(17-01-27) Weight Gain

After repeated Internet research, consultations with an oncology exercise specialist and an oncology nutritionist this week, five days of obsessive-compulsively logging my food and exercise, and a heart-to-heart with my oncologist, my fear has been validated:

The Tamoxifen is causing my weight gain.

9 pounds in six weeks.  12 pounds since October.  This is not an acceptable option for me.

I requested to meet with Dr. Curley to discuss alternatives.  “You need to be on Tamoxifen,” he tells me, before explaining to me once again that without taking a medication to block the estrogen in my body, my chances of recurrence are high.  My particular cancer NEEDS estrogen to survive.

I stare at him, unblinking.  “Yeah, yeah, i understand this … but i need YOU to understand that what i am currently doing to try to keep myself from gaining more weight is not sustainable, and it’s borderline unhealthy.  Going to the gym 1.5-3 hours a day, 6-7 days a week, and eating 1500 calories or less is not going to work long term  … and if i gain any more weight, you and i both know i will just abruptly stop taking these meds.”

We go back and forth about this for a while, stuck in our own perspectives of what is “best” for me.  He sees “keeping the cancer away” as best for me.  I see “being proud of what i look and feel like”  as best for me.  We are not on the same page; i get that.  Still, in the end, i am the one who gets to make the decision, and i am not willing to take this drug for the next 9.5 YEARS if it’s adding 4-5 pounds a MONTH.

In the end, we reached a compromise.  I agreed to take a smaller dosage of the drug every OTHER day.  Meanwhile, he’s testing my blood to see if i am eligible for a different type of estrogen-blocking medication.  I agreed to spend the next three weeks strictly abiding by the food and strength training plans that the oncology nutrition and exercise specialists laid out for me, and he agreed that we would figure out a different plan if i gain any more weight in those next three weeks.

I went home and hosted a book club social at my house that evening.  I overindulged in food throughout the night, snacking continuously on cheese and crackers, vegetables and hummus, dark chocolate, 1/3 of a vegetarian burrito, and 4 ounces of tequila.  2,531 calories for the day – way over my daily limit, but hey, at least i burned 591 calories from being on the elliptical for an hour.  That has to count for something, right??

This morning, the scale showed i had gained 2 pounds.

I didn’t take my Tamoxifen.

(17-01-24) Craig Harris

I wrote a letter on behalf of Craig Harris, whose work has been submitted to potentially earn a Pulitzer Prize.

The Pulitzer Prize Board
c/o Columbia University
709 Pulitzer Hall
2950 Broadway
Mail Code 3865
New York, NY 10027

 

Tuesday, January 24, 2017

 

Dear Pulitzer Prize Board Members:

In today’s day and age, Investigative reporting sometimes appears to be a dying art.  We consumers get “bored” if an article is too long.  We no longer read the newspaper before heading to work each morning.  We prefer the drama of television reality shows to finding out what is happening in real people’s lives all over the world.  We read, believe, and propagate fake news from the Internet so extensively that there is now a market for fake Internet news sites.  With all of these changes, it’s easy to undervalue the significant, crucial role that investigative reporters play in shaping the beliefs, attitudes, and behaviors of the individuals in any given society.

I, however, will never lose sight of that significant, crucial role they play … because one of those investigative reporters literally saved my life.

Arizona Republic journalist Craig Harris learned that the Arizona Department of Juvenile Corrections (ADJC) had fired me – an award-winning teacher with 12+ years of experience – while I was in the hospital undergoing advanced cancer treatment.  His research into the facts uncovered a blatant, ongoing, systemic pattern of employee mistreatment that went far beyond me; in fact, it went far beyond the agency I worked for.  Multiple state agencies, particularly ADJC  and the Department of Economic Security (DES), were routinely firing employees for reasons that had nothing to do with their job performance.

His coverage of my story went viral.  People all over the country were watching his interview with me and reading his article, and they were responding.  They were calling the news station, asking how they could help.  They were calling the governor’s office, imploring him to intervene in my case.  Craig Harris wrote a single article that touched both heart and nerve of countless Americans, and their responses were heard.  Two days later, as I lay in a hospital bed recovering from my third surgery in four weeks, a spokesperson from the governor’s office called to inform me that my job had been reinstated, and I was allowed to take as much time off from work as I needed to finish my cancer treatment.

I literally owe Craig Harris my life.  Had he not shared my story with the country, I would have lost the health insurance benefits that were tied to my state-employed job.  I would not have been able to afford the rest of my aggressive cancer treatment, including the life-threatening infection I got from radiation wound damage.  Doctors initially told me that without treatment, I had an 85% chance of being dead within two years.  Craig Harris helped ensure that didn’t happen.

He didn’t stop there.  He wrote a series of articles exposing ADJC and DES for unethical firing habits, decisions to merge adult sex offenders and juvenile inmates on the same property without following proper protocol, and bribe-like rewards from one director to employees who agreed to change from “covered” to “uncovered.”  His investigations led to 2 directors getting fired, as well as at least 6 ADJC and 40 DES employees being offered their jobs back.  In addition, the Department of Corrections agreed to stop housing adult sex offenders on the same property as juvenile inmates.

It is reporters like this – reporters like Craig Harris who make it their mission to discover, research, and expose injustices – who shape society to become a better version of itself.

 

Sincerely,

Tarah Ausburn

 

(17-01-22) Menopause @ 37

Hot flashes.  Mood swings.  No more periods.  These were the three pillars of menopause, as far as i was concerned.  I remember being in 8th grade and watching one of my best friend’s moms go through this.  We would run up to Lizz’s bedroom and laugh after watching Mrs. Gloner stick her head in a freezer to cool down.  We would turn our faces away and pretend we couldn’t hear her extensively screaming at one of the children for some minor offense.  We would sit beside her and console her silently when she broke down into hysterical sobbing.  This is what we knew of menopause; sure the hot flashes and mood swings were enough to turn a relatively stable womyn crazy, but at least there were no more periods.

A LIST OF THINGS I *DIDN’T* REALIZE ABOUT HAVING MENOPAUSE

  1.  Menopause messes with your weight.
    Menopause lowers my estrogen level, which affects my lean mass and my bone density.  Suddenly, despite exercising 6 days a week (typically for 1.5-2.25 hours each time), i am GAINING weight.  So i adjust my diet.  Nothing.  So i adjust how i use weight lifting machines.  Nothing.  So i get more sleep.  Nothing.  So i get less sleep.  Nothing.  So i use pre-workout mix before the gym.  Nothing.  It’s been six weeks now of intensively working out, and i am still a good five pounds overweight.
    *** I’ve been hesitant to discuss this with anyone.  Most of the womyn in my life are bigger than i am, and they probably don’t want to hear some skinny bitch talk about how she can’t fit into her size 4 skirts anymore.  So… let me break this down another way.  I just spent the last year getting sliced open and surgically implanted and constantly drugged.  I lost my hair and breasts and one of my implants – essentially losing my sense of femininity.  I lost my energy, strength, and the muscle mass that i had literally spent the last two decades cultivating.  Now here i am a year later, all scarred up and weak and squishy and physically deformed … and all i have been wanting to do for the last five months of treatment is start putting my returning energy to good use at the gym so that i could get back to looking and feeling like myself.  Except no matter how much i monitor what i eat, how much i eat, and when i eat, and no matter how many days i play racquetball or hike or lift weights or climb 123 flights of stairs on the StairMaster or run 7 miles on the elliptical at a resistance level of 12, I STILL CAN’T GET BACK TO LOOKING LIKE ME.
  2. Menopause messes with your sex drive.  
    Sex used to be fun – right?  I mean, I’m pretty sure i liked it.  I’m pretty sure that there were periods in my life when i associated with some pretty questionable people *because* of it.  But now?  Now, i don’t think about it.  I don’t want it.  I don’t miss it.  And when i find myself about to engage in it, i dissociate from it.  My parts and my drive have both dried up…at 37 years old…seriously, living another 3-6 decades without ongoing sex is going to turn me into the biggest bitch anyone has ever seen.  I already know.
  3. Menopause messes with your ability to watch television like a normal human.  
    If i cry over a Subaru commercial one more time, i seriously might throw my computer monitor through my bedroom window.  And can someone please tell me WHY the plights of vampires and werewolves are so overwhelmingly emotional to me?  (Okay, that’s always been true.  I’m just trying to figure out why we’re all so obsessed with these types of shows.)  Seriously, though.  I’m *always* crying about some character, or actress, or plot twist, or commercial break.  I get these breakouts on my face whenever i cry, and for the last two months, there has been this permanent trail of whiteheads along the right-side edge of my face, a testament to me lying in bed in fetal position, crying over yet another scenario that isn’t even real.
  4. Menopause messes with your appetite.
    I might be making this one up.  I just can’t figure out why all i ever want to do is eat, even when i am not even fucking hungry.
  5. Menopause messes with your sleep.  
    I’ve honestly had insomnia since i was an infant.  My mother will attest to this.  I take comfort in reading articles about how people who sleep less are typically more intelligent than the average person.  Still, it’s annoying.  I take a lot of drugs (prescribed and otherwise) to get normal amounts of sleep.  It used to be that as long as i didn’t drink alcohol that night, and i abstained from coffee after 11am, and i worked out that day, and i took some melatonin an hour before taking 1-2 sleeping meds, i would eventually fall asleep and STAY asleep for 6-7 hours.
    Not anymore.
    Now i still wake up throughout the night to pee or stress or wonder if the latest episode of Scandal is available on the Hulu website yet or think about how many more pets i will have in the course of my lifetime.  I wake up, even while drugged on the highest allowed dosages of prescription medications, and i stay up – compelled to stay in bed just in case i do get tired again, but fully aware that this will be yet another night where i’ll be missing out on at least one REM cycle.
    I even wake up early now.  Automatically.  No matter what time i went to sleep the night before.  “Sleeping in” used to mean waking up in the P.M. hours.  Now, “sleeping in” means not waking up before the sunrise.
  6. Menopause messes with your finances. 
    I’m already hungry from extreme exercising, and emotional after watching all this TV drama, and irritable because i stopped giving my body bursts of oxytocin and sex-induced endorphins … and now my sleep is further disrupted because these hot flashes are suffocating me all night?  Sleep-deprived Tarah typically uses her insomnia to peruse the Internet … which leads to Internet shopping … which leads to things like a $700 purchase of sheets and a mattress pad that are specifically designed for thermally incompatible couples but seem like they could also work well for a menopausal Party of One.  The sheets and pad are pretty damn cooling … but yeah.  I’ve noticed a significant increase in my impulsive purchases.  (That reminds me: Where the hell is that Himalayan sea salt lamp with the built-in dimmer switch?  That should have been delivered by now, and i need that to balance out the ions in my bedroom atmosphere!)
  7. Menopause messes with ALL OF YOUR BODY PARTS.
    It’s not just the weight and the vagina and the hormones.  My skin is dry…and dehydrated-looking.  It itches.  My hair is growing back with a vengeance, but there are still patches on my scalp where it’s barely visible.  I sweat in places i never even considered – like at my knees.  My bones ache … like, for no actual reason.
  8. Menopause messes with your memory.  
    Chemobrain was pretty terrible, but i continually reminded myself that it was only temporary.  Little did i know that chemobrain would leave, only to be replaced by memory problems brought on by menopause.  I had trouble remembering all the names of my exes even BEFORE my cancer treatment started.  Now it’s downright impossible.

I always knew the time would come when my body and mind would start to slow down, affecting my appearance, sex life, feelings, and mind.  I really just never considered what it would be like to go through all this before i even hit 40.

(17-01-19) Prosthesis

Walking towards the door of Barbara’s Mastectomy Boutique, i still wasn’t sure what i was expecting.  I wasn’t even sure why i was doing this.  I have spent the last five months parading around with my one-breasted status; why get fitted for a prosthesis now?  Maybe it was simply because my reconstructive surgeon had handed me a prescription on Monday for a prosthesis, and i was just following up on her idea.  Maybe it was because the idea of going back to work and teaching a classroom of teenagers who would be staring at my chest even *more* now was unsettling.  Or maybe … if i am being really honest with myself … it was because even after five months i still hadn’t learned to embrace what the new me looks like.  Whatever the reason, here i was, walking across the parking lot to where Barbara was waiting for me outside the door.

“Are you looking for Barbara’s?”

I looked down at this womyn and nodded my head.  She was seriously so short; even with chunky 3″ heels, i still only measure up to 5’7″, but i was TOWERING over this womyn.  She introduced herself as Barbara, the owner, welcomed me inside, and instructed me to head to the back room and remove my shirt.  “I’ll be right there,” she assured me.  “Just have a seat and make yourself at home.”

I’m pretty sure i don’t sit around my home topless on a regular basis, but i did as she instructed.  I walked down the hall and quickly removed my sweater, collared shirt, and sports bra.  (I don’t know why i always feel like i have to rush to remove my clothing when i am in places like these; i always end up just sitting/lying there, awkwardly waiting.) Barbara appeared and immediately started pulling forms out of a folder.  “Sign here … and here … initial here … remember to postdate these pages because we haven’t finalized authorization from your insurance company, but you should be fine … Susie handles all the paperwork, and she really knows her stuff….”  On and on she droned while i sat there topless, feeling completely ridiculous to be filling out paperwork while half of my clothes were missing.  I mean, couldn’t we have completed the paperwork BEFORE she had me remove my shirt?

In hindsight, she was probably just trying to normalize the situation for me, acting like it was completely no big deal that i had to be half-naked for an entire hour while a complete stranger took my measurements, helped me in and out of bras, and inserted prostheses into the garments.

… but it was still weird.

For some reason, i thought that a prosthetic breast would be hard, heavy, some sort of over-the-shoulder-boulder-holder kind of contraption.  Not even.  These things are light, teardrop-shaped pieces of silicone that slip easily in and out of pockets sewn into the mastectomy bras.  They have the same soft squishy feeling as a natural breast, and they weigh about the same.

The bra selection – while fairly extensive, with about a dozen different styles – was a little disappointing.  Of course, this is coming from a girl who has over 30 different Victoria’s Secret bras in a vast array of colors and textures, with all of them aiming for “sexy” more than “functional.”  The only actual color they had (besides black, white, and nude) was lavender, and many of the styles were … well, not that stylish.  Still, i appreciated the space i was in.  Here i was, standing in a room filled with bras, sports bras, tanktops, and swimwear – with every single item designed specifically for post-mastectomy womyn.  I was being educated by a fellow survivor who CLEARLY enjoys the service she is able to provide to this particular cancer community.  To top it all off, the prosthesis and four bras were being covered 100% by my insurance company.  United Healthcare was actually paying for me to have the luxury of looking “normal” to the outside world.

20170119_184222

I walked out of Barbara’s Mastectomy Boutique wearing the navy blue post-mastectomy tanktop  and the prosthesis.  Sure, it was only 67 degrees outside, and yes, i was cold … but there was something about walking out of that store looking like a two-breasted womyn that just FELT good.  It was like it was my secret to hold onto, this cancer battle of mine.  For the first time in a year, i no longer LOOK like a cancer patient.  My hair is growing back, my skin has color to it, i’ve regained all my weight (ahem…and then some), and now i have two mounds properly filling out my shirt.  Am i ashamed of the cancer that almost claimed me but didn’t?  Of course not.  I fought an intense battle with my own biology, and i WON … but i don’t necessarily want the rest of the world to know all that i endured.  I want cancer to be one of those things i share with people after i have gotten to know them a little better and learned that i can trust them with my more vulnerable parts … but to the rest of the world, I just want to be seen as my original fierce, confident, sexy self.

20170119_114241

(17-01-17) Reconstruction

I met with my reconstructive surgeon yesterday to discuss “next steps.”

To reconstruct or not to reconstruct?  That is the question that has been keeping me up these past several nights.

I have a consultation at the Mayo Clinic on February 7, to see if my body is eligible for IGAP Flap Reconstruction*.  I have three weeks to choose between more doctors, more hospitals, more pain, more recovery time, and more risks; or living out the rest of my life feeling lopsided and less attractive and constantly on display as the one-breasted cancer survivor.

The “strong” choice seems to be NOT getting reconstruction.  I just don’t know if i have it in me to live happily with that choice.

 

(17-01-17) Thought Process

I think i am starting to understand postpartum depression a little better now.

I feel like i should be more happy.  Chemotherapy is over.  Radiation is over.  My PET scan came back showing “no evidence of cancer.”  The wounds have FINALLY healed.  I can technically get cleared to go back to work.  My energy has returned.  So has my memory.  I feel eager to get on with my life.

So why am i not dancing on euphoria clouds right now?

I guess i thought that if/when i beat the cancer, there would be some sense of finality to it all.  Every race has a finish line, right?  Every war has a final battle.  But i am not finished.  I will never be finished.  Yeah, the cancer is gone, but the treatment keeps going.  It’s anticlimactic.