The last thing the typical 25-year-old is thinking about in the months after becoming engaged is mortality. Audrey Rossi, having earned her bachelor’s degree and master’s degree from the University of Delaware in 2014 and 2015, respectively, was planning a life and a career — not a long recovery from illness and cardiac arrest. But cancer had other ideas.
For years, Audrey suffered from a number of gastroenterology distress symptoms, but assumed their cause was some kind of food intolerance. Ultimately, these symptoms landed Audrey on the colonoscopy table, 25 years sooner than most of us will experience such a procedure. Age 50 is when the American Cancer Society recommends men and women at average risk for developing colorectal cancer begin screenings. Audrey has no family history of colorectal cancer, and still, she was diagnosed with cancer the same day as her colonoscopy.
“It was as shocking as you can imagine… here we were — Andy and I — minutes after the procedure, still giggling about me being drugged up, silly and letting it rip, and in comes Dr. (Michael) Bass to drop that bomb on us. I didn’t even know it’d be possible to get a diagnosis same day.” Details of Audrey’s cancer diagnosis and her ensuing treatments can be found in her surprisingly lighthearted blog, the whimsically named Dat Ass Tho, in which she refers to her diagnosis as “booty cancer.”
Andy Phillips is Audrey’s fiancé of just over a year. They had six months to enjoy being enfianced before her diagnosis. Sweethearts for around eight years, Audrey calls Andy her rock: the voice of reason who can calm her, despite his own anxieties over the circumstances.
Audrey was advised to immediately seek attention from Johns Hopkins, where she received her first chemo treatment. She learned that the stage four adenocarcinoma colorectal cancer had already spread to her liver and lymph nodes. She’s since had radiation, a five-day course that brings with it delayed and long-lasting side effects. Seven months into her treatment, she is about to undergo two surgeries, the first to remove the rectal tumor and begin to address the metastases in the liver, and the second, another partial liver resection.
These will not be her first surgeries: she has received a chemo port and a defibrillator placement procedure, and also had a laparoscopic procedure to move her ovaries out of the field of radiation.
In addition to her primary oncologist, radiation oncologist and two surgeons (liver and rectal), Audrey also engages a homeopathic doctor. She’s undergoing mistletoe therapy, which uses an extract of the Christmas-kiss plant in a subcutaneous injection three times a week. It eases the side effects of chemo and increases the patient’s energy and is believed to help survivors remain cancer-free.
Her Western doctors do not object to this complementary treatment; in fact, Johns Hopkins is conducting an infusion-strength mistletoe trial. At its monthly colorectal support group meeting, Johns Hopkins surgeons and doctors frequently make presentations to attendees; Audrey’s homeopathic doctor will soon present to the group, as well.
Audrey armed herself with information on dietary choices believed to help cancer patients. Intermittent fasting and ketogenic (very low carbohydrate) dieting were already part of her usual, health-conscious routine, and she was prepared to continue. Turns out, her oncologist recommended she “pump the brakes” on any kind of strict dietary choices at first. Chemo is enough to manage, and saltine crackers are a staple in chemo rooms. Cancer patients are urged to simply consume plenty of calories, including a lot of carbohydrates, due to the expected weight loss.
But there is another reason her nutrition focus was put on hold: in September — a month into her chemo treatment — Audrey suffered a cardiac arrest while on a run. (Yes, in the midst of all this, she continued her commitment to fitness, although she’s been forced into long breaks.)
She credits a series of coincidences – and her special bond with family and friends – as reasons she survived. “There were four things that occurred on 9/20 that were down right freaky and have me convinced I was being looked after that day,” she posts in her blog. “It just wasn’t my time yet… despite what my heart thought.”
It is through her blog that Audrey has built some of her support network, although the stress of formal writing has given way to her return to social media as a means to distribute information broadly. Having once found it therapeutic, she now lacks any desire to write in long form. Instead, she spends time with family and friends.
Not surprisingly, her family has been great, with her mother wanting to do everything she can – including unsuccessfully urging her daughter to move home. Her father is agreeably stoic, and her always-close sister gives her space while offering to be a resource. Audrey’s illness has brought her closer to her brother, the one who asks all the questions about her situation. Her soon-to-be in-laws, Jill and Keith, visit from Florida often; Jill had just returned home from a Delaware visit when the cardiac arrest happened, and she flew right back. She can count on her cousin Jody for a fun time out of the house.
“It’s helpful to talk about cancer. There’s a time for that, but also a time to go out and forget that I have cancer,” Audrey says.
Brittany Keller was an old friend of Audrey’s who happens to work for the Cancer Support Community of Delaware; Audrey says that without Facebook, Keller probably would not have learned of Audrey’s diagnosis and come back into her life personally and professionally. Audrey also relies on support groups on Facebook for information and inspiration and has found patients and organizations on Instagram worth following.
Niki Roberts, Audrey’s coworker at the University of Delaware Center for Disabilities Studies, came into her life a few months before her diagnosis. She is one of several people Audrey believes the universe put into her life at the right time. In addition to setting up a GoFundMe account (https://www.gofundme.com/audreyrossi), she makes Audrey feel better with statements like, “You look like s**t.”
Audrey explains that after a typical vent session, people respond with bromides, such as, “Well, at least there’s…”—complimenting her appearance or her still-present head of hair.
She’s grateful to friends and family who can acknowledge the way she feels and be honest and candid. “As a cancer patient, you just get sick of hearing other people, who have no idea what you are actually going through, give you a rundown of silver linings. Cancer sucks. Let’s keep it at that.”
Fiance Andy attends every chemo treatment and doctor visit, always knows exactly what to say and how to comfort her; he also supports her by joining in on her dieting and fasting experiments. Their courtship began when they were both young, and Audrey believes, once again, that the universe placed someone into her life for a reason.
They got engaged at Va La Vineyards. Since then, the company has donated to her GoFundMe several times. She and Andy go to what they consider their happy place, and despite knowing the wines very well, the couple still enjoys the tasting option every time.
Audrey says, “I have not given up red wine. No one has told me I have to.” And in recent months, she’s returned to her ketogenic diet, and fasting prior to her most recent treatment reduced her gastrointestinal symptoms, including her nausea.
Beyond the effects of the treatments, life is challenging. She urges patients to constantly advocate for themselves. For her, electronic communication is key, and she cannot imagine how hard advocating for oneself would be without computer skills. Clinical social workers and a physician’s assistant help her coordinate treatment details.
Audrey has maintained full-time employment throughout treatment, despite prolonged and frequent appointments at Johns Hopkins. Every chemo treatment is a five-hour infusion but includes another five to six hours of travel and appointment time. She manages that by taking off Fridays and working from home on Mondays when she has treatments. Both Audrey and Andy feel fortunate to work for organizations that support their need for a flexible schedule. They both work night and weekend hours from home to continue to demonstrate their commitment to their professional careers.
Another obstacle the couple has had to consider is Audrey’s reproductive future. Harvesting, fertilizing and freezing her plentiful eggs would have delayed the start of her chemo, so they opted not to pursue it. The surgery to relocate her ovaries was performed to keep her from going into menopause post-radiation, but not necessarily to preserve fertility. Radiation damage to her uterus means it cannot support the growth of a baby. The idea of never carrying a child has been one of the hardest things to cope with.
Audrey’s biggest piece of advice for patients is to connect with other people who are in similar situations. She has found relief in the Cancer Support Community of Delaware, specifically a young adult support group, as well as some financial help. CSCDE services are all free: they offer help from licensed clinical social workers, yoga and varied support groups made up of breast cancer patients, head and neck cancer patients, caregivers and more.
Coincidentally, CSCDE’s director is friends with the men who discovered Audrey unconscious after her cardiac arrest. One had just finished CPR training a month beforehand. Audrey was grateful to be able to connect with them after her recovery, later learning that one of the men had visited Christiana Hospital the day after her admission. Privacy laws prevented the hospital from saying much more than that she was alive.
Her blog lays out the many coincidences on the day of her cardiac arrest. Having unwisely left her wallet behind when setting out on her run, her rescuers were unable to identify her. Family friend and former teacher, Brent Thorpe, had a sudden urge to ring Audrey out of nowhere just when the EMTs were able to answer the mystery patient’s phone. Then her mother spontaneously visited a new trail for her own run, with no clue she’d soon be encountering a team that was saving her daughter’s life.
The universe putting people on Audrey’s life path, indeed.