Finding Our Way Back

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Monday was Radiation Day 20, and with that, my treatments came to a close. After my last nuking, the radiation technicians asked me if I wanted to keep my plastic mask. Nodding my approval, they went looking for a bag. It seemed that the only one they could find was a pink and purple pastel gift bag with pretty flowers, shimmery organza handles and turquoise sequined tassels, so they dropped the mask inside and handed it to me, apparently oblivious to the rather odd juxtaposition of the terrible radiation mask against the sugary sweet gift bag.

I proudly showed off the mask to my parents and husband, who were actually a little stunned by how absolutely horrific it looked. I am not sure what I am going to do with the rather large, bulky mask, but it just feels right to hold on to it, its vacant eyes a witness to the month I spent being microwaved. I now have this curious attachment to it, like I used to have with my retainer, which incidentally, I don't think I have thrown out either.

The end of radiation was a little anticlimactic. In September, when it was thought that the completion of my chemotherapy marked the conclusion of my battle with Hodgkin's, my family, including in-laws, went out for dinner to celebrate. A month later, when my oncologist called to tell me that the cancer had made a comeback and that I would need radiation, in some ways I was catapulted back to the time of my original diagnosis and all the associated feelings of fear and uncertainty. So this time around, when it came time to celebrate the end of my radiation treatments, while we once again commemorated the occasion with a dinner, we were a little more guarded. Instead of toasting to the end my treatment, we reframed the event to mark Dan's and my departure back to Toronto. We really aren't a superstitious bunch, but why tempt the "evil eye".

With treatment apparently over, I was overwhelmed with the unsettling feeling that I had been trying to avoid for months as I thought, "What Next"? Yes, I had my job to return to - but when? Would I be able to achieve a better work-life balance this time around? And of more immediate concern, how would I transition back into the world of the healthy? The doctors have repeatedly advised me to take a few months off, although my plan has been to take a few weeks off at most. I realize that the focus should be on my health - and it will be. However, it makes me anxious to feel that I have fallen behind my cohort, that I have fallen behind in my carefully constructed life because I was slapped with a disease that put everything on hold.

For some people, an abrupt interruption to their lives followed by months of treatment will dramatically shift their world view. They may wish to leave their job and set out on a new path and do the things they always wanted to do. For others, this same interruption just means that the pause button had been pushed for a while on their life (thankfully not the eject button), and they just want to go back to doing what they used to do. While having Hodgkin's Disease has certainly been life-altering, and has allowed me to grow in new ways and discover new interests, I still just want to get back to the office.

No matter what impact cancer has had on an individual, I would imagine that for most survivors, it isn't always easy to immediately glide back into the world of the healthy. When you have cancer, it really can feel like you have landed on a different planet. The hospital, with its blue gowns, its sanitizers that reek of alcohol, its weird machines and long needles, is an alien world when you have been healthy all of your life. That is why the name of the immensely helpful website for young adults, Planet Cancer, is so apt - when you get cancer, you just aren't in Kansas anymore.

The moment you were diagnosed, you were abducted by odd creatures in white lab coats (with a proclivity for spewing out long lists of side effects), and you have spent months on end trying to adapt to this strange new world. Then one day the frequent hospital visits come to an end. You'll be out with friends and it will be fabulous, and then your mind will wander for a moment back to all that you have been through, all that may still happen, and you know that no one else can really understand. That healthy state of denial that most people have is a luxury that is not available to you after you have had cancer, particularly in the weeks and months after its aftermath.

All of a sudden, the alien creatures that have taken you captive for months on their foreign planet have said that you are free to go. But they don't take you back to the land of the healthy - they basically just show you the exit sign. So when treatments end, the question becomes: How do you find your way back?

Strangely, since my treatment has ended, I keep getting that feeling of "did all that really happen"? In the weeks after I was diagnosed, there would be moments where I would almost forget what was going on, and then a surreal feeling would wash over me as part of me asked the rest if this was really happening. This mind-bending state wasn't entirely unpleasant, since it was in those fleeting moments that I could allow myself the possibility of being in a reality where none of this was happening, where everything was fine and this was all a very, very bad dream. The worst sensation was what came next, when the kaleidoscope of thoughts came into focus and I could no longer deny that I really had left work, that things like IVs and CT scans and chemo were no longer foreign, and that, in essence, I had cancer.

I think that these eerie moments have recurred because I am trying to build a bridge back to the world of the healthy, and it just isn't easy to connect your "healthy" identity with your "sick" identity. I suspect that as the days go by, the memories will fade and life may become a little more carefree. I am reminded of a comment in my "Chemotherapy and Radiation for Dummmies" book. It lists ten myths about cancer, and number 10 is: "Nothing is ever the same after cancer". The authors say that "this myth has a lot of truth to it. But then, nothing is ever the same after your first kiss, or the birth of your first child...or your first trip to Venice. Frankly, nothing is ever the same - ever - whether you get cancer or not. Some people say that change is good. You may or may not agree, but this we know to be true: change is inevitable".

Cancer Warrior

Today, I went to a hot power yoga class with my sister-in-law. There is a true feeling of serenity that comes from the yogic breathing, the meditational silences and the astonishingly beautiful poses that we create. The "warrior" and the "dancer" are among my favourite positions. With each class, I feel that my balance is improving and my muscles are strengthening.

The classes also focus on heightening awareness of the body. When I am working at the office, I tend to spend long hours sitting at my desk without a break. The result is that I arrive home stiff, sometimes with excruciating foot cramps as soon as I remove my heeled shoes. When I am focused on my work, I forget to eat, and am not even aware that I am hungry until my stomach starts to growl its discontent. I will stay at work until the wee hours of the morning, and I am not conscious of how very tired I am until I fall asleep during the cab ride home.

Sometimes, in our very busy lives, it is more convenient to ignore our bodies and to just press on. It should not take a serious disease for us to learn to be in tune with our bodies and to listen when our bodies are telling us that they are tired, stiff, hungry, in pain, or just need a break. Nourishing our bodies with rest, relaxation, nutritious food and exercise are really the only things that we can do to help our bodies stay strong and powerful.

Thirty for an Evening

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Yesterday evening after my radiation session, I flew into Toronto from Montreal for my colleague's farewell dinner. Michelle is leaving our law firm for a fabulous in-house position in New York that has better pay and better hours. I helped organize the firm-sponsored event and Michelle chose the guest list, which consisted of all the remaining lawyers in our year. Our cohort started out with 38 lawyers back when we articled in 2002, and now, five years later, there are nine left, and that includes Michelle.

Working at a law firm is a bit like being on Survivor. People drop like flies, and you never really know who will outlast the others to become partner. There are any number of reasons why people leave, ranging from a decision to go back to school, to a spouse finding a job overseas, to a realization that their true calling is art, to not being a good fit with the firm (this decision is not always a mutual one), to simply wanting a balanced life.

Despite a snow storm and work emergencies, eight out of nine of us managed to attend the dinner (and the ninth person I understand is on leave, like me). This was actually an extremely impressive attendance rate, particularly if you consider the long hours and stressful deadlines that are part of being a lawyer. There are many reasons why people made the effort to attend. Of course, they wanted to show their support for Michelle, plus, going out for dinner is always a bit of a treat. But I think the attendance rate also reflects the strong sense of solidarity that exists among the people in my year. There was an unquestionable bond that developed among my cohort from the very beginning when we articled together. I am close to several among this group, including both alumni and those who are still at the firm. And I think fondly of each my colleagues who attended the dinner.

Our evening bore semblance to a reunion, since we had not truly socialized together as a group since our articling days, which had been filled with swanky events and nights out on the town. Over dinner, we reminisced about old times and shared updates on alumni. Between the eight of us, we were able to determine the status of most of our former colleagues - one was in Australia, another one in England, a third in Curacao, several had children (although only one out of the nine of us at the firm had time for progeny), some worked in government and others had moved in-house. Some of these individuals had left a strong impression, while a few we could barely recall.

The evening was certainly meaningful for Michelle, who thoroughly enjoyed her sendoff. She was also grateful to me for coordinating the event, for saying a few words about the Top Ten Things that we would miss about her, and for selecting a gift on behalf of the firm (which was a gorgeous little Kate Spade wristlet - the Gansevoort noel zippered chrissy, pictured at right) and a Kate Spade key chain.

The event was perhaps hyper-meaningful for me because I am currently on leave from the firm while undergoing my fabulous cancer treatments. When I was diagnosed with Hodgkin's Disease back in May, 2007, I left work to start my life as a cancer patient - biopsies, fertility treatments, bone marrow tests, chemotherapy and self-administered neupogen shots (to increase my white blood cell counts) followed. Perhaps the worst part of it all was the isolation that I felt and the loss of my daily routine. It is not until your life is devastatingly interrupted that you realize how comforting it is to have a routine and to see the same colleagues on a daily basis. While vacations are fantastic, there is something grounding about having a reason for waking up early, and something validating about going to work.

Living in a different city intensified my sense of isolation. I decided to receive treatment in Montreal, where my parents are physicians, and so my husband and I relocated to their home for several months. While my parents have been invaluable, I was inevitably infantilized both by them and by the hospital system where I was plastered with the labels "sick" and "patient". My life as a functioning adult existed only as a memory.

Returning to Toronto for yesterday's dinner was something that I had looked forward to for weeks (could I sound more pathetic?), and the evening itself lived up to my expectations. I drank too much, and probably talked a little too much - I was hungry for camaraderie, conversation, collegiality and normalcy. The focus of the evening was on Michelle's departure and on shared experiences - my cancer was not discussed, and that was perfectly fine with me. Some colleagues mentioned that they were glad that I was there and that they were pleased to see me, but overall, I could cast away my cancer patient persona and just be an associate among a group of colleagues who had grown up together from naive students to sophisticated lawyers. Sadly, we did not snap any photos of the event, and I am really kicking myself over this.

We closed down the Yorkville restaurant, Pangea, when we left at midnight, and went our separate ways. I walked one of my friends, Nadine, from the event to her apartment and then continued on my own the few blocks to my place - I could have taken a cab, but had a craving to walk along the familiar Toronto streets. I even relished the cool winter air, which seemed to freeze the walk in time. I arrived at my apartment where I was greeted by my husband - he was back in Toronto for the week on business.

That night, I dreamt that I was productively working on a file at the office, when it suddenly dawned on my that I had missed the flight into Montreal for my radiation treatment. I approached various colleagues to ask for help, to see if anything could be done, but they simply shrugged their shoulders. They didn't understand.

The following morning I returned to Montreal where my mother sat waiting for me at the airport. She picked me up and a few hours later she drove me to the hospital, where I had my head strapped in a mask to the radiation table for my nineteenth treatment. As usual, I lay perfectly still and let the technicians draw on me, measure me and position me. As usual, both my parents sat in the waiting room. When I emerged from the treatment room, my parents stood up and we walked down the hall together. My father kissed me goodbye and went back to work, and my mother drove me home. Afterwards, my mother drove my brother, who was visiting from Washington, D.C. during Thanksgiving weekend, and I, to see my grandmother. We went to her apartment and my grandmother - our Nanny - stood in the hall and opened her arms and pretended to bend down so that we could run into her arms like we did when we were little. She adored having us all there, like when we were little. It is a good thing to spend time with family. But not when you are thirty-years-old and are made to feel so little.

Looking Out the Window, copyright Judy Guiao 2006 Image Source

A Fashionista's Guide to Cancer

For a fashionista, looking effortlessly chic is a full time job. Consistently wearing stylish outfits, complete with coordinated accessories and fabulous shoes, requires constant maintenance and systematic planning. At the start of each new season, the fashionista will carefully study the pages of Vogue and a handful of other magazines for good measure, taking mental notes on the hottest colours and trends. Once she is thoroughly educated on the season's must-haves, she sets out on her hunt for clothes and paintstakingly starts to build her new wardrobe, ensuring she has matching necklaces, earrings, tights, bags and makeup. The fashionista is always looking for some item or another to complete her ensemble, and is forever having hair and nails pruned at the salon. The fashionista may very well be gainfully employed in an actual full-time job (which helps support her shoppoholic tendencies), but she always manages to sneak in some time to ensure that she maintains her discriminating style standards.

For a fashionista who has found herself with cancer, looking good requires a whole new foundation, so to speak. For starters, getting chemo will often result in hair loss, and sometimes eyebrows and eyelashes go too. The drug cocktails (none of which come with an olive, although some are the colour of sangria) - leave recipients with a queasy feeling that basically makes them want to spew vomit in every possible direction, so their complexion tends to have a sickly greenish hue. Those who have had surgery are probably showcasing an unbecoming scar, and some people are left with only one boob, or no boobs, which is generally not considered to be all that flattering. For cancer vixens (a term coined by Marisa Acocella Marchetto), cutting edge takes on a very different meaning.

If you are a fashionista and end up with a tumour, or three or four, as your latest accessory, the most powerful tool in the fight to stay stylish is your own creativity. You will quickly learn that covering up bandages, scars, hair loss and blotchy skin is an art form that takes cunning, skill and an arsenal of accessories.

To those who think that staying stylish and attractive is, or should be, the last thing on someone's mind who is faced with a life threatening disease, I respectfully submit that this is simply not the case, nor should it be. First, the way people feel about themselves, for better for worse, is intricately connected with what they see when they look in the mirror. It is hard to feel energetic and ready to conquer the world when you look in the mirror and see drab hair, pale skin and blah clothes. And there is nothing like wearing a new, fabulous outfit to put that little hop in your step, that smile on your face and that polished confidence in your demeanor.

Second, hospitals are the most drab places on earth (except the Sloan Kettering international centre, which I admit was pure luxury, with a price tag to match) and can make you feel like a "sick" person. Walking in to the oncology ward with a stylish ensemble can actually liven up the atmosphere and keep you feeling like a healthy person. Looking and feeling good can be contagious and puts others in a good mood too - a fabulous accessory is actually a great conversation starter, and doctors, nurses and patients alike tend to brighten when they talk about something as fun as fashion. Plus, wearing something stylish adds an aesthetic element to the grey walls and the grey clothes that everyone in the hospital seems compelled to wear. And a shot of colour can truly liven the atmosphere while waiting for that shot of chemo.

Third, and perhaps more importantly, it is completely natural to want to look your best. This is particularly the case for the fashionista, who takes such pleasure in style and aesthetics, and for whom fashion is such an enjoyable part of life. If her appearance becomes lacklustre, this is a clear sign that something just isn't right, that her joie de vivre has been put on hold.

Throughout my battle with cancer, medical procedures and the effects of treatment have thrown some serious curve balls in my effort to stay chic:

Fashion Challenge #1: The Neck Bandage

The first curve ball was the truly massive bandage plastered on my neck from my biopsy. The bandage took up much of the square area of my neck and shoulders. (To make matters worse, and far more disgusting, a yellow, thankfully odourless substance kept oozing out and soaking up the bandage. Can you say gross?) As luck would have it, my mother happened to be in her fashion heyday during the decade of excess that was the 1980's, and had kept a box full of gorgeous Oscar de la Renta and Hermes scraves that I now had at my disposal. The scarves transported me from a gauze-wrapped Egyptian mummy into a sophisticated Audrey Hepburn type.

Fashion Challenge #2: The PICC Line

The next curve ball, however, would pose an even greater challenge. By that time, thankfully, the bandages on my neck had come off, the bruises underneath had disappeared, and a simple necklace could easily distract from the fading scar. Apparently, chemotherapy drugs can fry your veins. My oncologist wanted to protect my veins by having the drugs administered through a PICC line, which is a thin, plastic tube inserted into your vein that essentially shields it from the chemo. In my case, the entry point for the PICC line was the inside of my arm just above my elbow, and the tube was threaded internally all the way up to my heart. (And yes, I was fully awake when they inserted it.)

The problem with a PICC line from a fashion perspective is that the plastic tube and a three inch cylindrical attachment are left dangling from your arm. The doctors bandaged up the PICC line and held it together with some netting, so that I basically looked like there was a large, gross object sticking out of the inside of my arm. I was horrified. This contraption would be attached to my arm for the next four months, and for the entire duration of the summer. So much for the gorgeous little strappy dresses I had bought.
PICC chic: This is a picture of me in one of my puffy sleeved shirts - no PICC in sight!
After shedding quite a few tears, I regrouped. I went shopping and bought every top that I could find with puffy sleeves, which, as luck would have it, was one of the summer's major trends. My family dubbed the look PICC chic. For scorching hot days and less formal affairs, I bought a bandage and made it look like I had a sports injury.

Fashion Challenge #3: The Hair Loss

By the time I had accumulated a wardrobe full of puffy sleeves, my hair started to fall out, and the act of straightening my naturally curly hair became a very dangerous game. Once I began to lose my hair, people suggested that I cut it short in order to make my hair appear thicker and to ease the pain of seeing my long locks fall out of my head. Yet I was determined to maintain its length for as long as possible. I found that as my hair thinned, the fact that I had long hair helped cover up the spots that were beginning to bald. Also, while my hair became too thin to wear down, the length of my hair permitted me to tie it back in a bun, which actually created the appearance of more hair.

Eventually, the hair loss became quite visible on the crown of my head, but I sought to avoid wearing a wig for as long as possible, particularly in the sweltering heat of summer. So I put on my thinking cap (which, unfortunately, did not in itself cover up the hair loss) and realized that thick hair bands, scarves wrapped around the head, and even turbans were all the rage for Summer '07. I promptly went out and bought a dozen shades of stylish, thick hair bands. My hair actually took several months to thin, and I made it through the entire summer without a wig. My hairbands and scarves, coupled with tight buns, allowed me to completely cover up any sign of thinning hair. (Admittedly I did not venture into turbanism - no matter how you slice it, unless you are Mary-Kate Olsen, turbans say Cancer.)

While I never ended up being completely bald, I did reach a point where hair bands were no longer doing the trick. So I ventured into Wigdom. I actually spent an obscene amount of money on a natural hair wig, which ended up looking completely unnatural, plus the hair on the wig was so thin that you could see the bands that held it together. (I bought the wig from Orly's Creations in Montreal. I advise that you stay far, far away from there.) Ultimately, I found a fabulous synthetic wig that even had its own highlights. The irony in all this is that the wig actually looks hotter than my own hair, and women frequently ask me where I get my highlights. For variety, I wear a pageboy cap which can actually look pretty cute over long blond locks.

Although I did not ultimately need them, I also bought false eyelashes, which are available at many pharmacies, and I ordered some amazing natural hair eyebrows from Headcovers Unlimited.

Fashion Challenge #4: The Radiation Marks

Just as I was starting to get comfortable with wearing wig, it was time to face my next fashion challenge: huge red and blue crosses painted onto my neck and chest, which were required for the entire duration of my radiation treatments (today, incidentally, was Day 17.) I looked to Fall '07 fashion for guidance and began accessorizing with scarves and silk and wool turtlenecks.

Over the past few months, I have built up an arsenal of accessories and an armoury, or shall I say, armoirey, of strategies in my unwavering determination to maintain my appearance and sense of style. For every fashionista out there who finds herself in the same predicament, and I hope that this number is very, very small, it is important to realize that you can stay stylish and feel good about yourself throughout your treatment. The key is to work with the latest styles and use them to cover up any unsightly scars, bandages, swollen arms, or anything else that is better kept under wraps. Plus, there are workshops at Canadian hospitals as part of the Look Good, Feel Better program, which help women look their best during treatment. As a bonus, they give out tons of fabulous free makeup.

Admittedly, there will be times when covering up just isn't possible. You may have to sit in a waiting room for a test sans wig and wearing a horrendous blue gown. Or you may be undergoing a major procedure that requires hospitalization, such as a stem cell transplant, that leaves you completely wiped. Or you may, from time to time, have a very bad day and just not feel like dressing up. These days, hopefully, will be few and far between. As for the rest of the time, just use your carefully cultivated fashion savvy and you will be able to stay as stylish and polished as always.

Find the Fun in Funeral

Photo: Daniela Edburg, Death by Lifesavers
When at first I found out that something was very wrong with me and that it had something to do with cancer, I cried a whole lot. I cried like I had never cried before, I sobbed incessantly until my belly ached. The word cancer loomed large like a sinister cloud over the life I knew, and over all that I had hoped to accomplish. During those terrifying first days when I crossed over into the world of the sick, I also thought a lot. I mused about my own death and about how my family would deal with the loss.

To be honest, way before I was diagnosed with cancer, when my life was completely normal without any signs of lumps or bumps, I sometimes imagined what would happen if I was diagnosed with cancer. I thought about how I would cope with all of those needles, how I would deal with hair loss, and how people would react. I also envisioned what my own funeral would be like.

I am fairly certain that I am not alone in terms of people who think in the abstract about how their own funerals would go. In fact, it really is a rather egotistical line of thinking. I am not referring to the concrete planning of one's own funeral with the knowledge that death is imminent - rather, I am talking about indulging in the fantasy of an event that is all about you (and beyond this, didn't Freud have a theory about the death drive, a desire to return to an inorganic state?) What would the eulogy be like? Would it be standing room only? Would any old boyfriends confess their undying love?

During those first few days, I really did think a lot about death, but it wasn't all gloom and doom. I lugubriously daydreamed about who would show up at my funeral. I pragmatically selected which friend would receive my Diane Von Furstenberg wrap dresses and who would be honoured with my highly coveted shoes, and whether perhaps the shoes could first be placed on display, perhaps at a small exhibition at the Bata Shoe Museum. I chose who of my friends I wanted my husband to marry, and who would receive my gorgeous dark wood, uber modern furniture. (But then I remembered that my husband was still alive and would still have a need for a dining room set).

Photo: Daniela Edburg, Death by Cake

Some of my thoughts during those early days were downright petrifying - like whether I would see my next birthday, whether I would ever be able to have children, or whether all the toxic drugs would turn me into a different person and make me lose my sense of self. Yet other thoughts, such as those that revolved around my own funeral, may have stemmed more from self-centeredness than anything else. Would the room at the funeral hall be packed? The death of someone who is still young tends to draw quite the crowd. Would I be buried back in Montreal or rather in Toronto, where I lived for the past nine years - and if I was to rest in peace in Montreal, who from Toronto would make the trip to Montreal?

When I began to educate myself about Hodgkin's Disease, I learned that in all likelihood I was not going to die anytime soon. Hodgkin's is not fun, but it is often curable. And for a while during treatment, all indications were that I would make a swift recovery. The PET scan that I had received mid-way through treatment showed no signs of cancer - it was gone. Based on this highly sensitive test, it seemed that I was cured, and I would only need to complete the rest of my chemotherapy to ensure the destruction of any renegade cancer cells still lurking beneath the radar.

Unfortunately, during a routine PET just a few weeks after I had completed chemotherapy, it appeared that the cancer cells were still there, and they were multiplying. That is when the doctors decided to try radiation.

This past Friday was my fourteenth day of radiation out of a total of twenty days, based on the current plan. I am hoping that all of this zapping will do the trick and nuke the last of the cancer cells, but if I am really going to be honest with myself, if I dig deep down, I am not entirely sure how well it is working.

With the risk of getting a little personal, it seems that I can monitor the growth of cancer cells by how much I itch. Several months before my diagnosis, I became increasingly itchy and grew obsessed with finding the cause of the itch and trying to get rid of it. At first I thought the culprit was the soap or detergent that I was using, so I switched to milder brands. When that didn't work, I tried everything from vacuuming my mattress (was the cause - horror of horrors - bed bugs?), eating a gluten-free diet and wearing only natural fibers. Nothing worked, until I was diagnosed with Hodgkin's Disease and things fell into place. A minority of cases list pruritis (itchiness) as one of the possible symptoms of the disease, and it seemed to me that I must have been one of those cases. The doctors however weren't convinced that a connection existed between the disease and my itch.

Chemotherapy seemed to do the trick for a time, and my itching decreased significantly. The doctors at that point were still skeptical but began to wonder if the itching and the Hodgkin's were related. At the time that I had my mid-term PET scan, which indicated that I was cancer free, I was itchy, but it wasn't so bad.

However, within a few weeks of completing treatment, the itch came back with a vengeance. I couldn't sleep, and on some days could barely function. The itch was so intense that it became a form of pain and nothing seemed to help all that much. At that point I was due for a follow-up PET, and to the doctors' surprise, the test came back positive.

And so, it was back to more treatment for me, this time radiation. Within a few days, there was a dramatic decrease to my itch - suddenly I could dispense with the cortizone, antihistamines and ice packs that I had been using to try and control the itch. The doctors gradually became convinced that the itching was connected with the disease. It seemed that a chemical was being released as the cancer cells multiplied, which may have caused my pruritis.

Well, I am more than half way through radiation treatment, and the itch is better, but it isn't gone. This has even left my radiation therapist concerned, because Hodgkin's Lymphoma is typically highly sensitive to radiation and it would have been preferable if my itch had disappeared by this point in the treatment.

It is also possible that the cancer is gone forever and that the itch will never completely go away, but remain a permanent vestige of the tumours that invaded my body. A lingering itch would be fine with me. What I am worried about is that the itch is an indication that the cancer is still there, lurking. If radiation doesn't succeed in eradicating it, I will need a stem-cell transplant. This is a life threatening procedure that I hear makes chemotherapy look like a walk in the park. Basically, you are given enough chemo to kill you and then are "rescued" with your own stem cells. It usually gets rid of the cancer for good, but not always, and it has toxic ramifications. After the "rescue" treatment, you are at a significantly increased risk for secondary cancers and you become completely sterile, not to mention the fact that you need to interrupt your life for a further six to eight months and lose your hair all over again, as well as your eyebrows and eyelashes. None of this thrills me. My disease was caught at a fairly early stage, so it would be quite rare - but not unheard of - if I wound up requiring a stem cell transplant.

It worries me that I am still itchy. Perhaps some of the cancer cells are resistant to treatment. This concern has renewed my thoughts about death. To be completely honest, sometimes I wonder if I might die in the next few years. I don't actually think it will come to this, but it is one of the possible outcomes.

I am not in the mood to die and, while nobody is ready to die, thirty years old is on the young side. I sometimes think about childhood cancers, about boys and girls who do not make it past the age of four, or seven, or twelve or fifteen. I have made it past my youth, I have experienced adulthood. At least I have that. But at the same time, I have so much life that I want to live.

So I am back to thinking some fairly morbid thoughts. Some thoughts are indulgent, while others are unbearable. I know that my death would take an unspeakable toll on my parents - it is not natural to bury your own child, and my parents are so devoted to me. I think about my husband - I look into his eyes and see a limitless capacity to bear grief. I know that he will be able to move on, but I am not quite so sure about my parents. My brother would be tormented as well.

I hope that I will be okay. I want to live, and I want to get over this. In some ways, I feel more alive these days than ever. While jogging outside in the crisp autumn air amidst golden leaves and under a bright blue sky, you can't help but brim with energy. While exploring how your body moves and contemplating your very breath in a hot yoga class, as I did this morning alongside my husband and sister-in-law, you can't help but feel present and happy and whole. After spending time on the mountain in Montreal and then warming your hands with a cup of hot chocolate, as I did yesterday with my wee nephews along with their Mommy and Daddy who came to visit from New York, you can't help but feel that life is good. So these days, I often feel wonderful. But I know that inside my body is fighting a war, and I just hope that it can win.

Approaching People with Cancer - 101

Many cultures and traditions emphasize the importance of visiting the sick and being kind to them. Interestingly, it has also been said that people who are sick should be kind to others. I can understand this dictum to a certain extent. It can sometimes feel awkward to approach someone facing a life threatening disease, particularly when that person is an acquaintance and you aren't close enough to be in touch on a regular basis, but aren't distant enough not to be aware of the health issue. Do you ask the person how they are feeling? Or do you avoid the topic altogether in case the person just doesn't want to go there? Plus, if you only heard about the health issue from someone else, are you even supposed to know? If that is the case, should you let on that you know? And if you don't ask about their health, will the person be insulted? Or at the very least, will the health issue become a huge elephant in the room as you discuss the movie you saw over the weekend or the new restaurant that opened up? Do you both even see the elephant, or is it just one of you that sees it? Perhaps the person with the health issue doesn't actually feel sick and isn't thinking about being sick, and at that particular moment, the fact that the person is facing a serious disease is only occupying the mind of the healthy person. On the other hand, perhaps the healthy person has, at that particular point in time, completely forgotten that their acquaintance has a serious disease, and meanwhile the acquaintance may be in a great deal of physical or emotional pain or discomfort and may be quite irritated that their health issue is being completely ignored.

So it is clear that when you approach an acquaintance who is facing a serious health issue, there is a potential minefield of awkward and uncomfortable moments embedded beneath the surface of any discussion that will ensue. Goodness knows that before I ended up with cancer, I was probably as tactless as the next person when it came to approaching someone facing a disease as serious (and fear inducing) as cancer. Since my diagnosis, I have tried to be considerate and understanding when I see people struggle with whether or not to ask me how I am feeling or how to acknowledge the fact that I won the cancer lottery. Occasionally, someone will put their foot so far back into their mouth that they leave me genuinely shocked, but again, I try my best to avoid being overly critical. One of the real gems I received was: "You aren't going to die, are you? Because I really don't have a lot of friends". Then there are the misguided comments from acquaintances who think it is appropriate to mention that their brother's girlfriend's roommate had the same type of cancer as me (they think) and has my skin gotten all yellow and bumpy and crusty yet from the chemo, because that is what happened to that other person.

On the other end of the spectrum, there have been a few considerate superstars who have completely surprised me with their compassion and thoughtfulness. One colleague from work emailed me soon after my diagnosis, but before the word had spread around the office. She noted that I had not been around for a few weeks and wanted to see if I was okay. To be honest, I responded rather curtly that I was fine and would soon be back at work. At that point in time, I was still in a profound state of shock and confusion about my diagnoses, and I was also in quite a bit of pain from various pre-treatment procedures. So I wasn't prepared to discuss the matter with most of my colleagues or acquaintances. However, entirely to her credit, this colleague followed up with an email about a month or two later, when I was far more receptive to overtures from people who wanted to get in touch with me. I ended up getting together with that person for brunch and on a few occasions after that, and each meeting has left me practically giddy from the delightful company and conversation. Our discussion weaved in and out of topics related to my treatment, and we ranged from talking about chemo to where she bought her cute jacket to how many embryos I had frozen to her relationship with her boyfriend. The balance we struck between my disease and other topics was comfortable and effortless.

My journey through cancer, and the way people have treated me and reacted to my diagnosis, has given me insight into how to approach people who are going through cancer treatment. I would like to share some of the things that I have learned:


Get In Touch

First and foremost, do not hesitate to get in touch with the person when you learn about their diagnosis. While it is legitimate to be concerned that the person may wish to keep their privacy, that should not keep you from sending a card or an email along to show your concern. If the person does not wish to respond, then they won't. But chances are that the person will appreciate the note. While this may sound a little cheesy, I recently read a book called "Now That I have Cancer I am Whole" about an ordained minister who had colon cancer, and he said that every time he received a card it was like a prayer was being sent to him. I do not consider myself to be religious, but can truly understand where he is coming from.

What do you write? The answer is that you don't need to say much. A lengthy soliloquy about what horrible news it is and how scary it all must be will not win you points. A short, simple note might go something like this: "I have heard that you are going through a tough time right now. I want you to know that I am thinking about you." You can add a number of other things, as long as they are genuine. If you aren't sure what is appropriate based on your relationship with the person, as long as what you are saying is from the heart, you probably will not go wrong. Some examples of things to say are:

-Ask if there is anything you can do. For example, if you are a colleague, you might offer to check their mail at the office.
-Say "If you would like to talk about it, I am here to listen."
-Ask if you can call them up, drop by, or go out for lunch/coffee.
-Again, as long as you mean it, tell them that you know they are strong and that you feel in your heart they will get through this.
-Say that you miss them or that their presence is missed.

I can also tell you that care packages are fantastic - flowers, chocolates, books and baskets are always welcome. When you have spent the morning puking your brains out and trying to wash your tresses without clogging the drain with clumps of fallen hair, a bouquet of fresh cut flowers delivered to your door can genuinely brighten up your day.

If you have more of a friendly, social relationship with the person facing cancer, then books, magazines and body lotion are also appreciated (skin can get dry during chemo and radiation).


If You Don't Succeed, Try Again

What I have also learned is that, if the person does not respond to your attempt at contacting them, you may wish to try again after some time has passed. People go through several stages of emotions after they find out that they have cancer, and they may become more open to communicating with others after they have had some time to process what has happened to them. I was extremely impressed with my colleague who emailed me a second time after my response to her initial email was less than warm. Initially I wanted to keep my diagnoses very quiet at the office, but that changed over time as I became more educated about what I had and was able to wrap my head around having cancer (as much as that can be done). After about a month or two after my diagnoses, I was much more receptive to hearing from colleagues. However, I would not recommend waiting two months before contacting them for the first time.
It is also important to keep in mind that if the person does not respond after your second attempt at getting in touch with them, then they may genuinely wish to be left alone, and they may not welcome further notes and emails from you.


It Is Never Too Late To Get In Touch

So you have known for quite a while now that a colleague or acquaintance is going through treatment, but have been too uncomfortable to make any contact with them. By the time you work through things and decide that you want to get in touch with them, two months have gone by. While it is preferable not to wait such a long time before contacting the person, it is never really too late to reach out. You may want to tell the person that you have been thinking about them but weren't sure what to say, and that you hope that they will understand.


Check-In

It is also appropriate, and important, to check-in with the person every so often. There are people who just send chocolates and completely ignore the person for the next five months. If you really are concerned about the person, then try to call or send emails every so often to "check in". The emails do not need to be long and drawn out, nor should they be. A simple note asking them how they are doing and letting them know what you have been up to will work just fine. The frequency of these e-mails or calls will depend on your relationship with the person, but I have some colleagues and acquaintances who email me once every two or three weeks, and I have appreciated this. I should note that if your relationship with the person has included getting together with them socially from to time, then you may wish to check-in with them more than you would usually communicate with them. I can say from personal experience that it can be spectacularly isolating to suddenly be labelled "sick", to require treatment that makes you feel sick, and to have to take a leave of absence from work. Your entire daily routine, your social contact with your peers, the sense of validation that comes from working, all suddenly evaporate. Life as you know it is temporarily interrupted and the things that have grounded you are suddenly yanked out from under you. So under these circumstances, calling or emailing every few days - perhaps when things are very rough, even every day or so - can be entirely appropriate and appreciated.

I should also note that this advice applies equally to family members. The extended family of in-laws, for instance, may want to consider checking-in quite often and calling on a regular basis. If you care about this extended family member who has cancer, show this by making a call or visiting them (call first). You need to be in touch with the person more than you normally would, because your care and support will help them through this very difficult time. Sometimes, brief visits are best - the time you spend together does not need to be long and drawn out.


Bring Up The Elephant in The Room

So you are out for coffee or have decided to call a colleague or acquaintance who is going through chemotherapy. What do you say? Do you wait for them to bring up how they are feeling or do you ask? My recommendation is that you should ask them how they are doing. Don't wait for the person to bring it up, because they may actually be waiting for you to see if you are comfortable discussing it. If you have questions about what exactly their disease is or what type of treatment they are receiving, feel free to ask, as long as you are asking because you care and want to understand what they have been experiencing. During the course of my treatment I have appreciated when people have genuinely wanted to get a sense of what I am going through, what the toughest part has been, whether I like my doctors, whether I have met others with the disease or even whether I am part of a support group.
You can start by saying that you have some questions but totally understand if the preferance is not to go into any detail.

What happens if you go out with the person as part of an extended group of friends? Do you start asking questions about how the person is feeling in front of others? Sometimes in these group settings, discussing cancer may not be appropriate. I do think that it is best to discuss how the person is doing when you get together with the person one on one, or with a few close friends.

If you are an acquaintance and just find yourself at the same social function as them, you should proceed cautiously before asking them how they feel. I was at my brother-in-law's wedding and people I barely knew - long lost relatives or friends of friends - came up to me and asked me how I was feeling with a look of exaggerated concern painted on their face. I must admit that I could have done without these comments. The rule of thumb is that if you did not proactively seek to contact the person before the event, and do not intend to check-in with the person thereafter, then you may want to avoid the cancer topic altogether. Let's be honest, you don't really care about them all that much, and they know it. But you shouldn't worry, because chances are they don't care much about you either. We can't all care about everyone, and that is fine. Under these circumstances, any questions you ask will feel more like prying.


The Bottom Line

These are some of my tips and guidelines for approaching colleagues or acquaintances who are going through cancer treatment. Yet you may find these tips equally helpful with respect to people who are going through any number of challenges or hardships in their lives. My own experience with cancer has allowed me to go beyond being able to approach others who are undergoing treatment. Before my journey with cancer, I would not have been comfortable approaching people who were going through a difficult time. Now I know from my own experience and from the responses I have received from others, that asking the person how they are doing and raising the issue that they are facing can be entirely appropriate and appreciated. A family friend in his fifties recently lost both of his parents within a few months, and I asked him how he was dealing with these losses - something I would never have known to do before my own diagnosis. We had a long talk about how he was coping and what he missed about his parents. Based on his response, I think that my willingness to discuss their recent passing was helpful to him.

The bottom line here is that if someone is going through a rough time, you have the power to help them and to brighten their day. All you need to do is reach out and keep in touch.

She Radiates Warmth

For today only, my radiation session was moved to 7:00 a.m. This time slot actually worked out well because it gave me an early start to the day. I have been going to bed at the ungodly hours of 3:00 and 4:00 a.m. and waking up at noon, and have been trying to break out of this pattern.

When I returned back home this morning after Radiation Day 12, I spent several hours cooking, since it was my night to prepare dinner for my family. On the menu was: pumpkin soup, avocado salad with honey-mustard dressing, veggie burgers with a creamy sauce, sweet potato fries, bok choy and baked apples for dessert. All items were basically made from scratch, so the cooking took way too long, but the process was rather peaceful and soothing. Cooking can be unpleasant and stressful when there is little time to prepare, but today I didn't feel rushed and enjoyed the colours and textures of chopping and mixing and heating. For the burgers, I even made my own bread crumbs, since the only ones that I could find in stores were made with hydrogenated vegetable oil and other unhealthy products. I have always been extremely health-conscious, but have become even more so since I began radiation. (I have a long-standing theory that hydrogenated vegetable oil, a.k.a. vegetable oil shortening, is the personification of evil in western society, but that is a story for another time). I am acutely aware of the long-terms risk that are associated with radiation, which include breast cancer, heart disease and other delights. So I have ramped up my nutritional intake to include tons of leafy greens and a wide variety of fruits and vegetables.

Exercising has been another major focus, since it is really the only thing that I can do, along with eating and sleeping well, that may lower my chances of facing these side effects. Included in my exercise plan, as you may know from my past blogs, is yoga. Today I took a hot-yoga class (also known as bikram yoga) and invited along my sister-in-law and husband. The instructor was talented and intense and the positions were interesting and challenging - it always amazes my how many different ways our bodies can move.

I wore a high-necked t-shirt, but some of my radiation body-art showed through the neck and arms. I probably puzzled onlookers, but I didn't really care. Besides, the movements required concentration and focus, so there was little time for people to look around at each other. Which was a good thing. If I saw someone who looked like me before I was treated for cancer, I would not have a clue what the crosses were for, and might have suspected they were related to goth or part of a highly suspect religious movement. The whole process of treatment has made me less judgemental, since I now understand there are so many reasons why people look, act or speak the way they do. And this sentiment is reflected in the meditation exercises that accompany yoga. We are asked to observe ourselves without judgement, to simply take note of what we are thinking or how we are feeling. And that can only make us into more open, receptive and kind human beings.

Healing Through Yoga? Now That's a Stretch

Today, just before Radiation Day 11, I returned to HappyTree Yoga for a free class designed for young adults with cancer. As it turned out, I was the only one there, so I had a private lesson with the instructor. The session focused on restorative yoga, which involves a series of postures that are said to promote healing and even improve the immune system. A number of the exercises required me to hold stretches for several minutes at a time.

The class began with some relaxation and breathing exercises, and to be completely honest, it didn't take long at all for me to start feeling content and even soothed. Some of the poses were semi-acrobatic and others were just plain awkward, so it was a challenge to maintain them for relatively lengthy periods of two to three minutes. However I was asked to avoid tensing up and to instead observe my discomfort, and to breath and fall further into the pose. The point of these exercises was not to cause pain - and I never was in pain. Rather, the goal was to promote healing and to improve mobility and flexibility, particularly in the spine.

One of the poses involved sitting in a cross-legged position with an adjustable strap to maintain proper tension, with my back against the length of a cylindrical pillow and my hands spread open at either side. This exercise not only involved stretching, it also had an emotional element by making you feel open and vulnerable. The mind-body connection was very real in this pose since the open position my body was in created an emotional vulnerability. During the pose, the instructor asked me to focus on giving but also receiving the things that I needed from others.

The instructor also introduced a pose aimed at strengthening the thyroid. This exercise was of particular interest to me, since my doctor had informed me that there is a 50% chance that the radiation will completely fry my thyroid. Once I explained this to my instructor, she showed me a number of healing and stretching exercises for my thyroid. During these poses I was asked to visualize keeping it strong.

I am not entirely sure whether or not the exercises actually work to promote healing. I do however know that yoga is an ancient practice and that its practitioners seem to engender a sense of well-being and come across as being at peace. Often my yoga instructors also strike me as being very wise. So perhaps the stretching, visualizing, breathing, and time spent focusing inward actually do symbiotically have a healing effect. Is that really such a stretch?

Pretending to be Normal

Friday was Radiation Day 9, and after that I enjoyed another weekend free of hospitals, masks, doctors and technicians. I went with my mother to a Kundalini yoga class at a new place that opened up called HappyTree Yoga. Purple pillows were scattered artfully along benches and walls and the scent of spiced tea permeated the studio, creating a warm, inviting atmosphere. The class itself involved some heavy breathing exercises that apparently do wonders for your lungs. Since radiation puts me at risk for various possible side effects to my lungs, the deep breathing exercises were worth a shot.

On Saturday evening, my husband and I went to his parent's cottage. The weather up north was cool and crisp and on Sunday we bundled up and went for a walk, breathing in the fresh country air as our shoes crunched against the golden autumn leaves. The air smelled like wet bark, sweet moss and Yuletide chimney smoke.

From the yoga class to the walk outdoors, my weekend was quite literally a breath of fresh air. It would have been a perfectly pleasant weekend except that it reflected how askew my life is at the moment. My normal life is in Toronto, yet I was in Montreal going to a yoga class on Friday afternoon and doing all sorts of things that are completely not in keeping with my busy life as a lawyer.

I have spent much of my life trying to be normal, and trying to fit in. I am not sure if this is something that we all do. High-school was a disaster but CEGEP, my undergraduate days and law school yielded increasing success and were filled with friends, extracurricular activities and traveling. My good fortune continued at my law firm, but I have always remained steadfast in my focus on excelling at my work while remaining nice and normal. I have strived to be pleasant to all and avoided complaining or calling attention to myself (except I do perhaps pay extra attention to my clothes, but that is in keeping with the Montrealer in me - we simply must dress well!). Above all, I have made every effort not to ask for anything, to make any requests for any special treatment that would set me apart in a request for lenience or convenience. The thought of having children left me petrified because it would require special arrangements for me, and I just wanted to do my job and do it well.

Clearly, the past few months have thrown my plan through a loop. I am now Different, I am set apart, I am the girl with cancer, the girl who showed up at her firm's Chicago retreat in a wig and the girl who had to make a request for the firm to fly her into Toronto for her colleague's going away dinner. I have to ask the firm to make concessions for me now. I am just not fitting in any more, and I am as far from normal as normal could be.

I have also avoided ever taking any time off and have focussed on navigating efficiently through social and educational landmarks. From a social perspective, I was engaged at 24 and married at 26, which among my cohorts was considered a very desirable age to tie the knot. From an educational perspective, CEGEP led into university which led right into articling and an associate position, without any breaks in between. That is why I am among the youngest in my cohort - I plodded straight through in order to reach every landmark ahead of the others or in keeping with the front runners. Now, however, I have winded up taking nearly six months off, and there is uncertainty as to whether I have even gotten rid of my cancer. It seems to be as determined as I am.

My life has gone from a linear fast lane to a winding, twisting, circuitous route. In some ways, the road ahead has never been more exhilarating because it is now vast and open. I have ventured off the path that I paved and it has created possibilities for me, it has allowed me to venture onto other paths that I would have never taken. Just conceptually, the idea of stepping off the paved road has shown me that there are other places and ways to live. There are the writers and the artsy types who work on their own time, when they want to, and take long walks for inspiration. There are the yummy mummies in the park where I jog, who have taken time off to raise children. There are all sorts of people shopping and sipping lattes at cafes at 2:00p.m. in the afternoon on a weekday. There have certainly been some enjoyable aspects to joining their ranks. It is quite pleasant to jog at my whim, to have the time to cook my own healthy, flavourful meals, to exercise and to write. I do not deny that there have been pleasures in my painful time off.

Yet the difference is that these artists and moms and others who I see on afternoon strolls have made the conscience choice to wander down their own paths. In my case it is because I am in treatment for cancer that I have been thrust among them completely without any volition. I do not feel normal going to yoga in the early afternoon without having to quickly change and return back to the office. I feel unsettled when my jog isn't crammed into my hectic work schedule. My life right now is not normal, and all the normal things I am doing in the meantime, the cooking, the exercising, the long country walks, have a malignant shadow cast over them. The only reason I am here in Montreal as a lady of leisure, is that I am being treated for cancer. This is simply not normal, and it has completely put my life - my normal, crazy, hectic, wonderful life - on hold. Until I return to it, there is no normal life for me. There is just the "new normal", a term ubiquitous in cancer self-help books. The "new normal" takes some getting used to, because it is the result of an abrupt interruption of life and involves accepting the unacceptable and learning to live with uncertainty. The best that I can do right now is pretend to be normal, and to keep breathing.

You're Too Young to Be Here

Today, on Day 8 of my radiation treatment, I spoke to my radiation therapist about a pain in my chest. She examined me and concluded that it was too early for potential side effects, and that everything seemed normal. She added however that she doesn't typically have patients that are as physically active as I am, and that it is possible that my level of activity might have something to do with it. I suspected that she was accustomed to treating an older population and that this might have had something to do with why her patients were less physically active, and I raised this point with her. She responded that most of her patients with Hodgkin's fall into my age group, yet typically they are too tired to exercise.

It is possible that I am simply lucky to have such a high level of energy during my cancer treatment. It is also possible that the dreaded fatigue that is associated with radiation just hasn't yet hit me, although I do know that during my four months of chemotherapy, I worked out at least three times a week, including the day after chemo. My exercise classes helped me feel normal and the pumping music and energy in the class contributed to a sense of well-being and also made me forget how much I wanted to vomit.

Yet to be completely honest, I don't think that I am anything special - there are others in my young adult support group who are also going to the gym. Rather, I really do think that physicians, including my own, just aren't used to treating younger patients. Why? Because as a general rule, it is older people who get cancer. While Hodgkin's patients do bring down the average age of the adult cancer population, there aren't many of us with the disease, and I will bet that my radiation therapist typically sees patients who can at least remember where they were on the day of John F. Kennedy's assassination. At the very least, they were born by then.

A quick look around the radiation waiting room at my hospital room reveals that I am the youngest person there (by several decades), and this was also the case in the chemotherapy unit. On occasion, I will bump into a young, bald woman in the halls who I know from my support group, but other than that, I mainly see people who look like they could play bridge with my grandmother. In fact, during one of my chemotherapy treatment sessions, as I energetically walked down the hall with IV bags in tow, an older man looked at me and simply said, in an almost accusatory tone, that I was too young to be there. I don't think that my hospital is different than any other hospital - I simply think that there are not, relatively speaking, a lot of young adults with cancer.

During the course of my cancer treatment, it has become clear to me that oncologists, radiation therapists and their staff are used to treating older patients, and this is reflected in their expectations towards cancer patients. These professionals are simply not accustomed to dealing with younger patients, because twenty and thirty-year-olds are typically off starting their careers and families rather than coming in to see them.

The concern here is that since their practices are geared towards treating older people, there may be any number of social, biological, and medical issues that physicians are missing when they treat young adults. Cancer treatment is divided into childhood cancers on the one hand, and adult cancers on the other, and since adult cancers typically strike people well past their twenties and thirties, there is a gap when it comes to treating young adults. According to the Vanderblit-Ingram Cancer Center, in contrast to younger and older cancer patients, survival rates for young adults have not increased since 1975. There are a number of possible reasons for this, including later diagnosis (since no one expects a thirty-year-old to have cancer) and lack of enrollment in clinical trials. The media has gradually began to notice this, especially since cancer rates among young adults are increasing, as noted in the New York Times. It is unclear why more young adults are getting cancer - although I have a sneaking suspicion that the influx of chemicals in our food, in the products we use and in the air we breath may have something to do with it - but I digress. What I do think is clear is that cancer will affect a thirty-year-old body in a different way than it will affect a seventy-year-old body. Beyond this, there are unique social issues that a young adult with cancer will face. The sad truth is that cancer treatment in young adults has fallen through the cracks and young adults are paying with their health.

Adventures of...SuperFlab!

It's not a bird - it's not a plane - it's SuperFlab! Yes, SuperFlab, a squishy, flat substance made of synthetic oil-gel, comes to the rescue to help fight cancer! As its name suggests, SuperFlab is a highly technical, extremely advanced technology. How does it work? Simply place the fake boob-like substance on your skin, and the radiation beams will not be able to penetrate as deep into your body. Why? Because they have already had to go through the layer of SuperFlab, which the radiation beams treat as part of your skin. The result is that the radiation beams will target cancer cells that are closer to the body's surface.

On Day 6 of my radiation treatment, I was introduced to the stupendous and spectacularly squishy SuperFlab. As I lay down on the narrow table under red lazer beams and an array of space-age machines, the technicians cut the SuperFlab into a small strip to fit the width of my neck, and then taped it on to me for good measure. Standing back to examine their handiwork, the technicians weren't quite sure if the makeshift contraption looked right, and called their head technician, who in turn paged the radiation therapist physician, who could not be reached. The head technician assured me that they were quite certain that the contraption reflected what the doctor had ordered and that in any event, if it wasn't perfect, one day of radiation like this wouldn't kill me. (Okay, so I admit that they did not use the word "kill". But that was the general idea.) The other technicians boldly reiterated the head technician's assurances, and as they strapped on my mask, which incidentally is oddly reminiscent to the one from Friday the 13th, and exited the room to start the radiation session, I of course felt anything but reassured.

As the buzzing sound began, indicating that the nuking had started, I realized that in fifty years from now, these radiation machines would be nothing but historical artifacts, and SuperFlab would only be found in museums. I pictured the flabby subtance set behind a glass case, alongside scissors and a roll of tape. A small plaque beside the display would read: "Humerous medical tool used at the turn of the 21th century. For related artifacts, visit Medieval Quackery in Room E2."

It is a strange sensation to have my body treated with machines and techniques that are so evidently archaic. Radiation may be curing me but it may also be setting in motion some serious health problems down the road.

When you have cancer, you quickly realize that modern medicine is only a relative term. There is so much more that doctors don't know. While their knowledge, tools and techniques have advanced over the years, they continue to be primitive. Chemotherapy and radiation are both treatments that cannot differentiate between cancer cells and healthy cells, and so they indiscriminately destroy both types. Patients are left to suffer the consequences. Yes, chemotherapy and radiation are all we've got, and they have saved many lives. But let's not kid ourselves - they are highly toxic and already seem antiquated. Eventually, current treatments for cancer will become mere medical curiosities, as those who received these treatments gradually die out.

On Growing Up and Growing Old

One two, buckle my shoe. Three four, shut the door. Day five, still alive. Yes folks, five full days of radiation and I am still feeling groovy. This afternoon I went for a jog. I have come to relish running outside on crisp, cool fall days under the glowing yellow, bright orange and fiery red leaves. On the way home from rads, my mother and I went grocery shopping. I chose to walk with a separate cart and fill it with the items I planned to use for preparing meals during the week. I am staying with my parents during treatment, but prefer to make my own meals and eat with my husband based on our own schedules. Once a week I will prepare a meal for my family, and on Friday we eat altogether.

At the cash, my mother said that she wanted to pay for my groceries. I thanked her but declined, however she nonetheless shot her credit card at the cashier alongside my card. The cashier processed Mommy's card. I felt completely infantilized and frustrated by the experience and my mother and I promptly began to fight. I explained to my mother that I have very little control over my life right now, given that I am being treated for cancer in a city that I do not call home and am staying with my parents, and it is therefore important that I have some control over the food I would like to eat and that involves paying for it. I understand that my mother felt uncomfortable having me pay for food while living in her house, but this was something that I wanted to do.

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The entire process of having cancer is incredibly infantilizing. At times you are physically weak and your parents want to take care of you. As grateful as I am for having supportive parents, it has been a constant battle to try and maintain a sense of space and independence.

On top of this, you have to hand over your "healthy person" badge and trade it in for the one that says "sick person". You have lost control over your health and doctors are making decisions for you and nurses are caring for you. Your body is no longer your own as you are poked, prodded, cut and medicated. For good measure, you may also become bald.

Ironically, for a young adult, having cancer both completely infantilizes you yet simultaneously catapults you into a far more advanced stage of adulthood. At thirty years old, instead of balancing career and family with thoughts of pregnancy, I found myself balancing chemo with radiation, collecting disability and getting hot flashes. The only thing I remained stuck with in either scenario was morning sickness.

I am not sure at what point in the process of having cancer that I actually became an adult - if I did at all. Was it when I received the final diagnoses and was forced to contemplate my own mortality? Perhaps it was when, as a result of the terrible constipation from the drug I was taking to counter the nausea from chemo, I started to eat Bran Buds, a cereal that on the side of the box declares itself to be, and I kid you not, "An Adult Cereal". Perhaps it was when my terrible fear of needles was replaced with a sick pride at being able to give myself the daily neupogen shots that were required to maintain my white blood cell count. Or, perhaps it was when I received my first lupron shot, which put me into a state of temporary menopause, in an attempt to preserve my fertility during treatment.

All of a sudden, at a point when I was just tiptoeing into my third decade, I was faced with all sorts of ailments fit for someone venturing into their sixth decade or beyond. Yes, I would have fit right into an old age home as my vocabulary now included haemorrhoid, enema, Actonel and, horrifically, Vagifem. (Which, for the record, I never actually used. But my physician parents wanted to prescribe me some. I can't decide whether that is totally infantilizing to have this prescribed by my parents without my even asking, incredibly mature to be discussing these issues with them, or just plain gross.) I can now relate to the elderly, adults past their prime who have now begun a regression back to childhood, who have lost control over their lives and their bodies, who require their own children to make decisions for them.

The experience of having cancer has offered me a glimpse into different ages and stages of growing up and growing old. It has allowed me to skirt across the universe of life and to linger in fault lines typically reserved for a much older crowd. Do I feel significantly older as a result of having cancer? Yes. Do I feel wiser? Indeed. Has the experience overall made me feel more adult, despite the constant infantilization and loss of control? I am not sure. When a young adult has cancer, boundaries between childhood, adulthood and old age blur and there are no "You Are Here" stickers for where you are at any given moment on the road of life.

Prison Break

On Friday afternoon, ecstatic with the prospect of a weekend without any strapping and zapping, I jumped on the train to Toronto from Montreal. I was eager to set aside some physical and emotional distance from the hospital and from the dark shadow that radiation had cast on my being, and elated to be returning to my own apartment. (My parents are in Montreal and they have been immensly supportive. Their medical background and connection to the hospital where I am being treated is a main reason why I received chemo and now radiation in Montreal.)

Back in Toronto, feeling positively giddy with freedom, I packed in a full weekend of activities. Brunch with a friend, Susan and her husband, was followed by two back-to-back exercises classes. One was Gingadeira, which is derived from Capoeira, a Brazilian type of martial arts dance with some African influence. The dance can be spectacular when two professionals weave in and out of various kick and defense poses, or spectacularly pathetic when done by yours truly. After this I did yoga, which made me feel liberated and whole.
Susan (right) and I in October, 2007 at her piano concert














With time to spare before dinner, I snuck in a manicure (colour: O.P.I. Got-a-date-to-knight) at a place that gives you a back massage while your nails dry! The aestheticians are Chinese and the massage they perform is like no other - they can find pressure points you never knew you had, which makes the experience verge on erotic, and then they rythmically beat your back in a technique that, based on my google search, is called "tapotement". (Either that or "assault".) Honestly, you can practically attain nirvana with those two minute nail-dry massages.

At night I went for dinner with my in-laws and family friends, and then played poker with friends Phil and Julie. All this was done sans husband, who was in Calgary for a few days on business. Sunday morning was the party for my new little neice Aliza - which is why my in-laws were in town - and then it was back to Montreal for another week of having my body burned and my soul sapped.

Resistance is Futile

Photo below: When your pesky tumour just won't go away

Once you begin to accept the unthinkable without putting up a fight or even shedding a tear, without showing any resistance, you know that you have been sucked into the institutional world of the sick. Case in point: Before I was diagnosed with cancer but when things started to get suspicious, I was required to have a biopsy on my neck. While I clearly understood that the surgery needed to be done, I was still rather distressed that the scar would be on such a visible part of my body. When I voiced this concern to my surgeon and asked if there were ways to perform the surgery that would better hide the scarring, he became visibly irritated and said that I shouldn't be concerned about this since there were far more serious things I needed to worry about. My response to said surgeon was that I understood the severity of the situation, but if I was going to live, then I preferred not to live with a massive post-surgical scar on my neck.

Needless to say, I changed surgeons, and the second one - Dr. Black at the Jewish General in Montreal - was far more sympathetic. He explained that he would try to perform the cut on a crease in my neck, which would allow the scar to blend in with the crease and minimize the scar's visibility.

The point here is that the first surgeon was probably accustomed to seeing patients who had already taken on the role of "sick" person. These are the people who have been broken down by the hospital system, by tests and procedures and inconveniences and pain. They are a lot easier to deal with.

Another case in point: Just before starting chemo back in June, 2007, I was told that I would need a picc line, which is a tube for administering chemo that hangs out of your arm for the duration of treatment. I was not happy about this. In fact, I was rather miffed, and I cried long and hard.

But now, just a few months later, I have grown to accept these types of things and see them merely as medical inconveniences rather than as the assaults that they are on my freedom, mobility and sense of dignity. Patients even begin to expect these frequent assaults - it starts with the little things, like walking around in gowns that reveal our butt cracks. But it ends up with spending the night in a bed in the hall because there are no hospital rooms left, or sitting in a public waiting room with a huge contraption affixed to the head and featuring metal posts jutting out of the forehead. (I have seen this guy with the head device every day when I have gone in for radiation - it was Day 3 for me today, by the way. I guess we have back-to-back time slots.) Perhaps patients are too weak to have their voice heard. Or perhaps they have just stopped caring. They have been so worn down, so beaten up by all the public humiliation, the pain, the exposure, that they have become numb.

I try to care. I still pull myself together in my carefully coordinated outfits, my loose tunics, belts, tights and booties, my necklaces and bracelets, my wig and my baker boy cap (these hats are all over town now even though they didn't really hit the Fall '07 runways). But the bottom line is that I have to some extent succumbed to the world of the sick. I wasn't supposed to even receive radiation, but barely lamented when told that I would need to have my organs microwaved. It seems that resistance is futile.

Radiation patients feel your pain, Jean-Luc





















FAMILY STUFF

On another note entirely, my little brother (26 years old) was hit by a car today. He is okay. But he fell onto the hood of the car and catapulted back onto the ground. An ambulance came to the sight but my brother said he was fine and didn't go to the hospital (needless to say, my parents and I were not impressed by this). His back started to hurt once he arrived home and ultimately he did go to the hospital. The doctor examined him and he seems to be fine. Between me getting radiation and my brother being hit by a car, this was a little too much for my parents today. They were overwhelmed and ferklempt earlier today, but have since recovered. I cooked them dinner (something I have done on occasion but plan to do on a weekly basis while in Montreal - I live in Toronto but am in Quebec for treatment) and they seemed to enjoy this. I have started to really relish cooking, particularly Asian-themed dishes. The meal consisted of a mango-spinach salad, tilapia with coconut-peanut sauce, asparagus with black bean sauce, and squash, with fresh cantaloupe, grapes and kiwi for dessert.