• Baljit Khamba, ND, M.PH

The bald eagle


I've now been within this cancer journey for what feels like both an eternity and a second, but in actuality 34 days since diagnosis. Since the day I yelled out "What the F*ck?!?!" in my surgical oncologists clinic room, I've been thrown into a world of fertility, mastectomy, chemotherapy, radiation, genetics, nutrition, lifestyle and spirituality. What hasn't been thrown at me really? My foundation was rocked. Thankfully I have a vast network of family and friends who have been there to catch me. Each one of them carry a piece of me and with that remind me of who I am and what I'm capable of.

Additionally, during moments when I was feeling my most frail and vulnerable, I looked to my husband, James, and could see that his bright blue eyes seem to reflect some hidden reservoir of tenacity and willpower he convinced resided within me. During such times I had to peer within the recesses of myself to gather some deep ancestrally motivated volition and venture to uphold the Strength and Victory that resides within the very meaning of my name.

One of the first decisions James and I had to make was around family planning. We were wanting to start a family, and now that would have to be put on hold until I had fully recovered. However, as the cancer treatments and my age will likely leave me unable to have children, it was preferred that we see a fertility doctor who specializes in cancer patients to go through our options. We had to make our decision quickly and stand by them, as there was no time for hesitation. We had decided that I would undergo in vitro fertilization, or IVF, which involved hormone treatments to basically make my ovaries mature many follicles at once, as opposed to the typical 1 each cycle. I had come to the appointment at a late stage in my cycle so the added hormones need to change my entire cycle around to produce these follicles. We only had this one opportunity of 14-17 days to go through what some couples spend many months to years on. Once the follicles have grown to a sufficient size and matured, the doctor would surgically go inside each follicle to retrieve an egg, then immediately mix them with James' sperm and then hope 5-6 days later we get some healthy blastocysts or the beginning cells of our one day children. Not exactly how I pictured us conceiving, but we found our ways of making light of the entire situation. Under the breath quips about providing project 'deliverables' and endless references to being a hen helped us to cope.

Fortunately, I had a successful egg retrieval. We were able to save 5-6 day old embryos instead of eggs alone, as they would withhold the freezing process better. As such, we were able to thankfully freeze 2 healthy Irish-Indian embryos who will be ready for us when time comes. As my husband, James, likes to boast "We've put the kids in the freezer!" Bless him, I never tire of that Northern Ireland lyrical humour.

During the 17 day period of our onco-fertility path mixed with the barrage of various oncology appointments, I applied the same steadfast rigour and sheer determination that I had previously allocated to my academic studies, clinical practice, research and teaching. I created binders, tabs, cover sheets, plans, charts, and resources. It seemed the only way I could mentally fathom the chaos around me was to do what was familiar to me, so I organized. During my many academic years, before I could start studying for anything, I required that my space around me was catalogued and clean. My desk space had to be spotless, all my notes had to be methodical, I created lists around what I was going to study. My type 'A' personality did not let me down during those moments. Fortunately, it was something I thoroughly enjoyed doing. It worked for me, and aided me in remaining calm and focused during the daily travels from Brampton to the downtown Toronto fertility clinic for 7am during cycle monitoring.

Two days after I had the egg retrieval procedure done, I was to begin chemotherapy. My chemo-squad consisted of my brother, Sunny as well as James. Off we went to Credit Valley Hospital's Carlo Fidani Regional Cancer Centre, armed with a homemade nutrient dense, blended "green juice", fruit, snacks, water, and close behind was a fully equipped bundle of nerves. Fortunately, I had a lovely nurse who had a long history of working at Sick Kids Hospital and it was apparent in her nature. She spoke to me in that same nurturing and soothing voice that I could imagine her having used used on all her apprehensive paediatric oncology patients. Quite honestly, I was truly thankful for it. I felt like this was a moment where I wanted to be treated with the same gentleness, softness and kindness as a child.

Overall, the chemotherapy went well, I didn't experience too many adverse effects from it. I took the medications as directed, ate healthy and well, as directed by my nutritionist and naturopath. My appetite was lower during the first 7 days post chemotherapy and then picked up to normal by the time I was one week post-chemotherapy. I noticed that the steroid medication was its own beast. Each time I took it I felt a huge surge of energy, as if I had 7 shots of espresso all at once. It did disrupt my sleep mildly for one night and then much more so the next. That last day I took the steroid medication, I ended up remaining awake all night. I felt like I had enough energy to run 2 full marathons, while solving complex math problems, and coordinate my entire wardrobe all at the same time. So I ended up prepping 8 hours worth of lecture material complete with assignments for the research methods class I was to teach that weekend. I felt really productive and happy that all my work was complete. I didn't fight trying to sleep, instead I went along with what my body was doing at the time. Further during that first week post chemotherapy, I was able to go on a couple slower runs and yoga. Whenever I could be active, I tried to be. When I needed to rest and sleep, I did just that.

As I reached 7 days post-chemotherapy another symptom that started to come up was the mouth dryness. It seemed that there was never enough water that I could drink to soothe the feeling of constantly being parched. It would be accompanied by soreness in my gums, as if I had both just got braces put on my teeth and flossed too hard. It made chewing foods and having any strong flavours difficult. The medicated mouth wash, various manuka honey pastilles, and some herbal teas made it all bearable. It all lasted about 3 days before returning back to normal.

One thing that I had underestimated the importance of was the sheer amount of water I needed to drink to flush out the chemotherapy treatment. I definitely required a few litres of water per day, if I had anything less than that, I would feel some burning on urination. So, to avoid such unpleasantness I really stayed well hydrated.

I was also required to give myself an injection a couple days after chemotherapy to increase my body's production of white blood cells, which are used to help fight infection, and are lowered as a result of chemotherapy. I was warned that there would be bone pain felt from it, and they were not kidding. Definitely had some soreness and pain for about 2 days. It felt like I had done a really hard workout and my joints were all sore from it. The soreness was mostly bearable, one night I did need to take an extra strength Tylenol to keep comfortable.

Also, to further help with the chemotherapy detoxing and healing I saw my massage therapist and a dear friend of mine had been doing some Bowen therapy on me to help with myofascial release. I find that self-care and aspect of physical human touch to be so important when I'm feeling a loss of control of my body. It felt like a reassuring hug urging me towards healing.

Lastly, my medical oncologist had told me to expect some hair loss approximately 10 days post-chemotherapy. She warned me that hair loss was a guarantee of treatment and that I ought to make my preparations for that. I had seen other women shave their heads in preparation for chemotherapy, but I couldn't get myself to go bald right away. After spending some time thinking on it, I decided I would cut my hair short, in a style that I feel would make it somewhat easier for me to transition to being bald. I chose a short stylish haircut that was left my hair chin length and longer in the front and short and layered in the back. I went to my aunt's salon to get it done and I sincerely loved the cut. I look forward to my hair growing back one day to continue this style again. Pity it took cancer for me to take a risk on my hair, but I'm glad that I did. Getting my hair cut felt like my way of providing some control in a situation that I couldn't change.

It wasn't the baldness that I had feared, it was the hair loss and transition to loosing my hair that I didn't want to see. I looked on YouTube and Pinterest and saved many different scarf wearing styles and caps. In addition the mother of a friend of mine had been through 2 different cancer diagnoses and had a beautiful wig made for it. She passed it down to me and I was truly honoured to have received it. I remember her going through both cancer treatments and had spent a good amount of time speaking to her about her experiences. It was good to know that I had support from a mother-like figure who could relate her journey with me. She warned me about the mucositis from the mouth symptoms and I was glad to have heeded her advice for when it began with me.

I saw the medical oncologist 10 days post chemotherapy to see if I was ready for my next round of chemotherapy. Fortunately, the injection worked and my white blood cells were back to normal, which gave me the green light to start the next round of chemotherapy. Then she took a look at the thick full head of coarse Indian hair atop of my head, and said that maybe my hair would start to fall out soon, but not sure when. While logically I knew my hair would go, I still was not mentally ready to deal with the process and still worried over it.

2 days later I was in the shower and as I washed my downstairs lady space, I had some hair come away. Now, I've kept a regular schedule of Brazilian waxing for about 15 years, so I didn't really have too much hair there anymore. Since I had the cancer diagnosis I thought I would forgo my regular waxing schedule until I was better. As the hair came away I burst out laughing. Of all the places for the hair to depart! Of course my body would do something like this. I felt like since humour has played a large part of my coping, my body created an opportunity for me to deal with my upcoming hair loss by giving me something to laugh about. Someone had to hear about this, so immediately after showering and getting ready, I found my mother in the kitchen and approached her in the most serious face I could muster "Mom, the hair loss has started", she looked back at me with the same severe and concerned face. Before she could say anything, I simultaneously made hand gestures towards my groin and said ".....but it's not where you think". She roared laughing, in fact she laughed so hard so had to grab onto the counter to hold herself up. She chuckled and jested about not needing a wax anytime soon. So here I am, a bald eagle but not where I thought. So be it! Tomorrow begins chemotherapy session #2. Let's see what happens next.

#breastcancer #cancer #hairloss #oncofertility #fertility #MentalHealth #invasivecarcinomainsitu #oncology #eggretrieval #sideeffects #haircut

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