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.

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

Surgery: Clearly in Sight

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 in 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?

Think. Who, me?

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-critical 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.

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.

What's the Diagnosis, Anyway?

There are two possibilities for what's wrong with me. Either I have morphea (a rare type of scleroderma) or I have morpheaform basal cell cancer. Obviously, I'm hoping for the latter. Unfortunately, from all of the credible sources I've found on the Web, neither of them match my symptoms. We've got a biopsy, though.

Morphea is an extremely rare type of scleroderma, occurring in approximately 25 in one million people per year. It's characterized by red or purple splotches that gradually turn whitish. I assure you that if I'd had red or purple splotches running down either side of my spine, I would definitely have noticed. Unlike generalized scleroderma, it will not kill me. That's a plus. No one knows what causes it. It's not hereditary.

I don't even want to talk about morpheaform basal cell cancer. Will that kill me? Oh yeah. You can see why I'd prefer the first diagnosis.

I've been searching for information, obsessing, being absolutely crazy about it. Everyone assures me they would be, too, given my breast cancer diagnosis. Originally, my dermatologist had scheduled an appointment for me on August 21 to discuss the diagnosis and treatment options. This is after they rather frantically tracked me down to tell me the doctor wished to see me. It's not like I didn't make myself very available. There are two numbers where I can be reached and both have voice mail options.

I'm supposed to see Dr. Ross on the 23rd of August, so I contacted him and I'm having biopsy slides sent for his review. I started to think that was a really stupid idea and that I should just cancel the message I left asking for instructions on how to do that. My mother, my therapist, my co-workers all insisted that I shouldn't have to wait that long to find out what's going on. Furthermore, if biopsy results aren't examined by a pathologist at M.D. Anderson in advance, Dr. Ross will have no ability to make a reliable diagnosis. You know how I trust this man, so even if it's totally crazy and stupid, it will at least ease my mind to have his opinion.

Meanwhile, physical therapy continues. There are numerous places on my body, both inside and outside that have scar tissue build-up that we're trying to break down. I was surprised to find out that I even have scar tissue running from my groin to my new girl from the drainage tubes I had to have after reconstruction. Obviously, my upcoming surgery will only create more scar tissue.

Breaking up scar tissue is painful. Now there's a surprise. Has anything in the past two years not been painful? Hell no. It's all relative, though, and it's far less painful than the needles-in-the-breast episode and the whole reconstruction (so far) ordeal.

I have exercises to do every night to get my lymphatic system up and running. Then I have to use a hand-held massager to work away at that scar tissue. That's in addition to the twice weekly manual manipulation with the physical therapist.

It feels like virtually every working moment is dedicated to some sort of body maintenance or bodily healing or trying to get my records sent here and there or trying to get an earlier appointment. I could go on and on.

But I won't. I spend so much time now in my weblogs cataloging the latest events that I never get around to how I'm feeling inside these days. I guess there's not much point in examining it. I'm emotionally ragged and exhausted. I'm so stressed out that I'm barely functional. Maybe tomorrow I can think about that a little more and feel it a little more.

Right now, I'm going home to eat something and work out to manage my stress level. Manage. There's a laugh. There's no managing to be done; I'm just trying to get through this. I don't think that counts as actually coming to terms with anything.

With any luck, I'll have enough time tomorrow in between resolving more medical issues to chronicle the latest emotional debacle.

Things Can Always Get Worse, Part 57

Note: I attempted to post this yesterday, but it disappeared into cyberspace.

I got back from physical therapy a few minutes ago to find a message from my dermatologist's office. You know, I'd already decided that everything was fine and I'd just have stitches from the biopsy taken out text week and be on my way. Wrong again. Something is wrong. The message said they'd been trying to get in touch with me and want to set up an appointment to discuss my "diagnosis and treatment."

You know they're not going to tell me anything over the phone. They never tell you anything over the phone. I don't think it's skin cancer because I've never heard of skin cancer manifesting that way before.

Nonetheless. Things can always get worse. Can I put that on my headstone? I'd prefer to be cremated, but maybe they could just put a headstone in some random, unfilled corner of a cemetery. It wouldn't have to be big, obviously.

If not "Things can always get worse," then I'm considering just "Fuck you."

Keep you posted on the fun new developments.

Skin Biopsy Results

I got back from physical therapy a few minutes ago to find a message from my dermatologist's office. You know, I'd already decided that everything was fine and I'd just have stitches from the biopsy taken out text week and be on my way. Wrong again. Something is wrong. The message said they'd been trying to get in touch with me and want to set up an appointment to discuss my "diagnosis and treatment."

You know they're not going to tell me anything over the phone. They never tell you anything over the phone. I don't think it's skin cancer because I've never heard of skin cancer manifesting that way before.

Nonetheless. Things can always get worse. Can I put that on my headstone? I'd prefer to be cremated, but maybe they could just put a headstone in some random, unfilled corner of a cemetery. It wouldn't have to be big, obviously.

If not "Things can always get worse," then I'm considering just "Fuck you."

Keep you posted on the fun new developments.

Skin Biopsy and Self Injury

I had an appointment with my radiation oncologist on Thursday morning. He diagnosed the pain and swelling as localized lymphedema. I'd considered that possibility before, but my several sources of information only mentioned swelling down the arm, not under the arm. I don't understand why sometimes it's localized and sometimes it isn't. He said that physical therapy might be very helpful and referred me to a clinic here in town. They're supposed to contact me sometime this week. I'm enormously relieved that it's nothing more serious, although lymphedema, untreated, can produce disastrous results. It's also really unattractive.

Thursday evening I fell four times. Four times. That's excessive, even for me. I'm not sure why I fell the first two times, although I think all of them may have been a result of having my eyes dilated earlier in the day. I had an opthamologist check the progress of my macular degeneration. (It didn't get any worse--Yay!) It's possible that, even though it seemed my vision was back to normal, there may have been some depth perception distortion.

Anyway, the first couple of times I fell I was just walking around in my house. I didn't sustain any injuries. The third time, I misjudged the two steps down from my bedroom into the living room, slipped and sprained my ankle. Within about an hour, I was going through the den to let Andy the Demon Dog outside, fell and bruised my knee. Both the huskies' crates are in the den, but his is close to the path to the back door. I usually keep the crate door cracked so he can go in if he wishes. I've had disastrous encounters before with the wide-open crate door and I'm actually a quick study when it comes to ways to prevent collisions. I've had a lifetime of practice.

I guess Hubby left the crate door wide open and I didn't turn the lights on in the den. Too much time and trouble to turn on lights, you know. I slammed into the door with my knee and just collapsed on the floor. Luckily, the knee wasn't sprained, too.

Earlier in the evening, I accidentally whacked my head against a cabinet door. I have a bruise on my nose and forehead. They're not bad; they just look like maybe I'm not the most fastidious person in the world. My husband thinks I'm trying to get him arrested for assault. (Note I did not say "domestic assault." I think it minimizes the crime.) The most amazing news? I did not go to work. I always go to work with sprained ankles. Yes, I have them rather frequently. I think it runs in the family; my mom's ankles collapse for no apparent reason.

Today, I had my annual skin cancer check with my dermatologist. She found an area on my lower back that looked a little weird. It wasn't a mole or anything like that; it was a gray area that spread across my hips. We did a biopsy; results expected within 3 to 5 days. I'll have to have stitches taken out in a couple of weeks.

The great news here is that if it turns out to be something scary, my beloved Dr. Ross is an accomplished skin cancer surgeon. As a matter of fact, he consults throughout the country on difficult cases. Lucky me. Have I mentioned lately how much I love him?

Last Wednesday was Hubby's birthday. I was confused. I thought it was Thursday. Good move. I don't know--I was confused about the date all last week. Who am I kidding? I never know what day it is. I mean I'm not even sure if it's Tuesday or Thursday. It's either the monotony of daily life or the lingering effects of chemotherapy. I like the latter explanation later.

I'd already bought a gift for Hubby, so I was clear on that count. However, I didn't wish him a happy birthday until he pointed out to me that I should have. I noted that he forgot our wedding anniversary last year. We're even now.

Aside from giving you a blow by blow account of the numbers of loads of laundry I did this weekend, that about wraps it up. How timely. It's only about ten minutes before I get to go home. I'm working on being much more entertaining in the days to come, so don't give up on me now.

Distractions

"Her mind lives tidily, apart From cold and noise and pain, And bolts the door against her heart, Out wailing in the rain." ~ Dorothy Parker

I just ate an apple without washing it. Do you suppose it will kill me? Big ironic smile here. My dark sense of humor has grown much darker the past couple of years.

I finally broke down and called the radiation oncology office yesterday. They were busy, of course, and the recording suggested I leave my name, number and what hell I was calling about. I did that. Have I heard anything? Hell no. With the help and encouragement of my online friends, I overcame my fear of seeming like a crazy hypochondriac and called. Thanks so much for getting right back with me about the pain and swelling, cancer guys. I guess they figure those two things don't necessarily mean anything that will result in imminent death, so no rush.

I can't recall whether the oncology office recording said they'd get back to me within 24 business hours. That's the usual standard these days. It's been 24 business hours now. Maybe I'll have to call back, just to check. I don't want to miss the opportunity to give people an enormous amount of trouble about breaking the 24 hour rule.I'm generally such an empathetic personality that I'm willing to cut people an enormous amount of slack. However, woe be to those who overestimate my level of good will. Ask the folks at Holiday Inn. They can attest to that fact.

As far as I can tell, I'm not overcome with anxiety anymore. God only knows what's going on beneath the level of ordinary consciousness, though. Nothing like having a brain that walls itself off automatically to protect against unwanted emotion. Generally speaking, though, it requires that I put some active effort into it.

There are all kinds of thoughts and fears that I examine, then put aside into little individual compartments in my head. "I'll just get back to this later," I think. It's highly conducive to the ability to function, no matter what. Thank you, crappy childhood. Of course, it's not the most mentally healthy way to deal with things, I've been told.

From time to time, when I talk about moving problems over to their own little room in my head, my therapist asks me how I do that. I have no idea. I do know that there have been times when keeping things in those compartments requires visualizing many locks and an occasional barricade. I've been able to count on the locks and barricades when it's absolutely necessary.

All of that is a clearly pragmatic decision to put things aside until later. As I mentioned before, sometimes my brain kindly moves fear and anxiety directly to secret places without any effort whatsoever on my part. Sooner or later, though, the gates somehow open and I'm flooded with the memories, thoughts or emotions that have been hidden from me. The surprise is invariably unpleasant.

I think everyone does that to some extent. There are all kinds of nasty things floating around in what Freud would have called the unconscious. I'm not a big fan of Freud's view of the world, but when he's right, he's right. Carl Jung (among others) agreed. He's much more palatable to me.

For instance, I suspect that each of us harbors ill-will towards others, even though we may never perceive it. We might vehemently deny it, as a matter of fact. When I clearly see into what Zen Buddhists call "Hatred Mind," I always find some previously buried hatred, resentment or anger. It requires "opening the hand of thought" to find Hatred Mind and what lies within it. I try to be benevolent towards everyone, but I'm not seduced by that desire.

Freud would say there are shameful desires, primeval fear, unassailable rage that we're incapable of confronting because they pose unspeakable danger to our psychic wholeness. It's sort of like the mind-splintering direct encounter with the divine, alluded to in every spiritual tradition of which I'm aware. The infinite, though blindingly loving, is too much for us to bear. Wholeness can lead to madness just as surely.

Notice how I veered off into theoretical exploration? That's my brain offering up distraction and solace. Every once in a while, I can see it as it happens. It no longer matters to me, at this moment, whether the sacred 24 hour rule has been violated. I'm still stuck on the idea of hatred mind and the mystical meeting of humanity with infinite love.

The Outskirts of Consciousness

"I've been trying to get as far away from myself as I can," "Things Have Changed," Bob Dylan

I tried calling in sick to Life. "Hello, Life? I'm not myself today, so I won't be coming in. I'm sure I'll be back tomorrow." Life does not accept those kinds of calls. I'm reduced to living on the outskirts of consciousness, tamping everything down and floating around the edges where nothing serious lives.

I'd love to take a vacation from myself. I get that old claustrophobic feeling I had after my last surgery. If only I could rip some part of myself open and step out of this body for a while. Or if I could just scream long enough, maybe all of the anxiety would drain away.

I've written several posts and abandoned them or saved them for some day when I can concentrate. I haven't been visiting my friends online. It feels like half of my brain is dead. Maybe more than half. I spend my Crazy Land days trying to work on the database, but it all seems so complex and unfathomable. I haven't accomplished much.

I've been crying at the smallest of things. Even writing that sentence makes me teary. I become enraged at unpredictable moments. When I'm not enraged, everything irritates me. So, let's see...crying, then being enraged, then being irritated, then back to crying with a little irritation mixed in. I've got my own private Crazy Land going on in my head. No one pays me for showing up every day, though.

My mother seems to call me every 15 minutes. I love my mom, but get off the damn phone already. I had a psychobitch meltdown with Hubby yesterday. I'm sure he'd like to get away from me almost as much as I would. Crazy Land is easy. I'm in my office where I pose no danger to anyone else. If I don't see them, I don't yell at them. I don't crumple up into a little ball and cry at the copier. I don't expect them to understand where I'm living these days.

Most of the time, though, I'm able to keep it together. I chat with people, I read, I listen to music. I do not talk about fear. I try not to engage fear on any level. My inner debate continues: Am I being crazy about the mass under my arm (and the pain and swelling) or does it make complete sense that it terrifies me? The question arises regularly and just as regularly, I push it away.

It's one of those times, I suppose, when no one can help me out of this. Why don't I go to see my radiation oncologist, people ask me. I don't know. I don't want to. That would require that I allow fear a free hand in my consciousness. Maybe I just don't really want to know what's going on. Maybe it's stupid to even think I need to see him. If I see him, won't he just tell me he doesn't know what's causing the problems, that I should give my oncologist a call? Or maybe he'd tell me to get over it. Hell, I can tell myself to get over it without having to shell out the $15 copay. Maybe if I just wait a little while longer and keep the panic corralled, my logical brain can get control over things and I won't have to go at all.

Anguished. That's the word. If I had to sum up everything going on inside me, that would be it. Feeling it is almost more than I can bear. As I type these words, there's a voice inside reminding me that my problems are small compared to most people's. There's a whole lot of suffering going on in the world.

I either need to get some greater perspective on my problems or open my heart and mind to the anguish. I should observe the fear and rage and sadness. I should note how they feel to this physical body. Mindfulness meditation. Maybe I can get around to that later on. Not now, though. Right now, I'm going to summon the energy to push it all away again.

Ignorance and Insensitivity

"Consider that thou dost not even understand whether men are doing wrong or not, for many things are done with a certain reference to circumstance. And, in short, a man must learn a great deal to enable him to pass a correct judgment on another man's acts. ~ Marcus Aurelius

Warning: If profanity offends you, stop now.

Want to know what offends me? Continuing conversations with my co-workers about Elizabeth Edwards. Not only does it offend me, it enrages me. The owner of my company just called me to advise me again that he doesn't believe Elizabeth Edwards should be out campaigning for her husband.

I muzzled my rage and told him, in a reasonable tone of voice, that I've given her circumstances a great deal of thought. I don't judge other people trying to endure cancer, especially when it's clear that ultimately they will not survive. Even if it seems like they will survive, no one and I mean no one, has the right to make those judgments. Especially when you have not experienced the disease yourself. I don't mean just reading about it or watching documentaries about it or even knowing someone who has it. When you have walked the walk, then and only then, do you have the smallest scintilla of right to criticize others who are just trying to get through the fucking day. How ever they can.

"Well, I just think it's a matter of priorities. They have children, you know." he said.

No. Really? They have children? What would you have her do, sit around her house all day, waiting to die while her children crumble? You don't know. Maybe you would do it differently, but here again, you don't have fucking cancer. So shut up.

What would I do if I knew with certainty that death by cancer was going to severely limit my time with my children? I have no idea. I know I used to have a lot of ideas about how to get through the struggle, even shortly after my diagnosis. You don't know until you get there. I don't know what I would do. How can so many people in my office be so deluded as to think they know? Well, aside from being judgmental assholes, of course.

If you don't like John Edwards, I don't give a fuck. Campaign against him. Vote against him. I don't have a horse in this race. Don't call me up to argue with me about his "arrogant campaign tactics." Allow me to repeat myself: I don't give a happy goddamn about John Edwards. He doesn't have a snowball's chance in hell of winning the nomination, in my opinion. People do not contribute to political campaigns out of pity, in my opinion. (This is politics--anyone can have an opinion as to the mechanics and outcomes of political campaigns.) Who the hell are those people? Find some for me, provide me with some reputable sources of information on that score and I might be willing to change my mind. That really isn't the point. Judging someone who's dying of breast cancer, who's going to endure an enormous amount of pain (including the certainty that your children, young and adult, will have to live their lives without their mother--that's the point.

Furthermore, could you just stop talking to me about this? I'm emotionally ravaged by two years of doing whatever I had to do to get through it, sometimes sixty seconds at a time, because that's all I could manage. I have this weird thing going on under my arm. Everyone here knows that and, even though I don't wander around with a worried look on my face, cut me some fucking slack, could you? I expend an enormous amount of energy every day trying to keep my own internal debate at bay. "Oh of course it's fine. Silly me," alternating with, "Fuck! This is how it happened the first time. Why is there pain and swelling? Why is there that hard mass?" I do not have the extra energy to stuff all of that back down just because my co-workers think it's their right and duty to express their ignorant opinions. To me. If you'd like to talk about it, if you think you must, talk to someone else.

I've asked that people not talk to me about it. I've asked politely and patiently. I've told them it makes me anxious. I've walked away when they ignore me. I sincerely hope that no one here (or anywhere) has to find out what it feels like to actually experience this disease. In these circumstances, I say that with a certain amount of bitterness. When and if my esteemed co-workers wake up to their own cancer diagnosis, they can come to their own conclusions about the behavior of everyone else with the diagnosis.

Until then, fuck off.

My Own Inner Cancer Survivor

Today is the one year anniversary of the end of radiation treatment. I spent seven weeks, five days a week, lying on a big table in some kind of molded stuff that was supposed to keep me in exactly the same position every day. The molded stuff did not feel good and sometimes it was hard to get my body to fit back into that particular configuration. (When I left every day, they'd label my mold and hang it up, along with lots of other people's molds.)

Then everyone would leave the room and this huge machine would circle around me like a vulture. It would radiate for a while here, move, and radiate in another place. It usually went on for about half an hour. The machine made a lot of noise and, from my vantage point, I could see it internally repositioning itself (by technician-controlled computer) . Blades inside made a whirling sound as they moved. I started to have burns before many days passed. Big deal. I'd just finished up chemo. A few burns meant nothing to me.

As I lay there, I'd sometimes contemplate my radiation oncologist's explanations about the need for precision. If I moved during the radiation treatment (I love that word, "treatment"), it could radiate my lungs and/or heart because of the size of the area and its proximity to those organs. Sometimes I didn't think at all, drifting still in my poisonous haze. I just lay there and felt how much my body hurt. When it was over, I smiled and told the techs I'd see them tomorrow. I'd get dressed and go back to work. It makes me sad to think about that time.

I got unaccountably attached to my radiation techs, a young man and woman. We never talked much. I'd say hello and ask how they were. They'd answer and ask how I was. They knew how I was. I was dazed with pain, beaten down and generally felt like shit. I looked really good, too. It was nice that they asked, anyway.

Those techs were two more strangers I became comfortable with pulling and pushing my body around. At that point, it didn't really seem much like my body anyway. On my last day, the young woman tech rushed out and stood beside the door with a handful of confetti. As I walked out, she threw it up into the air. I actually hugged her. We hadn't had that kind of relationship, but I suppose all cancer treatment relationships become intense, if only for the patient. Actually, I think it's probably a little intense for the care providers, too. However, they need to protect themselves emotionally, of course, in order to survive the jobs they do. When I think about my own two radiation technicians, I'm still grateful and marvel at their gentleness. I would hug them both if I had a chance.

My own personal victory: I did what I could to liberate my fellow cancer patients by not wearing my wig. I was completely bald, of course, because I'd just finished chemo. By the time radiation was over, I was beginning to have a little baby bird fuzz. There was another young woman receiving radiation treatment for breast cancer whose appointment was always just after mine. After seeing me with my naked head for a couple of days, she started showing up without her wig. She told my mom one day, while I lay on that table in the radiation room, that she had never gone anywhere without her wig. Even her husband had never seen her without it. I gave her the courage.

I had begun to feel that, by wearing a wig, I was giving in to a sense of shame, almost. I was bald because I was trying to survive a terrible disease. Why would I hide that? I had lost all pretense to vanity a long time before my hair completely went away. Wearing a wig became more a gesture of protection for other people than for me. And, in fact, when I started coming to work without my wig, people were troubled. I told them that I'd gotten used to it and they would, too. I have no idea if they ever did, of course.

I decided that being bald was a profound symbol of exactly how difficult my life had become. It became a statement of pride. This is how much I can endure. This is how committed I am to staying alive. I not only have enough inner strength to keep going, I have enough strength to let you see how I've suffered. Furthermore, fuck you, cancer.

We all get through it how ever we can, though. I would never, ever judge another cancer patient for making a different decision about it. I think everyone should be as comfortable as they can be, in every possible way. If a scarf or a wig helps a little, then hallelujah. It's important to celebrate your Inner Cancer Survivor somehow, though, if you have enough energy. My way didn't take much of that.

I have my six-month check up with my radiation oncologist soon. We'll be having those little visits for the next five years. Sometimes it feels like all of it will never end, especially as I mark time until the next ultrasound.

Radiation ended, though. A year ago today. Here's to my own Inner Cancer Survivor.

The Object Of My Desire

Another day of uselessness. Don't think that I'm unaware of what's really going on. It takes a tremendous amount of mental energy to manage that delicate balance between terror and quasi-serenity. The only defense against emotional turbulence and obsessive worry is dedication to minimal synapse firing. In short, I don't work. On the other hand, I haven't had to visit the Ggirl Crying Building in the past couple of days. If I don't accomplish anything other than that, I've already done more than the majority of my co-workers do in a week.

I spend a lot of time fantasizing about my oncology surgeon. It is so not about how he looks. The men (or boys, really) I dated before I met my husband were all good looking, as is Hubby. I was exactly that shallow. On the other hand, if they couldn't keep up intellectually, they were banished in short order. I didn't care much for emotional accessibility, either. As a matter of fact, expecting me to be loving and open counted as a serious liability. Hubby is the only man with whom I've ever been truly vulnerable.

Back to the object of my desire. He's middle-aged, a little paunchy, seriously balding and he wears very thick glasses. I look around and see men every day who are far more attractive, but arouse absolutely no libidinal interest. It's that ineffable something. It's sexual attraction that arises from a primitive part of my brain. Maybe it's those expensive, heavily starched white shirts. (Although I see a lot of those around, too.) Or maybe it's the profound intimacy that develops when someone cuts off one of your breasts and calls you sweetheart, anyway.

My need to fuel this harmless obsession has resulted in some unpleasant consequences. I googled him, of course. (Of course!) Unfortunately, it led me to an article he published a couple of years ago in a medical journal. It impressed on me the seriousness of my illness. I hate it when I come across things that clarify the dangerous extent of my breast cancer.

A couple of weeks ago, I was editing some old entries from when I was first diagnosed. I thought I'd share them with Hubby, since my online friends are the only people who've ever been privy to the daily grind of that period in my life. The unvarnished truth can be emotionally devastating for loved ones. Hubby already seemed very fragile; helping him get through it would have forced me to really confront my situation. It would also have depleted my own energy reserves critical to survival. (See synapse management above.)

Now, I'd like to offer him the best of my literary self in addition to authenticity. In editing those posts, it became clear I'd forgotten the things my surgeon told me after the sentinel lymph node biopsy. It took my breath away. I have a truly world class ability to deny reality when it's too harrowing.

I try to put those things out of my mind, though. I get right back to obsessing about my surgeon. I know what's important. It's that delicate balance that must be preserved. If he's the necessary vehicle for that, I'll step into it wholeheartedly. I just need to be careful about knowing too much about exactly what he does.

Maybe if I Yahoo him, I'll be able to entertain myself for the rest of my work day. If not, I'll have to simply imagine the beauty of what lays beneath his starched white shirt.

All Manner Of Things Shall Be Well

Today I planned to get around to checking in with all of my online blogging friends. I always miss sharing in their daily lives when I have to be gone--usually because of a trip to deal with cancer in one way or another. I may not get around to that, after all.

I'm crying now. In my office. At the mercy of anyone in Crazy Land who happens to knock on my door. I do not wish for them to see me cry. It's too personal to explain and there is no consolation to be found. Certainly not here, anyway. Actually, I'd love to explain it to myself, but crying is only crying. No explanation necessary.

It feels so silly to be afraid. Is there something wrong in the new girl? Probably not. My mom thinks everything is okay. I should just banish the fear and rest in the thought that most likely all is well. Right? I'm almost certain everything is fine. Why would I choose to believe otherwise?

On the other hand, having once been overly optimistic, it's well nigh impossible to exorcise that anxiety gnawing around the edges of my consciousness. Two summers ago, I thought we were just going to have a look around, maybe remove a benign tumor and get on with things. Then I believed Dr. Ross would perform a little lumpectomy or a big lumpectomy and I'd go on my merry way. Obviously, that didn't happen.

Money Man's daughter poked her head in my office a while ago and, though I tried to pull myself together, I'm a messy crier. My eyes get puffy immediately and my nose turns red. Very, very attractive, I assure you. That's when I decided to take a little trip next door and get over myself. At least there I could cry noisily if it came to that. It did. But I'm back now.

A few seconds ago, Crazy Employee, who engaged in some egregious back-stabbing behavior last week, knocked on my door and made some ridiculous excuse for entering my office. If I wanted chocolate donuts, bitch, I would go to the receptionist's desk to get them. I do not wish to share anything with her. I'm insulted that she would think otherwise.

In what's come to be the Official GGirl Crying Building, there is an abandoned plant. I've been trying to get someone to take care of it for a long time and now it's dying. That touched off another round of crying and, as I sit here, tears are welling up again. Goddamn it. I'm going to try to find a way to get some water to the poor thing and, in the meantime, I slanted the blinds so it could get more light. I just need to find a big enough container to take some water to it; it's a very large plant and needs more than a cupful or so.

Back to the matter at hand, be afraid or not? Maybe I don't have any choice and I should just go with whatever the moment brings. Oh yeah. That was supposed to be one of those lessons I learned from having breast cancer. Being in the moment is being completely alive.

I tell everyone that I wish to live until I die. When I'm sitting on the floor next door, crying about a dying plant, that is exactly living until I die. Yesterday I was reminded of a quote from a Medieval mystic named Julian of Norwich. "All things shall be well. And all manner of things shall be well." They shall.

In the meantime, I may be vying for the office nickname, "Crazy Employee." I'll have to think of a new name for her, though. The possibilities are endless. I'm officially taking suggestions, but I have dibs on "Back-stabbing Bitch." I'll get back to debating fear later. I've got my priorities straight, you know, because all things most certainly shall be well.

Same Song, Different Verse

I got back from M.D. Anderson several hours ago. The good news: hotel was fine, water was hot, no one suggested that I might be feeble minded. The other up side: I saw my beloved Dr. Ross. One of my online friends asks what's special about my surgeon. Excellent question, which I'll answer later.

The mammogram process was terrifying. We did the usual four x-rays, they sent me to wait in a little room to make sure they hadn't missed an area. I was the only person there. After a period of time, they came to get me again. No big deal, I thought. We just missed something; that's not unusual at all.

Oh no. We had to do a different kind of mammogram because they needed to take a closer look (they being the radiologist and person who did the mammogram) at something. Hand crank makes a comeback. I was sent to sit in the little room again. Alone. Time passed and passed and passed.

Finally, after about 15-20 minutes of waiting, the mammogram person came to get me to take even more x-rays. Now I'm really afraid. That's how it started the last time. Picture, pictures, wait, wait, then bad, bad news. "This must be making you really afraid," the mammogram person said. "Yes," I answered. No response. She put the x-rays on a light board, told me to come over and pointed out several areas they were concerned about. Great. That also happened the last time.

More hand crank action and some highly unusual poses that I had to hold, without breathing of course. Back to the tiny room. As I waited, I became more and more afraid. I was almost ready to cry when she came back and said they looked okay. Too late. That's what the radiologist told me two years ago. Then I showed up at my local surgeon's office where I found out that things weren't fine, after all.

I was still terrified while I waited for Dr. Ross. He came in and asked about any problems, then reassured me about the right breast. I could relax enough to tell him they took my oncologist away from me. I asked him if he was going away, too. "I'll do anything you want me to do." Okay. I was feeling better enough to think, "Oh, really? How about I move in with you and we spend the rest of our lives together?" Instead, I said, "Please don't go away. You're my guy. I trust you. I know you're going to take care of me."

Dr. Ross then started examining the new girl and found a hard place where I had a lot of radiation last summer. He was concerned about it and wants to have a better look. A mammogram? Ultra sound? I don't know. "See?" I said, "You're my guy. I know you'll take care of me."

We scheduled another visit in a month, I think. Or in August. When your oncology surgeon registers concern, there's a part of your brain that shuts down. Or at least that's my experience. Off he went to fetch his appointment schedule. He wrote me down for whatever date it is and gave me a hug He's a very, very compassionate man.

Now, on to why he's so special. He saved my life. I had an unusual form of breast cancer that manifested itself in unusual ways. He found it. He told me. Then Dr. Ross took care of me. He's the best surgeon in one of the best cancer hospitals in the world. He's very gentle and cares about all of his patients as individual human beings who deserve kindness and support. He gave me hugs. Dr. Ross knows how terrifying any kind of cancer diagnosis is (he also specializes in skin cancer surgery).

Here's the final and saddest reason why I have such a huge crush. He's the first man I've ever known who's taken care of me. I can count on him. That's remarkably special.

Thanks for all of the prayers and good wishes. They help, you know, both emotionally and physically. That helps to take care of me, too. I have to rest now. See you on Monday.

The Hand Crank vs. Crazy Land

Okay, here's the deal. Tomorrow morning, I will take my little Andy to be boarded, then I'm going to drive four hours to get to Houston. Thursday, I have a bone scan and a mammogram. The bone scan is no big deal. There's no pain involved in that.

As for the mammogram, my insurance company should be pleased that I am receiving the best screening possible. They manage to scrunch all of the skin and muscle from my neck to my bellybutton in between what I think of as the jaws of death. We spend a good twenty or thirty minutes getting me all lined up and making the plates capture the skin and muscle. Then, my friends, the hand crank comes into play. All of that bodily mass will eventually be compressed into a quarter of an inch. I swear.

After all of that, I'll be sitting around waiting for my beloved oncology surgeon. At least 45 minutes at best will be spent sitting in a hospital gown three times my size in a tiny, freezing little room. Given the size issue, I don't even know why they give me the gown thing. It's fastened in front and, having only two ties, I'm virtually naked from the waist up. I used to expend a considerable amount of energy trying to keep myself covered up in case one of the many nurses or Fellows or assistants show up. Going down the hall to the bathroom was always interesting. I'm shameless at this point. So many absolute strangers have not only looked, but touched extremely private parts of my body that I don't bother with modesty.

On mammogram days, I usually get back to my hotel room around 9:00 p.m., exhausted and starving. They make it impossible to actually eat anything substantial in a day always positively action-packed with waiting. In spite of all of this, it seems infinitely preferable to another day in Crazy Land. I know it will still be there waiting for me on Monday. But for the following three days, I can occupy my thoughts with more important things than back-stabbing attempts by co-workers, random rage attacks by others and my own weariness with it all. Bring on the hand crank. What a relief it will be. See you on Monday.

On The Other Hand....

Okay, well maybe not an up side. More like random thoughts that aren't quite so glum.

I'm back to some semblance of my old workout schedule. The good news: there really is muscle memory! The butt is making a comeback. The triceps--not so much. They need lots and lots of work. The rest of me is getting more muscular and my stamina improves every day. It was vitally important to get the muscle tone back to some extent so I can resume flirting with my oncology surgeon. That's such an odd concept--trying to flirt with a guy who regularly makes me lie down and then touches my breast (and now the new girl, I suppose). I have hair now, though. That's got to be an advantage. Yes, I will leave my husband. In a heart beat. Or a breast check, whichever.

I had a compliment from one of our contract employees last week. I always call him "The Ladies Man," although he's known by his peers as Killer, a tribute to his lady killer days. I've known him for years now, but he's still a looker. Killer told the Superhighway that I'm looking very sexy. I naturally thought she was making this up as a tonic to my poor physical self-esteem. Now I'm not sure. She looked pretty sincere. That used to be a thing that irritated the hell out of me--I always wished men would pay less attention to how I looked than how the brain worked. Now? It made my week.

I passed the compliment on to Hubby. Interesting how that made him actually see me again. After 30 years, in at least a couple of which I looked like absolute hell, we tend to take each other's positive attributes for granted. I don't care. I'd still leave him for surgeon noted above.

Should there be another post? Yes, I think there should. I write these long, verbose posts and I'm always afraid they're too long. They may become tedious. So next topic. I'm making up for my absence later this week. I can always tell myself that, anyway.

Another Month, Another Trip

I've got a trip to M.D. Anderson this week...it's never-ending. Bone scan and a visit with the ever lovely Dr. Ross. Even my great affection for him isn't quite a panacea for the stress extravaganza. I woke up four times last night. It never fails. Even when I'm not thinking about, my brain is working overtime with anxiety.

I think I get the month of July off, except for a visit to check on the progress of my macular degeneration. I fear the news will not be good because the eyesight in my left eye (the one most affected by the disease) has deteriorated. I can still see the grid I use to check md's progress, so that's good news. I'm tired of doctors and I'm tired of bad news.

In August, I have a follow-up with my radiation oncologist. He's here in town, so that's something, I suppose. August 29 is my next (and, I hope final) surgery.

In September, it starts all over again. I'll have to schedule a visit with my medical oncologist. I'll never forget the last visit after chemo ended. I told my doctor that I really like him, but I'd be thrilled to not see him again. Oh no, he told me, you'll be seeing me for the next five years, at least. Four times a year. My heart sank.

There will never be an end to this, unless they find a cure. I have my very own M.D. Anderson page on the web. A dubious distinction. It could be worse, though. As far as we know, there's no cause for concern. The Watcher notes the one-cell rule.

Just Another Bad Day

I'm having a bad day today, sitting in my office crying. Why? Well who the hell knows. I actually had to leave a minute ago and spend some time in the other building, sobbing. Then I walked around the block to make sure I wasn't carrying the Dreaded Fleas into the main building.

Today I guess I'm thinking of everything I've lost. It wasn't just a breast, it wasn't just a childhood, it wasn't even innocence. It wasn't any of those individual things. I'm not sure I can even enumerate them. And, after all, what would be the point of that? Sometimes hope seems so far away I have no idea of how I'll reach it, or if I ever will. Hope for what? If I knew, I'd be working hard to get it.

It's a bad day. That's all. One of the great things that breast cancer taught me is that it's just fine to cry. Furthermore, I couldn't stop it even if I wanted to. And I really, really want to. I'm a person who just gets up every day, hoping to learn whatever lessons the universe has to teach me, and I get on with things. Buck up. Get a grip. Move on.

I'm more composed now. Thanks for listening. I am now officially bucking up. I could do that a lot faster if I had chocolate, though.

Visit With Oncology Surgeon Slated

My next visit to M.D. Anderson is slated for June 21. It's a full day, though, so I'll be gone from June 20 through June 22. I'm going to have a bone density test, a mammogram and (I hope) see my oncology surgeon. Given my recent experience with my oncologist visit, I can't be sure about actually seeing my surgeon.

I love Dr. Ross. I'd leave my husband in a minute for him. He takes excellent care of me and he's one of the best in the world in his field. If I'm shifted off to a Nurse Practitioner, even if she's advanced, I'm going to be very, very unhappy.

If my insurance company and I are paying big bucks for the top of the line cancer treatment, why would I choose to not get it? Why wouldn't I see an actual oncology surgeon here? The answer is, I wouldn't.

So far, they haven't altered my schedule to reflect such a change, but I'm clearly going to have to monitor the situation. That's why I went there in the first place. Trust. I'd like to see my real surgeon, please.

Oncologist Appointment

I made a trip to Houston to visit my oncologist last week; it was just a standard "waiting and watching" kind of appointment. The blood tests were good–nothing to be concerned about. My platelets are a little low, some other cryptic stuff is high and I probably need to address some bone density issues. I had the beginnings of osteoporosis before I began chemotherapy and the treatments sped up that process. We’re not medicating now because I take a lot of medication already. I already take calcium with vitamin d, so I need to concentrate on getting more natural sources of calcium, in addition to addressing my anemia. These are small problems in the grand scheme of things. Thank you, kind friends, who were sending positive thoughts and prayers.

The seriously bad thing is that I won't be seeing my oncologist anymore. Ever. Unless I have some recurrence of the breast cancer. I get to see an "Advanced Nurse Practitioner." She seems like a very nice person and probably knows her business. My other meetings with nurse practitioners is that they don't necessarily have the level of information that doctors have. I have had wrong information imparted from my plastic surgeon's nurse practitioner, among others. Furthermore, I do not go to M.D. Anderson to see a nurse practitioner. It's expensive, it's grueling and I could see a real oncologist here.

The Department of Oncology needed to cut the budget and it was either we all see nurse practitioners or people were going to be laid off. The standard procedure was that patients saw the nurse, then the oncologist. All of that is gone now. The woman I saw said the oncologists were taking credit for their work. Hmm...maybe the oncologists were merely taking credit for their own work.

Obviously, I'm extremely unhappy with this turn of events. I'll have to make a decision about what to do now. Damn it.

The Watcher

"I'm back." It was only a couple of weeks ago that I had that epiphany. I might even be better than I once was in some respects. I seem to laugh more easily. I joke with people and poke fun at myself. It seems I'm more chatty, more friendly and less anal. Yet another medical marvel brought to me courtesy of the new medication I'm taking.

Underneath the new, better me is the Watcher. She hovers just under my consciousness, ever mindful of the fact that a mastectomy, six months of chemo and seven weeks of daily radiation do not in any way guarantee that all the errant cells have been killed. The Watcher is the mad woman in the attic. She's extremely irritable and the closer I get to my three-month blood test, the more easily frustrated the Watcher becomes. I can hear the annoyance in my voice as I talk to someone while I'm struggling to get the batteries out of my wireless tracball. Everything demands more from her than she has to spare.

The Watcher notes every unusual physical experience. What is that itchy spot on my upper left shoulder blade that I keep forgetting to show someone so I can get some reassurance? As if anyone could reassure me. Is that a new mole on my face? I have a new cough. That's particularly troubling to the Watcher. She knows where breast cancer will metastasize and, even though the rational mind remembers we're in the middle of allergy season, the Watcher knows she needs to keep track of how many times I cough every day. My radiation oncologist told me months ago that part of the carcinoma was very close to the chest wall. The Watcher remembers as if it were yesterday.

Friends, co-workers and family know nothing about The Watcher. As far as they're concerned, I'm fine. The minute radiation treatment ended, I was officially fine. My mom thinks I should have a positive outlook. I do. I just wish someone would figure out that worry doesn't end when radiation does. The fact that it doesn't makes me feel like a hypochondriac. I feel silly and embarrassed.

The Watcher knows it's not silly. Just under the level or ordinary consciousness, she reminds me about that one cell.

Tales of the Ditzy Oncology Nurse

It's 4:29 here now, so this will be a short, venting kind of post. I got a call from my oncology nurse this morning, telling me we need to reschedule my appointment with my oncologist. We agreed on 11:00 (same day as scheduled); she advised me that I'd need to do lab stuff an hour earlier than previously scheduled (that was originally scheduled for 11:00).

That sounded odd to me because the whole point of going there is to review blood work with my oncologist and I assure you the lab would never have results to my doctor within an hour. I decided to check my personal page at their website and, lo and behold, Pat (the oncology nurse) got it wrong again.

My lab work appointment is scheduled for 8:45 a.m. and I'm going to see the nurse-practitioner at 11:30. I wonder if I should feel comforted that they're not making me see the doctor. That's probably too much to hope for.

Pat. I'm sure she's extremely competent somehow. Unfortunately, my experiences with her have been less than satisfactory. She's ditzy. When I was having sores in my mouth and on my hands because of the chemo, I called Pat and explained my symptoms (as they told me I should). She asked me in a vague tone of voice whether I was doing prescribed oral hygiene. Oh God yes. Believe me, you will do anything to try to get rid of those.

As things got worse over the weekend, I called my oncologist. He immediately called me back and prescribed antibiotics to prevent the sores from getting infected. Had I depended on Pat, I would have had twice the problem--and infection and the sores. My immune system was almost completely shut down by the chemo, so an infection would have been difficult to overcome.

I really try hard to respect and value Pat The Oncology Nurse. If only she'd give me more reason.

Remembrance Of Loss

I started writing a post about lost abilities, but the universe (or the cyber-universe, at least) took it away. As I was writing, it disappeared. I take it as a sign that, though I may examine it briefly, I should not pursue this topic at length. All things have a reason.

Maybe breast cancer has taken far more from me than I ever imagined it could. Today, I realize that's the very definition of spirituality for me. We lose everything, eventually. No matter what. No matter how many vitamins we take, how many trips to the gym, the body will deteriorate and, eventually, die. Intellect will fade and personality will alter. That's how it goes.

I just have to remember that, accept it and, ultimately, I must embrace it. That which I believe myself to be is just an illusion. The whole is more than the sum of its parts. The one I truly am will not be touched by deterioration of any kind.

Chemo clarified the things I am not: not hair, not intellect, not memory, not physical health, not my emotions. These are merely things that I've stepped into, only to leave them behind when the time comes. It's a liberating and mournful clarity.

Today I remember and I see the task stretching out into the distance. Celebrate. I'm here to learn this lesson. Remain open to suffering and dissolution. Greet them as friends. Just like all friends, they can be problematical at times and hard to love.

Along the way, smaller realizations lead me to the greatest one. At every moment, I can choose to search for the lesson that invites me. Seeing the truth is strenuous work and sometimes I'm not up to the challenge. That's why I'm reminded, from time to time, in many ways, that life slips away.

There's a great Zen precept "Do what is in front of you."

That which is in front of me today is a remembrance of loss.

Learning To Live With Someone New

I type things and then erase them. Over and over. The bad day began last night. I got weepy earlier in the day and now it appears there's no point in trying to remain upbeat. I had some fun this morning, writing about Crazy Land. Then a friend asked my opinion about Phil Spector. That's currently one of my favorite topics.

I told my mom it would be okay to bring over my book, Living With Breast Cancer. She took it away during the time I was undergoing treatment because every time I started to read parts of the book, I would become terrified of what was going to happen next.

All clear, I thought. Treatment is over, so I thought I might get some useful info about what my radiation oncology nurse called "reclaiming my life." Instead, what I found was confirmation that some of the bothersome things I've been experiencing may be treatment-related. And permanent.

I read that chemotherapy used for breast cancer (and maybe other types) can change the structure of the brain and how it functions. Or doesn't. Antidepressants can exacerbate the bad effects. As can steroids used in treatment and Tamoxifen used post-treatment.

They may affect memory, spatial-visual abilities, verbal (especially written) skills. There may be permanent alterations in concentration and attention span. I've experienced a lot of these. I chalked it up to depression, hormones, and/or age. Any (or all) of those things may actually be part (or all) of the problems. Or not.

It's yet more potential for the possibility that breast cancer has taken away all of the qualities by which I've defined myself. The ability to write well and think sharply would be great losses. They have always been self-defining. I'm not sure I can recognize whether verbal skills have deteriorated. Certainly cognitive functioning has changed and not for the better. I'm kind of stupid now and I have absolutely no memory at all. Maybe permanently.

One of my co-workers has a daughter who's participating in an American Cancer Society event which will culminate in an all-night walk by cancer survivors. Luminarias will light the way. It brings tears to my eyes as I type these words.

I've developed an abrasion underneath the new girl where some scar tissue has formed. There is a patch of irritated skin on the scar that runs across my lower stomach. It's hard for me to tell what's going on, from day to day, with my incision sites. Sometimes things hurt for no apparent reason. Even in places where I'm numb to the touch. I note it and move on. What else can I do?

I've had pain for a couple of days now in those places, so I asked Hubby to look in case something was actually wrong. Obviously, something was. So. Back to the vesty bra and underwear that comes up to my waist.

I'm not sure why this seems overwhelming to me today. I gave it my best shot to buck up and was doing fine, it seemed, for a while. I have extensive experience with bucking up. Not today, I guess.

Living With Cancer

I just wrote a lengthy post about Ted Koppel's documentary, "Living With Cancer," that was on the Discovery channel last night. (The post went flying out to Internet Purgatory.) The documentary will be aired again tonight at 8:00 Eastern time. If you have a friend or family member who has cancer, this program can be very helpful.

Leroy Sievers is Ted Koppel's best friend. He is dying of colon cancer that metastasized to several parts of his body. He is in Stage 4. That diagnosis almost inevitably ends in death. Elizabeth Edwards (who participated in the town hall meeting shown after the documentary) has Stage 4 breast cancer. No matter where the cancer travels, it will always be colon cancer or breast cancer. Just in a different location.

I can't imagine suffering through the treatments only to postpone death. We're all going to die, but some of us have medical proof that we're going to die sooner rather than later. There will be an end to Christmas lights, an end to friendships, to all of those daily things we tend to take for granted.

Since about halfway through chemotherapy, I've been almost certain that I would not choose to go through it again. Even if it meant dying. Of course, when I was first diagnosed, I thought I would refuse chemo and radiation. In retrospect that was profoundly naive. So maybe I would do another round of chemo, another round of radiation. I guess that's just one of those things you don't know until you get there.

All of the people at the town hall meeting were either currently being treated or had been treated for cancer. Without exception, everyone could see some positive things about having cancer. It certainly changes your perspective and clarifies priorities. It measures the level of inner strength you possess. I have attained heretofore unknown amounts of suffering. I care less now about how my hair is looking every day than to celebrate having any hair.

Cancer changes everything. It robbed me of all of the things I thought defined me. I'm trying to get some of them back. Some of them were inaccurate measures of who I am and needed to be left behind. Some of them are things that frustrate me, make me angry and cause me great sadness. Nonetheless, I'm still here. That's a lot. I know that I will live every day until I die and I will learn to love whoever replaces the person I used to be. No matter how hard that may be.

Phase 2 Reconstruction Scheduled

I finally got in touch with my plastic surgeon's nurse, Brenda. The last time I visited him, he told me Brenda would get in touch with me with a new surgery date. He thought it would be about four months down the road, but he cautioned me that he has an (outrageously) busy schedule.

I waited and waited and finally sent an email to Dr. K's scheduler. I just wanted to get the surgery date scheduled so I could attempt to put this out of my mind. It never does me any good to think about this stuff in advance. It's highly anxiety provoking, though not so much as my visits with my oncologist and surgical oncologist. There will be drains. That is one of the big reasons I need to put this out of my mind. Well, that and the pain.

My date is August 29, much sooner than expected. I immediately freaked out. Yes, it's good but no, it's not good at the same time. Let me just say it again: drains. My mother points out to me that I had drains for the mastectomy and they were very bearable. I'm not certain that didn't have more to do with the psychological trauma of having a breast removed than the lower pain level in having plastic inserted into your body. Maybe if I just get my beloved Dr. Ross to do it. Of course, Dr. R. is much better at cutting things off than at recreating them.

I probably won't be writing much more about this until the drop dead date (no Freudian slip here). I will be posting about the upcoming oncologist visit (the end of May) and my trip to see the wonderful Dr. Ross (sometime in June). I'm putting surgery out of my mind now.

Maybe I'm Manic, Maybe I'm Not

It's Monday and I haven't ventured out of my office. I've sent one email to Owner and spoken with Crazy Employee over the intercom. Oh wait. Crazy Employee just spent twenty minutes in my office, telling me about Rat Cleanup Day. Just send me a memo, okay? Do not make me talk to you. It's Monday. I'm in my office. Isn't that enough?

I think my new antidepressants are finally kicking in and I have to say, last night the thought actually arose, "I'm back. Is that right? Am I really back?" I'm more animated (like I used to be). I'm funny and quick-witted (Only about funny things, though; not important things like where I put my keys.). Last night around 7;00 p.m., I started dreading having to come to Crazy Land today. Surely that's a sign of improved mental health. For a while, I actually wanted to be here. But that was during chemo. Then there was a bout of it right after that last surgery, when I wanted to be anywhere but sitting on a sofa, being despondent. I can be despondent so much better here.

I actually wrote something with paper and pen last night. I haven't done that since my beloved friend Becky died. It was something intellectual. Oh my God. The end must surely be near. I need to check that supermarket tabloid that warned me the end is imminent and find out if my name is listed under the "Who's Going to Live?" part of the article.

It could be that I'm just a tad manic today. It looks like rain outside my windows and I haven't started drifting downward into weather-induced melancholy. Yes, that's definitely a sign of tad-ish mania. So is making up words like "tad-ish."

My mom just called me to tell me she got one of those spaghetti cookers you see on tv. It's like a clear cylinder and you pour hot water over the spaghetti in it and--voila--fully, but not over cooked pasta. It was a short conversation because, as she rightly notes, she has to hurry over to my house so she can be there when Phil Spector gets going. I urged her to hang up and get on the road. Trial is due to start in about 13 minutes. See? Maybe I'm just a tiny bit manic.

There are important things I need to share with you, but I'll be damned if I can remember what they are. I've been having serious memory problems lately (that's probably the real reason I'm so chipper--has nothing to do with meds). Maybe I'm just not remembering I'm unhappy. I'm blaming the Tamoxifen. I don't always think as clearly as I once did. I have to hang onto the thought that the memory and thought processes will improve as time goes on.

Now I remember. I spent some time over the weekend thinking about breast cancer long term. I have an appointment with my oncologist later this month. We'll do the blood test that confirms there are no cancer cells. This is always an anxiety provoking event. There went that mania thing. Not feeling so frisky suddenly. It's good to face reality, but it's sobering to remember this is a disease for which we have no cure. Many things in my life will never ever be the same. I'm now severely lacking in pep.

I had "Take care of ggirl" day on Saturday and Sunday. I've never done that before (unless I was forced). I read, did some yoga (very gentle), took a bubble bath, laid down to rest for a couple of hours and just generally focused on things that would be soothing. I should probably mark my calendar because I think this is the first time I've ever devoted two days to making myself feel better. Do I feel better now? Well, no. It's Monday now, but that's not really the point.

I finished the Primo Levi biography and thought about the puzzle of why people choose to commit suicide. Thoughts on that will be available at my book site sometime soon. I started Wild Ivy, by Hakuin Ekaku. I'm taking a hiatus from depressing, intellectually demanding, concentration camp reading. Hakuin is intellectually demanding, but he also lifts my spirits and reminds me of the precious gift of this very moment.

More notes from Crazy Land tomorrow. Or maybe that tale I keep meaning to tell of the peculiar behavior by an old friend of mine. Either way, you win.

It's The Tiny Little Rooms That Get to Me

I'm worn down to a nub today. I ended up sitting in one of those little examination rooms for over an hour. Surgeons' schedules are like that, I know, but I start to feel a little claustrophobic after 30 minutes or so.

Everything is progressing nicely, except for some thickened scar tissue. I had a series of steroid injections along the incision site across my lower stomach. I had two at my belly button and two or three right around the new girl. Everyone (the nurse, 2 physician's assistants, the surgeon) was concerned about the pain involved. I'm still numb in several places. The other sites hurt, but I now laugh at pain. Hahaha. A few steroid injections doesn't even really show up on my radar screen.

I'll have another surgical event in four or five months (whenever he can fit me into his very, very busy schedule). We're going to do some liposuction and other work on both the new and old girls. I'll have to be in the hospital overnight and more drainage tubes. (Oh no!!! Anything but that!) Those really hurt. Maybe they won't extend so far into my body this time. Nothing like having sensitive inner body contact with plastic.

Still waiting for the day when I'll be able to wear normal clothes and/or everybody stops hurting me. My psychiatrist tells me I shouldn't think of it that way. It's not very "empowering," you know. She can get back with me on that when she's gone through the same things I have. I have not, for the past year and a half, chosen to be hurt.

Aside from all of that, the skies are blue, the trees outside my windows are lush again and waving in the breeze. Nesting continues and the squirrels are feeling energized. They run along the branches and make daring leaps from one to the other. Out of my other window, I have a bit of a crepe myrtle tree visible and the roof of a church. The crepe myrtle isn't in bloom yet; it's too early still.

There's plenty of action on the church roof, though. The courting going on over there is hilarious. There are a lot of pigeons in the neighborhood and they like to hang out on that church roof. Since it's mating time, there are constantly three or four male pigeons chasing after (usually) one female at a time. She keeps moving away and here come the gang of boys right after her. Generally, when the females get exasperated and leave, all the boys stand there, looking at her as she flies away, collectively baffled. That's usually about all they're willing to put into the chase, so they mill around until some other hapless female arrives.

It's so good to be back. I have another M.D. Anderson visit with my oncologist coming up next month. I'll cross that bridge when I come to it.

Temporary Visit to The Dark Hole

There's nothing like a trip to M.D. Anderson to throw me for an emotional loop. My depression got even worse as the day wore on and there's a good chance it will return (in spades) today. That's just how it goes. I thought I'd get this post in before I take up today's temporary residence in Crazy Land.

There won't be any painful tests. There won't be any bad news. This is just a check in with my plastic surgeon to make sure the New Girl is doing okay and the tummy tuck hasn't killed me (from accidentally ripping out stitches). It's the mere fact that I have to enter that building. Everything comes back to me, even before I get there. Like yesterday. Things got very grim.

I saw Elizabeth Edwards on Larry King last night. It was really nice they made room for her after the wall-to-wall Imus coverage. There is a woman who is most definitely bucking up. More than I ever have. She's chosen not to give any more of her life to this disease. I get it. I've lost almost two years now that will never come back. Choose to live until you die. That's about all any of us (both people with or without serious illness) can do. She has my deepest respect; I am humbled by her courage.

So that's how it is. I'll be away until next Wednesday, by which time I'll probably have returned to the Land of Crazy and be back to my cranky self.

Hogging the Pity Vote

"We are discreet sheep; we wait to see how the drove is going, and then go with the drove. We have two opinions: one private, which we are afraid to express; and another one - the one we use - which we force ourselves to wear to please Mrs. Grundy, until habit makes us comfortable in it, and the custom of defending it presently makes us love it, adore it, and forget how pitifully we came by it. Look at it in politics." ~ Mark Twain

It's started already. My esteemed co-workers think Elizabeth Edwards' revelation about her cancer constitutes an attempt to get the pity vote. After I commented that I need to limit how much I think about the subject, they're off and running anyway.

Then they moved on to Tony Snow. I just had to tell them (more than once) that it was making me anxious and depressed to continue that conversation. Finally, I walked away. I came over to my side of the building where, for the moment, I don't have to offer up my opinion "as a cancer survivor" about any of this.

As if the anxiety and depression and fatigue weren't enough, I'm now having colon pain. Thanks, guys, for stressing me out just a little bit more. What the hell. It's important that you express your opinion to me. We all know I can take it, but it might just cause an eensy bit of pain in my stomach. What's the big deal, anyway? I think they should all just talk amongst themselves.

Apparently it hasn't occurred to anyone that I'm still struggling emotionally. Despite the number of hours I'm whiling away at the office and the fact that the girls are sporting a new bra. Even though I regularly (though not always) expend the energy in the morning to actually put on make up. I'm still in free fall. On the inside, I'm still bruised, you assholes. Wake up!

Maybe I'm just being too demanding. Why should anyone get the hint when I tell them I don't want to talk about it anymore? Suddenly the words from an old folk song come to mind, "If I had a hammer, I'd hammer in the morning..." right on the tops of your heads, you inconsiderate lumps of humanity with whom I have to spend my days. Jesus.

I guess I'm just trying to hog some of that pity vote.

When You're Going Through Hell...

"If you're going through hell, keep going," ~ Winston Churchill

Owner of Company is on a rampage. He most definitely does not approve of the Edwards' decision to continue the Presidential campaign. He's been calling me all morning on the intercom, reading his own satires of news stories about them, asking me for synonyms, wanting definitions. He just called me while I'm writing this to tell me that "satire" was, indeed, the word he was looking for, instead of "parody" or "lampoon" or whatever. When Owner of Company gets worked up about something, he can get obsessed. This is a quality we share. I'm just not obsessed about this one.

He thinks that it's really John Edwards' decision to continue the campaign, no matter what his wife wants. I don't know. I don't think that's necessarily the case. Sometimes it's helpful, when you're battling cancer, to just try to get on with daily things. For them, political campaigns are a regular part of their lives. You certainly don't need to be sitting around with nothing to do but think about your diagnosis or how the chemo is making you feel or any of the other wrenching sidetracks you mind creates. Maybe you just campaign, if that's what you do.

Owner of Company thinks John and Elizabeth Edwards should spend their time, however much that is, being with their small children. I have a stepson I first met when he was 7. I don't feel qualified to judge. Owner just told me that they plan to take their children out on the campaign trail with them. I've worked on several political campaigns and they are incredibly grueling, even if you're young and healthy. I'm not sure how much time they'll really have to spend with the kids.

These are very early decisions, though. Those decisions may change as treatment and illness progress. I didn't have stage 4 breast cancer that metastasized to the bone, but early on in treatment, I thought I could maintain my regular schedule. That vision of my future was incorrect. That may be so with Elizabeth Edwards. As I said before, you deal with it however you can.

Everyone has their own way of coping with cancer and with death, I think. I'm reluctant to seem judgmental or be judgmental. It's a tough journey to even get through treatment. I know that when I was first diagnosed, I didn't know where I would find all of the mental, physical and emotional resources I'd have to call upon to endure.

Throughout my own treatment, people felt comfortable suggesting how I might deal with it. Many friends pushed me to confront my feelings about everything that was happening to me. I wasn't hurt or irritated by those suggestions; I didn't have the physical or emotional luxury of being offended. I just plowed through, hanging on until it was over. I know everyone has to find their own way. The path isn't always easy to see.

Owner will be working on emails about this all day. He calls me up and asks me how I feel, as a cancer survivor, about what he has to say. I'm not really the person to ask. I have a predilection for dark humor. I can be very sardonic. What he's saying is fine with me.

But then I don't have Stage 4 breast cancer that's metastasized to my bones. He might need to check back with me should that come to pass. (I'm superstitious about this. I'm knocking on my fiberboard desk.)