Thursday, November 15, 2012

Your Silence Will Not Protect You...

As you know, for the past 2.5-ish years, I've been devouring all the books and films about environmental carcinogens that I can get my hands on. 

A few weeks ago, I was browsing the "new non-fiction" section of my local library, and came across a book that looked intriguing: Full Body Burden: Growing Up in the Nuclear Shadow of Rocky Flats, by Kristen Iversen.  I checked it out.  About three days later, when I had only read a couple chapters, I came across a little blurb online saying that the author was going to be speaking about her book in just a few days, about two miles from my house.  What serendipity!  I mean, what are the chances?!  She's not even a local author - she lives over 1000 miles away.  So, I knew just had to go.

I didn't have much time, but I read furiously for the next few days, wanting to finish the book before the event so that maybe I could actually have something to say during the question and answer session that followed her lecture.  Sadly, I didn't even make it halfway through the book.  I thoroughly enjoyed Kristen's presentation but was too shy to say anything during the Q and A...Then, she went to a table in the back to sell/sign her book... so I went up to her, intending to tell her about what her book means to me and how I've been reading it all week trying to finish it in time, and instead, I got tongue-tied and blurted out, "Thank you so much.  I'm on page 158!!" and left.  WHAT A DORK!  (Yes, I'm bold and long-winded in writing, but often shy and quiet in person.)

So I will tell all of you, here, what Kristen's book means to me:

I've spent 2.5-ish years learning all about the dangers of environmental carcinogens, and advocating for their abolition.  I've learned about and spoken up about chemicals in cleaning products and cosmetics; fracking; pesticides; GMOs; BPA in cans and packaging; chemicals in clothing, furniture, and toys; etc.  I've sent letters and emails to the government, advocating for the passage of the Safe Chemicals Act.  I've signed anti-fracking petitions, and boycotted products, and made sure the store I get most of my groceries from doesn't use receipt paper with BPA.  I buy organic everything as much as possible, and write for Breast Cancer Action, and I've volunteered with an organization from my hometown (close to a Superfund site!) that researches and does education/outreach about carcinogens in the environment. 

But I grew up 30 miles away from a nuclear power plant, and have now spent the past 8 years living 5 miles away from another, and have, until now, totally ignored the topic of nuclear power and its dangers.  The topic terrifies me.  But it's time I start delving into it.  I'm announcing that publicly, so I don't chicken out.  Stay tuned...

Friday, November 9, 2012

Breast Cancer Action blog

Guest blogging again at Breast Cancer Action - check it out! 
"Put Down the Pink, and Pick Up Your Pen!" 

Monday, October 15, 2012

Down with Pink

It's Breast Cancer Awareness Month.  I'm not thinking about pink ribbons.  You know what I'm thinking about?

Superfund sites.  These are the approximately 1500 most hazardous toxic waste sites in the country, as classified by the EPA.

I grew up on Cape Cod, about 5 miles from one - the Otis Airforce Base, and about 45 miles from another - New Bedford.  The New Bedford site is Massachusetts' TOP priority toxic waste site, identified as a priority for clean up when I was four years old.  The site has one of the largest concentrations of PCBs in the nation.  Otis Airforce Base is the 13th most polluted site in Massachusetts.  The EPA put this site on their list when I was 10 years old.  It's contaminated with carcinogenic VOCs, formaldehyde, and DDT, among others.  

Eleven out of fifteen towns on Cape Cod have a breast cancer rate at least 15% higher than the rest of the state, and the Silent Spring Institute's research shows that the longer a woman lives on Cape Cod, the more at risk she is for breast cancer.  I was in utero on the Cape, raised on the Cape, and spent 23 years there.  I was diagnosed with breast cancer six years later at the age of 30.  Coincidence?  We'll never really know, will we?




Thursday, July 12, 2012

Exercise

I'm lovin being Tamoxifen-free!  It's now been 2 and a half months without it!  At first, I was solely focused on how happy I was to be free of the Tamoxifen side effects... but after a month or so, it dawned on me (although it's so obvious it shouldn't have been a surprise to me!) that while it was great that I wasn't experiencing the yucky side effects, I also wasn't getting any of the protective benefits of Tamoxifen.  Isn't that crazy??  That it took me a month to have that perspective on it??

I got a little nervous.  So I increased my anti-cancer supplements (or rather, made a better effort to take the full doses every day!), and also decided to double the amount of weekly exercise I'm getting.  I read somewhere on the web that while the CDC recommends a minimum of 2.5 hours of weekly exercise for adults, you need 5 hours per week for the exercise to truly have a cancer-risk-reduction effect.  Soooo, I bought a used Wii Fit. :)  It's lots of fun, and really there are no excuses for not exercising when it's right here in my living room.  I don't have to plan time to go to the gym, bring money, pack a workout bag, and blah blah... I can exercise in my living room in my PJs or office clothes or nothing at all, at any time of day or night, for no cost beyond the one-time purchase cost of the Wii!  And it tracks my progress for me!  

And a week after buying the Wii Fit, my partner and I brought home an even better form of exercise... we ADOPTED A DOG!  A dog who gets us walking around the neighborhood and woods for at least 60 minutes a day!  His name is Tayo and he's a total sweetie.  I highly recommend dog adoption to all cancer survivors (and people in general!) who are trying to exercise more.  A dog won't LET you procrastinate or wimp out of your daily workout... s/he needs a walk every day, even several times a day!  I can't even count how many times my partner and I, before we got a dog, would say, "We should go for a walk," and then just not do it.  I think it was easy to skip the walk because it felt too much like exercise.  Now, walking doesn't feel like a chore or some obligatory thing I do because this nagging voice tells me I "should"... walking is something I do to keep my lovable little dog happy and healthy, and the fact that it keeps me healthier, too, is a sweet bonus.


Thursday, May 24, 2012

Is the Sun Your Best Friend? Set Some Boundaries!

Did you know May is Melanoma Awareness Month?  Yep.

Did you know that breast cancer survivors are at higher risk for melanoma?  Neither did I, until I was diagnosed with melanoma two years after being diagnosed with breast cancer and started researching it!  The reverse is also true - melanoma survivors have a greater risk of being diagnosed with breast cancer.  Some breast cancer treatments, such as radiation and certain drugs, can increase your sensitivity to sunlight.  This makes protecting yourself from the sun even more important.

Who else is at risk for melanoma?  People who have fair skin, tend to sunburn easily, have ever had even one blistering sunburn, or have had multiple sunburns in childhood or adolescence, have more than 50 moles, use tanning beds, ETC. ETC.!!

 Dear 16-year-old me is a video that really hit me hard - it's a bunch of melanoma survivors telling their 16-year-old selves (and today's teenagers) to be more careful in the sun, and all the things they wish they knew when they were 16.  I would bet my whole bank account that the melanoma I was diagnosed with last year was directly related to my childhood and adolescence (and exacerbated by radiation and Tamoxifen) - I was your stereotypical Cape Cod beach bum.  I lived in my bathing suit, lived at the beach, didn't care much for sunblock, and got numerous sunburns.  Sunburns before age 18 hugely increase your risk for melanoma.


None of us can turn back the hands of time and slather sunblock on our teenaged selves!!  So let's encourage the teenagers we know and love to watch that video, and let's start protecting ourselves from the sunlight now, to whatever extent we can.  While it's true that sunburns during our youth are the biggest contributors to melanoma risk, it's never too late to start sun protective measures and it really does matter.

Melanoma is one of the deadliest cancers.  Thankfully, it also seems to be the most preventable!!!  That's such a blessing!  Having breast cancer can feel so overwhelming, confusing, and devastating, because while there are risk reduction strategies we can engage in in an attempt to prevent a recurrence, it often just feels like a crapshoot.  Why did I get breast cancer in the first place, when I was young, healthy, fit, had no family history, never smoked or drank, exercised regularly, and ate lots of organic vegetables?  I will never know.  And there's no guarantee that my risk reduction strategies (exercise, lots of cruciferous vegetables, green tea, turmeric, various supplements) will really prevent a recurrence.

But we know what causes melanoma: too much exposure to UV rays from sunlight and tanning beds!  And we know how to prevent it: reduce exposure to the sun's UV rays and don't use tanning beds!  This is great news.  Cancer has a way of making you feel so powerless, but when it comes to melanoma, we have a greater degree of power over it than we do with other types of cancer.  By consciously and consistently protecting ourselves from sunlight, we can greatly reduce our chances of getting melanoma.  It's impossible to prevent it totally, of course, and I would never suggest that someone's melanoma diagnosis is a result of them "not trying hard enough" with the sun protection - because like I said, none of us can turn back the hands of time and un-do the sun damage of our youth.  In addition to conscious and consistent sun protection, it's also important to get annual full-body skin/mole checks from a dermatologist.  By doing so, we greatly increase our chances that even if we have melanoma, it's caught at an early stage.  When caught at stage 0 - in situ - it's fully curable with surgery!

I won't deny it - protecting yourself from the sun can feel like a total pain in the ass.  Most humans, myself included, love the sun.  We're gray and gloomy when the sky is, and then when the sun comes blazing through the clouds, we're happy and relieved and love to bask in its warmth.  Some people hate the sun, and I guess they're the lucky ones in this sense...

I read the typical sun protection guidelines - "Avoid being in the sun from 10 AM to 3 PM, wear long pants and long sleeves and a wide-brimmed hat, re-apply sunscreen every two hours" - and I want to yell back, "Oh, like it's REALLY THAT EASY??"  I instinctively gravitate to the sunlight - being immersed in a sunbeam feels so warm, bright, and happy.  But this is why I got melanoma.  I eschewed sun protective measures, partially because I guess I didn't believe it was that big of a deal, and also because all of the recommendations seemed SO unrealistic and unachievable.

Of course now I'm changing my tune!!!  I've been learning a lot, and I've discovered that sun protection is neither as horrible nor as impossible as I had believed.

Do you hate sunscreen as much as I do?  There are many alternatives!!

I won't spend too much time talking about sunscreen, because that's the main sun protective measure we all know about and are probably sick of hearing about.  I don't think it's so great.  Most sunscreens actually contain carcinogenic chemicals - how stupid is that?  And most people don't apply nearly enough sunscreen for it to be effective anyway.  If sunscreen is your thing, though, get a good kind - check out the Environmental Working Group's Sunscreen Guide (the best and the worst!).  My favorite is Badger Balm, especially the new Damascus Rose SPF 16 facial sunscreen.  It's expensive but worth it.  It's completely healthy and safe, and smells nice, and best of all, it's the only facial sunscreen I've found that doesn't make me white as Casper!

Other sun protection methods:

UPF Clothing
You can buy UPF 50 clothes that block 99% of the harmful UV rays!  This works even better than sunscreen, giving you more complete and reliable coverage, and it's much less of a hassle.  The only downside is that it's pretty expensive - at least up front.  Over time, you'll probably save money by relying on UPF clothing more than sunblock, because you don't have to keep buying tube after tube.  My favorite UPF clothes are from Coolibar.  I can't afford to buy entire UPF 50 outfits (e.g. pants, shirts, dresses), so I prioritized and just bought a few items.  I bought a Coolibar wrap that I can throw on over whatever outfit I'm wearing, and a bathing suit on sale (the kind that's a short-sleeved shirt and skort!), since the beach is where my sunburns are most likely to happen.  Since a lot of my sun exposure comes from my 1-hour RT commute in the car each day, I also bought a pair of UPF 50 sleeves from Sunny Sleevez.  No, they're not so fashionable, but they're great for wearing in the car.  They get the job done, you know?  And they don't make a mess like sunscreen.  (And you don't have to shower every night to get the sunscreen off of you!  Ugh!).  If UPF clothes are too expensive for you, wait for sales (check the websites frequently), or just buy one or two versatile, key items.  e.g. this UPF 20 "buff" that can be a headband, scarf, etc.; or sun sleeves; or a jacket/hoodie/cover-up; or a UPF 50 sarong to cover up with on the beach no matter what bathing suit you're wearing.  If you just buy, say, one dress or one shirt, you're only protected from the sun that one day of the week when you wear the shirt or dress, whereas if you buy one accessory or outer layer, you can pair it with any outfit at all.  

Wide-brimmed Hats
These can actually be fun!  I think they're coming back into fashion.  Look around and see which hat(s) appeal to you.  There are the usual boring classic hats, like this ,but there are also fun hats like this and this.  Of course I will tell you that the wider the brim and the higher the UPF, the better, but any hat is better than no hat!  Check out the Village Hat Shop, Hats in the Belfry, or go to Etsy and search for "summer hat."  And don't forget thrift stores!  Buy as many hats as you can, in a wide variety, so that when you're leaving the house, you're likely to have a hat that matches your outfit.  And/or buy one or two hats either in neutral colors (black, white, beige) or in a color most likely to match a lot of your outfits.  I made the mistake of first buying a blue hat that was on sale and seemed nice, not thinking about the fact that I hardly have any clothing in that color!!  A hat that has a brim wide enough to put your whole face in the shade may prevent your need for facial sunblock.  (I know dermatologists would say you should wear the sunscreen even with a hat... but I'm trying to make the sun protection methods more manageable for real people!!)

SunGuard Laundry Product
Okay, I haven't tried this one.  But the idea is, you add this product to your laundry and it makes your normal clothes UPF 30.  (A white tee-shirt is about UPF 5 on its own).  This seems like an easy, inexpensive thing to do...my problem with it is that I can't find an ingredients list for this product and I worry that it contains the same carcinogenic chemicals that sunscreens do.  If anyone has more info about this, let me know!

Parasols
I haven't tried this one, either.  But theoretically, you could carry a fashionable UPF 40 parasol/umbrella with you, if you didn't want to wear sunscreen or UPF clothing or a hat or anything!!  Lots of the sun protection websites sell sun-protective umbrellas, but they're not that attractive.  Sara's Parasols are colorful and fun.  And yes, expensive.  At least it's a one-time investment, unlike sunblock, which you keep using up and having to buy more of.  (And if one tube lasts you all summer, you're not using enough!!!)  A parasol would be great because you could wear anything underneath it and still be protected.  Sometimes sun-protective clothing is annoying because I either get too hot in it, or I want to be wearing my cute little sundresses like everyone else.  The downside to a parasol, of course, is that you have to continually hold it above you - hard to do if you're walking to work with a laptop in one hand and and iced coffee in the other! 

In Summary...
There are multiple methods of protecting yourself from the sun, not just sunblock, so you can find something that works for you.  Which sun protection method is best depends on your personal circumstances, and the situation.  When I'm going out to the back deck to hang laundry out to dry, I can't hold a parasol, and I can't be bothered to apply sunscreen...so I'll thrown on a wrap and hat.  When I'm at the beach, even if I'm wearing a UPF 50 bathing suit and sometimes sitting under an umbrella, there's really no way to get through the day without sunscreen.  I also use sunscreen to spray on my feet when I'm wearing flip flops.  Figure out what you need, then do whatever you can to make using sun protection easy and convenient!  If you're using your sun sleeves mostly for driving, keep them in the car, not in your dresser in your bedroom.  Keep sunscreen in your purse or your desk at work, and in your bathroom so you can put it on your face as part of your morning routine.  Keep some hats in the car, some near your car keys or by the door.  The goal is to make sun protection as much of a habit as brushing your teeth!

Most people know that they should be doing more to protect themselves from the sun, than what they're actually doing...sometimes it's because sun protection is inconvenient and we can't be bothered.  When I get frustrated by the inconvenience of having to put on sunblock or wear a hat when I'd rather not, I try to change my perspective and instead be grateful for the fact that melanoma is so preventable!  And sometimes we do try to protect ourselves from the sun, but we're just caught unaware.  Sometimes it's raining in the morning, so I leave the house with no sun protection, and then the sun comes out in the afternoon and catches me off-guard... it happens!!  If you know you should protect yourself from the sun but really don't, it would be so helpful to at least get a full-body mole/skin exam each year at the dermatologist's office.  Remember that when melanoma is small, early-stage, and has not yet spread through the skin, it's completely curable with surgery.  Such good news!

The sun used to be my best friend, and we were so close... being diagnosed with melanoma made me so angry I considered breaking up with the sun.  But I've reconsidered, and we're still good friends - now that I've learned to set appropriate boundaries!

Tuesday, May 15, 2012

Tamoxibyebye

Great news - 
My new oncologist is pretty awesome and immediately agreed with me that I should NOT be on Tamoxifen right now.  She has given me her approval to take at least 3 months off, at which point we'll meet again and re-evaluate!  I was soooo happy about that!  And after a little over a week with no Tamoxifen, I felt so much more "alive" - I was happy and chatty at work like never before, and in a 24-hour period, I did 90 mins of trapeze, walked about 1.5 miles, did a circuit of the exercise machines at the YMCA, and a little bit of swimming.

Today, I had minor gynecological surgery to figure out what the Tamoxifen was doing to my uterus.  My surgeon removed "numerous" polyps, which appeared benign to her, but we won't officially have the biopsy results for a week.  I'm grateful that the surgery went so well, but I'm majorly frustrated that cancer-related stuff is once again taking up so much of my time and energy.  I'm missing two days of work plus two trapeze sessions.

The hardest part of the day, actually, was the fasting.  I was under strict orders not to eat anything past midnight last night, and not to drink anything at all other than water today.  My surgery wasn't until 3:10 PM, then I didn't get home until 7 PM, so that meant over 11 waking hours with no food or coffee.  I was quite hypoglycemic and miserable because of it.  Waiting in pre-op, they offered me TV, but I turned it off because the pizza and granola bar commercials made me want to throw the remote.


The pasta and sauteed swiss chard and mushrooms A made for me for dinner tonight tasted like the best food I've ever eaten.  I savored that bowl of pasta for a good half hour.  And I had a big mug of heavenly delicious coffee, at 7:30 PM, not giving a damn if it will keep me up tonight.  There's always ibuprofen PM, right? :) 


Oh, and more good news - my iron levels are improving.  My hemoglobin is now up to 12, instead of 9!  Today, my blood pressure was low/normal, my pulse was good, my temp was good, and my oxygen saturation was 100%.  I'm sick of hearing about the abnormal stuff, so it helps to have a whole list of normal/good things like this, even if they're little things.  It helps to remember that there's more about my body that is working wonderfully and perfectly, than there are problems with my body... even when it seems like the problems are all that get focused on.  You know?  Maybe my uterus is having problems, I'm anemic, I've had two cancers, and I have ongoing Repetitive Stress Injury pain from too much typing, mild allergies and asthma, and undiagnosed digestive problems... but besides that, I have a great heart, good liver and kidney function, excellent eyesight, all of my body parts, normal hearing and smell and taste and touch, an excellent brain, a good body to trapeze with, pretty good lungs, and lots of other well-functioning body parts and systems inside of me.  All of that stuff that most of us take for granted if it's working well.  Tonight A and I watched "Soul Surfer," the movie about the teenage girl who had her arm bitten off by a shark and still lives a wonderfully happy life and achieved her dream of being a professional surfer.  I'm grateful for my arms and all of the rest of my good, healthy body.

Thursday, April 12, 2012

A window into my mind right now....

BRITTA'S BODY, Plaintiff
v.
TAMOXIFEN, Defendent

Before:
The Honorable Britta, Judge

Counsel Present:
Britta1, for Plaintiff
Britta2, for Defendent


Opening Argument, Britta1:
The side effects and risks of Tamoxifen are not worth the benefits of it.  After 22 months of taking Tamoxifen daily, it's time for me to stop.  
Tamoxifen is causing bloating and hot flashes, and increases my menstrual bleeding, which has caused both an abnormally thick endometrium and the need for an endometrial biopsy, and rather significant anemia.  After oral iron supplementation failed, my primary care doctor recommended I have a three-hour iron infusion, three times.  I had a severe adverse reaction to the first one, with a rash all over my legs, and incredibly painful swelling in my feet, toes, ankles, knees, fingers, and hands, which landed me in the ER when I should have been in trapeze class.  This also caused me to miss a day of work and thus lose money.  The swelling and pain lasted for 2.5 days.  
As for the thickened uterine lining, an endometrial biopsy is recommended, which can be an incredibly painful procedure for a small percentage of women.  Some women whose stories I have read online have reported that the pain was the greatest pain they have ever felt, worse than childbirth, and some women either fainted or vomited.  Because this only happens to a small percentage of women, the standard is for the procedure to be performed NOT in an OR or with sedation, but just in the clinic the same way a pap smear would be, with maybe an Advil or an Ativan.  I have a low pain tolerance and also a very low tolerance for enduring any more of these anxiety-producing procedures and would flat out refuse to have this done unless I could be sedated in the OR.  
The problem with Tamoxifen is that it leads to one problem after another, and the treatments for those problems often just lead to more problems.  It takes a lot of time, energy, and money to keep going to all of these medical appointments, some of which cause me pain, some of which cause me to lose time at work, and all of which cause me stress.  Exercise and stress reduction are extremely important for reducing one's risk of a breast cancer recurrence, but the medical problems and appointments that the Tamoxifen causes inhibits my ability to exercise and increases my stress levels.  
Because my oncologist and surgeon strongly recommended Tamoxifen for me, I have diligently taken it for almost two years, but that's enough for me.  My risk of recurrence was low to begin with, and undoubtedly even lower than the recurrence risk calculators said, because of the fact that A) my tumor was the mucinous type, which is so rare there are hardly any studies, but the existing data agrees that it's a highly favorable prognosis; and B) I am not your average, mainstream American, and I take very good care of myself, consciously eating many anti-cancer foods and taking many anti-cancer supplements daily.  
It is unacceptable to me that despite the fact that breast cancer has been researched for years and years and is so in the spotlight that we're all gagging on pink ribbons, still the "best" treatment is itself a carcinogen.  Studies have shown that the longer one takes Tamoxifen, the higher one's risk of uterine cancer grows.  It is only logical that the best thing a cancer survivor can do to take care of her health is to strengthen and nourish her body and avoid as many carcinogens as possible, given the fact that all humans are unknowingly and involuntarily exposed to numerous environmental carcinogens on a daily basis.
Until now, my Tamoxifen has been free/covered entirely by my health insurance, but now that my work hours (and pay) have increased, I am forced to switch health insurance plans and will now have to pay $55 per month for Tamoxifen.  Instead of paying $55 for a drug that negatively affects my quality of life, and is a known carcinogen, and might not even be necessary for me, it would be much more beneficial to spend that money on truly nourishing things.  For example, $55 a month would get me about 180 ounces of cruciferous vegetables, about an hour and a half of trapeze, a stress-relieving massage, 3/4 of a month's membership at the YMCA, or an item of SPF 50 clothing, all of which would reduce my risk of cancer and not have any nasty side effects.
There are many good reasons to stop taking Tamoxifen, and few good reasons to continue on it.
Opening Argument, Britta2:
Tamoxifen is one of the oldest, most well-studied cancer drugs, and the data clearly establishes that the benefits are well worth the minimal risks and the temporary side effects.  As frustrating as the side effects may be, they are temporary, and highly unlikely to be life threatening.  A recurrence of breast cancer would be much worse than temporary Tamoxifen side effects.  Anyone who is bothered by annoying hot flashes and biopsy pain that goes away in a few days should be grateful that those are the problems they are dealing with, as opposed to chemotherapy for liver metastases.  It is crucial to maintain perspective.  
Studies show that while the side effects end very quickly after Tamoxifen has been discontinued, the benefits of the Tamoxifen (decreased risk of breast cancer) last for many years beyond the 5-year course of treatment.  Putting up with some discomfort during the course of treatment is worth it for the increased likelihood that I will live a long, healthy life.  Twenty-two months of Tamoxifen, instead of five years, would not give enough protection.
My tumor was the "favorable" kind, yes, but cancer is also a nasty beast that eats the rule book for breakfast and is impossible to really predict.  I also had over three centimeters of DCIS.  It may have been the kind that never would have become invasive cancer, but it is impossible to tell, and until doctors are able to determine which DCIS will lead to invasive cancer and which won't, some women will end up being overtreated and that is the way it must be.  While the DCIS was removed with surgery, my atypical ductal hyperplasia was still present after surgery was completed.  ADH is a pre-cursor to DCIS, and very responsive to Tamoxifen.   
When it is impossible to predict or be certain about one's risk for recurrence, it's important to do everything possible to reduce the risk.  My tumor was highly estrogen receptor-positive, which means it is the kind that responds the best to Tamoxifen.  I'm grateful that an effective treatment for me exists!  There are many women with other types of breast cancers who would not benefit at all from Tamoxifen and have no other options, and I hear them say how they feel like they are just lost and adrift, with no treatment other than hoping and praying that the cancer doesn't come back.
No one should go off of a life-saving drug because of the cost.  There is financial aid available and help is always there if I reach out, and I can still put my money towards other nourishing things such as trapeze and cruciferous vegetables.  My risk of uterine cancer from Tamoxifen is much, much lower than my risk of a breast cancer recurrence would be if I quit Tamoxifen.  
The bottom line: I would rather deal with uncomfortable-but-not-life-threatening-or-permanent problems like heavy periods and occasional biopsies than a life-threatening cancer recurrence that would require many painful procedures and poisons.  In this case, Tamoxifen is clearly the lesser of the two evils.
Court will now recess.  Following the recess, Britta1 will take the stand.
 

Sunday, April 1, 2012

Tamoxifighting

I have HAD it with Tamoxifen.

Tamoxifen has made my periods go crazy.  I bled for 3 weeks straight, and then became anemic.

A month and a half of oral iron supplementation, along with eating iron-rich foods, did nothing to raise my iron levels.

So, I needed iron infusions.  Before the procedure started on Thursday, I had a bad feeling - I asked a nurse, does anyone ever have an allergic reaction this?  I wanted reassurance that it was safe.  She told me no, she doesn't think so.  Unsatisfied, I asked a second nurse the same question.  No, she said, she's never seen anyone have an allergic reaction.  So I settled into the chair for the 3 hours while an iron sucrose solution dripped into my vein, but I kept the cord with the call button on it very close to me.  I was relieved when I made it through the 3 hours without any problems.

I went home, and when I went to sit down on the couch, my knees almost buckled.  The pain was incredible.  Thinking my knees were just stiff from having not moved for 3 hours, I tried to "walk it off"... that only made the pain spread to my ankles.  I was getting increasingly agitated, because trapeze class started in about 30 minutes, so I had to find a way to get rid of the pain.  Despite the fact that now my whole legs hurt so much I could hardly get up and down the stairs, I stubbornly got undressed to put on my trapeze clothes... only to discover that my knees, ankles, feet, and toes were so swollen it was like someone had filled my legs with a garden hose.  Then I started getting hives on my legs - it was like dozens of mosquito bites all over me.  I called the hospital, and they told me to go to the ER.  I hung up with angry tears, wanting so badly to be at trapeze class instead.

A brought me to the ER, where the receptionist person went to put a hospital bracelet on me, saw that I already had one, and then just put the new one on top of the old one. 

A and I spent the next 2.5 hours in the ED and the pain and swelling spread to my fingers and hands.  Benadryl took care of the hives, but apparently there was nothing to do about the pain and swelling other than take ibuprofen and wait 3-4 days for it to pass.  I sat there in the hospital bed, in a hospital gown, wearing my TWO hospital bracelets, wondering what the trapeze class was doing at that very moment and feeling so pathetic.


Why was I there in the hospital, hobbling around like an 85-year-old, with knees that felt like softballs?  Why was I not climbing the trapeze ropes instead?  Why did I get hit with the "rare but severe" side effect that only affects less than 1 in 1,000 people?


I couldn't go to work on Friday, and spent the whole day either on the couch or in the bathtub.  My legs and feet are better now, but my hands are still sore, to the point where I shouldn't be typing... but writing is how I cope, and dammit, I have to write.  But now I should go put arnica on my hands, and have another anti-inflammatory dose.


F*cking Tamoxifen.  I'm contemplating quitting.

Wednesday, March 28, 2012

A first!

Good news!
I just got my first ever NEGATIVE biopsy results! :)  Okay, so it was only the third biopsy I've had, but still - the first two (breast lump, then mole) were positive for cancer, despite all the doctors telling me "I'm sure it's benign!"  So when I went to my dermatologist last week for my 6-month, post-melanoma-surgery check up, and she wanted to biospy another mole, I was trying really hard to not freak out but inside I kind of was.  And yesterday when I called my voicemailbox and heard a message from someone from the dermatologist's office, my stomach flipped over... and then I heard the word "normal."  Thank god.

Thursday, March 22, 2012

$@%^^&#&%$#!!!!

I AM SO SICK OF MEDICAL APPOINTMENTS!!!!

I work full time now, and have Thursdays "off."  What this really means is, Thursdays are the days I spend either scheduling, going to, or discussing the results of medical appointments.  This is my day so far:

8:30 AM: I call the hospital to tell them that I can't make the 9 AM appointment my PCP had scheduled for me, because I didn't know about the appointment until last night and I was already booked at 9 AM.  The appointment was for an intravenous iron infusion, because I'm anemic and oral supplementation hasn't worked.  I have to go once a week, for three weeks in a row.  I said I'd look at my schedule and call back with dates/times that would work for me.
8:45 AM: I call the hospital back to tell them I can come from 9 to 10 AM on the next three Thursdays.  The woman informs me that actually, I will need to come for THREE HOURS each time.  I tell her I need to look at my schedule again and call her back with new dates/times.
9 AM: I shower
9:30 AM: I have my 6-month check up with my dermatologist, the one who diagnosed and treated my melanoma last fall.  The appointment takes 40 minutes and she shaves off another one of my moles to be biopsied.  The nurse puts a little bandage on it - on my hip - and tells me to leave it covered like that for 24 hours.
10:10 to 10:40 AM - I quickly go home to clean a bit, make a PB&J sandwich for later, check my email, etc.
10:45 AM - I go to my first physical therapy appointment, re: my arm/shoulder/hand pain that is a result of too much prolonged typing.  During the appointment, my phone rings, and I let it go to voicemail.
12:10 PM - I listen to the voicemail in the car: my PCP has scheduled me an appointment with a gynecologist for 3 Thursdays from now.
12:15 to 1:15 PM - I bring my friend's dog for a walk, like I do every Thursday at noon.  It's shockingly hot/sunny for March 22, and I spend the whole walk freaking out about the sunlight, having not brought sunblock, a hat, sunglasses, etc.  I obsess over trying to walk in the shady parts of the trail.
1:30 PM - I arrive home, and change my clothes, and in the process, discover that the bandage covering my biopsy site on my hip has been dislodged.  The bandage is now covered with fuzz from my clothing. Worried about the possibility of infection, I wash my hands, and am about to go cover the wound with a bigger bandage when the phone rings.
1:30 to 1:40 PM - I talk on the phone with my FORMER oncologist, who is calling to explain why she is calling THIRTY EIGHT DAYS after my ultrasound to tell me the results.  That is partially why she is my FORMER oncologist.  Making a cancer survivor wait THIRTY EIGHT DAYS to hear abnormal test results is unacceptable for any reason.  Yes, abnormal.  Now I have to schedule an endometrial biopsy.  That is, if someone allows me to have the procedure sedated in the OR, because I'm NOT risking the pain otherwise.
1:45 PM - I re-bandage my wound.
1:55 PM - Here I am.  I've been awake for 6.5 hours and have done almost NOTHING other than schedule doctor appointments, attend doctor appointments, or discuss the results of doctor appointments.  And I still have to call the hospital back to schedule the iron infusions.

Saturday, March 3, 2012

Life is Strange

I've been struggling lately with what to write in this blog.  Several times over the past few weeks, I have felt the urge to write lengthy rants about all the things that suck about being a cancer survivor, and all of the difficulties I'm dealing with because of it.  I even wrote a long post, published it, then deleted it about a half hour later because I felt guilty for complaining so much.


The thing is, my life overall has drastically improved since being diagnosed with breast cancer.  I can't say that my life has improved because of having had breast cancer, but on the other hand, I can't say whether these positive changes in my life would have occurred if I hadn't had breast cancer.  I guess there's no way to know.


When I weigh the good against the bad, the good wins.  There are so many wonderful things about my life right now, that I feel like I can't just come here and write big long complaints about what's not going well, even if that's what I feel like doing.  It would give a skewed picture of my life.  But on the other side of it, if I just wrote a long, flowery, gratitude post about all the wonderful things in my life, that wouldn't accurately depict the on-going difficulties that I - and probably most cancer survivors - am dealing with.


It's a constant dilemma inside of me - I want to vent about how awful it is to have 22 medical appointments in 7 months, versus Shut up, you have an awesome partner and home and you're lucky to be in remission instead of dealing with metastasized cancer!


So I guess I will write about both the good and the bad.  I will start with the bad, so that I'm ending on a positive note with the good.


THE BAD:
  • I have had about 18 medical appointments in the past 7 months and still need more.  I'm so frustrated by how time-consuming it is to schedule and go to all these appointments and it feels like they will never end.
  • After my MRI a few weeks ago - which took up half of my day because it's an hour away - I had sore spots on my ribcage for 3 or 4 days, because of having spent 30 minutes lying completely still while some hard plastic thing dug into my chest
  •  I have to go through the hassle of switching oncologists for the second time this year, because I'm not getting along well with my current one.
  • I have to get an endometrial biopsy (due to an abnormally thick uterine lining most likely caused by the Tamoxifen), and I'm scared and I'm going to refuse unless it can be done under "conscious sedation" like with my re-excisions, because I've read too many horror stories online about the pain.
  • There always seem to be "issues" with my medical appointments!!  For one, my instructions were to drink 32 oz. of water 45 mins before the appointment and not empty my bladder, and then the doctor was running late and I seriously thought I was going to pee my pants.  Another time, there was a mix-up and a male doctor attempted to bring me to his room for a procedure involving my female parts and I had to say for like the millionth time that I need female doctors only.  Doctors are late and I have to wait.  Things have to be rescheduled because they have to be coordinated with my menstrual cycle and it's impossible to predict.  Etc.
  • Lately I've been having increased cramping and pain in the left (treated) side of my chest.  This is "normal" and there's not really much to be done about it, but a couple nights ago, the pain was so sharp that it woke me from sleep and I bolted upright, gasping.  It only lasted a few seconds, but it's frustrating because I just never know when it's coming.
  • Hot flashes suck, especially when I'm at work and turning red and it's embarrassing.
  • Sometimes I worry about having a recurrence.  I don't worry about this strongly or often, but I don't think there's a single cancer survivor who doesn't worry about this at least sometimes.  My cancer was small/early stage and the "good" kind (mucinous is rare and unlikely to be aggressive), and my Oncotype score suggests I'm low risk for recurrence... but what increases my risk is my young age.  If a woman is diagnosed at age, say, 72, her risk of recurrence could be low simply because she dies a decade or two later of other causes and the cancer doesn't have time to recur.  If I live to be 100 (it's possible!  I have an aunt who's in her mid-90s and going strong!), I have another 67 years to go and it gives the cancer so many more years to try and make a comeback.  It's 67 years that I have to spend doing everything I possibly can to reduce my recurrence risk.
  • It's annoying and time-consuming and tedious to try and take 10 or 12 anti-cancer (and other) supplements a day.  Some have to be taken with food, others have to be taken on an empty stomach, and it's hard to coordinate.  The flax seeds have to be ground, the chickweed and green tea needs to be brewed, the iron should be taken with vitamin C and without dairy, and on and on.  Then there are all of the anti-cancer foods...
  • It's depressing to have THREE cancer scars, at the age of 33.


THE GOOD
  • I have the best girlfriend in the whole world.  She is the love of my life.  And we wouldn't have met if I hadn't had breast cancer!  We've been together for a year and a half now, and every single day, I think about how lucky I am to have her in my life.  It's better than I ever dreamed of.  She's so supportive and loving and amazing.
  •  She and I are now living together, in a beautiful 3-BR house that had every feature on our wish list.  (Pre-cancer, I was living in an apartment with a roommate I found on Craigslist and was not well matched with!)  We have a two-car garage, and a nice kitchen, and a clawfoot bathtub that I love taking bubble baths in.  I have a home office, and we have a lovely room to meditate in, and the sunlight here is beautiful.  We feed the birds and squirrels and they're so entertaining to watch out the window while drinking a mug of tea.
  • I have two part-time jobs that I enjoy, and that provide me with reliable income, and I'm starting a third part-time job on Monday.  My bosses are GREAT and so understanding.
  • My girlfriend has a great full-time job and for the first time in several years, I'm not stressed out about money.  We have enough for our needs!  I'm working on paying off my debt and even have a savings account.
  • I have wonderful family and friends.
  • Overall, I'm healthy.  My cancer is in remission.
  • I live a couple miles from the circus school, where I do trapeze, which I absolutely love.  It's the best "physical therapy" ever.
  • This has been the best winter for me ever, in the sense that it has only snowed like 3 times and mostly the ground has been bare!  Sometimes it has even been warm and sunny!  It's so refreshing and relieving to me!

Friday, February 24, 2012

Choosing our Battles

One of my main ways of coping with my cancer diagnoses and attempting to reduce my risk of recurrence is, as you know, learning about the links between cancer and the environment, and both doing what I can personally do to reduce my exposure to carcinogenic chemicals, and engaging in activism to push for stronger governmental regulation of chemicals.   

You know how overwhelming it is when there are so many worthy issues and causes to fight for, and you don't know how to choose, but you have to prioritize because your time is limited? I can't take action on every "Sign this! Call your Senator about this!" email that comes to my inbox, so I pick my battles... And I don't bother with activism that's focused on banning/regulating any ONE chemical, because it's just not enough.  


There's no point in buying something "BPA-free!" if it's poisoned with other chemicals. I mean, if strawberries were labeled "Formaldehyde free!!", would that make them appealing and safe to eat?? Not if they still have 6 other toxic chemicals in them! This is why it's so important to focus on an overarching policy that requires manufacturers to prove the safety of their products before they are used. Banning or regulating one chemical at a time, when there are 80,000+, seems like a misuse of time and energy.

So take a moment to ask your Senator to co-sponsor the Safe Chemicals Act!  The Safe Chemicals Act will put limits on the toxic chemicals that are in use today and found in our air, water, dirt, food, and products. 

Tuesday, February 7, 2012

Email me!

Hi everyone!
I don't know why I didn't think of this sooner... I've created an email address for this blog, so that you can write to me in private if you want to.  Sometimes people want to talk about cancer-related stuff without doing so in a public blog, and without having to give their email address in a public blog, either!  

SO, you can email me at BrittaBBlog@yahoo.com at any time.
I hope you're having a beautiful day.

Thursday, January 12, 2012

An Afternoon in Cancer-land

I had my 6-month oncology check-up a week ago, but I've been putting off writing about it.  I don't know why.  But now I'm stuck at home on a snow day...A is sick and still in bed.  I had to cancel my trapeze lesson due to pain/spasms in my lower back, but I can't even get to my chiropractor's office because that would mean shoveling the driveway, which my back can't handle.  So here I am stuck at home, and I might as well write, right?

Last Thursday was my 6-month check-up, and it was with a new oncologist, since my previous one is no longer practicing in the cancer center I go to.  It was also the 2-year anniversary of my lumpectomy.  It would have been an emotional, stressful day for me just because of all of that, but in addition, someone I love (who I won't name, out of respect for their privacy) had an appointment elsewhere in the building at the same exact time, because they had 5 out of 7 symptoms of a scary kind of cancer.  So my fear for my loved one's well-being pretty much eclipsed my fear for myself, and I was so distracted because of it.  We made plans to meet in the main lobby when we were both done with our appointments.

My new oncologist, Dr. J, spent 45 minutes with me because it was our first visit - I was used to these appointments being only 15 or 20 minutes.  We didn't hit it off too well, I'm sorry to say.  Then again, I totally got off on the wrong foot with my first oncologist, too, and then our connection improved greatly...so perhaps I just need to be patient and give it a chance with Dr. J.  What stressed me out was that Dr. J wanted me to have what felt like a gazillion tests and procedures, not because she was really worried about my health, was the impression I got, but simply because that's how she does it with all of her patients.  I've been feeling really great for months, trying my best to eat well, sleep well, exercising (there's always room for improvement, but I've been walking fairly regularly), de-stressing, taking all of my anti-cancer supplements along with the Tamoxifen, and continuing to educate myself on/engage in activism against environmental toxins.  I haven't been worried about the possibility of a recurrence.  I felt like I was happily living far away from cancer-land.  But these stupid cancer check-ups are a reminder that I will never get away from cancer-land... I will need regular check-ups of some kind for the rest of my life.  Dr. J wanted me to schedule a bone density scan, a pelvic ultrasound (to assess the cause of my irregular/heavy menstrual bleeding - which I'm sure is a Tamoxifen side effect, not a third cancer, geez), and have more blood work, a flu shot, a mammogram, and consider genetic testing.  I only agreed to half of that, declining the last 3 items.  Dr. J is super bothered by my refusal of mammograms, telling me that mammograms really aren't optional.  But it's my body, and I'm not willing to have that much radiation.*

The appointment dragged on and on, and ended with her telling me she wants to see me again in four months, because she's still getting to know me.  I was dismayed, for I had been expecting to not need a check up with her for at least 6 months, maybe a year...considering I'm now over 2 years past diagnosis.  Having my oncology appointments instead increase in frequency - along with the increase in tests and procedures - makes me feel cranky, too immersed in cancer-land once again.


Once I got my clothes back on, scheduled all of the stupid tests and procedures, and had my 3 vials of blood drawn, I practically ran to the main lobby to find my loved one.  They were there, waiting to go into the lab for blood work and an X-ray.  Within minutes, they were whisked into the lab, and I had to sit there for a full hour, so scared, waiting to hear whether or not it was cancer.  Then, they came running out, gleefully telling me it was a virus, not cancer.  Relief washed over me.  Never before have I been so thrilled by someone being sick with a virus!


There are so many things I hate about cancer; I hate having the fear of it lurking about.  My logical brain knew that it was very, very unlikely that that person I love had cancer... but that's what I had thought about myself, too, and twice now I've had the experience of being told, "Oh, it's probably nothing," and then finding out, BOOM, it's CANCER.  That has skewed everything for me and it's a constant challenge to maintain perspective and logic and not let the fear win.  Even young,  healthy, fit people get cancer.  Even cancer survivors who have been given an excellent prognosis and have a low risk of recurrence and feel certain that cancer is a thing of the past can end up dying from the cancer a year later (see my previous post).  We really just never know and there are no certainties when it comes to cancer...or anything in life, really.  Do I sound like a broken record when I say that all we can do is take life one day at a time?  Sometimes it's one hour at a time, one minute at a time, one breath at a time.  Inhale, exhale, repeat.


*By refusing annual mammograms, I'm not making a fear-based, uneducated decision.  I have thought long and hard about it, and have read a lot about mammography and other breast cancer detection methods, and have talked with many people about it, including medical professionals.  And I'm choosing annual breast MRIs.  My surgeon, who is also the director of the Breast Care Program at a National Cancer Institute Designated Cancer Center, has approved that choice.  She told me, "You know that if I felt strongly about your need for annual mammograms, I would beg you to do it, like I did with radiation therapy."  And that right there is good enough for me!  If something shows up on the MRI, of course I will get the recommended follow-up ultrasound, mammogram, biopsy, etc.  And I'll continue having at least 3 Clinical Breast Exams (CBE) per year, from my oncologist, surgeon, and gynecologist, and possibly thermograms on occasion.  I will consider having an occasional mammogram.  I will consider having mammograms on a more regular basis when I'm older and my breast density has decreased.  I have very dense breasts, like most young women, and I have a report from the radiologist who interpreted my mammogram a couple years ago that clearly says that my very dense breast tissue decreases the sensitivity of mammography.  On mammograms/X-rays, dense breast tissue shows up as white, as does cancer, so it's like...what's that expression...trying to find a polar bear in a snowstorm.  I see no point in annually exposing my breasts TO A CARCINOGEN (radiation) for the next SIXTY FIVE YEARS (ish), when A) it's really hard to detect cancer via mammogram, given my breast density; and B) the more mammograms I have, the more my risk of cancer increases.  I've already had a shitload of radiation to my breasts (the radiation therapy, I mean).  And we're all exposed to so many carcinogens on a daily basis, most of which we're not even aware of, and cannot avoid.  Thus, if there are carcinogens I can avoid, I will avoid them.

Saturday, January 7, 2012

Diana & Lily

In June 2009, I accepted a summer babysitting gig, for a sweet baby, just a few hours a week.  The family lived in New York but had a summer home here in New England, close to where I lived.  I had a really good feeling about the baby's mom, Diana, when I met her...and baby Lily was an absolute doll.  I wore her on my chest in a baby carrier, and we strolled in the summer warmth and light, over the covered bridge, and on the rail trail walking path.  The greenery was so lush around us.  And when the sun went down, I lay the big white cloth out on the bed, swaddled sweet Lily in it the way Diana told me she liked, and rocked her in my arms.

After just a couple weeks of babysitting for Lily, I showed up one afternoon as scheduled, and knocked, and no one came to the door.  I knocked and knocked, and tried calling Diana's cell phone, but she wasn't there.  I waited 20 minutes, and then I went home to check my email and see if there was any message from her.  And yes, she had emailed to tell me that the "flu" she'd had for a few days was more likely pneumonia, and she was in the hospital.   Two days later, another email... she told me she had leukemia, and was returning home to NY for chemo.  She closed with "I so enjoyed meeting you; your sunniness will stay with me as I start this journey," and I was so shocked and sad, because she had seemed so healthy and vibrant to me.  I was angry that cancer was stealing her and Lily away just as we had been getting to know each other.  Diana and her husband's wedding anniversary was in a little over a week and I was supposed to babysit that night so they could go out and celebrate.  Instead, she was spending that time in the hospital.

Three months later, Diana emailed me again to update me, saying how she was feeling so much better now, and that despite needing a bone marrow transplant soon, she was "completely certain that [she]'ll
get on the other side of this, get a huge tattoo that says 'Survivor,' and get on with life."  I wrote back with well wishes for continued healing... and a month later, had my breast lump biopsied, and was shocked to be given a cancer diagnosis of my own.

Six months passed.  I frequently wondered how Diana was doing, but we hadn't emailed...and then one day, the week I started radiation, I got the strangest voice mail from her - it was just 3 minutes of her having a conversation with someone, probably her husband.  It sounded to me like she had sat on her phone and called me accidentally.  I could hear Lily making happy baby noises, and banging some toys together, and I smiled.  I emailed Diana to tell her I'd received that probably-accidental voice mail, and asked how she was doing, and told her about my cancer.  Isn't it so strange, I mused, that she and I both had cancer when we met each other and had no idea.  And we were both in our 30s and so healthy!

Diana wrote back and was just as shocked and sad about my cancer as I had been about hers, but was glad to hear that I was recovering well and had such a good prognosis.  "I think my prognosis is excellent too...," she said.  "...at this point it's all recovery."  In that email, she shared with me her thoughts about cancer, and ended with:

"I had a vision, last time I visited the doctor (at an entire hospital for cancer patients), that cancer is a certain kind of demanding spiritual path, and everyone who has it has been chosen for it.  It's easy for me to see it that way now that I'm done with treatment and recovering.  But it's an interesting vision.

much love
Diana"

That was a year and 8 months ago, and it was the last time I heard from her.  This past week, I was thinking about her, and made a mental note to email her soon and see how she's doing now...hoping we could share stories of how well we're recovering.  This morning, I woke up to an mass email from her husband, a "reminder" (although I never received the first notice) about Diana's upcoming memorial service.  She died last month.  I didn't know.  I had been picturing her happy and healthy and enjoying time with the now-toddler Lily.  Hearing of her death was such a blow....she was a vibrant and kind-hearted woman.

Diana and I signed our emails to each other with variations of "much love," even though we'd only had about 3 weeks together, because there is a kinship between those of us who have been face to face with the cancer monster.  We both had undetected cancer when we met each other.  We both were treated at the same hospital.  We both had excellent prognoses... so why am I so healthy, and why is she DEAD?  I hate cancer.  Cancer is an ugly serial killer that does not discriminate... it takes down parents of little children, and little children themselves; people of all ages, all races, all professions, all parts of the world.  When I was 19, cancer took away my friend Cory, a single mother in her 30s, leaving behind her 7-year-old son with autism.  Cancer stole Cory when "Chicken Soup for the Survivor's Soul" was literally open on the nightstand next to her hospital bed, just like it stole Diana, a young woman with a baby daughter, who was ready to "get her 'Survivor' tattoo and move on."  Cancer doesn't give a damn, it takes who it wants to, and having an excellent prognosis, and "complete certainty" that you'll fully recover, is no protection.  It makes me wish that cancer was a corporeal being so I could bash its kneecaps in with a hammer.

May you rest in peace, Diana.  I wish we had had more time together.

Monday, January 2, 2012

Happy New Year!

Several of my family members write New Year's Goals (note: not resolutions), and one of my family members even writes extensive lists of New Year's Goals in over a dozen categories - which works really well for him and is really important to him. I used to write New Year's Goals as well, due mostly to family pressure to do so, but I stopped years ago. For a few years I felt guilty for not doing it, assuming that some personal flaw made me averse to goal-setting. Now I'm secure with who I am and what my life is about - I'm process-oriented, not goal-oriented!

Instead of setting goals that can be checked off a list when accomplished, I set life-long intentions for how I want to live:

Always put love first.
Keep growing and learning.
Maintain an awareness of my place in the interdependent web of life.
Be honest and real.
Support and strengthen my health.
Support and strengthen the health of the Earth.
Try my best.
Increase sisterhood and women's freedom in whatever ways I can.
Do what I can to make the world a better place for children.
Say "Thank you" and "I love you" on a regular basis and never take my blessings for granted.

These are my life-long intentions that I try to live by. Of course, I don't always succeed in that...not only do I of course make mistakes and poor decisions like all humans do, but I know those intentions are rather lofty. It would be impossible to follow them to a T at every moment. :) But I try! These intentions are not just for 2012, nor are they ever things I can check off as "done." They can be approached in many ways. My problem with goal-setting is that it feels too concrete, and doesn't leave room for the ways in which life is constantly changing - often in ways outside of our personal control. If you set a goal to do X, and then decide that doing X is not right for you, are you a "failure" because you didn't "accomplish the goal"? I spent 15 years working non-stop/often full time with young children, and then I burnt out, and quit childcare as my 30th birthday present to myself. Had I set a goal of "Be a teacher" or whatever, I would have had to count that a "failure." But really, my life's mission from the time I was a teenager was to "do what I can to make the world a better place for children." There are many, many ways of doing that, which don't necessarily have to involve being the direct caregiver for children on a daily basis. After I quit childcare [or rather, seriously reduced my hours - I must admit that I still spend time with kids because I can't not :)], I wrote a grant application that resulted in scholarship money for disadvantaged kids to take circus classes. Still a way of following my stated intentions!!

In the fall of 2009, I was all prepared to facilitate a Girl's Circle for a group of 10- and 11-year-old girls at a local library. I had gone through the training, purchased the curriculum and made changes to it to suit the group's needs, gathered materials, arranged my work schedule, etc. I had already facilitated an 8-week Circle and it had gone really well, and this was to be a continuation of it. Two girls were already signed up and as excited as I was. Then... you know where this story is going, right?.... I was diagnosed with breast cancer. And my surgery date was set for 2 days before the Girls Circle was scheduled to start. I had to cancel the whole thing. Had I set a goal of "Facilitate Girls Circle at the library in Fall 2009/Winter 2010," I would have had to say I failed to meet that goal. But I didn't fail at all. I succeeded by surviving cancer, both physically and mentally, and continuing to live a happy, healthy life. Facilitating a Girls Circle would have been a wonderful expression of my lifelong intention to increase sisterhood and women's freedom, but life through me a giant curveball and I had to find new ways. During the 2 years since then, I haven't facilitated any Girls Circles (maybe I still will?), but I have instead increased sisterhood and women's freedom by loaning money to businesswomen in developing countries (through Kiva), volunteering at a fundraising event for research on breast cancer and the environment, helping plan and implement a local fundraiser for two women in my community who are undergoing cancer treatments, volunteering at an event put on by the local Women's Freedom Center, and engaging in online activism in a variety of ways.

I don't set goals that are destinations I must arrive at, because I have NO IDEA what's coming up ahead in my path. Thus, I set intentions for how to travel the path. These are intentions I can try to live by no matter what happens in my life. When I was in college, I set a bunch of now-seemingly-arbitrary goals, like learn to play the fiddle by the time I'm 35, live in a house by the ocean, become a mother, go to Paris again. MAYBE I WILL, MAYBE I WON'T, but I'm taking life one day at a time and defining success so differently now. My life's intentions are ones that can be practiced whether one is a hardworking, married CEO and bestselling author and mother of 5, or a solitary person confined to a hospital bed...because it's not about what you accomplish, it's about who you are.

When I was in the midst of breast cancer treatments, I had bouts of depression because I felt so disconnected from the rest of the world/my "normal life" and unable to "do" anything. Had my goals been as specific as "facilitate a 12-week Girls Circle by Spring of 2010," yeah, I would have "failed." But even during cancer treatments, I could try to follow my life's intentions... I was filled to the brim with love and gratitude for all of my amazingly loving and supportive friends and family, and I was certainly growing and learning (haha, whether I wanted to or not! My mom refers to that 6-month period as my "cancer semester"), and while I was frustrated to not be able to do more/do what I wanted to do in the realm of helping women, I could at the very least write supportive messages to other breast cancer patients on the message boards, blog about my experiences in hopes that my words would be helpful to others, and sign up for a clinical trial that would result in data that would improve breast cancer treatments for future women. And, I comforted myself by trying to remember that while part of me felt useless/isolated/self-centered by not being able to do anything other than be a cancer patient, reality was that I NEEDED to focus on my own personal healing in order to be at all helpful to other women in the future! You know, that whole "put on your own oxygen mask first" thing.

So, if any of you reading this failed to accomplish last year's resolutions or goals, or are feeling apprehensive about the ones you've set this year, or guilty for not setting any at all, I say, don't sweat it! :) Be you. Be the best YOU that you can be, knowing that there are infinite ways of approaching that....including by setting specific goals and objectives if you really want to. If you include "Always keep learning and growing" as one of your goals, then you can't EVER fail, right?? Failing to meet some goal or objective you set is certainly something you learn and grow from, so, you're really always succeeding. :)

What are your New Year's traditions or rituals? Do you set goals or resolutions or intentions of some kind? What works for you? I know that some of my family members really get a lot out of goal-setting, so I hope this post hasn't sounded too anti-goals in general! It's just not MY thing, and that's okay! :)

Happy 2012!!!