IVF, Chemo and Spontaneous Date Night...

Today was another really great day. One I am happy to have had, didn't fully expect and am grateful for. I had appointments today - the fertility specialist and my oncologist, back to back. We were recommended by multiple doctors to make sure we see a fertility specialist for family planning purposes, as we had hoped to have another child someday. IVF is not something I thought I would ever consider and it came as a pretty big shock, right in the middle of a crucial and acute period of doctor appointments and life decisions where I felt sort of thrown into a bigger/different life conversation than I was prepared for.

Am I an only-child person? Are we prepared to only ever have 1 child, biologically? No...? Yes...? I never wanted only 1 child, but that was also before I had a child... and does anyone who thinks anything about children, but hasn't had them, actually know anything? Yeah... no.

My husband and I are both definitely open to, and would be so honored to, adopt, but how would that work? I have heard some difficult stories regarding the very shallow and practical parts of adoption - the financial aspect and the length of the process, and is that for us after this whole, trying, extravaganza? The future-child aspect of a cancer diagnosis in your mid-late thirties makes 100% sense, but it was just not on my radar 6 weeks ago when we were at the beginning of this.

We were lucky to get in with an amazing reproductive endocrinologist and to learn about how IVF would work, in the small pocket of time between my surgery and the beginning of my treatment. It seemed feasible and we had our lesson regarding the medications and how, where and when I self-inject them and what happens during the process, in order to get to the egg retrieval. It made a lot of sense and seemed like a completely reasonable situation until they mentioned that my estrogen level would spike during the course of the treatment...

That COMPLETELY makes sense and, as a woman, is semi embarrassing that I wasn't putting any of this together but it made me nervous and appreciative that I had the more important appointment, with my oncologist, after this RE appointment.

We take our bags (LITERAL BAGS) of supplies and medication to the car and drive to the oncologist. 

SIDE NOTE: Exam rooms are screwed. I'm just putting that out there. My mom and my husband and I sat in a row of chairs so close together that we were awkwardly touching and I felt like we were 3 dunce caps short of a really shitty party in the corner. Someone needs to figure out how to make informational doctor's appointments function in a way that doesn't make the patient, and family, feel like full on idiots. 

We meet with my oncologist and her support team and get her recommendations, based on my final surgical pathology, and facts about the treatment and how to proceed. 

I'll be doing chemo for 4-6 rounds (9-15 weeks, dependent on how I end up tolerating it) and will start in a few weeks. My cancer is early stage and my prognosis is great, but the grade is high (how quickly it is dividing and growing) and other, more technical factors, point to chemo as a sort of insurance policy for that looooong ass life I plan to live. The biggest factor in my treatment will be hormone therapy. I've mentioned it before in my blogs and personal conversations. My type of breast cancer/boob murderer is strongly Estrogen Receptor positive (ER+). It's driven by hormones and is feeding off of it. It's also why, when it clicked that my estrogen would spike during fertility treatment, I sort of died a little. 

My personal theory: I was diagnosed with breast cancer, regardless of stage, that was STRONGLY estrogen receptor positive and was advised that if I were going to CHOOSE between therapies in combatting my cancer diagnosis, I should choose hormone therapy OVER chemo, but would probably be recommend to do both. I was then considering, because my husband and I MIGHT be wanting to have another child someday, to do an egg retrieval after fertility treatments which would spike my estrogen levels for a period of time RIGHT AFTER having had a bilateral mastectomy and straight up slaughtering my boob situation in an attempt to save a spot for me in the whole "long life" crew... So, I would be drastically increase the thing that was trying to kill me in the first place and hope that somehow didn't matter? Hope that it didn't harm me? Hope that it was cool and would decide to just, maybe, help me have another baby in the future? W.T.F.

Anyway, we had a long conversation with my oncologist and we all had a lot to say and some questions and we left with strong and united feelings. We may be able to have another child someday, we may be LUCKY enough to be in that position. But, if I had a cancer recurrence, after IVF and a WILLINGLY spiked estrogen level for the length of the treatment, would I always regret trying to bring another human into this world when I'm trying really, really, really hard to NOT leave the ones who already exist?

YES.

We have the most beautiful family of biological family members and ones who started out as friends or strangers. If we are able to add another child to that someday, we will be blessed once again, but I would rather focus on how to heal my body now and not how to stress it out for further, possible, reproductive desires in future years. 

So while our fertility efforts were 2 appointments in and only a bit of time spent, they've ended. I'm on track and on board to spend the rest of the year killing any microscopic cancer cells that may have ever escaped from my boob, healing my body from cancer hell and making plans for a long and loud future. 

I'm looking into cold caps for the possibility of not losing my hair, or the majority of my hair, during chemo and am not sure if I will move forward. If anyone has any insight, opinion or information - please send it my way. I've heard some good things and possible downsides, so I'm undecided. I'm liking the idea of keeping my hairs on my head, but I'm not sold yet. And if I end not using a cold cap, or it doesn't work for me, and I end up looking like Moby, please remember that I'm just ahead of all you bitches who haven't figured out your halloween costume yet ;) My best friend has already agreed to portray Gwen Stefani and re-do that whole head licking situation from whatever video that was, so I feel like this could go well for me.

 Also, wigs. I'm not NOT into it.

So, why was it a great day? Decisions. So much of this process is living a life that doesn't feel like your own - you're naked in front of MANY strangers, you never see your friends, you repeat yourself in ways you wouldn't normally but are asked to, you talk about your body as though it isn't yours anymore, you create life scenarios that may or may not ever play out and you make LIVING a priority when, shockingly, it wasn't before. 

Surviving a bump in the road becomes your full time job. Even if you have an actual full time job...

So, your own decisions become rare and necessity takes over. But, today my husband and I talked about our future and easily agreed that we wanted OUR future. We chose to put expanding our family on the back burner and chose SAVING our family as our priority. And we feel great about it.

I got distinct information about chemo and learned of the strong recommendation to move forward and decided that YESSSSS I will hate the process, but YESSSSSSSSSSS I am grateful for an opportunity to do this. That my doctors feel confident that chemo will work for me, that it will make a difference in my life. It has been a sort of "if we move forward with chemo" limbo land for a while, but it's not anymore. And that takes a lot of weight off of the unknown column of all of my current and future lists. 

...And then I had tea with my mom and went out to dinner with my husband. Things we haven't had much time to do recently. 

You always hear that the small things ARE the big things, but when a BIG thing comes into your life and seriously dwarfs the "small" things, it's sometimes hard to see how they are your life and they are necessary and they can come back stronger. But then tea with your mom and a spontaneous 2 hour date night with your husband can become the only reminder you need, especially when the stakes are a little bit high ;)

xo.