Running with a Reason

During chemotherapy treatment last year I decided that I would train for an endurance event with the Leukemia & Lymphoma Society (LLS) when my health improved. After remission rolled around and I felt up to the challenge, I signed up with LLS's Team In Training (TNT) program to participate in a half marathon. This past weekend I completed a total of 13.1 miles at the Long Branch Half Marathon and finished in 02:53:08! I also raised over $3600 in funds for cancer research.

The marathon weekend was filled with pre-race jitters and joyous celebrations. The night before the race I attended a pasta party hosted by LLS for all the TNT participants. Here I got to meet some of 350 participants that each raised at least $2500 for cancer research and would be running in the race the following day. After dinner I got the chance to meet team members from the Southern NJ region, listen to some rather inspiring stories, and decorate race t-shirts. It was amazing to be amongst so many people who were equally committed to a great cause.

So I really didn't get excited about having to run 13.1 miles until the morning of race day. Since most of my training was done alone I was preoccupied that I didn't have a friend to consistently encourage me throughout the 13.1 miles; and many of the other TNT participants had be running together for months and had already created lasting friendships and support groups. Luckily I met Jackie from Toms River, NJ, who was in the same boat as I was: she raised funds, trained all on her lonesome, and now had a half marathon to face on her own it seemed. After meeting we decided to become each other's support and pace one another throughout the race. Believe me when I say that I finished as quickly as I did because of Jackie's motivation. She was obviously in better shape and could handle running for longer periods of time without as many walk breaks. However, she persistently encouraged me to keep going throughout the race.

At the end of the race I met with family and friends to take celebratory pictures and receive my race hat and medal. It was very surreal to finish 13.1 miles in the rain without passing out from exhaustion. Now, I'm set on doing a 5K run with the American Cancer Society for prostate cancer research and awareness. Stay tuned!

On the Road to Normalcy

Most people would consider going through cancer treatment one of the toughest things a person can face in their lifetime; your body becomes ill and you must deal with the accompanied stress and uncertainty of your health. Once a cancer patient is considered to be in remission, most people believe it becomes easier to deal with, however, the road from remission to normalcy may sometimes be as tough as, if not more difficult than, treatment itself.

With that said, the last few months haven't been a walk in the park, but as the days and weeks pass by I can see and feel the improvement in my health. I would definitely say that training for a marathon has helped expedite my overall improvement. My first follow-up appointments with my oncologist and radiologist were good; both confirmed that I was recovering beautifully from treatment. Luckily, I don't have to go back for another doctor's appointment until mid-April for a CAT scan, and then once again in early June to see my oncologist. After that I'll have 6-month appointments until I'm back to the normal annual doctor's appointment with my primary physician.

Today, I went to get my first haircut since chemotherapy, where I lost pretty much all of my hair. Surprisingly it has taken almost three months for me to be comfortable enough to cut my hair: I wanted to wait until every patch of baldness disappeared and I needed to wait until the radiation burns on my neck completely healed. Before entering the salon, I was a little nervous that my stylist's inquiries about hair care would lead to a discussion of my illness. (I always attempt to avoid directly discussing cancer with those whom aren't already aware of it. The last thing I want is for someone to feign pity.) Luckily, I've become quite adept at maneuvering conversations so as to avoid cancer-talk completely. My haircut was quick and successful! After a lovely scalp massage and shampooing, it took about ten minutes for my haircut to be complete. I would be lying if I said that I was not overjoyed to have my hair cut; it not only means that my body is healthy enough to grow copious amounts of cranial hair, but it also makes me feel a little bit more normal. People usually take for granted that they have to cut their hair every two to three months (depending on one's interest in hair care) and they don't realize how such a simple and mundane act can be so important. Anyway, I'm happy with my physical appearance. Now all I need to do is work on my endurance for my fast-approaching marathon!

A Radiating Remission

So it seems that allowing people to read about my journey through cancer was short-lived since the last time I posted was in October. Since then a lot has happened: I completed chemotherapy, celebrated a few holidays, started radiation, and secured a job as an SAT tutor. As of late, I have been feeling a lot better and my primary oncologist has stated that according my most recent CT and PET scans I am now in remission. Remission: a little three-syllable word that has brought many sighs of reliefs and tears of joy from my family and friends. For those of you who do not already know what the term means, it is to say that my cancer is no longer a direct threat to my health and I am temporarily recovered. 'Remission' is as close to being cured as I will ever be of Hodgkin's Disease. Unfortunately, I have been advised to continue with radiation therapy because combining chemotherapy and radiation has proven to be more effective in curing cancers in the long run. Today I received my 13th treatment of radiation out of a total twenty. Radiation is completely different from chemotherapy even though both procedures are used as treatment for cancers. In comparison, radiation is more so a "spot treatment" rather than injective, which is a nice change. For me, that means no more IV's and hopefully no more collapsed veins. However, I have to say that radiation treatment is rather quick and impersonal; it's also tedious getting up at eight o'clock in the morning every weekday. Aside from a three-day cold, which made my throat feel as if it were on fire, I've only suffered minimal side effects, including tanning of my neck, some hair loss, and a sore throat. I can't wait until I don't have to see a doctor so often!

Cancer and Employment

I often attempt to research information about Hodgkin's Disease on the internet. Reading blogs and posts by others who have gone through similar problems as mine helps me learn about the disease and also reaffirms that I am not as alone as I think. Since I've recently gotten a job, I started researching information related to cancer and employment to see what I could find. What I found was that most, if not all, of my anxieties about disclosure of my disease and the effects it would have on my working ability--things I always thought about during job interviews--are legally covered under the Disability Discrimination Act (DDA). If I am eligible for a job and can complete the given job description, even if there is a need to modify working hours and breaks to attend to fatigue and the like, an employer may not discriminate against me because of cancer. And, yes, anyone diagnosed with cancer is considered disabled and protected under the DDA even after remission--quite the useful information.

An Overwhelming Response

In the past 24 hours, I have had an overwhelming response to the initial blog I wrote about my journey through cancer. There has been an outpouring of emails, instant messages, text messages, and phone calls thanking me for writing about my situation and asking, if possible, how people can help me feel more supported while I continue medical treatment for Hodgkin's disease. I would first like to thank everyone for their messages of encouragement--I appreciate everyone who has written thus far and all those that will read my blog in the future and respond positively to my writing. Secondly, I must admit that I have never felt unsupported these past few months. There hasn't been a day where I have not known of the love and support each friend and family member has for me, and that love and support is not taken for granted. Even if you haven't consistently checked up on me or called on a daily basis, it does not mean you have failed at supporting me or have failed as a friend. I would hate anyone to feel a trace of guilt because of my condition.

With that said, I know that when someone hears that a close friend or family member is suffering from a horrible disease such as cancer there are moments of unsureness as to how one can help, especially when medicinal treatments are not yet fool proof and most are physically debilitating. However, since I have had quite a long time to think about my situation, I can share a few things I believe may help--things that would definitely help me feel more supported while benefiting yourselves.

To begin, one suggestion I have is to take care of your bodies especially if you are capable of doing so. This doesn't sound like the most novel of ideas, but I know that many people take their good health for granted. One reason I have reacted so well to chemotherapy is that at the beginning of my treatment I was extremely healthy. My oncologist cites this as one reason it has taken so long for my body to react to chemotherapy and exhibit the typical side effects. During my first few rounds of chemo, I was still playing tennis on a daily basis. As someone who used to be able to work out quite regularly and run a few miles without breaking a sweat, I am now too fatigued to even do a set of sit-ups or even take a long walk at times. This reality has definitely made me feel isolated and trapped in my own body since I cannot function as well as I used to. Even if you may not feel inspired enough by my story to incorporate a workout routine into your lives, perhaps you'll find it easier to limit sugar or fast food intake. Any little change may help; and all anyone really wants is for loved ones to live long healthy lives.

As a second suggestion and addendum to my first request, it would be beneficial to find out one's family medical history. I have always known that I once had an aunt named Sonia who passed away at the age of eleven because of leukemia. As I have learned, she was diagnosed at the age of two and lived through nine years of chemotherapy at a time when medical treatment for blood cancers was far more rudimentary and toxic to one's health. Due to years of medical research, I find myself lucky to have a spectrum of available drugs to combat nausea and vomiting that usually accompany chemotherapy. My aunt, however, did not. In addition, I knew that in my family there is a history of severe diabetes and obesity, however, I failed to realize that there were also histories of breast cancer, high cholesterol, and thyroid malignancies to name a few. Being aware of one's family medical history is beneficial because it provides a quasi blueprint for how one should live: if you discover there is a strong history of diabetes, perhaps you may want to avoid high sugar intakes and switch to sugar substitutes. Aside from dietary efforts, if you discover that your family history reveals a specific condition or disease such as breast cancer, for instance, perhaps starting mammograms at an earlier age and at higher frequency than the average female may help prevent further medical problems. Preventative efforts can help detect problems at the earliest possible stages. (Side note: If you have a stigma about going to the doctors, which many people do, I hope you realize that they know an unbelievable amount more about the human body; and if you ever feel uncomfortable with a particular doctor, you can always find a new one or ask for a second opinion about your health matters)

If I seem long-winded, please excuse me. These issues are very important to me and I hope that in reading this blog they will become important to some of you, if they already are not.

To continue, another way to take better care of yourselves and perhaps grant me peace of mind is to make sure you have a good health insurance plan. While many of my friends and colleagues begin new jobs, I have realized not everyone knows adequate information about their health benefits package. I would hope that those still looking for employment consider these packages during their job search. Luckily, I am still covered under my mother's state insurance package because I continued undergraduate education. I will be covered under her policy until I turn 23-years-old on April 16 next year. However, if I were not insured, or if I were dropped by her insurance plan once I graduated as so many college graduates are, I could not imagine how my family and I would afford paying for my hospital bills. I am only required to pay a 15-dollar co-payment every time I go to the doctor's office, receive further tests, go in for surgeries, and so forth. Nevertheless, my medical bills since August of this year are upwards of 150,000 dollars (the equivalent of a 4-year college tuition); and that only includes the bills the insurance company has forwarded for our own personal records. I would definitely say that I am thankful for having health insurance. It was never something I really gave any thought to before I started applying to the Peace Corps and before I was diagnosed with cancer.

Another supportive and perhaps noble idea is to participate in a local cancer event, such as a cancer walk, to show support not only for people you may know struggling with cancer (like me) but also for others going through similar battles. Once I am in remission and no longer suffer from extreme fatigue, I plan to join a local cancer walk with The Leukemia & Lymphoma Society here in Central New Jersey. Anyone is welcome to join. I will receive more information about the walk in the next few months, which takes place in March of 2009. There are other events to help bring awareness to the public about cancer and support to those fighting it. I have linked to a few different cancer sites in my sidebar that may help, if anyone would like to research and partake in events. And, of course, making monetary donations to cancer research is undeniably supportive.

I hope that those of you who read this post take my suggestions to heart. These are not the only ways that one can help support myself or others with cancer, however, I feel that they are some of the most beneficial and effective ways to do so. Some of you may feel surprised by my suggestions; especially those searching for ways to directly help me. The truth is that as much as fighting cancer effects more than just the person afflicted with the disease, it is inevitably an internal battle in addition to being a daily physical struggle. So, in a kind effort to ease my mind, I hope all of my family, friends, and perhaps unknown readers start taking better care of themselves; and maybe even think about other ways to help cancer-fighters. Donating time in any way is helpful, but taking care of yourself so that you can spend more time on this earth with loved ones is more important than reading this blog, or becoming an activist for a social cause, or feeling guilty about not overextending yourself to a friend that is sick.

Looking Back Over the Last Few Months

Starting this blog is probably harder for me than most people might think. In August of this year, I was diagnosed with Hodgkin's lymphoma, a blood cancer that attacks the lymphatic system of the body. For someone who has never had a medical issue in their entire life, this reality threw me for quite the emotional and physical loop. What made it even harder for me was that before I was diagnosed I was planning on the journey of a lifetime: I had been accepted into the United States Peace Corps, after a long and tumultuous applications process, to serve for 27 months in the country of Kazakhstan as an English-teaching volunteer. As a recent college graduate, I had deferred my ten-year scholarship, withdrew an application to Columbia University's Teacher's College, and arranged for my outstanding student loans to be paid off. Medical complications were the last thing I could have imagined to halt my entrance into the Peace Corps, but then again, cancer comes inexplicably and without notification.

As I finish my third round of chemotherapy, I find that it may be helpful for myself and others going through similar treatments to learn about my journey over the past few months. I say that it will be helpful for myself because, to be completely honest, I do not talk much about the effects cancer and treatment have had on my body and my mind. When people ask how I am I usually dismissively tell them, "I'm OK." However, most of the time I'm not. I try limiting myself from going too much into detail with my complications because I don't want to impose on my family and my friends especially. It is easy for me to do this because in comparison to others going through ABVD chemotherapy I have had minimal side effects. But that does not mean I do not struggle with my situation. Most of the time I think that no one could understand even if I tried to explain.

So, in an effort to explain, here's my story and what I can recall: For quite some time I had been very healthy. I exercised regularly and ate well--quite the opposite of most of my family. Exercising became a hobby that I shared with my close friends and it made me happy. During this past summer I lived in Ithaca, New York, at the top of a hill, which made traveling to the city center and walking to work a workout in and of themselves. I also took up bicycling, cliff jumping...I was active to say the least. The very first sign of something being different, or wrong, was when I was traveling south to Wildwood, New Jersey, with a group of friends and I could not hold my breath as we drove through a tunnel. After arriving in Wildwood and being there for a few days I also noticed some difficulty with holding my breath underwater, however, I shrugged both signs off because I had recently started smoking clove cigarettes. When I returned from vacation I got rid of any cigarettes I had in my possession thinking it would rectify any breathing difficulties.

To my chagrin, symptoms worsened slowly, but I never could've guessed the outcome. The next time I noticed something wrong was when I went swimming at one of Ithaca's gorges a few days before moving back home--something my friends and I did on a regular basis. As I hiked up the path back to the main road, I felt as if I were having an asthma attack. Taking in a deep breath released a deep, wheezing sound. After packing my things and saying good-byes, I traveled home for what I thought would be the last 18 days I'd spend in the country. While I tried to assemble good-bye gifts for my closest friends, make some last-minute phone calls, plan visits before I departed, and take on the herculean task of packing 100 lbs. of luggage for over two years of travel, I realized I may be sick. After an emotional good-bye with my grandparents at the Philadelphia International Airport, I decided I needed to go to my doctor because the night before I had suffered from horrible back pains and the same breathing problems. I thought I was coming down with a lung infection or a bought of bronchitis.

The next week or so would be the most difficult and revealing days of my life thus far. I remember almost every detail. During my physical exam, my doctor noticed a problem with my breathing and swelling in my neck--most likely swelling of my cervical lymph nodes. Her face displayed signs of shock as to how swollen my neck had become in a short period of time. I didn't even notice the swelling until she said something. She then sent me immediately for a neck and chest X-ray the following day. If you would've asked me if I thought something was terribly wrong during my neck X-ray, I would've said yes. The technician took an awfully long time examining my neck as she slowly scrolled over my cervical lymph nodes with a warming jelly, and she barely said a word. I remember joking that my neck felt as if it were having a sonogram. The next clue as to something being direly wrong was that the examining hospital told me I had to go directly to my physician and speak to her about the results. By this time, I was somewhat concerned.

I was quite calm as I drove to hear the results on that August 8th morning. I metaphorically prayed that the results wouldn't prohibit me from traveling with the Peace Corps. I then sat in the waiting room for an extended period of time as I realized my doctor was avoiding an unavoidable discussion. I was shown to an examining room where I then waited an inexplicably longer time--there was only one other patient in the entire office whom might have been impeding my results. I remember my doctor walking in and telling me that the X-rays showed numerous abnormalities in my neck and chest, and that I would not be able to travel with the Peace Corps for quite some time. She then asked if I wanted her opinion on the matter and, with my consent, said they thought it was cancer and I would have to see an oncologist as soon as possible. My mind went quite numb along with my feelings after hearing the results. I believe I was in such a state of shock that I couldn't express any emotion as I walked to her office to wait for a referral form. As I sat there in front of the two receptionists, I burst out into tears, all the while trying to hold in my emotions. As my mind raced, I blew my nose and took my referral from my doctor. On my way out, the Jamaican receptionist advised me to pray and that it would be the only thing that could help--quite the horrible advice to tell a 22-year-old secularist who has just found out they most likely have cancer. I kept my mouth shut, said thank you, and walked to my car.

I remember people staring as I sobbed my way to an olive green Hyundai Sonata in the parking lot and sat in the driver's seat for a while before I decided I could drive home. As I began hyperventilating and then immediately trying to control my breathing, I sent a frantic response to my ex-boyfriend and close friend via text message: something along the lines of, "the results weren't good. I'll call you later." As I stopped a few times on my drive home to let out some much excusable tears, I called my mother and told her to come home from work immediately. I had to tell her my results face-to-face and that I would be seeing an oncologist the following day. After a very emotional and frightening revelation of my current health problems, I let my closest friends know of my situation. The next month or so of inquiries about the Peace Corps would be hard for me to deal with. Each time a person asked how I was doing in Kazakhstan because they hadn't yet heard of the news, I would have to then tell them that I had cancer and wouldn't be joining the Peace Corps. What made it even more difficult was that my ex-boyfriend was scheduled to depart with the Peace Corps in September. I would be lying if I said I didn't feel jealous that he could go and I could not. My follow-up with a Dr. Bernard Grossman, one of the most reputable hematologist oncologists in the area who served as president on numerous medical boards and attended UPenn medical school, would reveal that I most likely had a case of lymphoma. However, discovering whether it was Hodgkin's or non-Hodgkin's, the two main categories of lymphomas, would be a tougher task.

I had a weekend to ponder my life and current health situation before I had to see a surgeon the following Monday about a neck biopsy. That weekend two friends who were preparing to say a final good-bye and spend a final few days with me came to support me during the next week of tests and surgeries. In total, I had a neck X-ray, chest X-ray, blood work, two biopsy surgeries, a CT scan, and a PET scan. These physically and mentally draining tests took a toll on my body, especially the second biopsy where they had to administer general anesthesia and post-operative morphine to relieve pain. The morphine was excruciating; I've never felt so horrible in my entire life. I remember hearing visitors come over to see me as I squirmed in discomfort in the guest bedroom, the closest bed to the front door of my house. I was probably the most scared at this point as family and friends tried to comfort me. I believe I lost a total of five to six pounds that week because I had to fast and also lost my appetite due to medicinal drugs.

I was finally diagnosed with stage 2A Hodgkin's lymphoma, the more forgiving of the two main categories. Hodgkin's disease, as opposed to non-Hodgkin's, infects the body in a uniform way, traveling from one set of lymph nodes to next closest set, making it easier to predict. Most people who suffer from Hodgkin's disease are in their 20's or 30's and male. Richard Harris (the original Dumbledore in the Harry Potter film series), Dale Carnegie (an American writer), and Jane Austen (the famous British writer) all suffered and died from the disease. Some fighters of the disease have a family history of blood cancers, some with exposure to Epstein-Barr virus, and some suffering from HIV/AIDS. I don't fall into any of these medical histories although I did have an aunt die at an early age from leukemia. To continue my diagnosis, Stage Two meant that the lymphoma had spread to more than just one area of my body: my neck and chest. Type A denotes that I did not suffer from systemic symptoms such as night sweats, excruciating back pains, and others. My oncologist said that out of most cancers mine was one of the most treatable, which gave me some relief, however, I would still have to endure 4 cycles of ABVD chemotherapy followed by minimal radiation, as oncologists have found that combination therapy proves more effective overall with cancer patients effected with abnormalities in the chest cavity.

After learning about ABVD treatment and the complications associated with each drug, I signed loads of paperwork allowing Mercer Bucks Hematology Oncology Center to administer the treatment. As I learned, the acute side effects included allergic reactions, vomiting, diarrhea, nausea, alopecia (hair loss), lowered blood counts, constipation, and neuropathy (numbness in fingers or toes). Out of these eight side effects I have experienced the latter six. In addition, I have also experienced the softening and bruising of my fingernails, extreme fatigue, collapsing of veins, worsened skin, and slight back pains. The scarier and delayed side effects of ABVD include infertility, pulmonary toxicity, cardiac toxicity, and secondary malignancies such as acute leukemias, tumors, and lymphomas. It's amazing the amount of knowledge one can absorb when suffering from a certain type of sickness. Sometimes I feel as though I'm an encyclopedia for Hodgkin's lymphoma. Furthermore, in order to track possible delayed effects, I routinely have lung and heart tests to make sure my body can handle further treatment. A whole new set of short and longterm complications accompany radiation therapy which I will receive a few weeks after the completion of my chemotherapy treatment.

After the lesson on diagnosing and treating lymphoma that I just gave, it may be important to say that throughout my entire treatment I have been surrounded by loved ones who consistently support me in my struggle to fight cancer. This along with the speedy improvement of my condition have helped to keep me optimistic. Within a week or so the swelling in my neck went from a measured 16.5" back to its normal 15" measurement. A follow-up PET scan revealed the abnormalities in my chest cavity normalized along with my left cervical lymph node. As I embark on my last cycle of chemotherapy with a full body of hair and minimal cranial hair loss, I can't help but wonder what my life will be like when I can function normally, work out regularly, and focus on starting a career in the education field rather than worry about if I'm going to pick up a cold from visitors, or a bacterial infection from using a public bathroom.

Now that I have reviewed most of my physical difficulties, I hope in another blog to discuss the mental struggle that accompanies cancer: the stigma of cancer, struggling with coming out about my disease, the negative effects on my social life, and dealing with the monotony of being an unemployed 22-year-old living at home. But before ending my first post, I would like to thank everyone that has written me a card or letter, sent me a loving email, or taken the time to call and check up on me. And even more importantly, I would like to thank the handful of close friends who have accompanied me throughout these past few months--those people who have consistently checked up on me, visited me at home, encouraged me to get out of the house, and those that have understood that I sometimes need time to myself and might not get back to my voicemails as I should. You know who you are. And to my family members, who care for me, cook for me, argue with me, comfort me, take me to my appointments, try to keep me active, and even those who offered to help shave my head, I thank you.