Entrusting My Care to His Hands

No one tells you that when you're diagnosed with cancer, so much of the emotional turmoil and overwhelming nature of the situation won't have to do with the diagnosis at all, but with all the planning involved in having cancer.

My brother commented that it seems unfair for people with cancer to have to plan and pay when they didn't choose illness and all of its life interruptions.

There's the taking time off of work.  Getting shifts covered by co-workers.  Making calls to your insurance company (I thought I hated them before--true medical crisis takes hatred to a whole new level).  Coordinating finances with medical providers.  Tracking down a clear retainer to use in lieu of your nose ring so the piercing doesn't close while in surgery (wait, that one's just me?).

I stare at my computer, switching back and forth between my online banking homepage and my insurance company's summary of benefits.  I try to figure out how this is all going to work.  Why doesn't anyone tell you how expensive and annoying cancer will be?  It's so distracting that you forget why you're making the calls and perusing the websites and adjusting work schedules in the first place.

I contacted my boss earlier to let her know that I will be having surgery on Monday, and that I will need to take next week off if it's not a problem.  Her response made me cry, because it reminded me that this is about my cancer.  She told me she's proud of me and that I'm going to kick this thing's butt.

I was thinking about my sweet Tobin, and how much money I've spent on him over the years without ever batting an eye.  When it comes to caring for him, money is never a question or issue.  I'll do whatever it takes.  And then I realized that I need to extend that same grace towards myself.  I am worth excellent treatment by a skilled physician.  I am worth the cost.  Why do I place his needs so high, while so easily discounting my own?  Why do I apologetically ask my manger for time off to treat my cancer?

Reaching out to people for financial assistance has been hard and good.  Hard, because I feel guilty asking people to help me fight cancer.  Good, because it forces me to not fight cancer alone, which I would be prone to do.  I would isolate myself and place the burden on my own shoulders and not want to inconvenience anyone.

But I realize that instead of being inconvenienced, people experience great joy in providing support.  When it comes to those we love, we think about doing the best for them no matter the cost.  I think sometimes I approach God in that same way, feeling like I am an inconvenience and burden or not believing in the gravity of His love for me.  Having Tobin has allowed me to see that my love for him is not only mirrored by God's love for me, but that God's love is so exponentially beyond the love I'm capable of giving anyone or anything that it's truly beyond my comprehension.  And He is the one in whom my well-being and care is entrusted.

I was told to not let red tape or insurance hoops stand in the way of the best care.  I'm terrified to have my surgery done on Monday, not because they're cutting me open, but because of the bills I know will be arriving in the mail in a few weeks.  But, I'm entrusting myself to the hands of the Greatest Physician and Provider, and trusting that He knows and sees my needs and already has a plan.

Jesus, calm my nerves.

Trading Beauty for Ashes

I've never observed and experienced something so painful and scary turn into something so beautiful and awe-inspiring.

When I woke up this morning, I realized that I already had over $1,000 in cancer treatment donations from friends and family members, and I was moved to tears.  For most of my life, I've been an activist for various causes, and it's always been natural for me to champion a particular group's fight for justice.  When my sister and I were working to create an online place for loved ones to give towards my medical expenses, it felt like we were planning for someone else (typical INFJ that I am, I just can't tolerate the spotlight).  I was distracted from my diagnosis because I was focused on a goal and on spreading awareness.  It wasn't about me.

But then when I awoke to messages of compassion and concern, an outpouring of notes on Facebook and e-mails in my inbox, plus everyone's generous financial gifts, it hit me that all this is about me.  And I realize that it's actually about God, and my family, and a variety of people touched by my life in different ways, but it was the no-strings-attached rallying on my behalf that made me feel more loved than I probably ever have before.

I am reminded that He is with me and for me.  He surrounds me, front and back.  He places His hand upon me.  This unconditional love and rooting for my healing is the tiniest reflection of the depth and extravagance of the love He holds for us.  To contemplate that fact boggles my mind.  These gifts are from Him, this love is of Him.  And so in spite of this past week being one of the hardest of my life, my being forced to rely on the profound love of those around me makes me more aware of Him, and at the end of the day there is nothing more I could want.

Cancer's Lessons on Love

I think for many of us, the word cancer conjures up images of hairless scalps and hospital rooms and colored ribbons and walks for cures.  We think of kids with leukemia and women with breast cancer and smokers with lung cancer.  In terms of media and popular representations of cancer, there is a group of people that seem to totally be skipped over--those from 15 to 39.  Until I was diagnosed, I didn't realize that as a 28-year-old, I thought of cancer as some far-off thing that might happen to me much later in life.  I think I somehow subconsciously thought that if cancer didn't affect me as a child, I would be safe from it until I was elderly, or at least more advanced in age.

Even though I've only known about my cancer for three days, my perspectives regarding and perceptions of the C-word are changing.  I'm learning that it's not all chemotherapy and hospital stays and planning for the end.

What I've discovered after three days of knowing about my cancer (and I write this to sound like a generalized experience, but know that it is actually specific only to me):

1. A diagnosis makes you an insomniac.  You find yourself up at 3AM trolling the Blue Shield and American Association of Endocrine Surgeon websites, trying to find a skilled doctor that is part of your insurance network.  Or, you start Googling the scientific words they used in your biopsy report to figure out what the hell they're actually saying about your cancer cells.
2. You will find yourself in the bathroom a lot.  It will feel like you're getting an ulcer.  Food won't agree with your stomach.  You'll wake up and run immediately to the restroom.  You'll realize that at a time when you should be taking the best care of yourself ever, you end up making poor food choices because the bad foods comfort even if you can't digest them.
3. You will become an experienced ugly-crier, complete with snot over-production, mascara-stained cheeks, and whaling sounds.  The hardest moments will be when you find yourself alone and in a quiet place.  Those are the moments when you don't feel like you have to hold it together or be strong for anyone, and all you'll be able to hear amidst the silence is your conscious reminding you, "I have cancer."

But, in all seriousness, I think the reality of my condition hit about 30 hours after I learned about my diagnosis.  I was driving home from work, and I just started crying uncontrollably.  All day I was assisting customers with their needs, focusing on solving problems and finding what they were looking for, while being totally distracted from my own woes.  But it's once I got in my car and didn't have to smile anymore or be helpful or take care and be supportive of anyone else that I felt the weight of the world on my shoulders.  It's hard to muster up strength to meet people's needs when really you just want to collapse for a while and let someone carry you.  In some ways, going to work has been beneficial because it does serve as a distraction, but I think it's going to take time for me to learn that it's okay to go home and be weak.  He is sufficient to be my strength once I'm not distracted, and He's given me my family to share in His duty of carrying me through this without my having to feel guilty.

And I think that's the hardest part.  Realizing that despite the fact that you're stronger than you ever realized, you're simultaneously weaker than you every dreamed possible.  I guess that's the beauty of His power being made perfect in weakness.  He provides you with strength and hope and courage and tenacity, while also bringing you to terms with your need to seek help and accept compassion and rely on others without being able to offer anything but gratitude in return.  You will likely see an outpouring of love, and all you can do is accept it and realize you deserve it because you're invaluable and that people don't expect you to feel indebted to them in any way.  I guess I'm discovering that cancer teaches you about love.

Getting the Treatment You Deserve

I stumbled upon an article last night, and one part in particular made me start crying.  I've had insomnia since Tuesday night, the day before my official diagnosis, and most of my major stress during the past few days has been due to thinking about missing work, figuring out finances, finding surgeons in my insurance network that I actually trust, and somehow trying to coordinate a lot of first-time consults to make a decision about who will do my surgery.  Reading this reassured me:

"Your doctors and nurses will become your source of comfort. You will feel safe with them. If you do not feel safe with them you need to change your care provider immediately. There is no time to waste. This shouldn't be a game played on anyone's terms but yours. When you find the right caretakers you will know immediately. Do not let insurance, money or red tape prevent you from getting the treatment you deserve. This is your only shot. There is always a way. Find those hands that you trust your life in and willingly give it to them. They will quickly bring you a sense of calm. They will spend time answering your questions. There will be no stupid questions to them. They won't do anything besides make you feel like you are the most important life that exists. They will never make you feel like they don't have things in control. They will be honest and accessible at all times. They might even become your friends. You might celebrate with them over drinks months or years after they have cured you. They deserve your gratitude, respect and appreciation daily. If you get upset at them during treatment know that they'll forgive you. They get that you're going through something they can't imagine--but they understand better than anyone. They see it every day and they choose to be there because they want to make the worst experience of your life more tolerable."

-Jeff Tomczek, "The Things I Wish I Were Told When I Was Diagnosed With Cancer"

The Day I Was Diagnosed with Cancer

For posterity's sake, since I'm sure one day I'll want to remember all the details...

It's been nearly 12 hours since my doctor gave me the news, and I think it's just now starting to sink in.  I have thyroid cancer.  I thought I was prepared for this diagnosis and that I expected this diagnosis--but somehow it still left me in a haze for most of the day.

At the beginning of May, I had my annual thyroid ultrasound and learned that my once-tiny nodule had doubled in size over the course of a year.  Because of this, the radiologist who analyzed images from my exam recommended a biopsy to determine the tumor's cytology.  I then had an ultrasound-guided fine needle aspiration biopsy performed on my thyroid last Friday.  Once the doctors tell you that they're seeing something suspicious, you start to brace yourself for the worst.  I had been mentally telling myself that I might have cancer--but still the whole idea of cancer didn't really sink in because I didn't know if I actually had it.  The assignment of that word seems to instantly make things sound a lot more serious.

I anxiously awaited news of the biopsy results from my doctor.  When I got off of work last night, I saw that I had a missed call and voicemail from my endocrinologist.  She didn't leave any specific information in the message, but I knew from her choice of words that it was likely not good.  She didn't indicate that there was no cause for worry, and made it seem very important that I speak with her as soon as I could.  I started to get a little emotional while driving home, and then once I was home and told my mom about the message, I broke down.  Here I had been talking for weeks about the possibility of having cancer, and then the reality hit that I might actually have it after all.  I just kept saying to my mom, "I have a feeling it's going to be bad."

I barely slept last night.  The hours I did sleep were restless, and then I work up nearly 3 hours earlier than I needed to.  I was making myself sick with worry, to the point that I went to the bathroom about 12 times in the span of just a couple hours.  I had to make a smoothie for breakfast because liquids were just about all I could stomach, and I knew I needed some nutrients.  Since my doctor didn't try calling me again last night or first thing in the morning like she had suggested she might, before work I ended up driving over to the imaging center where I had the biopsy done so that I could get a copy of the report.  Unfortunately, the pathology hadn't been faxed to them yet, so I left empty-handed.  Then I tried calling my primary care physician's office to see if they might have a copy of the report, but once again I was unsuccessful.  So, despite my best efforts at quelling the major anxiety I was experiencing, I was forced to continue to wait.

I got to work and couldn't really think about anything except for the fact that my doctor needed to talk to me and that she had the results and I didn't.  It's terrible knowing that the truth is out there, but is being kept from you.  I checked my phone a few times while at work, and saw that I had a missed call from my doctor's medical assistant, asking that I leave a message at their office with some good times that the doctor could call me.  I was so anxious to talk to my endocrinologist by this point that I left my work phone number and told her to call me there.  This situation seemed to grant an exception to a standard no-work-phones-for-personal-use policy.

Less than an hour after I called my doctor's office, the phone rang, my co-worker picked it up and then let me know the call was for me.  I excused myself to my boss's office and took the call there.  I don't remember everything my doctor said in those first few moments we spoke, but I don't think I'll ever forget these words: "They did find some cancer cells."  I was actually relatively calm and collect when she shared the news with me.  She told me about the type of cancer (papillary) and the prognosis (good).  She told me she would send me the names of some excellent surgeons and promised to be with me every step of the way.  She even offered to speak with my mom and explain it all to her.

After the phone call, I walked into the bathroom for a few seconds where I cried, but then quickly composed myself and got back out to the floor.  We've all heard the expression "I felt like I was dreaming," but I think today marks the first time I truly experienced what those words mean.  I was conscious and in my body, but it just sort of felt like everything was going on around me and I was totally detached from it.  Cancer.  Cancer.  Cancer.  At first, saying, "I have cancer," made me cry.  Now it's starting to sound more normal.  My new normal.

I realized that I should tell my manager what was going on, so I pulled her aside into the office and said aloud for the first time, "I have cancer."  She was truly wonderful and compassionate and actually managed to make me crack up amidst all of it, which I think is a gift of hers.  She excused me to make some phone calls and told me to not worry about getting hours covered.  I then called my mom, and for the second time I spoke the words, "I have cancer," and again the tears came.

Today was certainly not my most focused, but somehow I managed to get through a full workday.  While at lunch, I subtly broke the news to Facebook friends. My mom brought me flowers at work.  I contemplated the fact that not a single customer knew that the sales associate helping them was just diagnosed with cancer.

I got off work and returned home in that same foggy mental state.  I talked to my parents for awhile, and I cried fewer tears and had an easier time talking about my cancer.  I have cancer.

And life still goes on.  I ate my regular dinner and did my regular gym routine and the whole world kept on being normal.  Except I can't help but feel like everything's changed now--like my whole life is going to now be marked on a timeline of "before cancer" versus "after cancer."  I think about the fact that soon I will be a member of the group "cancer survivors."  I also think about the post I wrote several weeks ago and said that at least my thyroid disease isn't cancer--but now it is cancer.  One phone call changed me forever.

Before I heard the official news, somewhere amidst trips to the bathroom and the imaging center, I kept thinking about Psalm 139:5.  He goes with me and before me.  His hand is upon me.  Knowing that He's prepared the way and is not surprised by this and that nothing's changed for Him comforts me, because right now amidst all the changes I can be sure that He will be steadfast and unchanging.  I have peace and hope because I know that He is my Great Physician and oversees my life and health.

Once the diagnosis came and news had time to settle, the verse that came to mind was Psalm 23:4.  Even when I walk through darkness, He's with me.  There is nothing to fear.

I know it might take a few days to truly process the news, but overall I have actually been impressed by my own resiliency (and I say that with sincere humility).  Somehow the word "cancer" makes me feel like I should be freaking out, but, despite my shock, I'm actually not all that surprised.  I think somewhere deep down I knew this was coming.  He goes before me and guides me.  He leads me to green pastures and still waters.  He restores my soul and fills my cup to overflowing.

What If I'm the Five Percent?

It's funny how passively we can talk about cancer when it poses no obvious threat to us or the people we love.  We use it as a sort of slang word--a word used in casual conversation to epitomize profound suffering.

For the past five years, I've had to get ultrasounds of my thyroid.  Initially, the doctor that diagnosed me with Hashimoto's just wanted a visual baseline of what was going on with my gland (nodules are common in those with autoimmune thyroid conditions).  With every test, there have been small changes, but generally no cause for concern.  My thyroid was inflamed, but it slowly got smaller, and my nodules weren't changing in size (actually, I think one disappeared).

When I went in to pick up my report from this year's ultrasound, I was surprised to see that the radiologist recommended a biopsy.  Not only this, but the nodule had doubled in size since my last exam.  You can imagine my alarm in learning this, when last year the basis for my and the doctors' believing the nodule was benign was the fact that it wasn't growing.

In terms of statistics, only five percent of thyroid nodules are malignant.  However, that rate dramatically increases when various factors are considered, like the patient's age, whether the nodule is solitary, and the nodule's features.  Unfortunately, despite the fact that most nodules are benign, mine meets many of the criteria that make it potentially cancerous, and none of the criteria that indicate it's probably benign.

It's a strange feeling not knowing whether you're part of the five percent.  Of course, immediately there is a lot of fear and sadness.  You troll the internet in hopes of being able to self-diagnose the nodule as malignant or benign (this is impossible without a biopsy).  You ruminate about the fact that you may or may not have cancer.  You spend a lot of time going back and forth in your mind, playing out the scenarios either way.  You realize that you will be okay either way.  Somehow, I think an actual diagnosis is probably a lot less scary than the not knowing.  When you have a diagnosis, you know which mountain you face.  When you don't know, you don't know.

Aside from being emotional (but that's nothing new), the news doesn't exactly surprise me.  I've been so inundated in healthcare and medical treatments during the past few years that I've almost come to anticipate issues like this one.  Yes, I am worried, but less about what will be done if I do have cancer than I am about having doctors and treatment protocols I trust.  A potential cancer diagnosis is terrifying to someone who is skeptical regarding modern medicine and suspicious about most doctors.

Today, I saw a new doctor that told me God made my cells and designed them to know what to do.  She said that I need to start thanking Him for my body and realize that He gave me a healthy body; it's the environment and our food and toxins that have tainted my healthy body.  Her words made me cry, because I so often think of myself as being sickly and diseased that I forget that I didn't start out this way.  It's comforting to know that God didn't give me a lemon from the get-go.  I was given a healthy body that bears the effects of an unhealthy world.

I need to start thinking of myself as healthy with or without a thyroid or some lymph nodes--whether or not I'm part of the five percent.  "For while we live, we are always being given up to death for Jesus’ sake, so that the life of Jesus may be made visible in our mortal flesh" (2 Cor. 4:11, NRSV).  I am healthy because His spirit is within me.