Can't sleep thoughts

Tonight is the first night I haven't been able to sleep since this all began. I had my sentinel node biopsy this afternoon, everything went well, I'm not in any significant pain, but my mind won't shut off. So, while the rest of the house is peacefully at rest, writing is what I will do.

I was lying there perfectly still, cradled by pillows. I was not worrying or wondering about the future or sifting through "what ifs?" or anything to do with this change in my life. It was all about good memories--simple things like holding my babies and burping them (what a ridiculous and totally necessary activity--the giant "brrrap!" from that tiny body always made us laugh); the quality of the late summer light with the background sound of the first fallen leaves rattling across the driveway; sneaking through a hole in the park fence at sunset gathering pinecones for school projects; canoeing on the lake in a cool summer dawning; sailing "to Tahiti" with my dad; staying up late watching old movies with my mom; 12 years of amazing Girl Scout trips & activities; backpacking with Janet & Peter & my family in the Sierras; Thanksgiving dinners at the Willo house; the late night quiet at the radio station in college; hopping a freight train with Joann from Bakersfield to Stockton; Molly teaching me how to diaper Juli; Bill bathing Alex in the kitchen counter tub, every night in Vallejo; 5 years of Longaberger Bee slumber parties with my girlfriends; the pinochle club; birthdays & new years, picnics & parties, impromptu dinners, community gatherings, apple picking & camping trips with all our treasured friends in NY, and more, all piled together in a seamless tumble of reminiscing.

It's interesting, don't you think, that there isn't a NY winter activity in that list (especially when winter could last 7 months!). Okay then--I'll remember one now: Catching snowflakes on our tongues while walking to school with the kids; the palpable cottony silence of the woods during a snowfall; sledding on the school hill, with Loki chasing the kids down, as fast as he could.

These memories, these moments, this is the "gift" of having cancer. A slowing of the heartbeat, a slap upside my head to pay attention to the living as it is happening. The time ticks by inexorably, and we hardly notice it as it goes past when we take it all for granted. What I used to consider "normal life" wasn't really life at all, was it? Now it is, because it is a precious memory, but was I cognizant while it was actually happening? I was often just marking time with endless activity, always planning for the next thing, always focused on getting through the now to get to the next now and not really noting it with any significance. For all the Wayne Dyer-Dr.Phil-Oprah exhortations in our society to live in the present, we really don't do it, do we? Well, maybe the Dalai Lama does, but who else, really?

So much for my post-op morphine & demerol musings. That's about it, I think I'm done now. Time for more meds. I'll tottle back to bed and see if I can settle down. Thanks for listening.

Out of surgery, all is well

So much for my cynicism, I was wheeled in promptly at 1 pm, awake at 4, and home at the Goldberg's by 6, with a quick stop off at McDonald's for a caramel sundae and a McRib--eaten in that order.

Post-op pain is manageable, nurses were amazingly awesome, as usual.

Two days to rest up, then on to the main event on Friday.

Nuclear Medicine

Nuclear medicine turned out to be not painful at all, unless you count boredom and annoyance as pain. We were held prisoners in the maw of the big medical center for 6 hours yesterday, but at least I now have Sharpie marker dots drawn on me in the right places and a folder of clear plastic maps to give the surgeon this morning. And if all else fails, I still have radioactive stuff in me that they can use a Geiger counter on if they need to trace my lymphatic system another way.

What we found out yesterday is that even in a world-class medical facility there can be slackers and incompetents, and both happened to be my techs. Hunter (also known in the hallway as "Dude!"), had diction problems severe enough to make him functionally unintelligible, (either a tongue-piercing or sheer laziness was my guess), and the other tech, Jeff, tried to schmooze me when I questioned what the hell they were doing.

The doctor who did the injections was quite wonderful, a woman from Naples, Italy, who gave me her recipe for Butternut Squash Risotto for Thanksgiving while keeping me calm and mentally occupied. She was very disappointed that I knew no Italian, despite claiming to be of Calabrese ancestry, but she was pleased when I gave her a hearty "molto grazie" on her exit (I got an equally hearty "prego!" in reply). But after almost 2 hours of lying uncomfortably still with my arms over my head and listening to the boys "guess" as to which were the sentinel nodes, I spoke up and said "Guys, don't guess, be sure--this is important!" Jeff came over and gave me a speech about how it really didn't matter, that the markers didn't really have to be exact, and the surgeons didn't even look at the maps half the time! If that were the case, then why did my doctor order this test (costing me thousands of $ on a machine worth millions of $, no doubt) if the results were irrelevant? I told Bill that what Jeff just said was nonsense, and I resented being "handled." I warned him that I was about to become the "squeaky wheel," the "bad patient," or the "embarrassing loud and complaining woman" at about 3 pm, but fate blessedly intervened in the form of a new, no-nonsense tech named Wendy, who seemed to be as annoyed with Dude & Jeff as I was.

At about 4, Wendy erased all of their marks on my chest, took new pictures, and drew new marks, checking her work meticulously, and double-checking her placements and labels on the hard copies of the computer pictures. Hallelujah! Someone who cares if we identify the right nodes for surgical removal! Sheesh. So eternal vigilance is still required, and even when you think you're in the right place, you have to keep track of who is doing what and make sure they are competent. Mark says I should definitely tell Dr. Brenin of yesterday's follies in the Nuclear Medicine department, but I may hold off on that, at least until after the procedure today--I don't want to get my surgeon all steamed just before he starts cutting on me.

Today, we are to show up at 11:30 for the scheduled surgery at 1 pm. My guess (and I have experience in this now, unfortunately) is that the surgery will begin around 3. Dr. Mark says that's his best guess too. It will take about 2 hours, with another hour in recovery. So, another long day ahead, this time without food or water (though I am allowed one cup of coffee with sugar, as long as it is before 9 am).

I am cheerful and optimistic this morning. We can't control what the results of the biopsy will be, but I think that the smart people ("dudes" not included), who are taking care of me are doing what they need to do, step by step, trying to give me the best outcome they can.

Ready to go

I slept so well last night. I had many unidentifiable dreams, drifted in and out, got up once at 4 am for a trip to the bathroom, and yet, woke up after the sun came up for once, feeling rested and refreshed.

Dr. Mark is thrilled because his Boston Red Sox won the World Series in four straight games, ending last night. On Saturday, his NE Patriots trounced the whatevers 57-7 or something ridiculous, so he's going to just be impossible to live with for the next few days. Dr. Jo is anxious to get back to her lab to make sure her grad students didn't trash the place or hurt themselves while she was in Kauai, not thinking about them at all, for two weeks. Kona-dog will come home from "camp" today to find that interloper, Echo, in his house. And, Bill & I will mosey on down to the UVA hospital for our stuff around noon. Everyone back to normal, or on our way there.

We'll be cooking and laughing tonight, and every night from now on, if I have my way. No more crying. Just enjoying every single day and night as each comes. I am not nervous or sad or worried or scared. I'm just here, and I'm ready.

What time is it?

Oh, for crying out loud. Now my computer says it's an hour earlier than the clocks in the house.
Who's in charge of this system?!?!

And so it begins...

One of my calendars says that today is the end of Daylight Savings Time. Another says it is next week. This is a small problem, but I think it means that someone isn't paying attention to the ultimate consequences of a global economy. When people in far-away countries publish and produce our calendars, are chaos and tyranny far behind? I'm going with the one that says "Printed in the U.S.A." and shooting for next Sunday for the clock change.

The floor is ready, the house is clean, the bags are packed. When the sun comes up, we will pack the car and go. I have decided that I am not coming home next week without breasts, I am coming home without cancer. Small difference, big difference? It doesn't really matter. There is no point in worrying about anything, because the future is already written and it's marching along with or without my intervention or control. For now, I am at peace with whatever has to be done, whatever comes next. Que sera, and all that.

Much to do today

Well, big surprise, the floor really isn't done yet.

Bill was never convinced that this loft-carpeting project needed to be done to begin with, but he has humored me anyway, up to this point. Now, he is bored. Today, he wants to get out the chain saw and cut down the big old dead oak tree so it won't fall on our house while we're gone. That should keep him busy all day (much thinking to do, since he just decided this yesterday)!

In the meantime, the floor really has to get done today, sheets have to be changed, floors vacuumed, car checked and loaded, fridge cleaned out, dog stuff gathered and packed, bags packed, bills paid, details remembered. The good news is that it will keep me from being too introspective today. The bad news is that it still all has to be done. My only consolation is that when I get home, I won't be allowed to use my arms for awhile, so I can do my "Camille" bit on the couch without guilt. Or at least without the possibility of doing any more physical labor.

My mom asked yesterday (and others have inquired) what the deal is about the Sentinel Node testing, since the first ultrasound showed no visual axillary node involvement. Here's the scoop, for those who want to know:

Monday, I will go to my surgeon who will draw a felt-tip marker "map" on my chest, showing where the tumors are. I will then go to Nuclear Medicine (Radiology), where they will inject radioactive markers where the surgeon has drawn. We will then wait until those markers are "taken up" by the lymphatic system, and pictures will be taken of the specific lymph nodes that "light up"--those are the "Sentinels," the first lymph nodes that drain the areas of the breasts where the tumors are.

Those pictures will go to my surgeon, who will then know which nodes to remove in the outpatient surgery I am having on Tuesday. Those removed sentinel nodes will be sliced up and examined by pathologists on Wednesday. If there are cancer cells present, then the surgeon will know that he has to remove the lymph nodes under my arms after he does the mastectomy on Friday, because the cancer might have spread to the next nodes (under my arms) down the line. If those sentinel nodes have no cancer cells in them, that means the cancer probably hasn't spread beyond the breast tissue, and the axillary nodes won't have to be taken out on Friday.

So, while it was good news that the initial ultrasound look of the nodes under my arms showed no swelling or abnormal appearance, now they have to look microscopically at the actual nodes over by the breasts to make sure cancer cells haven't snuck past the sentinels and possibly headed into the arm nodes.

These tests, the "Sentinel Node Mapping & Biopsy," are relatively new--Dr. Susan Love says in the latest 4th edition of her Breast Book that this a "promising" procedure, perhaps a way to avoid the old hit-and-miss way of simply taking out a sampling of axillary nodes during the mastectomy, sending them out for a quick look by pathology, and the surgeon deciding right then whether to remove the axillary nodes. My surgeon will know a day or two before the surgery on Friday whether those nodes need to be removed. So, I feel fortunate that I have the benefit of this more definitive procedure, though I still fear the results. I really, really want to avoid the complications of the axillary node dissection, but I just don't have any choice in the matter. If the sentinels are cancerous, the axillaries have to go. If they are not, then I'll be very happy. Either way, I'll know ahead of time. So that's that.

So now it's time to get my working clothes on and get started on the day's fun-filled activities.

Puff Pastry & Home Improvement

I awoke this morning thinking about puff pastry.

Puff pastry, for those of you who don't know, is one of those amazing French inventions from the 18th century. It is indispensable even in the 21st. We usually buy it in the frozen food section, though 2 small sheets for almost $4 is a rip-off. Once, I managed to score a restaurant-box of 25 16" x 20" sheets for about $55 at Sysco in NY. It lived in my big basement freezer for over 2 years, ready for quick desserts or appetizers, a party on short notice, a cooking class where I could demonstrate why everyone needs puff pastry in the freezer at all times. It also had the bonus of parchment paper between each sheet, so I didn't have to buy that for baking either.

Making it from scratch however, is something out of literature, like spinning straw into gold or the umpteen labors of Hercules. In culinary school, we once spent a day making puff pastry on giant stainless steel tables, interminably encasing pounds of butter in pastry dough, rolling and turning, folding and chilling, then rolling and turning, folding and chilling again. And again. And yet again. By the end of the day, I was convinced of the absolute wonder and necessity of buying it in a box at Sysco or the grocery store, whatever the cost.

The results of all that rolling and turning and folding and chilling is a marvel too. Within a few hours, the number of alternate layers of butter & dough increases geometrically, so by the end of the day, you have what is known in French as "mille fuille," or "thousand layers."

When the cold dough is put into a hot oven, the water inside the butter turns to steam, lifting the layers and puffing the dough. The result is heavenly--the base for fragile, brittle, buttery Napolean pastries, filled with cream and chocolate, or shaped shells to be filled with savory fillings like herbed mushrooms or sauced seafood. Or my favorite quick dessert, slapped in a pie pan, filled with fruit, with the rectangular corners folded over toward the center, when puffed up and fanned out and sprinkled with coarse sugar, made for a faux pie crust that was more elegant than the same old crust that everyone else made.

So why in the world am I waking up with thoughts of puff pastry? Was I folding and rolling it out in my dreams? Not the most perceptive of humans, I'm missing the symbolism here.

We have spent the last two days working on the floor of the loft, getting it ready for the carpet installers on the day of my surgery. My hands are sore from ripping up the nasty old water-damaged carpet and the disintegrating pad that sifts a sand-like substance on the floor. And the floor is rotten in spots too. It was never built right to begin with (like the rest of the house). Particle-board floors were a bad idea, even 20 years ago. But because we waited too long to begin this project, there is no time to replace it all, just enough time to patch the particularly bad spots. Once the pad is pulled up and the "sand" vacuumed, then all the staples have to be pulled out with needle-nosed pliers. Hence, sore hands. And sore tempers. Bill knocked a hammer down the HVAC vent yesterday and I was sure the swearing could be heard halfway down the mountain, perhaps even in town. I had to resist the urge to laugh out loud. What else can you do but laugh?

So that's where our lives are today, somewhere between the sublimity of puff pastry and the absurdity of a hammer stuck down in the heating vents.

Today, when the floor is finally done, (and perhaps, with luck, the hammer retrieved), I will pack a bag for next week's medical follies. Life goes on, as they say.

Change of seasons, change of heart

It has rained for the past 36 hours, and this morning everything has changed. The leaves have all turned (or been rained off the trees), the air is cool and drier, our brief Indian Summer is over.

This was the time of year in New York when it would begin to snow. My first year there, not knowing what to expect, I was told to "think fur" when planning the kids' Halloween costumes--it would be cold enough by then to need the extra warmth. So here it is, another Halloween coming--no kids to sew for, no fur needed. Our fall in Tennessee may last another month or two, with winter showing up in January or even later.

I woke up this morning with Acceptance beside me for the very first time in this process. The noises in my head--the whining, the protesting, the disbelief, the yearning for a different outcome, the self-pity, the nostalgia, the sadness, the feigned courage, the anger, the angst--all of it was gone, replaced by a simple "OK."

It may not stay, but at least it showed up for the party. I'll enjoy the company while I can.

Tired of Waiting

I woke up at 4:30 this morning. As usual, my first conscious waking thought was "I have cancer." I am so tired of thinking the same thought every morning. It's boring.

I was able to get back to sleep for once, and when I woke up again at 8, my first thought was, "I'm hungry." Progress, I guess.

However unseemly it is, Bill and I have planned an adventure for our trip up to Virginia on Sunday. Instead of slogging up I-81 as usual, we're packing a picnic and taking the scenic route up the Blue Ridge Parkway. As Bill said, "Even if I was taking you to the gallows, I'd take you via the scenic route." Hardly an apt comparison, but a valid sentiment. The autumn colors should be at their peak, the dog will have plenty of opportunities for sniffing and marking new territory, and we'll be off the interstate with all its speed and trucks.

There are still many things that need to be done, but we're short-timing it now. It seems silly to say that I'm eager to get started, but it's the truth. I'm tired of waiting and worrying about what the future will bring. I'd just as soon get started on the future, whatever it holds.

Foggy Living

Everything about this coming metamorphosis is challenging my previous assumptions.

At age 54, I thought I had a pretty good handle on how things were, on how I moved through the world, on what I believed as truth and what I dismissed as total bunk. I looked back on my behaviors and beliefs of my adolescence and my early twenties, my return to sanity around 30, my hard-learned lessons of parenting, love, loss, community activism & personal growth, and pretty much thought I had it mostly figured out.

HA!

I am laughing now at my presumption. Chagrin reigns. I snicker at my past confidence. I am just as much a deluded teenager now as I was when I was a deluded teenager. What hubris! What a snot! It's so easy to be a know-it-all, when you only know about the big things like mortality in the abstract.

The only thing that keeps me sane right now is the faith that by golly, I'm going to get something positive out of all of this. If I have to stare down this awfulness and live it and move beyond it, I'm determined that I will become a better person for it.

These are the "bigs," where I get to find out what stuff is really in there and what I'm made of. Like the soldier who wonders if he has the courage to fight in the upcoming battle. Like giving birth, where the only way to get the baby is to go through the labor. There is a nagging doubt that maybe I don't have the courage to see it through--I think we all have the fear that we aren't up to the challenges and tests of life. This is where I get to see for sure and draw strength from both the battle itself and the eventual successful outcome.

So, I spend much of the day pushing away the niggles and bucking myself up. "Bring it on," I yell at the fear monster in my head. "I'll show you." ("Put your money where your mouth is," it yells back). All righty then. Game on.

Rain!

Come on rain, fill up the well! Fill up the pond and the streams and the creek! Keep raining!
(Happy dance, happy dance)

Bill's Treasures from Illinois

We spent the day going through all the stuff Bill brought home from his boyhood home in Illinois. Many treasures, no "trash," interesting, useful stuff for the most part.

My favorite is a picture I took of exhausted Bill watching over our daughter Juliana, just hours after she was born. My second favorite item is a leaf vacuum that sucks up leaves and chops them into tiny pieces for mulch...just in time for fall here in Tennessee.

We took a walk over our property in the late afternoon. The pond is even smaller than it was when he left a week ago. The forecast shows a possibility of rain for each of the next 5 days! Let us hope the meteorologists have it right this time!

Blogging as Exorcism?

Yes, I know that posts here on my blog have been getting "grittier." It was not so much a conscious choice, but part of the process, I guess. The more I wrote, the more in touch I got with what I was really feeling--and the more I wrote about really feeling, the further I got into and beyond the terror.

It's as if the act of writing it down makes it possible to belch it out in all its ugliness, and then I don't have to carry it around inside anymore. It feels good to make light of some of the funnier and more bizarre parts of this journey, those stories entertain me too. But sheer horror is part of this as well, and ignoring it, pushing it away, pretending it wasn't there and writing about something else--that wasn't working for me anymore.

You don't have to read it, but by God, I need to write it. I will continue to "screen" those posts behind a warning, so you'll have a choice about subjecting yourself to that kind of darkness.

I told a friend yesterday that this all seems eerily like an ancient purification process, an emptying out of all the negative energy before girding myself up for battle like a medieval knight. Each time I hit one of these bad spots, I emerge a little stronger, a little less scared, like I'm ramping up a scale of tolerance for what I can handle, a bit at a time. This is how I'm getting ready.

Bill's coming home!

Bill has thrown up his hands in frustration today and is headed for Aunt Mary's in Indiana. He's packed the van and the trailer, and decided any more effort is just unmanageable. He's done. No more helping. Someone else's problem now. Good for Bill.

I'm making fudge and chilling the beer. Come on home, sweetheart.

Two Weeks to Go & Two Visitors Come to Stay

WARNING: This post is depressing and contains gross details you may not want to know about.
Click "Comments" to read.
Otherwise, just ignore and move on.

Bouncing Betty's Basket o' Boobs

In almost every culture, there comes a rite of passage for marking the transition between childhood and young womanhood. For 1960's American culture, that ceremony usually took place at a department store in the imposingly-named "Foundations" department. If this were the National Geographic Channel, anthropologists would call this episode "Shopping for the First Bra."

There the smell was of clean cotton and faint traces of customers' mingling perfumes. The lighting was appropriately subdued, and salespeople murmured their suggestions, accompanied by the clack of tiny hangers and the gentle opening and closing of secret drawers under the display tables. Back in the fitting rooms (what I called "the dungeon" in my child-brain), it was a different story.

Back in there, the bra-fitting saleslady ruled her fiefdom. She was a tiny, ancient, wrinkled woman, with grey pin curls on her head and caking makeup powder on her cheeks. Her thin lips were enhanced with lipstick feathering up tiny crevices all around her mouth. Her words were sweet and soothing, ("just come on back here, dear, and we'll fix you right up,") but her tone was laced with an undercurrent of Marine Corps Drill Sergeant.

Whipping out her measuring tape and draping samples over her shoulder, she stood there, hands on hips, unimpressed by my naked embarrassment. "See that? See THAT!" she hissed, while poking an index finger forcefully at the springy center of the contraption she had just stuffed me into. "You need a bigger cup!" she cackled triumphantly.

That was the memory that zipped through my brain when retired-but-back-as-a-volunteer-nurse Betty bounced into our plastic surgery consult at UVA, carrying a big basket of implants for me to shop and choose. Bill and I looked at each other with half a laugh and half a horror--this had to be the most surreal moment we have ever shared.

Nurse Betty (who was very nice, but also a bit of a drill sergeant in her matter-of-fact practicality), efficiently snapped a sports bra up under my arms near my collar bone, pulled my t-shirt over it and started stuffing in what appeared to be clear water balloons. Then she started bouncing them, flicking them with her finger and saying things like, "What do you think? Too big? Too small? I think that one's too small for your frame, let's go a little bigger, you can handle a 400, maybe even a 450 would be better?" She kept up a steady patter of boob-talk--"too squishy? Too heavy? That looks nice dear, I think that's just perfect for you, what do you think?"

OMG, I think I thought, this is the most bizarre thing I've ever been a part of. Where's Rod Serling, this can't be happening to me. I'm either going to burst out laughing or burst out crying, I don't know which. Either would offend the poor dear Betty, who was doing her best to make this fun and not so awful. Besides, who gets to pick the perfect set?--we do! Hey Bill, come over here and pick your favorites!

In the meantime, Bill tried mightily to keep from even looking at this ridiculous process so he focused on the surgeon discussing the various characteristics of saline versus silicone and the engineering specifications of each. "I like the silicone," said the surgeon, "it's just a better-made product, and sturdier too." Now Bill was trying not to laugh too. In the end we came up with a minimum (don't want to go smaller than) and a maximum (wouldn't want to go more than), and by this time we were all laughing pretty hysterically--what else can you do? I just wanted to get out of the room before it devolved into implant-tossing.

The resident also told us that new reconstruction technologies were being thought up all the time. By the time these will need to be replaced (10-15 years), he's hoping that his new idea will be the standard: He'll liposuction out all your flab from belly, thighs and butt, and then blow it back into your chest like household insulation! Now there's something I can look forward to!

Late start on a day of inactivity

I had a couple of long phone conversations last night with especially close friends, working out some of my harder issues, bouncing ideas back and forth, a kind of unpaid-for therapy. As a result, I couldn't write this morning. I bored myself on every attempt.

It seems harder to write when all of the emotional intensity gets spent verbalizing. This is why I never talk about my writing when I'm writing. If I talk about it, then I don't do it on paper. This is also why I haven't published anything in about a decade. It's not "writer's block," it's "writer's over-regurgitation."

So, instead of writing, I exercised and walked the dog, and puttered around trying to figure out what to do next. Pull up the loft carpet? Move more stuff down to the basement? Make a sandwich? Why is it so hard to get motivated today?

I've plenty to do around here, many projects I want to finish before Bill comes home and tells me that the way I'm trying to do it isn't right, takes over, and then over-engineers it to the point where it really won't get finished at all. We work better individually or sequentially, like when I patch and tape the drywall and paint, and then he does the lighting installation. Bill and I have different styles, and only rarely are joint projects a good idea in our house. He is the clever, thoughtful perfectionist. He thinks and thinks and thinks and thinks and ... thinks some more, and then maybe, some of it will get done until a slight problem is encountered, and then he has another cup of coffee and watches the History Channel and thinks some more about the right way to do it. We have lots of these projects, most of them in quarter and half and three-quarters stages of completion. The tools are still out, the wires are hanging out of the ceiling, but nobody's home. Literally and figuratively.

I am the impatient one. I go out and buy the hardware or supplies, come home, dive in, and then when I hit a roadblock, or encounter unexpected difficulties (because I didn't think it through), I pitch a fit, or ask Bill for advice--then he sits down, has another cup of coffee, and thinks...while I fume or pitch another fit, or get tired of waiting for him and just finish it however I can, just to get it done. My "quality of work" is inferior, but by golly, things do get done. (I also clean up my messes and put tools away so they can be found again, so there). Bill's finished projects are beautifully done--that is, if they ever really get done. I keep thinking that there should be a way to integrate these two styles and get quality work done in less time than than a glacial epoch, but we've been trying for 25 years and haven't achieved that particular home-improvement Nirvana yet.

Finally, around 4 pm, I got started. I put a finish on the walnut trim moulding for the new kitchen dish cabinet, let it dry and installed it. I put all the dishes in the new cabinet. I installed a roll-out drawer for the under-sink trash and cleaned out all the grunge and jumble of cleaning products from that cabinet. I hung the spice rack on the new cabinet. I drilled holes in the new cupboard doors and put the knobs on that I bought at Ikea in Seattle this summer. I swept up the wood shavings and put away the drill.

My life insurance agent called while I was on the ladder (yes, I know, no one over 50 has any business being on a ladder, but realistically, if I fall and break my neck...well, never mind, let's not go there). The first thing he says is, "Hi, how are you?" Here's the dilemma: Does one enjoy a confidentiality clause with one's life insurance agent? If I tell him that I have cancer, will he rat me out to the company? Will my policy be cancelled or skyrocket upon knowledge of said medical condition?

Not having nearly enough time to work this entire line of thought, I wimped out. "Hey, love to talk to you, but I'm on a ladder in the middle of something, could you call me back next week?"

What a wuss I am. Maybe I'll have an answer for "How are you?" worked out by the time he calls again.

Lonesome for Bill

Life doesn't stop, even in the midst of a life-threatening illness. Activities press on, bills have to be paid, errands have to be run and other people go through their own dramas, (even though I expect everyone to stop and live mine with me).

Bill's dad moved into an apartment this summer (his mom is in a nursing care facility), and he really needs help clearing out the family home in Jacksonville, Illinois. He doesn't want to pay to heat the house through the winter, and the auctioneers have to get everything sold before the beginning of November, when attendance at an auction will make it worthwhile. When we came through from the west coast in late August, our plan was to go up and help do this in mid-September. When I was diagnosed on Sept. 14, that plan fell apart right away in the crush of appointments, tests and travel to Virginia.

Now that we had a window of a few weeks before my surgery, it was the right time to get this errand done, so Bill left yesterday morning. I was immediately lonesome, starting right when he pulled away, the first time that we've been apart for more than a day since this all began. After having had his full attention for the past month, I was sad and misty all day without him. How odd! We are the married couple that spends much of the year apart, and we've been doing that for more than 20 years!

We will celebrate our 25th wedding anniversary on December 6 of this year, and cancer is not what we had planned to do for that milestone event. (I was thinking more along the lines of a beach vacation with lots of tropical rum drinks)!

Despite that inevitable disappointment, these past few weeks have been some of the saddest, happiest, and sweetest times of our married life. I am reminded of the emotional intensity and closeness during our waiting times in late pregnancies, and the days following the birth of our children, a mental and soul-bonding of synchronous connection without words. A glance, a touch, a smile--all conveying a peacefulness of fullsome commitment. It is the same now, but with the added span of many years of shared experiences, some good, some not so good.

We speak now of the unspeakables, we share the tears and fears. We choose our words more carefully, gauging the other's ability to hear what we are compelled to say. I've noticed that we also choose at times to not speak of things until we are sure of what we want to say. We spend much of our time being kind and being funny and being affectionate to each other. We are more in tune with each other than I can ever remember being, even in the beginning.

This cancer is already changing us, and changing our marriage. We are even nicer when we are mad at the other. There is a sense that every moment counts, so it had better be honest, and it had better not be wasted. We are again reminded to treasure each other and our bond as a precious gift.

I occurs to me that we might not be able to run our lives the way we have in the past after this. I may not be able to bear having him gone for months at a time, and he may not be able to work halfway around the world without worrying to distraction about me. Our marriage doctrine of "separate but equal" may not work for us anymore.

Like everything else, we'll just have to wait and see what the future brings.

Chicken & Artichoke Pasta with Lemon-Garlic Sauce

Here is the great pasta we made Saturday night:

Served 4 with leftovers:

2 boneless, skinless chicken breasts
1 Tbls. olive oil
1 tsp. butter
2 cloves garlic, pressed
salt & pepper

1 Tbls. olive oil
1 bunch green onions, sliced into 1 1/2" pieces
1 can quartered artichoke hearts, drained
1 lb. fresh vegetables (we used asparagus, but zucchini or green beans or broccoli would work)
1/4 cup sun-dried tomatoes (if packed in olive oil, drain and rinse)
1/4 cup sliced black olives or roasted red peppers, or mushrooms (optional)
4 cloves garlic
grated zest of 2 lemons
juice of 2 lemons
1 Tbls. sugar
1/2 cup white wine
1/2 jar of prepared Ragu Alfredo or Roasted Garlic-Parmesan Sauce

1 lb. Barilla Pasta Plus or Ronzoni Healthy Harvest Whole-grain Linguini.

Crushed red pepper or chopped parsley for garnish.

Put a pot of water on to boil for the pasta. Trim and pound the chicken breasts 1/4" thick, then slice into strips or bite-sized pieces. Chop all the vegetables into 1 1/2" to 2" pieces, grate and juice the lemons, set everything out, ready to go.

When pasta water boils, add 1 Tbls. salt to the water and put in the linguine. Stir to separate, set timer for 10 minutes. In a large skillet or wok, heat olive oil and butter over high heat, add chicken pieces and quickly cook for 2 minutes, tossing with pressed garlic, salt and freshly ground pepper. Remove chicken to a bowl.

Add second Tbls. of olive oil to the skillet. Add scallions and vegetable pieces, cook over high heat for about 1 minute, then add the artichoke hearts and sun-dried tomatoes, and olives or peppers or mushrooms if desired. Press garlic over all, and quickly cook until vegetables are crisp-tender and artichoke hearts are lightly browned, about 5 minutes. Add lemon zest, then lemon juice, then wine and sugar, stirring to coat. Add chicken back into skillet. Turn heat down to medium and simmer.

Test pasta for doneness. Drain and return to pasta pot. Add Alfredo sauce to chicken & veg, stir, check for seasoning. Spoon sauce over pasta and sprinkle with crushed red pepper or parsley for garnish.

Orange Pound Cake

This is the cake that Jean & I made:

2 cups + 2 Tbls. granulated sugar
1 cup unsalted butter
1 1/2 tsp. salt
1/4 tsp. baking soda
1 1/2 tsp. baking powder
2 tsp. vanilla extract
1/2 tsp. orange oil or orange extract
grated rind of 1 orange
5 large eggs
1/2 cup frozen orange juice concentrate, thawed or softened
2 Tbls. freshly squeezed lemon juice
2 1/2 cups unbleached all-purpose flour

Topping:
1/4 cup granulated or super-fine sugar
1/2 tsp. citric acid (also known as "sour salt," found in the canning supplies)

Preheat oven to 325. Lightly grease 9" x 5" loaf pan.

Beat with electric mixer until thoroughly combined: sugar, butter, salt, baking soda, baking powder, vanilla, orange oil and grated rind. Beat in the eggs, one at a time until very light and creamy. Stir together the orange juice concentrate and lemon juice. Add 1 cup of flour to the cake batter and mix, then 1/2 the orange juice mixture and mix, then another cup of flour, the last of the orange juice, then the last 1/2 cup of the flour.

Spoon batter into loaf pan, it will be very full (make sure your loaf pan is really 9" x 5"--otherwise it will overflow. Note: when baking, this cake will rise up, look like it's going to overflow, then settle back down. If you're worried about spills, set pan on a baking sheet).

Bake for 1 hour, then tent lightly with foil and bake another 45 minutes, until tester in middle comes out clean with no crumbs. Cool in the pan for 10 minutes, then loosen all around and invert onto a plate.

Stir together the citric acid and sugar, and rub all over the warm cake. Spritz lightly with water and continue rubbing the topping all around and on top until used up.

Cool cake completely. Serve with vanilla ice cream, whipped cream or toast in toaster or on the grill and serve with fruit.

It's going to be a beautiful fall day

The furnace clicked on at about 4:30 am. We are going into autumn for sure now. Socks in the morning, extra blankets on the beds, warm sunny days and cool crisp nights.

Jean & Paige & Autumn (sheltie-dog) arrived. We spent the afternoon baking a cake, walking to the pond, prepping and cooking dinner, and talking. Today we will have breakfast, do a couple of house projects and then go downtown for the Heritage Days Festival.

We made a wonderful chicken pasta dish and a killer Orange Pound Cake. I will post recipes later, so you can enjoy them too!

And I have added a "Links" box to this site, for anyone who wants more information on the subject of breast cancer facts, treatments and supportive options.

It's going to be a beautiful fall day.

OK, PMS it is

Yahoo, I am not nuts, just normally unbalanced! I get surgerized in the latter half of the cycle after all.

Ups & Downs

Wacky, emotional, roller-coaster day yesterday. Barely controlled panic, out-of-character mood swings, too-loud laughter, snippy snipes with Bill, sudden tears during dinner.

PMS or just more assimilation? I wish my hormones weren't so whacked out while I'm trying to deal with this. I don't know where I am in my cycle anymore, because this was looking like it was going to be my final menopausal year. Oddly, one study shows slightly better long-term survival rates when this surgery is done in the latter-half of a woman's cycle, but I suppose it's one of those stupid statistical facts that really doesn't mean much. I will have the surgery when they can schedule it, and it probably has no bearing on what hormonal phase I'm in...I'm certainly not able to re-schedule it at this point, even if I did know. And while I'm thinking all this, I know I'm making myself crazy.

Preparatory changes and grim realities probably had more to do with my mood yesterday than anything else. Moving our bed downstairs, also symbolic of our life changing. Going to the bank to get serious papers signed and notarized (Power of Attorney, Health Care Proxy, Advance Care Directive). Necessary, but icky to think about.

And strangely, a great creative burst in the kitchen for dinner, using just leftovers and a slab of ribs from the freezer. I oven-roasted the ribs. I took one big, leftover baked potato and cubed it, cut the kernels off one ear of cooked fresh corn, and sliced a handful of grape tomatoes in half. I minced some fresh rosemary & parsley with 2 cloves of garlic and the skin from a half a lemon. I sauteed the potatoes in olive oil, tossed it with the corn & tomatoes and herb mixture, sprinkled it with salt and pepper and squeezed the juice from the half-lemon in while everything browned. It was SO good, and it tasted just like I had imagined it would--fresh and light and a stellar accompaniment to the sweet-sticky ribs.

So it was perfect, it was delicious, and we ate while making little happy-yum noises, and then I burst into tears while clearing the table. Bill leapt up and held me while I wailed and snuffled, saying "I don't know what's wrong with me today!"

?

Something's going on there, I just don't know what.

Sleeping in the new room, on a new side of the bed was odd. I don't think I've slept on the starboard side of our bed since we lived in Hawthorne, when Juli was an infant, so that's 24 years? But I slept well through the night, just waking up a little disoriented this morning. It's cold in the morning, 63 in the house when I got up at 6:30.

Today, we have friends coming! Bill's cousin (and my friend) Jean and her daughter, Paige, and their dog are driving down from Kentucky for a weekend visit and for the Rogersville Heritage Days festival that starts today. It gives us all an excuse to clean the house a little, cook a little, play a little. Jean's a "doer," so we will have some extra motivating energy helping us along on our chores. Bill will get a kick out of showing Paige the fish-feeding. The dogs will do dog things. Jean and I will enjoy each other's company and go downtown for the music and the crafts.

One day at a time. Breathe.

Correction

I've had it backwards up until now, sorry:

Treatment is Surgery, then Chemo, then Radiation, then Hormonal therapy.

Moving furniture and learning Spanish

My father often lectured us on the importance of having both long-term goals AND short-term goals. The distant objectives were to keep you from becoming bored with life, so you'd always have something really big in the far-off future to be looking towards. The in-the-now goals and the accomplishment of reaching them, then replacing them with new short-term benchmarks, would keep you motivated and optimistic.

Obviously, both goals have been the same for me since this started. Beating cancer has to be the "Really BIG Goal" in the near and far future, but I awoke this morning thinking that I need something a little more interesting to keep me going, something besides that big dark monster that lives in the closet and wants to kill me.

So, today my short goal is to get the house cleaned up and organized enough that I don't have to think about it for a year--hey, there's a positive, no house cleaning for a year! Yea! Today we will move our bed downstairs and guest beds upstairs to the loft, and maybe I'll even get the computer moved down too.

Bill and I are already started on what I want to be my long-term goal--learning to speak and understand Spanish. We have been listening to language lesson CDs on our drives up to Charlottesville, 1 lesson per trip. (We just finished numero 9, but Bill says he has to repeat it because he got confused. I had the same problem with numero 7). We've been using something called "Pimsleur" from Barnes & Noble, and it's been pretty good, very non-threatening for beginners, very easy to follow along. But it's very formal Spanish, very "Castellano," not this-side-of-the-ocean Spanish. I also get very frustrated with the lack of an accompanying written text. I have to "see" words mentally before I can register them in audio or even speak them.

For instance, customer service phone calls from New Delhi are a complete mystery to me--none of the syllables I hear in that Indian or Pakistani accent can be translated into visual words I can picture in my head. I keep waiting for the cartoon balloons to appear overhead, translating the gibberish I'm hearing into a logical sequence of English words. (And I confess, sometimes the Tennessee accent does this to me too--I stand there like a slack-jawed dolt, listening to someone talk at me, waiting for the translation to percolate into my brain. People here suspect I'm a little slow when I do this).

And speaking? I have such a jumble of languages I have learned over the years in my brain, I can't sort them out anymore. Four years of high school French, growing up hearing my father's German, a smattering of Mandarin Chinese and self-instructional Spanish in college, some Italian and Yiddish standbys in the family lexicon, and somehow I neglected to put each one in a separate folder in my brain. They're all in there, overstuffed into a big file labelled "FOREIGN" and when I go to say something in a different language, almost anything falls out of my mouth. I've been appalled to find myself speaking French in Mexico and Spanish in Quebec.

But I digress. We're going to run out of Spanish CDs soon and need to move on, and I've been researching various language programs for our continued study. I think we need something called "Learning Spanish Like Crazy." LSLC is supposed to be a faster-paced, more intensive program, that teaches idiomatic expressions and Latin American accents for speaking, while also training your ear to hear the faster, more informal, everyday Spanish of Mexico, PR, and other new world places. Sounds like just what we need, along with more verbs and some form of written grammar text so I can see the words I'm learning by rote.

I figure if I'm going to be sitting around in the chemo clinic, being infused for hours, then being sedentary and fatigued at home, (and not cleaning the house because I'm already so organized), I should spend that time learning something useful and productive, right? Then Bill can whisk me off to Mexico when we're done with this highly annoying delay in our lives. (Or at least out to El Pueblito for dinner, where we can say "Una mas cerveza, por favor," with verve and confidence).

Feeding the fish

Crisp morning, feels like fall at last. Our new ritual is to pack various stale snacks in our pockets and go down to the pond to feed the fish. The pond's volume is about half of what it normally has been--the overflow drain (the one that was "overflowing" last spring) is now about 4 feet above the level of the water.

I picture all the fish in there, huddled in the center of what is now just a very big puddle, fighting for space and oxygen. If there were fish conversations (and who am I to say there aren't?), I can imagine them saying things like "Ow!" and "Hey, move over, I was here first!" and "Just because he's a carp, he thinks he's entitled to more water than the rest of us," and "Look out, it's that darn snapping turtle again, we're all going to die!"

OK, maybe too much viewing of Finding Nemo for me. But I do feel for the little fishies, and I find the mindless activity of tossing stale Corn Chex and bits of dog chicken treats very relaxing.
My life isn't that hard compared to a minnow's or a blue gill's.

Just trying to identify what I'm looking at is intriguing, because there's no real way to tell if I'm right or wrong. Except with catfish, of course. That one I know, they're the ones with the big mouths and tails and whiskers. Bill keeps asking me if I'd like to eat one.

I think if you feed them and start anthropomorphizing them and making up conversations for them, the answer is probably "no." I think if I start to hanker after a catfish, I'll just go buy one wrapped in plastic down at the Food City, and keep my pond fish as pets.

Details, details.

Today is all about the list-making and calendar-filling, lots of errand-running too.

Bill is off to the dentist this morning for final crown and filling work. I have exercising and cleaning up to do. We both have to map out the time we have here and the time we will be spending up in Virginia. Bill will need to get at least 3 weeks of work in sometime before the end of December, and just how are we going to work that out?

I must quit using the Nicorette immediately--actually, I knew this, I just needed an excuse and this is it. I had already been tapering off, knowing that this was necessary before the surgery. So long, another loss, oh well. I guess now I can go to Singapore with Bill next time without panicking that I'd have to quit chewing nicotine gum (It's against the law to chew any kind of gum in Singapore).

I need to get as rested and as strong & aerobically fit as I can in the next 3 weeks. More oxygen capacity means better anesthesia experiences, less post-op pain, better healing. I know this routine from the neck surgery in 2001. Every bit of work I do now means an easier time later. And it gives me something to do, something that makes me feel that I have a modicum of body control. Also, exercise time is when I get all my current events reading done, and I am SO behind on what's been happening in the world for the past month.

Plenty to do, plenty to keep busy with.

OK, here we go

At last, we have a mission, a schedule, and a plan.

I actually have two different kinds of cancer, and it's on both sides. So, the mission is to remove the tumors and the pathways bad cells might have used, irradiate the site locally if needed, poison any cells that might have escaped, and then deny any that are left after that the hormones that tell them to grow. I guess I'm about to become a battlefield.

After a full day of medical follies yesterday (7:30 AM - 4 PM) I have another list of tests and procedures scheduled, starting 3 weeks from today and culminating with surgery on Friday, November 2nd .

When the pathology comes back 2-3 days after surgery, then the oncologists in Tennessee will finely tune a treatment plan that will possibly include radiation (5 days a week for 6 weeks), then chemotherapy (could last up to 6 months or so?), then oral Tamoxifen for at least 5 years.

There is good news to celebrate too: I passed my psych evaluation (I apparently mentally "qualify" for a life-saving procedure?), the cancer is estrogen-receptive (so we can use hormonal treatment as a weapon), and Bill & I chose cute new bionic boobs to be installed either at the surgery (if radiation is not needed) or later (after radiation is finished). I will be about half the size I was, which means I will be thrilled.

It is much more complex than described here, of course. But these are the simple facts that will rule our lives for the next year or so.

So we're going home today for a 3-week respite from what we've been working on non-stop for the last month. I'm going to get some things done around the house, Bill is going to go up to Illinois and help his dad get that situation taken care of, and we're going to get ready for the next steps. I may not write everyday as I have been, because I'm going to consciously try to take a break from thinking about it 24/7.

I'm a little tired and "let down" today from all the tension we've been under, like my whole self is taking a big, deep sigh. Time to relax for awhile.

Can't sleep

Ok, ok, Miss Get-Your-Comeuppance-Here can't sleep this morning. Up at 2:30, tossing until 3:45, on the computer at 4 am.

I'm hot, I'm sweaty, I can't turn my mind off. Menopause or nervousness?

Bill drove almost all the way yesterday, while I finally cracked open Dr. Susan Love's Breast Book. Heavily technical, jam-packed with statistics, generally anti-mastectomy in bias, full of useful and helpful and sometimes downright amazing information. Some of the info and stats make my toes curl and my stomach clench. The good news is that maybe I'll be able to follow what they tell me today, now that I understand the anatomy a little better, and understand how doctors arrive at their best guess as to what will work best.

The bottom line is that they know more now than ever before, but they still don't know why "good cells go bad" and they can't predict outcomes with certainty. Like most things in life, it's a crap-shoot. Some treatments should work and don't. Some patients look like lost causes and survive. What we're shooting for is a five-year survival without recurrence--statistically, if you can do that, you've pretty much beat it. How to get there is the big question.

Everybody keeps telling me that the choice of treatment is my decision. That assumes that I know what I want more than anyone else. I know that I want to not have this disease, and as Dr. Mark says, that horse is pretty much out of the barn. So my second choice is to "live long and prosper." I'll listen to what they propose, state my preferences, and make my best choice based on that priority. I have no absolute feelings of "I won't do that," if it means I get to live those 5 years and beyond, cancer-free. But I know they can't even guarantee that--all they can do is give me their best ideas on how to do that.

One day at a time. Today is one of the big days, but tomorrow will come too, and the next day. I can stay calm. I can breathe. But I don't think I can sleep.

One Month Ago, in a Galaxy Far, Far Away....

I went for my routine annual mammogram one month ago today. It seems like it's been eons ago, but that's it, just one month. Being a generally oblivious person, I went, I did it, I forgot about it. Just another day.

So, there's some sadness today, just nostalgia for that other life, the oblivious one. Will I spend the rest of my life remembering dates, marking the milestones? With these "life-changing" experiences--you know, the ones that are supposed to "make us stronger,"--I don't think you ever forget, even if you wanted to.

Mentally I mark my mom's accident, my father's death, my Loki-dog's death, my neck surgery, with thought-memorials to innocence gone, illusions dashed, grief recalled. But past experiences tell me with certainty that the immediacy of the shock, pain and yes, even horror, fades or just mellows with time.

"Why can't things just stay the same?" daughter Juli once cried to me. "Because nothing stays the same," said practical, suck-it-up Mom. Ooooh, I could just slap myself for my aged arrogance. As if I were immune to further changes myself.

The only antidote to sadness I've ever found that works for me is movement. Find a new place, go somewhere different, start a new project. Throw out the old, get on with the new. It's time to get this particular adventure on the road.

And so, time to make sandwiches, pack the ice chest and dog accouterments, grab a bag and head for my destiny. Well, head for Virginia anyway.

I figure I'll be smiling again by the time we hit the state line.

The Professional Caring Brigade

Friday is the day that everyone in medicine catches up and the phone starts ringing. Though I took the day off from blogging and attempted a get-away-from-it-all-day, I still spent the day talking about myself and my disease and how I feel--this time on the phone with what I've come to name the Professional Caring Brigade.

It started with the nurse at UVA, who kindly called to remind me of my various scheduled, sequenced appointments on this Monday. (They have been so great about bunching consults and tests into one day, so we can plan our travel efficiently). She also let me know that they had gone ahead and slotted me for my "required" appointment with the "counselor."

Gee. I didn't know I needed one.

This started me off on a whole line of thought on how the art and practice of medicine has changed generally, and breast surgery specifically. I remember when mom went in for a biopsy, (maybe 40 years ago)? She was told to pack a bag, show up at the hospital, go under general anesthesia and into surgery. They would excise the lump, send a frozen section to pathology, who would then say "cancer" or "no cancer" while she was still in the OR, and if it was malignant, they'd do a radical mastectomy, taking muscles and lymph nodes and all the tissue that could possibly be cancerous. She'd either wake up intact or not. Wow. I am astonished again now, as I was then, at her courage.

The good news is that the lump was benign and she went home with a scar. I do remember that she did her own pre-op counselling in the form of a shopping trip to Del Amo (I don't think they were called "malls" then). She bought an expensive (maybe $50?) sleeveless, form-fitting, shockingly low-cut cocktail dress in white crepe, with gold-sequined braid trim. "I'm going to wear that after my surgery," she said to me. And she did.

So things have changed, as we all know. There are studies and research, new techniques and tests, new diagnostics and new treatments. There are incredible reconstruction options, and hey, even insurance pays for it now. And, there is plenty of psychological support, all along the way, because mental attitudes do affect outcomes and survival. We know more and we do more. And I think most of it is extremely helpful to the patients, and I am comforted by having all these services available to me while I travel through this and choose what I want to do.

But it niggles me a little that while counseling is available, it is also "required." This has to be because of the litigiousness of medical care that has also come about in the last 40 years, right? UVA must see thousands in a year, and they have to cover all their bases in case of a future lawsuit or just plain buyer's remorse.

A lot of my rebelliousness must be due to my own intellectual arrogance. While I have chafed at the apparent slow pace of the progress of diagnosis, testing and eventual treatment, I now recognize that this time spent waiting has been necessary for me to mentally prepare for whatever lies ahead. And I've been doing that mental work on my own and with the help of friends and this blog, and I think I'm doing just fine, thank you.

"Counseling? I don't need no stinking counseling!"

But still, I have to go in for my mental "test" on Monday. Will I pass? Am I smart enough to outsmart the test? If I say I'm fine, I'm ready, will the counselor conclude I'm still in denial? If I say I'm a mess and I can't face it, will the judgment be that I'm depressed and not a good candidate for whatever? If I tell her I've thought all these thoughts, will the conclusion be that I'm just a complete over-thinking nut-job? The problem is that I know just enough psychology to be dangerous to myself and others.

You never get a straight answer from a counselor. Here's just one example: When I was told of my appointment, it was unclear as to whether both Bill and I need to go to this appointment, or just me. So I called back, left a voice mail for the doctor and asked one straightforward question: Did she want to see both of us or just me? I was out when she called back, and Bill said her answer was: "Either way, maybe you and your wife would like to talk about it." "What?" I said to Bill. "Talk about what? The appointment? My breasts? Like we ever talk about anything else?"

So, here's the conundrum: Now, whether we show up together or I come alone, that in itself becomes a signal, a piece of information on how we are dealing with my disease, together or individually. If we come together, it could mean that we are stable, committed to each other and will see this through in a healthy, equal relationship. OR, it could mean that I am too weak to face this alone and my husband is propping me up because I can't deal on my own. If I come alone, it could mean that I'm a confident, strong person on my own, sure in myself and our relationship, OR, it could mean that my husband can't deal with it and has abandoned me. See? I can drive myself crazy like this.

Actually, the way this particular scene is going to play out is this: the appointment is at 7:45 am. Bill will go with me if he's awake. How's that for a searing, insightful psychological analysis?

Later in the afternoon, I got another call from a new nurse. She said she wanted to touch base with me and answer any of my questions. OK, I said, here are my questions, and began to ask about technical issues, medical procedures, etc. Oh, she said, she didn't really know any of that, the doctors would talk to me about that on Monday. Now I was confused.

"So....what exactly is the purpose of this call again?" I wanted to know. "What kind of questions are you talking about?"

She explained that many people felt lost, helpless, uninformed as to where to get information, or had transportation, housing or financial issues that they wanted to discuss. I assured her that I have none of those concerns. She didn't believe me.

She was well-intentioned and kind, and it's her job to care about me. It was as if I was slapping her in the face to tell her that I wasn't buying what she had to sell. I felt a little bad for her, can any of us say "I don't need you" and not feel guilty just a tiny bit? I was essentially telling her that her function in life was useless to me. Rats.

So, I put on my psycho lingo and told her that I had an awesome "support network" and I had been "processing" through the "stages of grief." That I thought I was pretty much done with "denial" and "bargaining" and I was still working on the others in the fullness of time. "Well," she said with a sigh, "you may THINK you're done with denial and bargaining, but they have a tendency to come back!"

"Yes," I told her, "I fully expect that there will be more tears in my future as I go through this. But I'm a pragmatist, so I'm prepared--I went to Wal-mart today and bought 6 boxes of Kleenex, so I think I'm ready for what's next, OK?"

I think that might have done the trick. How can I be in denial when I've got 6 boxes of tissues ready to go?

Taking a day off from being profound

"Gone fishing"

Rainy day thoughts

I woke up at 4 am to the sound of RAIN on the roof! I wanted to run outside and dance in it--instead, I grabbed a towel, took a shower AND ran the dishwasher! What luxury!

People here say this is the driest year anyone can remember. I'm glad (once again) that I spent the summer traveling, for if I had stayed, we would have run the well dry 2 months ago. A quick look at weather.com brought even better news--three to four days of steady rain is forecast for next week. Maybe I'll even get to do laundry (imagine me looking forward to doing laundry)?

I feel very good this morning, full of energy and able to move my arms freely again. We have a few days to be "normal" before psyching up again for next week's continuing saga. Still, I am a mite resentful today. I think that of all the things I am resentful about, the loss of the "normal life" I had is the hardest to work through. I know I have to just get over that and get on with it, but it still ticks me off that THIS is what my life is about now.

In my weaker moments, I am a whiner. It's not so much "why me?" as "why now?" (as if there would be a better time)?

I already know the answer. There is no answer. You play the hand you're dealt, and you do it without snivelling, please. Stow the drama, bring it on. And in the meantime, be thankful for water falling out of the sky at last.

Nice people

Have I just been in a total fog of self-absorption for about the last gazillion years? Why does it take something like this to make me realize how truly amazing humans are, even the ones we don't know yet?

Suddenly, the whole world seems filled with people I have loved and who love me back, people I never knew but now have something in common with, people who care about me without even knowing me, and complete strangers I find myself caring about too. They are in waiting rooms, sitting as nervously as I, dressed in the same worn pink gowns. They are nursing and doctoring me, patting my arms, helping me breathe, sharing good news and bad as if they had a personal stake in the results of my tests. They are cooking for me, listening to me, housing us as if we were their own family. They are calling and writing and sending me jokes to make me laugh and keep my spirits up.

On waking this morning, I was overwhelmed with humility and gratitude. I've talked a lot about trying to show patience and kindness to others in my life--now I am the recipient, I am showered with it daily, and wonder if I ever knew how incredibly important it really is, whether I really did it for others with the open heart and unconditional generosity I am receiving now.

Knocks me out, that's what it does. Just knocks me out.

Great News from UVA!

My ultrasound was the first test yesterday morning, and they only did it under my arms and along the axial sides. After about 5 minutes of silent viewing under my left arm, the doctor sighed with relief and said, "Pam, this looks great," with a big smile. "I don't see any evidence of lymph node involvement here," she said. "That doesn't mean it's not there microscropically, but we can treat that with chemo or radiation. This is VERY good news." The same result was confirmed on the right side.

What incredible relief! I told Bill later that after all my reading, this was what I had feared the most today--not just losing a breast, or both breasts, but that I would lose arm function, muscle strength, resistence to infection, and ultimately my life, because the cancer had already moved into the lymphatic system and lodged somewhere else.

They let me go for lunch, and Bill and I walked on the campus, up to "The Corner," strolling along the sidewalk in the sunshine, reading the menus posted outside each little eatery. We chose "The White Spot Cafe" (later discovering that this is a UVA icon, one of Dr. Mark's favorite places when he feels the need for cholesterol-overload). Bill had a Gus-Burger, a massive, dripping, heart-attack-on-a-bun, complete with a fried egg on top. I had a gyro, with lamb, cucumber and yogurt sauce, lettuce, onions and tomatoes, wrapped in a puffy pita. I don't think I've ever tasted anything quite so vividly.

We walked back to where Bill was parked and decided to split up for a few hours so he could go back to the house and take care of Echo, and I would do my afternoon tests on my own, since they wouldn't let him be there during the procedures. I called Mom and the kids and told them the good morning news.

The afternoon was tougher, but the elation of the morning test results buoyed me throughout. They did stereotactic biopsies on both breasts, each lasting about an hour, with a half-hour break, complete with gingerale and crackers in between. Yes, quite painful, but the two techs, Angie and Lynette, were gentle, funny, loud and full of personality. They kept me calm, made me tell them stories, told me some of their own, kept me breathing, kept me still, talked me through it. I had 3 doctors also in the room--the female attending doc in charge, the one male resident she was training, who was observing and doing the procedure for the first time, and one female "Fellow," who had a little more experience . (I asked what a Fellow was, and was told by the attending physician that it is a doctor who has completed medical school, done a 5-year residency, and then does a year as a Fellow to specialize in a certain area, this one being Breast Radiology). That's the thing about a teaching hospital--there are always a million people in the room, and every patient is a learning experience for a couple of residents.

I learned that the involuntary, uncontrollable shaking I experienced at my first biopsy in Knoxville was due to the epinephrine they give to control the bleeding. This time, I got a "double dose" because they did both breasts. I was rattling away pretty good, but they were done with the "hold still" part by then. The other good news is that the epi took the swelling down on the spider bite I got on my thigh last week, and it doesn't itch this morning!

The techs packed me in ice afterwards, went and got Bill ("he's SO cute!" Lynette gushed in my ear) and sent us home around 4:30 with lectures on "Don't do ANYTHING!" and Tylenol.

They told me how brave I was, told Bill how brave I was (and showed him the 10-gauge needle they had used, hoping perhaps that he would faint and they would have to revive him?)! I got the "best patient" award of the week, and when I reminded them that it was Monday, so that wasn't saying much, we all had a laugh.

We spent a comfortable evening with Mark & Jo, eating Korean ribs, turkey & leftover steak, salads & chips, and watching Monday Night Football. I shared that Angie had asked me where we were staying, and when I told her about our friends, the Goldbergs, she asked "Dr. Mark Goldberg? I've never gone to him, but some of my friends do and patients we see, and everyone says he is absolutely WONDERFUL!" I assured her that he is. Bill showed me a newspaper article--Mark is going to be on a Discovery Channel special about rural health clinics and obesity, to be aired sometime this fall. I started fading as the Patriots were tromping the Bengals, and slept well until about 4, when I needed more Tylenol. I slept again until 7.

Life looks pretty good this morning. We'll head home after showers and dog walking, and come back next Sunday to hear "The Plan" on Monday from Dr. Brenin.

Test Day

While the guys watched football last night, I sat on the floor reading the giant notebook they gave me last week as my UVA door prize (door stop is more like it)! I kept a notepad nearby, and jotted down questions for today.

This is complicated. Dr. Brenin at UVA is my surgical oncologist. I will also need a medical oncologist, and perhaps a radiation oncologist, a plastic surgeon (or reconstructive surgeon, as they prefer to be called), and a host of others that I don't even know about yet? I guess these are all the butterflies from my dream, right? Or are those butterflies just what I feel in my stomach right now?

As a result of all the information I barely assimilated, I woke up a little fuzzy and confused this morning (no, it wasn't the wine with dinner last night)! I did some push-ups (keep up those arm muscles!), washed my face and did some deep breathing. Get a grip! Buck myself up!

Today, I may or may not find out the results from Thursday night's MRI. Today, I present myself to be poked, prodded, photographed, ultrasounded, biopsied, and whatever else they need from my body. My brain keeps going around and around with questions like "But, what about?" and "What if?" and I just push them away. They don't know what they need to know yet. This is not the time for me to pummel them with questions about the future. Today I am but a mere vessel, a collection of parts and signs and symptoms.

I am not a person today, I am a medical problem to be investigated. I resolve to be cheerful and stoic today. I resolve to remind Bill to go to the market for bags of frozen vegetables to put in my bra when they are done with me today.