The "Big Six"

Friday, January 22, 2021, we met with the doctor who would be my oncologist throughout my journey. As if being an oncologist wasn't already enough of a wow factor, she was immediately one of my favorite humans I've ever met, despite the circumstances. She was one of those doctors who just makes you feel at ease, makes you feel like she has your back, and most importantly, believes that we're going to come out stronger on the other side of this...albeit, a little balder.

Similar to our appointment with our surgeon, it felt like a fire hose of information: state of the state, treatment options and considerations for each, the paths we could/would take depending on treatment results, the medications I would be on long after chemo and surgery, chemo side effects. Plus a thousand other things thrown at us that we never dreamed we'd have to consider or think about.

The oncologist laid out two treatment options based on my case:

1. A clinical trial chemo cocktail of THP: 12 weeks of taxol + herceptin + pertuzumab; a treatment that has shown excellent results in patients with my same type of cancer, but negative lymph nodes. The doctor said that since I'm only showing one positive node (versus 3-4+, which apparently makes a world of difference), this could still be an effective option for me.

2. The standard TCHP chemo treatment - the heavy hitter, the side effects you've heard about but never believe you'll experience in your life; definite hair loss: 6 infusions over 18 weeks, with the highest success rate of wiping out the type of cancer I have. The "Big Six."

I don't know if it's COVID, or becoming a mom, or just a little more life experience under my belt with every year that passes, but in general I'm increasingly...nervous, a little anxious, worried. In my heart of hearts, I knew from the minute the doctor presented these two options, I wanted the Big Six. I wasn't even thinking about the side effects. I just knew that if I went down the clinical trial route, I would constantly be nervous, a little anxious, worried that the treatment wasn't doing enough - and I wanted the best chance at wiping. this. shit. out.

From there, a million things happened before we even left my appointment. Chemo education was scheduled for the following Tuesday, my echocardiogram and a port procedure the following Wednesday; another breast exam; COVID test; and some other things I'm forgetting. If nothing changed that following week, my first infusion of chemo would be on Monday, February 1, 2021. Two weeks exactly from the day I found out I had this awful disease.

The last big conversation Joe and I needed to have was whether or not we would want to delay the start of chemo to undergo the first part of in-vitro fertilization (IVF) to extract eggs and preserve embryos. Chemo will put me into menopause and while there are options that may help keep my ovaries safe/hidden during treatment, as well as a good likelihood that I will menstruate again (someday)...we also had a ton of what-ifs racing through our brains:

• What if we delayed the start of treatment to do this and the cancer spread even further?

• What if we decided against doing anything fertility-wise and regretted it down the road?

• What if we delayed the start of treatment to do this and in the end, came out with zero quality eggs?

• What if we preserved embryos and after all was said and done, we miscarried?

• What if we preserved embryos and I was able to get pregnant again - would my body do something else to betray me again? Would I get cancer again?

To say the least, it was too much to wrap my head around in the moment. It still is. But nonetheless we were scheduled with a fertility doctor the following week to understand what our options are.

The last thing I'll share in this post is that for some reason during this appointment, I was most fixated on being told I had to stop breastfeeding. I can't say I was shocked, I guess. But the reality of the statement hit me like a ton of bricks.

New moms might understand. You work so hard to keep your baby safe for 9 months before they rip out of your body - and then the hard part actually starts. For me, breastfeeding was a challenge initially. Set aside the fact that you're trying to heal, your hormones are going nuts, you haven't slept in two weeks, you have no idea what you're doing in general - but at the same time, you need six hands to try and get your D-cup breasts in the right position to feed your tiny newborn who hasn't yet mastered the latch; you're forced to use shields to guide your National Geographic nipples into their mouth; and it feels like you're testing a buffet of nursing pillows and body positions day after day to try and find the perfect feeding position. After weeks of working together and trying to get it right, Sadie and I finally did. I was so proud of us. And for me, the bonding time was something I couldn't get enough of. I love that time with her more than anything, and now, after all of our hard work, it's being taken away.

In the back of my mind, I'm already terrified that she won't recognize me once my hair is completely gone, or at minimum it'll be a little scary for her at first. It's going to scare the hell out of me, that's for sure. When the chemo inevitably takes its toll, I wish with with my whole heart that I could at least continue to be the food source for her that no one else but her mom can be. I wish she could understand that it wasn't my choice. Will she forget the bond we worked so hard to share? I've spent hours and hours tormenting myself over thoughts like these.

But then she'll smile or giggle at me, or do something else completely ordinary that I think is the most incredible thing in the world, and I forget all of the scary and sad things going on around us. She doesn't know it yet, but Sadie will save me a million more times before this journey is done.

(Her dad will too.)