Don’t cry for me..

Life begins at 40. Up until then you are just doing research. For Judy, this research had connected her to a group of friends with a hunger to create an impact. They were a group of 10 women — all professionals — who decided to visit their respective rural homes. “What will we do when we get there?” One lady asked. “We can teach them about cancer. Maybe breast and prostate.” Someone suggested. And because they had medics in the group, it was a go. So for four years Judy and co taught women about self breast exams, ominous signs to look out for, and the importance of screening. In that entire period, she never once took the time to taste the water she was offering others to drink and when she eventually did — she found something!

The discovery was not immediate. It started with a thought. ‘I have been teaching other women about screening and self breast examination but I have never done the same for myself.’ It was probably the classic case of ‘them’ and not ‘us.’ So she started to check herself every so often and one day there it was. The ‘something.’ This discovery paralysed her. For three months. She mentioned it to her husband but they stalled hoping the ‘something’ would probably turn out to be ‘nothing.’

It remained at the back of her mind until she had to go to hospital for abdominal pain that had been bothering her. While there, she brought the ‘something’ up to the clinician who proceeded to examine her and send her for tests. The wheels had been set in motion. But instead of moving forward she found herself running around in circles because the tests were not easily accessible. Time passed. It was only until a friend intervened and directed her to a private institution that she met Dr M.

Judy took to Dr M like a duck to water. Theirs was a natural, organic connection. “I remember when I got into the consultation room, she stood up, came round and sat in the chair next to me. Her voice was soft and tentative as she took time to take my history and explain what tests needed to be done and where.” She said they would start with a mammogram and take it from there. This gesture made Judy feel like this was a journey they would walk together.

The mammogram machine must have been invented by a man. Or by a contortionist. “I had to stand facing forward with my head turned to the side. Then I needed to somehow detach my breast from my chest far enough to fit into a rectangular space.” When the technician said, “Closer please, I need the whole breast in,” I felt like it would have been easier to just crawl into the machine. I was stretched to the limit. As they were still trying to position her, the tech glanced at her right breast and asked, “How long have you been having this?” She pointed to an area on the underside that had formed a dimple. The skin on that area looked like it was being sucked in. “I don’t know.” Judy had not noticed this before. “This does not look good Judy.”

“What is it?”

“Your doctor will tell you when you get the results.”

The journey back to Dr. M was wrought with stress and anxiety. What did the technician mean by this is not good? By the time she was called in she was a bag of nerves. The doctor picked on her fear and asked her what had happened. When Judy mentioned the skin change, Dr M said, “Judy even if you end up with breast cancer, it is not a death sentence.” That statement became her cloak of encouragement. She triaged her feelings, put the negative ones at the back and held on to the positive ones. The doc then counselled her extensively before telling her there was a suspicious mass in her Right breast and sent her for a biopsy.

By now the bills were piling up to Everest proportions. “The cost of investigations was so high and we hadn’t made a diagnosis yet. It was unsettling.” With some help they were able to raise the money for the biopsy and it was done. The two week wait for the results was a nightmare. Something was definitely off from the way the clinicians were treating her. She couldn’t eat or sleep. When she closed her eyes, she would see visions of her husband and two daughters seated in a tent at her funeral. She was plagued with thoughts of death. Her death. All thoughts of her counselling session forgotten.

The day of reckoning came — when she had to collect her results and see the doc. She watched her open the envelope and could see it in her eyes before it got to her lips. The doc reminded her of their previous counselling session and then said it. “Breast cancer.” The words left her lips, floated about in the air and then suddenly slapped her in the face. She felt like she had jumped off an aeroplane and was in free fall — her parachute refusing to work. The Doc however jumped off the plane with her and opened her chute; giving her a soft landing. “Judy, remember this is not a death sentence. You must believe that. And if I were to choose a type of cancer to have, I would choose the one you have. It is very slow growing.” Judy tried to smile but her face did not obey. She let out a slow sustained breath. “Ok. What next?” she asked.

Her acceptance came fast. She figured she might as well pick up and move because tears would not wash away the disease no matter how much she cried. Her husband however was not on that page yet. When she told him the diagnosis he took it hard. He seemed to be going through what she went through while waiting for the results — except his was a crash course. He looked so distraught Judy joked, “You look like the one with breast cancer dear. I am ok.” Friends from her group called and when she would tell them the results, they would hang up! Others would cry— needing encouragement themselves.

Next a CT scan was done to stage the disease. She was staged at IIB. (That’s read as 2B) and a treatment plan was formulated. There was only one hindrance — finances. Cancer is an expensive disease. It takes and takes and if one is not careful it can drain not only your wallet but your will. It doesn’t just hit the primary person, it affects everyone around that person. So you need to be surrounded by a lot of positivity and good will. “I thank God for my family who decided to carry this burden with us; and after a series of consultations we opted to continue the management in India.”

India was a whole new ballgame. “I remember walking through the hospital doors feeling like I had stepped into the twilight zone. The place was beautiful and bright with high ceilings and big spaces. You could eat a meal off the hsopital floors.” She found a team of clinicians waiting for her. Ready to take her through the comprehensive treatment plan, which included more tests, surgery, chemotherapy and then hormone therapy.

Judy underwent a Right Mastectomy (dont run away from hard words. You can use it in conversation and look intelligent) as the first step in treatment. “I remember waking up and feeling…nothing. I wondered whether the operation had actually taken place.” She peeped through her hospital gown and tried to lift the bandage to see what was there. Just stitches. It was done. There was a sense of loss that lingered. Still, she was happy to have made it out. The healing process was uneventful with so much support everywhere she turned.

Next was chemotherapy. Now this she feared. Because of the horror stories she had heard about. Someone told her, “Your hair will fall off. You will vomit your guts out. You will have blurred vision and all manner of side effects.” She went for the first session with built up anticipation for the worst. But, nothing. She even asked them whether they had actually given her the meds. When others were losing appetite, hers was increasing. If there was anything Judy did in India other than receive treatment, it was eat. ‘Where were those side effects?’ she wondered. It was only until her 2nd cycle that she woke up and found her hair had not woken up with her. The strands had been left behind on her pillow. Judy didn’t flinch. She picked a pair of scissors and snipped whatever she could — hair be damned.

She came back to Kenya to complete the remaining cycles. 4 to be exact. The only time she vomited and lost her appetite was in the 6th cycle and she was done anyway. Judy quickly resumed her usual routine. She even attended a wedding she was catering for, two days after completing her treatment. Her doctors told her that the surgical results were back and showed that they had gotten everything out. She has since been on daily medication and regular follow up.

So many people have met her and tell her she doesn’t look like she has been undergoing treatment for cancer. Through her journey she got to know of so many people who get diagnosed quietly, get treatment quietly and go into remission quietly; keeping their cards close to their chest. She has chosen different. “How will people be encouraged if I don’t give them a front seat to my journey. So many people are still so afraid. Some are ignorant. Some just need support.” So she takes time to talk people off the ledge. It is not a death sentence, she says. Do not die before your time.

“Are you afraid of recurrence?”

“Yes. But I don’t let that fear hold me back. When it comes, I refuse to let it leak into my life.

As Narrated to me by Judy Kayuni

Breast cancer occurs when normal cells in the breast change and grow out of control. It is commoner in women than men but men can also get the disease.

Women sometimes discover they have breast cancer because they find a lump in one of their breasts.

Breast cancer sometimes runs in families.

If you feel a lump in your breast, see your doctor right away.

Tests: — A special kind of X-ray called a mammogram is done to check for breast cancer. If a mammogram finds a spot that looks like it could be cancer, doctors usually follow up with another test called a biopsy.

During a biopsy, a doctor takes one or more small samples of tissue from the breast; then looks at them under a microscope to see if they have cancer.

What is staging? — Cancer staging is a way in which doctors find out how far a cancer has spread. The right treatment for you will depend, in part, on the stage of your cancer.

Treatment

●Surgery — Breast cancer is usually treated with surgery to remove the cancer. It can either be a mastectomy or lumpectomy.

•Mastectomy is surgery to remove the whole breast.

•Breast-conserving surgery (also called “lumpectomy”) is surgery to remove the cancer and a section of healthy tissue around it. Women who choose this option keep their breast.

●Radiation therapy — Radiation kills cancer cells.

●Chemotherapy — These are medicines that kill cancer cells or stop them from growing. Some women take these medicines before surgery to shrink the cancer and make it easier to remove. Some women take these medicines after surgery to keep cancer from growing, spreading, or coming back.

●Hormone therapy — Some forms of breast cancer grow in response to hormones. Your doctor might give you treatments to block hormones or to prevent your body from making certain kinds of hormones.

What happens after treatment? — You will need to be checked every so often to see if the cancer comes back. You will have tests, usually including more mammograms. You should also watch for symptoms that could mean the cancer has come back. Examples of these symptoms include new lumps in the breast area, pain (in the bones, chest, or stomach), trouble breathing, and headaches. If you start having any new symptom, mention it to your doctor.

What happens if cancer comes back or spreads? — That depends on where the cancer is. Most people get hormone therapy or chemotherapy. Some people also have surgery to remove new tumors.

What will my life be like? — Many people with breast cancer do very well after treatment. The important thing is to take your medicines as directed and to follow all your doctors’ instructions about visits and tests.