September: Endometrial Cancer Awareness Month #4

Ovaries.  I know it’s supposed to be about the endometrium this month but… bear with me.  I am amazed by the number of women who I have met over the past few months who believe ovaries are just good enough for making babies.  When they are done, they are perfectly fine with throwing them out.  I met a woman at a gathering recently who was upset about her friend’s cancer diagnosis and then she was scared.  Her period has been iffy as of late.  She said that she wanted to ask her doctor to take them out because she did not need them anymore.  She had two children already.  I had to stop her right there and told them… those are not just for babies.   Ovaries are so instrumental in maintaining your hormonal balance.  Yes, maybe some days you feel like your hormones are getting out of control but it’s all part of the ride as a woman. 

Ovaries also keep you healthy.  Keeping your ovaries significantly reduces the risk of osteoporosis and heart disease.  Sadly, many doctors do rush into removing ovaries.  And women follow along.  A friend’s friend was about to undergo hysterectomy recently.  She was about to have both of her ovaries removed.  I begged her to tell her friend to fight to keep at least ONE ovary.  One ovary was bad… but the other one can be saved.  I was relieved to learn the good ovary was saved. 

Surgical menopause is a difficult process as well.  Women who experience menopause naturally go through changes gradually.  Imagine the gradual process that spans about one-two years all squeezed into an overnight process.   Some women have to undergo surgical menopause.  Many do not need to undergo that.  Women who have endometrial cancer are often urged to do a full hysterectomy removing their ovaries.  Dr. Jewell has been practicing for almost ten years.  In this time period, she has only seen TWO women who had endometrial cancer who kept their ovaries get ovarian cancer later in their lives.  The odds are very low, making it worthwhile to keep the ovaries.  The benefits of keeping ovaries outweigh the risks for sure.

Ladies, hold on to your golden eggs!

September: Endometrial Cancer Awareness Month Tidbit # 3

Colors Galore

I have been asked if the color peach applies to all gynecologic cancers since pink applies to the 'other' private part of a woman- the breasts.  Nope.

The color peach represents endometrial/ uterine cancers
Teal: ovarian cancer
Teal/white: cervical cancer
Purple: vagina/ vulvar cancers

Lavender: all kinds of cancer

I proudly wear a bracelet daily... lavender or peach.  It represents a part of who I am... a cancer survivor.  I have a peach ribbon on my backpack.  A few people have asked me about the ribbon.  One person said she is so used to seeing pink all the time.  It was good to spread awareness that way.

September: Endometrial Cancer Awareness Month Tidbit #2

Some pictures are worth a thousand words....

Okay... endometrial/ uterine cancer is 4th most common cancer among women.  What are the 1st, 2nd, and 3rd most common cancer among women?  

1st: Breast cancer... the odds are 1 in 8

2nd: Lung cancer... 1 in 16

3rd: Colon cancer... 1 in 19

4th: Uterine cancer... 1 in 41.  And it happened to me.  It's real.  

Endometrial cancer is the most common gynecological cancer, claiming about 8,000 lives per year.  

Three-Month Follow-Up Appointment

August 18th was when I had my three-month follow-up appointment.  It was also the first time I participated in a live support group for survivors of gynecologic cancers.  I will be discussing the support group experience in a different post.  I am still processing the experience.

My three-month follow up involves a pap smear and a pelvic exam.  When I turned eighteen, I remember dreading my first pap smear.  I was relieved that I did not have to do it more than once a year.  The universe must be playing tricks on me because now I have to do it four times a year for the next two years then twice a year for the following two years.  In my fifth year and beyond, it's once a year.

I suppose I am still tender and recovering because the examination hurt really bad.  And the pain continued through the next day.  Around September 30th (six months after my surgery), the internal stitches should start to dissolve or come out.  Other women speak of it as an uncomfortable experience.  It will happen to me whenever it does and however it would be like.

Results of my examination did not come quickly which surprised me.  I would think that cancer patients are filled with anxiety awaiting results.  The doctor was quick to call me when the pathology results came in last January to tell me I had cancer.  I emailed the office asking about the results about two weeks after the examination and got no response.  I suppose it could be inferred that no news mean good news.  I got the results from the August 18th's examination in the mail.  It arrived the week I was in San Diego.  It was a simple form with the following language, "This is to inform you that the test done on the above date showed the following results: Normal Pap Smear (no malignant cells)."

Still in remission.  Life goes on.

September: Endometrial Cancer Awareness Month Tidbit #1

I could swear that every month has several different types of awareness.  Before I investigated further, I knew of Endometrial Cancer, Lymphoma, and Deaf for the month of September.  I decided to Google to see what other areas of awareness exist for this month.  Pain, Children’s Eye Health and Safety, Alcohol and Drug Addiction Recovery, Children’s Cancer , Guide Dog, Life Insurance, Honey, and many more. 

Those awareness months are notable.  Awareness needs to be spread year-round.  I have met women who tell me that they learn a lot from my blog and from talking with me.  I will continue to want to educate others.  It should not happen just in one month.  But… in honor of this month, I will be posting some tidbits about endometrial cancer this month.

Endometrial cancer is developed after endometrial hyperplasia develops in the lining of the uterus.  Endometrial hyperplasia basically means the lining of the uterus has become too thick.  Endometrial hyperplasia does not always lead to cancer.  Endometrial hyperplasia develops when there is excess estrogen.  There are four types of endometrial hyperplasia: simple, simple with atypia, complex, and complex with atypia.  I had complex with atypia.  I asked Dr. Jewell to explain complex atypical hyperplasia in layman’s terms.  She said it’s when the lining in the uterus becomes too thick and messy.  I suppose it was what caused uterine polyps to emerge.  Progesterone can be used to treat simple and complex hyperplasia without atypicality… in the form of a pill, shot, intrauterine device, or vaginal cream.  That was why I had hormone therapy at the beginning, which did not work quite well for me for numerous reasons.  Hysterectomy is the best way to treat complex atypical hyperplasia and endometrial cancer. 

According to the American Cancer Society’s website, if the hyperplasia is atypical, there’s an increased risk of it developing into cancer.  Hyperplasia can be treated if detected early.  If not treated, 8% of simple atypical hyperplasia and 29% of complex atypical hyperplasia turn into cancer.  It is clear I had complex atypical hyperplasia for a few years before it became cancer.  It is challenging to detect.  However, one warning sign was that my period was heavier than normal.  My doctors thought it was normal part of becoming older.  My advice to women out there… if your period becomes heavier than normal, go find out why!  If a gynecologist tells you to suck it up and that it’s normal, seek another opinion.  You need to insist on getting a transvaginal / pelvic ultrasound. 

The New Normal: A Progression, Not A Destination

During my battle with cancer, other survivors and caregivers often spoke of the ‘new normal.’  I was uncertain of what to expect.  What is going to be my new normal?  Now that I have been in remission for a few months, I still do not know what my new normal entails.  It is an ongoing exploration.  The post-surgical infection has made the journey to my ‘new normal’ a bit tricky.   The infection has affected how I navigate through life.  Are those reactions to the infection permanent?  I don’t know.  Let me highlight some examples.

As I write this post, I am on a flight to California for another work trip.  I used to require window seats.  I liked to be away from the busy happenings in the aisle.  I liked to gaze over the changing landscapes as I flew.  I liked to lean on that side to sleep.  This infection has made me require an aisle seat so I could get up and walk around to minimize the aggravation on my wound. I carry a travel pillow with me for me to sit on because many seats aggravate my wound.

My posture has changed.  It made me sit or stand in a particular way to accommodate the wound.   Is it good?  Probably not but it feels comfortable to me now. 

It was determined about 10 days ago that the infection was no longer in my body.  My white blood cell count has dropped to the normal ranges.  Goodbye, antibiotics.  I look forward to healing from the nausea and diarrhea that the antibiotics brought on.  After learning the good news, I decided I wanted a break.  The wound care specialist, however, strongly advised that I keep on using the antibiotic ointment and cleansing the wound area until it is fully healed.  After months of poking, medications, ointments, yada yada, I decided to be rebellious and ditched the ointment for a few days.  Bad idea.  It has slowed down the recovery.  I was encouraged to accept this wound as part of my new normal.  Oh brother.  That little open wound that keeps on draining…. and is a huge annoyance.  I suppose so. 

I have learned to adjust my schedule… I would do a task that involves sitting for an hour then I stand up and do other stuff before sitting again.  That is probably a good thing because I have heard repeatedly from numerous sources that one should get up and walk around at least every hour to keep ‘active.’  So… the wound is making me active.

To ensure my wound remains clean, I have to wear cotton underwear.  I used to dread them.  I preferred nylon, satin, or lace underwear.  Now… cotton!  Boring, old cotton!  Okay.  I got some new cotton underwear… and they are actually comfortable.  Does that mean I am wearing cotton for life?  I don’t know.

I think that the point of this blog is...  I still do not know what my new normal is.  When cancer survivors and caregivers spoke of it, I thought they were referring to it as a destination… like I would have arrived at a final place after experiencing cancer.  It is not.  It’s an ongoing progression in which I continue to learn and discover about the changes that have emerged.  For example, I wear cotton underwear now.  But later on, what would my underwear choice be?  I don’t know.  What would it be like when I finally have a closed and healed wound no longer hindering how I operate?  I don’t know.  I think I will probably make a beeline to the chiropractor to get my posture straightened out. 

For a while there, I thought that I would have to see doctors on a regular basis.  It was driving me crazy.  I was seeing doctors on a weekly basis or even more.  The hiatus in my insurance coverage was actually a blessing in disguise.  It gave me a 15-day break.  My life as a cancer patient/ survivor made me feel like I was in a crowded space where I could not have some privacy and serenity.  Before attending my grandma’s funeral in Portland, Oregon a few weeks ago, I stayed with a friend in Independence, Oregon.  I loved her hometown.  It was so small.  It was so quiet.  Stores closed early.  There were more open spaces than buildings.  It was nice.  A big city felt cancerous to me.  Does that mean I want to move to escape to the boonies?  I don’t know.  This was a powerful metaphor for me… a cause for reflection of how things are slowly quieting down with the medical appointments and then maybe I can hope for a month without seeing a doctor for a month.  So far I have no doctor appointments in September and I hope I can keep it that way for now.  I need a break. 

Part of the progression is seeing how I am getting better.  I played racquetball four times last week and it felt awesome!  I did not get hurt or drop dead.  I, however, was unable to work out other days as I felt tired.  But I still managed to keep up the goal of doing 10,000 steps each day.  Today, I was able to travel with my bags and Chocolate in tow without getting tired.  The past two trips were tough and I was too exhausted by the time I get to the check-in counter.  I am sure I will sleep well tonight as it’s a long day of travel but I am feeling pretty good.  I am ready to try swimming again and decided that San Diego is the place to try it again.  It makes sense.  After all, San Diego was where I started swimming laps as a workout when I first moved there.  I am going to try a hike this week too. 

I am also back to working on my dissertation proposal with a renewed sense of energy.  I am truly happy to be embracing my nerd-dom once again.  Yes, the stupid cancer was an obstacle in my doctorate journey but I am going to finish that thing!  Thinking about research, talking about research, and reading about research are stuff that excite me again.  What has changed, however, I have decided to shift my focus from educational interpreting to medical interpreting for my dissertation.  My dissertation will be tied to cancer.  I am still working out the specifics so I may disclose more details at a later time.   Someone once said to me that once the cancer battle is over, I should get back to my dissertation and forget that it ever happened.  I can’t.  Cancer has become a new part of my identity and I can’t just remove that from who I am.  I am finding kinship with people who have battled cancer.  I thought I didn’t know many people with cancer but now that I have had cancer, I am surprised by how many people have fought cancer and survived.  They are everywhere but I did not see them before.  I smiled when I saw the woman seated next to me on this flight wearing a breast cancer bracelet.  I am wearing an uterine cancer bracelet.  We bonded over this little thing.  Back to my point… I truthfully DID NOT want to learn about cancer.  My dear breast cancer survivor friend said to me back in January, “Welcome to learning about stuff you did not want to learn… but you need to.”  I continue to learn about cancer on a daily basis.  I was in a funk and was trying to get myself to feel excited about working on my dissertation proposal again.  I wanted it to be tied to cancer.  It took me a few weeks to find a way to make it all work out that I did not have to do a major topic change at all.  And I am excited again.  Does that mean I will spend the rest of my academic life researching medical interpreting, specifically in oncology?  I don’t know.  It is an ongoing progression as I mentioned.  For now, it is something that excites me and that is good in my book.

One question that keeps on lingering in my mind… will I return to my die-hard type A personality?  I don’t know.  I have slowed down significantly.  Was it from the surgery recovery?  Is it because of the infection?  For sure, yes.  … Alas, is it a permanent change? I don’t know.  I do know I find myself feeling surprised that I did not accomplish as much in a day as I intended to.  Slowing down a bit is okay.  I suppose I am stopping to smell the roses, so to speak.  This has been a lesson in acceptance.  I am guilty of maintaining extremely high expectations of myself.  I am trying to be more forgiving of myself if I don’t accomplish as much as I wished.  Ironically, I am posting this online at the Los Angeles airport on a three-hour layover before I get to San Diego.  I used to be really annoyed by long layovers but I enjoyed this one immensely.  It is nice to be in the moment and just… wait, enjoy, and observe. 

Part of my exploration of my new normal is taking a hard look at whether I am leading a quality life.  I do not have any clear answers yet.  Answers are emerging slowly, but surely.  There are some things I want to change.  There are some things I want to continue doing.  There are new things I want to try.  Before cancer, I remember I was continually looking for the ideal balance in life.  I think this is true for everyone.  I thought I had answers before.  What is clear, those answers did not work for me.  I look forward to unfolding what works the best for me, only me.