Archive | December 2014

My final post

When I first got diagnosed with breast cancer in June of 2014, I always said that I’m going to wrap “it” up by the end of the year. “Sure, the next six months will be tough, but soon after, this will just be a blip in my life story.” Here we are, six months later, at the end of the year. With my treatment largely behind me and reconstruction nearly complete, the time has come for me to start a new chapter in my life. With the new year around the corner, I say farewell to 2014 with this final blog post.

As I sat in the waiting room of Stanford’s Cancer Center recently, I chatted with an 80 year old woman sitting nearby.  She shared with me how she had recently been diagnosed with cancer, and how the diagnosis gave her a newfound appreciation for life.  I smiled and nodded in agreement.  That’s what everyone says right?  Isn’t that how we’re supposed to feel?  With something as big as cancer in our life story, we’re not supposed to sweat the little things, right?  I have to confess that I don’t always feel so impacted.  Perhaps my overly-positive mindset that always expected everything to be OK and aided in my recovery, also dampened my absorption of how life-changing this experience should be.  Perhaps old habits just die hard.

As I continue to physically and mentally return to my pre-cancer self, I find the need to remind myself to not get upset or nag over trivial things, to remember to exercise, meditate, and eat healthy.  As more time passes, I am sure I will need to be reminded of the key lessons I have learned through this experience:

  • Today is the day to take control of your health:  We’re never too young or too old to start exercising more, sleeping more, eating healthier, and stressing less.  As my mom always says, how we treat our mind and body today is what we’ll reap in 10 years.
  • You are your best medical advocate:  Recognize changes in your body and seek help accordingly.  Educate yourself, ask questions, and seek multiple opinions.
  • Appreciate your parents:  No matter how old we are, we will always be their babies.  No matter how independent we are, we will always find comfort in them during times of need.
  • An act of kindness goes a long way:  The outpouring of love and support I received from family, friends, and even complete strangers taught me a lot about how to be there for people in need.  If I want to do something to help someone, I should just do something.  Anything.  Whether it’s dropping off food or emailing a near stranger to let them know they are in your thoughts, each outreach is much appreciated.  As the opportunities arise, I will pay this kindness forward.
  • Surround yourself with positivity:  Life is too short to be constantly stressed at work, or unhappy in a relationship, or frustrated with so-called friends.  Positivity is a state of mind you choose to have, but is nourished or impaired by whom and what you surround yourself with.

Going forward, life will slowly begin to go back to normal.  After joining Weddington Way on January 6, 2014 and starting leave after my water broke on June 6, 2014, out of complete coincidence, I am returning back to work on January 6, 2015.  As friends learned about my diagnosis throughout the summer, many asked how I’m handling that with my job, and I always responded with:  “Well, technically, I’m on maternity leave.”  I look forward to rejoining the millions of working parents constantly striving to crack the nut on work-life balance.

Mira is now nearly seven months old and a complete bundle of joy.  I’m pleased to say that she does appear to recognize me as her mother despite the limited time she so unfairly received from me in her early months.  My heart will melt the day she first calls me “Mama,” and I will be able to forget that I ever once cried wondering if my daughter knows who I am.

With treatment complete, I am in the final stretch of my reconstruction.  After one more tissue expansion appointment, I will likely have my breast reconstruction surgery in February.  Yes, that’s the “boob job” surgery, and hopefully my final one.  Aside from more frequent screenings in these early years, as well as some ongoing medication, I will soon complete my shift to the recovery phase.  My involvement with Stanford’s Cancer Center will continue in these coming months through participation in their Healing Touch and Living Strong Living Well programs.  Given my BRCA status, I also have a decision to make regarding having my ovaries removed as a preventative measure against ovarian cancer.  While that conversation will begin soon, any action is likely at least a few years down the road.  Let us tackle just one obstacle at a time.

Many cancer survivors say their experience was a blessing in disguise.  I, too, have joined the bandwagon and believe many great things came out of these past 6.5 months.  I learned a lot about myself through this journey, including a newfound love for writing.  Perhaps I’ve always had a lot to say, but now finally had a forum through which to reach people.  I’ve truly enjoyed sharing my story with you all along the way and have found great comfort in, as well as encouragement and motivation from, the feedback I received.  I am very excited for 2015 and the many memories that await – including Ash’s and my 10-year wedding anniversary!  With 2014 in the rearview mirror, I will never forget the memories it too provided.  As a dear friend told me, 2014 was a remarkable year – it was the year I got a new job, the year I had a beautiful new baby, and the year I beat cancer!

 

Mira & Diya - The brightest lights in my life

Mira & Diya – The brightest lights in my life

 

A love letter to my parents

It was only after I got pregnant with Mira did I start to think about what it must have been like for my parents to be pregnant with me, their second daughter.  Did their pregnancy with me fly by in a blur since there was now a toddler keeping them preoccupied?  Was “second child syndrome” in full effect?  Did they wonder how they could ever love someone as much as their first child?

Likely due to my magnetic personality, they do love me a lot after all.

It was exactly six months ago today that my mom and I were in Mira’s room and I got the call with my cancer diagnosis.  I still vividly remember it.  My parents were in town to help us post-delivery – specifically, for my mom to help me with post c-section recovery – but after The Call, there was so much more help needed.  Their one-way tickets remained open as I needed emotional, and later, physical support.  My mom spent her days (and sometimes nights) caring for Mira, teaching Diya things (like our home address!), cooking us all healthy meals, and preparing special concoctions for me to expedite my recovery or help ease my chemo side effects.  My dad was my nutritionist, my exercise buddy, and my companion to many chemo and other Stanford appointments.  They were my arms in the weeks following each surgery – lifting Mira in and out of her crib, driving Diya to school when Ash was traveling, and even hiding the lawn chairs in the garden shed in anticipation of the overly-hyped “Storm of 12/11/14” .  There are no words to fully express how thankful I am for all my parents have done for us these past six months.

We all know to express love and support for the patient who is diagnosed, but it is easy to overlook how much such a diagnosis can affect those folks that are suddenly caretakers.  Whether a spouse, a parent, or a child, a caretaker’s life is significantly disrupted as well.  Their stresses magnify, as not only are they also emotionally impacted by the diagnosis, but they are likely also taking on a greater share of the responsibility at home.  Life is strained and tiring for the caretaker, but they probably feel unable to even vent about it, feeling guilty at the thought of it.

My parents put their own lives and life projects on hold to spend the majority of the past six months living with me to help us through this ordeal.  While they would do it again in a second, I also know it must not have been easy on them.  As recovery progresses well and I can once again lift up the girls, my parents returned home yesterday.  Nonetheless, they continue to provide love and support from afar.  Just today, I texted my mom from Mira’s room referencing how crazy it is that it’s been six months since we heard the diagnosis together.  She responded with an acknowledgment that that was a bad day, but a reminder that it is now behind us.

Yes, the scariest parts are now behind us, but Mom and Dad, I will always remember and cherish what all you did (and continue to do) for me…for us.  Love you with all my heart.

 

August 3, 2014 - Day of my head shaving and unconditional support from Mom and Dad

August 3, 2014 – Day of my head shaving and unconditional support from Mom and Dad

Mindfulness Meditation

It’s been nearly 20 years since I first meditated.  It was at a Jain ashram in India, and we were in a large room sitting cross-legged on a cold, hard floor.  I remember feeling uncomfortable as my back began to hurt due to lack of any support behind it.  More glaringly, I remember how my legs went numb as they fell asleep and then the tingly feeling turned into sharp, shooting pains.  That was also the last time I meditated.

Yesterday, I attended a session at Stanford titled “Mindfulness Meditation” – one of the many free programs Stanford’s Cancer Supportive Care Program offers current and former cancer patients.  I had envisioned a studio-like dynamic where we’re all sitting cross-legged on the floor facing forward with a teacher guiding us from the front of the room.  Instead, there were eight of us sitting around a conference room table staring at each other.  Unsurprisingly, I was the youngest person in the room.  The facilitator asked us to go around the table and share what brought us to that class.  My immediate thought was “because I like free stuff,” but I figured that might be an inappropriate response.  I had to think on my feet, but as I started talking, I realized I had more reasons than I even realized.  I shared how I was diagnosed after Mira’s birth, how after chemo and two mastectomies, I’m now focusing on surgery recovery and undergoing the reconstructive process, and most importantly, how with two young kids and a full-time job, my “normal life” going forward will be pretty busy.  I not only needed to learn how to calm my body into a meditative state, but I needed a forcing function to make me do it.

I did learn a few things during the session.  The first was how our body is like the ocean – there might be a lot going on on the surface, ranging from gentle waves to a vicious storm, but how deep down below, the water is very calm.  Similarly, we each have that “calmness” deep within ourselves, but it can take effort to tap into it.  This is where the “mindfulness” in “mindfulness meditation” comes in.  It’s all about being mindful, cognizant, focused on that inner calmness.  This can manifest itself by closing our eyes and focusing on our breathing, counting each breath or labeling them in our mind as “in” and “out”, as well as focusing on how our body feels as we feel the air fill our lungs, causing our stomach to expand and then slowly deflate.  Alternatively, mindfulness meditation can involve doing a mental body scan where we focus our mind to think about each part of our body from the toes up to our head as if we were a researcher analyzing each part.  I have pink nail polish on my toes…I can feel goosebumps covering my arms…etc.  Coincidentally, my dad sent me an article a few weeks ago titled “Harvard Unveils MRI Study Proving Meditation Literally Rebuilds The Brain’s Gray Matter in 8 Weeks.”  The article states that “The participants spent an average of 27 minutes per day practicing mindfulness exercises, and this is all it took to stimulate a major increase in gray matter density in the hippocampus, the part of the brain associated with self-awareness, compassion, and introspection…Participant-reported reductions in stress also were correlated with decreased gray-matter density in the amygdala, which is known to play an important role in anxiety and stress. None of these changes were seen in the control group, indicating that they had not resulted merely from the passage of time.”  Meditation practitioners have been touting the benefits of meditation for thousands of years, but you really know it’s legit when Harvard says so.

The second topic we discussed in the class was the healing benefit of meditation.  Apparently, there is a strong tie between our breathing rate and our heart rate, and a lower heart rate is calming to the body.  So not only do we feel more relaxed, but since stress attacks the immune system, meditation helps our body heal faster by reducing stress and boosting the immune system.  I liked how the teacher distinguished between “pain” and the “experience of pain.”  We all have pain that we can’t control, but we can control our experience of that pain.  Our mind magnifies the feeling of pain, drawing our attention towards it, making it easy to forget that much more of our body is pleasant (or at least neutral) than is in pain.  Conducting mindfulness exercises that focus our attention towards those neutral areas and away from the pain can actually alleviate our body’s experience of that pain.  After the first meditation exercise we did in the class, one patient said she “forgot about” (i.e., did not experience) her post-surgery shooting pains as her mind was so focused on the exercise.

There is one particular challenge that I, and most (if not all) others in the room, struggled with:  staying focused.  It’s easy to get mentally distracted and have your mind wander.  What I learned here, however, is that meditation is not about trying to control your thoughts or stop yourself from having thoughts.  Not only is it nearly impossible to wipe your mind clean of thoughts, but thoughts are actually indicative of a healthy mind.  So, we don’t need to control them, we just need to recognize that we had them and then come back to focusing on our breathing or body scan or whatever it may be.  Your mind is like a toddler – you can’t control it from wandering here and there, all you can do is try to guide it back to what you want it to be doing.

I believe there are benefits to meditation and I don’t want another ~20 years to go by before I do it again.  It’s not, however, realistic of me to go down to Stanford whenever I need to meditate, as driving home in rush hour after the class offset any potential benefit the meditation class had had.  Instead, I’ve downloaded a smartphone app called Headspace (“a gym membership for the mind”) that includes a variety of 2min to 1hr guided and non-guided meditation programs.  It includes a free 10-day program that teaches the basics of meditation in 10 minutes per day – yea free things!  Perhaps a smartphone app isn’t what the good folks at the Jain ashram would recommend, but I’m happy to embrace this 21st century approach to learning how to meditate.  Cheers to reduced stress, expedited healing, and rebuilding the brain’s gray matter.

 

The most thankful of Thanksgivings

The Starry Night has always been my favorite painting.  To be fair, I don’t know a lot about art or how to interpret paintings.  I look at abstract, Jackson Pollock-esque paintings and have a hard time distinguishing between great art and a preschooler’s project of the day.  I do, however, see meaning in The Starry Night.  The houses and the village representing life as we know it, trumped in size compared to the expansive sky with its swirling clouds and stars.  A visual representation of how life as we know it is just a mere element of a much bigger picture – how there are forces at work much larger than ourselves.

The Starry Night by Van Gogh

The Starry Night by Vincent van Gogh

I’ve mentioned my dad in previous posts – including how he’s more knowledgeable than my Stanford nutritionist!  He has always encouraged me to take on challenges, and is the one to blame for my inner debater.  What some of you may not know, however, is that my dad has profound hearing loss.  The decline has been gradual over the past ~30 years, and now his hearing is ~95% gone.  I remember the volume of the TV and car radio getting louder and louder in the first decade of his hearing decline.  As his hearing loss progressed from mild to moderate in that second decade, we all began to project our voices for day to day conversation.  We became a very loud family, and not just at our lengthy dinner table discussions.  This past decade has been the toughest.  As dad’s hearing loss descended into “severe,” it impacted his life on many levels.  I cannot imagine how frustrating it must be for a man who loves a good discussion to struggle with partaking in a group conversation, to smile and nod when everyone’s laughing to appear like he’s understanding.  When Diya was born and my dad would carry her around singing Hickory Dickory Dock, I remember thinking how nice it must be for him to be able to talk to someone without expectation of being heard in return.

We sought several medical opinions over the years.  Early on, dad’s hearing loss was diagnosed as being caused by EVAS (enlarged vestibular aqueduct syndrome) in conjunction with a head injury he endured in a car accident in the 80’s.  We were told time after time that there is nothing that can be done, no surgery that could be conducted.  He received multiple opinions that confirmed this view.  When I was diagnosed with breast cancer, Ash’s employer connected us to Private Health Management (PHM), a medical concierge service focused on providing patients with customized and uncompromised healthcare.  PHM assisted me greatly after my diagnosis to help identify the right oncological and surgical experts, and understand the tradeoffs of various treatment plans.  It was once chemo treatments were underway and PHM had less on their plate that I thought to ask them for help on identifying the top hearing specialists in the nation as well.  I knew it was a bit “out of scope” from my cancer case, but figured it never hurts to ask.  They were amazing and responded with their top two recommendations, the first being in Florida and the second in LA.

We decided to proceed with a remote consult with Dr. S in Florida and embarked on getting updated CT scans and hearing tests for my dad.  We continued researching EVAS in the meantime and kept finding articles indicating that nothing could be done for adults.  When the radiologist’s report came back, however, it indicated nothing particularly unusual about my dad’s aqueducts.  Something seemed off, and I hoped Dr. S’s interpretation of the CT images could provide some clarity.  The consult went better than any of us could have hoped for.  Dr. S is very confident that my dad does not actually have EVAS, but instead hearing loss due to otosclerosis, a condition addressable by surgery – in other words, he believes my dad has been misdiagnosed for the past 3 decades.  The surgery historically performed to treat otosclerosis is called a stapedectomy, but Dr. S believes we should proceed with a stapedotomy, as it has a much lower complication rate.  He believes that with a stapedotomy, my dad will once again be able to hear, at least somewhat, with no aid, and at nearly normal levels with the help of a regular hearing aid!!

There are many ways to react to such news.  The first and foremost is contained excitement – we don’t want to jinx anything, but for the first time, feel like we are being provided with hope that we can take action on.  The second is frustration.  Understandably, my dad can’t help but wonder “what if?”  What if he had gotten the correct diagnosis and surgery 20+ years ago – how different might his life be?  I told him that 20+ years ago, he would have gotten a stapedectomy, the surgery with a high risk of complications.  Who knows what complications he would be living with today?  I told him perhaps he was meant to wait until now, until we had access to someone proficient with the less risky surgical option.

This past Thanksgiving, my family gathered together at my house for the festivities.  My sister prepared and brought over all the delicious courses for my family’s traditional Thanksgiving meal.  Historically, we always went around the table before dinner saying what we are most thankful for from the past year.  Recently, however, my secret champion(s) left “Get Well” balloons at my doorstep along with a little box of blank cards.  I was advised to jot down what I am thankful for on those cards.  So, only slightly deviating from tradition, I instead passed a card to each family member and encouraged them to write down what they are thankful for.  “Parul surviving cancer” being off-limits.  After dinner, we laughed and cried as each of us shared the contents of our card(s) with the group.  While she couldn’t write it, Diya shared that she’s thankful for purple, green, yellow, and blue balls (I chalked it up to being thankful for all the colors in the world, but I’m pretty sure she’s referring to her ball pit).  Each and every adult at the table, however, included thanks for the potential that lies ahead for my dad – a 2015 with possible restored hearing.

I obviously have a lot to be thankful for this year: a healthy, happy, beautiful new daughter; an outpouring of love and support from family, friends, colleagues, and even strangers; access to excellent medical care and the insurance to support it; and a great new job at a start-up run by smart, compassionate women (to name a few).  I am also thankful, however, for the reinforced belief that everything happens for a reason.  When I was diagnosed with breast cancer at such a young age, it was difficult to reconcile my foundational view with this turn of events.  Over the past few months, however, the experience has not only helped me make positive changes in my life and appreciate every day that much more, but I believe that a solution to my dad’s hearing loss may be the ultimate purpose behind my diagnosis and treatment.  Had I not been diagnosed with breast cancer, we may never have been presented with the opportunity to restore my dad’s hearing.  As overwhelming as our daily struggles might be, there are greater forces at work in our lives.  A belief of mine that was once only embodied in The Starry Night is now integral to my breast cancer story as well.

Happy Thanksgiving Dad & Mom!

Happy Thanksgiving Dad & Mom!