We aren’t selling the horses just yet.

My husband and I have a phrase that we say to each other. It is that we aren’t selling the horses yet. This phrase needs a bit of background to understand. No we do not have horses. We do have two cats and if you worked with me during my residency you probably saw more than your fair share of cat pictures. Sorry about that or you’re welcome, depending on where you stand on the topic of cat photos!

Since I got diagnosed with breast cancer I have joined countless Facebook support groups for women with breast cancer. They all have a different schtick – my favorite one is called kick ass cancer mamas. It is a group for women who were diagnosed with any sort of cancer during pregnancy or in their first year postpartum. Last I checked there were more than 600 members. That both warms and breaks my heart simultaneously. Another group is specifically for women with triple negative breast cancer, which is the type of cancer I am living with.

Women post all sorts of things in these groups. We post photos of our children, ask questions about side effects and treatment plans, complain about our significant others… you name it, we talk about it. This one woman, who will remain nameless (out of respect and because honestly I don’t remember her name at all!), wrote a panicked post one day. She basically said that since she had Stage 1 triple negative breast cancer, she was definitely going to die, so she decided to sell her horses so they would be able to live a good life.

Those of you reading this are probably slightly confused. Huh? She has stage 1 breast cancer, that should be curable… why does she think she is going to die? I could go into a psychoanalysis of why she posted this. Trust me, I have thought about this and talked to my husband about it at length. Originally, I was diagnosed with stage 2 breast cancer and was told the intent was to cure. Note, that this is not the same thing as saying that this is curable. But, I digress.

Some women were supportive of her post – they told her not to worry, there was no reason to believe she wouldn’t live a long and otherwise healthy life. She ultimately was kicked out of the support group, my guess is for causing unnecessary drama and frightening the “masses.” Having stage 1 breast cancer seems pretty awful for people without cancer, but for people with cancer it is like winning the lottery. Oh, your cancer is only stage 1, lucky you!

This metaphor has really stuck with me, though. It was probably the right decision for this woman to sell her horses – it seems like a lot of work to take care of them, and she was being treated for breast cancer while still working a full time job as an ICU nurse. But, for me, I’m not ready to sell my horses just yet.

This has come up multiple times over the past year. After my mastectomy, when my husband and I learned that I only had a partial response to the brutal chemotherapy I had endured and there was still cancer present in 2/20 lymph nodes, we decided not to sell the horses. When we learned, furthermore, that not only was my cancer triple negative, but also metaplastic with squamous features – a subset of breast cancer that is even more aggressive than the already aggressive triple negative, we decided it was still not time to sell the horses.

I did fly down to MD Anderson to meet with one of the foremost experts on metaplastic breast cancer at this time. She suggested I participate in a double blind study that had a 50/50 chance of me getting a parp inhibitor as opposed to a placebo. I decided not to participate in the trial and go with the standard of care treatment, again, because it wasn’t time to sell those horses. There was no reason to assume that I would progress or recur, although I knew there was a 50% chance in the next 3 years that this would happen.

When my PET scan came back “highly suspicious” for metastatic disease, it seemed like maybe it would be time to sell the horses, but it still didn’t feel right. There are still treatments available and I still overall feel well, other than the pleuritic pain that I can mostly ignore.

I have an 11 month old son, so I don’t think it will be time to sell the horses until I really have no other options. It would probably be different if it was just me. If it was just me, I might have sold those horses from the beginning and spent my time drinking dirty martinis on a beach in Mexico. I don’t know, though. I suspect that it is in my nature to not sell the horses until the bitter end. It’s not over until it’s over.

I have plans for if and when it comes time to sell the horses. Where they will go. More specifically, where I will go. I am not disillusioned that my prognosis is poor. I know that if it comes to it I will transfer my care back to where I trained. If I get to the point where there are no more treatment options, I will return to my roots of residency.

I want to be buried in a Jewish cemetery, even though I am not religious and would describe myself as an agnostic jew. Are there even Jewish cemeteries in Ohio? I don’t know. Hopefully I won’t have to find out.

The point of this post isn’t to get too morbid. Although that ship may have already sailed. The point of this post is that I am not going anywhere just yet. Any of us could get hit by a bus at any moment, or more likely be killed in a mass shooting. I’ve broadcasted that I am Jewish twice now, so that may become even more likely.

Sometimes we tend to eulogize those living with illness before they have even passed. In a way it is nice, who doesn’t love hearing how wonderful people think they are! I certainly love it! But at the same time, I’m not dead yet, and I don’t plan on dying anytime soon. I’m not selling those fucking horses yet. Or my cats. Don’t even think about me selling my cats.

I told my oncologist this metaphor when we met to discuss the next game plan. I looked at her in the eyes and told her that I need her to tell me when it is time to sell my horses. I will let you all know if and when that time comes. Hopefully it won’t be for another 50 years and we will all be living in Canada by then because of all the climate change.

Until next time dear readers. Love and light to you all.