Nicole Upchurch is not the kind of person who despairs.
Not over the amputation that left her with nine fingers after a giant-cell tumor, a rare benign condition that occurs in one person in a million, recurred on her left hand.
Not over the giant-cell tumors that still dot her finely toned soccer player's lungs, where they migrated from her hand, requiring her to take strong drugs to shrink them.
At UK Healthcare, she receives denosumab, recently approved by the federal Food and Drug Administration for treatment of giant-cell tumor of the bone.
Her left hand was surgically restructured to allow for as much movement as possible. A quick glimpse at Nicole's left hand and you might not even notice that there's a finger missing.
That was intentional, according to Dr. Patrick O'Donnell, who did Nicole's surgery. O'Donnell specializes in treating patients with primary bone tumors, soft-tissue sarcomas and metastatic lesions to the bone.
O'Donnell gave Nicole's hand what is called a "ray resection," giving her hand a more normal appearance, with evenly spaced fingers and almost as much strength in her hand as she had before.
"It's a more cosmetic solution," O'Donnell said. "She only loses about 15 percent grip strength on her hand."
Despite her health problems, Nicole, 17, has a sublime optimism. The high school senior from Somerset, who plays midfield for Southwestern High School in Pulaski County, wants to keep playing soccer. Her athletic skills are currently headlining a University of Kentucky HealthCare billboard program that shows her seemingly in flight on the soccer field.
She loves English, hates math and plans on going to college, although she hasn't yet picked a school. She has applied to the University of Kentucky, Western Kentucky University and Georgetown College.
But she has picked a profession: Nicole wants to be a counselor for people like herself, those who got a bad health break and need to come to terms with their future.
"I love talking to people," she said. And it's true. Nicole appears to be one of those people who, in the language of Kentuckians, sees no strangers.
"When I come here (to UK HealthCare) and see little kids, I know I should never feel sorry for myself," Nicole said.
She is proud to be appearing on the UK HealthCare billboard.
"They are the reason I can get out there and play," she said of her medical caregivers.
Nicole, a homecoming queen at Southwestern High, is convinced that her future is bright. During a Dec. 4 appointment with Dr. Lars Wagner at Kentucky Clinic, Nicole was delighted to hear nothing but good news about her health.
The medicine to shrink the tumors in her lungs is working. The biggest tumor is shrinking, its edges more defined. That's good news.
Nicole's mother, Tammy Dorsey, sat quietly in a corner of the examining room, but her eyes began to well up with relief.
Before the checkup, Dorsey had praised her daughter's attitude. "She said, 'If my spots have got bigger, I guess we'll just deal with it.'"
Nicole does not schedule herself like a sick person. She leaves school at 2 p.m., goes home to nap, works out at a gym and then goes home to sleep. Her biggest problem is the tiredness: Sometimes it comes over her in a sudden wave.
Still, she deals with it in a sunny way, and with gratitude: "I get to live like a normal kid."
Nicole has a treat in mind for when she is formally declared in remission and can stop taking the shots: A tattoo of the word fearless. Her soccer teammates now write the word on their wrists in solidarity with her.
Already her maternal grandfather, an avowed anti-tattoo guy, surprised Nicole by getting the word tattooed on his shoulder in her honor.
Her advice for others going through difficult illnesses: Find other people like yourself with whom to talk.
She doesn't ask herself why she had this stroke of bad luck, she said. Getting her diagnosis and treatment has been a blessing, she said.
"I felt bad all the time," she said of the days before she was diagnosed. "It was kind of a relief to know what it was."