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Watching the River Flow

Annual physical. Check.
Dentist. Check.

Until next week, I'm finished with people in white coats. What a relief. Next week, another dentist appointment and an appointment to discuss genetic testing, which I'm going to cancel. With any luck, that will wrap up all of my medical commitments until December. I'm breathing easier already.

I don't know if this is an industry-wide change, but my primary care physician has a brand new way to do pap smears. Guess what? It involves more pain.

For ten years, I refused to have a pap smear. I had had one of the best ob-gyns in town, a man. From the first time I ever had one, they always evoked memories of my sexual abuse as a child. In my late thirties, I found a woman general practitioner whom I trusted. Since that time, they've all been bearable, until last year. My regular doctor was out, so I had a nurse practitioner do my annual physical. I thought the painful pap smear was because she was a stranger. Maybe the new, improved pap smear methodology was implemented last year. Welcome back to childhood.

I had a accident with my puppy (who weighs 50 pounds) on Sunday, when he rammed his hard, pointy little head into the bottom of my chin. There was a lot of blood (mine) and I was afraid I'd loosened a tooth from the force of his head against my jaw. My dentist says I'm fine.

It's been a tough couple of weeks, so I'm taking a break from work (and maybe the computer) for the rest of the week. Tomorrow, my mom and I are going to have lunch at a little restaurant about 30 miles from here. It's in an old grist mill, with decks perched among the trees, along the banks of the river. You can hear the river rushing beneath the tree canopies. It's one of my favorite things to do and something my mom and I did every year until I was diagnosed. We've been deprived of the fun for the past two years. I was determined to find a way to do it this year, so my colleagues in Crazy Land believe I'm on my way out of town to see more doctors.

I don't even remember when I last had a day completely devoted to relaxing and doing something I enjoy. It's finally here.

I may be away from the computer until next week; I'll have to see how it goes. Until then, I invite everyone to take a day for themselves and remember what's important in life.

From My Friends at M.D. Anderson

Here's a link to the people who've taken such great care of me for the past two years. They have some excellent information about breast cancer and, if you go to the main site, you can find links that lead you to articles about other types of cancer.

http://www.mdanderson.org/diseases/breastcancer/

Research indicates that breast cancer is a chronic disease. There is no cure, but survival rates continue to rise for most forms of breast cancer. Don't forget your monthly self exams and never, ever miss annual mammograms after the age of 40.

Men can get breast cancer, too, so encourage your male friends and family members to be alert to changes in their breasts.

October is Breast Cancer Awareness Month

It's a couple of days away, but I received a transcript from breastcancer.org this morning and I wanted to share the link before I forget. I worked as much as I could during my breast cancer treatment (and, of course, I'm working during reconstruction), but it wasn't easy.

On September 19, guest speakers Barbara Hoffman, J.D. and Irene Card and moderator Ruth Oratz, M.D., F.A.C.P. answered questions about the legal, financial, physical and emotional aspects of working during breast cancer treatment. You can find the transcript here:

http://www.breastcancer.org/community/ask_expert/index.jsp

The Leaves Fall Early This Autumn

"The leaves fall early this autumn, in wind. The paired butterflies are already yellow with August Over the grass in the West garden; They hurt me. I grow older." ~ Ezra Pound

It's shaping up to be a fabulous day. I saw my new medical oncologist yesterday and I'm not sure I like him. He spent a lot of time talking about the history of breast cancer treatment, dictated notes to be sent to my g.p., and made a book recommendation to my mom. He noted that I'm hypertensive, even though the exact opposite is true. My blood pressure usually hovers somewhere around 106/70. I'm almost certain he used that word. I managed to catch little snippets of information while he was doing the dictation, but he was talking so fast I couldn't understand much.

Here's a thought: Ask me. I think virtually everyone's blood pressure gets a little elevated when they visit a doctor. Maybe the doctor doesn't have time to ask me (although he could have worked it in if he hadn't been giving that long book report to my mom), but his nurse should have. I actually did tell the nurse, but I guess she didn't feel it worthy of writing down. I was also running a temperature. If my temperature is 98.6, I'm really sick. I constantly try to point this out to my phalanx of medical professionals and, across the board, they all ignore me.

On the osteoporosis front, I'm 1/2 inch shorter than I used to be. The rapid diminishment in height is a direct result of chemotherapy. Prior to breast cancer, I already had osteopenia (the early and less serious form of osteoporesis), but I had no idea how much my bone density had fallen victim to breast cancer treatment. Great. Now I only have one real breast, tissue necrosis, scars everywhere and I'm now bitty. Things are definitely looking up.

Dr. Sandbach (new M.O.) ordered a chest x-ray, which I'll have to pay for. Hubby has sucked virtually all of the money out of the Breast Cancer Slush Fund, so that won't be as easy as it has been in the past. This puts me in a simply marvelous mood. I have to admit that it's been a bad day right from the get-go (as we like to say here in Texas) and it's only 9:25 a.m.

Autumn is here. I got a few glimpses this morning of my steadfast squirrel friend; the leaves are already thinning enough to make it easier to find him. Autumn is never good. I've just passed the 3 year anniversary of my best friend's death and, in October, the ten year anniversary of my dad's suicide is coming up. Two years ago, right around this time, I was trying to prepare myself psychologically to get through my mastectomy.

Then there are all those awful memories from childhood that carpet the season. Flashbacks happen any time of year, but fall invokes a pall that is too rich, too complex in pain to be able to tease out the specific memories. It's always been this way and maybe the lack of distinct recall is a good thing, anyway.

I'm physiologically highly attuned to changes of season. The advent of autumn is the beginning of dying for so many things. My little squirrel soon will come to be very visible; all of the leaves on his playground of trees will have died.

The skies are overcast today. I've gotten to work on my seasonal affective disorder right away. Why waste time when you can get started now?

It's all pretty amusing, if I look at it in the correct context. I'm sitting here in Crazy Land, eating dry cereal and feeling like hell, contemplating the cycle of life. I'm stressed out over the continuing medical events and still in pain (especially my colon). For a little over 3 weeks, I've worn a girdle 24 hours a day, 7 days a week (because of the liposuction in the donor site), which is extremely uncomfortable, though significantly less so than how it feels without the girdle. Of course this is how I'm spending my morning. Otherwise, it wouldn't fit into the overall paradigm of my life. My entire life would lack consistency. As it is, in all of its soul-specific absurdity, this morning is further proof that God's in His heaven and all is right with the world.

The Solitude of Childhood

"How is it possible not to feel that there is communication between our solitude as a dreamer and the solitudes of childhood? And it is no accident that, in a tranquil reverie, we often follow the slope which returns us to our childhood solitudes." ~ Gaston Bachelard

I have a dear friend (Hello, C!) who recently suggested to me that two years of breast cancer treatment and reconstruction surgery triggered a recurrence of many Post Traumatic Disorder symptoms. She's a very wise person.

I saw my psychiatrist yesterday, armed with a list of my issues: crying (and crying and crying), nightmares so horrifying that I'm afraid to go to sleep, nearly invisible self esteem, a staggering inability to concentrate, colon pain (the return of IBS). I'm just hitting the high points here; there's no need to enumerate them all. I'm certain you get my point.

Having returned on Friday from a seminar about Post Traumatic Stress Disorder, my psychiatrist understood immediately that all of the new breast cancer related physical and emotional trauma reawakened the areas of my brain that store all of my childhood trauma. The brain recognizes the similarity. My friend, C., was right. My PTSD was relatively well-managed for almost ten years (things got out of hand when my dad killed himself), but the symptoms are back with a vengeance.

My ongoing brain fog is at least partly due to that area of my brain that controls cognitive functioning, logical thinking, etc. going on strike, so to speak. I've been attributing it to chemo brain (which I've read can last for up to ten years), but it may have nothing whatsoever to do with chemotherapy.

The nightmares were certainly no mystery. I dream of people chasing me so they can conduct medical experiments on me. I dream of being physically assaulted. (A humorous aside: my most recent assault dream featured some people beating me up with a large wooden penis. I'm guessing that's because my oncology doctors are all men. It wasn't so funny in my dream, though.) Some of the nightmares have clearly hearkened back to specific incidents of childhood abuse, a fact that hadn't occurred to me.

I have new, short-term medication to help me deal with those nightmares. I've been terrified to go to sleep, but last night there were no nightmares.

I've also started taking a very low level of a medication I just weaned myself off of with a great deal of difficulty. It addresses serotonin issues. I'd already guessed that might be part of my problems, but I've been trying hard not to add new medication to my already beleaguered body. If nothing, else, this will address the colon pain. Eliminating any single source of pain can only be helpful at this point. I'll deal with weaning myself from it again when I can. I hope that's in the near future.

Diminished cognitive functioning explains why I've had so much trouble formulating the structure of the database I've been working on forever now. Of course, knowing why doesn't help me be more capable of working faster and thinking clearly. At least I know I haven't gone permanently stupid, though.

Today, I have an appointment with my new medical oncologist/hematologist. No trip to M.D. Anderson this time, which means I won't be quite as tired and stressed as I usually am when regularly scheduled blood tests are required. Had they not taken Dr. Crisofanilli away from me, I would have gone, anyway. The upsurge in patients means they move those of us not actively doing chemo to nurse practitioners. Doesn't it seem like the better solution would be to hire more medical oncologists? Of course, no one asked me.

The saddest part of that situation is that it must mean an upsurge in cancer diagnoses. That means more people, their friends and loved ones will come to understand a new, higher level of suffering than they may have previously known. They will learn to live with a higher level of fear.

As for me, I'm optimistic about my new doctor and about my blood tests. It would be great if I could work in a nap while I wait. I'm trying to work longer hours this week, but today doesn't bode well.

In Other News

"The jungle is dark but full of diamonds," ~ Arthur Miller

I suspect you're just as tired hearing about my cancer travails as I am of talking about them and dealing with them. So let's take a little break.

News on the office front:

Loathsome:

Yesterday Loathsome dropped by my office to tell me his computer isn't working. I am not the IT person in the office and, even though IT Boy was out, I didn't offer to take a look to see if I could help. I get calls from co-workers regularly (when I'm here), soliciting computer help. They still haven't figured out that I know next to nothing about it. I experiment.

Of course, he launched into a recitation of his own physical maladies. I'm empathetic, but at the moment, I'm busy with my own.

Loathsome explained that his ongoing battle with pain (some back ailment and cartilage deterioration in his wrists) is taking a toll on his relationships. I know what that means. It means his wife (who's hated him for as long as I've known him) has resumed hating him now that they've had to share the same house for several months. (He was Our Man in the Out of State Office for several years and she continued to live here.) She's calling him an asshole a lot. He is an asshole, but here's a thought: Move out.

Foot Lady :

I ran into her on my way out of the office on Wednesday. I was holding back tears during the conversation because I had a migraine and the usual pain/fatigue from surgery recovery. I kept telling her that I had to go because of my pain level. Did that stop her? Well, no. On the up side, she did not plop either one of her feet on nearest flat surface and make me look while she waxed whiny on herpodiatry issues. You have to count your blessings. A foot would have been more than I could bear.

Work, work, work

Aside from my discussions with co-workers (which I haven't done justice to, unfortunately), I've been working hard while I have the intellectual focus. Mental clarity is in short supply these days, so I cram in a lot of work in a short period of time.

Yes, boys and girls, it's a new database. It's breathtakingly complex or it just seems that way because the brain isn't functioning at top capacity. Every morning, I come in at seven and wonder why there are glitches in the program. Then I try to find a way to work around them. Normally, I would enjoy the challenge. Now it's just irritating.

I rolled out the workers' comp insurance just in time for somebody to get hurt yesterday. I was filling out forms and sending letters most of the morning. I've had issues with the insurance provider's online reporting system; it wasn't working for a while. At all. I called tech support (in another city). The guy told me that there are diamond icons that light up when you've finished providing all of the necessary information. When you've completed that section, you move onto another. All was going well until I hit "submit." Nothing happend. Tech guy made me double check my icons. You know, I can tell when I've filled in every blank...and I had. My diamonds were fully lit. He suggested I call a more knowledgeable tech person in their company.

She called me back during the lunch hour. That's the oldest dodge in the world and one that I've been forced to use before when I used to have to interact regularly with The Oatmeal Lady, an employee of one of our clients. Another story, another time. Tech Lady wanted to know (in her voice mail message) if my diamonds were lit up. My poor mom had to listen to me ranting and raving about her all the way to Houston the last time we were there. Now, all I have to say is "diamonds" and my mom starts laughing.

Time is up.

I've run out of time and have to leave for therapy. God knows I need it. Monday, I see my psychiatrist. I predict lots of "diamond" talk with both of them.

Fabric of the Cosmos

New book: Fabric of the Cosmos: Space, Time and the Texture of Reality, Brian Greene.

Ten (or eleven) dimensions: nine (or ten) or space and one of time. The reality we see and feel isn't reality at all. I don't know. I always read this sort of thing when I'm feeling relentlessly down, physically, mentally and emotionally.

Not for the faint of mental focus, though. I do lots of backtracking.

It Goes On

"In three words I can sum up everything I've learned about life: it goes on." ~ Mark Twain

It dawned on me a couple of nights ago that things may never be the same. The swelling in the new girl had finally gone down a bit and I was able to feel a ridge running underneath it. It's like having an underwire bra under the skin. That may theoretically seem like a good thing, but it's not.

Everyone I know who's had reconstruction surgery has always told me that, in the end, no one will know that the "breast" I end up with isn't a breast at all. No one, they told me, will even know I had breast cancer unless I choose to tell them. I sort of had my heart set on it. Of course, I also had my heart set on everything being finished a year ago, but this is a lot harder to accept. I've gone through so much to make that outcome possible when it may not be, after all.

The problem is definitely radiation and possibly, to some extent, my body's tendency to create massive amounts of scar tissue. I heal quickly, but thick ridges of scars form almost immediately. Radiation caused a lot of tissue necrosis. There was a lot of radiation because of the wide-spread nature of the cancer (which wasn't a tumor) and the fact that it came so close to the chest wall and my neck. Once tissue is irradiated, it gets very hard.

When I was at M.D. Anderson a couple of weeks ago, I talked with a young woman while we waited to give blood. She had exactly the same conditions as I had and the doctors weren't enthusiastic about even trying to do reconstruction surgery on her. It was the memory of my conversation with her that clarified my own dire straits.

Dr. Kronowitz did an excellent job of cutting some of that necrotic tissue and scar tissue out, but there's still some there. Maybe there always will be. I thought about calling him last week when I had this epiphany, but then I decided that I might not be able to stand the answer. Not yet.

I was devastated last week. Today, I'm emotionally numb. I can only feel that bad for a limited period of time. Plus, I'm still exhausted and in pain from the surgery a couple of weeks ago. This is no time to obsess about visual wholeness.

Next week, a new round of medical appointments begins. I have an appointment with my psychiatrist (whom I'm probably going to try to fire because she's more than I can afford) and a blood check/medical oncologist visit. The next week is my annual physical and a trip to my dentist.

I'm not a human being anymore. I'm just a series of medical events.

Could We Get Along Without It?

"I have traversed many kinds of health, and keep traversing them...And as far as sickness: are we not almost tempted to ask whether we could get along without it? Only great pain is the ultimate liberator of the spirit." ~ Nietzsche

I'm Here, But Not Exactly Here

"Our life is always deeper than we know, is always more divine than it seems, and hence we are able to survive degradations and despairs which otherwise must engulf us". ~ William James

"Strength does not come from physical capacity. It comes from an indomitable will." ~ Mahatma Gandhi

I'm not online much these days because I'm battling post-surgical pain and loss of stamina. Did I mention depression and despair? They have a choke hold on my will to sit in front of a computer and do anything, from catching up on friends to reading email and comments.

First the news. I had an MRI on my abdomen last week and all was well. The skin abnormality didn't worry Dr. Ross. The surgery (with five, count them, five incisions and liposuction) was successful. Surprise. Plastic surgery is painful. Breast lift, painful. Liposuction, painful, Correction of donor site, painful. More surgery on my relocated navel, painful. I do not recommend plastic surgery. My last, physically devastating surgery gave me unrealistic hope that this round would be relatively easy. It was, in fact, not in the same league as reconstruction. Knives cutting through flesh is nonetheless not without physical consequences. Note to self: Surgery is painful. Now commit that to memory.

Earlier today, I read a review of a book written by a Harvard professor that purports to provide something of a blueprint for increasing personal happiness. Self reflection was right up there at the top of the list. In my opinion, introspection is highly overrated, especially as a strategy to increase happiness.

Here's where introspection leads me: I give up. I don't know anymore whether I can find my inner phoenix and coax it into yet another rebirth. I give up. I don't know what to do anymore to fix anything in my life. I'm overwhelmed and, as my therapist pointed out yesterday, it's most likely related to my pain level. Nonetheless, for right now, I give up. The reason is almost irrelevant.

What if the best that will ever happen in life has already happened? It's a standard mid-life crisis question, one we all face sooner or later, I think. However, when I review the history of my life, the best of my life has been only slightly less than grim. If that was as good as it will ever be, then what?

The answer to the question is obvious: Nazi death camps, Darfur, Katrina, human tragedy on a breathtaking scale. People survive, people triumph over much worse than I've endured. I will endure, too. This month, this week, today, I find nothing particularly inspiring in that understanding. I can endure. I will endure. Endurance isn't triumph, though.

I'm not sure I have the will or the energy anymore to push myself forward into the glorious future. Glorious futures require the vision to create them. They require relentless will, boundless energy and an immeasurable amount of luck or grace. I've experienced grace and luck. I've summoned will and energy. Were those things not true, I would not be here. I'm not sure where they've gone, though.

I have more surgery coming, in approximately three months. It's classified as elective, but that's a lie. I can't stop now. It's like the lie of remission. Remission means nothing to me. I have more blood tests coming, regularly, for the next five years. The next round will be at the end of September.

People at work say to me, with a smile, "You're in remission now, right?" What they do not know is that oncologists don't really like that word. "Not medically evident" is the correct phrase. I'm angry when comfort people comfort themselves or offer it to me in the form of the magical word, "remission." The question isn't if, but when.

I don't deserve this life. I require from myself the spiritual strength to not only accept the cross, but to welcome it. In better days, I've known how well equipped I am to carry my own burdens. Others may not be so blessed and it's always incumbent upon me to be mindful of that fact. These days, though, the burden is too heavy for me, too.

My old friend, the fascist who live within taunts me: Self pity and hanging onto being a victim are unacceptable. That's where I'm living and my inability to break away from this state of mind makes me embarrassed and ashamed.

This is my self reflection for today. I can check that off my list of things to do. Next step on the road to happiness requires that I enumerate the things for which I'm grateful. There are many, but this month, this week, today, gratitude is not enough.

Manifestation of Grace

"The weak can never forgive. Forgiveness is the attribute of the strong." ~ Mahatma Gandhi

I just hugged someone who betrayed me several years ago. I thanked her for stopping by. I'm not sure whether that means I've moved farther down the road to forgiveness or that I'm not brave enough to continue on with my cold indifference. I could say having cancer makes a difference in one's ability to see past human frailty, but I'm not sure that's true.

Every day, I pray for and work towards forgiveness and the abandonment of rage and hatred. In this particular case, hugging was a manifestation of grace in my life. There's still a small part of me keeping track of the things she did. Maybe someday I'll stop remembering. I'm not quite that strong yet.

Surgery countdown: 7 days

Too Much Going On, Including Surgery

M.D. Anderson is clearly in sight now. I'll be leaving Wednesday to ensure I get to an early morning sonogram. Later on, The Beloved Dr. Ross. I'm hoping on this trip, he'll ask me to move in with him so he can take care of me forever. Let's not forget that I have hair and muscle tone now. Anything could happen. (Obviously, I'm hard-pressed to contain my anxiety. Dr. Ross is the perfect antidote.) Friday, I drive back to Austin.

On Monday, I drive back to M.D. Anderson for pre-op consults and an appointment with Dr. Kronowitz early Tuesday morning. Wednesday: Surgery.

I got all new "roll out" materials to their appointed destinations and provided on-site managers with extra copies of required forms. I rock.

For all the lovers of Crazy Land tales, an encounter with Foot Lady for your pleasure. I went downstairs to her office to provide her with the extra forms to take to her supervisors. Guess what we talked about next? Yes! Yes! Her feet! She did not plop her foot on the desk for illustrative purposes, but she did flop it on a nearby chair. Some things simply will not change. Foot Lady's ongoing foot problems is one of them.

The workers' comp company is driving me to distraction. I received a new claim today for an insect bite. I recently allegedly gained the ability to submit claims online. Twice I have tried it, twice it has not worked. I called tech support today, told the guy the problem, and he says, "Well, you got me stumped. I'll have to have someone call you." Great. I've got all the time in the world.

I submitted yet another paper claim, after having wasted a fair amount of time and an enormous amount of patience trying to get the lightening-fast online reporting system to work. I got the letter to the employee printed, but that's as far as I got.

Crazy Land denizens kindly held a Team Ggirl meeting, complete with warm, homemade cookies (of many kinds) and a lovely parting gift. Let us all celebrate my upcoming surgery! My friend the Information Superhighway did lots of shopping and arrived with a whole grab bag of cookies, magazines, crossword puzzles, toiletries...all gifts that were useful and touching. I like to recount the foibles of my co-workers, but my feelings for virtually all of them are quite cordial. Clueless though they may sometimes be, frustrating in the extreme and wildly annoying though they may be, I'm very deeply touched that they care. Not to be cynical, but warm cookies is a Team Ggirl event that's a win-win for everyone and is not necessarily a reflection of how much I've endeared myself to my coworkers.

That completely halted the workers' comp paperwork fiesta, which just means I have to focus on it immediately tomorrow, along with getting my biopsy slides sent to M.D. Anderson. There will be plenty of faxing going on. I got a call on Friday from my dermatologist's office, letting me know they sent the biopsy results, instead of the slides. No one told me that's what they were sending. Nor did they tell me whom to call to arrange it for myself.

I have a late afternoon appointment with the dermatologist tomorrow. I'm sure we'll be covering all of this. That means my last day of Crazy Land will be a short one. That would be great, but my tasks require more time than I may have at my disposal.

I guess that's another antidote to anxiety. Owner asked me today how I got all of the new insurance stuff taken care of. "I worked my ass off." I will be working said ass off again tomorrow. Lots of the workout will be personal, so I don't suppose complaint is order here.

The upshot is that I may be away for a while from my online friends and my own weblog. Rest assured that all is well and all shall be well and all manner of things shall be well. (Bowing to Julian of Norwich.) I'll see you when it's all over, if not before.

P.S. Sorry for the wholly unimaginative title line. What can I say?

Too Much Going On, Including Surgery

M.D. Anderson is clearly in sight now. I'll be leaving Wednesday to ensure I get to an early morning sonogram. Later on, The Beloved Dr. Ross. I'm hoping on this trip, he'll ask me to move in with him so he can take care of me forever. Let's not forget that I have hair and muscle tone now. Anything could happen. (Obviously, I'm hard-pressed to contain my anxiety. Dr. Ross is the perfect antidote.) Friday, I drive back to Austin.

On Monday, I drive back to M.D. Anderson for pre-op consults and an appointment with Dr. Kronowitz early Tuesday morning. Wednesday: Surgery.

I got all new "roll out" materials to their appointed destinations and provided on-site managers with extra copies of required forms. I rock.

For all the lovers of Crazy Land tales, an encounter with Foot Lady for your pleasure. I went downstairs to her office to provide her with the extra forms to take to her supervisors. Guess what we talked about next? Yes! Yes! Her feet! She did not plop her foot on the desk for illustrative purposes, but she did flop it on a nearby chair. Some things simply will not change. Foot Lady's ongoing foot problems is one of them.

The workers' comp company is driving me to distraction. I received a new claim today for an insect bite. I recently allegedly gained the ability to submit claims online. Twice I have tried it, twice it has not worked. I called tech support today, told the guy the problem, and he says, "Well, you got me stumped. I'll have to have someone call you." Great. I've got all the time in the world.

I submitted yet another paper claim, after having wasted a fair amount of time and an enormous amount of patience trying to get the lightening-fast online reporting system to work. I got the letter to the employee printed, but that's as far as I got.

Crazy Land denizens kindly held a Team Ggirl meeting, complete with warm, homemade cookies (of many kinds) and a lovely parting gift. Let us all celebrate my upcoming surgery! My friend the Information Superhighway did lots of shopping and arrived with a whole grab bag of cookies, magazines, crossword puzzles, toiletries...all gifts that were useful and touching. I like to recount the foibles of my co-workers, but my feelings for virtually all of them are quite cordial. Clueless though they may sometimes be, frustrating in the extreme and wildly annoying though they may be, I'm very deeply touched that they care. Not to be cynical, but warm cookies is a Team Ggirl event that's a win-win for everyone and is not necessarily a reflection of how much I've endeared myself to my coworkers.

That completely halted the workers' comp paperwork fiesta, which just means I have to focus on it immediately tomorrow, along with getting my biopsy slides sent to M.D. Anderson. There will be plenty of faxing going on. I got a call on Friday from my dermatologist's office, letting me know they sent the biopsy results, instead of the slides. No one told me that's what they were sending. Nor did they tell me whom to call to arrange it for myself.

I have a late afternoon appointment with the dermatologist tomorrow. I'm sure we'll be covering all of this. That means my last day of Crazy Land will be a short one. That would be great, but my tasks require more time than I may have at my disposal.

I guess that's another antidote to anxiety. Owner asked me today how I got all of the new insurance stuff taken care of. "I worked my ass off." I will be working said ass off again tomorrow. Lots of the workout will be personal, so I don't suppose complaint is order here.

The upshot is that I may be away for a while from my online friends and my own weblog. Rest assured that all is well and all shall be well and all manner of things shall be well. (Bowing to Julian of Norwich.) I'll see you when it's all over, if not before.

P.S. Sorry for the wholly unimaginative title line. What can I say?

The Sound of Looniness

Craziness abounds, even over and above my daily sojourn in Crazy Land. Crazy Land continues to spin, though, and I'm definitely caught in its many manifestations of nuttiness-inspired stress. My anxiety about getting everything accomplished before my Wednesday departure is significantly diminished. Nonetheless I'm always aware of the endless shiver of anxiety burrowed under the level of my daily consciousness.

In the middle of conversations, I suddenly notice the lunacy in my voice. The more I try to tame it, the loonier I sound. Very disconcerting. I wish I could preface every interaction with an explanation that I'm soon having my fourth surgery in two years and that I'm therefore virtually unable to think clearly. As a matter of fact, I'm virtually unable to function.

Now and again, it strikes me that, since everyone around me seems to expect me to continue on as usual, I should most certainly be able to do that. Maybe I should be able to, but my mind periodically goes blank. The brain keeps track of pain and it will not be distracted from another imminent physical insult.

"How can you possibly expect me to do anything more than arrive at work and stay there for 8 hours," I think. Actually accomplishing things is simply completely out of the question.

Sometimes there's no choice. I've had the infamous "roll out" to orchestrate, a major coup considering the daunting amount of information not available. It's been a struggle to simply find out how many sites each manager services and how many employees are at each site. Is it any wonder my mind goes blank from time to time? It's a little like a cultural adaptation in this case. Everyone else is in some information-deprived haze. I'm just doing my part to fit in. Now there's a good excuse.

When it rains workers comp claims, it pours. Unfortunately, lately it's been pouring guys who've chosen to not report their work-related injuries for a week or so. The amount of paperwork alone that has to be generated and disseminated wears me out, even when reporting is prompt. When our employees wait to illuminate anyone about their hurties, my work becomes even more time-critial and positively stuffed with paper to be printed, faxed, copied, printed again and mailed to several people.

Last but certainly not least, I've been having serious issues with my dermatologist's office. When I visited, at their insistence, to discuss my diagnosis and treatment, the nurse practitioner was completely useless. No need for treatment, or maybe there is, who knows? Nonetheless, they called to make a six-week follow up visit. I also have an appointment with the doctor herself on Tuesday. To top it all off, I've been unable to have biopsy results successfully sent to Dr. Ross.

See? This is another moment when the mind goes absolutely blank. I have no idea what to do now. The nurse tells me to call the Pathology Lab and arrange it myself. They might have shared that with me when I called last week specifically to have them do that. I can't. The new hill of endless paperwork seems too big to climb at the moment.The noise you hear is my head as I beat it against the wall.

Inflammatory Breast Cancer

http://toddlerplanet.wordpress.com/2007/07/23/inflammatory-breast-cancer/

Important information about inflammatory breast cancer from a woman who knows. She's amazing. Check her out.

Tears

"Time engraves our faces with all the tears we have not shed." ~ Natalie Clifford Barney

My mom talked me into calling my psychiatrist today. We've been eliminating pills like crazy and I've been feeling psychopharmacologically triumphant. (Yes, it's a great word and yes, it was hard to type.) There's that one tiny problem of crying all of the time. My mom suggested that, since things seem to be getting worse instead of better, maybe I should clue my shrink in on how things are going.

I've been rolling along, thinking that the crying jags come with the territory. I have new cancer checks and another surgery looming. That would make anybody cry, wouldn't it? My mom pointed out that it's been getting worse. In fact, even talking about crying makes me cry. Bad sign.

So I called and we added in another 150 mgs. of one of my ongoing get-me-through-the-day drugs. My doctor said that crying just because you're talking about it doesn't, in fact, go with the territory.

Moving on. Reason number 5,000 for crying: an episode of Dr. Phil. Dr. Phil is always tricky. First of all, I live in terror that one of my relatives is going to show up on the program, although it's really more likely they'd have made an appearance on the Jerry Springer show. (Is that still happening?) Then there's the subject matter. I've had personal experience with most of the really bad stuff he addresses and it's not always a good thing to be reminded of that.

Yesterday's episode was about a grandfather who abused his five year old granddaughter. It reminded me that my own sexual abuse started sometime before the age of five. I managed to place it in time by asking my mom about the events that surrounded the first episode of abuse I remember. It had happened before then, I know, because I recall being afraid and, later, trying to hide from him in the bathroom.

I hate it when I'm reminded of just how young five years old is. It's different when you see it through the lens of your own personal experience. I forget just how tiny and defenseless I was until I see other children that age, going through a version of my own life history.

My husband was in the room when Dr. Phil was on and I told him how young I must have been when the abuse started. I'm not sure I'd ever shared that with him before. Why? It's not a thing that comes up much in conversation. It's something that makes me feel permanently wounded. I might even use the word "damaged." Consequently, not many people who know me know about this part of my life. As I think I've mentioned before, there are a lot of things people don't know about my life. It works better for me that way.

The grandfather was just like all child abusers. It wasn't his fault, you know. It was that seductive five year old. He was the victim.

I never talked with my uncle about why he sexually assaulted me, time and time again. I don't need to talk with him. I know all of the answers he'd ever give me. It was my fault. Everything he ever said to me spoke to his belief that I was the real perpetrator. The sad thing is that all sexually abused kids (all abused kids, generally) think it's their fault. I spent a lot of my life feeling guilty and dirty and, yes, damaged.

Sometime around the age of 40, I finally figured out it wasn't my fault. I'd been in therapy for many years by then and I'd dutifully absorbed my therapists' mantra that, indeed, it wasn't my fault. I never really believed it, though. I'm not sure why. I guess that's part of the power of childhood sexual abuse, especially when it starts at such a young age. It's a poisonous root that takes hold and wraps itself around every fiber of your being.

Here's something funny. Writing about this does not make me cry. I don't think it ever has. I can cry for that little girl whose grandfather used her for his own sexual pleasure, though. Someday maybe I'll cry for myself.

Things You Can Be Sure Of

"Everything Must Change" recorded by virtually everyone, my favorite of whom is Nina Simone.

Everything must change
Nothing stays the same
Everyone must change
No one stays the same

The young become the old
And mysteries do unfold
Cause that's the way of time
Nothing and no one goes unchanged

There are not many things in life
You can be sure of
Except rain comes from the clouds
Sun lights up the sky
And hummingbirds do fly

Winter turns to spring
A wounded heart will heal
But never much too soon
Yes everything must change

The young become the old
And mysteries do unfold
Cause that's the way of time
Nothing and no one goes unchanged

There are not many things in life
You can be sure of
Except rain comes from the clouds
Sun lights up the sky
And butterflies do fly

Rain comes from the clouds
Sun lights up the sky
And music
And music
Makes me cry

"Everything Must Change," Bernard Ighner

Time is limited these days. I'm trying to clean up a workers comp mess left by Loathsome, "roll out" a new workers comp insurance program and forestall the complete rewriting of the employee manual. Patience is also limited. So is emotional stability.

I cry at least four times a day every day. Today has actually been a really good day. It's 2:00 p.m. and I've only cried once. Crying is impromptu, it's always a surprise. Just thinking about crying can make me cry. I'm loads of fun to be with.

Every once in a while, the thought breaks through, "I'm having surgery on the 29th." That's when things really start to get out of hand. Every surgery is cause for new terror, if only because every surgery still hurts. I never cry when I see it coming. I do, however, freeze for a moment or two and wish there were some way to escape this life I've been assigned. The thought of another surgery is dumbfounding.

I'm out of sorts these days. Everything seems bleak. The future seems not worth living. I wonder why I tried so hard to stay alive. What exactly did I have in mind? Did I believe things will someday improve in my life in any meaningful way? If that's what I thought, I can't imagine why I believed it.

I'm angry at the universe. I keep thinking back, wondering what it was exactly that I did to deserve my impossibly difficult life. It's not just the breast cancer. It's the years and years of physical, emotional and sexual abuse. It's the rape. It's the suicide. It's the job I hate that just won't stop. No matter what, I have to be here. All of those things seem beyond the boundaries of good taste when heaped upon one small person who's made a lifetime career of not passing along the violence and pain.

I'm a good person, a gentle person, a person with enormous compassion. As if that counts for anything. I'm sure there's some purpose to all of this accumulated suffering, but lately I'll be damned if I can see what it might be. Oh. I know. I've been sent the plague of my existence to create the possibility for gentleness and compassion. It's a mighty big price tag and one that I don't feel much inclined these days to continue to pay.

Last night, I watched a program on the travel channel called "Jeff Irwin Inside Alaska," or something like that. The vast, primeval spaces reminded me of why I don't matter. As I watched bears tearing apart salmon they'd just caught in the river, I kept thinking, "Something dies so that something else may live." That seemed comforting somehow.

Over the weekend, I though a lot about the gift of seeing the end in advance. My life seems broken beyond repair, my body wounded forever, my mind diminished. The changes are irrevocable. It's the coming attractions, folks.

Unless we've somehow managed to find a quick end, death invites us to leave in tiny increments. We lose a little of ourselves, a little of our joy (assuming we ever had any) moment by moment. Alaskan brown bears die because they have cavities in their teeth. They suffer, dying bit by bit. We do, too. Right now it's not so much the leaving that bothers me as the slow, painful journey to get there.

Day after day. I get up and come to work. My body hurts. I "roll out" workers comp insurance. I cry about the pathos of the universe. I fill out forms reporting an injury. I rage against the injustice of the universe. I proofread invoices and wonder when my damn copies are going to be ready to be picked up at the local FedEx Kinko's.

When I look at it that way, it makes me laugh. I'm feeling dramatic today. It's nothing a good surgery won't cure, though.

Which Tarot Card Are You?

You Are The Lovers

You represent ideal love: innocence, trust, exhilaration and joy. You demonstrate the harmony of opposites, two sides coming together. At times, you also represent the struggle between what is right and what is tempting. Control is an issue for you, especially when you don't know your reasons for choosing something. Your fortune: You have an important choice you need to make about love, and it will be a difficult choice to make. You are likely struggling between the love you crave and the love that is right. In the end, you will choose what you crave, even if it's bad for you. Because without what you crave, you will feel empty and incomplete.

What Tarot Card Are You?

I've Given Birth Today To Several Dancing Stars

"You need chaos in your soul to give birth to a dancing star."~ Nietszche

There simply is not enough time in the day to catalog all of the crappy things going on with me. Most of those things are work-related and I'm sure I'll get around to complaining about them in depth at a later date. For now I'll just hit the high points.

I saw my dermatologist's Physician's Assistant yesterday in the vain hope of finding out the meaning of my diagnosis and potential treatments. I think that's why they called me in the first place. "Come in and discuss the diagnosis and treatment options." So I did.

The PA couldn't even see the affected area. That's interesting because my physical therapist saw it immediately. I was aggravated yesterday and, when my PT person saw it today, I got irritated all over again. Dermatologist PA gazed at my file for a while, repeated the diagnosis of morphea and looked a little confused.

That's it? That's what you have for me? You're just going to tell me the name again and then tell me you can't even see it? Oh my god. This is exactly the kind of thing that made me stop trusting medical professionals in the first place. I spent over 20 years rolling my eyes when people tried to make me see a doctor. Were it not for an abundance of excellent health care experiences the past couple of years, I'm sure I'd be right back to refusing to see any more medical experts after this.

This is exactly the argument I had with Dr. Ross' nurse the last time I was at M.D. Anderson. I was complaining that they'd taken my oncologist away and replaced him with a physician's assistant. "Oh, I've seen them catch things the doctors haven't," she confided.

Really? I've seen them miss things the doctor has already seen and I've heard them give me incorrect information. This latest experience doesn't increase my level of confidence.

I've decided to file this anxiety away somewhere in my brain and restrict further access until I see Dr. Ross. I just refuse to think about it. Luckily, I have lots of things going on at work to take up my precious brain power.

Surprise! We're "rolling out" a new workers' compensation program on September 1. The insurance rep showed up today with a notebook which purports to tell me how to "roll" it out. The upshot is this. If I'm working with a client and break my ankle, I'll need to let my foreman know. My foreman will make me fill out three or four forms and acknowledgments. My foreman will then call ggirl at the office and find out who's close by that I can see. No. I may not go to the hospital. Well, maybe I can. Only if it's an emergency, though. Of course, nowhere is there any definition of "emergency" to be found in any of the "roll out" materials.

I have no idea whether I have to continue to report things to the state in a new way or the old way or any way at all. Tomorrow, after I clean up the mess created by one of our foremen (that's right...it's Loathsome) , I'll have to try to track down the information on the state website. You know that will be easy. After I figure all of this out, I have from now until September 1 to get materials disseminated to four different sites.

I just took a break to have a 45 minute conversation with the Foot Lady about the issue of drug testing after injuries. Now it's almost time to go home. I'm not picking up that damn phone again for the next ten minutes.