decisions

Talking About My Cancer, and The Decision it Led Me To

Since I got to NYC I have spent a lot of time talking about my cancer diagnosis. I thought I was escaping the focus on my medical adventure when I left Vermont, but I should have known it would be impossible to escape. I don’t blame anyone for this and don’t discourage anyone from continuing the conversation, it was just not what I expected.

There are a few reasons for this. First was the fact that I hadn’t seen anyone since the surgery happened; every update was a medical recap. And second was the Cycle for Survival event. I can’t say enough how wonderful it was to be there, but an interesting side story was the light in which my experience was put. I was “a survivor.” I had been diagnosed with rare cancer – monophasic synovial sarcoma – and had been treated – surgery – and was now cancer-free.

During the whole process we talked about Tristen as a sarcoma, not as a cancer. These things are one in the same: sarcoma by definition is a cancerous tumor. But “sarcoma” is not as commonly known as “cancer,” so outside of the doctors, the c word has become more prevalent. That doesn’t change the fact that I still feel uncomfortable using that word. As Dr. Kalanithi put it, “there’s cancer, and then there’s CANCER.” Sometimes I feel like a cheat: I didn’t have CANCER, I didn’t have to go through radiation or chemotherapy, I didn’t have a years-long battle that took its toll on my body and my emotions… Or did I?

The whole time I’ve been thinking of my sarcoma as a quick process – diagnosis, surgery, 4-6 weeks healing, and back to normal life – when in reality it’s not. I started feeling the pain 10 years ago. Even though I didn’t know it was a tumor growing in my muscle, agitating a nerve once in a while that stabbed me in my side, that’s exactly what it was. I had already been dealing with a sarcoma for a decade.

“How did you discover you had a sarcoma?” I hadn’t even thought this would be a question because he popped out and said hi to the world. I was lucky he did. Some sarcomas don’t get discovered until the cancer has already spread, and if I had waited any longer its possible mine would have spread too. I was lucky he outgrew my muscle. I was lucky it was still contained.

And then I had surgery. 4-6 weeks healing was just for the incision and the mesh. The healing for the muscles that had large chunks removed is more like a year. And the close watch to make sure it doesn’t come back will continue forever. As my doctor pointed out to me on my last visit, this will affect me for the rest of my life. My battle with cancer may not be the typical struggle, it may be more of a passive watch, but it is not over.

I had cancer. I’m now cancer-free. I could not be cancer-free at any moment. At the same spot, at a different spot, or even a different cancer. I may be doing genetic testing to find out how susceptible I am to other cancers.

So my thinking has shifted. I have realized just how much a diagnosis like this resurfaces in even the most minimal ways (medical history forms and health plan enrollment are my enemies). And I have realized that I need to be responsible medically. This is not something that I can forget about, ignore and hope everything will turn out okay. For two years I have to be closely watched, and then it eases up a bit to every year. For 3-5 years I’m most at risk for it coming back, and then it’s a forever maybe. So for 2-5 years, I want to be near my doctors. I know there are great doctors all over the place, but I like the ones I have at DHMC. They know me, they explain things to me perfectly, they answer my phone calls and see me as soon as anything comes up.

So now, my sarcoma has decided one more thing: I am moving to New York City. I was back and forth between NYC and SF since my return to the US, another decision my sarcoma forced, but my medical needs tipped the scale. Who knows how many more times this will happen in the future? All I do know is that even though Tristen is physically gone, he will somehow be with me for the rest of my life.

Here it Goes Again

A funny thing happened at the end of June. I bought a flight to Mexico City.

It happened just like that – sudden and unexpected. But since it happened I haven’t looked back, so I am taking that as a sign that it was the right decision, since I feel pretty settled in it. So what does that mean?

I am going to Central America for 6 months.

Let me take a step back and explain how I came to this decision. When I returned to the US it was under the promise that I would be leaving again, I just didn’t know where to yet, so I was going to take the summer to figure it out. I knew I had a six month window between the end of my summer job and my sister’s wedding, an unmissable event in San Francisco next spring. With that in mind I narrowed it down to four options:

1. South America. To be honest, I really thought I would be going back to South America. I pretty much came back to go to South America. I knew the exact trip I wanted to do: I would fly to Lima, hit a few places I missed in Peru like Arequipa on my way to a few places I missed in Bolivia like Sucre and Potosi before a border-hopping adventure down Chile and Argentina into Patagonia, then I would loop around the southernmost point of South America and work my way back up to Buenos Aires. Sounds great, right? I even dreamed about continuing up the coast of Brazil to the beach towns I missed like Puerto Alegre, Fortaleza, and Jericoacoara.

2. Wanaka, New Zealand. I knew the work-study visa was an option until I hit 30 and I loved this town so much I thought about just finding a job and staying put for a while. It would be their summer so I could potentially farm or do something on the lake. I would hike, get to know a foreign country well, and do some wandering in the meantime. Maybe I would finally get to do more of the Great Walks or jump over to Tasmania or Perth.

3. Central America. This choice was a continuation of the backpacker lifestyle in a mostly new region. People raved about traveling through CA and my week in Nicaragua in 2011 was enough of a taste to make me want to go back and see more like it. It’s cheap, it’s got the kinds of adventures I like, and my timeline of September to March is the exact right time of year to explore it.

4. Europe. I’ve been talking about moving to Vienna for a long time now, and with so many friends going to Oktoberfest this year maybe it was time to bite the bullet and go for it. I have friends to visit across Europe who I’ve been telling I’ll see at some point, I could fly to England and go through France and the Netherlands on my way to Germany, with a quick Swiss interlude before ending in Vienna. I haven’t been to Europe in years and that should be corrected soon.

With four fantastic options I thought it would take all summer to decide and after Labor Day I’d end up flipping a coin or buying the cheapest flight to one of the regions I was considering. Turns out it didn’t take all summer to decide, but that cheapest flight idea may have been right.

I quickly eliminated Europe. As much as I want to go there, a six month window is not a time to try to move to a new place, it’s a time to do another adventure that I know I will return from. Europe would have to wait until after April. Next to go was New Zealand. I was forcing it on this time because of the age limit on the work-study visa. If I do want to go live in Wanaka I can do that any time, it’ll just be a little more complicated. But for any American under 30 who might be thinking about some extended time in New Zealand or Australia, I highly recommend looking into the work-study visa. It’s a great way to spend a year or two abroad and something I wish I’d known about before.

I was down to two options: South America or Central America. The two backpacking options that would again have me moving around quite a bit. South America had been calling me back ever since I left. I woke up in Myanmar longing for it, a physical pain in my chest that told me I needed to be on a different continent. I knew the exact trip I wanted to do and had originally said I needed 6 months for it. The time frame was right, an estimated December/January arrival in Patagonia would work out perfectly, and I would finally feel like I completed South America (at least for now). At this point you’re probably wondering why I don’t have a flight booked to Lima.

Central America wouldn’t leave my mind. The more I thought about what I wanted out of this six months the more I realized it was in Central America. I still have the stamina to travel in the backpacker way, on chicken buses and in hostels, and this region felt like the last frontier of backpacker life that I had to get to before I grew out of this phase. It has everything I liked from the last trip that would make for a great next trip: mountains and volcanoes to hike, jungles to adventure in, oceans to scuba and snorkel in, awe-inspiring architectural ruins from another era, charming colorful towns, cheap street food, and hammocks all over the place. It’s much quicker to travel around, with 3-hour bus rides between places instead of 24-hour bus rides, allowing me to cover more ground in my time frame. And the likelihood of being able to travel solely based on people’s recommendations was high. This is something that is really important for me on this next trip; I had such a positive experience going to places that friends recommended last time that I want to pick most if not all my locations that way this time.

Then there were the negatives for South America. First of all, it’s way more expensive to get to and from. Second, it’s freaking cold in Patagonia, and the stuff I would have to bring is bulkier and costlier. Third, I could actually do that trip in shorter spurts, going just to Peru or Argentina for two weeks at a time; it didn’t really have to be six months. Fourth, hiking alone is lonely, it would be nice to go with people, and that was putting a lot of stock in meeting people I wanted to hike with. I wasn’t really worried about it given the incredible people I’ve met on the road, but it wouldn’t hurt to have a buddy or few for a trip like that. Fifth, my motivation for returning now was partially fueled by the fact that I’d dropped a lot of money on visas for Bolivia, Argentina and Brazil that expire in 5 or 10 years, and I felt like I should use them again. I already said that visas weren’t a good reason for NZ so I had to remind myself of that again here.

Then there were the book-ends of Central America. I have friends in Mexico City who I would like to visit while they’re still there, and I would love to return to Colombia, which is possible by boat from Panama. Working at an eco-retreat or coffee farm in Colombia was also an option at one point, so ending my six months with a month in Colombia was an intriguing idea.

So one day I looked at flights, just to see what getting to Mexico City looked like. CHEAP. So cheap. And not only was the flight cheap but it was from San Francisco, meaning I could go see friends and family in SF on my way out of the country. Then I realized that my flight to SF could be covered by points, aka free. I slept on the idea and the next night bought the flight before it disappeared. Like I said, I thought I might just end up buying the cheapest flight out of the country…

I got a round trip flight SF to Mexico City and a one way flight Newark to SF all for $260.

September 10th I arrive in San Francisco. September 25th I leave for Mexico City. I plan to be back in San Francisco around March 25, 2016. In between, I will just see how far south I make it. If I end up loving Guatemala I could stay there the whole time, or if I get fed up with chicken buses I could jump down to Colombia early. The beauty of how I’m traveling this time is anything could happen.

I also still have a month plus until departure, and it’s not like Mexico City to Lima flights are totally outrageous, so if for some reason I have buyers remorse about this decision I could still change it at any point. The world is my oyster, and I will go where feels right. But for now, Central America feels pretty damn right.

Now begin the posts about my next adventure, what I have come to call my Round the Central America trip.

Here it goes again.

The Decision to Go to Myanmar

I added Myanmar.

In the original plan I was going to India on February 9th but, seeing how it’s almost the end of February and I’m not in India, that flight changed along the way; it was more important to go to Holi so now I’m flying to India on February 28th. This opened up a new three-week window in my Southeast Asia itinerary.

When this change happened I saw it as a chance to add another country. Myanmar is the place to go now, everyone says, since it just opened to tourism recently and will probably change drastically in the next 10 years. I’d heard so many great things about this country and knew I’d be just a hop away in Northern Thailand so it sounded like a perfect use of my new-found time.

The land border between Thailand and Myanmar is a tricky crossing, and since I’d had some recent bus frustration I looked into booking a flight from Chiang Mai. In thinking about timing for Myanmar I had outlined the last two weeks of February; the cheapest flight happened to be on Sunday the 15th, which aligned perfectly. Over the past months I’ve had route questions that always ended up working out in the way my first instincts thought they might, so I decided that would probably happen again and I should just book the flight. As much as I hate booking definite things like flights, I prefer buses mainly for the ease of getting tickets on short notice, it seemed like the right thing to do. I had a visa (acquired in Singapore) and a now-unmovable date to India, so this was the time. I was going. Flight, purchased.

Then Shambhala happened. The last day of Shambhala was February 15th, the day of my flight, meaning I would have to go back to Chiang Mai a day before it ended. I was torn up about this. Here I was in one of the best weeks of my trip and I had to leave a day early because I’d jumped the gun and booked a flight, something I rarely do. I cursed my planning self. My mindset at the festival was all about the now, the moment I was living, and the desire for ultimate flexibility. I’d already ditched my Pai and return to Chiang Mai plans, I could ditch my flight too. My visa was good until April, I could go after India; or screw the visa, it wasn’t that expensive. Then I could have more time to go to Pai and hang out in Northern Thailand. Why had I added Myanmar anyway? I should’ve just had more Thailand time.

Every day at Shambhala I was back and forth on this decision, but it was Josh’s encouragement to stay till the end of the week then still make my flight that stuck in my mind. He was right – this was an amazing experience, but for one final day I was going to completely miss out on a country that I had previously been excited about going to. I realized that while I was having the time of my life there, it would soon end, and once back in Chiang Mai I would remember just how much I had given up.

So I left. Goodbyes were hard; it felt like I was tearing myself away from my happy place. I had to convince myself the whole bus ride back to Chiang Mai to not get on the first bus right back to Chiang Dao.

Now I’m in Myanmar and I can, without hesitation, say that I made the right decision. This country is spectacular. It’s not easy by any means – hotels can be expensive, buses are always a question mark, and the signs of a country that is behind in development are obvious – but the sights and the people more than outweigh the hard parts.

As I write this I’m looking out over the town of Kalaw, nestled in between green hills. Single story tin roofs mix with multi-story stucco boxes advertising hotel names in big block letters. This is Myanmar, changing before my eyes, and I have become one of those “everyone” saying: “Go now. Go before the air conditioning tourists change it all.”

Tuktuks, Temples and Tarantulas in Phnom Penh

I arrived in Phnom Penh with the name of a hostel and a screen shot of a few back-up options nearby. I was hopeful that my “it will work out” mindset would continue to prove right. The tuktuk driver knew where the hostel Me Mates Villa was so at least that was a step in the right direction.

We wove through Phnom Penh’s streets surrounded by motorbikes, cars and other tuktuks and I had a giddy moment of awareness of the vehicle I was riding in. Tuktuks became standard to me during my time in Cambodia, but this first ride was exciting in the way that new abroad transportation can be: I’d heard about these, I knew they were coming, but I was finally in one. Being towed around in what is more or less a motorbike-driven golf cart took some getting used to. I felt like I wanted to be up on the bike with the driver, and the four posts that made up my carriage provided a false sense of security. Really I was no safer than the motorbike, probably less safe actually since I had no control over this vehicle, and a car could crush me. Once I got past those thoughts though I was able to just have fun in the tuktuk. Plus when something has the name tuktuk how could you not enjoy it?

Phnom Penh has a palpable energy. I felt it instantly while whizzing through the streets. I arrived on a Saturday night, so naturally I wondered if I would meet people at the hostel and experience the rumored crazy nightlife. I got to the hostel – they had a bed for me, so it did work out – and did meet people but had a very different night than expected. I ended up with a Russian, two Brits, and a handful of Aussies playing multi-player pool the whole night while drinking 75 cent beers at the hostel. Not quite the nightlife I was thinking but a fun night nonetheless.

The next day I set out with the goal to see the highlights of the city. I went right to the Royal Palace and discovered it was closed until 2:00 pm because it was Sunday, something the guidebook did not mention. I was accosted by a tuktuk driver offering me a tour of the city for $15, something I wasn’t willing to pay for, so I tried to find the next site on my list on foot. I quickly discovered that normally busy Phnom Penh on a Sunday is even busier and attempting to walk to everywhere I wanted to see in the heat was pretty uncomfortable. I backtracked to the museum to see if it was open yet and the tuktuk driver found me again. We agree on $8 and set off around the city.

My driver ended up being more of a tour guide than I expected. He hit all the places on my list and some that weren’t. Along the way he told me about the history and culture of Cambodia, from religion to politics to social concerns. I appreciated his candid opinion on the current situation in Cambodia, its Prime Minister, its relationship to other countries, and what it’s like to live there. There’s no better way to learn about a place than from a local.

He also protected me from a scam I knew nothing about. A woman from the Philippines approached me as I was looking at the statue of the King, politely complimenting my outfit and asking if I was just visiting town and if I had a tuktuk with me. As soon as I said yes and pointed in his direction she backed away, and as soon as he saw her he ran over yelling. He explained that these women pretend to be your friend and invite you over for a drink, then they kidnap and rob you. He threw more curses in her direction and warned another tuktuk driver who was passing by with a quad of tourists. I would go on to tell other travelers this story as a word of warning.

Some of the highlights of my morning tour of Phnom Penh included Wat Langka, a Buddhist temple, and Wat Phnom. Wat Langka was our first stop. A complex of beautiful, ornate design, it was a great introduction to the richness of Cambodian architecture. I wandered through the different buildings and was in awe of the interior decoration of the temples, as well as the individual stupas.

Wat Phnom continued to build upon this positive impression. After climbing up a long flight of stairs I was rewarded with another pretty building. No spot of interior was left undecorated. Visiting on a Sunday was particularly interesting because the temple was packed with people praying. It reminded me of my experience at the Jade Emperor Pagoda in Ho Chi Minh City, and just like then I was happy to have seen this Wat in use.

My driver dropped me off at the Central Market. I thanked and tipped him and went in search of some local lunch. I ended up with a Cambodian noodle soup that was somewhere in between pho and ramen, and of course I made it extra spicy. I have to say the incredibly fresh roasted chicken was delicious. Having spent just $1.75 I was full and satisfied. I wandered the market a little before hopping on a motortaxi back to my hostel. I still had some time to kill before 2:00 and needed to decide what to do.

My morning had been up and down: frustrating at first with the palace being closed and giving in to taking around a tuktuk, but improved once I got to see all that I wanted with an informative and friendly driver, but again lowered when he tried to convince me to pay another $15 to go see a local kickboxing match, raised by the food and lowered by the aimless wandering that led to a motortaxi. And on top of all of this I still hadn’t decided whether or not I would go see the main attraction of Phnom Penh, which still felt strange that it was the main attraction – the Killing Fields.

I called my sister. I needed to talk this out, and not only did she know me well enough to get why I was feeling conflicted but she had visited the killing fields a few years ago. I wanted to learn about Cambodian history but felt like I had seen enough of Phnom Penh to be ready to go to Siem Reap. Was it worth staying in Phnom Penh another day just to get out to the Killing Fields, knowing I was stressing about the cost of the excursion before I was about to drop $40 on Angkor Wat, and knowing that I was still a little emotionally and mentally off? Traveling alone I usually can make these decisions, but once in a while it helps to be able to talk it out with someone. At the end of our conversation I felt a million times better and had made my decision: I would go to Siem Reap tomorrow.

I know the Killing Fields are important and the decision not to go was a hard one that lingered with an unfortunate feeling for a little while. However I had told myself upon leaving Vietnam that I would not go to things purely because I “should.” I made the same decision with whether or not to visit the palace that afternoon, the main site in town I “should” see. I wanted to go to the National Museum of Cambodia more, so I went there instead.

I breathed a happy sigh as soon as I walked into the museum. The Art Historian in me was thrilled that I made it there as I strolled past statues depicting Hindu and Buddhist icons from a range of centuries. There was even a short video portraying what Angkor Thom may have looked like when it was a functioning city, which was awesome to see right before going to see it in its current state. The building is also gorgeous. I sat on the edge of one of the four lily ponds in the courtyard watching someone feed the koi, listening to a monk talking to a traveler nearby. In here the sounds of Phnom Penh disappeared. It was my sanctuary for the afternoon, the place I came to accept and be happy with my decision to leave in the morning.

Before I left I had to at least visit one of the must-see bars, Foreign Correspondents’ Club (FCC). I sat overlooking the mayhem of rush hour traffic below me, sipping on my Anchor beer. Another solo traveler sat down next to me. Turns out he’s from LA. We ended up having the night that I thought Saturday would be. We started with drinks at FCC followed by a delicious Cambodian cuisine dinner at a restaurant that is associated with Friends International, Romdeng. The employees are former street children and their teachers, and the decor is their artwork, so it’s dining for a good cause. We had deep-fried tarantulas. They are not disguised at all, this is clearly a tarantula. Spiders have always been my biggest fear (although the Amazon helped lessen my fear a bit), so in trying to pick up one of these to eat my hand would not listen to my mind. I played a jumpy game of almost picking one up and pulling my hand back a few times before finally going for it. My companion went for the all in one bite approach, but I bit off just the head. Not bad. I tried a leg alone. Crunchy. Then the rest of it. Surprisingly, deep-fried tarantula is actually kinda tasty. Not saying I’d want it all the time, but I didn’t mind it so much once I got past the appearance.

We celebrated our daringness by going to one of the shadiest bars in town, Walkabout, followed by another just-as-seedy bar where we distracted ourselves with a game of pool. The blatant prostitution industry was harder to stomach than the tarantula. Everywhere we saw scantily clad Cambodian women talking to elderly white men and it felt so wrong. We called it a night there, not needing to push through to any more bars or clubs.

In the end I was in Phnom Penh for about 36 hours. A day shorter than the original plan, if I had any hesitation about leaving my fantastic experience in Siem Reap washed it away. Timing is everything, and it felt like every move I had made thus far led me to the right place right time of Siem Reap.

The Decision to Leave Vietnam

I realize at this point the timeline might be a bit confusing so let me lay it out. Here’s how my last week in Vietnam went: Ho Chi Minh City for 2 days, Hanoi for a day, Halong Bay and Lan Ha Bay for 3 days/2 nights, Hanoi for one night, flight back through Ho Chi Minh City on my way to Cambodia.

Basically what happened was that I knew I wanted to get up to North Vietnam and at least see Hanoi and Halong Bay. I had a good time in Hanoi and adored Halong Bay, but I realized while I was out in Lan Ha Bay that I needed to go to Cambodia. Nothing against Vietnam, there’s still plenty to see and do there (Sapa, Hue, Mekong Delta, to name a few) but if I stayed to go to those other places it felt like I was just filling time before I had to meet friends in Thailand for Christmas.

I was in a weird place. Between family leaving from HCMC and meeting up with people for Christmas I had 2 weeks. It was not enough and too much time all at the same time. I love meeting up with people, but sometimes it puts a lot of stress on the planning process. So the beautiful part about traveling alone is that I can make any last minute decisions that will alleviate this stress.

So the night I got back to Hanoi I booked a flight to HCMC, which departed 13 hours later. I didn’t have a bus ticket to Cambodia but was confident I would figure it out when I got to HCMC. I knew where it left from and the names of two companies, and I booked an early enough flight (6:45 am eesh) that I had all day to get to Phnom Penh. That’s the other thing about traveling this long – I’m not afraid to wing it. It would work out. This became the theme of Cambodia for me, and something that is still happening. I’ll get there eventually, if it’s last minute so be it, flexibility is king right now. And I got there: less than 24 hours after booking that flight I was playing pool at a hostel in Phnom Penh. I love it when it all comes together.

So why did I decide to leave Vietnam? It’s hard to explain. I just wasn’t feeling it. It felt anxious, it wasn’t working for me. Something in me told me I had to go to Cambodia. Angkor Wat was one of the reasons I came to Southeast Asia, and it felt like now was the time to go there. Plus I can always go back to Vietnam. If something isn’t sitting right for this trip then I should make a change so I do feel right. I’m not going to get everywhere right now anyway so why force it?

Maybe it had to do with everyone talking about getting together for Christmas and I needed to be somewhere that clearly reminded me why I’m not there with them. Maybe I had some residual feelings from the Amanoi. Or maybe I just don’t vibe with Vietnam like I expected and it was bumming me out. Whatever it was, I decided to go. It was one of those times where I just had to trust myself; it will all work out. And as always, it did.