10 Practical Tips for the First 10 Days of Cancer

Inside Tips and Tricks from a Cancer Jedi

Originally published on Rebelle Society
April 3rd, 2013
If you’re reading this you probably have cancer. Or perhaps you have a friend or loved one who’s been recently diagnosed. Maybe you have a colleague who’s fighting the fight. Just look at this scary map, chances are either you or someone in your life has been affected by this undiscriminating disease.

10 Tips for the First 10 Days of Cancer by Caitlin Marcoux

If you’re like me, you’ve lost some people to the big C and now you’re getting familiar on a first hand basis.

The early days of a new relationship with cancer are tough. You’re just getting to know each other, and the circumstances around your courtship happen at breakneck speed. The following list is by no means definitive; just a few things I’ve picked up along my newbie way.

Bring a friend: 10 Tips for the First 10 Days of Cancer1. Bring A Friend.

The unveiling of a new cancer diagnosis and the subsequent myriad of information that cascades over your unprepared brain is overwhelming. Like being submerged beneath a waterfall, it can be difficult to tune into any input other that the deafening sound of water rushing over your ears.

A good friend will help you shake the water out of your head, and come back to reality. They can also take got down important information, run interference when you need an emotional time-out, hold your hand or rub your back and be in charge of those all-too-easy to loose hospital garage parking tickets. 

When I traveled to the Avon Breast Cancer Center for my most recent “routine” mammogram follow-up, I didn’t really think that cancer patient was going to be added to my resume. After all, I’m a 36-year old, green juice drinking, vegetarian yoga teacher. I thought women under-40 who exercise religiously, don’t drink, smoke or eat meat, and use only bio-friendly household cleaners aren’t supposed to get breast cancer, right?

So I told my boyfriend to stay at home and brought my friend Megan with me. I thought I’d be told, just as I had the last three times in a row, to get another mammogram in 6 months and we’d be on our way to Newbury Street for an afternoon of shopping and be home in time for dinner. Man, was I wrong…

Thank God Megan was there, because when the NP came in and said “So, you have cancer.” I had to focus all my attention on my childhood friend’s familiar face to keep from disassociating my way into a panic attack. Of course it would have been just as reassuring to have my partner with me, but I have to admit there was something really empowering about having my dearest girlfriend with me. We’ve been best friends since we were five years old.

Cancer will try to break you down, but there’s no way it can’t break a sisterhood bond. We shared champagne and a hotel room that night, and my new diagnosis didn’t seem so insurmountable.

After that experience, I brought a friend to every treatment.

 

2. Don’t let anyone tell you not to look at your phone.

Smart phones are one of the greatest inventions of the digital age. These compact devices pack a powerful punch and become invaluable tools in your cancer toolbelt. Forget your Garmin? Just use the navigation system on your phone, and you call up directions to anywhere you need to go.

Use the search options to find hotels near your hospital, connect you to coffee shops, dry cleaners, laundry mats and places to eat, and with the new integration between Google Maps and Yelp you can immediately review any near-by establishment and find out if it’s really worth investigation.

Many of use already use our phones to find our way around, take photos, and listen to music, but have you ever actually used the audio recorder function? This function can be a newbie cancer survivor’s best friend. Just remember, full disclosure is an ethical imperative. Ask your Oncologist if it’s okay to record your next appointment, and stop worrying about on-the-spot note taking!

 

3. Travel smart and be prepared.

Travel smart: 10 Tips for the First 10 Days of Cancer

The right cancer gear is key: a great bag, a small cooler and a piece of rolling luggage are the perfect combo for your diagnostic visits or trips to chemotherapy.

If you have breast cancer like I do, say good-bye to your old school messenger bag. I’ve been carrying my mine around the country since graduate school, but if I wear it now it either presses on the tumor in my right breast, or drags across my newly implanted portocath on the left. There’s no winning. So it’s staying at home from now on.

Even if you don’t have breast cancer, messenger bags are best left for co-eds. Now that you have cancer (of any kind), consider yourself in the Doctoral Program of Life, and upgrade yourself to something a little more befitting of the Professor in Residence that you are. A combo of small brief case/attache bag or tote and a carry-on size roller bag are perfect for your infusion visits. I use the Patagonia Lightweight Travel Tote and the Patagonia MLC Wheelie.

In the first couple of weeks of your new diagnosis, you’ll want to be prepared for the random surprise over-night stay.

Your new wheelie should be packed with an emergency change of clothes, a couple of pairs of underwear (they take up so little space you might as well), extra socks, pajamas, and toiletries.

If you´re not traveling that far from your home to your hospital and getting all the way home is not an issue, it’s still a good idea to bring a toothbrush and toothpaste. My first couple of diagnostic visits to MGH (Massachusetts General Hospital) were 8+ hour long events. Freshening up my mouth would have felt great!

During chemo visits, bring a small cooler bag, like the PVC, phthalate and led-free bag by So Young Mother. Find freedom from down-beaten hospital food and pack your own uplifting lunch and snacks.

If you’re too tired or rushed to pack your own, call your favorite to-go spot and order a picnic lunch ahead of time. Every time I trek from Nantucket (my home) to Boston now I stop at The Green and pick up a green juice and organic picnic lunch. This way I can bring a favorite part of Nantucket with me, and feel good about my nutrition all at the same time.

 

4. Do drugs. Lots of them.

Build you team: 10 Tips for the First 10 Days of Cancer

Okay, so I’m not really suggesting you smoking a blunt. Certainly not one with tobacco. Duh. But I am encouraging you to call your Primary Care Physician for some pharmaceutical assistance, right away. Before you even need it.

I know that might be a controversial statement, especially in certain circles—but this is not the time to be a martyr, hero, or suffer through any unnecessary discomfort. You have cancer. It sucks enough already.

So there’s no point in being caught off guard, whether it’s because of a headache or an anxiety attack or an unexpected procedure. It’s better to be prepared. Take this from someone who’s been living an exemplary clean life these past few years, and rarely reaches for something stronger than an Advil.

Taking an Ativan before a full day of diagnostic procedures (bone scans, CTs with contrast, and MRIs) goes a long way towards making an unpleasant experience tolerable. It certainly helped me immensely during my first 10 days of cancer and I’m not ashamed to admit it.

Just a couple of days ago I arrived at MGH for my first chemo infusion, only to be surprised by a last minute lymph node biopsy. This is not a procedure performed under general anesthetic, or even that trippy “twilight” sleep they talk about.

If I had been just as prepared ahead of time as I had been the week before, I would have not only taken an Ativan for the anxiety (which I forgot in my aforementioned uncomfortable messenger bag) but I would have also taken some ibuprofen for the torment I was about to endure. I don’t care who tells you it’s a cake walk, a needle deep in your armpit is not pleasant.

A little prophylactic pharmaceutical comfort will go a long way towards easing your discomfort and building your metal fortitude.

 

5. Build Your Team.

Build you team: 10 Tips for the First 10 Days of Cancer by Caitlin Marcoux

If you’re under the impression that you can do this alone, give it up. No man or woman should be an island, especially when it comes to cancer.

You need a solid team.These teammates are the family and friends who are going to be fighting with you, on the front lines. Choose them wisely, and appoint them well.

Having an inner circle of cancer ninjas will give you strength. Appoint a Secretary, Treasurer, PR Manager, Insurance Guru, Domestic Goddess and Hand Holder. Your PR manager can help you send out a cancer newsletter to the people in your community you care about but don’t have enough time or energy to reach out to personally. Websites like CaringBridge.org  allow you to do the same thing while also becoming networking opportunities that protect your privacy more than traditional networking sites like Facebook.

Of course, the very most important person on your team is going to be your Secretary of Defense & Homeland Security; your primary healthcare advocate. This person is typically a spouse, partner or family member. They should be willing and able to take charge of your “situation” at a moment’s notice.

They possess a no-holds-barred imperative to speak up for you and your well-being. This person will not apologize for getting the job done by any means necessary. They should be able to give amazing hugs, find organic fruit in a hospital and make you laugh when an IV is being stuck into your arm.

Internet savvy friends can be charge of organizing food donations or childcare support online. One of my friends used SignUpGenius.com to schedule meals for me and my family and my other friends used Rally.com to start and handle financial donations. Your web advocates can drive traffic to your fundraising website via Facebook and Twitter, or help you set up a widget for your own site, or your employers site.

 

6. Get organized.

You will be inundated with pamphlets, brochures, prescription printouts, discharge papers, authorization forms, and information packets. Designing a way to organize all your cancer materials can be empowering and will streamline your mission: getting healthy fast.

Print up a list of important phone numbers, emergency contacts, volunteer babysitters, and even plant waters should you be unexpectedly away from home for more than a couple of days. Make a calendar with all your doctor’s appointments, tests, infusions and follow-ups. Color code things, use stickers, be creative. Chances are you’re going to carry this thing around with you for a while, so you might as well make it nice to look at.

Many hospitals have all kinds of resources for cancer patients but it’s not always easy to find them. The posters and flyers hanging on your oncologist’s cork board will have a way of blurring over while he’s discussing the best way to attack your invasive tumor. Information reaches critical mass, and you might find yourself blowing off other wellsprings of guidance.

An Oncology Social Worker can help you navigate your way around your assistance options. My hospital, Mass General, offers financial counseling, fertility counseling, the PACT (aka Parenting At a Challenging Time) program, Palliative Care, support groups, a Networking for Patients and Families program, Chaplaincy, and classes in Chemotherapy, Acupuncture, Yoga, Music, Nutrition, Art, and Caring for Yourself.

Additionally your social worker can give you information about discounted hotels and travel assistance. My social worker hooked me up with PALS, Patient AirLift Services, a volunteer organization which arranges free air transportation for individuals in need of medical diagnosis or other “compassionate needs.” Last week, PALS coordinated with Cape Air, who generously flew me from Nantucket to Boston for Chemotherapy.

 

7. Clarify your intentions.

Decide how personal you want to be about your illness before you start posting it on Facebook. If you’re in a relationship, discussing this with your partner beforehand is a good idea too. Be on the same page, it will spare you drama and frustration.

If you decide to go public with your diagnosis and story, Facebook can miraculously put you in touch with other people who share your challenges.

Just this week I’ve met three other women who have survived breast cancer, and without so much as talking to them on the phone, I now feel like we share a deep common bond. When my chemo side effects kick up the cancer sisterhood is only a PM away.

But try to avoid the pitfalls of wasting too much precious time on pointless threads or status update voyeurism. It will zap you, tax you, and may even create jealousy or resentment. You need your energy now more than ever, don’t fall down a social media rabbit hole. 

8. Practice Yoga.

Grace & Fire: Using Yoga and Mindfulness to Navigate Cancer

Some combination of meditation and asana, or just meditation or just asana will serve you well in your fight. If you approach your practice the same dedication you use for brushing your teeth, you can make your practice a vital part of your treatment and healing plan. Focusing on your breath will help you stay calm under stormy circumstances.

Sitting tall in meditation or getting grounded through your legs in standing poses will help you slow down and stay focused on the present moment. Twisting will help you detoxify. Opening your heart through backbends will help you use your illness to cultivate deeper compassion for yourself and others.

Not feeling well enough to get to class? If you have an iPad, tablet or laptop, get yourself to a virtual studio. There are some amazing teachers out there who offer their classes online. In fact, since the original publication of this article on RebellSociety.com in 2013, I have created just such an online class for you. The meditations and Yoga for Chemo practice on Grace & Fire: Using Yoga and Mindfulness to Navigate Cancer can be done in a chemo chair, with earphones on, and no one else will be the wiser. I am thrilled to be able to add this content, available with a small donation, to the offerings on CaitlinMarcoux.net

 

9. Create a sacred space.

10 Tips for the First 10 Days of Cancer by Caitlin Marcoux

Chemo rooms are nothing special. Creating a sacred space for yourself can soften the sterility of the hospital experience and can be as simple as bringing a few special personal items from home or as involved as setting up a mobile alter.

For my first infusion I brought a small statue of Ganesha (the Hindu god and Destroyer of Fear/Remover of Obstacles), a rose quartz heart (a gift from my teacher), a beautiful aromatherapy eye pillow, my journal, my Lotus Wei Quiet Mind Energy mist and a few cards from friends I had saved to open for strength on that day. The intentional placement of each item helped me to feel in control of my surroundings and participatory in the healing that was about to take place.

My bedroom altar is a much more involved version with many symbolic pieces I’ve collected both BC (Before Cancer) and AC (After Cancer) and it gives me positive energy, courage and joy.

For a beautiful audio meditation on making things sacred. Listen to Sarah Blondin of the Live Awake Project here.

 

10. Stay stylish.

10 Tips for the First 10 Days of Cancer by Caitlin Marcoux

This can be a tall order, but I’ve learned the hard way, that putting a little effort into your appearance can go miles towards helping you feel more confident and self-assured. During the diagnosis phase of cancer you may simply not have the chance to freshen up. But as you embark on treatment you have an opportunity to uplift yourself every time you get dressed.

On my first trip to Boston for chemo, I was possessed by the Easter Bunny. For some reason I thought it was a good idea to put on a pair of bright pink terry cloth Juice Couture track pants, a white cotton t-shirt, a pink om scarf and my Uggs.  As I was running out the door I traded in my full-length black down coat for my lighter jacket—which incidentally was bright green! I was so caught up in getting to the airport on time for my flight I didn’t even brush my hair. Not a good look.

Even though no one else at the hospital gave me a second glance, I felt disheveled and awkward. I vowed to myself that in the future I would dress elegantly and project outwardly the inner strength and confidence I was hoping to harvest inwardly.

Dress the way you would for an important date with destiny. Whether it’s your favorite pair of skinny jeans and some cowboy boots or a beautiful dress and smart blazer, wear something that makes you feel rich.

Even if you can’t be bothered to put on make-up you can always bring a small stick of mascara with you. And remember, If you pack your roller bag wisely, you can bring a cozier, more hospital bed friendly pair of sweatpants or jammies, should you need to change.

So far cancer is a wild ride with one hell of a learning curve. May we all stay open and receptive to the lessons is has to teach us.

###

Life After the Knife: Keep Your Head Up

{ graphic / nudity}
Originally Published by RebelleSociety.com on August 12th, 2013
 

What happened after the knife?

 
Life After the Knife by Caitlin Marcoux, Cancer Jedi

photo by Robert Kricivich

Eight months doesn’t seem like a lot to exchange for the chance at living another 50 years, so I’m trying to be patient.

For me, the past 2 weeks since my mastectomy have been packed with a myriad of  emotional transitions and physical alterations and it’s been tough to stay attentive. Despite my lack of physical activity, all the emotional flux I’ve been navigating has turned slow days into full days, and I find myself feeling like the last 2 weeks have both flow by and crawled along at a snail’s pace.

It’s hard to believe that 2 weeks ago I had a body of disease and today I am making big strides towards a full recovery.

According to everyone, my double mastectomy and immediate reconstruction was a great success. With the guidance of my savvy oncologist, the previous 3 months worth of chemotherapy shrank my tumor and all of it’s many calcifications and satellite spots of carcinoma to an almost undetectable presence. My breast surgeon was then able to remove all the invasive cancer from my chest, get clean margins and perform what is called a nipple and skin-sparring mastectomy.

What is a skin-sparring mastectomy?

For those of you who are unfamiliar with this process, as I was before confronting it, this kind of mastectomy involves the removal of all of the patient’s breast tissue, but preserves a woman’s own nipples and surrounding skin. While nipple-sparring is said to alleviate  some of the emotional turmoil a woman will feel following a mastectomy, sadly she will never regain sensation in her nipples. Generally speaking the pain level following this type of mastectomy is greater than that of a simple or total mastectomy, but if it were possible, I was prepared to pay that price should I be able to keep more of myself self intact.

It was originally said that I was not a candidate for this surgery given the extensive and aggressive nature of my cancer, so going into my operation, I wasn’t sure what outcome to expect. My team had prepared me for a couple of possibilities: single stage reconstruction with implants, or tissue expanders which would help rebuild my breast over several months should everything need to be removed. I really had no idea if I was going to wake up with tissue expanders, flat chested or fully reconstructed with all my own bits and pieces.

Needless to say, I was scared.

I arrived at Mass General Hospital at 5:30 am with my teammates by my side. Both my partner Burr and friend Elisa helped shepherd me through not one, but two preoperative check points, and as we got closer to the surgical time of 7:00 my anxiety was mitigated only by a dose of Ativan.

The fear kicked in big time when Burr and I were greeted by my anesthesiologists who explained to me in detail the process of getting a PVB, or paravertebral block. The explanation, though sound, did nothing to make me feel better.

“PVB is an advanced nerve block technique, in which long-acting local anesthetic is injected below the muscles lateral to the spine and adjacent to the spinal nerves. Ultrasound guidance ensures correct needle placement, and the injected local anesthetic provides a band of numbness around the chest and breast area.” 

Ultrasound guidance or not, I was terrified by the thought of someone sticking a needle in my back. After all, I am the girl who’s primary motivation to birth at home was to avoiding an epidural. Put another way, I’d take childbirth over a needle in my back any day.

The explanation seemed to continue on for hours. The radiologists’ voices seemed distant and distorted, as if the words came out of their mouths in slow motion. Then, all of a sudden, they  disappeared. They went to check on the O.R. and the time space continuum swallowed me up. All I could hear was the thumping of my heart and the loud rush of adrenaline coursing through my veins.

Be here now, said a voice from somewhere deep inside my mind.

It occurred to me right then and there, that staying present has been exactly what I’ve been hoping to convey in my yoga classes all year. Crazy pre-surgical fear and all, this was just another golden opportunity to put my money where my mouth was, and be.

Be here now, the voice said again.

I fell back on my mindfulness techniques. I focused on the feel of the loose hospital garment draped over my shoulders, the sounds around me, and the cold bed beneath my seat. I remembered Thich Nhat Hahn’s gatha:

Breathing in I calm.

Breathing out I smile.

Dwelling in the present moment

It is a precious moment.

Pre-Op Mastectomy and Reconstruction. Caitlin Marcoux

When the doctors returned, it was time to lay down on my stomach and surrender the fear.

Burr was asked to clear the room and an ultrasound machine was switched on. Someone injected an intoxicating liquid mellow high into my I.V. and soothing female voices began coaxing me to relax. Reflexively I started ujjayi breathing, and somehow I faded into the ether. I barely remember the nerve blocks going in.

The next thing I remember was thirst. Thirst, then dizziness, then nausea and then Burr. By the grace of the divine, the marvels of modern medicine and several hundred friends and yogis praying and practicing for me, my surgery was a success.

My cancer was vanquished, my breast surgeon saved my nipples, the plastic surgeon reconstructed my breasts and everything was completed within the space of 5 hours. As I came to my senses, I felt a tightness around my chest and a tingling in my breasts.

Breasts! Yes, I had them.

Two of them; swollen and distorted from surgery, but exactly where the old ones had been. How amazing. 

I was released from the hospital just two nights after my surgery. Sent home with a monstrous surgical bra and an elastic band that wrapped around my chest to keep the implants from pulling north, I felt like a walking Ace bandage. With the residual effects of anesthesia and morphine still pumping through my body I was amped enough to entertain company for dinner.

I’d love to say that things went smoothly from there on out, but I can’t. I’d love to tell you that I kept the full sense of mindfulness and presence I had found in pre-op, and that I basked continually in gratitude for my medical successes, but that would be a lie.

A knife might be less painful than depression.

The truth is, that once the last of the intravenous drugs wore off, nausea and vomiting descended upon me like locusts, eating up any excitement or enthusiasm I had had for surviving the surgery. Since I couldn’t hold food down, I weened myself off everything except Tylenol and Ativan, three days after my hospital discharge.

But once off the narcotic pain killers I was haunted by strange phantom pain in my chest and bizarre let-down reflexes in my breasts.

Every time I thought about my holding or snuggling with my son Griffin, I’d feel the hot prickling sensation of my long ago dried up milk coming in, and a floodgate of tears would stream down my cheeks. No longer having milk ducts to produce and deliver milk, nor a baby to nourish, I felt bewildered by these sensations and overwhelmed by maternal yearning.

Try Googling “phantom let-down reflex after mastectomy,” and you might get two or three hits on some breast cancer message board, and that’s about it. So little information exists out there that I thought I was just imagining things.

I made valiant attempts to stay positive, but found myself spiraling into sadness.

The dirty, dark secret thing that no one wants to talk about, the possibility the doctors don’t warn you about, the trap that Glass-Half-Full-Cancer-Warrior-Troopers aren’t supposed to succumb to, is that cancer can cause clinical depression.

And about 7 days out of surgery, I fell into a deep, self-loathing darkness. The darkness in my heart matched perfectly the deep purple bruising spreading across my chest.

Life After the Knife. Post-Mastectomy bruising. Caitlin Marcoux

One week post-surgery bruising.

I’ve always believed that knowledge is power, so I’ve since done a little digging.

It turns out that studies show as many as 1/3 of people newly diagnosed with cancer, in treatment for cancer and those who’ve survived cancer suffer from PTSD, post-traumatic stress disorder, and according to HealthNews Day, 1 in 4 women with breast cancer report symptoms of PTSD following diagnosis and/or treatment.

Symptoms of PTSD include “trouble sleeping, memory problems, irritability or anger, feelings of guilt or shame and episodes of uncontrolled sadness and crying spells” (Post-traumatic Stress via The Mayo Clinic).

Well, this explained the unbearable darkness and tumultuous tears.

I rested all of my hope on getting my surgical drains taken out as soon as possible. These drains are a package deal when you have a mastectomy and keep blood and lymphatic fluid from collecting at the surgical site. The drains are embedded inside the breast area and extend externally from your body, where they connect to collection bulbs, sometimes called grenades. The bulbs are awkward at best, and need to be fastened with safety pins to your clothes.

While the drains functionally provide an important service, they are anything but sexy (if you’re interested in more about the drains, there are hundreds of amateur videos you can watch on YouTube), suffice to say that daily life with the tubes and drains comes with its own set of challenges.

I was crestfallen when at my July 31st follow-up appointment with my plastic surgeon, he told me I’d need to keep the drains in for at least two more weeks due to residual edema and the stubborn internal bleeding. For a short while I let this pull me down deeper into my depression.

“Let everything happen to you, beauty and terror, no feeling is final.” ~ Rainer Maria Rilke

The drains are a drag.

But they are temporary, at least that’s what I  keep telling myself, and isn’t that the lesson that has made itself clear since the beginning of this journey: that everything is temporary (beauty, youth, fertility, hair, health, even breasts). The only constant in life is change.

In her powerful and tender book, Being Well (Even When You are Sick), Elana Rosenbaum counsels those of us with illness that “To accept change, we need to accept thoughts and feelings as well as our resistance to an altered life.” I read that and thought, what sage advice.

So all that being said, I decided this week, it was time to accept my bulbous plastic friends and my depression and then maybe I would stop feeling so out of control. Obviously climbing out of a depression is easier said than done, but with support from my partner, my family and my therapist, I stopped fighting everything so hard, and started to embrace things as they are.

Acceptance is key.

I picked up my old copy of Pema Chodron‘s seminal work When Things Fall Apart, started walking the eighth of a mile to the beach a couple of times every day, and recommitted to my meditation practice. My partner came up with smart, creative ways to make the drain grenades more comfortable.

We used old Kaenon sunglass bags to cover the  sticky plastic bulbs (making them much less irritating to my skin) and carabiners to fasten them to my belt loops. This makes wearing the grenades more comfortable and it saves my clothes from holes made by the safety pins.

Then, when I wanted to shower, we made good use of one of my many malas. It’s easy to pin the drains between the beads, and this frees up your hands for sudsing and shaving. Loop a long mala around your head twice, and you have complete freedom.

Sometimes I keep the grenades pined like this all day long. If I leave the house, they go back in the sunglass bags and get pinned inside one of Burr’s boxy t-shirts. If I’m teaching class (yoga) I wear a flowy skirt with a roll down waist band that can cover the grenades and a loose tank top on top to hide the drains. I sit on a yoga block at the front of the class and keep pillows under my arms to remind me from excitedly gesturing with my arms while I queue.

Life After the Knife. Post-Mastectomy drainage. Caitlin Marcoux

My sacred drainage mala.

I even started going to the gym…with my parents!

As if it weren’t already sweet enough that each day this week, my father or my mother has picked me up and chauffeured me to the Nantucket Health Club, the entire staff welcomes me with open arms and showers me with encouragement. “We’re with you” they say. “You can do this!” they declare.

The reality is, I can’t do much (in the way of exercise); nothing with my arms until my drains are taken out, but I can ride the stationary recumbent bike. So that’s what I’ve been doing; about 10 miles a day, at a very mild pace.* The endorphins I release while exercising are giving me the kick in the ass I’ve needed to stop the depression in it’s tracks, and despite the drains, I feel better than I have in weeks.

*Sidenote: it is important not to get your heart rate up too high while recovering from surgery — exercise only under your doctor’s guidance.

My dad is a cancer survivor too. Stage IV throat cancer almost took him from us two years ago. It’s kind of a miracle he’s alive, considering he smoked well into his 50′s.

Never having been one for a workout, it’s impressive that this year he’s getting himself to a few group fitness classes per week. I’m tickled pink when we go there together: two cancer survivors, working out in the same gym, giving cancer a run for its money.

My life feels very different since I was diagnosed with cancer.

It certainly looks different. Some times things change at lightening speed; like the initial diagnosis which hits you out of nowhere at 180 miles per hour. Other times a treatment or procedure seems to go on forever: hours can be lost in trace watching chemotherapy drugs drip slowly from their IV bags.

The key for me I think, and perhaps for all of us no matter what the struggle, is to stay present with whatever’s happening, whenever possible, as much as possible.

I have a few more hurdles to jump before I can put breast cancer behind me, but with presence and acceptance things are getting easier every day.

“The curious paradox is that when I accept myself just as I am, then I can change.” ~ Carl Rogers

Making the Breast Decision: Mastectomy & Reconstruction?

Originally Published by RebelleSociety.com
July 23rd, 2013

 

{via Tumblr}

 

It’s been 4 months since a core biopsy revealed I have invasive breast cancer. Since then, my days have been chock-full of research and reflection, so I’ve had plenty of time to think about the upcoming July 24th surgery that will theoretically save my life.

In the past 4 months I’ve had 14 infusions of chemotherapy and 16 weeks toweigh the options: single mastectomy, double mastectomy, reconstruction, no reconstruction, nipple tattoo, artistic tattoo, no tattoo. I’ve grappled with whether the path of least resistance would be to peel myself back to the bone, bravely staying flat chested forever, or to move gracefully forward with the replication of what I am about to loose.

Each option has its pros and cons. Of course they are all preferable to have no options at all.

With all the decisions that needed to be made, I’ve researched all my available choices (there are many) and prepared myself for the various possible outcomes of resection (there are a few). I’ve asked everyone I knew who’s gone before me all the relevant (and delicate) questions: Are you happy with your choices? Would you do things differently? Do you like the way you look?

Some of my fellow breast cancer warriors elected to remove only the breast affected by cancer, and haven’t sought to reconstruct. Some of these women use an external prosthetic in their bras and bathing suits, some don’t.

Many women I’ve spoken to have removed both the diseased breast and the healthy one prophylactically, and have reconstructed both. Some of these women were candidates for nipple-sparing mastectomies, which left their original areola and nipples intact; some were not and could not.

For those for whom saving the nipple and surrounding skin isn’t an option artistic tattooing can be healing. These women are empowered by reclaiming this part of their body with stunning tattoos where nipples or whole breasts used to be. Each woman’s options are affected by her case, diagnosis and genetic background.

The possibilities are many. The choices can feel overwhelming…

{Via BreastFree.org}

I’ve taken a winding, sometimes bumpy road to arrive at my own decision.

In the beginning I researched various autologous reconstruction procedures, all of which create new breasts using some fat, muscle, skin and blood vessels harvested from another area of one’s own body. But I came to the conclusion that this option could leave me physically weakened in the donor area of my body, and might seriously interfere with my yoga practice.

Then I asked myself if I’d be okay using cadaver or bovine (yes, cow) tissue to hold a silicon or saline implant in place. As an aspiring vegan, this presented me with a bit of an ethical dilemma, and I wasn’t sure if I could introduce any kind of foreign body into my own; whether it came from a four-legged friend or a chemical manufacturer.

Down to the bone.

In May, I came to the momentary conclusion that I would choose mastectomy without reconstruction. I started compulsively feeling my ribcage, imagining a smooth hillside slope from my collarbones down to my bellybutton. I’d press my fingers into the divots between my ribs and try to picture myself with a full set of 12 impressions instead of the breast tissue that presently occludes the spaces between my fifth, sixth and seventh intercostal muscles.

For hours and hours I Googled images of women without reconstruction to see how I would feel when trying on a more Balanchine ballet dancer version of femininity: flat chested and boy-like. What I found were hundreds, maybe thousands of brave women who have documented their journey through breast cancer and proudly displayed photographed themselves or posed for others.

Coffee table books and websites, like The Scar Project, celebrate these women and beautifully illustrate the process of survival and recovery. The photographs I unearthed revealed incredible courage and strength, and touched places deep inside my feminine soul.

 

{David Jay Photography via TheScarProject.org}

 

{David Jay Photography via TheScarProject.org}

 

But after sitting with this decision for several weeks, I realized that something was off. My decision no longer felt personal. It felt political, forced and academic. I realized that the pressure of what I thought I was supposed to choose was strangling what I wanted to choose. 

Through meditation and self-inquiry, I realized how reactionary my initial decision had been. I had judged myself harshly in April for wanting “fake breasts,” and I had labeled myself vain. I needed to get out of my head and listen to my heart.

When I finally did, I realized that choosing not to reconstruct out of fear of being judged for having implants is no more authentic than choosing reconstruction for fear of being flat chested. Either path is honorable and navigating breast cancer is brave, period. Other people’s opinions are none of our business.

CM

 

Beauty takes many forms.

I have unending admiration for the women who have lost their breasts to cancer and have chosen not to reconstruct. I think they are just as beautiful as women who’ve never gone through cancer, or prophylactically opted for surgery. But after much debate with myself, I have chosen another path.

Tomorrow, June 24th, I am having a bilateral mastectomy. I have chosen to remove both my breast that has cancer and the one that does not. If single stage reconstruction is possible, it will happen shortly after my breast tissue and cancer is removed.

If my cancer is still too extensive to save the majority of my skin and nipple, my plastic surgeon will put in tissue expanders that will stretch my skin until it is able to hold a pair of implants. Either way, I am excited to have a new pair.

This decision has brought with it great freedom. I feel released now; released from the pressure I was putting on myself to practice the asceticism I had applauded as part of renouncing reconstruction.

With my mind settled on rebuilding what cancer has taken from me, I’ve been able to return my focus to my heart. Spending time in quiet meditation and holding myself with greater tenderness, I’ve been mourning the imminent loss of the breasts I used to feed my son, and pleasure my partner.

In honoring our time together I’ve been directing thoughts of loving kindness towards my breasts and letting go of any negative feelings I’ve had about them in the past. I’ve come to realize that for me saying good-bye to my breasts has also been about letting go of any shame, blame or animosity I’ve felt about them in the past.

I’ve forgiven their colossal and quite early development in my pre-teens, the shrinking they did when I lost weight in my 20s, the tear-jerking mastitis I had during the first few months of breast feeding, and their abrupt deflation after I weaned my son. I’ve reached back into my relationship memories and forgiven the right one for being smaller than the left (a physically perceptible fact that mortified and embarrassed me in my 20s) and I’ve reframed any disappointments I’ve had in my sense of self as they’ve related to my beautiful mammary glands. On the brink of momentous change, I think I’ve finally made peace and let go of all the old gripes and insecurities.

I’ve put my hands over my chest and thanked my breasts for all the amazing things they’ve brought into my world: a strapping, well-nourished toddler, a satisfied and engaged partner, and a deeply loving maternal sensibility within myself.

I’m ready now; ready to make space in my heart to welcome myself home again: perhaps a little modified, but healthy, cancer-free and just as much a woman as before.

{Photo: Larisa Forman / Caitlin Marcoux}

“Think of all the beauty still left around you and be happy.” ~ Anne Frank

###

Read more about my journey with cancer:

>> 10 Practical Tips for the first 10 Days of Cancer. 

>> How to Talk to Someone with Cancer.

>> Cancer and Equanimity: Can you see the forest through the trees?

###

Looking for more 411 on Breast Cancer?

Check out these resources and personal stories:

Breastcancer.org

BreastFree.org

StupidCancer.org

Susan G. Komen

American Cancer Society

Breast Cancer Resource Center

Living Beyond the Breast

National Cancer Institute

Caring4Cancer

Crazy Sexy Cancer

Breast Cancer Blogs:

Generation Why

Chemo Babe

Boo Cancer Your Suck

Stupid Dumb Breast Cancer

How to Talk to Someone with Cancer

Originally published on RebelleSociety.com
May 15th, 2013

Bummer. Sounds like you have to talk to someone with cancer.

I’m so sorry – for you both! After all, it’s no easy task for either party. Going through this very thing myself, I’d like to help you out with a little cancer context, so that we can put your inevitable dialogue into your loved one’s perspective.

How to Talk to Someone with Cancer by Caitlin Marcoux

Making the best of a bad day of tests at The MGH Cancer Center.

The thing about people living with cancer, is that we are a complicated bunch.

Our senses have been rubbed raw by diagnostic testing and medical evaluations. We’ve been graded, staged and given projected survival rates. We’ve seen the fragility of our lives held up before our own faces, and we come away from our treatments feeling vulnerable in a way we’ve never felt before. We cling to our independence, but know we’re dependent on others for healing and help.

We are emotionally taxed and psychically drained.

The very nature of our dis-ease has thrown us into a world off-balance. Not only are our bodies working over-time to halt the production of alien-like rapidly mutating cells, they are struggling to process the toxic poisons we voluntarily ingest to cure ourselves. The very treatments we implement to make us healthy, make us sick. We walk a fine, contradictory line on a daily, weekly or monthly basis.

Cancer survivors know better than most how fleeting life can be.

We live with a foreboding and heavy awareness of risk. We are almost painfully aware that each day we have is precious.While certainly there are many silver linings, we remember wistfully what our lives were like Before Cancer, before the silver linings needed to be pointed out. We navigate the remainder of our days knowing that we will never again feel the pre-cancerous freedom we may have taken for granted.

“Toleration is the greatest gift of the mind; it requires the same effort of the brain that takes to balance oneself on a bicycle.” ~ Helen Keller

We know it’s a tall order, and that our needs are inconsistent, but we really appreciate your patience as we figure out exactly what we need. We want you to be sympathetic, but we don’t want your pity. We want you to look us in the eye, but please don’t stare. We’d like it if you could meet us where we are, not judge us for where you think we should be. We want you to reassure us that we are capable and brave, but don’t blow smoke up our asses; being the authority on ourselves, we know we’ve looked better, felt better, or seemed more grounded.

We’d like it if you lent us a compliment or even two, but for heaven’s sake, please don’t go over board. Sure, Bald is Beautiful, but given the choice, most of us liked ourselves just fine with hair.

How can you love us? Let me count the ways.

We still want to be loved, and by that I mean made love to. Those of us withbreast cancer and facing mastectomy could be on the brink of loosing the very largest symbols of our sexuality and femininity. If in the face of buzz-kill cancer, we can muster up enough energy to jump in the sack, please do whatever you can to rise to the occasion.

We might complain all day long about not feeling pretty but at night we’d like to be pursued as if we were the most beautiful women you’ve ever seen. We might ask you to turn off the light, just go with the flow.

Shower us with empathy.

Shower us with Love. Talk to Someone with Cancer.

Compassion is a prized commodity amongst our kind. It’s better that chocolate, red wine, or our anti-nausea medication. A single empathetic commiseration that indeed things can suck may be more appreciated than any other grand gesture of affection you can bestow us. It’ll certainly go over better than the knee-jerk condolences you might be tempted to offer up.

The truth is, no matter how above it we may project ourselves to be, we are embarrassed by our vanity. Even those of us who walk a path spiritually devoted to cultivating an awareness deeper than the skin, know real and intense discomfort when our physical identity starts to fall apart.

We may attempt to take control of our hair loss by cutting it short, or shaving it off. We may throw ourselves a Boobvoyage party before a mastectomy or parade around with our newly bald head held high. BUT we are actively engaged in the most difficult task of accepting that we are completely and utterly out of control.

This week I’m grappling with something I find simply humiliating. As if it weren’t bad enough that my hair has fallen out only in patches, to add insult to injury I now have something called folliculitis, a bacterial infection of the hair follicles, not only on my scalp, but also in the soft downy follicles on my neck and all the way down the small of my back. It is nearly impossible to feel sexy when touching your own head gives you the heebie-jeebies.

For all the cancer patients out there who have experience this particular itchy, hot, and unflattering torture, I bow to you. It takes a formidable person to rock this particular look without tears. And to those of you, who like me, have wanted to hide far from society in the seclusion of your own homes, or in the very least under a hat, I feel you. I know the last thing in the world you want to hear is how beautiful you look, when you feel like shit.

Let’s get real.

We know that you know we are strong, but don’t you know we don’t always feel that way? Do you know how hard it is for us to be brave when our hair is falling out and our bones are itching? Do you know there are days we don’t feel graceful, moments we don’t act graceful and times we fail to live up to our own graceful expectations? It is hard for us to feel empowered with an icepack on our head and a heating pad on our knees, dry red eyes and a rashes lashed across our skin.

Sometimes we feel bad.

Post-chemo Prayers: How to Talk to Someone with Cancer by Caitlin Marcoux

Praying at the Post-Chemo Alter. Summer 2013

We don’t envy you: those of you who run into us at the grocery store, or the coffee shop on one of our bad days. We know it’s awkward to hear us panicking on our cells phones with our mothers, or crying to our husbands. But please don’t walk away and pretend that you didn’t hear. Chances are in a moment like that, we need your help and we might be too proud to ask.

Forget attempting to offer up some gratitude platitude (we are more grateful for the chance to keep living than most), just give us a silent squeeze. One hand on the shoulder is worth a million well crafted aphorisms. Most likely, we will hug you back with all our strength; perceived or projected.

We want you to see us. To see our strength and our vulnerability. To feel our pain and to know the depths of our gratitude. Ask us sincerely how it is, and we will tell you the truth.

“There is no difficulty that enough love will not conquer; no disease that enough love will not heal; no door that enough love will not open; no gulf that enough love will not bridge; no wall that enough love will not throw down; no sin that enough love will not redeem…” ~ Emmet Fox

Here are a few more things to keep in mind when you talk to someone with cancer:

1. If you know about our disease, address it immediately. Chances are we already know you had dinner with a friend of a friend the night before last and they told you all about it, so get it off your chest. Waiting for us to tell you how we are puts us in the awkward role of feeling like we’re complaining; usually things could be better, but if you’re curious about how we feel, just ask.

2. If you’re not prepared for some detailed response to your inquiry, just don’t ask. We may need to vent about some gnarly side-effect, and most of them are kind of yuckie. Be prepared to listen. Your shoulder to cry on might be the biggest boon we get all day.

3. Please refrain, if possible, from telling us a story about your friends and relatives who died of cancer. Just like a pregnant women gearing up to deliver her baby, it’s important that we surround ourselves with stories of success not fatality. If you haven’t experienced cancer first hand it is normal to want to relate in any way possible, but for our sake think twice before sharing a story with a bad ending.

4. Unsolicited advice might be great, but it’s still unsolicited. You might just have the most miraculous outside-the-box alternative therapy that you’re dying to put to the test, but please, unless we’ve asked, soften your enthusiasm. No one takes their diagnosis more seriously than the patent themselves. Most cancer survivors I know have thought long and hard about their treatment plans. They’ve often consulted their nearest and dearest and have gotten a second and third opinion. And by the time we are in active treatment we have a pretty solid plan of attack in place.

5. Empathy, empathy, empathy. Plain and simple, cancer sucks. If anyone wants to talk about how it’s a gift, leave that to the patient to offer up.

6. Shower us with love. According to the mother of Western yoga, Judith Lasater, all emotions stem from the two most basic: Fear and Love. We, cancer patients, are confronting our fears in a full frontal attack. Showering us with love is like helping us stock up our arsenals and helps us prepare for battle.

7. Lighten Up. The more you can make us laugh, the better. This is not to say we don’t appreciate you taking our challenges seriously, but let’s face it, laughter is the best medicine. If you can find a way to make us giggle we will love you forever.

I am lucky enough to have some of the best and silliest girlfriends in the world. When three of them came to visit me last month we took over the infusion room at the Nantucket Cottage Hospital. When Gretchen, my infusion nurse, slipped out to go to the lab, the girls promptly took over and we turned Cancerland into Clubland.

Here’s the video to prove it.

 

9. Touch us. Cancer is not contagious. We can’t give it to you. What we can give you is the chance to heal our aching hearts. Most of us just want to be held.

How to Talk to Someone with Cancer by Caitlin Marcoux

The healing power of contact.

###

when fight and flight turn out the light

3:00am April 11th, 2013
Nantucket, MA.
Breast Cancer Day 26
 

Taxol/Herceptin

Like I said in my last post, there are good days and bad days. This is just as true in regular life as it is in life with cancer.

So I knew it wouldn’t be long before the adrenalin my body’s been using to fight and fly it’s way through the first couple of cancer weeks would eventually wear off. Adrenaline is an amazing chemical that helps us deal with difficult things, prepares us for battle, gets us juiced up to win the big race. It gives us a powerful boost of fast acting energy, enables us to run like the wind, and in my case, got me from exam table to operating table, bone scan to CT, biopsy to chemotherapy. I didn’t have time to feel sorry for myself, I was too busy getting organized to save my life.

Over the last few weeks I’ve felt galvanized to attack my responsibilities with gusto. I’ve read the research, the this is your life with cancer books, created treatment plans and schedules, mapped out my calendar for the next 15 months, organized childcare and playdates, re-structured the medicine cabinet, organized the refrigerator, corresponded with countless friends, and plowed forward with work to the very best of my ability. I’m not bragging… I’m preparing you for the crash.

 office work in the MGH halls{Me: organizing my thoughts while awaiting a lymph needle biopsy}

Too much of a good thing is usually bad

Once you’ve won your race, passed the big interview, or absorbed the news without fainting, and bathed in your pool of epinephrin and nor-epinephrin, it’s time to get out. It’s not a good thing for anyone, to stay in a state of sympathetic nervous system overdrive. Too much cortisol; another neurotransmitter which is designed to act in harmony with adrenaline and perpetuate your state of fight or flight, will eventually cause damage to other parts of the body: things like

  • Exhaustion
  • Physical pain
  • Lack of concentration
  • Memory problems
  • Anger
  • Sleep problems
  • Aggression

Really? On top of having invasive ductal breast cancer, I was going to take on that list? No thanks…

So as it came a little closer to the time of my actual treatment I did my best to prepare myself to actually feel things, not sprint past them: fear, anger, resentment, shame, guilt, helplessness, and vulnerability, I let it all well up and come flooding out. I made  a pact with myself that I would allow myself to experience these things as they came up, sit with them, and then do my best to move through them.

So this is where the yoga, meditation, gratitude lists, thank-you notes and writing come in. I have absolutely no interest in becoming bosom buddies with cortisol, or any other part of chronic stress, or the PTSD they say many cancer patients cope with for the rest of their lives.

Have you ever been to a chemo session? The video below is of me, obviously before the recent haircut, getting my first infusion of Taxol and Herceptin (the two chemo drugs I’ll be taking until June 12th). It’s just raw footage, nothing very interesting… but if you’re curios, go ahead and watch. I won’t be offended if you don’t; it’s long.

 

Have a sense of humor.

It’s so true, having a sense of humor will take you far: way farther in fact than adrenalin, and without any side-effect.  Laugh at yourself wearing a stupid mask. Strike a gorilla yoga poses out in front of the hospital. Make a positive SPLASH in the murky, dreary often depressing world of deathcare, I mean healthcare.

Humor is merely tragedy standing on its head with its pants torn.  ~Irvin S. Cobb

my second chemo treatment{April 6th, 2013. Me: getting ready for infusion number 2}

Humor prevents one from becoming a tragic figure even though he/she is involved in tragic events.  ~E.T. “Cy” Eberhart

The truth is, I am very willing to be here and that makes it easier. I’m willing to sing out loud, probably off-key and to laugh at myself in spite of my fears. I’m willing to learn the most that I can from this crazy teacher named Cancer.

But just in case you thought I was playing this all too cool for school, I’, going to share one last (short I promise) video with you here. Maybe I’m the crazy one for sharing, but if my students are out there reading this, especially my Strong Girls, I want them to see that you can be fierce, loving and vulnerable all at the same time; that you can smile on the beach in the sunlight one day, and ball your eyes out the next – It’s all part of this amazing privilege we to enjoy as humans.

Don’t worry though – I’m laughing today 😉

Last thought for today..When life gives you lemons, make lemon aid! I hope anyone who has been affected by cancer will join me at the Yoga Room on Mondays, where I will be leading a FREE Yoga Therapy for Cancer Care class from 11-11:45am. You do not need to register, just drop in – just check the class schedule here, to make sure I’m not traveling for treatment that week.

Yoga Therapy for Cancer Care

Until next time, stay receptive.
Love,
C
 
 
turning tragedy up side down.

So, you have breast cancer.

Dear Friends, Students & Clients,

I have Breast Cancer…

On Tuesday, March 12th I went in for a routine mammography. Even though it’s not recommended to start getting annual mammograms until you reach 40, I’ve been getting them since May 2011, when I found a suspicious lump in my right breast. This particular exam was a follow-up to the last one, which was done 12 months earlier.  After having a mamo every 6 months (following the watch and wait protocol) it was decided that the mass was nothing to be worried about (you have cystic breasts with fibrous tissue I previously was told), so I was floored when it was suggested on the spot that we do a needle biopsy.

On Friday, March 15th, 2013, I went up to Mass General Hospital with my dear friend Megan. Things unfolded in both slow motion and fast forward from there on out. The pathology from my needle biopsy arrived just 9 minutes before we walked into the exam room, confirming my Cancer, and when I was told “So, you have breast cancer” for a hot dizzy moment, I thought it was the end of the world. Bone Scan

I was in shock. I was freaked out. I was scared sh*&less.

But 10 days later I feel very differently. As weird as it may sound, I am confident this is the beginning of a bright new chapter of my life. I’m no hero, and I’m not going to say something inauthentic like “I feel blessed” that I have Cancer, or “It’s a gift”, but I do feel like it’s an amazing opportunity for growth. As my teacher, Elena Brower, says, we choose our parents, we choose our life lessons, “We pick them perfectly”. So following this, somewhat Buddhist train of thought, I must embrace the fact that I have chosen Cancer too. This is the new reality for me, one I have chosen so that I may learn from it, so that I may teach from a place of deeper wisdom.

That’s the new plan. The total and compete acceptance of Cancer as my new Guru.

You will be hearing a lot from me, over the next 14 months. I plan to blog. I plan to write. To document. To teach. To inspire. To bring awareness to Breast Cancer in the under 40 population. To make sure my Strong Girls know that self-breast exams are mandatory. That we are our own best health advocates… that no matter who tells you your self-detected “likely benign” LUMP is not worth further investigation, should your intuition tell you otherwise it is. I plan to stay around for a long, long time. To love my family and friends, to nurture my partner and to parent my son.

Flight Like A GirlWhen I first found out I was sick, I preemptively took a leave of absence from teaching and massage therapy. But now that my treatment plan has changed quite a bit, I am hoping to teach as many of my regularly scheduled classes as possible. I am lucky that my chemotherapy treatment will not be scheduled on days I would normally be at the studio, and I will have several days after chemo during which I can recover without missing classes. So for those of you who would like to know as to whether or not I’ll be at The Yoga Room on any given Monday or Tuesday evening, or Sunday morning, please just consult TYR’s online schedule. I am forever grateful to my TYR colleagues for accommodating me and my last-minute needs.

Teaching has always given me strength. Walking away from it completely, would feel like a surrender, and I am very much a fighter.

Some logistical stuff:

Many people have asked me how they can best support us through these challenging circumstances. For those of you who would like to contribute financially my friends Jason Bridges and Emily Molden have set up the Caitlin Marcoux Charitable Fund at Rally.org. This is also where I will post medical updates from here on out, instead of on FaceBook, as it is a more appropriate platform.

And for those of you who would like to contribute domestically, my friend Kristen Lewis has set up a SignUp Genius campaign, where you can sign up to deliver a meal, volunteer to help with my son’s childcare (pick-ups or drop-offs to school, or playdates*) or help out around our home. *Please note: Griffin will really need some small friends to run around with on Thursdays and Fridays after school, even if it’s just for an hour. This is probably the best way anyone can help us.

I know that I can’t do this alone. And I am so very, very grateful to both my local community and my global yoga community for all the ongoing support. I can’t think of a better place than Nantucket to have Cancer, and I couldn’t be in a better place both spiritually and mentally to survive it.

I am a lucky, lucky girl.

A few special Thank-Yous to the following people who have helped me through this initial phase of my cancer treatment (many more thank-yous to come):Health Alter

Thank you to Shannah Green and Elisa Allen for facilitating an amazing and much needed retreat at Kripalu this weekend. To Alison Alpert for coming with me to my first needle biopsy. To Megan Soverino for being there now and always,  but especially for being there to hold my hand when I got the news at MGH on March 15th. To my parents Joanne and Steve, and my sisters Ariel and Grey. To my ex-husband Paul Budzynski, for being a rock at a time of need, for accepting me once again despite my mistakes and with all my faults, and for taking such good care of our son Griffin. To my friends Jason Bridges, Emily Molden and Kristen Lewis for setting up, in record time, all kinds of online support. To Amber Hinds, my web-designer. To Jenny Bence, owner of The Green, for making me drink way more wheatgrass than I ever would on my own. To Darya Afshari of Dayra’s Salon, for helping me feel pretty (sister, you will be shaving my head soon). To Elena Brower for being an ongoing source of wisdom and support and bad-ass coach. To my friends Kate Greer and Richmond Dickson for giving us a warm bed to sleep in and nurturing food to eat on Wednesday night, March 20th. To my beautiful yoginis in crime Caroline Pope Peavy and Juliet Loranger, for coming up on Thursday night, March 21st, to hold me after a long day of bone scans and blood tests. To Rebelle Society for giving me a place to write (the words are on their way). To my son Griffin, who inspires me to be the very best mama I can be. And of course to my partner, Burr Tupper, who is always, always, always there for me.