The Carousel

Published on April 26, 2019 by beatingcowdens2 Comments

Life is very much like a carousel… you must hold on tightly. It will not stop until it is over…

I always heard about the body changing every seven years. I never gave it much thought.A quick Google search brings a couple of interesting articles.Every Seven Years…

This has been on my mind a lot the last few weeks. I’ve never been one to spend New Year’s Eve wishing a year away, or blaming one for my misfortunes. However I do have a rock solid memory for dates, and 2012 is a year I will never forget.

Digesting our PTEN diagnoses from the fall of 2011, 2012 began with thyroid biopsies for my girl. It was the year of risk assessment and triage for us. In February there were breast and neck MRIs for me and another in a long string of embolizations for an AVM in Meghan’s knee. In March came my prophylactic double mastectomy that showed DCIS on pathology. In May of that year came my hysterectomy, as well as breast and an external pelvic ultrasound to assess my then 8 year old. In June she had another thyroid sonogram as suspicion of her nodules increased. She also had an MRI to assess the progress the embolization made on her AVM. Insert recovery times, and “normal people stuff,” and that took us only to the end of third grade.

In the summer she had kidney and bladder ultrasounds, and an MRI of her pituitary gland. I added an abdominal MRI to baseline hamartomas that to this day have continued to slowly outsize my spleen itself. That MRI was repeated in November, and we ended the year with an uptick in concern about my girl’s thyroid.

Things have not really calmed down since then, and I have never counted surgeries and procedures from 2012 alongside any other year to see if it truly was our most medically active, because by all accounts the year you spend trying to process this diagnosis is the longest one ever.

Over time we have adapted to our lives, dancing in between appointments, carefully trying to schedule doctors and surgeries around life, and not the other way around.

Its a valiant effort. Sometimes I am successful at it, and sometimes it is an epic fail. Regardless there is no alternative but to keep pressing forward. Adapting and changing.

Sometimes the adaptations make us stronger. Other times they make us more efficient. I am not sure the impact of the adaptations on emotional health. I am focused on not letting this diagnosis take away my life. I am determined to live my life in spite of it. But, sometimes I do wonder. I keep in touch with virtually no one. Unable to make plans for the likelihood they will need to be cancelled or changed. A deep fear of not being able to hold down a non-medical conversation reverberates through my soul.

So as I was hopping around on the crutches this morning it occurred to me that it is now 2019. It is seven years since the epic 2012. This year is shaping up to be one for the record books.

It is hard to tease apart the Cowden’s from the “Normal People Stuff,” because at this moment life seems to be a bit of an all-consuming medical drama.

That confuses people who see me smiling through the day at work with a large boot attached to my left foot for well over 6 weeks. It makes people I run into at the mall think all must be well. I smile. Most of the time. Frowning gives you uglier wrinkles.

Today was to be the day the podiatrist freed me from the walking boot. Instead he told me to trade it for crutches in the house. The boot is starting to hurt my knees and my hip. My foot is simply not ready to be full weight bearing. The partial tear is not healed. In fact it seems no better, if not worse than when I fell at work on January 8th. The delay in diagnosis caused by a denied MRI likely made things worse.

I was given names for a second opinion, and cautiously handed a script for PT, which cautions the potential therapist to be “NOT TOO AGGRESSIVE” with my foot. The weather is getting warmer. My pleasure comes from new sneakers and long walks…

Simultaneously working the juggling act with a few other issues, I have seen just about a doctor a day for the last week.

Fortunately my daughter’s brain MRI for lesions being watched for the last year was gloriously “unremarkable” on Tuesday and I am grateful for the little things – because they are the GIANT things.

My ENT was perplexed, as most doctors are. The hearing test was normal. The fluid that I feel was not visible to him as it had been to the other doctor. He spent a good deal of time listening. He decided he would offer me a tube to drain the ear with an anticipated 5% success rate. (No thanks) and an MRI of my head which would show the ear. He said he was 99% sure the MRI would show nothing. Then he corrected himself to say he was 99% sure it would show nothing in the ear… but I should anticipate incidental findings that will likely need follow up. Whatever. Brain MRI with Cowden’s is not a bad idea anyway. MRI tomorrow.

My thyroid labs, after 3 weeks on the new medication regimen indicated the need for another change. I’ve been having heart palpitations, and the highest blood pressure reading of my life. I’m awaiting the arrival of the new dose, and setting up the next blood appointment, all while wondering if this is an exercise in futility as it looks like the rest of my thyroid will need to be removed in the not so distant future. My partial thyroidectomy was in 1993. Clearly the body keeps changing.

I had a routine bone density screen on Weds. I also went for my abdominal sonogram to monitor the spleen. It’s a 45 minute ultrasound that requires 4 hours of fasting, but checks the spleen hamartomas for growth, while evaluating the liver and kidneys. Except it was done in 6 minutes.

Apparently there is a drop down menu somewhere when you order an abdominal ultrasound. I think the first item is Aortic screen. The “Complete” that I needed was a few clicks down. I’ll need to reschedule. But, I am looking forward to hearing the random screen I didn’t need was “unremarkable.” Results pending…

I am a different person than I was 7 years ago. We all are I suppose. If you evaluate your life in 7 year increments, you will definitely note changes.

The question is, will you be happy with them?

I am stronger. I am more fit. I am more confident in my knowledge. I am less drawn into drama.

I am also less social. I am less knowledgeable about world news, and more knowledgeable about rare diseases. My attention span is shorter. I am easily distracted. My brain is always on. Sometimes I catch really important things. Other times I torment myself…

I am introspective and honest.

Happy is a relative term.

I’ve spent a lot of time watching Netflix. More than I ever have. I picked up Grey’s Anatomy and keep hearing Meredith quote her mother.

“… But the carousel never stops turning. You can’t get off.”

I will hold on tightly and remain

#beatingcowdens

Forever…

Published on July 20, 2018July 20, 2018 by beatingcowdensLeave a comment

When I married my husband I committed to forever. It was a good call.

When we decided to have a child, we understood she would be our baby forever. No regrets.

But some time in the fall of 2011 a doctor diagnosed both of us with a rare genetic disorder. This forever, well, this one we did NOT sign up for.

At first there was no time to process the concept of forever as it connected to Cowden’s Syndrome. There was too much to do.

Neither of us had an “easy” medical history, so putting a name on it had its pros and cons. But, we were handed lists of appointments to make and things that suddenly needed immediate attention. We were quickly schooled on tumor growth and cancer risks. We were told to remain vigilant, and that we would be “fine”.

There was no time to process as 2012 had a traumatic thyroid biopsy in January and an embolization for her Arteriovenous Malformation (AVM) in her knee in February. Then, there was my double mastectomy and my “surprise” cancer diagnosis in March, followed too closely by my hysterectomy in May. And soon after that hysterectomy, Meghan had breast, pelvic and kidney and bladder sonograms. There was also another MRI of the knee, and two thyroid ultrasounds that brought in 2013 with a surgical thyroid biopsy.

2012 was salvaged largely by a third grade teacher who I swear was an angel placed in our path. Because there was real life too. There was work, and school, and activities, and appointments that were quickly starting to overwhelm.

There was probably close to 2 years after the initial diagnosis before I even looked up. And, when I did I had a whole host of emotions.

Forever had taken quite a toll on my girl. Tough as nails. Driven. Strong. Focused. Always. But, apprehensive, concerned and full of worry she was way too young to have to shoulder.

Forever. I did my best to keep as much “normal” as I could. Early therapists cautioned not to let the disease “define” us. I kept the schedule delicately balanced between the necessary medical screenings and the “fun” activities. She needed to be “like everyone else”. So there was swim, later theater, some voice lessons, all interspersed with surgeries too many to recount again. Some traumatizing, some annoying, some isolating, and some worrisome. All time-consuming. Some required physical rehabilitation, and others emotional.

Forever. The highway became our bonding place. She could read and do some homework in the car. We scheduled appointments on holidays as often as we could. We scheduled appointments after school. It made for some long days- often traveling 2 hours each way, and waiting forever in the offices- but we did it to preserve school attendance, and to keep her at as many activities as we could.

Forever. She grew up. Not just physically, but mentally. She has broad shoulders, literally from hours of butterfly, and metaphorically from carrying way more than she should at her age. The knowledge that this is her forever is difficult for all of us. We make the best of it. We talk about how grateful we are to know what to look for. But, that gratitude, while sincere, can never replace the innocence of youth. Innocence lost. Forever.

Forever. The wait time at most appointments is close to forever. No one typically knows what to say to us. They look at what they need to. They offer some empathy, sometimes. Then, sometimes out loud, and sometimes in their heads, they show gratitude that they are not fully responsible for us. We wait hours and hours so often. We have learned patience. We have learned to quietly accept that if they “google” us before, it means they actually care. We are rare. We are 1 in 200,000. This diagnosis is forever.

This summer we have already gone to our 16th appointment between us. There are 4 more just next week.

Yet, this summer she performed with a wonderful, talented, warm and welcoming group of young people at Staten Island Children’s Theater Inc. in a production of “Legally Blonde Jr.” They like her. Some of them know what she does with the rest of her life, and others don’t, and it’s all okay there. They give me hope that some people, teenage people and adults as well, are just good people.

She has been at swim practice most mornings between 6:15 and 8:15. She has spent this week in small group lessons for swim from 8:30-3.

She has accomplished a good deal of her summer work for school. She had peppered in the appointments in the crevices hidden in the schedule.

Forever. The reality is not lost. But, I am so proud. So proud of how hard she works to stay in this world, while living in the world of chronic pain and rare disease. It is hard work. She does it pretty gracefully most days.

Forever. Perhaps I could use a lesson or two from her.

Somewhere in the midst of this medical whirlwind we live. Somewhere in the midst of working full-time, and managing surgeries and appointments, and life as it happens to all of us, I have lost track of myself.

Forever. I have one speed. I operate in constant motion, or I am asleep. There is rarely any middle. The yellow legal pad is to the right of my computer, capturing every thought. The iPhone calendar alerts me to the plans of the day. My house, although not as clean as I’d like it, is in constantly good order. It is a control issue. I will own it. There is so much flashing by in the blink of an eye, I can be sure to get the dog fur off the floor once a day, and know that it actually got done.

Forever. I’ve lost touch with most of my friends. Life is busy, theirs and ours. There are only so many times you can tell the same story to people. Our story could be recorded. It just repeats itself. Doctor, testing, surgery, follow-up, rehabilitation, next body part, routine appointment, maintenance, worry about a potential problem, 6 months to watch it… I used to have other things to talk about. Now I would be one of those people I used to laugh at on night-time TV. I am so out of touch with the world. My experiences are significant, but without variety. They are heavy and too much for most people to hear. There are no answers.

Forever. The summer will pass. We will force in a vacation and we will hold those days to be without doctors, and without summer assignments. Then, we will do our best to put our feet in sand once. Just to listen to the water. We will try to get a few people to swim in our pool, so the activities of opening and closing it are not totally futile.

Forever. Life is busy. Too busy. And that’s not just a Cowden’s Syndrome thing. I heard of three deaths this week. All three tragic. One at age 19, one at 31, and another a bit older. Tragedy. They had plans. They did not think their forever was going to end this week.

Forever. My conscious mind doesn’t need but a split second to list dozens of real and significant blessings. There are countless things in my life that bring me to my knees in gratitude. But, the inner conflict is strong. With the knowledge of the wonder and beauty in my life, I should be able to take this diagnosis, this “Forever” that is Cowden’s Syndrome, and put it in its place.

Forever. The struggle is real.

Forever. Stopping to find the moment, and to embrace the joy right now is not as easy as it sounds. I can talk the talk better than anyone. The raw truth is that I can not always walk the walk.

Our Cowden’s sisters and brothers span the globe. Estimates are about 1,800 of us are in the United States. I do not know the world numbers. I know some of the people though. One in Australia just underwent 2 MORE brain surgeries a few weeks ago. Another, a teen who is with her Mom in Cleveland right now is waiting for news that is surely churning mom’s heart.

Forever. It’s such an arbitrary concept sometimes. I became a wife with the intent of forever in my heart. I became a mother with that same intention. But Cowden’s Syndrome threw forever at us. It’s got the same dictionary definition, but not the same feel.

Someone asked me recently why I can’t just take time off, or block my appointments so we have “breaks”. The truth is, I try. Doctors want what they want in terms of follow-up, and being vigilant means I need to comply. Most visits run us a minimum of 4 hours round trip. Many can not be “stacked”. I have a full-time job. I have a high school honor student. We need to be at work and school. I suspect those who ask are just trying to help. But, it makes me feel like maybe if I just tried harder…

Forever.

It took me 7 weeks to write this post. My attention span is not what it used to be. I have a whole lot of reasons to keep making this work. Forever. I am blessed. I am grateful. I am tired. I am human.

This blog was started in hopes that people stumbling upon it would read the story of a real family, fighting the same thing they are. With that comes real, raw, and honest emotion.

Forever is beautiful when you connect it to things you signed up for.

Forever is not so easy when it connects to a rare disease that wants to grow things throughout your body.

Forever. It is promised to none of us, that forever will last longer than today. It is our decision what we do with the gift of the time we have.

I am a work in progress. I am a wife. I am a mother. I am a survivor. I am worth the hard work.

Today I will start by opening all the blinds. Time to look at the sunshine. Time to look at the blue sky and the flowers. Time to breathe. In and out.

One step at a time.

We will remain

#beatingcowdens

Forever.

Superfluous Tissue

Published on March 4, 2018March 4, 2018 by beatingcowdens3 Comments

6 years ago I was trembling with fear. I sat up most of the night. I paced the floors. I was scared out of my mind.

No stranger to surgery, this one was way different.

Sometimes I actually forget things. But, most of the time, especially when it has to do with numbers or dates, I remember.

Six years ago I was only months past the diagnoses of Cowden’s Syndrome Meghan and I had received. Six years ago I was only learning about the mutated gene with astronomical cancer risks that I had passed unknowingly to my girl. Six years ago I was reeling with the knowledge that she had nodules on her thyroid, pronounced and alarming. I was trying to grasp the reality that this life of medical drama that I had hoped would subside, was going to require our vigilance and attention forever.

So, exactly 6 years ago tonight I was contemplating the overwhelming reality that my newfound breast cancer risk, which exceeded 85% on gene mutation alone, had been coupled with my 8 prior breast biopsies, and my mother’s “survivor” status, and had relegated my surgeon to tell me it was not “if,” but “when” breast cancer would strike me. When I met her for the first time a few weeks prior she had my chart with her. She had reviewed it before our consultation, and she cut right to the chase.

“When are we going to schedule your surgery?”

I paused, a little stunned and confused.

“For what?” I managed to ask.

“Prophylactic bilateral mastectomy.” She stated simply. “You will face breast cancer. The numbers, and your history make it irrefutable. I think we need to get there first.”

I always travel to my doctors alone, but that is probably one of the few times I actually regretted it. The room started to spin a bit. Thankfully, she didn’t skip a beat.

I managed to ask, “when?”

She said, “March 5th.”

I protested. I asked if we could do it over the summer. “I am a school teacher,” I told her.

She was kind, but unimpressed. “March 5th. My scheduler will help you coordinate with the plastic surgeon. We will be in the operating room together.”

I was numb. I called my husband, then my mother.

I drove home, and started to prepare.

I was unsure how I would handle the minimum 5 week recovery. There were no sick days left for me to pull from. I had an 8-year-old who had already had multiple surgeries, and I had quite a few myself. I started to wonder how to plan financially for a leave that would end up being at least partially unpaid.

A dear friend, who will never fully grasp the depth of the gift she gave, donated 25 sick days to me. The weight she lifted off me was astronomical.

I spent the next few weeks in auto pilot. We were still handling some new findings on Meghan, and I was reading and processing Cowden Syndrome. It made me nauseous.

I remember the drive into the city that morning. I remember walking with Felix. I remember praying over the phone with my brother-in-law.

I remember repeating over and over to the unbelieving doctors that I would NOT be having tissue expanders, the common course of action with a mastectomy. The plastic surgeon heard my concerns, and my need to simplify, and to get home without additional surgery. The knowledge that my child would likely one day walk this road filled me with a sense of urgency to make it seem as simple as possible. She agreed to do immediate implants. I lost count of the number of times I explained that.

I remember walking to the operating room, and looking into the comforting eyes of my surgeon before I fell asleep. “You are very brave.” And even though she never really gave me a choice, her reassuring smile helped so much.

I remember waking up feeling relieved and empowered. Not just because the surgery was over, but also because I had gotten out in front.

I remember seeing my husband, and checking on Meg. I remember seeing my sister and telling her she should be with my nephew. His birthday happens to be the same day.

I was discharged the next morning – about 28 hours after the surgery.

The next days were painful, and draining. My mom was with me for a few, to wash my hair, and to chat. I hated the circumstances but treasured the time with her.

After my mom’s mastectomy following her cancer diagnosis many years prior, she had dubbed the breasts “superfluous tissue.” I finally understood.

When my pathology came back days later with early grade DCIS, essentially one cm of stage 1 breast cancer, I missed my breasts even less. We were all surprised, and I was grateful for the knowledge that the cancer was not close to the chest wall and no follow-up treatment would be needed. I just had to heal.

I had no idea at the time that two months later I’d be back in the hospital for a hysterectomy. Cowden’s Syndrome does not mess around.

Except, it messed with the wrong family.

We get knocked down, but we get up stronger.

Sometimes I hate that I remember dates. Other times, maybe it gives me reason to celebrate, and to feel empowered.

I started owning my nutrition 6 years ago. I have worked on playing strong and fit. My weight has been stable, and I am proud to be one of the healthiest looking sick people you’ll ever meet.

“superfluous tissue” indeed.

#beatingcowdens

Rare Disease Day 2018

Published on February 27, 2018February 27, 2018 by beatingcowdens2 Comments

I took today off from work.

Sadly, it was not to enjoy the almost 60 degree February day.

Today was doctor day.

And as I traveled two hours for the 17 mile trip into Manhattan this morning, I had plenty of time to think about World Rare Disease Day, tomorrow, February 28th.

Rare Disease Day 2018 will pass for us unlike the last few. In recent years my family, spearheaded by my daughter, has held a sizable fundraiser to draw attention to Rare Disease Day. Our goal was always to raise awareness and funds to support research and treatment of our Rare Disease through the PTEN Hamartoma Tumor Syndrome Foundation. My girl needed some time off to address some things on her mind and heart. I gave her that time. She is still working hard, but she has already expressed an interest to join me in planning an event in October of 2018. Stay tuned.

While I was driving, I thought a lot about RARE. It has so many connotations.

Sometimes I think of snowflakes, and rainbows, and unicorns. I think of pleasant, beautiful things. Some of the buildings on the skyline look rare. Rare can be a thing, a sight, an action or even a feeling.

Rare is defined by Dictionary.com as:

adjective, rarer, rarest.

1. coming or occurring far apart in time; unusual; uncommon:

a rare disease; His visits are rare occasions.

2. thinly distributed over an area; few and widely separated:

Lighthouses are rare on that part of the coast.

3. having the component parts not closely compacted together; not dense:

rare gases; light-headed from the rare mountain air.

4. unusually great:

a rare display of courage.

5. unusually excellent; admirable; fine:

She showed rare tact in inviting them.

Rare can mean remarkable, wonderful and exciting. It can mean fascinating, and intriguing.

But life with a Rare Disease reminds you often, that RARE can have many other connotations.

A quick look at thesaurus.com generated these synonyms to RARE:

Synonyms for rare

adj exceptional, infrequent

Quite a list, right? And, if you really look with an honest eye, not all of them have super positive connotations.

Strange, uncommon, unthinkable, unusual, deficient, flimsy, tenuous, (and no this isn’t a typo, but I had to look it up) unwonted…

These are not the words you’d use to describe a beautiful natural event, and probably not the words you’d pick for a dear friend.

Yet, these words also mean RARE.

I set out today to get screened by 3 of my many specialists. The cancer risks with a PTEN mutation are almost astronomical. It becomes a game of “when” not “if” in so many cases, and the vigilance required to seek out the cancers so they are detected early can be overwhelming. Lifetime risks for breast (approximately 85% as compared to 7%), thyroid approximately 30% to .9%), uterine (approximately 28% as compared to 1.7%), kidney(approximately 24% as compared to 0.8%) and melanoma (approximately 6% as compared to 1.1%) eclipse the general population. (These numbers were midline from a graph in this link) www.myriadpro.com/services/clinical-summaries/gene-pdf.php?gene=pten&allele…

The risk of recurrence is also great, and that of developing a second, primary site cancer is also noteworthy. So, having had a double mastectomy with a great prognosis, does not eliminate the need for biannual screening. I love my breast surgeon. She is one of the best. She and I are both always pleased when she can tell me everything is good.

But, I held onto her a little longer today. I told her I was in the market for an internist. I need someone to play “case manager.” I need someone to be my doctor. She paused and furrowed her brow a bit.

That isn’t an easy request, she told me. I said I just need someone willing to learn a little, and consider that I don’t fit in a “box.” I need someone who will partner with me. She told me she’d led me know if she thought of anyone.

I’m not hopeful.

I waited down the hall for the hematologist/oncologist. When she was an hour late, I walked the half mile (in jeans and compression stockings from Wednesday’s surgery) BACK to the main hospital to see my endocrine surgeon.

She may be the weakest link in my chain right now. She scanned the remains of my “lumpy, bumpy” half thyroid that the surgeon 25 years ago thought would be an asset to me. She scanned a very slowly growing lymph node in the area that went from .6mm to .8mm. She told me to get some blood drawn and that all looked good. I showed her a recent chem panel. She pointedly ignored every out of range number, and zeroed in on the calcium level. “Good.” And she handed me back the papers. Then she ordered a short-sighted list of thyroid labs that I would never tolerate for my daughter. I was out of her hair in 15 minutes.

I walked back to the cancer center thinking “rare” thoughts.

I waited again for the oncologist, who was as always pleasant and happy. She examined my spleen, and what she could feel of the 4 hamartomas that live there. She felt nothing out of the ordinary, and ordered my abdominal sonogram.

I showed her the same chem panel I showed the endocrinologist. She agreed the irregular labs should be repeated, but did not feel concerned. I asked her about an internist.

She froze. She suggested a new genetics person that had recently come to the hospital. I may go for a consult.

But, and internist? I asked again.

Hesitation. Almost painful look. She explained that the internists have to move fast. They don’t really have time to get to know a new condition. She couldn’t be sure if she new any that would care properly for me. She basically gave me 4 names, but told me I was best left to do it myself.

Even though my rational mind understands it to a degree, I felt like I’d been punched in the gut. I have homeowners insurance, auto insurance, and life insurance, just in case. I have a 401K and am part of a pension system. I do my best to prepare. And I was basically told, by a major NYC hospital, that I stood little chance of finding an internist who would take the time to manage my case.

That scares me. I do it. I always do it, and I will continue to do it. However, I am managing health care for myself and my teen. And it’s not just routine stuff. Cancer is looming, lurking, and mocking us. All I want is someone to check behind, proofread per se, and make sure I am checking all the right boxes. I want someone who will know that a test result in us may not mean what it does in someone else. I want someone who looks me in the eye and knows I am a human who plans to live a long time even though her body doesn’t play by the rules. I want a name to put on the line every time someone asks me for my “primary care” doctor, and I want that doctor to at least glance at every pertinent paper sent to them about my health.

I got my blood drawn at the hospital lab.

It’ll be in the online system long before anyone ever discusses it with me. I’ll scan it, and hope that there are no alarm bells to be sounded this time.

RARE isn’t just snowflakes and unicorns.

RARE is that kid, who everyone looks past. The one without the cool clothes, or the right hair. RARE is the one who no one wants at their lunch table, and the one who is conveniently forgotten on fun excursions. Because, what it RARE can’t do what everyone else can? And anyway, truth be told, RARE has cancelled one too many times. RARE doesn’t really fit in anywhere. RARE is brushed aside, in hopes they won’t bother anyone, or maybe they it go away. People are afraid of RARE. They perceive it as fragile, needing too much effort, or too hard to understand. Sometimes people even envy RARE, without thinking through the late nights, the terror, the medical strategies, the constant advocacy. RARE wants to fit in, but it never will.

RARE is too much new, and too scary for a doctor to own more than one piece.

We are scared of things we don’t understand.

Right now, RARE is a bit of a loner.

We are all RARE in some way.

But, RARE as a lifestyle is not an easy road. And it is not a choice.

The choice comes in what we make of it.

Rare Disease Day 2018 will be a little different this year for us, a little more quiet. But, I hope there is no doubt, that we will come back.

RARE does not give up. Ever.

#beatingcowdens

AHCA, High Risk Pools, and My Child’s Future

Published on May 4, 2017May 4, 2017 by beatingcowdens2 Comments

I am angry. I am hurt. I am worried.

I have stayed out of politics through the entire tumultuous 2016. I have serious issues with many politicians. I am not here to talk about them directly. I am here to talk about an issue that transcends political party affiliation. I will not engage in a debate about Democrats or Republicans, or the should have/ would have/ could have game that people like to play with each other.

This is far more serious, and more important than any of that. This is about my daughter. It is about her life. Her future. And, it is about the lives of millions of American citizens, myself included.

I will concede that there are problems with health care in America. I will even agree that healthcare the way it exists today needs change. However, when I look at a situation that needs change, I think it through carefully. I work through every detail. I weigh out repercussions and ramifications.

The Bill that passed the House today, in my opinion was put together in an attempt to score a “win” for our President.

When millions lose. No one wins. That’s not just the math teacher in me. That’s real.

Three years ago I was in a car accident. It was a terrible situation, and I was T-boned at an intersection. I will contend to my dying day that the truck that barreled through me was speeding so fast it never should have made it to me before I cleared the intersection. I had the stop. I stopped. He never saw me and it took almost a block, in a school zone, for his truck to finally stop moving. Because the stop sign was mine, I was assessed with most of the fault for the accident. It made me furious. I was told speeding could not be “proven” despite the absence of skid marks. The other 6 accidents that happened at that intersection in the months preceding were not helpful either. In the end, I was grateful for my life. I walked away and took the penalty on my insurance. I paid that accident penalty for three years. And, while it did not make me happy, I did it. The accident penalty was annoying, but affordable, less than $200 a year.

The car accident happened once. It might happen again, but it will not happen regularly. I am 25 years driving, with one accident and no moving violations. I have proven I am not a reckless driver. I have control over that. Full control, and I take my driving very seriously.

I also take health very seriously. Unfortunately, there are aspects of my health I do not have full control over. My daughter and I have a rare genetic disorder called Cowden’s Syndrome. She is 30 years my junior, and at 13 and 43 we have seen the inside of an operating room close to 45 times combined. Cowden’s syndrome causes tumor growth. It carries with it an astronomically high risk of many cancers, most notable breast, thyroid and uterus. It carries also significantly elevated risks of kidney, colon, skin, and other cancers. Many of our tumors are benign. Some are not. The only route we have to long term SURVIVAL is constant surveillance.

Many doctors recommend surgery to remove things that are high risk. Thankfully, that suggestion proved life-saving for me in 2012 when a “prophylactic” bilateral mastectomy revealed stage 1 breast cancer. I was fortunate.

Two months ago I had surgery to remove a benign tumor from my vocal cords. It was impairing my ability to breathe and speak.

In 16 days my daughter will undergo the 18th surgery in her young life – the 7th on her right knee. Cowden’s Syndrome carries a high correlation to vascular malformations like the Arteriovenous Malformation (AVM) that grew in that knee. After 6 embolizations to curtail the blood flow, she now deals with the repercussions of having blood lingering in the knee. There is wearing away of tissue causing the patella to shift. There is extreme pain, not just in the knee, but all through her body. Her right foot stopped growing years ago, but the left one kept at it. Now a full size apart, different in length and width, her 5’8″ frame feels the repercussions with every step. She is regularly at the chiropractor in attempts to minimize pain medication and keep her in alignment. Pain medication caused such GI distress in 2014 that she spent a week in the hospital. Cellular changes in the esophagus are not good in anyone. At 10, with a condition that causes tumor growth, it was certainly another wake up call. We gladly purchase 2 entirely different shoes every time she needs a new pair. We are grateful she walks.

That is just the tip of what this child has endured in under 14 years on this earth. She has had her thyroid removed with 19 nodules and suspicion of malignancy at the age of 10. We still work to balance levels synthetically. She had had TWO D&C procedures to eradicate suspicious tissue in her uterus. She has had a lipoma removed from her back and vascular malformations from each palm. She has lost her gall bladder. She fights, stands up. Moves forward, and gets smacked in the face again.

Soon after our diagnoses in 2011, another mom told me Cowden’s Syndrome requires vigilance. I got it. I am on it. All the time. And with the GRACE of God alone, we are walking the path the best way we can.

We average between 6 and 10 appointments a month between us. The copays and travel costs are often daunting. But, we are fortunate. We have two good jobs my husband and I tell ourselves. We have good insurance.

We are careful with every morsel of food that enters her body. We eat largely organic and non-GMO to let her body use all its energy to stay healthy instead of fighting contaminants. Even at that she is acutely sensitive to almost all gluten, dairy and soy.

We treat as naturally as we can, often incurring bills, as these treatments are rarely covered. Yet, still we prioritize health because we realize its value. And we remember how fortunate we are. We have good insurance. We have two good jobs.

My daughter is awesome. And, not just because she is my daughter. She is a respectful, kind-hearted young lady. She has the voice of an angel. She acts in the plays at school. She reads for fun. She swims passionately. She is an honor student. She talks about her future, and what she will do with her life. I have no doubt she has the capability to make a real difference in this world, regardless of her career path. Today however, I am left to wonder. Will any job ever be enough?

If the AHCA passes the Senate, we will likely be placed in an unregulated “high-risk pool.” This is not like my car accident. This is not a minor inconvenience. This has the potential to decide the course she will have to take with her adult life, as her health issues will not go away. We have this genetic mutation with all its risks and ramifications for life. Lifetime caps, potentially re-instituted will likely be met in her 20s, if not before.

There is no way at all to prove where the mutation came from. I’d ask you to indulge in a theory with me a moment. My father, a Vietnam Veteran was heavily exposed to Agent Orange as a Marine in 1967-1968. My mutation was traced to my father. He never manifested with Cowden’s Syndrome, but somehow passed that mutation on to me. Wouldn’t it be ironic, if that toxic exposure in the jungles of Vietnam, in an attempt to fight for his country, ultimately led to this condition in his daughter and granddaughter? Dad died in 2013, pancreatic cancer that may or may not have been Agent Orange related. I’m glad he is not here to see the reality that our government may be on the cusp of turning it’s back on his family.

I was raised a proud American. In addition to my Dad, I have three Grandfathers who were World War II Veterans. I value the principles this country was founded on. I am grateful for the freedoms I have in this country.

I have not been raised to use the phrase, “that’s not fair,” but I will ask you to consider a few things.

Last night as I watched the news my head spun as I heard elected officials allege that people with pre-existing conditions have not led good lives. I am not here to compare, but I will tell you our “pre-existing” condition has NOTHING to do with lifestyle choices. And if you do not like the site this link came from – scroll to the video. Hear it from his mouth.

http://www.politicususa.com/2017/05/01/gop-congressman-people-pre-existing-conditions-bad-people-pay.html

I can name dozens of people off the top of my head, as close as within my own family, that would be grossly negatively affected by the establishment of “high risk” pools.

Should a cancer survivor, an MS patient, a diabetic, a person with a brain tumor, a rare heart condition, a genetic mutation, or countless other conditions be forced to make decision on the path their life should take because they are too expensive? Are they less valuable? Do they matter less?

Should we be asked to decide whether or not to keep critical screening appointments, or have access to necessary medication blocked by cost?

We have two good jobs, and this whole thing terrifies me. But, I will not be controlled by that terror.

This post will reach my Senators today. Social media can be used for good. I have a voice. I will not be quiet about this.

Tell your story. And if you can’t find your own words, share mine. Let our Senators know that we are real. We are not numbers. We are not a cost-cutting measure. We have faces, and names. We matter. We all matter.

We are determined to remain

#beatingcowdens

5 Years and “Sag-less” in my 40s

Published on March 5, 2017March 5, 2017 by beatingcowdensLeave a comment

March 5th. 2012

One of those dates that will stick with me forever.

On March 5th of 2012, I made my way early in the morning to the 10th floor of NYU. I signed all the papers with my husband by my side. I shook. I prayed. I was terrified. But, I had strong resolve, and there was no turning back.

Several months prior, my daughter, and then I had been diagnosed with the PTEN mutation that causes Cowden’s Syndrome. This mutation is responsible for increased tumor growth, both benign and malignant. It causes polyps, hamartomas, vascular malformations, and a whole bunch of other messy things. After our diagnoses, we began aggressive and age-appropriate screening.

Meghan was 8. I was 38.

They started with her thyroid. And immediately found issues.

At exactly the same time I was being sent through screening for the highest risk in my age group. Breast cancer.

I already had a mom- a 15 year survivor of bilateral beast cancer. (She does not have the PTEN mutation.) I had already had several surgical breast biopsies through the years, with increasingly foreboding pathology. But, I could not have been prepared for the surgeon I met in NYU Clinical Cancer Center in January of 2012. She introduced herself to me, having already torn through my previously received medical record, and said we should set a date. When I asked for what, she said quite simply, “For your prophylactic bilateral mastectomy.”

A little stunned, I caught my breath and asked why? “It’s not a matter of IF, but WHEN you’ll get cancer,” she said very definitively. “We need to get at it first.”

She sent me to her scheduler, who coordinated with the plastic surgeon. The date they came up with was March 5th. I asked why I couldn’t wait until the summer, and I was told that she thought that would be a huge mistake.

I called my husband, shaking. “Do what they say,” he calmly asserted.

So I left that January day with a script for a bilateral breast MRI – just to make sure there was no cancer- and a surgical date.

The MRI was negative. I am still amazed by that. Five weeks prior to the surgery there was NO FINDING on the MRI.

I met with the plastic surgeon, and much to her chagrin, I opted for immediate reconstruction, deciding to forgo the preferred method of tissue expanders. She reminded me that the results would be “imperfect.” I knew I could not delay my recovery by months. I had a daughter, a family, and a job to return to.

The surgery was uneventful.

I vomited repeatedly as I left the house that morning. I cried as I walked into the OR. My surgeon called me “brave.” I woke up with a strange feeling of empowerment.

I left the hospital 28 hours later. There were drains and wrappings, but there were things to do. I met on the refinance of our mortgage and managed parent teacher conferences with my daughter’s third grade teacher all before the drains were removed.

The day we went to have the drains removed, for whatever reason both Meghan and Felix were there. The plastic surgeon was the first to mention how lucky we were we caught “it” early. I was confused. She said, “The cancer. It was very early and far away from your chest wall.”

There was silence in the room as we all processed the word “cancer.”

She realized then she was the first to share the news. Our next stop was the surgeon. I pored over the pathology report and kept getting stuck.

I went from being a woman “getting ahead of things” with a “prophylactic bilateral mastectomy” to a “cancer survivor” in a moment.

I was told had I pushed the surgery to the summer, I would have been in a “fight for my life.”

I’ll always know I am more fortunate than any of the women who needed, chemotherapy, radiation, and other treatments to keep their cancer at bay. I have not traveled the road as they did. I will forever admire them. But, we are kindred spirits living with the daily knowledge that cancer cells once lived inside of us. That is a feeling, and knowledge that can not be explained. You either know it, or you don’t.

My implants lasted less than 5 years. The life expectancy is 15. This past summer they were replaced. Scarring was severe on the right side, and the scars needed to be broken up. A new pair replaced the old. Nothing flashy. Quick surgery, quick recovery. No big deal. Just a reminder of the reality that will follow me forever.

Today I celebrate that reality.

5 years officially Cancer-free.

Five years – and by the grace of God, countless more to go.

Five years- the first of many with sag-less silicone, size small shirts, and the ability to go bra-less without being noticed.

I celebrate my Mom – 20 years a survivor this year – my role model. My motivation.

I celebrate inside my own quiet- unable to speak as my voice heals. I celebrate even through miles of survivors guilt. I celebrate despite my broken heart as so many around me are taken by cancer. I celebrate because that is what they would want most.

Once you’ve been there. Lived it. Watched it. Seen it. You get a deeper sense of how precious life is. And you celebrate what you have each day. It’s not easy. Life can be messy. But, we do our best.

I celebrate to honor those who’ve been taken, those who work so hard every day to smile through, and for those whose diagnoses are yet to come.

Every day is a gift. As my friends at #stupidcancer would say – Get Busy Living!

#beatingcowdens

Set Up Surgery on Safari – check

Published on August 20, 2016 by beatingcowdens7 Comments

Last Tuesday, on Meghan’s 13th birthday, we woke early and headed to the airport for what has become an annual family vacation. Disney World is a “happy place” for all of us. Despite crowds, and heat, we seem to be able to locate so much magic there. Plus, it’s not here.

I like it here. In my house, with my family. But being “here” in a broader sense means doctors and tests, and appointments and procedures. And traffic, and waiting. And bills, and phone calls, and all sorts of obligations that often keep me tied to my desk chair.

In Disney someone produces allergy safe meals for us. In Disney there is no driving. In Disney there are fireworks and parades and shows. While we are in Disney Mom watches the dogs and the house.

Those 8 days designed as a respite. A safety zone. A doctor free area. And we look forward to it every year.

This year was even more special because Meghan brought a friend. She got to bring a kind, compassionate, witty young lady who had been by her side through some ups and downs the past year. There is not a long list of people who Meghan trusts enough to take into confidence, and I can’t say that I blame her. But, this young lady has similar loyalty standards, and held her composure as Meghan threw some tough stuff at her. Meghan is forced to think about things and process things that are not even remotely acceptable to have to deal with at her age. Most peers are overwhelmed. Many shy away. This young lady did not NEED Meghan as a friend, they CHOSE to be friends. As different as they are, they compliment each other nicely. So we set off on our adventure this year as a party of 4. The Ortegas plus one!

Once we found our groove, (adding a wheelchair takes finding a balance) we were off and running. Great food, lots of laughs, and the highs and lows you’d expect from two spunky teenagers.

I was distracted Friday when my cell phone rang, while we were on the Safari at Animal Kingdom. I should have seen the NY number and known what was coming. But, I answered quickly.

It was my plastic surgeon’s office. The one who had told me they could fix my implant some time in the spring… well, they were offering me a spot on August 19th.

If you don’t have the back story on this I’ll give you the quick version. After a double mastectomy in March of 2012, I opted for immediate reconstruction. I was very pleased. Then in November of 2012 I was in quite a car accident. I took a good hit to my totaled Hyundai. The implants were intact, but likely never quite the same. By the summer of 2015 I had been experiencing some pain and discomfort on the right. I went back to my plastic surgeon in November of 2015. She told me the right implant had fallen a bit, and I should have (non-emergency) surgery to pull it back up. Except, she was no longer accepting my health insurance. The year that was had Meghan in the OR I believe 5 times. I struggled to get the courage to call the new plastic surgeon. I was annoyed to have to do all this again so soon. The initial estimate on the implants was 15 years. This was under 5. I finally got an appointment with the new plastic surgeon a full year later, in July of 2016. He concurred that a surgical procedure to “tighten things up” was a good idea, and that I could schedule at my convenience. So, I tried to get it scheduled for the summer. Then I tried for October when we have a few days off. Then I tried for December… and before I knew it I was looking at spring break, almost another year of what had transformed from pain, to just an odd sensation, all the time.

I listened as I was told I could have the date one week away. I looked around at the animals on the African Safari. I tried to keep my conversation low enough to make sure the girls, and no one else on the vehicle was following along. I promised to return the call in an hour.

I hung up and managed to share the story with my husband. Then I called my Mom. Then I called the plastic surgeon back. “Let’s do it.”

So the following Monday was spent ducking away to make phone calls to set up pre-operative appointments. Because the plane was due to land at midnight Tuesday. I needed blood drawn, and a physical Wednesday in order to hold the spot.

Tuesday we left Disney. The step count on my FitBit was over 142,000 I had covered over 62 foot miles. I was tired, but happy.

We did have a great week, and while I was bothered on some level that the surgical planning creeped in, I am skilled at managing many things from my cell phone. And, the thought of getting all that straightened out months ahead of schedule was exciting.

Tuesday it rained. In NY and in Florida. There was lightning. There were delays. Lots of them. Our plane landed well after 1 am. I hit my bed hard at 3 and was on the bus to NYC for the lab work by 9. After battling NYC traffic there and back, I went for the physical. Passed, and papers faxed to the plastic surgeon by 4:00. Success.

Life moves quickly. We have to keep up.

The call came Thursday to be at the hospital at 6 AM Friday. While I am not a morning person, only the surgically experienced would realize that is like hitting the jackpot. It means you’ve got first case. And that is a giant win.

There was little time to share the plan with anyone.

Yesterday morning I had bilateral implant repair between 7:30 and 10 AM. I slept till 1, had some ginger ale and crackers and was home by 2:45.

Last night I laid in my bed catching up on Email and I caught one from Meghan’s endocrinologist. The thyroid numbers have gone a bit off again. He wants to play around before repeating labs in 6 weeks.

Medication readjusted. Again. Illogical. Like so many other things.

Apparently #beatingcowdens involves scheduling surgery on an African Safari and readjusting medications hours post-operatively.

We’ve got this.

Thank goodness for our time in the “Happiest Place on Earth.”

Body Betrayed

Published on July 30, 2016July 30, 2016 by beatingcowdensLeave a comment

The first time I felt the pain it was last summer. It was under my right implant, and from my armpit a bit down my side. The pain lasted a few days and then eased itself into a chronic state of discomfort. I went from almost 4 years of barely noticing, and sometimes forgetting the silicone implants that had replaced the breasts in their earliest stages of cancer in March of 2012 to thinking about them all the time.

Now I knew the right one was there. And it was bothering me. For physical, and deeply psychological reasons. It was getting in my head. Messing with my focus.

I went to see my plastic surgeon in November of last year. I adored her. I wanted her to make it better. Her words were reassuring to a point. The implant was intact. There was some minor movement. I should get it taken care of but it wasn’t an emergency.

Then there was the bombshell. She was no longer accepting my health insurance. I definitely cried right there in the office. She cried too as she apologized, handed me the name of the doctor I needed to see and scurried out of the office. I still adore her. But, I’m sure I’ll never see her again.

So, faced with the reality that I needed to start over, on a journey I wanted to forget ever happened, I did the logical thing. Nothing.

I lived in a state of denial for months. And slowly I started to restrict the activities I would do with my right arm. Certain basic tasks would make it bothersome. Fitness-wise, push ups, planks, weight lifting, and even the elliptical were out. I no longer trusted my own body weight on that arm.

One day in December I mustered up the courage to call the office of the new doctor. It took a lot. I trembled. I had my calendar set up for January and February. I was ready to schedule that consult.

“Late March…”

I heard nothing past that. After I was told the earliest appointment I could get for a consult was late March. I hung up the phone and did what I do when excessively frustrated. I cried.

When I saw my breast surgeon for our annual check up in February, she noticed the subtle problem. She asked who was looking at it. She also proclaimed it, ‘not urgent.’ I told her about my experience trying to get an appointment with apparently the only plastic surgeon that does breasts and takes my insurance left at this hospital. She vowed to have her scheduler help me get in.

I met with the scheduler.

I never heard from her again.

March came and went. Life was busy. Meghan was in and out of surgery, Pop had been so sick, Grandma was struggling, we had the fundraiser…I found a reason not to call every single day.

Then I really wanted to work out my arms again. Walking was getting boring. I mustered up the courage in April to call.

July 18th.

I had to take it. I cried again. I tend to cry most in my life when I am frustrated.

I brought Mom with me to this appointment. I never need another pair of ears. I did this day. I was a wreck.

The doctor was wonderful. Kind. Sensitive. Funny. Everything I feared he would not be. I exhaled. He said it was again, not an emergency. But, he saw my issue, understood my discomfort and agreed at my convenience he’d try to fix it. He ordered one test for a sensitive spot under my arm, and asked me to try some physical therapy when I could.

I talked it out with my mom. I talked it out with my husband. After waiting almost a year, I was ready to get it done and stop favoring my dominant arm.

I called to make the appointment for the test. Except it had to be done in the hospital. And it needed insurance pre-authorization. And I tried for one solid week to get in touch with this doctor’s office staff. Three Emails, 2 phone messages and several canceled appointments, I finally got a human.

I got them moving quickly, and they got the insurance authorization immediately. I scheduled the test, and it was fine.

Then I called to schedule the surgery. I was thinking I could still make August. I was wrong.

What about September?

UGHHHHHHHH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I took out the calendar once again. We have 4 days off in October… No luck there. No, he doesn’t work December the week I’m off. And in February we have the fundraiser…

Looks like once I calm down I’ll schedule for Spring 2017.

When the time came to have the double mastectomy I opted for the quickest route. I was out of the hospital with reconstruction complete in 28 hours. I wanted this done. I was so incredibly fortunate not to need treatment. I was grateful. More energy to focus where it mattered.

Except once cancer has lived inside of you there is this uneasy feeling that can not be explained. There is this knowledge that somewhere in your body those cells did what they were not supposed to. There is this feeling that you were violated and betrayed by your own body, from the inside out. It damages trust deeply. It’s hard not to trust your body. It can really mess with your mind. So understandably, I was interested in functioning without that thought process. I had become adept at ignoring my scars and “nipple-free” implants.

Until I started to feel them. Every damn day.

This is minor. This can be fixed. And it will be. Just not in a time-table anywhere close to my liking.

I picked up the free weights again today. Really light. In my chair. What’s the worst that happens? Really? If it becomes an emergency they have to move faster.

Otherwise, I’ll balance that full-time job, that beautiful, active 8th grader, and a boatload of afterschool activities. I’ll try to get out of my own head.

But, no matter how vigilant, or how confident… thoughts of the potential renegade cell, lurking like a thief in the night never quite go away.

#beatingcowdens is a full-time job

Mortality

Published on July 1, 2015 by beatingcowdensLeave a comment

The awareness that one day we’re not going to walk this earth anymore.

Not exactly dinner conversation, but, for lack of a more gentle way to say it, mortality is everyone’s reality.

We face this reality at different points in our lives. Some are frighteningly young, and others are blissfully old. But, eventually, that awareness either creeps in or hits us like a speeding train. (Figuratively, or course.)

In my opinion, so much of the rest of your life is defined by what you do with that realization, that understanding that there is no promise of tomorrow on this earth.

For me, my solace, my comfort, and my focus, come from my faith. My deeply held belief in God, and that life does not end, merely changes, as we are welcomed into Heaven.

Whatever your own belief, is, your own reality, my hope is that it brings you comfort, solace, and gives your life on this earth purpose.

As a daughter of a cancer survivor (18 years and counting!!) I watched my Mom grapple with her own mortality at an age I consider very young. (young for her, and for me too!) She got it. She found clarity, but it was a few tough months. And even then as close as I was, I knew the significance of what I was watching, but I did not get it, not really.

I like to say my breast cancer was found, “by accident” or “divine intervention,” whichever you prefer. But, the moment in the surgeon’s office, that day in March of 2012 when I became a “survivor” by default, started my own journey with mortality. I was 10 years younger than Mom was at the time of her diagnosis. I had just undergone what I had prepared in my mind to be a “prophylactic” mastectomy to battle astronomical cancer statistics associated with the new diagnosis of a PTEN Mutation called Cowden’s Syndrome, that Meghan and I had received less than 6 months prior. When the word malignant was read, there it was; laying thick in the air for my husband and 8-year-old child to process with me.

And there was reality. Unable to ignore. Cancer had lived within me. Could it live again? Would it? When? Why was I going to be OK when so many others were not? Was I going to really be OK? What if they missed it, something bigger?

I was fortunate. Fortunate in the sense that a double mastectomy removed the encapsulated stage 1 cancer. I needed no treatment, no medication. But, my status had changed. In the eyes of the doctors, I was now an even greater risk. Every single lump and bump would be scrutinized, scanned, poked, prodded, and usually removed. The loss of my uterus and ovaries weeks later were a testament to this new-found realization that I was a risk. A significant risk.

Cowden’s Syndrome is one of those diagnoses that forces you to face down your own mortality at sometimes alarmingly young ages. An internet friend just made a jubilant post today that her youngest was now 10 and cancer free, a title she did not have herself at that tender age. The things we celebrate…

My Cowden’s Syndrome people are known to me mostly through the internet. We live across the country and across the globe. We navigate through different time zones and support each other through scans, scares, surgeries, reconstructions, and cancer. While this syndrome does not manifest itself the same in each of us, there are alarming similarities that make us kindred spirits. There is that “Sword of Damocles” hanging above our heads. There is that constant sense of not knowing, of hyper-vigilance, of bi-annual screenings, and worry. We stare at our own mortality each time we look in the mirror.

We have an extra bond when it connects to our children. A universal acceptance of the unfair nature of these young ones even needing to understand a bit of mortality. We have juggled the questions, inevitable after MRIs, CT scans, and biopsies galore. We have gently answered questions about family, and future, that have no real answers to date. We ache for them. We wish to take it all away. We have some guilt in the knowledge that in most cases this disorder, (whether we knew it or not) was passed from us.

Mortality will bind you, and if you’re not careful it can blind you. That is why there are support groups, for cancer patients, and others who have come close to losing their lives.

This weekend I spent some time in West Virginia with another group of men, bonded by their grapplings with their own mortality some 48 ish years ago in the Vietnam War.

I will protect their privacy here, and tell their story as generically as I can.

I connected with Alan, about 6 weeks after my father died. Dad had earned a Purple Heart in my mind, for an incident that occurred while he was serving in the United States Marine Corps. The award was never granted, and I wanted to pursue it on his behalf. So, I sent some letters to Marines, whose contact information I obtained from a reunion Dad attended in DC in 2006. I wanted to know who remembered him, and his story.

Alan contacted me first, verified my information, remembered the story, and has been in touch with me since.

My Dad, the "Irish Marine" — My Dad, the “Irish Marine”

I sent 20 letters out. EVERY SINGLE MARINE responded to me. EVERY ONE. Whether they knew Dad or not, whether they could help or not, they ALL reached out to express their condolences. Many shared some funny anecdotes. And as hard as I’m sure it was, they all connected with me.

I had heard about the Brotherhood of the Marine Corps. I could not have fathomed the depth of that bond. One after another, they all left me with the same heartfelt sentiment. “You are the daughter of our brother. We will help you always in whatever you need.”

Now, I knew, or at least I could infer that their lives had not been any type of peaches and cream, on the island of Vietnam, or when they returned. My Dad battled his own demons for many years before our relationship began to form. But the offers of these Marines were sincere, and genuine.

Alan proved that to me through regular conversations, and almost heroic efforts to get someone to listen to the story of my Dad’s injuries. In the end, we lost the battle on a technicality. Although “The statements provided clearly establish that your father was injured as a direct result of enemy action, the available information fails to establish that your father was treated by a medical officer…Wounds not requiring treatment by a medical officer at the time of injury do not qualify for the Purple Heart Medal.” The letter was cold. The case was closed.

We lost the Purple Heart but gained so much more.

I was sad, mad, angry and disappointed. But I was so grateful for the Marines who wrote letters of support. I was grieving the fact that my Dad had carried this close to him for so many years, and lived with chronic pain as a result. I wanted this for him, because he never fought for it himself.

And as things go, it was not to be, but Alan did as he promised and remained in constant contact with me. He heard my sobs as I glanced at Dad’s headstone for the first time. His were the comforting words that started my healing.

So, this weekend I headed to West Virginia to thank him myself. I met a group of Vietnam Era Marines, several of whom had served with my father. I watched them together, in awe an amazement. I was welcomed into their group with instant acceptance. And as I sat and watched them laughing together, I noticed the war stories were sparse, and funny when they were told. Surely a contrast to the realities they had faced as young men years ago. But, the bond between them was unbreakable. There indeed was the Brotherhood of the Marines, but there was something else.

Mortality.

They faced it in the most horrendous of ways. They lived it daily. They buried their brothers. They knew their return home was not a guarantee.

And once you’ve faced that kind of life altering lesson in mortality together, you are bonded for life. As Alan said to me, “If you weren’t there, there are no words to describe it, and if you were, there are no words needed.”

I was among a group of people who had faced their own mortality almost a half century ago. And they have a bond that can not be explained. It is amazing.

And among the most amazing to me was the woman I met. She was not local either, but she, like I, had traveled for this celebration. It was not her first time. She had been around for almost 10 years. About 10 years ago the woman, who was an infant when her father died a hero in Vietnam, met the men he served with. She had never met her father, but here were father figures galore ready to embrace her. And they did.

A bit ago her father’s diary surfaced from his time in Vietnam. She shared it with me and the last entry written before he died was about the thought that so many of them must have had daily. His diary ends with, “When will it be me?”

Once you have looked your own mortality square in the eye, you can not walk away the same person.

But, it is up to you what you do with the rest of your life.

As for me, I choose bonding with people who “get it,” be they old friends or new.

I choose focusing on what we can do, not what we can’t.

I will not choose reckless living, but I will daily live with the knowledge that there is no guarantee of tomorrow on this earth.

Whether facing your mortality is something you endured, something you will live with daily, or something you are yet to face, how it changes you is really up to you.

As for us, in this house, we choose to remain focused on

BEATINGCOWDENS,

WHILE CELEBRATING ALONG THE WAY.

Three Year Old Memories

Published on March 4, 2015 by beatingcowdens1 Comment

It was about 4 in the morning on March 5, 2012. I was laying on the bathroom floor, vomiting the contents of my “nothing to eat or drink after midnight” stomach. I was dizzy, lightheaded and weak. The task looming ahead that morning was unlike any I had ever been through.

As I lay there, trying to gather every ounce of strength in my body, I thought about the whirlwind that had been the last 6 months. Just barely 6 months prior my daughter, and then I, had been diagnosed with Cowden’s Syndrome. I had read and researched and didn’t like much of what I saw. I digested elevated cancer risks in just about every body part – some of them astronomical – as I tried to triage the onslaaught of new specialists taking over our lives.

Cowden’s Syndrome was an explanation. It wasn’t something we had just “caught.” She was born with it, and its likely that I, a “spontaneous mutant” was born with that “frameshift mutation” on my PTEN gene as well. But now that it had a name, and a definition, now that there was knowledge, there was also responsibility.

We had Meghan to the endocrinologist almost immediately and 4 nodules were discovered on her thyroid. Emotionally scarring biopsy followed. We met an oncologist for intake as well. And I, I was set to deal with all those “peak at 40” risks that were now presenting like a time bomb in my own body.

I sat up when Felix came into the bathroom. I don’t remember much of our conversation. Somehow I got myself up and dressed and into the car.

We drove to NYU in a good deal of silence. I am sure I cried a lot. I shook quite a bit too. But it was time. The decision had been made.

Soon after diagnosis I was sent to a breast surgeon to address the 85%+ risk of breast cancer in Cowden’s Syndrome patients. I forwarded her my medical records before the appointment. At the age of 38 I had racked up 7 breast biopsies and had a mother who was a bilateral breast cancer survivor 15 years earlier. We barely had said our “hellos” when she told me, “It’s time to schedule a bilateral mastectomy.” I wasn’t stunned I admit, because I knew it was a possibility, but the matter-of-fact certainty with which she spoke was a bit unnerving.

“You will get cancer,” she told me. “It’s not a matter of IF, but WHEN.”

I asked if it could wait till July. She said absolutely not. March 5th was as late as I could push her.

She ordered an MRI in February “just to be sure” everything was ok. The MRI was clean.

Just a normal “prophylactic bilateral mastectomy.” If there is such a thing as “normal…”

I met with the plastic surgeon, arranged for the implants. I blatantly refused tissue expanders, much to her chagrin.

My mom, during the time of her surgery had once called her breasts “superfluous tissue.” I tried to keep that in mind when I was making mind- numbing decisions.

We got checked in at the hospital before 7 AM. There was a whirlwind of doctors and nurses traveling through. Some had me signing consent, others were checking various things. I wanted to run, and scream. I felt like I was stuck in a bad horror film. But, I sat. And I signed papers. And I waited.

And then it was time.

It was a long walk to the operating room after I kissed my husband. I couldn’t much control the tears. I was terrified. The last thing I remember preoperatively was my surgeon looking me right in the eye and telling me, “You’re doing the right thing. You’re doing the brave thing. There is NO other choice for you.”

I woke up hours later in recovery, and after first verifying that the anti-nausea meds had worked, and I had no urge to vomit, I checked out the bandages covering my chest and I felt… sweet relief!

Even now, as I think back three years later, I am certain that was my first, and most genuine emotion. I felt relieved. I felt empowered. I felt victorious. This was one battle Cowden’s was not going to win. We played on my rules and my time… ok, well the doctor’s time… but still! I knew of too many lives lost to breast cancer, and I would not be one of them. One less worry. More time to be the Mom and help my girl through this genetic mess.

I left the hospital about 28 hours after I got there. The drains were the worst of it all. There was pain, no doubt, but it was all tempered by the peace in my soul. Mom stayed by my side for days, and we had some of our best conversations as I sat in the glider I had used to rock my baby Meghan to sleep 8 years prior.

Pathology was almost an afterthought for me.

That was why I was taken by such surprise when, 8 days later, the surgeon removing the drains said, “you made the right call.”

At first I was confused. I thought maybe she was just advocating my decision. Then she showed me the multiple page pathology that cited 1cm of DCIS (Ductal Carcinoma in Situ) a “self-contained” malignancy. There were all sorts of other markers too. Cellular changes to indicate things were starting to go very wrong. Because the DCIS was so far from the chest wall, I would need no treatment at all. An hour before I didn’t even imagine I had HAD cancer. Now, I was being declared cancer free.

“If you had waited for July to get this done, you would have likely been in a fight for your life.” I will probably never forget that sentence.

I stepped onto the street in NYC with my husband and my daughter. We all took a moment to digest what had gone on. We hugged. Then I grabbed hold of Meghan.

“You my dear, saved your mother’s life.”

Confused, “How do you figure?”

“If it wasn’t for you Meghan and your diagnosis, no one ever would have pushed me into this surgery. I would have found the cancer much later. Possibly too late. I am going to be Ok BECAUSE of you…”

As we let the gravity of that sink in, it was the ultimate lesson in perspective.

The steps that put us in line to have her, and ultimately me, diagnosed were life altering in so many ways.

Every piece of our past is a bit of the puzzle we are forming with our lives. Some of the pieces are confusing, and don’t seem to fit. But, sometimes we just have to wait patiently and watch.

Three year old memories.

Gratitude.

Day One

Matthew West

from the album Day One (Single)

Buy on Amazon | iTunes

Play sample

Well, I wish I had a short term memory
Wish the only thing my eyes could see
Was the future burning bright right in front of me
But I can’t stop looking back

Yeah, I wish I was a perfect picture of
Somebody who’s never not good enough
I try to measure up but I mess it up
And I wish I wasn’t like that

I wish I wasn’t wishing anymore
Wish I could remember that nobody’s keeping score
I’m tired of throwing pennies in a well
I gotta do something
Here goes nothin’

It’s day one of the rest of my life
It’s day one of the best of my life
I’m marching on to the beat of a brand new drum
Yeah, here I come
The future has begun
Day one

Well, every single day Your grace reminds me
That my best days are not behind me
Wherever my yesterday may find me
Well, I don’t have to stay there

See my hourglass is upside down
My someday soon is here and now
The clock is tickin’
And I’m so sick and tired of missing out

It’s day one
And here comes the sun

Every morning, every morning
Every morning, mercy’s new
Every morning, every morning
Every morning, I will fix my eyes on You
Every morning, every morning
Every morning, mercy’s new
Every morning, every morning
Sun’s coming up, the beginning has begun

Starting over, I’m starting over
Starting over, I’m starting over, starting now
I’m starting over
Starting over, I’m starting over
Starting over
Starting over, starting now
I’m starting over