Another year...

December has come and gone....this year has been bitter cold. The winds were brutal creating windchills in the single digits. January is here. From my vanatage in the three season room, I can survey the back yard .The patio wind chimes ring and clang in the wind...none of the sweet tones of the summer. The tubes are blown nearly parallel to the ground, roughly tossed by blustery winds and rain.

The trees that used to shade me on summer afternoons on the patio as I recovered from surgery, are bare of leaves. The snow of December has melted over the last few days of unseasonably warm temperatures. It's grey, windy and a light rain is falling.

I haven't written in two months. November and December were very stressful, and to add to it all, I had an upper and lower respiratory infection hanging around for most of December.

It seemed to me that I've been writing mostly about the side effects of the medication Tarceva (erlotinib). That topic must continue in the hope that maybe someone else will find the information useful. I'm also having a lot more residual discomfort from my left pneumonectomy (lung removal) of June 7 that's extremely distressing.

Right now the nasty rash has decided to take up residence on my right inner eyelid,from the crease up. The area is swollen, papular, painful and itchy. It's also peeling. About every cream cautions "...avoid contact with eyes...", but I'm so desperate to stop the itch, I've tried about everything anyway.

I was discussing this problem with my mother-in-law, who I love dearly. She looked at me, brought her hands together and said, "Thank heavens!! I've been agonizing for days trying to think of how to tell you that the pink eye shadow looks terrible!".
Yeah...it looks like very badly applied pink eye shadow. If I put any makeup on the area, it just seems to look worse. It also irritates it. Lately the only thing that helps is a judicious application of Bag Balm. My eyelid resembles a small monkey butt. Truly.

I'm also having a terrible time with the eyelashes. On the lower lid, there are a few tiny lashes that come in growing the wrong way: toward my eye. There are also some coming in closer to the eye than they should, growing on that inner margin where some (brave) women put more blue eyeliner. They are very hard to see, even with a lighted, magnification makeup mirror. They're also hard to get a hold of.

In spite of very good medical management (medications), I still have serious problems with my left side as a consequence of the surgery. The incision area itself is numb. As I may have mentioned before, the pain is around front. If you place your hand under your left breast with your middle finger on the bottom rib, that's the location. Numbness, yet with burning, tingling, and some sort of interference with the tissues below. When I wake up in the morning, the medications have worn off. My left side is so sore and stiff feeling it hurts to take a deep breath. I have to get my meds on board immediately. Getting ready in the morning has turned into a much slower process than it was before. The discomfort slows me down substantially, and I have the additional task of applying handfuls of lotion to my entire body.



OK. Enough of that. David and I shared our first kiss on New Years Eve 2005-2006. We've been together a full 5 years. It's been quite a journey.

GOOD NEWS! Finally!

Health care professionals can be very difficult patients. For my part, I have heard so many stories about the sleep aid zolpidem, I had refused a prescription for it several times. Sleep walking, sleep eating, sleep sexing, sleep driving-- you name it, I wanted no part of any drug that has those kinds of side effects.

I admitted to my breast medical oncologist on Tuesday that during my frequent bouts of insomnia (nightly!)I would partake of my "Insomnia Jelly Bellys". He laughed and rolled his eyes. Yes, fatigue is my biggest issue. Well, I'm writing you a script for this, and you're going to try it. Yes, sir.

I have slept every night since I started taking it. No weird side effects, no weird dreams, just sleep. It's like a miracle. Now that I'm sleeping, I'm getting a better idea of what kind of energy I really have contending with just the cancer, the meds and one lonely lung.

I'm so excited about being able to sleep it's really been a boost to my outlook. Funny what we take for granted.

Remember how I bragged about the long and curly eyelashes I've gotten while on the Tarceva? I spoke too soon. The lashes get TOO curly...then they break off or fall out. Right now, I've got a long curly set on the right, and a short, kinda curly set on the left. The left looked almost bald for a few days.

Then there are the eyebrows. I have NEVER had eyebrows, neither in quantity nor in color. That has also changed. I'm getting old man eyebrows: darker, longer, and unruly...sticking out in all directions. I've had to resort to using an eyebrow brush and eyebrow gel to tame them. Sign me up for a weekly wax.

I'm terrified that I'm going to start to grow hair out of my ears next. It's very hard to see that yourself....am I going to have to ask my hubby to check my ears for hair? Eeeww!
Sorry fellas, but ear hair is a man thing, not a lady thing.

So, no more excuses for Jelly Belly beans... just have to rein that one in. Can't wait to tell Dr S that I'm sleeping. 'Round Midnight belongs to Monk again.

What you don't see

NOTE: not whining, but to say no one can tell what goes on in the body, mind and spirit of another. This is a continuation of the thoughts in "Everyday living".
______________________________________________________________________________

Skin so tight it hurts,
Lotion eases the tight wrinkles snd makeup almost hides the acne.
Blood. From where? The inside edges of my nostrils.
Bleeding.
My skin burns everywhere.
Red bumps and rash are coming everywhere.
It's rough like sandpaper: no lotion is enough.
It itches and itches.
I can't reach my back.
You'd never know if I didn't tell you.
The medicine that will lengthen my life has turned my skin to sandpaper.
I am alone
In this skin.

I awake from a decent night's sleep (unusual).
Aching muscles, aching joints.
Getting out of bed is like trying to swim through pudding.
Before my feet hit the floor, I remember. I have cancer that can't be cured.
Then the cough starts.

Why the cough? Reflux, anatomical changes, who knows? Who cares?
Typhoid Mary: out trying to shop and the damned coughing comes again.
Talking? Try it with vocal folds that have been beaten into what surely must be shreds.....
Coughing that causes the whole body to shudder and shake.
Coughing that wears a body out...only adding to the ever present fatigue...
Oh, Lord sometimes I feel so alone
With this cough and no voice.

I am always tired. Always. No amount of sleep fixes it.
How can anyone who looks so good be so tired? Nahhhhh....
You don't walk in my shoes, so you don't know what tired really is.

Is it any wonder that there are times when I am just sick and tired of being sick and tired?

Lord, I know you're there and you're working in my life.
I believe that all things work together for my good~~
And that I must keep my focus on you.

The psalmist writes that crying and sorrow will last for the night,
And joy comes in the morning.
Hold me tight as I close my eyes and take one step at a time,
And be ready to hold me up when I can't take one more step...

Return to "everyday living"...

The sense of urgency has passed. The shock of being diagnosed with two primary cancers has worn off. I've told the story so many times, I'm numb to it. I'm so used to it, I sometimes forget how shocking my story really is to people hearing it for the first time. In German I would call this "Alltag": everyday living.

I am living with my cancer, or some reasonable facsimile thereof. "Living" is different. There are medications to be taken at certain times on an empty or full stomach, depending. There is the horrifically
dry skin that requires repeated applications of heavy duty lotions.Parts of my body are covered with a hard, itchy rash. Even my nostrils are dry. My hair is fragile...but has become curly. My eyelashes are long and curly, thanks to the Tarceva. So...it gave me acne, the rash, the dry skin, but my eyelashes could get me a gig with Maybelline. I won't go into detail about the quantity of Immodium I ingest on a daily basis.

People say I look "good". I do. There are no outward, blatently obvious changes...short thin hair is nothing new for me. If they hang around with me for a while, they'd hear the wheezy sound of my breathing, my shortness of breath and the constant coughing. They'd hear the hoarsness of my voice caused by the coughing. They might see me steady myself during a dizzy spell. They'd see me looking for a place to sit! I try to conserve my energy for important things. Doing simple things like laundry or unloading the dishwasher are causes for needing to rest and catch my breath.

Yes...it's much better than this summer.What a long way I've come since my surgery...even with the side effects of the new medications...the post-op period is almost like a bad dream at this point. I had the pneumonectomy on June 7th. What I remember most about this summmer is the HEAT. It was mostly in the 90s with very high humidity. Most days I was stuck inside the house in the air conditioning. Taking the dogs out during the day was a scary ordeal. Cell phone in pocket, I'd take them out to the island of grass near the kitchen door for the fastest "business" on record. The dogs didn't like the heat either; they didn't waste any time getting back into the A/C..

During that time I was also taking a lot of pain medications. It's amazing I was functional at all.

Then there are the nights.....insomnia. Insomnia and itching. Insomnia caused by itching....with or without cough. Tonight--I write this not to whine, but to document...to put the night into words so that people might understand.
Today I was tired. Bone tired. I had to force myself to get up, move around, take a shower. The shower was a must because I need the Nioxin stuff for my hair, and I need to exfoliate my skin so that the moisturizers are effective. I use a mild scrub, then go over it again with a super duper moisturizing Dove body wash.

The shower has worn me out. I go to the vanity stool and sit...pondering the disarray on the counter before me. More moisturizer, then sunscreen. No problem; my skin is so dry the sunscreen doesn't make my skin gooey.

I survey my facial skin in the 5x magnification lighted mirror.Since being on the Tarceva and using extra, super duty moisturizers, the wrinkles are greatly diminished. This would be a cause for huge excitement, except for that the Tarceva has also caused three spots of true acne (which I never had as a kid), with a sprinkling of whiteheads for good measure. I believe the correct term is "zits". At the ripe old age of 51 I have produced a bumper crop of zits. Surely there's some kind of award for that!

By the time I've got the rapidly thinning, increasingly curly hair dry, makup on----I am exhausted. I still have to get dressed. By the time I emerge from the bedroom I'm ready for bed....and on days like today, I wonder how I can go on at all.

During this whole time, I have been coughing. If you've read my other posts, you know that this cough is deep, strong...almost violent. It's incapacitating. Talking to someone is incredibly difficult. Practicing the harp or piano--interrupted. There are two significant sequelae: I am hoarse, which also interferes with communication. Second, my chest and abdominal muscles hurt from coughing. The area under my left front ribs which is numb/burning/aching as a result of nerve damage from my pneumonectomy, seems to be especially irritated by the cough.

Finally, the cough just wears me out. On top of everything else, the cough brought me right to the edge of despair today.I felt like plopping myself down in the middle of the aisle at Target and crying.Not one more step, not one more breath.

After this terrible day of exhaustion, you'd think I'd sleep like a baby. No such luck. In spite of the moisturizers, I'm itching. In spite of the Nioxin, my scalp is itching and crawling. My whole body feels like one big itchy mess. At the moment, the cough is there, but less because of the narcotics I took for the side pain. The narcs don't help me to sleep; the itching is too severe.

Benadryl interacts with some of the drugs I'm taking, so that's out as an option to help. So, I got out of bed, came to the couch and computer, armed with my "insomnia" Jelly Bellys to check on Facebook and write here. One by one I pick the jelly beans out of the crystal jelly jar till finally, the jar is empty.

I return to bed relieved to know that it really doesn't matter if I'm exhausted in the morning...no patients to see, nowhere to go....I don't have to function at a high level.

When you are in line at the grocery and the person in line in front of you seems slow, it might be me. Wherever you find yourself among people, remember that their fears, illnesses and struggles may not be visible on the outside.

This is what I love about Christ...love people. Period. Whatever your religion or what your beliefs are, it's never wrong to show grace and kindness to others. I have experienced this so often and it's helped me uncountable times.

So...it goes on.

Frustration

Tonight I am allowing myself to vent some of my frustrations. I've come to terms with the physical changes for the most part...and certainly don't expect not to have any problems.

If you're going to read this, get some cheese to have along with my whine....

I am sick to death of coughing. Not little ladylike throat clearing...I'm talking about coughing like I'm trying to cough up a leg. My side is so sore from coughing...I have a hard time speaking...I finally just sat down and cried today. Boo hoo cry baby.

Can't play the harp very well when I'm having full body coughing fits. Imagine explaining that kind of cough to patients in the clinic. Doesn't exactly engender confidence in one's patients.

After my surgery, the area where my left lung had been filled up with fluid. This is expected and good. My heart, stomach, trachea and esophagus all shifted to the left. The fluid does not hold them in their original places. My sense is that my symptoms are related to this shift. I have developed terrible reflux...so of course I'm going to cough.

If you're a praying person, please pray with me that the cough would resolve so that I can function. If I'm missing something that I need to pay attention to, I'm listening.

September gone...

Where did September go? My favorite month. Lots of memories of Septembers past. I loved school, and I loved starting back to school each year. I love the weather: the beginnig of a crispness to the air as the humidity lessens. The first leaves start to fall.

September has not always been kind ~~

My mother died September 10, 1993. Probably the most traumatic event of my life.

Many of my precious Schipperke loves went to the bridge in September:
IvyRose: September 5, 2002. Oso: 9/14/2005. Obi: 9/20/2007. Israel 9/26/2008.

Other years were not so sad:

David and I got married 9/22/2007 and had a wonderful trip to the Outer Banks.

I took and passed my Adult Nurse Practitioner Cerification Exam 9/15/2005.

Earth, Wind & Fire's recording "September" is one of my favorite songs.

I wrote a decent song titled "September".

This year was a good September. The cooler temperatures gave me more time to spend outside with the boys and enjoy my outdoor recliner.

Three o'clock in the morning....

Coming out of sleep, I open one eye. I am assaulted by the green display of the bedside alarm clock. Three AM. A thought is trying to come to the surface...why is 3AM significant? What? Oh, yes. I should get up and take my Tarceva tablet. Next thought: I just woke up, so I've actually been asleep! Wow!

I ease myself out of the bed, night-vision straining to detect any of three dogs that might be underfoot. There is some light coming in through the blinds. I see that Boo, our 8 year old Schipperke, has left his bed and is laying on his side right in my path. I pad along carefully, so as not to disturb him. Duke, 9 year old GSP is still curled up in his bed, vocalizing ever so softly in his dreams of finding birds. Jack, 4 year old Schipperke, sound asleep in the ball bed. My husband David did not stir when I got out of bed.

I reach the vanity and tap on the lighted mirror. The Tarceva bottle is right there on the counter next to the water glass. My hand closes around the medication bottle and for a moment, I am keenly aware of what it is in my hand. A month's worth of Tarceva costs about $5,000 (yes, five thousand dollars). I am blessed to have excellent insurance: my co-pay: $10. I say a quiet prayer of thanks for that. The cost of the tablet in my hand is a day's pay for a lot of people. This expensive drug is working for me, though. It cost them millions and millions to develop it. I'm so glad they did. Another quiet prayer for the researchers who worked for years until they had a viable drug.

The cold water tastes good. My meds make my mouth dry. I notice how dry the skin on my legs and abdomen feels. My scalp isn't tingling so badly tonight. That keeps me awake quite often. Tarceva side effects. I'm grateful and mindful of living in a time, place and situation that a treatment like this is available to me. Another silent prayer of thanks. I set the glass down on the vanity as quietly as possible and carefully make my way back to bed. The drug is once again in my body, targeting the lung cancer cells wherever they may be. The drug is giving me more time...more "healthy" time, I hope.

I carefully slip back into bed. Boo and Jack didn't move. Duke has settled down, his nocturnal hunt completed. Sleep does not come: instead I consider what it means to my life to have access to this kind of care for this kind of illness. I need to honor this. I look at the clock again; it's nearly 4AM. I trust that the Lord can use cracked pots and broken bodies in His work. I pray my gratitude, thankfulness and at some point fall asleep.....because...

I feel a cold nose pushing on my arm. The mouth belonging to that nose bites down on the sheet and blanket, and with a hard tug, pulls the bed clothes off of me. David is not there. He got up very early. I'm still trying to fend off Jack, when Boo joins in on the bed, voicing his impatience with me with his rough, peculiar bark. Duke shakes himself, his long ears slapping together and on his head with loud smacks.

I struggle out of bed and walk over the retrieve my robe off the hook by the vanity. My eyes come to rest on the Tarceva bottle. I smile slightly, and with another small prayer of gratitude, allow my dogs to herd me out of the bedroom and into my day....

What next? Coming to grips with me as I am...

All in all I think I've done a pretty good job of coping with all the huge changes that have come into my life since April. I am, in many ways, a far different person now than I was then. The emotional and spiritual changes- all positive. The physical changes I am still dealing with.

This next section sounds like I'm whining. Maybe I am. I know there are people with far greater physical infirmities than I have...but I am coping with the hand I've been dealt. No, the Lord is not punishing me. I'm being pushed to change and to grow. I'm supposed to learn from all this. I know I have, but it has not and is not easy.

I'm not the first or only person around who suffers from fatigue; this is an age old problem with many causes. Not surprising in someone who isn't sleeping well.

I'll get it in my head to do something, and try to do it. I tried to do some weeding today. Sounds simple enough. Bending over causes bad reflux problems because of the way my heart, trachea and esophagus have shifted to the left since my surgery. It doesn't take long till I'm out of breath and just resting. The weeds don't care about my heavy breathing, or my coughing. I could do very little, even sitting on a rug scooting along. Simple tasks like laundry must be done in shifts. Do some, rest. Repeat. We've hired a lady to help with the big housecleaning because I just can't do it.

I would love to quit coughing. Not only has it toasted my voice, but it's exhauting. It wears me out. We're not talking about a little ladylike cough, I mean like I'm coughing up my toes. It's embarassing. It has made speaking incredibly difficult and talking on the phone almost impossible. It's a vicious cycle: coughing makes it hard to speak and speaking makes the cough worse. Not a good thing in a medical clinic. It's also made playing the harp in public impossible.

The shortness of breath can be significant. I frequently am very dizzy when I stand up.
I haven't even touched on the side effects of the medications, which are a delightful trip through goober-land on on their own.

Some days I feel like I'm just sitting here using up oxygen. I spent untold hours of study and devotion and the majority of my inheritance on my master's degree / Adult Nurse Practitioner. I've done an extra year's study in hepatology. Now--I'm unable to use that training. I want so desperately to go back to work, but do I have the stamina--emotional and physical? Will I get my voice back / cough control enough to make it possible?

Dear Lord,
You have given me everything and in such abundance, including the means to help people medically. There are physical issues that are preventing me from continuing that, and I'm feeling useless. Heal me enough Father, so that I may continue to serve You, or show me how I should otherwise serve. I don't want to miss your message or plan. I humbly ask this in the name of your precious Son Jesus...Amen

Good news! Tarceva is working! Sharing my story...

This post comes a bit late. I had my follow up CT on 9/20, and shortly after my scan, David and I took off to a cabin in Coshocton County near Roscoe Village. Our getaway had a dual purpose: to prepare ourselves for whatever the result of the scan might be, and also to celebrate our third wedding anniversary on September 22.

When the phone rang on Wednsday morning (coincidentally 9/22) at 7:30AM, we both knew it would be about the scan. My precious CNP colleague working with the medical oncologist called to tell us that the mass in my spleen had decreased in diameter from 3.8cm to 2.7cm. This reflects about a 50% decrease in mass, which is extraordinary.

When I hung up, there was gratefulness and praise to God, but it was not a gleeful kind of happiness. Both of us were prepared for bad news, perhaps I more than David. The good news was tempered with the knowledge that the Tarceva is working --- for now. It is not and never will be a cure; we are buying time.

Time~~time to live, to love my husband and my family, to serve God, to try to make a difference somewhere. Time~~not as I was before: strong, healthy and confident, but changed. Vulnerable, compromised. Not taken out of service, but the nature of my service and ability to serve has changed. I can no longer live my life 500 miles per hour with my hair on fire, consumed by my work, my patients, my pet projects.

Yesterday the medical oncologist told me that among patients on Tarceva, the average time until evidence of disease progression is about 12 months. I will have a CT scan of chest and abdomen about every 2 to 3 months. PET, bone and brain scans are not recommended for serial follow up. Those would be done if I become symptomatic. He has patients who have been on Tarceva for several years...I hope to be able to count myself among them.

I was honored to be asked by my pulmonologist (who originally diagnosed me)to speak to the second year medical students, both as as a patient, but also as a medical professional. Today, we presented my case to about 70 students. They were very attentive, and I was able to press home some points near and dear to me.

First: healthy non-smoker with chronic post-nasal drip / cough. At what point do you suspect cancer? Second: appearances don't tell the whole story. I am a perfect example of someone who looks good, but who is very ill and with substantial decrease in function. Third: level with your patients about your differential diagnosis, even if --especially if--- you don't know for sure. Explain your plan to get answers- tests, referrals, etc. Having a plan in place to get answers is comforting when that is all there is.

The students asked wonderful questions. I gave my contact information to one student who will get it to the group. I hope that I have put a face on lung cancer...that they might follow if they wish to do so.

On the bike

For as long as I can remember I have loved riding my bike. I can still recall in vivid detail the moment that my training wheels came off for the first time in the nice flat driveway of my gradparent's house. My bike meant fun, transportation, and freedom.
It got serious about age 13 when I started doing long distance rides with the local American Youth Hostels group (now Columbus Outdoor Pursuits). I would pore over Ohio county maps, looking for what might be interesting routes.

In short, since that time, getting out into the countryside on my bike has always been important to me not only physically, but emotionally, spiritually and psychologically as well. Any of you who knew the situation with me and my ex-husband know that I would never have survived the years 1998-2004 were it not for my bicycle...taking me to the roads that called to me to ponder, think and pray.

More recently, my husband took up cycling the year before we got married (2006). He has become a firm addict/afficionado. We love watching bike racing on TV, especially the Tour de France.In early 2008 we bought a Burley Rumba tandem. The way riding a randem is an analogy for marriage is a topic for another piece. Suffice it to say for now, we LOVE riding the tandem.

We can actually hear one another better on the tandem than when we are riding our single bikes side by side. Maybe he likes it because he can request a back-scratch any time he feels like it. Best of all, we can share the beauty of the countryside together: the gold to brown change of the soybeans as they approach harvest, the corn tassles, the freshly turned fields, an amazing variety of cloud formations and sunsets. We also have a game called "Roadkill Identification", but I'll omit those details here.

After thinking "Am I going to die soon?", "Will I ever be able to ride (a bicycle) again?" was my second concern after the doctors told me my left lung needed to be removed. There I was, the healthiest person they had ever seen with lung cancer. A non-smoker, no health issues other than some pretty impressive allergies....

For weeks after surgery the pain was considerable. Now, 12 weeks out, breathing is still an issue-- as is yawning and sighing....those things are not satisfying with only one lung. I'm feeling somewhat stronger and not quite as depressed by the limitations imposed by my physical changes.

I have prayed and prayed about riding again. A week or so ago, David and I went out on the tandem for a 3 mile ride. I was encouraged. Tonight, I prayed. The weather was a cool upper 60s, a light wind from the SW. I got my bright red Cannondale R600
down from where it hung from the garage ceiling. I felt excitement and dismay at the same time. Could I ride? Could I be satisfied with going 7 mph if need be, just to keep going?

Pre-ride checks done. Helmet, gloves, sunglasses on. Trip meter zeroed out. Water bottle iced and full. Inhaler and cell phone in back pocket. Driver's license and keys in handlebar bag. I walked the bike to the end of our gravel driveway and set her gently on the street.

Right leg over, clipped in. Deep breath...push off and up the street I went. Find the right gear. Easy spin up the long gentle incline that is Walnut Street. Not feeling any more winded than usual...so far so good.

As I went farther toward the edge of town, I could feel the breathing become much harder. The cough that has hounded me for months joined the party. I coughed and coughed the entire ride, inhaler not withstanding. When it would be bad, I'd slow down to barely more than a crawl, practically doing a track stand.

I constantly evaluated my breathing and exertion, bearing the cough in mind...and shifted gears accordingly. Once out of town, I was ecstatic that I had made the effort. Early fall in our part of central Ohio is lovely. Two minutes away from the house, I was in farmland. Most of the soybeans were a warm gold color...the last days before they go to brown. I visited with a group of 4 or 5 German Shorthaired Pointers (like our Duke) who live along the route. Repeatedly, I would slow down to a crawl to catch my breath....so I could go on...and go on I did. I stopped when traffic dictated, but otherwise really kept moving, albeit at a snail's pace.

This was not a ride about speed. It was a ride about "Can I even do this?". Yes, I can. I will not be able to ride like I did before, but so what? I can imagine other riders thinking, "What's up with that gal who's all decked out for riding, with the hot bike who's such a slow poke? Dag!" I don't care..yes I do. The prideful part of me wants to have a jersey that says on the back: "I only have one lung--but I'm riding!"

I don't know what the CT scheduled for September 20 will show. If the Tarceva isn't working and I have to go on an aggressive chemo cocktail, that will tear me back down again. If it's working, then I continue the path I'm on and continue to pursue the bike. My cough is a bit worse today...I challenged my respiratory system.

I was out there. I did it. I can do it again and each time will get better.

Cancer journey continues....

Yesterday saw lung medical oncology NP and the breast medical oncologist. My lung CT will be rescheduled so that I will have been on the Tarceva a full 8 weeks before the scan. That will give the best chance to show if it's working.Now it's scheduled for 9/20/10.

In the meantime, Dr S wants me to start tamoxifen now. I just took the first one. He's hoping it will control the breast cancer and surgery may not be necessary. I'm getting a baseline breast ultrasound Monday...will follow up in a few months.

See, in order to do any surgery, I'd have to go off the Tarceva for a week or so at least. It would greatly interfere with healing. The lung cancer is by far and away more life threatening....so no going off the Tarceva -- unless we find out it's not working..

If it's not working, I'll have to have some very tough chemo. Everyone is really focused on the lung cancer. Every friend who knows my diagnosis thinks I'll be around a long time and will kick it.

I choose to believe that. The Tarceva patient information provideed by by the manufacturer states in large letters that patients on Tarceva live 12 months instead of 11 months. Oh goody!! I'm going for 24, 36, 60 months. None of this 12 months crap. (Excuse me!)

So, I'll see how the tamoxifen hits me....more hot flashes, mood swings. OK. Maybe not!!!It's down the hatch!!

Insomnia

Side effect centrral here tonight. Can't sleep. Can't get comfortable. Even the dogs are sound asleep: Duke's occasional snore, David's deep quiet breathing, Boo laying tinkie-up, totally out. Jack is curled up in a little ball. They did not stir when I got out of bed and left the bedroom.

There must be hundreds of other people out there tonight who are in the same position I'm in: awake and wondering if the medication is working. At least the cough has calmed down since I took some meds; it was getting fierce and I was getting worried.

I pray for the people who aren't blessed with the wonderful support that I am: my husband, my family, friends, co-workers...is there someone out there tonight who feels really alone and is facing cancer with little or no support? David and I are having every need met, and more. Makes my little bout of insomnia seem rather insignificant.

I'm finally feeling a bit sleepy~~so with a thankful heart for all I do have, I'll take my one-lunged self back to bed...

A quiet afternoon of introspection

Finally a nice, not so humid day to sit outside with Jack, Duke and Boo. It's been a triple crown of side effects from the Tarceva today, so I'm not feeling so great. That being said, I have felt much worse...and am able to enjoy the yard, the wildlife and the antics of my boys as they also enjoy the wildlife!

I've had a few days where, relatively speaking, I felt almost "normal"...psychologically anyway. I've made a clear and deliberate decision to LIVE WITH cancer, and not let cancer pull me down. I can almost forget about being a "cancer patient" who has metastatic disease. The days when the side effects are bad and I'm feeling so very fatigued remind me. That's ok. It's still about living within the strength and capabilities I DO have.


I guess when we're confronted with our mortality, we become more introspective and look at how we've lived to now. I remember the horrific crap (excuse me) that went on when my mother died, and then when my father died....all about estates, land and money.
I'm as guilty of greed as the next one. But no amount of money and no amount of property could change my diagnosis or extend my life by one moment.

I'd like to believe that over the last years my attitutde has changed substantially. I spent my inheritance to get my master's and support me and my (now-deceased) ex until the time was right to send him back to Germany. I have interest in some farm land, but that's all that's left of the pile of money/inheritance that caused so much angst and anger in my family. What was left I've happily given to our church, given away to people or situations that are in a far tougher spot than I am.

It comes, it goes. That money was never mine to begin with. My great-grandparents and grandparents had scrimped and saved for years. My great grandmother and my grandmother would tie shoelaces together when one broke instead of getting a new one. Shoes were repaired, resoled, polished and worn.

I admit there was a time when I was flippant and arrogant about that money....money that was never mine to begin with. I did nothing to earn it, yet I felt entitled to it. I am so ashamed of this.

In going back to school to become a nurse practitioner, I hope I've done something positive with it. I hope that I have helped some patients cope better with their illness, offered some comfort to those in need, and educated patients and staff to the best of my ability when needed about liver disease. The Lord placed a calling on my heart to go into hepatology. I sincerely wish that my condition will allow me to return to this sometime soon.

It wasn't money that held my hand after surgery when the pain was so bad I just wanted to die. It's not money that sends me notes of encouragement and little gifts just for fun. It isn't money that plots a creative scheme to surprise me with all sorts of fun and wonderful things. It isn't money that comes to the house and sits and visits with me on Fridday afternoons... who explores the implications of a life-changing and life-threatening chronic illness. It was my husband, my co-workers,my family, my friends here in Ohio and those scattered all over the country. It'a about RELATIONSHIPS.

Money - necessary to live. Unfortunately, the cause of much bad feeling between people for myriad reasons. I want no money issues in relationships because it always causes problems, real or imagined, in someone's mind. The dollar signs hang there in the air and foul relationships in which one person feels slighted, or in a position of "less power".

What brings me joy? Worshiping the Lord in Spirit and Truth. Holding my husband's hand, listening to my stepson play his guitar, watching the silly antics of my dogs, marveling at the wonder of Creation: the complexity and sheer beauty of it all. Esspresso Chip frozen custard from Whit's. Hanging out with David's Mom and Dad. My many friends, near and far, old and new. Family. Giving secret, anonymous gifts. The sounds in my backyard: three sets of windchime, birdsongs, cicadas, distant traffic sounds. A cold nose bumping my arm off the keyboard---"Pet me, Mom!". Seeing my 37 year-old nephew and his wife for the first time in 5 years. (He's Navy, submariner, formerly posted out in WA).

I've been thinking about the good times with my family of origin. The independence that my mother taught me and modeled in spite of her alcoholism. The love of and respect for nature gained during many camping trips, hikes, etc. Both mom and dad nurtured my love for music. Mom got me interested in medicine. She was a surgical nurse in the early 1940s. When my first dog Yauni (Norwegian Elkhound) was spayed, mom brought home her uterus and we dissected it together. It was fascinating and something I'll never forget. How many moms do you know who would do that with their kid? And this was in about 1970.

My dad and I shared a similar physical reaction to beautiful opera music: goosebumps. From my dad I gained a love of the mechanical, especially engines and fast cars. I remember the two of us wrenching on my 1973 Mazda RX-3 with the Wankel rotary engine in it. From a very young age, Daddy taught me about astronomy. I'd sit on his lap and we'd go through the big "Golden Book of Astronomy". When I was a bit older--probably around 6 or 7, he bought a pretty decent telescope. We spent hours looking at the moon, Mars, Jupiter and it's moons ( we could only see 4), Saturn and its rings....nebulae...you name it. He even got a sun filter so we could see the sun. I've seen solar and lunar eclipses. In short---when Daddy shared his sense of wonder with me, I caught it and kept it. I think of him every time I look into the night sky.

My sister had the dubious honor of "raising" me~~Mom waited until she was almost nine years old before having me. Built in babysitter. And what wonderful gifts my sister gave me! I learned to read at an extremely early age. Entering first grade I had read ALL of the Laura Ingall's Wilder Little House books. That gave me an extraordinary advantage in school. She was my first piano teacher. We played several duets: O Solo Mio, and others I can no longer name.

Candy Land was my favorite game. I really believed that it existed. My sister created a Candy Land for me in a large walk in closet in our Cincinnati home. She carried me piggyback, told me to keep my eyes closed....and voila! It was remarkable.

There's a board game of sorts called "Puff Pool" that involves using your syringe - squiting air to protect a small cup in from of your syringe from getting in the cup. I had serious bladder control issues...age 5 or 6 playing this as home.

When we moved to Worthington, OH, our housing development was still under construction. We'd walk down to the banks of the Olentangy river, and sit on a large branch that hung way out over the water. We'd do Mad Libs--and laugh until we cried....or until I wet my pants, which was the usual scenario.

We swam together, canoed together, camped and hiked together. I remember one particular Christmas Eve night when we were living in Cincinnati. I must have been 4 or 5 years old. That night I slept upstairs in with Marti in her room. Lights out---several minutes passed, then --- a clicking sound like hooves....surely the sound was the reindeer on the roof!! (Marti had been tapping her fingers on the headboard!) She was hard put to it to keep me in the bedroom!


My sister was my advocate and protector before I knew I needed one, before I understood my mother's alcoholism. She taught me to dance in my bedroom one night to "Jumpin' Jack Flash". She taught me the dance "The Riot"-- to Creedence's "Heard It Through The Grapevine". Many, many years later she came to the house when I called her: my ex had used brackets and screw to secure the door to his basement room closed...and was drunk. I had to call the cops and the fire department....they had to tear the door down. She was also there when I graduated with my master's degree and won the OSU College of Nursing's award for Outstanding Nurse Practitioner Student and the Dean's Leadership award.

What a different person I would be if Marti had not been in my life?
Unimaginable. Our best times had nothing to do with money. Our worst times: yes. Money had nothing to do with those experiences --- and love had EVERYTHING to do with them--Marti, Mom and Dad.

Being diagnosed with a life-limiting illness has caused me to take a hard look at where I expend my energy and what is really important. I want my legacy to be found in the hearts of my family, my students, my friends and my patients. Love is the only thing that lasts.

Love in a Box

I mentioned my Schipperke family on Facebook in my last post Wednesday July 28. This may be the most loving, selfless and caring bunch of people on the planet. It should also be noted that there are a couple of people in our "group" who don't have Schipperkes. One of the friends is a lovely young woman in California who has a precocious chihuahua who we had made an "honorary" Schipperke. We also got together and collected funds to help this precious lady and her husband get a Schip.

David's mom called today and said that Dad had gone to the post office and picked up a very large box addressed to me in care of my in-laws. Huh? She spelled the name and said the return address....and I knew it was from one of my Schipperke mom friends.

I was NOT feeling good today. Upset stomach, dizzy, etc.etc,... I just wasn't feeling well. We went over to Mom and Dad's house. I was astonished by the size of the box.

Opening this box and discovering its contents was one of the top 3 memorable times of my life. I have never personally experienced such an outpouring of love and support. Tears of joy started and flowed freely as I carefully examined each of the little treasures, thoughtfully chosen for me.... in a basket... in the box.

But there was more in the box. I removed the colorful tissue paper that basket had been on, and -----whoa----there was a quilt.

Not just any quilt. These amazing women had collaborated on this amazing quilt project. Each friend had provided one or more squares for the quilt. Some of the squares were photos of them and their dog(s), transferred to the cloth. Some were comments, encouraging thoughts. Some squares were decorative. One of the women took on the formidable task of sewing all the squares together and physically creating the quilt.

I was so stunned and overcome with emotion as I examined each square of the quilt. David filmed the whole box-opening process while Dad watched from the sofa and Mom was there with me on the floor. These precious women --from all over the USA, and the world--- had been plotting this---with David's knowlege since the time of my surgery.

Another example of God's perfect timing. Back in June when I had the pneumonectomy surgery, we were still talking about a CURE for the lung cancer....and probably also for the breast cancer cause it's so early. Shortly before the quilt arrived, new CT and PET scans showed that I have metastasis to the spleen and possibly the left scapula. These findings took me from a potentially "curable" stage IIIa to a Stage IV---where all we can really hope for is some kind of remission.

A lymph node is now lighting up in my left axilla (armpit) that had not lit up before. So...things had become more complicated since my surgery, and the prognosis much worse.

So, when the quilt arrived, I was still trying to get my head wrapped around that. The love and care that went into the making of that quilt just boggles my mind. I am so humbled that these friends care enough about me to do something so wonderful.

The quilt has a place of honor in our living room. It's hanging from special wooden clamps attached to the wall. I can easily remove it at any time---and just wrap myself up in it when I feel sick---or am feeling blue and need a boost.

I am so blessed to have so MANY people pulling for me. All my colleagues at work, my church family, my family, my husband, my Facebook family. I can just imagine everyone in my mind...around me, walking with me into the unknown. The Lord has blessed me with these companions for my journey. I pray that He will use this experience to bless them. They are walking with me -- as I follow Him---

"Where He leads me, I will follow...". We can enjoy the journey as we consider the joy of love and friendship, hope and faith.

Tarceva journey begins...

This post may be disturbing--just a warning up front. Tonight, I start taking Tarceva, the tyrosine-kinase inhibitor that we hope will get my metastatic lung cancer into remission. I'm praying that 1.)I can tolerate the side effects, 2.) it works, and 3.) they see a result soon....so the surgeon can go after my breast cancer.

I've given a lot of thought to my faith, my life and living and dying over the last few weeks. I've done a lot of soul searching in terms facing death within the next year --five years, maybe longer if I'm VERY lucky.

One guarantee that we all have in life is that we will one day die a physical death. How, when...not for us to know or decide. One "fear" I've always had was becoming old, infirm and having to go in a nursing home. Dementia. Alzheimers. This fear flies in the face of Scripture---where it states "Fear not", "Do not be afraid"....dozens of times in several different wordings.

So...the bottom line is again, trusting the Lord to meet my needs, and to give me experiences that will make me more into the person He wants me to be. Cancer is part of that plan. It's an in-my-face call to evaluate my life.

I am blessed to have so many wonderful people pulling for me and praying for me....dozens of them I have never met face to face. Some of them are in the midst of their own personal crisis---health or otherwise---but they still have reached out to me to offer words of love and encouragement. I've gotten Facebook posts of fellow Schipperke lovers that moved me to tears. The love of the Lord coming through His people...

Getting metastatic lung cancer and breast cancer at the same time is not what I had in mind for this time in my life. I had actually planned on returning to school for my doctorate. Frankly, pursuing a doctorate at this age would be narcissistic over-indulgence. Did I take my body for granted? I've always been active and healthy --- and now my physical abilities are greatly changed, reduced. It is with a new paradigm of my physical self that I approach this medical regimen.

I'm excited to attack this chapter of life. Yes--many things have changed and will continue to do so. Having cancer doesn't mean that I am going to die tomorrow. I have cancer...but I am NOT cancer. I live with cancer, but it isn't going to define who I am. The cancer cells hanging out in my body are no more ME than the cellulite on my legs.

I have been blessed with a wonderful husband and new life after years in a miserable, loveless marriage. In David I found someone who really understands what makes me tick, someone I love to do things with, go places with, talk with, pray with; I have a new family. I have been blessed with more in the last 3 years than I could ever have hoped for.

This is not just my journey, but also David's. He his a man of incredible strength and faith. He believes that the Lord is using this to do many things in our lives and in the lives of others. He believes he is the one meant to go through this with me. (Thank you Lord!) I asked the doctor if she thought I'd have a year left to live. I did NOT ask "How long have I got?". She's hopeful that I will be one of the people who go into remission. The breast cancer is a wild card. David and I have things to do!

I am left with the choice of how I will live day to day from here on out. I must look for joy and happiness every day. I must choose to be happy in spite of the changes. If I only have 13 or 60 months left to live, do I want to spend them depressed and miserable? Heck no!

I know that I will have boo-hoo moments, and depending on the side effects, may struggle. My life will never be what it was before. Period. The challenge is to find a new "normal" and live within that. I pray all the time that I get the lesson/message that the Lord wants me to. How can I / we use this for Him?

It's almost time to take the pill. "One hour before or two hours after eating." I join the ranks of several fellow Stage IV NSCLC patients taking Tarceva who I have "met" on the Inspire website support group. There are so many people there who generously share their experiences and encouragment with others who seek insight, reassurance and hope. I thank them.

Lord-- I would really rather not have to go through this --- but not my will, but Your will be done!

First dog: Yauni

Autumn 1967; I was eight. My mom decided that it was time to get a dog. She had a dog on her grandparent's farm as a child, and had had a Samoyed named "Snuffy" during the early 1950s when living in Wisconsin. My dad had also had dogs as a child: a Great Dane named "Baron" and a little terrier mix named "Max".

Mom had trained and showed Snuffy in obedience and confirmation. I believe he completed his CD-X and was working on his Utility Dog when died unexpectedly. Mom said she believed that a "difficult" neighbor poisoned him. Mom was pretty knowledgable about dogs and had been giving a lot of thought to what breed she wanted to get. Dad left all that up to her...he was just excited to have a dog again.

Mom and I looked through the AKC Dog Book and went to several dog shows trying to narrow down the list of possibilities. We looked at Shelties, Huskies, American Eskimos....etc. Mom was interested in a "northern" breed of dog, as they seem to have less "doggy odor".

We went to visit a breeder who had Norwegian Elkhounds. Bea Cox and her son Bill had been breeding and showing Elkhounds for years. Our visit that day to Hickory Hollow Kennels was to give us an opportunity to get to know Elkhounds. Bea did not have a litter at the time. She had bred her NE male "Buffy", and had just received her pick-of-the-litter puppy.

After visiting with Buffy for a few moments, I spotted a small, grey mass of fur in the grass...it was the POL puppy...a female. It was instant love. Long story short: we took that puppy home. She was a sleepy girl, so we named her Yauni, short for Yauna av Engelman.

My Grandma (mom's mom) was adament about not liking dogs. She was totally against us getting a dog. Thanksgiving Day 1967 Grandma and Grandpa came over for dinner. She took one look at Yauni, and it was love at first sight for her, too.

Yauni and I were inseperable. She slept in my room and tolerated being dressed up in whatever I could find. The summmer of 1968 I went to a 2 week residence Girl Scout camp, and I thought I would just die for missing my girl.

Mom and I took Yauni to obedience school and started showing her. We won several junior showmanship ribbons. Mom showed her in the obedience ring, but I often showed in the confirmation ring. She got her CD title, but we never finished her confirmation title.

We had some interesting neighbors who found it scandalous that I was out chasing Yauni with a small frying pan trying to collect a urine sample. They were traumatized, however when they saw me helping with the actual breeding process. It was all very matter-of-fact for me...and my mom was a nurse. I didn't hear the conversation, but I'm sure that my mom let the neighbors know there was nothing to be concerned about.

I'll never forget when Yauni had her puppies. What a wonderful experience for me! Mom and I trained her, showed her in confimation and obedience. I showed her in Junior Showmanship. One of the puppies was returned to us when the family had to move unexpectedly. So, Cato joined us in traininag and shows. It all was a wonderful learning experience for me.

Cato died in 1978. He was 10. I remember the evening before his abdominal surgery, he and I spent cuddling on the living room floor. He couldn't get comfortable. He knew, and I knew. The next day, I called Mom from the student union: they opened him up and cancer was everywhere in his abdomen. They went ahead and put him down. I wandered around campus crying; I had never lost a pet before. I was devastated. Remember, I was present when he was born.

Yauni died in 1982 while I was on the road with the band. We were in Jamestown, NY, hometown of Lucille Ball. Yauni was almost 15. I was getting ready to leave the hotel room and go downstairs to the bar when the phone rang. It was my Dad. He told me about Yauni's passing. Eleven years later, Daddy would make another phone call to tell me that my mom had passed.

It was very difficult for me to go on that night. Yauni had been my best friend for years and years....and I was and had been far away from her for a long time. I still have some of her fur that Mom clipped off her.

Our childhood pets teach us so much about life, love, loyalty, responsibility, illness, death...a microcosim of life experiences. Yauni Paws-- play happily at the Rainbow Bridge until I can join you and all our other 4-legged loved ones....

My meltdown: what Jack, Duke and David did

I had a meltdown yesterday (Sunday July 4th), that lasted almost the whole day. I'm not proud of it; most of the time I've been fine since this whole thing with the cancer started. Yesterday was a shining example of a 51 year-old woman transformed into a cranky 3 year-old having a temper tantrum. Stamp the foot..."I don't want to be sick!!!!My whole life is xxxxed up!I don't want to be sick!!!" ....and so on.

Mixture of fatigue, not feeling well, menopause with a little depression thrown in? I make no excuses. It is somewhat shameful considering my great faith and the great support I've received from every corner of my life.

Anyone who has lived intimately with dogs understands the special relationship and unique communication that occurs between human and canine. What Jack and Duke did yesterday was extraordinary...and in 43 years of living with dogs, was something I had never experienced.

I was upset, in the shower crying. Got out, sat on the stool at the vanity. Sobbing with one lung is different than sobbing with two lungs. Sounds odd, but you'll have to take my word for it. Breathing effectively with one lung while sobbing is impossible.

The sounds I was making as I tried to get a breath were...disturbing, even to me, the sobber...a gasping, honking sort of sound. I was afraid I would pass out. I felt Duke's cold nose nudge my right arm and hip. Jack, standing beside him, barked sharply at me, once, twice, three times. He jumped and nipped firmly at my right arm, then barked again. Duke kept his head on my right thigh.

My utter astonishment at the dog's actions short circuited my sobbing jag. I was able to catch my breath and slow it down. As my breathing changed, Jack sat down, ears up, watching me intently, expectantly. "I'm OK boys, Mommy's OK. It's OK." The ears went back, and he jumped up to place his front feet on my right leg, rear end wagging. Duke lifted his head and gave me a sloppy, wet Pointer kiss.

Once I was "fine", their whole demeanor changed from one of concern and worry back to "happy as usual" morning ritual mode. This is not a dramatic case of saving someone's life, but Jack and Duke knew things weren't right with me, and they intervened. Wow.

My blessed husband had the most incredible insight later that afternoon. He realized that I had "stuff" that had to come out, and that I needed someone to push against to facilitate getting the job done. He sensed my anger. He knew that he was the one, the only one with the knowledge of me and my situation who had the authority and position to do it.

Anger is never pretty. It's all about not getting what we want, getting our way. I DO believe that the Lord is in charge, and that he has and will always work all things together for my good. But it's not about me getting my way...it's about His will for my life and dying to self. But as Christ prayed in the Garden of Gethsemene on the night he was betrayed, he said " My Father, if it is possible, take this cup from me....but not my will, but Yours be done." I am not angry with God, if that makes any sense.

I'm ashamed of my meltdown. I could not steer it. So I can only apologize to David, and vow to learn from it. We are emotional creatures, and emotion and intellect will get out of balance. I'm grieving, period. My prayer is that as I continue to grieve and come to terms with the physical changes associated with my illness, that I will do so graciously.

A courageous friend helps me

My best friend has MS. She was diagnosed in 1999 when her hands stopped working properly. This diagnosis presented problems, because she was a hairdresser: had her own chic salon, was an educator for several product lines, all around tops in her field. Long story short: she had to close her salon, move in with her sister and try to create a new life.

That was a very difficult time for her, and the subsequent years were
(are) very challenging. Loss of function, loss of endurance, loss of mobility, loss of dexterity, waves of severe fatigue...the symptom list is endless and ever changing. MS is a moving target... it changes its attack over time. Can you imagine the depression of coping with all those changes? She struggled, but never, ever lost her sense of humor.

As her friend, I did what I could. We eventually referred to her disabled parking permit as the "princess parking permit": we could park closer to the stores. Her wheelchair provided myriad opportunities to hang shopping bags when the shopping trips got serious. She went back for vocational training and started her own travel agency specializing in travel for clients with mobility issues. She is an expert on those motorized carts in the grocery stores, and navigates crowded stores with confidence. Her struggle and resilience were amazing and humbling to see.

Fast forward 11 years. Tables turn. I am the one who's struggling now. She's the one who understands what it means to have your life turn on a dime and change into something that you don't recognize. She knows what is means to be strong, healthy and active -- only to have that disappear.

Kristi is teaching me that it's OK to be sick, that it's OK that I'm not the strong one now. She understands what it's like to drive a scooter in the store -- as a relatively young person who normally wouldn't need one--- and have people look at you with pity. To feel you're pathetic in the eyes of the world. She understands what it's like to appear healthy and normal, but be so desperately fatigued, you don't know if you can go on one more minute...

Energy conservation. This is something that I have spoken about in generalities with my own patients for years. Now it is the reality for me. Kristi has become an expert in task analysis for this purpose. Living it changes everything.

What a gift that I have this wonderful friend in my life -- who I've known for 30 years -- who is willing walk through this with me, drawing on her own experiences to offer hope and encouragement to me!

I've only been down for about a month. I've lost a lung, and still have chemo ahead of me... then I have a breast surgery and chemo coming. Who knows what I'll have left after all this in terms of functionality? My body does not define who I am. Losing a lung hasn't changed who I am or what I believe in. If losing a breast is going to save my life, so be it. I am not my breasts.

The Lord has a purpose and a lesson in all this for me... I must keep my head and heart open for it.

Schipperke Jack comes home: companion for this journey

This is the first in what is likely to be a large group of musings about a subject very dear to my heart: dogs...in particular Schipperkes. I've had at least one of these wonderful dogs in my life since June 1984. The posts will not be in any chronological order... but I'll share things as they come to mind.

Jack is our current Schipperke. We adopted him from Ohio Schipperke Rescue on November 21, 2008. That adoption almost didn't take place.

Our last Schipperke female, Israel, had to be put to sleep on September 26, 2008 at the age of 12. I was devastated. She was the last in a long line of Schipperkes from the Kingfisher line that I'd had since 1996. I love Duke, our German Shorthaired Pointer, but I am a Schipperke lover to the core. There's just not another breed of dog that speaks to my spirit and heart like a Schip.

I had been watching the adoption websites for some time. I had wanted to get another Schip before Israel became ill. Our Ohio Schip rescue was empty at the time. I kept searching and found a wonderful rescue organization in Iowa called "Fluffy Butts Rescue Resort". FB had a Schipperke male named "Edgar". His photo just broke my heart. Long story short, 2 weeks after Israel died, we drove to Iowa to adopt Edgar.

Edgar was a beautiful boy, very shy, almost feral in behavior. We had him three weeks when he ran out the door on Beggars Night---never to be seen again. He was microchipped, had on ID -- everything-- but in spite of every effort to locate him, he has never been found.

I was again devastated. I felt sad and guilty about Edgar, and was again without that special Schipperke "something" in my life. The head of Ohio Schipperke Rescue (OSR) had been helping with the search for Edgar, so knew our situation. She asked if we'd be willing to provide a foster home for a 2 year old Schip male named "Jack". We drove to Ashville Nov 21 to meet Jack.

After 2 seconds with Jack, I was in love with him. My husband David could see that this wasn't going to be a foster situation, we simply adopted Jack that day.

Dr Q. of OSR said that Jack and a female schip had been left, tied up outside a no-kill shelter. She had received a phone call from a man a few weeks before that who said that he had 2 Schipperkes he was having to give up.

The female had already been adopted. Even then, my heart just ached for the people who had to give these dogs up. From the very start, Jack was a very loving little dog. A little shy, a little fearful, but with a beautiful heart and spirit.

Duke and Jack hit it off beautifully. Unlike Israel and Obi who were quite elderly when Duke got to know them, Jack is a young dog, full of energy and playfulness. Jack has really brought out the puppy in Duke -- who isn't young himself---he's almost 10. The two of them are a riot to watch, especially when 70-pound Duke imitates the play bow/ behavior of 16 pound Jack.

Schipperkes do a funny thing a Facebook friend of mine calls the "rippy romps". They like to run, jump, spin around, tear around at top speed from one end of the house to the other. Jack has taught Duke the rippy romps, an it's hysterical. They are best of friends. Having Jack as a companion has been wonderful for Duke.

As Schipperkes go, Jack is very typical of the breed. Curious, active, always looking for something to do, and very playful. He's very, very smart. He can be stubborn and willful, but is always so cute when being that way. His confirmation is good, but whoever docked his tail did it incorrectly. It's too long, and there's one area of about 10 hairs that are longer than the rest. It gives his rear an odd appearance, but a distinctive one. The tail says that he was not bred by a true Schip lover /breeder---who would have seen to it that the docking was done correctly. He's probably a puppy mill dog who was purchased at a pet store...but he is a Schipperke, through and through. I love him dearly.

In all the toughest times of my life, I've had the Lord and at least one fine dog to walk with me. I've never had any serious health issues until this year, 2010. Being diagnosed with both lung and breast cancer was something that totally surprised David and me, and set our world spinning. Jack and Duke are the dogs for this journey. The provide us both with unconditional love --- and exellent antics and entertainment to lift our spirits.

Since coming home from the hospital, Jack has been my shadow. When I'm on the recliner, he'll come up for some cuddle and a nap, or cuddle and then go off to chew a toy. If he's not with me on the chair, when he hears me put the footrest down to get up, he's at my side in a flash. He will then stay with me while I walk to the kitchen or the bathroom... right with me until I'm back in the chair. At night, he sleeps in his own bed next to Duke. If I get up in the night, he gets up with me, follows me, and only goes back to his bed once I am back in mine.

He seems to know that I am not feeling well, and that his presence gives me comfort. He just sits with me and waits. He doesn't push for petting or attention (as he might at other times). He's still and patient as he watches me. He watches and waits. When I'm settled in again, breathing quietly, he'll go off to play or nap...always listening for the sound of me moving, his cue to return.

What a wonderful little fella. He's brought a special happy, loving energy to our home. He's brought joy and playfulness to an older dog who was an "only" dog for years. When I think of the people who had to give him up, I just pray that they know that he is in a home with people who love him and cherish him. Bless them for taking him to a no-kill shelter. I pray that someday their circumstances will allow them the joy of having a dog like Jack again.

Three weeks post op: Pneumopenic Peg - thoughts on pain

The last three weeks are a blur. After getting discharged on June 12, I landed back in the hospital on June 15 with terrible /terrifying pain. I'm no wuss--this was really bad. They got me squared around on a new medication regimen and discharged me 2 days later.

The whole subject of pain and pain management is a tricky one in medical circles. I have seen my fair share of drug-seekers, putting on performances worthy of an Oscar trying to get a script for narcs. I have seen people in real pain, too. I see people everyday who probably do have some legitimate discomfort, who just accept it as part of life. Then there are those that believe that they should be completely pain free, all of the time.

June 15 I was in real pain: it hurt just to breathe. I couldn't get comfortable in any position- sitting, standing or lying down. The waves of pain came, causing me to cry and cry out. It was excruciating. I squeezed my poor husband's hand with a death grip, trying to connect with him and get away from my body. It was terrible. My blood pressure was 170 -180 over 100s.

They eventually got things under control, changed some meds, and I've been able to manage the pain adequately at home with oral meds. This pain experience was nothing like anything else I've ever known. Pain is a very personal and subjective experience, and we as health care providers are not to judge a patient when he/she complains of pain.

Legitimate pain needs to be managed and controlled to the best of our ability. This does not mean the patietnt will be entirely free all pain. When confronted with a drug seeker, we must be even more aggressive in leading those patients to chemical dependency programs.

The medications I'm taking right now have a terrible reputation in the news media as drugs of abuse. They are effective drugs for serious pain, that must be prescribed and taken with utmost respect. I personally will be glad to get off of them because the side effects are unpleasant.

This is another valuable lesson I've learned: what severe physical pain is. Luckily, I've gotten good care and good control, and the severest of the pain did not last a long time. A lesson from the university of life: to make me a better clinician, more compassionate care provider and human being.

Second Saturday

Two dear young friends of ours got married today up in Fredricktown. There was no way I could have gone. I've gotten several texts about how nice it was. We wish them well -- wholeheartedly.
Still struggling to find a balance between pain that I can tolerate and pain that brings tears and an inability to breathe. It's too hot and humid for me to go outside for more than 5 minutes.
I've been shopping online for a laptop weighing about 5 pounds that I can easily handle. This big one is heavy and hard to hold in any and every position.

I really want to take this time to write all those short stories I've been sitting on all these years. With any luck I'll be able to start this week.

First full day home after surgery (or thank God for pain meds)

Sunday June 13, 2010. Started out OK. I had more sleep on our old Value-City 1996 era recliner than I did in the hospital. Sleeping on any form of plastic, with just a thin sheet between your skin and the plastic, has NEVER been a good combination for nocturnal comfort. The mattress AND the pillows. All plastic. Enough to make Nanuk of the North sweat in his sleep. So, imnagine further with me now: a typically too-warm hospital room, outfitted thusly, bring in a very perimenopausal 51 year old female...amd you have all the ingredients present for quite a spectactular meltdown, if not all-out spontaneous combustion.

So-- at least here at home, lots of cotton, a fan, airconditioning and the opportunity to remove clothing as needed without worrying about hourly or bi-hourly visits from myriad staff members checking vitals. Here at home I can stand up and walk to the bathroon without most of the bedding stuck to my behind, trailing like the finest wedding couture. Oh, my.

The pain meds are something else. Oh, I suppose they work well enough...but I don't understand that there are people who take this stuff for "fun"! It makes me very sleepy and slightley incoherent. I'm nodding off now. So much for being bored and wanting to read. I'm not able to stay alert enough to read for very long.

I still have episodes of excruciating pain in spite of all the pain meds. Gives me a whole new perspective on the patient with legitimate pain issues.....and also on those who are just trying to get these drugs for "fun". Head nodding. Will continue soon.

No problems, only new adventures...

May 2010 just wasn't a great month for me. I went from being a happy, healthy (albeit a bit overweight), active 51 year old woman to being a cancer patient. And not just one, but two different cancers...in different places....but at the same time. Lung cancer, left lung. Workup for lung surgery showed breast cancer --also left side.

Not all my blog posts will be this serious. I've got some fun and some serious stories I'd like to share. These next few weeks I will finally have time to write them down.

The morning of Friday April 30, the day of the chest x-ray that started all this, I behaved badly. Hubby David has so much more vacation time stored up than I do...I was feeling jealous. I was feeling overwhelmed at work. My right arm had been hurting for months David was getting in all this time on the bike, and I wasn't. He'd had some really good rides, some real distances and was rightfully proud of it and excited about riding. I said some not-so-nice things to him that morning.

Did the chest x-ray after getting to work, then saw my patients. Later that afternoon, I read the x-ray report: a 3.5cm mass in the left lung. Suddenly, my pettiness of that morning seemed pathetically out of place.

May was a whirlwind of tests, imaging, biopsies, bronchoscopies and doctor appointments. Tomorrow, I go in for surgery to remove part of, if not all of my left lung. Kinda makes missing a few bike rides seem like nothing to worry about.

I've been griping and moaning for months about not having any time to really read a book...or write anything. I read 2 pages at night and I'm asleep. After this surgery, I have to be off work for 4 to 6 weeks. I'm going to have scads of time to read, right, sleep, talk on the phone, FB, blog....whatever.

I've never had a major surgery. In 2005, my deviated septum was fixed -- outpatient surgery. The NEXT DAY I was out riding my bicycle and did 30 miles. If I'm going to feel miserable, better on the bike that sitting around home.

Don't that will be the case this time. The old bod's going to have to adjust to less lung, less oxygenation...they say that over time the body adapts. I know about liver disease...lungs are not my thing. I am very uncertain what to expect. My heart and breathing tests came out better than expected for a woman my age. Hopefully, I'll adapt quickly.

What if this cancer diagnosis is actually a GIFT? The Lord is already working on me and in the lives of those around me. How is He going to use this experience to shape me, to change me...so that I can serve Him better? I've seen Him use really ugly circumstances for my good--- He got me through, and led me to use those experiences for growth and good. Why should this be any different?

I must follow my own advice to my patients: no, you will never be the same, your health will never be what is was 20 years ago. Your life will change. It will be different, but it can still be good. Finding a new "normal" can be difficult.

I pray that I have the grace to find and accept my new normal, and the strength and grace to make it as good as it can possibly be...to joyfully serve the Lord with my husband for the time we are given.

First try!

Thanks Tozer! Blogger is MUCH easier to use than the other!! Will post more soon.