Buh bye; hello

I can barely believe that there is only a matter of a few hours of 2010 left. I'm happy to say so long to a year that was so unexpectedly challenging, but grateful to be here in shape to bid it farewell. Glad to have my partner still with me; I really thought I was going to lose him for a little while there. I was too weak to allow myself to contemplate it at all. I made myself assume the best outcome, but truthfully, I was working hard at maintaining neutrality, feeling beset as I was, it was hard to stay present and not anticipate the outcome, or wallow in worry. Heck, that's been true all year, starting with the disintegrated drain pipe and ceiling tearout a year ago tonight, the ovarian cancer scare in January, the breast cancer diagnosis a couple of months later basically immediately upon my return to work from the first surgery, and then the non-stop treatment ending with the wow finish of his and hers hospitalizations. All of it has required meditation on being here now.

Just to amplify that, I had a fill-up yesterday, on Thursday, and discussed the recent high pain level with Dr. W, who is still unconcerned and stated that I show no signs of an infection, just healing muscle around the expander. I tend to feel better immediately after an expansion, but by the evening the increased tightness is pretty challenging. I overheard an awful story in the waiting room there though-a few women were discussing plastic-surgeries-gone-wrong, and one was describing how she went through expansion reconstruction only to find after she swapped her expanders for the permanent implants that rather than growing her pec outward, she had caved her ribcage inward. Yipes. Now she's looking into a flap. Her experience is not mine, but it is hard not to think "what if".  Hard to continue to "be here now".

Look Ma, cleavage!

I feel that I'm really done with "treatment" now; I'm just going through reconstruction. It's still challenging, but I feel well, just drained by dealing with pain. The better days, the ones where the pain is lower, are soooo much easier than the tougher ones. But I feel the end of this part of the journey approaching sooner than I expected. Still need to discuss the next steps with the PS, like how long do I wait to swap expanders for permanent implants after I reach the size I want to be, and how long after that before I get nipples. I've got 300 ccs of fluid in my expanders now and I look to myself like I'm about a B cup size; I'm aiming at a C, which should be here sooner than I had expected. But for now, at least I have a bustline again!

I'm happy to be here at home tonight resting in front of the fire despite the warmth of the evening. I can't call it a quiet night; there is too much noise outside with neighbors setting off fireworks causing the dog to whine. We watched the New York Philharmonic, after I sorted the black eyed peas for tomorrow's meal. Some say dried BEPs do not need to be soaked; I soak with some whey ala Nourishing Traditions. They seem to me to come out better, creamier and less gassy that way. I'll cook them with uncured organic smoked turkey wings as I just can't bring myself to use the hog jowl that is traditional around here. Every year BC (before cancer), I used to put a slice in my shopping cart, then put it back, then pick it up again, and again return it. Never brought myself to purchase it, although I did originally use a smoked shank. Now I just can't face pork at all anymore. And I don't have to worry about anyone else's traditions this year anyway; our previously annual New Years Day World Cultural Celebration is not happening this year, and I'm not sure I'm going to want to revive it to its former volume in the future anyway. It's always so much fun, but so much work that I'm absolutely exhausted at the end of the day, and it really requires a week to prepare for. With a "real" job, I'm not sure I want to take the necessary time off to make it happen. We'll see. That's the future. I'm sure glad it's not tomorrow.

So, I really need to make a list of resolutions. But tonight, I'm sure I can't handle committing to major lifestyle changes or achievements with deadlines. I know I plan to kick sugar...again...and to resume a regular exercise schedule. I want to write my book, and to join a band. I plan to try to do something to help other women going through breast cancer and folks and their caregivers going through cancer in general. But I think I'm going to resolve to formalize my resolutions next week rather than tonight. For now, I have accepted the use of pharmaceuticals to manage my pain, and I'm not feeling clear enough to organize my resolutionary thoughts. And I'm quite enjoying this lack of clarity. I wish everyone a healthy, happy 2011. I look forward to so much to whatever happens in the new year and the opportunity to comment on it.

Surprise Wake Up Call

I was prepared to enjoy one last day of sleeping late; I've been snoozing in until 10 am. Sadly, my body did not decide to cooperate, and I woke with very high pain in my left "breast" and numbness in my right hand. It not only hurt, it scared me. I think I probably just overdid my activities yesterday-I carried 3 loads of firewood upstairs and did some very gentle modified yoga, as well as some increased stretching. Didn't feel like anything at the time, but that's the challenge with getting back to a normal activity level. Today the left sided pain has been up around 8 or so and the right hand stayed numb until after dinner.

I had already made an appointment with Luby, my chiropractor/acupuncturist, who I like to try to see regularly just to stay "tuned up", so I felt very fortunate that it was planned for today already. Luby seemed to think that I just overdid it, which was comforting, and even immediately after the treatment I felt a bit better, and by now, a few hours later, I'm much better. Of course I finally gave in and used the Ox and half of a Valium, but even before those kicked in I was aware of feeling better. What had been a sharp, stabbing pain and sort-of searing feeling with motion on the left, as though my expander were aggravating the heck out of the pec minor. Now it feels like there is a small marble underneath the expander; certain motions, such as elevating my chest and pulling my shoulder blades down my back elicits the pain, but it is now down to about 4-5/10 and tolerable. It's still the left side bugging me, but the focal point of the pain has moved.

It was such a sharp pain when I woke that I really thought I'd damaged myself. Even thought for a bit about whether I was going to have to go to the ER. If it's similarly high tomorrow morning, I'll contact the surgeon, but I think it's probably going to feel a lot better when I can get some manual therapy. Something about that referred pain between the pec and the rhomboids seems likely to be involved here; if it were a rib out of alignment I think Luby would've sussed it out, but that sense of something being lodged underneath the expander is odd, and pain is relieved by grabbing the mound and gently pulling it toward center.  Reducing inflammation by laying off the last of the holiday sweets might help...but there are only a few chocolates left...

So today  I was extremely careful about exercise, making sure to do some, but to avoid lifting anything heavier than my purse, which is not saying much, but I didn't want to just stop moving around at all. Frankly the amount of laying around by the fire the last few days of enjoying our White Christmas has probably not done me any favors in the pain department, despite being spiritually valuable. So I'm glad I went to the Y today and did a gentle elliptical workout, and did the isometrics for my arms that are part of my rehab routine, but I did not do the shoulder stretches. I'm trying to decide if any are in order today; I think it is probably as well to skip this session.

Staycation

We've been basically snowed in today. The friends who had planned to drop by were unable to get out of their driveways safely, and although I surely could have gotten out in my little 4-wheel drive CRV, we chose to stay in on our own and continue our movie marathon. Snow fell lightly all day, small flakes flashing like glitter in the evening, the fire warming and entertaining, and I even cooked dinner, actually making a scratch recipe for the first time in a month or so. It felt good to do it, and it tasted divine. I've over-snacked on sweets, but I've eaten pretty well aside from that, and I think I'm ready to resume a routine, get healthy and greet the new year with some resolutions I will keep.

Pain is interesing; it will always get one's attention. And the larger pain will distract from the smaller. There is a spot on my left side where the drain exited that hurts most sharply of all the various pains associated with this surgery. There's tightness across the entire chest, almost as though I'm wearing a bra that I can't take off - ironic as it was the prospect of no longer needing a bra that was one of the prime motivators for my having this surgery in the first place. A little myofascial release performed on myself helps, but the pain is still quite profound, and somewhat unpredictable. I'm surrendering to the Ox on evenings when I'm home and don't have to go anywhere when the pain level gets up over a 5 or 6 with just the non-opiates. The last couple of nights have been in that category.

My hair is curling too; I need to consult a hairdresser about products that will help control this amount of curl in the short-short cut. The dressings I have that are designed to control ringlets are not appropriate, and the gels and pomades I do have don't seem so be giving it body and preventing frizz at the same time. It's a problem I'm happy to work at solving. I'm happy to have hair, period. It looks pretty cute too in this short-short length and the dark-dark roots of the silver ends. Wonder what it'll do next? Gotta post a new picture soon.

I'm glad I went back to work last week and I'm glad I'll be working this week, but I'm equally glad to have another day off before I go.

White Christmas

Written yesterday evening, December 25th, 2010

What a lovely morning it was; the perfect white Christmas. Every bit of the landscape covered in glistening cottony white dressing but all the roads dark and wet, easily passable. We spent the day tidying the house without haste, snacking a bit, preparing a trip to a local Chinese restaurant to enjoy my Christmeas tradition. Our friends, Grace and Billy, let us know that they were skipping Christmas celebrating this year and so we told them that the little gifts we had for them were thank yous for their help in our recent emergency, and joked that we are celebrating "Christmakwanzikah". It's true about the gifts anyway. I don't care for enforced gifting, and I have not done much of it this year. But when I have time and the ability to discern a proper choice of gift, I do enjoy it.  And thank you gifts are always easier to come up with than annual ones, for me.

I treated gift shopping this season as Occupational Therapy. I went out into the stores a couple of weeks ago, when I was just back to being able to get out and about, and I mainly focused on getting some things for my co-workers, who have been so supportive all the long year bringing me meals and making sure I was able to handle the load at work. And shopping was hard, despite having time without constraints of conflicting schedules to spend at it, I found it difficult to determine what would be a nice gift for each individual, how much I could afford to spend, etc. Judgement is impared when one is in-between opiates. I think I did okay though, and now driving, working and just getting my daily activities done is much easier.

Had my 3rd "expansion" on Thursday and Dr. W told me that I am now off of any activity restrictions. If I have the energy, if I have the strength to do it without pain stopping me, I am allowed to do it.

Time heals everything

Right after the surgery, I thought I had probably made the biggest mistake of my life, and that I was going to pay for it forever. I woke from anesthesia in extreme pain, like nothing I had ever experienced or imagined. My first ever night in the hospital as a patient, and my first ever experience of morphine, and although I felt amazingly well-cared for by my lovely nurses, I still took a scary blood pressure dip that first night and had quite a crew of staff gathered around my bed expressing concern. I was not worried about that - my BP is typically low, and I figured it would bounce back shortly - but the pain was frightening. Then it dropped rapidly and I felt pretty good while I had Mom here taking care of me, but after the first expansion, I thought I was going to truly regret the choice I made for completing my treatment.

Not now; I've still got pain, but it's reducing steadily. My range of motion and strength are increasing rapidly. Energy is bouncing back, and although I'd love to continue to focus on doing some around-the-house things rather than returning to work on Monday, I certainly feel up to it, and I think the purposefulness of going to my job will help elevate my still-fluctuating mood. Thursdays will be expansion days; that should be challenging, and I will give in to meds without resistance on those days.

I'm down to hardly any medication. What worked well yesterday, which I think I will try again tonight, was to take Salicin B in the morning, evening and before bed, along with a Valium before bed. I think I'm tolerating that better than the Oxycodone. And I think in it's muscle relaxant capacity it is targeting my sleeping trouble better than the narcotics. It's starting to feel good to sleep on my side again, but I still can't turn in bed well. Going from one side to another, or from back to side, is a huge effort and requires a lot of bed-shaking turning, which of course is hard on Dave. I would have worried about that if he had been well during my convalescence, but with him more compromised than I, facing a longer healing, it's difficult for me to relax and allow myself to rumble as much as necessary.

I was much less blue today, though still somewhat weepy. It's easy to be emotionally raw this time of year with sentimentality dripping from all media and every image one is exposed to. I focused on getting my haircut which felt good, and my eyebrows shaped, lip waxed, feet pedicured. I shopped and then came home and just have been hanging in front of the fire. Now it's time to hit the sack. See you tomorrow.

Deep Blues

Somehow today I fell into a dark blue hole. I just seemed unable to stop crying this morning. I'm feeling isolated and frustrated; there was a time when we would have had an invitation every night for the entire month and would have to figure out how much we could participate in-this year we have none, and it's not just because of our health status. These are hard times and we are no longer in a super-social field of work. 

Later on, ironically, I was undone by the prospect of our close friends dropping by on boxing day; just the thought of having 4 people visit at once completely freaked me out as I don't seem to be able to  handle even tidying up around here, much less cleaning and coming up with some refreshments. I had a meltdown on the phone with Sam; she reassuring me that the only thing wanted from me is my company and my efforts to heal, me boohooing while knowing with one side of my brain that the other is just off kilter due to cabin fever and medication.

Feeling lonely, I didn't know who to call to talk to; so many folks are going through hard times right now. I feel like a fool to go off on a poor-me run. I've been given so much sweet attention from my friends over the course of this cancer battle, and especially since the his-and-hers surgeries, i know feeling left out is just one of those holiday-time distortions. So I decided that what I need is action; I am too out of focus to shop or make any particular decisions, but I am now able again to push a vacuum, so I did at least get the pet hair up. Then I took my first bath in 3 weeks. The scar lines are still a little scabbed up so I covered them with Press N' Seal and avoided soaking them, but soaking my lower half sure felt good. Boy, do I need a pedicure! I will get a hair cut and eyebrow wax tomorrow. I at least had the energy to make an appointment. Maybe I'll be able to get a spontaneous pedicure along with it.

I decided that part of my problem had to be a lack of exercise, so I went to the Y and participated in my first Zumba class tonight. I wasn't able to do the whole class, and had to be very careful to keep my arm motions controlled to avoid overdoing, but it felt really good to work up a sweat and to stretch out afterward. I think that in the long run exercising is likely to help with both mood and pain. I have to find a way to work some classes into my schedule. Can't do yoga for a while, but careful Zumba, Tai Chi, striding on the elliptical machine-those are things that should be okay for me.

Came home and walked the dog briefly; she is begging to go out again for the 6th time tonight, suffering from cabin fever herself, dying of boredom from watching us lay around the house. After her walk, I made brown rice with mushrooms, onions, olives and roasted red beans inspired by some brown rice that Hilary brought last week, and ate too much of it. I feel much better now.

written last night, Friday December 17th, 2010

Good Day

Dave really gave me a scare last night with the abdominal pain at bedtime. Today he says it was probably having eaten too much at one time. His appetite is coming back but is unreliable and he occasionally is famished. He is trying to space out his meals and keep the volume low at each one. That's a good idea for anyone, but he's always been a one-big-meal-a-day kind of guy with small snacks in between; he will have to have more snacks and avoid that big meal at least for now. I understand that suddenly famished feeling while healing; I've had plenty of that myself. But I am now over 2 weeks past surgery, and hopefully can normalize my eating pretty soon, as I continue to want to nip the post treatment weight gain in the bud.

We are currently in the middle of a deep freeze, with highs around freezing and lows well below. I would have liked to go in to my clinic today as there was a holiday pot-luck for members and patients, Roland White's Bluegrass band performing and an opportunity for me to sit in, but of course Dave's followup appointment was scheduled for about the same time and there was no way he was in shape to go from clinic to clinic; it was enough to just get to his appointment. But his doctors were satisfied with his progress and removed his staples, exchanging them for steri-strips, and pronounced his wound healing to be right on schedule. I still feel that we need to come up with a nutritional strategy for the future, but for the time being, he just needs to eat his AMCAP diet-as many calories as possible. Lots of smoothies, peanut butter, juice, and anything that appeals to him basically.

I am feeling fairly well. I'm able to sleep on my right side for a while at night, which is huge for me, taking a lot of pressure off of my back. And I'm down to far less medication, thinking I may try to sleep without the narcotics tonight as my Salicin B, the herbal anti-inflammitant, has arrived. It worked well for me after my bout of shingles last year. Of course that pain was not as serious as what I'm experiencing now, so it remains to be seen how the stuff will do.  In the meantime, I've got what I need to sleep well and warmly; I still feel like a lucky girl even if outrageous fortune keeps on slinging those arrows.

Saturday I will get my first haircut since the chemo began. It will be a trim; I still don't have a whole heck of a lot of hair, but what I have is kind of messy. I like the look of the boy-cut, and am comfortable keeping that style, but it's shaggy around the ears and on the back of my neck. To some degree, I hate to lose even a fraction of an inch of it; my head is no longer cold all of the time, but still not warm, and  I'd love to be able to feel okay about my grooming without losing any of the precious growth, but it will grow on, I know it will. Some say that cutting hair increases its growth rate so I'm going to hope for that-I sure as heck hope that's true. I'm so grateful to have eyebrows again that I've been hesitant to have them shaped and trimmed, but I'm due for that too. It will have to wait a bit because I'm not sure who should do it, but the young woman who cuts Dave's hair does a great job for him, and I'm sure will do well for me.

Pain control strategies seem to be working

Written yesterday, 12/14, Tuesday.

I am so happy that I can report that my pain is under control again, but it certainly requires the use of medication. I'm down to far fewer pills daily now than a couple of weeks ago, and that is good indeed, but it's quite humbling to accept that I'll probably be wanting to continue to use prescription pain meds, including narcotics, for the next few months. Maybe I'll be able to get past it, but at least it's minimal at the moment.

Yesterday I had my second "expansion" and was able to deal with it much better than the first surprise fill up. I was prepared for it, had taken a muscle relaxer and a pain pill in advance of the experience, and got a prescription for Valium as well, which I had not been aware of is classified as a muscle relaxer; it apparently does work in that way and seems a bit more helpful in this situation than the Parafon Forte that I've always used successfully in the past. I told Dr. W that I have never asked for a refill of a narcotic prescription before and he said that this treatment is not supposed to be torture and that the Oxycodone will be available as needed throughout the expansion process over the next few months. I only need it to sleep right now, and right after the procedure, but it would be great if I can get the pain level under control to the point where I don't need it at all, as stated before. It gives me bad dreams, but at least allows me to sleep. A conundrum.

Tonight, Dave went to bed with a belly ache. He said it is not serious, but his face is drawn and pained looking. I am nervous about taking my pain pill in case I need to drive him to the ER. Guess if we reach that, God forbid, I'll call 911. Got a call from a very close friend informing me that he has been in the hospital for about a week with ulcerative colitis. Sure seems like a lot of illness and suffering going on among my crew at the moment. Whassup? Must be age, yet I look at my parents and they seem to be thriveing, along with many of their friends. How do I join that crowd, the happy, healthy over-70 social set? I mean, I want to be as well and able as they at their age. That's my plan. It would be nice if my gang is there with me.

Friday Fireside

I thought I was tired during chemo; sheesh! I'm just really struggling with exhaustion and pain right now. Pain has been steadily decreasing on the whole, but the constant nature of it is very trying and requires a lot of energy to deal with. It definately ramps up in the late afternoon/evening, and today I tried to take less medication by addressing it with acupuncture. That treatment left me sleepy and feeling a shift in my response, but did not prevent the increasing pain level as the day wore on despite my forsaken plan to shop after the needling today and a long nap. Now I'm wearing my TENS unit on the area on my left back that seems to be in spasm-a symptom my surgeon identified as a response to the rib pressure from the front side.

So I'm seeking strategies to manage muscle spasm pain, or to avoid muscle spasm in response to future expansions. And I'm eating like a person starved, which I am clearly not, but I live in a virtual candy store right now filled with many of my favorite treats. Home-baked breads and cookies, and even better, soups, veggie dishes, baked chicken-foods that I cannot resist. And I've been surprisingly hungry. I'm trying to be sure to focus on fresh fruit and veggies, lean protein, lots of supplements, and not to go too much for the easy fix of a sweet treat, but the food that I most crave is soup, and the house if full of a variety of this, much of which I've frozen. That's helpful now and will be when I return to work and have just enough energy to do my job and heat a frozen meal. Or maybe I'll do better, bust off of this plateau and start to find my mojo again. Yeah...surely that will happen soon. I'm not even 2 weeks out yet.

written yesterday, 12/10/10 Friday

Painfree in the morning; back with a vengence in the afternoon.

This week the pain has been quite a challenge, and quite unpredictable. I woke with really no pain to speak of this morning, and was able to do some of the de-cluttering that I had planned for today. Felt really good for the most part in the early part of the day for my shower and meals and then visits from my boss and our former housemate Mark who, between the 2 of them, brought us a refrigerator-full of groceries. Hallelujah! There were a couple of items though that I did not have here and wanted to get, so I figured that I would run out briefly and hit the bank and make a couple of quick purchases. Somehow though, driving drove my pain up. Way up. Surprised me. I am going to have to practice that, though, because I have to do some driving tomorrow, and I will have to drive myself to work in 10 days or so. Surely I'll be ready for that by then.

written yesterday, 12/8/10  Wednesday

Goals

1. Return to work on 12/20. That's 3 weeks after the surgery. I should be ready for half-days by then and I think it will make the return easier to start with a couple of weeks of shortened schedule. 
2. Get the coffee-table in the den cleared off tomorrow and in general do some de-cluttering of the  house. The clutter is getting on both of our nerves. I think it will help the healing process to cut down on it.
3. Get out of pain as soon as possible. Patience is a virtue..

this was written yesterday, December 7th, and I forgot to finish or post it...

ch ch ch ch changes....

Wow....amazing pain and the having of it; how was I pain free a couple of days after surgery? My brain must have just checked out in that department for a while. Today I went to see the plastic surgeon ahead of schedule for a follow up because I was having some trouble with my drains and was also concerned about some bruising. Dr. W was not concerned; he had the nurses whip those drains out but not until after he actually gave me my first fill up! I had heard that the "expansions" did not begin until 3 weeks after surgery, but he said that if I could tolerate it, it would be better to get it going before scarring down any further. Well, I'm still taking the big dog pain pills, so I can tolerate it, but I wouldn't want to try without the meds. Thank goodness Anita had driven me to the appointment-I didn't have the drugs with me, but I still don't think I could've driven home safely. Feels like I've got strapping tape cinched tight around my chest. The scar tissue under my left arm from the axillary node biopsy done during my initial surgery is talking to me and the pain in my armpit that I had thought was past has returned. When I am healed up enough to do some serious myofascial release to the area between my neck and my waist, I'll be able to deal with this better, but right now, I am grateful for codine and muscle relaxers.

But part of the problem is actually a good thing-nerves are waking up. The backs of my upper arms had been numb and now have nearly-normal feeling. I have some nerve pain in the breast area including some occasional zingers and some "phantom nipple" sensations that I hope will settle down as time goes on...it is changing daily...but I'm happy not to be totally numb. I'm glad to have the nagging irritation of the drains gone, but the sites are pretty sore so far. Maintaining proper posture takes even more intention and attention than pre-surgery. Gentle self-massage helps, but man, this is intense. Curious what tomorrow will feel like.

Dave is healing well; his home nurse came today and showed me how to dress his wound. He doesn't have much of an appetite; I have waves of ravaging hunger and fortunately plenty of delicious freshly prepared food provided by friends to tame it. He is frustrated that I am taking care of him rather than he me, but ya do what ya gotta do. I am much more relaxed now that he is home. I think we will need to do some inspirational speaking when we are well...I'm inspired anyway, that we have gotten this far through this ordeal and are still doing a lot of laughing about it. Tears are acceptable too, of course. I was prepared to experience pain during this recuperation, I just didn't expect the particular, surprise emotional side of it nor could I have imagined the actual intensity and type of sensation of this pain. I do believe I will be able to manage it and to be drug free again at some point; women who have been through this have told me that it becomes normal, unnoticed, but I have a long way to go before I get there.

I will take some pictures soon...this process should be interesting.

Rough Day

This is one of those posts that may be TMI for some, so don't read on if you can't stand the potty talk.

Hadn't had a movement since Sunday. I'm usually super-regular as I make a point of being that way, and eat a lot of fresh fruit and veggies, fiber and chia seeds, etc. I expected to have a bit of a constipation problem after a surgery, most everybody does, but I thought I was taking steps to avoid a major backup. No such luck. Despite stool softeners for several days before surgery and every day after, and also senna and some Benefiber once I got home, I had not been able to get my tubes to wake up enough to push the waste out, and today experienced the pain of a major backup.

Went to the pharmacy and the druggist recommended magnesium citrate, which I have taken to clean out for procedures in the past. It works well and fast, but I have been feeling kind of sick all day.

Later...
I am much better tonight than I was during the day. Mom took amazing care of me and kept me resting, which is hard to do as I tend to pop up and find tasks to dive into at all times. I started feeling less nauseous around dinnertime, and then finally had to go back to taking pills to address the surgical pain this evening, but I think I can stave off any further bouts of major constipation by remembering to keep hydrated, take senna, use probiotics and take more magnesium citrate if I have another day of no-go. Just a little dab'll do ya. Thank you CVS pharmacist.

I had planned to enjoy this week after surgery just lying in bed watching movies and letting Dave wait on me. Didn't go as planned. Mom waited on me plenty but having Dave incapacitated and away kept this from being the self-indulgent relaxation-fest I had planned on; I spent way too much time worrying. I'm hoping that I can cease and desist in that from here out as he has now reported working bowels, doctors planning release,  and eagerness to come home tomorrow. We will need help, but I think I will be better able to let loose and chill out with both of us here where we belong.  I really hate to let Mom go though...I will miss her terribly. She had offered to come to help me post-surgery before the big exciting prelude was added to the program and I had turned her down assuming that Dave and I would be fine on our own. It was heartbreakingly wonderful that she was willing and able to drop everything at the last minute and come after all despite my initial refusal. I hope there will be no next time to know better in.

Neglected to write about this earlier, but the initial stressor this morning was the result of my much anticipated shower; one is supposed to find a creative way to hang the drain bulbs so that the drains  don't pull out, and to cover the drain entry sites with something like Press N' Seal while showering. I made sure that the shower mat was in the tub to avoid slipping, got the Press N' Seal from the drawer in the kitchen, pinned the bulbs to a robe-tie hung around my neck, turned on the shower so that it was warm but not hot and jumped in, realizing in a second that I had just soaked my drain entry site bandages as I'd forgotten to apply the plastic before showering. Duh...here I am trying like mad to avoid infection and I did a dumb thing like that. So I called the Home Health nurse who came back and fixed me up, and provided supplies I had not previously been given to care for those sites. She checked me out and all seems to be okay. Whew...won't do that again. One must slow down and pay attention to detail. Everything is significant.

Day at Home

I woke up feeling sore from lying in one position all night. Moving around as I fed the pets and got some tea and coffee going helped me feel better, but I noticed that the drain on the right side is pulling out and I was concerned about that and anxious that I hadn't yet heard from the Home Health folks. But I managed to re-suppress the pain and to enjoy a brief head-and-feet massage, and when the home health nurse did finally come, she told me that my drain may indeed come out but that it will be okay and that I'm healing well.

I'm really amazed at how well my pain is managed and how able to use my arms I am; I had read from some other women that using the arms is so difficult for several days after this surgery that it's hard to wipe one's own bottom, but I am not having this trouble at all. Maybe because I'm so used to using my arms, so used to being busy and I continue to be, these factors may be involved with why I'm not having any noticeable limitations of my arms. I have to limit myself intentionally to avoid lifting objects over 5 pounds, but the arms are working just fine. The pain is in my chest. The arms don't hurt at all except where the IV was in my right hand and bumped up against a bone in my wrist.

Lots of friends visited, lots of yummy food was delivered. I will never go hungry again! There will be plenty of appropriate meals for Dave when he is finally back and eating, but I will need to freeze some more of the soups. I hate to waste a drop of anything; it's all so good.

Although there is little pain, there is a lot of odd sensation. Pressure in the chest, vibration-like sensations in the breast area, under the arms, below my scapula. Occasional shooting sensations, difficulty swallowing (not new but increased) and moments of crushing exhaustion. Considering this is my first week post-op, I think I'm doing great. Tomorrow I shower; that will be an adventure. Then Mom and I will go visit Dave. That will be another opportunity for excitement, hopefully of the reassuring kind. You can't write stuff like this; truth is stranger than fiction. Dave's doctor is our neighbor and friend. She says he's on the appropriate timetable for healing. I must believe her and trust that all will be well; believing otherwise would be crazy-making. I plan to stay sane. Goodnight moon.

Amazing Pain and the lack of it

Written yesterday, Wednesday, 12/2/10

Today has been a very strange day. After the surgery and through most of yesterday, my pain was crushing. Monday night I was basically delirious and fighting blood pressure crashes, and trying to manage the highest pain I've ever experienced. But last night things began to even out; maybe it was the presence of my mom, who arrived around 7 pm, and just cheered me right up. Today I fought some unnecessary anxiety as I anticipated the sting of the removal of my IV from my right hand; it didn't hurt at all. I was tired and feeling weak-kneed as we navigated the discharge from the hospital and traveled home, and then somewhat exhausted as we received the blessing of a parade of homemade soups being delivered, but once fed and settled in, after a brief nap on the sofa, I feel somehow energized and nearly pain free. How can this be?

Billy came by and picked up some of Dave's things and brought them to him at the hospital. He is not doing as well as I am, but not too bad either, especially considering the severity of his illness and intensity of his surgery.

Day 2 for me, 3 for Dave

I made it through the surgery and into this afternoon. I've never experienced such pain in my life, but in a weird way, I feel pretty good. It's odd but so far not freaky to look down and see my flat chest; I haven't had a flat chest since I was 8 years old; I was an early bloomer. I'm more freaked out at looking at this big IV in my right hand. And thinking about how low my blood pressure has been. At the moment, I have just taken some pain medication and now I'm about to fall out.

The low blood pressure is concerning. It goes up but then comes back down again. I'm off of the morphine hoping that it was the culprit in the plummeting pressure, but it's still unreliable.

Friends have dropped by all day; Anita brought a beautiful basket of fruit and cookies and sat with me for hours; Jennifer stopped by on the way to a session, Grace and Billy came with homeopathics and great friendship and support. Mom is on her way from California. I took a couple of walks down the hall to see Dave. I'm exhausted. I'm scared but not terrified. I want this to be smooth, I don't want any infections or complications of any kind, and so far, I'm not sure what's up. Friends are watching the house and the pets, and I expect to be home tomorrow.

His and Hers surgical proceedures

Dave didn't feel well last night and after being awake for hours, he began to vomit at 5 or so. Ended up in the ER and diagnosed with a small bowel obstruction. So he had surgery today; my bilateral mastectomies are scheduled for tomorrow at 7:30 am. Wow, this is going to be fun! Two convalescents at the same time!

So as much as I want to write tonight, I'm just whupped. I got nothin to say. Well, a little: I'm grateful that Dave is okay tonight, resting at Vanderbilt, I assume peacefully as I haven't heard from his nurse. I came home a couple of hours ago and took a bath and some last pictures of my current, original, born-with-em breasts, (don't expect me to post any of those!) and tried to tie up a few loose ends. The laundry I intended to do today, the errands, the last few dishes in the sink, cleaning out the fridge, bringing up firewood-none of that got done - oh well. The day was spent in the ER instead. The cosmic joke, Murphy's law; it always pays to be open to change.

Time to do a brief meditation and then to try to get a bit of sleep. Just a few hours. I'll sleep after the surgery. Thank you family, friends and neighbors for all your help and support through this.

Things I'm Thankful For Today and Everyday, in no particular order...

1. Life-grateful just to be here to ponder the blessings
2. Family-the older I get, the more aware I am of how much my family means to me; I don't do nearly enough to show them how I feel about them, and I never get to spend enough time with them. I hope to change that in the next few years. 
3. My husband-it's his birthday today,  a perfect reason for thanks-giving. Nearly 30 years together; we are lucky to have each other. 
4. My health-I know it sounds odd for a recently chemo'd person to be claiming to be healthy, but I have never felt that I was sick, just that I had a reaction to the treatment I was going through. I feel very healthy, and I intend to stay that way, despite interruptions in my mobility like the surgery I will undergo next week. 
5. My job and coworkers-I have a great job and I think the clinic I work in is very special; we are a wholistic provider in a major medical center. It's exciting to be on the cutting edge of the new medical paradigm of promoting wellness rather than just treating disease. Also, my employers offer me wonderful health insurance and support as I am taking time off to attend to my own health needs.
6. My friends-I am always aware of the value of one's own personal community, and mine is amazing. I've had so much support from friends near and far at all times, and never more than this past year. I can feel the good wishes coming at me from all over the planet. Sounds woo woo, but it's true true. 
7. My home-I love my house, and I'm excited that I'm going to get a new rug for my bedroom. Got plenty of firewood so I can be sure to be ready for a long week of lying in front of the fire snoozing after my surgery next week. 
8. My pets-they are a mess, but they give me a kick. I adore those furry freaks. 
9. My eyes-my vision has been becoming more challenged; got an eye exam a couple of days ago and am glad to know that it's just being another year older. Being unable to read while my eyes were dilated reminded me of what a gift it is to be able to do so, and how dependent I am on my eyesight. 
10. My favorite things-Wine, chocolate, organic turkeys and veggies and fall colors and hot baths and movies and music and books and vases of flowers and pictures and email and letters and so many things that I can't go on. It could last forever, and I've got to get dressed to go out to dinner. Happy Thanksgiving all. 
    

Racing toward the future

I had a great birthday weekend. Hard to believe that the next weekend is nearly upon us. And now it's the eve of Dave's birthday, and the eve of Thanksgiving too. We were feeling spontaneous tonight when I got home from work and went back to Table 3, the new restaurant we tried on Friday night for my birthday (and for Grace's) and loved. It's mid-priced, but still too expensive for us to make a habit of running off there. I loved the ambiance, and the mussels in a delicate tarragon white wine broth. Trouble with mussels in delicious broth is the amount of bread I eat with them. I'll worry about that later.

Getting closer to S-day. Gotta arrive at the hospital at 5:30 in the morning for my 7:30 surgery-the first one of the day, happily. I like getting my doctor when he is as fresh as possible. I'll spend some time on Sunday packing a suitcase with some cozy socks and slippers, silky pj bottoms, warm flannel shirts and the special camisole that provides some compression and has removable pouches to hold the drains that I'll have to deal with for the first week or so afterward.

I also plan to take a few pictures of my current bust line over the next few days. I had wanted to try to find a professional to take some shots, but really didn't have time to even pick up the phone to call around. It's probably better this way; the angles are limited when photographing with the computer, but I don't have to worry about the discomfort of baring my breasts to someone else.

Our Thanksgiving plans are to have dinner at a local steakhouse; when I made the reservation 3 weeks ago, they stated that they did not expect to be busy. Now they have called and told me that the reservation has been moved to 6:15 from 6 pm and that we should expect to wait. Turns out that they will be swamped, and 10 percent of all Americans are expected to eat Thanksgiving dinner at a restaurant this year. And here I thought we were doing something kind of unique. It's getting so hard to be creative! Dave is looking forward to a low key day tomorrow though, so this is perfect. Two dinners out in a row...how decadent. But we will be eating home for quite a while, I think, after Monday, so this is a nice treat in advance of that.

I've been feeling pretty good, and have had a lot of energy the last 2 nights, but had some crushing exhaustion last week and early this one. Feels like the recuperation from chemo is not a straight line on an incline, but a roller coaster, like so much of life. I have so much energy in general that in comparison, I now realize just how suppressed my vitality was while on chemo; I couldn't really feel how much I was dragging back then.  But I'm still not back to full strength. And I'm still doing some chemo-brained type things. Like last night, I completely spaced out a massage appointment with my very dear friend and best client. Just plain forgot to go. He was quite understanding, but everyone is disappointed when they are expecting a massage and don't get it. Hopefully, I'll get to catch up with him this weekend, considering I'll be out of commission for a while after that.

So as I was saying, I'm feeling pretty good. Hair is coming back, I have eyelashes and eyebrows. Minimal pain, mostly my tongue when I have any, and occasional boo boos seem to heal quickly. Anxiety is creeping in as I anticipate next week's adventures, but I'm still sleeping fairly well. My thumb is not bothering me nearly as much as it once was, which is good as there will be no surgery on it at this time. Can't think of any other symptoms to report offhand right now. A new friend came over yesterday to do some energy work with me to prepare for the surgery; it helps to calm me. I am a soul at peace.

Birthday Weekend

written on Friday 11/19


Wow, on days like today I realize why facebook is wonderful. I received so many birthday wishes from folks I've known in every phase of my life, and there are many. It makes me feel appreciated, validated, and brings home how many communities I've belonged to over my lifetime. Numerous incarnations of Adie Grey's life and so many other lives interacted with. It's lovely and a major stroke to realize that I have friends, however distant. I feel a Sally Fields moment coming on...she was on the student council of my junior high school ten years before I was....I understand the importance of the sense of being liked, after the years of growing up feeling like an outsider, which I suppose is typical for a creative, art-fart, bookwormish type kid. The feeling of being liked is a warm blanket...

Today:
It was a very nice birthday weekend. Dinner at a new bistro in Green Hills on Friday night with Billy and Grace to celebrate birthdays, both hers and mine. Loved the restaurant, love the friends and always enjoy their company. Woke early Saturday feeling funky and was really concerned that I would be too puny to enjoy my party that evening, but perked up in the afternoon and had a great party last night. Nice fairly lazy day today; am falling out now and will have to catch up on my writing later.

Birthday Eve

Tomorrow I will roll over another year. I am inwardly cheering, and at the same time, trying not to have a pity party. Today was rough, but not bad, and included a wonderful massage in front of the fire after work. But the morning traffic was beyond belief, and the few patients I saw today were struggling with various issues, and overall, the mood has been low.

Novembers in general have been difficult for the last several years, despite being the month of both of our birthdays. It was in November of '02 that Dave had the abdominal surgery that kept him in the hospital for a month, almost missing a trip to Paris where both of us were to perform with Sam Moore  just off of the Champs d'Elysees . We spent Veteran's Day, our birthdays and then Thanksgiving in that hospital room, wondering if he would ever make it out-he did and we spent a magical time in Paris. Several years later, November was the month that Dave received his lung cancer diagnosis. Then when I turned 50, 2 days later November was the month that my sister chose to quit fighting the chronic pain she had struggled with for many years. Last year, a patient fell during my treatment of him on my birthday and hit his head, fortunately without receiving an injury, just shaking me up on my new job. I heaved a sigh of relief when we welcomed December 1, 2009, without having had a major mishap that November. 

This year I have reason to celebrate. I haven't had a birthday party in many years, but this year I felt it was important to have one, and a friend who has been going above and beyond helping me throughout this whole ordeal of cancer treatment was kind enough to offer to host it. She has been handling all details of the party, scheduled for Saturday; today, Thursday, she is sick. (Self pity rears its ugly head.) I don't want her to stress about my party, I want her to put her entire energy into getting well. And I don't want to cancel the party. I don't feel up to doing it at my own home right now, while Dave is in school and I am trying parcel out my energy carefully as I prepare for surgery, but I will do it here rather than cancel. I feel that I need it right now. I had to cancel my annual New Year's Day party this past January first due to a plumbing disaster, and I have this irrational sense that if I cancel this party, I'll never throw another. Like I said, irrational. Self pitying. I don't like myself when I'm like this.

I also don't like myself when I am jealous. Jealous today that a friend had her breast cancer surgery and no malignancy was found in her lymph nodes. Petty of me to even think anything other than hooray for her.  I am so happy for her, just frustrated for me. And still, grateful every day to just be here to be jealous and frustrated and fatalistic and unprepared to hostess the party I desperately want. So glad to be here to be nervous about my upcoming surgery and the recuperation period that will follow. So overwhelmingly glad to be here to celebrate another birthday with or without a silly party, knowing that I have so many who love me, who I love, and so glad to have another evening to sit by the fire and enjoy living in my imperfect body. 

Ups and Downs

I'm really falling behind on my blogging, but it's because I've just been so danged busy LIVING! Having the energy to stay busy is wonderful. Two weeks from tomorrow, that energy will be seriously challenged once again, and I can't say that I'm looking forward to it, but I am happily anticipating being past the experience. If anyone out there reading this has any good advice, based on their own experience, for me on how to take the best care of myself that first week or so past surgery, I'd love to hear it.

I had a great weekend though, jam packed as they generally are. Went to an employee contra dance party for my clinic yesterday; as usual, I felt awkward to begin with. Dave had to work and wanted to study when he got home and I didn't have another friend to take along for a date, nor did any of my PT co-workers show up. So as usual, my shy side snuck up on me, and I'm grateful that my boss is incredibly gracious and came over to include me in some conversation. I also ended up chatting with the dance caller and her husband who were up from Alabama; the dancing was great fun, experience from my old square-dancing days helped me stay pretty well on course. Most of the crowd was new to contra and square dancing. I want to do more of it. Great exercise and good fun.

Even better was the party later on celebrating my friend Kathy C's 30 years in the local music biz; she has an amazing band and I have had the honor over the years of providing some backing vocals on some of her shows. I was a last minute addition to last night's appearance, and it gave me a chance to give my voice a nice workout. Use it or lose it. I'm working on getting it back as it has become pretty rusty with all my time spent on my new career day job and very little singing. The caliber of musicianship in Kathy's crew is so astounding, I'm humbled to be invited to join in.  And her fans include some of Nashville's finest singers and musicians, so the on-stage cast kept on rearranging and being added to as the night went on. Wish I could've stayed for the whole thing.

Got some sad news in the course of the evening though; another friend gone due to cancer. F*ck cancer. Went to a memorial for him today which was lovely, but sad, frustrating. I had to leave to go for a happy plan though, more singing at my friend Hilary's home, to be taped for a yoga video. Our friend Cliff was there with his guitar, Ron with his djembe. We jammed on some standards and my voice warmed up very well indeed. Then several girlfriends showed up for a light dinner and wine, a celebration intended to bid my boobs goodbye. The first of the birthday-week parties. See what I mean? I've been busy. It ain't going to let up until I'm post surgery and in the bed. Let the good times roll!

Sunday Night by the Fire

This was an odd weekend. Crammed a lot into it, including a very interesting new massage client (hope I'll see him again), but had to deal with a lot of crap too. I'm unwinding tonight by the fire; wish I could sleep on the sofa and stay home tomorrow. Ah well...duty calls.

Went to the memorial tonight for our friend who passed away a couple of weeks ago. Most of the gang, of which he was a part, who used to spend Thanksgiving together were there.  It was great to see everyone despite my having dreaded it all day long. I thought there would be more people there who would not recognize me, but I didn't have to deal with much of that. And the bar was not smoky, contrary to my expectations. I was delighted to have gotten out and overcome my apprehensions.

The oncologist told me that my best bet to avoid recurrence is to start getting 3 hours a week of cardio activity; I spent some time this weekend shopping Craigslist for an exercycle or elliptical or something that will work in the small, full den where we hang out. I think I'm going to have to order something off Amazon to get a size that will work here. Today however I took the dog for a half-hour walk, worked up a sweat and got my heart rate to aerobic range. Then I helped unload and stack 2 ricks of firewood and ran up and down stairs with lots of loads of clothes as I changed out my closet. I got my exercise.

Symptoms are minimal lately; I am feeling pretty good. Had some raised pain levels of the burning mouth on Friday and found that lead to some lisping as I couldn't control my tongue fully-that was kinda creepy, but it did not continue. Got a good yoga stretch on Saturday so am sore today, but in general, really feeling good. Yay. Life is good.

It's a date!

Well, I hope it's an auspicious day for surgery, because Monday November 29th is the date set for my bilateral mastectomy at Vanderbilt. I'm torn, because I could do it the following day with Dr. W who is associated with another hospital in the area, but I think I'm going to want to go ahead and do it at Vandy. Either way, it's that same time right after Thanksgiving, which this year is also Dave's birthday. I will work the Wednesday before the holiday and then be off for the rest of the year. In some ways I'm excited about it and I'm trying to focus on that excitement to stave off the dread.

I will have both the breast and plastic surgeons working together on me; I don't know how long the surgery lasts, but I know it's a lot longer than any I've had so far, and I will finally spend my first night in a hospital as a patient-all the previous surgical experiences have been on an out-patient basis. I've slept on a mattress on the hospital floor beside Dave's bed years ago when he was in for so long after his abdominal surgery, a few years before his cancer diagnosis and I hoped at the time that it would be the only time in my life I would spend an  overnight in a hospital, but it's not going to work out that way.

can you see the dark "mohawk" look down the center?

I'll have another surgery while I'm there to remove a tumor in my thumb. I met with the hand surgeon yesterday and he said that the left thumb anomaly is probably not a neuroma, but a giant cell tumor and is most likely benign. He said he feels so confident about it's non-malignancy that he would feel comfortable just leaving it alone, but that if I want to have it removed he would do it while I'm in the hospital, if not during my breast surgery as it only requires local anesthesia. And I do want to have it out-it has been fluctuating between hurting, tingling and doing nothing, occasionally interfereing with my work, and I imagine that left alone now it may impede me in future. It makes sense to me to attend to it while I'm going to be out of work anyway. And I don't really feel like leaving any tumors in my body right now, even if they are benign! Of course I'm not going to ask for a hysterectomy now just because I have 3 stable fibroids, but if the ovary scare I went through in January should have happened now, after the breast boogie, I would have gone ahead and had the complete hysterectomy that I opted out of at the time. Ah 20/20 hindsight...

So Thanksgiving is my last hurrah for a while. I wish I could beam myself to California for the holiday to be with my family; my aunt makes an amazing meal and I am in the mood to whoop it up with my gang before I begin sleeping it off for a few weeks. With Dave's birthday coinciding, I want it to be a special day for him, but I can't really plan to make a big meal and invite friends; I don't have the energy. And so far, we haven't had any other plans pop up.  I may have to do turkey-for-two, or maybe find a restaurant this year. I'll bet Wild Oats has a prepared meal that we could bring home...that might be the ticket. I'll have to look into it.

Never have enough time to read, to write, to run around with friends and to walk around the track, but life is good. Gonna enjoy some time by the fire catching up on reading, writing and playing instruments during my down days in December.

Symptom Log 11/1/10

• Energy-back
• Digestion-good
• Mouth pain-mild
• Neuropathy-mild
• Sleeping-good
• Nose bleeds-dwindling; still there but much less irritating
• Strength-improving but not back to par
• Sweats-happening less frequently and less severely, but still happening
• Anxiety-low

Going Strong

Somehow Sunday was rough for me this week. I felt bad about the way I look, the fact that I am quite weak right now and concerned about how that bodes for my recovery from surgery, my eating and planing for meals which is confusing right at the moment, the way the weekends just fly by...I felt badly about a lot of things and I got kinda cranky with Dave, but I didn't feel tired. That worn out/washed out feeling that stuck around for about 2 weeks after chemo seems to have finally worn off. I feel fairly well back to normal power. Oh...well, I must admit that I did crash out on the sofa at about 9:30 last night and according to Dave had to be practically peeled off of it to get to bed, but up until that point, I was quite clear and functional.

Tomorrow morning I meet with the hand surgeon to talk about the small tumor that has been identified in my left thumb. Most likely a neuroma, most likely benign; I'll know more about it tomorrow. I have no plans to address it surgically, but I guess I'll know more after I meet the doctor. Right now, on a bad day, it tingles in general and is painful when pressed. Most of the time, I don't even notice it.

I've started walking around the clinic without a hat on lately; my hair is soft to the touch and feels like real hair now, not like a 5 o'clock shadow when I stroke my head. It is nearly thick enough to completely hide my scalp now, and showing more dark strands and curl. A funny combination of too short and needs-a-cut, Dave says it looks kinda like a dyed mohawk as there is a V-shaped patch of darker hair right in the middle of my crown. I like it, I love it, I want some more of it...but heaven knows I'm so grateful to have hair on my head. I'll try to get a picture of it soon, but as I have only the built in computer camera to take my picture as Dave doesn't do photo, it's difficult to get the lighting right to see the subtle coloration.

I spaced out on Friday morning when I was scheduled for a fasting blood sugar and cholesterol test; I went ahead and ate breakfast before the labs were drawn. Somehow, despite the thought as I went to bed on Thursday that I would need to remember to skip breakfast on Friday, I just got up and packed my lunch and ate my morning meal as I always do, realizing my goof-up late Friday night. Sheesh...guess I'll have to do the test again. I'm blaming it on chemo-brain; I may be over the fatigue, but I'm still a bit ditzier than usual.

Still not getting enough exercise, but am working on it. Got in the pool today for over an hour with patients today. It was great, very soothing, and a stroke in the right direction.

Saturday Super day

I got my energy back yesterday and it was still present today. Oh yeah...it feels good to be back. I hope it is not a temporary reprieve and that I will continue to experience a increase in umph, and that I've truly gotten my mojo back.

This morning I sold the hand-cranked wheatgrass juicer my folks sent to me at the beginning of the chemical treatment phase of this journey and then made myself a glass of wheatgrass/apple and assorted greens juice in the Omega electric. I traded stainless steel man-powered for plastic and polycarbonate plugin. I prefer stainless in principle, but just couldn't deal with the constant falling off of the counter, not to mention the amount of exercise required to turn the crank. Much better for me to use the machine that I'm using and get the juice than to be off put by the requirements and not end up getting the elixer. It's like the question about organic brocoli-better to eat organic than conventional, but better to eat conventional than none at all. 

Spent the early afternoon with my friend Sandy who is a long time breast cancer survivor; she was kind enough to take me out to lunch and to tour the Country Music Hall of Fame. I've been there before, in fact I play there with Dave in an educational presentation about twice a year, but I haven't toured the exhibits in several years. It's always inspiring, always interesting. It's also meloncholy, looking at the artifacts associated with so many people I've known personally and some who are gone now, who I miss desperately. It also just in general sends me down memory lane, reviewing so many great moments in my life as an unknown musician. I had a damn good time back in my former life, and today.

Took the dog-girl for a walk by the lake in the late afternoon, with perfect fall weather and the trees still dropping red and golden leaves. Xena shines on walks like that-she loves them, the smells, the critters and all the admiration she gets from passers-by. I did too, but am so out of practice that my feet were sore afterward despite having worn my sneakers.  I still had the energy to make dinner afterward, and am now relaxing and watching TV. A really nice day. The front lights are off and we are not participating with the few trick-or-treaters who are roaming the neighborhood. We are cuddled up, hunkered down and staying in. I wish I had some apple cider to heat up.

Great Day

Today was the first Friday in a long time that I didn't crash. I actually had pretty normal energy today. It is 10:30 at night and I have been out to celebrate my end of chemo with the office crowd who wouldn't let me pay for a thing...too sweet of them as I really feel as if I should've treated them. It's humbling how generous and supportive my coworkers have been, and I know they have made things soft on me, but working has been so helpful to me. I'm sure this would have been a rougher road to travel if I hadn't been able to work. Now that I feel myself coming out of the fog, I just don't want to expect myself to do so much more that I become as worn out as I was at the time that I was diagnosed.

I've also been out to hear some friends play at Brown's Diner and sit with Dave as he ate his dinner and I nursed a beer to be justified in taking my space at the bar. It was nice to be out in the kind of environment in Nashville that charmed me from the start. And to have the energy required to be spontaneous and to jump on a chance to go out and spend time with my husband.

I've spent so little time out aside from going to work that I am not unrecognized frequently; I don't see much of anybody I know. But tonight a friend I hadn't seen in a long time introduced himself to me. I tried to stop him from being embarrassed about it, but he was. How could he know? I had very distinctive hair b.c. (before chemo),  and the boy-cut I've got now, all silver-and-gunmetal, is a very different look. I kinda like it. I don't mind the very short hair thought at all, but I'd like a bit more of it.  Anyway, I'm sorry anyone is embarrassed if they don't recognize me, but it's kind of fun sometimes to be incognito.

Still In Detox Mode

Written on Tuesday: 

My hair is showing evidence of a curl. Eyelashes are beginning to bud. Eyebrows still very sparse, but I think they are growing. It's all too slow; I'm ready for full-hair action. And it's weird to need a haircut with only a half inch on my head, but there are random wires sticking out all over and it's starting to look unkempt. I know there is still plenty of chemo in my system...not really sure what the half-life of those chemicals are, but I'm still pretty danged tired although getting better every day. I wonder if I'm still anemic?

Got a much-needed massage today, and have been barely functional since, requiring all my strength to make dinner, although I kept it very simple. I really do need to consult a nutritionist, I just don't know who would be appropriate. I need help with meal planning and preparation to focus on the types of foods I think we should be eating here.

Dave is working on posting some record reviews that he's written lately-all classical and baroque. I am the inadequate computer tutor and doing my best to help him navigate these confusing sites. The evenings go by too damn fast; time for personal pursuits is so precious and my energy is still so limited.

Itch, itch, itch....

One of the symptoms I was warned about was general itchiness post Taxol. Oh, yeah....   Some of it is due to dry skin and goes down with an application of lotion, but there must be a chemo-detox factor to it as well. There's a bit of contact dermatitis-looking rashiness as well as just itching with no visible reason. Very annoying. I'm drinking lots of water and have been meaning to without success get to the Y and sit in the sauna. Need to do some exercise to work up a sweat too; maybe I'll have a cancellation at work tomorrow.

Right now there is a tornado warning for the part of the state south of us. The weather man on channel 2 is naming off towns-Hoodoo, Hard Scrabble, Stringtown, Gassaway, Bug Scuffle, Defeated-the names are so great, it distracts from the severity of the situation. Right here in Nashville at the moment, all is calm, just wet.

I've been tired. Really tired a lot of the time this week. That too, I think, is a function of chemo detox, and probably a little bit because I finished chemo and immediately went into a super busy schedule of hanging out with my folks, then having a longer work schedule this past week as well as doctors appointments, and lots of general catching up to do. I've been trying to respect the fatigue, to rest well and sleep long and hard on the weekend. Spent the morning today sitting on the back porch with a book and a cup of weekly coffee; a treat and a very peaceful way to kick off the day off.

One of the things I've been learning about triple negative breast cancer is that it is thought to be responsive to insulin levels; it's suggested to keep them low and consistent. So I'm thinking about getting a nutritional certification of some sort myself, and in the meantime, visiting a nutritionist who can help me with a low fat, low carb, alkaline diet. I have no trouble with the concept of focusing on eating my fruits and veggies, but in what combination and proportions, that's a question I'm not quite able to answer at the moment. And I don't think I've ever had a fasting blood sugar level taken, nor a fasting cholesterol, so I will email my doctor and ask for this.

There is a clinical trial coming up of a drug called Metformin, used mainly to treat type 2 diabetes, testing as to whether it is useful for improving the long term prognosis for breast cancer patients. I expect to be asked to participate in it. I'm not sure about doing that-it sounds like I would really like to get the drug, and I'm not sure how I feel about taking the drug twice a day for 5 years without knowing if I've really gotten the goods or a sugar pill. This one will never be un-blinded; I would never know what I actually got. I don't feel good about that as I just think about it in advance here, but I suppose I may change my thinking as I learn more.

Today's symptoms:
Dizziness-every time I bent down today, I felt lightheaded upon standing up. Skipped yoga today because of it.
Itchiness-all over, not constant but consistent. Annoying.
Mouth pain-3/10, right side of tongue
Swallowing-pretty good.
Nose bleeds-diminishing; no major bleeding today!

No More Mammograms/Today's symptom log

Today I went to see Dr. K for my follow up to the lumpectomy surgery done back in April. It's almost exactly 6 months since that surgery-time sure flies when you're having fun! Anyway, I had been scheduled for a mammogram today, but because I have decided on the bilateral mastectomy, we decided to hold on it. A permanent hold, I believe, as there is no plan to do them post surgery. I will continue to do self exams, and of course images will be made if anything suspicious arises, but otherwise, with no symptoms, we assume I'm healthy.

I am, but I'm tired the last few days. Came home from work today and took a nap. I think my body is so used to being jacked up on steroids on Thursdays that it didn't know how to handle a day-after-Wednesday with no Decadron to bolster my energy. The nap helped though, and I'm ready to go out and do a couple of massages this evening. Not the King Kong feeling I've had on Thursdays for the last 3 months, but quite refreshed.

The doctor told me that women who are more flexible in the pectoral region do better during rehab after surgery, so the next 6 weeks are boot camp for flexible pecs. I want that best-case-sceanario after each surgery (there are 3 involved with the mastectomy and reconstruction) and during the period while my expanders are being expanded. I intend to do some traveling during this period, and I plan to feel as great as possible during it as well.

I need to get back to keeping the symptom log, but won't get around to it tonight, so I'll include them here:

Neuropathy: still going on; the oncologist told me that all kinds of odd sensations that I've been experiencing lately are the result of Taxol-induced neuropathy. Today it's lots of itching, along with the occasionally needle-jabs of pain in my feet and hands. I've got a few rashy places particularly on my left hand, ring finger, that I'm thinking are also related, but not sure exactly how.  6/10

Swallowing: not too bad; haven't been taking many of my pills though. Burning tongue 4/10




Sleeping: mostly good; sometimes need to listen to my guided imagery on my Ipod to turn my head off, though.



Appetite: beginning to taper off. Now if I can just get this weight to start backing down again...

Looking forward to the weekend. It's right around the corner.

Wonderful Weekend with the Folks

I'm having a great weekend; my folks have come to Nashville from L.A. to visit me and we have been enjoying each other's company for the past couple of days. Long walks, long talks, art exhibits and train rides, a real treat for me as I haven't seen them since my graduation a year and a half ago, and a triumph of energy as I've had the most active Friday and Saturday that I've had in a very long time. I hope I can keep it up tomorrow; I want to make it to yoga class in the afternoon, after brunch with the family before I kiss them goodbye and send them on their way to other parts of Tennessee.

It's been perfect weather, too, a rare occurance here in middle Tennessee where it is usually too hot, too cold, or too humid. We really lucked out for our train trip looking at the changing leaves and the silly train robbery skit. My friend Hunter has a coffee house in the little town where we stopped and walked around; it was great to see him, even if only for a minute-the shop was mobbed. I was tired when we got home though, crashed out for a while, then off to another yummy dinner tonight. Gotta get back on the mostly-veggie diet again tomorrow! Xena is moping today as she knows it's Saturday and I neglected my doggie duty of taking her out to a farmers market or park in our usual manner in order to spend the time usually spent with her with my parents. It's a people thing; she wouldn't understand.

I'm nervous about going back to a fuller schedule at work again. I think I'll be fine, heck, I'm not going to have a weekly poisoning session anymore, and it's only 2 additional patient hours, but this first week back I didn't realize that my schedule had reverted to my old schedule for Monday - Wednesdays (full days) and my newer schedule for Thursday and Friday (5 hour days) which for this one week will add 4 patient hours -

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Well, I crashed out yesterday in the middle of the blog. Today I was pretty whupped and took a long nap after we came home from brunch, the last family meal before the parents went on to Chattanooga. Spent the evening making soup. Aside from being so dang tired, I feel pretty good today. Wonder what the coming week will be like, with no chemical interruption. There goes that excuse....

As I celebrate another beautiful day of being on the planet, I am reminded to appreciate each nuance of life with the news that another dear friend has passed away suddenly. Years ago, after a series of losses of his crew, John Hartford told me repeatedly that you've gotta be tough to grow old; it's not for sissies. Indeed. Those we miss live on in our hearts but that is cold comfort when you just feel like sharing a story and having a laugh with them. I'm grateful to be here to mourn, sorry that mourning is in order. Farewell dear friend.

Gratitude

This is it; even as I write, I'm receiving the last drops of chemo. I'm just about done here. The side effects will probably go on awhile, but with the knowledge that I'm healthy and finished with this long experience, I feel that I'll be able to tolerate them and to reconcile myself to them without the need for pain killers. Maybe some physical therapy, but not until after my surgery. I am quietly thrilled to be at this point and in a position to plan to have my teeth cleaned, my toenails spruced up and to freely eat salad once again all in a couple of weeks from now. Hallelujah!

I'll keep taking the Glutamine; apparently the side effects of the Taxol are partially delayed and long lasting, perhaps taking the next couple of years to fully wear off. The pain I've noticed along the border of my left breast, the heart palpitations and dizziness over the last couple of weeks, all of these are deemed by my oncologist to be in response to the neurotoxic factor of the Taxol of which I've now had 12 treatments. Hopefully, continued Glutamine consumption will lead to continued nerve and digestive support.

My sister and others have warned me that there is an inevitable let down after chemo is through. Suddenly, you're done, with checkups every few months, but none of the intensive attention that go on during the treatment. And you wonder and you worry about every new ache or pain and you get the blues. I will try to steel myself for this, and to consider myself forearmed by the forewarning. Besides, I have a followup appointment with my breast surgeon a week from tomorrow, and surgery to schedule and then the surgery itself and rehab afterward, Christmas/New Years off, and frequent visits to the doctor for expansions as I transition from the expanders to being large enough to accommodate the implants. I expect that if I'm going to get the "after cancer blues" they are going to hit me after I'm done rebuilding my chassis.

Today is a beautiful day. I'm excited to be alive in it.

Symptom Log 10/12/10

1. Neuropathy: Mostly left thumb, but whole left hand is effected, shooting pains in the feet continue as well. 5/10. The neuroma on the left hand was tingling a lot today and the hand was very sensitive to hot water while washing dishes.
2. Appetite: Fresh juice in the morning is just great; holds me for about 3 hours.
3. Mouth: Sores gone. Burning Mouth Syndrome back most of day, not very high though. 3/10 in the tongue. Some tingling/pain in the teeth and gums as well.
4. Anxiety: low today, but still running my mental worry tape and trying to silence it. I've at least gotten it to quiet down.
5. Strength: Continuing to feel it improving.
6. Nose bleeds: continuing to improve. I wonder how long until they go away?
7. Energy: Pretty good; never really hit the wall, but I had PT myself today and kinda dozed off, so got a tiny nap.
8. Hair: coming back, all straight and white everywhere. Thought I saw the beginnings of a curl, but I think it was just messed up from the way I slept.
9. Swallowing: Another really good day with that; may it last.
10. Pain: Still feeling that tight pulling pain at the lateral border of my left breast. It's not right at the surgical site, but within a couple of inches of it.
11. Shortness of breath/Palpitations: These continue. Not debilitating, but concerning.

The Eve of the Final Infusion

Wow, tomorrow I finally reach the end of the chemo part of this journey. Well, that's not really true, as the chemistry will remain in my system for a while, and it's effects are intended to be long lasting. But the Taxol has been mild, tolerable compared with the Adriamycin/Cytoxin, and things are coming back. Hair, white and straight,  softly covering my head with a shadow of dark shadow amid the snow but not enough of it yet to keep me warm. Pubic hair now beginning to show signs of dark kinky strands, eyebrows filling in, but lashes not yet quite taking. They start to bud, but every week, the little buds disappear. So after tomorrow, perhaps they will go on and grow. I have a very strong appreciation of hair now, and how much comfort it provides cushioning raw edges of eyes, brow ridges, private parts and the cold cranium.

So much I wanted to write today, but as so often happens, I became caught up with food preparation and small household details. White beans and fresh greens from Sylvia's farm, cornbread from Whole Foods. Clean the kitchen, walk the dog, take a bath as I won't want to soak for a couple of days after having the hole poked in my chest accessing my port tomorrow. Had to actually dig out some shampoo and conditioner, which is something that I haven't had to do in a long time. (I've been able to get by on liquid soap on my head but now really have hair that responds to the chemistry of the cleaning product.) Time is eaten up with little bites of chores and distractions, and the blog does not write itself.

Tomorrow I will celebrate by coming home and doing whatever I feel like doing. No particular plans, but my folks come on Thursday. I will celebrate with them, and then continue to celebrate, everyday. Every good day is a good day. Today was one of those, I expect another tomorrow.

Symptom Log 10/11/10

1. Neuropathy: Particularly left hand today, but shooting pains in the feet as well.
2. Fresh juice in the morning seems to be balancing it out a bit, but still quite hungry much of the time.
3. Mouth: Sores gone. Burning Mouth Syndrome back most of day, not very high though. Some tingling/pain in the teeth and gums as well.
4. Anxiety: well, I wrote that it was low yesterday and then had a hard time going to sleep as I spun my mental worry video around in my head. So moderate anxiety. 
5. Strength: Continuing to feel it improving.
6. Nose bleeds: Better today than the last few. Using Ayervedic oil drops at night before bed, just a couple in each nostril, really seems to help. That, and getting off of chemo after this week ought to take care of it.
7. Energy: Reasonably good energy today, considering I slept well but not enough. Hit the wall late afternoon.
8. Hair: coming back, all straight and white everywhere. 
9. Swallowing: If only every day could be as good as today in that department. One time, I chocked on a sip of water, but I think that was one of those timing issues-got distracted, tried to talk while swallowing, you know the drill. It wasn't much of a problem, and pills went down easy tonight. 
10. Pain: Doing a little yoga tonight at home, side angle pose to the right really woke up my left side along the lateral left breast, below the surgical area. Yow...I really don't remember that hurting that much before. The surgeon warned me that it would come and go. I'd like to keep it going until it is gone!
11. Shortness of breath/Palpitations: Yes, I'm having some of this. My dog-walk is probably a bit shy of  a mile, and I am puffing a bit by the time I get home. Lying in bed, I really feel the strong palpitations in the area just behind the bottom of my sternum. I don't like it. 

Symptom Log 10/10/10

1. Neuropathy: Not too bad today, but occasional shooting pains.
2. Appetite: silly to keep documenting this one. Quite healthy. A little occasional heartburn the last couple of days, especially after eating a "Skinny Cow" ice cream bar at the race yesterday.
3. Mouth: Sores gone. Burning Mouth Syndrome was there most of yesterday, but I don't remember noticing it at all today.
4. Jaw/Teeth: no major clenching last night.
5. Anxiety: low
6. Strength: I feel quite strong. I made it through the 5K plus all the extra walking, probably a couple of miles worth, yesterday and was only slightly sore today.
7. Nose bleeds: pretty consistent bloody discharge today; yuck. I look forward to that being over with. 
8. Energy: Lots of energy today and yesterday. Having fresh juice for breakfast daily since my juicer got here and am just going going going like the Energizer bunny.
9. Hair: coming back, all straight and white everywhere. 
10. Swallowing: no major trouble today, no slowdowns. No hiccups today, but haven't tried to swallow any pills, either. 

Day after the Race

It's been a gorgeous Indian summer weekend. Cool in the mornings, highs in the '90s, dry and sparkly with the leaves changing. The walk was fun and I was so happy to have my crew with me, although, I wasn't sure how we were going to meet up when I got there and found out that the decision to rendezvous at the Vanderbilt tent would be complicated by there being 2 of these, one for checking in and picking up shirts and bibs, etc, and the other in the race village for community outreach. So there was a lot of time spent on the phone trying to find one another, shouting into the receiver while opening ceremony music blared in the background. But somehow, find each other we did, and my small group of friends, none of whom had previously met, had a nice walk in the midst of the throng, with my pooch Xena trotting along happily, getting lots of attention as she is one pretty dog, and surprising me by tolerating the noise and the crowd even better than I. We dealt with more sun than I can usually tolerate, but I did not get burned, and I kept going yesterday long enough to do some shopping, get the house cleaned and spend the evening playing games with my group of friends who get together for this monthly.

Today, a festival at a friend's farm, lots of shopping, a no-show massage client (hope he's okay) and lots of cooking. One of my favorite pastimes, shopping and cooking. Sometimes, I think I have a grocery addiction.  I need to plan better though; groceries are expensive, time is scarce, and I really need to economize in both areas.

Should I buy a Wii? I'm trying to design a Wii-hab program for the clinic, and it's really hard to do without time outside of patient hours to practice with the equipment.  I think I'd enjoy it too, and maybe get some additional exercise.  I'm going to need to something to increase my fitness, especially when it gets too cold to walk outside, and when I'm healing from surgery and unable to go to yoga classes, etc. I should put my Y membership on hold during that time, and save at least that much money. I should stop worrying about money, I should just plain stop worrying. I am trying.

Friday I felt great but crashed hard finally, scaring Dave with my orthostatic hypotensive behavior, becoming dizzy and feeling faint every time I stood up. Saturday morning, just fine. Today, Dave freaked me out a bit by taking a couple of bites of dinner and then telling me that he needed to lay down, he was tired. He's sleeping now, I'm wide awake. I shouldn't worry about him-why shouldn't he have one of those nights? I'm having a great weekend, but fighting the worry monster. I guess it's time to return to meditation. I'll get on it pretty quick here, get off to bed and work on it. Gotta get up early to get the car into the shop. Will listen to a relaxation guided imagery by Belleruth Naperstek on my Ipod to get to sleep.

Taxol #11-one more to go

I'm getting it right now -the  next-to-last chemo infusion, 15 of 16 all together, 11 of 12 Taxols. Wow...it's been a long haul. I want to have a party to celebrate, at least with my co-workers, and will have to contact them to see if we can find a time to go have a drink or two. I think about bringing a cake, but them, I don't really want to eat sugar beyond the little bit that's added in the tart frozen yogurt I love or the 1 oz  of dark chocolate I eat nearly every day. I'm trying to be moderate about my neurotic avoidance of certain foods, sugar being the lead suspect in the dark underworld of cancer-promoting nutritional villians. I avoid it as much as I can without going crazy. I would probably feel even better and look much better if I could avoid it altogether. So no cake, but another way of celebrating will surely come to mind at some point. Right now all I can think about is dinner.

It's weird to be so hungry with chemo when the stereotypical chemotherapy patient is emaciated and nausiated with therapy. I remember it being that way for Dave; I fretted over him and made smoothies stuffed with as many healthy super-food nutrients and calories as I could get into them, hovering over him as he ignored them, begging him to just drink 2 ounces an hour. He did choke it down and it got him through, and eventually he gained some weight back. Despite the steriods he was given weekly with the therapy, he remained skinny and got skinnier. But I am gaining weight steadily, though not eating more than my pre-cancer normal. It's frustrating, and I'm trying not to worry about it until done with therapy. They say it's the steroids although I am getting a very minimum dose of them.  I really enjoyed the leaner frame I experienced for a few months at the start of this adventure. Probably would help if I were getting more exercise; again, after chemo. After next week, no more steroids, no more poison, no more excuses...until the next surgery.
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Of course it makes sense that one must be well nourished to do well while going through chemo hell, and to recuperate fully. So celebrating a healthy appetite by eating well and the resultant weight gain is probably okay right now, but I'm very bored of fighting it. I've been quite happy to have left my ovaries and the worries I battled over their health behind with my first surgery this year, but my concern about letting both of them go was partially a fear of fatness and I can't help musing that perhaps the trend I'm seeing is related to the hormonal lack. Initially, after the ooferectomy, I maintained a low weight with no effort and was elated about that. Then I started to worry about it, one of the preminitory senses I had before my diagnosis that cancer might be in my future, that perhaps my low weight maintenence was not a good sign. Then after diagnosis I was afraid to eat or drink anything and weight fell off me for a couple of months, to the point that I started to worry about that. So I guess there's just no pleasing me. Somewhere, somehow, I'll find the balance point.

My repaired juicer arrived and was waiting on the doorstep when we got home this afternoon. I made a wonderful refreshing fresh wheatgrass shot and am now enjoying the autumn breeze on the back patio, trying to get enough energy together to walk the dog. Saturday, the Race for the Cure is on; Xena and I will walk with a group of friends among the throng. If you'd like to sponsor me, my personal page is

Personal Race for the Cure page

Don't worry about it; we are all overly called upon to donate time and money. I always mean to contribute more that I do or even can, but I am looking forward to this walk as a celebration of nearing the end of this phase of cancer treatment and survival.  Anyway, Saturday mornings I generally have an outing with Xena; this one'll blow her doggie mind!

Hope your day is as beautiful as the one we are having here. Be well.

Symptom Log 10/5/10

1. Neuropathy: yeah, it's still there. A bit worse today.
2. Appetite: still more than I'd like, but healthy. I'll worry about the weight when I'm done with the chemo.
3. Mouth: sores just a bump now. Burning Mouth Syndrome consistent all day. VAS 4/10
4. Jaw/Teeth: tight jaw, some tooth pain and tingling especially in the morning.
5. Anxiety: low
6. Strength: no trouble with doing manual therapy today. 
7. Nose bleeds: pretty consistent bloody discharge today; yuck. I look forward to that being over with. 
8. Energy: much better today
9. Hair: coming back, all straight and white everywhere. 
10. Swallowing: no major trouble today, just occasional slowdowns. No hiccups today. 

Symptom Log 10/4/10

1. Neuropathy: still some occasional shooting pains in my hands and feet, not consistently. Still painful nailbeds on both thumbs. My shoulders still feel somewhat numb. 
2. Appetite: good. 
3. Mouth: sores just about gone. Burning Mouth Syndrome seems to increase toward the evening.
4. Jaw: tight and popping. Need to remember to sleep with my mouthguard.
5. Anxiety: low
6. Strength: no trouble with doing manual therapy today. 
7. Nose bleeds: pretty consistent bloody discharge today; yuck. I look forward to that being over with. 
8. Energy: spacey and sleepy all day today. Mornings and just after lunch are worst. Maybe I need to eat less. 
9. Hair: coming back, all straight and white everywhere.

Symptom Log 10/3/10

1. Neuropathy: some shooting pains in my hands and feet, not consistently, just occasionally, but quite sharp when they happen. Still painful nailbeds on both thumbs. My shoulders feel somewhat numb; not sure if that counts as "peripheral neuropathy", will have to ask. 
2. Appetite: good. 
3. Mouth: sores almost healed up. Burning Mouth Syndrome is back, not too bad, but pretty consistent after not really being noticeable for the last few months. 
4. Jaw: tight and popping. Need to remember to sleep with my mouthguard. Teeth are not hurting much today-just the one with the root canal in front that hurts whenever my sinuses are irritated. It hurt some today, about 4/10. 
5. Anxiety: lower. Feeling better about surgery again, still very anti-radiation.  Feeling reasonable peaceful and hopeful.
6. Strength: not great, but made it through yoga class this evening.

Symptom Log 10/2/10

• Mouth: sores are healing; teeth less painful today than yesterday. Burning tongue increased somewhat, about 4/10 which is higher than it has been in a while. 
• Neuropathy: not bad; about the same as yesterday. Occasional shooting pains, some diminished sensation particularly in left hand, mostly the thumb and index finger, and in both thumbnail beds, about 5/10
• Anxiety: decreased today; back to feeling strongly about the surgery. Frankly, I don't really want to do any further therapy after finishing chemo, but I think the least anxiety going forward will be associated with the mastectomy. I really don't want to do radiation. 
• Appetite: too good. Not out of control, but very active. Had dinner at Ted's Montana Grill tonight though, where I've gone to eat red meat as it's all free range, but the meatloaf I ordered tonight was too heavily peppered with black and white pepper and I am just over that place-way too corporate. The only thing that got me back there 3 times is the fact that the meat is trustworthy, but I think I'm going to have to prepare it myself, for the occasional times that I eat it, to be sure of the source. I'll eat other things when we dine out. 
• Sleep: slept deep and long last night. Didn't get a chance to work out or walk today. Will do tomorrow.