Happy Anniversary! Now lets dig for veins!

Yesterday Brandon and I celebrated our 14th wedding anniversary with a full day at UCLA for scans and treatment.  Each year that passes, I love him more and more.  When I look back on our life together I'm amazed at the storms we have weathered and survived.  From burying a child to terminal cancer, we haven't lost hope or each other.  When we decided to get married, people thought we were crazy!  At 19 years old, what did we know about love?  I'm not sure what the heck we were thinking, but boy am I grateful we didn't listen to people who thought they knew better than us.  Of course it hasn't been easy.  And of course there are days when I love him, but I don't necessarily like him, and anyone who knows Brandon can totally understand!  He can be somewhat of a smart ass at times.  It's secretly one of my favorite things about him, but don't tell him I said that ;).  Having Brandon by my side through this stupid cancer has been my saving grace.  He is an incredible man.

Yesterday morning we dropped off the kiddos at school and were on the road headed to UCLA (Santa Monica Facility) by 8am for several appointments.  Because the trip is so far and takes so long, I try to schedule everything on the same day.  It makes for a very long day, but at least I'm not taking multiple trips out there each month.  With my CT appointment scheduled for 10:20am and my other appointments later in the afternoon, we figured we'd make with no problem.  Yeah...wrong.  By 10am GPS put us nearly an hour away.  I was starting to panic.  This long awaited scan was to be the first since starting my new treatment and would be the first peek at whether or not it's working on holding off my cancer.  If I missed the appointment it meant I'd have to reschedule for another day, take another day off work, and fight the LA traffic to get there.  I called radiology and explained the situation.  The receptionist was so nice!  She put me on hold and contacted the radiologist who said not to worry.  He switched around his lunch and pushed my appointment.  AMAZING.  I feel so blessed to be at UCLA for treatment.  The compassion and care I have been treated with from every department and every person is extraordinary.

When I arrived for the scan, the tech immediately came out to greet me.  He handed my a bottle of a liquid I had to drink within an hour to coat my intestine before the scan.  One hour late he returned to take me and Brandon to the back to prepare for my scan.  I explained to him I can only use one arm for my IV since I had lymph nodes removed when I had my mastectomy.  Because of all the chemo I have had, my veins are weak.  During my last few rounds of chemo, things got so bad with finding a vein that I had to be stuck multiple times by multiple nurses.  Yesterday proved to be no different.  The CT scan itself (chest, abdomen, and pelvis) literally takes less than 15 minutes, but I was in that room prepping for nearly 2 hours.  The first nurse stuck me twice digging around for a vein.  When she couldn't get it, she called in for reinforcements.  The second nurse stuck me twice digging around for a vein.  When she couldn't get it she called for a specialist.  Those poor nurses!  They felt so bad and kept apologizing.  I kept telling them not to worry, I've been through much worse.  It's really not their fault my veins suck...it's cancer's fault!!!  When the specialist arrived she stuck me twice digging around for a vein and once again was unsuccessful.  Things got serious at this point.  She straight put on her game face and told me to brace myself.  She meant business.  She pulled my arm straight, prepped the nook, and told me to take a deep breath.  And with that she went deep.  Super deep.  She plowed through scar tissue and nailed a juicy vein.  It was the most painful IV I have ever had. Ever.  I burst into tears.  Not because I couldn't handle the pain, but because I had just been poked seven times.  SEVEN.  And I was just done and exhausted.  I cried because this freaking suuuuuuucks.  But I'm a badass and my self-pity lasted about 30 seconds before I sucked it up and womanned-up.  The staff was so wonderful and comforting.  Every visit to UCLA, no matter what department, is an affirmation I made the right choice to switch my care.

After my CT, I met with Dr. Callahan.  Amazingly when I met with her the results for the CT of my abdomen and pelvis were already ready and in the computer.

drumroll, please.........

No new cancer activity!!!  Cancer is stable!  Thank you Jesus!  Can I get an AMEN!

Dr. Callahan explained that the results for the CT of the chest usually takes the longest.  Today the results came in.

Another drumroll, please.........

No new cancer activity!  Cancer is stable!  Shout out to the Big Man upstairs!

The best part of the new treatment, aside from the fact that it seems to be working, is there are minimal side effects.  The worst being hot flashes (they're the devil!) and fatigue (generally at the end of my day).  They suck, but they're manageable.  Nothing impeding my quality of life or my daily activities.  We are still waiting for the results of my tumor marker, which hopefully has dropped since my last one.   Before I left Dr. Callahan's office, I had a blood draw done and got four shots of my cancer fighting cocktails.  12 pokes total in one day.  That's a new record.  One I hope NEVER to beat.

Aside from this stupid cancer, life is good.  If it weren't for the cancer I'd say it was damn near perfect.  I'm living life and enjoying every minute of it.  I keep a smile on my face and positivity in my heart.  Don't get me wrong, there is panic and fear simmering under all my emotions.  That is unavoidable.  It's my new normal.  But I refuse to let it boil over or rule my life.  There will be a time (hopefully a very long time from now) where I will let the pain and fear and panic wash over me.  That time is not now.  I'm good now.  I feel good and life is good.  Why waste my time on allowing this disease to take away my joy?  Ain't nobody got time for that!  I have too much to live for and so much left to do with my life.  In the midst of all this, I have my babies to think about.  And while I'm grateful that Leo is too young to really understand what is going on, Ava understands it all.  She understands it in a way that makes me both proud and sad.  They hear what we say, our little ones.  They soak it in.  It's amazing what little minds can comprehend.  But alas, that story is for another day and another post.

Bye Felicia...I mean Kaiser

You know it’s time to post an update when people following your blog start messaging you to check if you’re still alive.  I know, I’m way overdue. 

I met with my Kaiser doctor in late June, 6 weeks after chemo ended, to review the results of my last CT scan, which showed my cancer is stable and that’s about it.  No follow up appointment scheduled, no treatment plan.  Nothing.  She was in a rush and I had too many questions.  I knew leaving there that day, it was time to move on.  Lucky for me, I already had an appointment scheduled to see a new doctor at UCLA.     

On Wednesday I headed off to UCLA to start a new treatment plan with the latest and greatest in breast cancer research.  What an amazing and incredible difference from Kaiser.  In May I made the decision to switch my insurance to a PPO.  This switch meant losing my double coverage (we have health insurance through Brandon’s work as well), but allows me to seek medical care just about anywhere outside Kaiser.  I was at a breaking point with my doctor and my care.  My questions were never really answered, my appointments were few and far between, tests and scans were taking weeks to book, and my doctor made me feel like I was a nuisance, like with stage 4 cancer, I shouldn’t bother.  I’m guessing a lot of doctors are like this, very analytical, focusing on facts and statistics.  But there is a lot to be said about hope.  It’s powerful.  

Hope has a direct impact on how you perceive a situation and how you chose to face the obstacles in your way.  It is well documented that outlook has a profound influence on your prognosis.  Optimists do much better than pessimists.  And while I consider myself the eternal optimist, I am human and I have my moments of doubt and depression.  Understandably so.  Most people in my situation would as well.  There are times I feel panic start to rise up and threaten to engulf me in sheer madness.  Raw and undiluted.  And boy, does it sneak up on you!  A fellow cancer fighter once told me, when I was first diagnosed, to never linger or let my mind stray to the idea that my kids will grow up without their mother.  But the mind is complex and plays trick on you.  It betrays you and holds you hostage to its thoughts.  It’s a terrible feeling, worse than any physical pain I have yet to experience.  But hope is the best medicine for depression.  It breathes life into you and pulls from the panic and allows you to live.  It rescues you from captivity.  When I was at Kaiser, I felt the hope slowly seep away and no matter how hard I tried to hang on, I was losing my grip. 

When my Kaiser doctor told me my cancer was terminal, it was over phone.  Yes, that’s right, over the phone!  Brandon asked her what the test results meant, could I beat this?  Her response was, “No, this is a terminal diagnosis”.  Then…silence.  She sat there silent over the phone as the panic overtook me and I sobbed and Brandon sat frozen and shocked.  She was silent for quite some time.  Six little words destroyed any offer of hope.  It is by far the most excruciating pain I have ever experienced in my life.  I felt trapped.  I was suffocating on her words.  And in that time, she failed to console or offer any hope.  Of course, many might say it is not the responsibility of the doctor to lift you up or give you hope, but that's like saying a teacher isn’t responsible for giving students hope either, for making them believe they have the power to succeed, to overcome their circumstances.  And, you know, maybe that’s true, that doctors and teachers aren't obligated to foster hope…but those that do are often the ones that make a difference and achieve greatness.  Words are powerful.  Deep down I knew I needed a new doctor, one that had the same passion for their patients, like I have for my students.  I found her at UCLA.  

Dr. Rena Callahan was prepared for our first visit in a way that proved her expertise and compassion.  The first thing she asked when we met was to tell my story from start to finish.  She asked me questions in between and didn’t make me feel rushed.  When we discussed medications she knew what the latest studies and trials showed and had reasoning for every decision of the treatment plan she made.  She treated me like I had a life to live and we were going to do our damn best to make certain I had the right medications to ensure it.  At the end of our appointment, she left me with a solid plan and renewed hope.  At the end of the appointment, as Dr. Callahan left the room, Brandon, Jeanette (my die hard, crazy protective, at every appointment sister), and I each looked at each other in disbelief.  I could breathe again.  On Wednesday I met with Dr. Callahan again and a palliative care nurse. I started four new medications:

1. Ibrance

One pill a day for 3 weeks then 1 week off

Ibrance was just FDA approved last year and is hailed a “breakthrough” drug in the fight against breast cancer.  In studies, it doubled the median delay in disease progression.  Ibrance works by disrupting proteins in cancer cells from signaling and therefore slowing it’s ability to grow and divide. 

2. Faslodex

2 Monthly injections

Faslodex works in conjunction with Ibrance.  Their a killer team…no pun intended.  Faslodex essentially blocks estrogen.  It sits in the cells and leaves no room for estrogen to take up residence and feed the cancer.   I get two injections at a time.  One in each cheek.  The medication is so thick it has to be given slowly. 

3. Denosumab

Monthly injection

Denosumab is a very expensive bisphosphonate that helps stop bone cells from breaking down while strengthening bones.  My last CT scan showed no new cancer grown in my spine and showed what looked like new bone growth.  But my back is still hurting.  I am hoping this medication will be the ticket to some much needed relief. 

4. Lupron:  

Monthly injection

This medication will shut down my ovaries and put me into menopause.  My cancer is estrogen fed, so shutting down my ovaries will help to reduce the amount of estrogen in my body.  

The last thing to do is sit back and brace myself for any side effects.  The most common side effect that I will have to keep a close eye on is a drop in my white blood count due to the Ibrance.  Dr. Callahan said if my counts do drop, I may need to hold off Ibrance an extra week.  2 weeks off instead of one.  I feel confident with my decision to continue treatment at UCLA.  The care so far has been far superior and is worth the crazy 2+ hour commute to get there.  Both visits the waiting room was empty when I got there and empty when I left.  It felt like I was the only patient of the day.  No overbooking, no rushing, no half ass answers and care.  Dr. Callahan wants to see me once a month for my monthly dose of injections and to see how I’m tolerating my cancer cocktails. 

 

I know the reality of my situation.  My switch to UCLA isn’t going to save my life, but I have no doubt it will extend it.  Whether by 1 week or 10 years doesn’t matter, I just know UCLA will give me more precious time with my family.  I’ll take whatever I can get. 

Stage 4 Explained

One of the hardest things to deal with since I found out my cancer came back is the fact that so many people have no idea what stage 4 means.  Heck, I didn’t even know and I had cancer! 

I get lots of responses like:

“You’ll beat it” and “You don’t look sick”

Yeah, there’s no beating stage 4 breast cancer.  It’s terminal.  There is no cure.  But people don’t understand this because they’re right, I don’t look sick.  And most days I feel pretty good.  When we found my cancer had spread and we started telling family and friends, everyone wanted to come see me and they were always shocked to see I wasn’t on my deathbed.  I looked perfectly healthy.   

The truth is this cancer will kill me.  Eventually I will look sick. 

Are you confused?  So was I.  Stage 4 cancer differs from all other stages because of the fact that treatment is aimed at extending life as long as possible by suppressing cancer growth.   Let me break it down.

Sage 4 Explained

What does stage 4 mean?

Stage 4 breast cancer means the cancer that started in the breast has spread beyond the breast and lymph nodes to an organ or another part of the body (liver, lungs, bones, brain, etc).  My cancer has spread to the bones and lungs.   Stage 4 breast cancer is also known as metastatic cancer, advanced cancer, and terminal cancer. 

If your cancer has spread to the bone, isn’t it bone cancer?

When breast cancer has spread to another part of the body it is still considered breast cancer because the cells are breast cancer cells.  When my cancer came back and it was discovered in the bones I had a CT guided bone biopsy done.  This is a rather uncomfortable procedure.  I had to lay face down on a table and stay very still.  They sent me into a machine for a CT scan so the doctor could find a bone with cancer that was easy to access.  The winner was my hip.  Still laying face down and staying perfectly still, the doctor used a syringe to numb the area then he took a very long needle with a small drill at the end and went to work.  You don’t actually feel anything until the needle hits bone.  You can definitely feel that.  The drill takes a core from the bone where the cancer is.  This was repeated 3 times.  Once the cancer sample was collected was sent to a lab for testing.  The testing tells doctors whether the cancer cells are breast cancer cells or a new cancer like bone cancer.  The biopsy confirmed the cancer in my bones is the breast cancer from my original diagnosis. 

How can you be terminal if treatment is working?

My breast cancer is the most common and treatable kind, Estrogen receptor positive.  There are quite a few different drugs that can be used in the fight against it.  The tricky part is, cancer is an evil uninvited guest that eventually becomes resistant to everything in your arsenal.  Every drug you use will eventually stop working.  My doctor describes it as a string of beads.  Each bead represents a different treatment option.  As you work your way down the beads of treatment, you take the beads off once they stop working and move on to the next one.  Eventually you will get to the end of the line.  What happens when you get to the end of the string of beads?  No more options.  This is what terminal means.  The goal of treatment is not to “beat cancer”.  The goal is to hold it off as long as possible.  This doesn’t mean I’m going to die tomorrow.  It’s important to understand that EVERYONE IS DIFFERENT.  Some people will have a huge response to treatment while others have none.  Some people live months while others live decades.  Breast cancer is unpredictable.  I don’t look sick because the chemo I’m on is doing its job and forcing cancer to retreat, but eventually the cancer will outsmart it and I’ll move onto another weapon in the fight against it. 

What comes after chemo?

No one can do chemo forever.  The goal of chemo is to get cancer under control and kill as much as possible.  The ultimate goal is NED, No Evidence of Disease.  This does not mean there’s no cancer.  When you are stage 4 there’s always going to be cancer lurking in your body.  NED simply means the chemo has killed enough that you can no longer see it in a scan.  Once we have the cancer “under control” I will have my ovaries removed and move on to hormone therapy and targeted therapy Arimidex and Ibrance.  These two drugs are taken by mouth and work against cancer from two different angle.  Their goal is to hold the cancer at bay.  Starve and kill it so it won’t grow again.  Ibrance is a new drug that was recently FDA approved last year and is showing promise in treating metastatic breast cancer.  Our hope is that these drugs will not only work (remember everyone’s different and some people won’t respond to certain drugs) but will work for a very long time! 

When does treatment end?

Never.  It will never end.  Whether it be chemo or pills, I will forever be in treatment keeping the cancer at bay.  A small price to pay to live as long as possible to see my babies grow.  If I stop treatment I give the cancer permission to infest and spread. 

But you don't look sick.

Yes, I know.  I hear this almost every single day.  It’s so frustrating to know that there is cancer feasting in my body when I look fine.  The most difficult part of not looking sick is people relate how you look to how sick you are.  I can’t possibly be THAT sick.  But don’t underestimate what’s going on in a person’s body.  Cancer that has spread to the bone is one of the most excruciating pains a person can experience.  The pain is how I discovered the cancer was back.  I was experiencing terrible rib and back pain that wasn’t going away.  It was getting worse instead of better.  I complained about my pain to 6 different doctors that just wanted to give me pills before I started doing my own research and discovered it could possibly be cancer in my bones.  Worst pain in my life, and I delivered a 10lb baby!  The point is cancer wrecks havoc on a person physically and emotionally regardless of what they look like on the outside.  There a battle going on inside…trust me. 

So how long do you have?

Your guess is as good as mine.  People are scared of this question.  They want to ask it, but they don’t of course.  I can give you all the statistics in the world like the average survival for someone like me is 2-3 years or that I have a 22% chance of surviving 5 years.  The truth is no one knows how long I have except God himself.  My oncologist did say that my initial response has a significant impact on my overall survival.  The better the response, the better the prognosis.  There are women who live well beyond what is expected and newer drugs are slowly making their way to the hands of metastatic breast cancer patients. 

What should I do to help?

The best advice I can give is if someone close to you is fighting an illness or going through a hardship DON’T BE SILENT.  This is quite possibly the most hurtful thing you could do.  Send a card in the mail, set a reminder on your phone and send a weekly text message letting them know you’re thinking of them, drop off flowers, cook a meal, set up a play date with kids, stop by for a visit and let them talk about what they’re going through,.  Brandon and I are blessed to have so many people in our lives that have shown their endless support.  It is what has kept us going and has fueled us with positivity.  Feeling loved can breath life into a person.  It can make all the difference in the world. 

A few months back, I went to church with my sister and her family.  While there, they called me to the front during the service and the entire congregation prayed for me.  This is by far one of the most spiritually uplifting experiences I have ever had.  Powerful.  A few days later I began receiving text messages from a church member named Rose.  She happened to be there that day and somehow got my number.  She has texted me religiously every single week since.  She sends me the kindest words of encouragement that I have come to look forward to and rely on for support.  A complete stranger does this.   I recently met her in person and I am forever grateful to her.  I am shocked myself by how powerful these messages have been in my life.  The point is, find something you can do and do it.  Don’t ask what you can do to help.  Chances are the person will NEVER REALLY TELL YOU.  Find something that you can do that will be helpful and is within your ability. 

I was diagnosed with stage 4 two days before Christmas.  Needless to say, it made for a very depressing holiday.  After Christmas, my beautiful and incredibly amazing coworker Kathy showed up at my house one Saturday morning with her husband and two sons and began taking down all my Christmas lights.  She didn’t ask and she didn’t knock.  They just showed up and did it. It meant more to me than she will ever truly know.  It was a total act of kindness from the heart.  She felt compelled to do it and so she did.  She had no idea that the thought of taking down my lights was causing me terrible anxiety.  Let me tell you, had she asked me, I would never have let her do it!  I would have felt terrible to inconvenience her on a Saturday.  She didn’t give me the option of saying no.  I love her for it. 

Is it oaky to talk about it and ask questions?

Yes, yes it is.  At least it is in my case.  It’s definitely okay to talk about, just be sensitive and honest.  If you have a question you want to ask, but you’re not sure it’s okay, then say that.  “Hey, I had a question, but I’m not sure it’s oaky to ask and I don’t want to hurt your feelings or make you upset”. I’ve had people come and visit after finding out my cancer is back and then not ask me a single question about it.  They’d avoid the topic like the plague, and of course, I wouldn’t bring it up either because I don’t ever want to make someone feel uncomfortable.  Coincidentally, that’s probably the reason they did’t bring it up either.  It’s OKAY to ask questions.  It’s OKAY to talk about it.  Trust me, anyone going through illness just wants you to understand what they are going through. 

Hope, Believe, Strength, and Faith...and the power of prayer

Every cancer patient knows the term scanxiety all too well.  It’s legit.  It’s the anxiety that infiltrates and taints any hope for peace leading up to a scan and waiting for the results.  I had my first CT scan since starting treatment on March 16th.  Scans during and after treatment tell how effective chemo and/or other treatments are in the fight against cancer. It can be overwhelming and hard to escape the stress associated with these scans.  I feel very blessed to have an extraordinary support system to help me through it.  So many people have reached out to me during this difficult time and words don’t do my gratitude justice.  It’s been a huge source of support that has honestly kept me going.  Thank you to the many who have offered relentless prayers on my behalf and words of encouragement and support.  I love you all so much for it!  

On Friday I had an appointment to meet with my oncologist to review the results of my CT.  Although my pain has virtually disappeared (a good sign the chemo is working) I couldn’t help but feel anxious.  How could I not?  I was relieved when my oncologist, Dr. Moon, sent me an email Wednesday telling me she had received the results of the CT and they looked really good!  She didn’t offer any details, only that the visit on Friday would be good news.  But how good???  I spent two sleepless nights tossing and turning wondering what was going on inside my body.  How much cancer had been defeated?  How much was still lingering?  

On Friday I entered Dr. Moon’s office with Brandon and my sister Jeanette by my side.  When Dr. Moon came in she pulled up my CT scan I had done prior to treatment and next to it pulled up my most recent CT from the 16th.  I was blown away.  My cancer had shrunk…a lot.  When I asked Dr. Moon if she had been expecting this kind of result she said she had expected a response, but not this significant!  Typically, after 3 months of treatment a 50% reduction in cancer is good.  After 2 months of treatment I showed an 80% reduction!!!  Incredible.  What a victory!  I can only attribute this to the power of prayer.  Relentless and unwavering prayer from so many.  

When I got home from the appointment a package was waiting for me from a very wonderful and thoughtful friend Ginnell. She had no idea how perfect her timing was.  Inside the package were four necklaces.  One for myself, my mom, and each of my sisters.  Each necklace has a key with a single word inscribed on it. Hope, Believe, Strength, and Faith.  This gift was meant to come to me on this particular day.  The significance of these words is astounding.  Each represents my fight against a terrible disease meant to rob me of my life.  These words represent everything that I have tried to embrace in spite of the fact there are days I fail miserably.  

HOPE:  The HOPE key went to my sister Jeanette.  She took a 3 month leave of absence from work to be by my side every single day.  She has been by my side for every doctor’s visit and chemo appointment.  She has been there to listen when I feel everything falling apart.  I know I should have argued with her when she told me she was taking a leave from work, but the truth is, I wanted her by my side because it’s easy to feel hopeful with her there.  I am hopeful that no matter what, everything will be okay. 

BELIEVE:  The BELIEVE key went to my sister Liz.  That woman doesn’t let me linger on the negative!  She is the constant force behind me, reminding me that I need to have hope and faith and that I need to BELIEVE I can overcome the obstacles before me.  

STRENGTH:  The STRENGTH key was most fittingly meant for my mom.  The woman that radiates strength.  She taught me how to be strong and to not let even the most devastating moments break me.  If she can be strong through this, I can too.  

FAITH:  I kept the faith key for myself.  With all the trials Brandon and I have been through I have never lost faith.  I would often tell Brandon that God was not done with us because my faith had never been truly tested.  This has definitely threatened to test my faith.  There are days I feel angry and devastated.  I try hard to focus on the positive and relish in the blessing that have revealed themselves.  My amazing sister-in-law Kimber sent Brandon and I a beautiful portrait of Christ after my diagnosis.  I keep this portrait by my bedside to remind me that Christ is by my side.  When I feel myself falling I look to my bedside and know I am never alone.  

There is no denying that I am beyond blessed.  I need only look at the countless messages, texts, cards, gifts, meals, and thoughtful love and support to know this.  I definitely feel the love :).  

A Mother's Grief

When I was first diagnosed with breast cancer we weren't expecting it.  I had been told over and over I was too young, that the lump I had was a cyst, a benign tumor, hardened fat from an injury and finally cancer.  The day we drove to the doctor's office for the results of my biopsy was the day we were heading to camp for the summer.  For the last 8 years we have spent our summers working in Santa Barbara at Circle V Ranch Camp.  Not only do we get to impact the lives of thousands of kids each year, but you can truly and honestly feel the spirit of Christ everywhere you go there.

Our car was packed to the brim that day and I remember telling Brandon to just wait at home with the kids while I went to get the results.  We were confident this was nothing.  Why waste time finding someone to watch the kids.  No big deal.  Of course Brandon refused to leave my side.  I remember sitting waiting for my doctor and knowing something wasn't right when he walked in.  There were tears of course and shock, but there was something else there too.  Gratitude.  On the way home I remember turning to Brandon and telling him it's okay because I am strong.  I'm not scared, I can do this.  It could have been my child sick with cancer.  I couldn't take it if it were Ava or Leo.  I remember talking to the Lord that day in the car and telling him he chose the right person to fight this battle.  I gave him my gratitude that this wasn't my child suffering.  I could handle this trial, but I couldn't handle seeing either of my babies in pain.  That's the love of a mother. I know any mother reading this can understand.

In the midst of my prayers and my gratitude we pulled into my parents driveway.  They knew I would be getting my results and had been trying to call me for well over an hour.  But cancer isn't news you break over the phone.  In the midst of my praying and thanking the Lord, I forgot something.  I am my mother's daughter.  When I broke the news to her I'll never forget her look of grief.  She held my hand and said, "I ask God why my Kathy?  Why not me?".  My mom had been praying for the exact same thing as I had been praying for.  I failed to realize that while God had granted my prayers, hers were not.  This was my mother's worst nightmare, and while I felt relief, she felt undiluted pain and grief.

No matter what I have to go through, my mother will always suffer more than me.  I know this because I am a mother.  Nothing hurts more than when your children suffer.  I guess it's because we're helpless to make the pain and suffering go away.  The other day I asked Ava if she wanted to talk about anything.  Her feelings in particular.  I had been in the hospital for 3 days and she hadn't seen me.  If you've never met Ava, she's an incredibly special and intuitive child.  She's an amazing kid with personality for days!  We are open and honest with her about cancer and what it means.  She knows what chemo is, has seen all my scars, and liked to rub my head when I was bald.  When I asked her how she felt when I was in the hospital she said, "I was scared because I thought you weren't coming back".  I asked her, "Where did you think I was going?" she replied, "To heaven".  What do you say to that?  I can't tell her everything will be all right or that I'll be here a long time because the fact is, I have no idea.  What I did tell her was we come from a family of strong women and that she has that strength inside her too.  She is fierce and can overcome things that would destroy grown men.  We come from a line of women that stand and face difficulty head on and we don't back down.  I know now looking back at my childhood and my life that I got my strength from my mother.  She taught me I cannot be easily broken.  She taught me the true meaning of unconditional love.  These things I hope to teach my children, not just with words, but by example.

I'm so grateful my mother showed me her grief, that she didn't try to hide it or shield it from me.  Her grief taught me that pain is real and that no matter how consuming our grief may feel we have the strength and faith to rise above it.  I will never shield Ava from it either.  I hope she will see my bad days and know that I am a fighter and stronger than anything cancer can throw my way.  I want her to see and know the strength she will inherit, a gift from her mother.