My point of view: Living with cancer

Editor's Note: Theresa Karle has been writing since she was 12 years old. She has won numerous awards for her poetry and fiction stories. Karle has worked for 35 years on Fort Rucker where she is currently employed as a data system's analyst with the adjutant general's department. The Southeast Sun thanks her for sharing her story.

Commentary by Theresa Karle

It may be strange to consider oneself blessed by a cancer diagnosis, but that's the only appropriate word that seems to fit my situation.

Five and a half years ago, I was a timid little thing who lived to do the bidding of everyone else. Always the quintessential good girl, the word "no" was not in my vocabulary. Who I was, what I believed and my true passions in life were buried beneath several layers of shyness, responsibility to family, friends and community, and the conviction that Helen Reddy was right when she sang, "I can do anything - I am Woman!" The only thing that kept me going was the certainty that "one day" my children would be grown and on their own; the bills would all be paid; my husband and I would have more time together; and I could write a novel or two, crochet to my heart's desire and finally go on that promised honeymoon to Disney World.

But then I got lucky. I found out that I'm not immortal. In the space of one year, I learned that I could no longer live by Scarlett O'Hara's philosophy: "Tomorrow is another day." Nor could I continue to be the sweet, selfless, goody-two-shoes Melanie Wilkes. With a diagnosis of IBC - three innocuous letters that describe an aggressive, deadly, and very rare carcinoma - I suddenly became what no woman wants to be - a statistic.

In 2006, not much was known about Inflammatory Breast Cancer. In fact, most physicians had never even heard of it, nor had they encountered it in one of their patients. Because its early symptoms usually mimic a relatively mild breast infection, known as mastitis, doctors generally treat the symptoms with antibiotics. Eventually, mastitis heals. IBC, on the other hand, spreads like kudzu.

In March 2006, just before departing on a cruise to the Bahamas with the Enterprise High School Encores, I forced myself to visit my family doctor. For eight weeks, my left breast had felt swollen and tender. My normal monthly self-breast exams had found no definitive lumps or any other signs that something serious could be wrong, but it was unusual, so I plodded into the office of Dr. Christie Riley. After the exam, she tentatively diagnosed mastitis and gave me the usual prescription. But, "just to be on the safe side," she also scheduled me for an immediate ultrasound, x-ray and mammogram. After all the tests were completed, she wished me "Bon Voyage" and told me the results would be waiting when I returned. Riley had been our family doctor for some time so, even through the smile and casual demeanor, I could read concern in her eyes. And so began the nightmare ...

When I returned to Enterprise, there was a message on our answering machine. Riley indicated that the results were back and I needed to see her as soon as possible. That caused the pesky little bud of worry I'd held in restraint in the back of my mind to blossom into full-blown terror. Fearing the worst, I chose to ignore the message and go about my normal busy life, living my favorite quote from Thoreau: "The mass of men lead lives of quiet desperation." That goes for women, too.

When my mammogram results came in the mail, I hid the unopened envelope in the back of a drawer. I didn't want to read in Times New Roman, font-size 12, what I already suspected. Another phone message from the doctor's office, however, caused my husband, Rich, to become involved. He told me he was worried and he wanted me to go back to the medical center. He offered to go with me, but this was personal and I needed to handle it alone. By this time, I was so frightened I could barely function on a daily basis. Even though I'd never vowed to "obey" my husband, I was tired of sleepless nights and constant fear so, feeling like a sacrificial lamb, I went to see Riley again.

She gave the results matter-of-factly: The ultrasound and x-ray showed no abnormalities; however, the mammogram did find an area of dense tissue in the left breast. The radiologist who had read the mammogram indicated that whatever it was, it appeared to be benign. I felt relief wash through me, but Riley wasn't convinced, suggesting a second opinion, so I left her office with a referral to a surgeon.

Daniel Gadzala was like no other doctor I'd ever met. A man of short stature, Dr. "G" had thick dark hair, a devilish twinkle in his eyes and a warm, genuine smile. He was brilliant, personable, meticulous and looked way too young to be a surgeon. I've dealt with many doctors in my life, but Gadzala is in a class by himself.

He talks "to" you, not "at" you. During my first visit, we spent several minutes discussing my medical history and my current symptoms; then he did an exam, finishing with a needle biopsy. I remember asking him what he thought it could be, and he named off several possible diagnoses. He explained that the malady was probably nothing serious, but he also mentioned what he called a "nasty condition" that neither he nor I would want it to be. That was the first time I heard the words Inflammatory Breast Cancer.

Eight weeks later, after two more needle biopsies involving 51 breast tissue samples (49 of which came back negative, with only two being "suspicious"), Dr. "G" and I were perplexed. But when he suggested one more biopsy - an invasive surgical procedure where he could harvest a larger sample of tissue, I balked. I'd had enough needles and scalpels and waiting (always the interminable waiting), wondering why the test results kept telling us that nothing was wrong.

I made the appointment for the surgery, but I left his office that day intending never to return. My husband had a differing view when I told him I was done with tests; he threatened to handcuff me and drag me to the hospital if I wouldn't go willingly. I'd been married to the man for nearly twenty-five years, so I knew he wasn't kidding. I went ahead with the surgery.

Another agonizing week went by before the results were in and, this time, the news was devastating. Dr. "G" told me I had the aforementioned (and dreaded) IBC. I only half-listened as he explained the modified radical mastectomy he would perform only four days after my younger daughter, Ember, graduated from high school. I remember leaving his office and driving home. Some time on the way, I called Rich to tell him the news. I had inflammatory breast cancer, the worst and most aggressive kind of cancer a woman can have, and I was going to die. He left work immediately to be with me. I didn't care, because I was on a mission.

I made one stop at a convenience store, bought a large bottle of champagne, then went home and toasted my health until the sparkling wine was gone. I remember crawling into my waterbed, thick-brained with shock, grief and alcohol. I was 54 years old. I had a good marriage, a great husband, two beautiful, intelligent daughters and a job I loved. I had two wonderful siblings, amazing parents and even a 92-year-old grandmother. I also had breast cancer.

It was not the first time the disease had touched my family. At the age of 49, my dad was diagnosed with advanced lung cancer. Doctors removed half of his right lung. Noting that numerous lesions were in the upper lung, they sent him home with no further treatment. The odds were against him surviving six months, but he didn't die. He lived cancer-free and healthy until 2004 when the disease returned. This time it was in his left lung.

Further surgery was out of the question, so at the age of 74, he began weekly radiation treatments at Enterprise Cancer Center. He was two years into his second battle when cancer reared its ugly head in his older daughter - me. I think he took the news harder than I did.

The next twelve months were a whirlwind of doctors, surgeries, chemotherapy and radiation. I approached all with a calm acceptance. After the initial shock, I never really felt sorry for myself. After all, I was just one of many women fighting a horrific disease. I never mourned the loss of my breast; I had never really liked them anyway.

As a ‘stacked' teenager, I despised the boys who could never make eye-contact because they couldn't look any higher than my boobs. There was a scar, and there was some pain after, but the mastectomy was an easy procedure, and I was able to leave the hospital within 24 hours.

Strong chemotherapy began in July, just before Rich and I left for our usual anniversary beach trip. It was while I was swimming in the hotel pool that I noticed my hair was starting to fall out. By the time we returned to Enterprise, I could easily pull fistfuls from my head. Luckily, I was able to find a natural-looking wig to wear to work and a pink turban to cover my nearly-bald head while at home.

While I did not grieve for my missing breast, I despised being without hair. Although the wigs were very close to my hair color and usual hairstyle, they were incredibly hot and they itched. I remember wondering if I'd live long enough to ever get my own hair back.

It was two months after my surgery and one month into chemo when cancer reached out its tentacles to another innocent victim. My closest friend, someone I'd considered an older sister, was diagnosed with stage four lung cancer. Her husband called me at work with the unbelievable news.

I was stunned; Sharon had never smoked, had routine yearly checks, yet at 55 years old with one boy in college and another in high school, she was struck down by this awful disease. To make matters worse, my father's radiation treatments didn't seem to be working anymore. He was losing weight and stamina. It was the same month, August, when he stopped trying to work and eased his traumatized body into his living room recliner. He never got up again.

A few days later, my sister, Liz, called from Tennessee to tell us her fiancé had colon cancer and would be undergoing surgery to remove the tumor. And, to top it off, my 4-foot, 10-inch, 98-pound mother fell and broke her left arm.

That put me in a tailspin of hospital visits for chemo and to see Sharon, who had not been told she was terminal. After my treatment and visit, I would head to work for half a day. At 4:15 p.m., I'd leave the office and go to my parents' house where I ensured they had food (Faith Baptist Church members took turns bringing them homemade meals - bless them!). I usually spent an hour cleaning and mopping, getting dishes into the dishwasher, helping mom into the shower, and making pain med runs to the nearest pharmacy for dad.

By the time I got home, I was exhausted, and I'd lie down in bed, alone, with every nerve in my body tingling. Rich had taken to playing computer games until all hours of the night. He had been my rock during the diagnosis and right after the surgery, but now, he seemed distant, almost as if he were withdrawing from our life together. I sensed the aloofness, but the poison flowing through my veins and the bad karma hitting my family kept us from something vitally important in all marriages: communication.

By October 2006, I had graduated to the second chemotherapy. This magic potion didn't make me tired or nauseated, but it finished off my hair and sucked the feeling from my hands and feet. The scientific name for this is neuropathy. My hands ached, tingled and felt swollen. While I could still operate my work computer, I couldn't button my own shirt.

As for walking, I found that wearing kids' sneakers with the wide bottoms helped me maintain balance. Heels and sandals were simply out of the question. I lurched and stumbled like a drunk on a three-day binge. When I asked my oncologist if I'd ever get feeling back, he assured me that it would ‘probably' return to normal following the chemo.

He lied. Even now, five-plus years later, all sensation has not come back.

My life, or what was left of it, continued to spin out of control. Dec. 29 of 2006, my beloved "Big Sis" passed away - only four months after her lung cancer diagnosis. Her funeral was on New Year's Eve, and my entire family attended.

I had not shed a tear in years, not even when I learned that my own cancer was Stage Four IBC but, when one of the guests began to sing "Amazing Grace," I broke down. Rich was at the entrance to the funeral home; my daughters were just outside the room where I sat. All three had rarely seen me cry, so they were at my side immediately. It would be the last time I cried for nearly six months.

Four weeks later, on my brother and sister-in-law's wedding anniversary, Jan. 25, my dad quietly went to sleep in his living room. The whole family, with the exception of my mom who had been coaxed to go to the beauty shop, was with him. Daughter Ember, who'd had an especially close relationship with her granddaddy, kissed him goodbye on the forehead. He'd fought so hard for so long; it was time for him to rest.

The irony of that day is that while the funeral home directors were loading Charlie Wright into the back of a hearse, Rich and I were leaving for the Enterprise Cancer Center. My final radiation treatment was to be at 1 p.m. I can remember lying on the same gurney as my father had for two and a half years, watching the technical machinery hovering above me and wondering if it was really doing any good. My father was buried on Jan. 27, 2007, my sister's 49th birthday.

I had second-degree radiation burns on my neck and shoulder; I was bald as an egg; and my "sister" and father were dead of the same disease afflicting me. As I watched my father's flag-draped coffin being carried to his last resting place, a familiar saying came to me - "God won't give you more than you can handle." Actually, the exact biblical quote is from 1 Corinthians 10:13. "No temptation has seized you except what is common to man. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can stand up under it."

Five weeks later, a tornado hit Enterprise, killing eight young people and an elderly woman. After March 1, 2007, God and I were no longer on speaking terms.

Elizabeth Kubler-Ross describes five stages of grief: denial, anger, bargaining, depression and, finally, acceptance. Typically, I did not follow them in order. First was blind acceptance. After the breast cancer diagnosis, I was content to let the doctors lead me around by the nose. I was in unfamiliar territory, and I respected their opinions. I was very fortunate to have specialists who followed through and I know I am alive today because of them and because my husband insisted on that last biopsy.

Second was bargaining: I'd never really been religious, but I did believe in God. I talked to Him a lot before and after the IBC diagnosis, promising anything and everything if He'd just let me see my daughters finish college, marry and have children of their own. After dealing with all the horrors and tragedies of Breast Cancer: Year One, I reasoned that if there was a God, He was not listening; and, if there wasn't, I was wasting precious time trying to make a deal.

The emotional barriers I'd built to keep up my pretense of coping with a possibly fatal disease began to crumble in Year Two. Every three months, I dragged myself to three separate doctors' offices, terrified of what they would tell me but, luckily, each time, the surgeon, the oncologist and the radiologist found no recurrence. I'd exit the offices, limp with relief at another reprieve.

But on the home front, Rich and I were becoming increasingly more out-of-sync. Having once been accused of being the presidents of each other's fan clubs, now it was more like he just wanted to be left alone. He buried himself in his work and his computer. Rather than talking to him about it, I withdrew myself, preferring to spend time with the girls, my mom, and old television shows.

I did go online to check the statistics on marriage and cancer. They were unsettling, showing that three out of four men left their cancer-stricken wives. On the other hand, the opposite was true of women: three out of four wives stayed with their sick husbands. My IBC survival rate for two years was 20 percent and now I realized that the marriage and husband I'd always treasured and felt secure in, i.e., taken for granted, now had a 75 percent chance of failure.

And so began the grief stage - I cried every day at the loss of the life I'd loved. I cried while driving to work and I cried while driving home. My appetite went away, causing a loss of forty pounds in less than two months (which led to more aggressive tests at my next quarterly doctors' visits).

Most of my life, I'd held everything - good and bad - inside. Even now, after the surgery, chemo and radiation, most of the people I knew were unaware of my breast cancer diagnosis and prognosis. Friends and co-workers just knew that for whatever reason, Theresa was a changed woman, inside and out.

Halfway through my second year, I stopped crying. If my timetable was correct, I had about six months left. Most breast cancer survivors are grateful for that extra time. They have their families and their close friends to sustain them and they feel a need to let the world know how cancer changed them for the better. They are generally kinder and more forgiving of friends' and families' past indiscretions. Spirituality increases, and many feel an obligation to help others get through the battle they've fought.

I, on the other hand, wanted nothing to do with anything cancer-related, especially pink ribbons and Breast Cancer Awareness month.

Although my family had participated in Relay for Life for more than nine years, I refused to attend anymore. Rich, Miranda and Ember had been on teams, walked the track and spent the night many times, and I had always been there with them. For years, Ember begged her granddaddy to join the Survivors Team, but he always refused, saying that when and if ever she won the Miss Coffee County Relay for Life pageant, he would participate.

In 2006, she took the title and, ever true to his word, my dad got involved, attending the Survivors' Breakfast in the morning, then walking to the podium at the Relay and announcing in his distinctive voice that he was a 26-year lung cancer survivor. Ember, Miranda and I joined in the first walk around the track. It was two weeks before my own cancer diagnosis.

Anger suddenly became a new protective shield. I had felt angry before, but now, it was different. The fury and vitriol permeated every fiber of my being. At times, it was so intense that I don't know how I managed to appear normal at work and with friends. Demons took possession of my soul, whispering vile suggestions. I took no joy in anything, even considering and attempting suicide twice. Luckily, both times, my daughters and my husband managed to save me from myself.

Daily panic and anxiety attacks finally drove me to my radiologist, Dr. Steven Stokes. Stokes had been my father's doctor and had seen me through the IBC radiation treatments.

A man who deals daily with terminal illnesses, Stokes is personable and attentive, yet understandably reticent with his patients. But as he looked into my eyes that day, I knew he could see the storm of madness brewing inside me. At first he suggested hospitalization, but I immediately nixed that. With no other option, he then gave me a prescription for anti-depressants and referred me to a Dothan therapist, Dr. Ann McDowell. Two weeks later, in December 2008, a raving maniac walked into the office of a fiery-haired angel. The healing had begun.

Today I'm three and a half years past my anticipated "expiration" date. In January, I was given a clean bill of health from Stokes; he recommended I have reconstructive surgery. I'm considering it.

In March, I had my five-year tests for Dr. ‘G'. The mammogram and blood tests were negative, but the x-ray showed a dense area in my left lung. Always the thorough doctor, he skipped a second x-ray and ultrasound and sent me for a full-body PET scan. It was negative. One week later, he pronounced me a living, breathing, walking cancer-free miracle.

Life has been a roller coaster, but I'm grateful the ride isn't over yet. That bucket list I bargained for back in 2006 still has a few items left on it.

Rich and I have been to Disney World three times since 2008 - once as a couple where we strove to reconnect our lines of communication; once as a family, with both 20-plus daughters who were suddenly 6 years old again; and once more in 2009 with Ember. Miranda couldn't join us because she and her new husband, Kurt, were in Germany.

I got to plan two weddings - a backyard civil ceremony in April 2009 and a wonderful formal one in June. Two weeks later, they flew to his first overseas assignment. In December 2012, we plan to go to Disney World again.

We're hoping our beautiful daughter and wonderful son-in-law will be with us. We're also hoping Kurt's parents, Kurt Sr. and Dianne, can join us, too.

It's October again! The leaves are changing color and falling off the trees, the weather is growing cooler, and pink products and pink ribbons are sprouting everywhere.

Last month, Miranda and 6,999 others ran in a Susan G. Koman For The Cure marathon in Frankfurt, Germany. Ember has changed her Facebook photo to her annual "Feel Your Boobies" shot, and next week, she will participate in a Dothan 5K run for breast cancer awareness.

The three of us are also in a personal competition - we're letting our hair grow long so we can donate to Locks of Love. Personally, I have good days and bad days.

In May, my mother passed away unexpectedly. She had never been happy after my father died, so her death was a bittersweet shock. Eight days later, Rich, Ember and I traveled to the Memphis Film Festival where I got to meet (and hug and kiss) my favorite actor of all time: Robert Fuller. I told him about my mother, and sweet man that he is, he stroked my hair and whispered that he was sorry. His eyes told me that he knew the pain of losing parents.

We returned to Enterprise, but one week later, we were heading to Fort Payne to attend my grandmother's funeral. She was 97; her daughter (my mom) would've been 81 on Sept. 12.

Ember is close to graduating from college and has moved into her own apartment, making Rich and I empty-nesters. In July, we bought a beautiful house in the country. During the day, we work at jobs we love - I'm a Systems Analyst and he's a Platform Instructor on Fort Rucker.

At night, we work on making the house a home, taking care of our seven fur babies and picking out constellations in the night sky while we stroll the property. So far, I've beaten the 20 percent IBC cancer survival odds, and Rich and I have talked our way back to a stronger, deeper relationship.

Cancer has touched my life in so many ways, yet I am still blessed by the trials I've endured. I've had the privilege of knowing that life cannot be taken for granted. Every human being on the planet is terminal, but only those of us who've battled life-threatening diseases allow that realization to surface from the inner-consciousness. That awareness makes every sunrise glorious and every sunset a celebration. For this, I thank God (with whom I'm back on speaking terms). I also thank Riley, Stokes (and his amazing, caring team), and Dr. "G", who also has some of the best nurses and staff around. They saved my life. And, last but definitely not least,  McDowell, who saved my soul.

For more information about Inflammatory Breast Cancer symptoms, check out the following link: www.webmd.com/breast-cancer/guide/inflammatory-breast-cancer.