About to undergo surgery to relieve crippling pain in her kidneys on Oct. 13, her doctors delivered a devastating blow: The cancer that had been found in her stomach and colon in August had spread to her liver and lymph nodes.
"That was a shocker to me," the MTV reality star and PEOPLE.com blogger, 34, tells PEOPLE. "I was blown away. It really crushed a little bit of my spirit."
A veteran of facing difficult truths after fighting cancer on-and-off for nearly 10 years, "I go into trauma mode," she says. "My mind goes, like, cyborg. I don't want to get emotional, and I ask a whole bunch of questions – as many as I can."
'A Dark, Dark, Dark, Dark Place'But nothing could have prepared her for the after-effects of her most recent procedure, called a nephrostomy, in which doctors replaced a stent in one of her kidneys with a tube that empties into a urine collection bag.
"Waking up from that surgery was horrific," recalls the MedGift founder, who has been frank in the past about her earlier colostomy. "I was told it was going to be easy. I woke up screaming, 'You are all liars!' I was so angry. It was so painful."
Eventually, though the surgery helped alleviate her pain in a big way. "I'm so glad my doctors strongly encouraged me to do it," she says, adding, "I may or may not be a verbally dramatic patient when I wake up from surgeries!"
But even as her kidney pain subsided, it was soon to be replaced by brutal side effects from her latest chemotherapy cocktail on Oct. 21: nausea, severe lower-body aches and exhaustion. A few days later, after undergoing a blood transfusion on Oct. 23, she says she hit her lowest point yet.
Courtesy Diem Brown
"I've never had a reaction to chemo the way I just had with this one," she says.
Now that she knows what to expect, she's preparing herself for her next treatment on Nov. 18.
"I know what it's going to feel like going forward," she says. "I'll be better equipped to go through it."
"I'm hoping when they do another scan of everything, they see things shrinking."
'I'm Going to Have a Family'In the meantime, she remains fiercely determined to focus on her goals for a life after cancer.
"It's my personal perspective that you live as hard and as vigorously as you can," she says. "My goals are something I believe in, because I believe I'm going to make it."
"I'm going to have a family and get married and the whole American, 2½ kids, white-picket-fence dream," she says. "It's something that's really important to me, because it means a long-term future."
And she has short-term goals as well, including redecorating her New York City apartment and gearing up for Halloween.
"It is one of my favorite holidays," she says. With her pain finally under control for the first time in months, "I kind of want Halloween to be my first night out where I'm not using a cane or a walker," she says. "I really want to have that as my goal."
What costume is she contemplating?
"I kind of want something hot!" she says, with a laugh. "Everyone else is going to be hoochie."
"I was thinking, 'What if I'm a medical experiment?' " she says. "But someone might pull one of my cords and think it's fake."
Whatever she ends up wearing, "Today I feel so good," she says. "I cannot tell you the difference between now and two days ago. I haven't had a pain break since my first surgery, and finally it's like, 'Ahhhh.' "
"It's a complete 180. It reminds you that when you're at your lowest moment, the turnaround could be the next day. You never know what the next day could bring."
Friends have set up a support page for Brown on MedGift, a gift registry she founded to help those suffering from any illness.