FRANKFORT — Two months into her treatment for breast cancer, Sharon Givens says she has cried only three times since she was diagnosed, on May 11.
She cried when she told her daughter, Danyelle Jackson. When she felt like she couldn't breathe and could barely move after her first chemo treatment, she cried again.
The last time, she said, was when her hair started coming out in clumps.
Yet as she recounted her story in early August, a few weeks after her first round of chemotherapy, a single tear made a glistening trail down her cheek beneath her mostly smooth scalp.
"People tell me all the time I don't act like I have cancer," she said. "I just tell them I have too much to do."
Givens has always been the one who helps, not the one who needs help. She raised her daughter on her own. She worked while taking classes until she graduated from college at age 37. A trained social worker, she is "Mamma Sharon" to her daughter's friends who hung around their house in Frankfort when they were teens and still visit to get advice.
In those first days and weeks after her diagnosis, she made it a point not to talk to too many people about their experience with treatment. She said she didn't want to be scared by horror tales of how bad chemo can be. Instead, she wanted to understand what was happening on her own. After her diagnosis, she went home and read every paper given to her by the team at Commonwealth Cancer Center in Frankfort.
On Saturday when thousands of people — many of them breast cancer survivors — will be in Lexington running the Susan G. Komen Race for the Cure, Givens will be at home trying to get well.
In Kentucky, 120 women out of 100,000 will be diagnosed with breast cancer, according to the U.S. Centers for Disease Control and Prevention.
Givens, 52, has been diagnosed with Stage 2, triple-negative breast cancer. One of the most aggressive forms of the disease, it affects 15 percent of cancer patients but twice as many black women like Givens. Breast cancer does not appear to run in Givens' family.
Like many breast cancer patients, Givens has other health issues. She had quadruple-bypass surgery in 2005. She is diabetic, and before her cancer diagnosis she had eye-cataract surgery.
She has a degree in social work from Kentucky State University, but she has spent the past several years caring for an aunt who was ill. She returned to Frankfort in 2011 to live with her daughter Danyelle's family and take her place as "GiGi" and help care for her grandbabies, 6-month-old J'Lea and 5-year-old Jaeden.
She worries more for them, she said, than for herself.
"I know that they hurt for me, and that makes me hurt," she said.
Danyelle, 25, works at CVS, and her husband, Will, works at Starbucks. They met as students at KSU. The plan is for Danyelle to finish her teaching degree; she has about three semesters to go. Then Will, an associate pastor at a Frankfort church, hopes to go back to school and eventually work full-time as a minister.
An accident left the family without a car. Will and Danyelle walk to work. Givens catches a shuttle bus to get to treatment, which can make a long day even longer and potentially expose her to germs when her immune system is compromised.
Givens' health issues led her to go on disability benefits, but her household's total income puts her over the limit to receive full Medicaid benefits. Early on, she was trying to sort out what it means.
"I think bottom line is the state pays probably 80 percent, and I am responsible for 20 percent. I think that's how it goes," she speculated. As it turns out, for July her bill was $432. It was twice that for August. She got an invoice for $13,000 for chemo drugs that she isn't sure will be paid. She plans to pay it off somehow, $50 or $75 at a time, she said.
The side effects
The worry is amplified by the physical toll of treatment and its side effects.
Each patient is different, but the drugs used to combat triple-negative cancer can lead to more side effects, said Charlye Quenemoen, a nurse who is part of the team, led by Dr. Aruna Arekapudi, that is treating Givens at Commonwealth Cancer Center.
Givens' other health problems mean "she has a little more of a challenge" with side effects, she said.
For example, one of the drugs in Givens' chemo cocktail — which for her is a combination of Taxotere, Cytoxan and a powerful drug called Adriamycin, aka The Red Devil — can cause a loss of sensation in the limbs called neuropathy, a problem she already had as a diabetic.
Givens said she was surprised how bad she felt after her first treatment.
"I was to a point where I couldn't really catch my breath or just move around," she said. "I felt like I was coming down with the flu times 100. It hurt me to blink my eyes. Saturday, I felt like stuffed sausage."
It took a trip to the hospital and 2 pints of blood to make her feel human again.
Even after the first few difficult weeks, Givens is optimistic. She jokes that she's not sure sometimes whether what she is feeling is a side effect from chemo or menopause.
She plans not to fuss with scarves and wigs but to let her bald head shine to the world. She wants to be "like the old black men in the church who wipe their heads with a white handkerchief," she said, letting out a low chuckle at the thought of it.
She knows she has to finish the five rounds of chemo but is hopeful she can avoid radiation therapy. She plans on being able to still help out with the little ones.
"I had my little five-minute window of crying and that was it," she said.
Her family sees that she has slowed down. Watching her mother walk unsteadily down the front steps to the bus that will take her to her next chemo treatment, Danyelle stood in the doorway looking worried.
"It's weird to see her like this," she said "She's always been so strong."
Even Jaedan has seen the changes in GiGi.
"Why are you sick every day?" he asked her after about six weeks of treatment. "Why don't you go to the hospital so they can fix you?"