A Woman of Substance

2

2009-02-09T17:12:00.000-08:00

I was diagnosed with breast cancer two years ago today. I was sitting in the repair shop customer lounge waiting for my car to be finished. I will never forget the feeling of numbness that hit me as I struggled to find a piece of paper to write on, demanding to my nurse practitioner that she read me "exactly what the pathology report says!" The numbness continued as I went home and immediately started to look up every single word of the pathology report online. I am an emergency care provider, not an oncology provider. I had no idea of what was happening to me.

I spent the first several days after my diagnosis feeling very numb yet very certain of each decision I made. There was little discussion about how things would unfold...I would do everything I could to maximize my recovery and long-term survival. I never want to look bad at the decisions I made about my breast cancer and regret something...or wish I had done something different. Thus far, I have been very comfortable with my decisions. Confident in them? Not so much...that remains to be seen.

A friend recently asked me what the experience of breast cancer was like for me. I couldn't really answer her. Today it came to me. It was like standing on a road that you could see for miles (the kind they show in movies, out there in the desert southwest) and right in front of you was a HUGE hole in the road. You can't see exactly what is in there and you can't quite figure out exactly how big the hole is but you can see the road on the other side, continuing on to somewhere in the future. I had to get over that hole in order to contine on the road that was my life. The hole is my breast cancer. I could go around it but that may have have some consequences and problems associated with it. Going over it? Probably not such a great idea. If I wanted to keep moving along on my road, I had to go through it...climb down the hole that was surgeries and chemotherapy to emerge and continue on the road.

I entered the hole with tremendous love and support. The days were dark and some of them scary but I got through it. I began to climb back out and now, continue on my road. There were some interesting lessons in the hole. I hate to say it but all of those 'living in the moment' cliches ARE true so believe them.

I experienced some tremendous losses during my care and treatment. I lost body parts, dignity, privacy and occasionally, hope. But some of these things are back...except the body parts. In fact, since my diagnosis I have lost more. What I have realized though, is through the losses comes some wins. A life. A new perspective. Different relationships with people around me. Different thoughts about life, love and hope.

So as I mark this day, I have this revelation: A loss is a win. At least it has been thus far!

Happy Birthday Piper!

2009-01-24T10:37:00.000-08:00

Piper is 2-years-old today. We love this silly, goofy, naughty Great Dane! Her breeder has new puppies and we are going to Florida in March...

Personal Responsiblity

2009-01-18T10:30:00.000-08:00

Something that has always been important to me is personal responsiblity. Just to be sure I thought Iknew what Iwas talked about, I turned to Google.com and put the term in. I expected to find thousands of responses. I got just 10 back. Apparently it is not the issue I thought it to be.

One website I looked at said this "Taking personal responsibility means you acknowledge and accept that you are answerable for the outcome of your life. Life always gives you the consequences related to your actions or inaction. Being responsible indicates that you accept accountability and are in control" (about-personal-growth.com, para. 1). Hmmm.....

I try to take responsiblity for all of my actions. I cannot take responsiblity for those that I am not aware of, like if my words or actions wound someone. I rely on that person to bring this to my attention. In those cases, I can then take responsiblity for my actions with an apology, a change, or an ammend. I do use a very direct communication style, expecting those with whom I communication to talk back to me, ask questions and to respond to my words. Again, without that give and take, I cannot take responsbility for my words...but I would given the opportunity.

Because I feel strongly about personal responsibilty, I get very impatient with people who do not take responsiblity for their actions. I deal with this in many areas of my life. Some of my students do not like to take responsiblity for their actions. Instead of simply saying they forgot to do an assignment (or turn it in or whatever) they feel as though they must create gigantic sagas for what they missed and why they do not deserve to have any consequences for their actions. Ok. I can be a bit forgiving on this. After all, they are learning.

The ones that I get most impatient with are my comtemporaries who cannot seem to take responsiblity for their actions. These are mature adults who feel perfectly justified in stealing something from others by saying "it's what I was owed". Mature adults who will lie and implicate other people to protect themselves from the consequences of their own actions. Those are the people that will throw their "friends" under the bus to protect themselves. These are people that I do not have the time for in my life.

Imagine a world in which people took responsiblity for their actions...what if they said, "you're right, I do owe you that money." Or, "I'm sorry I lied to you about that." Or, my favorite and seemingly the simplest, "I'm sorry I hurt you."

Wouldn't we all be happier and calmer?

Reference
About-Personal-Growth.com (2009). Are you mature enough to accept responsiblity for how your life turned out? Retrieved January 18, 2009 from http://www.about-personal-growth.com/personal-responsibility.html

Winter Sun

2009-01-13T15:19:00.000-08:00

Spots in which to sun yourself during the winter are difficult to find. My little Piper seems to be the master at finding the sunniest spot in the house. This was her this morning. Note...the temperature was -12 F and there is alot of snow out there!

Is this as good as it gets?

2009-01-01T10:21:00.000-08:00

Happy New Year to everyone. Over the years I have found there are a couple of days each year that I am more pensive. Today is one of them. It's a point at which we naturally pause, look back and decide where to go from there.

We are lucky. We had a very good year. We are both healthy and my cancer is in remission. Our family members are healthy as well. We lost no one close to us this year either. Our mutts think we are the best humans on the entire planet. We are fortunate to be working in recession-proof fields and do not have to worry about layoffs or unemployment. We have plenty of everything we need and many things we don't.

Is this as good as it gets?

Maybe...in fact, for me it is. We are comfortable and blessed. Certainly there are ways in which I can be a better human. Practicing more compassion for those around me and approaching situations more gently would be a welcomed change. Fortunately people (me) are able to change and grow at every age.

And into 2009, I plan no resolutions. They are just ways in which we set ourselves up to fail and feel bad. Regrets? Just a couple and they are staying in 2008. There is no reason to carry them on into the new year.

May 2009 offer the best to you and your loved ones. Happy New Year.

The Holiday Letter

2008-12-22T08:41:00.000-08:00

It's that time of year when our mailboxes fill with holiday greetings and inevitably, a few of those holiday letters. This year, we haven't gotten much mail from the mailbox. A few things but not as many as in the past. This could be a sign of the times for a couple of reasons. The economic downturn has many of us changing our traditions a bit. For those of us who are more 'computer savy' we are turning to our keyboards and sending paperless greetings. For Mary and I, it is more likely related to the fact that we haven't sent cards for a couple of years. Whatever the reason, it's okay. It is easy to stay connected to those we love and care about.

We have gotten one wonderful holiday letter. It's from some friends of ours that are the parents of quadruplets (you know who you are!) It's a wonderful letter with a photo. Both Mary and I enjoy it every year. It is a combination of a news update and reflections on the season. Perfect.

So here we go...M and Mary's Holiday E-Letter

Merry Christmas* Everyone!

Of course it is hard to believe that another year has passed. We all say that, and they do go by quickly. Faster as we age. We had an uneventful year and for that, we are very grateful! We spent our time in what has become our typical fashion...working very hard through the cold months so we can play during the warm ones! This spring we spent about a month working on our old boat. The bottom needed to be scrapped, sanded and painted. It doesn't sound like much but that old tub has a big bottom! It took lots of time and thankfully, we had some help from Pat and Mark. It is also a very messy job! The bottom needed some repair. We are so lucky that Mary can take care of so much of this. It is much more economical this way!

Once the spring work was done, it was time for fun. During the early part of the summer we painted the top of the boat with help (?) from Allyson and Tal Christian. I'm never sure how much help these two are...but nonetheless, the boat is now white with blue trim and it is much nicer. It was officially named "Proud Marys'"...and yes, that is plural-possesive. I checked with one of the English professors. The rest of the summer was spent enjoying our friends and family at our floating summer home. We were lucky to be visited by most every one we know, and even some we didn't. Our friend list expands a bit more every year. We particularly enjoyed our 4th of July party and heading our for 5th of July fireworks in Hudson.

But alas, summer ends and we have to cover our girl up. She's now sitting in some icy cold water covered by blue tarps. There is also no floor right now. Some "hey...let's get rid of that icky carpet in the kitchen" has turned into new sewage and water systems, floor and walls. Now I am feeling the need for new cabinets and why we're at it...how about a new sofa? Boat projects are much like house projects.

And now for the family update. George continues going strong at 87. He's living at Mount Olivet Careview in Mpls. on a memory-unit. He is doing very well and surprises us when he rallies back from various challenges. My mom and Bob Cook are happy and well in Golden Valley. They seem to have some new house project or vacation going on all the time. Alas...that is the reason for retirement. The Goldbergers are all fine. Sam just turned 17 and Halle will be 12 in January! I don't have anyone to go to animated movies with anymore. My sister Pat continues to see Mark. I have started referring to him as my brother-in-law. "My sister's boyfriend" sounds too cheesy when you're 50! Allyson (our little Alvin) will be 22 soon and is attending school. She says she is majoring in nursing but then tells me she doesn't really like people much so I am not sure how that is going to work out for her. Mark has 3 great kids: Erin, Matt and Ashley. Along with Erin's boyfriend Shane, we have expanded our circle of nieces and nephews again and we are so happy about that. Our Norway family is doing great as well. Geirid is fine, Silje is 28 already and Tal Christian turns 19 in March. He is finishing his last year of high school and we are thinking about having him live with us full time. He is hoping to enlist in the US Navy (like his dad) next summer so we'll see.

In other events...

I turned 50 this year, mostly quiely and well-supported by alcohol.

Pat walked the Breast Cancer 3-Day Walk-a 60 mile event that culminated with camping each night. For those of you who don't know Pat that alone is an accomplishment but the fact that she walked every single step of it is truly amazing. I worked on the medical crew so got to see her at various times. I can't describe how emotional it was to see her at the end of it. I am so proud of her!

We have both returned to hockey and are playing on a women's team called the Breakaways. We are the last place team in the lowest division of women's hockey in the state. I am the lowest ranked goalie and we are having a blast! We have met some wonderful new friends through this team and while we don't enjoy those games late on cold Sunday nights, it's all fun.

It's been a great year...cancer is in remission and I feel great. Mary is doing well and starting to ponder what she wants to do with retirement. She has some work to do on the boat before we can have you all down there this summer! We have been fortunate to travel some, catch up with friends and make new ones. Below is a slide show of our year.

What more could we hope for...just that all of you are healthy, happy and doing well. Merry Christmas (*yes, we say Merry Christmas) to all of you and yours. Much love and best wishes for the New Year,

M and Mary

We're published.

2008-11-19T16:36:00.000-08:00

Yes. We're published-Mary and I. A chapter I worked on for this nursing textbook was published. To those not in nursing, it isn't particularly interesting reading but I am proud. And so is Mary. I couldn't have done it without her!

Chapter 24 , page 536-548; Using Nursing Research in Practice

Here's the official citation:

Mackenburg-Mohn, M. (2009). Using Nursing Research in Practice. In J. A. Zerwekh, and J. C. Claborn, Nursing Today: Trends and Transitions (pp. 536-548). St. Louis: Saunders Elsevier.

Bad dog...

2008-11-12T09:58:00.000-08:00

Mom says I've been bad. She wants to ship me to my friend Piper in Australia. So maybe I haven't been the best dog in the world lately. I know she liked that pair of shoes that was way up high where she didn't think I could reach them but the butter caper...that could happen to anyone. She shouldn't leave things on the counter especially something so tasty like whole sticks of butter!

Aussie Piper is a very cute puppy and I know she and I would be great friends. I could also visit Chelsea and Shiloh while I am there.

Hmm...maybe a trip to Australia wouldn't be so bad.........

It's here...

2008-11-07T08:28:00.000-08:00

It's here. It's snowing. I know that it won't stay around but it does remind me of what is to come. It was actually quite beautiful this morning. The trees were coated with white. Sure, there is more yardwork we could have gotten done (isn't there always?) but we didn't. The first snow of the year means that the fall chores end. We turn our attention to hockey and hanging in front of the fireplace. At least that is what the dogs think is true.

I also noticed a significant number of deer in the yard today. I suspect they have always been there but today with the snow, they became more evident. Of course that resulted in significant barking.

Friday Foto Challenge: Irreplaceable!

2008-10-31T07:17:00.000-07:00

A Day in the Life of Piper

2008-10-14T12:18:00.000-07:00

A while ago I received a lovely book entitled "A Day in the Life of America". For this book several photographers were asked to take pictures of their world on one particular date. The photos were compiled into the book. It is a wonderful snapshot of live on day in our country. There was a day last week that I was working at home, grading papers. I was planning to spend the entire day at my desk and decided to conduct my own "A Day in the Life of..." photo shoot. At 2 hour intervals I grabbed the camera and took Piper's picture...wherever she was and whatever she was doing. I chose 9 photographs to present. The first one was taken at 8 am and the last one was taken right about midnight. You will notice a significant lack of action. For some she didn't even pick her head up to see what I was doing.

Ah...it truly is a dog's life.

Fall in Minnesota

2008-10-04T10:09:00.000-07:00

Yesterday we were both off and decided to embark on an adventure. We put the dogs in the truck and headed to the north shore. We drove through Duluth and up to Silver Bay where we found our friend Marsha at the cabin. We paid her a visit, enjoying a stop at Split Rock Lighthouse on the way. We headed home after dinner at the Scenic Cafe (excellent!) with two very tired dogs! Enjoy the photos.

October is Breast Cancer Awareness Month!

2008-10-02T10:27:00.000-07:00

It's always something...October is Breast Cancer Awareness Month. Please~check yourself, schedule your mammogram, support a breast cancer group with a donation, buy Amy's Blend at Caribou or just hug a woman who has dealt with the disease.

Thank you for the support and compassion you all have shown me as I have learned to live with breast cancer.

I Knit...

2008-09-29T17:52:00.000-07:00

In addition to my work in the Emergency Department, I teach nursing for a couple of differnt colleges. For one college, I teach in the graduate programs, working with master's and doctoral students in mostly an online format. For the other college, I teach exclusively online. Consequently, I spend literally hours in front of my computer. The majority of my work (curriculum, papers, etc.) is all done electronically and I don't have tangible things to show others.

One of the assignments my graduate students have is to create a personal blog. One of my students did her blog on her love of knitting. Knitting is something I have a passion for myself. Lately I find myself almost craving time to knit. I started thinking about this desire to knit. It was more than just a desire to sit and do something I find relaxing. I think it is related to the amount of time I spend online.

Interacting with a screen and a keyboard doesn't always feel good. Not in an emotional way, but in a physical way. I miss using my hands to interact with something besides a keyboard. I know...it sounds weird. I also miss creating something that is not a word document. I think that is why I knit.

I'm not crazy (or at least I don't think so...) It keeps me sane.

She did it!

2008-09-24T09:59:00.001-07:00

She did it...walked every single step of the 60 mile Breast Cancer 3-Day walk. I am so proud of her! I was there as a medical provider and got to see her periodicallly during the walk. She looked great every time I saw her. The event was so powerful with so many women involved, both with and without cancer. But all 3,000 walkers and 400 crew members had some connection to breast cancer. Since pictures speak louder than words, take a few minutes and watch the slide show of the event. (Hover your mouse over the picture to read the caption.)

Flat Mary

2008-09-13T10:02:00.000-07:00

I went to Yosemite.

At least Flat Mary went...

For my birthday, my hockey friends created Flat Mary on a stick. One of our friends, Shelly took me (Flat Mary) to Yosemite on a hiking trip. Check out my adventures...

Back to School

2008-09-01T19:48:00.000-07:00

Today is Labor Day and to me, a more significant day than the New Year's Holiday. Today is a change day, a turning point. While the calendar says we have another 3 weeks of summer, to many of us, summer ends today.

With the end of summer comes the beginning of school. For as long as I can remember, I have loved the first day of school. It is the first day of the next step, a new beginning, a new year. The possibilities lie before us. As a student, I was so excited to begin. I loved the new notebooks and pencils. I couldn't wait to see the syllabus and to meet those who I would spend the next several months with. As a teacher, I am equally excited but for different reasons. I enjoy the excitement the students bring with them. I look forward to the challenge of presenting the information in new and unique ways. I can't wait to witness the 'aha' moments that my students will hopefully have.

But it is the end of the summer. I left the marina today with a melancholy feeling. It was such a great summer. The weather was phenomenal (I know, we need rain) and none of our plans were washed out. We have great tans and I am truly relaxed. We spent time with family and friends alike and enjoyed every moment of the season. But somehow, I feel like the fun times are over and it is back to business only.

The Dog Days of Summer

2008-08-17T10:24:00.000-07:00

Ahh....the dog days of summer. When there is nothing to do but lounge in the water with your favorite people and canines. Yesterday was quite warm so we took to the beach for an afternoon of relaxation. Last summer Piper was terrified of the water. She would run from waves as they hit the beach. She never got her paws yet except for the one time in which she fell off the dock. Most of this summer it has been the same although she would walk in the water, getting just her paws yet. Yesterday we had a breakthrough. We weren't able to get the 'Mother Ship' all the way up the beach and the water was about 6 inches deep at the end of the ladder. When torn with the need to go through water to go potty or stay on the boat, she opted to get off. OK...she needed some encouragement. But then she discovered how much fun it was and spent the rest of the afternoon splashing through the water and playing with Kaja. I don't think she will ever be a recreational swimmer like our Kaja is but she did discover the water is an enjoyable place to be on a warm afternoon.

50+

2008-08-14T14:49:00.000-07:00

I am now closer to 100 than I am to the day I was born. That was pointed out to me by one of my ED co-workers...thanks.

I have receovered from my birthday angst and the melanoly feelings I had. It was a wonderfully quiet day...quite unlike what you would expect a Leo-woman would want. We spent the day on the boat, went up to Stillwater and had dinner at a great resturant~Nacho Mama's. I would have linked their webpage but I can't seem to find one for them. They have an interesting menu, good drinks and a pretty good beer list. Their patio is nice even though it is bordered by a street. It ws fun.

Since my birthday, well...actually all summer I have been thinking about the concept of normal. How many times I have said "when my life gets back to normal" I do whatever. So what is normal?

There are definately normals in healthcare: normal vital signs, normal x-rays, normal mammograms. While some of these things are absolutes (either positive or negative) most are still a range of what we consider usual or consistent for a given situation. When it comes to people and life situations, I am not sure there is a normal. Sure there are things that we do in the same way every single time we do them...I would suppose that is the closest thing we have to normal. When I look at my life, I am struck by how un-normal I am! I work unusual hours, live in Woodbury, have a giant dog. play hockey and don't generally, act like a 50-year-old.

So what is normal? Whatever we think it is on a given day. Ever changing and evolving...we redefine ourselves and our situations in light of what is going on in our world.

Normal. It is what I am...perhaps.

50

2008-08-05T09:38:00.000-07:00

Today is my 50th Birthday.

I have never experienced sadness with a birthday before but today is difficult. 50 is a turning point. I cannot deny that I am now, middle-aged. I have to check a different box on forms. I am no longer "in my 40's". While women today are different than our mothers were when they turned 50, it still represents a half of a century. And I am not sure that I am "aged to perfection" but I liked the picture. In fact, I am no where close to perfection and thankfully, will never be.

I did some checking online to see if I could come up with an idea of how long I might live. I found this life expectancy calculator online and did it. According to my results, I can expect to live 88.62 years. This calculator is published by the University of Pennsylvania (a reputable agency) and asked questions about my family health history and some about mine but did not ask if I had a history of cancer...hmmmmm. Since this one did not ask very many questions about my personal health, I looked for another one and found a site call "Living to 100" and did theirs. According to them, my life expectancy is 85. According to the Centers for Disease Control (2007), my life expectancy is 77.8 years.

So, based on this information I have somewhere between 27.8 and 38.62 years of my life left. That doesn't seem like enough. What should I do with it?

I want to lose 12 pounds, engage in regular physical activity, drink less and eat better, and live debt-free. This sounds a bit like making New Year's resolutions and we all know how that goes. Perhaps my effort should be aimed at just being myself for another 27.8-38.62 years. I will try to be a bit nicer and I would like to travel more and retire. But aside from that...

I think I will head to the back deck of the boat to sit in the sun (without sunscreen) with a plate of chips and cheese and an icy cold beer...Happy Birthday to me.

References

Centers for Disease Control (2007). Life expectancy. Retrieved August 5, 2008 from http://www.cdc.gov/nchs/fastats/lifexpec.htm

Foster, D., Chua, C. and Ungar, L. (n.d.) How long will I live? Retrieved August 5, 2008 from http://gosset.wharton.upenn.edu/mortality/

The Breast Cancer 3-Day

2008-06-16T12:29:00.000-07:00

The slogan for the Breast Cancer 3-Day walk is...everyone deserves a lifetime. When I was diagnosed with breast cancer I began to reconsider how long a lifetime was. Was it only 48 years? Fortunately for me, I believe it will be much longer. But for many women diagnosed with breast cancer, a lifetime is not that long. The Breast Cancer 3-Day walk is a fundraiser. Thousands of people, across the country will be walking 60 miles over the course of 3 days to raise money for breast cancer research, treatment and awareness. My sister Pat is one of those walkers. She has surprised me. She is a quiet sole who keeps most things to herself. She has never really shared with me what it was like for her to have her sister diagnosed with cancer. I sometimes worry about her silence but she does seem to manage it all pretty well.

Anyway. Last year I worked on the medical crew for the Twin Cities 3-Day event. I was just past chemo and didn't have the energy so I worked instead. It was a powerful experience for me and I met some incredible women along the way. As I was sharing my experiences with Pat after the event, she told me she was going to walk this year. Okay. We'll see...she can be kind of procrastinator. I told her if she did the walk, I would be her fund raising manager (she has to raise $2200). Much to my surprise, she registered. She printed out the suggested training schedule and has been walking since early this year, training for the event. Even though we have had a rather cold, wet spring, she has been out there with her training walks. And now the pressure is on me...to help her to raise the funds.

And that's where you all come in. If you have ever been affected by breast cancer in any way, please consider a donation to my sister's walk. You can click on the link to the right and it will take you directly to a donation page. You can use plastic online to donate or print a donation form and send your donation in. We've also planned a couple of fun events for the summer which you might be interested in. Sunday, August 24 we are having a wine tasting cruise aboard our boat. Join us for an evening cruise (6-10 pm). Bring a bottle of wine to share and we'll do the rest. Hopefully you'll have such a great time, you will want to throw some cash at my sister too.

Here are some links to the Breast Cancer 3-Day Site and to my sister, Pat Eggert's 3-Day webpage. Check them out. It is a wonderful cause because we all deserve a lifetime.

Summer?

2008-05-28T17:48:00.000-07:00

Sun, cool temperatures, tornadoes...quite a variety for the Memorial Day weekend. It is our official beginning of summer though and we did spend it on the water. Judy and Steph were our first guests and cruisers. Check out the photos. It was a fun weekend, despite the weather!

Difficult Decisions

2008-05-20T09:00:00.000-07:00

I had a difficult case last night while working in the ED. It was a school-age child who was depressed. He was there with his Mom who discussed a long family history of mental health concerns. She also revealed her husband was deployed with the military, still in the US but readying for service abroad. From there, our crisis social worker took over to assess the child's and family needs. In the meantime, I got a call from the American Red Cross stating they had a request for emergency medical leave for the father of this child. It was up to me to approve or deny this request. I told them I would contact them when I had more information.

When the social worker was finished she updated me. The happy, smiling boy and mother were heading home. The social worker thought things were fine so I called the Red Cross back and denied the request for emergency leave. About an hour later I got a phone call from a very angry, threatening mother who challenged my decision. Words like 'audacity', 'dying', and 'kill' were included. The phrase 'how dare you' was also mentioned. I got a bit uncomfortable with this and informed her I would call them back and change my decision. When the Red Cross worker asked me why I had changed my mind, I just said there was a change in the situation.

Did I do the right thing?
What would you have done in my situation?

I looked over my should as I walked out to my car after work...

Friday Photo Challenge: Numbers

2008-05-17T12:09:00.000-07:00

Two.

And I know...it's Saturday.

Ron...Ron Burgandy

2008-05-08T17:59:00.000-07:00

For those of you who have seen the Will Ferrell movie, Anchor Man you will recognize the name Ron Burgundy. That was the name of Will Ferrell's character, a womanizing TV news anchor. Last year when we bought our old houseboat, our niece Alvin named it Ron...Ron Burgundy because of the color. The name has since been shortened to Ron. Are you going to Ron today? Are we staying on Ron this weekend? Is there beer in Ron's refrigerator. You get the idea.

While at work last Saturday, we were talking about our plans for Sunday. I said that I would be laying under Ron for a few hours. The people I work with knew we have been sanding and prepping to paint Ron so they all understood what I meant...except our pharmacist. She pulled me aside and suggested that I should watch what I say in a children's hospital! Made me giggle.

I did spend several hours under Ron and he's looking good. His bottom is now painted black and most of his hull dings are repaired. Mary has been working on Ron everyday, all day regardless of the weather. I guess those 4 days off every week are kind of handy. We are painting the rest of Ron blue. A lovely marine blue. I can't wait to see him done. But then he won't be Ron anymore.

Here's Ron, sanded and ready for some new paint! At least down below. We have to finish the hull work before he can go back into the water. That should be in the next few days! We will still have the sanding and painting above the waterline to finish but that we can take our time with. For some perspective on Ron's size, you can see our Lexus just behind Ron's bow. Sanding and painting Ron is no small task!

Ron...Ron Burgundy.

Stay Classy!

Friday Photo Challenge: Angles

2008-05-08T17:48:00.001-07:00

Here's my skinny dog.

She is composed of many angles.

Do dogs get spring fever?

2008-04-24T06:25:00.001-07:00

Yes.

They do.

Just like we do.

The last few days have actually been nice. Kaja and Piper have been going crazy outside. Running like maniacs, sniffing, rolling in the grass...smiling the entire time they are out there. Going until they flop down in the yard in the sun.

They embody the way I feel.

Why don't humans take a few lessons from our pets. Run! Sniff the spring air and roll in the grass.

Happy Spring.

Stick It to Breast Cancer

2008-04-21T07:31:00.000-07:00

My hockey team played their last game for the 2007-2008 season yesterday. It was in the Stick It to Cancer tournament. This is an annual tournament, the 10th annual in fact, and my team plays every year. Last year I was not able to play because I was in the middle of my chemotherapy. But this year...a different story. I did play. I played the best that I could given my circumstances. My team took 4th place in our division (yes, there were more than 4 teams in the division) and we had a great time.

Being a part of this tournament as a breast cancer survivor was a different experience for me. In years past, I just played because it was a good cause. Last year it was a more personal experience. And this year, I am a survivor.

Friday Photo Challenge: Rough

2008-04-17T14:03:00.000-07:00

Race for the Cure~Sunday, May 11

2008-04-14T08:16:00.000-07:00

It's that time again...RACE for the CURE. I am hoping that you will consider joining me for this year's walk. Children's is a corporate sponsor for this event and I am encouraging you to register for the Children's Hospital team. They make the check-in process much easier and throw a few extra goodies into your race bag. Unfortunately, their deadline is creeping up so if you can get it done, it would be the easiest way to go. The benefit of registering with Children's team is that your t-shirt and other items will come to me at Children's so you won't have to go and pick up your stuff at the mall.

choose to register as an individual or a team. To register with Children's, scroll through the list until you geet to Children's Hospitals and Clinics-St. Paul and select that. From there, it will ask for the usual information.

Let me know if you have any questions.

Friday Photo Challenge: Heroes

2008-04-11T08:34:00.000-07:00

For those of you who don't know her, this is my partner Mary Mohn. She is a Minneapolis Firefighter. She joined the department nearly 22 years ago, one of a few women on the job. This photo was taken last fall when she (and her firetruck) made a visit to one of my co-worker's neighborhoods. His little guys (That's Quinn and Will) who were dressing up as firefighters for Halloween, quickly put on their costumes and got to crawl all over the big truck. They were so excited.

She is my hero...

The Sum of Her Parts

2008-04-06T15:29:00.000-07:00

Karl Ludwig von Bertalanffy was an Austrian-born biologist (d. 1972) who is credited as one of the founders of general systems theory (GST). His work has undergone various applications and revisions over the years but essentially is known as being the first that suggested a system was greater than the sum of its parts. General systems theory has been used in health care to describe family dynamics and relationships. It is a very complex theory but can be picked apart rather easily and defines system as a set of interacting or interdependent entities which together, form an integrated whole.

I am not sure if systems theory has been considered in terms of the human body but I am guessing that someone has. If you think about it, a human body is a set of interacting entities which come together to form an integrated and functioning whole. Ok. So what happens if some of these entities are removed? Like various parts...tonsils, adenoids, appendix, gall bladder, breasts, ovaries and uterus? Is the system, the human, the same? Or is the system permanently altered to become some other system...

When we are born we have a pretty standard set of 'parts'. These parts form the human anatomy and provide the physiology that makes the 'system' work. Certain parts of the system, like the reproductive parts, create the distinction that occurs between men and women. Having my breasts removed caused me to do some thinking of what makes one female. I went through a process of thinking about that last year when I was post-op and going through chemo. I pretty much resolved that in my head and redefined myself as a woman missing the parts that society used to identify us as one gender. Done. Then came tamoxifen side effects and a hysterectomy. I know have all of the 'parts' that differentiate female. The process began again...redefining, reconsidering, rethinking what I have known to be true in my life.

But then came Thomas Beatie...the pregnant man. I watched his interview with Oprah this week. He is the transgendered man who is now pregnant. In the interview he revealed that he had an elective bilateral mastectomy, began hormonal therapy but decided to keep the uterus, ovaries, etc. One the outside, he looks like a man...facial hair, deeper voice, etc. but on the inside has female parts and is now 6 months pregnant. So is he a pregnant man or a pregnant woman with facial hair?

So how does this relate to me today? We have two selves~that which we present to the world and that which we know intimately. And in applying GST to this, certainly the human body requires certain 'parts' to make the system work. There are some anatomical essentials but reproductive parts are not essential. The body does not rely on the presence of reproductive organs for effective functioning. So despite the loss of many minor body parts in the course of my life, I still consider myself to be greater than the sum of my parts.

Mediocre Dane

2008-04-04T14:40:00.000-07:00

This is a photo of my pda. My iPac...a very expensive, wireless, electronic device that holds all of the information necessary for life in it. Things like phone numbers, calendars, emergency texts, professional licensure, online courses that I am teaching, the combination to my father's safe and a couple of games. All of that information (and more) is still in it; however, I cannot access it. Yesterday, Mary and I went out for a bit and came home to find bits of black plastic on the carpet. As you can see, Piper has destroyed my PDA. It did power up once but that was it. It's gone. It's like having a lobotomy. I know, right about now you are wondering why I left it in Piper-territory...after all, it really is my fault. Right. It was inside a leather case on top of my desk. Today I spent some time looking for an interactive online calendar program that will get me through for a few months. At least until I decide what kind of product I need next. She is kind of a mediocre Dane today, certainly not a great one.

She kind of redeemed herself with me later today though. It was a beautiful afternoon and I decided to take the girls out and let them run wild...which they did. Their noses were in high gear with the delicious smells of spring~deer poop, rabbit fir, dead frogs in the pond. They went crazy! And I got to enjoy watching them enjoy it all. Oh to be a dog...even if you only were a mediocre one. Enjoy my first attempt at digital video with a still camera.

Creamy White Filling

2008-04-01T13:45:00.001-07:00

I had my surgery yesterday and it went very well. The surgeon came to meet with the two of us in the preoperative area. He went through his talk, finishing with he would meet with Mary when I went to the recovery room. He summed it all up by asking if either of us had other questions. My partner asked him what he would be putting into my abdomen to fill in the space. He looked a bit confusing, like he didn't understand the question. She went on to make some suggestions...packing peanuts, blown-in insulation, and creamy white filling~the stuffing from stuffed toys. He caught on and started laughing, asking me what I would prefer. Mary suggested that packing peanuts would be too lumpy and Piper would want to get the creamy white filling out since that is one of her favorite treats. I think it is good to have your surgeon laughing before he starts cutting on you.

I went into surgery at 11:10 and was awake in the recovery room just after 2:00 pm. We were home just after 7:00 last night. Hysterectomies used to be done through a large open incision with a hospitalization that lasted up to 10 days. Things are different and it was great to sleep in my own bed last night. Of course, I have Mary dotting on me. "What's your pain level now?" "Can I get you anything?" She is also running interference with my large puppy who seems to think that if I am laying down it is to hold her. Right now, that would be a bit painful for me.

All things considered, I am doing great!

3658-182-15-3

2008-03-28T11:49:00.000-07:00

We are home. We drove a total of 3658 miles, pumped 182 gallons of gas, slept in other beds 15 nights and listened to 3 complete audiobooks. I am happy to report that aside from some mustard on a hotdog at the Kennedy Space Center, there were no disagreements. At all. Amazing what vacation can do for you!

We are happy to be home. It is cooler here than Florida but there is little snow to be seen. Our girls were so happy to see us, they ran from one of us to the other for quite a while when they discovered we were home. They look terrific and have been very well fed and cared for. Thanks Alvin! And we're real sorry about your camera. (Apparently a digital camera was placed next to a dog toy which Piper decided she needed to have RIGHT NOW!)

St. Augustine, Easter and Disney

2008-03-26T06:29:00.000-07:00

We are winding down our time in Florida. In fact, today will be our last day without traveling. We are planning on heading home tomorrow. And I think we are both ready. Even vacationing can get old! Mostly, we miss our girls.

We spent the weekend playing tourist. We visited St. Augustine, Fl., the oldest city in the United States. Some of the buildings are original including Castillo de San Marco, a fort built by the Spanish to protect their territory. Remember? The Spanish originally settled in Florida, long before the Pilgrims arrived to the north. The fort was interesting and made me very happy to have been born in a time when everything about life was exponentially easier. The Fountain of Youth is also located in St. Augustine. We went there and yes, even drank from it. Mary suggested that it may have been too late for me. Nice.

We spent Easter Sunday engaged in worship at our favorite place...the Church of the Open Water (also known as the beach) and then enjoyed a lovely Easter dinner at McDonalds on our way to Orlando. We switched venues and are now staying in Orlando. We have had to spend our days poolside rather than at the beach.

Monday was cool and cloudy. Mary, my theme park lover, picked a park to visit. We initially went to the Magic Kingdom as we have not been there in many years; however, a view of the parking lot confirmed that we had made a bad choice on a holiday and headed for Epcot where we had a great day, complete with eating the ears off of Mickey Mouse.

Today, it's our final day at the pool. We are leaving at 0500 tomorrow to avoid hitting Atlanta during rush hour...a mistake we made just once. We will be home, back to normal life with work, our girls, snow and cold, on Friday.

Ahhh...relaxation!

2008-03-21T06:48:00.000-07:00

We are settled into the routine of vacation...getting up when we want to, walks on the beach, and then some playtime. We've hit a couple of local sites when the weather has been less favorable for beachtime. Mary, Mark and Pat went to the Daytona Speedway on Tuesday while I graded papers. Yesterday we all went to Kennedy Space Center. Today the weather report is 78 and sunny! We'll be heading to the beach very soon. The photo at the top is the sunrise Mary and I watched from our balcony this morning. Enjoy the other shots.

Road Trip

2008-03-18T12:18:00.000-07:00

We are road trippers...so when it came to making arrangements for our spring vacation, there was no thinking about transportation. It would be a road trip. We left home on Thursday, March 13 with our first destination, Louisville, KY about 10 hours away. Why Louisville? The National Houseboat Expo! We arrived on Thursday evening and settled in. The next day we found some time to spare and decided to take a tour of Churchill Downs. Very fun! We saw the sights (in the rain), had a mint julep and I put my toes on the track.

From there we went to the National Houseboat Expo. It was a boatshow with really big boats! These houseboats were HUGE~120' long and 20' wide. They had hot tubs, fireplaces and every amenity you could think of. One was 5 bedroom, 5 bath with a hot tub and 2 fireplaces. We went hoping to get some ideas about remodeling ours but instead, looked at some incredible vessels.

From there we drove to Knoxville, TN home of the University of Tennessee and Mary's favorite women's basketball team the Lady Vols. It is also the home of the Women's Basketball Hall of Fame. After touring that on Saturday morning, we crossed drove through Asheville, NC in the rain. From there we headed south through South Carolina and ended up Saturday night in Savannah, GA. Finally on Sunday, we arrived at Daytona Beach.

We have a couple of issues with our road trips. The first one is that I am not particularly fond of driving. Most of the time, that is fine with Mary who would prefer to drive anyway. After all, she is a professional driver. When she drives, I am more than happy to provide entertainment and refreshments. I will look at the map when requested. When I do have to drive it is usually because she is sleepy; however, she had a knack for turning the wheel over to me at the least ideal times. For example, I got to drive through Chicago and Indianapolis. I also got to drive on Saturday afternoon through torrential rain, high winds and flying objects. We noticed quite a few cars in the ditches as we continued on. The driving really sucked and Mary decided that would be a good time to discuss hydroplaning, following distances and when the speed limit is not the speed limit. In other words, it was a no-nag critique of my driving. Later on Saturday night on the Weather Channel, we learned I (we) had driven through a line of storms that included multiple tornadoes. No wonder I don't like to drive.

After a night in hotel in Savannah (where it was 82 degrees) that had no electricity (the storms), we headed into Florida. We are now enjoying ourselves on Daytona Beach with Pat and Mark. I have included a few photos and will post more as we go.

Back to where I was...

2008-03-13T19:47:00.001-07:00

Weight is another one of my issues. Just a quick recap: I had gastric bypass surgery just over 2 years ago. I lost 80 pounds after the surgery and felt great. On the first anniversary of my surgery, I was diagnosed with breast cancer. Through my surgery and chemotherapy, I lost an additional 20 pounds and hit my goal weight loss of 100 pounds. I was wearing a size 10 (from a size 26) and feeling thin for the first time in my life.

I've gained some weight. About 20 pounds. I still wear (mostly) a size 12 yet, I feel like the size 26 I used to be. I feel like the old person I was.

This picture was taken in January, 2006 just before my surgery. This is what I feel like I look like now.

Where does this come from?

So, when is your surgery? Part 2

2008-03-11T07:14:00.001-07:00

Monday, March 31

Random Thoughts

2008-03-07T07:18:00.000-08:00

I had an appointment with a new OB/GYN yesterday. A guy a bit older than me. I've worked with him professionally and he's been great to work with. We talked, he did a quick exam and we decided to go ahead with the surgery. Now I am waiting for their scheduler to call and set it up. He is scheduling 4-6 weeks out so it will be a while. Stay tuned.

Instead of having surgery, we've actually gotten some things done around here. Mary installed a new garage door opener for me and the cabinets above the bar in the kitchen are gone! What a huge difference that makes. The kitchen is brighter and obviously, the whole thing is open to the family room. I love it! Now we need to install some lights above the bar and get rid of the ugly light fixture that hangs in the middle of the room.

We've also gotten together with friends this week. How nice that has been! We went to watch Mari Anne's curling match and visited with her and Lil. Last night we had dinner with Judy and Steph. Tonight we are doing a family event with my Mom, her husband Bob and Pat and Mark. That will be nice too.

Piper has grown another inch...since January 21. I can't believe it. She is now just 0.5 inch shorter than Olivia was. She has gained a couple more pounds but is still a skinny thing. She needs to gain about 20 more. If only we could move it from Kaja onto Piper!

The biggest event of the week is that the world is still turning even after my surgery was cancelled. It is always amazing to me what a difference some time makes. I do believe everything happens for a reason although I am not sure what the reason for having to replan for the surgery is yet but I am sure I will figure it out eventually.

So when is your surgery?

2008-03-04T07:40:00.001-08:00

Hmmm....that is a good question. My hysterectomy was scheduled for tomorrow, March 5. With just 36 hours remaining in my countdown, I learned it was cancelled. Something about a surgeon who was "really sick." Of course I don't want my surgery done by someone who is "really sick" but really...don't these people have back-up plans? Apparently not.

Let's just recap (and this is going to turn into a rant...but it is MY blog and I can do that if I want to). This surgery was scheduled in December when I was in the midst of some rather unpleasant tamoxifen-related side effects. I decided to wait until March to do it rather than January because this date would give me more time to 'get my affairs in order' and was not during the height of the illness season. Had I not been trying to be good to my students and co-workers, I would be fully recovered by now. But NOOOOOO......instead I have spent (literally) the last 2 months working extra shifts in the ED to build up some extra time as well as planning and posting all of my curriculum for the remainder of the school year. This has created some very long days, particularly in the last 2 weeks.

Additionally, Mary had to make some work exchanges. These are days she will have to work later in the year to repay those that are working for her. With both of our jobs, once you cover your shifts you don't get to change your mind and take them back. You just have time off...in March...with no specific plans. Furthermore, Mary and I planned our vacation around this. We currently have an unused condo in Orlando because we thought it would be too soon for me to travel.

And then there's my hockey team...we qualified for the state tournament this year. An unexpected and very exciting first. As we approached our final games with the possibility of a state tournament in our future, I encouraged the coaches and captains to look for a sub. They have found one who is excited to be playing in the tournament with our team. I am now replaced.

So am I mad? Yes. Not only do I have to live with the continued side effects of tamoxifen, but this little ripple has caused a tsunami in my life. And my choices? Wait until my surgeon returns to work in JULY (she's pregnant and tomorrow was her last surgery day before her delivery) or find a new surgeon. Right now, neither of these options are appealing to me.

And aside from all of the inconveniences, there is the issue of another surgery. I wanted to have my extra parts removed. They are hollow organs located deep in the body which provide a wonderful hiding place for cancer cells. Having the hysterectomy is another step toward stashing the cancer firmly in my past. But I can't do that yet. I can wait and wonder longer. My last breast cancer tumor marker was up some. From my limited understanding of oncology laboratory values, tumor markers are not supposed to increase. When I got the results, I was going to wait to figure that out until after my surgery. So now that I am not having surgery, I have to confront that. And I am scared.

And I am tired...and frustrated...and crabby.

Things we are not proud of...

2008-02-25T17:49:00.000-08:00

We all do some things that we are not proud of. Well, at least I have always thought that was the case. After all, we are human and do not always make the best choices all the time. I am struggling with something that I am not proud of. I drink. Too much. Too often.

After this summer, I decided that I could no longer drink red wine as I couldn't seem to stop. I figured this would be a good measure for me. Most of the time that was true and I allowed myself to drink beer. Now, I have discovered this is not good for me either. Sure, I could drink one or two and be fine. If I could drink one or two. And I don't think that I can in all circumstances so, I have decided to be a non-drinking person.

This is very hard for me to admit to myself, and even more difficult to admit to others. I am ashamed of my behavior of late. I don't like having to worry about angering people, particularly my partner. I do not want to disappoint her. And I want to be healthy. I decided that sharing my decision with people (even if no one ever reads this) will help me with personal accountability. And I might need that.

Anniversary

2008-02-09T07:21:00.000-08:00

An anniversary (from the Latin anniversarius, from the words for year and to turn, meaning (re)turning yearly) is a day that commemorates and/or celebrates a past event that occurred on the same day of the year as the initial event (Wikipedia.org, 2008).

Today is my anniversary.

One year ago today, waiting for the oil to be changed in my car, I learned I had breast cancer. Invasive and dark. Looming and hiding. And I found myself at a cross-roads, having to make decisions that would change the path of my life and significantly affect those around me. The kind of decisions you cannot change your mind about...once they remove your breasts, they cannot put them back on. Sure, they can put in new ones but that is not the same.

What a year it has been...

One of the ED nurses keeps asking me what I have learned as a result of my cancer diagnosis. I have been telling her that I know have learned things but I have not taken the time to put my thoughts together...There are so many things rolling around in my brain. So what have I learned? I am afraid to admit that all of those motivational cliches are true. Live everyday to its fullest, tell people you love them, insight through challenge and learning through painful experiences. Sure, they're all true. And I am kind of disappointed to say that I believe in all of these things. I have never been one to embrace cliche as truth. But I suppose cliche comes from somewhere.

In the past year, I have found tremendous strength in my family and friends. There is nothing like a little cancer to challenge your relationship with those you love. This year has challenged both Mary and I. We have spent periods of time talking about all of this and periods not talking about all of this. The periods of silent being have been just as important as the periods of talking. I know that I would not be sitting at my computer, healthy and centered without Mary's support, encouragement and love.

I think my health needs have also challenged my relationships with my other family members. The lines of communication among all of the members have been extended more. As a group, I feel we are more comfortable with each other. The newer family members are more integrated. There seems to be new understandings of who each of us is and what we each bring to the family unit.

And my friends...incredible. We are blessed with loving, caring friends.

I am looking forward to a quiet day today...relatively speaking that is. I am teaching class today and then working in the ED. Not truly a quiet day but to me, one that is normal. A day that is comfortable and one that I feel competent with. I know how to teach and care for my patients. I am the expert today, not the novice handed some devestating news.

So here's to the next year. Continued health, life and love. Here's the year in review...

Sisters

2008-01-25T08:22:00.000-08:00

Sisters...

I've been thinking about Olivia this week. Perhaps that is because of Piper's birthday, but for whatever reason, she's been on my mind. Olivia did not think much of Piper and Piper adored Olivia. She wanted Livie to play with her, and regularly Piper tried to snuggle with her. We did make some progress before Livie died. This photo sums up their relationship to me. This was taken in April, 2007 and is one of my favorites. There are so many captions for it in my head...but what I would like to think it is a photo of is Olivia showing Piper around the big world. In actuality it was probably Livie trying to get away from her, the little pest.

The Growth Velocity of a Great Dane Puppy

2008-01-21T16:57:00.000-08:00

Today is Piper's birthday...she's is a year old. Days like this make you stop and think about change. For Piper, there has been some BIG changes. Great Danes grow an incredible amount in their first year of life. A typical Great Dane puppy is born at a weight of 1-2 lbs. Piper and her nine siblings were all of 'average' size as Danes go. When we picked her up to bring her home she was about 15 pounds and about 12 inches at the shoulder. Today she is about 95 pounds and 30 inches at the shoulder. I am guestimating her weight since neither of us can pick her up to weigh her so we have to wait until our next vet visit for an 'official' weight. These puppies must achieve the equivalent growth in one year that a human adolescent experiences in 18 years. Amazing. No wonder she naps so often...

In honor of Piper's birthday here are a couple of photos:

This photo was taken on April 2, the evening after my first chemo.

This photo was taken in November.

Many people thought we were nuts to bring a new puppy home the day before beginning chemotherapy. We've always been a bit impulsive and this was no exception. Piper was my constant companion during these couple of months. We regularly napped on the couch and she seemed to know when it was okay to play and when it was time to be still. She has been a bit of work, and yes, she has cost us a tremendous amount of money this year but I am so thankful to have her.

Happy Birthday Piper!

2008

2008-01-01T07:29:00.000-08:00

When I was little, I remember thinking about how old I would be at the turn of the century. I couldn't imagine being that old...ever. And now here we are, beginning the 8th year of that century and yes, I am that old. As 2007 ended, I spent the last few days thinking about the year that had been. Inevitable I would imagine. That is what formal endings encourage us to do. To take inventories and make plans.

So here I am...on New Year's Day with a cup of coffee (Norwegian coffee...yum) in front of the fireplace~pondering the year that was and thinking about what is to be. My intitial response is to be happy that 2007 is over and in many ways I am. It wasn't the best year for me or for us. Being diagnosed with cancer will taint one's perceptions a bit. While the surgery and the chemotherapy wasn't a great deal of fun for any of us, there were some true gifts in my diagnosis.

I survived. I know that sounds contrite but you have to understand, I've had a pretty easy life. I have not been faced with significant personal challenges. I haven't had many hurdles to overcome and pretty much what I have wanted in my life I have gotten. I have achieved many things personally and professionally. I have been more than comfortable, I have been blessed. So here in the divine plan, I was tossed a challenge which was more than I had ever been given before and I survived. A friend commented on my courage. I don't think of myself as particularly courageous. I do think of myself as someone who just deals with what is there. And that is what I did with my cancer. I just dealt with what was handed to me. And I didn't do it alone. I could not have done it alone. I found tremendous support and encouragement in my partner, my sister and niece and in my family of friends. Each time I see the oncologist, I get great news. My CA27-29 continues to go down. A CA27-29 is a tumor marker that is found in the blood of patients with breast cancer. It is used in conjunction with other screening to check for recurrence. It can also be elevated by cancers of the colon, stomach, kidney, lung, ovary, pancreas, uterus, and liver. Like your golf score, a low number is better. I will continue to see the oncologist every 3 months this year. I don't want to ever have to deal with cancer again in my life but I know that if (and when) I am challenged with it again, I will survive.

Professionally I have had a very good year. I am teaching more online and going into school less. That is a wonderful thing. There is nothing like going work in your jammies. I am waiting to hear about a formal promotion at St. Kate's to Associate Professor and am becoming involved in more of the technology work going on at the college. I managed to finally pass my acute care certification exam as well. Perhaps this coming year will find me in the ED less and at home more. My work colleagues (all of them) have been a wonderful support for me as well. A beautiful tree grows on our property that serves as a daily reminder of the incredible group of women I work with.

My family has provided me with a solid base to continue to grow. I am looking forward to celebrating our 12th anniversary this summer. Can you believe Mary and I have been together for that long? Who knew what could become of an online ad... Our family has grown this year with the addition of Mark, Erin, Matt and Ashley. My sister Pat and Mark are so happy together! His kids are great and we are looking forward to spending lots more time together! My mother and Bob are doing great too. Bob got a new knee in November and is already more active than he was before the surgery. With the addition of Bob to the family came his son, Rob. He joined us for Christmas this year. I am not sure that he really could appreciate our loud family but here was there with all of us.

All of the kids are getting old. We have or will be celebrating several important birthdays this year. Sam turned 16 in December and is looking forward to getting his license. Alvin turns 21 on January 4 and is looking forward to...well you know! Tal Christian turns 18 in March. We are looking forward to another summer with him. We weren't sure that he would want to come to the US this year but he does. Silje with be 28 this year and Halle will be 11 soon. No more little ones in the family. The parents of all of them got a bit older too, but we won't discuss that!

I have also had the opportunity to reconnect with some friends that I had lost relationships with. That has been bittersweet in many ways. While you do get the gift of that relationship back, it can be difficult to understand and embrace the behavior that caused the rift. But true friends can forgive each other. And true friends can re-establish new relationships that are wonderful and supportive and loving. There are a couple of people on my list for renewal this year as well.

So what will 2008 bring? Good question.

I suppose one answer is MORE! But not too much...

There is more surgery in my future as I look forward to a hysterectomy on March 5. I have been having some rather significant side effects of my tamoxifen and a hysterectomy will take care of that. I am hoping for more good lab results and a continued decrease in my tumor marker.

I am expecting to become more involved with technology work at St. Kate's and am hoping to continue to work more online and less in person. I like working from home. So does Piper and Kaja.

I am planning on more time with friends and family alike. In the winter we both work more in preparation and anticipation of the summer. This summer Mary planned her vacation time to allow her to be off for nice stretches of time. I will actually have some vacation time to use myself. You will most likely find us aboard Ron...or whatever we finally name our old boat. I know we will be spending every free moment this spring working on the boat. Mary has been reading everything she can on restoring older boats. We are planning to paint the whole thing before it gets put in the water for the summer and I would like to spend Memorial Day weekend cruising the river with friends. I am also planning on more hockey, skiing, knitting and just time with those I love.

Then there are the usual New Year's resolutions: lose the 10 pounds I've gained since chemo, save more money, be a better person and orchestrate world peace. Sure. I'll be working on those too.

When I consider everything that has happened in the past year, it is difficult to sum it all up. Sure there were challenges but there were gifts and these were more abundant than the challenges. 2008 will be the same: some challenges and many gifts. Without a crystal ball I can't know what lies ahead. But I know that whatever comes my (our) way, I (we'll) manage it. And I will be here, on New Year's Day 2009 hopefully 10 pounds lighter and content with a life well-lived.

Happy New Year to my dear friends and family.

May 2008 find you ready for the challenges as well as the gifts that await you.

Just when you think you have control...

2007-10-16T19:37:00.000-07:00

Just when you think you have developed some control over the events of your life, something happens to remind you how wrong you are.

My hair was growing. All summer if grew, fractions of inches per week. It was coming in, all over my head and thick. Before I went to Phoenix, I got a haircut. Mostly to trim things up, keep things even, etc. A couple of weeks ago, on a Wednesday I noticed a couple of flipped up ends. No big deal...hair is like that. When I got out of the shower the next morning, I had curls. Not a few. They were all over my head.

This is cancer's way of reminding me who is in charge.

If you haven't seen me with curles, here's a visual for you.

Brillo pad.

Poodle.

My mom's perm in the 80s.

As an adult, I have never had curly hair. My mom alledges I had curly hair as an infant but that remains to be proven. But today...I have curly hair. Gray and curly. Like a brillo pad. Or a poodle.

Mary looks at me and reassures me that the curls are going away...that the back is not as curly as it was...that I look beautiful.

The nurses I work with tell me my hair is great...or fantastic...or like some model from J.Jill. I just flipped through their catalog and saw no one who looked like me. Gray, curly hair is something our grandmothers have. Models and our friends do not.

With the approach of Halloween I guess I can approach this in two ways. It can be an opportunity to be something that I am not (a character, a costume) or something that I am. I guess it depends on whether you are a glass half full or half empty kind-of-person.

Each morning I check. Is it still curly? Then I remember that I am thankful to have hair. To be on this side of my cancer. To be able to worry about hair.

Then I rejoice.

A Grand Slideshow

2007-09-25T10:14:00.001-07:00

The Dark Place

2007-09-24T10:17:00.000-07:00

A couple of weeks ago I ran into a colleague at Children's who was diagnosed with breast cancer two years ago. We started talking. We were never close, just colleagues. Immediately we started comparing note: diagnosis, stage, treatment plans, surgeons and oncologists. It is amazing to me that when you meet another survivor, the talk quickly becomes the intimate details of your personal course with the disease. Kind of like women needing to share birth stories I guess. Or perhaps it is because an unspoken understanding exists. Whatever it is, we were standing in the professional staff lounge talking. She had just had her annual check and things were going well. She then asked me if I ever went to the Dark Place...that part of your mind that thinks about the other side of the statistics. You know, the 1% of women with my kind of cancer and treatment who still die from the disease...the Dark Place.

I had to admit to her that I traveled there from time to time but really tried to avoid thinking about that. Call it denial if you'd like but I am not planning to be that 1%. But what if I am. What if that sore spot on my chest is a metastasis? I had my 6-month visit with my oncologist last week. Here was pleased with how well I am doing. All labs and cancer markers (CA27-29) returned to normal and in the case of the cancer marker, dropping like it should. We discussed routine examinations, CT scans and the need for chest x-rays. He told me he isn't too sold on doing alot of routine diagnostics. When I asked him more about this, he (essentially) told me that early diagnosis of breast cancer complications doesn't really change much except that you start your treatment 'weller', before the cancer makes you too sick. I didn't find this very encouraging or comforting at all. What I heard him say is that if I experience a recurrence, there isn't much to be done about it. He also told me that most recurrences are diagnosed within the first two years after treatment.

I left the appointment with Zander feeling relieved that things are well for right now. By the time I got home, I was in the Dark Place pondering the question of how I should live my life knowing that I have a greater chance of dying young. I don't know that I have answered that question yet. I know that I need to keep myself living in the moment, doing my best work and giving my best self whenever possible. But there is so much more that I want to see and do in my life.

For a start, I went on a mini-adventure yesterday. I am in Phoenix right now, to attend the National League for Nursing's Education Summit. It begins on Wednesday but I have been here since Saturday. Yesterday I drove up into the mountains through Sedona and Flagstaff and on to the Grand Canyon. It was a long, and sometimes boring drive that I am so glad I decided to do! Standing at the edge of that canyon helped put me into perspective with the rest of the world. I am such a little part of all that is around us and came before. The natural beauty around us is incredible.

I felt so fortunate to stand there and take this all in. Taking time to just be and observe is not something that I do well or often. I am tooooooo busy for that. I am so glad that I took that time yesterday.

So how does the Grand Canyon tie into the Dark Place? On the drive down the mountain last evening listening to some good music and sipping some good coffee, I reflected on the day. It was an excellent adventure. I began to think about how fortunate I am.

Today I am healthy and have the means to enjoy some travel and new experiences. To do that and enjoy all that I have, I must stay in the light. Going into the Dark Place limits my vision. It interferes with my ability to see what is all around me. It limits my life experience.

I am sure that I will venture into the Dark Place again from time to time. I am hopeful that my visits are short and needless. I hope that I will have the ability to travel back into the light and all there is for me.

A ps on my excellent adventure. It was missing one essential element: Mary. To have her experience this place with me would have made things more interesting and exciting. I miss her.

Reflections on 3 Days

2007-08-30T09:07:00.000-07:00

It's been quite a number of day since my initial breast cancer diagnosis. Some of those days were very difficult and painful. Others were easy physically but emotionally trying. The days that I spent working with the Breast Cancer 3-day were quite enlightening. An important transition occurred for me this past weekend. I am still not sure that I can quite articulate it but I am closer.

I made a transition from patient to survivor this weekend. Up until last week, I viewed myself as a woman with breast cancer. Being among thousands of women this past weekend helped me to rethink how I view myself...One of the questions asked over and over was "Why did you become involved?" When asked this, I started out by saying "I have it." But then I began to think more critically about this response. I was diagnosed, had bilateral mastectomies followed by chemo. I have been cleared by my surgeon and my oncologist. I don't HAVE it anymore, I HAD it. I am no longer a patient, or as some would like to think, a victim. I am a survivor. I got through it. I am done with treatment. I am back to school and work in the ED and soon, hockey. I am returning to my life as it was before I was diagnosed...or at least as much of my life as I can because I know that my life will never be the same again. Having lived through a cancer diagnosis and treatment permanently alters one's life and perspective.

Today I am a survivor of a disease that still kills thousands of women, and some men, each year. While it has not quite been six months since my diagnosis, I have undergone some incredible transformations. Seeing myself as a survivor is just one of them. Each day it seems as though I learn something else.

The 3-Day Walk

2007-08-29T06:16:00.000-07:00

This past weekend was an incredible experience for me. I cannot yet, put my feelings into words. At this point, I will just share some photos...

Luck Revisited

2007-08-23T07:49:00.000-07:00

When my cancer was diagnosed, well meaning people told me I was lucky because it was diagnosed early, that my lymph nodes were not involved, that I had health insurance. While their sentiments were true, and I know, well-intentioned, I did not feel lucky. What was lucky about being diagnosed with cancer? What was lucky about losing your breasts and undergoing chemotherapy?

Today, nearly six months after my diagnosis I am able to consider my luck in a different light. Yes. I was fortunate that I was diagnosed early, that my lymph nodes were not involved and that I had great health insurance. I was also fortunate to have a very supportive network of family and friends and I was very fortunate to have a relatively easy time though my chemo. What I am most fortunate to have is have had the opportunity to enjoy the summer and turn 49. I also have a different attitude toward returning to school this year. Typically I begin to dread the start of school. It means the end of sleeping late, reading fiction and wearing flip flops. This year it signifies that which is normal...being able to go to work.

I am also fortunate to be able to participate in the Breast Cancer 3-Day walk. The walk officially starts tomorrow and there are estimated to be 3,000 walkers. I have volunteered to be a part of the medical crew and am assigned to work in the main medical facility 'in camp'. Today I have a training session to attend and am very excited to do my part. Look for an update next week.

So back to luck. It's all in how you define it. And today, I feel lucky.

You've missed the boat...

2007-08-06T08:45:00.000-07:00

The first Taste for the Cure is a wonderful memory. 19 guests, a beautiful summer evenings and lots of food and wine. The second cruise schedule for August 21 is FULL! So if you were thinking of coming, you've missed the boat...literally. If you RSVPed before today, you've got a spot.

Another Taste for the Cure

2007-08-02T18:22:00.000-07:00

Here's another opportunity to join the fight against breast cancer. As many of you know, the Breast Cancer 3-Day walk is fast approaching. Another one of our friends has made the commitment to walk: Shelly Swenson. She needs to raise $2200 in pledges to participate and she needs your help... so due to popular demand:

Another Taste for the Cure!

Who: You and your guest(s).

What: Wine-tasting party.

Where: Aboard Mary and Mary's boat on the beautiful St. Croix River.

How: Bring your favorite bottle of wine to share and a $20 (suggested) donation. Appetizers and non-alcoholic beverages will be served. If you don't want to do the tasting part, just come along for the ride!

When: Tuesday, August 21 at 7 pm. We will return to the dock by 10 pm.

If you can't make it for this fun and relaxing evening, you can still contribute funds to Shelly by clicking: https://www.kintera.org/faf/donorReg/donorPledge.asp?ievent=202293&lis=1&kntae202293=5EACAE5F978F4B7286199A78D874C5A4&supId=57913367

If you are intereseted in participating, please contact me at mackenburg@comcast.net or Shelly as soon as possible. The cruise is available to a limited number of guests. Be one of the cool kids and join us!

Taste for the Cure

2007-07-30T13:10:00.000-07:00

Here's your opportunity to join the fight against breast cancer. As many of you know, the Breast Cancer 3-Day walk is fast approaching. One of our friends have made the commitment to walk: Noelle Olson. She needs to raise $2200 in pledges to participate and she needs your help...

Taste for the Cure!

Who: You and your guest(s).

What: Wine-tasting party.

Where: Aboard Mary and Mary's boat on the beautiful St. Croix River.

How: Bring your favorite bottle of wine to share and a $20 (suggested) donation. Appetizers and non-alcoholic beverages will be served. If you don't want to do the tasting part, just come along for the ride!

When: Sunday, August 5 at 7 pm. We will return to the dock by 10 pm.

If you can't make it for this fun and relaxing evening, you can still contribute funds to Noelle by clicking: https://www.kintera.org/faf/donorReg/donorPledge.asp?ievent=202293&lis=1&kntae202293=FFC2FA8F52264292AA2E9A15FDA5C52F&supId=174202004

If you are intereseted in participating, please contact me at mackenburg@comcast.net or Noelle as soon as possible. The cruise is available to a limited number of guests. Be one of the cool kids and join us!

That which doesn't kill us makes us stronger...

2007-07-18T09:41:00.000-07:00

Those words have become our mantra this week.

First, a cancer update. My hair is growing back (appears to be gray, just like it left) and I feel great. The fatigue is gone and I am able to work my shifts in the ED without too much chemo brain. I still doubt myself at times and double check my drug calculations but that's about it. Tamoxifen does have a few side effects. Most notable are the aches I feel and the hot flashes. The aches is bone pain and isn't enough to stop me from doing what I want but is enough that I feel it. In fact, yesterday I noticed that I didn't hurt and realized I had forgotten to take my drugs in the morning. I am also becoming an expert on hot flashes. I am having 2 kinds: flashes and flashettes. The flashettes happen many times per day. They are short episodes of "boy, I am really hot right now" and aren't too big of a deal. The flashes are not so good. These last longer and a more significant with feelings of nausea, light-headedness and profuse sweating (like change your clothes). Fortunately these only happen every couple of days or so. Taking prescribed medications regularly does help to reduce the side effects so I faithfully take my Tamoxifen hoping that the side effects will begin to subside.

Yesterday Mary and I had to make the very difficult decision to put our Great Dane, Olivia to sleep. About a month ago we noticed she just didn't seem like her usual self. We took her into the vet for the first time on June 21. From there we have had multiple vet visits, x-rays and CT scans, lab tests, and IV fluids. The diagnosis=diskospondylitis. This is an infection of the disks of the spinal column usually caused by a bacteria or a fungus. We spent the last 10 days of her life giving injected antibiotics as well as potent oral ones. She did not respond to them and we watched her grow increasing disabled. The last time she was able to walk on her own was July 5. Since that time she became increasingly paralyzed, incontinent of urine and stool and her back paws were cool to the touch during the past couple days. We took her in yesterday knowing what we were likely to have to do but hoping in our hearts that our trusted vet could suggest one last thing to try. Unfortunately, disease won and Livie went to sleep with her head in Mary's lap...her favorite human on the earth.

Mary and I often reflect on how lucky we are. We both have great jobs we like, a home we love and the ability to do pretty much as we want. We get to travel and enjoy our friends and family. But we have felt challenged this year. First the loss of Greta then my cancer and now Olivia. Losses. Certainly not on par with a death but challenges nonetheless. Sometimes I wonder if several "smaller" challenges are more difficult to manage than one big one. It feels like we have recovered from one and then are faced with another. Hence, our mantra for the week. That which doesn't kill us makes us stronger.

OK...we are strong enough for now!

The 3-Day Walk

2007-06-11T05:47:00.001-07:00

The Breast Cancer 3-Day is coming up. Haven't heard of it? It is a 60 mile walk held over 3 days to raise funds for breast cancer research. It is sponsored by the Komen Foundation (the same foundation that sponsors the Race for the Cure) and is held in several cities across the country. The Twin Cities walk is being held August 24-26. I have signed up to participate as a medical volunteer this year...I wasn't sure I would be up to walking 60 miles by the end of August. My friend Shelly Swenson is walking and her team "Treasured Chests" will honor me on their t-shirts. Perhaps you would consider donating to Shelly in her efforts to raise $3000 for the cause. You can do this easily online by following this link:
https://www.kintera.org/faf/donorReg/donorPledge.asp?ievent=202293&lis=1&kntae202293=00188B7D806E4C6DBE472D414A8E08E5&supId=57913367

Many thanks to everyone is their efforts to find a cure for this disease!

Back at Work

2007-06-09T10:56:00.000-07:00

I've been back a work for a full week now, completing 5 full 8-hour shifts! I know that doesn't seem like a feat to most people but coming back from an illness, it is a big deal and I am proud of myself. I haven't been very productive in the evenings (I've been working day shifts thus far) but that's ok too. Who really cares if the folded laundry is sitting on the dining room table and dog toys are everywhere?

Returning to work has been an interesting experience. Somewhere in my mind, I thought I would just come back like nothing had happened. That wasn't the case. The first day I was greeted with a beautiful floral arrangement from some of my co-workers (THANK YOU Kellee, Donna, Masha, Marsha and Kristen!) and lost of people surprised to see that I looked so well. Like me, many people have the idea that people with cancer look awful and I guess I don't. I am still bald though and the stares and second looks continue.

Because of the nature of our work, I don't often work with the same group of people more than a day or two in a row. That means each time I come to work I am asked the same questions. Of course they start out with "How are you?" but what people really mean is "How ARE you?" Thankfully I am able to answer truthfully that I am doing very well. But I have to admit (this is hard to say without sounding snobby) it's getting old. Each time someone asks me that or wants to hear more about my treatment, status and prognosis (again, because they really care about the information) their questions bring everything back up for me. Returning to work was a turning point for me. Coming back to this place where I have a certain level of expertise and satisfaction allowed me to put an ending point on my cancer treatment. It was done~see...I'm better and I'm back to my usual self. But the questions push me backwards a bit. Just a bit each time but when you've worked in a place for 27 years, you know a lot of people!

I know this will decrease with each shift I am here. It has been a good week. I have been very happy to be back doing my job with my chemo brain dramatically improving. Perhaps I just had to start using my brain a bit more! And as always, the patients are delightful. Yesterday I had a very philosophical discussion with a 6-year-old girl who has leukemia. She was in for a twisted ankle and had just had a chemo run the day before. She still had her hair and we talked at length about why she had hair and I didn't. Enlightening.

And that is why I love my job.

Going back.

2007-06-01T04:39:00.000-07:00

Today I get to do something that alot of people don't like to do...go to work. I am going back to work in the emergency department (ED). I haven't worked a shift since February 13, right before my mastectomies. That is a long time to be off and yet, seems like just yesterday in many ways.

Lots of women with cancer work throughout their treatment. Our friend Liz is a firefighter with Mary who did this. She moved to a "quiet" station, tried to avoid direct contact with sick people and rested when she could. Even my oncologist encouraged me to work during my chemo, and I did~at the college. But I couldn't do both. There was no way I could avoid direct contact with sick people as that is the very nature of our job in the ED during the winter months.

There have been some benefits to being away from the ED. Certainly the most obvious is being off during the busiest time of the year. But being away has given me the time I needed to recuperate and heal, to stop and rest when I needed to and to wallow in my self-pity without having to be nice to anyone else when I wanted to. But I think those days are behind me.

I have missed being in the ED. When you really think about work, it is an important place we go to socialize. We get a certain amount of esteem and hopefully, respect from our work. We feel a sense of satisfaction, challenge and reward for our work. Sure, some days are better than others and some days, I would rather not go but overall, I like my job and have missed it.

Today I also move from being the patient to being the health care provider. I am on the other side of the chart providing rather than seeking the medical care and advice. I'll be the one with the pen in my hand, listening and trying to figure out how to best help my patient. That frightens me. I worry about chemo brain. I worry about making math or medication errors. I worry about making the right or the best decisions for my patients. Today...I will double and triple check everything. I will doubt myself and everything I think I remember. Thankfully I am working with physicians that I trust and respect, who I know will not think less of me if my questions seem silly or dumb. They will help me.

Today...I am going back to work. Today I feel like a survivor. Cancer is becoming a thing in my past, something that I have dealt with. Of course I will think about it and worry about it and it will touch my life again but returning to work is helping with my that perspective. I am finally moving on. I am doing something normal...I am going to go to work.

Coming back.

2007-05-30T04:51:00.001-07:00

I have finally confirmed what I had always thought was true...a weekend on the river will cure whatever is ailing you.

We spent the long weekend on a houseboat on the St. Croix. A HUGE rented houseboat with a group of wonderful women we are fortunate enough to call friends. We left the dock on Friday afternoon with plenty of food, beverages and high hopes for great weather. We were not disappointed! Ok...a bit of rain on Saturday but that just caused us to move from the table out on the front deck to the one inside.

But soon we were back out there, sitting around the table. The conversation didn't even stop. It just paused long enough to refill beverages and get settled again. By Saturday afternoon the sun was out and it was getting warmer. Sunday was an incredibly beautiful day. We had difficulty keeping up with moving our chairs to maximize sun exposure, reading, napping and chatting. We ate some wonderful meals (THANKS Pam!) and enjoyed some nice bonfires on the beach.

During the weekend I didn't nap...except for a short one on the beach. When we got home on Monday evening, I was beat and ready for bed early. But yesterday I was struck by something. I feel like my old self. In fact, as I thought more about the weekend, I felt more like my old self over the weekend too. Perhaps it was being in a place that I love, doing something that I love. Perhaps it was feeling the warmth of the sun on my skin. Perhaps it was being among a group of wonderful women. I am not sure what the reason for this feeling was and it is not important to me to figure it out. What is important to me is that I feel it.

At several points during the last few months, I wondered if I would every feel like myself again. I hoped so but was afraid there wasn't an old self to feel like. I worried that my cancer and its treatments would somehow alter me as well as my physical self. Who would I become as a cancer survivor? Would the assets of my personality be enhanced or would the deficits become more prominent? Much of this remains to be seen. What is clear right now is that I am slowly returning. The veil of cancer is lifting away and I feel as though I am coming back. And for the days of this past weekend, I forgot I had cancer. Oh sure, I had to put sunscreen on my bald head. Oh...and there was the debate in my head about whether you are topless if you take your shirt off and have no breasts, but aside from that...I forgot. I was just me. Who I am right now, enjoying myself. And it felt great!

Decoratively Bald

2007-05-25T07:14:00.000-07:00

This week I got a new tatoo. Not a permanent one, a temporary henna tatoo on my head! Long before I was bald I found a website called Chemo Chicks (http://www.chemochicks.com/home.htm) where they sold different types of products for women going through chemo therapy. One thing they have are stencils for temporary head tatoos. I ordered one along with the henna kit. Finally this week I went to see my friend Chuck (my hair guy) and had one applied to my bald noogin.

The first step was to transfer to my head. Some eucalyptus oil first then the ink from the paper transferred to my head.

From there, Chuck used a small plastic applicator to trace the pattern with henna.

After that the henna stayed on for 6 hours. I was able to wash it off later in the evening and I was left with an iteresting and intricate pattern on my head. It should last a week or so and is a fun alternative to being bald!

It's over.

2007-05-21T09:18:00.000-07:00

My chemo is done and it's time to feel better. That's what I think but apparently that is not what my body thinks. I was under the misguided assumption that I would finish my chemo and feel better and be done. Today is 8 days past my last treatment and I feel awful again. Thankfully Mary is home and let me sleep for hours.

I just finished talking to Lucy, one of my favorite Children's Hospitals and Clinics pharmacists. I wanted to know more about the pharmacology of my chemo drugs, doxorubicin in particular. That seems to be the one that has the most significant side effects. She kindly informed me that it takes 21-28 days after your last treatment for your body to completely clear the drug. Great. My last treatment was May 14. Some not so quick thinking (chemo brain) and I figure it will be mid-June before this drug clears my body completely. I am assuming that I will continue to feel crummy and tired until then. I am also assuming that it will take a while before my hair comes back in, although I am getting used to being bald and don't even see the stares of people any more!

Here's the other thing that is over~chemo night dinners. A nice tradition came out of my chemo schedule, dinner with Mom and Bob. I should be more clear. Mom and Bob came over each Monday afternoon that I had chemo and cooked dinner for Mary and I. Sometimes Pat and Mark would join us as well. It became something that I looked forward to...visiting with the two of them and a great "mom" dinner. This is a photo from my last chemo dinner: roast beef and mashed potatoes. What says Mom like mashed potatoes?

Another thing to check off.

2007-05-15T15:59:00.000-07:00

I can check another thing off on my list for breast cancer care. Yep. I am done with chemo! I finished yesterday. My sister and my niece were there with me when Wayne pulled out my IV and announced to the room of patients getting chemo that "Mary is done with her chemotherapy!" It was wonderful to hear these words announced. I walked out of there with a spring in my step and a congratulatory coffee mug.

So...what is next? I haven't really thought too much about the next phase of my care. I was really trying to take it one step at a time. Right now, I have a month off from 'cancer care' with no appointments scheduled at all. Hopefully, I will recover easily from this last chemo and will see my hair start to come back in. I am returning to work on June 1 and for those of you who know how stubborn I am, you know I will be returning to work on June 1! I may still be bald, but hey...it's been said I have a nice head!

When I go back to the oncologist in June, I will be started on Tamoxifen. This medication comes in a daily pill that has been used for more than 20 years to treat patients with advanced breast cancer. It is now commonly used as an additional therapy following primary treatment for early stage breast cancer. It works by suppressing the production of estrogen-a hormone made by your ovaries which promotes the growth of cancer cells. Sometimes tamoxifen is called an "anti-estrogen" and helps prevent the original breast cancer from returning. Like any drug, there are positives and negatives to being on tamoxifen. Some women experience a lowering of their blood cholesterol levels and slower bone loss (osteoporosis). But...tamoxifen does have side effects (NCI, n.d.). In general, they are similar to the symptoms of menopause including hot flashes, headaches, fatigue, nausea/vomiting, vaginal dryness and/or itching, and skin rashes. Weight gain is another side effect (ACS, 2006). Tamoxifen also increases the risk of uterine and endometrial cancer In one study, women who took tamoxifen had more than twice the chance of endometrial cancer. Data from one large treatment study also found there is a small increase in the number of blood clots in women taking tamoxifen; and are at increased risk for developing cataracts, corneal scarring and retinal changes in the eyes. Tamoxifen has also been known to cause liver cancer in lab rats but this has not been documented in humans. It can cause liver toxicities in humans though and in one study was associated with gastrointestinal cancer (NCI, n.d.)

By my read, this is not a great drug to be on. The question becomes: Do the benefits of tamoxifen in treating breast cancer outweigh its risks? According to the National Cancer Institute (n.d.) the benefits of tamoxifen as a treatment for breast cancer are firmly established and far outweigh the potential risks. But I keep going back to this question: if I have to take a drug for the next 5 years that has so many side effects, why not just remove the problem-the ovaries. They are the organs that produce that estrogen that the tamoxifen is suppressing. From there I think, why not remove the uterus too...and any other useless organ that can just become a haven for cancer cells?

Of course I had to ask Zander, the oncologist this question. He said it was an option but the surgical risks may be greater than the benefits it I was able to tolerate the tamoxifen. Not getting the answer I wanted, "oh...great idea! Let's schedule you for surgery" I had to ask Chara, the oncology NP. While she gave me more information about tamoxifen and long-term use (more than 10 years), she essentially agreed with Zander. So we decided on a 1-year trial of tamoxifen. If I'm having problems with it, off to surgery I go. If not, stay the course.

So what else is store for me? Visits to the oncologists every 3 months. These will include blood draws for a blood tumor marker called CA27-29. This marker is found in the blood of most women with breast cancer. Typically it will remain at a stable level, somewhere less than 34. I will have it drawn and observed over time. An increase in the level of this marker can be a cue that my breast cancer has recurred or I have developed a cancer of the colon, stomach, kidney, lung, ovary, pancreas, uterus or liver (medicinenet.com, 2006). These cancers will also cause an increase in CA27-29. During my visits I will also have a chest x-ray or a chest CT scan to look for recurrence in the bones of the chest. That is one of the more common sites of breast cancer recurrence.

So much to look forward to! I will do it all. I want to be able to look back knowing that I took every step I could to treat my cancer and increase my chances for a long and health life. I've still got quite a few things to do. And tomorrow, we are going to look at a boat.

References

American Cancer Society [ACS] (2006). Hormone therapy. Retrieved May 15, 2007 from
http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Hormone_Therapy_5.asp?sitearea=

Medicinenet.com (n.d.) Definition of CA27-29. Retrieved May 15, 2007 from http://www.medterms.com/script/main/art.asp?articlekey=39199

National Cancer Institute [NCI] (n.d.) Fact sheet: Tamoxifen: Questions and answers. Retrieved May 15, 2007 from http://www.cancer.gov/cancertopics/factsheet/Therapy/tamoxifen

Pictures from the Race

2007-05-14T17:56:00.000-07:00

I finished.

2007-05-13T19:14:00.000-07:00

I finished the 5 K walk. Mary told me that if I had won the race, I would have gotten the cure. Oh well. I'll have to be satisfied with finishing my chemo tomorrow.

The race experience was incredible. I had no idea what kind of impact it would have on me. I can't put it all into words yet. I have lots of photos that I will post. I am exhausted tonight yet somehow very satisfied and content.

Race for the Cure

2007-05-10T17:00:00.000-07:00

The Race for the Cure is just a couple of days away. According to the race website, they had 45,000 participants last year and this year are hoping for 60,000. I will be there with my family members, my friends, and my co-workers. I will be walking and hoping that I am able to finish the 5K route.

Today I stopped at Children's ED to visit. It is always so bittersweet to go there now. I am always met by such enthusiasm and always feel a bit sad that I am not a part of the team right now. I miss the people so much. I think you don't realize how important your work place is within your social network until it is not there. Certainly I've had contact with people I work with~lots of cards, phone calls and visits but going in there is different. Today was especially difficult and this will related to the Race for the Cure!

Children's Hospitals and Clinics of Minnesota (http://www.childrensmn.org/) has always been a strong supported of the Race for the Cure. This year there are more than 300 employees throughout the organization who will be participating. They will also have a booth at the associated health fair...stop by and tell them what a great place Children's is to work for because it is. But this year there is more. Karen A., one of the nurses in the ED designed and took orders for a special Race for the Cure t-shirt for our department. It is a stunning pink and white tie dyed t-shirt. The front of the shirt has the corporate logo displayed. The back is...well, beyond description.

I had heard that Karen had taken on this project but I had no idea of the magnitude. She took orders for 44 shirts and now that they have arrived, she has had requests for more. I would even like to order a few more! These are the shirts that my co-workers will be wearing on Sunday when they participate in the Race for the Cure. She called me yesterday to let me know the shirts were in. While I was there today, I picked up my shirt. I stood in our office and unrolled it and admired the front. It was really pretty. And then I looked at the back...

Amazingly, I did not cry. Until I got back into my car, that is! I cannot believe that Karen and the ED did this for me. I do not deserve this attention and support! I am just one of many thousands of women who have had to deal with this disease. And I am not even that nice at work sometimes! I get crabby and short-tempered. I forget to say thank you to the staff and sometimes take my co-workers for granted. Despite my significant shortcomings, they did this for me...because they care.

The lessons of this cancer diagnosis have been many. Today I add humility to that list. I am so fortunate to be able to work with such a caring and wonderful group of individuals. They are more than co-workers to me. They are a part of an ever-growing support network of concerned others. I am so thankful to them, for their support, encouragement and love.

On Sunday at the race, look for my co-workers. They are the ones who will be wearing these beautiful t-shirts. Karen will be running. If you see her, let her know how wonderful she is. In fact, if you see anyone wearing one of these terrific tees, let her/him know who wonderful she/he is!

And please, don't forget. Mary and my sister Pat have planned an open house lunch back at our place. We're hoping to be home from the MOA by 1 pm. Please stop by if you can. We would like to thank everyone for their kind support of me and my entire family throughout this past 4 months.

I am celebrating another thing...Monday, May 14 is my last chemo!

Mammograms

2007-05-07T06:58:00.000-07:00

Someone I love needs a mammogram. She doesn't want to get one and I am having trouble understanding this. No woman looks forward to her mammogram. It doesn't usually come with presents or fanfare but it is something that we need to do. It is a part of routine health care for women. It is a necessary evil.

The first time I had one, I was a bit nervous. Someone told me it was like having your breast driven over with a truck. Great. But I was determined as someone I worked with had just been diagnosed with breast cancer through a routine mammogram. Into the x-ray room I went. There I met a very compassionate woman who described the procedure to me, talked me through it, told me when things were going to be "uncomfortable" and when it would be over. The entire thing took less than 15 minutes. Was it fun? No...but it was necessary. And each year since then I went in, never looking forward to the procedure with happy anticipation but always ready to face it. It was the mammogram on 1/30/07 which quite likely will give me many more years of life. Great wisdom out of painful experience~what a gift I have been given.

So...back to this woman. She's my age, intelligent, well-educated, capable and yet, she refuses to have a mammogram. In discussions with her I can't get an answer about what is so frightening to her. "I just don't want to do it" seems like such a lame response, particularly when people around her will be living healthy lives as a result of a simple x-ray. Perhaps she knows something she isn't sharing. Perhaps she has found a lump and is too scared to know the truth. I can almost understand that. By now everyone in her life has been on her to have the mammogram and perhaps that is the reason for her inability to make the appointment. I'll never be able to really understand.

What I do understand is how much I love this woman, how much she means to me in my life and how difficult it would be to lose her. Perhaps that is what she needs to hear.

I have chemo brain!

2007-05-03T15:47:00.000-07:00

Chemo brain is a real side effect of chemotherapy. Researchers don't talk much about it because they don't typically do cognitive testing on patients before beginning chemo so there isn't anything to compare it with (ACS, 2004). Other sources describe memory loss and mood change as commonly reported side effects of chemotherapy. I attribute the mood changes to fatigue but apparently the direct neurotoxic effects of chemo agents (or the metabolites), and hormonal changes induced by the treatment may all play a role. Dose and dose timing, age, genetic factors, and the specific chemo agents may also influence the extent, duration, and the type of side effects each person will experience (Lymphomation.org, n.d.).

What chemo brain feels like to me is being in a fog, Not all of the time, but a good bit of it. Kind of like waking up from a nap a bit disoriented, only this feeling is very difficult to shake and move on. I am not quite myself and definitely not a sharp as I used to be. I have been forgetting little things and it is difficult for me to multi-task. Through in a bit of fatigue and I can't be trusted to remember anything important! Some cancer survivors have report they know it is just something that they need to deal with. As they move further into their chemo cycle, the fog is easier to lift and life gets a bit easier (Sievers, 2006). For now, it is hard to write legible sentences and hard to read anything more difficult than the comics. I have been trying to read a cold war spy novel but had to give up...there are too many characters to keep track of!

What is most difficult for me about this particular side effect is the way it is affecting me emotionally. What if it never goes away? What if I am never able to trust myself and my professional abilities again? Of course, time will tell and other survivors report that the problem gradually disappears.

Chemo #3 was this past Monday. Zander (the oncologist) told us that each round would be more difficult for me. He was right, again. This was the worst so far. I was sick by the time we got home and went right to bed. I was able to get up for dinner and visit with my family but it was short-lived. I was back to bed rather early. Most of the time since then I have been sleeping. I get up to let the puppy out, play with her a bit, try to eat something and I am back asleep. This is difficult for me. I am not a napper and I often equate napping with lazy. Since I am now napping, I am therefore, lazy and I don't like to think of myself that way. The weather is beautiful that I would like to be outside digging in the dirt but the thought of those tasks seems insurmountable to me right now. Chemo redefines the term 'fatigue'.

I did have a big outing today though! I went for a short visit to Children's ED. I really miss everyone there so much! It was very nice to be there, catch up on the gossip and see people. I am looking forward to returning to work on June 1. I hope that I will be able to handle the job, particularly given my chemo brain. Thankfully I work with a wonderfully, caring group of professionals.

References

American Cancer Society [ACS] (2004). Seeking solutions to chemo brain. Retrieved May 3, 2007 from http://www.cancer.org/docroot/NWS/content/NWS_2_1x_Seeking_Solutions_to_Chemo-Brain.asp

Lymphomation.org (n.d.). Chemo brain. Retrieved May 3, 2007 from http://www.lymphomation.org/side-effect-chemo-brain.htm

Seivers, L. (2006). The fog and fatigue of 'chemo brain'. Retrieved May 2, 2007 from http://www.npr.org/blogs/mycancer/2006/11/the_fog_and_fatigue_of_chemo_brain.html

Puppy Update

2007-04-29T13:47:00.000-07:00

It's been a quiet week for me spent slowly starting to feel better after last week's chemo. For Piper, it's been an exciting and busy week spent mostly, growing. In the past 2 weeks, she's gained 6# and grown 3 inches. Now at 13 weeks of age, she is 30# and 19" at the shoulder. We're still working very hard on getting outside in time to go potty and making some progress. We have been attending puppy school and thus far, she's working on sit/stay and down/stay. She seems to have sit mastered pretty well. She also has learned how to dig holes and her big sister's have taught her all about eating deer (and other) poop outside. She even had the chance to play with some busy 5-year-olds!

The first photo is by master photographer, Annika Johnson!

We've had some progress with big sister Olivia. They have been caught on several occasions, playing together. This occurs mostly outside but that's ok. Progress is progress. And please, don't tell Olivia. What she doesn't know won't hurt her!

There were even caught sharing the little dog bed. At the rate Piper is growing, she won't fit much longer.

Tomorrow is chemo #3...yea! I will be 3/4 done. No pity party this time. I am ready to get going so I can be done. As has become a nice routine, Mom and Bob will come over tomorrow afternoon to make dinner for us. It is so wonderful to come home and not have to think about dinner. Thus far, it's been really good stuff too! Tomorrow will probably be no exception.

Here's one more cute puppy photo. This is something we are both really good at~taking naps!

Photos from the Tournament

2007-04-24T08:08:00.000-07:00

Team Mack

Stickin' Around

Other photos from both Team Mack's and Stickin' Around's games can be viewed at: http://www.kodakgallery.com/BrowsePhotos.jsp?&collid=62450694206.717928067206.1177428052568&page=1

An overwhelming weekend.

2007-04-22T17:04:00.000-07:00

It was an overwhelming weekend for me. The Stick It to Cancer Hockey Tournament began last Friday. There were 77 hockey teams registered for play that covered 3 full days. There were womens and girls teams of all ages and from various parts of the region. To many of the teams, this was simply an opportunity to play more hockey in an organized and well-run venue. To others though, this was an opportunity to play some hockey while benefiting a cause that touches the majority of us~cancer. On Friday afternoon I spent the afternoon monitoring the silent auction area. As a job, it was not tough. I sat on a chair and watched people look at the donations and encouraged them to make bids. I did the same thing on Saturday for another 4 hours. During these hours I had lots of time to observe people. Apparently I was feeling a bit more philosophical than normal as my observations seemed to extend beyond your typical 'people watching.' There are two things that seemed to emerge as themes for me.

First, everyone is nice to a bald lady. I am not wearing a wig and I don't like wearing hats...they pinch my head and since I look like a pirate wearing a scarf, I am left to be bald-headed. So there I sat, bald wearing a volunteer t-shirt and some good earrings. Most of the people that passed by made a point of saying hello, good morning or some other pleasantry. Other volunteers and vendors in the area came by frequently wondering if I wanted or needed anything. Many people stopped to ask how my treatments were going or how I was feeling. One man stopped to tell me about his daughters who were playing in the tournament and how he had a discussion with them about cancer and why their teams were playing in this particular tournament. He wanted them to know it was important to give of themselves. A couple of women whose teams were playing in the tournament stopped to introduce themselves to me as they recognized me from my blog.

Second, everyone has a cancer story and many, many people want to share it. I heard about sisters, mothers and grandmothers with breast cancer. I heard about prostate and colon cancer. Some of the stories were tragic ending in the death of very young, vital people. Others were hopeful and inspiring...like my team mate Judy's Mom who celebrates her 10-year victory over breast cancer! I met her and she looks wonderful! And Judy's partner Lisa, whose mother is a survivor also. No matter what the story, there seemed to be an underlying theme. Everyone is afraid of the big C. And rightly so. Recent studies report that 1 in 3 Americans will be affected with some type of cancer some time in their lives (sorry...no citation, something I heard on MPR). It's an intangible force that can't be challenged directly and carries tremendous morbidity and mortality. It is more than most people can comprehend for their own lives.

I came away from this experience with these two new awarenesses and have to find a way to use them in my life. Why aren't people nicer to those with hair? What is it about baldness that makes us go a bit further for someone? Is it because they are obviously sick; and therefore, more needy? Perhaps I need to be just a bit friendlier, more cordial and willing to chat with those around me. The other lesson relates to the fear of cancer we live with. I have always believed that it did no good to fear things that were out of our control. Afterall, there was little we could do to prevent certain things. While that may still be true, perhaps we do need to fear cancer a bit more. It does come calling with pain and heartbreak, destroying people in its wake. I know that I will never be the person that I once was. My life is, and will be different. I hope that I will be better but maybe this experience will make me more cynical and bitter than I was. While there is no magic prevention plan for cancer, maybe those healthy lifestyle issues we talk about really can help. They certainly can't hurt.

During this weekend, there were some tremendously personal gifts as well. There was a group of women who renamed their hockey team Team Mack and skated their hearts out for me. There was my team, Stickin' Around who also posted my picture and story on their bench and locker room and scored all of their goals for me. There were key chains and bracelet links with my name on it. There was a beautiful and touching gift basket from my Stickin' Around friends. There is not a way to thank everyone for the gifts I received, both the tangible and the intangible. I am overwhelmed and I am just one of many thousands of women who live and survive with breast cancer. But I am lucky. I have a network of love around me that is vast and endless.

During the night I woke with a fever. I didn't measure it with a thermometer as it may have been exceeded the level at which I am supposed to call the oncologist. The fever came with a bit of a sore throat and a headache...most likely a viral illness preying on my altered immune system. I took some Tylenol and went back to sleep. Today has not been a great day but I don't have a fever but I did not get to return to the hockey tournament to watch my teams' last games. Neither team won their tournament brackets. But they are all winners...and they are my friends...and I am blessed.

Tomorrow I will publish photos from the tournament. Please stay tuned.

4:08 am

2007-04-20T02:09:00.000-07:00

I am a professional sleeper. At least I have been up until this diagnosis. Now, the wierdest stuff gets me up and my mind going. This morning it was the puppy that started it; however, she is now sound asleep in the middle of our bed and I am in the kitchen, awake.

So what is going on my head that is preventing sleep? One would think it would be life-altering and profound questions but it is just stupid stuff like...I forgot to order the groceries, there's laundry to be folded, did the Wild win? (no), Olivia bit the mailman, there are student papers to look at, did I set up the online quiz for them correctly?, there is a faculty meeting coming up...and oh yea...I am craving macaroni and cheese. Not any mac and cheese-I want the stuff in the blue box that we all ate when we were growing up. Since we don't have that around, I guess I can substitute a grilled cheese sandwich...but what is in that bread that has kept it edible for so long?

See what I mean? Nothing earth shattering, just life's little irritations.

So it is now well after 4 am and I am eating my grilled cheese sandwich (with milk), trying to get a bit of perspective on all of this. I am not up thinking about cancer. I am not worrying about if and when I am going to have a recurrence. That is progress. My cold, bald head assures me there are very powerful drugs circulating in my body that are preventing that recurrence from coming. I wonder if those drugs are also responsible for this sleepless night?

So I will finish my sandwich, double check that I posted the quiz for my students correctly and try to go back to sleep. The puppy will be awake soon...

I am not my hair.

2007-04-18T07:56:00.000-07:00

Chemo 2 is over. It went well. The oncology nurse practitioner made some changes in my home meds and I am feeling better...as long as I don't eat much, I don't have nausea and so far, no vomiting. The biggest event is the loss of my hair...

On Monday morning when I was washing my hair, I noticed a weird kind of feeling on my scalp. I mentioned it to the NP and she told me this was the beginning of the end of it. By the time we were on the way home from chemo later that day, there were a few hairs coming out. By early evening, I was able to painlessly pull handfuls of hair out. It was time to shave it off. Why not, it was a beautiful evening and my family was there to witness it. Mary and I went out onto the deck and began.

It as been important to me to maintain a sense of humor throughout this process. Having your head shaved was no exception! Mary seemed to enjoy the experience as well...starting out by giving me a "bowl job" and then working up to a mohawk.

Yes, we throw gang signs here in Woodbury!

Mary also wanted to leave a few tufts for good measure but I knew someone would have to vacuum them up so I had her just do it all. We swept all of my hair (what little of it there actually was) off the deck into the wind for the birds and little animals. Perhaps they will use some of it for nesting materials.

I cried while Mary shaved my head. My Mom cried while Mary shaved my head but then decided I looked like the day I was born. My sister took photos for us. She didn't cry which I found a bit surprising. Here is an after photo of my Mom, my sister and I.

And yes, I do look like a cancer patient now. My head is cold and it feels weird. I wear a baseball hat with my pajamas. I am startling to see for the first time. My friend Betsy stopped by yesterday and was a bit startled but then said she quickly got used to it. Our friend Lorin stopped by yesterday afternoon to kiss my bald head. It's just weird.

But I am more than my hair...much more. Losing my hair is an outward sign of the fight I am waging. And hair grows back.

My friend Kellee sent me a song called "I Am Not My Hair" by India Arie. I don't know how to link it directly here so you can listen to it, but here are some of the lyrics:

I am not my hair, I am not this skin, I am the soul that lives within...

Does the way I wear my hair make me a better person? Does the way I wear my hair make me a better friend? Does the way I wear my hair determine my integrity?

Breast cancer and chemotherapy-Took away her crown and glory... She promised God if she was to survive, She would enjoy everyday of her life...Baldheaded like a full moon shining Singing out to the whole wide world like hey~I am not my hair, I am not this skin, I am not your expectations.

If you want to listen to this song (and the album...it's good!) go to iTunes.

Oh...woe is me.

2007-04-15T16:30:00.000-07:00

I'm having myself a bit of a pity party tonight. It is the eve of my second chemo session and I have had a tremendously great weekend. The weather has been incredibly beautiful and I have felt great. No vomiting in several days and no need for naps the past couple. I was able to get outside dig in the dirt a bit and enjoy the spring. And now, oh...woe is me.

Tomorrow is my chemo #2. I got a call from the oncologist's nurse to let me know my blood counts were great and I was ready for the next treatment. Yippee. I get to go in there tomorrow for 5 hours, get stuck with needles and infused with medications that are going to make me feel horrible for days. What is so ironic about all of it is that no one is making me go. I am choosing to participate in my treatment plan freely. There is no penalty for not showing up and no contract to violate. If I didn't go the only person harmed is me. I can't imagine how I would deal with the guilt and shame I would feel if I have a recurrence knowing I didn't do everything I could possibly do.

So I will go.

On a brighter note, I got an email from my NP friend Kristin to say that she had passed her national acute care certification exam. Congratulations Kristin!! I am very happy for her and her success. I did not pass. I missed the passing grade by 9 points. I have known about this for 3 weeks but was toooooo ashamed of myself to tell anyone but my family and the closest of friends. It is the first thing that I can remember failing in my life. Kristin noted in her email that she downloaded some information about the test and found that the test administrators state that those who fail often have some mitigating life circumstance going on at the time of the test that contributes to their failure. I suppose cancer counts as a life circumstance which could interfere with my test-taking abilities. Nonetheless, I consider myself a bright and well-educated person who should (after being a nurse and an NP for this long) be able to pass a certification exam. I find this failure embarrassing regardless of the circumstances. And yes, I get to take it again. Oh, lucky me.

I will now return to my pity party, already in progress.

There is no escaping.

2007-04-13T07:09:00.000-07:00

There is no escaping cancer in our society. Yesterday I got an email from a woman that I used to play hockey with. She had just been diagnosed with breast cancer herself. She is younger than I am. That makes 2 women we know who have been diagnosed since I have been. And that is only women we know...

You cannot pick up the paper, go to the grocery store or sign onto your computer without messages regarding cancer of some kind. New warnings, new studies or new products re-designed to increase our awareness and generate research funds. I recently received this in an email from our friend Kris. Apparently M&Ms are now available in a breast cancer awareness package. A check at the M&Ms corporate website finds that they are "Passionately Pink for the Cure." You can find their pink products and recipes at http://us.mms.com/us/news/promotions/komen/

Kitchen Aid has also gotten on board and invites you to "Cook for the Cure" with their line of pink appliances: http://kitchenaid.com/content.jsp?sectionId=457. I am not sure that I need a pink mixer but ok...I admire their attention to the cause. There is also this website called "Think Pink" offering everything adorned in pink ribbons that you can think of: http://thinkpink.homestead.com/Index.html. They even offer the plaid Better Homes and Gardens cookbook (you've all seen one of these...many of you probably own your own copy in red plaid) in pink.

Perhaps I am getting a bit tainted as my life has been filled with breast cancer since early February. If I am not reading about it or thinking about it, I am at an appointment related to it. More recently I have been napping as a result of it. But in the greater society, there is no escaping our attention to cancer in general.

Please don't misunderstand me. I am grateful that there has been the attention to breast cancer thus far. Because of the attention it has gotten, more is known about treatment giving me greater treatment options. That is all good. But if you are someone with cancer, short of closing your eyes and ears when you leave the house, there is no way to escape it for a moment.

About a week ago there was a letter to the editor in one of the local newspapers. It was from a woman who was a breast cancer survivor. I didn't think to clip the letter itself but I found her words interesting. Her point was that she had put her cancer into perspective within her life but society has created so much attention around cancer that she can not escape it. I suspect this will be true for me and all of us diagnosed in this time period. I know there will come a time in which I will truly be able to put this in my past but will the world around me allow it to remain there?

Progress

2007-04-10T09:00:00.000-07:00

When we brought the puppy home a week ago, Olivia was insensed. She would get up and move away whenever the puppy came near her. She wasn't mean or aggressive in any way...just indignant perhaps because she once again, had to share her space with a new creature. Yesterday I found the two of them laying together on the dog bed in the sun. They weren't interacting but they were on the same bed. They may have even been touching. Now that is progress!

It has been 8 days since we brought Piper into the house. While Kaja warmed to her immediately, Olivia clearly has a different process and her progress has been slower and perhaps, more deliberate.

Observing the progress of my girls got me to thinking about my personal progress. Yesterday marked 2 months since I heard those words, "you've got breast cancer" for the first time. What is progress? We typically equate the term with positive and forward movement. Ok. I think I have achieved a degree of that. I no longer burst into tears when I talk about breast cancer and it is no longer the only topic discussed in our household. That's progress...right?

Many times in the past couple of months, I taken a few steps backwards. From that perspective, I have been able to take a different look at myself and my situation. That's progress too, isn't it? Even if it did involve a move backwards. And certainly, I am progressing in the treatment of my cancer. I survived my first chemo session and look forward to the next, if only to have it too, behind me.

So how do we measure progress? Sometimes in baby steps. Perhaps that is what I am seeing in Olivia and Piper. It is also what I am seeing in myself sometimes. I no longer am so shocked when I see my naked self in the mirror yet my body doesn't feel like mine yet. It still feels different and foreign and the scars are still horrific. I no longer burst into tears for no good reason yet still cry when I have an intimate conversation about my cancer with someone close to me.

I also think we can measure progress in backward steps. Some life experiences cause us to stop, back up and consider the bigger picture...that which is greater than ourself. Our relationships for instance. Without stopping and taking a step backwards for observation, how can we ever do the periodic reevaluation that is so necessary. At many points in the past two months, I have had to look at the relationships in my life. How have they been affected by my breast cancer? How is my partner...and what will our new relationship look like as a result of this diagnosis? What about my other relationships? From that perspective, we become better prepared to move forward once again. Chances are no relationship will be the same as it was before.

So I take a lesson from Olivia. Progress is growth and change. It is allowing ourselves exposure to new things or even, revisiting old things. Progress is a process. It can be difficult or painful. It may be tremendously rewarding. It is often slower that I would like but happens despite us. We could fight progress but that doesn't seem to make much sense to me.

Happy Easter

2007-04-08T09:02:00.000-07:00

Happy Easter. To those who do not participate in the religious aspect of the holiday, today is a day to celebrate the best in seasonal treats...the chocolate rabbit. Who among us can resist those velvety ears? Unfortunately, the Easter Bunny did not make a stop at our house this year and as such, we have no chocolatey ears to nibble. Alas.

And what about those marshmellowy little devils, the peep? You remember them. The bunny was notorious for using those as filler when I was a kid. Since then, the peep has become an icon for the holiday showing up in various settings. For an Easter chuckle, check out this website, http://photo.twincities.com/index.php/2007/04/07/peeps-diorama/ to view dioramas constructed with peeps. I am amazed at what people can think of and choose to spend their time doing. It made both Mary and I laugh!

5 Days Out

2007-04-07T07:57:00.000-07:00

Today is Saturday, 5 days post-chemo and I feel pretty good! More like myself with a bit of an appetite and no vomiting for 2 days! This is good. I actually have some energy and feel as though I can get some things done today. I still have hair. I can probably even keep up with the puppy today! And we have a big day planned with visits to PetCo (socialization) and the fire station for dinner.

On Thursday, Mary and I were out with the puppy. It was near 3 pm and we decided to stop at Children's ED for a visit. Good socialization for the puppy and I knew a couple of my friends who would appreciate a visit from a puppy (Marsha and Kellee) were both working. 3 pm is change of shift in the ED and there were lots of staff around. I can't believe how wonderful it was to see these people that I work with. They are so much more than co-workers. They are my friends and I miss them! Don't misunderstand...I don't miss the work per se but I really miss going to work. I miss seeing people, gabbing with them, finding out what is new with their kids and their families. I want to hear about their puppies and their vacation plans. I miss it. Who knew.

Team Mack

2007-04-05T15:11:00.000-07:00

Here it is...the Team Mack logo! Is this not incredible or what? I think everyone should be buying at least one for their own.

I have to admit I have struggled a bit with the amount of attention that I have gotten around my diagnosis and treatment. Yes. I have breast cancer and many women do. Breast cancer is the most frequently diagnosed cancer in U.S. women accounting for nearly one out of three cancers diagnosed in U.S. women (ACS, 2004). An estimated 178,480 new cases of invasive breast cancer are expected to occur among women in the United States during 2007. An estimated 40,460 women will die from breast cancer. It is estimated that 2,030 men will be diagnosed and 450 men will die of breast cancer during 2007. In addition to invasive breast cancer, 62,030 new cases of in situ breast cancer are expected to occur among women in 2007. Of these, approximately 85% will be ductal carcinoma in situ (DCIS) (Susan G. Koman, 2007).

And back to my point...I am just one of many women facing breast cancer. I am one of the most fortunate ones. I have several things going for me that other women may not. First, I have an incredible support system. My family and friends have rallied the wagons and circled our entire household with love and support. Some of them have "been there" themselves in one way or the other and they can offer a different perspective. I am also finding that most people we have come in contact with have known someone else who has struggled with cancer themselves. Since my diagnosis, we have had another friend diagnosed and our friend Kristin told us of having two other friends of hers diagnosed. This is clearly an endemic issue.

The second thing that I am fortunate for is my medical background and incredible health insurance. I don't know how people without some type of medical understanding get through this. There is a lot to know, understand and coordinate. There are many questions to be asked, treatments to consider and outcomes to ponder. Mary has become a breast cancer expert as well! I came home from chemo on Monday with 5 different prescriptions. Just knowing which one to take when can be difficult to understand. As for insurance, well...one of my prescriptions was $3010.84 alone. Enough said.

Initially I was embarrassed by the attention I was getting around my cancer. While I am an extroverted person, I tend to keep personal issues to myself. But this I couldn't. I wanted to share this news because I am just one person. And next week it could be any one of you or someone you love...and I don't want that to happen. Perhaps right now you are looking at me as if I am your daughter, your sister, your aunt or your mother. That's ok. I am spreading the word.

Get Checked!

References

American Cancer Society (2004). Breast Cancer Deaths on the Decline. Retrieved April 5, 2007 from http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Breast_Cancer_Deaths_on_the_Decline.asp

Susan G. Koman Foundation (2007). Breast Facts: Statistics. Retrieved April 5, 2007 from http://cms.komen.org/Komen/AboutBreastCancer/BreastFacts/BreastFactsStatistics

They weren't kidding.

2007-04-04T16:08:00.000-07:00

When Mary and I attended Chemo class in March, one of the side effects they talked about alot was fatigue. Their solution was to take a nap. Well...they weren't kidding about the fatigue. And I am following their complex advice by taking a nap. We think the puppy is in a growth spurt (wait! Great Dane puppies are in a year long growth spurt!) so she is more than happy to nap with me.

I went to school today and it was as easy a day as I ever could have had: Mary dropped me off and picked me up door-to-door, I watched student presentations and had 3 short meetings. Total time=6 hours. By the time Mary picked up at 3 pm, I could hardly wait to get home and crash. Now, after a 2 hour nap I finally feel like I can get out of the recliner and maybe do something...like fold a load of laundry. We still aren't completely unpacked after vacation either.

The rest of my side effects aren't bad. I've had some nausea but ativan has taken care of that. It seems to be worse at night for some reason...like after 11 pm. That's a good time to take ativan anyway. I also don't have much of an appetite but again, that's not the end of the world.

I've only got 3 more sessions and I am tougher than chemo!

Hockey and Breast Cancer

2007-04-03T07:33:00.000-07:00

Who knew these two went together? They do, at least in Minnesota and in a big way! The Stick It to Breast Cancer Women's Hockey tournament is coming up later this month at the SuperRink in Blaine. My team, Stickin' Around is playing. The have put an ad in the tournament program that I find incredibly touching.

They are wonderful group of women that I have been so fortunate to meet and skate with this past winter. I am planning on rejoining them in the fall.

My former team is called Icy Hot. They are also playing in the Stick It Tournament and have done a couple of things that I want everyone to know about. First, they have renamed their team to Team Mack in my honor. They have also created a jersey just for the tournament. They will be skating in their new jerseys but have also made them available to anyone interested in purchasing them as an additional fundraiser for the tournament.

Here's the information they published about the jerseys:

As you know, we've changed our name for the Stick It tournament to "Team Mack" to show support and encouragement for our former goalie Mary Mackenburg (current goalie for "Stickin' Around"). Mary Mack also managed and played for "Blades of Steel." Mary Mack has been a great proponent of women's hockey over the years. Because she is an educator at heart, she has chosen to blog the entire story of her cancer at http://a-womanofsubstance.blogspot.com/ so that all of us can follow her journey and learn. Our team knows there are many women standing bravely to fight cancer. We know none of us are exempt. We are pleased to have an opportunity to skate in the Stick It Tournament to fight cancer.

Mike Curti (Chicks with Stix, and illustrator for Hockey Magazine) is graciously designing a jersey logo for Team Mack. The jerseys will be a practice quality dark color and the illustration front will say "GET CHECKED" in pink. They'll also say "TEAM MACK" and will have a # on the back. Size L or XL. We've gotten a break on the jerseys from Dave's and the screen printing company so the net cost is about $15/jersey. We were going to only order these jerseys for our team and to our surprise -- others have expressed an interest in owning them. We are offering an opportunity to anyone involved in Stick It to buy one of these jerseys. We'll sell them for $20 and give $5 back to the tournament. They must be ordered April 9th.

If you are interested in ordering your own jersey, here is the information:

Team Mack Jersey Order Form

Your name___________________________________________________________

Best phone # to reach you ________________________________________________

Your email___________________________________________________________

Jersey size? L XL

Number on your jersey? _____________

$20 payment in full to Stick it Jersey/Sapa Carlson
Jerseys can be picked up at the Tournament Office at the Super Rink during the tournament.
Our cost is $15/jersey. $5 from each jersey sale will be donated to Stick it to Cancer.
If you have any questions, please email Sapa@sapaRealtor.com

Orders and payment must be received by Monday, April 9th.
Please send your check and order to:
Alison Talley
8817 West 35th Street
St Louis Park, MN 55426

If you decide to order a jersey, I will be attending the tournament and will be sure that you receive it. You might want to consider attending the tournament yourself. In addition to watching some great women's hockey, they are having a waffle breakfast and a silent auction. All proceeds from the tournament and other events (including the Team Mack jerseys) goes to breast cancer research.

How about now?

2007-04-03T07:11:00.000-07:00

1 down, 3 to go. I survived my first chemo session. It was a long day! It started with a blood draw then a visit with the oncologist who was not impressed with my tan...go figure. From there, it was into the infusion room. They tuck you into a comfy recliner and get your IV started. The first medication given is called Aloxi (palonosetron HCL). This is a long acting anti-emetic in the family of zofran but lasts up to 4 days. Anti-emetics are drugs that control nausea and vomiting. After that it was a dose of IV decadron (a steroid) with some NS. From there, the big stuff: adriamycin and cytoxin. The drug infusions along with some IV fluids took 2.5 hours. Aside from the discomfort of the needlepokes, it was fine. I layed there and watched Grey's Anatomy on my iPod. We were at the Piper Center for about 5 hours. Poor baby Piper had to stay in her kennel for that time...it was a first.

When I got home I actually felt pretty good. I made some phone calls, did the dishes, etc. Mom and Bob arrived and made us a delicious dinner which tasted great to me. We then moved into the living room to watch the Twins opener. It was then the nause moved in. Throughout the evening it was tolerable but slowly worse. My demeanor changed from this first photo to this one taken at 12 noon, to the second one taken at about 10 pm last night. It continued to get bad until it was intolerable at about 1 am. The words of my nurse came back to me...stay on top of it! Use the drugs we give you. I finally took a dose of Ativan (lorazepam) and it seemed to help. This morning I am just a bit nauseated. I have compazine I can use as needed as well. My other post-chemo meds include decadron daily for the next 3 days, and zofran as well as the other anti-emetics. Today I have to have a subcutaneous (that's into the fat...of which I have plenty yet) injection of a drug called neulasta (pegfilgrastim). It is a bone marrow stimulator that increases the production of white blood cells so that you bounce back from your chemo runs more quickly. Apparently one of the side effects of this drug is bone pain as you marrow goes into overdrive. That side effect typically begins about 5 days after the dose, or right about the time the bad side effects from chemo start to wan...it could be a long week! I also learned yesterday that it could take 2 weeks before my hair falls out. I did check this morning, just to be sure it was still there. So far, so good.

One of the things I worried about was if I looked like a cancer patient when I went back to work after my surgery. At that time, I didn't. I felt good and looked like my usual self. So how 'bout now? Do I look like a cancer patient? Not really. I probably won't look like one until my hair is gone. Of at least that would be my take on it after spending yesterday in the chemo infusion room. The only other patient there with hair was wearing a wig. But even though I don't look like a cancer patient today, I feel more like one.

1 down, 3 to go.

Home

2007-04-01T16:42:00.000-07:00

We have safely returned home. It was a long trip with a puppy although she did very well. Thankfully, she does not get car sick! She quickly learned how to move from her kennel in the backseat into the lap of the front seat passenger. By the time we got home she was already getting pretty good walking on a leash and would pee the second her paws hit some grass. Her name is officially, Piper. Meeting her sisters went pretty well. Kaja wants to play with her. When Kaja comes too close though, the puppy gets scared. She has also been busy stealing the puppy's toys away from her. Livie is interested in her...from a distance. I have been trying to get a picture of Piper next to Olivia as a size comparison but every time we put the puppy next to her, Livie moves away. Our best effort is posted.

I did take my Acute Care Certification Exam on Friday, March 30. We'll see. It was the most difficult test I have ever taken in my life...and I, a professional student, have taken a lot of different exams in my life.

My chemo begins tomorrow. We have to be at the Piper Center at 9:50 am. I hope I feel better after my chemo is done than I felt after my test was over.

A Quick Update

2007-03-29T15:13:00.000-07:00

I am scheduled to take my acute care board exam tomorrow morning at 9 am. When I recieved notice that I was approved to take it, I called the exam agency. When they asked when I wanted to take it, I told them tomorrow. The guy told me that couldn't possibly happen. I told him my situation with chemo beginning on Monday and he put me on hold. When he came back, he said I could take it tomorrow morning at 9 am. That is perfect and exactly what I wanted. I think it is interesting that many people have told me that things "can't possibly happen" like I want them to until I play 'the cancer card.' At that point, things happen. I think that is so interesting. If they can happen after that, why can't they happen before that?

Thus far, the name for our new baby is still undecided. Those of you who have been sending your thoughts to us, have put Harley or Piper in the lead. We'll let you know.

We leave for MN on Saturday morning. I am anxious and dreading it at the same time. I am interested in being home again. I miss home. I miss my bed and my big girls but the same time, being home means starting chemotherapy and that is scary.

Meet Blue Collar Girl.

2007-03-27T17:40:00.000-07:00

Yes. We are crazy.

Meet blue collar girl. She will be coming home from Florida this week. We probably need a puppy right now like a fish needs a bicycle but sometimes need is a secondary (or further down the list) factor in decision making.

When I was hospitalized for my mastectomy, my roommate told me about getting a red convertible after she was diagnosed with her breast cancer. She called it her cancer car. Hmmm....what did I want? I started out by asking for a cancer Harley. Mary agreed but pointed out that it would be a real shame to survive cancer only to be killed on a Harley. Ok. Point well-taken. She countered with a cancer Lexus but that wasn't too exciting. I recountered with a cancer boat but this year, that is out of the financial question. One night last week when we were out to dinner, we discussed getting another great dane puppy. I agreed but put some parameters on the purchase...must be black, floppy ears, ready to go now and remind me of Greta. Darn it all anyway if Mary didn't find the perfect little girl here in Orlando. She and Alvin did a preliminary visit with them last Saturday and today Mary and I returned to look. There were 5 females in the litter. I met the mom first and she reminded me of Greta immediately. Her puppies are beautiful and after an hour of playing with them, I chose blue collar girl. We will be picking her up on Friday night and bringing her home with us. Yes...we are crazy.

This baby has no name yet. She is 8-weeks-old (born 1/24/07) and has 4 sisters and 5 brothers. Her parents are beautiful. Since she is my cancer Harley, we have been trying to think of cancer/treatment related names. Some how though, Mamie and Chemo just aren't cutting it. In the front running is Piper (Piper Cancer Center) and Annie (a trimmed down version of zofran, one of the drugs I will be on). Let us know what you think her name should be...we'd love to hear your thoughts too.

In the meantime, call us the crazy girls in Florida.

What a weekend!

2007-03-26T17:44:00.001-07:00

This past Saturday we had to move from Daytona to Orlando. I had a conference to attend beginning at 7 am on Saturday. Poor Mary and Allyson had to leave at 5 am with me! The conference was a review course for my Acute Care Pediatric Nurse Practitioner Boards. I am currently certified in Primary Care but need to be certified in Acute Care as well. If I complete the exam successfully before the end of this year, I am not required to complete any additional coursework. I had registered for this conference before receiving my diagnosis and delayed the onset of chemo so I could get this out of the way before I had any brain effects from my chemo.

The format is this: sit in a room listening to lectures while following along in your 560 page review book for 12 hours on Saturday and 10 hours on Sunday. On Monday morning you show up and take the test. Kind of 'dump it in and pour it back out' format. The two days were grueling only made better by hooking up with Kristin, one of the NPs I work with. Together we got through the sessions with muttered comments, wheat thins and really good cookies from the Disney Resort it was held at. Last night we returned to our condo and studied until midnight complete with oreos and milk. This morning we returned to the conference site to take the exam. Neither of us felt completely ready to do so, but showed up nonetheless. Unfortunately for me, my name wasn't on THE LIST of those approved to take the exam. By that they mean those that had all of their paperwork in and had paid their $385 test fee. If your name is not on THE LIST, they don't permit you to take the exam.

The women administering the test here in Orlando were friendly enough and did try to help me. They contacted the national office and found that I was missing one piece of paper...something that I had passed off to be completed and faxed to them on my behalf but in the midst of the past month, forgot to check on. I (stupidly) assumed it had been done as requested but it was not. I pleaded with the women on site to allow me take my exam. I had just completed the review course and my studying. As the standoff went on, I got more and more upset (tired and stressed to begin with!) and began to cry. I explained to them my need to get the test done before starting my chemo. I even told them they didn't have to grade my test until they had the right paper in the office, just allow me to take it today. I think they would have but they had to check with the CEO...her name is Dr. Janet Wyatt. I mention her name because she could not have been more rude and condescending to me. She is a nurse practitioner and I am glad she is working as a CEO because I cannot imagine her providing care to children and their families.

I am not the kind of person who asks for special favors or other shortcuts. I play by the rules. I ended up talking with Dr. Wyatt on the phone myself. I explained my situation to her to which she could not have cared less about. With a "how dare you" kind of attitude, she informed me that I had failed to provided the appropriate documentation to them in advance and therefore, should not have even tried to compromise their standards by asking for such an accommodation. She scolded me on the phone like I was some kind of naughty child. I did not take my exam this morning. After sitting on a bench sobbing (crying people make Disney employees very nervous! Apparently no one should be sad in the most magical place on earth.) Mary picked me up and we headed to Kinko's where I could print a new form, fax it to the appropriate person for completion who assured me she would fax it on the the Pediatric Nursing Certification Board immediately. IF...and that is a big word right now...everything is approved in time, I may be able to take the exam here in Orlando on Friday. That is if God, I mean Dr. Wyatt deems I am worthy and meet their standard for the exam.

Dr. Wyatt was right about one thing. I should have taken the time to assure that all of the necessary documentation was in place. I did not need to be humiliated and scolded about it. And there would have been absolutely no harm to anyone if I had taken the exam this morning. Perhaps I would have had to wait longer for my results or maybe even they would have thrown it out if they didn't feel I met their standard for testing. I could have lived with that. There is a big lesson here for me. As one who does not ask for special accommodations, I have had difficulty providing them for people. Here is the lesson learned. People have special needs and from time to time, things happen. There doesn't seem to be a good reason to deny people their requests just because their is some kind of rule in place. If there is not a good reason to deny a request, what is the point? Perhaps this frustrating and irritating experience can help me to become a more compassionate human, nurse and and educator. And yes, special care is just what some people deserve sometimes.

Kristin has returned to Minnesota, certain that she failed the exam. We will stay in Orlando through the week so I can take my exam on Friday...I hope. I will have a few extra days to study. Perhaps I will be better prepared for the exam this way. Perhaps Dr. Wyatt really gave me a gift in her stubborn self-righteousness. By delaying my exam, I may actually be better prepared for it. During the next few days, you will be able to find my poolside with my 560 page study guide.

Mrs. Edwards and me.

2007-03-23T13:36:00.000-07:00

The news of Mrs. Edwards breast cancer metatsizing has me reeling a bit. This has got to be what every woman diagnosed with breast cancer fears the most...hearing the words that your cancer is back.

Breast cancer recurs...often. A recurrence can happen months or years after the original diagnosis and treatment. For example, even though a breast cancer tumor may appear small and localized, it may be aggressive and may have spread beyond the breast; this spread cannot always be detected by current methods. This aggressiveness, as well as other factors, can lead to breast cancer recurrence (Y-Me, 2007). Selecting a course of treatment that covers all of your bases (chemo, hormones, maybe radiation) is supposed to significantly decrease our risk of recurrence. At least that is what they told me and probably what they told Mrs. Edwards too. Now she is facing palliative treatment and a death sentence.

Other times in this blog I mentioned the fact that our heads (the rationale part of ourselves) and our hearts (the emotional part of ourselves) do not always match and this is one of those times for me. My cancer was not advanced when it was diagnosed as hers was. I should; therefore, fare better long term. But each new body finding is going to throw me into a tizzy. Like the lump I found earlier this week. The nurses at the Piper Center were wonderfully reassuring. So was my friend Kellee when I talked with her on the phone. I have every reason to believe that the enlarged node I am paying attention to is nothing but a localized reaction. After all, cancer doesn't spring up overnight. However, what if it is not. What if this node has been slowly getting bigger and just now, this week has grown to the point that I can feel it?

Please don't misunderstand. I am trying very hard to keep these feelings to myself this week. We are supposed to be relaxing on vacation. And for the most part, I am. But then it sneaks back in...the nagging doubt that like Mrs. Edwards, my cancer lays waiting to strike again.

While here, I have had time to think about all these things. Perhaps too much time. I spend my days on the beach watching Mary and Alvin trying to bogie board, reading and thinking. Perhaps too much time thinking.

Tomorrow morning we head to Orlando. I will be attending class for a couple of days and Mary and Alvin will be left to their own devices...kind of like not having a parent around. I suspect they will be heading to some Disney property. Good for them. I hope they feel just a tiny bit sorry for me sitting in class all day!

References

Breast Cancer Recurrence (2007). Y-Me National Breast Cancer Organization. Retrieved March 23, 2007 from http://www.y-me.org/information/concerned_about_breast_cancer/recurrence.php

Do I miss them?

2007-03-22T06:50:00.000-07:00

Yesterday our niece Allyson (Alvin) arrived in Daytona to spend a few days with us. It was nice to see her and we started out with a nice beach walk. She should be one of those 20 year old spring breakers trying to scam drinks with a fake ID, acting crazy and hanging out. Instead, she is hanging with us. We feel honored. She is going to be with us through the weekend as we move onto Orlando. I have my conference starting Saturday and she and Mary will hopefully, spend their time doing things I don't want to do like Disney. I have always been close to Alvin and it is a pleasure to see her growing up and an honor to be developing an adult relationship with her. She's way more fun now except that she was always my date to those animated movies that I wanted to see that were geared for the kids.

This morning no one wanted to accompany me on my daily beach walk. Alvin was still out cold (after all, it was 7:30 am) and Mary declined today too. So off I went, alone. As I walked along I started to get too warm and took off my t-shirt and continued in just a ribbed undershirt. It is quite obvious that I don't have breasts. I started thinking about something that happened yesterday after our walk. I was wearing the same thing...an undershirt and shorts. Again, it was obvious that I have no breasts. Two co-eds were laying in the lounge chairs...one nudges the other and points at me. They begin whispering and staring as I stood there on the pool deck waiting for Mary. It was quite obvious they were talking about me and I imagined they were noting my breastlessness. I wondered what they were thinking.

Today as I walked along, I pondered the question above...do I miss them? My initial response is no, I don't. Particularly as I walked along the beach. No sweating, bouncing or other discomfort related to them. No more having to buy expensive underwire bras, and no more mammograms. But those are the immediate and obvious responses. Many of you reading this would probably agree with me at this point. But in our society, breasts are a big deal. They are a symbol of womanhood, like it or not. They are extensively dressed and undressed, photographed, altered and otherwise revered by a significant cross section of the population. They are an outward identification of gender.

I thought about the co-eds again. I wondered if they thought I was a man. After all, short hair and no breasts. I was also wearing sunglasses and running shoes. Nothing on me to advertise gender.

I would like to think that in society, women are more than their breasts. In fact, I used to believe that we were. Now making observations of people as they look at me, I am not so sure we are in a societal way but I have to continue to collect data on this issue. One thing that I am learning is that I am sometimes too quick to judge others on their appearance. After all, I don't want people to judge me based on my appearance. This revelation is one of the gifts of my cancer. I can be too judgmental of others and must remember that each of us has a story and life events that make alterations in us that we cannot control. We are all more than our appearance.

And now, off to the beach. Sunscreen? Yea...I think we have some SPF 8 somewhere!

And so it begins...

2007-03-20T04:34:00.000-07:00

My cancer phobia. Yesterday morning in the shower I found a lump. In my left armpit. It is obviously a lymph node...approximately 2.5 cm, firm, non-tender and not infected. I came out of the shower yelling that Stoller missed one. Mary thought I had slipped over the edge for sure this time. Of course I was on the phone to the Piper Center in minutes. Darla, one of the nurse called me back. We talked and she had a lot of reasons why this was a reactive condition rather than a missed cancerous node. Things like the airplane flight to Florida (we drove), swimming in salt water (haven't put one toe in the ocean yet), change in activity level (I've slept more since leaving MN than since my surgery), or cutting my armpit while shaving (no, not even a nick). Then she said that cancerous nodes don't "grow overnight." She concluded our phone call with the sage advice "Don't forget the sunscreen." As always, she was kind and compassionate. Ok. But let's go back to the node. Of course, I have rechecked it multiple times since discovering it. It's still there...I am trying not to focus on it and worry constantly. After all, I am in paradise.

Paradise was interrupted at 6:03 am today when the fire alarm went off in the building. Typically, I stayed in bed while Mary Mohn got dressed and went into the hall to check things out. I figured if there were smoke or an actual fire, she would come back for me. We are on the 18th floor and I didn't want to expend needless energy evacuating myself for nothing. All is well and it was a false alarm (thanks spring breakers...all that is evil in the world is because of spring breakers this week!). Now, she is back in bed sleeping and I am wide awake watching a spectacular sunrise over the Atlantic.

In true vacation style, we have no plan for the day. You can picture us in any one of these chairs or perhaps a bit further east, lying on the beach. Yesterday we did a casino boat trip. Something for everyone...boat trip for me and casino for Mary. I sat outside on the deck and relaxed, watching dolphins and pelicans while she lost some money. She assures me it wasn't much.

And now, a walk on the beach.

Road Trip!

2007-03-18T14:17:00.000-07:00

After 1600 miles and 24 hours in the car we have arrived in Daytona Beach, FL. We are pretending we are the typical spring breakers...except that we go to bed early and like to watch the sunrise!

After a 3-day journey we have landed in a place of beauty. The journey; however, was an important part of the process. On Friday night we stayed in Chicago with Uncle Dan and Auntie Lala. We like to call this staying at 'Lyons by the Lake.' The innkeeper is wonderfully accommodating and his wife is incredibly charming. They also have a son who is a terrific young man. The cuisine is exquisite and the company...unmatched. In all sincerity, we arrived at Dan and Carla's on Friday to be greeted with the words "you don't look like a sick person!" To this I reply, "check me out in a month." We went to dinner at a lovely French Asian restaurant in Wheaton, IL. Of course, we had some cocktails and some very deep discussion. Alcohol does seem to increase the depth of the conversation some but some there were some points made that were exceedingly important.

1) Be very careful of what gets into your brain now and going forward! No more reading obituaries. Obits are about death energy, so that's something that gets into your head and your subconscious gets thinking about that for hours or days, and it's the last thing you need. [What we hold in mind manifests in kind.]

2) Movies that have gloomy topics? Don't see them, you'll never miss 'em. Negative nellies? Move 'em off your list. You have different priorities now and if people can't understand that, too bad. You must surround yourself with loving, healing energy.

3) I am not a churchified person and I, like my Lala, absolutely abhor those big-mouth, Bible-banging hypocrites! But...this might be a time to consider a return to some sort of formal religion or religious affiliation. Definitely not the Catholic church of course...they are not friendly folks but there are other. For example, Unity is extremely gay and lesbian friendly, which is awesome. It has no "rules". It's all about positive thinking and prosperity. Prosperity means having everything you need, and that goes way beyond money, of course. And for some, Unity has helped some when their lives were in the "13th sub-basement." While it is not for everybody. It's comprised of many people who have been damaged by life. But what many people like is they admit it and they're doing something about it! They don't prance around pretending that nothing's wrong, when a lot is wrong. It's very authentic and a thinking-person's belief system, so no wonder it's not very popular!

My La La claims that she sticks her nose in everything but she loves us and offers us some incredibly wonderful support. Both Mary and I are so happy Dan decided to marry her and bring her formally into our family!

We are in a beautiful place. It is warm and sunny and the waves are breaking on the beach. I could forget that I have cancer...until I look down or get dressed and then I remember. When we left Chicago yesterday morning, I cried for many miles. It started when I said goodbye to Dan and Carla. It is in those moments that my cancer gets big. I think about how many moments I will have with the people I love. I know...all of our days are numbered but it is not until you have been diagnosed with a potentially life-threatening illness that you start thinking and counting.

Today, my cancer is little. I am in a beautiful place with someone I love and we have no schedule. We are having a drink together, overlooking the ocean. The perspective is correct.

Scars

2007-03-13T18:23:00.000-07:00

Scars are areas of fibrous tissue that replace normal skin (or other tissue) after destruction of some of the dermis (the top skin layer). A scar results from the biologic process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound. Scar tissue is not identical to the tissue which it replaces and is usually of inferior functional quality. For example, scars in the skin are less resistant to ultraviolet radiation, and sweat gland and hair follicles do not grow back within scar tissue. Often physical sensations around scars are altered as well.

There's your physiology lesson on scars.

We all have scars. When you look at your body you probably can remember how some of them were created. Stupid things we have done to ourselves often end up with scars...riding your bike down a flight of steps, "helping" Grandpa's dog eat his food, or cutting the tip off you finger when 'trying' to do do food art. Other scars are from happy events. Some women very dear to me have some beautiful scars from their C-sections. Without these, I wouldn't have some great kids in my life. And other scars are caused by devastating life events like accidents or cancer.

Most scars show up on our bodies for reasons out of our control. They happen to us. They are the result of some action. For the most part, we don't pay too much attention to them. They become part of how we look to the rest of the world and we don't think about them. But some scars are different. They might remind us of a funny story or event, or something more joyous. They remind us of experiences and of lessons learned.

I have a number of scars on my body...a dog bite, some stitches in my leg necessitated by trying to be a boat mechanic and of course, knee scars from my skiing adventures. But now most of my chest is scarred. Actually, two separate scars. They are not very attractive. The first time I saw them I cried...sobbed actually. The process of embracing these scars is a difficult one. No woman wants to look down and see scars where her breasts were. Now, almost 4 weeks after my surgery I can look at mine more critically. And I now have a choice about how I want to label the scars. I can choose to look at them as being horrifically ugly or I can choose to look at them as something necessary to prolong my life.

I choose the later. I have these scars on my chest for life and for the rest of my life.

My friend Sue is a holistic healer. She brought me a lovely potion of evening primrose, lavender, rose and frankincense to rub into my scars. This soothing combination of essential oils not only smells wonderful but makes my scars feel better...and makes me feel better. Soothed and calm as I await the next step in my cancer journey, scars and all.

Menopause and Mammograms

2007-03-11T09:34:00.000-07:00

In the past month since my diagnosis, I have really tried to find the positive things in having cancer. I have two more things to mention today: menopause and mammograms.

My period began yesterday. My LAST period! When women get to be my age we start having irregular periods and funny little symptoms like hot flashes and night sweats. Each month we wonder hopefully, if this will be our last period. For me, this is it! The last one...because I start chemotherapy in early April which will stop my periods at least temporarily. At the end of my chemo I will be placed on tamoxifen for the next 5 years. That will further suppress ovarian function (and double my risk of ovarian cancer~but that's for another day) keeping me in menopause. By the time I am finished with tamoxifen, I will be nearing 54 years of age. Well into the time of my life in which I am naturally menopausal, therefore, I began my last period yesterday. Ironically, as I am writing this post, I am having a hot flash. Sweat is dripping from me and Mary just brought me towel.

I remember sneaking tampons from my mother's stock when I was in high school. Tampax was her brand and this started a life long relationship for me as well. I wonder how much I have spend on tampons during my life. The last time I bought tampons, I bought just the box of 20. I wonder how much I have spent on tampons in my lifetime That was before my diagnosis. I was hopeful that I wouldn't need them for much longer and I was right. I am ending a 31 year relationship with Proctor and Gamble, makers of lots of common household products like Tide and Dawn. Look around your house and you'll likely find their presence. I doubt their stock will fucuate any since we still will be buying other P&G products like dog food but they won't be making any money on my tampon purchases!

I will never need to have another mammogram either. No breasts=no mammograms! I will worry about other things. Like yesterday when I woke up with a headache for no good reason. Is it a brain tumor?

I guess when you get to a certain age, it is always something.

Join my team!

2007-03-10T16:57:00.000-08:00

Join my team to Race for the Cure!

Each year I think this will be the one the I actually participate in this race but never do. In the past, I have had to work, had other plans, was out of town, etc. But this year is different...my life has been touched in a new way. The research dollars raised for breast cancer are making a difference. Gone are the days when women diagnosed are all handled the same way with radical mastectomies and prolonged courses of chemotherapy and/or radiation. Because of the emerging information, each woman diagnosed with breast cancer can have choice about her health care.

The Race for the Cure is being held on Sunday, May 13 in Bloomington at the Mall of America. You can choose to walk or run a 5K course. There is also a way to register to "Stay in Bed" for the cure if you wish to support the cause but can't make it to the event. So many of you have asked what you can do to help me...and this is it! Join my team! Bring your moms too! I will be almost finished with my chemo on May 13 but I will be walking for the cure. Come and walk with me. Race organizers are hoping to register 60,000 people for the event.

If you are interested in joining my team, Women of Substance, you can register online by clicking this link: http://www.racecure.org/Susan_G__Komen_Twin_Cities_Race_for_the_Cure_.htm, then choose 'Register Online.' You'll be taken to another website where you will need to click on Register Now! Once you agree with the waiver and attest to the fact that you are older than 13 years, you can proceed. From the drop-down box on the next page, select 'Women of Substance' and complete the information. The registration fee is $25 if you walk or run or if you just want to contribute but can't attend. You can send additional donations too, if you want. This is all done electronically with a Visa card, of course! And men...don't let the team name stop you. We will allow you to be honorary women of substance with us. And you know, men can get breast cancer too.

C'mon...join my team! It'll be fun, you'll see.

Do I feel lucky?

2007-03-08T06:38:00.000-08:00

There are some words spoken in movies that are infamous. Dirty Harry said "You've got to ask yourself one question: 'Do I feel lucky?' Well, do ya, punk?" in 1971 (AFI, 2006) and many people have used that line in their own lives at some point. It is an interesting question to ponder...do I feel lucky?

Since my cancer diagnosis, many people have told me how lucky I am...lucky that I get routine health care resulting in an early diagnosis...lucky that the tumor was small...and lucky that my lymph nodes did not contain any cancer cells. But am I lucky? And, what is luck?

Wikipedia (2007) defines luck as 1) that which happens beyond one's control; 2) a fallacy: probability taken personally; 3) an essence or that which can be influenced through spiritual means by performing certain rituals or by avoiding certain circumstances; and 4) a placebo. I'm not sure I agree with any of their definitions or their assertions, particularly when considered in light of a medical condition such as cancer. I do not think it is lucky to be diagnosed with breast cancer. To me, luck is finding a great parking space on campus in the middle of the day or a quater in the Byerly's parking lot.

I do believe that all things happen for a purpose. There is a reason why your dog dies, you fight with your mother or your father dies why you are away on a family vacation. There are lessons to be learned from the events that we experience in our lives. Things may happen in the lives of those around us as a result of the events that take place in our lives. Sometimes, the more painful the experience is, the greater the lessons that result. It can, however; take years before we experience the lesson.

If I look at my cancer from this perspective, I can cite a few things that are happening around me as a result of my diagnosis. At this very moment, our friend is having her lumpectomy. She finally checked out the lump in her breast that she had been watching and learned that it was cancer. Another friend is scheduled to have a non-malignant lump removed...also something she thought she should have checked out as a result of my diagnosis. Several other women have had their routine mammograms done (including Mary) since my diagnosis. For me, there are several things that have occurred for me that I believe are directly related to my diagnosis. First, I have been able to reconnect with a couple of people in my life with whom I had become estranged. To have new relationships with these people is a wonderful gift. I have been offered kind words of support and encouragement from them. Second, I have been able to negotiate some new parameters in my relationship with my mother. I received a card containing some very emotional sentiments yesterday and I realized that, since my diagnosis we have a mutual relationship. I feel that I am heard, cared about and loved by her in a way that is new to my adult life. Our relationship is not totally focused on her any longer! I also am learning more about living in the moment. I have always had a tendency to do that so this is not entirely new to me but it has become even more important to me now.

I think the biggest gift of my breast cancer is my attitude. All of those little annoyances in the world are just that...little annoyances. It's not breast cancer. This has become the mantra at our house. "Hey, it's not breast cancer!" And if it's not cancer, it is manageable and not a big deal. This kind of fits with our other life rule that Mary and I live by: "It's not a problem if you can fix it with a Visa card."

Finally, I want to share something very touching that has occurred. Each April there is a large women's hockey tournament held to benefit breast cancer research. The tournament is called The Stick It to Cancer Tournament and will be held April 20-22, 2007 at the SuperRink in Blaine, MN (see the link at the right). In 2006 the University of Minnesota Cancer Center was the designated donation recipient, receiving 80% of the proceeds for this event. Come join more than 72 teams as they skate in support of family and friends in their fight against breast cancer. My team, Stickin' Around is playing and my former team, Icy Hot is also playing. You won't find Icy Hot on the roster though. You have to look for "Team Mack" which is how they registered for the tournament...in honor of me. Try to make time to get to this tournament. You'll be treated to some fine hockey and will have the chance to spend some money to benefit a wonderful cause.

A special thanks to Icy Hot.

I am so touched by your gesture of support and encouragement!

References

Luck (2007). Wikipedia: The free encyclopedia. Retrieved March 8, 2007 from http://en.wikipedia.org/wiki/Luck.

American Film Institute (AFI) (2006). AFI's 100 Years...100 Movie Quotes. Retrieved March 8, 2007 from http://www.afi.com/tvevents/100years/quotes.aspx.

Chemo class and back to work.

2007-03-06T17:53:00.000-08:00

This has been a big couple of days. Yesterday (Monday) I went back to work at St. Kate's. I found myself feeling lots of different things as I returned. First, it was my first 'real' trip out of the house. By that I mean, the first time I had to be dressed in something other than jeans, wearing makeup and on time somewhere. It took me forever to figure out what to wear. I didn't want to look like a cancer patient. It was also the first time I wore the prosthetic breasts I got last week. I was so completely self-conscious of my appearance it was a bit irritating. I kept bugging Mary about how I looked. I must have asked her a dozen times if I looked like a cancer patient. Each time she patiently said no, that I looked great. She has little credibility with this question ; however, because she either doesn't look too closely or just tells me I look fine. Finally I was able to get out of the door and on campus. I was so nice to be back in my office! I had a nice stream of visitors as people noticed my office door was open~a bonus for moving up a level this year! It was also great to be back in the classroom and see the students again. I have been so moved by their responses to my news. I have received some very emotional and touching words of support and encouragement from some of them. As a group they have shown me some true compassion. I am so excited to see that side of them as people as that tells me so much about what they will be like as professional nurses. It is nearing mid-term so they are getting tired!

During the afternoon I had my post-op appointment with Dr. Stoller, my surgeon. No surprises there. She thought I was doing very well and my scars look fine. She said they would continue to remodel and "smooth" out over the next few months. Right now they are still a bit swollen, numb and tender. If you want to see them, let me know. Stoller lifted my restrictions with the exception of no skiing, hockey or piano playing. Since I didn't play the piano before surgery, that shouldn't be an issue! We also spent some time meeting with Joyce, one of the nurses. She had so much terrific information for me. We talked a lot about beginning chemo and managing the side effects, particularly the sudden chemically-induced menopause I will go through. She referred me to a nurse practitioner who works in the Menopause Center at United Hospital (who knew there was a Menopause Center!). The other thing we talked about is "chemo brain." This is a real side effect and includes cognitive changes including short term memory loss, fuzzy thinking and difficulty with multi-tasking. Since I just finished my PhD, I am particularly worried about this side effect. Apparently there is nothing to be done in terms of prevention or management. Not all women get it either.

Today Mary and I started out bright and early for my mandatory Chemo Class at Minnesota Oncology Hematology, PA (MOPHA). They pride themselves on being a one-stop shop for cancer and think highly of their patient education resources. They did give us a wonderful binder full of information. Today's class was disappointing though. Essentially, a nurse put in a 30 minute video which outlined their services and then went through the various side effect potentials with recommendations for how to manage them. Here is the level the presentation was at: "Many people feel fatigue, the most common side effect of chemo." Their solution: "Take a nap when you need it." OK. I admit. Both Mary and I have been doing a great deal of preparation for this next phase of treatment and are probably overly prepared. My friend Betsy is going to be my home health care provider back-up. She and I were going to go to Chemo Class on Thursday (she was busy this am) but based on what I experienced today, it is not necessary. We did tour the chemo administration room though. It's not bad. A bunch of recliners lined up around the room with a nurse's station in the middle. The patient gets the recliner and can have 1-2 people with them. The nurses and pharmacists mix the chemo right on site. There were patients getting chemo when we visited. They all looked like they were doing well enough. It helps me to know more about what to anticipate with these chemo days. I'll probably be there 3-4 hours for an MD visit, labs and a chemo run. Not bad!

At the end of these 2 very full days, I am tired. By the end of the days, my armpits are swollen and very tender. The pain has definitely increased now that I have been more active. I was tempted to use vicodin last night but really want to avoid it if I can. I am still having trouble turning off my brain to stop thinking about breast cancer. I don't want our household to become breast cancer 24/7. We need time to have some aspects of a normal life. To try to do this, Mary and I went to a movie this afternoon (Wild Hogs) and laughed a lot. That felt good. It was a dumb plot with lots of slapstick kind of humor and just what we needed!

But then I start thinking about the cancer again...I am anxious to get started with my chemo, mostly to get it over with. I prefer to take things head on and get through them. Waiting around doing nothing is not my style! Let's giter done.

I added a couple of things to my blog. First at the top, you probably noticed the chemo countdown. Once I start, it will become my counter for when I am finished. I also added my list of Good Reads. During the past two weeks when my days have been filled with complex decisions like, should I read or knit?, I've read some good books. I thought I'd share my recommendations...if you are interested in a good read!

Contrasts and Opposites

2007-03-04T06:45:00.000-08:00

This morning as I sat at the counter and sipped my coffee, I looked into the sun room and these beautiful spring flowers stopped me. This blooming garden was sent to me by my friends at the College of St. Catherine. The day it arrived, it was a basket of dirt. There was nothing showing and receiving a basket of dirt made me laugh. Now, 3 weeks later it is an incredibly beautiful assortment of blooming spring flowers...tulips, daffodils, hyacinth and iris. All of my favorites and it is as fragrant as it is beautiful (Thank you again my friends!). As I admired it, I was struck by the contrasts it has created. First, it was nothing more than an basket of dirt. Now it is a basket of beauty. Secondly, it creates a stark contrast with the view beyond the windows. It is on the table in our sun room which is open again now that the temperature is above zero. Beyond the beauty of these spring blooms lies acres of white and in front of a door, a snow drift about 36" tall. What a contrast to the view in the sun room. Even Olivia decided to stop and enjoy the fragrance of these blooms.

The contrast between the inside and the outside of this room made me start thinking about all of the ways in which contrasts and opposites present in our lives. I then started thinking about hearing my cancer diagnosis for the first time...somehow this always gets back to cancer! What a contrast these words created in my life. At one year (to the day) after my weight loss surgery, I was thinking about the improvements in my life. I was 90# lighter with a cholesterol of 155. I didn't ache anywhere even after skiing in the mountains all day or stopping 39 shots on goal. I could shop where I wanted to and buy what caught my eye and was pretty. I felt more attractive than I ever remember feeling. And then suddenly, the words on the other end of the phone changed all of that. While that tangible things were still true (my cholesterol is still 155...or maybe 160 now that the Girl Scout cookies have arrived) but the other things may not be so true any longer. I have now gone through a tremendously disfiguring surgery with the loss of parts of my body. So many questions are now running through my head...what will chemo bring? What about my future beyond chemo? While my partner still love me and want to continue to have a life with me? Where will I fall out in the statistics of breast cancer...the lucky 94% who live cancer free 10 years out or the not so lucky minority.

I think more of this is in my control that we imagine. Cancer sucks. That will always be a reality but there are a couple of ways I can view this disease. I can take the news in and lie with it in a sobbing ball in the dark. I can embrace it, tune out those around me who love me and allow this potentially terminal illness to become who I am now. Or, I can challenge it. I can learn all that I can. I can surround myself with light and information and healthcare providers who are my allies in this battle. I can choose to fight.

I am an obituary reader. It started after my Dad died and so many people learned of his death through the newspaper. I read them because I want to know if someone I know needs to know that I am thinking about them. I am particularly drawn to those obituaries of young people~you know, like my age. I read them searching for the cause of their death. Often, it is cancer. Frequently in these obits are the words "courageous" or "brave" associated with their battle of the disease. Before I knew I had cancer myself, I couldn't imagine how someone could face such a horrible disease in a courageous way. I think I am learning what that means now. I think that is the other side of one's choice with regards to cancer. I can choose to allow it to take my spirit and maybe my life or I can choose to fight it courageously.

I want my obituary, if it is related to cancer to say that I was courageous. I want that to be the true about me and my relationship with this disease. I don't want to be a coward, crying in the dark. Sure. I've had my moments...many of them. But thus far, they are moments. Memories of some of them will stay with me forever, like hearing the news of my cancer while waiting for the oil to be changed in my car or looking at my incisions for the first time.

There is no doubt that cancer is a dark disease. Each of us who is given this diagnosis will react differently to the words. There is no right way to be a woman with cancer. This is an individual as we are. For me, I choose to try to be as courageous as possible. I want to be the opposite of the woman who is crying with despair. I choose to live long.

Another woman diagnosed.

2007-03-02T18:08:00.000-08:00

I've just returned from the home of some friends of ours. One of them was diagnosed with invading ductal carcinoma today. Another woman with breast cancer. With the current statistic of 1 in 9 women contracting breast cancer, I thought I would be the one among our group of friends. I thought I had them all covered but I guess I didn't.

This woman is a lesbian too. She was born the same year as I was, although with a January birthday, she is MUCH older than me. We have somewhat similar health histories although she hasn't dealt with obesity (I have) and I don't smoke (she does). When they heard the news, they asked me to come to their house. I quickly assembled some written information...afterall, knowledge is power, and headed to their home. She was right where I was exactly 3 weeks ago, believing I had just been handed a death sentence. At times I still feel that way but now, armed with 3 weeks of knowledge and the allies of wonderful specialists, I feel better prepared to face this disease. While this disease may ultimately be responsible for my death, I know that it won't happen for a while yet.

In reality, our friend has a small cancer like mine. 1.1 cm in size and a grade 2 (slower growing than mine) is a small cancer with the best of odds associated with it. Today though, it might just as well be the size of a bowling ball. That is what it feels like when you hear the news. She does need to have surgery, either a lumpectomy or a mastectomy with sential node biopsy. She then needs to spend time waiting for the full pathology report as well as the staging. That is the essential aspect to understanding long term treatment and outcomes. Those hours become endless. After that begins the process of making very important treatment decisions.

I am three weeks ahead of my friend, hardly in a position to offer much in terms of support or encouragment. I am still in the early stages of this disease myself. Everyday I read more and learn more. One thing that I know for sure is that this is a horrible disease that is altering our live in many important ways.

Remember...get your mammograms. Early diagnosis and treatment is key for long term, successful outcomes. Say a prayer for me AND my friend tonight.

Making sure I am healthy enough to be sick.

2007-03-01T15:50:00.000-08:00

It's rather ironic. Today I spent the afternoon at Abbott Northwestern making sure that I am healthy enough to start chemotherapy. Please don't misunderstand. I wouldn't want to start chemo if there is something else going on that needs to be treated but it is rather ironic to think that I have to have diagnostic testing to be sure that I am healthy enough to tolerate something that is sure to make me sick.

Today I had a CT (computerized axial tomography) scan of my chest. According to Zander, breast cancer can metastasize in patients who had lymph nodes that were clear of cancer cells. He also told us that the most common site for metastases is the bones. What they are looking for with this test is metastases. I am hoping that it is negative! It's an easy test. They inject some iodine-based dye into your vein and you just have to lay still for a few minutes.

The other test that I had is called a MUGA (Multiple Gated Acquisition) scan which is an extremely useful noninvasive tool for assessing the function of the heart. The MUGA scan produces a moving image of the beating heart, and from this image several important features can be determined about the health of the cardiac ventricles (the heart’s major pumping chambers). It is more specific and sophisticated than an EKG or an ultrasound. I needed to have an IV placed so they could inject me with a couple of things. The first thing they injected was pyrophosphate which makes the red blood cells sticky. I needed to wait around for about 30 minutes for this to circulate then I was injected with technetium which is a radioactive tracer. This attaches to the red blood cells (because they are sticky from the first injection) and makes them visible to the gamma ray camera. After that I just needed to lay there for about 15 minutes while they took the pictures. The photo is of a MUGA scan in process...that's not me in the scanner!

The MUGA scan is needed because adriamycin (one of my chemo drugs) can be toxic to the heart. Researchers believe that it is dose dependend and that it is rare in patients getting 4-6 cycles of chemo but "there may be long-term cardiac effects that we don't know about" (Love, 2005, p. 426). Love goes on to note that recent long-term studies of adriamycin use in women with breast cancer have found that "few" have heart problems even 10 years after therapy. She does add that one of her patients did have cardiac failure requiring a transplant...Swell. The MUGA scan will be repeated during and after my chemo.

On the way home in the snow, I had plenty of time to think about my day. I had another IV, was injected with iodine-based and radioactive dyes and exposed to x-rays and gamma rays. All in the name of health. How could this be anything besides ironic? Am I healthy enough to be sick? Will I tolerate the side effects both in the short- and in the long-term? And here's where we get back to statistics...80% of women experience this...35% never have this...and a "few" experience this. How many is a few? What side of the statistics will I fall into.

If only Zander had a crystal ball.

Reference

Love, S. M. (2005). Dr. Susan Love's Breast Book, 4th ed. Cambridge, MA: DaCapo Press.

Doing my homework.

2007-02-28T15:05:00.000-08:00

I've been doing some homework...reading all of the information that I was given by the oncologist's office. Yikes. The two drugs that I will be given with each of my chemotherapy cycles are doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan). After I finish those 4 rounds of chemo, 2 weeks apart, I will be started on hormone therapy with either tamoxifen or a newer kind of drug called an aromatase inhibitor.

Here is a partial list of potential side effects:

infertility (Oh well. I had my chance.)

total hair loss (including eye brows, lashes, pubic and other body hair)

cystitis (bladder infections)

immune suppression with decreased resistance to minor illnesses

fuzzy thinking (also called "chemo brain")

fatigue (increasing with each cycle)

conjunctivitis

mouth sores

runny eyes and nose

anorexia

nausea

vomiting

diarrhea

constipation

weight loss

weight gain (21% of women gain weight during chemo)

heart damage

increased risk of leukemia

increased risk of ovarian cancer after age 50

menopause (side effect or bonus? You be the judge.)

hot flashes

night sweats

mood swings

fluid retention

loss of feeling in hands and feet

local tissue damage (skin burns) if medications leak out of vein into surrounding tissues.

Perhaps I will stop reading now.

It is important for me to keep in mind that these side effects don't occur in all patients. It is also important for me to remember that our friends in the pharmacy are very good at suggesting different ways of dealing with side effects including decadron (a steroid) and zofran (an anti-vomiting medication). We love our pharmacy friends! I must also remember that the side effects will stop when the medications are done. That means just 8 weeks of potential discomfort. That is a small trade-off for a longer, cancer free life.

Please remind me of that during my chemo. I might have trouble remembering that then...you know, chemo brain!