Then and Now: Reflections for a New Year of Survivorship After Cancer

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Doing a little reflection about where I've been and how far I've come is just as important as making resolutions.

I’m not much of a resolution-maker. I hate the idea of setting a goal too lofty to accomplish, only to be sorely disappointed in myself. Plus, my son’s birthday is during the first week in January, and with all the cake and special meals and last-minute shopping that accompany a birthday, starting a bold new fitness and diet routine in January is bound to end badly. Normally, my new year’s reflections are much like those in September when the new school year starts, when I decide what changes need to be made to make my schedule flow more smoothly.

This year, I’m coming up on three years since finishing treatment for triple-negative breast cancer. I didn’t let myself entertain such thoughts, but I think subconsciously: If I made it three years, that would be when I would escape the haze of cancer, when I’d be healthy again, when the worry would stop. Now coming up to that self-imposed deadline, I’m not sure that it will automatically free me from the purgatory that is waiting for the next scare that cancer has returned. At least, if that nagging never subsides completely, maybe it will quiet with more time? There are some parts of my life that have been irrevocably altered, and yet, in some ways, I can see my pre-cancer self returning.

After three years, I think I thought I might “outgrow” some of these things, but alas, that ship has probably sailed.

  • I will never wear a seatbelt the same way again. On the passenger side, it doesn’t bother me too much, but on the driver side, the seatbelt cuts between my breasts and touches the inside of my right breast in such a way that it drives me crazy — the nerves there were damaged during surgery, just not so much that I have lost every last bit of sensation. Any time I’m in the driver seat, I instinctively hold my seatbelt out away from my body.
  • I still have some occasional peripheral neuropathy. Very rarely I feel it in my fingertips, but on a pretty regular basis, I’ll feel some neuropathy in my toes when I get up from couch. I can almost always feel it for the first mile of a run on any day that I wouldn’t consider hot. It feels much like when you’ve been standing out in the cold way too long and you can’t really feel your toes anymore. It’s a weird sensation when you’ve been outside for two minutes and it’s 50 degrees, though.
  • I cry more. I’ve never been a big crier, and save a few difficult moments immediately after receiving my cancer diagnosis, I didn’t cry at all during my cancer treatment. (Yes, I can see now that my reaction was not normal. Maybe even not so healthy. But there it is). Lately, I find myself getting weepy so much more easily. Obviously I cry when it has anything to do with cancer — either at a triumphant remission or the heartbreak of a metastatic recurrence or a family facing a loved one’s final days. But this summer I was also a complete mess when my daughter worked crazy hard to earn her place on a team after hearing she probably wouldn’t make the final cut. I cry at sporting events, when I hear certain songs and when I think too specifically about the future. Maybe I’m more in touch with the preciousness of life. Or maybe I’m just a little bit of a basket case.
  • I’m a worrier. I never used to be a worrier. I didn’t worry about little aches and pains. I took care of what needed to be taken care of, but I didn’t worry about things that got better with Advil, and I certainly didn’t worry about them before the Advil. Now I struggle to even take the Advil, worried I’ll mask a potentially significant pain. Somewhere in my head, I thought getting to the three-year mark would make those fears would disappear. Now I’m just hoping that eventually they’ll dissipate.
  • Chemo brain is real. There are numerous studies demonstrating the long term cognitive effects of chemotherapy. I’m pretty lucky and don’t find that it interferes with how I live my life, but there are definitely a lot more of those "it’s on the tip of my tongue" moments. It’s pretty frustrating, because I know that I know the word I’m looking for. There is a perfect word or phrase that I want to use, and I know the letter it starts with or its cadence. I know it’s in my brain somewhere, but I just can’t get to it.
  • I always want a nap. Now let’s be honest, I’ve always loved a good nap. They were a mainstay in college, and when I was pregnant, anemic, and getting into the lab at 5:30 a.m. to secure a parking spot in Georgetown. The afternoon nap was all that was keeping me going some days. But I became a hardcore napper during chemo, logging three hours in bed at least five or six afternoons each week. I’ve always been distractible, I can do fun things and my fatigue doesn’t really catch up with me until I sit still. But there are still days when I run a bunch of errands in the morning and come home, only to decide to take a nap because the thought of taking the time to eat lunch seems like too much.
  • I overuse hand sanitizer. Coupled with not being much of a worrier, I was never a germaphobe. I managed to avoid going overboard with germ fears, but after I was diagnosed, a bottle of hand sanitizer made its way into my car, and while it has been replenished, it is still there. I use it almost compulsively every time I get into the car.

While I hate to use the phrase “back to normal,” it’s interesting to see some of the pre-cancer me returning.

  • I can sleep on my stomach again! After my mastectomy, sleeping on my stomach was at first forbidden, then painful, and then with the expanders (part of my reconstruction), felt much like trying to sleep on my stomach while wearing a coconut bra. No matter how many pillows I tried to prop under my head and stomach to let my coconut bra-boobs suspend in mid-air, I couldn’t get comfortable on my stomach. Once I had my swap-out surgery and went home with my squishy silicone implants, I still struggled to sleep on my stomach, though for reasons that were more mental than physical. I knew it wouldn’t really happen, but somehow I worried that they would pop if I laid on my stomach. (Why is it that recognizing the irrationality of a fear doesn’t make it go away?) This time last year, I thought sleeping on my stomach was something that cancer had forever taken away, but am glad to say that little by little, I have trained my brain to accept that it is OK!
  • My hair is getting longer! Since I had such long, lovely locks when I was diagnosed, I have decided to try to let my hair regain its former glory and grow long. I’m guessing it will be at least two more years before it gets to the length it was when I had it shaved off, but it’s currently a style that I once chose on purpose, so that feels like a win.
  • I am drug free! I realize that not all breast cancer patients can say that just three years out, but since my tumor lacked any hormone receptors, there was no reason for me to be on any hormonal maintenance therapy. For a while, I was on a cocktail of anti-depressants, anti-convulsants, steroids and narcotics to manage a whole slew of side effects from my treatments. It’s so nice not to have to remember to take a handful of pills every morning, or to have list out a half dozen drugs and their dosages everytime I cross the threshold of a medical office.
  • While some women are thrown into menopause by chemo and just stay there, I am one of the “lucky ones” who got to come out of menopause and look forward to it a second time around. Yes, there are some obvious reasons to want to put off menopause for as long as possible, but I don’t see monthly cramps to be such a lucky break. I try to go all Pollyanna on myself, saying that I should consider this a reminder that my body is functioning just as it should. But mostly I complain and search for the Advil ... just like the good old days.
  • It’s a daily struggle to get out the door for a run. Being diagnosed a month before the Girls on the Run race my daughter and I had been talking about for at least a year, I felt like cancer was threatening my ability to run and enjoy that special time with my daughter. Probably a little bit inappropriately, I put a lot of weight on making it to — and through — that race (bald!). It gave me a huge sense of accomplishment. Running became a way for me to maintain control, to keep something out of cancer’s grasp, to be stronger than cancer. I did it as a matter of pride. Now, it’s just back to the same old “be healthy” reason, and it’s harder to convince myself to leave my cozy bed for an early run.
  • I’m back to being the caregiver. I still did a lot while I had cancer (my friend called me a very high functioning cancer patient!), but I let other people take care of me, too. My husband helped out around the house and with the kids, neighbors and people from church brought dinner and friends gave up time (even took off work, traveled or got sitters) to spend a morning or a day with me. Now I’m back in charge of my little family, but I’m also so much more aware of how to take care of friends going through tough times. I’ve cooked, given rides, emptied dishwashers, switched out laundry and met friends for pedicures or lunch when that’s what they needed. I know how much a quick note or small gift can mean, and I try to show the same kindnesses I so appreciated.

Yes, I think it is important to look ahead to a new year, and of course, I'll resolve to eat better, run more, and "be present" right along with everyone else. But for me, doing a little reflection about where I've been and how far I've come is just as important.

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