Lindsay Ruland: Ovary Overload

As we finish out the month of January, the C4YW Blog welcomes back, Lindsay Ruland, for the third installment of her monthly series! Check back often to read more into her journey. Here, Lindsay shares with us the experience of egg retrieval surgery. Be sure to visit the website and register for this year’s event in Seattle!

There’s nothing quite like the moment you hear those three little words,“You have cancer,” unless, of course, they are then followed by,“Treatment may compromise your fertility.”

While some young women in this situation may initially worry about losing their hair or their breasts, the first thing that popped into my mind was that I could lose my ability to have children.

As soon as my breast surgeon called for neoadjuvant chemotherapy, I asked, “Is there any way I could freeze my eggs before we get started?”

He pointed me in the direction of several fertility clinics, but reminded me that I had a very small window of time to complete a cycle of IVF before beginning chemo: 3 weeks.

Two days later, I found myself uncomfortably sitting in the office of a fertility specialist. He went over the procedures very brusquely, explaining that I would need to have blood drawn every day to measure my estradiol levels, and that every 3 days or so, I would need a vaginal ultrasound to check on what my ovaries were cooking. I would also need to take an estrogen blocker while undergoing the fertility treatments to avoid feeding the tumor.

“We have to start now,” he said, abruptly getting up from his chair and opening the office door. Confused, I followed him down the hall and found myself in the ultrasound room. Without drinks or dinner, that man had my pants off and my legs up in stirrups in record timing. Needless to say, I was a little embarrassed. Apparently, however, he liked what he saw with that alien probe. My insides got the green light and he sent me back to meet with his nurse to go over my hormone shots.

My head was spinning as all of this information was flying at me. I had just been diagnosed with cancer, how could I keep track of everything they were telling me? I started to cry in the consult room with the nurse as she gave me my first hormone shot, not because the needle hurt, but because I was totally overwhelmed. My mother had been wise enough to bring along her notepad and had recorded everything that had been said along the way. Without her, I would have been lost.

The next day, I showed up for my blood work and they found that my estradiol levels weren’t high enough, so I would need to bump up the dosage. This would also be the first time I would give myself the shot at home. I had to find YouTube tutorials to remember how to accurately mix the hormone solutions. I prepped the site, pinched my skin, and stuck the needle into my abdomen. A huge welt appeared on my skin and I freaked out, hysterically calling the nurse on call. Apparently, I’d used the wrong size needle tip and hadn’t stuck it in deep enough. As the days went on, I got to be somewhat of a pro at giving myself the hormone injections.

Lindsay Post-Op

Lindsay Post-Op

“Wow! You’ll have enough eggs to fill an Easter basket!” the doctor said as he examined my painfully full ovaries. About two weeks in, I certainly felt as though I was pregnant. I found myself waddling to get around because my ovaries were so huge and full of eggs. I was officially on ovary overload.

The nurses called and said that my hormone levels were so high that I would likely be triggering over the weekend. That meant I would need to get a giant intramuscular shot of HCG in my buttock. My mom and I combed over trusty YouTube and found a crazy Russian video of this very procedure. When the time came, I lay on her sofa, pulled down my pants, and let her jab me in the butt muscle with HCG.

The day of my egg retrieval surgery, I was being a wise-ass  It was the only way I could cope. They took me back to the cold OR and had me get onto the table. They strapped me down and put my legs up into stirrups.

“What is this, some kind of bondage movie?” I asked as the anesthesiologist shot me up with the good stuff. I never got to hear a response. I woke up and I felt as though someone had taken a baseball bat to my uterus. All I could think about was getting a vegan “ cheese steak.” The doctor walked past and gave me a double thumbs-up,

“Thirty-seven!” he exclaimed.

Thirty-four eggs survived the freezing. I was proud of myself. At least in some way, my body hadn’t failed me and I had a safety net for the future. One week later, I started chemotherapy. The roller-coaster had only just begun.

Lindsay Ruland is a 26-year-old survivor and a native of Baltimore, MD. She currently works as a histotechnician, and aspires to become an oncology nurse specializing in patient navigation and breast health education. It is her goal to raise awareness and to make resources and information more readily available for younger populations of women affected by breast cancer. Come back to the C4YW blog for future posts by Lindsay, or follow her story on her blog: CANCERLAND

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Kathleen Hammett: Before I was diagnosed with breast cancer, I knew I was a survivor.

Welcome back to the C4YW Blog, as we welcome Kathleen Hammett to our growing group of writers. Kathleen has a very compelling story, and she will continue to share with us the ups and downs of parenting after diagnosis. Her strong voice is one of the many that C4YW strives to represent. Be sure to visit the website and register for this year’s event in Seattle!

On October 1st, 2007, we joyously welcomed our third daughter, Clara Elizabeth, into our family. The C-section went smoothly and we were looking forward to a speedy recovery. Things did not go as planned. Sixty hours after her birth, barely alive, I was rushed into surgery to evacuate a massive retroperitoneal hemorrhage, so large it had displaced my kidneys and bladder and had even caused my lungs to collapse.

Barely alive after multiple blood transfusions. At least I'm off the ventilator!

Barely alive after multiple blood transfusions. At least I’m off the ventilator!

This was the end of a long journey for my husband and me. Our first daughter was born blind (our Amazing Grace who can now see), our second daughter was born asleep; we were blessed with Ella in our third pregnancy, but lost another daughter on our fourth try. We were physically and mentally exhausted. I woke up in the ICU on a ventilator, 57 staples running from my chest all the way down, minus a uterus, and a long way from recovery. My baby, along with my dreams of a large family went home two weeks before I did. It took an amazing nurse, many generous blood donors, extremely supportive friends and family, and a lot of inner strength to begin healing.

When Clara was 7 months old I decided it was time to get a physical, with a family history of breast cancer this always included a mammogram even though I was only 36.

Obviously I would not be posting on this blog if the results had come back clean and clear. After 7 months of constant medical appointments dealing with the aftermath of a horrific birth experience I was facing the prospect of death again and my tank was completely on empty.

In life, it is so amazing how quickly our perspective can change.

As I went through the normal battery of diagnostic testing we were thrilled at how BLESSED I was to have DCIS. Since both of my breasts were scattered with DCIS coming to terms with a double mastectomy proved to be very difficult for me. My breasts were how I had fed and comforted my babies. Clara was only 7 months old and I had just lost my uterus, could I really stand to lose all my female parts in under a year? Would I ever feel like a woman again? Would a love of shoes be all that separated me from the boys?

Again, after almost dying in child birth and then getting a double mastectomy less than a year later I found myself proclaiming how BLESSED I was: negative nodes! Perspective is an amazing thing.

As I began to heal from yet another major surgery, I started walking daily. Clara took her morning and afternoon naps in the stroller as I pushed my way back to health. After several months I began jogging between mailboxes….this was a MIRACLE! Having developed large breasts in the 6th grade I had literally never been able to run, I could teach step aerobics and spinning all day long, but the repetitive motion of running was too hard on my breasts and back.

As my body regained its muscular strength, I was regaining my inner strength. I am a longtime group fitness instructor and have had the opportunity to help so many women as they heal from breast cancer treatments. I am able to listen and relate to their struggles as I teach them to return to exercise slowly and safely. Each time I get another survivor physically ready to return to live their normal lives, I feel like I have beaten cancer one more time. Our minds heal so much more quickly when we are moving.

Our bodies can overcome so much and with enough work, passion and dedication it is possible to come back and be as strong as or even stronger than before. We are often surrounded by people with excuses or an “I can’t” attitude, coming back from breast cancer, or any cancer shows us that obstacles are meant to be hurdled, cleared or completely obliterated!

Me today, happy healthy and strong!

Me today, happy healthy and strong!

Having never run before cancer, I have now completed five marathons (even qualifying for the Boston Marathon by ten minutes), many 50Ks, and other (even longer) distance races.

Life is good and I am happy to say how incredibly BLESSED I have been!

Perspective.

Kathleen is a wife and full time mom to three amazing, energetic and dramatic daughters.  She loves her part time job teaching group fitness and manages to find time to train for and compete in many running events, ultra-marathons through wooded trails being her favorite.  Kathleen has been cancer free for four years and credits a loving family, a lot of yoga and many trail miles for her happy outlook moving towards the future. Come back to the C4YW blog for future posts by Kathleen,  and you can also follow her story on her own Blog.

Mary Craige: This is Going to be a Great Year!

As the C4YW Blog starts the new year with a plethora of inspiring writers, we welcome back Mary Craige with her January entry. Be sure to  check back each month, as Mary has bravely decided to keep us up-to-date on her fertility planning and treatment after a breast cancer diagnosis at age 34.  Her strong voice and particular story is one of the many that C4YW strives to represent. Be sure to visit the website and register for this year’s event in Seattle!

That is the statement I start every New Year with, along with a list of two or three attainable resolutions. I am not a ‘I want to lose weight” kind of resolutioner because I try to stay fit and eat healthy all year round. My normal resolutions are usually small things, like “make the bed every morning”. Silly things like that are easy and give you a sense of accomplishment.

This month will mark almost three years since my initial breast cancer diagnosis and two years since I completed treatment. It also marks two years of taking Tamoxifen, the drug I have been taking to keep my cancer from recurring. My fingers are crossed that the annual scans and blood work will show that I am holding steady at “No Evidence of Disease” (NED).

It is also the month I’ve been waiting to arrive for almost two years. When my oncologist released me from active treatment in December 2010, she told me, “In January 2013, we’ll start talking about having another baby.”

Mary Craige

Well, its 2013 and I’m ready to start talking.

There is a lot to do over the next two months. I started with a visit to a new reproductive endocrinologist at the fertility practice my husband I am went to in 2010 to preserve my fertility using IVF. This was a ‘getting to know you’ meeting to discuss risks associated with another pregnancy, my fertility status and potential next steps. After a 45 minute consultation and review of my medical history, I left with a plan…that wasn’t much of a plan.

Cancer seems to always throw a monkey wrench into things. Not that this was a monkey wrench, but it was more of a ‘hold your horses’ moment. Although there is no definitive research saying that pregnancy after breast cancer can cause recurrence, doctors are often reluctant to do anything until a survivor has finished at least three years of Tamoxifen. I just passed year two.

Why stop Tamoxifen before three years? It certainly wasn’t a rash decision, or one that my husband and I made overnight. It was an informed decision but it is also a risky one. Tamoxifen wreaked havoc on me, physically and mentally. It helped push me into early menopause, helped to cause osteopenia and osteoporosis and gave me unbearable nightly hot flashes.

Life on Tamoxifen was challenging. While I understand that five years of hormone therapy is best, I often liken the Tamoxifen regiment to a daily exercise regime. We all know that we should do 30 minutes of exercise daily to stay healthy. Doctors have found that daily exercise decreases our risks of some cancers, heart disease and stroke. Do we always take the 30 minute walk around the block or the daily trek to the gym? Not always, but many of us try. That’s how I think of Tamoxifen. Should I take it every day for 5 years? Probably. I tried my hardest to live with the side effects. I took other drug, I pushed myself physically and adjusted my sleep to try and get through the night without a hot flash. Unfortunately, like many young women, I found the side effects to be difficult to mitigate without other drugs or treatments.

Once my scans and annual blood work are complete, I will revisit my options with my reproductive endocrinologist. Until then, the focus is on getting through those tests with a clear bill of health. Hopefully next January 1st, I will continue with the phrase, “It’s going to be another great, cancer-free year”.

Mary Craige is a wife, mother, daughter, friend and breast cancer survivor. Diagnosed in 2010 when her son was seven months old, Mary found blogging to be an outlet for her feelings about treatment, fertility challenges and survivorship. Since finishing treatment in 2010, she rode in two 200 mile Tour de Pink West Coast rides. The Tour de Pink helped her take her body back after treatment and proved that she could thrive after cancer. Mary currently works as a Content Marketing Manager for a large data company. Come back to the C4YW blog for future posts by Mary, and head over to the C4YW site to check out the wonderful programming for this year’s event, as well as the great deals we’ve put together for airfare and hotel prices.

Mary Craige: Call it a Woman’s Intuition

This month, the C4YW Blog welcomes Mary Craige as one of our newest recurring writers. Be sure to  check back each month, as Mary has bravely decided to keep us up-to-date on her fertility planning and treatment after a breast cancer diagnosis at age 34.  Her strong voice and particular story is one of the many that C4YW strives to represent. Be sure to visit the website and register for this year’s event in Seattle!

I always knew I would be diagnosed with breast cancer. Call it a woman’s intuition. Call it an insane hunch, but I always knew it was my fate. My mother was diagnosed at age 51 and my paternal grandmother lost her battle with the disease in her 70’s. But I never imagined I would be diagnosed with the disease at age 34, when my son was seven months old.

Unfortunately, some women hear the words, “you have breast cancer” and immediately think it’s a death sentence. When my surgeon delivered the news, my first thoughts and words were not the typical response. My reply was simply, “I can’t have breast cancer; I want to have another baby!” My surgeon, taken back by my reaction, immediately began talking about five years of Tamoxifen, chemotherapy and additional ‘options’, ignoring my response. I chalked that up to his inability to grasp where I was in life. I was a new mom with an infant at home. I had just returned to work from my maternity leave.  My son had just started sitting up. How could I have cancer?!  Driving home, I was still stuck on the notion of having another baby. This desire was a catalyst for many of the decisions I made over the next two months.

My husband and I immediately began researching our options to preserve our chances of having another baby. My medical oncologist told me that at my age and with my pathology, we needed to throw the ‘big guns’ at my cancer: six rounds of Taxotere, Adriamycin and Cytoxin (TAC), 34 rounds of radiation and five years of Tamoxifen. Chemotherapy gave me a 50/50 chance of becoming permanently infertile. This statistic scared me. As an only child, I always dreamed of having a big family and I didn’t want cancer to put an end to that dream. We decided to meet with a reproductive endocrinologist prior to beginning treatment to determine what our options were for fertility preservation.

My medical oncologist and reproductive endocrinology became a team and worked to determine a plan that would not jeopardize my health or treatment plan. We talked through options and decided to try and create as many embryos as possible, in only one cycle. We were very lucky; our medical team created multiple, viable embryos through one cycle of IVF. This limited my exposure to additional hormones and allowed me to start chemotherapy on schedule.

Two days after the egg retrieval procedure, I had my port placement surgery.  Three days after surgery, I had my first chemotherapy infusion. Life was moving too fast for me to fully appreciate the risks and dangers associated with a future pregnancy. At that point, my focus was on beating cancer and moving on with my life.

Almost three years later, I am ready to revisit my options for carrying another pregnancy. This decision is scary, exciting and risky. My cancer was estrogen receptor positive, had a high Nottingham score and a high Ki67 score. Layman’s speak for this pathology:  my cancer grew quickly and was trying to move beyond the breast. So while my desire for another child is still strong, my fear or recurrence and metastasis are always there, influencing my decisions.

For many, January is the month for ringing in the new and getting rid of the old. For me, it’s the month for my annual mammogram, blood work and breast MRI. But this time, I will also have a consultation with my reproductive endocrinologist to determine my fertility status and what my options are for another pregnancy. The anticipation of the annual scans and tests are always accompanied by a great deal of anxiety and stress. This year, I am strangely calm and at ease with this obligation. My anxiety now is due to what lies ahead, and what may or may not be possible.

Mary Craige

Mary Craige is a wife, mother, daughter, friend and breast cancer survivor. Diagnosed in 2010 when her son was seven months old, Mary found blogging to be an outlet for her feelings about treatment, fertility challenges and survivorship. Since finishing treatment in 2010, she rode in two 200 mile Tour de Pink West Coast rides. The Tour de Pink helped her take her body back after treatment and proved that she could thrive after cancer. Mary currently works as a Content Marketing Manager for a large data company. Come back to the C4YW blog for future posts by Mary, and head over to the C4YW site to check out the wonderful programming for this year’s event, as well as the great deals we’ve put together for airfare and hotel prices.

Sarita Jordan: C4YW, A Place Where I Am Not Alone

This post was originally featured on the LBBC Blog on February 9th, 2011. Here, LBBC volunteer Sarita Jordan shares how she found strength and purpose through C4YW, even through some extraordinary circumstances.

I was diagnosed with breast cancer in September of 2005. I was 36 years old. Breast cancer was an event in my life that I had no idea was coming. I didn’t have history in my family. I knew nothing about the disease. I was aware of monthly self-breast exams, but that’s about it. When I was first diagnosed, I was told “it probably isn’t breast cancer because of your age.” I am currently a 5-year breast cancer survivor, and counting…

After such an ordeal, it had become apparent that I wanted to dedicate my life to helping other women cope with a breast cancer diagnosis and all the unpleasant episodes that come along with it. When I was in treatment I looked for any and every kind of help because I didn’t really have a strong support system. I developed a relationship with the oncology social worker at my hospital. I later learned about Living Beyond Breast Cancer (LBBC) and the Conference For Young Women Affected by Breast Cancer (C4YW) — finally, a venue where I could express age-appropriate concerns. Because I was 36 at the time, this was great!

As a result of the effort to make it to my first conference in 2007, every year I look forward to this event and the source of help available to me. I will never forget the first conference that was held in Arlington,VA. I am a parent of 4 children, one of which I became pregnant with after breast cancer treatment.

C4yw, annual conference for young women affected by breast cancer, YSC, LBBC, orlando, florida

Pregnant, bald and excited, I drove in a snow storm because I was determined to be at this conference. The conference in Jacksonville, Fl., had a workshop about fertility issues that young women affected by breast cancer face. The wonderful speaker described her diagnosis at a young age and how she considered maximizing her chances of future pregnancy, knowing the risk breast cancer treatment had on the ability to conceive. Although my story was slightly different from hers, I was able to offer my experience, which was a sense of hope to some of the other women that were present in this particular workshop.

Attending C4YW keeps me up-to-date with the latest treatments, workplace protocol and rights, medical research, healthcare reform news, etc. I wouldn’t miss it for the world. I look forward to meeting up with friends that I met from other states over the last 5 years since I’ve been attending the conference. More importantly, though, I look forward to volunteering and sharing my story, in the hopes that it would encourage someone else. Last but not least, the group photo! The photo is especially important to me because as we all gather — all races, creeds and colors — I am reminded that I am not alone.

Although there are some friends that I have lost to this disease, I don’t get discouraged. This too reminds me that life is precious and we have to just live, love and laugh. Tomorrow is not promised to anyone.

Thanks LBBC and YSC for such an event. This experience compares to no other.

This year’s Annual Conference for Young Women Affected by Breast Cancer (C4YW) is being held Friday, February 22 – Sunday, February 24, 2013 in Seattle.  If you, like Sarita, are looking for a network of women who share your similar concerns as a young women affected by breast cancer, C4YW may be a good place to start.