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A Pinch of Joy
Inspiration Monday

I am a breast cancer and ovarian cancer
PREVIVOR living with the
diagnosis of BRCA2+ genetic mutation
and high cancer risk (87% with family history).

Even though this diagnosis received a ton of press,
and a wide discussion of inherited breast cancer
ensued thanks to Angelina Jolie, you may
still be confused about the complexity of it all.

I chose Prophylactic Surgeries to wipe out the
chance for developing ovarian and breast cancers,
which turned the lives of my mom, aunts, cousins,
and friends, upside down and has been fatal for
too many of my female relatives.

Happy Birthday, Mom!

Today is my mom's birthday, and she is
nearing the 5 year anniversary
 of her breast cancer diagnosis.

Her birthday seemed like a great time to
celebrate her vibrant life while also raising
awareness about BRCA+ genetic mutations.

Writing about this experience has been healing.

Inherited breast cancer involves one of two genes:
BRCA1 or BRCA2, and all of us, both men
and women, possess these two genes.

The role of these genes is to repair cellular damage
and to keep breast cells growing normally.
In my case, the BRCA2 gene has an abnormality
or mutation, so it cannot do the job of
suppressing tumors as it is supposed to do.



Genetic mutations are complex, but I read an analogy
which shed some light: 

We can think of the mutations as spelling mistakes
or typos. Since genes are instructional manuals for
a cell, the same spelling mistake or typo in the
instructions keeps appearing in every cell
containing that gene.

(As a writer...OY...can I just tell you how frustrating it is
to think there's this spelling error in my genetic code
which cannot yet be edited to give the proper
instructions to my sweet little cells that only
want to suppress tumor growth and repair
themselves?)

*end of writer's pity party*

Living with BRCA+ genetic mutation has its moments.

BRCA1 and BRCA2 mutations are harmful because
they increase the risk of several cancers including
ovarian, breast, pancreatic, and melanoma.

Who has this rare mutation (beyond me and Angelina)?

People of Ashkenazi Jewish descent (who have a higher prevalence of BRCA1 and BRCA2 mutations than people in the general U.S. population) and Norwegian, Dutch, and Icelandic peoples also have a higher prevalence.



The difficult decisions I faced about surgeries
to prevent breast cancer and to reconstruct my breasts
were not made easily or alone.

With the help of excellent specialists, my husband,
my mom, and my sister (who also tested positive),
I chose a Prophylactic Surgery strategy because
it felt right for me.

Many women living with the cancer risks involved
with BRCA+ diagnosis choose
Enhanced Screening, Chemoprevention,
and nonsurgical preventative options.

I deeply honor my BRCA+ sisters and brothers who for
personal reasons do not choose the option I chose. 

I'm BRCA2+ and a PREVIVOR

No stranger to dramatic diagnoses, I have been
living with Crohn's Disease (in remission since 2012)
since I was 18 years old...but learning about
the BRCA mutation was completely different.



I wasn't yet sick yet I felt like a timebomb.
I faced critical decisions, fears,
and questions about my health and future.

I felt some fear, but I did not feel unlucky or doomed.
In fact, I felt grateful to be armed with
information about my genetics and indebted to
my mom who requested genetic testing for the
BRCA mutation
to possibly help her children avoid
the trauma, pain, and grief she endures.

Just before my mom's bilateral mastectomy and lymph node removal

Witnessing the suffering of my warrior mom as she
fights breast cancer, colon cancer, and melanoma
with surgeries, chemotherapy, and radiation,
has changed me in profound ways.
Joining her in the fight has helped me
gain perspective, beyond simply
issues of physical health.

Her pain and cancers have been a
teacher for me and my family about what it
means to be here on earth for a short time,
growing in wisdom and love.

Living with BRCA+ Genetic Mutation

I wish I could say the journey has resulted in
linear personal growth and that as I deepen and grow,
life gets better and better...oh my, that
has most certainly not been the case.

Real life previving.

Instead, the journey with BRCA and Crohn's
is much more spiral-like, much more dizzying
and tricky to navigate than I ever imagined, 
more ripe with meaning and
more rich in opportunities for
humility and
gratitude than I can say.

And I should really capitalize Humility
because. Oh boy. I had no idea how
much puffed up ego was in control
before my BRCA+ journey which
brought with it an extraordinary opportunity
t o   l e t   g o
of a whole lot of self-absorption and illusion.

Enough said.

One of the preventive surgeries I chose after
the BRCA+ diagnosis was Full Hysterectomy
with Bilateral Salpingo Oophorectomy.
which resulted in surgical menopause, and
menopause has been especially
challenging for both me and my sister.

We share a BRCA2+ diagnosis and an appetite for shenanigans.

Both of us developed chronic migraine with auras,
which has been a debilitating health condition
affecting our daily lives.

About a year ago, I was experiencing 12-17 days
with severe migraine each month and feeling
increasingly hopeless about coping with
the illness.

Last summer, I sought treatment from a headache specialist,
who was determined to help me identify and eliminate
the possible triggers of these recurring headaches.

Living With BRCA+ Genetic Mutation (photo by Melissa James)

After eliminating aspartame, pain relievers,
and medicine which could be contributing factors,
it became clear that the main triggers
for my headaches are allergies, barometric pressure
changes, and dappled light.

My friends since childhood.

(By the way, it's unwise and insensitive to insinuate
to someone suffering from headaches that their
pain is likely psychosomatic...unless you
have graduate degrees in medicine,
psychology, and neurology, have lived
life in their skin, AND want to get smacked...
since I can tell you that hearing that
feels like being punched in the migraine.)

I tried multiple prescriptions to treat the headache
pain, but unfortunately have not yet found
one that helps so have pursued alternative 
options like Botox (which for me has reduced
the number of migraine headaches
but may not have that side effect for everyone)
and Accupressure/Reflexology
(weekly treatments for a time, and now I administer
treatments to myself and family members).



I realized just the other day that there are
multiple Allergan products which have
comforted me along the journey.
Products which  have helped me to heal,
feel more like myself, and even
experience fewer headaches per month.

During a particularly difficult season with the
Crohn's Disease, at a time I was not sure I would
survive the illness, a medicine made by Allergan
(Asacol) helped to calm the inflammatory condition
of my diseased bowel as it healed and returned to health.



It is still upsetting for me to return in memory
to those 18 months of dark days where
I could not eat or drink anything
without rushing to the bathroom.

Grace, medicine, love, and a hard fight
for my health (which meant eating small quantities
of food around the clock, though it was the last
thing I felt like doing) eventually led to brighter days
of calm and remission.



In 2013, when I opted for a double mastectomy
and reconstruction of my breasts with implants,
I chose implants made by...yep...Allergan to feel more
comfortable and at home with the physical changes.

But the evolution doesn't end there for some of us!

I am also deeply grateful for AlloDerm tissue required
in my reconstruction surgery offered by the company Acelity.

Since there wasn't an area of my body to borrow skin required
for my surgery, it was necessary to secure another source.