Friday, April 29, 2011
Fabulous
I enjoyed watching part of the royal wedding while I got dressed this morning. As expected, everything was grand and lovely. I enjoyed the costumes, glimpsing Elton John, and the sacred music and text. The real highlight of my day (so far) was getting my drain removed. It turns out I really prefer not to have surgical tubing in my chest wall, dangling out of my chest, hanging on by a suture, culminating in a grenade size plastic bulb that needs to be regularly emptied. I was instructed to continue restricting use of my left arm as well as continuing to avoid lifting more than ten pounds. Kevin & I enjoyed chinese food for lunch with a couple of my work friends. (Really I had lunch with a couple of work friends, and after the bill was paid Kevin showed up and ate what I had left on my plate.) Then we went to Scott's Dairy Freeze in North Bend for soft serve. I had chocolate. Kevin had swirl. This was followed by briefly (yet productively) shopping the outlets. On the way home, we stopped at Krispy Kreme in Issaquah for soft serve. I had chocolate. Kevin had swirl. We have concluded that Krispy Kreme is better than Scott's Dairy Freeze for soft serve (though Scott's is not bad). Right now there is a casserole in the oven courtesy of Aunt Barb. I invited a couple over for dinner. I figure Kevin might enjoy taking a break from being cancer husband for a normal night of socializing and playing cribbage with his guy friend.
Sunday, April 24, 2011
Two Tenths of a Millimeter
I fell off the grid for a few days as I was in a narcotic haze. I am glad to report I am off the narcotic. I feel rather like I've been soundly beat with a sack of oranges, but it's preferable to the nausea, blurry vision, lack of appetite, nightmares, and general fog.
Last Thursday I saw the surgeon. He went over the final pathology with me. The tumor was 2.7 in it's greatest dimension. The DCIS was 5.2 cm. He said there were some close margins. According to the pathology report, 1 mm margin for invasive and .2mm margin for DCIS on the skin side. The team of doctors reviewed my case and all agreed that I need to be re-excised to remove some additional skin. They also agree that rather than delay chemo, the additional tissue can be removed at the time of reconstruction. I'm not certain I will still have the stamina to have reconstruction by the time I get that far, but at this point I'm committed to at least one additional surgery.
I also met with the medical oncologist. I think I mentioned earlier that 14 of the 19 lymph nodes they removed were cancerous. The oncologist told me that at one time anyone with my condition would have a recurrance, but with the advances in chemotherapy we have a good chance of beating it. I asked him what a "good chance" is to which he replied maybe 50 or 60 percent. (On the bright side if you're in the unfortunate 40 or 50 percent and have a recurrance, it's not necesarrily lost. You go after it again.) Regardless keep praying.
Right now one of my goals is to get my surgical drain removed. I expect I'll be a lot more comfortable once I get this tubing out of my chest wall / armpit. I'm still waiting until I'm draining less than 30 ccs per day. Just a bit north of 30 today. I think I'm getting close.
Despite everything, my spirits are high. Yesterday was truly a sunny spring day. Between the weather, the love of my family and friends, and the resurrection, it's impossible to feel gloomy.
My advice for today. Kiss someone with passion, and don't forget there's more than one way to skin a cat.
Last Thursday I saw the surgeon. He went over the final pathology with me. The tumor was 2.7 in it's greatest dimension. The DCIS was 5.2 cm. He said there were some close margins. According to the pathology report, 1 mm margin for invasive and .2mm margin for DCIS on the skin side. The team of doctors reviewed my case and all agreed that I need to be re-excised to remove some additional skin. They also agree that rather than delay chemo, the additional tissue can be removed at the time of reconstruction. I'm not certain I will still have the stamina to have reconstruction by the time I get that far, but at this point I'm committed to at least one additional surgery.
I also met with the medical oncologist. I think I mentioned earlier that 14 of the 19 lymph nodes they removed were cancerous. The oncologist told me that at one time anyone with my condition would have a recurrance, but with the advances in chemotherapy we have a good chance of beating it. I asked him what a "good chance" is to which he replied maybe 50 or 60 percent. (On the bright side if you're in the unfortunate 40 or 50 percent and have a recurrance, it's not necesarrily lost. You go after it again.) Regardless keep praying.
Right now one of my goals is to get my surgical drain removed. I expect I'll be a lot more comfortable once I get this tubing out of my chest wall / armpit. I'm still waiting until I'm draining less than 30 ccs per day. Just a bit north of 30 today. I think I'm getting close.
Despite everything, my spirits are high. Yesterday was truly a sunny spring day. Between the weather, the love of my family and friends, and the resurrection, it's impossible to feel gloomy.
My advice for today. Kiss someone with passion, and don't forget there's more than one way to skin a cat.
Wednesday, April 20, 2011
Be Thou My Vision
Yesterday was rocky without the narcotics. Eventually, the doc called in a new prescription for a different anti-nausea med, compazine. Kevin picked it up on his way home from work so I was able to start playing catch up with the pain management by evening. The scopolamine patches cost me about $25 for two. Each patch is supposed to last 72 hours. The compazine pills are every 6-8 hours, and a supply of 20 costs me 40 cents. I think the patch was ideal for the actual surgery since it keeps self delivering through out the process. Otherwise, the pill seems a better way to go. One of the side effects of the compazine is blurred vision. This morning I experienced some improvement in my close vision, but it's now blurry again. I've decided, based on yesterday's experience that my preference is going to be blurred vision.
In general, I'm feeling a lot of love coming my way. Yesterday my mom came over and kept vigil with me while I napped and my brother did yard work. My sister in law is here from Germany sacrificing her spring break to help us out. Kevin's mom came over yesterday for a visit in the afternoon. My brother in law, his fiancee, and their baby came over in the evening. The nanny and her family continue to be a huge support. People are praying and sending food, cards, flowers, gifts, and virtual hugs and kisses. Kevin is such an amazing husband and father. He is so patient and supportive of my changing needs. I have a girlfriend bringing lunch today. I've had a visit from one coworker and expect a couple more to drop by Friday. This morning I thought about being depressed for a moment, but then Midori ushered me into the closet under the stairs to play. I think it's impossible to be depressed with her nearby. She just has such a brightness about her.
Here's the hymn I have on my heart today.
Be Thou my Vision, O Lord of my heart;
Naught be all else to me, save that Thou art.
Thou my best Thought, by day or by night,
Waking or sleeping, Thy presence my light.
Be Thou my Wisdom, and Thou my true Word;
I ever with Thee and Thou with me, Lord;
Thou my great Father, I Thy true son;
Thou in me dwelling, and I with Thee one.
Be Thou my battle Shield, Sword for the fight;
Be Thou my Dignity, Thou my Delight;
Thou my soul’s Shelter, Thou my high Tower:
Raise Thou me heavenward, O Power of my power.
Riches I heed not, nor man’s empty praise,
Thou mine Inheritance, now and always:
Thou and Thou only, first in my heart,
High King of Heaven, my Treasure Thou art.
High King of Heaven, my victory won,
May I reach Heaven’s joys, O bright Heaven’s Sun!
Heart of my own heart, whatever befall,
Still be my Vision, O Ruler of all.
In general, I'm feeling a lot of love coming my way. Yesterday my mom came over and kept vigil with me while I napped and my brother did yard work. My sister in law is here from Germany sacrificing her spring break to help us out. Kevin's mom came over yesterday for a visit in the afternoon. My brother in law, his fiancee, and their baby came over in the evening. The nanny and her family continue to be a huge support. People are praying and sending food, cards, flowers, gifts, and virtual hugs and kisses. Kevin is such an amazing husband and father. He is so patient and supportive of my changing needs. I have a girlfriend bringing lunch today. I've had a visit from one coworker and expect a couple more to drop by Friday. This morning I thought about being depressed for a moment, but then Midori ushered me into the closet under the stairs to play. I think it's impossible to be depressed with her nearby. She just has such a brightness about her.
Here's the hymn I have on my heart today.
Be Thou my Vision, O Lord of my heart;
Naught be all else to me, save that Thou art.
Thou my best Thought, by day or by night,
Waking or sleeping, Thy presence my light.
Be Thou my Wisdom, and Thou my true Word;
I ever with Thee and Thou with me, Lord;
Thou my great Father, I Thy true son;
Thou in me dwelling, and I with Thee one.
Be Thou my battle Shield, Sword for the fight;
Be Thou my Dignity, Thou my Delight;
Thou my soul’s Shelter, Thou my high Tower:
Raise Thou me heavenward, O Power of my power.
Riches I heed not, nor man’s empty praise,
Thou mine Inheritance, now and always:
Thou and Thou only, first in my heart,
High King of Heaven, my Treasure Thou art.
High King of Heaven, my victory won,
May I reach Heaven’s joys, O bright Heaven’s Sun!
Heart of my own heart, whatever befall,
Still be my Vision, O Ruler of all.
Tuesday, April 19, 2011
If It's Not One Thing...
I woke up this morning having some trouble with my glasses. I decided to clean them. What a novel idea? Only it didn't help. I then tried replacing my glasses with my contacts. Still no better. So I decided the blurred vision must be a side effect of one of the medications I'm taking. Sure enough. It's the most common side effect of the scopolamine patch. I am continuing to use the anti-nausea patch so that I can tolerate the pain pills. So now I'm in a bit of a pickle. I have a call into the doctor. In general, I've decided that cancer is not about making good choices. It's an exercise in choosing the least bad option among all the crappy choices.
I think in my last post or so I mentioned that I was less creeped out by the surgery than I expected. Well that was before I removed the surgical dressing. It's pretty crazy looking. It's what they call a skin sparing mastectomy which means that they conserve as much skin as they can in order to support future reconstruction. Since skin is elastic, the extra retracts so it's not just hanging there. Anyway, imagine my breast swallowed a very tart lemon and retreated into my chest wall making a sour pucker on it's way in. It also doesn't help that when we were in the hospital having the hematoma problem, the resident marked the area so we could see if it was continuing to grow or not. Instead of using a surgical pen, he used a sharpie permanent marker. So, above the weird lemon boob, there is a black elipse that doesn't want to wash off It's pretty distinctive to say the least.
In other matters, Alina and I have decided that instead of the three day walk, we will make an annual "shop for the cure" trip. She very dutifully pushed me around in a wheel chair throughout the entire Southcenter mall Sunday while Kevin pushed Midori around in her stroller.
I've now removed the patch. Gonna see what I can do with alternating ibuprofen and tylenol for pain. Hopefully, my vision will return soon?
I think in my last post or so I mentioned that I was less creeped out by the surgery than I expected. Well that was before I removed the surgical dressing. It's pretty crazy looking. It's what they call a skin sparing mastectomy which means that they conserve as much skin as they can in order to support future reconstruction. Since skin is elastic, the extra retracts so it's not just hanging there. Anyway, imagine my breast swallowed a very tart lemon and retreated into my chest wall making a sour pucker on it's way in. It also doesn't help that when we were in the hospital having the hematoma problem, the resident marked the area so we could see if it was continuing to grow or not. Instead of using a surgical pen, he used a sharpie permanent marker. So, above the weird lemon boob, there is a black elipse that doesn't want to wash off It's pretty distinctive to say the least.
In other matters, Alina and I have decided that instead of the three day walk, we will make an annual "shop for the cure" trip. She very dutifully pushed me around in a wheel chair throughout the entire Southcenter mall Sunday while Kevin pushed Midori around in her stroller.
I've now removed the patch. Gonna see what I can do with alternating ibuprofen and tylenol for pain. Hopefully, my vision will return soon?
The A B C's
It's just me, Kevin.
Here's part C of my blogging for Paula. It's early Tuesday morning and we've been home for about 3 days now. We've had so many people offer to help in many ways. So much so that it can be a bit overwhelming at times - but we're not complaining! We just don't really know what we need yet. Kind of a crazy statement, I know, but bare with us. I'm sure we'll think of something. :-) [By the way, thanks so much to those church friends and coworkers that are making meals for us. It is greatly appreciated!]
Alina: My sister has come from Germany to spend her spring break helping Paula. She came in on Friday night and is staying until next Tuesday. It's been a great comfort to know that someone is here for her during this first week after the surgery as I have to return to work. Thanks, Sis!!
Bath time: One of the many things that Paula can't do at this point is submerge the surgical wound in water. So, yes to showers, but no swimming or baths. So, that means that I am now responsible for bathing Midori. We had our first bath together on Sunday night. Everything went fine, but there was an amusing ending to the experience. In the past couple of months, Midori has been noticing differences between her body and ours. Last month she said, "Momma has hair on her butt?!" (To her, everything below the waist qualifies as "butt," because during potty training we tell her that we need to "wipe her butt," which of course includes the front, as well.) In the same vein, while drying off after our first bath, she looked at me, then turned to Paula and said, "Daddy has a tail?!" I think some trunks are in order next time.
Chemotherapy: Right now Paula is in a holding (and healing) pattern. The tube that is attached to the mastectomy site is helping to drain that wound. Gross, I know. But, the good part about it is that it helps us to know that she is actually healing from the procedure. Once the drainage is minimal, they'll remove the tube and can begin the next stages of the treatment: Chemotherapy. So, in about two to three weeks, Paula will begin the first of two rounds of chemo. The first round is eight weeks long and is apparently the more debilitating of the two. The injections are so intense that it takes two full weeks before your body is prepared to have another injection. And, that may even require the help of blood count booster shots and the like. :-/ Not fun. Once those eight weeks are over, we then proceed directly into the second round of chemo. We have been told that these drugs are "much easier to handle," although they come every week for twelve weeks, so I have my doubts about how much easier it will actually be. (Keep prayin', y'all!) So, a total of about five months of chemo before moving on.
A, B or C ?: The hardest and most nerve-wracking part about the post-surgery news is the upgraded staging of the cancer. As Paula mentioned in her last post, she was initially rated as Stage II B. This feel into the "we caught it early" category. They did tell us that they wouldn't know for sure until they took the tumor out, measured it, and counted in affected lymph nodes, but they seemed pretty sure we were in good shape. However, the surgeon came into the hospital room on Thursday night and told us that 14 out of 19 lymph nodes were affected and the tumor was approximately 3cm. This put Paula directly into Stage III and in the "more advanced" category. (Stage II requires a tumor less that 2cm and fewer than 9 affected nodes.) Stage III has three possible sub-categories: A, B or C. Based on the pathology of the tumor and lymph nodes, the surgeon told us she feel into the "III B" category. After he left the room, Paula immediately went to look up info of Stage III B on "cancer.org." In doing so, she found that "III B" has the most undesirable mortality rates of the bunch, but also that, based on the info he told us, she actually falls into the "III C" group. Now, we were both incredibly tired and one of us was on "happy drugs" at the time, so it was quite possible that we didn't clearly remember all of the details he told us. So, we asked the oncologist on Friday afternoon. He read the pathology and, of course, said that she falls into group "III A." Ugh! Good thing God is in control!
The ABC's: The best part about coming home was seeing Midori. She actually grew up a little while we were gone. She is not using her "B and blankey" anymore (read: pacifier and blanket). She's getting to be such a big girl. We missed her so much! I especially missed her singing - "Old MacDonald" and the "ABC's" are her favorites. While I hope Daddy and his tail don't make it onto the farm, I do appreciate the music. At least those ABC's are predictable.
Here's part C of my blogging for Paula. It's early Tuesday morning and we've been home for about 3 days now. We've had so many people offer to help in many ways. So much so that it can be a bit overwhelming at times - but we're not complaining! We just don't really know what we need yet. Kind of a crazy statement, I know, but bare with us. I'm sure we'll think of something. :-) [By the way, thanks so much to those church friends and coworkers that are making meals for us. It is greatly appreciated!]
Alina: My sister has come from Germany to spend her spring break helping Paula. She came in on Friday night and is staying until next Tuesday. It's been a great comfort to know that someone is here for her during this first week after the surgery as I have to return to work. Thanks, Sis!!
Bath time: One of the many things that Paula can't do at this point is submerge the surgical wound in water. So, yes to showers, but no swimming or baths. So, that means that I am now responsible for bathing Midori. We had our first bath together on Sunday night. Everything went fine, but there was an amusing ending to the experience. In the past couple of months, Midori has been noticing differences between her body and ours. Last month she said, "Momma has hair on her butt?!" (To her, everything below the waist qualifies as "butt," because during potty training we tell her that we need to "wipe her butt," which of course includes the front, as well.) In the same vein, while drying off after our first bath, she looked at me, then turned to Paula and said, "Daddy has a tail?!" I think some trunks are in order next time.
Chemotherapy: Right now Paula is in a holding (and healing) pattern. The tube that is attached to the mastectomy site is helping to drain that wound. Gross, I know. But, the good part about it is that it helps us to know that she is actually healing from the procedure. Once the drainage is minimal, they'll remove the tube and can begin the next stages of the treatment: Chemotherapy. So, in about two to three weeks, Paula will begin the first of two rounds of chemo. The first round is eight weeks long and is apparently the more debilitating of the two. The injections are so intense that it takes two full weeks before your body is prepared to have another injection. And, that may even require the help of blood count booster shots and the like. :-/ Not fun. Once those eight weeks are over, we then proceed directly into the second round of chemo. We have been told that these drugs are "much easier to handle," although they come every week for twelve weeks, so I have my doubts about how much easier it will actually be. (Keep prayin', y'all!) So, a total of about five months of chemo before moving on.
A, B or C ?: The hardest and most nerve-wracking part about the post-surgery news is the upgraded staging of the cancer. As Paula mentioned in her last post, she was initially rated as Stage II B. This feel into the "we caught it early" category. They did tell us that they wouldn't know for sure until they took the tumor out, measured it, and counted in affected lymph nodes, but they seemed pretty sure we were in good shape. However, the surgeon came into the hospital room on Thursday night and told us that 14 out of 19 lymph nodes were affected and the tumor was approximately 3cm. This put Paula directly into Stage III and in the "more advanced" category. (Stage II requires a tumor less that 2cm and fewer than 9 affected nodes.) Stage III has three possible sub-categories: A, B or C. Based on the pathology of the tumor and lymph nodes, the surgeon told us she feel into the "III B" category. After he left the room, Paula immediately went to look up info of Stage III B on "cancer.org." In doing so, she found that "III B" has the most undesirable mortality rates of the bunch, but also that, based on the info he told us, she actually falls into the "III C" group. Now, we were both incredibly tired and one of us was on "happy drugs" at the time, so it was quite possible that we didn't clearly remember all of the details he told us. So, we asked the oncologist on Friday afternoon. He read the pathology and, of course, said that she falls into group "III A." Ugh! Good thing God is in control!
The ABC's: The best part about coming home was seeing Midori. She actually grew up a little while we were gone. She is not using her "B and blankey" anymore (read: pacifier and blanket). She's getting to be such a big girl. We missed her so much! I especially missed her singing - "Old MacDonald" and the "ABC's" are her favorites. While I hope Daddy and his tail don't make it onto the farm, I do appreciate the music. At least those ABC's are predictable.
Thursday, April 14, 2011
Does This Boob Make My Butt Look Fat?
I'm still in the hospital. My spirits are okay. The chest wall where they performed the mastectomy is healing well. The chest tube continues to be a source of pain. My pain management right now consists of either taking the narcotics that make me vomit (despite the scopolamine patch), taking the narcotics that make me itch all over in combination with benadryl which stays the itching a little and puts me to sleep, or taking a cocktail of pills (tylenol, pill to address nerve pain, and muscle relaxor) This third one seems to be less effective in terms or pain management, and you can only do it every eight hours. Anyway, you can imagine I had a restless night.
Kevin already filled you in on the chest tube insertion, but having experienced it, I thought I would elaborate a little. First of all this all happened in the middle of the night so I got the thoracic resident. He had the nurses give me some drugs via IV. He explained that these drugs would not numb anything, but they would serve two functions. One, they would help me relax. Two they would make it so I would not remember how much it hurt. Before those drugs really kicked in, he began the procedure by numbing my skin with Lidocane. The incision he made in my skin to introduce the tube did not hurt. The insertion of the tube HURT LIKE A BITCH and has been a source of aggravation ever since. The chest tube is hooked up to a suction device which is hooked up to the wall, so it means I can't travel far. I have to use an adult potty chair at my bedside which is pretty charming. Once I see the thoracic team and have x-rays I'm hoping they will change the device to a water seal. I don't know exactly what this means. I just know that if I'm not on suction that I can carry the water seal device and probably be un-hooked from the rest of my stuff long enough to go to the real bathroom. I'll be glad when I'm done with the chest tube; however, I expect it's going to be painful when they pull it out. I would also like to shower, but obviously that is out of the question.
We spoke to the surgeon last night. Based on the surgery and pathologist review of the actual tissue, my cancer staging is worse than we expected. I think he said the tumor was a few centimeters, there were 5 centimeters of DCIS, and at least 10 lymph nodes involved. I need to review this with him again when I'm not so hopped up on narcotics, and see the printed report, but I think this puts me in the 3C stage. Stage 3 is not considered early stage cancer. You can google the survival rates for this stage if you're interested. The surgeon said he was able to get clean margins, but a couple were close.
My proportions are obviously different now then they were, but I'm finding I'm not really as creeped out as I expected I might be. I'm signing off now to eat something so I can take another pain pill.
Kevin already filled you in on the chest tube insertion, but having experienced it, I thought I would elaborate a little. First of all this all happened in the middle of the night so I got the thoracic resident. He had the nurses give me some drugs via IV. He explained that these drugs would not numb anything, but they would serve two functions. One, they would help me relax. Two they would make it so I would not remember how much it hurt. Before those drugs really kicked in, he began the procedure by numbing my skin with Lidocane. The incision he made in my skin to introduce the tube did not hurt. The insertion of the tube HURT LIKE A BITCH and has been a source of aggravation ever since. The chest tube is hooked up to a suction device which is hooked up to the wall, so it means I can't travel far. I have to use an adult potty chair at my bedside which is pretty charming. Once I see the thoracic team and have x-rays I'm hoping they will change the device to a water seal. I don't know exactly what this means. I just know that if I'm not on suction that I can carry the water seal device and probably be un-hooked from the rest of my stuff long enough to go to the real bathroom. I'll be glad when I'm done with the chest tube; however, I expect it's going to be painful when they pull it out. I would also like to shower, but obviously that is out of the question.
We spoke to the surgeon last night. Based on the surgery and pathologist review of the actual tissue, my cancer staging is worse than we expected. I think he said the tumor was a few centimeters, there were 5 centimeters of DCIS, and at least 10 lymph nodes involved. I need to review this with him again when I'm not so hopped up on narcotics, and see the printed report, but I think this puts me in the 3C stage. Stage 3 is not considered early stage cancer. You can google the survival rates for this stage if you're interested. The surgeon said he was able to get clean margins, but a couple were close.
My proportions are obviously different now then they were, but I'm finding I'm not really as creeped out as I expected I might be. I'm signing off now to eat something so I can take another pain pill.
Wednesday, April 13, 2011
Two For the Price of One (2-4-1)
It's just me, Kevin. Again.
I only expected to make yesterday's post, but Paula started today's and lost interest right away. It's been a hectic night heading into a hectic day. So, here I am again. (2-4-1)
Last night we had Paula's second and (sorta) unexpected surgical procedure of the day. (2-4-1) It was one of those things that the doctor mentions "might happen" in passing, but assures you that he/she doesn't expect to have to worry about it. Unluckily, Paula did have to worry about it. That procedure happened right in front of me in the room. While this procedure was probably much less painful than the initial mastectomy, it was much more traumatic because, while she was knocked out for the initial surgery, this only involved local anesthetic - and not enough of it, by the sounds Paula was making. :-(
After the first surgery, she was restricted to clear liquids only. The fact that she needed the second one meant she was back on NPO - a Latin abbreviation for nil per os, which translated means nothing by mouth. (Yes, I'm that nerdy.) Anyway, because of this, she only had a small window where she ate a cup of jello and some diet ginger ale. Otherwise she was food- and drink-less for about 36 hours. Yuck. But, on the bright side, I got to order off the patient menu for free! (2-4-1)
God has played a huge role in our lives - and he showed up again last night. Sometime during the middle of the night, Paula rolled over and knocked a tube loose. Because she was up anyway, she checked the mastectomy site and noticed some significant swelling. The nurse saw it and said, "I've got to get the doctor." The resident came in and said, "I've got to call the surgeon." Apparently, the surgeon said that they'll need to "go back in" to clear out what he believed was a hematoma - a large blood clot - that was building up. It was concerning because the "flap" of skin that covered the mastectomy sight could be affected by the lack of blood flow created by the clotting. God came in here and directed the first doctor. He said, "I could call the on-call team of people who don't do this regularly, or we could wait until morning when the breast-specialists are back at the hospital." He elected to wait and ordered a 5-pound sandbag to be put on for a few hours. He checked on her every hour after that until morning. (Remember, this was the middle of the night.) When the surgeon arrived at 6:45 am, the swelling was all gone and the clot was vacating the premises! No third procedure needed! (still only 2-4-1) Thank you, Jesus!
So, all of this means that we'll probably be here until Friday. Our original plan was over one night - two days total. But with all the other stuff, we'll be here about four days. Crazy! (4-4-2... which reduces down to 2-4-1) Yes, I'm that nerdy!
I only expected to make yesterday's post, but Paula started today's and lost interest right away. It's been a hectic night heading into a hectic day. So, here I am again. (2-4-1)
Last night we had Paula's second and (sorta) unexpected surgical procedure of the day. (2-4-1) It was one of those things that the doctor mentions "might happen" in passing, but assures you that he/she doesn't expect to have to worry about it. Unluckily, Paula did have to worry about it. That procedure happened right in front of me in the room. While this procedure was probably much less painful than the initial mastectomy, it was much more traumatic because, while she was knocked out for the initial surgery, this only involved local anesthetic - and not enough of it, by the sounds Paula was making. :-(
After the first surgery, she was restricted to clear liquids only. The fact that she needed the second one meant she was back on NPO - a Latin abbreviation for nil per os, which translated means nothing by mouth. (Yes, I'm that nerdy.) Anyway, because of this, she only had a small window where she ate a cup of jello and some diet ginger ale. Otherwise she was food- and drink-less for about 36 hours. Yuck. But, on the bright side, I got to order off the patient menu for free! (2-4-1)
God has played a huge role in our lives - and he showed up again last night. Sometime during the middle of the night, Paula rolled over and knocked a tube loose. Because she was up anyway, she checked the mastectomy site and noticed some significant swelling. The nurse saw it and said, "I've got to get the doctor." The resident came in and said, "I've got to call the surgeon." Apparently, the surgeon said that they'll need to "go back in" to clear out what he believed was a hematoma - a large blood clot - that was building up. It was concerning because the "flap" of skin that covered the mastectomy sight could be affected by the lack of blood flow created by the clotting. God came in here and directed the first doctor. He said, "I could call the on-call team of people who don't do this regularly, or we could wait until morning when the breast-specialists are back at the hospital." He elected to wait and ordered a 5-pound sandbag to be put on for a few hours. He checked on her every hour after that until morning. (Remember, this was the middle of the night.) When the surgeon arrived at 6:45 am, the swelling was all gone and the clot was vacating the premises! No third procedure needed! (still only 2-4-1) Thank you, Jesus!
So, all of this means that we'll probably be here until Friday. Our original plan was over one night - two days total. But with all the other stuff, we'll be here about four days. Crazy! (4-4-2... which reduces down to 2-4-1) Yes, I'm that nerdy!
Tuesday, April 12, 2011
It's just me, Kevin
So, I'm writing this while sitting here in with Paula in her room about three hours after her procedure. (Procedure - sounds so antiseptic, doesn't it? I guess it fits this setting, though.) Anyway, here's how the day has unravelled so far:
5:30 am - Wake-up for the Hibiclens shower. Paula hits the snooze. Can't blame her.
5:45 am - Paula hugs Midori for quite a while. Won't see her until Friday. Hoping life won't be changed too much for her, but only time will tell. (Midori has been extra sensitive to the situation and asks Paula on a daily basis if "the doctor fixed Mama's boob?!" or if "the owie is swimming in Mama's boob?!")
5:52 am - Paula gets up for the "special soap" shower and I hit my own snooze button.
6:30 am - I'm actually on time for once! We're heading out of the house and on our way!
7:00 am - After being flipped off by a lady for taking too long to back into a parking space, we head inside the hospital. (I suspect she was a nurse who was late for work. Hopefully not ours.)
7:05 am - Hurry-up...
7:20 am - ...and wait. :-/
7:30 am - After finally being allowed to use the restroom, Paula's taken back into the pre-op waiting area. There are giant comfy chairs for the patients and tiny hard ones for the support staff (read: me). It's rather amusing, actually. Paula's feet don't reach the floor. Reminds me of Lilly Tomlin in "The Incredible Shrinking Woman." Especially when she starts kicking her legs like a little girl.
8:10 am - After the 17th person asks her to spell her name and recite her birthdate and doctor's name, she gets to see the surgeon. Paula says, "Tell me you brought your A-game today." He responds, "Yup. Always bring it on Tuesdays." They're on the same page. Good man. Stronger woman!
8:45 am - Two nurses and an anesthesiologist later, we're ready to go to surgery.
8:55 am - Hurry-up...
9:05 am - ...and wait. :-/
9:10 am - One bad joke later [don't ask, I've already begged for forgiveness (I think)], Paula's off to surgery. Good luck! I love you!
10:00 am - Hurry...
11:00 am - ...up...
12:00 pm - ...and...
1:00 pm - ...wait. :-/
1:10 pm - Surgeon calls me and says surgery went well. He explains all the gory details which, surprisingly, I didn't mind. I'm so excited that it went well that I forgot to ask him some (what I think are) important questions. Oh well, I'll see him again soon. The really important part is that she's doing fine. She'll be out of recovery by about 2:15. I head back to the hospital. (Don't worry, Paula told me to run errands, etc., since I was here by myself. I used the time to buy her a gift.)
2:15 pm - I get to the hospital where I receive a pager similar to those you get while waiting for a table at a restaurant. Though she's scheduled to be out of recovery, they tell me she isn't.
2:45 pm - Hurry-up...
3:12 pm - ...and OK, I'm tired of waiting. I go back up to double-check to see if maybe my pager isn't working. The lady tells me that she has been moved to a room after all. 30 minutes before. Did they page me? No. Did they check? No. Am I frustrated?
3:14 pm - Moving as fast as I can without getting yelled at by the hall monitors in scrubs, I make it to Paula's room in 2 min. Elevator and all.
5:15 pm - Off to X-ray for a follow-up chest exam. I start this blog entry.
5:45 pm - The secondary chest X-ray reveals air around the lung - a condition called pneumothorax. Crazy name that means we'll be staying 2-3 days longer in this antiseptic hotel while they do another surgery to insert a chest tube and watch what happens.
6:30 pm - Hurry-up and wait...
Monday, April 11, 2011
(o)X
We found out Friday that the genetic testing results came back negative. Phew! I've got my bag packed. Check in time is 7:00 am. Surgery is expected to start about 8:30. I've got to stop eating, take a couple of showers with Hibacleanse, apply my anti-nausea patch, and that's about it. Kevin suggested that I mark my right boob with "MY LEFT NOT YOURS". One of my girlfriends said to me, "you sound like you are as prepared as you can be for this experience that you never expected. You have a legion of care takers, doctors, and prayer warriors, and of course the Lord is with you and for you. Picture him on his white steed, covered in armor, looking down on you saying... we are ready, I am here." I hope this is a vision of the Lord taking me through the wilderness to a place of healing (as opposed to the more haunting alternative.) Thanks to everyone for the love, encouraging words, positive thoughts, and prayers. I expect I will be on narcotics the next time you hear from me. Now get off the computer, and go tell someone you love them!
Friday, April 8, 2011
Scripts
Kevin got a call that the family photos are ready. I intend to frame several of them for my bedside as an inspiration during my recovery. We left work early today to go see the surgeon one last time before Tuesday. He gave me a prescription for a scopolamine patch to put behind my ear the night before so I don't have nausea after the surgery. That will be nice. We met with a nurse to sign surgical consent forms, go over pre-op instructions, etc. I got to see what the drain looks like. It's the size and shape of a grenade, at least as far as I am familiar with grenades, which is not very. She wrote me a prescription for a post mastectomy camisole. We also stopped by the medical oncologist's office to pick up a prescription for a "cranial prosthesis". This is insurance speak for wig.
From the cancer joint, we went to the wig joint. I felt kind of like Macaulay Culkin, "I see wig people". There were rows on rows of ladies heads (sans body) displaying hundreds of wigs. I settled on one creamy toffee "Erika", and one Pralines and Cream "Julia". I was tempted by "Stevie" but the consensus seemed that she was too 80s.
From the wig joint we went to Southcenter Nordstrom to find the camisole, and ended up at the Bellevue Nordstrom, because they have more sizes / selection. A post surgery camisole has pockets for a lightweight form where your breast used to be as well as drain pockets at the waist.
Kevin wanted to go happy hour and a movie, but instead he graciously drove me all over creation getting cancer stuff. Thanks Kevin! On the whole, the evening didn't turn out like either of us wanted. If I had it to do again, I would choose the movie. It was foolish of me to squander our last date night before surgery on cancer crap. Sorry love :'(
At this point there's not much left to do. At work tomorrow I have quarterly budget stuff and saying goodbye for six weeks. It's similar to going on maternity leave in the same way that having a mastectomy is like going to the spa. In other words, it's completely different. I have a midday jaunt over to The Landing to have lunch with Kevin's mom. I have to get the patch and some "Hibiclens" soap to shower with Monday night and Tuesday morning. I have a PTO day Monday to clean the house (probably won't happen), buy a couple of tops that button or zip up the front, and center myself. Then I should be good to go more or less.
Monday, April 4, 2011
In No Particular Order
A few of the things I like:
My blue Hello Kitty nail clippers (although they have been missing for months)
Briny olives
Sticky rice (don't care what the carb police say)
A very large handbag to carry everything
Trader Joe's
Boots
Soy lattes
Photos
Pedicures
Loralee's carrot cake
Reuniting with old friends
Singing
Feeling like I have the right thing to wear
Sincerity
When someone else puts gas in my car
Sunshine
Trina's potato salad
Hugs
The idea of the public library (though I rarely use it myself)
Seeing the world through Midori's eyes
Important decisions I've made:
I like the regular potato chips more than the kettle chips
You don't have to be related to be sisters
You don't have to be in the same time zone / be on the same continent / or keep in touch regularly to be close
If Midori wants to wear Sponge Bob pajamas to Christmas Eve service instead of the Christmas dress I bought her, that's fine with me
Some adventures are better than others, but even the bad ones can be good in some ways
It's good to live expectantly
It's good to practice gratitude
I don't plan to ever make a pie crust from scratch
You can accomplish a lot in fifteen minutes
I'm looking forward to the new Winnie the Pooh movie coming out in July
Chapstick is addictive
Being too careful can be just as bad as being too reckless
Rhinestone glasses make you look smart
My blue Hello Kitty nail clippers (although they have been missing for months)
Briny olives
Sticky rice (don't care what the carb police say)
A very large handbag to carry everything
Trader Joe's
Boots
Soy lattes
Photos
Pedicures
Loralee's carrot cake
Reuniting with old friends
Singing
Feeling like I have the right thing to wear
Sincerity
When someone else puts gas in my car
Sunshine
Trina's potato salad
Hugs
The idea of the public library (though I rarely use it myself)
Seeing the world through Midori's eyes
Important decisions I've made:
I like the regular potato chips more than the kettle chips
You don't have to be related to be sisters
You don't have to be in the same time zone / be on the same continent / or keep in touch regularly to be close
If Midori wants to wear Sponge Bob pajamas to Christmas Eve service instead of the Christmas dress I bought her, that's fine with me
Some adventures are better than others, but even the bad ones can be good in some ways
It's good to live expectantly
It's good to practice gratitude
I don't plan to ever make a pie crust from scratch
You can accomplish a lot in fifteen minutes
I'm looking forward to the new Winnie the Pooh movie coming out in July
Chapstick is addictive
Being too careful can be just as bad as being too reckless
Rhinestone glasses make you look smart
Sunday, April 3, 2011
Trials
We met with the oncologist Friday. He is truly amazing in my estimation and something of a workaholic. First of all, how many doctors do you know that take appointments at 5:00 on Friday and then make you feel as though they are in no hurry at all? There is an oncologist on call 24/7, but he also invited me to call him at home if I need anything. He takes two weeks each year for vacation and plans to be here for my entire treatment. He seems to know everything there is to know about cancer and then some. He has a lot of research interests, and seems quite interesting. It's too bad we didn't meet him at a dinner party or in some other context, but since I need an oncologist, I'm grateful to have him.
We talked about the clinical trial. He said investigational cancer drugs are generally reserved for terminally ill patients. This is a trial for women with newly diagnosed locally advanced breast cancer to test whether adding investigational drugs to standard chemotherapy is better than standard chemotherapy alone before having surgery. The treatment phase of this trial will be testing multiple investigational drugs that are thought to target the biology of each participant's tumor. The trial will use the information from each participant who completes the study treatment to help decide treatment for future women who join the trial. This will help researchers learn more quickly which investigational drugs will be most beneficial for women with certain tumor characteristics. The trial will test the idea of tailoring treatment by using molecular tests to help identify which patients should be treated with investigational drugs. Results of this trial may help make investigational drugs available to more women in the future.
Sounds great except for a few things. I would have to delay my treatment and submit to additional scans and core biopsies to determine the biology of my tumor and whether one of the investigational drugs is thought to target the characteristics of my tumor. The answer may be no, and I'd be right back where I started. I'd have to have additional blood work, MRIs, and core biopsies throughout the study. And here's the deal breaker - they have just finished treating their third trial participant. The oncologist would of course like me to participate if I'm eligible, and it would be altruistic, and it's possible it could benefit me. However, I've decided to decline. Based on where things are with me, they are already pulling out the biggest guns they have so I'm going to go with the standard chemotherapy and pray.
So now the train is gaining momentum down the track. Or maybe it's more like an avalanche? I have surgery on the 12th. Two to four weeks later I will start chemo. For the first two months, I will have chemo every other week. For the last three months, I will have a milder version each week. Each treatment takes half a day. I should be done with chemo near Midori's third birthday.
So what will I do before the surgery? I'm not planning a boob voyage party though I think it could be a great theme. We're going to a close family friend's birthday party Tuesday. I'm seeing my mom and brother Wednesday. Doctor appointment and wig shopping Thursday. Gotta get a post surgery camisole. This is a non- irritating garment with pockets for my drainage receptacle. Did I mention I'll be draining for three weeks? I'll probably try to have lunch with my work friends next week. Lunch with Kevin's mom Friday. I'll probably go to church Sunday if I can find my bootstraps. Everyone else, I'll see ya when I see ya.
One thing I forgot to mention earlier is that the surgeon said more than half of patients that have their lymph nodes removed will have lymphodema. I'll see the physical therapist at some point shortly to figure out how to try and head it off as much as possible. Another thing I forgot to mention is that the MRI is suggesting a 4 centimeter tumor which is larger than we thought originally, but as long as it's under 5 it still doesn't impact the staging. They'll know for certain when they get the thing out. I think I just have one more doctor appointment before surgery unless the genetics testing comes back showing I a heritable mutation.
I feel inclined to say something funny, though I'm lacking inspiration. So, I'm going to steal this funny story from an email I received. (P - I hope you don't mind.)
As I read your blog, it reminded me of a friend whose situation was similar to yours. She was 38 when she was diagnosed with Stage 3 breast cancer (which she beat), and her treatment was similar: mastectomy, chemo, radiation, reconstruction. One cancer story that she loves to tell occurred during the time between the mastectomy and the reconstructive surgery. The doctor had given her a prosthetic breast to help “even her out.” One day, while pushing a shopping cart down the aisle at Walmart, she looked down in horror and shrieked to herself “OH MY GOD, I FORGOT MY BOOB!!” and put her arms up to cover he chest. (She had forgotten her prosthetic breast at home.) After a few seconds, she thought: “Ahhh, what the heck – it’s only Walmart”, put her arms back down, and continued with her shopping. Adversity has a way of making us reassess our priorities and focus on the things that are truly important in our lives.
We talked about the clinical trial. He said investigational cancer drugs are generally reserved for terminally ill patients. This is a trial for women with newly diagnosed locally advanced breast cancer to test whether adding investigational drugs to standard chemotherapy is better than standard chemotherapy alone before having surgery. The treatment phase of this trial will be testing multiple investigational drugs that are thought to target the biology of each participant's tumor. The trial will use the information from each participant who completes the study treatment to help decide treatment for future women who join the trial. This will help researchers learn more quickly which investigational drugs will be most beneficial for women with certain tumor characteristics. The trial will test the idea of tailoring treatment by using molecular tests to help identify which patients should be treated with investigational drugs. Results of this trial may help make investigational drugs available to more women in the future.
Sounds great except for a few things. I would have to delay my treatment and submit to additional scans and core biopsies to determine the biology of my tumor and whether one of the investigational drugs is thought to target the characteristics of my tumor. The answer may be no, and I'd be right back where I started. I'd have to have additional blood work, MRIs, and core biopsies throughout the study. And here's the deal breaker - they have just finished treating their third trial participant. The oncologist would of course like me to participate if I'm eligible, and it would be altruistic, and it's possible it could benefit me. However, I've decided to decline. Based on where things are with me, they are already pulling out the biggest guns they have so I'm going to go with the standard chemotherapy and pray.
So now the train is gaining momentum down the track. Or maybe it's more like an avalanche? I have surgery on the 12th. Two to four weeks later I will start chemo. For the first two months, I will have chemo every other week. For the last three months, I will have a milder version each week. Each treatment takes half a day. I should be done with chemo near Midori's third birthday.
So what will I do before the surgery? I'm not planning a boob voyage party though I think it could be a great theme. We're going to a close family friend's birthday party Tuesday. I'm seeing my mom and brother Wednesday. Doctor appointment and wig shopping Thursday. Gotta get a post surgery camisole. This is a non- irritating garment with pockets for my drainage receptacle. Did I mention I'll be draining for three weeks? I'll probably try to have lunch with my work friends next week. Lunch with Kevin's mom Friday. I'll probably go to church Sunday if I can find my bootstraps. Everyone else, I'll see ya when I see ya.
One thing I forgot to mention earlier is that the surgeon said more than half of patients that have their lymph nodes removed will have lymphodema. I'll see the physical therapist at some point shortly to figure out how to try and head it off as much as possible. Another thing I forgot to mention is that the MRI is suggesting a 4 centimeter tumor which is larger than we thought originally, but as long as it's under 5 it still doesn't impact the staging. They'll know for certain when they get the thing out. I think I just have one more doctor appointment before surgery unless the genetics testing comes back showing I a heritable mutation.
I feel inclined to say something funny, though I'm lacking inspiration. So, I'm going to steal this funny story from an email I received. (P - I hope you don't mind.)
As I read your blog, it reminded me of a friend whose situation was similar to yours. She was 38 when she was diagnosed with Stage 3 breast cancer (which she beat), and her treatment was similar: mastectomy, chemo, radiation, reconstruction. One cancer story that she loves to tell occurred during the time between the mastectomy and the reconstructive surgery. The doctor had given her a prosthetic breast to help “even her out.” One day, while pushing a shopping cart down the aisle at Walmart, she looked down in horror and shrieked to herself “OH MY GOD, I FORGOT MY BOOB!!” and put her arms up to cover he chest. (She had forgotten her prosthetic breast at home.) After a few seconds, she thought: “Ahhh, what the heck – it’s only Walmart”, put her arms back down, and continued with her shopping. Adversity has a way of making us reassess our priorities and focus on the things that are truly important in our lives.
Friday, April 1, 2011
(o)(o)
Today feels like a bloggy day. We had another appointment with the surgeon yesterday. We talked more about the chemo before surgery approach. There are several reasons to consider this approach. I’ve already touched on this topic, but I feel I can describe it a bit more clearly at this point.
We are meeting with the medical oncologist today. He will have more to say about items 1 – 3 above.
So here is what is in my immediate future. I will be having a surgery on 4/12.
Most likely it will be to have a mastectomy of the left breast and to install a “portacath”. The portacath is a medical appliance that is put, in my case, in the upper right portion of the chest. They want it on the left to be out of the field of radiation later. A catheter connects the portacath to a vein. Under the skin, the portacath has a “septum” which is a self sealing deal that they stick the needle through. This is what they will use to inject the chemo drugs and take blood samples.
If I decide to do chemo first, the 4/12 surgery will be just to install the portacath. I have a meeting with the medical oncologist at 5 pm, and I should be able to decide tonight whether I’m doing chemo or surgery first. Right now I’m leaning toward surgery.
The last piece of the puzzle is getting the results from the genetic testing. I expect those to be back next week. It’s unlikely, but if I do have a heritable mutation, then we will remove both breasts. I pray this is not the case both for the impact to me and for the far reaching implications for those related to me.
Okay, so that’s the medical stuff. Now for the other stuff.
Kevin is right beside me in this which I have to think makes all the difference in the world. He has recently become so present for me. He’s reading a book called “Breast Cancer Husband”. I have to share a bit from the book, because I think it’s hysterical. Did I mention I have a bit of a dark sense of humor lately?
It’s a rainy day today. I’m thinking about this old Eurythmics song. (I think I’m going to make a Cancer Playlist. Will let you know what it looks like when I’m finished.)
1. If you can shrink the tumor you may be able to spare more of the breast. In my situation, the area that is involved is too broad to be able to spare the breast. At this point I have seen multiple doctors who all agree on this point. In addition, I have two types of breast cancer. One of them is DCIS (ductal carcinoma in situ). The other is invasive. In DCIS, the cancer cells are contained within the ducts of the breast, and the cancer cells have not invaded the surrounding fatty and connective. DCIS seems to be easier to cure overall, but not as responsive to chemotherapy. None of this is to say I couldn’t do chemo first, just that I wouldn’t get the gain of sparing the breast which seems to be one of the primary reasons for the chemo first approach.
2. If you have chemo first, you will be able to see how the cancer is responding to the chemo. (This would require additional imaging and biopsies. I will have to review my earlier posts to remind myself how much I enjoyed these the first time.) If you remove the cancer before chemo, you won’t be able to see whether the cancer is responding. On the other hand, some of what is removed during the surgery and examined by the pathologist can be informative in determining the course of chemo. This is information you would not have by doing chemo first.
3. There is a clinical trial underway for neoadjuvant (chemo first) treatment. If you are a good candidate for this trial it would give you access to newer medicine that is normally only given to people with advanced cancers or old people. Is newer better? Don’t know. It’s kind of the point of the trial right? Anyway, it could be better, and you’d be promoting science (which is not my highest priority at the given moment).
So here is what is in my immediate future. I will be having a surgery on 4/12.
Most likely it will be to have a mastectomy of the left breast and to install a “portacath”. The portacath is a medical appliance that is put, in my case, in the upper right portion of the chest. They want it on the left to be out of the field of radiation later. A catheter connects the portacath to a vein. Under the skin, the portacath has a “septum” which is a self sealing deal that they stick the needle through. This is what they will use to inject the chemo drugs and take blood samples.
If I decide to do chemo first, the 4/12 surgery will be just to install the portacath. I have a meeting with the medical oncologist at 5 pm, and I should be able to decide tonight whether I’m doing chemo or surgery first. Right now I’m leaning toward surgery.
The last piece of the puzzle is getting the results from the genetic testing. I expect those to be back next week. It’s unlikely, but if I do have a heritable mutation, then we will remove both breasts. I pray this is not the case both for the impact to me and for the far reaching implications for those related to me.
Okay, so that’s the medical stuff. Now for the other stuff.
Kevin is right beside me in this which I have to think makes all the difference in the world. He has recently become so present for me. He’s reading a book called “Breast Cancer Husband”. I have to share a bit from the book, because I think it’s hysterical. Did I mention I have a bit of a dark sense of humor lately?
Anger Management
Which brings me to another point. People will say – and ask – all sorts of things about your wife’s cancer. No one would ask you how much money you earn or how often you have sex – but good friends, casual acquaintances, and coworkers might want to know which breast it is, and did they catch it early, and did her hair fall out, and all sorts of other intimate details.
When one husband heard the “did they catch it early” question one time too many, he snapped back, “Nope, it’s too late. Do you know anybody you can fix me up with?”It’s a rainy day today. I’m thinking about this old Eurythmics song. (I think I’m going to make a Cancer Playlist. Will let you know what it looks like when I’m finished.)
Here comes the rain again
Falling on my head like a memory
Falling on my head like a new emotion
I want to walk in the open wind
I want to talk like lovers do
I want to dive into your ocean
Is it raining with you
So baby talk to me
Like lovers do
Walk with me
Like lovers do
Talk to me
Like lovers do
Here comes the rain again
Raining in my head like a tragedy
Tearing me apart like a new emotion
I want to breathe in the open wind
I want to kiss like lovers do
I want to dive into your ocean
Is it raining with you
Falling on my head like a memory
Falling on my head like a new emotion
I want to walk in the open wind
I want to talk like lovers do
I want to dive into your ocean
Is it raining with you
So baby talk to me
Like lovers do
Walk with me
Like lovers do
Talk to me
Like lovers do
Here comes the rain again
Raining in my head like a tragedy
Tearing me apart like a new emotion
I want to breathe in the open wind
I want to kiss like lovers do
I want to dive into your ocean
Is it raining with you
Thanks Kevin for walking and talking with me like lovers do. I need you. You’re my heart.
Here’s some stuff about some girlfriends.
Here’s some stuff about some girlfriends.
I have a girlfriend who left for Korea
LR: Miss you and worry about you. It's very hard being so far away.Me: I miss you and worry about you too... Next time you see me I will be different in some ways.
LR: You will be the same in all the ways that matter. Trust in yourself. Trust in the part of you that will always stay the same through everything and invest in that. Let the rest slip away. It doesn't matter.
I know it doesn’t matter really that I will have one less breast and more scarring and no hair and a bunch of side effects, and I’ll probably age a decade in a year’s time. I’m sure it will come as a bit of a shock for someone who hasn’t seen me in a year, but because my friend loves me and I love her, I know she won’t let her face betray a bit of shock. She’ll tell me I’m more beautiful than ever or that I look like absolute hell. Either way, it doesn’t matter. My real fear is that I’ll be a little less innocent, and a little more tough, and my heart will harden a little more. So I guess if you know me, you know I’m not that innocent, and I’m pretty tough to begin with. So that leaves my heart. I will have to work and resist and pray to keep a soft heart. It might mean all of it will hurt more, but it’s worth it mainly for my Midori.
I have another girl friend in Saudi Arabia
One of my sisters in law lives in Germany
Then there’s my dear girlfriend that actually lives on this continent. Okay so she actually lives closer to Cuba than Seattle , but still Florida is part of North America . She told me she is coming to Seattle
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