Tuesday, March 10, 2015

The Preferred Excerpt

         
         I had been near unconscious since I stepped foot into school and I was dragging, literally, my feet scrapped across the floor, and my backpack was on the ground behind me. When I reached my locker I yawned and just kept on walking. Several steps later I realized I’d passed it. I huffed dramatically and stuck my bottom lip out before turning back to it. I had no idea how I was going to get through the second half of the day.
As I was unloading my books, I caught a glimpse of Carrie and her gang in my peripheral vision and immediately knew what was coming. I turned away from them and in the direction of my next class when Carrie stepped in front of me.
She stuck her left hand out to the locker and blocked my way. Tucked under her other arm was the second book in the Star Light Series: Moon Light. I knew it well, because it was McKaela’s favorite series. Carrie and the gang all carried around their copies as though it was a holy book. I would’ve been surprised that they knew how to read if this weren’t such a prestigious school. Then again, most of their parents were benefactors.
I glared down at her, careful to remain expressionless and waited as she looked me up and down. She finished her appraisal and seemed pleased with what she saw, because she sneered at me.
“So, here’s the school’s very own, real life, hero,” she looked at her minions. “Don’t you think she deserves a round of applause girls?” She clapped. The rest followed suit, except for Angela who was currently trying to cover her softball sized goose egg with her bangs. “It serves you right for what you did to Angela. You know what they say about Karma?”
“And all this time I thought your name was Carrie….What do you want, Karma?”
Her pulse throbbed at her temple. “We need to talk,” she said after several awkward, silent moments.
“Why?”.
“Jessie is mine—you can’t have him,” she told me as calm as could be. I had the impression though that it was a carefully measured calm, like how many inches she’d removed from her skirt to make sure it’d be just shy of showing her panties.
My face twisted. “What are you talking about?”
She cocked an eyebrow. “I know that Jessie asked you to Kyle’s party on Friday,” she snapped. She looked over at her crowd and reined herself in, then smiled at me.
“You do know that you and Jessie aren’t dating anymore, right? Remember he broke up with you months and months ago.” Okay, I’ll admit the second months was uncalled for, but she was irritating and I was tired.
Her face turned a deep red. I took that as an opportunity to try and escape, but I guess she wasn’t finished with me yet because she encircled my arm with her purple taloned fingers as I tried to get by.
“You listen to me,” she said as her nails dug into my skin, “Jessie is mine and if you don’t stay away from him I will make your life a living hell.”
“And that would be different from this how, exactly?”
“Stop!” Carrie shrieked.
I jumped.
Carrie released my arm and moved Moon Light to her left hand, tucking it against her chest. “You can joke around all you want, but unless you want your nose to be broken you’ll back...”
“Hey, Carrie,” Michael said, surprising me, as he brushed by, “you have something in your teeth.”
Carrie squealed, her hand went up to her mouth and she pushed me out of the way and ran down the hall toward the girl’s bathroom. I watched her go, impressed by her speed considering the five inch heels she was wearing then looked in the opposite direction at Michael’s retreating form. I could just make out the top of his blond head in the crowd. I opened my mouth to thank him, but he was too far away to hear.
I was surprised he wasn’t at lacrosse practice with Jessie and Ben and even more that he had just intervened on my behalf. Then I remembered a moment at the car wash when I’d tripped over a hose. He’d caught and righted me before I’d even had a chance to flare my arms and then he was gone, just like now.
I started toward class when I heard McKaela call out to me from the direction Carrie had run. She carried her backpack in one hand and waved at me with her other. She then pointed to the boy walking next to her. Not that she’d needed to.
He had at least nine inches on her and the difference was palpable. He wore a cocky expression on his face that was near completely covered by jet black hair. He was wearing a black wool coat over his white shirt, which was unbuttoned a few buttons revealing a wife beater underneath. His blue tie hung loose and to the side and he had chosen the plaid pants that most the boys never wore except when the rest of their options were dirty. It seemed like a bold choice for his first day. I’d gone as neutral as possible on my first day. Not that it’d helped.
I glared at his tie and hoped I wouldn’t embarrass myself by straightening it. Not that he would’ve noticed if I had, it seemed, by the way every single person in the hall was turning and staring at him and the way he was somehow managing to make eye contact with all of them. It was like some alternate reality, watching him. Like watching a rock star make his way through a crowd, winking and blowing kisses as he went. One of Carrie’s minions swooned.
I didn’t get it. Sure, he was attractive enough, I supposed, but the amount of cockiness seeping off him was enough to make any sane girl want to run and hide. As a matter of fact, I’d lost my mind and still wanted to run and hide.
McKaela stopped in front of me and smiled. I noted that she didn’t seem sad like she had yesterday and I was even more pleased that she appeared unaffected by the new kid.
“You’re nose looks so much better,” she said slightly in awe.
“Yeah, I iced it,” I said lamely, while purposefully keeping my eyes off the superstar interloper.
She looked up at him then back at me and blushed. “Oh, sorry. Eva, this is Mal, Mal this is my best friend Eva.”
I turned to him and immediately cringed at the pervy look he was giving me. McKaela took a text message. I smirked at the red, white and blue, “Vote for Brightman” sticker that was peeling off the back of her phone.
Mal threw his head to the side sending his bangs out of his eyes and my mouth dropped open despite myself. His eyes were purple. I leaned forward searching for contacts, but there weren’t any.
Who has purple eyes?
“How do you spell your name?” he asked catching me off guard.
I took a step back. “Um... E.V.A.”
“Good,” he smiled a wide toothy grin, un-proportionally pleased, “most people spell it A.V.A. these days. Your way is much better.”
“Thanks.” I tried to smile, but had the feeling it looked weird. That feeling increased when his smile faded ever so slightly and his expression became befuddled.

Tuesday, March 3, 2015

Making the Breast of It: BRCA2 Gene Mutation


Story and Photos by Emily Clark

The Path that Lead Her Here

Lily Webb in the Leeds, Utah cemetery

Lily Webb walks thoughtfully down the Juniper lined pathway in search of her aunt and grandparents. A cool breeze, that is in stark contrast to the blazing sun, swirls around her in the cemetery in Leeds, Utah, guiding her forward.

Her four-year-old daughter, Lois, runs excitedly ahead of her as Lily looks to the right and then the left.

“I could’ve sworn they were over here,” she says as she continues her search. “Let’s try the other side.”

Lily Webb searches for the graves of her grandparents and aunt.

Another few minutes of searching yields the discovery of their graves. Lily kneels and reminisces.

“Oh, Grandpa,” she says in a heartfelt whisper as she reaches forward to touch an engraving in his headstone. It reads: He tried.


Lily Webb with daughter, Lois Schoenhals, at Lily's grandfather's, Lavarr Beames, grave.

“You did, Grandpa,” she says out loud as her daughter crawls into her lap. “You did great.”

A moment passes in silence before she speaks again. “I was holding him when he died,” she continues. “He died of cancer. It’s ironic, because he didn’t die of the BRCA2. My grandma died of BRCA2, as did two of my aunts.”

She wraps her arms around her daughter, rests her chin on the little girls shoulder and becomes pensive.
Lily has BRCA2 gene mutation, along with 30 of her 40 cousins that have so far been tested for it, but unlike her grandmother and her aunts she’ll survive, and it’s all because of the discovery of the BRCA2 gene mutation.
           
Discovering BRCA 2

Lily Webb waits to see one of her Mastectomy Surgeons, Dr. Rosenthall

BRCA2 is a genetic mutation that is hereditary, and can be passed down on both the mother and the father's sides, and makes the possibility of getting cancer at a very young age an inevitability. It can cause many different kinds of cancer, but for women it typically causes breast and ovarian cancers.

The gene mutation is very rare and because of this almost unheard of. So how then does a family like the Webb’s come to discover its existence?
           
“Two of my cousins were up at Huntsman Cancer Institute being treated for breast cancer,” Lily says, pushing a lock of her hair behind her ear. “They found each other in the hall one day and were talking. That’s when the doctors discovered they were cousins. They told them immediately how strange it was that they both had cancer. Wheels were set into motion, my family was flown in from all over the world and the testing for the BRCA2 Gene Mutation began.”

It never seemed strange to Lily or her family that so many of them were getting cancer.

“We grew up knowing that we would die of cancer. It was an inevitability that we had all come to terms with. Everything’s different now, we aren’t destined to die.”

Cheating Death

Lily speaks with Dr. Rosenthall about her upcoming Double Mastectomy.

Lily quickly decided to take every preventative measure available, 
Questions asked of patients deciding on surgery.

including a double mastectomy and hysterectomy, in effect pioneering the way for her cousins who are still struggling with what they should do.
           
“I [...] know that I have done what I can to be with my young daughter for longer, (Webbmakingthebreastofit.blogspot.com, A Bit Extreme? Yes.).”
            
“Having a hysterectomy now could cause other serious complications,” Webb explains. “My doctors won’t let me have that surgery until I’m 35.”
           
Despite not having to worry about a hysterectomy at present, she still had her mastectomy nearing and regardless of her frequent doctor’s appointments, life continued.




Work Family


Lily talks about her new benefits plan with fellow co-workers Jake Walton and Julie Pizza

One day at work Lily sat at her desk looking over her potential medical expenses for the double mastectomy and felt, once again, the relief that came from working at Nelson Laboratories.

Having a double mastectomy and reconstruction requires two separate surgeries and at least six months of total recovery time. Her work colleagues, including her direct boss, and the CEO of Nelson Laboratories have assured her that they will help in any way they can, including holding her position for her during her recovery, allowing her part time disability so she can work from home, and have even offered to help her pay for her surgeries if the insurance decided they would not pay for them.

“Insurance not paying was a real possibility given that I didn’t have cancer yet and that my surgeries were just preventative. So it was extremely relieving to know that I wouldn’t be buried in medical expenses for the rest of my life.”
           
Her last day at work, before her first surgery, was a particularly emotional day.

“I asked my boss if I should clear off my desk and she panicked and asked me if I wasn’t planning on coming back,” Lily recounts with a smile. “They threw me a going temporarily away party and my teammates and boss surprised me by donating forty hours of their PTO, (Paid Time Off,) that was then matched by the company.”

On The Move

Part of the stress of having a double mastectomy came when Lily realized that she would have to move. Being every bit the proactive protagonist she immediately began the process by putting almost everything she owned into a personal storage unit so she could prepare to move back in with her parents.

“My parents have been so great through all of this. They let me move back in, my dad came up to Salt Lake to help me move and my mom is going to help take care of me and Lois while I’m recovering."

Lily and her father, David Webb, move her bed out of her Midvale, Utah town home and down to Springville, Utah.
           
It’s never easy being a single working mom as any single working mom would attest to, but adding the stress of a double mastectomy on top of that is one that she knows she wouldn’t have been able to handle alone.
           
“My mom had planned on coming and staying with me in my new apartment after surgery, but in the end it just made more sense to move back in with my parents.” 
           
She continues, “I will also be able to save the money I would’ve used on a cheaper apartment and apply that toward expenses, medical and other, later on.”

Being Mommy

Lily holds her daughter Lois Schoenhals at Lois' fourth birthday party.


“I have three reasons for having this surgery; first so that my daughter doesn’t have to grow up without a mother, like some of my cousins had to do because of this gene,” she explains ticking her reasons off on her fingers as she goes.

“Second, I’m doing it for myself and third for my cousins. But first and foremost is Lois. I have a responsibility to her and I need to make sure that I am around to fulfill it.” 

Lois is still too young to understand what’s going on right now, which is in part why Lily decided to go ahead with her surgeries now. She knew that the amount of stress that Lois will feel now will be considerably less than what she might feel in five or ten years.
           
“She asks a lot of questions, wanted to go to doctor’s visits with me, and after the surgery she even went with me when I had my drains removed. She’s not frightened by it, just curious."




5:30 a.m.

Lily arrives at the hospital with her mom, dad and friend, Emily, in tow. They wait approximately ten minutes before being escorted into the back.
           
She is then asked to shed her clothes and to put on the hospital’s stylish gown and thigh-high compression socks that are almost too confusing for her, her mom, and her friend to figure out. Once they’re on she still isn’t sure they’re on correctly. When her dad is invited back into the room they all have a momentary chuckle about it.
           
Then nurses begin to file in one after another. Tension starts to build, the room feels smaller, and the Webb’s become stoic.
           
Her dad is the quietest of the bunch, staring on with his arms held firmly against his chest. It’s not until after the surgery that he admits to her what he’d been thinking. 

Lily's parents, Robin and David Webb, wait with Lily before her double mastectomy.
          
“The gene comes from my dad’s side of the family,” Lily explains. “He told me that he was watching me prepare for this and was angry at himself for having given me the gene. I told him that his only other option would’ve been not to have me and that I’d much rather have my life and this gene than no life at all.”
           
Lily keeps her face calm, trying to convince her parents, her friend and herself that she’s fine, but her body language speaks differently. She tucks her legs back and balls her hands into fists. 

Lily waits for her double mastectomy.




Two hours, five nurses, two doctors and an anesthesiologist later, the surgeons  finally come to collect her.
           
She gets a hug from her friend, then her dad, and a hug and kiss from her mom. She doesn’t see what happens when she’s wheeled out of the room.
           
She doesn’t see her mom give way to tears, or the huge hug her dad gives her mom.
           
She doesn’t sit anxiously with her mom and friend while they wait to hear how she doing, or hear her mom say, “I’m so proud of her.”

Robin, Lily's mom, kisses her before she is taken into surgery.

A Success

Surgery is over. It was a success. Her mom and friend go to her room to find her groggy, but awake. The doctors assure her that everything went according to plan. She had a double mastectomy and was able to keep her own breast skin, and her likelihood of getting cancer has dropped from over 90 percent to three percent, in just over eight hours of surgery. 

           
Friends and Family

Lily feels very fortunate after her surgery to have such warm and genuine support from her friends and family.
           
Her little sister Xanthe flew in from Winchester, Virginia, with her infant daughter Zara, so that she could be with Lily after her surgery. 

Lois, Lily, Lily's little sister, Xanthe Aintablian, and niece, Zara Aintablian, spend quality time together after Lily's surgery. The "grenades" are still attached to Lily's sides. Xanthe and Lois both have a 50 percent chance of having the BRCA2 gene mutation. If Xanthe tests positive for the mutation then her daughter, Zara, will have a 25 percent chance of testing positive.

Lily’s mom, Robyn, helped her walk, dress, eat, sit up and do other basic tasks, which we all take for granted every day, for several days after the surgery.

“I couldn’t even hold a bottle of water without her help,” Lily recounts. 
           
She had visits from many of her friends and extended family. 
           
“The presence of my extended family was a sign of their acceptance and support of the path I have chosen, which was originally considered to be extreme.”

A Possibility

Lily sits in Dr. Chen’s office for one of her post-surgery tissue-expander fills. The doctor sticks a magnetic needle in her chest which finds an integrated port in her tissue-expander and allows saline to be injected, stretching the muscle to prepare for the implant she will receive in her next surgery.
           
Her daughter, Lois, and mom, Robyn, sit with her as she goes through the process.

“Lois was really interested in seeing how it works. She asked to come,” Lily smiles recounting Lois’ curiosity. “Lois has been a little frustrated that I can’t pick her up. Coming to the doctor’s appointments have helped her to understand why that is.”

Lois watches as Lily recieves a tissue-expander fill, post surgery.

Lois has even shown great empathy toward her mother despite not completely understanding.
           
A few weeks ago Lily and Lois went on a walk with a friend and Lois fell down and hurt herself. Lily immediately bent down to pick her up and comfort her. Lois waved her away in the midst of tears and said, “Let Emily hold me.” She was too afraid to let Lily hold her because she knew it would hurt.
           
Lois has a 50 percent chance of testing positive for the BRCA2 Gene Mutation, so Lily hopes that everything she has done now will mean a lot more to Lois later on in life than just being able to grow up with her mom.
           
Lily realizes that it’s not likely that Lois will remember much of what she did but when she’s old enough to appreciate the significance of it she’ll have her mother’s blog and a photo record provided by their friend Emily.
           
In 14 years Lois will be tested for the gene mutation and if she has it she’ll then have to make a decision on how to proceed.
           
If she chooses to take the preventative measures she’ll have a clear record of what her mother went through, plus the advantage of 14 plus years of further medical advancements.
           
“The hope is that the detection will be so advanced that preventative measures will be better and that she might not even need to have the surgeries,” Lily says.        

A Brighter Future

With one surgery behind her, one planned for the week before Christmas, and a hysterectomy expected in five years, you might think that Lily would be less than optimistic, however the opposite is true.
           
“Some people may accept that eventually these things may need to be done, but will still wonder why I feel the need to do them now. I turned 30 in April, and it is unlikely that I would see cancer develop until I am between 35-40. My answer is that I know exactly what my life involves right now. 

Lily gives Lois a piggy-back ride.

“I have an amazing family, most of whom are currently local and can assist me after I’ve had the surgeries. This may not be the case in 5 years. I work for an amazing company with managers who have assured me that they will work with me during the recovery period. I don’t know who my managers will be in 5 years. I have an insurance company that will most likely cover the procedures. I have no idea who I will be insured by in 5 years, if at all [...] I am healthy and happy right now, putting me in an optimal place to make such a decision. (Webbmakingthebreastofit.blogspot.com, My BRCA2 Journey.)”
           
Lily takes one last look at her aunt and grandparent's graves then stands up, takes her daughters hand and heads back to the path.
           
“I’m trying to make the best of it. It’s all anyone can do with the challenges they are presented in this life.”
           
Dying young is no longer an inevitability.
           
“I am the mother of a beautiful little girl. I am a Regulatory Specialist at an amazing company. I am a friend to some amazing people. I am scuffed up but not broken. I am really happy with who I am. I am grateful to my family. I am blessed, (Webbmaikingthebreastofit.blogspot.com, Profile.)”

If you’d like to learn more about Lily or BRCA2 gene mutations you can visit: http://webbmakingthebreastofit.blogspot.com/, or read my news article entitled, Understanding BRCA Gene Mutations: What They Really Mean For Those Diagnosed