The Last Thanksgiving Lunch

When you check the stats on your almost-abandoned blog, and realize that most of the referring URLs are out-of-country sites that McAfee doesn't approve of, it is probably a sign that you should give it up. But. I don't think I was ever writing this for anyone but myself anyway. I mean, I was and I wasn't. I was writing it for myself with the hope that what I had to say might someday help someone in a similar situation, the same way that I found solace in other people's blogs that I suspect were also written mainly for themselves. So here I am. If you came here looking for pictures of Big Tits, I'm not going to apologize for letting you down.

And besides, I am on a Facebook hiatus following the aftermath of the U.S. Presidential Election. I just couldn't take it, even the stuff I agreed with. I'm now mostly Facebook free, and loving it. The only problem is that I have way too much time on my hands. OMG WHAT CAN I POSSIBLY DO ONCE I HAVE ANSWERED ALL MY E-MAILS?! Hence this post.

Believe me, I've been wanting to write. It's just that my life was very complicated for a while, and there's no way I could have explained everything that was going on, and there's no way anyone would have wanted to listen to it anyway. Now my life is calm again. I can breathe. I'm happier than I have been in a long, long time.

I've been working with my daughter on summarizing events in a brief and concise way, so that I can ask her about a movie or a book without having to listen to an excruciatingly long play-by-play recap of the entire story. I usually ask her to tell me about the book in one sentence, and after she fails, I give her a few more. Five, max. By the end of five (very long, run-on) sentences, I usually have a pretty good sense of what's going on, so that's what I'll try to do here. So:

1. I've mentioned in previous posts that I've been working on a career change.
2. That career change was applying to PA (physician assistant) school. 
3. After 16 years of working toward this goal, including three years in graduate school in biology, followed by nine years teaching biology at a university level, I finally got it together enough to apply. 
4. I came really close, but in the end, I didn't get in. 
5. I thought I would be devastated by not getting in, and although I was/am sad, I am also extremely relieved. 

There are many reasons for me to NOT go to PA school, including things like I have young children and I'd basically have to be away from them for three years, I have a husband, I have a life (a GOOD life!), I have job (what many would consider a GOOD job), I'm 42 years old (and a less energetic 40-something than I used to be after my whole cancer ordeal), PA school is expensive, and I'm not exactly made of money, and... and... and... In contrast, there's really only one reason for me to go to PA school, and that is that I think I'd really like being a PA - and I think I would be a really good one. When I lay it out like this, part of me wants to scream at myself, WHAT IN GOD'S NAME WERE YOU THINKING?! And the answer is very simple: I have no idea what I was thinking. And I think when I got up to the interview, and suddenly my fantasy world became very real, I panicked a little, and thought, OMFG WHAT WAS I THINKING?! I do NOT belong here! 

I've had a while to reflect on this whole experience, and I'm still not quite sure what I think. On a practical level, I feel mostly relief. I only applied to one PA school, because there is only one program that is even close to do-able for me at this point in time. And even so, it was going to be tough. I would have had to spend weekdays away from my family, in a different city, for 2-3 years, AND they probably would have had to move into a different house because without my income AND trying to pay for PA school, we really couldn't afford our house, AND we'd need more money for babysitters and summer care for the kids, and... and.... and...

Most of my sadness comes not from not getting in, but from a feeling of personal failure. I knew that applying to only one school was an extremely long shot, because PA schools are extremely competitive. In a way I think it might have been easier if I had just been flat-out rejected, rather than making it to the interview stage and then being rejected. According to the PA program I applied to, they got over 1,700 applications, and 144 people got an interview. From those 144 interviewees, they choose a class of 44. So... not being chosen in the original phase is understandable, but making it past that first stage and then not being chosen... that just seems more personal. Especially for someone like me, whose strength should supposedly be in interviewing.

The other hard part is that Dr. T and his PA, Pamela, were sooooo supportive of my exploit, I almost feel... embarrassed? I shadowed Pamela and Dr. T for hours and hours and got to see some super amazing things that I will never regret being able to see, even if I never become a medical professional. Pamela used to be an interviewer for the PA program she attended, and really tried to help me prepare for the interview. So on top of feeling that I have let myself down, I feel that I have let so many other people down as well. That is a hard feeling to swallow.

Ultimately, I think it's a good thing I didn't get in. I definitely had my doubts, but if I had gotten in, I would have gone. (I mean, who would NOT accept a spot in a program with a 2.5% acceptance rate?!) And I'm not convinced going would have been a good thing. I think, more than anything, that I needed the possibility for change. I needed to dream, to imagine a different future. For many years, this possibility of a different future kept me going, kept me from being stagnant, able to work toward something new, something exciting. Now that that possibility isn't there, I've realized that just because I didn't get into PA school doesn't mean I have to be stagnant, that I can't work toward new and exciting things, even if those things aren't what I once imagined they might be. And, of course, I could always reapply.

My daughter has been struggling a little academically, which has been part of my hesitation about committing to something as time-consuming as PA school. Even reading, which has always been a strong point for her, is difficult now that she is in fifth grade, and the expectations are much higher. She is supposed to be reading a book a week, but has been having trouble finding books that keep her interest. At our recent parent-teacher conference, her teacher said she had tried to get her to read Jennifer Murdley's Toad, a book she felt all her girls (and boys!) should read. I haven't read the book, but according to my daughter's teacher, it is a modern-day fairy tale about a girl who wants to be prettier, and has the opportunity to be prettier, but then realizes that the sacrifices she would have to make to be prettier aren't worth it, and ultimately realizes that she is happy the way she is.

In other words, it's my life, in a nutshell.

Not that I want to be prettier, but I want to be better in a lot of ways. (And, of course, I wouldn't mind being prettier, but it's not at the top of my wish list.)

I've never been a great mom, despite my best efforts, and I always assumed that my kids were better off spending their time with someone other than me. Maybe that's just a fancy way of saying I've felt minimal guilt in being a professional, working mom while rearing young children at the same time. However, something interesting happened yesterday. I dropped my daughter off at school, and as we were waiting for the bell to ring, I was standing around talking to some other moms. As we were talking, the son of one of the moms came up and whispered something quietly into his mom's ear. Eventually she said to him, 'Oh, okay, you want me to come have lunch with you today? I'll be there.' And I was reminded, at that point, that it was the Thursday before Thanksgiving, the Thursday when parents are invited to have a turkey lunch with their kids. My daughter had asked me to go, a few weeks ago when we were going over the school lunch menu, and I was non-committal about it, telling her, I'll make it if I can. She hadn't mentioned it since then, so I figured I was getting away with not going. And then the bell rang, so even if she had remembered that it was Thanksgiving Lunch Day, she didn't have the chance to run over to me and whisper in my ear.

So off I went to work. I gave a lecture, then had office hours, but the whole time I felt this pang of guilt, that I needed to be with my daughter for the Thanksgiving Lunch. My office hours ended at noon. Lunch was at 12:15. I could make it, maybe. I went back and forth in my mind, because I had so much fucking shit to do at work (pardon my French), and told myself that plenty of parents don't/can't go have lunch with their kids in the middle of the day in the middle of the work week, and besides, my daughter wasn't even expecting me. At the same time, I felt a sense of panic, a sense of urgency, a sense of You want change? Something better? WELL HERE IT IS!! So, at 11:57 AM, I decided, I am going to have lunch with my daughter. Because next year she'll be in middle school, and this is probably the last time she is going to want to have lunch with me at school, and it is a privilege that I have a job where I can go have lunch with her when she wants me to have lunch with her! I cut out of my office hours three minutes early so no one could trap me in my office, and I raced to my daughter's school.

I can't tell you how happy I am that I went to that lunch. It made so many things so much clearer in my mind. Unlike many parents at my daughter's school, I don't spend a lot of time at the school, so I feel like a bit of a stranger when I'm there during any time other than drop off or pick up. My daughter didn't know I was going to be there, so I felt insecure as I went onto the school grounds. I at least knew they had recess right before lunch, so I wanted to find her on the playground so she would guide me through the process of standing in the lunch line.

I was relieved to arrive at her school at 12:14, just enough time to scan the playground before the kids went into the gym for lunch. I was even more relieved that when she spotted me, she came running over to me and gave me a huge hug and wouldn't let go. When I told her I had come to have lunch with her, she thanked me over and over again, and held my hand all the way into the lunch room. She told me, I am so happy you made time to have lunch with me, and continued to thank me throughout the day, and thanked me numerous times before she went to bed that night - JUST FOR HAVING LUNCH WITH HER! I am crying just writing about it.

But here's the thing. I don't want anyone (as if anyone but me is reading this - but, you know, just in case!) to misinterpret my message as one of Hey women! You MUST stay home and take care of your babies! It's just more of a relief for me to understand that there are many paths to happiness, many of which are completely different from what I had imagined. Maybe I've never given motherhood a fair chance. Whatever the case may be, I feel almost giddy with the wide-open possibilities of a happy future.

Whether you are one of a few dear friends still reading this, or whether you are here looking for porn photos, Happy Thanksgiving to you all!

One year ago today...

Last night, I went to a PTA meeting for my daughter's school. I've never been to a PTA meeting before, and quite honestly, I went mainly because there was free pizza. (I don't think you ever outgrow the allure of a free meal.) When I walked in the door, one of my good friends, who was PTA president last year, gave me sort of a dirty look and said, 'I can't believe you're going to start coming to PTA meetings the year after I stop being president!' Since I did not want to admit that I, a grown woman with a job and a nice house, was just there for the pizza, I had to do some quick thinking.

I, um, was sort of busy last year. You know, I was working on my career change and stuff. And oh yeah... remember how I had cancer?! 

It's funny how cancer is not even the first thing that popped to into my mind as an excuse. Of course, I never went to a PTA meeting before I knew I had cancer, either. (What can I say? The pizza idea was brilliant.) But that's not the point. The point is that it is hard to believe that it was just last year that I was going through the most major ordeal of my life. In fact, exactly one year ago today, I was in the middle of the most major surgery I've ever had, and ever hope to have, in my lifetime.

In so many ways, cancer seems like such a distant memory, and in others, it is still with me, every day. It is a weird paradox to live with, not knowing if you had cancer or have cancer, whether you are a survivor or a patient. The physical scars from the surgeries remain somewhat problematic and serve as a constant reminder of cancer. I don't regret this, though. If I hadn't done reconstruction, I would have the constant reminder of cancer in a different way. Nonetheless, sometimes I feel a sense of inner loathing that I went through all of this mutilation for a sensationless lump of flesh with no function. And I am still receiving care for my scarring; in fact, I have an appointment with Dr. T tomorrow.

And then there is the tamoxifen, which I continue to blame for my hot flashes, cold flashes, general fatigue, and pretty much anything else I can blame on it. I've been extremely depressed lately, and because I cannot think of a reason I should be depressed, I blame the tamoxifen. But that's not my biggest gripe. In fact, I've spent so much of my life in various states of mental disarray, I'm used to it, and it could very well not be the tamoxifen and just the fact that I am me. My biggest gripe about the tamoxifen is that it gives me horrible leg cramps. HORRIBLE. I mentioned this to my oncologist the last time I saw him, and he pretty much blew me off, to the extent that I didn't even write about it. Later, however, I did some Googling to try to see why tamoxifen would cause cramps, and while I could find no explanation that could satisfy my nerdy mind, I did discover that this is apparently very common. In fact, many women who stop taking tamoxifen before they are supposed to cite leg cramps as the #1 reason they stop!

I've always had a bit of a problem with leg cramping, usually in the morning when I wake up and do my early morning stretch. But the tamoxifen-induced leg cramps are like the normal cramps on steroids. In the past, I used to get cramps on either the front of my leg OR the back of my leg, but these new ones involve the entire circumference of my leg, often both legs at the same time, often multiple times per night. Let me just tell you, it is extremely painful and also disruptive to my sleep. In fact, it's ridiculous. The other day I was sitting in my office and I got a cramp that crept all the way up my leg and along my hip, and it felt so weird that after a while I started to wonder if I was, like, having a stroke or something. And yesterday while teaching, I got a horrible cramp in my toes that then worked its way up my calf and shin and I seriously thought I might have to stop class. I could go on and on about this but I realize it is a super boring topic that probably reminds you of your Great Aunt Ethel going on and on about her hemorrhoids, so I'll stop. Just feel sorry for me, yada yada. 

And oh, remember my hip saga? Last night, I had a terrible nightmare that I had to wake myself up from. After realizing I had not actually killed anyone, and that my son was not actually dead, I tried to stay awake long enough to not lapse back into the same terrible dream. After a bit, I tried to go back to sleep, but realized that my hip was throbbing. And I mean throbbing. After about 15 minutes I realized my hip did not want me to go back to sleep, so I fumbled around and tried to find some Ibuprofen, which in itself was an ordeal, because I was sleepy and it was dark and I have 20/900 vision without my contacts and I keep the Ibuprofen right next to my tamoxifen (and it's actually in a tamoxifen bottle because I am an idiot) and even in my sleep-induced stupor, I realized the last thing I wanted to do was accidentally take a handful of tamoxifens. LOL. I would have taken something stronger than Ibuprofen because the pain was really that bad, but it was 3 AM, and I did not want to have an opioid hangover during class this morning. I think I got back to sleep around 4 AM, then woke up to - you guessed it - horrible leg cramps around 5 AM.

But OMG ISN'T LIFE AWESOME?! Ha. Really, life is awesome, it really is. It's just cancer and hip dysplasia that suck. :)

Absence of breast, acquired

There is no real reason for title of this post other than the fact that I was looking through my medical history on the patient portal, and I'm sorry, that is just sort of funny. Absence of breast, acquired. It makes me wonder what other ways there are to acquire an absence of breast other than a mastectomy. LOL.

It has been a long time, I know. As I alluded to in my last post, I've been pretty busy living happily ever after, yada yada yada. But in all seriousness, breast cancer seems like something that happened in the very distant past. It's hard for me to believe that whole trip from hell was just last year. Fortunately, I have Facebook memories to keep me abreast. (Get it? Abreast, hahaha.)

So, after all this time, you might be wondering what inspired me to grace you with my presence today. Well, I just had my first post-mastectomy mammogram. It was about four months overdue, but eh, whatever. Part of me just didn't feel like going and the other part of me just felt like living in ignorant bliss for a while. Plus, I was really insanely busy there for a while. (More on that later, perhaps.) You're probably used to the type of cancer survivor who is hyper vigilant about eating healthy and not drinking and exercising maniacally and getting all her screenings done STAT, but that is not me. I've always been a bit phobic of going to the doctor (especially a new doctor) and having procedures done (especially when they involve undressing) and DUDES, you'd think I'd be SOOOO over that by now, but alas, I am not. In fact, my life is so normal right now, I've just slipped right back to being the old me.

I set up my appointment last week, because the semester is getting ready to start and I'm going to have a rather insane schedule once it does. (More on that later, perhaps.) I figured if I didn't have the mammo done before classes start, I very likely would not have it done until Christmas break, which would be a seriously big no-no. Of course, I forgot about it until this morning, when I was transposing events from my planner onto the family calendar, and I went into a bit of a panic. In the end, it was probably a good thing because I didn't have time to get worked up about it. 

Interestingly, I was pretty surprised by how emotional I got about it. I don't quite understand what emotions I was feeling, but they made me a super jerk when I was filling out the required paperwork and doing the whole registration thing. I calmed down a little once I got back to do the mammogram because the tech was super sweet and has apparently worked with women who have had mastectomies before, so it was hard for me to be mean to her. Ha. After I got the pictures taken (right breast only; apparently the foob is considered safe), I went and waited while the radiologist read them. Apparently having cancer puts you on the fast track, and there's none of this 'We will read your mammogram and get back to you in a week' nonsense.

When I was waiting, I actually started crying. I'm not quite sure why, but I did. Maybe it was because I was overcome with the memory of crying in the same waiting room over a year ago. Or maybe it's because there are a lot of moving parts in my life right now, and I'm a bit overwhelmed by some of them.

Apparently I'm fine, or 'stable' as the tech reported. Ummm, yippee? I could lie and say I was hugely relieved, but I wasn't. I figured I was fine. Fine, as in, there's no mass in my breast. I've been checking occasionally. Having no lumps is good, don't get me wrong, but I don't think I'll rest easy ever again just because I have a clear mammogram. I mean, whatever. 

So now that I sound like I need to check myself into a psychiatric hospital, I should stop. But coming here was a good reminded of how cathartic writing is for me, so I promise to come back soon and write about something other than crying in a waiting room, because there is a lot more to life after cancer than that.

Happily Ever After

While I was in the throes of cancer, I started reading blogs about cancer. Of course. I still have a number of those blogs on my reading list, but only a few of them get updated with any sort of regularity. There seem to be two ways that blogs end. One is that the blogger ends treatment, moves on, and lives happily ever after (or something like that). The other is that the blogger dies, which sadly, is not an uncommon ending in the world of cancerland blogging.

Seeing as how it has been over a month since my last entry, I suppose one could say this blog is coming to an end, too. But since I don't feel comfortable throwing a 'happily ever after' party just yet, I figured I should write something.

So, I saw my medical oncologist, Dr. M on Friday. The fact that I almost didn't write anything about it speaks volumes to how far I've come since my first meeting with him. It's a good thing. My daughter didn't have school, so I had her in tow, and Dr. M spent about seven minutes with me, three of which we talked about our dislike of crowds, and how we don't have any desire to go to Disney World. The other four minutes, we talked about the effect that tamoxifen is having on me (hot flashes, cold flashes, nausea, fatigue, moodiness, and generally not feeling like myself), the fact that I haven't had a period since my surgery in September (can I really be in menopause?), and whether or not I should have a pelvic ultrasound for the mass in my uterus (the one that keeps showing up on my hip MRIs). Dr. M did a brief physical exam (not of my uterus, thankfully), told me I was due for a mammogram (OMG it has been one year already!), and asked me a lot of questions that made me realize that he pretty much has no idea who I am. And that's fine. I don't want to become close with my oncologist. That is certainly not something that lends itself to a 'happily ever after' blog termination. In the end, he suggested trying some sort of herbal supplement that might help with the side effects from tamoxifen (I forget what it is) and said he would read the results of my hip MRIs and call me that afternoon to discuss the pelvic ultrasound (he didn't). I hope that he and I remain cordial strangers.

On the other end of the spectrum, on April 12th, Dr. T drove down to my school (the 130-mile trek I'm always complaining about when I have to go see him) to give his talk on advances in plastic surgery that I arranged last October. He gave a fascinating talk, then we went out to dinner - Dr. T, my parents, me, and a colleague I invited along. My parents always take the speakers out to dinner after cafe talks, and sometimes they invite me if they can't find any other faculty to go with them. Of course, me going along this time was a no-brainer. The evening was quite pleasant, and a funny thing happened. Afterward, my parents and my colleague just went on and on and on about how FABULOUS and AMAZING Dr. T was - not just as a surgeon, but as a human being. I was a little surprised at first, because to me the evening had the same feel as, like, an evening out with my book club friends. You know, a nice evening with good food and wine and conversation. Dr. T seemed very relaxed, not as if he were putting on a big show. But then I realized that my dad had never met this man before, and my mom only met him once (and was apparently lusting after him the whole time), and my colleague only knew what few details I shared about him with her. And I remembered the first time I met Dr. T, how awe-struck I was, and how I knew he was the answer to my prayers. I then understood that was what my parents and colleague were experiencing, and it reminded me to never get so used to something that I take it for granted.

I had had a bit of a crazy day leading up to the talk/dinner and was exhausted by the end. When I get so tired/worked up, I often lose my appetite. However, after Dr. T's comments at my last appointment about how I had lost weight and do I even like food, I was determined to show him just how much I can eat, haha. Sad but true story: I felt super self-conscious trying to eat dinner with this guy who thinks I don't eat. Nevertheless, I enjoyed my trout and managed to fit everything on my plate into my GI tract. After dinner, we left the restaurant and said our goodbyes in the parking lot. Dr. T went to shake my hand, but at that point it seemed more appropriate to hug him, so I did, and he hugged me back. It's hard to believe that after all this, that was a first. I love this guy.

Meanwhile, life continues at the relentless pace of 100 MPH. I do think my fatigue is improving (considering it's 11:24 PM as I write this sentence), and that is good. On the other hand, I have been emotionally very fragile, crying long and hard over stupid, stupid, stupid shit, sometimes not even anything sad. For instance, I was at the park today with my kids and the ice cream truck drove by, playing typical ice cream truck music, and upon hearing it, I burst out crying. That is not good. On the other hand, reflecting upon it, I realized the music brought forth so many memories, and while processing these memories, I was full of a genuine love for life, and realized that I want to live for a long, long time. I am not sure if I started crying because I was so happy, or because I am afraid I won't get my wish. Hopefully it's the former. Then again, maybe it's just the tamoxifen.

Kenalog Injection

On Friday, I went to see Dr. T to get a series of Kenalog injections for my 'hypertrophic scarring.' I've been doing all sorts of stuff to try to reduce the scar (massage, cocoa butter + vitamin E, silicone strips), but apparently the whole Asian skin thing (a thick dermis, according to Dr. T) is going to be a perpetual curse to my scar. I figured the injections were worth a shot, although I'm starting to realize that a recurring theme in my personal medical saga is that by the time Friday afternoon rolls around, I'm never in the mood to drive 60 miles to see Dr. T. This past Friday was no exception, as I was having the most bizarre day in which every little thing that could go wrong did go wrong, and I was anxious because I needed to get home and pack because we were heading out of town that afternoon to go skiing. I was supposed to be packed already, but... I wasn't.

As Dr. T was preparing the syringes, I told him I had been dreading the appointment all day, to which he responded, 'I'm not going to sugar coat it; this is going to hurt.' When I lay down on the table and exposed myself, Dr. T reached over casually and grabbed my foob to cop a feel, commenting on how it looked good, and how nicely it had softened up. It practically feels like a real breast. The level of familiarity we now have with each other is amusing and alarming all at once - I think nothing of a strange man reaching out and grabbing my boob, yet the fact that this happens so naturally is rather creepy, if I really think about it.

Then he started the injections. They were not fun, but at least I was prepared for the fact that they would suck. It ranked right up there with getting a cortisone injection. Individually, each injection wasn't as bad as a cortisone injection, but because the scar extends from hip to hip, Dr. T did multiple injections all along the length of the scar as well as in my off-center belly button (which I finally complained about to him, haha), and the overall unpleasantness was up there. And there is something about needles in the belly that's just gross, grosser than needles in other parts of the body. I lost track of how many injections he actually did, but it was probably around 10. Some hurt more than others, because I have varying levels of numbness throughout my abdomen, ranging from no feeling to full feeling. Supposedly the feeling will come back eventually, but when I asked Dr. T how long it would take, he said 'about six months.' And... after a quick calculation, I realized it HAS been six months, so... whatever.

During one series of injections toward my side, where I have full feeling, I almost started crying, although that might have been as much due to weeks of stress and fatigue as actual pain. At one point, Dr. T instructed me, 'I need you to breathe. I'm afraid you're going to pass out.' LOL. He worked his way across my scar, and eventually got to the side that's actually not that bad. As he remarked that that part of the scar wasn't bad, I quickly said, 'Yeah, it's fine,' and pulled the gown back over me. 'I think I've had enough.'

On a side note, as I lifted up the gown so Dr. T could do the injection, he commented, 'I see you've lost some weight.' I was somewhat taken aback, because, hello, it is rude to comment on a lady's weight like that! But then I realized he was using his concerned doctor voice on me, not his 'I'm making casual conversation with you' voice. Did I detect a hint of criticism in his tone? 'I have?' I asked. I'm not usually aware of my weight, except insofar as it affects how my clothes fit, and I haven't noticed any drastic changes as of late. I shrugged the comment off, and told Dr. T I had been really busy, and really stressed. That seemed like enough of an explanation for him, and we left it at that. However, later on he told me that Pamela, his new PA, had found a really good barbecue place in the town where I live, one that does Texas-style barbecue. (Both he and Pamela moved here from Texas, and apparently like the way Texans do barbecues.) I immediately guessed which restaurant he was talking about, and he said, 'Yes! That's it!' Then he asked me if it was good. I told him I didn't know, that I'm not a big fan of barbecue. So then he asked, 'What type of food do you like?' Before I could answer, he gave me a sort of funny look, then said only half jokingly, 'Do you even like food?' Geez, have I really lost that much weight?!

As for the scarring, Dr. T cautioned me that the injections wouldn't have an immediate effect, and that I'd need to come back to repeat this in 6-8 weeks. UGH! I told him that almost made me hope that the feeling in my abdomen never comes back! 

Anyway. At least Dr. T is a lovely person with whom I enjoy visiting, which makes the appointments bearable. Throughout the appointment, we talked about our families, about traveling, about skiing, about my career change, about his upcoming talk at my school. He said that he was going to Costa Rica for spring break, although he didn't know where in Costa Rica, because his wife arranges everything. However, next year he is taking his family to Korea and Thailand, because his daughter is almost 15, and 'pretty soon she won't want to travel with us.' He said he wanted to show his children the type of village that many people in Korea still live in, despite the fact that Korea is industrialized. Then he said that when he was in college, he used to wait tables at a Thai restaurant, and during that time he gained a great appreciation for Thai food, Thai people, and Thai culture. I told him we weren't going anywhere for spring break, then said jokingly that it was because I had spent all my money on medical bills. 'Sorry about that,' he said with a grin, not looking too sorry. LOL. I did mention that we were going skiing, though, so we talked about skiing, the best places to go skiing, and how insanely expensive skiing is, the latter reason being why I never skied much as a kid. He said he never skied as a kid, either, because his family was very poor - We were a typical immigrant family, with three families living in a two-bedroom apartment. (Not to mention, he grew up in Virginia, which isn't exactly the skiing capital of the U.S.) He said he only started skiing as an adult, six years ago, and while he was interested in learning to snowboard, he didn't want to break his wrist. (Yeah, wouldn't it be annoying if he had a surgery planned, and had to cancel it due to a broken wrist?!)

While some of the conversation was surely his attempt to distract me from the unpleasantness of the injections, most of it was like talking to an old friend, and it filled me with an inexplicable sense of ironic awe. Something like this: Wow, I am so unlucky to know this incredible man so well, but at the same time, I am so lucky to know this incredible man so well. Life is funny that way. As my colleague put it, it's the bright side of a dull gray cloud. But clouds are okay. Clouds bring rain, and rain allows us to grow food and pretty flowers. Despite what Dr. T may think, I love food. And flowers, too. :)

What if you only had six more years to live?

I've been thinking quite a lot these days about priorities. Although I'd love to be a model cancer survivor and attribute this to cancer, in all honesty it's something I contemplated a lot even before cancer. Of course, cancer has helped me understand priorities in a different way than before. I've always tried to make time for things that are important to me, and live my life in a way that would leave me with no regrets, but there was always an underlying assumption of a normal timeline for my life, one in which I would live to be at least 80, and where my early 40s would truly be 'midlife.' There was always the 'what if?' element, for sure, but in the past that 'what if?' scenario usually involved some statistically improbable freak accident that I couldn't really plan for anyhow, so why waste time thinking about it, other than maybe buying extra life insurance? Now that 'what if?' scenario is much more tangible, much more real. The possibility of having limited time isn't just some crazy scenario I conjured up in my mind; it could actually happen. And if it does, there's a very real timeline attached to it.

What moved me to write this entry was an article I read this morning. I've mentioned that I teach biology. One of my colleagues sends out a 'Biology of the Day' e-mail every day that is a round-up of all of the major biology news, from mainstream news sources such as CNN to major science journals such as Nature to obscure journals like the Journal of Eukaryotic Microbiology. It's actually an amazing resource for me that helps me stay current in my biology knowledge and oftentimes gives me interesting material to share with my students. Unfortunately, I rarely have time to click on all of the links in the e-mail, so I pick and choose based on my own interests and what I'm in the mood to read about at the particular moment in time I happen to open and read the e-mail.

One of the links in this morning's e-mail was to this article, about a project called 'Photo Ark,' which is a project to capture portraits of all of the world's animals, especially endangered species. I clicked on it because... well, okay, I'll admit it, I like looking at pictures of animals (and so do my students!). And once I clicked on it, I saw that the photos were by Joel Sartore, and I was even more interested. Joel Sartore is a photographer for National Geographic magazine who lives in Lincoln, Nebraska. I first became familiar with his work while I was living in Lincoln, Nebraska, and read a piece that he wrote about Nebraska in National Geographic. After a minor amount of stalking investigating, I realized he lived very close to me, and somewhat marveled at the fact that this world-renowned photographer hailed from the town I was living in, yet received virtually no attention. (Nebraskans are much more into their football heroes.)

Anyway. The point is that if it had been anyone else, I probably wouldn't have scrolled past the gorgeous picture of the African white-bellied tree pangolin. But it was Joel Sartore, so I read the article. The article explained how his 'Photo Ark' project had started. It explained how he was always traveling around the world on photo shoots, while his wife was staying at home with their three kids, until... his wife was diagnosed with breast cancer in 2005, and had to undergo chemotherapy, radiation, and surgery. So he had to stay at home and help out for a year. And while he was at home, he started photographing animals in the local zoo, and the project was born. 

Sadly, his wife's cancer returned in 2012. The article did not elaborate on this, of course, because it was really not an article about his wife's cancer. I'm sure I'm, like, the only person who read it who was more interested in his wife's cancer than of his pictures of naked mole rats. But the article concludes with the following: 

Kathy’s cancer came back in 2012; she had a double mastectomy. That same year, their son Cole, who was 18, was diagnosed with lymphoma. Both recovered, but the illnesses have left their mark. “We don’t get uptight about too much anymore,” Sartore says.

Photo Ark has changed him as well. “It has made me very aware of my own mortality,” he says. “I can see how long it’s going to take.” If he can’t finish the job—he still has thousands of species to photograph—Cole will take over. “I want the pictures to go to work,” Sartore says, “long after I’m dead.”

Perhaps this struck a particular chord not just because I've been contemplating my mortality a lot lately, but also because I've been working on a major career change at the same time. And I want to be clear: the career change has nothing to do with cancer. I was working on it long before the cancer. Interestingly, cancer has added a new sense of urgency to this goal, while at the same time making me doubt whether it's something I should bother pursuing. On the one hand, there's that voice inside me saying all sorts of clichés to the tune of 'just do it!' On the other hand, this career change involves up to three years of schooling for me, which is not trivial, especially considering I am 41 years old and have a family, who will be greatly affected by this. My husband and I have discussed this at length, many times over, and agree that long-term, this will be good for the family, and we can make it work, and in the large scheme of things, three years is not a long time. 

But that 'three years is not a long time' mentality assumes I've got, like, 40 more years in me. Of course I hope that I do, but what if I don't? What if, say, the cancer comes back? The good news of my prognosis is that there's supposedly a good chance the cancer won't come back. The bad news is that due to my age and variables that are not well understood at this point in time, if the cancer does come back, there's a good chance it will come back as metastatic, terminal cancer. 

If I weren't contemplating this major career change, I'm sure I wouldn't be spending nearly the amount of time thinking about this as I am now. I'd just go about my job and home life trying to make the most of each day, checking items off my bucket list, and working toward that 'life with no regrets.' And while I see no compelling reason to derail my plans for the future by convincing myself of a worst-case scenario, it's hard not to ask 'what if?' Are the plans that I have for my future what I want to be doing if I only have, say, six more years to live? I'm not sure why I chose six years, but I guess I'm giving the cancer a few years to come back, then figuring I'll live a few years after that.

Six years, it's reasonable. 

Then I ask myself... suppose all goes as planned, and next summer I'm in school for my new career. What if, at some point, during school or immediately afterward, I discover that the cancer has come back, and it's metastatic? What would I do? If I'm still in school, would I finish school with the optimistic hope that I will beat the odds and live for many, many more years, or would I immediately drop out of school and spend every precious last minute doing the things that 'really matter'? If I've already finished school, would I be angry that I spent the last three years of my life working toward a career I'll never have, or will have for only a few years?

Ultimately, I've decided to go ahead, full force, with the career change. Although it goes against my pessimistic nature, I am also a scientist who believes in data and statistics, and data and statistics tell me there is no reason to be pessimistic. But the decision comes with some caveats, and those caveats center around worst-case scenarios. My new litmus test goes something like this: suppose in the near future, I find out I have terminal cancer, and will likely only live for a few more years. Would I regret how I spent the previous years? If the answer is yes, it's not okay. Whereas before, I saw a reasonable amount of suffering as some path to a better future, I'm not willing to risk that anymore. If the experience is truly unpalatable, it is not worth my precious time, regardless of whether I'm going to live for six more years or sixty. Of course, no experience can be 100% positive 100% of the time, so it's not as if I'm going to say, 'Oh yeah, I had a shitty day/week/month, so I give up!' I'm just thinking that for me, no matter what, there needs to be some reward in the process; that the process must not just be some means to an end... because there might not be an end destination, other than an untimely death. Maybe the present is all there is.

The neurotic, control freak in me needs to have a plan for everything. It's a strength and a weakness. And although I know there are no easy answers, I leave you with some questions. What if you knew you only had six more years to live? Would you live differently than if you had 20, 30, or 40 more years to live? Or... what if you were told you only had one year to eighteen months to live? What would regret?

These are the things I think about a lot these days.

I can't go on. I'll go on.

Something bad is happening, I'm afraid. Whether I'm in the midst of falling apart mentally or falling apart physically or both remains to be seen, but whatever the case may be, I don't like it.

In the past two entries, I wrote that I've been sick. I've been sick for the entire month of February - not falling down sick - but anywhere from low-level annoying under-the-weather sick to thinking I am going to pass out in the middle of a lecture sick. I've dealt with each day as it's come, and mostly kept up a normal schedule, simply because normalcy is what I crave, and because I've got too many irons in the fire right now to drop the ball. (Wow, how many idioms can I fit in one sentence, lol?) I've chalked a lot of what I'm feeling up to pure exhaustion, the type that seeps into every tissue in your body and lays you out flat when you lie down to go to bed a night. The type of exhaustion where you don't wake up and get out of bed in the morning, you peel yourself, one limb at a time, off the bed. But I've kept going, because that is what people do: they keep going.

Then yesterday, something happened. I woke up feeling terrible, the falling down sick kind of terrible. My daughter woke up with a sore throat but wanted to go to school anyway, and we let her, because she didn't have a fever and because we both had to work. I dropped my son off at daycare, and fumbled my way into work. I answered about a dozen e-mails before I got a call from the daycare saying that my son had a 102.7 degree fever and needed to be picked up. It was 9:00 in the morning. Somehow in the morning chaos, between my own illness and my daughter's illness, my son had been overlooked. It was suddenly too much for me to handle, and I literally just sat there for a good five minutes staring at my computer screen, trying to figure out what to do. My husband, who normally has a flexible schedule, just started a new job, and over the weekend, we had just had a lengthy discussion about him needing to put the pedal to the metal for the next year or so. But I had to teach, so what's a working mom to do?

Eventually, we worked it all out, as we always do, but the process exhausted me, way more than it should have. After coughing my way through a lecture about pathogenic bacteria, I came home to tag team with my husband, who had taken our son to the doctor and then brought him home. By the end of the day, my son, my daughter and I had all been to the doctor, and we all had prescriptions for antibiotics. My kids: strep throat. Me: unknown. As I had sat talking to my NP about what type of antibiotic to try next, she rattled off all the other things I should try to get better: sterilize my toothbrushes, wipe down my computer, take a probiotic, gargle salt water, and so on. Then finally, she asked me, 'Rest? Is there any way you can rest?'

I just looked at her. What a dumb question. Of course I can't rest. Who has time for resting? No one I know. But in that brief moment before I responded to her, it dawned on me that I really need some rest. Not as in, yeah, I should try to take it easy. As in, I really need some rest. As in, something bad is going to happen if I don't. I guess I've been ignoring all signs of my body rebelling against me and demanding rest because I already feel like I'm not doing enough. I've had to start going to bed around 9:30 every night, whereas not long ago, my goal was to be in bed by midnight, and I considered lights out at midnight an accomplishment. I simply can't do that anymore. I go to bed early and sleep late, relatively speaking, anyway. I've always been the type who would rather trade morning rituals for an extra hour of sleep, so I can pop right out of bed at 6:30 and be ready to be out the door in 20 minutes. Giving up those few hours of work every night, which used to be my most productive time, has not been trivial, and dammit, that should be enough. But it's not. For whatever reason, it's not enough. I need more rest, no matter how ridiculous it might seem to me.

So today, I did something I've never done before, and canceled my classes and stayed home with my sick kids (who are now acting totally fine) to try to get some rest. In the seven years at my job, I've been pretty dang sick, my kids have been pretty dang sick, including calls to 911 and hospital stays, and I've never canceled class. This latest bout pales in comparison to other things we've weathered, but somehow I felt some urgency this time. I can't keep going in this state I'm in; something's gotta give. Just trying to keep up my normal, everyday routine is physically sucking the life force out of me, and I'm overwhelmed with this feeling of I cannot do this anymore. I'm not sure if this is my body in pure rebellion mode, or my mind falling apart from stress. Either way, I don't like it. It's unsettling. The idea that it's possible that I'm physically not capable of achieving all the goals I've laid out in my mind is not acceptable.

Of course, given my recent medical history, it's hard not to think of worst-case scenarios. I'm not going to lie. I also, in my brief convalescence yesterday afternoon and today, read from start to finish When Breath Becomes Air, a memoir of a 36-year-old neurosurgeon who dies of lung cancer. While it was a truly amazing reflection on how we must face our own mortality, I'm not sure it was the best choice for me in this very moment in time, when I'm already feeling so fragile emotionally and physically. But the author of the book, Paul Kalinithi, frequently repeated the words of Samuel Beckett to himself, so I'll do the same. 'I can't go on. I'll go on.'