A cancer diagnosis

It was December 15, 1998 and I trotted down 8th Avenue in New York City and into the doctor’s office to get the lump in my left breast checked out. The lump had grown slightly over the past few months and it was a little sore. I had first felt the lump in college, and had it examined by several doctors. They looked at it, felt it, did a mammogram, and told me, “You’re too young for breast cancer, don’t even worry.” The mammogram was always “inconclusive” as it is with most young women. “It’s probably just a cyst. Young women always have lumpy breasts,” they would always say. The doctors were never worried and neither was I. Mostly I was going to the appointment to appease my mom who constantly nagged me to get it checked.

I had a new doctor today, Dr. A. whom I immediately liked. She was funny, quirky and seemed extremely intelligent. Her fingernails were each painted a different color and she joked around with me. “You need a new bra,” she said as she looked to the ground where I had thrown my clothes.” I thought it would sound too defensive to tell her I had no clean clothes that morning, so I just laughed. She looked at the lump, felt it and sent me in to get a mammogram. The mammogram technician decided I would need an ultrasound as well. “No problem,” I said, “but it’s my first week at my new job so it has to be quick.”

In the ultrasound room, they covered my left breast in a slimy, clear goo and rubbed a stick over it while they looked in the screen of the ultrasound machine. As she slid the stick over the lump a strange expression appeared on her face. “It’s a cyst, right?” I asked. I was used to diagnosing myself. “Hmmm. I don’t think it’s a cyst. We’re going to need to do a biopsy.” Still unphased, I hopped off the table with my blue gown still on, retied the straps and went into the next room where Dr. A. would perform the biopsy. She said it would just hurt a little as she stuck a long needle into the lump. “Ouch!” I yelped. It killed. She sent the needle down the hall to the pathologist. Ten minutes went by, then twenty. Impatiently, I walked out to see what was going on and accidentally bumped into Dr. A's assistant, Chrissy, as I rounded the corner. “Do you need help?” she asked. “Yeah. I’ve been waiting over twenty minutes for them to come back. I think they might have forgotten about me. I really have to get back to work.” Chrissy said she'd check on but in the meantime to have a seat in my room.

Another fifteen minutes went by and the door to my room finally opened with what seemed like a swarm of doctors piling in. I had already gotten dressed, just waiting for the results to come back, so I could jump in cab to work. Dr. A. didn't look as cheerful as she had a half hour before. For some reason it still didn't register that anything could be wrong. “So, I’m all set?” I asked. She responded in a way that I had never expected. “Asha, you have breast cancer.” Time froze as those words rang through my head over and over. Is this a nightmare? Did I misunderstand what she said? She must have the wrong person. Then time unfroze. I studied her to see if I had heard her correctly. She stood there with a solemn look. I looked at the other doctors in the room. They all had the same expression, almost waiting for my reaction. My purse fell from my hand, as I crumpled into the chair in back of me. “Wait, are you sure you have the right person?" In my mind I was thinking that breast cancer only affected older women with large breasts. “Yes, Asha. We’re sure. You have breast cancer.” Did they really need to repeat those words? They sounded so horrible. Covering my head with my hands, I sobbed for the next five minutes. I was in shock. The doctors were more in shock. They told me later they had never heard of someone so young having the disease. After exhausting all my tears, I looked up, my face drenched with lines of mascara. I realized there was nothing I could do, so I quickly pulled myself together and I went into survival mode. “OK, what do we do next?”

Suddenly nothing in my life made sense. I had always been healthy and at 24 years old, I felt invincible, like my whole life was ahead of me. Now the only question that kept running through my head was, “will I die?” After all, I’d let this lump grow for the past two years. It must have spread all over. How much time did I have left? How would I tell people? How would I tell mom? Was this really happening? This wasn’t how I pictured my life. “Am I dying?” I said, choking on my sobs.“ We can’t give you an answer until we do surgery to see if and how much the cancer has spread.” This wasn’t what I wanted to hear. I wanted them to tell me not to worry and assure me that I would still be around in a year, five years, ten years and even sixty years. They couldn’t.

In one instant and with four words, my life completely changed – I walked into the doctors office in the morning, a 24 year old girl with long-term plans to climb the corporate ladder, own my own company, have tons of money, marry, raise four kids and eventually grandkids. Now I didn’t even know if I’d be alive to see my 25th birthday.

How do I tell my friends and family I have breast cancer?

As soon as my doctor told me I had cancer, all I knew is that I wanted it out of my body as soon as possible. “We can schedule your surgery for next month. That’s the only availability we have,” Dr. A. told me.“A month? I need to get this out of my body immediately. Can you take me today?”I couldn’t believe I was begging someone to cut me open and remove part of my body.

Dr. A. made several calls, came back minutes later saying she could fit me in the next day. I was beyond grateful.I knew I needed to call my mom because she was the one who was originally so concerned about the lump. But I also knew the news would kill her; after all I was her only daughter. I didn’t think I could handle hearing her upset. Instead, I called Z, my 22 year old brother, who was by far the most calm, levelheaded person in my family. I had no doubt he could take the news without adding more drama to the situation. I would give him the job of breaking it to mom.

Out in the hospital hallway, I hesitantly put a quarter in the pay phone. My stomach was in knots and I felt queasy, but I slowly dialed the numbers trying to see past the water welling up in my eyes.“Hello?” my brother answered.I paused, not knowing what or how to tell him. I tried to stay strong, but my voice quivered.“Z…I have breast cancer. Can you call mom and tell her?” I lost control and began sobbing, quickly hanging up the phone before I could hear his response. I knew he would be scared and I didn’t want to frighten him more by crying. I rarely cried and if I did, my tears quickly turned into laughter. This time was different.

I walked back into Chrissy’s office who would now help me arrange my appointments. Chrissy was young, cute and bubbly. She was the kind of person I would have been friends with if I had met her outside of the hospital. She offered to phone mom for me and explain the situation. As she dialed, I sat motionless in the chair, still not wanting to believe this was actually happening. Mom answered not even halfway through the first ring. I could hear how frantic she was through the receiver.Chrissy spoke calmly. “I’m sure you’ve heard the news by now. Asha will be going in for surgery tomorrow morning.” “Is she going to be ok?” I heard my mom scream into the phone.“That all depends on how the surgery goes tomorrow and what they find.”I knew that’s not what my mom wanted to hear. Looking at me, Chrissy asked if I wanted to speak to her. The lump in the back of my throat made it impossible to talk so I shook my head ‘no.’ She hung up the phone and I kept my eyes on my knees, somehow thinking that as long as I didn’t look at her, it wasn’t really happening.

“Your mom and dad are flying into New York this evening from Boston so they can be at surgery with you tomorrow,” she told me.I immediately felt guilty. How could I do this to my parents? This would totally disrupt their schedules forcing them to take time off work. I knew they would be more upset than I was. Please let this be a really bad dream, I begged." I have to go back to work because I’m really late now,” I tried to tell Chrissy, still in shock. Instead it just came out as little whimpers. She asked if I wanted her to call my boss and tell her I wasn't coming in, but I told her that I had a lot to do and couldn't afford to miss any work. I didn’t want her to worry about me. For some odd reason, I was trying to protect everyone else in my life, even the office assistant who I barely knew. Was this so I could focus on something other than myself? I still don’t know the answer.

Wally, the hospital receptionist who had greeted me with a huge smile upon entering the hospital this morning, looked at me with grave eyes. He must have seen these same tears many times before. After all, it was the St. Vincent’s Comprehensive Cancer Center. He asked if I wanted to some kleenex but I shook my head holding up my hand already filled with tissue that Chrissy had given me. I hoped that I could fool people at my new job into thinking nothing was wrong. In fact I was so concerned what they would think that I reapplied my makeup before leaving the hospital. I smiled a couple fake smiles in the mirror to see if I could make it look genuine for the outside world. It was passable.

A week before, I had been thrilled to land this new job as a Public relations Coordinator for a Dot.com start-up. Everyone except the CEO was under the age of 35, and my boss, Laurie, was only four years older than I. She was thin, stylish and wore funky black glasses flattering her angular face. I was slightly intimidated by her but was taken by her brilliance and confidence and knew I could learn from her. I hoped to work my way up the PR ladder to be like her in four years.

Upon arriving at work after my cancer diagnosis, I hesitantly walked into my Laurie’s office. “So, how’d everything go?” she asked optimistically. I took a deep breath hoping I could stay in control. As soon as I opened my mouth, I lost my composure again as tears ran down my face. We had just had a conversation the previous day how the lump was nothing to worry about. My seemingly perfect world was crashing down and all of a sudden I had no control of my life. She led me to the bathroom and let me sob on her shoulders. I apologized profusely. I felt terrible that I had just been hired a week before and already I would have to take time off. I told her I would try and come in to work after surgery the next day. “Don’t worry about the job right now. You need to take care of yourself,” she said.

I went back to my desk and tried to get some work done before my parents arrived. I couldn’t concentrate. Pulling out my phone list, I began scrolling through my list of friends. I wanted my closest friends to hear it from me directly. First I called Liz, one of my best friends from high school who was living in Boston. We talked for a minute and I tried to pretend nothing was wrong. Then I started crying. “What’s wrong?” she asked concerned. I stuttered not able to get any words out. She got worried.“Ashie, what’s going on?”“I have breast cancer,” I was finally able to blurt out.There was silence.“What do you mean?” she asked, not comprehending what I said.“I have breast cancer. I just went to the doctors and I have breast cancer. They are doing surgery tomorrow morning.”Without hesitation, she said, “I’m coming right now. I’ll call you when I get to New York,” and hung up the phone before I could respond.

Thankfully I had my own office so I was able to sit at my desk staring blankly at the computer screen without any interruptions. Could I ever trust my body again, I wondered? I had always been healthy, was in good shape, had never been in the hospital for anything, let alone surgery, and had never before had any health issues besides the common cold and flu. How did I do this to myself? What did I do wrong to cause this to myself? How could I prevent it from happening again? I felt betrayed by my own body.

Laurie came into my office around 5 p.m. and told me I should head home because it was getting late. The concern in her voice made me cringe. The thought of having someone feel bad or pity me made me feel helpless. Right now, that was the worst feeling I could think of. I hadn’t moved from my desk since noon and certainly hadn’t done any work, but the real reason I didn’t go home was my roommates didn’t get home until after 7 p.m. and I didn’t want to go back to an empty apartment.It was beginning to rain, but instead of taking the subway home, I decided to walk over 60 blocks from 28th street back to my apartment on 90th so I could pull myself together before my parents arrived. As I walked home in the rain and the people rushed past me, I saw everything in a new light. My thoughts were racing but the world around me seemed to move in slow motion. I longingly remembered how different my life was less than a week ago. My whole life had been completely turned around in one day.I wanted to tell the couple on the street to stop fighting about being late to their dinner reservation and appreciate the time they had together; I wanted to tell the cabs to stop honking and enjoy their ride; I wanted to tell the girls on the street to stop complaining about their hair frizzing from the rain and be thankful that they had hair. I noticed things I had never noticed before, like the way people walk down the street in a hurry without looking up. Just yesterday, I was one of those people.

Today, the rain looked so calm and beautiful as it hit the ground. For the first time, I appreciated how short, how fragile and how pretty the simple things in life could be.When I finally reached my apartment, I decided to make one more call to Ben, who was one of my closest guy friends. I hadn’t spoken to him in over a month but desperately needed some male attention from someone who liked and cared about me. At first I didn’t want to tell him. To tell a guy I had breast cancer felt embarrassing. It certainly wasn’t very sexy. How would he respond? How would I want him to respond?I nervously dialed his number not knowing how I would tell him. He answered and was very happy to hear from me. I paused not knowing if I should just come out with the news or try to catch up first. I attempted the former, but he noticed my voice shaking.“…is everything ok?”“Umm. Well, I guess…not really. I, umm, just found out…umm.” I started choking up as I forced back tears.“Asha. Talk to me. You’re getting me worried.”“I…ugh. It’s too embarrassing. I don’t want to tell you. You’re going to freak out and it’s kind of weird.”“You know me. I’m not going freak out. Please, just tell me what’s going on.”“I…have…ummm. I have…breast cancer.” The phone went silent. I pulled myself together for his sake and continued.“ I have surgery tomorrow and may have to go through chemotherapy,” I said.“I’ll be right over.”

Within twenty minutes he showed up at my apartment with a little teddy bear and some chocolates. We didn’t say much, but I didn’t need to. He just understood me and held me until my parents arrived shortly after.When the buzzer rang, I hesitated before letting my parents in. I knew it would be difficult keeping myself together when I saw their devastated faces. As I opened the door, I kept my eyes toward the floor to avoid eye contact. Before I could say hello, they enveloped me in a huge sandwich hug that lasted what seemed like forever. They didn’t want to let go. To break the high tension of the unfortunate reunion, I pulled away and introduced them to Ben before he left.My parents and I walked silently to the local restaurant down the street to get something quickly because I couldn’t eat after 8:00 p.m. due to surgery the next morning.

By this time, I had rationalized all the different possibilities and outcomes and how I would handle each.“So, here’s what I’ve figured out,” I told my parents almost in a joking tone as our food arrived. “Worst case scenario, I die. I’ve never wanted to live an “average” life. If I died at 24 years old of breast cancer, that certainly wouldn’t be normal. Then I will have accomplished one of my goals.”They didn’t look pleased and my dad interrupted, irritated with what I was saying.“Asha! You’re getting…” “Dad, I’m not done,” I said calmly. There are three other scenarios. Please just listen to my thought process.”He leaned back in his seat, almost angry with my honesty. We had never discussed death before and I had never realized what an uncomfortable subject it was.“Second worst, I need chemotherapy and lose my hair. I’ve always wondered what I would look like bald. Plus I’d have a chance to experiment with wigs and change my style a bit,” I said, trying to lighten the mood.They didn’t look amused. The next worst would be a little strange to say in front of my dad because I had never discussed anything remotely sexual with him including breasts. However, it was breast cancer we were dealing with here so the word ‘breast’ would have to come up at some point soon. It might as well be now.“Third worst, I have a mastectomy – either one or both of my breasts are removed. Maybe they could remove some fatty tissue from my rear end and enlarge my breasts.”My mom finally jumped in.“That’s the third worst? That seems much worse than losing your hair,” she said freaking out.“Mom, I’ve always wanted to upgrade from my normal 34A and my health insurance would cover it,” I said trying to look on the bright side. “But, best case scenario is that the cancer hasn’t spread, and hopefully I can live a normal life after treatment. “I just hope I can still have kids.” I had rationalized this all before they came, but it was the first time saying it out loud.

My parents just listened as I talked. I felt like I was reciting a monologue in a really bad movie.Dinner was uncomfortable to say the least. No one knew what to say and I tried to break the silence by making jokes. They sat motionless just staring at their uneaten pizza. I attempted to eat as much of my pasta as I could because I knew I wouldn’t be eating all day tomorrow but my stomach was upset. If they looked into my eyes, they would see how petrified I really was so I avoided all eye contact with them. I did glance up quickly a couple times to see how they were doing. They looked like they had aged ten years overnight.

After dinner we hugged goodbye and they headed to their hotel while I returned to my apartment. There I saw my roommates and I broke the news to them. They looked at me in stunned silence with mouths open trying to comprehend what I had said. Suddenly, they both grabbed and hugged me. I had been strong for the last couple hours and now I lost it again. I drenched their shoulders in tears. “I am so scared, guys. I have no idea what’s going to happen to me. I might be dying. I’ve never been this scared in my entire life.” They just held me and let me cry. The night before we had all been complaining about the line to get a drink at the bar. Now that didn’t seem so important.

Going in for surgery

The night before surgery, I crawled into bed, curled up in my blankets and tried to sleep. I couldn’t. All I could think about was the next day. I began to realize that the Unknown is a very scary concept. I didn’t know what was in store for me tomorrow, what they would find out and how much longer I would be alive. How did I how do this to myself? The doctors seemed to think I might be genetically predisposed to get it, but that couldn’t be the only reason. Could it be all the Tasti-D-Lites frozen yogurts I had been eating? Did my deodorant cause this? Did I bang my breast on something? Or maybe it was all the alcohol I had consumed in the last few years. My body was obviously trying to tell me something. What was it? I racked my brain for an answer.One thing I knew for sure is that I needed to learn to deal with my stress a lot better. I was also realizing that with all my type-A goal planning, I never enjoyed the process of doing anything – it was all about results. I had no control of this situation and it was extremely uncomfortable. But I knew that if I didn’t learn how to relax, this cancer was going to kill me one way or another.

After a fitful couple of hours of sleep, I got up to prepare for my 7:30 a.m. appointment at St. Vincent’s. I washed and blew dry my hair, put on my best pair of jeans, a cute black fitted top with sheer sleeves and my long winter coat with my favorite high heels. I’m still not sure why I got dressed up for my surgery especially when I knew I’d be in a hospital gown for the rest of the day. Perhaps I was in denial, not wanting to admit I was sick. After all, I didn’t feel sick. Perhaps it was an attempt to hold onto the last bit of vanity I would have for a very long time.

When I arrived at the hospital with my parents, the receptionist said hello to my mom and asked if she was ready for the procedure. She looked confused. It was the first out of many times that the doctors assumed my mom was the patient rather than I. They had never seen anyone my age come in for breast cancer treatment. In a strange way, I felt special, like I had been chosen for some reason. But mostly, it freaked me out, especially since the doctors continued to tell me that breast cancer in young women is very aggressive and fast growing.

Each doctor or nurse I had met so far had performed some kind of exam on me. I think I had been felt up more in two days than I had in my entire life. They all asked the exact same questions: what happened, how old I was, how I found the lump etc. I spoke on automatic because I had repeated this story so many times in the last day. I wished I had had a tape recorder so I could just play them the answers to their questions.

Thankfully the final doctor who would take care of me for the next few hours was a tall good-looking guy with a great smile. I didn’t mind answering his questions. He led me to the room where he would inject me with a blue dye which would show up later in surgery and let them know if the cancer had spread to my lymph nodes.I lay under the X-ray machine for the next couple hours waiting for my body to absorb the dye, my entire future flashing in front of me. I didn’t like being alone in this room because it felt so cold and lonely. I had no doubt in my mind that because I had ignored the lump for over a year, it had spread. I knew I had to start preparing myself for death. How do I do this? I’d never had a course on dying and no one prepares you for a test like this.

I stared solemnly at the metal machine surrounding my body wondering where to start. Maybe it was listening to me. It seemed appropriate to spill my entire life to an X-ray machine; after all it could see everything inside me anyway.“First I have to figure out how to say good bye to everyone in my life,” I said out loud. I went through a mental list of all my family members and friends. I wanted to say something meaningful to each of them, what I liked about them, how they had made my life special and what I hoped they would do with their own lives after I passed away. There were so many people, I had to start cutting down what I would say to get through them all. When I finished with everyone, my mind started wandering again. Now that I might be dying, I was realizing all the things I never did in my life that I always wanted to do. I never took my junior year abroad. I didn’t travel like I had always wanted. I never played the Star Spangled Banner at Fenway Park. I'd never run a marathon. I'd never fallen in love…All of a sudden, life seemed so simple. By now I was confiding in the metal machine. Judging by the corridor when I walked in, this machine must have heard a lot of stories. I started talking to it again.“If I can just have a second chance, I promise I will do all the things I’ve always wanted to do.” I started making grandiose plans for myself. “I will travel the world, I’ll pursue a career I’m passionate about and I’ll let myself fall in love.”

As the dye absorbed into my body, childhood memories came flooding back. At this point, I was positive the machine was sick of hearing my stories but for once in my life I didn’t care what it thought of me. A single tear fell down the side of my cheek and onto the hard plank behind me. The machine remained silent. More tears slowly came to my eyes as I imagined my funeral. I was supposed to remain motionless on the table, but I reached up to touch the cold, solid machine. Was it listening? Was I still alive? The metal contraption was freezing and I knew again this was definitely real, so I continued. I wanted my funeral to be a really happy event, for people to celebrate my life. It would suck for people to be depressed. I think it would be cool to have the party on a beautiful hilltop with an amazing view. I was attempting to rationalize everything in my head to make myself feel better. Music would be playing, people would be dancing and laughing and telling stories about our friendships. I wondered what they would be saying about me. What would I want them to say about me?“Asha was so full of life and enjoyed every one of her days to the fullest,” they would all agree. Yes, that’s how I would want to be remembered. If I got a second chance, I would learn to live my days to the fullest, enjoying the people, the scenery, and everything else around me, rather than stressing about the inconsequential things of everyday life. I have never been religious. But lying under this machine, I prayed for the first time in my life. I wasn’t sure who I was praying to, but my only wish was that I would get a second chance at life. And I promised that if I did, I would do things differently. I would take more risks and do things I was passionate about. Making money wouldn’t be my priority but rather enjoying each day to its fullest, no matter how many days I had left.

Three hours later, Liz met me, my parents and my brother in the waiting room for surgery. My dye job was completed and now I would have surgery to remove the lump. Dr. A., who was both my doctor and surgeon, came out to meet my family in the waiting room. She introduced us to another woman in scrubs, Miss X. "Miss X will help prepare you for surgery and then I’ll see you in the operating room in a little bit. I know we didn’t talk about this before, but I want to let you know that you will have to do chemotherapy after you’ve recovered from surgery.”“But I thought that was only if it spread?” I asked, hoping she would change her mind. My second biggest fear was coming true – I would go bald.“No matter if it has spread or not, it is an aggressive cancer and you will most likely need chemotherapy and radiation. And just so you are aware, most women who undergo chemotherapy go into premature menopause.”My stomach sank and I began shaking uncontrollably.“Can I freeze my eggs before I go into treatment?” I asked hopefully, holding back tears.“No,” she informed me. “To extract eggs, they would need to inject you with hormones. Unfortunately, they can’t do this because your cancer is estrogen receptor positive, meaning it feeds off hormones. Listen, let’s do one thing at a time. Let’s finish the surgery, find out what’s happening with that, then we’ll have a talk about chemotherapy and menopause.”I grabbed Liz by the hand and pulled her out into the hall with me as tears streamed down my face. I didn’t want to cry in front of my parents – that would only upset them more.

“Liz, can you come with me to ask Chrissy a question?” I asked, still shaking. “I just need to get out of that room for a second.” I knocked on Chrissy’s open door and walked in. She was young and cool and I felt like I could ask her anything. “I’m wondering if I can still go out tonight after my surgery is over. There’s this really cute guy, Trent, that I just started working with and I kind of wanted to see him tonight at my work party.”We all started laughing at how messed up my priorities were.“Sure. As long as you don’t let anyone touch your boobies,” she assured me with a smile.I was relieved. I didn’t know how soon chemotherapy would start, or how soon I would be bald so I wanted to maintain normalcy as long as possible.

Back in the surgery waiting area Miss X. asked me to leave all my important items in the waiting room with my parents.“Do you have a living Will?” she asked.“A Will? I have a friend named Will, and he’s definitely living.”“No. A Will. Who will you leave your possessions with if something happens to you?”Was she serious? I was 24 years old. I don’t know anyone my age with a will. “Is this surgery going to kill me?” I asked, not understanding her point.“You never know. Anyway, the doctors are going to take out the lump and the entire mass around it,” she continued.“You mean she’s going to be deformed?” my dad blurted out.I thought this was amazingly inappropriate of my dad.Beads of sweat now formed on my forehead. I said goodbye to my parents not knowing if I would ever see them again, told them how much I loved them, made some stupid joke about dying and went into the pre-surgery room to put my gown on. Liz sat with me. This time I got to wear a sea green gown, a much more flattering color on me than the pasty blue colored gowns in the ultrasound rooms. I felt I was losing control quickly and it didn’t feel comfortable or safe. Shortly, they would knock me out and I didn’t even know if I would come back alive again afterwards. I had to put full trust into these doctors, most of whom I didn’t know and had never met.

Liz found a black sharpie for me. I was afraid that once they knocked me out, Miss X might forget which breast to operate on. I didn’t realize at the time that she was only the receptionist. With the sharpie, I drew a large circle around my left breast with three arrows pointing towards the circle. “Operate on this boob only,” I wrote next to the arrows. As I finished writing, they called for me and escorted me to the operating room. I felt like I was on death row, being walked to my final destination.

I had never been put under anesthesia before nor had I felt so out of control. The operating room had an unpleasant fluorescent light and the room was about 15 degrees cooler than the waiting area. My stomach dropped from fear and I began shivering uncontrollably from the cold temperature in the room. Or maybe I was just shaking because I was literally scared to death. I attempted to act calm around all the doctors, like I was used to this, and climbed fearlessly, or so I tried to appear, onto the operating table. They strapped me down as I began making small chitchat and asking where they were from, more to calm my own nerves than because I actually cared. Within minutes I was out.………………..“Breathe. Breathe, Breathe,” I heard someone say. Groggily, I attempted to take a breath and open my eyes. I could vaguely make out several people looking down at me. Slowly my vision became less blurred and I saw mom’s face.Still doped up from the drugs, I asked, “Did it spread to my lymph nodes?”“It didn’t spread,” mom answered.I started crying, almost yelling. “Why are you lying to me? You can tell me the truth. It spread, didn’t it?”Dr. A. chimed in, “Asha, it’s all good. It didn’t spread to your lymph nodes. I think we got it all, but we will have to do some more tests to make sure.” This was a huge relief. Now I would have to wait another two weeks to determine if it had clean margins or if it had spread to the rest of my breast tissue. My chances of survival would hinge on these factors. This would also determine if they had to do more surgery and perform a mastectomy.

I asked Liz if she still wanted to go to the work party with me.“You’d better get some rest.”“I don’t need rest. I just rested for a couple hours during surgery. Plus I really want to go and hang out with Trent from work tonight.”We hailed a cab and I started planning what I would wear to the party later. I felt as though I had had about five too many beers already from whatever drugs they had injected into me. My head was spinning but I was ready to go out and party. I must have passed out as soon as I got home because I didn’t make it to the party.

I woke up at 8 a.m. the next morning and was back in reality. The drugs had worn off and I was completely bandaged up and in serious pain. Wow, this is really happening, I thought to myself. I began laughing. I think it must have been laughter of disbelief and shock. The next year of my life was beginning. In several weeks I would know whether the cancer had spread to my body, I would start chemotherapy, I would lose my hair and I would be sick. The whole process was set to last about eight months. Little did I know that it wouldn’t feel healthy for at least another two years. When it was all over, would I ever trust my body again? I didn’t know.

The morning after surgery

I couldn’t have asked for more supportive friends and family. The morning after my surgery, the phone began ringing at 8:30 a.m. that morning with a call from my grandparents asking how I was feeling. I felt like crap, but they didn’t need to know that. I told them I had taken some Advil and felt much better. I was getting call waiting. I hung up with them and clicked over. It was Tony, one of my best friends from high school. He called to tell me that he’d heard about what was happening and was beginning to plan a fundraiser party in my honor to benefit the American Cancer Society. Most people didn’t know what to say or how to be supportive and helpful. His idea of throwing a party was perfect because it showed support and friendship without being intrusive. Next call was from my friend Molly, in DC. She was calling to tell me that she was flying in for my first chemotherapy appointment whenever that was. Her mother had recently been through breast cancer. I have to say that I really lucked out with such incredible and supportive friends and I don’t know how I would have managed without them.

The phone kept ringing througout the day I was tired of repeating the same story over and over again. I felt like I had to be strong for all of them and not let them know how frightened I really was. I wanted to protect them because I knew they were probably as scared as I was. I also hated the idea of people feeling badly for me and didn’t want to be a charity case.

I also needed to learn to take care of myself rather than worry about taking care of everyone else first. It was draining to assure people that everything would be fine. I had no idea if things would be OK or not. Liz picked up several times and spoke to family or friends who called saying that I was sleeping. Finally we decided to turn off the ringer. But before doing that, we composed a message for my answering machine saying, “If you want to leave a message for Asha, press 1. If you want to know how she is feeling, press 2. If you want to know what her treatment plan will be, press 3.

My mom started booking my calendar, letting me know which weekends people wanted to visit me. The last thing I wanted is people flying to visit me in New York and feeling like I had to entertain them. “I can’t have people coming in all the time. I don’t have the energy for it. Can’t they cancel?” I begged my mom. This is when we decided to create a web site. (http://www.ashamevlana.com/ashastory.htm) On the web site, I would document my experiences. Family and friends could find out how I was doing without being intrusive. The amount of calls I was getting was already stressing me out. I knew this stress was not good for my body, in fact I suspected it probably caused the cancer in the first place. I had no time or energy to call all these people back, nor did I want to explain the exact same story to each one of them. I needed all the strength I could muster to get healthy.

This is not to say I didn’t appreciate the calls. I did because it meant that people cared about me. If I didn’t have that support, I wouldn’t have been able to get through it. However I was inundated beyond the point being able to manage it. The calls I most appreciated were the ones who left messages saying, “I know you’re probably getting a lot of calls so don’t worry about getting back to me. I just want to let you know I’m thinking about you and if you need anything at all, please let me know. It would be my honor to help you in any way I can.” This way, I didn’t have to worry about calling them back if I didn’t want to talk.

A new scar

My left arm was practically glued to my chest as if I were wearing a cast. Though I am a lefty, I was forced to do everything right-handed now because if I even slightly moved my left arm, it hurt too much. Immediately after surgery, the nurses had helped me into a sports bra that I would wear over all my bandages. They told me I needed to take a shower the morning after surgery to keep the wound clean. I was unsure how I would manage this because I was in so much pain.

The next morning I stepped into the shower with my sports bra still on and rinsed off my body with my right hand. The doctors had wanted me to redress my wounds but I couldn’t bear to look at my chest that was covered in bloody bandages. Mom offered to do it for me. I kept my eyes closed as she removed them and put on clean ones, still not ready to see how my chest looked. I didn’t want to see mom’s face as she changed the bandages for fear that her eyes might tell me how bad it looked. “It really doesn’t look so bad” she told me. “Look.” “No. Not yet,” I said with my eyes still closed. I had to come to terms with this on my own time schedule.

It hurt more than anything I had experienced so I was positive it didn’t look so great either. She redressed my wounds for the next three days because I was too scared to see the scar. Finally when the pain began to subside on the fourth day, I peaked under the bandages during my shower. It was purple and bruised and hard to tell what it would really look like until it healed. The horizontal scar was about three inches wide on the left side of my breast only cutting slightly into the nipple. It wasn’t as bad as I had expected. But I still wondered how I would explain this to a guy I might eventually date.

Ben came over in the morning to check on me. (Ben and I had dated on and off, but had broken it off about a year before because we had decided we would be better as friends.) So I decided to test Ben’s reaction to my new scar. “There’s something I want to show you.” I had always felt completely comfortable around Ben, so I lifted my shirt with my right hand and told him to peel off my bandages. I was surprised at how bold I was, but if I couldn’t show him, who could I? I needed to see how a male my age would react.

“Really? You want me to see?” he asked, almost flattered. Most guys would have avoided this moment, but he embraced it as I thought he might. “Why aren’t you grossed out right now?” I asked him. “Why would I be? This is part of who you are. It’s only skin and blood. We all have it. It just looks a little different than it did before. No big deal,” he said as he peeled away the bandages. “Hey! It doesn’t look bad at all. Actually it’s kind of hot. Asha, seriously, you are the hottest cancer patient I’ve ever met,” he said with a huge smile. I laughed, knowing I certainly wasn’t ‘hot’ but appreciating his comment nonetheless.

First, second and third opinions

The two weeks after my lumpectomy were the two longest weeks of my life as I waited for the results. The day I had been dreading arrived. I called the hospital in the morning to find out if cancer was all over my body. “The margins are clean,” Chrissy told me. I had prepared for the worst so I started crying with relief at her response. “You’re sure, right?” I asked, not wanting to get too invested in her answer. “Yes, I’m sure.”

This was incredible news. It meant that the cancer was contained and had not spread to the rest of my body. I felt like the luckiest person alive. “Luck” was now relative but my one wish had come true – I had a second chance at life. My next step would be meeting with an oncologist who would tell me what needed to be done next. Dr. A. referred me to Oncologist #1. She would be able to tell me about my chemotherapy options. Mom and Dad accompanied me to the appointment.

I assumed, walking into her office, that she would have a set plan for me and I could get started. She didn’t. “Well, you have a lot of options. You can do Adriomycin/Cytoxin, Taxol, Taxotere, a combination of them, anywhere from 4-8 treatments…” she recited without the slightest bit of compassion and as if she’d had way too much caffeine. “OK, wait. You need to slow down. I don’t know what any of those things mean,” I said to her. She told me that each one is a different type of chemotherapy. "Anyway, it’s your choice about what you want to do.”My dad wasn’t happy with her answer. He grilled her about facts and figures for each treatment. “I want to know what studies have been done on each of these treatments; I want to know the survival rate for women taking these drugs; I want to know what evidence you have that these drugs will work on younger women." She paused, not having answers to any of his questions. “Unfortunately none of these drugs have been tested on younger women because there have not been enough young women diagnosed to study.”

My dad’s faced visibly reddened. He was becoming furious. “Do you mean to tell me there are no hard facts on any of these drugs for younger women?” he almost screamed. My mom placed her hand on his leg to calm him down. “Yes. That’s what I’m saying. Also, I would like for her to get genetic testing because of her ethnicity.” She was no longer talking to me but to my parents. I felt like I was five years old again when adults talked about me as if I wasn’t there. “Ashkenazi Jews often have the BRCA gene mutation, which is linked to breast and ovarian cancer,” she informed us. I secretly hoped that since I was only half Jewish, I would only have half the gene. I already had the breast cancer half, so hopefully I wouldn’t have the ovarian half. “If in fact she does carry the gene, I would recommend an oopherectomy, removal of her ovaries, so she won’t be at risk for ovarian cancer.” I sat in silence. “Does that mean I would be able to have children?” I asked quietly. “Yes. But ultimately your entire treatment plan is your decision,” she told us frankly.I left the office more scared and confused than I came in. How can she expect me to tell her what treatment I want? She’s the one who has been trained in this, not me!

My parents weren’t happy with her and wanted me to get a second and third opinion. “I can’t get another opinion. That is so offensive and will totally hurt her feelings.” I said. My dad told me I needed to get over hurting people's feelings. "In medicine, second and third opinions are expected,” my dad advised me. I had an unsettled feeling in my stomach – like I was cheating on her, except that this was a life and death decision. Reluctantly I agreed to seek out more opinions.

Later that week I was able to finagle an appointment with Oncologist #2, who was a big name in breast cancer at Sloan Kettering. He seemed surer of himself than Oncologist. #1 and recommended four treatments of Adriomycin/Cytoxin followed by four treatments of Taxol. At the end of our appointment, he recommended I get an oopherectomy and a double mastectomy. I would then avoid having to go through radiation therapy. This was getting worse by the moment. But although I thought he was intelligent, he was also a man. How would he like it if I told him, “You need to have your penis removed even though there might not be anything wrong with it?”My third opinion was scheduled at Beth Israel in Boston, which I again went to with my parents. I had spent the last four days straight with them going to appointments.

Within minutes of arriving in the waiting room, an attractive woman came over to my chair and introduced herself as Oncologist #3. I felt an immediate connection with her. Her warm smile was inviting and personable. My dad insisted on being in the meeting with me and he grilled her as he did with every other doctor. But he soon softened. Her kindness and quiet competence put us all at ease and for the first time since being diagnosed, I thought I might end up OK.

She asked me a little about myself and when I told her I played the violin, she made a little note on her paper then looked up at me. “My recommendation would be four treatments of Adriomycin/Cytoxin without Taxol. Taxol can make your fingers go numb and prickly indefinitely which concerns me since you are a violinist. You’re young, you’re going to be alive for a very long time and I don’t want to put something so important to you in jeopardy.” Then I asked her the dreaded question. “Should I get an oopherectomy as well?” “Asha, you’re young and I think it’s a bit drastic at your age. Ovarian cancer doesn’t usually start showing up until 35 years old or so. We are not going to worry about an oopherectomy until you have children. Then we can take care of the ovaries.” I felt utter relief. My dad announced that we would be doing the treatments in Boston because we liked and trusted her.

She then asked to speak to me alone. My dad looked from her to me and back to her, concerned that he may miss out on some information if he left the room. “Uh, I’d like to stay in…” he started. She quickly interrupted him saying she needed to ask me some personal questions. As soon as he left the room she looked at me with the kindest eyes I’d seen thus far from a doctor. “Asha, what are you thinking?” I teared up a bit, touched that she would care enough to ask me this. The other doctors seemed to want to get me in and out so they could see their next patient. “You are by far my favorite doctor. I totally trust you and I will do any treatment you recommend. But the problem is my whole life is in New York. If I move home to Boston for treatments for the next six months, I will be living at home again and my entire life will revolve around breast cancer.”

My dad was a mess and not handling the situation well. I knew it would not be healthy to be around him because I needed to surround myself with positive energy. If I stayed in New York, I would continue working and have some sort of distraction. She agreed and now I was totally confused as to what to do. “Should I get a double mastectomy? What kind of chemo should I get? I will do anything you tell me to do.”“Asha, from the research I’ve seen with your stage and the type of cancer you have, it is unnecessary to get a mastectomy. As far as treatments, protocols for chemotherapy are well established and you can certainly have it administered in New York as well as Boston.”

I sat for a second and then timidly asked her, “Do you think I’m going to be OK?” She smiled. “Yes, I do. In fact, I think you are going to get through this with flying colors.” She had given me the encouragement I needed and I knew if she believed in me, I would somehow get through this. She is my family’s living angel and I will be forever indebted to her.

Relationship with my parents

Every time my dad looked at me he started bawling. “Dad, I’m going to be ok, I tried to reassure him.” “But I’m not,” he responded. “I can’t handle the idea of my baby girl dying.”I had always put other people’s feelings first, but for once I needed to be selfish. One evening I told him that I needed to take care of myself at this time and I couldn't worry about taking care of him too. I also told him that he needed to be strong for me, but if he couldn't do that, then I'd have to wait until this was all over to talk to him again. We didn't talk for another year.

Several months later I had heard from my mom that my dad was severely depressed and called Dr. #3 for her advice. She explained that he probably felt very guilty because he had somehow passed along a gene to me causing me to get cancer. She thought it would be beneficial for him to talk to other men going through similar situations and found a group of men for him to talk to. Besides feeling guilty, he felt helpless. He was in the medical field and used to finding solutions to problems based on evidence. There was no exact solution to this, nor was there enough evidence about younger women and breast cancer and it made him crazy. I have no doubt that she saved his life. He only told me later that he had contemplated ending everything during that time.

Mom had a slightly easier time than Dad because she had many friends she could talk to. Still I felt that I couldn’t cry in front of her because she was already so upset. I knew that my crying would only make it worse. She cried often while I was back in Boston. One night as we sat on the couch trying to watch TV, I saw out of the corner of my eye, tears falling down her face. I looked over at her and asked her to please stop. She said, "I just wish this were happening to me instead of you.” I asked her if she would get anything out of having cancer and she said no. “That’s precisely why I’m glad it’s happening to me." I knew that no matter how tough this was going to be, I was going to learn a lot from this situation. It would put a lot of things into perspective and I knew somehow it would change my life for the better. She started sobbing.

Emotionally I was OK, until I saw either one of my parents cry. When they cried, everything felt worse. It was terrible knowing I was causing them this pain and I knew they were taking it much harder than I was. I avoided crying in front of Mom to protect her. I knew that if I could appear strong in front of her in the beginning, she would see that it would be ok. I needed to build up her strength at first so she could take care of me later. But after several weeks of protecting her, I knew the time had come where I couldn’t be strong for both of us anymore. Later that night, I had a long conversation with mom telling her what I needed from her during the next year. “Mom, I know this is really hard for both you and dad, but I need to be able to cry in front of you. I need to be able to rely on you right now and I can’t be the strong one for both of us. Do you think you can be strong for both of us?” She looked at me for a long time and nodded her head. From that point on, I never once saw her cry.

The New Year

With the holidays approaching, the doctors wanted to wait until January to begin chemotherapy. This was very upsetting news and I begged them to let me start sooner. That probably sounds crazy to someone who has never gone through it, but the thought of having some wild runaway cancer cells in your body makes it hard to sleep at night. I felt like getting on chemotherapy would kill them all and I was impatient. I wanted them dead now. The doctors assured me that waiting a couple more weeks to start would not make a difference.

I stood on the street after a meeting with Doctor #1 waiting for the crosstown bus. A news reporter with a microphone interviewed people in line about their New Years resolutions. It would air later that night on the local news station. “The New Year is approaching, what is your New Year’s Resolution?” the reporter asked. All the normal responses were given.“I want to lose weight,” said a middle-aged heavy-set man. “I want to have more money,” said a young man a couple years out of college. “I want to exercise more,” responded a 35 year-old woman with a baby. “And how about you?” she asked me pointing the microphone in my direction. “I want to stay alive,” was all I could think of.

Mouths dropped around me when I answered. There was an uncomfortable silence like I had just said something dreadful. Awkwardly, the news reporter moved onto the next person in line. At that moment I realized how much I had always taken my life for granted. These people standing next to me didn’t even realize how lucky they were.

Strangely enough though, my biggest concern now was not over how sick the chemotherapy was going to make me. It wasn't over the possibility that the cancer might return once my treatment was over. What I agonized over the most was the fact that I was going to lose my hair. While a part of me realized that this was really the least of my worries, I couldn't stop thinking about how terrible I was going to look without hair.

Chemotherapy...First treatment

I finally had a plan...If I chose to do the treatments at Sloan Kettering, I would pay out of pocket and probably be in debt for the rest of my life. So I headed back to the Doctor #1 because she was on my insurance plan. I knew from then on, I would be responsible for taking my health into my own hands. Previous to being diagnosed, I thought doctors knew all. Now I began questioning everything. Being proactive about my own health was one of many lessons I would learn on this journey.

My first chemotherapy appointment was scheduled for a Thursday at 4 p.m. I never thought I’d be spending a Thursday night at a hospital. Not knowing what to expect, I was on edge. I knew that the more preparation and fewer unknowns I had, the less anxious I would be so I asked the nurses to walk me through the process the day before. “First you will check in with Wally at reception, then he’ll send you to get blood taken. After that, you’ll go to Section C, also known as the chemotherapy room,” she told me taking me around the hospital. When the nurse brought me into the chemo room and I saw all the other bald patients getting their treatments done, I gagged. I ran to the bathroom where I threw up several times. I couldn’t believe that the next day, I would be sitting in the same room as these patients who looked like they were from another planet.

That night I went home and tried my wigs on once again just to make sure they were OK before I lost my hair. Mom arrived that night and would stay through the week to take care of me. Liz was still staying with me and loyally said she was would try to find a job in New York so she could remain in New York for the duration of my treatments. Tony drove from Boston, Molly flew in from Philadelphia and several other friends from New York asked if they could come to my treatment too. If it weren’t for the cancer part, it would have been a big party.

I woke up terrified the day of my first chemotherapy treatment. I lay in my bed for twenty minutes, frozen under my covers. I had been trying to remain so composed and positive around my friends, but I was scared. I didn’t like being alone because when I was, all my scary thoughts flooded my head. Could I actually go through with this? I didn’t know. I wanted it to be over so I could have my life back again. But to brush past this experience and be eight months down the road would mean giving up eight months of my life. That's not what I wanted to do. I knew these would be the toughest eight months I would ever go through but I hoped it would add a whole new dimension and appreciation for life. Eight months would be a long time. Gathering my courage, I looked at my ceiling and gave myself a pep talk. “I can do this and I am going to get through it with flying colors just as Doctor #3 said. I am ready for the challenge,” I announced to myself as I threw the covers back triumphantly. I was still scared but knew I could get through it.

I arrived at Section C for my treatment with my mom and five friends and because it was such a large group, I got a private room where I would be for the next four hours while the chemotherapy seeped into my arm. The room was fantastic – it had its own bathroom, a TV with VCR hooked to the ceiling and a fancy metal hospital bed. I would have to get used to this place quickly. We picked out two movies to watch, Tootsie and You’ve Got Mail. Uncomfortably, we waited for the nurse to tell us what was going to happen. My friends tried to ease the tension with their humor. “You know,” Liz said, “if you’re in here too long, we may have to wheel you out on the hospital bed to meet some men.” We all laughed nervously as the nurse entered the room.

From there on out it all happened quickly and much more easily than I had expected. It took her several attempts to find my vein. When she did, the blood came shooting out of my arm and into the tube. She hooked me up to an IV with a clear liquid. These were the steroids. After this bag was empty, she would put in another bag of clear liquid, the anti-nausea medicine. It took over two hours for these to drain into me. In the meantime, we watched You’ve Got Mail and were reprimanded several times by the nurses for talking and laughing too loudly. “You know, people are getting treated in here and they are very sick. Can you please keep it down? The laughter makes them feel bad,” the nurse told us. At the time I didn’t understand. How can they be upset at us for laughing and making this easier for ourselves?

Looking back, I realize I wouldn’t have been laughing so hard if I didn’t have such caring and supportive family and friends around me. Instead of being a lonely experience like it was for many of the others getting treated, the cancer brought us all closer together.

The nurse came in occasionally to check on me. My eyes were getting heavy from the steroids as the last drops seeped into my arm. Now it was time for the real thing — the Adriomycin/Cytoxin, or as “insiders” call it, The Red Devil. This was the hard-core stuff that would stop all the fast growing cells in my body. The result of this would be hair loss. Now I was scared. This was the beginning of the next year of my life. As she changed the bag to a red liquid, I panicked. “Wait, not yet. Are you sure this is a good idea? You’re putting poison into my body. How can this be okay?” She must have heard this all the time. “Instead of thinking of it as poison, I like to think of it as an army of red soldiers marching into your body to kill all the bad cells,” she calmly responded. This was a much better image and I reluctantly let her insert the tube.

Surprisingly, everything so far had been completely painless. This was going to be easier than I thought. I tried to keep my eyes open for the sake of my friends but at some point I must have fallen asleep. Two hours later, I heard someone say my name. “Asha,” the nurse said as she gently nudged me. “You’re all set. You can go home now.” Besides my nerves acting up a bit, I felt pretty good. My friends looked relieved. This would all change later that night.

My hair-cutting party

After my first treatment, the six of us, excluding my mom headed over to another friend’s apartment for the party where we met eight other friends. I knew my hair would fall out soon. I also knew that losing my hair in clumps would be traumatizing, especially if it was still long. How would my friends react to this? I had had almost a month to accept the fact that I wouldn’t have hair and I could now laugh about it. My friends still didn’t see the humor in it.

To make it a less traumatic and taboo subject, I had decided to throw a hair-cutting party to involve my friends in the process. I didn't want them to feel uncomfortable seeing me without hair and I certainly didn’t want them to feel bad for me. The party would be beneficial in other ways as well. It would allow me to feel like I was in control of the situation, instead of at the mercy of chemo's side effects.

Once at my friend’s apartment, we popped open a bottle of champagne, (though I stuck to water), put on some music and danced around, laughing. My friend, Josie, who was at Columbia Journalism School at the time, decided to document this experience which we could eventually take to high schools and colleges to educate other young women about breast cancer. The hair-cutting party would begin the documentary.

It was getting late and I kept delaying chopping my hair, but it was getting late and I couldn’t stall anymore. Some of my friends who didn’t want to watch went downstairs so they didn’t cry in front of me. I understood. Ben wanted to watch, but I made him join some of the other girls downstairs, not wanting him to see me until I was done. What if he didn’t think I was attractive after my hair was gone? Would I still be sexy to him? Of everyone, I was most concerned what he would think. After all, he was a guy.

I faced the wall so I couldn’t see myself until I was done. Molly was brave enough to go first. Her mom had gone through chemotherapy for breast cancer the year before so she felt the most comfortable. She took a chunk of my hair, careful to leave enough for the others. I held my breath as I heard the sound of cutting. The first cut had been made and some clapped. Reaching up to feel where the hair had once been I began laughing and crying at the same time. There was an inch of hair left and there was no turning back. “Are you sure you didn’t cut too much off?” I asked, concerned. “No, it’s going to look great,” she said hopefully.

Christina went next. She looked nervous and took a very small piece of hair in her palm. Hesitatingly she cut and quickly gave the strands of hair to Aysha whose job it was to tie the chunks in pink ribbons for “party favors.” Christina disappeared into the other room. I saw her out of the corner of my eye. Her face was red as tears streamed down her face. One by one, the rest of them took turns cutting handfuls of hair. It was a bizarre situation but by the end everyone had relaxed and now felt at ease talking openly to me about the cancer.

When they finished, Michele took the scissors and tried to style what was left of my hair. I had no idea what it looked like. All I could do was feel what was left of my long black hair. Anxiously I waited to see what I would look like with short hair. “It looks great,” they said, complimenting me. I didn’t believe them. It took over twenty minutes to build the courage to look at myself in the mirror. Finally, I peered at my reflection from the side of the mirror, only seeing half my head. Somehow I thought if I didn’t see my whole head at once, it wouldn’t be as bad. Eventually, I looked at myself head on, and didn’t mind the inch long spiky boys cut.

It was time to show Ben. I self-consciously walked downstairs with a towel over my head. “Let’s see what it looks like,” Ben said, smiling. “I look like a boy!” I said, scared to show him. “Come on. I’m sure it looks good.” He gently took the towel from my head. I watched his face carefully, waiting for his reaction. “It looks really cute,” he said. “Are you just saying that?” “No. I’m actually surprised. It’s kind of sexy,” he said running his hands through it. “Really?” I asked, fishing for compliments. “Yes. I told you you’d look good with no hair. You have a gorgeous face and it doesn’t matter if you have hair or not.” He always knew how to make me feel attractive.

I couldn’t have asked for a better response. I felt relieved. All of sudden, feeling sick to my stomach, I ran to the bathroom. My friends thought I hated the cut, but actually the nausea medicine was wearing off. I went into the bathroom and threw up for the next five minutes. In the bathroom I gave myself a pep talk as I puked. “Mohammed Ali once said, “I hated every minute of training, but suffer now and live the rest of your life as a champion.’” I kept repeating a similar quote to myself until I finished throwing up. “I hated every minute of chemo, but suffer now and live the rest of your life as a champion.”

I continued to throw up and Ben knocked at the door before letting himself in and he knelt beside me. I hated the thought of him seeing me like this so I told him to leave. “I’m not leaving you like this,” he said as he held my forehead over the toilet and rubbed my back. He stayed with me for the next hour. Between throwing up, I curled up on the cold floor and he quickly moved my head into his lap. When I was done for the time being, he lifted me gently off the floor and helped me wash my face. “I’m going to take you home so you can get some rest.”

I wondered if I would have been so good to him if he were going through this. It was a Thursday night. I had planned on taking the day off from work on Friday and then using the weekend to recover. I didn’t sleep and became very good friends with the toilet that night, running to the bathroom every couple hours.In the morning, I called my violin teacher, Janice, to tell her I would not be able to make it to my lesson that day. “Asha, you have already paid for your lessons, I will not refund them and I expect to see you here this afternoon,” she said firmly. I was so angry with her, but I was used to her strictness. Besides not feeling well, I hadn’t been able to practice my violin and viola since my lumpectomy because I couldn’t lift my left arm. I didn’t realize that it would take more than two years before I had full range of motion again and gain sensation back.

A different kind of meditation

I had been taking classical violin lessons when I was six and although I had once had a dream of being a musician, I gave it up to have a more stable job. But I had continued taking violin lessons with a woman named Janice who was teaching me improvisation and other non-classical styles. In addition to being a violin teacher, she also acted as a life coach to me.

I had a lesson scheduled for the day after my first chemo treatment because I had no idea how horrible I would be feeling. I called Janice to cancel. “Asha, I’ve told you already, I’m expecting you to be here at 6 p.m. If you get sick while you’re here, then you get sick, but you need to come.” She never let me get away with anything. I hated her for this but also appreciated because I knew she was pushing me to be a better person and player.

I was vomiting all day and sleeping for the rest of it. I couldn’t imagine getting across town just for an hour lesson. The idea of it made me miserable. There was no getting out of it. At 5:30 p.m. I dragged myself out of bed and brought a plastic bag with me in case I got sick in the cab ride over.

Slowly, I unpacked my instrument in her studio, angry with her for making me come. I wasn’t even sure I would be able to hold it correctly because I was still in pain from surgery. “Asha, I’m glad you came. We’re going to change our path a little in your lesson while you are undergoing treatments.” I was silent, still irritated with her. “First, we’re going to drone. Droning is a sort of meditation. I want you to close your eyes and find one note that resonates within your body.”

I lifted up my instrument and surprisingly I was able to hold it with little pain. I closed my eyes and started wandering around the fingerboard trying to find a note that I liked. Finally I found it. It was a low G. I played long bows on the G a couple times and then opened my eyes. “Is this what you want me to do?” I asked, looking for validation. “Yes. But keep your eyes closed and continue to play.” I began droning on my G string.

“Let yourself really feel the note through your whole body,” she continued. Within three minutes or so, I had completely lost myself in this single note. My body felt more relaxed and I noticed my queasiness lessening. “Good,” she said softly after ten minutes of droning. “Now you’re going to play a sound story. I want you to close your eyes and take a deep breath. Explain to me how you felt about going into the hospital yesterday from the moment you woke up until after your hair-cutting party.”

“Well, it was sort of…” I began. “I don’t want you to tell me in words. I want you to tell me through your music and your instrument.” Keeping my eyes closed, I began my sound story, softly and hesitant at first. After all, this is how I felt when I entered the hospital doors. I guided her through my day through notes, dynamics and different tempo. There were soft sections where I was scared, fast and loud sections where my heart raced as the nurse approached me with the needle, lighthearted sections where my friends and I attempted to joke and more calm parts as the drugs entered my system. My story incorporated every kind of emotion possible that I had been through that day.

I opened my eyes when I finished, keeping my eyes towards the ground. I felt a huge sense of relief to express myself in a way that I hadn’t been able to in words. When I finally looked at her, she had a smile on her face that I had never seen. “Asha, that was the best improvisation you have ever done. It was incredibly moving and I understood everything you were saying. You get a sticker today.” I had never received a sticker in the entire year I had worked with her. She rarely gave them out, but I had finally deserved one.

My first day in a wig and some bad side effects...

I used the weekend to mentally prepare myself for returning to work. My boss was the only person that knew I had cancer. I wanted to get used to wearing the wig before my hair actually fell out, so on Monday, I would sport my red wig.

I woke up extra early to get ready. It was a tough morning, trying to get the wig situated in exactly the right position, flattening the flyaway strands and making sure it wouldn’t fall off while at work. I would have to change my wardrobe since the red wig didn’t match any of my clothes. I wore a completely black outfit and walked toward the subway with my head down, feeling like all eyes were on me. They must know, I kept telling myself. Is it that obvious? Maybe my black hair is showing through? Does it look stupid? I hope it doesn’t blow off.

Luckily it was a quick subway ride to work. I took the elevator up to my office, avoiding eye contact every time someone got on. Since I had just started working there I didn’t want to have to explain my new look to anyone. At the water cooler, Trent, the cute guy from the office, introduced himself to me. “We’ve met. I'm Asha.” “Wow. I didn’t even recognize you. You got your hair cut and colored.” “I guess sort of,” I mumbled.Later in my office, the CEO, Matthew came to talk to my boss. Known for being brash, he saw me and exclaimed, “What happened to you? This is an inauspicious way to start the morning.” Already more self-conscious than I’d ever felt in my life, I responded, “Yeah, having cancer isn’t the best way to start a morning.” His jaw dropped. My boss, who was protective of me, ran out of her office, grabbed him by the arm and led him away. Later he came and apologized profusely saying he had no idea.

It certainly was not the best day for me. The doctors instructed me to drink water and pee often to flush my system. They warned me that my pee would be red from the drugs for several days. But they hadn’t warned me that I might have a severe case of diarrhea. I’m not sure that first day back at work could have gotten any worse. Around lunchtime, I couldn’t hold it in anymore and ran to the women’s room. There were three stalls and I opted for the large handicapped one because I knew I’d be in there for a while. I just hoped that no one else would walk in.

I sat on the toilet for several minutes until I was done. The pee was red from the medication and I worried I would clog the toilet with number two. When I flushed, the water level started rising. Please stop, please stop, I whispered to the toilet. It didn’t. It came up slowly over the rim and flooded the entire bathroom floor, so much so that it flowed onto the rug in the hallway. They closed the bathroom for the day.

First three weeks after my first chemo

The next three weeks after my first chemo treatment certainly weren’t great, but they were bearable. The first week I encountered serious side effects including constant nausea and throwing up, stomach pains, diarrhea and dehydration. Not to mention I had lost my appetite. I have never had a problem eating. In fact it’s one of my favorite things to do. But the thought of food made me sick. Everything I put in my mouth had a metallic taste. Even my cravings for Tasti-D-Lite had vanished. Mom stayed with me for the first week and forced me to eat bread and soup. She also started me on a macrobiotic diet.

In the meantime, I had appointments with the nurses, my oncologist and the blood lab on a weekly basis. I brought my new wigs in to show all the doctors and nurses and made some dumb jokes about going bald. In the four times I had been in to see them, I had never been cried around them.

“You know, Asha, it’s OK to be upset. Many people go through denial when they find out they have cancer because it’s a very hard thing to deal with. It’s not healthy to pretend this is just a joke. This is serious,” my oncologist had said. I was flabbergasted. Was she kidding? I was far from being in denial. I knew exactly what was happening and of course I was taking it seriously. I was doing everything I needed to do to get through this. But I refused to feel bad for myself.

Three weeks later, I began feeling better again, almost back to what I felt like before my first treatment. Thankfully I felt well enough to fly home to Boston despite the doctors’ warnings about traveling. My next chemo appointment would be three days after Tony’s party. My hair still hadn't falling out and now I was becoming worried that I had cut my hair for nothing. I hadn't been warned that it wouldn't start falling until three weeks after the first chemo treatment.

Beginning of hair loss

My friend Tony began making last minute arrangements for the Cancer Benefit Party in my honor. It would be held in three weeks at a huge bar in the South End in Boston. Already over 300 people had RSVP’d ‘yes’. This would be the first of many parties Tony threw in my honor over the next year. Because of my weakened immune system and susceptibility to getting sick, my doctors told me not to travel during treatments. But how could I not attend a party in my honor? Tony was one of my best friends growing up and was an absolute genius at throwing parties because he had a huge network of friends and is always at the center of the action. By 10:30 p.m., over four hundred people packed the inside of the bar. Many of the people I didn’t know or hadn’t seen since junior high and high school. I chose not to wear the wig, so most people commented on my short hair and reached up to pat it or look at the new cut. They all asked how I was doing. Pretending nothing had changed, I tried to keep up with them by doing my share of shots, trying to forget that in three days I would have my next treatment.

After 1 a.m. I don’t remember much except that Tony dragged me home. By 2 a.m. I was passed out on his bed. The next morning I woke up next to him, opened my eyes and stared at the ceiling trying to remember where I was. Tony and I looked at each other without saying anything but instead moaned in pain. My body ached from throwing up and my head was sore. “Did I fall down last night? I asked. “My head kills and it’s not like the pain of a headache, it’s just sore.” What I didn’t realize was that scalp soreness was the beginning of hair loss. I tried to lift myself from the bed to go to the bathroom and when I did, Tony gasped. “What?” I asked as I followed his gaze to my pillow. There was a huge chunk of hair on my pillow. I gagged. It was happening.

I was terrified. Tony and I looked at each other horrified and then started laughing hysterically with tears streaming down our faces. (I always begin laughing when I"m scared or upset.) “This sucks,” I told him, still laughing. “Yeah, but it’s kinda cool,” he admitted. “Can I try pulling one of your hairs out?” he asked.

We then took turns testing out strand by strand. First he took one piece of hair to see if I could pull it out. It came out easily without any pain. Then I took a turn. He tried a tiny handful at once and it all came out painlessly. I told him not to get carried away, because now that it was happening, I wasn’t so sure I wanted to lose it yet.I dressed in a button down rather than a pullover sweatshirt to preserve any extra hair loss. Nonetheless, by the end of the day, my shirt was covered in shedding hair. I felt slightly better than I had been especially without a hangover to add to my sickness. As I was almost back to normal, it was time for my second treatment.

Second chemo treatment

Now I knew what to expect so the fear of getting my chemo had subsided slightly. I had been going in for weekly blood counts where they drew blood to monitor my white and red blood cell counts. The day before my scheduled second treatment, the nurse informed me that treatments would be delayed due to my low white blood cell count. I begged her to let me have my treatment on time. But she insisted that they would have to wait until the counts were high enough to handle the chemo drugs, otherwise I would get really sick since my immune system was already weak.Despite the fact that it was just a brief postponement, it was very upsetting. It was the first time since surgery that I cried, this time out of frustration rather than fear. It was frustrating that I couldn’t will my body to be ready for the treatment. Once again I had no control of the situation. By saying I couldn’t have my treatments, I relinquished any power I had left. That night I visualized white blood cells growing rapidly for the next day. To humor me, the doctors took my blood cell counts again in the morning. They weren’t high enough and I would have to wait two more days.

After the second treatment, the nausea wasn't as intense, but it persisted for a couple of weeks this time. I didn't vomit, but instead suffered an upset stomach and flu-like symptoms. To add to the queasiness, I got my period which I’m definitely not complaining about. The doctors had originally told me that I would lmost likely go into menopause. Two of my friends offered to have my babies for me if I became infertile. Luckily (for all of us) it never came to that because I continued to menstruate throughout all my treatments.

On my way to work one morning, several days after my second treatment, I started sweating profusely, my body temperature changing quickly from hot to cold and back again. I was dizzy, and sat down in the middle of the subway platform, hoping I wouldn’t pass out in the middle of all these people in rush hour. People kept coming up and asking if I was ok. I nodded, with my head in my hands trying to conserve the little energy I had.

I was panicking and really didn’t know if I would be ok or not, but I didn’t feel like explaining my situation to a complete stranger. I hated feeling so vulnerable in front of all these people. What was happening to my body? “Just three more stops until the hospital,” I whispered to myself.

When the sweats lessened and my vision became clearer, I fearfully stepped onto the next train finally making it to 14th street.  I stumbled down the street to the hospital until I found a building I could hold onto to keep my balance.  Wally, the hospital receptionist, greeted me. “Asha, what are you doing back so soon? You don’t have blood counts ‘till Thursday.” “I don’t know what’s going on. I need a nurse as soon as possible,” I managed to say before falling against the wall.

He quickly called the nurse and she came running out to find me in a heap on the floor. I explained my symptoms to her as best I could. “You must be dehydrated. This happens sometimes when people go through treatment because they don’t drink enough water.” I told her that it didn't really feel like dehydration." “Believe me, many cancer patients don’t drink enough water and this is what happens.”

I didn’t have the energy to argue with her and she helped me to the chemo room, hooking me up to an IV for the next two hours. When I finished, the sweats and chills started again. By now I was really upset and on the verge of tears. I didn’t understand why they didn’t know how to fix this. I checked myself out of the hospital without saying goodbye.     I got back to work without any drama but as soon as I sat down at my large wooden desk, the sweats and chills began again. I crawled underneath, knowing that no one would see me there, until it subsided. My thoughts started up again and I called Ben from under the desk. Thankfully he answered. “I don’t get it, Ben. I thought I was different – that I could get through this without getting too sick from all the treatments.” He told me I was in denial. I didn't think I was. I knew I had cancer and had accepted that. Why did everyone think I was in denial? “I’m not saying you are in denial you have cancer, I’m saying you are in denial that any of the chemo drugs will affect you.”I was mad at him for being right so I told him I had to go and called mom. I explained my symptoms to her.“It sounds like a hot flash,” she told me. “A hot flash? There’s no way. Isn’t that for older women?” Unfortunately, as I found out later, the doctors had failed to mention that hot flashes were a normal side effect from chemotherapy. But at 24, hot flash wasn’t even in my vocabulary.