Monday, June 30, 2008

6/30/2008: Weekend at the Beach

Hot sand billowing up between my toes made me smile. The warmth of the sun upon my face lifted my heart. The cool breeze trickling over my skin made my pores stand at attention. And the sound of the waves crashing, married with the giggles of children left me peaceful. A weekend at the beach was exactly what I needed to regroup for the next phase of my journey.

It appears that my oncologist was right … he strongly encouraged me to take some time before surgery and get away. This was just what the doctor ordered! Don't get me wrong … it wasn't all G-rated for goodness sake. The weekend consisted of swimsuit malfunctions on the beach, losing credit cards, cell phones in the cooler, doing the robot, plenty of interesting storytelling, hugs when I broke into tears, 'Napoleon Dynamite'-style tetherball, getting knocked over and scraped up by waves, beach yoga, joining the lifeguards in their run, feeding Herman and Simone (our seagulls), walking like an Egyptian and plenty of other memories that will always be held near and dear to my heart. Friday night I danced non-stop with Rita and Annalisa for almost four hours to the tunes of the '80s at Rusty Rudder in Dewey Beach. Then Saturday morning I could barely walk. This poor body had very little exercise throughout chemotherapy. Even today my tummy aches from the weekend full of laughter.

Tomorrow is the BIG DAY … surgery. Quite frankly, I have mixed emotions. I have already said goodbye to "the girls" and am confident that the surgery will go well; however, it is the days that follow surgery that I dread. This will be my last blog for awhile, but my best friend Kere and my Mom will be keeping you all informed on my progress until I can type again. I promise I will write as soon as I am able to. I will be at my parents' house for the next three to four weeks and would LOVE some company to keep me "entertained." Please call me or my parents to see if I am up for visitors before stopping by. Just don't be offended if I don't get too dolled up for you. Haha!

People have been asking what they can do for me, and now I have an answer … please keep my family and me in your thoughts and prayers over the next couple of weeks. This is the second hurdle of my journey and one that I need your help to overcome. This is difficult emotionally, mentally, physically and spiritually for me and I really need your help to summon all the strength possible to get through this battle. I want to thank you in advance for your love, devotion, selflessness, compassion, understanding and endless thoughtfulness. It means so much more to me than you know.

Wednesday, June 25, 2008

6/25/2008: Ode to the Girls

"Girls," you've known for several months that we would eventually need to have this talk. You have been there for me through thick and thin (literally) and now you have made me quite ill, for which I feel extremely hurt and betrayed. We haven't always gotten along, but I have always taken good care of you and dressed you in the prettiest of garments. I even allowed you to be the star of several Halloween and late-night outfits. In the last five years or so, I really feel like our relationship has matured and that I started to accept you and embrace your small, yet adorable nature. Isn't it ironic that it's when we start getting along that you stab me in the back? (Well, technically, the stabbing happened under my left armpit.) This is why we need to end our relationship and part ways for good.

I think maybe I put too much pressure on you in the past and that's why you made me so very sick. I remember in fifth grade being so jealous of my bestfriend Mehgan's boobs that I cursed you "girls" and covered you with tissues. I wonder if Mom and Dad ever realized why we needed to buy Kleenex more often in those days. I even named you Wayne and Garth after my favorite party-time movie 'Wayne's World,' don't you remember? Can you recall the day when I ran home crying from the pool in middle school when a girl sang, "Roses are red, violets are black, your chest is as flat as my back?" What a dumb girl, violets are blue! I cursed you then too, "girls" and wished that you would grow faster. I know I was demanding, but you didn't need to be this extreme in getting back at me.

I have said many things over the past five months that were out of pure fear, frustration and exhaustion. One comment was that I would rather go through 18 more weeks of chemotherapy then lose you "girls." First of all, that is ridiculous, because chemotherapy is pure hell. Second, no offense, but you "girls" made me sick and I am actually looking forward to an "upgrade." I know we have had some special moments over the years and, yes, even some chats in the mirror over the past couple of months, but it is time to finally part ways. You have hurt me deeply and for that I cannot forgive you. I will move on with my life as a healthy and strong woman and I will find a better pair of "girls." You, however, will be tortured for making me sick by being dissected into tiny little pieces.

Goodbye "Wayne and Garth," "Barbie and Stacy," "Laverne and Shirley," "Thelma and Louise," "chi chis," "taa taas," "my girls." I'm sad things had to end this way, but I will be better off without you. I need to take care of me now and I realize that you are only holding me back from being healthy and happy.

Jennifer's "Girls"
December 19, 1981 -- July 1, 2008
Here rests my "girls"
Once perky and plump
Replaced by a health new pair
That runneth over my cup.

Thursday, June 19, 2008

6/19/2008: Big Little Victory

Today I met with my oncologist (Dr. David Heyer) to review my PETscan and go over the recommended strategy post-chemotherapy. The PETscan showed that the cancer is GONE except for one tiny lymph node under my left armpit. My oncologist was extremely pleased with the way my body and the cancer responded to the aggressive chemotherapy regimen. He explained that during the operation my surgeon (Dr. Kenneth Mason) would remove all of the breast tissue along with the lymph nodes under my left armpit. He said, "We're going to get it all. You're going to be fine."

This is just the reassurance I needed to hear from my medical team as I am still struggling mentally and emotionally with the thought of losing my breasts. I had the same problem prior to chemotherapy, but I think in time I will make peace with the decision I have made. This is not the simplest path, but it is the one I have chosen and will need to embrace it over the next week. I seek clarity and peace in the coming days. Perhaps my trip to the beach next weekend with my friends will give me just that. Right now, my nightmares and 3 AM panic attacks consume me. Somewhere and somehow, I must strike a balance.

My oncologist said I will begin radiation a month following surgery. Radiation is Monday through Friday and lasts six weeks. This is shorter than I originally thought, so I was pleased to hear the news. Once that is over, I will most likely have to go on a hormone regimen, which does not make me happy. Dr. Heyer said he didn't want to review those options just yet. I need to continue celebrating little victories and taking baby steps. These times that I feel darkness and a sense of defeat, I listen to the CD my friend Sarah made me. There is a song on there called
'Little Victories' by Matthew Nathanson. It helps me gather my strength.

Although I know the purpose of all of this is to get healthy, I am concerned about my future in wanting to one day have a family. Chemotherapy threw me into early menopause and Dr. Heyer told me this morning that some women don't bounce back and remain there permanently. With my young age and the chemotherapy drugs they used, I run a better chance of resuming a normal "cycle." I find it ironic that I am now praying (begging and pleading) for my period to return. Who would have thought a year ago that I would have been praying for my period? Life is such a quirky thing!

So now I ask for your help in praying for a successful surgery, NO
lymphedema (1 in 20 women develop this from having a mastectomy) and for my period to return. I know, I am being quite demanding these days, but I sure would appreciate all the help I can get. I need you in order to make it through this second phase of my journey.

This week, I will try and focus on my great PETscan results, which according to my friend Andrew "is quite a BIG 'little victory.'"

Wednesday, June 18, 2008

6/18/2008: PETScan Results

"There is physiologic accumulation of FDG in the myocardium, liver, bowel and excretion tracer in the kidneys and urinary bladder," I read the PETscan results aloud to my mother as we stood outside my surgeon's office embracing the gorgeous sun for a moment. We looked at each other, both scared to say aloud what we were both thinking. Dear God, had the cancer spread?

My mom suggested I go talk to my surgeon about the test results. My stomach turned, my vision became blurry, my eyes swelled and I shook. I wanted to know what those words meant, however part of me could not bear hearing more bad news. I talked to Dr. Mason's assistant and she said that I could sit in the waiting area and Dr. Mason would be with me shortly. Sitting in the waiting area my heart raced with fear and panic. Do I have to have chemotherapy again? Will I spend the rest of my life fighting cancer? Am I going to die?

Dr. Mason entered the waiting room and said, "Everything looks great!" I jumped into attack mode. "What does that last line mean? What is FDG?" Dr. Mason smiled kindly and said, "Come on back, Dear." Dr. Mason ushered me into one of the examining rooms and I asked my questions again. I know Dr. Mason could see me shaking violently and my eyes swelling with tears. He said, "Everything looks great. I cannot remember what FDG stands for, but the G is glucose, which is sugar."

(Note: FDG stands for Fluorodeoxyglucose. When you have a PETscan they take your sugar level first, and then give you an injection of glucose. Cancer cells metabolize faster than normal cells, so the imagining can tell where the cancer cells are in the body.)

I said, "Does 'physiologic accumulation' mean that the cancer has spread." I couldn't believe I was able to actually craft the words. Dr. Mason looked at me with kind eyes, "I need you to take a deep breath and try and relax." He reached out touching my armpit, "Your cancer is all right here. It hasn't spread anywhere and I assure you that we will get it all. We're going to get it all, Dear" He repeated himself again in order for his words to resonate. I felt my body grow less tense. He told me that his only concern is the two lymph nodes still left in the armpit. However, they have shrunk and will be taken out during my mastectomy. I thanked Dr. Mason for being so wonderful and told him that I would see him on July 1 for surgery. "I expect your best work on surgery day," I joked as I walked through the door.

PETscan Findings
There is an abnormal enlarged left axillary lymph node with abnormal FDG metabolism and maximum SUV of 9.9. This mass is smaller than prior study. Smaller left axillary lymph node demonstrates a maximum SUV of 1.9. Left axillary seroma is smaller. Other axillary lymph nodes do not demonstrate abnormal FDG metabolism.

Previously seen left internal mammary chain lymph node is smaller and also demonstrates no abnormal FDG metabolism.

Left anterior 6th rib also no longer demonstrates abnormal FDG metabolism.

Findings are compatible with marked response to chemotherapy.

There is physiologic accumulation of FDG in the myocardium, liver, bowel and excretion tracer in the kidneys and urinary bladder

Friday, June 13, 2008

6/13/2008: B or C?

"Hi, can I talk to you for a second?" I asked nervously. The beautiful brunette with bronze, sun-kissed skin propped herself up on her elbows as the sweat ran down her tummy and stopped at her belly button. She was probably the most stunning young woman I have ever seen and I had been debating whether or not to speak to her all afternoon while I sat in the comatose heat at my condo's pool.

I spent my Sunday afternoon doing something I never thought I would. I went to the pool, despite the crippling heat, and did a bit of "window shopping." I know it sounds ridiculous and even slightly perverted, but looking at balloons filled with liquid really doesn't give me a sense of what I want my new breasts to look like. Do I want to be a B or C? Round or tear-drop? Saline or silicone? I feel like this is the one choice in this whole journey that I actually get to make for ME. No one else has a say (unless I ask for opinions) and I can have anything I want. It's exciting.

Luckily, one of my closest girlfriends, Marisa, has been investing time in doing my research for me. She found out that silicone is actually the recommended choice for women who have reconstruction done because they are now FDA approved to be incredibly safe. Another plus is that they are gel-filled so they give you a much more natural look and feel without any rippling (which can happen due to the thin layer of tissue and skin that is left over after the mastectomy). She also found two websites that you can enter your height and weight and see women's breast of all different sizes on your body type. AMAZING! How else am I supposed to know what I want without seeing actual breasts on my body type? My lovely friend, who I am so bless to have in my life, has taken my worry and anxiety away by doing this research and helping me find "the perfect girls" for me. Thank you, Sweets!

"Sure thing," said the beautiful brunette. "I don't want this to be awkward or to offend you in anyway ..." I responded. With that opening her boyfriend quickly sat up in his chair and looked at me defensively. Great, I thought to myself. "... My name is Jennifer and I am battling breast cancer." Both of their faces turned sullen. "I am preparing for breast surgery and don't know what I want, but I love your boobs." As though he had created them himself, her boyfriend sat up a little taller and looked so incredibly proud. Typical male reaction, I thought. A smile came across her face and she thanked me for the compliment. She said she was a C, but recently they have gotten bigger and she could even fit into some D-cups. Hmm ... a little bigger than what I was anticipating. Obviously I need to pay better attention to the boobs in my life. I thanked her and apologized again if I made her uncomfortable. She said, "No, not at all. I'm happy to help."

I spoke to two other women at the pool that day, approaching them as though I was inquiring about needing a tissue. One woman was a small B and the other a full B/small C. I felt like Goldilocks that afternoon searching for the perfect porridge. My beautiful brunette friend was too big, the small B was too small and the full B/small C looked just right. The good news is, I have time to think about it and continue my "window shopping" and research. So beware while sunbathing, because if I am in your vicinity I may approach you and inquire about your lovely girls.

Monday, June 9, 2008

6/9/2008: Race for the Cure

"My name is Jennifer Kwiatek and I am 26 years old and battling an aggressive form of breast cancer," I mustered up the energy to say, "And I just finished 18 weeks of chemotherapy." Cynthia Nixon, also known as Miranda from 'Sex and the City,' looked at me with warm eyes. She reached forward taking both of my hands in hers and said, "I am so incredibly proud of you."

The Susan G. Komen Race for the Cure started a day early for me, since I attended the kickoff cocktail reception at the Newseum in D.C. with Andrew. The event was done with such class and elegance. I was feeling really good for only being seven days out from my last chemotherapy treatment. I drank my pink cosmopolitan, did frequent wig checks to make sure "I was straight," divulged in pink rock candy, did the robot (my signature dance move), and met several sensational women.

In addition to meeting Cynthia Nixon, I also had the opportunity to speak with singer Vanessa Carlton. I told her about my journey and thanked her for being an ambassador for the Race for the Cure. Her mother who was there with her was moved by my story and began to cry. There was another woman who approached me who had heard me talking with Cynthia. She told me about her personal battle and shared words of encouragement. I was truly touched. Two women from Evansville, Indiana shared a lounge ottoman with Andrew and me. They both traveled to Washington, D.C. with several other friends who are all survivors to participate in the race. One woman told me that she was 25 years old when she was diagnosed with breast cancer. She is now and 18-year survivor with no reoccurrence and was blessed with a beautiful baby girl. They gave me a Susan G. Komen ring and their hometown RFTC pin.

I realized that I have now been initiated into a new organization. Just like being a cheerleader, a sorority sister, an alumnus … I am now part of a new chapter of sisters (and brothers). The support and understanding I feel from this group is one that I cannot find the words to express.

Race Day was one that I will cherish forever. The National Mall was a sea of pink with over 40,000 participants. Walking down the mall and seeing my friends standing under our designated area decked in pink, holding signs and high in spirits, was all it took to move me to tears. It was such a hot day, yet that didn't stop the love and support of my dear friends.

During those three miles my friends constantly checked in on me to make sure I was continuing to brave the sticky and humid weather. It was this unselfishness, awareness and support that truly warmed my heart. We stopped at several points to take photos and wait on others who were following close behind which gave my tired little legs a nice break. Finishing the race was a magical moment. The announcers saw Kelli jumping up and down with our team sign and they said "Team Jen" over the loud speaker as we crossed the finish line.
For those of you who participated in the Race for the Cure and helped us raise our $5,000 goal, I thank you from the bottom of my heart. I am so incredibly blessed to be surrounded by such amazing people. Thank you for being you and loving me unconditionally. It is you that has made all the difference in my journey … please know that.

Friday, June 6, 2008

6/6/2008: The Dance

I have been going back and forth debating about whether or not I should write about this, but since I have been brutally honest with you to this point, I do not see why I would stop now. Something pretty astonishing has occurred in my life and I still do not know what to make of it all.

I have been swept into this dance where I am being spun in a light twirl one minute then swooped heavily grazing the floor the next. It is in this graceful, yet intense embraced that I conjure the nerve to analyze my raw emotion and find my rhythmic balance. Have I completely lost my footing? Not in the slightest. I feel as though I have already seen the steps played out in my head and I am now trying to envelope the routine to a science.

I have been reading a book called 'Pretty Is What Changes' and although my personal life and battle with cancer does not mirror Jessica's perfectly, I am able to notice some psychological similarities between her actions and mine. She and I are very similar in our drive, career, the way we wish to be perceived, even down to the relationships we find ourselves in. It is almost eerie. In reading her story, I began thinking about my own. I started analyzing the growth work in my life and how I have changed over the last five months. Is it possible to experience a lifetime of growth in five months? I don't know, but I know I have changed significantly. I have spent so much time really embracing the raw emotions I have felt instead of trying to ignore them, or just coast through this experience. I have psycho-analyzed the way I feel and how I react to certain things in order to determine what it is I am seeking internally. Do I lash out because I am angry about my cancer? Do I engage in negative conversations because I seek the normalcy I knew from before? Would I really want to go back to being the person I was previously? I'm not sure I have fully fleshed out all of these answers, but I do understand how I have changed psychologically. I am acknowledging the madness that lies there and am putting each graceful motion into its appropriate place in my dance.

I am sure I sound like I have completely lost my mind at this point, but I truly believe that I am the very best version of myself possible right now. I was always told by my mother that I would do so very much growth work in my mid-to-late twenties and little did I know that with this whirlwind dance I would do just that and so much more.

Monday, June 2, 2008

6/2/2008: Chemo is OVER!

IT'S OVER! It's difficult to be excited about the end of chemotherapy right now when I am sleeping more than sixteen hours a day, but I know when my body toughens up I will be beyond ecstatic never to have to go through this again. I wish I could just bounce back immediately after chemotherapy and be "normal" Jen, instead I just shift from my couch to my bed shaking and panting in pure exhaustion. Just lifting myself in and out of my bathtub takes every ounce of strength in my shaky muscles. It's not a pretty site and typically I cry in frustration, but I continue to remind myself that this too shall pass. My oncologist warned me that by the time I got to round six of treatment I would feel as though I had been run over by a truck. He was certainly right.

My final chemotherapy treatment consisted of family and friends surrounding me, a beautiful Coach handbag, gorgeous flowers, balloons, Panera breakfast pastries, a beach bag full of goodies, a thoughtful cake that my shaky hands could not hold on to and landed upside down on the floor, text messages and e-mails, hugs and kisses, and yes, even laughs.

We have made it through the first phase of this journey together … eighteen weeks of chemotherapy. I cannot begin to express my love and gratitude for your endless prayers, warm thoughts and support. There is no way I could have done this without you. Now I must gather all of my strength and positive thoughts in order to readjust my focus. My main objective now is to get my body healthy and strong for surgery scheduled on July 1. Surgery will be tough, with three to four weeks of recovery, and I know I will need to summon all of my mental, physical and emotional strength to get through it.

Here is my schedule for the month of June:

June 16: PETScan and Pre-Op with my plastic surgeon (Dr. Wendy Gottlieb)
June 18: Pre-Op with my surgeon (Dr. Kenneth Mason)
June 19: Review PETScan with oncologist (Dr. David Heyer)
June 20: Herceptin Treatment (Every three weeks)
June 26-29: Weekend at the Beach
July 1: Mastectomy and Reconstruction at Virginia Hospital Center

It is time to head back to bed. I will try to write again later this week when I am, hopefully, feeling significantly better.