Happy Cancerversary

It's been a little over a year now since Karen's breast cancer diagnosis. We "celebrated" her Cancerversary on April 15th -- a day now marked for us with taxes and cancer. It's hard to imagine two things that are more despised. Despite the dread this date might elicit, I hope that instead it will be a day we embrace for many, many years to come. My hope is that it will forever be a day that marks triumph over fear and hope over despair. In the end, these are the characteristics that Karen -- and many thousands of survivors like her -- embodied as she stood up to cancer: courage, strength, hope. They are words used over and over to describe the qualities of those who battle cancer. I can tell you, they are words never over-used or under-appreciated for those who fight this disease.

We've come full circle since a year ago at this time. The beautiful pink flowers on the azalea bushes are blooming again, just as they were when I took the first picture of Karen for the blog. And although I haven't blogged at all since Karen finished her chemotherapy in November, the "journey" did and has continued.

Chemotherapy was followed by seven weeks of daily radiation that ended in February. While the side effects were few, the lasting effects of the chemo drugs on top of daily radiation wore her down to the point that getting out of bed some days was a real struggle. Harder still was dealing with the expectation that since she was finished with the chemotherapy that she would quickly be back to her "old" self. She learned -- we all learned -- that it would take months before she regained her energy and felt good again. But thankfully, those days have arrived!

Although her toenails have yet to grow back -- her hair has grown back in. There's no sign of the predicted "chemo curl", but she looks right in style with her "pixie". In fact, last week she said goodbye to the gray that highlighted her hair and she's back to a brunette.

The Spring of 2010 may always be a time of change for Karen. Last year, her big news of course, was her cancer diagnosis. This year, she has made a change by accepting an exciting and challenging new job with Deloitte Consulting. It was a tough decision since it meant leaving the friends, colleagues and company that supported her during one of her most difficult years.

To mark Karen's first Cancerversary, I put together a short video that chronicles some of the past year -- particularly the support that she got from friends and family. The theme song for the video is "I Run for Life" by Melissa Etheridge, a cancer survivor, and includes highlights from last year's Susan G. Komen 3-Day Walk for the Cure in Philadelphia in which Karen and the team she joined -- "For Our Girls" -- participated.

The video tells a story of resiliency and hope -- not just Karen's, but that of all women who battle breast cancer and other forms of the disease. Looking back now on the past year, and the photos in the video in particular, throughout it all, Karen's smile remained bright -- a smile so bright, it's as if she swallowed the sun.

Giving thanks

It's not what we have in our life, but who we have in our life that counts."

j.m. laurence

This Thanksgiving, as our family counts our blessings, we have so much for which to be thankful: For the strength to fight cancer and tolerate the treatment...for the courage to face this daunting challenge....for the hope and optimism to beat this disease...for the skill and knowledge of the doctors and the compassion of nurses. But above all, our gratitude runs deepest for all of the love and support we have received from our friends, family, co-workers, neighbors and many others, including people we've never met before.

Over the past six months, these caring people have provided Karen with a daily infusion that's far more powerful than any of the drugs that have flowed from her IV bag during chemotherapy. Their generous infusion of support counteracts the fear of cancer and the sick fog of chemotherapy. Their care and concern is a kind of anti-toxin -- a remedy that nurtures Karen's spirit and has sustained all of us during these past months. Indeed, the support of those who love you is a cure itself.

A year from now, when we think back to this time, our memories won't be of the diagnosis or the treatment, but rather, it will be of the many simple acts of kindness, friendship and love that have been repeated every day along this "journey", including:

• Soft blankets and a hand-woven prayer shawl -- gifts from Karen's friends -- have provided warmth and comfort during long chemo sessions.
  
  
• Over three dozen family, friends, colleagues and neighbors have provided gift cards and meals -- from homemade soups to roast chicken with mashed potatoes. From slow-cooked ribs to Turkey Tetrazzini. From chicken Marsala to Cuban chicken. From Mexican lasagna to meatballs made from a friend's secret family recipe. Some meals arrive with bottles of wine and even dog biscuits for Caramel. Every dish was special -- not only for its unique flavors and the talent of the cooks, but because of the time, energy, care and thoughtfulness that went into preparing and delivering them.
  
  
• Friends and family have bought Karen a myriad of hats and scarves -- colorful, fun, practical, whimsical and too many to count. They allow Karen to make a fashion statement every day and keep her bare head warm as the weather gets colder.
  
  
• Other friends have sent over their "cleaning lady" to help with household chores -- a generous gesture and a big help for me since my job forced me to travel almost every week.
  
  
• With 16 rounds of chemo -- all in Philadelphia -- we were fortunate to have a reliable group of friends who drove Karen to many of her treatments and spent nearly a day at the Penn breast cancer center with Karen as she met with her doctor and received her infusion.
  
  
• Care packages filled with lotions and other soothing items, books, magazines and CDs to help make each day a little easier.
  
  
• And a steady stream of flowers, phone calls, emails and cards -- enough to fill a shopping bag -- continue to arrive with words of encouragement, support and offers of prayers.
  
  

These are simple acts that have had a powerful impact on us -- especially Karen.

This past year has been a long and often difficult one. But it has been made easier because of all that our friends and family have shared with us. It's difficult to imagine getting through this without such incredible support. I recently came across a fitting Turkish proverb, "No road is long with good company." Battling cancer is often a long road, but with good company -- friends, family, co-workers and neighbors -- that road is made shorter and less bumpy.

Thank you!

Strength, courage and wisdom

And it's been inside me all along

Strength, courage and wisdom

Inside of me

India.Arie

Twenty-two weeks and 16 rounds of chemotherapy later, Karen is still strong. Sure, her body has been ravaged and her energy drained by the cumulative effects of nearly six months of a difficult regimen of chemicals, but today, as the final drops of Taxol dripped from her IV bag, she took the first steps toward getting "on the other side" of this journey. The same strength, courage and wisdom that she drew upon for her first chemo treatment on July 9th was still inside of her when she finished her final round of chemo today.

Looking at the two photos above -- one taken on her first day of treatment and the other on her last -- the toll of the experience is apparent. On the outside, chemo has stripped her of her hair, eyebrows and eyelashes. Her skin is milky-white and her toenails are falling off. But her smile remains, always, as does her buoyant optimism. On the inside and on the outside, she's been fighting cancer every day, never losing hope and inspiring all of us along the way.

Karen could have opted for a less intensive and shorter treatment protocol. But faced with a diagnosis of the more aggressive triple negative cancer that has a higher rate of recurrence, she never thought twice about participating in a clinical trial that required 16 cycles of dose dense drugs, including the trial drug, Avastin. After all, she didn't want to ever have to go through this again if there was any chance that she could knock out cancer for good now. Bravely, she said yes to the trial. In the end, she endured that long trial only to learn after the 10th cycle that she was in the 20% of the trial participants that received a placebo instead of Avastin, the drug added specifically for the trial. Disappointing? Greatly. But she can rest easier knowing that she received more chemo than she might have otherwise received with a standard treatment protocol.

Today was an important milestone in the cancer journey. Yet, in many ways, the last treatment was strangely anti-climatic. Oddly, there were no cheers or high-fives in the "infusion room." Of course, we were both glad to end this chapter. Karen is anxious to begin the process of recovery and healing. To grow hair. To rediscover the taste of food. To sleep well. To simply feel good. But first there is radiation treatment -- perhaps as many as four to six weeks of daily radiation. While it doesn't loom as threatening and scary as the the chemotherapy, it represents another phase in the treatment course. And so, the journey continues.

And how was your morning?

I have been travelling a lot these past few weeks for work and keeping up with what's happening at home and checking in is often done via email. I got this blog-worthy email response from Karen when I checked in with her this morning from Austin, Texas:

Woke up at 4 AM after three hours of sleep.

Found stink bug under covers with me. Freaked out.

Got up. Changed sheets. Did laundry.

Unloaded dishwasher.

Scanned Internet for news clips on my client. Sent client emails at 5:30 am.

Showered and dressed. Woke exhausted Phillies fan. Fed him healthy breakfast. Made myself eggs and English muffin. Did dishes.

Walked dog. Kissed child goodbye.

Got on 45 min conf call with client at 7:30 am. Left to catch train to Philadelphia for chemo appointment at 8:20 AM.

Bought coffee and Tastykake donuts. Sat squishy fat ass down on train at 9:00 AM.

Enjoying foliage of Lancaster County as I decompress and regret eating all six donuts. How's your morning? xo

Karen

Walking on Sunshine

There are heroes, and then there are superheroes. Ordinary people doing extraordinary things.

People like the six women from the Neiman Group -- Amy, Cate, Whitney, Alex, Kelly and Karen -- who joined thousands of others this weekend in the Susan Komen 3-Day, 60 mile Walk for the Cure in Philadelphia.

Despite a Nor'easter that swirled around them and prompted the organizers to cancel Friday and Saturday's walk segments, the Neiman Team -- "For Our Girls" -- kept their promise. They stuck to their plan and their commitment to a greater cause. With the official walking course closed, they took to the shelter of the King of Prussia Mall and walked 20 miles around the mall. On Saturday, with the official walk still postponed, they braved the unseasonably cold temperatures and steady rain and walked another 20 miles. The weather would not stop this team.

Karen joined the team on Sunday, originally hoping to participate in the opening ceremony and walk just a few miles to show her support. But those of us who know Karen also know that she never does anything part way. When she's in, she's all in. And so just three days after her chemo treatment, and without the juice of her wonder drug, Decadron (more on that later), she walked today's entire 15 mile course.

Was it lunacy for Karen to undertake such an ambitious effort with no training and weakened by 11 chemo treatments? Maybe. Her doctor gave her a green light to participate -- but that was when Karen planned to only walk a few miles. Yet she walked -- energized by the honor of participating in a emotional tribute and celebration of cancer survivors -- a group to which she now belonged. She walked -- lifted by the support of her friends and propelled by an inner strength that only she could understand. Though the weather was gloomy, as they walked across the finish line, Karen and the Neiman Team were walking on sunshine.

Many tears flowed as the walkers raised their sneakers to honor the cancer surviors. I can't adequately capture the emotions these women felt as they walked the course or participated in the emotional closing ceremonies. For Karen, the event, was incredibly moving. It was a moment she had not yet experienced in her "journey" and may very well prove to be a transformative one.

To Amy, Cate, Alex, Kelly, Whitney and Karen -- and to all those who participated in the 3-Day Walk or made a donation (the Neiman Team raised over $15,000; the Philadelphia walk raised over $8 million), congratulations on this extraordinary achievement!

And to those who read the blog, please take a moment to congratulate Karen and the Neiman Team by leaving a comment on this blog posting. I am sure that they would appreciate your support and encouragement.

For more photos of the walk and the event, go to: www.flickr.com/photos/forourgirls

This One's For the Girls!

The invitation read: Beef, Beer and Boobs! -- an invite sure to get the attention of any guy. But this wasn't about the guys (it never is). This one's for the girls!

Once again, Karen's friends and her colleagues at work have turned out in force to show their support for her and the fight against breast cancer. Last week, her colleagues (including the guys, of course) from the Neiman Group held a benefit to raise money for five women in the office who will participate in this weekend's Susan G. Komen 3-Day Walk for the Cure in Philadelphia.

The well-attended event brought together many of Karen's friends, co-workers, clients, fellow breast cancer survivors and even a guest celebrity, Dr. Andy Baldwin, the star of the 2007 television series, Bachelor: An Officer and a Gentleman. Baldwin is raising awareness for his own cause -- childhood obesity -- with a 420-mile bike ride across Pennsylvania.

Thanks to the generosity of so many wonderful people, the team raised over $15,000 on Wednesday evening. The team from Neiman Group -- Alex Wagner, Amy Muntz, Cate Olyer, Kelly LaMark and Whitney Shaeffer -- head into this weekend's 60-mile walk energized by the success of the fundraiser and eager to honor and celebrate the courage and determination of the thousands of women battling breast cancer, including many like Karen who they know personally. They walk for those who face cancer today, but also "for our girls" in the future, so they might not face this ugly disease.

The Burden to Be Strong

With last Thursday's treatment, Karen has reached the half way point in her chemotherapy. There was no singing and dancing to celebrate the metaphoric "light at the end of the tunnel." Instead, she approached it just like the week before, and the week before that: get up, get on with it and move forward.

That's what you do when you have cancer. Is there a choice, really?

Karen's hope hasn't faded, but the facade of strength has begun to show cracks. Behind her ever-present smile that seems to buoy others more than herself is a flu-like fatigue that no amount of rest seems to ease.

New in town for the chemo production playing out at home is: "The Change of Life". Hot flashes have thrown Karen's internal thermostat off kilter. And weepy emotions flow without warning. It's all new here..for all of us. Yet still, there's: get up, get on with it and move forward.

We've heard it before, "That which does not destroy us makes us stronger." Some might say it's a challenge put before cancer patients as they go through treatment. The pressure to be strong is very real.

I've come to realize that Karen carries a burden to be strong, because she must, but also because we want her to be. We expect cancer patients to battle cancer as brave fighters. These words -- and I've used them repeatedly in my blog, helping to fuel this expectation -- convey the image of a strong warrior. But Karen is not a warrior. Yes, she is strong -- in more ways than one -- but when it comes to cancer, she has no choice but to be strong. As she puts it, "you do what you have to do."

There are days when falling into self-pity and despair would be much easier than fighting. But in the six months since her diagnosis, I'm not sure I could count even one day when she retreated into self-pity. This is tough work...to stay upbeat as your body and mind tries to bring you down.

Soon, there will seven treatments left, then six, then five....and Karen will move beyond all of this. Perhaps stronger, but relieved of the burden to constantly be strong.

Race for the Cure

This past weekend, the Walsh family made a strong showing in support of breast cancer awareness and research -- participating in two Susan G. Komen Race for the Cure events in Scranton, Pa. and New York City. On Saturday, over 20 family members in Scranton ran and walked the 5k course as part of a team organized by our niece, Sarah. I joined my brother, Chris, and his family and my brother, Will -- along with over 25,000 other supporters -- in a race through Central Park on a beautiful Sunday morning.

These were great events that brought my family together to support an important cause and to honor Karen -- and thousands of others -- fighting breast cancer. A huge thank you to Chris who raised a very impressive $5000 and to Sarah who recruited family members and friends in Scranton.

For me, the event marked my first race. Not my very first charity race...my first race ever (unless you count when I ran track in middle school). I can't think of a better way or place to have made my entrance. The scene in NYC was overwhelming as a sea of runners and walkers of every age, gender and race came together to show their support. Given our family's personal experience these past several months, it was impossible not to be moved by the commitment, concern, hope and encouragement of so many wonderful people. They ran or walked in memory or celebration of their own friends and family, but I also realized that those 25,000+ people were running for our family...for Karen. It's powerful when you stop to realize that these people run for someone you love.

"The worst is over...but your tongue may turn black"

I've fallen behind on my blogging, but not because there's nothing happening here. To borrow Ted Kennedy's line replayed so many times over the past few weeks, "the work goes on, the cause endures, the hope still lives..." It's a fitting battle cry for Karen.

Her treatments have taken a toll on her as the chemo toxins build up in her body. She has become increasingly weary as the chemo wipes out her red blood cells. Migraines grip her head like a vice. Her infusion port bulges like a transmitter just under her chest. Mouth sores line her lips. And the waves of nausea have grown stronger and last longer.

Here's the crazy thing about all of this: none of Karen's pain or exhaustion is from the cancer -- the evil, scary cancer that we feared more than anything. Not a single moment of pain was ever from the cancer. It's hard to make sense of it, but all the pain and discomfort comes from that which is meant to cure her. Karen is caught in the crosshairs of a battle between her doctors and cancer. The chemo drugs are the weapons; her body a battlefield.

The doctors always presume that at least some rogue cancer cells may break loose from the original tumor and find their way into the blood stream, travel to somewhere else in the body and then divide and conquer. So, chemotherapy becomes, in some ways, a kind of scorched-earth defense -- kill everything that grows and divides -- even the normal, healthy cells. The result: you have to become sicker to get better.

Thursday marked another milestone in Karen's treatment. She finished four cycles of the powerful Adriamycin and Cytoxan (AC) drugs and has moved onto the chemo drug Taxol.

"The worst is over," say the doctors.

It's hard to find comfort in these words knowing that Karen still has 11 more Taxol treatments ahead of her. The "AC" may be one of the toughest regimens to tolerate, especially with infusions every two weeks. But Taxol has its own set of destructive side effects: pain in the joints and muscles, numbness and tingling in the hands and feet, skin and nail changes, mouth sores, mood changes (oh, joy!), and occasionally, the tongue may turn black. She can also expect to lose the last few hairs on her body -- her eyelashes and eyebrows. But remember, the worst is over.

Still, her spirit remains positive and her resolve is strong -- bolstered in large part by the support of many amazing friends, neighbors, family and colleagues.

It has been 22 weeks since Karen first found that lump and nine weeks of chemo treatments have been crossed off the calendar. Eleven more treatments in as many weeks stand between her and the end of chemotherapy. Radiation therapy will add many more weeks. And then it will be a new year. Surely, a year of recovery, healing and renewal.

Walk in Jen's Shoes

Walk a mile in Jen's shoes. Better yet, walk 60 miles in Jen's shoes.

Last weekend, Karen's sister-in-law, Jen, joined hundreds of other women and men in the Twin Cities for the Susan G. Komen 3-Day Breast Cancer Walk. She walked in honor of Karen and Dick, for Nancy and Oma, and for so many friends, mothers, fathers, grandparents and children whose lives have been touched by cancer. The event raised over $6 million for breast cancer research and Jen raised an impressive $5000!

But more important than the money she raised is the personal commitment that Jen made in training for this weekend and walking the 60 grueling miles over three days -- an effort at least as challenging as running a marathon and just as exhausting.

For Jen, the walk was a humbling experience. Despite blisters and aching muscles, Jen and her team endured the pain, knowing that those who battle cancer experience much greater pain and discomfort.

Without being there among the hundreds of walkers and supporters, it's difficult to convey the incredible emotion and energy driving these selfless individuals. They honor us all. And for that, we are grateful.

I applaud Jen's dedication, hard work, compassion and great physical exertion. Awesome job, Jen!

A Father and Daughter's Shared Journey

This past week, while Karen underwent her fourth chemo treatment in Philadelphia, over 1100 miles away in Woodbury, Minnesota, her Dad sat in a similar blue recliner as toxic chemo drugs ran through an IV line into his veins and raced through his bloodstream in search of hyperactive cancer cells.

While Karen is battling breast cancer, her father, Dick, is battling prostate cancer.

It's a dark reality: a father and daughter fighting their own cancers and enduring lengthy chemo treatments at the same time. Separated by five states, they find themselves on similar paths hoping to -- no, determined to -- beat cancer and move on with their lives.

Sharing this disease can give way to a multitude of empathetic emotions between father and daughter. Yet, it's also a strange, almost awkward, bond to share. Is it somehow easier for Dick, who’s left with tiny wisps of a white crew cut after months of Taxotere, to relate to the trauma that Karen is facing with her own hair loss? I know that it's difficult for Karen to be so far away from her dad at this time.

They speak little of their fate or their fears, or the details of their treatments. Instead, they share useful tips, like Dairy Queen strawberry milkshakes, Dick's near-daily elixir for taste buds that have all but lost their receptors for flavor -- unless you consider metal a flavor, and Karen’s craving for scrambled eggs and spinach to ward off nausea.

Dick fights his battle with a “play-the-cards-you're-dealt” acceptance and a determination to get out on the golf course as often as possible. But they haven't been easy cards to play. Only retired a few years, he's already endured quintuple heart bypass surgery, radiation for his prostate cancer and now a long chemotherapy regimen. This isn't exactly how Hallmark or Charles Schwab portray the golden years, but he never complains. Dick still finds great joy in his Saturday morning golf games, his weekly cardiac workouts and a good book curled up with his dog, Bella.

Sadly, cancer is no stranger to Karen's family. Her mother, Kathy, valiantly fought colon cancer, losing her battle after four difficult years in which she tried every drug imaginable in an effort to have more time with her grandchildren. Karen's stepmother, Nancy, bravely fought cancer as a new mother, beating Hodgkin’s Disease some 25 years ago when the anti-nausea drugs were not anywhere near as potent as they are now. And Karen's cousin, Larry, took on colon cancer with his trademark guts and wicked sense of humor right until the end.

One thing we have learned from Karen’s loved ones is that there is great strength and faith in this family and they have all shown Karen how to fight cancer with courage, dignity and grace.

I am not my hair!

Karen has decided to bare it all...her bald head that is. These days, as the temperature has broken 90 degrees for several days in a row, she has tossed aside her caps, scarves and hats and stepped out into the world -- or at least Harrisburg -- as bald as a full moon.

Clearly, she's feeling more comfortable with her new look. She has the good looks, not to mention a nicely shaped skull, to pull it off. She strides down the street like some sort of exclamation point (an upside down one, perhaps) that proclaims her new-found self-confidence. And she's having fun with it too.  Sitting hairless in a colorful summer dress among a large crowd of 9th grade students and parents at Jack's high school orientation today, she laughed, "I look like you stole me from a department store."

Her friends shout out, "You go girl!"  I agree.  

Yes, she's feeling bold, but her acceptance of her transformed beauty hasn't quite caught up with her boldness. Because, despite how easily she appears to throw caution to the wind, she admits it's still quite jarring when she catches her reflection in a window or stands before the bathroom mirror in the morning. And no matter how good she may feel about herself or how bold she may be, the hair loss remains a constant reminder of the journey she is on and the toll of cancer.

I am not my hair

I am not this skin

I am not your expectations, no, no

I am not my hair

I am not this skin

I am a soul that lives within

(I am not my hair...India.Arie)