The Last Day

Today is a weird sort of day. I joked all weekend that we were into bonus material; anything I accomplished was extra. I've accomplished a lot in the past few weeks, but there is still so much more to do that I know I won't be able to do for a long time. I can't decide if I want to run around like a chicken with my breast cut off today or just... chill. And enjoy what I've come to think of as The Last Day.

The last full day of my old normal.

My last day with my two God-given breasts. It's a weird feeling. I feel... I don't know. In a way, I'm so sick of all of this, I have no energy left to feel. I just do. But the anticipation of how I am going to feel after I wake up tomorrow with a hard lump where my breast used to be and a drain with bloody discharge leaking out of it is what has me the most worked up. I've had a long time to contemplate this - two months - so you'd think I'd be over it by now, but I'm not.

Because the reality is that you just don't know how you are going to feel until you are actually there. Maybe I'll feel fine afterward. Maybe I'll be one of those people who bounces back right away and is driving within a few days, returning to work, and moving on with life. Maybe I'll feel so fine I'll cancel the reconstruction. Maybe I'll be able to let my family go on the trip they were planning for this weekend. Or maybe I won't. Maybe it will be even worse than I'm expecting. Maybe I'll sink into a deep depression and want to kill myself. Maybe I will feel anger and self-loathing every single day for the rest of my life.

So many women declare with such bravado that they would definitely have no problem having their boobs cut off and living the rest of their lives happily free from wearing a bra. They say this because they think it will make me feel better, but it doesn't, because I know that it's not true. I also know they aren't lying; I just know that they don't know what they would actually choose if it were really them. And in the end, very few women choose a bilateral mastectomy with no reconstruction. Even nipple reconstruction, which seems like a lot of trouble for such a trivial body part, and one that I despise no less, isn't completely off my table right now, in the event that I end up losing my nipple. I never would have guessed even six weeks ago that I'd desperately want to save my nipple.

People react to their cancer diagnoses so differently. For me, it took a long time for the reality to sink in. My parents and my husband took my initial diagnosis much harder than I did, mostly because I was too stupid to understand how truly life-changing this would be. Even when there was a very real possibility that the cancer had spread into my rib, I wasn't that worked up. I was just thinking there must be a quick fix for this. Ribectomy, anyone? (Who needs their rib, anyway?) I didn't know that this would technically put me into Stage IV, terminal. Others seem to react with more hysteria initially; the visceral OMG GET IT OUT OF ME! GET IT OUT OF ME! reaction that leads people to get bilateral mastectomies for 0.5 cm, stage 0, grade 1, ductal carcinoma in situ within a few weeks of their diagnosis. It is the treatments that give these people comfort, whereas for me, it's the treatments that I loathe. I don't know if I will ever feel that elation over 'having the cancer gone' that some describe after a mastectomy. Then again, maybe I will. I don't know.

Some people have told me it's too bad I've gone through all of this, only to have it end this way. I could have had this done in May, and I would be all recovered now, happily getting monthly shots to put me into menopause, taking an aromatase inhibitor, and in the middle of a lecture this very moment, instead of at home. But the truth is I wasn't ready back in early May. Even after lumpectomy #1, I wasn't ready. Even after lumpectomy #2, I wasn't ready; I honestly would have considered a third re-excision if every single one of my doctors hadn't counseled me otherwise. I actually feel pretty strongly that I have cancer in my right breast, too, I just know it. I probably ought to proceed with a bilateral mastectomy, but I'm not ready for that. It's easier for me to wrap my mind around having to go through all of this again sometime in the near future than it is for me to wrap my mind around a bilateral mastectomy, and since none of my doctors counseled me to have the double, I continue to proceed one conservative step at a time. All of this is part of my 'new normal' of living with cancer.

I started praying for my surgeons ever since I had a date for my mastectomy, and I feel that God must be mocking me in some way by doing this to me. Nonetheless, I will keep at it.

Blessings

• I'm grateful to be back in the hands of Dr. L, and thankful for who she is. After she was so helpful to me last Tuesday, I sent her a thank-you e-mail, and concluded with: Please take care of yourself this week. (No darts please!! :)). She replied: You are so sweet, I'm so glad we could help out. (...) I absolutely plan to stay away from darts, especially now! Gives me the willies just thinking about it!! See you next week! Jane
• I continue to be thankful for the love and support from my family, friends, and colleagues.  
• I'm thankful for a new Chair who has worked tirelessly to make my work situation as minimally stressful as possible, complete with the e-mail he sent me last Thursday: I met with [The Dean], [his administrative assistant] and [the head or HR] today about your leave. The bottom line is you are totally covered and will receive full pay for the semester. Even if you don't do another minute of work for ABC College this semester, you’ll still have at least 5 days of sick leave left. You might even have 10 if you continue to accrue sick leave days over the semester – [head of HR] is checking into the official policies on this. If you want to come back before the end of the semester and work on "other duties", you can stop drawing as much from sick leave. Everyone is very happy to be flexible with how we structure your leave, so don't worry about it. We'll sort it out when you feel ready to come back. For as much as I complain about work, this is a true blessing.

Hopes

• I pray for Dr. L, for her safety, health, and clear mind tomorrow. I ask the same for Dr. G, the plastic surgeon who will be assisting her. 
• I pray the surgery goes as she planned, that she will be able to do a nipple-sparing mastectomy.
• I pray for clear margins, that after all of this I won't have to do radiation or chemotherapy.
• I pray that I will make it through with no complications, and that the pain will not be too horrendous. And if it is, I pray for the strength to get through it.

I realize a lot of people have life-changing things happen to them without the luxury of contemplating them. Sometimes people are thrust into things full force, waking up the next day with a 'new normal' that is so devastating it boggles the mind. But people are shockingly resilient. We often admire the strength of others, not believing that we have it in ourselves to behave the same way, but I believe we do. At least, I pray that we do, that I do. While I'm thankful for the time I've had to come to terms with everything that is happening, I need to stop circling and start moving forward again. I pray this surgery happens tomorrow. I pray that all of my mourning is done, and that I will wake up feeling happy.

From the Inside Out

All is quiet on the cancer front. If I were to stay totally in the moment, I would say that I'm overcome with happiness to be here, in front of my computer, taking a break from doing projects around the house, rather than recovering from surgery in the hospital. But staying in the moment is futile, counterproductive, even. Conditions like this require planning, both for the short-term (How will my daughter get home from school when I'm in the hospital?), intermediate-term (Who will cover my classes for me when I'm gone?) and long-term (Should I consider putting more money into life insurance?).

My daughter doesn't have school today, and since I was supposed to be in the hospital, she was supposed to have a play date at her friend's house. However, since I'm not in the hospital, and I figure my daughter will probably be over at her friend's house a lot in the upcoming weeks, I offered to have her friend over here instead. I love this friend; she is the only nine-year-old girl I know who might actually be just as weird as my daughter. She's the only girl I know who responds to my daughter's bizarre and out-of-blue comments by laughing and declaring, 'Ellie! You are my favorite friend!'

I just had a rather endearing conversation said friend. I had just cooked the girls pasta for lunch, and while they were eating, I was doing a meatball-cooking marathon, because there is nothing I love more than coming home from a long day at work, having no idea what to make for dinner, and discovering a bag of frozen meatballs in the freezer. Plus, I was cleaning out the refrigerator and found a pound of sausage and a pound of on-the-bubble ground beef that needed something to happen to it ASAP. My daughter had left the kitchen for some reason, so it was just me and Friend. Exercising proper etiquette, Friend tried to make conversation with me about my cancer.

Friend: So... it looks like you're doing a lot better than...
Me (thinking): Oh I can't wait to hear what follows this.
Friend: ... than... before.

It came out awkwardly, but somehow, probably because I know a few things about nine-year-olds, I know what she was trying to say. You look a lot better than I expected. As in, Wow, you don't look gravely ill. You don't look like you might be dying. She was trying to reconcile this woman who just cooked her lunch and was making meatballs and looks perfectly normal with the woman everyone has been talking about in serious, hushed, tones: OMG did you hear Ellie's mom has cancer?

And it struck me what an odd disease this is. Because you can look and even feel completely normal, despite having this potentially deadly condition. And not only that, you can look normal and sometimes even feel fairly normal up until pretty close to your death. This disease, it gets you from the inside out. Of course, there are others that do the same, but it's hard to think of many that can leave so few traces on the outside that something is going terribly wrong inside. Even the hair loss everyone associates with cancer isn't from the cancer itself.

Right now, I look and feel great, especially now that I've been able to sleep again. On any given day, I feel far more like a woman who desperately needs hip surgery than a woman who needs a mastectomy, oophorectomy, and possibly hysterectomy. Aside from the lump in my breast, cancer has given me no concrete symptoms. And even if it metastasizes, it will likely be caught by a scan before it causes me any health problems. It doesn't usually end well for people who don't discover cancer until after it starts to give them problems. How many of us have heard a story about someone who went to the doctor because of abdominal pain and died less than a year later from some sort of cancer that had been eating away at their insides?

It is confusing. It is confusing even for adults, so many of whom tell me that I look great and they cannot believe I have cancer. Why shouldn't I look great? As someone on another blog said, I don't have cancer of the face. LOL. And while I'm glad to look great, sometimes it is difficult to look and feel so normal. Hell, I could making all of this up! Or maybe there was a terrible mistake on my test results and I don't even have cancer. I don't feel ill. I don't feel like I might be dying. The treatments are worse than the cancer itself.

All these thoughts, they ran through my head in a brief instant after my daughter's friend valiantly tried to make conversation with me and I tried to think of an appropriate response. So I offered: 'I feel much better now than I did after my surgeries over the summer.' Then I added, 'But I'm getting ready to have more surgeries.' She looked at me for a moment, then said, 'Are you nervous? If it were me, I'd be SO SCARED!' I thought for a second, then admitted to her that I'm scared. I'm not scared about the surgeries so much as I am about the future. But I wouldn't expect a nine-year-old to understand why all of this makes me scared for the future, nor do I even want her to. In fact, I've spent a lot of time trying to cover up the fear, to protect my kids from it, perhaps too much. All they know is that I yell a lot these days, which in a child's mind means I might not love them anymore. But being scared about surgery is something a child can understand, and perhaps a good compromise for conversations with my kids. A child can understand Mommy is nervous about surgery, but not Mommy is nervous the surgery won't take care of her problem, that it won't be enough.

No one has asked me if I'm scared before, at least not in such a forward and point-blank manner, until today. Perhaps with adults, it's a given, something that doesn't need to be stated up front. There is so much of this to be afraid of. We all understand this fear on different levels. Even adults can grasp certain aspects of this better than others. I may look and feel great, but inside, there is fear. So much fear, it scares me.

The Bright Side of a Dull Gray Cloud

I've never been a person who believes all things happen for a reason, unless bad luck and life is unfair count as 'reasons.' However, I do think that sometimes clouds have a silver lining, and things work out in the end, and perhaps that's pretty much the same thing as believing things happen for a reason.

I had to laugh at the response I got from my colleague, Admiral, when I e-mailed him to let him know that my surgery was postponed and I wouldn't be needing food after all. I explained a little bit of what I thought was going to happen in the future, and he replied that he was happy that at least Dr. L was back in the picture - followed by Feels like I'm looking for the bright side of a dull gray cloud. Exactly.

But, I'm oddly at peace with everything right now. I'm not sure how long it will last, but for now, I'll take it.

Today I had to make a pretty big decision about work, which was tough, because I had everything so well planned out, which took me I don't know how many hours of banging my head against the wall. Basically I had planned for my colleague to cover for me through the first exam, and I would return on October 5th. This was sort of pushing it, since my surgeon recommended six weeks off, but I figured I could make it work. Unfortunately, with my surgery now being delayed by at least two weeks - I'm still skeptical about the September 8th date - it complicates things. There is no way my colleague can cover for me past October 5th. Her schedule right now is so insane, I'm not even sure if she can cover for me through September, at least not without quitting at the end of the semester. She is brand new, has never taught this class before, and has five sections of it, each with 80 students. Talk about being set up for failure.

Fortunately, there is an adjunct, Dave, who is chomping at the bit to teach more classes, and has volunteered to teach anything we throw at him. He is retired, and, I think, bored. And lonely. Basically I think he just really likes to hang out at the university and feel like he is a part of something, which I totally get. He is a nice guy, and the students like him, but man, the guy can talk. I usually try to avoid him because it's not often that I have an hour at work for pointless gabbing, and if I do, I prefer to do it with some of my closer colleagues.

But anyway, it turns out Dave will be a lifesaver. Today he and I and the colleague who is currently covering for me met with the Chair to discuss various options, given my new situation. Dave said he was more than willing to cover for me until I was able to return, which I appreciate, but I also think it is not in the best interest of the students to have three different instructors. If it were an upper division class, that would be one thing, but 90% of the students are first semester freshmen, and their minds already seemed blown that they are getting a 'substitute' for the first six weeks.

We threw around all sorts of different scenarios about how Dave could cover for me and how we could make my return easiest for the students, and on and on until everyone's heads were about to explode. But eventually I realized that it would be much easier for everyone, myself included, if I just took the semester off. I have enough leave to do this, and while I'm nervous about blowing all of it at once, that's why it's there, right? Like... sometimes I get all pissy about taking money out of savings to pay medical bills, then I think to myself, well duh, isn't this why you are supposed to have savings in the first place? To pay for stuff like this? Supposedly I've earned 11 days of leave for every year I've been full-time, which would give me 55 days. I think I could actually argue I should have more, because I've been here for six years, only I dropped to 75% the semester after my son was born, and because it was easier, the university made me 87.5% for the entire year. Anyway, technically a semester is 80 days, but there's wiggle room. For example, I already taught a three-credit course, which is 25% of my load. Also, I'm working now. Basically the Chair made it clear that I could take the semester off using my leave and We'll make sure you're taken care of. I mean, duh, what idiot would REJECT that offer?!

Eventually the Chair looked at me and said, 'What would be the least stressful option for you, Waning?' When he said it like that, it was a no-brainer. I said I thought it would be the easiest for everyone, including the students, if I just took the semester off. After all of these ridiculously complicated scenarios we were throwing around, everyone seemed relieved I had finally come to my senses. I guess part of my resistance was in response to how freaking long the summer seemed, and how much the time flew by once I went back to work and started teaching. I do think I'll be bored by mid-October, once I'm hopefully feeling better. At the same time, teaching is stressful, and it's especially stressful trying to coordinate with so many other people, dealing with the 'baggage' they leave behind, etc., etc. And I certainly don't need more stress in my life right now.

I also keep reminding myself that if I need time off in the future (which hopefully I will not), I always have the option to take a pay cut, like I did when my son was born. But there's really no reason to do that if I don't need to. And God knows I need the money right now.

All in all, I feel good about the decision, and it's mostly a relief. Combined with Dr. L doing my mastectomy in less than a week, I am happy with how things have worked out, especially considering that 48 hours ago I pretty much wanted to stab myself in the carotid. As Admiral said, it's the bright side of a dull gray cloud.

Hey, I'll take it.

What a long, strange trip it's been.

I should be in surgery right now, but instead I'm sitting at home in my nightgown, typing this. I'm still trying to wrap my mind around the events of the past 36 hours, and I honestly feel a bit fuzzy, like this isn't real. It's like one of those weird dreams you have where nothing makes sense and when you wake up you're like, 'Ah! No wonder nothing made sense! It was all a dream!'

On Monday, I had pretty much theeeeee most stressful day at work, but worked my hardest to put out as many fires as I could before leaving, thinking that I was not coming back until October. I left as a huge ball of stress, and later had to e-mail colleagues to ask them to water my plants for me, take my lunch that I didn't have a chance to eat out of the fridge, to put in a work order to have more chairs moved into my classroom, etc., etc. I wanted a day with no work before my surgery, and knew that if I went into work on Tuesday, I'd get sucked into all sorts of things I really didn't want to be sucked into.

When I finally got home, I was practically excited about my impending mastectomy - at least as much as one can be excited about amputating a body part.

Then Dr. T called.

Or wait.

I called him, and he called me back. After my post on Sunday night, I was starting to get a little stressed about the fact that I was getting ready to have this LIFE CHANGING SURGERY, and had heard nothing from any of the surgeons who were going to chop off my boob, then turn the fat in my abdomen into a replacement boob. I mean, geez, my local hospital seemed much more concerned about me when I was just going in to have an ice cream scooper put into my boob in an outpatient procedure. Now I'm having this surgery that requires a 3-5 day hospital stay, and I wasn't convinced anyone really knew I was having the surgery, including my surgeons. I intended to e-mail Dr. T and ask him WTF?! once I was done with my blog post, but he actually e-mailed me before I got to it. He asked me to call him 'tomorrow afternoon,' ( = Monday afternoon) to 'discuss your upcoming surgery.'

No big deal, I thought, he's just checking in. Finally.

Around 6 PM, we were having a conversation that went something like this:

Him: I have the results of your blood tests, and you don't have a clotting disorder. Your CT scan also looks great. But there is something about the surgery that has nothing to do with you.

Me: * silent * I can't believe he's pulling off the oldest trick in the book - It's not you, it's me!

Him: It's me.

Me: * silent *

Him: I hurt my eye over the weekend, and I have blood in my anterior chamber. Basically I can only see out of one eye right now, and I'm unable to do any surgeries.

Me: * silent *

Him: Are you there?

I honestly can't recall a lot of what followed. He did a lot of uncomfortable rambling - clearly, he felt really bad - and I did a lot of uh-huh's and ok's, and yeah's, while not really listening to him and just thinking I cannot fucking believe this! over and over and over.

We left things sort of open-ended because I cannot make decisions about realities I haven't yet accepted. After I hung up I wanted to curl up into a ball and have a good cry, but we had to go over to my parents' house for dessert - ironically, to firm up the plans for the week - so I had to hold it together. Later that night, I did have a good cry, then immediately sat down to start regrouping.

One of Dr. T's recommendations was to go ahead with the mastectomy on Wednesday and delay the reconstruction. However, after talking, I realized I've had zero communication with the surgical oncologist because I just assumed this was mostly Dr. T's surgery, and he was taking care of it. The surgical oncologist wasn't my favorite, but I figured Dr. T was the most important person in the surgery. The bottom line is that with Dr. T out of the picture, I saw no reason to go up to University Hospital just for the mastectomy. So late Monday night, I shot off several e-mails:

1. I e-mailed my Chair, asking to meet with him Tuesday morning. Clearly that October 5th return date isn't going to work for me now. After all my careful planning. Sigh.
2. I e-mailed Dr. F, the surgical oncologist at UH, asking her get back to me about my options, and whether or not she thought she would be able to do a nipple-sparing mastectomy. Since Dr. L seemed confident she could do one, I figured there was really no point at all going with Dr. F if she wasn't willing to try. 
3. I e-mailed Dr. L, explained the situation to her, and asked her if she could do a mastectomy for me ASAP (like, next week). I told her I completely understood if she couldn't, in which case I would keep my appointment up at UH on Wednesday. However, if it were possible, I preferred to do it with her. I crossed my fingers she would get back to me promptly because I really needed to make a decision fast. 

On Tuesday morning, I was meeting with my Chair about the possibility of just taking the semester off, if need be. He said he would look into the university's policy on sick leave, which is weird territory for faculty because no one really takes 'sick days.' But apparently we do have them. In fact, after six years, I have 55 days of leave. You learn something new every day. While in the meeting, my cell phone rang, and I apologetically pulled off the pompous this call is more important than you are, and said I really needed to take the call. And I'm glad I did, because it was Dr. L. She said she had just gotten my e-mail and yes, she could do a nipple-sparing mastectomy for me next week, and she had already arranged for me to meet with the plastic surgeon she works with; he could see me at 11:30. All this by 9 AM. (See? This is why I love her!) (And I knew there was a reason I brought her flowers the last time I saw her, other than the fact that I love her. You should always have a surgeon on hand who is willing to do a last-minute mastectomy for you.)

I wrapped up my meeting with my Chair, went to my office to answer a few of the ten bazillion e-mails that are inevitable the first week of classes, then headed off to my appointment with Dr. G, the plastic surgeon. While I was waiting, my cell phone rang, and since I wasn't sure when I would be called back, I didn't answer it. I checked my voice mail, though, and it was Dr. F, the surgical oncologist from UH. She asked me to call her back on her personal cell to discuss options. Seeing as how I was working my own set of options, I immediately felt guilty, like I was cheating on her.

I had a relatively uneventful visit with Dr. G. I liked him, and I'm glad I met him, as I'm starting to accept there is a real possibility that Dr. T won't come through for me, in which case I need a Plan B. Dr. L had already filled him in on the situation, and he explained that he would have a very minor role in the mastectomy, as all he would be doing was putting in either a tissue expander or an implant to hold everything in place before the reconstruction. He said it would be very easy because my skin looked healthy and 'Your breasts are the shape the designers were thinking of when they designed implants.' LOL. Amazingly, I left with a date and a time for the mastectomy, which had been worked out between Dr. L's people and Dr. G's people while I was having my breasts measured and photographed.

September 1st, 1:00.

I left feeling much lighter than I was feeling just a few hours earlier. It all fell into place so seamlessly, it felt like the right thing to do. Of course, I also 'knew' that Dr. T was the right surgeon for me when I met him, so I understand that cautious optimism is the appropriate attitude.

I left Dr. G's at around 12:15 and went home to grab some lunch before realizing I didn't actually have time for lunch before getting downtown to my 1:00 appointment with our lawyers, to sign the final copies of our wills, powers of attorney, and advance directives. I wolfed down a tomato from the garden and headed out. So much for gaining weight.

The attorneys were sooooo slow. They actually seem like fun people, but every time we've met, it seems that at least one of us is in a huge hurry. My husband had an appointment at 2:30, and my cell phone was exploding with text messages, e-mails, and phone calls while we were sitting there discussing a hypothetical scenario in which I am diagnosed with stage IV cancer, then get into a car wreck and need CPR. Does marking 'withhold CPR' on my advance directive mean I don't get any life-saving measures if I become stage IV, which is technically 'a terminal condition'? Or suppose I become a vegetable during surgery, and my husband is so distraught that I'm a vegetable that he wrecks his car driving home and becomes a vegetable, too. So we're both vegetables but we aren't dead. What then? As one of the attorneys said, she practices 'soap opera law,' meaning we get to discuss all these dramatic and highly unlikely scenarios, the type of things that really only happen on television.

Anyway, eventually my husband had to leave, so the attorneys said they would finalize the papers and send them home with me. While they were organizing all of it, I stepped out to put more money in the meter and make some phone calls. Only I already had a $20 ticket! Jesus H, are you f-ing kidding me? The meter must have JUST EXPIRED; I could still see the meter reader the next row of cars over. Great, just great. I should have just left the ticket and gone back, but because I am honest, almost to a fault, I stuffed the ticket in my purse, put money in the meter, and headed back toward the lawyers' office. I had a little bit of extra time, so I sat down in front of the courthouse to try to call Dr. T, who somewhere in all of this had texted me and told me he could do the reconstruction on September 8th. I wanted to make sure this would work with a September 1st mastectomy before canceling my appointment at UH. He didn't answer, so I decided to go out on a limb and call Dr. F anyway. It was almost 3:00 and I figured she deserved to know that I wasn't going to be showing up for surgery the next day. I couldn't hear very well, because the wind was blowing and there was a lot of traffic and construction, and there are a lot of weird, loud people and weird, loud conversations that take place outside of a courthouse. Dr. F was actually quite nice, and said she was really sorry things had turned out this way. She was also understanding of the fact that I wanted to do the mastectomy locally, and had nothing but good things to say about Dr. L - As you know, she will take great care of you. She said that in 19 years of doing surgery, this was the first time another surgeon had canceled on her, and in 19 years she had only had to cancel surgery once, because she had the flu. So when I ask in an exasperated voice, WHAT WERE THE CHANCES OF THIS HAPPENING?! I now know. They were about the same as me getting a blood clot after my hip surgery. Minuscule.

After picking the final will and other papers up from the lawyers, I headed back up to the university to pick up my son and take him to his annual physical on the opposite end of town. I was supposed to get there at 3:45 to fill out the 'ages and stages' questionnaire but we were pushing it to even make it by 4 PM, which was our actual appointment time. Or so I thought. While we were driving through traffic and I was cursing all the slow people who were not paying attention because they were on their phones, Tara, the secretary from the pediatrician's, called to ask me where I was. LOL. This comedy of errors pretty much sums it up: Tara called on Monday to remind me of Katie's appointment at 4:00 on Tuesday, and I called back to confirm that she meant my son and not Katie, because we don't have a Katie in our house. She said, oh yes, that's what I meant, I just got confused because Katie was the next person on my list. So when she called me this time, I was like, 'What do you mean where are we? I thought our appointment was at 4!' and she said, 'No, your appointment was at 3:30. Katie has an appointment at 4.' Jesus. Finally I just barked at her, 'I've had a really bad day so just tell me what you want me to do.' Meanwhile, I missed my exit onto the freeway because I cannot drive and talk on the phone, and having to drive through the downtown added at least an extra 10 minutes (though we did actually get there at 4:00 on the dot).

After the appointment, I raced home, helped my husband with dinner (OMG I was starving!), then after dinner, some of my lovely friends came by for what was supposed to be a last-glass-of-wine get-together before my surgery that was supposed to be happening the next morning. I realized around 7:45 PM that I needed to call my mom and let her know for sure that I didn't need her to come by at 3:30 AM this morning, so I excused myself to make a quick phone call. On my way back outside, my cell phone rang, and it was Dr. T, so I answered, because we had been e-mailing and texting back and forth and doing a lot of phone tag, so I wanted to touch base with him. I could tell he was still feeling bad because he talked for a really long time, and by the time I got back outside, my friends had left. OOPS! I felt bad, but I was too tired to feel bad for very long. I mean gosh, what a crazy day.

Crazy!

And surreal.

After we got the kids in bed, I pretty much crashed. I was so worn out - both physically and emotionally - that I fell asleep with no sleep aids whatsoever before 10 PM and actually slept like a baby until 2 AM. I dozed on and off between 2 and 6, and finally got out of bed around 6:30. But it was weird not having anything pressing to do.

It's 11:30 and I'm not even dressed yet. I think I'm still recovering from yesterday. So I shall wrap this up, go take a shower, get dressed, then head up to work for a meeting with my Chair and the good folks who are covering for me during this saga. And then I will take my kids to gymnastics.

And wait.

And wait some more.

Best Laid Plans

I don't actually have words to describe what the last 24 hours have been like, but to make a long story short, after all my anticipation, nothing is happening tomorrow.

Apparently Dr. T hurt his eye and can't see out of it.

After a ridiculously hellish day today, and I do mean RIDICULOUSLY HELLISH, I've rescheduled the mastectomy to happen in town, with Dr. L, on September 1st. Supposedly the reconstruction is happening a week later, on September 8th. I won't hold my breath, though.

I'm still waiting to wake up from this bizarre dream.

3... 2... 1

So wow, it has been a while. I've been insanely busy and insanely stressed out, way too stressed out to form coherent enough thoughts to write in a public blog. And for the first time in a long time, I can't blame it on insomnia. Over the past 10 days, I've slept like a baby for at least five hours a night with either melatonin only, or nothing at all. Just because I feel like all hell is going to break loose this week, I feel like I should do a quick recap of what I've been up to since I last wrote.

• Last Tuesday, I wrapped up my five-day intensive human biology course. I think it went fine, but... after six years of teaching in higher ed, I've learned that you just never know. So... whatever. Part of my insane stress levels over the past week have been due to trying to coordinate with the colleague who is going to be covering the first six weeks of class for me. Let me just say that I'm fully prepared for really horrible evaluations this semester. 
• On Wednesday, I went to work in the morning, then went to get the CT scan that Dr. T had requested. (So I guess things are on? Seriously, I don't really know where we are right now, and it's a good thing I've been so busy, or I'm sure I'd be annoying Dr. T so much that he would be changing his mind about accepting me as a patient right about now.) Fortunately I didn't have to drive all the way to University Hospital, but was able to get the scan done at a UH clinic about 45 minutes away. I left plenty of time to arrive by 1:45 for my 2:00 appointment, though after driving around suburbia for 15 minutes, I actually ended up getting there right around 1:45. Fortunately, they were quite prompt, and the scan was fast - even with the IV and contrast dye and everything, I was back on the road by 2:15. Pretty impressive!
• I made it back into town in time to join my husband for a 3:00 appointment with a lawyer to talk about redoing our will, power of attorney, and getting an advance medical directive. That was actually a fairly depressing conversation, although the lawyers kept it light-hearted, which was a good thing. I mean, let's face it, this isn't a conversation anyone really wants to have, regardless of the circumstances, so I'm sure they are used to trying to maintain an appropriate mood. After the meeting, I raced off to pick my son up at daycare while my husband stayed to pay the bill. LOL. In case you are curious, the basic 'will package' is $1,200, which was much less than I feared after walking into the swanky office in the heart of downtown ( = expensive real estate). 
• On Thursday, I went into work, and FINALLY met face-to-face with the woman who is covering my class for me while I'm gone. See bullet point #1. I'll hold off on commenting further for now. I left around 2:15 to go pick my daughter up from school, then drive back up to get my son at the university daycare, and take both the kids to a make-up gymnastics lesson, because we missed Wednesday's lesson. We got home just in time to head off to a beginning-of-the-year department party downtown. It also happened to be the same night as the open house at my daughter's school. So, my husband went to the party for an hour, then left to go to the open house.
• On Friday, I went into work for a few hours, hoping to get my syllabus printed off, but didn't. See bullet point above and bullet point #1. I left at 11:15 to go get my hair chopped off. Almost seven inches!! I really wanted to grow it long enough to donate it to a wig cause, but I wanted it gone. I needed a change. I usually just get my hair cut at a cheapie place but figured I needed a 'real' hairdresser with references (LOL) if I were going to go from having hair halfway down my back to a total butch do. So I went to my mom's hairdresser, and invited her along. Afterward, she took me out to lunch, and we had a really nice time. I think she appreciated being a part of this small but yet rather big moment. I haven't had really short hair in about 15 years, and I'm absolutely positive I still wouldn't have really short hair if I weren't having a mastectomy on Wednesday. 
• After lunch, I raced back up to work, said 'fuck it,' typed some shit into my syllabus without the approval of my substitute teacher, and printed it off just in time to get my son at daycare before 4:30. 
• Saturday was my son's birthday, and I somehow managed to pull off the most last-minute party EVER (thank you Whole Foods!) at the swimming pool. Even low-key parties are a lot of work! But I'm glad I did it. My son turned four, and is starting to understand the concept of a birthday party. He had been requesting a Spider Man birthday cake for a very long time, and it would have been sad to have had a Spider Man cake with no party.
• Since the party was just as much for the adults in my son's life as it was for him, we had pear sangria at the party, which kind of ruined me for the rest of the day. LOL. I had enough to drink that I actually went off the diving board. Fortunately, I had not had enough to drink that I agreed to try the crazy shit all the other people who had also had a lot of sangria were telling me to do. But God was I sore last night... and today, too. 
• Today I cleaned, cleaned, cleaned, and cleaned. Our house is a disaster, and I just feel really unsettled going off for surgery and knowing I'm not going to be able to do much for, like, a month, with the house being such a train wreck. My mom actually came over and helped a lot by sorting through a huge pile of clothes that has been sitting on our dining room table for several weeks now. I guess it has been annoying her. LOL. One of my husband's colleagues gave us four trash bags full of hand-me-down clothes, for which we are absolutely grateful! Nonetheless, going through them is always a task, and one I just haven't found the time for, so my mom was a super help!
• Tomorrow... I have to teach. Even though I'm going to be gone after tomorrow, my colleague and I thought it best if I did the first day of class, seeing as how the classes are ultimately my classes. Plus, I want the students to know who I am when I return in October. I'd rather them think of my colleague as my substitute rather than me being her substitute. Plus, the first day of class is important, and... um... I trust myself more than I trust her. I haven't quite figured out what I'm going to tell my students tomorrow, but figure I have six hours of sleeplessness to figure it out. Ha. 

Somewhere in all of this, my daughter started 4th grade. I thank God she got the teacher she wanted and has some of her best buddies in her class with her. We had a little bit of a rough start centered around a few things that are ongoing issues, but things are going better now. I pray this surgery doesn't upset the apple cart so to speak.

On a final note, I wanted to share something that a colleague did for me that was super nice. She had mentioned to me that her teenage daughter loved kids and volunteered her to babysit for us if my husband and I wanted to go out for a nice dinner before my surgery. As it turns out, said daughter ended up watching our kids during the department party on Thursday night. I had originally planned for the kids to come with us, since it was supposedly a 'kid-friendly' party. However, after asking around, I discovered no one else was bringing their kids. So, my colleague said her daughter didn't want to go to the party, but would happily watch my kids for us at our house while we were all at the party. That seemed like a good arrangement, and we agreed to that as an alternative to us going out over the weekend. My colleague made it sound like she was volunteering her daughter and I didn't need to pay her, but I felt uncomfortable being a charity cause, especially given that I don't know her daughter. And while I was sure she was a lovely person, given that my colleague is a lovely person and thinks her daughter is a lovely person, I still found it hard to believe a 13-year-old would be psyched about this volunteer babysitting job. So I asked how much her daughter charged for babysitting, because I definitely wanted to pay her. My colleague said not to worry about it - then, as if she had read my mind, she said, 'Don't worry - she's getting paid - just not by you. I'm going to pay her.' So basically that was her gift to me - her daughter's babysitting services. I thought that was very sweet, and it was a novel concept for me. We really appreciated it, and I will definitely keep this type of gift in mind when my kids are old enough to babysit and I have a friend with young kids who has cancer. Wait... hopefully that won't happen. But still, you get the idea.

I continue to be uplifted by the love and support of the people around me. I've always known I have good people around me, but lately I've felt so many of my relationships have moved to a different level. I've been reveling in this love so much that it has actually taken my mind off of what brought us here in the first place. Regardless, I am thankful.

Let the Countdown Begin...

My son, who will be four this coming Saturday, was really into rockets at one point in his young life. He learned to count backwards before he learned to count forwards. In fact, come to think of it, I'm not sure he even knows how to count forward. We'll have to work on that before kindergarten. But we use countdowns all the time. Ten seconds until the shower gets turned off. Ten seconds until the video gets turned off. Ten seconds until Mommy gets really, really angry and puts you in time out. 10...9...8...7...6... 

I now realize I'm finally within 10 days of my mastectomy, and suddenly, it seems like time is flying. I can start a countdown. 9...8...7... Teaching this all-day, intensive class, which started last Wednesday and will end tomorrow has been an absolute blessing. It has been exhausting, for sure, and I've had a couple challenging students, but overall, I'm so, so glad that I am teaching this class. It made last week fly by, and I feel like this week will be over before I know it. Tomorrow is my last day of class, and my daughter's first day of fourth grade. Tomorrow will fly by. That brings me to Wednesday, which will be exactly one week pre-mastectomy. One week. That's easy. After waiting a month and a half, a week is a piece of cake. In fact, I've accomplished so little of what was on my original mastectomy bucket list, I'm sure I can fill up the week with no problem. I've always been a last-minute type of gal anyway.

It looks like things are a go as far as surgery. I mentioned that all my blood tests came back 'normal' from the clotting panel my PCP did on me, and so far they are all coming in normal from the tests Dr. AC ordered as well. Apparently I'm normal enough that my plastic surgeon finally ordered a pre-surgery CT scan to help him plan the surgery. Unfortunately, he is insistent that I do the scan up at UH, which is kind of annoying considering a CT scan is a CT scan, no? Whatever. These past 3.5 months have been so surreal I don't even question things anymore. I keep waiting to wake up from this bizarre dream, only apparently I'm not actually asleep. What is three more hours in traffic in the large scheme of I cannot believe this is happening to me things? And my appointment is for 2 PM on Wednesday, which will help Wednesday fly by, at which point I will return home and resume my countdown. 6...5...4...

Anyway, as a follow up to my post about one of my colleagues trying to arrange for department members to bring me and my family food post-mastectomy, I feel compelled to share the following story. Today was the official 'start date' for the new school year, and thus, our first department meeting of the year. The meeting was from 10-12, so I thought I might be able to make the last half hour or so, depending on when I let my students out for lunch break. According to my notes from previous years, I was done with the morning session by 11:30, but apparently old age really does make a person ramble more. LOL. I didn't finish until around noon, at which point I went up to my office, figuring the meeting was over. However, I noticed no one else was around, so I went back downstairs to catch the tail end of the meeting. I didn't sneak in or anything; I opened the door, walked in, dragged a chair across the room, and plopped down between two of my colleagues, and started whispering about what I had missed (obviously a lot, lol, since the meeting was from 10-12 and I was walking in at 12:05). Everyone was sitting in a 'U' formation looking forward toward the Chair, and while I tried not to make a big scene when I came in, I'm pretty sure a lot of people saw me. Around 12:15, the Chair asked if anyone had anything to say about any department affairs, etc., etc., and Admiral raised his hand and said, 'Yes. Waning Moon is having surgery next week and I'm arranging to have the department bring her family meals...' At that point, I honestly JUST ABOUT DIED!! Like... it's not a secret. In fact, the only reason Admiral knows at all is because I've sent out a few FYI e-mails to the department letting them know what's going on. BUT STILL! I felt really uncomfortable having this all 'out there' like this. As I glanced around desperately, a few of my colleagues shot me sympathetic looks across the room, and I quickly grabbed one of my colleague's agendas and jokingly put it over my face. However, as Admiral continued on I jokingly bent over and pretended to hide under the table. Finally, the colleague who was sitting next to me was like, 'Um, she's sitting right here.' I didn't hear anything that happened after that because I pretty much thought I was dying of embarrassment. As it turns out, Admiral didn't realize I had walked into the room (his back was to mine) and was just as embarrassed when he realized I was there after all - for the last 15 minutes of the meeting. Oh boy. Hopefully I didn't offend him; it was honestly just a bit much considering our department is fairly large these days and part of the reason I went to the meeting is because there are three new faculty I haven't even met yet.

ANYWAY.

As the countdown begins, I think it's time for some prayers.

Blessings

• I continue to be so thankful for my friends. I've never been a person who has a lot of friends, and that's okay, because the friends I do have are Quality Friends. They are all helping me get me through this, each in their own way. I have a friend for every need - a friend I almost never mention the C word to; a friend who will indulge me with frivolous shopping; a friend who will bring drinks over and talk until midnight about anything and everything. I am so very grateful for that.
• I am thankful to be in such a better place with my parents than I was in mid-June.
• I am thankful for my supportive colleagues and work environment, even if it's embarrassing sometimes.
• I'm thankful that all my blood work is coming back normal and that I am a candidate for the reconstruction I want to have. 
• I'm thankful for my husband, who has been a rock throughout all of this.
• I'm thankful that I have been able to sleep for the past week.

Hopes

• I continue to pray for my surgeons; that they will not be distracted and will be at their absolute best when they are planning my surgery and operating on me.
• I pray for my children; that they will be okay throughout all of this. They know what is going on in that I am having surgery, but I don't know if they really get it. 
• I pray for my husband, for strength. I think in many ways this has been harder for him than it has for me, and I am sure that what lies ahead will be harder for him than for me - logistically, anyway. 
• I pray for everything to run smoothly for my family. I am the 'boss' of this family. I organize things; I tell everyone where they need to be and when. If I can't take care of the kids, I am the one who arranges their care. I'm the one who corresponds with my son's daycare and my daughter's school and makes sure she gets picked up from school. I pray all of this can continue to happen without me. 
• I pray I'm not making a mistake doing this reconstruction. I pray Dr. T is really the answer to my prayers and that I won't regret this.
• I pray my daughter has a good school year and hits her stride. Yes, this is unrelated, but while I'm praying, I just thought I'd throw that in there. My daughter causes me so much stress, knowing that she is going to be okay would really help in my healing.

In less than an hour, I'll be one week and one day away. While I am dreading this on so many levels I won't even begin to try to get into right now, I also want it to be over. I would say I want it over with so I can move on and 'be done,' but I realize there is no 'done' until I die of something completely unrelated to breast cancer. For the rest of my life, there won't be a 'done.' Nonetheless, I just want this done for done's sake. So let the countdown begin.

Blood Test Results

Today was a good day. Exhausting, but good. It actually feels good to feel exhausted because of physical exertion rather than emotional trauma. I taught the second day of my class and it went really well. I got much better vibes from the students than I got yesterday, when I had an I'm not sure how I feel about y'all feeling. I took a prescription strength naproxen last night and a meloxicam this morning for my poor, tired hips, and that definitely helped. I'm still in a world of pain, but it is much improved over yesterday.

I surreptitiously condensed the day's lessons and semi taught to the test (which is tomorrow) because I had an appointment with Dr. A, my PCP, at 4:00 to discuss the results of my blood tests, which I requested a few weeks ago when I felt that Dr. T wasn't moving quickly enough. It was the latest appointment they had, and I figured I just had to make it work. I figured no one was likely to complain about getting out early, but if they did, I would just tell them I had cancer and had a really important appointment to get to, and they would probably feel sorry for me. LOL. Bless the Cancer Card. Fortunately, going into my seventh year of teaching, my gut feeling was right: no one complained when we were finished by 3:30.

Apparently having the last appointment of the day means you get two providers for the price of one, as both Dr. A and his new NP met with me. He made small talk with me, then finally I couldn't stand it anymore, and asked him if he had test results for me. He did. And... they are all normal! This is a HUGE relief for me. Even though my results have been trickling in from my appointment with Dr. AC, it's good to have confidence that everything is going to be normal, and that this surgery CAN happen. I do have two proteins that are high, protein C and protein S, but apparently high is okay; it's low that is bad. I verified this with Dr. Google promptly after I got home, and it appears to be a true story. I feel so much better knowing this, and continue to remain hopeful.

Sort of out of the blue, Dr. A said, 'You can't lose anymore weight. You need it for healing.' He commented that I had lost a few pounds, which is not good. Argh. I'm trying soooo hard to keep my weight up and even gain weight, but I am so f-ing stressed I think I must burn a thousand calories just thinking about having a slab of my gut fat sliced out and stuck onto my chest. Add a thousand more if you Google pictures of this process. We talked briefly about the type of surgery I was having, and I mentioned that I was very nervous. Dr. A said, 'You know, you don't have to do it.' I said I knew, but implants freaked me out. He said, 'I know. You don't have to do those, either.' I said I knew, but having just one boob freaked me out. He said, 'I know.' LOL. Then he mentioned that his mother had had a double mastectomy without reconstruction at age 80. I said if I didn't do reconstruction, I'd be inclined to lean toward the double without recon, but that also freaked me out. So basically everything about this freaks me out.

Dr. A also asked me how my hip was doing, and I said terrible, as I had been teaching all day for the past two days. We talked a little about teaching and how amazing it is my students can pay attention for so long. I told him I had no idea how they did it, but they really do, even when I start to lose interest in myself, haha. He asked how sleep was going. I said terrible, and told him my Ambien zombie story, which he got a real kick out of, then he told me a few of his own. So he gave me a prescription for something else - temazepam. I'm going to try not taking it unless I'm in a dire situation - and I'm definitely not going to take it for the first time before I have to teach an all-day class. It's good to have another weapon in my ever-increasing arsenal, however. I've actually been sleeping better using just melatonin for the past week or so. I think it has to do with resolving some tension with my parents; I really didn't understand just how much they were stressing me out until they weren't anymore. Of course, better = about 4-5 hours of sleep, which is still not enough, but at least I'm not, like, crazy anymore. I mean, I am, just not sleep-deprived crazy. I was actually doing pretty well last night, sleeping very soundly from about 11 until 2, at which point I woke up with a horrid cramp in the weirdest spot - the side of my lower leg. Not the calf or shin - the side! It was so bad, my foot was all twisted so I couldn't really even walk it off. But, I actually managed to go to sleep after I dealt with it, and slept from about 3 until my alarm went off at 6.

All in all, it was a good day, and I feel like August 26th is finally a visible blip on the horizon. And so we continue to creep forward.

Square Meals

I chose the title of this post based on my memories of my dad telling me about the 'square meals' he had to eat while enrolled as a student at a military college. A 'square meal' involves picking up food with your fork, lifting it to the level of your mouth, then bringing it in a straight line to your mouth, although apparently Google isn't familiar with this term. A 'square meal' is just a substantial, nourishing meal. Either idea works, though.

I'm in a sort of tricky situation right now as far as work goes. I have a love/hate relationship with work, with not a lot in between. But even when it's pure love, my job is not something I could do for the rest of my life. Based on money alone, I just... couldn't. If I weren't married to someone who makes over three times as much as I do (literally), I couldn't keep this job and feel like a responsible parent. But this is a story for a different blog, one that I started a while ago, but just couldn't keep up with all my health drama.

There are many great aspects to my job, however. One of them is that for the most part, I really enjoy my colleagues. Even though most of them aren't actually friends, overall, I couldn't ask for a better group of people to be around every day. Also, everyone has been super supportive as I've gone through all this cancer crap. I honestly don't know how people with inflexible jobs and/or jerkwad bosses could do this. Anyways, I have a colleague who is... um... interesting. Honestly, he's sort of nuts. BUT, he's not a bad person. I really think his heart is in the right place. I just think he has a hard time fitting in because he is ex-military, and quintessentially so. He had a fairly high rank in the military, whereas in our job you are treated pretty crappily as an instructor (see paragraph above), and I'm sure that's hard to handle. (It's even hard for me, and I've never had a job with any sort of status.) We are not a military institution. Most of the people in my department are fairly to extremely liberal, with a disproportionate number of atheists. Some of the women occasionally dress like hipsters, wear hats, have piercings in places other than their ears, and tattoos in places other than the areola of a reconstructed breast.

But I digress. The other day, aforementioned colleague - we will call him Admiral, lol - came into my office, plopped down, and declared that he was on a mission. He informed me that he wanted to arrange for members of the department to bring food for my family after my mastectomy, and basically there was no saying no. Like he said, he was on a mission. And honestly, it is suuuuuuper nice of him. Like I said, he is not a bad person. After the past two surgeries, my book club friends were awesome about bringing me food, but this surgery and recovery is a different beast, so more people is not a bad thing. Plus, my book club friends do a lot of other things, like help watch the kids. Admiral informed me that he had already spoken to one of my colleagues, who is also a book club friend, and that he was going to include all the book club members in his e-mail for his sign-up sheet, and wondered if there was anyone else he should put on his list. Um, no. I'm not going to sic him on my friends like that, haha. He then whipped out a pen and paper, and proceeded to ask a zillion questions, military style. Husband's name? Husband's cell phone (so he can let him know who will be coming each day)? Is he a decent guy? He must be, you chose him. Where does he work? Will he be home a lot? Kids' names? Kids' ages? Food allergies? What do they like? What do I want them to eat? How much do they eat? What pets do I have and do they need care and food and what do they eat? Do we want the food in recyclable containers only? Do we want it warm or not? How well can my husband cook? Is he capable of following written directions if the food isn't totally ready? What time do we want it delivered? Where is the best place for the person to park who is bringing the food? How often do we want food - every day, every other day, Monday/Wednesday/Friday or Tuesday/Thursday/Saturday, and on and on and on.

OMG!! It was seriously comedic! I'm a little nervous about what the e-mail he is going to send out is going to be like. At least everyone in the department knows he is a little crazy, and that 'recyclable containers preferred' did NOT come from me, but I will have to warn my book club friends. (I said that yes, we do recycle, which in my mind doesn't translate into 'recyclable containers preferred.' LOL.) When he asked if there was anything I wanted my kids to eat, I said that I tried to feed them healthy food, but, you know... beggars can't be choosers. Plus, I'm pretty sure that everyone who is likely to bring us food is at least as health-conscious as we are. So... no special requests. His response to this was to pretend to write something on his notepad while saying, 'Gummy bears for dinner are completely acceptable.' Like I said, OMG!

It was like The Wolf in Pulp Fiction.

http://www.buzzquotes.com/wolf-quotes-from-pulp-fiction

I don't want to sound ungrateful. I really do appreciate it, and Admiral's heart is in the right place. I don't even really know him that well. I am not above accepting help at this point - it's honestly the only way we are getting through all of this, and I will pay it forward 100x over when I can. But... OMG. It's actually kind of funny, so I think at this point, all I can really do is laugh about it. Laugh and be grateful for what it is.

In other news:

• Today was the first day of my five-day intensive course. While it felt good to teach, and I feel like it went pretty well: a) gosh, I SUCKED (I haven't taught this course in a long time and it showed); and b) My HIPS! OMG, they. are. killing. me. :( It's horrible. I'm going to go up and lie in the bath after I finish this, but I'm really worried about making it through the next two days. I'm in a serious world of pain right now. Argh. 
• We are having our annual back-to-school department meeting on Monday. I'll be teaching, so I'll miss the meeting, but I read through the agenda anyway. One of the items on the agenda is to adopt department bylaws, which believe it or not, we've never had before. I read through the proposed bylaws and, without getting into specifics, some of them really irked me. Under different circumstances, they would make my blood boil, but... I don't have the energy to be angry. And I especially don't want to be angry when my department has been so good to me in so many ways. OTOH, we have a new Chair, so I feel like it is a good time to make some really positive changes. I've always been the one who has spoken my mind, not worried about pissing people off, and been an advocate for instructors. If I just let it go, it will be a missed opportunity. We've made so many good changes recently that I actually enjoy going to work again, and I feel like I mobilized the forces to make these changes happen. I'd like to continue in a good direction. But... I also don't know if I can take the stress of mobilizing the forces again, and the potential negativity of making waves with people who are being super amazingly supportive of me right now. I want to revel in my current LOVE. Sigh.
• My blood test results continue to trickle in, and so far so good. Nothing out of the normal range - aside from a few low values that have nothing to do with blood clotting (mean corpuscular hgb and mean platelet volume). I actually have an appointment with my PCP tomorrow to discuss the results of the duplicate blood draw I did way back when. Continued prayers and all that jazz. 
• Things are much better with my parents right now. Praises. 

And now, I am off to soak my poor, aching hips and try to prepare for class tomorrow better than today.

Meeting with the Hematologist

I went up to University Hospital today to meet with Dr. Anti-Coagulation, upon Dr. T's insistence. It was a pretty useless and uninformative consultation, and Dr. AC was sort of weird. He was weird in that way that my husband seems to love; in fact, he reminded me a lot of my PCP, Dr. A, who is also weird in a way that doesn't necessarily work for me, but that my husband loves. But at least he was not like OMG no way you can have this surgery! In fact, he seemed to think it was pretty stupid I was there, and that Dr. T was stupid for wanting me to be there. Overall, he was extremely snarky about pretty much everything and everyone, and seemed anxious to get home. That was actually good, because my appointment was at 4:00 and we had dinner reservations at 6:00, so it wouldn't have worked if he had been running late and had not been clearly anxious to get home. Traffic was really bad on the way up to UH, and it took us about an hour and 45 minutes to get there. We arrived around 3:55 and were called back so promptly I didn't have time to finish out the health questionnaire they gave me. I was trying to finish it during the pauses when Dr. AC was going through my records until he barked, 'Don't worry about that. I'm not going to read it!' LOL. There you go.

He did take a very thorough history, up to a point, and we talked about everything from my childhood nosebleeds to my tonsillectomy to my post-pregnancy bleeding to my recent DVT. We really didn't talk about cancer, though. I'm not sure if he was actually aware I have cancer. Seriously. Somehow we didn't really get that far, and I'm not sure how well he really read my history. I mentioned my two lumpectomies, but I'm not sure if he was listening. It is hard to describe his very quirky personality, but this illustrates it pretty well: In going through my history, he asked if I had ever had any bleeding problems during or after surgery or childbirth. I said no, though I did bleed a lot after my daughter was born, but that was because part of the placenta was stuck inside me. He replied, 'For real, or did someone just make that up?' I said no, for real. He said, 'Real as in you actually went into the operating room and had the placenta taken out?' I said yes, I definitely had surgery. Then he said, 'Okay, because you know, sometimes medical people just make things up.' HA! Then we got to the part about my hemoglobin E, and apparently somewhere along the line it got recorded as hemoglobin E/beta thalassemia. As he read it aloud, he looked at me, and I said, 'I do have hemoglobin E, but some medical person just made the beta thalassemia part up.' He thought that was hilarious. I told him it was so long ago that I was told I have hemoglobin E that I was starting to wonder if I had made it up, except I was pretty sure it was real because my son has it, too. That much I remember. In the end, he said having thalassemia wouldn't be out of the question, as it's a very common mutation, and, 'Since you're here, we'll run a test for you to be sure it's made up.'

He said he would run a number of tests on me, but they likely wouldn't be very helpful. He said that approximately 1 in 20 people have some sort of factor that makes them 'more likely' to develop blood clots, but that 1 in 20 people don't, in fact, develop blood clots. So whatever. Then he added, 'And besides, I don't know if you've seen these e-mails between me and your surgeon, but I asked her [sic] what she would do if you did have an elevated chance of a blood clot.' Which is exactly what I've been trying to get at! I mean, that's the important part, right? So I asked what Dr. T had said, and he read the response to me verbatim, 'I just want to be sure she doesn't develop another blood clot during surgery.' Then he rolled his eyes and made a comment about how this was such a typical wishy-washy doctor response. So he had replied to the e-mail, 'Yes, but what are you going to do?' And Dr. T had replied that he would do a 'less invasive' surgery. Which is exactly what I've been worried about! And exactly what he will not admit to me! Which is exactly what has been keeping me up all night, tossing and turning and wondering if I'm being wined and dined and if, after all of this, I will wake up with an implant on August 26th! ARGH! So I guess Dr. AC is at least sort of advocating for me, even if in a really bizarre and roundabout way. Like... what exactly does Dr. T want to hear? And what will he do if he doesn't hear what he wants to hear?

Eventually Dr. AC said he didn't see a reason to think I had a substantial risk above the usual risk, and hopefully all the blood tests would come back normal, in which case he would be fine recommending a low dose of prophylactic anticoagulant post-surgery. I asked him what his recommendation would be if the results weren't normal, and he shrugged and said he didn't really know. He said I could possibly do the surgery and be on a high dose of anticoagulant post-surgery, but that plastic surgeons were always worried about hemorrhaging 'messing up their work.' I said I didn't think I was as worried about thrombosis as Dr. T. I mentioned that he had read some obscure study about how people with hemoglobin E who had had their spleens removed were at higher risk for blood clots, which is why he was so worried. I said I had looked up the study, and the reason the people had their spleens removed was because they had hemoglobin E plus another mutation. Dr. AC snarkily congratulated Dr. T for reading journal articles - impressive for a plastic surgeon. LOL. He said spleens were, in fact, very important as far as blood clot formation goes, but my spleen was intact, so it wasn't really an issue. Which is exactly what I think!

Then he asked me, 'Since you've obviously read up on this and thought about it a lot, what worries you more? Hemorrhaging or thrombosis?' LOL. I said neither sounded great to me. I said I wasn't super worried about thrombosis because everyone seemed confident that my DVT was a result of my hip surgery and not a clotting disorder. He interrupted me to ask who 'everyone' was. Oncologists, I said. 'Oncologists?' he scoffed. 'What do they know?'

Did I mention that he IS an oncologist? I mean, it seems that almost all medical oncologists are board certified in oncology and hematology, but most are oncologists above all, and only hematologists insofar as it allows them to treat leukemia patients. Dr. AC is obviously a hematologist first, oncologist second, but it was still one of those comments that leaves you scratching your head. I said I didn't want to have to choose between hemorrhaging and thrombosis, and started to say, 'Isn't that why you make $400/hour?' but then changed my mind and said, 'Isn't that why I'm paying you? So you will tell me your opinion?' He laughed and said, 'Don't you know? The modern medical model is not that we tell people what to do; we collaborate with patients and give them information.' I don't like that model, I said. I'm tired of making decisions. I am old school.

So he said the potential clot formation would worry him more than the hemorrhage. 'I mean, you're not going to bleed out.' Then he said, 'What's the worst thing that could happen? You might have to have a mastectomy.' Huh? Newsflash - that's already happening. IS IT ME, OR IS EVERYONE AROUND ME CRAZY?! Finally I said I was fine taking an anticoagulant after the surgery, especially if that would make Dr. T feel better. Then my husband interjected, 'Yeah, I don't want his hands shaking when he's trying to reattach all those blood vessels.' LOL.

In the end, Dr. AC said, 'Now that I've been completely unhelpful, is there anything else you want to ask me?' So my husband jokingly said, 'Yeah, what's the traffic going to be like on the way home?' Then we made small talk for a few minutes. Earlier he had asked me about my job - noting that I taught at ABC College, and asking me what I taught. So then he asked me where I went to college and grad school. I said I went to college on the east coast and grad school on the west coast. I usually don't bother with the specific names of the schools because most people here haven't heard of them. But then he asked me, 'Do the schools have names?' HA! So I told him, and it was obvious he was familiar with them because he replied, 'So which one did you like better? Do you like cold weather with an air of elitist or warm and laid back?' I told him I was a definitely a cold and elitist person, much more than warm and laid back. He thought that was funny. Then my husband declared he was a proud graduate of a warm and laid back school, and somehow we started to talk about swimming and diving, and he and my husband started gossiping about some former executive director of USA Swimming.

I can't figure out if I loved the guy or if I think he is absolutely crazy cakes. Maybe a little of both. Either way, it doesn't matter, because I won't be seeing him again, I hope. So whatever. He definitely seemed willing to try to help me make the surgery a go, so that helps put my mind at ease. Like, he's definitely not in cahoots with Dr. T or anything. Overall, he seemed very reasonable, even if a little nuts.

The whole appointment took about 45 minutes. Afterward, he walked us to the blood draw lab and I sat there until 5:00 waiting to have blood taken. The phlebotomist was having a hard time getting blood from the woman ahead of me, and by the time she got to me, the cleaning lady was in the lab. Fortunately, I have good veins and the draw was fast. I probably should have said that I had already had some blood drawn by my PCP, only I wasn't sure exactly what tests either doctor had ordered, and I wanted to make sure that EVERYTHING that needs to get done by August 26th gets done, and figured duplications are better than leaving something out. Hopefully my insurance will pay for duplicate tests.

When we left, the clinic was shut down and everyone was gone. See? I was right. They were anxious to get us in and out. We left shortly after 5:00 and went and had a really nice but really insanely expensive dinner. (Thank you to my mom, who volunteered that we should have a nice dinner on our way home. Go mom!) When we got home, it was around 8:30, and we could hear my mom with the kids upstairs. We decided it would be easier if we just let her finish putting them to bed, so I came into the office to check my e-mail. Apparently the lab is open later than 5:00 because I had two test results back already! And the results make me very hopeful. The first result was just a standard CBC (complete blood count), but the second was a test for antithrombin III activity. Since antithrombin III inhibits coagulation, I should be worried about having a deficiency. Only I don't. Apparently the normal range is 72.0 - 125.0 U/dL and I was 91.0 U/dL, which I feel is safely smack dab in the middle of normal. Go me.

And so I continue to pray that this can happen and happen well.

Ah, to be young again...

I turned 40 on November 9th of last year, 2014. Although I occasionally get nostalgic about my younger years, I'm mostly happily settled into 'middle age.' I have an awesome family with two kids (I always wanted two, but the second one was never a given), a good financial situation, a good job (despite my complaints), and a really lovely group of friends. A lot of my friends, most of whom have kids the same age as my daughter (who is going into 4th grade), are older than I am, and have said that the 40s are their favorite decade so far. I can feel that. I love life. The 40s are good.

Minus the cancer.

And come to think of it, even with the cancer, I still have an awesome family with two kids, a good financial situation, a good job, and a really lovely group of friends. So the 40s are good. I just hope I live long enough to compare the 40s to the 50s and the 60s and the 70s and the 80s.

So you think I'm being morbid and melodramatic, do you? Well, not so much it turns out.

2014 was filled with a lot of stress over my hip situation. I felt like 39 was too young to be having such severe hip pain, and that I could not live with the pain for the rest of my life. So I had hip surgery, which led to DVT. Hobbling around and taking Xarelto definitely makes you feel older than 39 or 40. These are an old person's problems. I wanted to feel young, or at least 40 years old, and not 70.

Now I have cancer. Talk about an old person's problem. In Cancer Land, I am young. In some studies, I even qualify as Very Young. All three oncologists I saw mentioned this, but I never fully got it. After all, I am not Very Young! I am middle-aged, and happily so!

But now... I understand. It all started with a discussion on breastcancer.org centered around a 31-year-old reporting that her oncologist had told her she needed to double her risk factor because of her age, and her age alone. She recommended chemo despite the fact that that this woman is early stage with a non-aggressive, hormone-positive breast cancer. Some people were disbelieving of age as an independent factor in risk, and indeed, there is a school of thought that the only reason young people with breast cancer have a worse prognosis than old people with breast cancer is because young patients tend to find the cancer themselves ( = larger tumors and later stage) and the incidences of triple negative cancer ( = harder to treat) are higher. But there is also a school of thought that the cancer itself is different when you are younger; it is more aggressive for reasons we don't yet understand. Age by itself is an independent prognostic factor for risk of recurrence and metastasis. All of the oncologists I saw seemed to belong to this school and told me I needed to add 'one degree of severity' to my diagnosis because of my age. I kind of shrugged it off at the time, reveling in my relief that I was early stage with a treatable type of cancer.

Of course I reacted to this conversation in typical science-y fashion by doing a PubMed search. And apparently, you can argue it both ways. There are studies to support both schools of thought. But the data that support the idea that age alone is a risk factor are fairly depressing. Those 90% cure rates you hear about? Not applicable to younger people. And even at 40, I am considered 'young' in all studies, and even 'very young' in others. I'm still picking through piles of articles, and there are loads of complicating factors in all of this, but I now understand the full gravity of what oncologists have been telling me. Cancer at 40 is different than cancer at 60, for whatever reason. I may want to consider being more aggressive. I didn't really pay attention to this because it was too hard for me to wrap my mind around having my ovaries taken out, and according to stats, I should have around a 10% chance of recurrence without putting myself through that hell. But those are stats based on old ladies, who often die of something else before the cancer comes back or at least before it comes back enough to kill them. People try to tell me that data lie, and you can interpret data however you want to come to the conclusion you want to see, but this goes against everything I believe as a scientist. Data are data. Data give us live-saving treatments. Even if the data are not conclusive, they are at the very least eye-opening. And trust me, my eyes are now wide fucking open. And they don't like what they see.

It just goes to show that you should be careful what you wish for. I wanted to feel young again, and boy, do I ever.

News Round-Up

Some random news bits, in no particular order:

• I slept for about two hours last night, so I am feeling HORRIBLE and CRANKY and exhausted to the point of nausea. (Does anyone else get nauseous when they are exhausted?) Ever since my utterly humiliating middle-of-the-night e-mail to Dr. T, I've become super paranoid about Ambien, and it's not even working very well, so I decided to try not taking it when I don't have anything of huge consequence the next day. Last night was the beginning of this little experiment. Instead of Ambien, I took a melatonin + Belsomra, and it did nothing. I went to bed by 10:30 and tossed and turned and scratched until 4:30 AM. 4:30 AM. I caught a few hours of dozing time in approximately half-hour increments between 4:30 and 7:00. But man. This has to stop. I can't even nap anymore. I keep thinking I have to reach a point of exhaustion where I just crash, but that doesn't happen. After dropping my son off at day care and my daughter off at gymnastics camp, I went up to work and mostly just sat there and stared at the computer until 12:55. Then I went to pick my daughter up and took her out to lunch, and almost fell asleep during lunch. But when we got home, I tried to take a nap and I couldn't. I repeat: This has to stop. Maybe tonight I will try melatonin + Benadryl.
• Preparing for the upcoming semester has been a good distraction, but also extremely annoying. One of my colleagues is covering the first six weeks of two of my classes for me, so I need to coordinate with her. Unfortunately, she is a new hire and is not being very responsive to any of my correspondence, which is extremely nerve-wracking. Technically, new faculty are not actual employees until August 17th, which is ridiculous, because that's a week before classes start, but basically there is nothing that anyone can do to force her to respond. I keep telling myself that if this isn't resolved before I go for surgery, it's not problem, only... it is.
• Something that has been in the back of my mind is the results of the PET scan I had done way back when. When I saw the first medical oncologist, Dr. U, she suggested that my uterus was of concern and that I needed a pelvic ultrasound. No doctor since then has brought this up, so I conveniently forgot about it - only I didn't really. I meant to ask Dr. L about it at my last visit with her, but then I ended up bawling the whole time and never did. I'm not sure if this is something that has just gotten overlooked or if it's something that isn't of real concern. Dr. U did say that it could just be my period, but that we would need to know for sure. I was supposed to schedule an ultrasound when I went back to see her, but I never went back to see her. So... I e-mailed Dr. L about it, asking her if she thought this was necessary, and if so, who did this sort of thing. If it was an OB/GYN, could she recommend an OB/GYN who could deal with cancer AND OB/GYN stuff? Regardless, I feel like I need a good OB/GYN about now, especially since I'll be messing with my hormones very soon, increasing my chances of uterine cancer, killing off my girl parts one by one, etc. And while I love Dr. M, I'm not psyched about him looking up my katonga, if he even does that sort of thing. I figured Dr. L is a female doctor with kids, so she must have an OB/GYN she likes. Of course I didn't ask her who she sees, just for a recommendation. She wrote me the sweetest response, which I would share, but it was actually fairly personal, so I feel like it would be some sort of violation of something. Like... choosing to blab all of my own personal information here is one thing, but sharing others' is another. At any rate, she did say that in her opinion, the results of the PET were very consistent with me just having my period, but that I should bring it up with Dr. M. She said I definitely needed a good OB/GYN and gave me her recommendation. So that's that.
• My husband and I spent about two hours each yesterday dealing with a bill that we never got (and therefore never paid) that was supposedly going to a collection agency. There is some ridiculous story involving our insurance that I won't go into, but all this freaking ado over a bill for, like, $30. And apparently the same thing happened last year with the same folks, and the bill did go to collections, so my credit is pretty much f-ed up over a $16 bill from last May that I never got and therefore never paid. WTF?
• Because we don't have enough to deal with, my husband managed to tear his meniscus in his sleep. Okay, so it's doubtful he actually did it in his sleep, but he literally just woke up one morning, about a month ago, and said his knee hurt. I pretty much ignored him like I usually do, because I'm a self-centered bitch, and he has been known to whine excessively on occasion. Only it kept hurting, like a lot, and I figured it was pretty bad around the time he stopped showing off all his fancy dives at the swim club. Eventually he went to see an orthopedist - actually the same orthopedist who told me I needed PAO surgery - and what do you know, he's not faking it. Great, just great. 

So in conclusion, in case you couldn't tell, I am suuuuuuper cranky pretty much all the time right about now, even worse than normal, and trust me, that is saying a lot. I'm hoping that my appointment with Dr. Awesome Anticoagulation Hematologist puts my mind back at ease and helps allay some of this horrible anxiety so I can stop being such a jerk, or at least stop seeing everyone else as a stupid jerk. LOL. In the meantime, if I could just get some sleep, that would be seriously awesome.

Ambien Zombie

I feel like I sort of left things hanging with the post before the last one, so I should at least write a follow-up to that. While I was driving my daughter home from gymnastics camp just a few minutes ago, I was thinking of when we moved here six years ago, and were going through a very worrisome time due to her significant developmental delays. For the first three years of her life, we took numerous trips to various specialists, including a pediatric cardiologist. (Talk about a depressing waiting room.) A while ago, I was trying to recall the specific details of those visits, so of course I consulted my blog. Nothing. Nothing except a vague reference to the fact that I had gone to the pediatric cardiologist and didn't feel like writing about it. At the time, I suppose I figured I would rally and write about it eventually, but I never did. Now I regret that. I want that time back. I want the details; I want to remember exactly what I was feeling at the time, other than distraught. So I shall sally forth and try to write down as many details as I can now, because someday I will want them.

To make a long story short: It looks as if the surgery I discussed with Dr. T on 7/15 is a go. I am planning on it, with cautious optimism.

To make a short story long: Remember how I have not been able to sleep? How I went to see my PCP to get a prescription for Ambien? Well, apparently my anxiety levels are so high that even Ambien doesn't do the trick. It definitely helps, but even with a melatonin + Ambien cocktail + scarf over my eyes + earplugs, I'm lucky to get five hours of uninterrupted sleep. And once I wake up from whatever sleep the aforementioned give me, it's all over. There is no going back to sleep for any significant amount of time - just dozing for maybe half an hour at a time or so.

One night last week, I woke up around 1 AM sweating and itching and was convinced I was experiencing early onset menopause, but that's a different story. The next night, I didn't want to mess around, so I drank a huge glass of wine with my Ambien and fell asleep while watching Harry Potter with my kids. I remember waking up at the end to go to the bathroom and help my husband get the kids to bed, going to sleep, and waking up with a horrible Ambien + wine hangover. I staggered into the office to check my e-mail before the kids got up. I had an e-mail from Dr. T. It said:

Waning,

I am confident that we can make the surgery happen. I am a very safe surgeon and do a very thorough preoperative evaluation. I want to make certain that we do this for you without causing any problems and I definitely don't want you to have another blood clot.

Rest assured. 

Ty Tahm, MD

Confused, I scrolled down. To my horror, I discovered that somehow, in the middle of the night, I had sent him a horrible, panicky, anxiety-filled e-mail that is so embarrassing I can't even paste its contents here. I pretty much told him if he was going to back out on me, to tell me now. I needed to know.

Holy shit.

I promptly Googled 'side effects of Ambien' and came across this article, which made me feel a little better. So Ambien really can make you do crazy shit, apparently. At least I didn't kill anyone, just HUMILIATED myself. Although, oddly enough, my e-mail was extremely coherent. Everything I said was certainly what was on my mind, it just needed editing to not be so overbearingly forward and presumptuous. I even told Dr. T about all the reading I had been doing on PubMed about hemoglobin E, including: There do not seem to be any clinical issues being heterozygous E or even homozygous EE, unless in combination with another mutation. The concern you spoke to me about was with patients whose spleens had been removed, but in reading through the literature, it seems those patients had splenomegaly because they had hbE + another abnormal hemoglobin.

OMGIWANTTODIIIIIIIEEEEEEEEE!!!

I didn't even know splenomegaly was in my vocabulary. Apparently it's a real thing, though. See? http://www.mayoclinic.org/diseases-conditions/enlarged-spleen/basics/definition/con-20029324

Let me just repeat: OMGIWANTTODIIIIIIIEEEEEEEEE!!!

I replied:

Dr. Tahm,

Thank you for the reassurance. I appreciate your thoroughness. I am always trying to prepare myself for the worst case scenario (and there have been several over the past two months). And sorry for the panicky e-mail... I have been taking Ambien so I can sleep after two months of not really sleeping, and apparently it makes me write middle-of-the-night crazy e-mails. Yikes.  

If there were a sheepish emoticon, I would have added that, but honestly, what else can you do?

But, when all is said and done, the reassurance is good. I just pray the next time I see Dr. T, I'll be unconscious already. So I guess I should change that to: I just pray the next time Dr. T sees me, I'll be unconscious already.

Can this nightmare be over already?! Oh wait, you have to sleep to have nightmares. This is real. This. is. real. Unbelievably, horribly real.

Why do I write here?

It has been a while since I've written anything. Part of that is because I don't have a lot to report, and the other part is that I don't know what to write. Which is weird. If you know me, you know my fingers are rarely at a loss for words.

Writing has always been a huge part of my life. I've kept a journal since, like, forever ago. I've always seen blogging, along with various other Internet ventures, as a natural, 21st-century extension of my journaling. Writing in my diary as an angst-filled fifth grader in 1985 helped to relieve anxiety, and blogging 20 years later in 2005 served that same purpose. Somewhere along the road, I realized that blogging is different than writing in a journal, if there are people who actually want to read your innermost thoughts about how stupid it is that your boss hates yellow so much that you can't even use standard Post-It notes at work. And apparently there are. And I have no regrets about this whatsoever, because I've met some really cool people along the way, people I've never met in real life, but whom I consider to be very, very good friends. People who probably know me way better than 90% of the people I see on a daily basis, people who cared about me long before I spent four months on bed rest, before I developed debilitating hip pain, before I had cancer. But still, knowing that people are reading what you are writing changes the nature of the writing.

Thus, I suddenly find blogging here to be somewhat difficult. I originally started to write here because I was bored, and because, being an avid blog reader, I had read a number of other blogs that were useful to me as I dealt with excruciating hip pain at a relatively young age. As I deal with cancer, also at a relatively young age, I find reading blogs to be even more important. And I've read a lot of blogs lately, perhaps too many. In the world of cancer, or even just Unfortunate Medical Conditions, there seem to be two types of blogs: those written to inform others of their status, and those written as therapy. But it is an ironic situation: it is the raw emotion of the latter that draws me in, the blogs that are written as if there is no expectation that anyone is actually reading them. Information about side effects, risks, recovery time, and other logistics is easy to come by, but knowing you aren't alone in being unable to express your grief over losing a breast is why I read.

And it is also why I write - to get all of the things out of me that I don't tell people in a normal conversation. To foster this part of me that is for the most part not visible in my everyday interactions. Most of all, I write for myself, either as therapy, or so I can have a record of my experiences. I write to inform, but mostly to inform myself. Even reading back through what I wrote a few months ago is like reading something written by another person; I only know I was at a particular place at a particular time in a particular state of mind because I know those words came from me.

But yet... here you are, reading this. It would be a lie for me to say writing this is all about me. I'm writing this for you, too. There are a handful of you who only know this side of me (my 'Internet friends'), there are a handful of you who know or at least knew me in real life, who want a little more detail than I share on Facebook, and then there are a handful of random folks from all over the world, at least according to Blogger stats. I have no idea why you are here, or if you are here to stay, or what. And so I find myself at a loss for words. Will you tire of my self-absorption and self-pity? Will sharing what I'm really thinking make you see me differently, lose respect for me? Will you get bored if I share the minutia of my e-mail interactions with my doctors? There is so much to write, and yet nothing at all.

So while I contemplate what I'm doing here and what I should write about next, I'll finish with a story.

A few evenings ago, I went to the grocery store. I saw a man get out of a taxi cab with a suitcase and stagger halfway across the parking lot. He was in my way, and many others' ways, only he didn't seem to care too much. He didn't seem to know what he was doing or where he was going. He didn't seem drunk, though, just dazed - as if he himself couldn't believe he had come to be the center of this parking lot spectacle, yet resigned to the fact that he was. It was quite a sight. People drove around him with puzzled looks on their faces, ultimately deciding to pretend he wasn't there. He eventually made his way across the parking lot and sat down on the cement base around a light pole, rubbing his eyes. After a few minutes the cab that he came in left. It made me want to cry. Then again, a lot of things make me want to cry these days.

When I was a kid, probably about 10, I read a Dear Abby column that has had a lasting impact on me. Someone had written a letter complaining about the fact that the woman in front of her at the grocery store was using food stamps, but had on a diamond ring, then went and got into a fancy car. Abby's response was to try not to be angry, because we have no idea what circumstances led to this woman needing food stamps, then rattled off a couple of possibilities. I don't remember the exact details, but it was something like this: Maybe she was newly divorced and waiting for alimony. Maybe she didn't want to sell the ring because it was a family heirloom. Maybe the diamonds weren't even real. Maybe she couldn't sell the car because she owed more on it than it was worth. Maybe she borrowed the car from a friend. Maybe her husband just died, and parting with the ring would be too much. The point is there are practically endless scenarios. To this day, whenever I feel myself getting super judge-y - and trust me, it happens a lot - I think, what would Dear Abby say? and try to make up a story to justify the actions of the person I'm judging. Maybe she's having a really bad day because she just found out she has breast cancer.

I do this a lot, make up stories about other people. I'm not a naturally compassionate or empathetic person, so the stories help me. I could think up a zillion stories that might lead this poor, disoriented man to his current state, and knew I wanted to do something for him. I would have given him some money, but I didn't have much cash, and thought Hey, here's $2, go buy yourself half of a latte at Starbucks wouldn't exactly be helpful. I figured he would eventually make his way into the store, where I could offer to pay for his food for him if I had the chance, or... something. But when I came out of the store, he was still sitting in the same place, looking a number of different things, but most of all, tired. People continued walking past him as if he were not there. Are we really so desensitized to others' suffering that we don't notice? Or do we not know what to say or do, so we say and do nothing? I'm certainly guilty of the latter. It's like that teenage girl who survived the plane crash in Washington, then spent two days hiking through rugged terrain to get to the highway. Once she got to the highway, she tried to flag down cars, but no one would stop. I imagine she was quite a sight - burned, dehydrated, dirty, traumatized, hysterical. I probably wouldn't have stopped either. Only after reading about it on CNN would I have realized, Holy shit, I drove right past that girl and did nothing.

Eventually, I built up some courage and drove up next to this man and asked him if he needed help. He didn't say anything, but his eyes grew wide, as if he couldn't believe someone was talking to him. And let's be honest, what can someone like me really do to help him? We both sat there stupidly, staring at each other. I had gotten cash in the grocery store, so I asked, 'Can I give you this?' and held out a $20 bill. He gave me a huge smile, and while accepting the bill declared, 'God bless you!' I wish I could have done more, but not being trained in social work, I slunk away awkwardly while he smiled and held a thumbs up and bowed in thanks to me as I drove off.

Other than my cancer-induced, sleep-deprived super emo state, I'm not sure why I felt such a connection with this guy. I see panhandlers every day, and live in a neighborhood where homeless and other types of desperate people roam the alley and go through my trash and recycling on a daily basis. But then I read this post on one of my favorite cancer blogs, and it became clearer to me. We all suffer for various reasons, and we all deal with our suffering in different ways. For those of us who tend not to be outwardly emotional, it is hard to let people know that absence of tears does not mean absence of grief. We don't want our grieving to become invisible, yet we don't know how to share it with others, and we dare not, because we know others aren't equipped to handle it. We do not want to burden ourselves knowing that we have burdened others with something they don't know how to react to; we don't want to make those we care about feel bad that they cannot help us.

I had no idea how to help this man in the parking lot, and was scared to try, but I could not let his grief become invisible. Who knows what this man's story is? Maybe he was once a typical man with a job and a house in the suburbs and a wife and kids. Maybe he lost all of his money in a financial scandal, then drank himself into oblivion, only to wake up on the streets to find out his wife had taken the kids away and he wasn't allowed to contact them. Or maybe he lost a kid in a horrific accident and it made him crazy. Maybe someone he loved very much died a painful death from a terrible disease and he saw no reason to keep living afterward, only didn't have it within himself to end his own life. Maybe he once read the same Dear Abby column that I did when I was a kid, while he was reading the paper over his morning coffee before heading off to his job. Maybe as I trying to get away as quickly as possible after giving him money, without looking him in the eye, he was thinking to himself, Maybe that woman is feeling generous today because she, too, is grieving in her own way.