Now for the Funny Part

I cried. I cried the same way I cried when I found out my father was leaving when I was thirteen. Sobs. Fearful, deep, breath-stealing sobs. I'm not ready to die. I actually love life, and my life in particular.

Oddly, I had just read an article in The New Yorker all about the bad choices sick people make when they near the end of their lives. If they had only said no to more treatment they might have had a lovely few months, maybe even years, of normal-ish life with hospice care instead of dealing with constant chemo and experimental therapies.

I decided right then and there that I wouldn't die while suffering from treatment. I didn't want to die in pain, and I didn't want to die after a long struggle with treatment. I needed to tell someone. Someone needed to know my wishes.

I called my sister Lizzie, who was waiting for my call anyway.

"Ingy, are you ok? What happened?"

"Hi Lizzie. [sob] It turns out I have cancer. [sob sob sob]."

"What? Oh Ingy, what?"

"The call was from the doctor in NYC. My biopsy came back positive for endometrial cancer. It's FIGO grade 1 to 2, slow growing, and apparently the friendliest cancer. Can you believe that? Friendly cancer. Fuck. A hysterectomy should fix it but I'll probably lose my ovaries and I may need radiation and it might have spread because they can't stage the cancer until surgery." [sob sob. sob.]

"Oh God Ingy, I'm so sorry. What do we need to do? You should come to Boston. We need to find a doctor."

"I don't know Lizzie, I can't think right now. I just want you to know my wishes if I become incurable. I don't want to pursue a lot of treatment. I want to die feeling as normal as possible with the people I love around me. I don't have a living will so you need to remember this!"

"Oh Ingy. Of course. I'm listening."

Pause.

Wait a minute - is she really buying this? Does she really think it's possible I might end up in hospice care? Am I really going to die? I had expected Lizzie to say something along the lines of "Ingrid, you're going to be fine. We don't need to talk about this stuff right now...etc." But, there she was, lovingly listening to my instructions and promising me that she would help me carry out my wishes. I couldn't decide whether to laugh at myself, or freak out because she actually believed this malarky about the cancer and stuff. I mean, it couldn't really be bad or true because it's not possible. It's not really real, and Lizzie was supposed to snap me out of it with a well-placed barb about my melodramatic nature. But she didn't, and I couldn't even think of a single thing to say. I got myself off the phone because I had to call Mom, Dad, my other sister and my closest friends to tell them the news.

The Non-Voicemail

Once I got the doctor's voicemail that I was a-ok, I felt great. The bleeding stopped entirely. Entirely. I was walking on air.

I spent my last few days in the NYC office feeling sentimental about the people there, the city I grew up in, and life in general. I called friends I hadn't talked to in years, and I went out. I had fun.

I flew back home Friday July 30th, excited to get back to normal life. I hadn't stayed in touch properly with my friends there and it was summer - all two months of it.

I landed in Sea-Tac airport feeling good but a little sad. I always feel a little sad when I arrive home from trips (and I travel a lot for work). No one to welcome me. I see the large "welcome home!!" signs and balloons for other passengers, or at least the car service signs with people's names on them. That's not for me. I have a pug at home. No one to eagerly await my return - at least no one who wants to wait at the airport gate. Poor me, right? Well, I think so.

I went to bed that night tired but so glad to be in my own apartment with my dog and my sheets and my kitchen.

I woke up late the next day, Saturday. I called a couple of friends. At around 10am I got a call from an unknown number.

I ignored it. Then I got a voicemail notification.

"Hi Ingrid, this is Dr. Shin. I'm not sure where you are but I'd like to talk with you. You can't call me unfortunately because it's Saturday and the service isn't at work but I'll call you back."

Oh God. Why didn't she leave an "everything's fine" voicemail like before? Why is she calling me on a Saturday morning?

I call my sister Lizzie immediately.

"Lizzie, it's Ingrid" I manage, in between intense body consuming sobs.

"Ingy, what's wrong??"

"I got a voicemail from the Dr in NYC and she didn't say everything was fine and she called on a Saturday and I'm just sure something..." [BEEP]

"Oh my God Lizzie, she's calling back, I need to go." [CLICK]

"Hello?"

"Hi Ingrid, it's Dr. Deborah Shin. How are you?"

"I'm fine thanks."

"Are you still in NYC or have you gone back to Seattle?"

"I got back to Seattle last night."

"OK, well I would ordinarily deliver this news in person but since I can't we can do this by phone."

"What news?"

"Well your biopsy results have come back and it looks like you have endometrial cancer. But you should know that this is one of the friendliest cancers there are. 85% of people survive and your cells are low grade which means they are very slow growing."

Silence.

"I know this is a lot to take in, and I'm so sorry. So sorry."

"What do I do?"

"Well, the standard treatment is a hysterectomy. That usually takes care of it."

"Will I lose my ovaries?"

"It's a good chance that you will, to be safe. I'm so sorry Ingrid."

"What stage am I?"

"We can't stage the cancer without surgery and a proper pathology report. Your cells have a Figo score of 1 to 2, which is very good - very slow growing. The cancer is staged based on how far it has spread into the uterine lining, then the next stage is cervix invasion, then ovaries, then lymph nodes and all other organs which would be stage 4. But again, your cells are very slow growing and your ultrasound didn't show any obvious tumors so you are very likely stage 1, and again, with slow growing cells."

"Will I need chemo or radiation?"

"It's not likely if it's stage 1. You might need some radiation if there are any cells in your cervix."

"OK, well, I can't think straight right now, but thank you for everything Dr. Shin. You've been fantastic."

"I'm so sorry again, Ingrid. Call if I can help with anything."

"Thanks."

So, it wasn't menopause.

Anemic Performance

I took a taxi to work. So tired and hot. Late for work, even though I was working in the NYC office and my boss would be there - no wiggle room. I usually don't mind being a few minutes late - it balances out the days I wandered into the office insanely early or logged on to the company's web portal from home at 6am. I don't worry about my commitment to work. I know I'm there when I need to be and go above and beyond when I think excellence is at risk. I'm also descended from crazy Germans who tend to be ridiculously early - not late.

But here I was, late for the fourth time in my second to last week in NYC. I wasn't sure if a taxi would be faster than the subway, but I couldn't handle the subway that morning. I was late and stressed out and tired. Very, very tired. And, notably, not hungry at all. My lifelong, glorious appetite that had at one point managed to make me 205lbs (at 5'6") was gone. At least that's a positive, I thought.

I was still bleeding, but I had decided to wear a full, white summery skirt and a black t-shirt that day. I was sick of my same old black skirt or dress, and the spotting was lighter that morning. It was July 22, a Thursday, and I wondered if my period would return in full force soon (my last full period was June 17th). Oh well, a white skirt can be bleached if necessary.

Got to work in a sweat and managed to appear normal-ish. In the ladies' room I mentioned to a co-worker, Ali, that I had been bleeding for over 6 weeks.

"What? That's crazy. You should see a doctor."

"I called my doctor and was told to wait until I get back to Seattle. Guess it isn't an emergency. The assistant told me I was probably in menopause or pregnant - which is impossible. Very annoying."

"Just see a doctor."

"I've actually tried. I called a couple of friends for referrals, but couldn't get an appointment."

"I'll find one for you. My doctor is in Long Island, but I have a friend who likes her gynecologist."

"Thanks Ali, but I think I'll wait."

"No, don't wait. You should go now and find out what's going on!" Ali was and is bossy.

"Ok ok. Got it. I'll call."

A few hours later my boss called me into his office to catch up. We talked for around 30 minutes and then I felt something. Wetness. Lots of it. I couldn't leave immediately so I squirmed to try and keep whatever it was from seeping into my white skirt. As soon as we were done talking I ran out of the office to the bathroom.

Blood. Everywhere. Up and down my legs. Soaked through my underwear, which I immediately stuffed into the sanitary pad trash can. Dripping, gushing blood. I was so scared. Weirdly, it hadn't hit the white skirt at all. Looking back, this may have been the first sign that I had damn good luck.

I clean myself up and go back to the office.

"Ali, get me a doctor's number. I need to see one asap."

In 20 minutes I had a number, and I called. They could take me that afternoon.

I went to a doctor on the upper west side, which was awfully convenient for me since I was living up there. It's worthwhile to note that this visit marked the first of nearly 50 times that I would be filling out the same three pages of basic 'demos' and health history forms.

I was bleeding heavily, not my favorite time to be in stirrups.

Dr Shin was very nice. She put a bunch of extra sheets under me in case I bled onto the table.

She proceeded to perform a pelvic sonogram and saw a normal looking cyst in one ovary and a slightly thickened uterine lining.

Pause: I thought that I wouldn't be experiencing or saying or typing the word sonogram until I was looking at my first baby. I flash back to my doctor's assistant telling me she thinks this is early menopause. I push the thoughts back. Way back.

She then decides to do an endometrial biopsy. It might be uncomfortable, she tells me, but since I'm already having my period my cervix should be pretty open already.

It hurt more than anything I've experienced in my life, and she had to do it twice. Shocking, piercing, mind-numbing pain that recalled scenes from civil war movies when soldiers had to have limbs sawed off without painkillers. Some women don't mind it. Some women say it's worse than childbirth. I don't know. It hurt a lot.

Then I was sent off to 'clean up and get blood taken.'

She told me I couldn't use a tampon for 24 hrs. I said ok. Then I thought about it: how can I even leave the house if I can't use tampons right now? As I walked out of the bathroom I dropped into Dr. Shin's office and asked her "what exactly will happen if I use a tampon? Will I die?"

"You won't die, but you could get an infection."

"OK, thanks."

Screw it, I thought.

I went back into the bathroom and put in a tampon and added one of the doctor's office-provided weak-ass pads.

Then this crazy rebel wandered down the hall to get her blood taken.

And that was it.

The next day I got a voicemail from Dr. Shin: "Great news - you are anemic, a bit, but otherwise your blood looked great. Your biopsy results should be back in a week. If you don't hear from me personally expect results in the mail."

Pre-Diagnosis Menopause

For reasons that I could barely explain to my boss, let alone friends and family, I managed to figure out a way to spend the month of July, 2010, in NYC. I stayed at my dad and his wife Martha's apartment on the upper west side and worked in my company's NYC office near Times Square.

It was a terrific studio apartment that they weren't using (in fact, they were selling it). What a lucky break, I thought, to be able to work in my company's NYC office for a month, see my NYC work contacts and friends, and theoretically prove some points I'd been trying to make about the futility of my efforts to raise my company's profile among media luminaries from my perch in our Seattle office.

In any event, the setting is NYC, July 2010. Very nearly one of the hottest in history (or, as the weathermen like to say "in recorded history").

I got phone calls and text messages from all of my friends in Seattle. How's NYC?? Are you out every night? Have you been sleeping with that married guy who hit on you a year ago?

The easy answer is, not really. I'm sitting in my dad's studio apartment with excellent air conditioning thinking: I don't want to go outside. I can't deal with this bleeding anymore. I'm so tired.

What's wrong with me?

My period had become annoyingly long in the last six months. Ten to fourteen days, in fact, but I'd ignored it. Now I was dealing with spotting that was happening constantly. CONSTANTLY. As far as I was concerned I had had my period for six weeks even though the spotting was light then heavy on alternate days. It was there every day. I wanted it to stop. I was sure of a million different reasons for it, including cancer, but I decided to ignore it.

Like so many women I know, I didn't know for sure when my period was supposed to start or end. I didn't really pay close attention to it. It came, it went, and I was just glad it was over. Usually it hit when my friends' periods hit. That was neat, and made me think back to my last one and confirm a general 30-35 day window. I'm normal, I would think.

This time I knew it wasn't normal. I knew because it should have been over when I went to Alaska for a long weekend. I was traveling by myself because I'd always wanted to see the midnight sun during Solstice weekend (June 21st). My period was supposed to be over days before then, but I had experienced such long ones in the last six months I just assumed this was another example of that. But it was weird. It was more like heavy spotting, and it didn't stop.

Then I flew to NYC July 1st... and it hadn't stopped.

I was in "I'm not normal" territory.

I called my doctor in Seattle, a general practitioner who looks and acts exactly like Ned Flanders on The Simpsons. He's very nice. He didn't call me back, though. His assistant called. She said that unless I was filling a tampon every hour it wasn't an emergency. I might have an ectopic pregnancy, so I should do a pregnancy test, but the most likely cause is early menopause.

"Menopause?"

"Yes, menopause. It's not that common, but it can hit as early as 36."

"But I'm bleeding too much, not missing periods."

"Well, it sounds a lot like what I had when I experienced early menopause, so it's probably that. Don't worry. Set up an appointment for when you return to Seattle in August."

I was devastated. Menopause? And I have menopause because SHE had it? Sounded like bad medical advice, but I was willing to believe it. I spent that night crying about the fact that I wouldn't have children, and calling girlfriends.

So I kept on using tampons for medium spotting and went on with my life. I was freaked out, and tired all the time, but I was relieved that I didn't have to go to a doctor in NYC. It wasn't an emergency.

Milking It - Introduction

When you settle on the type of car you think you want to buy, you suddenly see that car everywhere and it invariably feels like a sign from the universe. You’re absolutely MEANT to buy a Volvo, you think, because a cute old Volvo station wagon was remarkably parked in front of your apartment building this morning. God wants you to have a Volvo and that’s that.

Receiving a cancer diagnosis is a lot like buying a car, except you hope that God isn’t actually telling you something. Even before you’ve told people about it, cancer is absolutely everywhere you look. On TV, in the newspaper, at the Starbucks counter, and, needless to say, in every issue of O Magazine. Everywhere. I found myself wondering whether anyone in the world could possibly be just plain old-fashioned healthy.

Admittedly and predictably, my first thought was “Why me???” And if you’re lucky like me your entire social circle is ready to confirm that sentiment. “It’s unfair; it’s cruel; it’s meaningless and horrible. You poor thing!” I loved those friends and family members who said those things to me. I was especially grateful to them because I had (weirdly) assumed from an early age that I would one day get cancer and die young from it. I had a dark imagination, I suppose. So when I got my very own diagnosis I kept thinking – well, here it is: the moment I’d been waiting for. Having a whole bunch of people around me who were certain it was a totally random twist of fate made me feel better. They were a needed counterbalance to precious, longstanding “Terms of Endearment” reenactments cycling through my head.

This is not to say that I didn’t and don’t continue to feel enormous amounts of self-pity. I do. It’s just that I, like so many of my fellow ‘battlers’ (don’t love that term), secretly fear and believe that I’m to blame. Any therapist, including my own, will tell you this is normal but that you must not ever entertain this thought. Well, I did and everyone does. So there.

I’ve lived in Seattle, WA for six years, but was raised in Manhattan and am well known as one of those annoying east coast transplants that can’t shut up about how much better east coasters are in all ways. Only recently have I become a true west coast transplant, but that's for a later post.

I am the youngest of three daughters to our mother, a psychotically brilliant speller, piano player, spiritual dilettante, singer, psychiatric nurse and excellent tennis player, and father, a retired neurosurgeon, late-in-life golf prodigy and fellow “expect the worst” type. When my parents divorced the same year I got my period I decided that was the end of life as I knew it. Now that I’m on the other side of that phase (my period, I mean, thanks to the removal of my uterus recently), I can honestly say that my thirteen-year-old self really knew what she was talking about.

This is the story of my cancer diagnosis – Endometrial – and the mostly ridiculous incidents that ensued. I survived because of early detection. A very, eerily early diagnosis made it possible not only to survive but also to keep my ovaries in tact and avoid chemotherapy and radiation. Oh, and I lucked out with a very curable form of cancer.

These essays won’t tell you anything new about cancer. To be clear, I’ve had an especially easy time of it. I'm writing this series of essays to share my particular, light-weight cancer story to give representation to those of us who have actually benefited from awareness efforts, found cancer early, and then survived rather uneventfully (so, that’s it, I asked myself? Yes, that’s it). I guess I wanted to share my, dare I say it, “positive” experience if for no other reason than to offer a slightly less tragic view of a scary disease that strikes all of us in some way or other.