What is a JayDiva?

JayDiva (noun) a writer of blogs who is an attorney, feminist, New Englander, child advocate, reader, hiker, cancer survivor, Mormon.



Tuesday, September 30, 2014

Media and Cancer


Either various media outlets are following me around to gather material to use for their editorials, or else cancer is sweeping the human race and making headlines.  Unfortunately, I fear its the latter that is true.  Regardless, I keep coming across several interesting bits of media that highlight what I’m going through right now. 

It has been eye-opening to realize that all of the unthinkably crazy things that I am going through are actually happening to people everyday, all around the country.  It has called to mind a favorite passage from Matilda written by Roald Dahl (if you’re not already obsessed with Dahl, read The Twits and I promise that you WILL be!).  Matilda was a bright young girl in an oppressive, ignorant family who treated her like dirt.  She found solace in books, reading about heroes and heroines—other smart people who, like her, were misunderstood or treated badly, but who ultimately rose triumphantly.


“So Matilda’s strong young mind continued to grow, nurtured by the voices of all those authors who has sent their books out into the world like ships on the sea.  These books gave Matilda a hopeful and comforting message: You are not alone.”


Seeing the following videos definitely proved that I am not alone in my bizarre experiences in Proton Therapy.  These videos were actually taken at the facility I attend daily at UPenn, and the creator and I actually have a mutual friend!  My sweet former roommate pointed me to these videos.  Not only are they creative and cool, they are actually pretty accurate at showing what treatment is like.


 (P.S. That is totally one of my therapists on the right and she was SO embarrassed when I told her I saw her in this video!  Haha!)




Huge cyber high-five to creator Thomas Ashley, and nice choice of music on above^ video—Radioactive by Imagine Dragons.  (Coincidentally, I saw them perform this song live shortly after I moved to Philly with my main man friend, Vic, who is a medical student here!)


Seriously, click the links and WATCH THESE VIDEOS!

As you could see in the videos, the patient was wearing this awful mask.  He looked so jolly when they took his off, but for me I’m always like, “Get me outta this thing!”



NPR highlighted an Art Show in Washington DC where many of these masks were converted into artwork and displayed.  The show was called Courage Unmasked.  Very cool.  I like how one patient who donated his mask to the project stated, “[The mask's] goal is to restrain, and they’re [the masks used as art] going to expand.  And so, it’s a thing of contrasts…” 



The artwork from this event was auctioned off and the proceeds went into the 9114HNC (Help for Head and Neck Cancer) fund, which gives grants to patients with head and neck cancer.


I already have BIG plans for my own mask art post-treatment.  My canvases are purchased and everything! 


Here’s a LINK to the photo gallery: http://courageunmasked.org/photo-gallery/



Additionally, I have recently started subscribing to a free podcast called RadioLab from WNYC.  And maybe it just happens to seem this way with the ones I have happened to have already downloaded, but I swear that they are obsessed with tumors!  They even had one episode dedicated to people with brain tumors and criminal law!  Its like they made that episode just so that it would be interesting to me!  If they had added something about rugby, feminism, and farmer’s markets, I would have been kinda freaked out, since that’s me in a nutshell.

Here’s a couple of their tumor-related shows…
(also FREE on iTunes)








 

And get ready for this final one, shared with me by my cousin and mom.  Seriously, don’t press play until you have a tissue…




No matter how crazy things get, you are not alone.  I have known that in a spiritual sense, but I am now seeing it in a very tangible, physical sense as well. 

Tuesday, September 23, 2014

My Proton Plan


Greetings, Earthlings. 

I’m telling you—Proton Therapy is from the space age.  It is like being in the Twilight Zone.  There’s some CRAZY science happening all up in this brain!



I begged my Oncologist to print these out for me at our weekly meeting and I thought I should share them.  These images are from my  individualized “plan,” ie the computer mapping they did after a million MRIs and CT scans so they could program the Proton Beam to cover the area where any lingering malignant cells may still be lurking. 

 (P.S. sinuses are really strange...)


 (P.P.S. isn't that a cute little Michelin Man?)



They are attacking the area from 3 different angles, as the images show.  I think they had to kind of get creative with the angles since I have all these metal plates going on [As a side note, I get an X Ray of my head everyday to line up the beam and my Radiation Therapists tell me they love seeing my plates everyday ;) I’m glad they’re still there too!], and they don’t want to interfere with really important parts of my brain…oh, and my tumor was like right smack in the middle of my brain, so I’m betting they had a lot of head scratching trying to make my plan.

Oh, I’m just so special!

And can you see that gap in my skull at the bottom right of the third image?!  The bottom center shows the metal plates, but the bottom right is just a bare gap!  I was like, “What is THAT doctor?!  Is THAT supposed to be there?  How did THAT happen?!”

He looked at me like-- what is wrong with you?  It’s just a little hole in your head!   --and said it was a place the surgeons cut into my skull.

“There’s still a hole!?!”

(practically rolling his eyes) “Oh, it will grow back…”


I’m sorry, am I the only one concerned that there’s a hold in my skull without a metal plate over it??  Alright, well all these doctors seem to think I’m over-reacting, so I guess I’ll just forget about it.

My life…


Signing off from the planet Mars.

Good News… And The C-Word


Some good news!  Turns out my dad was right all along—the squeaky wheel gets the grease!

All Proton Therapy patients get free parking at the hospital because we have to be at the hospital every day for treatments for about 2 months straight.  If you know anything about Center City Philadelphia, you know that parking is a BEAST.  My husband (who knows things like this) even considers parking in Philly to be harder than New York City!  And that is saying something.

So I live on the east side of Center City, and the hospital is on the west side; a little over 2 miles away.  It is a pitiful distance to drive a car for three reasons; 

1) It is only TWO miles, 

2) We have great public transit in the city, and 

3) Once I find a parking spot by my house I DO NOT leave it!  Not unless I’m going out of state or getting big stuff from The Home Depot or something.  Seriously.  Parking around here is horrible.  If I drove to the hospital every morning, I would spend every afternoon circling around for hours looking for a new spot within a mile of my apartment.

So I always get a little peeved because the hospital receptionists always ask to validate my parking ticket, but I don’t drive to the hospital, I take the Subway.  The Subway is cheaper than it would be to pay to park, so I see no reason why it shouldn’t also be subsidized.  $2.25 per ride (X) 2 –there and back—(X) 5 for every weekday (X) 7, for every week of treatment…that really adds up for a person who is too busy being at the hospital and feeling lousy to earn a wage.

Ergo, I began using my powers of suggestion, which sounds a lot like whining…I’m sorry to admit…and telling everyone who would listen that they should give tokens to patients taking the Subway or Bus!  We mass-transit-folk save room in the parking garage, save the valets some headaches, and save the environment!



After running this spiel several times, finally my AWESOME hospital social worker actually listened to my crabbing and she helped me secure a transportation grant from a local nonprofit organization, The Breathing Room Foundation—they bought me a ton of Subway tokens!  HOORAY!

They even gave me some additional funds to buy a train ticket to be with my hubbie in Connecticut for a nice weekend.

They also gave me a hand-sewn bag with things to help me out while at the hospital, like cocoa butter for my burns from the therapy, a word puzzle book for sitting endlessly in the hospital, tissues for when I cry (which is thankfully becoming less frequent), and a really sweet card that made me choke up.  Such a nice gesture from a lovely organization.


As you can see, this is a nonprofit to help serve people affected by cancer.  Which begs the question, Do I Have Cancer?

In the very recent past, the answer was No.  But kinda yes.

I’m here to tell you that the answer is now Yes.  But kinda no.

To explain, I think it would be illustrative to share some of the evolving things that doctors have been parroting into my ears over the past several months.  Medical professionals, please take note—you are dealing with people’s LIVES here.  It is their life, and they ought to know the truth about it, even if it is a bitter pill to swallow.  As hard as it may be for you to say it, I’m telling you that it is even harder to hear different things from different people. 

Just be honest. 

That’s a principle that applies across the board in life, and it also applies here.

In fairness to my doctors, I’m a really oddball situation.  A dear friend of mine at an Ivy League medical school recently told me that he just took a special course on Neurology and that they didn’t even cover my type of tumor because “You will never come across this in practice.”  SURPRISE!    Here I am!  Coming across!
~~


March
-You have vertigo, take these pills and do these maneuvers- they will help.

May
-You have vertigo, but stop taking the pills and doing the maneuvers- they will make you worse.

June
-It will show nothing, but lets have you take an MRI.
-There are abnormalities on your MRI.
-There is something there…we don’t know what…worst-case scenario it is a tumor.
-We can’t know for sure if you have a tumor until we get in there.
-We don’t need to get in there to see that you definitely have a tumor, but it is slow-growing and benign and will never come back if we remove it.
-We can take the tumor out if you want, but your surgery is ELECTIVE at this point!**

July
-Umm…about that tumor being benign…we’re making you an appointment with an Oncologist, but we’re not gonna say anything more than that (most terrifying phone call of my entire life).
-So yeah, your tumor was actually fast-growing, not slow-growing, and it’s not the most benign tumor in the world. (Direct Quote)
-Your tumor was malignant, but you DO NOT have cancer.  The tumor will probably try to grow back in the same exact spot.

August
-I don’t know who told you that you don’t have cancer, but I disagree.  You DO have cancer, the cancer just isn’t likely to metastasize to other parts of your body. 


**This is my favorite one from a surgical resident.  He claimed that my impending surgery was “elective” and could wait.  Okay, lets imagine that I waited one measly little month, just to think about it.  Later docs realized that my tumor was capable of doubling its size every ten days.  So 30 more days would have brought me from one lemon in the head, to 8 lemons in the head…AKA skull-cracking death.  How’s that for elective, Mr. Resident?  Pardon me, but I respectfully disagree.

~~

August was when I first talked with my Oncologist.  That was the first “you have cancer” conversation.  Perhaps the old expression may ring true, that everything is a nail to a hammer, and he is a cancer doctor after all.  But whatever label you put on my poor, stupid brain, it needs to at least be treated like it has cancer at this point, because we want to pulverize any possible lingering mutated cells who could decide that hey are lonely and want to make friends.

So there it is, the C-Word. 

Cancer. 



One of the most prevalent, confusing, and resilient diseases in modern medicine— striking at will among the young and the old, the strong and the weak, the healthy and the troubled.  It took me about a week to even say the word out loud after that first conversation with my Oncologist.  It felt uncomfortable and foreign rolling around in my mind and evading the tip of my tongue.  I still don’t like to talk about it.  But there it is.  Even now it makes me clam up.  So I guess that will have to be it for now; more to come as I learn more, experience more, and accept more.


Monday, September 15, 2014

Moving Forward-- Beginning Marriage and Proton Therapy


I’m sure you’ve seen photos ad nauseam at this point (if you haven’t, check out our Wedding Website!), but MY SWEETIE PIE AND I GOT MARRIED!  What a pleasure it was to have a small temple sealing, ring ceremony, and picnic with close family and friends.  Thank you to everyone who made it special for us.  And a HUGE thumbs up to all of my surgeons, doctors, physical therapists, etc. who made their deadline of  having me “Feel Normal By The Wedding.”  WE did it!  I felt great and I didn’t even fall over in my high heels!  How lovely!



 (And didn't these make great favors!)

Since going on an airplane with my head being a mess was still kinda iffy, we decided to drive/ferry up to Martha’s Vineyard for our honeymoon and we had a blissful, beautiful time.




The bummer was coming home and having to be back in Philadelphia by myself for Monday through Friday radiation.  I have now completed over one full week (out of 7) of my daily Proton Beam Therapy radiation treatments.

Here are some general FAQs from this site: http://www.proton-therapy.org/questions.htm


How does proton therapy work in relation to other mainstream radiation therapy and chemotherapy?
  • Proton therapy is the most precise and advanced form of radiation treatment today. It primarily radiates the tumor site, leaving surrounding healthy tissue and organs intact. Conventional x-ray radiation often radiates healthy tissue in its path and surrounding the tumor site. Chemotherapy moves throughout the entire body, unlike radiation and surgery which are considered "site specific" treatments.

What are the side effects from proton therapy?
  • Minimal to no side effects, compared to conventional forms of radiation. Much more easily tolerated than standard radiation therapy.


Sounds groovy and all that, but in reality, it really isn’t quite as peachy as they make it sound—especially if they are radiating your brain.  As with anything irritating or damaging tissues in the brain, there are naturally going to be side effects from either 1) specific damage to affected parts of the brain, or 2) symptoms resulting from general swelling of the brain.

Of course they have to tell you the worst up front for liability reasons, but based on where my radiation is being focused, my oncologist tells me that I may come out of this bout of radiation blind, deaf, and mostly bald.  (Jaw dropping to floor)  The vision and hearing loss would come from swelling of the particular areas being radiated, and those issues would resolve themselves when treatment finishes and the swelling goes away.  The hair loss will likely come at the site where the Proton Beam enters my head.  And, lucky me, I get THREE entry spots!  And they’re not like the size of a laser pointer, this beam is like the circumference of a baseball.   So picture three baseball-sized bald spots appearing on one side of my head, on the top of my head, and at the back of my head.  I think because of my metal plate situation at the base of my skull, they had to get creative with the beam angles…oy vey.



So you can see why I am fighting with my nurse practitioners for permission to take Hair-Skin-Nails Biotin pills to help prevent all that hair loss.  Unfortunately, I am losing that battle.  No; I have officially lost that battle.  Interestingly enough, the only real prohibitions on my diet during radiation are to not consume mega doses of antioxidants (including those Biotin pills!), in case they offset the damage intended to be caused by the site-specific radiation.

Huh?? 

When they told me this, all I could hear –even though it wasn’t the doctor’s actual words—was “Don’t take antioxidants, we are trying to damage your brain and don’t want you undoing our damage.”



I guess it makes sense, but it still struck me as a really odd thing for a doctor to say.  I guess I’ve been living life wrong all along.  Last year my primary care doctor told me to not exercise so much (yeah, that was a strange conversation) and now they’re telling me not to eat too many vitamins and antioxidants...  

 Hey, there was a lemon-sized tumor in my brain; nothing surprises me anymore.

Oh, and my only other diet prohibition is not to gain or lose any significant amount of weight because it will throw off my calibrations and my mask won’t fit.

Did I tell you I get to wear a mask?!

Think of that scary movie Jason meets The Man in the Iron Mask meets E.T.  Roll those pleasant images all together and that’s my life these days!  Ha!



The mask is super tight fitting—so tight I can't even open my eyes more than a tiny squint—and it wraps all the way around the back of my head so the technicians can clip it into the hospital bed so I am utterly immobilized.  The cherry on top is the mouthguard built into the mask that I get to chomp on the whole time.  Fortunately, years of rugby taught me that mouthguards are my friend :-)

So picture me strapped to a bed with my face all smashed getting radiation baseballs hurled into my skull, all while wearing a super foxy hospital gown, and that’s my daily routine.

I get to have this kind of fun for two exciting months, just waiting for my hair to fall out.   Whaaaa!



My words are likely betraying the fact that with this going on, I’ve kind of just wanted to sleep and do nothing.  Proton Therapy does make people tired and my Oncologist recommends that I do take a nap after treatment each day, and to try to go to bed early if I feel like I need to.  So now that the wedding is over and I have no major events to agonize over, I’ve been taking this “radiation makes me tired, so I’m gonna sit on my couch and watch Netflix” attitude probably a little too far…


So to try to keep me in high spirits, I am looking forward to continuing to put me & Jack’s new house all in order—so fun!—on the weekends when I get to be up in Connecticut with him.

And a really good decision I made a while back, motivated by my mom’s superior example, as well as her subtle suggestion when I was feeling depressed, I have started volunteering at the library!  It is good because I have a task to do in a place that is nice and quiet.  So even if I feel like crap, I can have some peace while I put my mind on other things.  Applying to help out at the library is definitely one of the better ideas I’ve had in a while (besides marrying my sweetheart-- that was the BEST decision I’ve made all year!).



And this volunteer work is in line with a Priesthood Blessing I just received last week, encouraging me to serve others and prophesying that I have “many years of happiness ahead.”


This was such a needed reassurance for me, since I feel confused sometimes about what comes next.  I sit in the waiting room at the hospital every day with a fabulous hospital gown tied on haphazardly, surrounded by white-haired men in their 70’s and the occasional sullen, smooth-headed child in a wheelchair.  I just feel really out of place at a cancer treatment facility as a 27-year-old who is already plotting the route for her jog as soon as her day’s treatment (and nap) is complete.   



But it is such a waste of the mind and body I have been given to just sit around feeling sorry for myself—at least not all the time!  So I have been looking for inspiration to get motivated to look forward to happier times and not get bogged down in boredom or loneliness.



From the Apostle Paul, “let us run with patience the race that is set before us.”  



This is a really old quote from a previous prophet of the Church of Jesus Christ of Latter-day Saints*, President Kimball, but I really like what he said and I know it is still relevant:


There is so much yet to be done! Let us, then, move forward; let us continue the journey with lengthened stride. The Lord will lead us along, and he will be in our midst and not forsake us.

President Spencer W. Kimball, Let us not Weary in Well Doing, April 1980


In the world and in my life, there is still so much to be done.  My sweet, handsome husband is always really good to help me see the forest from the trees, to not get too caught up in the emotions of the day, but to look forward to the future.




Additionally, my caring cousin Ali recently reminded me of a talk that I had listened to post-op, before I could see well enough to read printed text.  I just want to add my favorite parts, even though it is a fairly long excerpt, because I think it gives a really nice analogy.  A modern day Apostle of Jesus Christ, Elder Bednar, talked about a friend who won a benign battle with his wife and bought a new 4-wheel drive pickup truck, and here’s what happened:



“Sadly, my friend went too far along the snowy road. As he steered the truck off of the road at the place he had determined to cut wood, he got stuck. All four of the wheels on the new truck spun in the snow. He readily recognized that he did not know what to do to extricate himself from this dangerous situation. He was embarrassed and worried.

“My friend decided, 'Well, I will not just sit here.' He climbed out of the vehicle and started cutting wood. He completely filled the back of the truck with the heavy load. And then my friend determined he would try driving out of the snow one more time. As he put the pickup into gear and applied power, he started to inch forward. Slowly the truck moved out of the snow and back onto the road. He finally was free to go home, a happy and humbled man.

“…It was the load. It was the load of wood that provided the traction necessary for him to get out of the snow, to get back on the road, and to move forward. It was the load that enabled him to return to his family and his home…

“Sometimes we mistakenly may believe that happiness is the absence of a load. But bearing a load is a necessary and essential part of the plan of happiness. Because our individual load needs to generate spiritual traction, we should be careful to not haul around in our lives so many nice but unnecessary things that we are distracted and diverted from the things that truly matter most…

Recall the Savior’s statement ‘For my yoke is easy, and my burden is light’ (Matthew 11:30) as we consider the next verse in the account of Alma and his people.

"'And I will also ease the burdens which are put upon your shoulders, that even you cannot feel them upon your backs’ (Mosiah 24:14).

“Many of us may assume this scripture is suggesting that a burden suddenly and permanently will be taken away. The next verse, however, describes how the burden was eased.

'And now it came to pass that the burdens which were laid upon Alma and his brethren were made light; yea, the Lord did strengthen them that they could bear up their burdens with ease, and they did submit cheerfully and with patience to all the will of the Lord’(Mosiah 24:15; emphasis added).

“The challenges and difficulties were not immediately removed from the people. But Alma and his followers were strengthened, and their increased capacity made the burdens lighter. These good people were empowered through the Atonement to act as agents (see D&C 58:26–29) and impact their circumstances. And “'in the strength of the Lord' (Words of Mormon 1:14; Mosiah 9:17; 10:10; Alma 20:4)…

…"The Lord desires to enliven us…to strengthen and heal us.”

April 2014, Bear Up Their Burdens With Ease, Elder David A. Bednar



Finally, I want to share one of my favorite scriptural stories that I have been pondering while seeking inspiration to act amidst adversity.  The young people involved in this story were known as the Stripling Warriors.  These little warriors totaled about two thousand and sixty young and untrained boys.  They lived in a society who, after years of war and bloodshed, now centered around peace and liberty.  But when this society was unjustly attacked by enemies, these boys volunteered to fight to defend their families because the older generations had made an oath to the Lord that they would not bear arms ever again.  Rather than having their fathers, uncles, and grandfathers break their promises, these Stripling Warriors decided to defend them.  Even though they were under-qualified to be soldiers, they bravely chose to defend their people, with strong faith that the Lord would deliver them.

Their leader recapped what happened after these boys were in battle—


Alma, Chapter 57

25 And it came to pass that there were two hundred, out of my two thousand and sixty, who had fainted because of the loss of blood; nevertheless, according to the goodness of God, and to our great astonishment, and also the joy of our whole army, there was not one soul of them who did perish; yea, and neither was there one soul among them who had not received many wounds.

 26 And now, their preservation was astonishing to our whole army, yea, that they should be spared while there was a thousand of our brethren who were slain. And we do justly ascribe it to the miraculous power of God, because of their exceeding faith in that which they had been taught to believe—that there was a just God, and whosoever did not doubt, that they should be preserved by his marvelous power.

 27 Now this was the faith of these of whom I have spoken; they are young, and their minds are firm, and they do put their trust in God continually.


What I like about this story is that God didn’t put the whole army on a cloud and save them all from the horror of war.  Instead, God demonstrated His power more subtly to these boys by having them participate in a battle where many on their own side died, but each of the Stripling Warriors, young and inexperienced though they were, survived. 

But again, they weren’t placed within some spiritual force field! (Although that may have been cool…) They ALL had to fight and they ALL received wounds. 

About 10% of them received wounds bad enough to make them pass out from blood loss!  They fought, they got hurt, but they lived and their faith was strengthened.  Being protected from evil and from harm doesn’t mean we get to sit on the sidelines, it usually means we have to fight and even face some collateral damage, but we will ultimately triumph if our hearts are right.




And I will finish again with a poem by John Greenleaf Whittier, an American poet and abolitionist—


Press bravely onward! — not in vain
Your generous trust in human kind;
The good which bloodshed could not gain
Your peaceful zeal shall find.



*P.S. I really like this simple video explaining my church: