Every six months, I go to the doctor to make sure I don't have cancer yet.

Yet.

This knowledge is a blessing, they tell you--it's a gift. And even on my worst days I have to agree. Knowing you have a gene mutation that gives you an increased risk of certain cancers really does hand you a lot of options in the way of hopefully not ever getting cancer. But then they take your blood and feel you everywhere and after you shake their hand and walk out the door they call you a few days later, when you're somewhere in Alabama on your way across the country, to tell you that your CA 125 levels are concerning. You need to have more tests as soon as possible.

I've been here before. After she encouragingly explains that you can breastfeed all of your unborn children at your own pace, the ultrasound tech gets quiet as she hovers over a black spot on the monitor; then calls the radiologist who makes you an appointment for a biopsy. 

Usually it's nothing. They're just being thorough, and that's why you got the gene test in the first place. But then the pressure is on--I have to eat better. Exercise harder. Stop leaving dishes in the sink. Call your friends more often. Train the dog to stop pulling on the leash. Have kids as soon as possible. Start planning some surgeries. Basically just get your life together, because you don't know when it's going to start to be over.

I've re-read this piece more times than I can count, and the following passage sticks to my soul every single time:

“Shortly after my breast biopsy, I scheduled a prophylactic double mastectomy. I held the implants up to my chest wondering what it would feel like to have all of my breast tissue hollowed out and replaced with pockets of silicone against my bare rib cage...

...But then, I couldn’t go through with it. Every six months when I had the testing and traveled down the emotional rabbit hole I would schedule my surgeries, and once I had rebounded, I would cancel them.”

— Patricia Fall, "Waiting for Cancer"

This happens to me too--the weeks before and after check-ups are a mindfuck. What if they find something? Even if they don't, is it just a matter of time until they do? And there I am, sitting on a table in a hospital gown, listening to a doctor tell me how lucky I am.

In my own mind--logical or not--having kids is the first step to not getting cancer. You have babies, you feed them, you get your ovaries taken out and your breasts removed. It sounds harsh and extreme but it helps me sleep at night. Two (three?) cute (blonde?) babies and new boobs, what's not to love? So I go to the appointments and a few days later I frantically schedule the follow-ups and finally they tell me great news, you don't have cancer and I breathe a sigh of relief; and then a few days pass before my brain says yet yet yet yet yet. 

And then, even though the small but occasionally present side of me that knows the statistics begs me not to, I go to a place where maybe I don't get to have kids--where maybe I don't choose surgery, but surgery chooses me. Where 28 is suddenly very old, and time is running out and it doesn't matter that you just moved across the country and your husband has a brand new job and your dog barks at children plus you guys haven't even finished unpacking yet and don't really even know where you'd put one baby, let alone two. None of it matters when you're overcome with grief over something that isn't even real yet. 

It gets obsessive, the need to plan these things. The puzzle is there and I created it and I think I'm holding most of the pieces, but I don't know how or where to start putting them into place.

When my mom got cancer for a second time and I got the gene test, she told me she wished she could take it away from me--the pain, the fear, the burden of not yet having cancer. I'll never forget that. And while she went through hell and one day I probably will too, I would never want her to carry this for me. I would never wish cancer on anyone, especially not my own mother, but if she didn't get sick again I don't know if I ever would have gotten the gene test. And I needed it, because it could save my life.

Because even when it's so terrifying you think you might fall down, it really is true what they say--it's a gift to know these things. And to not have cancer.

Not yet, maybe not ever.

Since November, I've had two people tell me, in some way or another, that having a BRCA mutation is scary and all; but I have a lot more control over my likelihood of getting breast or ovarian cancer than I think, because of my diet and exercise. Paleo will save me, they seem to believe.

And listen, I'm not going to be someone who writes one of those "15 Things You Should Never Say to a ____ Person" (pregnant, short, BRCA+, you know the drill) pieces, because I know these people aren't being offensive or stupid on purpose--they're just trying to help.

“A positive BRCA test does not mean a leap to surgery. I have spoken to many doctors, surgeons and naturopaths. There are other options. Some women take birth control pills or rely on alternative medicines combined with frequent checks. There is more than one way to deal with any health issue. The most important thing is to learn about the options and choose what is right for you personally.”

— Angelina Jolie Pitt, Diary of a Surgery

I believe that eating whole foods, exercising regularly, and staying away from sugar has a lot of benefits, but telling people that they should replace a preventive double mastectomy with a healthy diet is not just stupid, it's dangerous. I've been working out a lot more this year but it's not to kettle bell-swing my breasts away from cancer, it's to get my body ready for (hopefully) pregnancy, labor, and delivery; then (hopefully) a few years later surgery and the recovery that follows. And that's how I'm going to avoid getting cancer.

I grew up in a household that was very naturopathically inclined. We didn't really take antibiotics, if we were sick we doubled down on Vitamin C and chicken soup; and I still don't run to the doctor for every little ailment. I'm not into flu shots and I drink kombucha, but I also know you don't fuck with cancer. 

Angelina Jolie called it "My Medial Choice," and that's exactly what it is. I have a lot of anxiety in my life about a number of irrational things, but then this one--the most rational fear that could be--doesn't really bother me that much. I think about it a lot but it's not keeping me up at night or anything. And that's because I have a plan. I will be making my own medical choice.

I know that the BRCA and cancer thing is a lot, and it's kind of a new topic here on Freckled Italian, but it's been a big part of my life the past year, so I'm going to keep writing about it periodically. I want people to know that they have options, and I want to encourage people to know as much as they can about their family histories and genetic mutations, so they can be empowered to make the best decisions possible for themselves and their families. It's funny how your passions present themselves to you over the years. 

I've quoted this piece before and I'm sure I'll do it again, because it rings true to me on so many levels:

“Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.”

— Angelina Jolie, My Medical Choice

I hope that, no matter the type of trials you may be facing, you can find the strength and courage to tackle them head on. It's something I'm working on every single day. And if I really want a donut, I'm probably going to have one. Paleo or not. Cancer or not. Life is here so we can live it.

So let's live it.

I had my first MRI last week and I walked away from that experience feeling overwhelmed with new things on my mind.

 First things first: if you have to get an IV, drink a ton of water a few days before. Maybe you're working on a big project with an approaching deadline and forgot or were even too hopeful that they wouldn't be giving you contrast dye for your MRI, so you accidentally spent the day before drinking coffee and Dr. Pepper and can't remember the last time you had a sip of water. If that's the case, they're going to have trouble finding a vein and you're going to walk out of there with so many little bandages on your arms that it looks like you got in a fight.

So far in my BRCA journey, the procedures have scared me more than the results. Maybe it's because I'm only 27 and still relatively healthy, or maybe it's because I have a bit of a needle phobia, but when I was getting the gene test all I could think about was getting blood drawn. And then I freaked out about how uncomfortable a mammogram was going to be (PSA: they aren't--don't be scared, go get your mammogram). And even when the radiologist told me he wanted to do a biopsy on something that looked a little suspicious, at the time I was more afraid of the numbing injection/biopsy itself than the possibility that I had breast cancer. All of this is to say that I freak myself out about things and they are never as bad as I imagine.

This MRI, though, was the one thing I wasn't afraid of, and it just so happened that I had a pretty terrible experience. And yet, it was over in an hour and I didn't waste any time before then worrying about it. That has really stuck with me these past few days (along with the bruises I have from the four tries it took them to get an IV in me).

“Don’t worry about the future
Or worry, but know that worrying is as effective as trying to solve an algebra equation by chewing bubble gum
The real troubles in your life are apt to be things that never crossed your worried mind
The kind that blindsides you at 4 p.m. on some idle Tuesday”

— Baz Luhrmann, Everybody's Free (to Wear Sunscreen)

I can make myself sick worrying about something that will never actually be as bad as I make it out to be. Or I can take things in smaller doses and worry about the things worth worrying about only when they are actually presented to me. 

Easier said than done, as usual; but always worth remembering.