A year down the road: still raising a middle finger to cancer (and the IRS)

Happy Tax Day, everyone!

Just kidding. Fuck the IRS. Those bastards make it damn near impossible to claim healthcare costs on your taxes.

The out-of-pocket expenses for my cancer treatment made a huge dent in my cash flow, but noooooo, it wasn't enough for those sadists at the Internal Revenue Service, who apparently want you to experience catastrophic medical bills before they'll entertain the notion of throwing you a couple of tax-relief bones. So this year, I have the insult-to-injury situation of actually owing the government money.

But seriously, enough about those asshats. I'm ready to celebrate.

Hard to believe, but today marks my chemoversary. Yep, it's been a year since I had the last infusion. Compared to then, I'm feeling a whole lot better obviously. My normal skin color (fishbelly white) has returned and my hair kinda looks like Rod Stewart's now (OK, I don't feel better about that). I still get bouts of fatigue during the day, although it's hard to say whether that's from the lingering effects of chemo or the tamoxifen I'm now on - or maybe a combination of both. (The tamoxifen keeps my body from being able to utilize any remaining estrogen, which fed my tumors, and I'll be on it for at least the next 10 years. Yay.) In any event, it's nowhere near as bad as chemo fatigue.

Yes, what a difference a year makes.

This time last year, I was getting the equivalent of toxic Hudson River water pumped into my veins (that would be chemo) and subjecting myself to needle-stick bruising and the pain of white blood cell boosters. My tear ducts were inflamed, leaving my eyes constantly running and red-rimmed. On most days, me and my Humpty Dumpty head were draped over my recliner like Spanish moss.

Fast forward to this past weekend: I was able to take my son to the American Museum of Natural History's "Night at the Museum" sleepover to celebrate his 6th birthday. At least, it was under the guise of being totally about his birthday. A little part of me also made the reservations as a middle finger to cancer and a celebration of my health slowly returning. None of that "I have to schedule a trip on my 'chemo off-week.'"

From 6 p.m. till midnight, our family and about 450 other people had free rein of the museum. We played tag in the dimly lit halls populated by long-dead animals. I held my son's hand and skipped through the museum's ode to the Pacific Northwest's native people. I screamed along with him as 3-D spiders creepily reached out to us in the movie "Tiny Giants." I smiled at every "That's sooo beautiful, Mommy" as butterflies flitted gracefully around us in the Conservatory. And I sat back, a little teary-eyed, as I watched him speed around the Hayden Planetarium, forcing his scientific knowledge on anyone in earshot, and later, as he sat enthralled by a teenage girl with autism who took the time to tell him everything she knew about space matter. I stared at his little face and the faint smile on his lips as he fell asleep, tucked cozily into his sleeping bag in the Hall of North American Mammals.

Being able to experience these moments, to recapture a little of that lost childlike wonder myself, was truly amazing. And it made all the pain and suffering I had experienced during treatment so unbelievably worth it. I live for these moments.

Whether I have ultimately finished the war with my genetic foe or whether I will have to eventually suit up again for battle remains to be seen. But all I know is, in this moment, I'm alive and I plan on living like I'm alive, making memories cancer can't take from me.

In losing 'the filter' I gained new perspective ... and other really deep, philosophical stuff

You know what's really dangerous about cancer? I mean, besides the fact it can kill you?

It's deactivation of "the filter."

Pray tell, what is the filter? you ask.

Why, it's that part of your brain that keeps you from saying inappropriate or downright crazy stuff. It keeps you from dropping the "F" bomb during a big corporate meeting and from blurting out “OK, so your mouth is moving, but still I find myself not giving a shit" to an acquaintance who is incessantly complaining about rush-hour traffic in whatever overpopulated city he/she lives in.

Admittedly, my filter has always been a little warped. It's the only explanation I have for why I liked to regale people with a play-by-play of the time I got food poisoning from a local Chinese restaurant and stupidly went to bed without a diaper on. But still, I could be counted on to show some restraint...occasionally.

Nowadays, I just blurt stuff out, usually in response to someone being an idiot. It's like I have voluntary Tourette syndrome or something. (See, there I go, probably offending people with Tourette.) So add "ability to silently take bullshit" to the list of cancer casualties. I used to be such a champ at masking my emotions. But I just don't see the world the same way anymore. And when the majority of people haven't had cancer, and don't share the same perspective, that can be an isolating feeling. Ask cancer survivors how being diagnosed changed their lives and they will probably tell you they spent a decent amount of time re-evaluating relationships, careers and everything in between.

Danger, Will Robinson, danger!
She's about to speak!

Now, not every cancer patient will have their filter switch to “off.” There are some people out there who, following such a diagnosis, will still manage to show amazing vocal restraint and spend their free time twirling around in a field of wildflowers like they’re in a goddamn Sting video or something. I am not one of those people.  

In the aftermath of a potentially deadly diagnosis—and amid the reality of a BRCA2 mutation that will dog me for the rest of my days—I’ve come to fully appreciate laughter, my children’s accomplishments and my friends’ milestones. But I have also become steadfast in my belief that most everything else we deal with on a daily basis is self-inflicted or at the very least, in the grand scheme of the universe, not worthy of more than a passing thought. Certainly not the drama-rama people stir up.

As my oncologist pointed out, it’s not really fair to judge how the rest of the world reacts to so-called stressors. Most people have not faced their own mortality and doing so provides you with a much different perspective on life. And I wholeheartedly agree.

I guess I just wish people wouldn't wait for such perspective to come from a cancer diagnosis or other life-altering event.

Meet Heather LaBruna: A cautionary tale for the Angelina Jolies of the world

The following is a piece I wrote for another publication, which didn't use it, so fuck it. I'm publishing it here.

*****

I’ve gone and done it, blown my New Year’s resolution to stop reading the comments on any given news story.

“I'm so scared about dying in a car accident that I'm thinking about removing the tires. Angelina Jolie should go see a psychologist you cannot live in fear of everything.”

 

I dug up that gem—one of the less hostile ones, actually—in the comments section of a  Huffington Post news story about Angelina Jolie’s New York Times op-ed piece. These insults were sprinkled among comments praising the actor, mother and humanitarian for using her celebrity pulpit to spread awareness of hereditary cancer risks. I could probably post a hundred more that criticized her choice, just to prove what D-bags people can be, but I won’t. Because right now I’m pissed.

Had I known about my BRCA status in advance,
I could have taken the necessary steps and likely avoided
this whole baldness mess.

I take such comments personally, not because I have a huge girl crush on Angelina, or because we’re obviously twinsies (cough, cough), but rather, because we’re both mutants. For every Angelina Jolie, there’s someone like me, someone who didn’t know she carried a potentially fatal genetic mutation until after being diagnosed with cancer.

Yes, look at me, world! I’m a cautionary tale!

In 2013, at the age of 36, I went in for a baseline mammogram. I left that warm September day with x-ray images of diseased-looking breasts burned into my brain and the radiologist’s words, “There’s a lot I find suspicious” echoing in my ears. I wanted to tear my boobs from my chest.

Three biopsies later, I learned I had breast cancer. Not just in one breast. Both.  The tumors, while caught early in stages 0 and 1, were grade 3, which, in cancer-speak, means they were aggressive. In addition, there were signs that cancer cells had breached my blood vessel walls and could have escaped into my bloodstream. All this, and I never had a lump or any other symptoms.

A few weeks later came the smoking gun: a positive test for a BRCA mutation. The deaths of my paternal grandmother, my grandmother’s twin sister and my aunt from breast cancer weren’t bad luck. In my family, we had genes that killed. BAM! IN YOUR FACE, every-doctor-who-ever-told-me-that-I had-nothing-to-worry-about-because-the-cancer-was-on-my-father’s-side-and-that-my-breast-cancer-risk-was-probably-the-same-as-the-general-population!

Over the course of a year, I would have a double mastectomy and breast reconstruction using a technique known as Deep Inferior Epigastric Perforator (DIEP) flap, which harvested fat from my abdomen to recreate the breasts. I would also undergo eight rounds of chemotherapy, a hysterectomy and oophorectomy (removal of the uterus and ovaries, respectively), and nipple reconstruction, along with facing down at least 10 years of taking the drug tamoxifen to suppress any residual estrogen production, because my tumors found estrogen DEE-lish. Thanks to the drug regimen and forced menopause, a good day for me means feeling like I’m 70 instead of 90.

So please, don’t think we BRCA mutants take such decision-making lightly. It’s just that the alternative—namely, death by cancer—can be a lot worse. Angelina and I carry mutations in our BRCA genes, she BRCA1 and for me, BRCA2. We all have BRCA genes, which normally produce proteins  that help stop cancer-causing DNA errors. However, for BRCA mutation carriers, these proteins  don’t work properly, making us more susceptible to the Big C.

I remember Angelina taking heat for the first op-ed piece she penned, describing her preventative double mastectomy. But I envy women who are able to reduce their risk of hereditary cancer by being knowledgeable, getting the necessary screenings –and yes, if they choose to, surgeries—to help reduce their risk before cancer ever has the chance to rear its big, fat, ugly head. 

Just how effective is this surgery for preventing breast cancer in women who are at high risk? Try 95 percent or more, according to the National Cancer Institute . You don’t think that statistic haunts me, that had I known about my genetic mutation I might have had the opportunity to reduce my cancer risk drastically? If I had my surgeries preventatively, I’d feel a whole lot better right now about the odds of seeing my two young kids grow up. As for ovary removal, that reduces the risk of ovarian cancer by up to 90 percent and breast cancer risk by 50 percent in high-risk women.

I feel for Angelina and all others who are faced with the choice of removing seemingly healthy parts of their body—the very parts that society so often uses to define womanhood and sensuality. For me and my breasts, things were more cut-and-dry: I had cancer in both of them and they needed to go. But the hysterectomy and oophorectomy?  I was removing my uterus and ovaries based on odds. Though I hated doing it, I never wanted to be facing a cancer recurrence or new cancer and have “coulda, shoulda, woulda’s” filling my head.

Hopefully my journey is winding down, with just my areolas to be tattooed on. My BRCA2 mutation also carries increased risks for pancreatic cancer and skin cancer, to name a few. These risks are nowhere near as high as those for breast cancer and ovarian cancer, but having this knowledge allows me to be vigilant just the same.

So, I just want to say, Ang, GOOD FOR YOU! You were your own advocate and set the course that best suited you—all that any of us can really do, whether we choose surgery or surveillance. Let no one criticize you for your choice. It was yours to make, and yours alone.

And for that HuffPost commenter who used the automobile analogy I referred to earlier, I’m going to break down Angelina’s recent decision for you with another auto analogy, one often used in BRCA circles: If you knew you had a 50/50 shot of your brakes failing, would you continue to drive that car? Or would you do something to fix the friggin’ brakes and keep yourself from dying in a fiery crash?

Yeah, that’s what I thought.

An open letter to Derek Jeter

Dear Mr. Derek Jeter,

Do you feel bad for people who have or had cancer? OK, good. Keep that answer in mind as you read this.

A lot of people have been sharing that Gatorade commercial you made, and that's all well and good, but I think you're being ridiculously selfish. Those of us who are the same age, who spent our formative years watching you play drama-less, Hall of Fame-caliber baseball, are now forced to acknowledge that we, too, are getting old. But we are nowhere near retirement. So I think it's only fair that you share your retirement money with us - or rather, me.

See, I dedicated many years to your cause, shepherding breathless and overexcited young girls to the latest Jeter merchandise as part of my thankless job at a sporting goods store. Their giggles still ring in my ears like the sound of kittens being tortured. Oh, and did I mention that I had cancer? That should be good for some extra dough. Anyway, PM me and I'll give you the account number for wiring money.

Yours truly,
Heather LaBruna




p.s.
I met your old pal Bernie Williams the other day when he landed in a hot-air balloon behind our house (honest to God!) and he gave his blessing to my "Derek Jeter Wealth Redistribution Plan." So please do the right thing. (Oh, and despite what the picture may look like, I swear I was NOT high on medicinal marijuana!)

P.P.S.
Should you feel uncomfortable giving a mere mortal such as myself your hard-earned dough, go ahead and donate some moolah to the Young Survival Coalition in my name. Somebody should benefit from your damn retirement.

My mammoversary

A lot has changed in a year. For one thing, my boobs
are smaller and perkier...

Exactly one year ago today, I opened a can of worms. A big, fat, malignant can of worms.

I remember the feeling of the blood draining from my face as the mammogram technician pointed to the suspicious areas on the screen. Maybe the radiologist, Dr. Solomon, might like additional images of those troublesome spots, she said. Yes, of course he would.

I remember how it felt to sit in that oddly placed, uncomfortable little chair in the hallway outside his office, my right leg twitching uncontrollably because the adrenaline was really pumping by that point. I felt like the bad kid, sitting outside the principal’s office as I watched a much older woman breeze out the door, another clear mammogram under her belt/bra.

I remember walking in as Dr. Solomon was talking to my ob-gyn, Dr. Charles, on the phone and hearing him say to her, “She’s very young...,” and realizing for the first time that, when it comes to breast cancer, those words probably don’t mean anything. I was nine years younger than my aunt, who, at 45, had been the youngest Connors woman to be diagnosed.

I remember Dr. Solomon pointing to various parts of my breasts on his computer screen and uttering the words "very suspicious" over and over again. I lost count. Everything about my breasts seemed to be suspect. I was harboring terrorists. Mammorists.

I remember Dr. Charles' voice on the other end of the line, reminding me to remain calm. It could be nothing. But if it was something, we likely caught it very early, and that’s why we do these tests.

I remember the look on the mammogram technician’s face as she walked me down the hall to the neighboring breast surgeon’s office to make an appointment for a consult. I had gone from having a routine baseline mammogram to a consult with a friggin’ breast surgeon. Yet, I actually felt bad for the technician. Even though I was the one with the shit test results and uncertain future, you could tell I had completely ruined her day and she took mammograms-gone-wild very personally.

What I don’t remember is the drive home, though I arrived there and no massive pileups or catastrophes were reported in my wake, so I guess I did OK.  I do remember trying several times to dial Sal’s work number but my fingers were suddenly like Vienna sausages and I kept messing up. Finally, I got it right. 

... I also found myself a "doer." Here I am actually engaging
in a group activity, the American Cancer Society's Relay for Life, back in June.
My friends and family have been a constant source of love and support for me.
Without them, this would have been a much more difficult journey.

“So, how did it go?” he asked, probably expecting me to crack some jokes about boobie pancakes or something.  
But there was only the sound of my labored breathing.

“How did it go?”

I struggled with my composure, but like my number-dialing, I failed. “I…I…uh…I… Can you clear your work schedule? I need to have a breast ultrasound,” I croaked out. I lost it at that point and sobbed about my worst fears coming true and all the suspicious spots on the mammogram.

I remember the big hug he gave me when he got home, because words were not needed and he was just as scared as I was.

I remember as I waited for my ultrasound and biopsy appointments, some older folks tried to be helpful, telling me their close encounters with suspicious mammograms, which ultimately showed benign growths. That's what I had, some harmless cysts, they said. But these people didn’t have my family history, hadn't lived their lives with a nagging suspicion that one day they'd develop breast cancer.  So although I appreciated them trying to ease my mind, I admittedly wanted to hurt them when they said stuff like that. Like, hurt real bad. Like the way people get hurt in the “Godfather.”  (On a side note, if you ever encounter someone going through a similar situation and you really haven’t been there, and you really want to keep all of your limbs, just offer your support, positive energy, prayers, whatever. Tread lightly when drawing parallels, lest your comforting words sound like you’re dismissing that person's legitimate fears —“You know, my cat had suspicious spots on his x-ray but it turned out to be just some undigested Meow Mix!”)

I remember thinking, if all this testing shows what I think it's going to show, things would never be the same.

And I guess you can say the rest is history.

Goodbye, girly parts!

Today's the day... Thanks to all who have supported me throughout this ordeal in little and big ways. This should be it - hopefully! - for the major surgeries. With just nipple reconstruction ahead, I'm finally starting to see that light at the end of the tunnel!  Next stop: Menopause Station!

Check out this BRCA2+ chick, locked and loaded for her hysterectomy/oophorectomy today. Special shout-out to my son, who loaned me his toy ray gun, and my husband, because it takes a special kind of guy to help his wife fashion a tampon bandolier.

Hello surgery, my old friend...

Here I sit, on the day before my second surgery in eight months. For some reason, I dread this one most of all. Compared to the first, it’s certainly not as massive of a surgery, this “ectomy” combo meal (“I’ll take the No. 2: a hysterectomy with a side of oophorectomy. And let’s see. Oh yes, I would like to wash it down with some dee-lish-ous magnesium citrate. ”)  

For a good time, call 1-900-POO-PARTY

I’ll be in the hospital one night, recovering from the loss of the “girly parts”—very technical terminology my gynecological oncologist has asked to borrow—and coming one step closer to being done with all of my surgeries.

***

But let me back up a bit. So much time has passed since my last blog—almost four months, to be precise—that I feel a recap is in order. (Or if anyone made a shitty Hollywood movie about my life, you’d insert a montage here.)

 The big milestone for me was finishing chemo on April 15. The actual completion of it was pretty uneventful. I kept thinking that after eight, seemingly endless rounds, this deserved to be aired on Telemundo, where there would be balloons dropping from the ceiling and shit. “Chemotherapy Gigante! Arriba! Arriba!” But no, I got my last infusion and quietly went on my way, left to traverse that vast terrain known as “Oh shit! Chemo’s over so I no longer have a safety net.” 

 

Yay! No more chemo! Now what?

I grilled my oncologist at follow-up appointments about what we’d be doing to make sure the cancer hadn’t come back. I felt disappointment settle in as he informed me that, for the most part, screening would consist of clinical breast exams by the breast surgeon every six months and testing if I had symptoms. Given my relatively young age, they had to be judicious with any radiation-based screenings, as getting those frequently could result in radiation-related cancers. Oh, the malignant irony! And technology such as MRI is super expensive. But given I had no symptoms when my breast cancer was discovered, I wasn’t keen on waiting for some to appear before I took action. (Mental note to self: Harass oncologist to abide by my made-up surveillance program, which involves having several oncology specialists on stand-by, 24/7, to check out my every ache and pain.)

The really tough thing after finishing chemo was how I managed to look sicker. The last drug in the regimen, Taxotere, had finished off my eye lashes and eyebrows and done a real number on my tear ducts, leaving me simultaneously with dry eye and tears streaming down my face. My eyes were red-rimmed from all the wiping I was doing.  

Chemo is not kind to the ocular area.

Every morning in those early weeks, my eyes were glued shut and every morning my husband, Sal, had to retrieve a warm, moistened washcloth from the bathroom and wipe the ‘ol ojos so I could actually open them. Taxotere also seemed to upend my reflex response time, so much so that I took myself off of driving duty for a bit; you and your rear bumpers can thank me later, drivers of New York. 

Anyway, my zombie eyes and headscarf were a dead giveaway to everyone around me. “Look, I don’t mean to get into your business,” the girl behind the bakery counter at Adams said to me as she scribbled something on the back of a business card. “But here’s my mom’s name. She’s on Facebook; look her up. She’s been our rock, our inspiration.” I couldn’t read her handwriting. Another time, when I was at the customer service desk, signing up for a Price Chopper discount card, the girl behind the counter started asking me questions about my diagnosis. Turns out her mother had had breast cancer and succumbed to it less than a year prior. “Did you get your boobs reconstructed?” she asked. I didn’t even flinch. Ah, cancer. The great modesty-killer.

 A mom at my son’s dojang asked me politely about my headscarf. After I told her, she smiled and tugged on her short, blonde hair. She, too, was a survivor. We were apparently everywhere.

***

But back to this surgery business. Maybe it’s because of the preventative nature of the procedures that I’m fretting; unlike the mastectomy, there would be no big, bad tumor to target, although my gynecological oncologist had warned me they could find something malignant. Maybe it’s the dreaded sudden menopause at age 37. Or maybe it’s because I’ll no longer be able to do the one thing I was put on this planet to do: reproduce. Likely, it’s a mix of these things. My husband and I were done with kids anyway. (Sorry about that unnecessary vasectomy, Sal!) But this marks the no-going-back point.

A calm day in Menopause World

There are also health issues associated with plunging the body unsuspectingly into menopause at such a young age. 

I’ll be more prone to heart disease and osteoporosis, as my trusty pal estrogen will no longer have my back. I’ll struggle to keep weight off thanks to a metabolism that’s in the shitter and my hair will likely thin. (I’ve also been told by several of my older friends that I’ll need to start carrying tweezers, as the hair will pop up in unwanted places, such as the chinny chin chin.)

But you know me. I like silver linings. So I guess I can be happy that the end of periods has come. To mourn this “loss,” I had my husband go out and buy me a box of tampons. I’ll never use them. Mainly I just wanted one final opportunity to make him buy tampons.