Archive | August 2014

Week 7 (of 12)

I was very nervous going into my blood draw at chemo this past Monday.  Email exchanges with my care team last week indicated that, given the timing of coordinating the logistics of a port surgery with the schedule of my immune system, the earliest I could get scheduld to have a port installed would be right before the beginning of my fourth cycle (i.e., mid Sept)!  At that point, I may only have 3 sessions left, and it doesn’t seem to make sense to undergo surgery and scar for so few treatments.  So, now it was a question of whether I want a PICC installed or we continue to give the veins a shot.  As I explained to Dr. T, I have no personal eagerness to have the PICC installed, so it’s really a question of what she medically recommends as being necessary.  Turns out, she thinks we can continue hitting up the veins until the nurses let her know they are no longer an option.  That way,  if we do need to insert a PICC line down the road, at least the inconvenience of maintaining one will be for a shorter period of time.  Unfortunately, however, this means the tension I have going into every appointment and wondering if a functional vein will be accessible continues for now.

As expected, the first IV insertion this past Monday failed.  The nurse was eyeing the untapped vein in my right wrist, but I suggested my right arm inner elbow at that point.  It too had not yet been tried, and if the IV was going to be at a joint location, hindering my use of that arm anyways, better it be the elbow than the wrist.  Fortunately, that vein was a success and we were all able to move on with our lives.  It was a longer than usual chemo day, but I was glad to have Drasti and Michelle by my side bringing me up to speed on the latest Jay-Z/Beyonce drama.

Drasti & Michelle keeping me company at chemo!

Drasti & Michelle keeping me company at chemo!

 

It just so happened that this past chemo fell on the morning of Diya’s orientation day at preschool, the one where the parents also join.  I never thought I would have to miss my daughter’s first day of school.  It turns out (unsurprisingly) she loves school and all the new people and toys with which to play.  There was no way I was going to miss the parents-only “What to Expect Night” at the school that evening, so as drowsy as I was from the Benadryl, I insisted upon going.  I’m pretty sure I butchered the English language while introducing myself (which of course I’ll blame on chemo brain), but nobody else seemed to notice.  Funny thing about looking young and wearing head accessories – nobody assumes you have cancer.  I made the mistake of inquiring about the responsibilities of an open board seat, only to have to listen to 15 minutes of information that reminded me that “ain’t nobody got time for that.”

I’ve been on-and-off exhausted since Monday night.  It’s just been one of those tougher weeks on all fronts – fatigue spells, Diya acting out at home (maybe age, maybe delayed regression to Mira’s birth, maybe reaction to the variety of change happening in her life?), and Mira seemingly coming down with something.  As I’ll be largely quarantined at home this long weekend since it’ll be my cycle’s nadir (i.e., when my immune system is at its lowest), I really hope things turn around soon.

Blame it on the chemo

The list of similarities between pregnancy and cancer treatment continue to grow.  You may have heard of “pregnancy brain” – a forgetfulness that affects soon-to-be moms.  No joke, the list of chemo side effects that my doctor shared with me at the beginning of all this officially included “chemo brain”, also referring to memory lapses, trouble concentrating, etc.  For some, this mental fog might be longer lasting, but it is usually a short term side effect.

It first hit me last weekend.  We had all gone to the zoo for a fun outing for the kids.  Diya needed to go to the bathroom, so I scooped up her, my phone, and her portable potty seat so she could do her business.  While awkwardly struggling in the small bathroom stall to move around and help her out, I put my phone on the top of the toilet paper roll and deliberately told myself “I have to remember to grab this on my way out.  It would suck to lose my phone at the zoo.”  After Diya finished and we said “bye bye pee-pee”, I put the portable seat back in the bag, picked Diya up and helped her wash her hands at the sink, and back out we went to meet up with the others for lunch.  It was a good half hour later when I tried to reach for my phone – yes, that’s shocking will power in this day and age – and realized I indeed left it in the bathroom.  I rushed back to the same stall, but unsurprisingly it was no longer there.  What followed was a frenzy of action involving calling my cell only to have it ring and then go to voicemail, accessing “Find my iphone” (thanks Anila!), expressing frustration when the app indicated my phone was offline, and checking with Guest Services twice if anybody had turned in a lost phone.  I was so annoyed at myself for being so careless, especially when I had given myself the whole pep talk to not forget my phone.  While this definitely could have happened to anyone, including myself, for any reason, I was blaming it on chemo brain being in effect.

Fast forward to last night.  Ash and I were sleeping in Mira’s room since we don’t have the night nanny come over the weekend.  It was about 3:20am and I had recently gone back to sleep after completing my turn of giving Mira a middle of the night feed.  My eyes shot open as I felt the whole bed shake for what felt like 3-5 seconds.  I wake up Ash insisting that we just had an earthquake.  His initial response, expressing his desire to keep sleeping, was “So what do you want me to do about it?”  As I explained my concern over the potential for aftershocks, he began to question whether anything had even happened since he hadn’t felt anything.  Given he’s always been the lighter sleeper of the two of us, I began to question myself as well.  After his check on Twitter for any earthquake announcements from SF QuakeBot showed no results, he was convinced that I was hallucinating.  Since I had blamed my earlier cell phone loss to chemo brain, I was persuaded to believe that I was going crazy.  I told him “Blame it on the chemo,” and acknowledged moments later that my descendency into the world of cray-cray will make for an entertaining blog post.  It was about two hours later when Ash awoke to take his turn with Mira’s next feeding and saw all the texts and emails on his cell.  We had been hit with a 6.1 magnitude earthquake, the largest earthquake to hit the Bay Area in 25 years.

Fortunately, I am not going crazy and experiencing major chemo brain after all.  That said, it’s interesting how easily I was convinced that it was all in my head.  It may also mean that I have nothing to blame losing my phone on after all, but better that than me hallucinating shaking beds.

P.S.  For those wondering, a kind soul found my phone and returned it to Guest Services at the zoo later that day.  Whoo hoo!  Good reminder to everyone to back-up the photos and contacts on your cell!

 

Milestone chemo day

Yesterday was a milestone chemo day – it was my 6th weekly infusion of my initial 12 week plan – meaning halfway through my first phase of treatment!  Whoo hoo!

It’s a bit unclear just how long the overall chemo plan will be.  Near the end of the 12 weeks, I will have an MRI to assess how the primary tumor has responded to the chemo so far.  If there is residual disease, I will have another 8 weeks of a more toxic chemo treatment.  If I have a pCR (i.e., pathological complete response), meaning the primary tumor has completely disappeared, then I will go straight to surgery after a few weeks once my body has had a chance to recover from the chemo.  Then, depending on what the lymph node sampling during the surgery indicates (the surgeon removes some lymph nodes from my armpits and analyzes whether they are or were ever cancerous), I will either start the 8 weeks of more toxic chemo then OR be done with chemotherapy and focusing solely on reconstruction post surgery.  So basically, lots of unknowns remain.

Anyhoo, back to yesterday’s chemo.  Unrelated to the fact that it was a sort of halfway point, it ended up being an emotional appointment.  For some context, since chemo is delivered through IV, it can either be through a newly injected IV during each visit, a surgically implanted port, or a PICC (peripherally inserted central catheter).  Though a port and a PICC mean that a usable vein doesn’t need to be found each visit, a port requires surgery and leaves a scar and a PICC is super high maintenance since it just hangs off the arm day in and day out and requires dressing changes and whatnot at home.  Since I haven’t yet had surgery, meaning both of my arms are usable for IVs, the doctor thought I could go ahead and start treatment with a new IV each visit, and if my veins begin to give out due to the repeated number of pricks, then we could explore a port or PICC option at that time.

Surgically implanted port

Surgically implanted port

PICC line

PICC line

Well, over the last couple of infusions, it has been increasingly difficult for the nurses to find a functioning vein to insert the IV.  This has been pretty stressful since it has resulted in a failed IV insertion, followed by a search for a new vein and a new IV insertion each time.  At yesterday’s treatment, we thought the first IV was working, but then the blood flow stopped.  The nurse had to put on a fancy “vein finder” device to search for the veins in my arms, but apparently they have shrunk down (happens with chemo).  It was becoming clear that I would likely need to get the mini-surgery and have a port installed into my chest, meaning I will be left with a 1-1.5″ scar at the end of this ordeal.  I started tearing up as the nurse was talking to me, and the next thing I knew, I couldn’t stop crying.  It was so bizarre since I had always known that was a possibility, and logically, it makes a lot of sense given the number of treatments I still have left.  I’m still not sure if I was crying because of the likelihood of having to get the port installed, or if my body was just needing a good cry.  After several tissues and a couple of cups of water, I sufficiently composed myself so the nurse could move forward with the blood draw.  She ultimately inserted the IV into the top of my right hand, but since that’s a sensitive area, it stung more than usual.  Actually, there’s still some slight discomfort there even now.

Anju comforted me as the tears continued to flow when I returned to the waiting room, and by the time my infusion appointment began, I was totally fine once again.  The remainder of the appointment went well with no reactions, and I was actually able to sleep well Monday night for a change.  I have yet to speak with my doctor about the options and whether a port is indeed what she recommends, so will keep you posted on how that evolves.

Anju at chemo!

Anju took me to chemo last week too!

My winning wig’s debut

It’s been a week since I shaved my head.  I generally just go bald around the house, but do throw on a cap or scarf if I head out somewhere.  Last night, however, was my sister-in-law’s birthday dinner and drinks, so I figured it was as good a time as any to debut my winning wig.  I went into the experience thinking it would be a fun night of dress-up, and it was off to a good start with Diya pointing at me and saying “Pretty.  Mommy wear new hair.”  I came out of the experience, however, with some unexpected perspectives.  While most folks (who knew I was wearing a wig) thought it looked great, I felt fake, insecure, and uncomfortable.  Funny enough, more so than I likely would have felt just going to the party bald.

The winning wig

The winning wig

It’s obviously not uncommon for cancer patients to wear wigs. People wear them for a variety of reasons, one likely being wanting to hide the fact that they are a cancer patient. Perhaps it is because I’ve been reasonably public about my diagnosis, or at least comfortable with people knowing and sharing, but I felt overwhelmingly fake wearing a wig. I felt like I was behaving like someone that I’m not – and I don’t just mean someone with hair – but more like someone who didn’t own the decision to go bald in the first place. When everyone knows I’m bald, and I’m comfortable with being bald, disguising that look just made me feel artificial.

I’ve generally had a strong level of self-confidence in my life. Given this high level of self-esteem maintained itself through the suboptimal bifocal-and-braces-wearing early teen years though, my sense of self may be a bit misguided. Regardless, one would think that I’d be more self-conscious being out bald than wearing a wig that looks like a styled-up version of my original hair. Strangely, I felt more insecure with the bangs and long hair. It’s almost as if by wearing something that was supposed to help me look more mainstream pretty, I became focused on whether I looked good or not. I kept wondering if my bangs were swept properly and if my long hair was falling correctly. It was a distraction that made me think and behave in a more self-involved way than is normally the case. I wonder if I would have felt more secure in a bald or scarfed look since it just is what it is at that point.

Lastly, I felt ridiculously uncomfortable. I had heard wigs can be hot and itchy, but I didn’t expect to be fidgeting with my wig the entire night. Perhaps I didn’t tighten the inner hooks tightly enough, but I constantly felt like the wig was loose and potentially crooked. It does indeed make your head feel hot, which did no justice to my hot flashes. As someone who lives their life with a motto of comfort > fashion, I couldn’t wait to take the darn thing off.

Wearing a wig turned out to be an interesting introspective experience for me. I realize, however, that the reality, confidence, and comfort I have walking around bald at home may not translate to external settings. It was very uplifting when Diya saw me again today though, once again bald, and still said “Ooh Mommy, haircut so pretttty.” Sounds like I’ll need to embark on a social experiment of hitting up the town bald for an evening and see how that compares. Stay tuned 🙂

FOMO (Fear of Missing Out)

I knew I would be missing out on things this summer.  Business school reunion, weddings, bridal showers, bachelorette parties.  If it wasn’t due to my inability to travel late into my third trimester, it would be due to some combination of c-section recovery and having a newborn at home.  I expected that, and though marginally bitter, was overall at terms with that being the necessary tradeoff to bond with and nurture my second baby girl.  What’s not fair is having been deprived of the ability to bond with and nurture my newborn as I anticipated.

I received an email from BabyCenter a few weeks ago reminding me that my baby has turned 6 weeks old and that “At 6 weeks, about half of all babies can recognize their parents, and many of those babies are so delighted that they welcome Mom or Dad with an excited, gurgly grin.”  My immediate reaction was to start crying because the first thought that crossed my mind was that I don’t know if my baby even knows who I am.  Between nursings, massages, baths, tummy time, etc., the number of hours I had logged with Diya by the time she was 6 weeks old was comparable to the number of hours I had spent away from Mira due to medical consults, biopsies, other procedures, research calls, and chemo itself in her first 6 weeks.  During whatever precious time I did spend with her, I found myself overdoing the “Hi Mira, I’m your Mommy.  Me – I’m your Mommmmmyyyyyy.” thinking if I said it out loud enough times it’ll somehow compensate for lost time.

Mira turned two months old today.  While these recent weeks have been relatively better in terms of available time, as I’m now running through the motions of the treatment plan and no longer bogged down with diagnostics, I still can’t spend as much time with her as I wish.  Today, for example, the fatigue side effect from the cumulative Taxol was in full force and I spent nearly the entire day passed out in my bedroom – waking (with tremendous effort) only for meals and medication.  Only in the evening did I feel enough energy to finally emerge and take Mira’s “2-month” photos.  We can’t be letting that slide, a scrapbook will eventually need to be made after all.

I am still waiting for that “excited, gurgly grin” that’s in complete recognition of me being her Mommy.  She does smile a lot, but if I’m honest with myself, those smiles aren’t yet directed at me.  Yet.

 

Taking control: making baldness a choice

Today was an emotional day.  It started with excitement, had a layover in sorrow, and ended with empowerment.

Throughout the course of this past week, the Taxol’s side effect on my hair really kicked into high gear.  I mentioned in a previous post that multiple strands had begun to fall out.  I did not anticipate how rapidly the hair loss would progress.  Initially, just a greater number of strands were falling out.  By mid week, I was feeling a tingling sensation at the back of my head when I would touch those hairs.  Apparently, that must be what it feels like when your hair follicles are dying.  At this time, the process of removing my hair band alone would result in large quantities of hair falling out.  When the failed removal of a hair band resulted in half my hair becoming entangled to such a terrible extent that it seemed like the whole chunk would need to be cut off, I knew my hair was in a hot mess.  By the end of the week, I was going crazy constantly collecting fallen hair from my clothes, pillows, etc., and I felt unable to even brush my hair in fear of the handfuls that would come out.  The picture below shows how the hair on the right side of my head was still smooth and “brushable”, while the other half was all curled up into a big tangled knot.  The tingling sensation had reached the hairs on the top of my head by this point, and I knew there wouldn’t be much time left before the chemo would make me bald.  Similar to how a woman’s body becomes so incredibly uncomfortable late in the third trimester that she is distracted from the fear and concerns of labor since she just wants the baby to come out and the pregnancy to be done with, I felt like the process of my hair falling out was so annoying and frustrating, that I was distracted from the fear and concerns of being bald and I just wanted to expedite the process.

Left side of hair was a big, tangled mess

Left side of hair was a big, tangled mess (my left)

That’s why I made an appointment at a hair salon for today.  I wanted to cut my hair really short, like a Halle-Berry style pixie cut.  I was under the impression that I might have another week or two left before total hair loss, and I figured I could try out something new while also minimizing the length of the hairs that I would need to be collecting around the house.  I was genuinely excited to chop my hair off and try out a fun look in a relatively low-risk way.

Halle Berry Pixie Cut

Halle Berry Pixie Cut

Before we could proceed with a new hairdo though, the stylist needed to untangle the mess that was now my hair.  I knew that his combing and brushing would cause a lot of hair to fall out.  After all, the tangled knot was a bunch of broken hairs tied up into the still-healthy hair.  I was mentally prepared for what was going to happen.  Or so I thought.  As he began to spike at my hair with the pointed end of the comb, my eyes unexpectedly welled with tears.  Before I knew it, my chest was tightening and tears were rolling down my cheeks.  I was feeling a sudden sense of sorrow, and I didn’t even know why.  Was it because I was concerned of how much hair would fall out?  Because I was afraid of looking ugly?  Because I was losing my birth hair?  Because it was a reminder that I’m “sick”?  Because I would now look sick even if I didn’t feel that way?  I have no idea.  Maybe all of the above.  I cannot articulate the driver of my emotions, but can say that it is an emotional experience regardless of how prepared or strong you think you might be.  The strangest part was that all this emotion was happening when I thought I was still going to have a cool cut for the next week or two.

I knew a lot of hair had fallen out after my stylist finished untangling it, but I couldn’t get myself to look at the floor to see how much had fallen.  It was after the shampoo, during which surely even more hair had come out, and I was walking back to my chair that I saw the ground.  There was a lot of hair.  Then I looked in the mirror – I still had longer hair, but more scalp was showing than ever before.  It was clear that any cut would look pretty sub-optimal and that it was unlikely the remaining hairs would last even another week.  Regardless, I wanted the stylist to go ahead and do the pixie cut just in case it didn’t look half bad.  He cut away at the hair, making it shorter than I’ve ever had in my non-toddlerhood life.  The sense of excitement was returning, I was so curious to see what it would look like.  Had it been actually styled and spiked after the cut, it may have looked pretty cool.  The bald spot, however, was large and showing through.  I couldn’t stand the idea of having to watch the bald spot continue to grow, and feel the hair continue to fall out, for even another few days.

My scalp showing through after the shampoo

My scalp showing through after the shampoo

 

My pixie cut pre-spiking

My pixie cut pre-spiking

I suddenly felt very much at peace.  It’s as if I gave having super short hair through this experience a chance, but now knew exactly what I needed to do.  I needed to take control.  I needed to make baldness a choice versus something that would happen to me.  I asked the stylist to get the clippers and go ahead and shave it all off.  I did not feel any sadness at this stage.  I remember how several years ago I had a haircut that went very wrong.  The cut was unexpectedly MUCH shorter than I had anticipated and I felt like I didn’t recognize myself in the mirror.  As vain as it may sound, I cried for two days and wouldn’t leave the apartment.  One of Ash’s less tactful friends even asked me “Was that haircut Ash’s idea so nobody would hit on you?”  We can just go ahead and put him in the “former friend” category :-).  But now, watching the clippers go to work and my baldness emerge, I didn’t feel shocked or sad as I would have expected.  I felt empowered.  I had made the choice.  As Diya said, “Mommy’s hair go bye-bye.”

Taking control

Taking control

I always wondered what my head looks like – whether it’s bumpy and dented looking or has marks I didn’t know were there.  It turns out my head is “not crooked” according to my stylist and is “certified 99+% round” according to my dad.  The coloring still has patches that are darker than others since not all the hair has fallen out yet, but overall, I am not embarassed of my head.

The next several months will be a time for experimenting with new looks – wigs, scarves, caps, etc. – and when my hair begins to grow back after chemo, new hairstyles as well. As my sister told me, now I can enjoy seeing it grow back instead of watching it fall out.

Certified 99+% round

Certified 99+% round

 

“New job” – you are not forgotten

This blog to date has really lived up to the “new baby” and “new cancer” part of its name, but today I’m going to give “new job” a chance to shine.

There are a lot of ways to perceive your job:  an outlet for personal achievement, a get-away from the relatively stronger demands of being a stay-at-home parent, or even just a means to pay the bills.  Whatever our individual reasons for having, wanting, needing a job might be, the reality is that many of us spend most of our waking hours at work and with colleagues.  Seriously, we probably invest way more time into finding a life partner than we do choosing the right job, even though the latter can have just as much (if not greater) impact on our life balance and mental sanity.  Just as with friends and family, how a company responds in an employee’s time of need is more indicative of their values and culture than how they behave in the good times.  Ultimately, it is the actions of a few individuals at a company that influence an employee’s experience, perception, and loyalty to a firm – before, during, and after actual employment.  I’ve only had two “real jobs” (i.e., excluding internships) in my entire life, but I’m thankful that they are led by and comprised of thoughtful, truly good-hearted people.

I began my career many years ago at Bain & Company, a global management consulting firm.  I’m biased, but I think the Associate Consultant (AC) role at Bain is truly one of the best jobs someone can have immediately after college.  Aside from the incredibly rich professional experience, the people and culture really set it apart from other firms.  My AC start class resulted in what I am sure will be several lifelong friendships, and the supervisors that I worked with are invaluable mentors.  As impressed as I was with the culture while working there, at some level, I recognized how the benefit to the company of treating its employees well could be a primary motivator.  Therefore, after I made the difficult decision to leave Bain in late 2013 to pursue a more entrepreneurial experience, I had no expectations from the company.  I have always known it has an active alumni program, but I didn’t hold any expectations of Bain impacting me on a personal level after I left.  Perhaps that is because I forgot that, in the end, “Bain” is a collection of amazing individuals.  As my former managers and partners learned of my diagnosis, their outreach has been heart-warming.  Just yesterday, I got an email from the head of my most recent Bain office recognizing me as “an important member of our family” and sharing with me that they have donated $500 to Susan G. Komen For The Cure in my honor.  This act of personal support, especially for someone who is now a former employee, is remarkable and most appreciated.

The personal support demonstrated by my current employer is also extraordinary.  I joined Weddington Way, a collaborative commerce site making it easier for brides to coordinate wedding fashion across their geographically dispersed bridal party (check us out!), at the beginning of 2014.  As a growth-stage start-up, we are a small team of only ~20 people.  I had a glimpse into how supportive the company culture would be early on, before I even joined.  I was in my first trimester of pregnancy and was anxious of how flexible and accomodating a new job would be.  I knew I would only want to join a company that would be truly supportive of my pregnancy and the lifestyle demands that might be required after delivery.  For the sake of full disclosure, I shared the pregnancy news with Founder and CEO, Ilana, before I even told my closest friends, knowing that her reaction would inform my acceptance decision.  Not only was Ilana genuinely happy for me, but we then spent half an hour discussing her questions about how she and WW could support me once I return from maternity leave (e.g., pumping room).  The WW team was wonderfully supportive of the pregnancy – I was actually at the office at a surprise baby shower they threw for me just 3 hours before my water broke!  Thankfully I was back home by that point and mortification was avoided.  I am currently on maternity leave, but Ilana and others have gone above and beyond in their support following the diagnosis – especially for someone who was only there for such a short time so far.  In addition to Ilana and Karishma visiting me at home to meet the girls, they sent me beautiful sandals from India indicating that they hope the fun colors –> happy feet –> happy Parul.  Ilana, especially, has been more of a good friend than “boss” throughout this process – regularly checking in with me, taking me to a mani/pedi before chemo began since I can no longer go, helping me look for yoga studios, and even joining me at a chemotherapy appointment!  (shout-out to Niki S who joined me the week before!)

So, yes, the year of 2014 has been one of a new job, a new baby, and a new cancer.  While this triad is overall a perfect storm of craziness, I’m so thankful I can add former and current colleagues to the list of people helping me stay afloat.

 

Ilana & Parul's Happy Feet

Ilana & Parul’s Happy Feet

 

Parul & Ilana at chemo

Parul & Ilana at chemo