Monday, October 5, 2015

A Video and Thanks

I have been providing updates on my website: www.sarahfenlonfalk.com and consequently have been letting this blog go.  I wanted to let those of you who still follow me here know where to find me and keep up to date on the cancer journey, book project and all in the life of the Falk family.  Here is a video that will be playing in the Chicagoland area in the month of October for breast cancer awareness month:
The Lexus and NBC 5 Salute to Cancer Survivors
I'm so thankful for all of the support, encouragement and prayers...

Saturday, September 12, 2015

Hurdles and Bumps

"Just another hurdle on the road to recovery."
I ran track in high school for one year.  It took me two years to get the guts to go out for track, then after running one year I was diagnosed with bone cancer in my left femur and have been unable to run since.  I remember back in those days, during practice after a long day at school, we would run until we couldn't run any more.  Sitting there huffing and puffing, trying to catch my breath, I would look at the hurdles set up along the outside of the track for the hurdlers to practice.  The hurdles were so tall, about up to my chest, and I would think, how in the heck can anyone jump over those?  Most of the female hurdlers were no bigger than myself, so I simply could not fathom how they were able to get there legs apart wide enough and foot up high enough to get over the thing.  I loved watching them practice though, it was amazing watching legs propel faster than what seemed should be humanly possible, legs stretched almost in a straight line-one ahead, one behind-and up into the air with the hurdler.  It almost looked as though they were flying.  And they might as well have been as far as I was concerned
Here I am at the edge of my hurdle.  The next bit to get through.  The next hill to climb.  The next thing to overcome.  I'm not excited about having surgery.  I will say I am excited about the time I will have off afterward, but not thrilled about having drainage tubes on either side of my body for a couple weeks, or the pain of incisions and manipulated muscles and temporary implants.  I am looking forward to eliminating a potential threat to my health.  And while I'll miss my kids while I'm in the hospital, and then miss playing and wrestling with them for a while after I return home, it will be worth it for the many more days I am hoping I will be able to be in their lives.  That's the whole point of this hurdle.  To buy more time.  While I can't fathom what the next few days are going to bring I am planning on pushing myself, like the hurdlers in practice at Cheboygan Area High School once did, and fly!
"Just another bump in the road of life."
Yes, it is time for yet another one of these.  Technically, two bumps, as a coworker's sister so astutely pointed out.  (She just had a double mastectomy herself, she's earned the right to joke like that!)  I laughed when she said it.  If you don't get it, two bumps because both breasts will be surgically removed (mastectomy) and reconstructed.  And "two bumps" because this isn't the last of the surgeries.  In another several months (maybe about 6) I will be having another surgery to put in the permanent implants.  In the meantime, the expanders that will be placed immediately after the mastectomy on Monday will be filled little by little to stretch the chest muscle they will have been placed under.  Then once they have been stretched to an appropriate size the surgery for the permanent implants will be scheduled.  Beyond that, in another several weeks, after surgical wounds are healed, the detail work of reconstruction will take place to create nipples and areola.  
All throughout the reconstruction process I will be receiving Herceptin treatments by IV once every three weeks.  Herceptin is the targeted therapy that is used to block the Her2 protein that was feeding the tumor in the first place.  The deal with Herceptin is that it effects the heart.  And since my heart has already been effected by previous chemotherapy from 1991-92, I have to be followed closely by an Oncology Cardiologist.  As has been the case in my care, I was sent (by God and a google search) to a wonderful doctor at the University of Chicago, Dr. DeCara.  She was very kind, patient and knowledgeable and seemed interested in my case as well.  I'm very thankful to have added her to my team.  After each Herceptin treatment I will have an echocardiogram done and she will look it over to be sure the treatment does not do any further or lasting damage to my heart.  The positive thing about the effect that Herceptin has on the heart is that the heart typically bounces back after discontinuing the treatment.  So, all in all my visit with the Cardiologist was very positive.
My visit with the Cardiologist was positive as was my visit to my GP this week.  I didn't actually see the GP (general practitioner) but instead saw his Nurse Practitioner, Liz, who has been on my team for a long time.  I was being seen there to be cleared for surgery.  And while I have had a cold for about a week now, everything else checked out and I was cleared.  Liz did call yesterday to see if the cold was gone yet.  As it is not, she ordered some medication for me to start immediately.  Although I am tired I must say that the symptoms have reduced even since yesterday morning and I am feeling better.  Let's hope Monday's surgery will be a go.  I'm nervous that I'll get there and they'll send me home again.  If that's the case then surgery will most likely be rescheduled for November.  But, I'd rather wait than take any risks just because I want to be done with it.  The anticipation is no easy thing to cope with, but I can wait if I must, if that's the safer option.  
Now as the day is so close I find myself withdrawing a bit, getting frustrated very easily, and feeling as though there is not enough time in a day to get my tasks done and spend time with my children.  Even though I won't be in the hospital for very long I am feeling and acting as though I'll be away for weeks.  Perhaps this is because I know my activities will be limited after the surgery, so I've been getting in all the chores, boy-wrestling, baby-lifting, and home-rearranging that I could handle in the last few days.  And now it's time to go to sleep and wake up to "the day before".  Those days always go quickly.  Instead of dwelling on the event to come I think I'll visualize the hurdler, defying gravity, gracefully leaping over something that is almost as tall as they are and totally blowing the minds of on-lookers.  Yep.  That's what I'll do.

Monday, September 7, 2015

Firsts and Lasts

It's been a couple weeks of firsts and lasts around our household.  I've been very emotional.  The first of the firsts was our oldest boy Bobby loosing a tooth.  It wasn't as dramatic a thing as I remember tooth removal being when I was loosing them.  He was eating breakfast one day and his loose tooth just fell out.  This being a Sunday morning, Bobby requested to take the thing to church.  So, mother that I am, I found a tiny zip lock baggie type thing (the size that used to hold a spare button for a shirt), punched a hole, tied a string and he proudly wore that tooth around his neck all morning.  He was sure to put it under his pillow that night in hopes of the tooth fairy bringing him "a coin" in exchange for his tooth.  I thank Jake and the Neverland Pirates for setting the expectations low by suggesting that the tooth fairy brings "a coin" for a tooth.  Bobby did however receive a dollar bill AND a coin (quarter) from the tooth fairy for his first tooth.  That first tooth was followed by a second tooth not more than two weeks later.
Which brings us to another first, kindergarten.  I find it difficult to fathom the passing of time which has brought us from returning home from the hospital with a tiny, helpless baby to then dropping said baby off at a building miles from home for multiple hours in a day with people we have barely met.  And all of this apparently "normal".  I can't express how nervous and sad I was leading up to that day.  My son on the other hand has been looking forward to his first day of school for months, possibly longer.  We drove him to his first day of school and I was able to walk him to his classroom.  He was cool as a cucumber.  Once inside he behaved as if he knew exactly what he was doing and was eager to do it.  I shed a few tears as I left him there that day.  Those tears were for me, not for him.  He has enjoyed each day of school more than the last.  I'm so thankful he likes it.
The same week we took our oldest son to kindergarten was the week that our youngest son, William, turned two.  Just a day or two before his birthday I entered my bedroom and took inventory of a stack of baby carriers and books stacked there (waiting to go to another family by way of eBay or baby-wearer's Facebook page) and saw in that pile the baby book I had bought for William before he was born.  The wrapper removed, no entries made.  I have a million or more pictures of the boy but have yet to write in his baby book.  (All milestones are documented on the kitchen calendar from last year and this).  So we officially said good-bye to the baby stage.  This guy is a little boy, but for the diapers and bedtime miney (pronounced mine-e, what the twins called their pacifiers and the name stuck).  Our last baby, growing up so fast.  He does his darnedest to keep up with his three older brothers.  He does a pretty good job of it too.  Counting, reciting ABC's, learning bedtime prayers, singing songs, playing games and navigating tech (iPhones, iPads, etc.) like he was born with it in his hands.  It wasn't long ago I was tucking him into his little carrier at the park, feeding him from my own body, watching him learn to roll over, sit up, pull up, stand.  Again, the passage of time confuses me.  Looking back at pictures of this child as a baby leaves me in awe and wonder: was that a hundred years ago, or just yesterday?  
And as I contemplate these firsts and lasts, I consider the firsts and lasts I am experiencing with this body of mine.  Though my PET scan and breast MRI showed that I am clear of cancer at this time, my genetic risk factors are so high that a bilateral mastectomy will be done a week from Monday.  Preparing for the surgery has been an interesting process thus far.  Really I feel like I've been preparing for it since I found out I had cancer back in February.  I've been gathering my facts, talking to people, reading, etc.  But I've also been going through a phase that looks a lot like the nesting phase in pregnancy.  I'm making sure everything is just so because once the surgery is done it will be weeks, almost months, before I'll be back to full capabilities.  I'm trying to grasp what will be happening to my body in the course of this surgery next week.  It's quite an emotional thing.  At the very least because I've taken for granted the idea that when my soul leaves this body, this body will still have all it's original parts.  In 1991 when going in for surgery to remove the tumor in my left femur, not knowing whether or not I would come out of the procedure with a leg or not, I never considered actually losing the leg.  I assumed, or perhaps I was unable to think otherwise, that I would come out with my leg in tact.  And I did.  But now, with breast cancer and in this upcoming surgery, the doctors will remove, parts will not be spared.  In my mind I have made peace with the fact that this is for the best.  I sense it's the right move to make.  However, I'm also acutely aware that I am spending the last days with all my original body parts.  I am blessed beyond belief that there are surgeons (artists, really) who can remove what was diseased or holds potential threat and replace it with form and shape that once healed, will restore a sense of balance and normality to this body.  After September 14th I will never be the same again.  I'm not the same person I was yesterday for that matter.  Last days are being celebrated and mourned here,  but there is also an expectancy, a hope, of firsts yet to come.

Friday, August 28, 2015

Re-Gifted

Several years ago, while reflecting on my cancer journey from 1991-92, I wrote a song. When I write, sing, play my guitar, I truly feel God's presence.  I believe His Spirit fuels the flame of inspiration.  Inspiration is a gift!  James 1:17 says, "Every good and perfect gift is from above, coming down from the Father of heavenly lights, who does not change like the shifting shadows."
The beauty and wonder of His divine presence illuminates the holy and supernatural in what may otherwise seem mundane, "normal" or ordinary.  To me, nothing is ordinary.  It's our vision that imposes limits on the extraordinary.  
That song, written in the early 2000's, was sung at cancer walks, cancer survivor events, church functions and even for personal reflection.  When I was diagnosed with my second primary cancer in February of this year I turned to that song and could not. recall. a. single. word.  I had the tune in my mind, remembered the chords for guitar but could not pull the lyrics for anything.
I frantically rifled through all handwritten songs, notebooks, and journals looking for it. Nothing.  I searched all Word documents, folders and files to no avail.  That song was gone.
Apparently, I had trusted the song to be so engrained, so much a part of me that it did not need to be written down.  It was drawn from such a deep and important time in my life, how could I forget it?  I can't explain how upsetting the loss of those words was to me.  I was soul sick, and almost physically sick over it.
"Pray about it," my mom instructed when I relayed my frustration and sadness.  This being a standard response to questions posed and problems presented, I will admit I did not immediately heed the advice.  However, a few weeks later I did pray.  I prayed just a few weeks before losing/misplacing an important ring.
I prayed, "God, that song was a gift from You the first time.  I'm asking, please, return the gift to me in the perfect time, in the perfect way."  Then, I had to let it go.  And I did.
Weeks later when I thought I had lost the afore mentioned ring that a family member had given me and again felt that wrench in my stomach.  I prayed a similar prayer then, "God, if the ring is meant to be restored to me, please bring it about."  It was nearly a week later and the ring was found in a bag that had been unpacked from a recent overnight trip!
The finding of the ring reminded me of the song and I prayed again for it to be returned to me.  Then yesterday I received a call, THE call from my surgeons office to schedule my surgery.  I'd been humming the tune of my song all day in hopes of shaking loose the memory of it's words.
My surgeons have been waiting for me to decide on a date for surgery.  They had put me on their calendar with a question mark for September 14th.  This date is not ideal as one of my cousins is getting married in northern Michigan on Saturday the 19th.  If I have surgery that Monday I will require support and assistance with all ADL's (activities of daily living) for at least the first couple of weeks.  I'll be back and forth to doctor's appointments as well during that time and will need the extra help for the fellas.
While I am most thankful to have Pete, a supportive husband with vacation days and an understanding superior and Cindy, a soul sister with a flexible schedule and the willingness to help whenever it's needed, I am sad that I will be missing the wedding and a virtual mini family reunion.  It also puts my family in a pickle-feeling torn between being present for me or being present at the wedding. Just not an ideal time.
When in the conversation with the surgeons office it became apparent that the surgery would need to be on September 14th or else the unforeseeable future, I ripped the proverbial bandaid off and confirmed for the 14th.  Emotionally I just need the deed done. The wait is excruciating.  Having an actual date is nerve racking, nonetheless:  Monday, September 14th.
My boys and I had been playing at the park with friends when the call came.  I felt physically weak after making the decision to schedule the surgery and was thankful it was time to go soon after hanging up.  I continued to hum my tune as the boys raced back to the van and all piled in, buckled in and yelled their music requests.
I continued to hum, and as if by some miracle words flooded into my mind.  I had prayed for the gift to be restored at the perfect time.  Some, not all, of the song was returned to me that afternoon.  I sung the words of the bridge and the chorus as if they were never lost, they come forward as smoothly and confidently as ever:

                        And in my darkest hour You came, bringing strength to my weakness
                        In the midst of all my pain, You held me up within your hand where I sing

                                                            Faithful, You are faithful
                                                           Loving, You are so loving
                                               Precious, You are precious, Lord, to me

Sunday, August 23, 2015

Life and Death, Daily

I've been kicking around thoughts about life and death these days.  I say this knowing I run the risk of sounding irreverent or even flippant when the idea of death is introduced.  That's how it is in our society.  Death is a taboo topic.  I will admit I've been afraid to say the word a time or two or to allow myself to think too deeply on the matter because I didn't want to "jinx" myself.  After all, our thoughts effect our lives in very real and lasting ways.  But recently Pete brought a book home to me from the library, Being Mortal by Atul Gawande.  This book, as you might expect given the title, takes a look at how different cultures approach mortality and what impact our views about death have on our lives.  I made it about 3 chapters in before it was due back.  (I was chewing on it, not just breezing through AND I have 4 children and 2 jobs!) What I read floored me.  I had even read the introduction, something I will admit I usually skip.  Atul Gawande is a doctor.  As someone who has both worked in the medical field and been a patient of it, I have seen and experienced it's shortcomings.  Dr. Gawande has too and focuses on some of the dehumanizing practices in the industry.  He also shares his thoughts and experiences regarding the beauty that can be found in caring and being cared for, living and dying.  I think I need to own this book.
Dr. Gawande's words triggered more thoughts about dying for me.  Not the fear that I am going to die, or the idea that I need to prepare myself for a near and untimely death.  But, to try to acknowledge death more openly.  To approach aging, living, dying with a confidence, a strength and dignity.  Death is a very natural part of life.  Perhaps it's easy for me to say that as, after completing chemotherapy treatment, I have received an "all clear" from a PET scan and breast MRI exam.  Yes, good news!  And I thank God!  Yet, even now as I am planning surgery as part of my treatment and prevention, I'm reminded there are no guarantees in this life.  I am given the moment and hope to cherish it, not let it pass me by.
So I allowed myself to contemplate the reality of death being a natural part of life.  One of the interesting things to consider about living and dying is that we carry around death and life in our physical bodies every day.  Our bodies experience different types of cellular death moment by moment.  In the event of an injury the cellular death is of a traumatic nature called necrosis, a result of acute cellular injury.  Apoptosis is a highly regulated form of cellular death, a controlled process that is for the benefit of our life cycle.  Our bodies experience the birth of new cells as well, the rates vary.  (If our cells fail to die regularly as in apoptosis, but instead continue to produce, a tumor is formed.)  Life and death on a cellular level.
I also considered this daily experience of life and death on a spiritual level.  I recalled a verse I had been given by way of encouragement while I was going through my chemotherapy treatments and one I've used during past difficult times: 
2 Corinthians 4:8-9 "We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed."  
But it was the next verse that really caught my attention this time.  Verse 10:
"We always carry around in our body the death of Jesus, so that the life of Jesus may also be revealed in our body."
I am no theologian.  (That's my disclaimer).  But it stands to reason that even as Christ died, so also must we all die.  If God's own Son was not exempt from this experience on earth, how then would I imagine to ever be?  Any followed prophet or holy person in our history on this earth has been made subject to it.  For the Apostle Paul writing this passage, it was because of the death and resurrection of Christ that he was intent on dying to himself, putting aside his personal desires and expectations so that the life and message of Christ was what was seen in him.  Dying to self and surrendering whatever would be to the strength and will of the God he served.  
I believe this is the message for me in the midst of all these thoughts of living and dying: choose to live life well, to the fullest, while dying to my own expectations of how long life should be and everything I would want life to be.  This allows me to move graciously forward into an uncharted future; holding all that I have and am with open hands; making precious each and every moment.
Of course I have wishes and a will of my own.  I have expectations and desires for this life. But as I integrate those times and places of frustration and pain, I will grow.  I will find beauty in the pain and pleasure, the living and dying.

Monday, August 17, 2015

The Number of My Days


I've been feeling so exhausted lately.  I'm almost certain it is from sheer mental and emotional overload.  The recent days have been filled with doctors appointments, trying to arrange and rearrange schedules for more appointments and an upcoming surgery all the while planning to send my oldest baby off to kindergarten.  The last two events are ones I am not in the least prepared for.  How could I be?
I read something about how surprised by time we (and "we" being everyone) tend to be.  We remark about how fast summer has gone, how quickly babies and children grow and how holidays seem to run together anymore. But what is more natural than the passing of time?  Yet I am one of the first to make any one of the mentioned remarks and to truly be amazed by it.  When I consider these things I become almost frantic and sad.  I can never have tomorrow back.  Bobby will never be a "preschooler" again.  The phases my children have passed through are gone forever now.  That makes me sad.  Forgive me for being graphic, but when I consider the permanence of cutting off a body part or two as part of cancer treatment/prevention, it makes me sad.  I have actually envisioned waking up from surgery crying, realizing that what was done can never be undone.
So perhaps part of this exhaustion I'm feeling is a byproduct of the grieving process. Grief is a natural and arduous journey through various emotions all in relation to the loss of something or someone.  (My definition).  Our society tends to take what is known as ambiguous loss, for granted; those losses that are not directly apparent.  For instance, it's obvious one would grieve the death of a loved one or pet, but not always "obvious" to grieve an unfulfilled dream or the sale of a childhood home.  In my case, I'm grieving a number of things: the loss of health for starters, but also the disruption of my family life, and what will be lost after a bilateral mastectomy, to name a few. 
To balance out the sadness (not dismiss it or minimize it), I have made it a point to look at the flip side of the coin.  This deep sadness has led me to deeper relationships, grief has taught me greater empathy, frustration has led me to seek peace in solitude, and disruption has stirred up creativity.  I bless God for the fact that my family is healthy.  I am so thankful for an abounding support system. There is beauty in the midst of pain and emotional exhaustion.
When I become anxious about the fleeting passage of time I have realized that it is wise for me to learn to be more mindful and present of and in each moment.  As I have been reflecting on these lessons I find these words coming to mind "teach me to number my days".  To me this is a measured approach to mortality, a reminder that every moment is rich.  Instead of whipping myself into a frenzy so as not to "waste a day", I am savoring each moment.  I am not rushing in to tomorrow.  I am not bemoaning the passage of another day.  I simply am.  I know that I will not be forever.  But right now, I am.   
Psalm 39:4-7 (New Living Translation)

4 “Lord, remind me how brief my time on earth will be.
      Remind me that my days are numbered—
      how fleeting my life is.
5 You have made my life no longer than the width of my hand.
     My entire lifetime is just a moment to you;
     at best, each of us is but a breath.”
6 We are merely moving shadows,
     and all our busy rushing ends in nothing.
     We heap up wealth,
     not knowing who will spend it.
7 And so, Lord, where do I put my hope?
     My only hope is in You.


So, after another day of mental and emotional exhaustion I've decided to rest here.  Understanding and being content with the fact that my life is but a breath.  I don't need to rush around, gaining nothing.  I put my hope in God and find peace in the moment. 

Wednesday, August 12, 2015

Bridle This Blessing

I'm preparing for a colonoscopy tomorrow.  There are worse things.  But I cannot say how many times I have had to remind myself that I cannot eat today.  (Liquid diet until midnight then NPO).  It's amazing how often throughout the day I have gone to put something in my mouth reflexively.  As I was making breakfast and lunch for my boys, while I was cleaning the kitchen, and now as I sit at the kitchen table to write and there is a bowl of fresh-out-of-the-garden peas nearby the urge to eat has been a tough one to overcome.
The good news is that after 4 months of struggling to get food into my mouth past chemo-riddled taste buds, I am now able to eat.  Slowly over the past few weeks my taste buds have been healing.  Food went from being abhorrent, to just not-awful, to most things are alright, and now everything tastes good and I am out. of. control.  
The last few days I have found myself eating anything and everything that crosses my path. It's a luxury and a pleasure that I have been missing and I am not holding back now.  This is not a good for a number of reasons.  First, sugar feeds cancer.  Since I am in the business currently of working to rid my body of cancer this sugar consumption is counterproductive to my health and wellbeing.  Second, I am diabetic and know well enough to limit my sugar and simple carbohydrate intake.  Finally, I am rapidly gaining back some of the inches I had lost during chemotherapy.  While I could afford to gain back some, it is the bloat from eating foods that are toxic that is the issue.  I cannot afford to neglect the health of my body in such a way.
As I contemplate the blessing of being able to taste food for real and to eat without choking, I realize I must work to bridle this blessing.  Bridle: to control or hold back; restrain; curb.  If I do not exercise self-control, discipline and restraint here it will be detrimental.  In order to do so I must plan.  Before my diagnosis I had worked very hard to become structured in my eating and meal planning.  I didn't hit the mark 100% of the time but I did a very decent job of it.  Now it feels like a free-for-all and I want to allow it.  It's time for a visit to my nutritionist.
I am thankful for taste buds that have been restored.  I am blessed with returning strength. I am also very grateful for the lessons I have learned this go-around with a cancer diagnosis. I have learned so much about nutrition, my body and how to care for it, healing and wellness.  Because of this knowledge I will make wise and healthy choices.  I will bridle this blessing.