in turn, freaked me out because as a medical student I knew how one could develop resistance to antibiotics. I did not want to be given so much antibiotics, so I decided to ban all contacts with people unless absolutely necessary. It was easy to do, since my hospitalization scared my parents more than me, and they turned our living room and the loft where I slept into a sterile environment. They told relatives and friends they could not visit and stay over anymore until I was done with chemo. They stopped kissing me, and they would only hug me when they have showered and washed their hands. One of the couch chairs was designated as “sterile: Nancy area only,” and my mom covered it with a sheet that she washed every few days. Yes I had become bubble girl.

However, as extreme as what we did was, and way beyond the doctors’ recommendations, it worked. I was not hospitalized anymore after that one time, and I completed the rest of my chemotherapy without any complications or infections. On top of that, I did not really mind the not seeing people part, because I did not want anyone to see me in that state and I did not feel very social during chemo.

Anyways, I later searched online and found this wigs website that could help me expand my wig collection for fun without hurting my bank account too much. It was time for me to have some fun with this, and it was also time to give synthetic wigs a chance. I got two more wigs, one that was long brown hair that cost about a fraction of what that mall store wig had cost. The other was a HOT PINK wig that I felt the need to get for no reason at all other than that I wanted it. Yes, you read that right, it was hot pink. My 16-year-old brother thought that I looked like Lady Gaga when I wore it, which he meant as a compliment. I loved that wig. First time I wore it in public was to my last radiation session on May 18th, and the radiation oncology staff loved it. They took pictures and told me it made their day. Some even told me the color looked good on me. Hmmm, I may be dying my new hair hot pink. I have two little cousins here in Arizona (11 and 7 years old), and when I wore the wig to visit them one day, they ran to their room and brought this DVD cover of a kids’ movie (I cannot recall the name) to show me where the star of the movie is wearing the exact same color of my wig in almost the same style, so naturally they thought I was the cool older cousin.

The final wig to add to my collection I acquired for free. It was a pale blonde Merlyn Monroe-style curly wig. It was so cute. I obtained it through a program I attended hosted by the American Cancer Society, called “Look Good, Feel Better.” They had a number of wigs there they were giving out for free, along with the brand-name make-up collection each attendee gets that cosmetic companies donate to this program.

But, since I already mentioned that wigs are not comfortable to wear, I experimented with other modes of covering my balding head. I bought different colored bandanas which became my favorite, because they were comfortable, easy to wear, and light especially for Arizona’s weather. I also had several baseball caps, and a couple of cool stylish hats. Finally, I had long scarves that I tied different ways to make them into some sort of style. I was doing everything in my power not to lose my fashion sense, especially after I was done with chemo and feeling up to going out again.

The hair has grown back. It is still boy-length, but at least I don’t look horrible in it. One advantage that I can see now: I get to experience every possible hair length/style. I still miss my long hair every day. I miss running my fingers through it, I miss having something to brush every morning and night, and yes I even miss flat-ironing and styling it. I miss feeling feminine as my hair strands danced in the wind, and wisps of it brushed over my face. But as one of my close friends told me one time as I was complaining to her over the phone about how slow my hair growth was that she did not care if I was bald for the rest of my life because “bald Nancy is better than no Nancy.” Of course, I laughed at the way she said it with such a passion, but I also understood what she meant. I am surrounded by people who love me, and would rather see me bald every day than not have me around. I know the pain they experience when a thought of not having me around ever crosses their mind. I hate to have caused so much pain to so many around me. So, I am doing my part, and trying to handle my hair drama with grace. Meanwhile, I am hanging on to a phrase another good friend told me when she saw a picture of my current hair-she said “you look hip in this new hair.” That is a lot better than hearing “you look like a boy” which was my fear…so for now, I will accept the fact/fabricated truth/plain lie that I look trendy, and continue praying that the day will come when I have hair long enough to run my fingers through it…

God is faithful and will not let you be tried beyond your strength;

but with the trial he will also provide a way out,

so that you may be able to bear it

1 Corinthians 10:13

CHAPTER 8: POWER OF HUMAN KINDNESS

You’ll never know the way it tears me up inside to see you
I wish that I could tell you something
to take it all away
Sometimes I wish I could save you
And there’re so many things that I want you to know
I won’t give up till it’s over
If it takes you forever I want you to know
“Save You” by Simple Plan

I had requested from my family that I be the one to call my dad, who was working overseas, to tell him about the new developments. My rationalization was that it would somewhat be reassuring to him if he heard my voice, and knew that I was not in critical condition or on my deathbed. You know how parents are, you tell them you have the flu and they think they should fly across the country to make sure you are ok. So imagine if you had to tell them over the phone, with an ocean separating you, that you had cancer. It was not something I was looking forward to doing, but I knew I had to do it. I was the best one in my family anyways who could keep a composed tone at this point, and not break down crying over the phone. I absolutely could not do this to my dad; I had to keep strong until he made it home. I knew he would be extremely worried, and he didn’t need me to add to his anxiety. I had discussed it with mom and decided we should postpone telling dad until after we had a definite diagnosis. My dad would call me regularly when I was in Florida to check on me. So for the few days that I was home, but he did not know, he would call me on my cell phone and I would talk to him pretending I was still in Florida; then he would call mom or my sister and they would pretend everything was fine as well. I hated lying to dad like this, but it was for his best interest at that point. There was no need to preoccupy him, if it turned out that I had something benign and easily treatable. After all, we were all still praying that it would be benign.

I cannot recall exactly who called who that Thursday, the day of my first chemo, and I don’t remember the details of our conversation. Somehow I had found the strength to blurt everything out to him. I felt like pieces of my heart were tearing off as I told daddy the news. I could not bear what I was doing to him emotionally, and I felt so guilty for making him go through that. Yes, I knew that it was not in my hand to change the situation; I did not will this sickness on myself or my family. Yet, I still could not escape the feeling of guilt. Perhaps, it was this guilt-along with my love for my family- that helped keep me strong in times when they needed me to be so. Somehow, somewhere along this journey of life, we suddenly find ourselves worrying about our parents just like they’ve always worried about us, and I had hit that point a few years ago. I remember talking to one of my best friends one day a couple of years back about how it scared me that my parents were actually aging, but I suppose that is all a part of it. The role of who worries about who slowly reverses, until one day we understand (never fully of course-until we have children of our own) how our parents feel every time they sense one of their offspring in trouble or facing some sort of life crisis.

As I had anticipated, dad did not take the news very well. I asked him if he could come home for some time off, and he said he will inform his employer that it is a family emergency, and work it out with the Red Cross so they can send him home immediately. He was going to send me the details to give to the Red Cross people when I called them. I hung up the phone feeling more miserable than ever; I was relieved that I had finally told dad, but I would not stop worrying about him until he arrived home safely. I started having those painful thoughts of “what if something happens to him before he gets here?” even though my dad is in perfectly good health (thank God!) To make matters worse, I had one of my uncles, who was also working overseas where my dad was, call after he heard the news. He semi-yelled at me for telling dad myself; according to him, I should have told him first so he could go and break the news more gently to my dad face-to-face. I personally did not believe this news could be made gentle, it was harsh information to break to anyone especially parents, and I did it the way I thought was best.

While I was at the hospital that week, I had the privilege of being looked after by a truly amazing doctor-Dr. Angel. I have seen very few like her; she was a hospitalist (an internal medicine doctor who cares for hospitalized patients only). She was the exact embodiment of what a doctor should be like-caring, full of sincere compassion, encouraging, never in a rush, and always willing to sit down and listen (even when I was not very willing to talk). As silly as it sounds, I wished that she could be every specialist I needed to see during this time; I wished she could oversee my care. Unfortunately, with her being a hospitalist, our doctor-patient relationship ended when I left the hospital. She made me wonder what extraordinary new doctors society would have if the preceptors who trained us possessed half of Dr. Angel’s qualities as a doctor.

One day, before we had the definite diagnosis from the biopsy, Dr. Angel was in my room explaining the next steps in my treatment plan, and responding to my questions. She was sitting on a chair that she had pulled close to my hospital bed (she ALWAYS followed the rule we are taught in medical school, but few doctors follow in real life because of their rush to get in and out of patients’ rooms, and that is: always make sure to be on eye-level or lower with the patient, never talk to the patient while towering over them because it makes patients feel more intimidated.) After we finished discussing my care, she leaned forward in her chair and placed her hand lightly on my arm and said:

“My dear, I must say you are being awfully calm about all of this.”

To which I replied: “yeah, I am just trying to stay rational so I can make informed decisions and understand everything”

To be honest, I could not explain why or how I had stayed calm so far. I had barely cried since hearing the news back in Florida considering the enormity of the situation.

Later that day, my sister was with me in my hospital room and I just started crying. I felt sad, and I just could not hold it inside anymore. I suppose being confined to a hospital room adds to one’s depression. During this time, a nurse had come in to check on something. As she saw me in that state she quietly left the room generously allowing me some privacy as my sister attempted to comfort me. She came back afterwards, and as she was checking on my IVs and such, she said:

“Dr. Angel will be here to check on you later. She had wanted to come in earlier but I had told her ‘now may not be the best time’ and told her you were crying. She just replied ‘good I had been waiting for that’”

the sweet nurse smiled at this, and I smiled back. I suppose Dr. Angel, being the marvelous doctor that she was, also knew of the therapeutic power of tears, and was glad I was getting to that point-the point beyond the numbness and shock of a situation.

After my conversation with my dad, I had told Dr. Angel that I may need her to tell the Red Cross people about my condition so they can work on expediting my dad’s trip home. She asked if I had the local Red Cross phone number; I did not but I was planning on looking it up later. She left and came back shortly after, with the number of the local Red Cross written on a piece of paper. She had taken out of her precious time to look it up for me, or had asked someone else equally busy to look it up; either way it was a very kind gesture. She dialed their number while still in my room, and within minutes she had explained the situation to them and took care of everything for me. She handed me the phone, and I gave my dad’s information to the Red Cross lady, who then reassured me that they will be working on this case immediately, and my dad’s employer should hear from them within hours.

Wow! It is amazing when small humane acts like that restore someone’s faith in the human race. Dr. Angel had not only restored my faith in human kindness, but also in the medical profession. I wanted to be like her! I wanted to be such a doctor, who through small every day deeds can make a huge difference in the patients’ lives. I will forever be indebted to her for showing me that one can be such a doctor, despite the challenges that he/she may face because of this messed-up healthcare system.

Two days later, dad was on his way home. I had been discharged from the hospital, and was anxiously awaiting his arrival…

Do nothing out of selfishness or out of vainglory;
Rather, humbly regard others as more important than yourselves,
each looking out not for his own interests,
but also everyone for those of others.
Phillippians 2:3-4

CHAPTER 7: FINDING OUR "-NESS"

But with life we never know
When we’re coming up to the end of the road
So what do we do then, with tragedy around the bend?
We live, we love, we forgive, and never give up
Because the days we are given are gifts from above
And today we remember to live and to love
“We Live” by: Superchicks

The other day I heard about a 16 year old boy who died during a trip to the Grand Canyon…he jumped into the Colorado River with two other boys wanting to get a cold dip from the summer heat, and never came back home.

It got me thinking…we never know when our last day on earth is going to come… we don’t know if I that day will arrive unexpectedly or after a long time of unwanted suffering. That young boy never had a fighting chance for his life. Whereas, as horrible as cancer is, and as sickening as the experience of going through it may be, at least I get a fighting chance…at least I get a chance to battle for my life.

Some people’s lives are taken away in the blink of an eye, and what sometimes we humans may judge to be prematurely. These people never get a chance to make a list of the things they want to do before their time on earth is over. They never get a chance to re-examine the relationships in their lives and decide which ones are worthy of their time, and which ones need to be kicked out the door. They never get a chance to remind the people they care about how much they really love them. They never get a chance to decide to not care about mean/obnoxious/rude/unpleasant people that they encounter, but to instead try their best to ignore such people in an effort to make their own lives more fulfilling and healthy. They never get a chance to relax and enjoy the little things rather than rush through life. These people cannot vow to enjoy every sip of their Starbucks cup of coffee while quietly and serenely reading a good book. They cannot vow to appreciate the shining sun and cool breeze outside more, or to take pleasure in the neighborhood park. Yes, it is very unfortunate what some people never get to experience, or rather experience more thoroughly without letting stress or unwanted people to get in the way, because their lives get taken away from them without a warning.

I used to be one of those people who wanted to die quickly, painlessly, and without prior knowledge of it (I believe this was my exact description a couple of years ago). However, things have changed and I have changed my mind as well. Of course, I still would like to die painlessly (and when I am a very wrinkly old woman!) Yet, being diagnosed with cancer has opened my eyes to so many things. Mortality becomes a part of reality when diagnosed with cancer. Death is not a remote concept anymore. The thoughts of dying at a young age before accomplishing much are undeniably scary, but the determination to fight for life also becomes stronger than ever.

Not only that, but I am also more determined now to live most of my days surrounded by happiness and enjoying what good things life has to offer (and there is plenty of loveliness that can be experienced once we decide to slow down and open our eyes.) Don’t get me wrong, I still have my crappy don’t-dare-get-near-me-or-I-will-blow-up-in-your-face days (I do have cancer after all-that’s when I like to play my cancer card), but seriously I am actively trying to limit those days, and heal my soul…with practice I hope to limit those unpleasant days to a minimum, or dare I even say completely eliminate them? (thereby becoming Monk Nancy) After all, they do say that practice makes perfect.

The point of this post is not to freak any of you out by talking about death. I know it is a very sensitive topic that can send many people running in the opposite direction. Rather, the point of this chapter is to call on all of you busy-bees guys and gals out there, who are rushing through life not enjoying any part of it (all the while convincing yourself that you will slow down once you reach that goal, get that promotion, have a family, or reach professional success). STOP DOING THAT! Life is happening now all around you. Stop waiting for that moment when something is accomplished before you can start enjoying it. You know as well as I do that day will never come, because there will always be something more that needs to be done. So, why not start enjoying life now while you still have it? It is all about adjusting your attitude, and then you will realize you can actually LIVE and be grateful for every day of your life. Life is happening now, while you’re busy thinking of the future. I am just as guilty of this as any of you. Why does it have to take something major and life-altering as a cancer diagnosis to get our wake-up call?

So, that is why I write this post…that is why I decide to share this chapter…in hopes that some of you will hear this call before it’s too late. So tomorrow morning when you wake up, try to listen to the birds’ chirping outside, try to enjoy the smell of freshly-brewed coffee, and try to look at a gorgeous blue and sunny sky (or a cloudy and rainy one if that’s more your thing). I hope by taking these small acts you will truly be able to alter the direction of your day. If you are happy and energetic that is when you will be the most efficient. Even better, hopefully your positive energy will emanate to others around you…after all, who says only negative forces have to spread like California wildfires? GO ON, I DARE YA! Spread that positivity and see if it doesn’t change you for the better.

Phew, I’ve become good at this inspirational talk. Maybe I need a change of career? Maybe, I should become a motivational speaker instead…I will find my “Nancy-ness” and help others find their “-ness” as well like Dupree in the movie “You, Me, and Dupree”! (If you have not seen this movie yet, go watch it NOW-it will give you a good chuckle)…

I have told you this so that my joy might be in you
And your joy might be complete.
This is my commandment:
Love one another as I love you.
John 15:11-12

CHAPTER 6: TURKEY DAY PLANS

My strength is almost gone, how can I carry on, if I can’t find you?
As the thunder rolls, I barely hear you whisper through the rain “I’m with you”
And as your mercy falls, I raise my hands and praise the God who gives and takes away…
You are who you are, no matter where I am
Every tear I cry, you hold in your hand
You never left my side, and though my heart is torn
I will praise you in this storm!
“Praise you in this Storm” by Casting Crowns

Thursday Nov. 27th, 2008: America is busy cooking turkeys, mashing potatoes, and baking pumpkin pies in preparation for Thanksgiving dinner; whereas, my family and I were preparing for my first chemotherapy session. While the rest of America was busy eating home-cooked food, I was busy enjoying my first-taste of the delicious ABVD combo. What is the ABVD combo? And where can you get some of that goodness? Well, I’m glad you asked; that is what I am here for-to tell you! ABVD stands for the 4 chemotherapy drugs most commonly used to treat Hodgkin’s Lymphoma (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine)…you got them memorized? Good, because I am going to quiz you on them next time around. As for your other question of where you can get this tasty combo, well I apologize, but we Hodgkin’s folks like to keep that as our little secret-the only way to get a taste of this treat is by developing Hodgkin’s and then you can get back to me and I will gladly share the secret with you.

Anyways, I was going to receive only my first session of chemotherapy in the hospital, the rest were going to be outpatient. They prefer to do the first session inpatient to monitor the body’s reaction to it, especially Bleomycin which can cause pulmonary (lung) problems or an allergic reaction in some people. They tested a small amount of it on me first; I did not develop an allergic reaction -bummer! Now there was no escaping receiving the combo (ok fine, I did kind of want to get the treatment if it was going to cure me). Speaking of cure, this has become like my favorite word (NOT really). So, Hodgkin’s has a very high cure rate, about 75% of cases are completely cured (with no future relapse I believe). But this becomes a slightly annoying fact, especially when everyone likes to remind me of that statistic every time I question their optimism-the doctors, the medical staff, family, and friends. It is as if the stats make the whole experience easy, just because there is a chance I am going to be cured. Yes, I know 75% is a high percentage, but it is not the same as a 100%. It is not a guaranteed cure, which means the doubts, the fear, and the uncertainty that comes with any cancer diagnosis is still present. Plus, I still had to go through chemotherapy AND radiation, so the experience of cancer is similar to any other cancer whether curable, temporarily treatable, or not. Oh, and to tell someone with Hodgkin’s something along the lines of “this is the good kind of cancer” or “if someone was to have cancer, this is the one they would pick/want” is absolutely ridiculous! Cancer is bad, all of it, in all of its forms, shapes, names, etc. No one wants to have ANY kind of cancer, no matter how curable it may be. Yes, I understand there are some cancers that are more bearable than others, but please do not ever tell someone they have the “good” kind of cancer, got it? Ok, I am done lecturing now.

My first chemotherapy session is not that memorable, besides the fact that I was in the hospital on Thanksgiving Day and I did not want to be. The oncology floor nurses at MC were amazing! Most were extremely nice and sweet, thus making my 5-day hospital stay a lot less miserable. The nurse who was administering my chemotherapy talked to me throughout the whole thing so I did not even notice the passing of time. Since this was my first chemotherapy session, I was not really nervous. I know that sounds paradoxical, but the fact that I had not experienced its side-effects yet meant I could not completely fathom what they were going to be like. It did not matter how many times the words nausea/vomiting/hair loss etc. were mentioned-hearing the words is completely different from actually experiencing them. Still, I was a little worried about the side-effects that were to come, but these days they have some pretty awesome anti-emetic drugs (drugs that counter the nausea/vomiting) that help tremendously.

In medicine we study about the five stages of grief that everyone goes through (or SHOULD go through) when dealing with any difficult situation (death, illness, divorce etc.) The stages are taught to occur in the following order: denial, anger, bargaining, depression, and finally acceptance. I believe that these stages do occur and are in fact needed, but they don’t occur in that same order necessarily-at least not in the case of cancer (or perhaps any chronic illness). Because I knew about the five stages of grief, I was consciously looking for their appearance in my life post-diagnosis. I was looking for the day when I would get to the acceptance stage and everything will become perfectly fine, cancer and all. Well, it does not exactly happen that way. I think I have hit the acceptance phase multiple times already in the past six months, along with the other stages as well. I keep going through the stages over and over again. I have experienced anger, depression, and acceptance too many times already. As for bargaining I do not always notice myself doing it, but I think it happens a lot during my prayers. I think I only experienced denial in the very beginning; after the definite diagnosis, it is hard to deny the fact that I have cancer especially while going through the treatment. My mom tried to take me down that route a couple of times as she voiced her concerns, telling me that maybe I should get a second opinion or maybe there was a mistake in the medical reports. I would consider it for a moment, but then refuse to go down that path of doubt. I trusted MC, and I trusted my doctors. I was in the medical field already as a student and it was easy to spot incompetence, and MC was definitely not one such place! (As if they needed me to certify that for them; as if they did not already have the worldwide recognition they deserved anyways).

I remember the day before when my oncologist (Dr. Scotty) spoke to me about the biopsy results and the treatment plan. I had just been brought up to the room post-biopsy, and I was still pretty groggy. I was trying so hard to keep my eyes open and listen to him speak, but the whole time I was thinking to myself: “why can’t you wait until I’m fully awake to come talk to me, when I’m actually able to focus and communicate!” The next day when Dr. Scotty came to see me during his rounds, I made sure to ask him a bunch of questions most of which he had probably already addressed previously, but oh well, it was his fault for talking to me when I was half-conscious. Dr. Scotty was the kind of doctor you instantly liked; with his Scottish accent, perpetual smile and optimism it was hard not to like him. He explained to me that I was going to have a chemotherapy session once every two weeks for a total of eight sessions (4 months) followed by radiation as they determined necessary. He also seemed to save his biggest goofy smile for when he reminded me, pointing to my long hair, that I will be losing it all during chemotherapy-just seemed a tad bit inappropriate to tell me that with a smile plastered across his face (but that is another story I will get to later).

“When can I leave the hospital?” was what I wanted to know. I was told I could leave the next day-so I just had to slightly modify things in 2008 and celebrate Thanksgiving Day on a Friday…

Have no anxiety at all, but in everything, by prayer and petition,
with thanksgiving, make your requests known to God.
Then the peace of God that surpasses all understanding
will guard your hearts and minds in Christ Jesus.
Philippians 4:6-7

CHAPTER 5: LET THE FUN BEGIN!

You only get just one time around,
You only get one shot at this,
One chance,
To find out,
The one thing that you don't want to miss,
One day when it's all said and done
I hope you see that it was enough,
This one ride,
One try,
One life,
To love.

"One Life to Love" by 33 Miles

My eyes opened, blinked a couple of times to try and re-focus the blurry image, and looked around barely moving my head…hmmm, ok I guess I'm in the post-op recovery area. "Man! My lips are so dry I could drink an ocean!" I thought. Just then a nurse noticed me moving and came towards me; she confirmed what I suspected, I was in the recovery area and the biopsy went fine… "Can I have some ice chips please?" I asked knowing that water is not allowed. After popping a few of the delicious ice chips in my mouth I drifted back into sleep (or more like being half unconscious). Not long after, I felt my hospital bed being wheeled upstairs to the oncology floor where I was to remain a resident for a few more days.

Things had moved quite fast once I had arrived to Arizona on Saturday. Since it was the weekend, I had to wait until Monday morning to call and try to get an appointment. I was lucky enough that one of the renowned cancer treatment centers was located in the phoenix area (I will refer to it as MC)-I decided after I did a lot of research on the web that this is where I should go, after all it was world famous on its cancer research for a reason! I was so glad that things worked smoothly for me. When I called MC Monday and asked for an appointment as soon as possible, the lady told me that she may be able to schedule me in for next week…next week?! Sheesh I cannot wait that long knowing there is a tumor roaming around in my body-well it wasn't really roaming thank God; it was just sitting there chilling and being rowdy sometimes but still! So I begged the lady ever so nicely to please try to find something for me that same day or the next day if possible. I explained to her about the mass and the thrombus and how urgent it was that I see someone pronto, but I did not know exactly who to see or where to start. She put me on hold. Dum dum da dum doo da…music playing…I hate it when they play music while putting people on hold, because you focus on the music and forget how much time has passed. Anyhow, phone lady comes back and tells me she scheduled me in to see a general Internal Medicine doctor who will then refer me to the appropriate doctor/department. Halleluiah for small miracles like getting same-day appointments when your life depends on it!

I made it to MC that afternoon with my sister not knowing what to expect or how things were going to turn out. The first good sign was the building itself. It was so beautiful and clean and airy that I did not feel like I was in a clinic. Second positive sign was the doctor herself whom I was scheduled to see (Dr. #1). Dr. #1 was so nice and understanding, and her physical exam was so thorough-due in part to the fact that she found out I was a 3^rd year medical student, and I would notice if she just put the stethoscope on my lungs and moved it before I even took a breath…so she actually listened to my lungs! (Ok it could also be because she is an excellent doctor who is working at an exceptional clinic, but she was going to refer me anyways and having been introduced to the clinical world myself and seen how doctors work the first reason for her thoroughness made more sense).

I ended up being admitted to the MC hospital that same day. Dr. #1 thought it would be easier and faster to run all the necessary tests and see all the appropriate doctors if I was inpatient. The hospital was in a different location, and I was stunned even more when I saw the hospital building. I thought the clinic was nice, ha! The hospital felt like a 5-star hotel; they even had a piano in the lobby where a volunteer was playing some sweet music. Ok, I suppose this qualifies as good sign #3. So far so good…that is until all the poking, probing, and scanning came along…oh yeah and the ever-so-fashionable hospital gown! What is it with hospitals and trying to force patients out of all their dignity with the stupid open-back gowns? Well, I was a freaking med student and as fragile as I was at that moment, I was determined to keep some of my dignity however hard that may be. So I asked for a second gown which I wore with the opening to the front that way covering up my dignity, and I brought my scrub pants from home to wear under the gown!

Being the good medical student that I was, I had typed a history form of myself and printed out several copies to give to every doctor, resident, student, PA, nurse, or janitor who came in to question and examine me (the history for non-medical people is when the doctors ask you all these questions about your illness, your past illnesses, your social life, your ancestors illnesses etc. trust me they do that for a reason other than to annoy you!) well, I did that for two reasons: 1) it gave me something to do besides driving myself crazy with thinking during the long flight home, and 2) I really did not want to be annoyed and repeat the same story and answer the same questions over a 100 times. I wrote down everything I could think of, including any symptom I had experienced in the past few months whether imagined or real (that was for the real doctors to figure out.) I was so happy I had written that history, it saved me a lot of talking sometimes, and I got a few impressed looks and comments from some of the medical people (it was about time too for someone to tell me something positive about my medical skills after being stomped on as a med student for the past few months!)

I had such a difficult time internally accepting that I was on the other side of it-now I was the patient. Giving up control, and trying to become a cooperative patient who did not question every single thing the doctors said (whether out loud or inside my head) was a really hard task. As the months passed by though, I realized that sometimes it is easier to just be a patient. Sometimes I even hated that I knew so much, and I could search scientific medical articles and read them in the blink of an eye. I got some un-needed stress as I read about all the horrible side-effects, complications, and mistakes that could happen. This is one situation where sometimes it helps to be ignorant or at least not know so much. But on the other hand, my medical background helped me tremendously at other times (like that time when I was in the hospital and the nurse kept bringing me medicines to take that my doctor had already stopped, but they were still on my chart. I had to tell her that I'm not on those meds anymore, so she would smile, apologize and go double check!)

Anyways, I had a bone marrow biopsy and a thoracoscopy (took a sample from the mediastinal mass to analyze in lab and determine what the mass was definitively) done on Wednesday. Between the time I had checked into the hospital Monday afternoon and the biopsy on Wednesday, I had undergone numerous other tests and was seen by multiple doctors. Most of the other tests came back negative (meaning normal), which was especially comforting when it came to the Brain MRI and the Echocardiogram they had ordered. YES! At least my heart and brain were normal and functioning like they're supposed to-I have got to celebrate the little victories like these when my world seems to be collapsing around me!

That same day, on Wednesday Nov. 26^th, 2008, the biopsy results confirmed what the doctors had primarily suspected. I definitely had Hodgkin's Lymphoma; no doubt about it now after the pathology report showed that the mass sample contained Reed-Sternberg cells (which are THE cells that identify Hodgkin's.) These cells are the ugliest looking little monsters with two huge eyes that stare back at you as if mocking you and telling you "I've invaded your body, now what can you do about it?!"

I was told that my first chemo session would be the very next day! Oh joy! Ok seriously, things were not just moving fast, things were zooming past my eyes at the speed of light making it hard for my brain to digest and absorb all these new unwelcomed facts. I mean less than a week ago my biggest worry was how to impress my attending, now I'm getting chemotherapy?!!! Whoa! Actually in a way I realize how lucky I am that I was diagnosed with cancer this quickly, because most cancer patients spend months going from doctor to doctor with their symptoms before they get diagnosed. So, at least I did not have to go through that, but still I needed at least a two-week notice to be able to process all of this. Nope, no such luck!

Chemo, here comes Nancy-your newest victim…

I have told you this so that you might have peace in me.
In the world you will have trouble,
but take courage, I have conquered the world.
John 16:33

CHAPTER 4: TELLING MOM

When you can't wait any longer

But there's no end in sight

when you need to find the strength

It's your faith that makes you stronger

The only way you get there

Is one step at a time

“one step at a time” by Jordan Sparks

Arriving at Phoenix Sky Harbor International Airport the next day was one of the greatest moments of relief I had experienced in a while. I was HOME! I was with the people who will take care of me selflessly and unconditionally-my family. I caught a glimpse of my sister who was anxiously awaiting my arrival. I hurried over towards her, and when we hugged it was as if this was the first time I had breathed since learning of the terrible news. Still, I could not forget that the hardest task remained ahead-telling MOM!


On the drive home, my sister and I discussed how to approach the subject so that I can deliver the news to mom as gently as possible. Dad was working overseas and we would have to tell him over the phone (which was exactly what I wanted to avoid doing), but we will tackle the dad issue later. We decided that we would ease mom into this by telling her that the mass could be something simple and benign and possibly easily treatable. Since we really did not know what it was yet, there was no point of mentioning the frightening word “cancer” in that conversation.


However, I realized that I had underestimated mom. Sometimes in situations of extreme difficulties, certain people who may otherwise be fragile and vulnerable may surprise us. I was mom’s child, and I think she realized how much I needed her to be strong for me during this time…and she was! She accepted what I was telling her so much better than I had imagined, and we quickly started discussing what the next steps were that we had to take. Of course she was my sweet emotional mom too, so the tears still flowed, but she remained strong and rational even though I know inside she was full of fear and uncertainty. So was I, so was my sister, and so were my brothers. We were all just putting on a façade of being strong, because sometimes when life hits you with unimaginable blows that is the only way to survive! Breaking down and crumbling into a human ball may seem like the more attractive alternative in such circumstances, but it is not the way that will win the battles of life. To win a struggle, one must face it with determination, strength, hope, and sometimes even belief in what may seem like the impossible…Kind of like what Elizabeth Gilbert says in her book Eat, Pray, Love:

“…my Guru once said---that you should never give yourself a chance to fall apart because, when you do, it becomes a tendency and it happens over and over again. You must practice staying strong, instead”...

For in hope we have been saved,
but hope that is seen is not hope;
for who hopes for what he already sees?
But if we hope for what we do not see,
with perseverance we wait eagerly for it.
Romans 8:24-25

CHAPTER 3: GOODBYE FLORIDA

I think I'm moving but I go nowhere

Yeah, I know that everyone gets scared

But I've become what I can't be, oh

Stop and stare

You start to wonder why you're 'here' not 'there'

And you'd give anything to get what's fair

But fair ain't what you really need

Oh, can you see what I see?
“Stop and Stare” by One Republic

I was thinking about what to include in this chapter of my story, and I had the sense that it was going to have a mainly melancholic tone. However, I woke up this morning and listened to one of my favorite spiritual leaders, Joel Osteen, on TV. His message for today was titled “Be Glad Continually” and it was exactly what I needed to hear during this time of my life. His message can be summed up when he says, “Don’t be determined to never have problems, but be determined to always have joy in the midst of all your problems.” Basically, he calls on us to always have a smile on our faces despite what we might be going through in life; the smile that reflects that even when we feel that we have no control of our own lives, we still know that God is in control! After listening to that, I want to somehow make this chapter “upbeat”, and try to make at least a couple of my readers laugh or smile by the end of it. I hope I am successful, so here it goes-chapter 3…

As I was getting ready to leave the Florida ER, Dr. Comfort gave me prescriptions for the medicines I would need until I made it home to Arizona. That basically included a steroid to keep my facial swelling under control so I don’t unintentionally scare any innocent bystanders by having another “puff face” episode. I also got Plavix (a blood thinner) for the suspected thrombus on my neck. The intern, Dr. Blessing, walked with me as I was leaving the ER. At this point, her eyes were visibly red from all the crying she had done as we heard the CT scan news. We stood outside. She hugged me goodbye, now crying even more, and gave me her phone number to call her if I needed anything. The funny thing is that anyone seeing the two of us then would have thought that she was the one who was just diagnosed with a mass, and I was the one comforting her. Poor thing kept apologizing for breaking down like that, and telling me how strong I was for keeping it together. I wish I could have told her two things. First, I just wanted to make her understand that apologizing for something like this was not only silly, but it was a crime! She was apologizing for being compassionate, for being supportive, and for feeling sad that such a monster was growing in me. No one should have to apologize for being that humane, but I did not have the strength to tell her that at the time. All I could do then was hug her back, and say “thank you!” Second, the truth is that I am good at faking being in control of my emotions in public; it is really like a kind of art. Proof of that is that I had only shed a few tears in the ER, which I quickly put under control, but as soon as I made it to my car and I was alone, I broke down crying. It was little tears at first of “oh my God, is this really happening to me?!”, but the flood gates opened wide when I finally made it to the loneliness of my apartment!

Except there was a lot that needed to be done, and I obviously could not do any of it if my hands remained occupied with the box of tissues! So, with tears under control, first thing I did was call my brother in Atlanta; I decided it would be easier to start with him. Plus, I wanted to arrange for my flight home to have a layover in Atlanta so I could see him. I made sure my voice was as calm as I could manage before I called him. He was shocked to say the least; I only talked a few minutes with him and we hung up, I could tell it was a lot of “fresh” news for him to handle. But he called me back a few minutes later, and started doing the brotherly thing, you know, comforting me, telling me not to worry and that everything will be just fine etc. etc. He later confessed that in between the two calls he had kicked a few walls and doors on his way to class! (This explains why he was much more composed during the second call ;) Next, I called my sister in Arizona after I booked my flight, explaining everything all over again. I told her to pick me up the next day from the airport, and to not mention ANYTHING to mom. It would be much easier to explain things to mom face to face.

After that, I realized staying in my apartment alone was out of the question. So, I gathered up my laptop and purse and went to a Panera Bread that was just down the road from my apartment. If I was going to stay sane, I needed to be around people---even if the people were complete strangers. Once there, I called the only true new friend I had made down in Florida, “Zero”, and asked her to meet me at Panera after work (there is a very funny story behind the nickname I chose for her, which I will not disclose here!) I also called my good friend, HRL, and asked her if she would meet with me after her shift ended because I really needed to be with someone. HRL told me she would meet me at Panera as soon as she could leave; she called me back less than 30 minutes later and told me that her attending allowed her to leave early and that she was on her way. I felt so relieved, I really did not want to spend that evening/night alone, and now the two people I could count on in Florida were going to be there for me when I needed them the most.

That night turned out to be a very fun one, which is ironic considering the circumstances. After I explained my current life crisis, Zero and HRL did what friends do—they started comforting me and offering their help. Zero offered to drive me to the airport the next morning, which I appreciated greatly considering I had to leave at 6AM! (She had also made me a “get well” card from scratch and colored it with crayons when she had run into me in the ER earlier that morning!) Zero left after dinner, and HRL said she would spend the night with me even though she had to be at work at 5AM! And in a typical HRL fashion, that night, I laughed more than I had in a long time. We were even making jokes about the possibilities of what this mysterious mass may be. Somehow we ended up watching “Patch Adams” after I had mentioned that I’ve never seen it; HRL of course thought that it would be the perfect end to a memorable night of ice cream eating and laughter. She actually drove all the way to her apartment and back to fetch the DVD just so we could watch it that night. We fell asleep halfway through the movie. I did not have the deepest of sleeps that night, but when I woke up around 4AM and glanced towards the other couch where HRL was sleeping (we had decided to just camp out in my living room), all I could feel was peace and gratitude that I had friends who cared.

When it was finally time to get off the couch and get ready for the airport, I had this sense of excitement and relief. I had made it through the night, and I will be home with my family in a few hours; I don’t know what else I was expecting, but I suppose the previous day’s news had rattled me a little more than I thought.

Zero was at my door right on time, all awake and smiling as if it was not only 6AM! During the short drive to the airport, I realized that I did not know if I would see my friend Zero again. I did not know what the future held, but I knew I would not be coming back to Florida anytime soon. I felt a little sad. I had grown to love this friend even though we had only met a few months ago; she had definitely proven to be a true friend-the kind that a person would like to keep for life. She dropped me off by the curbside, and we hugged each other goodbye.

I boarded my flight. Soon, the plane started to move, and I found myself silently saying a little prayer. “Dear God, please just get me to my family safely and without incident…please, don’t allow the little thrombus to dislodge and damage my beautiful brain!” Following that little plea I could feel all of my fears evaporating, or at least becoming temporarily suspended for the rest of the flight…

Consider it all joy, my brethren, when you encounter various trials,
knowing that the testing of your faith produces endurance.
And let endurance have its perfect result, so that you may be perfect and complete, lacking in nothing.
James 1:2-4