"...and the seasons, they go round and round, and the painted ponies go up and down, we're captive in the carousel of time. we can't return, we can only look behind from where we came, and go round and round in the circle game." the circle game, by joni mitchell

i was watching the cbs special this morning on cancer- which was very good, by the way. of course, cancer is such a big complicated issue, that it would be impossible to cover every type of cancer, potential problems associated with a particular cancer , treatments ,etc. but i will have to admit, the producers of this program did a pretty  good job. two predominate themes in this program, at least in my opinion, were the future of more effective treatments  and the  prevention of cancer.( i will lump those into one theme ). the other theme, as i saw it, was reminiscing , or looking back at choices made by cancer patients and the ramifications of their  choices.

in treating cancer, there is no one size fits all, unfortunately. there may be recommended guidelines for treatment in certain types of cancer, but there are treatment options and choices that every cancer patient has to make. it is really a gamble. what if the treatment causes problems on down the line? heart issues and possibly other cancers just to name a few . is the risk worth the gain in other words. when i was practicing pharmacy, i felt that the most important part of my job was to counsel patients on the side effects/ interactions of their medications. i felt that once the patient was aware of possible side effects, they could  weigh the risks versus the benefits of a particular medication. in most cases, i felt that the benefits would outweigh the risks, or side effects, but i always made it clear that this was the patient's decision. i told them to be their own best patient advocate. get the good advice from their physician and pharmacist, and then make a decision that was right for them.

i had to take my own advice and be my own best patient advocate for both of my cancers. choosing a physician, hospital, treatment plan,etc. were tough decisions that i had to make myself. that is not to say that i did not listen to my doctors, family and friends before making those decisions. but i am the one who ultimately has to live with those decisions. that brings us to the carousel part of this blog. having cancer has made me feel helpless at times. i do feel like i am on a carousel going up one day- feeling good about the choices that i have made, but then going down the next- doubting my decisions.

on the cbs program, there was a segment on " going flat" for breast cancer patients. that is a decision that i labored over. my surgeon and plastic surgeon were horrified that i was even considering not having reconstruction. my feelings on this were, well, i am losing both my breasts and even though my plastic surgeon is amazing, there is no substitute for a real breast. and i will not lie to you- reconstruction is painful. the process began when i was on the table having my mastectomies, continued during the time that i was having chemotherapy, and did not wrap up until six months later- with a final surgery to receive my permanent implants. there has been off and on pain in my reconstructed breasts, but it has not been unbearable. i think the one unexpected thing that sealed the deal for me, that finally made me realize that i had made the correct decision for me, was the 3D areola and nipple tattoos. when i look in the mirror now, i do not see two huge scars stretching over my chest, i see a semblance of normal. it is the new me 2.0. not necessarily the best me, but a more acceptable me to my eyes.

i will tell you one funny thing that was said  about reconstructed breasts. the plastic surgeon that cbs interviewed for the cancer program said, " well, i tell my patients that if they sleep on their stomachs, it will be uncomfortable. it will be like lying on a frisbee." hahaha... she is correct on this. i am a back sleeper totally, now.

so, as a cancer patient i go round and round on the carousel. i am up some days, and some days i am down. i look back at the decisions that i have made about my treatment and hope for the best outcome. i am not a warrior. i am not out to beat cancer ( remember, in my last blog i said that cancer beat the stuffing out of me). but i am a decision maker, a planner, and i try to stay positive and enjoy my life. really, that is all that any of us- cancer patient or not- can do.