Archive | September 2014

Bald is all the craze now

Today’s MRI appointment went seamlessly enough.  Much more comfortably than my pre-chemo, soon-after-csection MRI that I wrote about in an earlier June post.  Unfortunately, now the waiting game begins as we await the results.  Chemo or surgery?  Time will tell.

Speaking of waiting, I saw a woman reading the latest People magazine in the Stanford Imagery waiting room today.  It features a bald Joan Lunden, former co-host of Good Morning America, on the cover as she too was diagnosed with breast cancer this past June.

joan-lunden-435

A friend of mine actually sent me the link to the Joan Lunden article last week, titled “Joan Lunden’s Breast Cancer Battle: Why I’m Taking Off My Wig.”  The article refers to Joan’s decision to proactively shave her hair before the chemo took its toll, as well as her struggle with the decision to be photographed without her wig for the cover.  I responded to my friend saying “been there, done that”, and called out how uncanny it was that Joan is also battling the same breast cancer subtype as me, “triple negative”.  My friend wrote back saying she’d noticed that similarity as well and teased that Joan could probably benefit from my blog!  That got me thinking and I decided to actually reach out to Joan Lunden.  Thus commenced a minor online stalking session as I tried to figure out how to contact Joan.  I didn’t want to have to upgrade my LinkedIn account just to send her an InMail.  I also didn’t want to break my “passive reader” persona on Twitter by tweeting her.  Ultimately, I sent “Joan” an email through the Contact page on her website.  I shared my empathy, my own breast cancer war story of finding my own lump when 38 weeks pregnant and getting diagnosed on my newborn’s 1 week birthday, my thoughts on going bald, and just for kicks, the link to my blog as well.  I was pretty sure I would never hear back.

I was wrong.  I received an email response within two hours!  Sure, it wasn’t a response from Joan herself, but it also wasn’t some automated email acknowledging receipt of my message.  Someone on her production team responded thanking me for sharing my story, asking if she can share it on Joan’s Stories of Courage column, and then inviting me to join Joan on the Today Show on October 1 as she kicks off Breast Cancer Awareness Month!  I’m guessing there’ll be some empowering moment of a lot of bald women gathered together, but the production team lady indicated I “will be featured in this bald and bold moment with Joan.”  Unfortunately, the Today Show is in NYC and I’m busy being quarantined in California.  So, this is the anti-climactic story of how I will NOT be on the Today Show.  Would have been cool though!

The People cover story triggered an outpouring of support for Joan from other breast cancer fighters whom have chosen to go bald as well.  Not only is bald beautiful, but now it’s also all the craze.  🙂

Let the quarantine begin

Booooooo – chemo was put on hold again today!  This time it wasn’t the platelets or the fact that I’m still really anemic, but it was neutropenia rearing its ugly head.  In layman terms, my white blood cells that fight infection are super low.  The roller coaster story here is that my doctor still had me take one Neupogen (WBC booster) shot the Sunday before my last treatment even though chemo was put on hold the Monday prior as a “just in case” move, but that caused my neutrophil count to spike to 22 (normal is ~1.5-4.5)!  Since my WBC starting point was so high, my doctor had me do only three Neupogen (WBC booster) shots last week instead of four.  The problem though is that last week’s chemo included the carboplatin drug which hits the WBC especially hard, and despite my super high starting point, the counts plummeted.  I’m not just talking low, I’m talking if-I-get-a-fever-I’ll-need-to-be-hospitalized-low.  So, since I need to avoid germs as much as possible, the multi-day quarantine begins today.

Except for a very important appointment tomorrow.  Though this schedule shift pushes off my last date of treatment (still have two taxol infusions to go), I still have the green light to go in for my MRI tomorrow!  Since the carboplatin is the main drug we’re counting on to fight this tumor, and I got my last treatment of that drug last week (score!), Dr. T is comfortable proceeding with the imagery to assess how the tumor has responded to the chemo so far.  The MRI will inform whether I then have to do two more months of a more toxic chemo or whether I get to take a few weeks to recover after my last two taxol treatments and then go to surgery.  Wish me luck!!

Thanks to Kristin for taking me to the chemo-that-could-have-been

Thanks to Kristin for taking me to the chemo-that-could-have-been!

 

(Hopefully) Final Chemo Stretch Begins

After chemo got put on hold last Monday due to my low platelet count, I embarked on a week of positive energies leading me to today.  And by today, I mean the day I began Day 1 of my fourth and (hopefully) last cycle of chemotherapy!  Yes, we were a GO for chemo today – whoo hoo!!!

Nourising Food:  Many friends and family brought over delicious, healthy food this week to help us out.  Huge thanks to:  my sister Payal for always knowing what makes me happy – her homemade batch of my favorite lasagna; to Vanita for not asking and just telling us that she’ll be stopping by to deliver homemade food (which she did multiple times!); to Jasmine and Jake for a yummy multi-course homemade Mexican fiesta; to Supriya and Annie for their lovely company and introducing us to new, healthy, local falafel and Italian joints that we’ll need to be patrons of again soon!

Relaxing Hobbies:  My mom taught me how to sew at a very young age.  She then taught me how to crochet a blanket, that after being saved for over 15 years, was the blanket I brought both Diya and Mira home from the hospital in.  She then taught me how to knit.  Yes, I have a pretty epic mom.  I spent nearly an entire IAP (Independent Activities Period in college where we got the month of January off) knitting a royal blue chenille scarf for Ash.  It’s a bit of a sore point since apparently royal blue clashes with black and the scarf is largely unused, but I’ll try not to digress.  It’s been about 13 years since I last knitted, so I gave it a go again and knitted myself a hat!  Thanks to Sheila for encouraging the stress relieving activity with the kit and yarn!

Hat-making in progress

Hat-making in progress

The final product

The final product

Ta-da!  It fits!

Ta-da! It fits!

Loving Friends:  In addition to the great company provided by the aforementioned friends, we had a relaxing weekend with Miraj visiting from NYC.  We took Miraj and Mira Baby on their first trip to Sausalito and our favorite restaurant there – Avatar’s.  Mira then looked on with no jealousy whatsoever as the rest of us indulged in some Coldstone ice cream deliciousness.  All in due time Mira Baby, all in due time.  Great seeing you after so long Miraj!

Sausalito with Miraj!

Sausalito with Miraj!  There’s a Mira somewhere in that carseat.

Conclusion:  All the positive energy concluded in a successful chemo appointment today!  My one last big juicy vein is still coming through for me and we got the IV in on the first try again.  After a nerve-wracking wait for the blood draw results, we got the green light!  The platelets had recovered to the normal zone after taking chemo off last week – score.  The RBC measurements were still low in “very anemic” range, but better than before and not too symptomatic (no dizzy spells since Tuesday), so still no blood transfusion required.  My oncologist had advised me to not take Neupogen (the WBC booster shot) during the week since I didn’t have chemo, but to take one shot on Sunday so we’re definitely in the safe zone come Monday’s treatment.  Turned out that my WBC was SUPER high in these lab results.  We all were sure that it was just due to the booster shot, but protocol requires I provide a urine sample so they can confirm the elevated WBC count is not due to my body trying to fight some infection.  Trying to give a urine sample with an IV in my inner elbow preventing me from bending my right arm was not at all awkward.  Fortunately, the lab results confirmed our hypothesis – indeed no infection.  We were then able to proceed with my Taxol infusion and then my last (hopefully ever) Carboplatin chemo infusion.  They both went without a hitch and I spent the appointment enjoying time with another great Weddington Way friend, Karishma.  As usual, I later passed out at home for three hours from the Benadryl and am now on a steroid high – the result of which is this late night blog post.

Thank you to all of you for your ongoing wishes and support – another win for a positive state of mind!!

Karishma at chemo!

Karishma at chemo!

Shout-out to my secret champions

I’ve always loved mysteries.  To a possibly unhealthy extent.

When I was 7, I would checkout mysteries/scary stories on audiotapes from the library, play them on a cassette player in one corner of my room, and then crawl into bed under the covers on the other side of my room so that I wouldn’t be tempted to turn them off.  (Note to my kids reading this in the future:  I know you don’t know what an audiotape, a cassette player, or possibly even a library is, but these were all integral elements of your mother’s childhood.)

When I was 10, I was obsessed with the children’s mystery TV series Ghostwriter.  Not only did I diligently take notes during each show to try and solve the mystery, I also founded the first ever “Ghostwriter’s Club” in my elementary school.  I use the word “club” loosely since our membership comprised of me and one other fan of the show.  It’s unclear what mysteries we needed to solve, but we wore pens on lanyards just like the characters, so we were pretty legit.

When I was 16, I needed to choose a subject for an AP Government research project.  Others chose presidents, judges, etc, while I chose Jeffrey Dahmer.  What’s more mysterious than what causes an innocent newborn to become an infamous cannibal?

My passion for mysteries carried through to my adult years.  So much so, that for my 27th birthday, Ash surprised me by organizing my friends to join us in participating in Accomplice:  The Show in NYC.  A super fun experience where you are given a secret mission and need to walk around the city solving clues and interacting with role-playing actors to succeed.

Given my history, it is no surprise that I am loving having mysterious champions.  Over the past several weeks, gifts have been placed in my mailbox or at my front door from someone (or several people) anonymously supporting me.  The note on the first gift was signed off “Champions for Parul” and the notes in the others were equally cryptic.  Since I have no other way of thanking them, I am publicly acknowledging that I love the enigma and truly appreciate the gestures.

I’ve been working on solving the mystery.  I’ve done handwriting analysis of the different notes.  I’ve interrogated Ash.  I’m considering lifting fingerprints, but don’t have anything to compare them to.  As much as I love playing detective, it’s probably a good thing I became an (ex) consultant.

 

Surprise package #1:  Signed off "Champions of Parul"

Surprise package #1:  Signed off “Champions for Parul”

 

Surprise packages #2 and #4:  Motivation to exercise

Surprise packages #2 and #4: Motivation to exercise

 

Surprise package #3:  For the scrapbooker in me

Surprise package #3: For the scrapbooker in me

 

The Good, The Bad, and The Beautiful

I went to Stanford today for Day 1 of my (potentially) last 21-day cycle of chemotherapy.

The Good:  For the first time ever, the nurse got my IV in and blood drawn on the first poke!  Granted it was a big juicy vein that I had been saving for a taxol+carbo day, I still let the nurse know that she had “won.”

The Bad:  Unfortunately, my chemo was put on hold this week and we never got to use the IV.  My platelet count has fallen even further below 100, and since carboplatin hits the platelet count especially hard, it was non-negotiable to continue with an infusion today.  A platelet transfusion is only done when the count falls below 10, so I’m in the “you’re screwed” range.  My RBC count has also fallen further, but not significantly.  I’ve already been in the “severely anemic” range for awhile now, but today I had my first dizzy spell.  Everything was spinning, I thought we were having another earthquake.  The plan is to resume treatment next Monday, but now the entire schedule (including MRI and surgery) are shifted by a week.

The Beautiful:  While initially very bummed that chemo was put on hold, two great things came out of it:

(1) Fingers crossed, I most likely won’t need a blood transfusion:   Since I’m not significantly symptomatic of the anemia now, an urgent blood transfusion is not required.  Had my RBC counts continued to decline with additional chemo, I likely would’ve required a transfusion over the next week.  By taking this week off, however, my RBC counts may sufficiently recover that we can avoid a transfusion altogether.  Whoo hoo!

(2) I got to enjoy the hours of my life that would have otherwise been spent lying in a hospital bed connected to an IV:  First, I finally got to do one of the free chair massages at Stanford that I’ve never had time for before.  The Neupogen shots can cause bone and muscle aches, so the massage was most welcome.  More importantly though, I got to have quality time with Ash and my sister!  She drove 1.5hrs each way to keep me company at chemo today, so when that got cancelled, we all went to near Stanford Mall and enjoyed a nice lunch together.  She also brought me a homemade batch of some of my favorite food that I can’t wait to indulge in this week.  Thanks Payal – love you!!

SISTAHs!

SISTAHs!

 

BRCA Testing & Self Exams

It was exactly 3 months ago today that I received news of my diagnosis.  Since then, many people have asked me how I knew I was BRCA positive and how the cancer was found.  I hope the below information helps you decide if you would like to get tested and understand how to conduct a self exam so that you can be in control of your own health.

BRCA Testing

BRCA (BReast CAncer) genes (BRCA1 and BRCA2) are human genes that develop proteins that help repair damaged DNA.  When one becomes altered, or mutated, the cells are at higher risk of developing more mutations that can result in cancer.  There are specific mutations in BRCA1 and BRCA2, however, that are hereditary (can be inherited from mother or father) and are associated with (1) significantly higher risk of breast and ovarian cancer and (2) breast cancers that develop at a much younger age.  Knowing whether or not you are a BRCA gene mutation carrier enables you to understand what options are available to you.

1.  Understand the prevalence and nature of breast and ovarian cancer in your family history (relationship and their age of diagnosis)

2. Discuss with your doctor whether you should consider getting tested based on this family history (this may involve speaking with a genetic counselor as well).  You can also take a hereditary cancer quiz to assess whether you should consider further action.

3. Check with your insurance provider whether genetic testing is covered.  The cost can vary from a few hundred to a few thousand dollars out of pocket depending on insurance policy and family history.  The extent of coverage is often contingent upon the family history of the disease.

4. Provide a DNA sample to take the test.  This is done via blood test or simple saliva swab of the cheek at the doctor’s office.  Sample is sent to Myriad for genetic testing and can take a few weeks for results.

5. Understand the implications of your results by discussing them with your doctor and/or genetic counselor.

6. If you learn that you are a carrier, at minimum you will want to do more frequent screenings.  The great thing about this is that if you have a family history, at some level you probably know that you’re at higher risk anyways.  By getting test results confirming this, you most likely now qualify for insurance to cover more frequent screenings so that if you do develop a cancer, you’re more likely to catch it early.  These screenings generally include a mammogram (month 1), clinical breast exam (month 4), breast MRI (month 7), and a clinical breast exam (month 10) for breast cancer.  Screenings for ovarian cancer include transvaginal pelvic ultraounds (every 6 months), CA-125 blood tests (every 6 months), and a pelvic exam (every 6 months).

7. If you are a carrier, you may then consider discussing additional preventative options (e.g., surgery) with your doctor.  They will likely recommend that you wait on such action until you are done with any plans for child-bearing.

Note that the most effective chemo treatments for breast cancer patients differ for those with the BRCA gene vs. those without, so if you have already been diagnosed but don’t know if you are a carrier, it’s in your best interest to get genetically tested before finalizing treatment plan.

Self Breast Exams

Do it regularly (at least monthly) and do it well.  That means knowing how to do it and knowing what to look for.  Check out this how-to video from Pink Lotus Breast Center.

As evident from my story, even if you are pregnant (or just crazy busy), don’t delay getting any new or unusual lump evaluated by a doctor.  My lump was repeatedly referred to as likely being a clogged milk duct since I was pregnant.  My life story would be very different had I dismissed it as that.

My bald head’s day out

I always thought I’d do my bald head outing social experiment over a “night on the town.” Let’s be real though, as the mother of two young kids undergoing treatment, nobody’s got energy for a night on the town. Unlike yesterday when I was tired and more out of breath and concerned the anemia symptoms were appearing, today I felt energized (take that anemia!). So, when my attempts to pre-order the iPhone 6 online hit a roadblock, I figured I’d go to the store and run some other errands. Given how beautiful it was outside, I figured it was as good of a day as any to conduct this experiment. So, I did a more suburban-style outing sans cap or scarf to observe reactions.

My bald head's day out

My bald head’s day out

First of all, nobody seemed to care. I expected curious eyes and hushed whispers, and maybe the occasional pity. Perhaps it’s because people have much more self-discipline and social awareness than I would have expected or because I still walk and talk with a high energy spirit, but either way, I MAYBE got one double-take from someone at most. Even the Levi’s Stadium cheerleaders that were sitting at the table next to me as I enjoyed lunch by myself at Crepevine didn’t seem to take a second look. Well done society. Well done.

Second of all, I sometimes forgot I have a bald head. Compared to my experience wearing a wig, today was MUCH more comfortable for me. I wasn’t fidgeting and wondering if the hairs were falling the right way. I wasn’t wondering if people could tell the hair was fake. And, though this should potentially be credited to my first observation above, I didn’t feel insecure. I felt like I was living life as it is, as the cards were dealt to me, and there’s some comfort in that.

Lastly, there’s a reason it’s taken me this long to do this experiment – temperatures are extreme having a bald head. There’s a draft I never felt before. Given my hot flashes, it is a welcome relief when I’m at home, but it’s usually too chilly when I’m outside. Since I was out and about on a warm day, it felt nice airing out my head, but I’m not used to feeling the sun’s heat on my head like that either. I guess there’s a reason my scalp is so much whiter than the rest of my skin!

The biggest thing for me was finding comfort in going out bald.  Ironically, I was never concerned how I would feel about it, but how it would make others feel seeing me that way.  I’d generally be wearing a scarf/cap when guests would come over, and if my hot flashes got bad, I’d feel the need to give a heads up that I’m going to take it off and reveal my head – as if I needed to mentally prepare them to see me bald.  If strangers don’t seem to mind though, I can’t imagine my friends and family would.  Going forward, if you see me with a scarf/cap on, know it’s because I’m cold, not self-conscious.

Any chance you know your blood type?

The drama continues.  There were only two potential complications I was aware of and concerned about going into the chemotherapy process:  (1)  that my veins might give out and I could need a port or a PICC line and (2) a low white blood count could put me at increased risk of infection and postponed treatments.  We can now add a third to the list.

Regarding the first, I’m somehow still sliding by with use of my own veins (knock on wood).  I mean seriously just sliding by.  In last week’s treatment (shout out to Komal for taking me!), the nurse actually called one of my veins a “little bastard” when it stopped giving blood for my blood draw and she had to do a second poke.  I told her to not feel bad since literally every single one of my previous appointments had resulted in two pokes as well.  She was bummed since she thought she “lost” – I tried to make her feel better by letting her know she actually tied.  It’s a good concept though – maybe I’ll drum up a little competition amongst the nurses in the future to see who can “win” by actually getting a successful IV and blood draw with just one poke.  Yesterday’s treatment session also resulted in two pokes, but was more stressful.  That time, the nurse got a good IV in on the first (meaning it could be used for the chemo infusion), but it wasn’t drawing blood.  Not surprising I thought, it always takes two turns.  But then, her second attempt failed too!  There was absolutely no blood – I asked if it was because there was a valve, and she said she missed the vein.  Umm…ok.  I thought we were going to have a real “loser” on our hands if this was going to require a third poke.  She returned attention to where she had placed the IV though, and after applying some heat and letting gravity do its job, somehow blood began to flow!  Whoo hoo!  With hopefully just three more treatment sessions remaining, wish me luck that no PICC line will be needed!

Komal - AKA as the witness to the nurse calling my vein a "little bastard"

Komal – AKA the witness to the nurse calling my vein a “little bastard”

Regarding the second potential complication of infections, we’ve been in good shape so far.  In the weekly blood draw, the key measurement is what my neutrophil count is.  Neutrophils are the specific white blood cells that fight infection.  Chemo is tough on neutrophils and inevitably cause them to fall, so patients take white blood cell boosters to keep them elevated.  Above 1.5 is normal, so below 1.5 is low, but only below 1.0 is neutropenic, meaning the body is incapable of fighting off infection.  Given the specific drugs I’m currently on for chemo, I was doing self-injections of the booster Neupogen for three days following each weekly chemo treatment.  Though my neutrophil count is generally within the normal range due to the boosters, during my first two nadirs (i.e., Days 7-10 of my 21 day cycle which is when my immunity is at its lowest and I generally don’t leave the house) the count was just barely above 1.0.  If it had fallen below 1.0, the doctor would have put a hold on my chemo.  Given the downward trajectory, I was concerned that my third nadir’s neutrophil count would fall below 1.0.  Upon Ash’s suggestion, I raised the question to my doctor of whether I can take Neupogen for four days instead of three to provide an extra boost.  It turns out there’s no problem with doing this.  In more toxic chemo regiments (like the one I’d be on if I have to continue chemo for two months after the MRI), patients either take one Neulasta WBC booster shot or 7-10 days of Neupogen shots between treatments.  So, I now do four days of Neupogen and that kept me above the 1.0 threshold during this last nadir.  Score!  Side note, you’ll notice a running trend that I am often needing to manage my own treatment plan.  You would think my medical team would proactively be telling me that I should begin taking four days of Neupogen, but no, they only agree it’s a good idea when I raise the question.

This brings me to the third, unexpected complication.  In addition to my white blood cells, chemo is really tough on red blood cells and platelet counts as well.  Over the past couple of weeks, my hemoglobin, hematocrit, and platelet levels have been trending down into the low range.  At last week’s appointment, the term “blood transfusion” was being thrown around as if we were just talking about giving me a flu shot.  Naturally, I was starting to freak out, and was relieved when my doctor said it wasn’t yet low enough and we could continue monitoring.  At yesterday’s appointment though, I found out I’m apparently very anemic with my hemoglobin and hematocrit at extremely low levels.  To everyone’s surprise though, I am not (knock on wood) exhibiting symptoms of anemia (i.e., fatigue, dizziness, fast heart rate, etc.) in any meaningful way.  Well, no incremental fatigue to what the chemo already causes me anyways.  Had I been exhibiting such symptoms, the doctor would have been requiring an immediate blood transfusion.  After a lengthy discussion with the nurse where I once again felt like I was managing my own treatment plan (“You can get a blood transfusion.” “I can or I should?”  “What’s the worst case scenario if I don’t right now?”), I ultimately decided to hold off since I wasn’t symptomatic and didn’t want to rush into something like a transfusion when it didn’t seem medically critical.  The thought of having some random person’s blood pumped into me was also super weird.  Unfortunately, since this is a chemo-induced anemia and not iron-deficiency-induced anemia, there is nothing I can do to reverse the trend.  If I begin exhibiting symptoms, I could need a pretty last minute blood transfusion.  I’m not sure how much blood I would need, but I’d prefer to get it from friends and family than randos.  So, if any of you in the Bay Area are a B- or O- blood type and would be willing to donate if needed, give me a holler 🙂

Unfortunately, my platelet levels are also low – low enough to put me at risk of having chemo held next week (ugh!), but not low enough to get a platelet transfusion (which I only realized today exists and is different from a blood transfusion).  Please send all your “Let’s Go Plate-Lets, Let’s Go!” positive energy my way 🙂

Shout-out to a couple of my Weddington Way girls, Ilana and Vanessa, for taking me to chemo yesterday with my awesome WW bag (that originally came to my house filled with an amazing care package from the entire WW team – you all rock!!)

Weddington Way peeps - Vanessa & Ilana

Weddington Way peeps – Vanessa & Ilana

Going to chemo in style

 

Talking to children about cancer

I was pretty shocked when I got diagnosed so soon after delivering Mira.  I, along with many others, wondered how the timing could be any worse.  It was definitely sub-optimal undergoing testing and figuring out my treatment plan while I was recovering from a c-section, and I’ll always wish I could have nursed Mira for longer, but in some ways, I am thankful that my girls are as young as they are.  Young enough to not fully understand, nor remember.

I took a chemo class at Stanford before I began treatment to learn about what to expect in terms of side effects and whatnot.  A social worker came in to discuss the emotional aspects of undergoing treatment.  When I asked her her thoughts about how to discuss such a sickness with children of different ages, she was so kind as to give me a paperback book fully dedicated to talking to children about cancer.  It’s broken out into different sections depending on the age of the child since the depth of their understanding of any sickness varies so much.  It includes a plethora of sample dialogue that I’m sure would result in really awkward conversations.

Fortunately for me, all the children in my life – my girls, nieces, and nephews – are all under five years of age.  The experience of my “sickness” has impacted them in varying, sometimes comical, ways.  The oldest is my 4+ year old niece, who is a little prodigy child seemingly going on 14.  Her comprehension ability is so far beyond her age, that after seeing Mira in the NICU, she cried for 1.5 hours later that night because she “just wanted Mira Baby to get better soon.”  We always give each other “big arm hugs”, but given her school-age exposure to germs, she knows to only hug me around the legs now.  Then, there’s my shy, but ever-so observant 3+ year old nephew.  A couple of weeks back, he pointed out to me that I have no hair.  I responded by asking him if I could cut off some of the hair on his head and tape it onto mine.  He promptly said no.  Good talk.

Now that I think about it, I never really talked to any of the children about cancer.  I don’t think any of them have even heard the word.  At their age, there’s no real reason to.  It doesn’t mean they don’t notice that things are different though.  I’ve mentioned in previous posts about how Diya just thinks of my shaved head as a haircut that she likes to touch.  While that’s the comical side of things, there is a more serious grasp that she has on what’s going on.  Before when I would grab my jacket and purse to head somewhere, she would always ask “Mommy go office?”  Now, she asks “Mommy go doctor?”  When I return from chemo and she sees the bandage around my arm from where the IV was, she asks “Mommy got boom-boom?”  When she sees me looking fatigued, she says “Mommy OK?  Mommy feel better.”  Even a 2.5 year old can know that her world has changed.

Selfishly, I’m thankful that the kids are so young that I can avoid the awkward conversations, the more serious conversations where cancer and chemotherapy are something more than a “boom-boom.”  Perhaps a day will come when the kids are older and want to understand, and that is the day this blog will serve its purpose.