Depression...

... i got it.

There is so much stigma around mental illness that I hesitate to write this post. In a blog where I've spoken openly about my breasts, among other pretty personal things, I wonder about whether or not it's wise to disclose my history with anxiety and depression. But I never claimed to be wise.

Over the course of this whole cancer fiasco I've come into contact with just a ton of doctors. The D section in my phone contacts is thick. They start, invariably, by taking a medical history. Then at the end they ask if you have any other conditions that they should know about. Which is when I get a dumb blank stare when I tell them that I have chronic anxiety and depression. Which, I think, is pretty relevant information to have about someone who is about to go through hell, but I'm not gonna go on about the medical establishment at the moment.

it's actually not.

Clinical depression is not new to me. I'd been taking medication for my depression for years. Then I self-medicated with booze for a while. Then I self-medicated with vitamins (mega B-stress from whole foods, plus another 400mg of folic acid and a D vitamin every morning was super effective). Then I got a new, fulfilling career and wasn't depressed at all for a while. And then I got cancer. I knew I'd be fighting a battle on two fronts from day 1. But my options are more limited, now.

I didn't want to start up on antidepressants again. Coming off of them is just too hard. And I don't want to take my vitamin cocktail because I'm scared that something will be contra-indicated with some of the poison I'm taking every two weeks and my chemo will be less effective. (I've had this fear since a doctor neglected to tell me that the zinc I was taking to help with wound healing when my legs were all messed up from surgery would interfere with the antibiotic he prescribed me for same, infected wound and my oncologist refused to andminister my chemo for a third time because my stupid wound infection wouldn't go away. I had to google that shit.) I have a stockpile of benzos, but I'm trying to stay off them because of the sexual side effects (going HAM with the disclosures today).

So that leads me to today. I hit a wall with depression on the evening of June 25th. I was going about my business as usual when I found myself sitting alone in a room staring into space mentally listing everything that sucks about me. It's like that sniffle that you know is going to turn into the flu. Depression season is here!

Since then I've tried a lot of things:
crying hysterically
crying quietly
watching a funny movie
crying alone in the kitchen with a cat on my lap and watching a funny movie
fighting with my boyfriend
drinking till I feel better
candle magick
sitting on my stoop
mentally listing all the things I haven't accomplished
crying on my stoop
hanging out in the shed for no reason
napping under the dining room table
mentally listing all the ways I let the people around me down
crying alone under the dining room table until my bf actually suggests I go shopping to try to cheer up
crying at Goodwill and Target
VISINE
texts from mittens
the "everyone hates me" chant
internal dialogues about why they're right
sleeping

Surprisingly, none of these has worked (well, drinking did, but I can't carry on with that). Don't worry, though. I'm taking a Valium, like, now. Writing this post has convinced me of the exigency.

I know I said I wouldn't get on my soap box, but: It totally baffles me that psychiatric care isn't integrated into cancer treatment. Counselling shouldn't just be offered, it should be mandatory. (also, don't worry, I have the phone number of a shrink that I'll make an appointment with as soon as the Valium kicks in.)

Round 3 and Round 4 and Gratitude

I haven't been updating about my infusions. In the time leading up to one, I'm trying not to think about it. I only have a short window afterwards before I start to feel pretty crappy and don't really have the energy for getting a blog post out. Not to mention the chemo-brain that has me thinking every thought three times in a row. I'll presume on your forgiveness.

Cytoxan headache of death. Round 3.

For round 3 my mommy-kins came into town and saved the day. She cooked, cleaned, taxied me to run errands, taught the boy to bake bread, made us a headboard, and listened to me wax poetic about my most gnarly chemo side-effects. Just having her around made me feel peppier.

matching shirts, matching haircuts, and the cute, tufted headboard momma made. 

Yesterday I had my last infusion of adrithromycin/cytoxan. I would say I'm glad to be done with such pain-in-the-ass drugs, but I'm not done. It's the side effects that get ya. I feel fine now, but I won't tomorrow and this time I don't know how long I'll be out of commission. It's a special sort of torture to have to do this to yourself right after you start to feel better. The day before, I went crazy cooking and cleaning and drank an entire bottle of Riesling. I felt like I was about to go to prison (25th hour and shit). I got maybe 3 days of relative health and energy at the end of round 3. I broke. I knew I couldn't face my last infusion of 'Red Death' alone. That's where your other family comes in!

I had only just mentioned to my mom how scared and upset I was about round 4 when I got a text asking what time I need to be picked up and what trashy magazines I wanted. Bridget had already taken off work to come with me. Family helps even when you won't ask. And knows me well enough not to leave any room for me to try to politely decline .

My "I don't have cancer" disguise. 

I'm going to get on my soap box for a second: Oncology doctors and nurses these days like to throw around the line "tell us about your side effects. there's no need to suffer". They like to make it sound like they have a drug for everything that'll get you down during chemo. Having heard this for over a month and finally feeling like I really needed some help in between doses, I came in with my wish-list; Can you help with the crippling fatigue? No. How about the dizziness and body aches? Not really. How about the cognitive straightupdumbness? Sorry. I walked out of there with a mouthwash to help with the sores and a suggestion for a different OTC med to help with bloating and constipation. It's like a drop in the bucket for the things that are actually making my life miserable. I was livid. Stop saying you can help with side effects if, in reality, you can't. Apparently I DO need to suffer and I'd appreciate you just being real with me. Or prescribe me the cocaine and ecstasy that'll really fix me up on those miserable, post-chemo weekends. There's an idea.
Ok. I'm finished ranting.

Bridget looks super cute in my wig!

Round 4 was a fiasco. I won't rehash the entire thing. I got the run-around when I got there, had another substitute oncologist who talked a nice game but ultimately forgot to call in any of my prescriptions, had to sit through an additional hour of pre-meds for my "very positional" (which just means it doesn't work right) chemo port. By the time I rolled out of there I had taken so much Valium to deal with the anxiety and opiates to try to stave off the insane headache I get from cytoxan that I was suuuuper glad to have a ride home.

It's on a freaking pizza tray.

Through it all, I had my shining star by my side. She introduced me to the giant pancake at City Diner which literally gave me a reason to wake up that morning. She let me go on about my boring little life (chemo, my cat, chemo, my boyfriend, cancer, chemo, that one time I went somewhere, chemo, the dog and the cat). Showed me photos and told me stories about babies to keep my mind off things. She bought me an embarrassment of riches in reading materials. She rubbed my back when I cried, held my hand when I almost cried, and even ran to the cafeteria when things were really getting into overtime. She reminded me that this was all for the best, which sometimes you need someone else to say to make you really, truly believe it (at least for a little while). I can never repay the kindness and support and thoughtfulness that Bridget offered me when I so desperately needed it. I'd like to thank her publicly, here, from the very bottom of my heart.

Seriously? Amazing.

Reconstruction

I just watched this video and wanted to share it. I'd heard about Vinnie awhile back and had planned to have him finish off my foobs when the time comes. I'm in the midst of chemo so a lot of my more superficial concerns have kinda gone out the window. I haven't thought a lot about my breasts, their thighmeat replacement lumps, or what will ultimately be filling out my swimsuits in my years of survivorship. But having been reminded, there are some things I'd like to get off my chest (pun intended).

First, if you're recently diagnosed and thinking about what sort of reconstruction you'd like to have, take a step back. You need to ask yourself and your surgeons and hopefully at least one oncologist whether or not immediate reconstruction is worth the risk. Lemme quote myself and give you my HIPAA protected medical history real quick.

Here's what happened with me: I found out that I had cancer. Then, I found out that it was serious. At least the one mastectomy was strongly recommended. I chose to go bilateral because I didn't want the possibility of having breast cancer ever again (although, scientifically, I know it dosen't actually make a difference). I also thought it'd be easier to get a matching pair if my plastic surgeon started from scratch. My breast surgeon gave me the name of two plastic surgeons and told me to pick one within a week. One pitched implants, the other autologous reconstruction.  

There are two options when it comes to breast reconstruction: implants or autologous breast reconstruction. Breast implants are exactly what you know them to be, however, once all your breast tissue is removed you're left with just skin and implant. It's not quite the same as an augmentation. The woman in the Times video had implant reconstruction. Autologous reconstruction, on the other hand, takes tissue from another part of your body (usually the lower stomach) and transplants it to your chest to make new breasts. I decided to go the frankenboob (autologous) route for a lot of reasons. There are costs, benefits, and risks unique to each procedure. I won't rehash them here.  

Because I'm so thin, there wasn't enough fat on my stomach to build two breasts. The transplant came from the back of my thighs. I had healing complications that pushed the start of chemotherapy (desperately needed, lifesaving chemotherapy) back from the recommended ASAP to a full 59 days from surgery. I also got the gift of four disfiguring scars. Autologous reconstruction is done in two sessions. The initial transplant then the revision. Revision surgery happens after all your cancer treatment is complete. My plastic surgeon promises that I'll look normal again when it's all over. Inside the body I have right now, it's hard to imagine. 

This is where I'm coming from when I say STEP BACK. Reconstruction at the time of mastectomy is seen as beneficial for two reasons. First, one surgery is considered better than two in the opinion of the medical community. Second, the patriarchal medical community seems to think that not having breasts (those same breasts that were trying to kill you) for some period of time is more than the fragile female psyche can handle. But what you get initially aren't breasts. They aren't yours. You don't look the same in the mirror or in your clothes. You can't even feel the damn things. I, personally, think that it was an added psychological burden to have to get used to what took the place of my glorious Little Sisters while at the same time getting used to the idea of having cancer. I think that having my breasts simply removed would have made me feel less threatened, like I had taken a step in the right direction. I think I would have felt powerful, the same feeling that leads me to rock my bald head on a daily basis.

However, not having the reconstruction at the time of surgery was never even presented as an option. Not only would "just going flat" have actually saved me some body issues, it still may make a difference in my survival since the effects of the chemo delay won't be known till it's too late, if ever. I may have sacrificed years of my life for dumb little fake titties. That's a hard pill to swallow.

When all this is over and I'm in whatever body cancer leaves me with, I'll probably go to Vinnie's for fake, 3D nipples (the woman in the video had a surgically-made little nubbin that I skipped. I figure: if they aren't going to function, why have them at all? Bra-less 4 lyfe.) I also am going to probably get something pretty to cover some of the scars. But when the woman in the video said that reconstructed breasts are hard for women to talk about, it prompted my contrary nature. If you are recently diagnosed, you're so much farther from "normal" than you think, it's not even funny. There's no rush to reconstruct.