3am

What is it about the 3:00am hour? Lately, I wake up every night at 3:00am on the button. This is starting to get annoying. Under normal circumstances, I sleep like the dead. I can go to bed with lights on, TV blaring, kids arguing over the latest minutiae and husband packing for his next business trip. And I will stay asleep for 9-10 hours, waking up well-rested and refreshed. So what the heck am  ding up at 3? There can only be one explanation.
Cancer.
I swear that I'm not scared of anything anymore. With a second degree black belt, a lifetime of skiing fast, kayaking class V, and coding numerous patients, it takes a pretty big thing to keep me up at night. Once I had recovered from chemotherapy, radiation, adjuvant treatments, menopause, and the initial discomfort of the daily meds, I did not look back. Many survivors suffer from the anxiety that cancer will return. Coming up on five years, and ultimately getting my NED chip, I continue to look forward. I REALLY want that chip.
Then my CA 15-3 spiked. Thankfully, my doc is on it and I've explained before that he is my knight in shining armor, wearing a white lab coat and dorky leather shoes. When he called me and told me about the lab test, I allowed denial to do its magic. Knowing full well that it was denial, I embraced it, and focused on fun and anecdotal statements to flirt with my doctor.
"It's nothing," I keep telling myself.
Meanwhile, it's summer. Summer is the time for soccer practice in the mornings, games, sleepovers, birthday parties, river trips, swimming parties, rope swings, nighttime trampoline jumping and swimming, and the daily onslaught of Mom, Mom, Mom, Mom, Mom, Mom, Mom......(Can so-n-so sleepover? Can we go shopping? Movie? Shopping and a movie? Can I call someone? I'm bored.)
I don't have time for cancer. And that right there is the fatal mistake. Nobody has time for cancer, but cancer doesn't really care. I've taken a page out of cancer's book for when I visit my friends in Park City.
"Hey I'm in town. Let's get together"
"Oh we're so busy, I don't know if we can squeeze it in."
"Okay, I'll be there in five."
Yeah, I don't care either.
Anyone, even me, can carve out 15 minutes for an old friend. So, I agree to carve out some time for Cancer whenever it decides to drop in. I get poked, injected with glow in the dark shit, sit in a scanner, and give up my Tuesday to hang out in waiting rooms and visit Pete's deli on the corner. Love Pete's deli. I get the cream cheese veggie sandwich loaded with tomatoes, cucumbers, sprouts and avocado. They toast the bread just right....mmmmm. It's part of the ritual. I make my peace with it. I do what cancer tells me to do. My body is the battleground where my sexy, jewish oncologist/knight in shining armor goes to war against the evil-doer,  a.k.a. my cancer. This part of my life resembles a Claude Rains movie.
I wasn't paying attention this time around. So close to my five-year chip, I started to get cocky that I'm making it. "Not so fast," cancer says as it grabs my gonads (quite literally).  I have cysts in my liver and on my ovary. It's as if cancer is holding them at gunpoint and saying, "if you ignore me, I will take this to the next level." It demands to be paid attention to. It's a small price to pay really given the richness of my life this summer, and I understand that it must be done to pay the piper. I've agreed to give it it's due by practicing denial and not sleeping, so that it thinks it has me by the balls.
...And technically, it sort of does. The "cysts"that they found are significant. I finally took a look at my report and the news is not good. I have a bunch of old cysts, probably related to my ski accident. 2 have gotten bigger and there are 2 new ones. All of them are in the 4-10mm range and the report indicates that "interval growth is worrisome for metastatic disease." Everyone has hepatic cysts and therefore, their presence is easy to downplay. However, it can't be argued that the growth and change signifies that something is brewing, something that probably shouldn't be ignored. Additionally, there is a new cyst on my left ovary that has grown to 5cm in size. Yep, it's pretty much a golf ball, and it doesn't hurt, which is also a really bad sign. It would be so easy to ignore this right now especially with all of my personal issues resolved, my marriage in a great place and my kids being able to take care of themselves. I feel obligated to at least pay attention.
Going back to chemo and radiation and the ugliness of it all is a daunting thought. It seems like I JUST got my body back, my hair in a good place, and my psychology handled. I reached out to my home of Park City and connected with so many great friends who have become my family. All my ducks are in a row including a trip to Tahiti next March that Marek arranged for us. Tahiti is one of the last stops on my bucket list. My life is a dream right now, which begs the question, "What better time to die?"
A cancer survivor battles with "What if it comes back" constantly. You start evaluating the way you lead your life and suddenly your moral compass points in a different direction. Some things just don't seem like a big deal anymore, and you feel as if you've evolved. You feel as if you have transcended the human experience. Problem is, not everybody is on the same page so issues of love and sex and escalating credit card debt continue to be points of contention. I'm going to die so what do I care? Well, when other people are IN-volved,  and not so highly E-volved,  it gets sticky.
Patience is an absolute necessity when it comes to keeping cancer dormant. It is the difference of life and death. I am certain that learning patience is the goal of this whole experience. Be patient, specifically, be patient with others. Not everyone is in your head or your particular level of the evolutionary process. Don't rush to cut stuff off and don't jump to any conclusions. Let your sexy oncologist do his job and have faith that he will do it well, but don't get sucked into the idea that he is in love with you too. He's not there to help you because he's in love with YOU. Either way, the insurance company pays him enough money to overcome his shortcomings. Live or die, he's just doing his job, and I'm not so disillusioned to think otherwise.  
Cancer has been a gift on so many levels. My life is richer for it. Currently, I feel that Cancer is a lot like Rumplestiltskin. It comes out of nowhere, grants you certain wishes and then later, comes to collect. I take comfort in the fact that I have not wasted ANY of my second chances. I have made the most of every moment given to me and despite pushing the boundaries of what is deemed socially acceptable, I have lived with my heart and have shared it with everyone I deem worthy. I give myself fully to those I love in whatever capacity they will have me. I do fear that this is it though. Liver cancer and even ovarian cancer are among the worst in terms of quality of life. I fear that I will soon have to make the very difficult decision of whether or not to choose treatment. I don't feel any obligation to torture my loved ones by hanging on by a thread for an extended time. Let death come. Let it come and let me face it bravely and not in the tattered, fragile shell of a human being I've seen far too many times as a nurse. I have recently reconnected with an old friend who has given me this courage to face my end. It took a great deal of courage to reconnect and the outcome has been extremely positive. I pray that he will be my side with the rest of the people I love, as I slay my last beast or more accurately, it slays me.