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Lemonheads

This friday, our family went to a Halloween Spooktacular. We go to it every year. Its always busy and crowded with little kids in costumes and stressed out adults trying to keep up with the frenzy. There are jugglers and clairvoyants and men on stilts. Its the best place little kids can be.There are pumpkins and straw bales and a haunted house. Perfect set up.

As my kids were collecting candy, my daughter handed me a packet of candy to open. It was a yellow packet with the words in blue “Lemon heads”, and suddenly I heard the chemo nurses voice, “Can I get you some juice or cracker”, “why dont you try these “lemonheads” they should help with the nausea”.

Yes, the little tart lemon shaped candy was my savior last year. However, in my mind Lemonheads will be associated with chemotherapy for the rest of my life. I suffered through incredible amout of nausea during chemotherapy. All the blessing of the part in the brain called the “chemorecepter trigger zone” being so brand spanking and unused. Being a non smoker and non drinker without any history of sleep medication use, my brain was hyperactive when it came to generating nausea. It did not let me forget that I had had chemotherapy.

The AC cycles were excruciatingly nauseous. I would typically vomit for a good half of the night and stay nauseous for about a week after it. I ate Zofran like candy but to no avail. Finally after two cycles from hell, I asked my oncologist, if something could be done differently.

She said “Why don’t we try Olanzapine?”. I stopped dead in my tracks, as a psychiatrist, I know very well what Olanzapine is. Olanzapine is an antipsychotic medication that is used to treat illnesses like Schizophrenia and Bipolar Disorder. I have prescribed it. I know all the side effects and effects. Is she talking about that Olanzapine?

I asked her again, “You mean Olanzapine (Zyprexa)?”.

She said, “Yes” “there is good data, why don’t you look it up?”

Of course, as a Doctor, she knew i would,

I read the paper myself. It was convincing , it could help.

I send my oncologist a message saying I am willing to take it. But I told her the dose I was willing to take.

I needed to maintain some control. It was humbling enough that I was just prescribed an anti-psychotic medication. The one that I prescribe to others. Tables have turned. I am the patient now. Cancer allowed me the opportunity to connect viscerally with those that I treat.

A few days ago, a patient was ranting and raving in my office, “Doc you don’t know what being on these medications is like…..”

I smiled and empathized with his frustration.

Lemonheads, olanzapine, zofran, whatever it takes, you need to fight with whatever it takes, thats what fighting cancer is. Humbling and strengthening, all in one.

A lost week

When you have had cancer in one breast, the relationship with the remaining breast is scarily ambivalent. It is part of your body but a part that you have lost trust in. It feels like it is an accessory to something sinister or it may turn to the dark side anytime.

Its credibility is pretty much ruined. Keeping it poses a fear, a fear of cancer in the other side.I have had discussions with my breast surgeon about this risk. I was reassured that the risk of cancer in the contra lateral breast in not very high. However, I have been vigilant about my right breast.

A week ago I noticed some swelling in the right breast, a small area near my right arm pit seemed suspiciously swollen.

Cold shivers through my spine and a wave of anxiety went through me. I was convinced it looked different.

Next day I saw my doctor and as expected, earned my self a mammogram and ultrasound for starters.  I have already written about the mammography technician and her ” compassion” so I will skip over that part.

The Ultrasound revealed a solid mass which was consistent with a fibroadenoma. Mass in my breast is enough to scare the day lights out of anyone but when you are still not over the betrayal of one breast a mass in the other is enough to push you over the edge.

The very familiar and haunting word, biopsy was mentioned. Yep I am a vodoo doll, stick another needle in me, such is the fate of a cancer survivor. The “lets make sure” thinking was in action.

And I got a date for a biopsy.

Four days later, iodine, alcohol, poking , prodding , squishing, bleeding, ensued. 6 samples were taken and then came the wait.

Wait for the results. The world was moving but I was frozen in time. I looked at my  hair that have grown back, I prepared my self to go get it shaved again, I remembered the violent vomiting with AC protocol, the pain post op after the mastectomy, the days of fatigue, the radiation burns.

I could possibly have to do all of it over again. I seriously asked my self, would I be able to? What is the point where a person screams they have had enough? Its not fair!

But such luxuries don’t exist in the life of a cancer survivor, you bow your head to fate and do whatever it takes to live. Giving up body parts is the cost most of us happily embrace.

We are used to losing time to these tests and investigations, a week of paralysis is part of being a cancer survivor.

The biopsy came back as benign but now the thought hurling in my brain , Is there a second mastectomy in my future?

I dodged this bullet but is the war really over?

The Cancer God is looking for another sacrifice, what will I give up now?

Toxic Pink

Toxic Pink:

The more time I spend as the recipient of health care or as a” patient”the more I realize the impact of the people that provide health care.
The value of human interaction, the importance of kind conversations, the willingness to listen and make time, the effort to make the patient feel comfortable and an equal partner in what is being done to them.
My recent interaction with a mammography technician is a great example of this. Of course this is October and a lot of women are being prompted to do mammograms, after all, that’s what most women equate it to…I need to do a mammogram so I don’t get cancer or its caught early.
The center for Breast Death as I call it is also splattered in pinkness and pinkification since it’s the fountain of pink in the hospital.
The suite is decorated with different words such as faith, hope etc. One statement that caught my eye was “hair is so overrated”, not sure which genius thought that putting this up was a good idea.
Hair is overrated? Perhaps having two breast is over rated too, you could live with one or none? Are they over rated too? Sometimes ridiculous accompanies pink.
To aggravate further, the staff was wearing neon pink t shirts. Three cheers for awareness and especially for the lady that had a fake pink lock in her hair just to make the point.
There is a difference between promoting awareness and making a show of pink. There is a thing called dignity and grace that should accompany the ” Operation Pinkify”
A lot of people don’t know how to walk this thin line. They have not seen pink closely. Some have but want to keep it light and bubbly, sort of an upbeat thing, like there is anything upbeat about cancer and yes ” hair is so overrated”. Try being bald for 6 months, may be the rating will improve.
So amidst that sea of pink, I arrive to get a mammogram for odd swelling in my right breast ( the one breast that is still alive). The waiting room is full of anxious women, as if they are being strangled by the pink ribbon. Sometimes I feel sorry for them, since they are in fear of what a mammogram might show, for me, the worst has already come true so I find my self generally more relaxed.
I get called in and am escorted by a technician whom I am not familiar with. She is shuffling though papers as she takes me in.
She looks at me and says” You had a mammogram on your right breast three months again, only one side..and now you want another one just one the right side”.
Thank you pink, thank you awareness, thank you for your decorations and t shirts and the pink bears but are you really aware what breast cancer does to a woman? That it is possible that if you remove your pink goggles and read the form I filled out that I have only one breast, thanks to breast cancer, yes that cancer that your neon pink shirt and your Pepto-Bismol colored reception area indicates?
I found myself feeling angry and sad simultaneously.
I responded, “I have only one breast, I can have only one side done”
Yay for awareness, Yay for pink.pink_ribbon5

The Pink Ribbon

It’ on the bottle, it’s on the caps,
It’s on the box and on the socks,
It’s on the shower gel,
and the napkins too.
It’s everywhere,
and it’s so true,
we all need to know
we need be aware
the real life scare
that you and I share.

It is all around
a lump has been found.
The cutting,
the treating,
the constant torment,
the reminder for some
a mockery to others.
Some are living it
some have lived it
some are pink
some pink and blue
some hate it
some really do.

The ribbon reminds
what I don’t forget.
It aches my heart
when I look at the threat,
to know its October
that may be you are next,
maybe you are not.
I have had my turn and
I hope you do not.
So take your time
and be aware
we care
without the fanfare
we share
so you don’t
have to hate pink
like some of us do.
1yrsurvivor

I love fall

I love fall.

It’s a season of opportunity. A season to plan for transformation and then to wait for the right things life has in store for you.

I love fall. As the leaves turn color, their surprise potential is over whelming. One never knows what one holds inside them, what mysteries lurk in the depth, it’s only the right circumstances that bring it out. Sometimes it requires an inner change of season, color, approach and attitude. What follows is unabated eruption of vivid colors leading eventually to a new life, new perspective.

I love fall. There are no commitments. It could be cold and crisp, or unusually warm and humid. No obligations. Just going with the flow. Taking life as it comes. Giving up and starting over. No questions asked.

Fall is the season of redemption. To get away from what has been, embrace the impending change and then letting it go. Letting go is the only choice to start over. Resisting the cycle of nature, destiny and fate is futile. Letting go will lead to transformation, rebirth and rejuvenation .
We all hold on to things that once were full of life and vibrant, they moved with the wind, they responded to the rays of the sun but then times change. And what follows is gradually the withdrawal of the vigor and life substance, and when it happens, colors change, brighten, make room for more and go.

Trees let go gracefully, bowing to nature’s will, choosing to be vulnerable open and naked. We need to do the same. Then, there is the wait.
The wait for life to turn around and return with a force that is twice and strong, ripping through layers and forcing vitality to drench its new being. New hope, new will, new goals. I love fall.

So whatever is holding you back in life, whatever is not serving you, whatever that has run its course needs to be let go of. The cycle of nature demands renewal. Whether it’s a toxic attachment or an unhealthy relationship, if it has lost its vitality, it needs to be shed. Yes it will feel barren for sometime, but spring always follows fall.

Sometimes its hard to have faith in spring. I have seen brown leaves sometimes stuck to a tree even though their time has passed, they aren’t serving the tree, just taking up space to impede the growth of new buds.

 

 

We all justify why unhealthy attachmentsphoto should persist. Nature, when ready to let go, sheds it all with great might. The key is the insight to the soul. Knowing when your fall has arrived.  There is a reason fall is short. Changes are always drastic and require intense work over a short period of time. If fall went on for months, the intensity and need for change would be lost. Progress happens in intense bursts. You put in the effort and then wait for the results.

Fall teaches us anticipation. Anticipation of what is to come and what is to leave. It encompasses a broad range of transition, from subtle to intense.
Embrace it, embrace life with all its seasons. If fall never came, life would be monotonous and boring. Reinventing life requires a good look at the bigger picture and then deciding a course of action. We all change during the process, we all change colors, we all redeem ourselves, grow, transform and blossom again.

I went through my fall last year and am now waiting for the flowers to bloom.

Why Awareness And Mammograms Aren’t Enough

The month of October is upon us. The surge of pink is impending. Admittedly, everything looks cuter with a little pink in it. At least that’s my take on it. But there is nothing remotely cute about Breast Cancer.

Absolutely nothing.

I still embrace pink. I am aware. O God, I am so aware of this illness. Every 14 minutes someone gets diagnosed with this illness. How can anyone not be aware? Awareness is a good thing, raising awareness is a good thing.

I was aware, aware for the last 20 years that this is a fatal illness. When I said goodbye to my aunt, I was aware what breast cancer can do. So aware of the trauma her kids underwent.

I was aware, as I sat with my other aunt during her chemo infusions at the hospital, taking time off from my medical school classes to keep her company.

I was aware that some survive, others don’t.

I examined my self regularly since my 20s. I was very familiar with the texture of my dense breast. Lumpy and nodular especially before my cycle. My first mammogram was at 25 years of age.

I was always familiar with a breast surgeon in my network of doctors. I breastfed two children for over a year each.

I was aware of the risks.

I had 2 mammograms six months apart prior to my cancer, a 7 cm mass that never formed a lump. Just a change in the texture of the breast tissue, that only I could tell felt different.

I was aware of the density issue, I had an ultrasound too, which was normal.

Yes, awareness and mammograms help, but in the end, it was my gut feeling that made me locate the lump in my armpit. A swollen axillary lymph node that is never good news.

So those that read this today, please, examine yourself, know your body and your breasts. Mammograms do save lives but maybe not yours. For me, mammograms were a false sense of security. It was a self-exam that saved my life.

So when you see the pink ribbons all over, ask yourself, when was the last time I properly examined my breasts? When was the last time my doctor taught me how to examine my breasts?

Know your genetic risk, I don’t have the BRCA gene but due to two family members, my risk was higher. Know your family history.

Take care of yourself, eat well and exercise. I did all of that. I still got cancer but it was my fate based on my genetic makeup.

Your outcome can be different, why wouldn’t you give your self that chance?

Before and After

I walk forward
I march ahead
I try hard each day
Then again someone will ask
“Didn’t you have long hair before?”
I did , I did 
A before and an after
There always will be.
I console my self
I seek comfort
Sometimes I lie
And hide from the truth.
Pretend it never happened,
Pretend it was never there,
Then again someone will ask
” didn’t you have long hair before?”
I did , I did
A before and an after
There always will be 
Life expects more
More from us than others
Bravery, courage, right attitude
Every day 
We are different
A tangent that our lives
Have taken
In and out of the flow
Pretending
To be
One of them until
Some one will ask again
“Didn’t you used to have long hair”

“Some Days”


“Some Days”

Yes, I am thankful
Yes, it’s really great
I have made it so far
so far I have been spared
but some days I get flaky
and sad and angry too.
some days I get so flaky
I want my life renewed.

Some days I want hair
thats long and straight
sometimes pretty nails
a carefree attitude
both breasts too,
Some days I get needy
Some days I have wants
Some days I want protection
from fears to be gone
Some days I just get flaky
and sad and angry too

My freedom has left
My mind occupied
My dreams conditional
My life uncertain
But
But I have to pull this burden
a life marked away
a life marked as traitor
day by day
moment by moment
bit by bit

Suppress the fear
Hold on to hope
Distract yourself
It works, sometimes
It works some days
but some days I get flaky
and sad and angry too.
Uzma Yunus

It’s time to go again

Its time go again:
A tribute to my sisters undergoing reconstruction

The OR is ready,
the sheets are clean and crisp,
He is scrubbed and gloved,
Slow music in the back ground,
the masks are on,
The monitors are anxious
the I/V is expectant,
All over ,once again.
It’s time to go.

And you, on the gurney,
ready to count,
till your sleep connects you to them,
quiet hours,
slow breathing,
pain and grogginess,
All over, once again,
It’s time to go.

I am trying,
again and again,
to undo what I didn’t ask for,
All I want,
is to feel whole,
whole again,
like I was,
It’s time to go.
It’s time to try
and to regain
a fraction of what was lost,
I am ready,
I am ready,
I am ready to count,
I am ready to endure the pain,
Ready to be whole again.