Winter Storm in the Middle of Spring: Second Episode:27th of December, 2004.

Winter Storm in the Middle of Spring: Second Episode

27th of December, 2014.

The exact day came for biopsy and surgery. I printed a kiss on the foreheads of my children, and while I hugged them I breathed in their smell, asking God to grant me safety and wellness. I went to the Radiology Department to do the so-called Localization to locate the tumor by using iron wire that ends with a hook. The hook is then implanted in the tumor by tracking the location through ultrasound, and that helps the surgeon to access the tumor directly. It is not necessary to make a large hole to search for the tumor. The selection process was a bit painful, especially as I watched as they implanted the wires in my body, and saw drops of my blood spill in front of me. 

Suddenly I noticed that my doctor was confused for some reason. She took me to do a mammogram, but I didn’t know why I needed to do another one. I went with her while there were still two metal wires in my breast. However, I really did not care about why we were doing this as my main concern was to complete the biopsy and do the surgery. After this procedure I rushed to the hospital for my surgery.

Surgery

The lights of the operating room were shining in my eyes, but began to fade with the start of the anesthesia. I prayed to reassure my heart as the sense of losing consciousness with anesthesia scared me. I focused on the sound in my mind of my dad’s voice, reciting the prayers that I had memorized by listening to him from a very young age. 

I lost consciousness before I finished my prayers.

I awoke from the operation feeling heavy weight and pain in my breasts. It seemed like a complete surgery had been done, not only the biopsy. I was very afraid that a mastectomy had been performed, but only the tumor had been removed. I found my father and my husband beside me, although I was still feeling the effects of the anesthesia. But still I noticed a change in their faces, and saw sadness in their eyes. 

“What happened and what are you hiding from me?” I asked.

They answered that they were worried and were just waiting for me to wake. I asked about the results and they told me the doctor would come in the evening to tell us the results together. 

I was transferred to my own room. Waiting for the evening to see the doctor was difficult. I prayed to God to reassure my heart and to give me comfort. I fell asleep due to the anesthesia and time passed quickly. I woke to a knock on the door. A nurse entered and I put on my hijab. My heart beat fast and hard, and I felt as if it would come out of my chest. My forehead was sweating and my hands trembled. Was this worry, or exhaustion after surgery, or because I could not sleep the night before?

The doctor began to talk. 

“Thank God the surgery went well, we wish you a speedy recovery. We took a biopsy and because of its result, we removed the tumor. We found it to be a malignant tumor. You have breast cancer. Your husband asked to be the one to tell you, but I prefer to inform my patients myself.”

So without introductions or trying to temper the atmosphere the doctor gave me the very shocking and sad news that I had cancer.

The news came with the impact of a thunderbolt. I felt very dizzy and tight in my chest, and tears fell from my eyes. I could only picture the image of my small babies. God inspired me to say, “O Allah, reward me in my affliction and replace it with something better than it.” This was what my dear mother did when struck with her calamities. Perhaps her strength, her steadfastness and her satisfaction with fate and destiny were among the strongest and most important lessons she instilled in us. And she was the best example for us in this. When she was in pain she said, “Oh, Allah” instead of “ow.”

The doctor continued. 

“The good news is that we discovered the disease at a very early stage. The bad news is that the tumor is very active and spreading very fast. The tumor type is a grade 3 out of 4 Invasive Ductal Carcinoma. I advise you not to travel because getting into the health system in Canada is difficult at first, and you will need support during your treatment as you have two small children, especially if the oncologists decide to go with chemotherapy. But I think the tumor is too small. Only the tumor has been removed and the breast is complete, but you should think about having a future mastectomy as a preventative measure due to your age and your family history. You should also conduct genetic testing.” 

I did not need to hear these last words.

The doctor left.

And I cried. 

My father and husband hugged me, and we kept silent. What can we say under this shock?

My husband tried to be strong and said, 

“You will be fine. Thank God the disease was discovered early, and our God is generous and merciful. Do not cry and do not grieve. I know that the doctor's method was not good in conveying the news to you. I wish I did not follow his request and had told you myself instead.”

I remembered my mother, may God have mercy on her, and her suffering with the disease. And how we suffered after losing her, and I did not want my children to suffer in this way. I remembered all the pain, suffering, and death, and I called to God to connect with my heart. Despite my mother's illness and death, I never thought that one day I would have the same illness. I tried to direct my thoughts in another direction. My diagnosis did not necessarily mean that my illness and suffering would be the same as my mother’s. I had also known the stories of women who survived cancer. And I remembered that the cause of my mother's death was ovarian cancer, not breast cancer. So I decided it was better to think of God and His will as best as I could, and remain optimistic with faith and hope in God.

What saddened me then was that I most likely could not travel with my husband to Canada, and that would split our family. 

That was a horrible night. I had so many mixed emotions and felt terrible.

The next day I left the hospital. I missed my children so much. I went back home and took them in my arms before I even took off my hijab. I hugged them and carried them tight, even though it was painful because of the wound. I had a terrible pain in my rib cage.

 And My Winter Started

Sadness hung over everyone in the house, and after discussing it I decided to stay in Jeddah for treatment while my husband goes to Canada. There were only a few days to go before our scheduled departure. Now I had to start separating my children's belongings from my husband's luggage. This process was very difficult. Separating our luggage felt like cutting parts of my heart. Separating my things blended with my pain and my sadness. Any thoughts brought tears that fell from my eyes like rain. I cried to God Almighty and asked Him to bring down His mercy and kindness, and to comfort me to face this journey.

I remembered then that my friend had a dream during my pregnancy where she saw my mother in a high tower. She had to ascend to its highest level with great difficulty, but when she reached the top of the tower she had comfort. Then my friend saw me as I climbed up to my mother, also with great difficulty, until I arrived and rested with her. I asked my friend how to interpret this dream, and she in turn asked a knowledgeable expert, who explained that I might go through hardships like my mother. But that with our patience through the tribulations God will grant us a great reward and a high place in heaven. My friend told me about this dream to soothe my grief and pain, as I was suffering during  my pregnancy. At that time I thought the hardship was only what I was facing in my pregnancy. I never imagined that I would suffer in the same way as my mother. Cancer.

As I mentioned in an earlier post, I suffered in both pregnancies from hyperemesis gravidarum, which is a severe condition with vomiting up to forty times a day. I was very dehydrated and it was difficult for the hospital nurses to find a vein for the needle, so used my leg instead. It was so severe I was hospitalized for a month during my first pregnancy. My weight was about twenty kilograms. My vomiting problem continued during childbirth and lasted for a month afterward. The doctors explained that this was a physical interaction with a change in the level of hormones. Only one medicine, which was sold only in Canada, was my savior (after God) and gave me a lot of relief. Thank God, God was pleased to have a relative of mine studying medicine in Canada! Thankfully he sent the medicine to Saudi Arabia for my first and second pregnancies. I was very tired throughout, but I was convinced that God had wisdom for me from this affliction. Perhaps preparing me to face something more difficult? 

I felt this wisdom the day I discovered I had cancer.

My husband's friend called him after my diagnosis, but he didn’t know about my illness. He told my husband that he saw him in a dream facing a great fire. Perhaps that fire was the cancer that invaded our family, and the upcoming separation.

I had been afraid of the cold winter of Canada. But now it was a much stronger winter inside of me. Another kind of winter. 

We were actually in the winter season at the time, but the winters of Jeddah are as nice and warm as spring. I, however, was living in the coldest of winters within the warmth of Jeddah in the middle of the spring age of my life. 

I prayed to God to help me and soothe my inner burning pain with the coolness of certainty and faith.

Winter Storm in the Middle of Spring: First Episode

Winter Storm in the Middle of Spring: First Episode

The Beginning: In Dhahran

My story began in Dhahran, in the Eastern Province of Saudi Arabia. It was 2004, I was 23 years old, a mother to a toddler(who was eighteen months old) and an infant (who was three months old). I had been married for three years. My husband had completed his Master's Degree and was accepted to the University of Waterloo in Ontario, Canada, to do his doctoral degree.

I started packing my home.

My biggest concern at that time was finding empty boxes to fill with all of our belongings that were scattered throughout the house. Although we had only lived in that house for two years we had a lot of things because of the two little boys. The house was like a yard full of boxes.

My young son made a game of it, at one time hiding inside a box, and another putting his toys inside. But the great disaster was when he would take everything out of a box that I had already filled, and then clap his tiny hands celebrating his achievement that reversed my achievement! It was more fun for him than playing his usual games.

I was so busy, packing and running after my walking baby and infant, whom I sometimes had to carry in the baby carrier while packing to protect him from his older brother, who thought of him as a puppet or a toy. Putting the baby in the carrier also helped to keep him calm and fall asleep, smiling at Mommy and listening to her heartbeat.

My other concern was shopping for winter clothes to protect us from Canada's extreme weather. My dear friend Abrar had gone to Canada earlier that year. She was in Vancouver, one of Canada's warmest areas, but I still remember the phone call where she described to me the cold winter of Canada. She had been shocked when she arrived, walked out of the airport door, and the cold wind hurt her face. Everything was covered with snow. Everything was completely white. Just remembering her words now makes me shiver as if the cold air is beating my face.

Packing and shopping was difficult with my two little boys, but in the midst of my busyness I felt a strange painful tingling in my right breast, which continued for several days. I began to worry with many thoughts popping into my mind.

I remembered my late mother (may God shower her soul with mercy) who had had breast cancer when I was in primary school. I was not pessimistic but it is good to learn lessons from the past. Having a first degree relative diagnosed with breast cancer made me more susceptible than the general population. The thing that made me optimistic was that I was too young. I thought the disease only affected women over the age of forty.

I also remembered that my mother was diagnosed with ovarian cancer when I was in secondary school. Her doctor had a suspicion about a small ovarian cyst and asked her to follow up, but she was a busy physician, university professor, and a mother preoccupied with us. So she didn’t follow up, and that was the ovarian cancer that spread and caused her death. At that time, nearly twenty-five years ago, there was no awareness about the relationship between breast and ovarian cancer in young women who had breast cancer before menopause, and who had a family history or genetic factor. There was insufficient awareness that ovarian screening was as important as breast screening. No one suggested preventative surgery to avoid the risk of breast or ovarian cancer. What happened to my mother was a harsh lesson that made me think again and again that I would take a break from what I was doing and go to the doctor to check. Better safe than sorry.

I remembered that before I felt the pain I had a severe rash, cracked skin, and bleeding. The diagnosis was fungal infection from the baby’s mouth during the breastfeeding.

I was shopping with my dear friend to buy winter clothes when I told her that I needed to go to the doctor. We went together that day. My heartbeat accelerated when I was in the waiting room. When it was my turn I told the doctor about my situation and family history, explaining to her that I had a first-degree relative who had breast cancer.

Her response was, “You are a young woman and you are just twenty-three years old. It is normal for you to feel pain as a breastfeeding mother. Breast cancer usually comes without pain.”

I told her that this pain was different from what I had with my first child and I asked her for an ultrasound, but she refused.

I went out to my friend and told her what had happened. I was still worried and wanted to do an ultrasound, but as I got busier with packing I got distracted from thinking about it. Everything I was doing pushed away my anxiety.

In Jeddah

Two months after my doctor’s visit we moved to my hometown Jeddah, a city on the west coast of Red sea in Saudi Arabia, to say goodbye to our family before leaving to Canada. It was the end of December 2004, and our date of departure was January 4^th, 2005. The pain was still in my right breast and did not go away, but the accumulated tasks that needed to be completed helped me just ignore it. But then I spoke with my lovely father and he advised me to go for an ultrasound. He told me that in either case I wouldn’t lose anything. If the results were good – praying to God that it would be – great. And if the news was not good, early detection is one of the best cures for cancer. He said, “Go my daughter. We do not want to repeat the tragedy of your mother.”

I went to the ultrasound, and the radiologist who examined me was the same one who performed the first imaging to see my first baby and check his heartbeats almost two years before. In that same place was the beginning of my deepest joy. This was where I took my first steps on the path of motherhood, hearing my baby’s heartbeats for the first time.

But when my doctor asked me again,

"You are twenty-three years old, right?"

I replied “yes,” and her facial expression changed.

She said, "You are young, by God’s will you will be fine. But what I saw is not a good sign. It looks like a solid mass with an irregular wall. Please see a surgeon and do a mammogram.”

I made an appointment with a surgeon who was considered the best in town in the field of oncology, especially for breast tumors. I returned to my in-laws’ apartment in Jeddah. They had come from Yanbu Industrial City to say goodbye. All my boxes and luggage moved from my house in Dhahran to this apartment. I had to sort them out, deciding which to leave in my dad’s house and which in my in-laws’. The rest would be in our luggage or shipped to Canada. The place was jammed with boxes that were stacked like the thoughts stacked in my head. I tried to escape these thoughts by diving into the depths of my scattered luggage. I also had a list of visits to friends and relatives for farewells before traveling. Sometimes keeping ourselves busy may help to distract us from stress and anxiety, but if the escape is long, the confrontation will inevitably come.

I was counting down the days before my doctor’s appointment. I wanted this story to be over as soon as possible. There were only a few days left before we went to Canada.

The long-anticipated appointment date came and I met the doctor. I was nervous about the examination because he was a male doctor. I was so anxious during the clinical exam – he was nearly as old as my father. I think this is not easy for any woman from any culture, but probably more difficult for a woman from a Muslim culture who wears a hijab and covers her hair and body. This was the first time I had to reveal such areas of my body to a male doctor, but what could I do? I had no choice. It was a necessity. At that moment I asked God to help me face this, and hoped that I would not need to do this more in the future. I asked God to help me maintain my modesty, and to keep me feeling secure and comfortable.

The doctor told me that there was no significant mass that he could feel, but that he was not happy with the ultrasound due to the shape and nature of the visible mass. He asked me to have a mammogram and an MRI as well. He told me that both tests would give us more clues about the nature of the detected mass, and that an MRI is more accurate for young women under the age of 40 who have a family history of breast cancer. The doctor also confirmed that a biopsy of the mass must be taken. With my family history we must be cautious and it was better to be safe than sorry. I was a little worried about these tests that I was unfamiliar with and did not know how to do.

Things were getting busier with sorting, packing, and visiting, but the medical tests became a priority. I went to the mammogram appointment and thanked God that they were female technicians so I would not feel so uncomfortable exposing my body again. I wore the hospital gown with an opening in the front and stood in front of the machine. The technicians supported me, asked me not to move, and explained the procedure. The device would be adjusted to compress the breast to be flat, allowing X-rays to access the tissue. When the machine started, the pressure was more painful than I expected! But as the Arab saying goes, "pain for a second is better than pain for hours." The pressure pain for a few short moments would certainly be much better than the pain of cancer if it was not detected early.

I still remember those moments, the coldness of the room, its smell and its details. After the examination I asked to meet the radiologist, and I told the technician that I was going to Canada a few days later. She took me to the doctor and I felt some reassurance when I saw her. She had been a close colleague of my dear mother’s, (may God shower her soul with mercy). My mother loved her so much and consulted her often during her own battle with cancer. She stood in front of the radiology reading screens and repeated the same question that had been asked at every appointment or examination:

“You are only 23 years old, right?”

Again I said “yes,” while my heart beat hard.

She looked at me after a moment of silence and said,

“The mass is calcified and you should do a biopsy of it. Thankfully we were able to see it because you are breastfeeding and milk in your ducts can often obscure the imaging.”

I thanked her and left to get an MRI appointment. Unfortunately, appointments were too far away, so I went back to the other hospital with the surgeon. He was satisfied with the tests I already had and gave me an appointment for a biopsy with the possibility of removing the tumor based on biopsy results. The date was December 27th, just a week before the day we were to leave for Canada.

All my questions to the surgeon were about the duration of recovery after surgery and could I travel right away? Could I wear a baby carrier to carry my baby while traveling? Despite all the signs that were not reassuring I ruled out the possibility that it would be breast cancer. I trusted in God, I was optimistic because of my young age, and I was excited about traveling and that new stage of adventure in my life.

The doctor told me that I should stop breastfeeding and wrote me a prescription for medicine to dry up my milk.  was very sad, because breastfeeding is one of the best things that a mother can offer her baby. It is not just about feeding, it is also one of the most important elements of the love relationship that is built to continue and grow with the child in all stages of his life. With all the touches and eye contact and laughter between mother and child it can lead to the growth of a healthy child physically and psychologically. I asked God to make it easy on my baby, and hoped to continue our strong bonding after switching to bottle feeding.

I went back home and started to take the medicine. I had severe side effects, suffering intense vomiting and nausea. I was not surprised as that had always been my body’s reaction to hormonal changes. During both of my pregnancies I had developed a medical condition called Hyperemesis Gravidarum where vomiting exceeded 40 times a day and required hospitalization.

I tried to feed my baby with a bottle but he refused and cried and cried. The doctor advised me to hand him to someone else because whenever he smelled my smell he would cry for my love and milk. My mother-in-law and sisters-in-law alternated in offering the bottle. He looked at them and cried, still refusing the bottle. It was a difficult time for all of us.

Introduction: Welcome to my blog

Introduction 

Welcome to my blog, Passion of the Soul. I write my words with passion from my heart and soul. I am a mother, counsllor, family therapist and ADHD Coach. I live in Dhahran, in the east of Saudi Arabia. I lived six wonderful years in Canada. 

Writing has been my passion since childhood. I used to write articles and poems, some were even published. I was encouraged by my mother (may Allah shower her soul with mercy) Dr. Laila Fatani, who passed away about 20 years ago. She was also interested in writing, but her job in the medical field as a cardiologist consultant prevented her from practicing this hobby. I was also inspired by my grandmother, Lutfia Al-Khatib (may Allah shower her soul with mercy). She wrote the book, With the Saudi Girl on the Path of Hope, and was a role model for me. She was one of the pioneers in girls’ education in the Kingdom of Saudi Arabia, using her writing to encourage the advancement of girls' education. She was the first Saudi female author who published articles with her real name.

My mother’s grandfather, Sheikh Abdul Hamid Al-Khatib, was also a poet and author. He is the first Saudi writer to publish an article in a magazine.

Perhaps most influential to me was my mother’s  dedication to her own mother’s writing, assembling what she wrote into a collected works and having it published while she (my mother) was in the midst of her doctoral studies and while she was pregnant ( carrying me). She then published her mother’s second edition of collected works in the last few days of her own life. Her commitment to seeing her mother’s work published has inspired me to do the same with my own.

I did not write for many years due to various life circumstances, but throughout this time my dear friend (who’s more like a sister), Abrar Albar, encouraged me to return to writing. We have shared a love of writing since childhood. Likewise, Ms. Fatima Bajbir, my grade five Arabic teacher, has encouraged me since childhood to continue writing, and has helped me refine my Arabic writing skills.

When I write my words come from the passion of my heart and soul. I associate the words “passion” and “heart” with the spirit of my mother. As a cardiologist she was a passionate doctor of the heart. The blog’s name reminds me of my beloved mother my first teacher, my dear friend, and my first inspiration. When I write here it will be for those who are passionate about the heart, in memory of my dear mother.

What Will I Write On My Blog?

I will address several areas here, God willing, starting with my personal story of breast cancer. I will write it in the section, Winter Storm in the Middle of Spring. As a marriage and family  therapist specializing in ADD/ADHD, I will also write in the field of mental health, family and marital education, and will include some resources that may be helpful, including articles, perspectives, and poems. I’ll touch on any area that I think may be beneficial.

Why This Date?

I have chosen this date for several reasons. In the Hijri(Islamic) calendar today is 29/4/1440 (Rabi al-Thani 29th, 1440). In the Gregorian calendar today is 5/1/2019 (January 5th, 2019). The first date is my birthday according to the Hijri calendar. The second was my mother’s birthday.

The Hijri calendar is follows the lunar cycle, whereas the Gregorian calendar uses a solar dating system, so they do not cycle together. In other words, on the day I was born the Hijri calendar was 29/4/1440, and on the day my mother was born the Gregorian calendar was January 5th. This year, these two dates coincide. So it felt appropriate to choose this day to give life to my new blog.

More than twenty years ago, my mother left this world in this month. I was also married in Rabie II, so this month is special to me as it has marked new stages and beginnings in my life.

Today I am 39 years old, just one step away from 40. I am so grateful to reach this age, fourteen years after my breast cancer diagnosis.

Winter Storm in the Middle of Spring: My Story With Breast Cancer Introduction and Dedication

Winter Storm in the Middle of Spring: My Story With Breast Cancer 

Introduction and Dedication

Dedication

To my precious mother, who was hit by a winter in her late spring, and whom death stole from us.

To every flower who faced  a winter in the spring of life. Do not despair. There is a spring coming after winter. I dedicate my words from the bottom of my heart.

Introduction

During my annual ultrasound, and nearly fourteen years after my cancer diagnosis , in October 2018 (the month of Breast Cancer Awareness that catches me every year), I decided to write the story of when I was hit by a winter in my spring. 

 I put off writing all these years for several reasons. Maybe I did not have enough courage. I had hidden this from my children Omar and Ahmed, feeling that they were too young. There were also other personal and social considerations.

However, recently we have seen an increase in young women’s cancer diagnoses. Perhaps this is due to environmental damage, certain foods, stress, not enough exercise, etc. This increase was a strong motivator for me to write in support of all these young women. During my illness and treatment I wished there were more books to support me in my journey, especially at times where I had no social interactions for days.

Occasionally young women I know who develop cancer connect with me, looking for support and asking to hear my personal experiences. I am very happy to do this for them, and see the positive impact this has on them. So I asked myself, what if I expanded this support to reach as many people as possible? I hope it will be helpful, God willing.

After I decided to write this story, I was aware this month of some symptoms  that made me and my doctors worry, still doing my medical investigations and hoping that everything will turn to be fine. I am currently living caught between moments when the heart swings from hope in God to fear, sadness, and anxiety. Perhaps God arranged  these conditions to motivate me to write with stronger feelings and more honesty. Either way, it is my hope that this blog will be a source of strength and inspiration to both me and those who experience these circumstances. I will write my story in weekly episodes in the section Winter Storm in the Middle of Spring.

I was very impressed by the courage of Dr. Samia Al Amodi, my mother’s colleague and a survivor and a leader who raises breast cancer awareness and she is a public figure and speaker as well;  Ms. Hana Hakim, who is also a survivor and public speaker; and my dear friend Noor Al Bar May God shower her soul with mercy, who passed away after being so brave. Their stories inspire me. I looked for such a support in my sick days and I decided to follow their steps.

Finally, I would like to thank all those who supported me and encouraged me to launch my blog and write my story, and to anyone who helped me to check, correct, guide or advise. I cannot mention everyone, but most notably Mrs. Iman Khatib, Dr. Najla Kurdi, Ms.Fatima Bajbir, Dr.Samia Al Amoudi, Ms.Hanaa Hakeem, Dr.Hatoon Kadi, my dear friend Abrar Al Bar, Amal Abdo and Dr.Arwa Khumais.

A very special thank for my dearest friend Dr.Laura Morlock, who worked so hard with me in a very short time to write and edit my blog in English. It is fair to have an English version of my blog, as many of my friends who were part of my story and support system are non-Arabic speaker.