The Inspirationals #4: Cancer Survivor

Welcome to the fourth installment of BeFreeMySheeple.com’s The Inspirationals where I interview people who inspire me. 

This week I interviewed Sarah Farnam, a friend that I met through the media industry in 2010 who was diagnosed with and defeated cancer 1.5 years ago. I’ve closely followed her journey through social media from being diagnosed with leukemia (blood cancer) in 2017, her battle against it and her victory. Yesterday (February 28th,) she celebrated her 2-year anniversary of being diagnosed with cancer (her “cancerversary” as she calls it).

Cancer has been a very personal topic for me as I lost my mom to a cancer that metastasized in 2009. During my mom’s battle, my dad neglected paying attention to his own health and found out after her passing that he had colon cancer (undiagnosed and untreated for years). Fortunately, it grew very slowly so with surgery and chemotherapy, my dad won. Neither the Vietnam War or colon cancer could stop my dad. He is a survivor! 

According to Statista, “Cancer is the second leading cause of death in the United States, making it one of modern medicine’s greatest challenges. The percentage of the U.S. population who has or ever had cancer has increased over the past 15 years.” As we get older, it is unfortunately likely that we will see our close friends and family affected by cancer. These can be dark times but we can look to cancer survivors for hope.

Today, as Sarah celebrates her 2 year anniversary of being diagnosed with cancer, I wanted to share her inspiring story.

BeFreeMySheeple.com’s Exclusive Interview with Sarah

Adam Francisco: Congratulations on your 1.5-year anniversary being cancer-free! Thank you so much for sitting with me and sharing your personal story on the 2-year anniversary of being diagnosed with cancer. How did you originally find out that you had cancer and what made you get checked for it?

Sarah: In January 2017, I began experiencing what I describe as mysterious symptoms for about two months prior to my diagnosis: nausea, fatigue, headaches, loss of appetite and weight loss. I say they were mysterious because although they were affecting my quality of life, I was able to push through the symptoms and go about my day-to-day duties. I had just begun a new job, and chalked up a lot of these symptoms to common side effects from the stress of starting a new job. It wasn’t until one Friday afternoon in late February 2017 when I was headed to the airport after work to fly to my friend’s wedding that I knew something was seriously wrong. I became extremely carsick, and had to turn around to go back to my home and ultimately missed out on the wedding. I was sick for the entire weekend, and assumed it was food poisoning, and just kept hoping time and rest would take care of it. It wasn’t until four days later, when I was dehydrated and so weak from vomiting all those days that I could barely walk that I finally mustered up all the energy I had and took myself to the nearest emergency department.

Adam: I can’t imagine how awful it feels to do everything you’re supposed to do when you’re sick and there’s no improvement.

Sarah: Yeah. It turns out my terrible symptoms were caused by a kidney infection, which was most likely caused by my very low immune system brought on by leukemia, as infections manifest so much easier in people with active leukemia. It’s common for undiagnosed leukemia patients to present to their Doctors or the ED with bad colds, pneumonia or other infections, and often, the infections are treated without diagnosing the underlying cancer. This is very problematic, because the longer leukemia goes untreated, the harder it can be to get the patient into much-needed remission. Early detection is critical in so many cancers, and leukemia is no exception. Luckily, the doctor I saw in the ED ordered a standard blood test, called a CBC, which among other things, checks for a white blood cell count. My WBC was high, which could have been attributed to the kidney infection, but luckily my doctor thought to consult the hematologist at the hospital, which is a doctor who specializes in diseases of the blood. Around 12 hours after I had initially presented myself to the ED, I was notified that the doctor had run tests and confirmed I had acute leukemia and that I would have to be checked into UCSF’s hematology oncology ward immediately for treatment.

Adam: The worst possible news. What were your thoughts and feelings when you first found out?

Sarah: My first reaction when the doctor notified me was visceral. I held my hand out to him in a “stop” formation. I truly wanted him to stop talking and rewind back to five minutes before, when I was a young woman living in San Francisco (my dream location for so many years), just trying to work, travel, date, be independent and all the other things a lot of women my age are seeking. Being diagnosed with a life-threatening illness didn’t fit into that narrative at all, and I think my body and mind immediately knew that, and resisted what he way saying to me. I had also unfortunately known two people in my life who had passed from leukemia, and assumed it meant I would eventually pass from it as well. So the next question I asked him was, “When am I going to die?” He paused and assured me there were many who had overcome a leukemia diagnosis, and he was right.

Adam: In just a few words from the doctor, your life completely changed, but at the same time there was hope that you’d be cured.

Sarah: We still have a long way to come with treating leukemia, especially with regards to adult leukemia, because the cure rates are much lower for adults with leukemia than children, but cure rates have gotten better in the decades that I have been alive, and I hope that trajectory continues.

Adam: How did you cope with hearing that you have leukemia?

Sarah: To be frank, I was a mixed bag of emotions when I was first diagnosed because there were so many unknowns and I’m someone who likes to get a lay of the land with answers to all of my questions as soon as possible. I’ve since come to realize that unknowns are a part of being human, and to be able to find peace with that discomfort is something I’ve been working on in my healing process.

Adam: I have always heard that we need to be comfortable with being uncomfortable.

Sarah: After the initial shock, I was fairly positive and started most of my mornings off listing things I was grateful for, which I for the most part continue to this day. I also attended the groups they had for patients where we would do creative expression or centering practices like deep breathing. I remember my first admission in UCSF, there was an extremely talented woman who volunteered to play a harp for us on our floor, and I thought that was incredible, and would always stop to give her a listen. I also welcomed friends and former co-workers in to visit me with open arms, and would also forge friendships with other patients or their caregivers. And lastly, I would try and find ways to laugh as much as possible. It was usually in conversations with my friends or my Mom where we would do silly things to just laugh out all the stress we were carrying.

Adam: “Laughter is the best medicine.”

Sarah: It is. I’m Iranian, and I remember one time while I was in-patient, my Mom and my friend, who is also Iranian, starting playing Persian music and dancing all over the place, and I was laughing so hard and having the best time. Another time, two of my good friends and I were watching “laughter yoga” videos and just cracking ourselves up to tears where we were falling all over each other. I was actively seeking out laughter like this because I knew the power it possessed to relax and heal me.

Adam: I heard that many hospitals offer patients Laughter Therapy which has many physical and mental health benefits.

Sarah: I also want to make what I think is a very important point. For the most part, I worked hard to stay positive and find happiness and laughter whenever posible. But I also had my fair share of dark moments of hopelessness, depression and anxiety. In fact, one of the things I am hoping to speak out on more is mental health care for cancer patients because I feel like it is more of an afterthought than a priority for medical care professionals when it comes to treating cancer patients, and I hope that changes soon. I think a lot of good feedback and encouragement is given to cancer patients who are positive with a great attitude and always smiling and keeping faith. While I took pride in being positive, finding humor and keeping hope and faith alive as much as possible, I had some really rough patches that I hid from a lot of people because I didn’t want to disturb or make anyone feel uncomfortable.

Adam: That’s so heartbreaking because I can imagine that it makes you feel even more isolated in your battle.

Sarah: One of my most distinct memories was when my brother was visiting me within the first few days of chemotherapy, and I was having a really bad reaction to it. I was vomiting almost non-stop, and the care team was very concerned. And all the while, I kept thinking, “I don’t want my brother to see me like this.” I wasn’t as concerned about the fact that excessive vomiting would make my healing process harder, I just wanted to ensure my baby brother didn’t see his sister having a violent reaction to chemotherapy, because I wanted to protect him from that image. And I’ve heard other cancer patients say similar things, which makes me sad.

Adam: I never knew how much pain my mom was dealing with because she always protected us from seeing it.

Sarah: A lot of us are really concerned about how others, especially our loved ones, perceive us, when they really should be concerned on getting better. So I guess my point is, positivity and humor is important, but so is acknowledging pain and accepting that being positive and hopeful 100% of the time is unrealistic.

Adam: What kind of treatment and therapy did you undergo?

Sarah: I was put on chemotherapy almost immediately, because my particular cancer, Acute Lymphoblastic Leukemia, is very fast-moving and if untreated, can take the lives of those afflicted in a matter of weeks or months. I proceeded to go through almost eight months of high-dose intensive chemotherapy and six lumbar punctures where I received chemotherapy intrathecally in order to prevent the spread of Leukemia to my central nervous system. Once high-dose chemotherapy was done, I was put on a “maintenance” chemotherapy regimen where I receive a monthly infusion of lower-dose chemotherapy and take two forms of oral chemotherapy. I am still undergoing this treatment, and will be doing so until one year from now. All together, if things continue going according to plan, I will have been on one form of chemotherapy for roughly three years. The reason I am on a maintenance chemotherapy regimen is because my cancer has a high chance of relapse, and maintenance regimens have been proven to dramatically reduce relapse rates.

Adam: Looking back as a survivor, what advice would you have told yourself at the beginning of your journey?

Sarah: I would tell myself to document as much of the journey as possible, be it through writing, photos or my personal favorite, videos. At the time, it seemed absurd to capture pictures of me receiving chemotherapy or to write down my emotions and feelings, but I now look back on all of those moments that were captured, even the sad ones, with appreciation. Yes, sometimes a picture makes me want to cry from sadness, but it also helps me with reflecting on my experience, which is something I place a lot of value on and make time for as a survivor. I would also want to give myself a heads up that some people in my life just don’t know how to react to a cancer diagnosis, and that I’d come out of this experience short a few people in my life because they ended up stepping out of my life instead of lending me the support I needed. This is a pretty common theme among cancer patients, and once you process the pain and feelings of abandonment, you can actually come out of it and view them leaving as a positive. In my opinion, this experience weeds out the people who don’t deserve your love because they weren’t tough enough to stick around when times were really bad. And better to know this now than later. Plus, the experience usually brings you more incredible people to fill the void of the people who left, so it works out.

Adam: How do you define happiness now?

Sarah: I no longer find the most high-paying job the most desirable, and place an emphasis on work/life balance and my health above other priorities. American culture and some other cultures around the world prioritize material goods and possessions such as homes and cars above so many other things, and extreme competition to gain money to purchase these things is encouraged. While I believe healthy competition is not bad for an individual or our economy, I personally think our culture has taken it overboard, and the pressure to “have it all” is happening at the expense of the health of many employees.

Adam: Yes! That is the message that I am trying to share. The endless pursuit of wanting more, needing more, getting more…it doesn’t create happiness because there is no end in sight. I also don’t think that it is the responsibility of the company for an individual’s work/life balance, but rather it’s up to the individual to create their ideal lifestyle.

Sarah: I can’t say with 100% certainty that one of my former jobs in 2016 contributed to me getting cancer, but I do know I was not living a healthy lifestyle because of it. We were understaffed and I was tasked with doing the job of multiple employees. Because of the long hours, I was eating poorly, not exercising and had excessive stress from all of the pressure.

Adam: Sadly, you’re describing how many people feel in their careers. We can change our lifestyles faster than a corporation can change their culture.

Sarah: And as trite as it may sound, another change I have noticed is that I thoroughly appreciate the small joys in life so much more, the ones a lot of us don’t rush to post about on social media because they’re not exactly noteworthy to anyone but ourselves and the people we are with at that moment. So if I’m lucky enough to have a day where I’m feeling healthy and energized and get to take a walk with someone I love through a beautiful piece of nature, I cherish it more than ever. Or a simple night in with a home cooked meal and good company. Or getting to eat raw foods when I couldn’t for so long because my immune system was so low. Or if my good friend’s daughter, who is 6, is asking me to play with her, I put my phone down and give her my full attention, because I realize she’ll eventually going to grow up to be a teenager who is too cool to talk to her Auntie, so I soak it up.

Adam: You are speaking my language. I was a high-income individual in New York City but I had to be because my rent was almost $4,000 USD a month. When I traveled, I would stay at the Ritz. While those were nice experiences, my happiness comes from every day moments such as a good cup of coffee, hanging out with my dogs, relaxing on the beach. The things that cost the least or that I can do for free ultimately bring me the most happiness. What advice would you give to someone who finds out they have cancer?

Sarah: Find support as soon as possible. For people who have cancers that are more prevalent, a quick Google search or search of that hashtag on social media will get you connected to people in similar circumstances quickly. If you have a cancer that’s not as common, it may be more challenging than just a simple search online. But that’s where I would try and find other similarities besides your cancer type. If you’re between 18-40, the young adult cancer community has some great resources, and the Stupid Cancer organization is something I mention time and again to adults in that age range who are newly diagnosed. Your local hospital and cancer center may also have support groups based on cancer type, age or just a general one for all cancers and ages, and I highly encourage patients to check them out. It can be awkward at first, and you may end up realizing it’s not for you, but you won’t know unless you show up, and it could be the extra little thing you need to get through this challenging ride.

Adam: You don’t know if you don’t like something until you try it.

Sarah: Besides that, I would also seek out mental health resources. I think it’s really important to be proactive here, because I think the initial shock and rush of things needing to be done after a cancer diagnosis can mask underlying mental health problems that happen as a result of the diagnosis and treatment need to be addressed and treated. I’ve heard from so many patients saying they felt fine initially, and then one time, a few weeks or months into treatment, they would wake up in the middle of the night, with terrifying anxiety that they just couldn’t seem to shake. And that situation is so relatable. There’s the rush of appointments, treatments, procedures, medicine to take and other things to do, and those moments at night where you’re alone and pondering how all these messy, moving pieces are going to come together to get you through the other end are the absolute worst. I have made a commitment to myself to see a therapist once a week until the end of my treatment, regardless of how I’m feeling that particular week, because of this very reason, and I hope any other patients going through treatment can find resources through their care teams to do something similar.

Adam: Great insights. What can a person do to support a family member the has cancer?

Sarah: Listen to your loved one without judgment or trying to interject with what you think, especially if they’re sharing fears or anxieties with you. This kind of ties back to the thing I was mentioning about positivity, because while it is great to have someone who is optimistic around you, sometimes we just want to be heard without hearing, “It’ll work out” or “you’ll be fine” again and again. We hear words along those lines a lot, and from personal experience, it can make us want to not share much.

Adam: I definitely have learned that sometimes it’s better to just listen.

Sarah: Instead of trying to minimize the fear or anxiety, I find that having someone acknowledge it and showing support can be very powerful. So responding with, “I can’t even imagine the pain you’re feeling. I’m here for you.” is personally preferred because you’re acknowledging the enormity of the pain and also reaching out a hand in support. Other than that, I would make a point that if you are one of the caregivers or the sole caregiver, to not forget that you need to care for yourself as well. It’s ok to ask for help from others to do things for yourself, even if that’s going to the gym or getting the haircut you’ve been putting off. There are both in-person and online support groups for caregivers, and as much as your friends will be able to support you, they’re just not going to get it as much as the people in the groups will. It’s easy to forget that the caregivers need help, but it’s ultimately more of a necessity than luxury, because a caregiver isn’t giving their loved one the best care possible if they haven’t been taken care of themselves.

Adam: Sarah, thank you so much for sharing your story with us and congratulations on celebrating over 1.5-years of being cancer-free! You are an inspiration.

***

Have another person that you’d like me to consider for next month’s The Inspirationals? Leave a comment or you can e-mail me adam@befreemysheeple.com. If you enjoyed reading/watching this, you can follow me on Instagram, @adamfrancisco & @befreemysheeple.

Be Free My Sheeple!