Chemo is everything and nothing I expected, all at once. After making it through the first round, I was determined to take control over my side effects and do everything within my ability to improve my day-to-day life with cancer. I spoke with the nutritionist at the infusion center and she gave me advice on what foods to avoid (like cruciferous vegetables, dairy, or anything known to cause heartburn or gas). She also suggested starting my day by drinking hot water with lemon, to soothe my digestive system and get it working before I eat anything. So I've ditched coffee and replaced it with hot water and lemons, drink loads of water and tea throughout the day to stay hydrated, and being more conscious of what I'm eating has nearly eliminated my uncomfortable digestive side effects. ​

No nausea, just a little tired at times. I've already identified the pattern. I go for chemo on Friday mornings and take the rest of the day to relax. The weekend is ok, nothing too stressful but I'm able to keep grading and prepping for the week. Tuesday/Wednesday/Thursday are my tired days, and Wednesday in particular is rough. Apparently, that is the timeframe when my white blood cell count hits a low before starting to rebound. This would typically take longer, but they have me on Neulasta, which is an injection the day after chemo meant to boost my immune system. It's a pretty odd medication. At the end of my chemo infusion, the nurse attaches the Neulasta on-body injector, a small box about the size of a tealight candle. Once she attaches it, there's a series of beeps and then a snap, like a rubberband hitting my skin. It's actually the injector inserting a tiny needle, then a tiny IV. The little box continues to blink with a green light. It's so bright that if I wake up in the middle of the night, it throws me for a few seconds seeing that bright blinking light reflecting off the ceiling. 24 hours after the nurse attaches and activates the injector, it beeps again, uses the tiny IV to inject the medication, retracts, and the light turns red. I pull it off and throw it away. Easy peasy.

So thankfully, the Neulasta helps my immune system recover more quickly so that I can receive chemo every two weeks, where some people have to spread it out every three weeks. This is a more aggressive approach, which my oncologist recommended due to my age. But on Wednesdays, when my white blood cells hit their low, I feel it. Not physical symptoms so much as emotional ones. Hopelessness. Frustration. Despair. I feel sad and angry and exhausted and like I-can't-do-this-anymore and why-is-this-happening-to-me or what-have-I done-to-deserve-this. The first and second time this happened, I didn't quite understand it. Now that I'm on infusion #3, at least I know what to expect, and so mind-over-matter I will remind myself it's just the chemo talking. I can do it.

Especially since infusion #3 was the smoothest yet. The IV went in easy (took multiple tries with infusion #2), I had no site reactions to the drugs (after some redness on my skin last time - thank you, Benedryl!) so I didn't need as much saline and was done an hour earlier than usual. I only have one more infusion of AC (adriamycin and cytoxan) which is the harsher chemo cocktail. Infusions 5-8 should come with less severe, though different, side effects. If nothing else, it will be easier on my veins, which I'm looking forward to! I'm grateful to have not needed a port for my chemo infusions, but I wasn't quite prepared for how difficult the IVs would be throughout this treatment.

Even though I'm a little tired and a little emotionally drained, overall things are going well. The hair on my head is completely gone, peach fuzz included, and I'm getting used to wearing my wig for teaching and hats the rest of the time. A student who took my class last semester commented on my dark hair color and didn't even realize it was a wig! It's thick and heavy, but it always falls perfectly into place and takes no time at all to style, so I guess there are some perks to chemo after all. Trying to keep a positive attitude. Succeeding every day but Wednesdays.

Some good news in the midst of the terrible, terrifying journey that is cancer treatment... my genetic testing results came back normal. I think this is good news, anyway. I was tested for 8 gene mutations associated with breast cancer. The most well known genetic mutations for breast cancer are the BRCA1 and BRCA2 genes, but there are several others that I was tested for as well, many of which are associated with other types of cancer as well including ovarian, lymphoma, melanoma, and uterine. 

All results came back normal which means I do NOT have a proven genetic mutation and there is no reason to think I'm at higher risk of breast cancer recurrence or another instance of breast cancer in the future. I can move forward with plans for a lumpectomy after my chemo treatments and do not need to worry about more aggressive surgery or treatment at this time. 

Of course, there's always the chance I do have a genetic mutation that the scientific community hasn't identified yet. Statistically, only 1 in 227 women in their 30's are diagnosed with breast cancer, so my situation is pretty rare. And the genetic counselor said that there must be other factors that have led to my developing cancer at such a young age.

There's just no way of knowing what those may be. 

So this is why I say I think this is good news. Good because if I had tested positive for one of the BRCA genes, I would have probably gone with a double mastectomy. If I had tested positive for one of the genes associated with ovarian or uterine cancer, I might have also have considered an oophorectomy or hysterectomy. A positive genetic result of any kind would have mean higher risk of recurrence, which means more testing down the line and near constant anxiety over when my cancer might return or spread. Still, it would have been an answer.

Negative genetic results feels like, well, a big fat question mark. You got cancer? Huh? In your 30's? How did that happen?

The doctors tell me sometimes it just happens. There's no way of knowing how long it's been growing inside me or what factors contributed to my cancer. But my friend Dr. Google tells me things, risk factors, some of which I've had control over. Oral contraceptives, which I've taken for nearly 15 years to regulate my cycle. Never being pregnant, having a baby, or breastfeeding, and being over 30. Drinking alcohol. Being overweight. 

Without a confirmed genetic mutation for breast cancer, I can't help but feel at least partially responsible. Could I have done things differently? Would it have mattered? 

It's not really worth dwelling on this now. There's no way to know what caused my cancer, or if I could have done anything about it. All I can do is look forward, attack this cancer with everything I've got, and take responsibility for my long, healthy, hopeful future.