I’ve been having some “woman” issues lately. Like the past month or so. Actually, it’s been a bit longer than that, but things sort of took a nose dive in the last month in a more noticeable, “uh oh, guess I better go talk to the doc” kind of way.

No one was sure Aunt Flow would even come back after chemo (which threw me into a sort of menopause). But last August it did.

I’ve always had a pretty healthy cycle. It normally comes right on time. But when it came back it was a bit heavier than what it had been. And then around December/January my PMS started kicking in a bit more fiercely and earlier than normal.

Then the periods started coming more. Like every 3 1/2 to 4 weeks instead of 4 1/2 to 5. Then in May it was supposed to come on May 13. Or around there. Nothing.

I had some symptoms, fully expected it, but it never showed. A month passed and still nothing. But, again, I was starting to get symptoms, along with some wicked pains. I chalked that up to my period being late and making up for lost time.

We went to St. Louis to see friends 4th of July weekend and I thought I might die. The drive there wasn’t bad. I was doing so-so. But as the night wore on I felt the pain growing and growing until all I could think was, “This is it! It’s of course going to strike now, when we’re on vacation trying to have fun.”

But…nothing.

And that first night as we drove back to our hotel from our friend’s house I had to pull over and let Wayne drive. I was doubled over and was seriously considering a trip to the ER.

But a few Advil and sleep made things more bearable for the morning. I then popped more Advil because we were headed to Six Flags with our friends and their kids and no way was I going to rain on their parade.

I made it through okay, but I knew something was wrong. I was having too much pain, and a very weird smell (sorry, maybe that’s TMI but it’s part of my symptoms).

I took a pregnancy test because my 3 month oncologist checkup was this past Tuesday. They always have to x-ray me and I knew they’d need to know if there was a bun in my oven. The test was negative.

I mentioned my period problems to my onc nonetheless. They told me I better schedule with my primary.

I luckily got in the next day. They had me pee in a cup and confirmed, nope, not prego, but there was another cause for concern: there was some blood in my urine.

Say what? So what does that indicate?

It could be a cyst, a fibroid tumor, maybe even my kidneys. However, I should be in more pain if it was kidney related. Oh, yeah, and there’s always the possibility I could have another hitchhiker. They took some blood and scheduled a vaginal ultrasound for the next day. (Which was yesterday.)

Lovely.

Hearing the C word of course flipped me out. Especially since my aunt is dying of a female cancer. But Wayne surprised me and went to my ultrasound appointment with me. It really helped because otherwise I would’ve been freaking myself out in the waiting room. Instead, he was there distracting me with funny commentaries about stories on Today.

But here’s the part where “here we go again…” comes in:

Test was yesterday. The radiologist should have gotten them to my doctor by yesterday afternoon. But if they did they never called to tell me.

And of course my doctor’s office closes early on Fridays, so they never called this morning with results either. I tried them at 11:40 (thinking they closed at noon). Wrong. They close at 11:30. ARGH!

So now I have to wait all weekend.

Wonderful. That’s a lot like last time. Except I’m not in near as much pain and it’s not Christmastime.

Hopefully it’s something easier than another hitchhiker. But you better believe I am NOT ready to check out of this world yet. Bring it. I’ve got more fight left in me!

My friend Chris V. (whose blog is Candid Canine) sent me a very timely article she came across on Yahoo!News: Americans are treated, and overtreated, to death.

Americans increasingly are treated to death, spending more time in hospitals in their final days, trying last-ditch treatments that often buy only weeks of time, and racking up bills that have made medical care a leading cause of bankruptcies.

That was just one of the snippets from the article that resounded with me. The other was an anecdote about a 32 year old woman who’d been diagnosed with an incurable brain tumor. She’d undergone two surgeries, chemo, plus radiation. She spent months in the hospital, finally being released and able to spend time with her family, including her two year old daughter, before she died the very next day.

A stunning number of cancer patients get aggressive care in the last days of their lives, [Dr. Martha Twaddle] noted. One large study of Medicare records found that nearly 12 percent of cancer patients who died in 1999 received chemo in the last two weeks of life, up from nearly 10 percent in 1993.

Guidelines from an alliance of leading cancer centers say patients whose cancer has spread should stop getting anti-cancer medicine if sequential attempts with three different drugs fail to shrink their tumors. Yet according to IntrinsiQ, a cancer data analysis company, almost 20 percent of patients with colorectal cancer that has spread are on at least their fourth chemotherapy drug. The same goes for roughly 12 percent of patients with metastatic breast cancer, and for 12 percent of those with lung cancer. The analysis is based on more than 60,000 cancer patients.

The Woman in the Room Across the Hall

When my mom was in the hospice the woman in the room across the hall from her was young. Forties.

When my mom first was checked in the hospice that lady was vibrant. Her room was decorated with pictures, flowers, all kinds of neat personal knicknacks. Friends and family often were with her, laughing and playing games. You’d never have known the woman was dying.

The next week her door was often closed, a note posted on the door: “I love visitors but please limit visits to 15 minutes. My energy is down today.”

The next week her door was closed, there was a book on a table outside her room, and the note on the door said, “Unable to see visitors. Please sign my book so I know you were here. I appreciate you stopping by.”

I’m not sure when she died. That’s when my mom took her turn. But I sure admired that lady. I often found myself thinking, “That’s how I’d like to go out. If I have a chance, and know the end is coming, that’s how I’d spend my time. Celebrating my life with the people who’ve touched it.”

The American Way

I’ve really been struggling with my aunt’s diagnosis. But this article Chris sent today helped me understand in part why. (Besides the obvious reasons.)

The American way is “never giving up, hoping for a miracle,” said Dr. Porter Storey, a former hospice medical director who is executive vice president of the hospice group that Morrison heads.

“We use sports metaphors and war metaphors all the time. We talk about never giving up and it’s not over till the fat lady sings …. glorifying people who fought to their very last breath,” when instead we should be helping them accept death as an inevitable part of life, he said.

I’ve really struggled with my aunt saying, “You know what? The time for treatment is past. I’m going out on my own terms.”

I am most definitely American through and through with respect to the “fight to the bitter end” mentality. Ain’t no way I was going out without a fight.

But I also had hope. If my treatments worked I might just be cured, and the odds were in my favor for that. If that had not been the case…well, I still would have fought. I would’ve held out hope for a miracle.

But now? I still might fight. I’m still young. I still have a lot to do.

Not Quitting, It’s Transitioning

But if I went through aggressive treatments, the tumors didn’t shrink, or, worse, spread, I’d opt to spend my last days peacefully. No needles. No drugs. (Except ones to keep me comfortable.)

Comfort. That’s the key. If I’m lucky enough to have the luxury of knowing my estimated end date, I think I’d do like my aunt. I’d opt for comfort. And a higher quality of life and goodbye time with my loved ones.

Because, lucky for my aunt, right now she’s not in much pain. She just wants to enjoy her kids, grandkids, and her husband during the time she has left. Running to doctor appointments, hospital time, dealing with treatment side effects…it sucks all the good time away.

Like she has all her life, my aunt is living –and now dying– with her trademark style and grace.

This article really helped me put some things in perspective. Chris, if you read this, thanks again for sharing it with me.

Over the weekend I found out my aunt’s cancer is back. It’s a blow I’ve been struggling with ever since. (And in part why I needed a restorative movie weekend to get my mind off Real Life.)

I really wish I could remember when she was first diagnosed. I want to say September 2008. I know it wasn’t terribly long after my mom passed, nor was it terribly long before I discovered mine.

My aunt (Alice Kotso is her name if you care to send love and light her way or keep her in your prayers) is a rare breed of woman. On her outside she’s as coiffed, polished as poised as they come. But inside she’s tough as nails. There’s not much that gets passed her, and not much she’s afraid of.

If anyone could beat cancer into remission, it was her. But she was always afraid her cancer treatments would affect her already existing health problems. She reluctantly agreed to chemo the first time around.

This past May they found another tumor. They operated and told her she needed chemo again. She refused. They suggested radiation at the very least. She refused again. She said she was putting it in God’s hands. She left for a three week trip to China with her husband, but instead of getting better she only got worse.

She had ovarian cancer to start with. She now has leukemia, which they suspect was caused by her initial cancer treatments. The very thing she feared most happened.

Now the cancer has now spread. They’re running tests to find out if it’s the ovarian or the leukemia that’s spread. They’ve basically said it’s definitely terminal, but there may be some kind of treatment to slow it down.

Except she doesn’t want to do it. It’s not that she wants to die exactly. As she tried to explain it, she’s 75, she’s lived both a very full and blessed life, and if it’s her time to go out she wants to go on her own terms. She already experienced the indignities and hardships chemo brings. She doesn’t want to put her body back through that. Nor does she want to be treated like a sick and dying person.

I respect that. Chemo sucked. The first two treatments weren’t too bad. The last four almost killed me. Or that’s what it felt like. Uncontrollable throwing up. Shitting myself. Having so little energy just trying to eat a couple of spoonfuls of soup used up so much energy I’d nap for three hours.

She had it even worse. She had to have a blood transfusion when her white cell count fell too low. And losing her hair was a devastating blow. She’s always been a beautiful woman who prides herself on her vanity. Suffering the indignity of her looks being totally robbed from her was much harder on her psyche than it was on someone like myself who’s never known what it’s like to have looks matter like she has.

Sunday I was pretty torn up about it. Mostly because she’s the only one who understood what I was going through. Even after I hit remission I confessed to her that I, too, feared the future. The day when I might not start feeling quite right again. Or worse, feeling just fine but on a check up visit being told “It’s back.”

She understood the anxiety that gradually starts escalating about a month or so before the next scheduled check up. She understood the mood swings and impatience with “healthy” people. (Meaning, non-cancerites.)

Better than anyone she understood me ranting about how we get this one shot at life, and, yes, you can go at any time. In a car accident, being in the wrong place at the wrong time and being done in by some wacko on a shooting spree. Or maybe just having a massive heart attack.

Those are terrible, sudden ways to go. But learning you have cancer is worse. I was so, so, so lucky to have a kind that could not only be treated, but potentially cured. I’m not fully cured though yet. I won’t reach that status for another 4 years –if I’m lucky.

Aunt Alice understood that. She was in the exact same boat. She’s now transferred to another one. One we’ve both been made painfully aware exists thanks to others sharing their cancer horror stories.

Like her good friends who lost their son after his brief battle with pancreatic cancer. He lived maybe four months after being diganosed.

Or our neighbor who just lost his brother. He’d gone to see the doctor because he was constipated. He thought he’d get an enema or something. Wrong. He, too, was diagnosed with cancer. A late stage one. He was immediately referred to hospice. Just two weeks later he succumbed.

There was also the lady at tennis. Her sister went in for fatigue. She’d been stressed, working hard. She expected the doctor to tell her she needed a break. Nope. End stage breast cancer. Three weeks later she was gone. She had just turned 37.

It can happen that fast. And when you’re confronted with that kind of death sentence, even if you get a bit of a stay like myself, it changes everything.

People often tell me having a baby changed how they viewed the world. That’s what cancer’s done for me. My aunt is just another example and reminder to myself that I’m living on borrowed time at this point. Maybe my stay will become a full fledged pardon and it won’t be cancer that takes me out.

I don’t know. All I do know is I can’t take anything for granted. Not my health, not those I love, not my passions, and most of all not my Authentic Self. My life has to honor that and be a tribute to all those who’d love to have their lives back and chance of fulfilling their heartfelt destinies restored.

I just have to get this out: I hate telling people what kind of cancer I had.

Don’t get me wrong. I never mind talking about my cancer. I’m not ashamed of it like some people are. I had it, it was a huge part of my life, and it always will be. It’s part of the Courtney package now.

However, everyone always wants to know what kind it was. It’s not their fault. That’s how society has conditioned us. We think of cancer by their labels. (And in some cases associate them by the celebrities that had them.)

• Breast cancer. Very bad. Very sad when a woman gets it. Has the potential to be very deadly. Lots of ways to support the fight. Pink ribbons everywhere.
• Lung cancer. The smoker’s cancer. Very bad. Very deadly. Basically a death sentence when you’re diagnosed. Not much sympathy. Everyone assumes you brought it on yourself with your bad habits.
• Testicular cancer. For men only. a.k.a “nut cancer” or “what Lance Armstrong had.”
• Prostrate cancer. Also for men only. Has the potential to be very deadly. Not discussed as openly as many others.
• Pancreatic cancer. Bad news. Not curable. (a.k.a. the “Patrick Swayze one”.)

These are just some of them. The list goes on and on. (Unfortunately.) As do the way we associate them. (Also unfortunately.)

I understand doctors and researchers need to classify the different cancers because they all respond to treatments differently. But for the rest of us?

Cancer is cancer.

It’s scary. It’s life changing. It’s surreal. And it’s different for everyone. Both the treatments and how they experience it.

It’s driving me nuts that some cancers, like breast, are everywhere. It’s like some Pink Ribbon Club now. There are times I almost feel left out that I got lymphoma, a very common cancer in its own right, instead of freaking breast cancer because there’s no “club” for mine! (You don’t see lime green ribbons on products in every store from grocery to department to sporting goods, do you?)

But thanks to my family’s history, chemo and radiation I have plenty of opportunities to join that club at some point in the future. Great. (In case it’s not clear, I’m being sarcastic. I really don’t have any desire to become a member of the Pink Ribbon Club.)

But see there? Anyone who had breast cancer might now be offended. “What, my club’s not good enough for you?”

See what all this labeling has the potential to do? That’s exactly why I don’t like it and why it drives me nuts!

Something I see a lot of people doing when something bad happens to them is asking, “Why me?”

Long before I ever learned I had cancer I had resolved if anything bad ever happened to me, I would not go there –to the “Why me?” pity place.

I always thought, “How presumptuous can a person be to ask that question? What, did you think when you were born you’d get special privileges that would exempt you from suffering life’s tragedies just like everyone else?”

Yes, I always felt it was an extremely arrogant and self-centered question. And, should something horrendous ever happen to me, it wouldn’t even be worth whispering those words.

And I didn’t –not once at any stage in the “Oh shit, I have cancer!” process did I ever go there. I wasn’t even tempted.

However, ever since I’ve survived the Black Cloud’s wrath I find myself asking a “Why me?” question nonetheless. It goes a little something like this: Why did I survive when others don’t?

For example, the other night we watched the Survivor season finale. During the reunion portion of the show they paid tribute to former Survivor Jenn Lyon who died of cancer earlier this year. She was only 37.

Wayne immediately dove for the remote wanting desperately to change the channel. But he was too late. I saw it. Images of the beautiful young woman who once upon a time purposely subjected herself to enduring the elements for 39 days (if she could make it that far) with perfect strangers in a quest for a million dollar prize.

I tried and tried to hold back my tears, to not react the way I always do when I learn of a fellow cancer soldier losing his or her battle with the disease. Mostly I tried to put on a brave face because I knew Wayne would beat himself up for not having changed the channel fast enough to spare me from seeing it.

It’s his way of protecting me. I love him for it.

I could almost feel him holding his breath as he waited for the inevitable: the deluge that always follows. But, as it always does, it finally came.

And with it so did my string of “why” questions: Why her? Why not me? Why am I still here? Why are some cured and others aren’t? Why was I so lucky?

Then we had to staunch the flow of panic that also accompanies these events when I’m reminded of how lucky I am to have had 16 months, two weeks, and a day more with Wayne than I could have had if the alternative had happened.

I know I’ll never have an answer to any of my questions. I’m not sure I’d really want to know the answer anyway. But this is what I do know:

I know I’m here thanks to many factors: the scientists and researchers who invented the treatments that saved my life, those patients who went before me to perfect the treatments, the doctors and nurses who know how to correctly administer them, friends and family who lent their strength, support and comfort when mine was weak, and even my own Life Force willing me not to go out just factored in.

Most of all I know the “Why not me?” feelings I have is survivor’s guilt.

I know all of that, but it’s never enough to keep me from wondering it anyway.

Blessings to you and your life, Jenn Lyon. You accomplished whatever you were put here for faster than those who loved you would’ve preferred. I hope their memories of you provide comfort as they mourn your passing.

I watched a bio of Shirley Temple Black on Biography channel the other day. It was actually a re-run. I’d seen most of it before.

But not all. Or if I’d seen it, I spaced it. Because one thing I was shocked to learn was that Shirley Temple was a cancer survivor! In 1972 she found out she had breast cancer and ended up getting a mastectomy. Then she ended up talking publicly about it –during a time when it was still taboo to talk of such things.

When my mom got cancer she refused to talk about it. At least with me. (I was only 12 at the time though too.) But I do recall on several occasions her saying, “Cancer is not something people talk about.”

This was 1983. But my mom was 50 something by then. She was from that era when they didn’t talk about cancer in polite society –or any society really.

But Shirley did. And in the Biography profile of her they said it was because she did that other women went to go get checked out.

Shirley Temple’s been a lot of things, but she also might be remembered as a pioneer on the cancer awareness front.

(And once again I found myself counting my blessings that I live nowadays. I can’t even imagine bearing societal pressure to keep hush about my cancer. I’d never have made it!)

When I heard I had cancer, having it freaked me out. I’d heard tales of people throwing up the second they received bad news, but I’d never done it myself –until Diagnosis Day (a.k.a. D-Day.)

And since I’d just lost my mom to lung cancer five months earlier, and was well aware the tumor in my chest was gynormous, I figured I’d most likely be a goner too.

After all, I was having to do some of the same stuff I’d just gone through with my mom as her caretaker. The being out of breath. The coughing so hard I was spitting up mucus and blood. Needing breathing treatments every four hours.

That’s what scared me the most. Visiting her in the hospice. Waiting and watching to see if she was any worse today, any nearer to the inevitable end we knew was coming, and seeing all those other people and their loved ones going through the same thing…waiting for the goodbye they both dreaded and welcomed. (Because there comes a point you wish the end would hurry up. You just don’t want to see your loved one suffering anymore.)

Confronting the idea of death at only 38 was frightening enough. It didn’t seem fair. I hadn’t got to do so many of the things I’d wanted. I never finished my other books yet. I hadn’t gone to France. I’d never gotten to use a bidet. And really? The last year of my life I had to remember was caring for my mom and fighting with my sister? I know Life’s not fair, but what a crappy way to end it all with all that toxic mess as my finale.

But what scared me most was the deterioration I knew was coming. I’d seen it. I didn’t want to go out that way.

The only good thing about it is I’d have a little time to say goodbye. To tell all the people I loved and who had influenced me during my life how much they mattered to me.

But the getting sicker and sicker part before the end came? I didn’t want to go out like that. I didn’t want my last days on Earth with Wayne to be spent like that.

Although, now I’ve come to realize I’d do what I did when I found out I had cancer: I’d let myself freak, then I’d embrace my reality. If that’s how I’m meant to go out, not much I can do about it –except find the blessings and make the most of them with whatever time I was given.

Last year around this time one of Wayne’s co-workers gave him a Magic Bullet. Well, it was intended for the both of us.

I had just started chemo. I couldn’t eat much. I didn’t feel like eating much. However, I had a hankering for banana shakes. Not with ice cream or anything. Just a simple blend of bananas, milk and a little bit of vanilla sugar.

However, I didn’t always have the energy after whipping up one of my banana shakes to clean out the blender. Wayne was doing most of the dishes at this point.

Along with working his day job, taking care of cleaning cat boxes and walking Murph three times a day, picking up groceries, fixing dinner, doing laundry, cleaning the house…I wasn’t able to do much back then. Cleaning out the awkward blender left him belly aching.

Well, his answer was just to throw the parts in the dish washer. But fat lot of good that did me when we weren’t running it every day. I’d have to ask him to help me clean it. (My left arm was useless and trying to do things one-handed drained what energy I had that much faster.)

His co-worker Rosemary had the answer: the Magic Bullet.

I’d seen them on TV and thought they looked neat, but I was wary because it was being peddled in infomercials. Can’t trust what you see on TV and all that.

But Rosemary had bought one and loved it. LOVED IT! She said we absolutely had to have one so she ran out and got us one.

It didn’t take but one use for Wayne to see why Rosemary had been raving. No awkward pieces to clean up anymore!

And he quickly started whipping himself up his own version of Slushies…just juice or Gatorade with some ice. He was making those from the moment he got up until he left for work, and that was among the first things he’d do when he cam home at night.

Yes, we’ve greatly enjoyed the Magic Bullet ever since. It’s a Happily Ever After Small Appliance story.

But I got to watching the infomercial again the other night. They were doing all sorts of things with the Magic Bullet. Including grinding coffee.

Not that I’m a coffee connoisseur. I only drink it occasionally, and always decaf. (It doesn’t seem to upset my tummy like regular coffee often does.)

Anyway, I’ve always wanted to grind my own coffee at home and then brew it. Just to try it. Mostly because anytime I can play with my food I’m on it! Grinding looked fun!

Sure, I can use the grinders in the store. But to have one at home would be neater. Plus, then I could see if it really does brew a fresher cup.

So when I saw that was one of the things we could do, I bought some decaf beans and went hunting for the other blade. (Wayne had stashed all the parts that came with our Magic Bullet because he was the one to unpack it.)

Anyway, I found it PLUS all the other shaker tops and stuff that came with it –which I also saw demonstrated the other night and didn’t even know we had!

WOOHOO! More playing with my food to come!

And how was the grinding process and the resulting cup of Joe? As fun as I’d hoped (maybe even funner) and DELICIOUS!

Woohoo! I had my three-month follow up with my oncologist today.

Chest x-ray? Fine!

Bloodwork? Fine!

BP? 96 over 68…I’d say that’s pretty damn FINE!

Aches and pains? Fine! (None! So better than fine!)

Breathing? Still doing it! (I have asthma so sometimes it flares up and requires me to suck on my inhaler, but overall I’m still doing okay!)

The only thing is my ding dong weight. They didn’t say anything about it, but I’m back up to 188. Grrrr.

But I’m still alive and kicking so…I’m just going to have to be fat and fine with it!

Today I had a delightful lunch out with my friend Karen. She and her husband are up from Jacksonville for a big photography conference at the Gaylord Opryland.

But today at lunch she broke some very sad news. Her friend Marie, who had been battling breast cancer for the past four years, died last week. Today was actually the memorial service.

Karen hadn’t wanted to tell me. I never even met her friend Marie, but she was an inspiration nonetheless. She wasn’t even supposed to live the last three years she did. But she kept setting goals for herself, and she willed herself to meet them. At least three times she’d been put on hospice and told she had less than six months. This time she willed herself to live to see the New Year, but that’s all she had left.

When I was first diagnosed last year, Karen told me all about her. She used her as an example of why it was so important to keep a positive attitude. Because it really could help.

It did. In two chemos my tumor shrunk from grapefruit-sized to golf ball-sized. Not all of that was my positive attitude. Much of that was because of the medicine and the astounding number of prayers.

But keeping hopeful, inspired, and motivated? I used Marie as a benchmark of how important that could be.

So Marie, I didn’t even know you, but you made a HUGE impact on me nonetheless. I know it was much too early for you to go. You’ve left behind a huge hole from what I know from Karen. Everyone who met you loved you. And from the sounds of it you had quite the family. I know their hearts are grieving. I hope you’ve found peace from the pain. That you suffered all you did for as long as you did…you were one tough cookie! But your will and grit, combined with your zest and optimism, have had an impact on reaches even further than you can imagine. Thank you for setting such an amazing example of how to live with cancer until your dying day.

Tomorrow I go in for a three month checkup. I haven’t been in since last October. This will be my first non-scan follow-up. (There will be blood work, and possibly a chest x-ray, but no CT scan.)

I hope I’m still doing fine. I feel good, but there’s always that niggling of “what if” now. Maybe it’ll go away one day. I don’t know. The trauma of all I’ve been through is still fresh.

But I am alive, and as long as I’m alive I will live each day like Marie did: bravely, with a smile, and above all a can-do attitude combined with a will of steel.

Rest in peace, Ms. Marie.