Graduation Day

Graduation. The rite of passage that we all seek to achieve throughout our childhood after the many years spent in school and for some into adulthood - possibly several times over. It’s a marker of the achievements we have made, the work that we have put in and a celebration of the end of a significant phase in our lives. 

I have fond memories of both my high school and college graduations. They were proud moments for me, my parents and my grandparents. They were periods in my life that shaped me both academically and socially. They helped build a foundation for my career, prepared me to venture out into the world and steered me to make dear, life long friends - many of whom I still talk to on a regular basis today. 

My 30 year high school reunion was earlier this month. I had planned to go and was excited to continue reconnecting with people I had not seen in many years as part of my 2025 mission to “Reconnect, Rebuild and Reimagine.” (See 2024: A Year to Remember… or A Year to Forget?) I had missed all of the previous reunions for one reason or another but I was determined to make it to this one. When I told my friend Barb, she told me that her mom always told her to go to the 30th reunion. “That’s the best one.” she said. I was going to travel solo for the first time in 2 years, leaving my husband and kids at home as I reclaimed a shred of my independence. I made several plans to meet up with old friends I had not seen in many years - before, during and after the reunion. I intended to visit with two teachers that have become like family to me. And I wanted to see my dear long time family friends that watched me go through high school years who in effect are family to me already. But alas, life… or I should say Cushing’s Disease… had other plans.

The ongoing journey with the curable disease that never seems to go away that I had been on since November of 2022 decided to have its final swan song. A 42 day migraine. In the 35 years I have been getting migraines, this was the longest and worst one to date. There was no amount of medication, acupuncture, physical therapy, injections, infusions or nerve blocks that could seem to break it and the cause was unknown. Fearful that with my recent surgical history something bigger was going on, I went in for an emergency MRI just days before I was scheduled to travel only to find no answers other than to rule out the truly scary causes of a headache such as this. I was grateful for the information and the piece of mind but my doctor’s were unsure of the next steps with no visible cause to explain it. Thankfully, a solution surfaced and I was instructed to try a new preventative medication. Literally it became the magic pill. But it was another pill in the series of pills that I have had to take this year and the possible side effects from the medication made traveling alone risky. So once again, I would pivot (flashback to 2024: In Three Words) and cancel my intended plans. 

So in addition to the debilitating months of recovery, the weeks in bed, the countless doctors appointments and labs, and the already missed milestone birthdays, weddings and other important events that preceded this - I was taken down again. I would miss yet another event that could not be recreated and have to virtually and vicariously experience it through photos on Facebook. 

Shortly after my headache broke, I was due for one final set of labs and my 1 year follow up with my wonderful endocrinologist. This would be the labs that would determine if after 6 months of taking no synthetic steroids whether or not my pituitary gland had woken up and was producing a normal amount of cortisol again. While I knew the tumor had not started growing back, thanks to the emergency MRI for my migraine, the labs would confirm if I had indeed reached the ultimate goal… Remission!

I completed the labs and dropped them off. They were mailed to the Mayo Clinic and for days I waited to see the text or the email pop up notifying me that I had new lab results. The message did not come. My doctor said to keep my 1 year post-op appointment anyway and we would hope that the results showed up in time.

In anticipation of the big day, I made a big batch of my giant chocolate chip cookies. After all, who doesn’t love a soft, delicious cookie that is so large you need to eat it with a spoon? Of all the things I bake, this is probably one of the top 3 recipes that consistently gets rave reviews and is requested time and time again by my friends and family. It is also the first recipe that I ever baked on my own from scratch. I have made it so many times in my life, that I have it memorized, can double or halve it without having to do the math and have even figured out how to make it gluten free… for my celiac friends. In my opinion, life is too short to not be able to have a really good cookie and I am an equal opportunist when it comes to sharing the love!

Cookies for the Dream Team!

I packaged up the cookies, wrote out cards to all the staff, and got ready with the intention that a broken, tired, diseased Cara would not be entering the hospital that day - but Gayle in the flesh. As I have mentioned before - Gayle is well put together and the best version of me. She would be bringing it and this would be her coming out party!

For this occasion, in addition to full hair and makeup - I knew immediately what wardrobe piece I would be wearing. Not a long graduation gown and cap but THE white jeans. For those of you that don’t know, the white jeans are a sacred rite of passage for a mom of young kids. They are a wardrobe piece that screams victory. It means you’ve graduated past sippy cups, spit up and diapers. You’re no longer carrying a diaper bag or living in your stained sweats. White jeans are for winners and I was winning today no matter what. There would be no hospital gown, no worn out yoga pants, no IVs… just me making a victory lap. 

As I arrived at the hospital, the other patients in the elevator looked jealously at my basket full of cookies and one even joked that he wanted to go where I was going. After checking in at the front desk, I sat waiting for my name to be called. Almost immediately, my endocrinologist walked another woman out, saw and greeted me by name, assuring me she would be with me shortly - then turned to finish with her previous patient. When the other patient sat down with her friend in the waiting room, they launched into a discussion. They discussed the lab tests she had taken and the ones that still lie ahead. It was word for word the plan that had been laid out before me a little over a year prior. (Yes, I was eaves dropping.) It was like deja vu listening to her talk through everything and I was shocked at the parallel journey she was on. I refrained from inserting myself into her conversation but I thought to myself how sad it was to hear that another individual was potentially facing a long and tough road ahead. Maybe her experience would be different. Maybe she would be one of the lucky ones. All I knew is that I had the wisdom and experience to know that I was happy to be on the other side of it all. It was a full circle moment. 

Me with Dr. Asha Pathak, MD. The greatest Endocrinologist I could have ever hoped for.

After being called back to the exam room, I asked the nurse that was checking me in to have everyone I had come in contact with the last 15 months stop by my exam room. There were so many people I had only spoken to on the phone or over MyChart but had never met in person. I wanted to acknowledge what they did for me and thank them in person. Although not everyone was available and in the clinic that day, one by one those that were came by. I thanked and hugged each one of them, cried tears of joy, offered the basket of cookies to them and requested pictures with those that were willing to take them. It was every bit as sweet as I hoped it would be. 

That night Dr. Pathak called me but I missed the call. She left me a long and very sweet voicemail message. She gushed about how much everyone enjoyed the cookies, how they saved some in the freezer for my neurosurgeon and his staff that were not in clinic that day. She told me how immediately after my appointment she went looking for her cookie and how the staff had barely managed to save one for her, the woman who was truly my guardian angel, because all of the other staff were fighting over them. Once again, my cookies sparked joy and expressed gratitude. 

Two days later, the lab results came in and I received the mychart message from my team that I was indeed in remission. It was official. Finally. Cue the Pomp and Circumstance. I was graduating.

One of my other angels, Christa.

Today is a new day. A happy day. Instead of throwing my cap in the air, I will be throwing out the gallon sized ziploc bag of unused and now expired prescription medication into the medication disposal at the pharmacy. That bag has been a reminder of all that I have endured - the more than 800 steroid tablets I nearly finished, the many sleeping aids that did not curb my insomnia, the pain medications and muscle relaxers for my months of aches and pains and the headache remedies that no longer work for me.

I also was given the green light to remove my medical alert ID bracelet. I hope that I do not ever have to wear one again. And I no longer have to carry the special bag I had in my purse for over a year with an emergency dose of injectable steroids. The weight of having to endure that crisis is also lifted. One little bag removed but it carried a metric ton of emotional weight with it. 

The drugs. So many drugs.

As at any graduation ceremony when the speaker delivers the commencement speech, I too want to share some words that comfort and inspire me. I offer this poem to all of you that I found in a book gifted to me from my dear friend, Sioux. It summarized my journey perfectly and reminded me of… just how far I have come. 

“The Long and Winding Road Ahead”

Invite joy to meet your sorrow,
Let in hope for tomorrow.
Bridge the fragments of who you are,
and learn to see beauty in your scars.

Imagine the table designed to seat
The family you have known and long to meet.
Invite the stranger, and learn his story, too.
Be the bridge to all these persons passing through.

Because in love, there will be room.
For each and every one of us
And in love there is room for all of you.

-Morgan Harper Nichols, How Far You Have Come

Final Thoughts

If I had to describe what it has been like living with this disease, I would compare it to that of an earthquake. My mom always talked about how some days in California, it just felt like “earthquake weather.” I didn’t really grasp that concept as a kid but now I do. It is a change in weather that precedes the actual quake but it gives off the eerie feeling that something is about to happen.

Cushing’s Disease felt a lot like that for me. The weather suddenly changed in my world. I could feel something terrible coming in the form of symptoms. It was building and building as I went through the diagnostic process. Then the big 10.0 earthquake hit. I was told I had a tumor. It had to be surgically removed. Brace for impact!

My tumor was eventually removed after several false starts. It was the epicenter of it all. It sent waves of illness through me during the year that followed - like a series of aftershocks. Just when I thought I was past it, and I was feeling like my life might be put back together - another mini quake would hit. It happened again and again and again. Unrelenting. Eventually, the aftershocks got smaller and smaller and I could start to put everything back where it was… but it is not exactly the same. It never will be.

But today, for the first time in a long time… I feel the sun coming through the clouds, the calm all around me and I know just how far I have come.