New Numbers in Arcata

My doctor wrote a script so that I could get my labs done while we are in here Arcata, California visiting our pals Naomi and Peggy. We were hiking around the Arcata marsh watching the panopoly of birds when I realized that I had a message from Tanya at Duke. Peggy had taken me to the local hospital this morning to have my blood drawn. Tanya wanted me to have another blood count done this week, just to track the white cell count. Thankfully my numbers are continuing higher still-my white count is now up to 4.9 with 2200 neutrophils, my hemoglobin is up to 14.0, and my platelets are 217,000. Everything has improved from 2 weeks ago when my counts took a brief nosedive. Tanya thinks my bone marrow needed more time to recover after that last chemo treatment and the stress of recovery.

Regardless, it's nice to have all the numbers behaving themselves. And I'm free to run longer distances again. Watch out!

Merry Christmas

We've dropped off the kitties and Quigley at Carver St Animal Hopsital in anticipation of our trip out tomorrow. We enjoyed the dinner here last night with 11 other friends for Christmas Eve, Eve. We had a terrific time; so glad everyone could make time to come and share their friendship.

Today we've been doing odds and ends, last minute details before our 9 day trip to Kansas and California. We opened our gifts tonight and ate delicious leftovers from last night's feast. We also shared stories of childhood Christmas's past-the year of my sister's Gemeinehart flute, Holly's guitar and bow and arrow set, etc.

Everyone have a Merry Christmas and Happy New Year. Thank you for remembering us with all of your cards, well wishes, and gifts. Though it has been a trying year in many respects, I feel incredibly lucky to have so many caring people in my life.

Photos: Christmas Eve, Eve dinner; Christmas sweater, Spread the Joy

Better Numbers

I had my labs redrawn yesterday at the bone marrow clinic. They are improved from last thursday, and my doctor thinks the "blip" is just my bone marrow resetting itself. He did have me back off some on my running since exercise can drop your white blood cell count. Who knew? I've never had a doctor tell me to exercise less. That's a first.

Anyway, we do get to leave Dec 25th on our trip. (Leaving on a jet plane...) The numbers were white cells 2.5 with 30% neutrophils, hemoglobin 13.0, and platelets 158,000. Everything is normal except the white cell count. At least my neutrophils have come up out of the dangerous range and are above 500. Just to be safe, we've decided to cancel the side trip from California to Oregon. I don't want to tempt fate and get into any health issues out on the cross country ski trail.

When I was checking into the lab yesterday, Kristen, the young girl with the fancy shoes, was checking out. She did not seem happy, and they made her another appointment for Dec 29th. Apparently something is going on with her labs too, and she got bad news. I know how she feels. We almost had to cancel our whole trip to Kansas and California, the first after 7 months of chemo and blood transfusions and pneumonia medications. Christmas is no time to hear you have to be galavanting back and forth to the clinic for anything, even if you are wearing fancy red leather pointy toed shoes. She had a transplant for aplastic anemia when her bone marrow just stopped working. The last time I saw her, she was so happy, sitting in the blue recliner next to me, waiting to drive home several hours away after her transplant and other treatments ("I've been here 43 days," she said to me). This bone marrow stuff is hard. There's the hard of I have a life threatening illness; there's the hard of chemo and other treatments, and there's the hard of whatever else the bone marrow just decides to do like quit making blood cells or reject the transplant or make a new cancer. Well that's just the life we're going to have, one that lacks even the illusion of control. I'm still trying to get used to it.

Photo:My nephew Ethan with Lacy the Rein Dog

Old South, New South

I went back to the clinic this afternoon when we got back from our weekend trip. My white cell count was low on Thursday, and Tanya wanted me to come back today to have them rechecked. I'll hear about my numbers tomorrow and hope they are better. I want us to be able to go on our 10 day trip on Christmas (to Kansas and then on to California). Even more, I don't want to have anything wrong with my bone marrow. I am hoping the dip in the counts was just a "blip" as Tanya said. It's very nerve wracking having to wait for the news. I have had to get used to this kind of thing, but it never gets any easier. My mind goes through all the possible explanations-everything from a temporary dip in the counts to a relapse of my leukemia. That would be the worst outcome, of course. However, I had a bone marrow biopsy only 6 weeks ago, and it was normal. I suspect that if my counts stay down, they will want to do another bone marrow biopsy sooner rather than later. My next one was supposed to be January 12th. I'll be very disappointed if we don't get to go on our trip. We finally get to travel after 7 months, I book us flights to Kansas and California, and then this comes up. Hopefully all will be better tomorrow.

We drove to Georgia for the weekend to visit my sisters. One lives in Atlanta and the other one lives about 2 hours further south in Columbus. Becky had to work unexpectedly so we went by her house in Atlanta on our way home Sunday. I finally got to see Haley, Becky's new dog, and the house she is now renting. It's a cool bungalow with old pine flooring. Very nice and near her work and lots of other fun city stuff.

Saturday morning Beth, Henry, Holly and I drove over to Ft Benning so that we could show Holly the post. Henry is a Ranger in the Army, but he and Beth live off post in their own house about 20 mins from Fort Benning. We drove all over my old biking and running routes and saw our old housing. Some of it seems a bit run down after all of these years. But then that was more than 30 yrs ago. Wow, it really has been a long time!

Saturday night we attended Emma's dance recital along with about 150 other families. They held it in one of the local HS auditoriums-that's how many people attended. There were wee little girls (2-4 yr olds) up to HS students, who did an elaborate Hairspray number. It was all quite fun, and Emma seemed happy to be part of it. I took a photo of her with her roses after the performance. I'm not sure why dance is so big in the south, but it is very popular. It's a little like soccer with all the practices and recitals and even competitions sometimes. Ethan thought something was wrong with Emma's face when she was in costume. She pointed out that she had on makeup. Oh to suffer the comments of a bigger brother.

Sunday we attended Ethan's hockey game. Part of the New South experience after our Old South one the night before with the dance recital. He was tough and focused and even scored 1 goal and 1 assist. I'm biased, of course, but I thought he did well. He is quite an athlete and knows no fear. Hockey is great for him.



We are having friends to a potluck here tomorrow for Christmas Eve Eve. That will be lots of fun with 13 of us getting together. Holly is doing a turkey; I've made sweet potato casserole and pound cake. I bought a carrot cake from one of the nurses at the bone marrow clinic when they did the bake sale to benefit the Leukemia and Lymphoma society. Everyone else is bringing a dish to share. Should be fun and yummy.
Photos: Old South and New South Fun

Low Counts Again, Darn It!

We are on our way to Ga to visit with my sisters for a few days. Before we left Hillsborough, I had my blood counts drawn yesterday at the Bone Marrow Clinic. It's been about 6 weeks since my last chemo treatment and 2 weeks since my last lab tests. They were beautiful the last time -so beautiful that they pulled the catheter in my chest and told me that I could eat anything I want, get a flu shot, etc.

But I just got a call from Tanya, the Physician Assistant for Dr Long, telling me that my counts are low again. My white cell count is only 1500 with the absolute neutrophil count at 400. A count lower than 500 is dangerous since these are the cells that fight infection. My hemoglobin and platelets are low too at 11.3 and 128,000 respectively. So it's back to food precautions again-no salad, only cooked vegetables, no playing in the dirt, back to avoiding those with a fever or illness, and off to the hospital for IV antibiotics if I run a fever. Oh bother!

Tanya told me to go on GA trip, but I have to be back in the clinic Monday to have my blood drawn again. She is hoping that the counts will be up by then, and this is just some blip. Only 2 weeks ago my neutrophil count was 2200-more than 5 times what it is now. Darn.
Despite the lab numbers, I feel great. I just finished a 7 mile run around the lake here and included 2 steep hills on my route. Hmmmm, wonder what is going on now???

Good Advice

After writing that I am still having hot flashes & can't sleep if I don't take the meds my doctor gave me, I got a very helpful email from my old friend Karen N, who is also a doctor. We were interns together at UVA in 1996-1997 and shared many a night on call together during our training. You develop a special relationship when you've seen each other bone tired from trying to keep up with all the work on the floor. We shared a call room often and helped each other answer the nurses questions when they paged us frequently. In her email, Karen reminded me that I need my sleep to heal, to fight infection, to resume work with energy, and to maintain my immune system. She made me see that this thing I have of toughing it out w/o sleep medicine is just plain stupid. Thanks for that. It takes a hard headed, no nonsense doctor to get through to this hard-headed, no nonsense doc what is right. Truth is I am not that far out from my last treatment, only 6 weeks, and my body still has work to do. I keep forgetting that. I keep forgetting how much sleep is part of good health. I owe Karen a big thanks for reminding me of all that and giving me "permission" to keep taking those little pills that let me sleep, even if I don't want to need that. Get over it already.

Little Things I'm Getting Used to

Now that I don't have to go to the hospital or clinic on a daily basis, I am not sure how much writing I intend to do here in the blog. It's been a great way to keep my family and friends abreast of my daily events, but I don't have much to report these days now that my treatments are completed. Your comments and emails have been very helpful and uplifting, especially when I had to stay here to avoid infection or take chemo for 5 days in the hospital. Soon my life will be getting back to normal and I won't have much out of the ordinary to report.

Recently, I received my job paperwork from Piedmont making January 5th my official restart date. That was the last piece to complete before heading back to work at the Drew Community Health Center, where I worked previously. I was always a little nervous about the whole job situation. In June, I took Family Medical Leave which guaranteed my job for 12 weeks. That put me to September when I had to resign my position. I still had 2 more chemo treatments to go, the economy was tanking, and I worried about whether my non-profit, indigent care clinic would even have a place for me in 2009. I really didn't want to have to find a new job, interview and explain this baby bird hair. I know that primary care doctors are hard to come by, but they might be hesitant to hire someone who has had not one but two cancers, finishing treatment only a month earlier.
But I don't have to worry about any of that. Piedmont is taking me back, at my former center. The staff there is terrific, and I have a lovely supervisor and colleagues. I'll try to shake out all of the cobwebs for them before I get back there on January 5th.

There are some things I am still getting used to with my health and body. They include this baby bird hair, that seems to curl and frizz in its grayness. I'm still waiting on my MaMa hair. Maybe it will be brown & thick again eventually and maybe it won't. My eyesight is worse again-the readers are now 1.75, and I seem to need some distance correction too. Gotta get that checked in a few months once the chemo effects are completely out of my system-they say I should wait 6 months. I'm still having chemo-induced hot flashes at night. I tried to sleep w/o medication last night, but I was up at least 6-7 times between 10pm and 2:30am. Thankfully I have more of the sleeping pills they gave me, but who likes to take those? And like every other woman in menopause, I forget words just moments before I have to use them. I can't wait to see how bad it is when I'm speaking spanish all day because even the english is halting at times. I thought it was my own special chemo brain thing, but Gail says she has it too. Whew, I'll rest easier.

Photo: Me in the Asheville garden this past w-e

Rein Goat

Holly and I spent the w-e in Asheville, and she got this picture of the Rein Goat who was at one of the holiday farmer's markets. Both Asheville and Hillsborough do a terrific job of showcasing local farmers as well as handmade goods and local shops, especially this time of year. We have felt more than a little worry for our local shop owners, hoping all the businesses that we enjoy weather the current economic downturn. There are lots of places we like but don't frequent much. Hope they hang on too, places like breakfast spots and tailgate markets. Holly bought delicious pumpkin ginger cupcakes just to support the folks at the tailgate market on Saturday (duty calls). We watched the fireworks from our deck later, though the picture doesn't quite capture it.

Over the w-e, I received a package from work with my paperwork to restart my job. That feels like a long time coming. I've been trying to do all of the last minute things I can before I am back to work and busy with a real schedule again. Today I've been cleaning up my desk, my files, and all of the bins and baskets I have everywhere to dump stuff like loose papers, cards I need to write, etc. I live in two places, really, with some stuff at the Asheville house and some stuff here in Hillsborough. I have a large boat and tote bag from LL Bean that I use to haul stuff back and forth, always dropping things in the bag during the week as I realize I'll need them at the other house. You have to stay organized to do this back and forth thing. When I notice the bins and shelves are overloaded with papers or books stuffed everywhere, I know it's time to clean up, reorganize and file things away. Today was that day.

I wish I had taken before and after pictures of the Asheville garden this w-e. We did so much getting it trimmed back and cleaned up. I'm happy that we got ALL of it done, even the gutters and grapevines. We worked hard. Our reward was pizza, beer and a Netflix movie. We're easy to please.

Some Serious Gardening

Yesterday I went out playing Santa Claus, driving around to deliver a few gift bags and Christmas cards to friends in our old Woodlake neighborhood. I was determined to get that stuff delivered despite the bad storm we had yesterday. It was very rainy and gusty, but I prevailed. Just after I finished, Holly and I jumped in the car and headed up to Asheville. We had dinner at our old stomping ground, the Asheville Pizza and Brewing Co because they are so close to the house and have lots of choices in dinner and microbrew beer that we like. We noticed that the little shopping center on our corner has a new Patisserie (Creme patisserie and confectionary, who knew?). What a tough time to start a new business, especially a bakery. We, however, will give them a go, just to help them stay in business of course. We also stop at that shopping center for the homemade ice cream at the Hop, the delicious burritos at Urban Burrito, and breakfast at Rise and Shine. Someday I hope we try the Sushi place and the Pizza/deli too.

After my run this morning, I started right in tackling the garden chores here. Now that the leaves are off the trees and the perennials are all done for the year, they are leaves and stalks galore to clean up. I managed to get one side all trimmed neatly and even cut back the sage plants this year. I was slipping and sliding on the hill so I know that I will be sore tomorrow from trying to hold myself in place. Somehow running just isn't the way to "train" for gardening on a hill. Shame that. Tomorrow we'll tackle the other side and hit the gutters.

This w-e is my pal Billie's birthday. We'll meet up to celebrate, I hope. She is my oldest friend, a we've known each other since 1986 or '87 when we were both in Charlotteville for graduate school. That's a long time with lots of iterations of schools, jobs, and living situations. Glad she still keeps me around as her pal.

Pinking Up

Holly and I have noticed that I am starting to get some of my color back now that my red cell blood count is rising. For a while there, I was pretty pale. I really noticed it in my feet that seemed to blanch paler and paler all the time. Now I actually have some color in my face and even at my toes. Ah, the beauty of improving the hemoglobin number from 7.5 to 9.8. To you non-medical people out there, it probably doesn't seem like much of a difference. Well, let me assure you it is-more than the numbers would indicate. A little extra blood means you're not as tired, you can exercise more heavily without becoming short of breath, and you're not as cold. So I'm happy to be pinking up.

It is unseasonably warm here today-64 degrees and balmy. It's supposed to rain, and I'm sure that is where the warm front originated. It made for a pleasant run this morning over to Ayrmount. I did two laps on their trail as well as the loop there and back. I'm still a little draggy, but I realized that I still haven't even been back running a month yet. I've gone from 3 miles to 7 miles in less than a month. I shouldn't expect much more from my body at this point. But I always want to do what I could in the past. I am sure the joys of aging are much the same. Maybe this is my practice.

Today's photo: My Mom and me in front of the Christmas tree at her house this past we-e.

Gardening at Last

I wanted to do some gardening here yesterday after my run, but it was cold and gray. I ran over to Ayrmount, the historic house and plantation with trails, which is beautiful any time of the year. I had hoped to tackle the perennials here that need pruning and clean up. When I read that the rest of the week would be warmer and maybe even rainy, I decided to hold off. This morning it was warmer so I got to them after my row. I cut back all the stalks from things like mums, verbena, coneflowers, etc. I also planted the pansies into the window boxes at the front of the house. It felt good to get my hands in the dirt and clean up all the old dead stalks that we can see from the bedroom windows. Much neater looking now. It would have been nice to end my treatment in time to have planted some bulbs for next spring, but it wasn't on my time. Next year. We'll just have to look out at the tree blossoms when spring comes next year.

This w-e I'll start cleaning up the Asheville garden. It's much bigger and tougher to maneuver. For one thing, it's a hillside and the whole time you're pulling old stalks or lopping limbs, you're balancing yourself. You feel it the next day when your calves and legs are sore. My old pal Barbara Newman used to call it full contact gardening after all those w-e athletes who complain of being sore after playing a sport they aren't used to. It's much the same.

I just finished the book "Hot, Flat, and Crowded" by one of my favorite authors Thomas Friedman. He's an opinion columnist at the NY Times and writes frequently about globalization and the need to make the world greener before we pollute ourselves off the earth. He travels extensively to developing countries and has first hand knowledge of the ways they are ahead of us (education and investment in alternative energy). It's a good book and very thought provoking. I hope the Obama administration reads it and takes the ideas for green energy investment to heart. Gas is sure to go back up to $4 per gallon (and $5 and $6 and...). We should produce more of our own energy or at least get some of our it from countries that don't hate us.
Photo: more from the birthday party, left to right Aunt Dot, me and MaMa

What 94 looks like

Holly and I headed to Charleston this w-e to attend my MaMa's 94th birthday party. Her birthday was actually December 7th though the party was Saturday (a day that will live in infamy...and our hearts since that is her birthday). Anyway, her children threw her a small birthday party at the Elk's Club. Next year, if she makes it to 95, we'll have another big blowout party like we did for her 90th birthday. This was a light one, if you will, with a potluck supper and birthday cake. Even though it wasn't one of those big Fralix blowouts complete with singing, line dancing, and poem reciting, there were a lot of people in attendance (she had 9 children producing 33 grandchildren). Most of my Dad's siblings and their kids live in Charleston, so they didn't have far to travel. I know for sure there were 4 generations in attendance.

MaMa looked great in her outfit and fur pillbox hat. The woman has style, and at 94, is only slowed by that darn knee of hers with bad arthritis. I had hoped she would get it replaced years ago, but she didn't. It has continued to get worse and is pretty angulated at this point, being bone on bone for a decade or more by now. Her brother Leroy just had his replaced, and he looked great at, oh 84 yrs old. They say he still does the Cooper River Bridge Run/Walk, a 6 mile event held each year in April. I hope to be that mobile at his age and that mentally sharp at MaMa's age.

We took advantage of being in Charleston to eat at our favorite restaurants. It was the Fat Hen on Friday night, followed by the Hominy Grill for Saturday brunch, Bessinger's chicken bbq to cart home with us, and Joseph's for brunch on Sunday. The beignets did not disappoint.

I did get to visit a little with MaMa despite the throngs of other people there. Her sister Aunt Dot sat right beside her, not doing poorly herself at 91 yo. Sure was great to see everyone and be part of the celebration. It's not everyday that your grandmother turns 94, is ambulatory, mentally sharp, and independent. Besides being the most Christian and caring person in the world (she'd give the Dalai Lama a real run for his money).

Photos: from the birthday party

I'm Free to Play in the Dirt

I had a follow up appointment with Dr Long and Tanya Helms, his physician assistant (PA), Thursday afternoon. He checked my blood counts and saw me in the return clinic. The area with the row of Duke blue recliners is for everyone who is getting checked after their bone marrow transplant or chemo and for blood transfusions or the infusion of electrolytes like potassium and magnesium when they are low. It is also where I received my IV antibiotics and anti-fungal medicines everyday back in July when I had pneumonia and all those fevers for days on end. The return clinic is their name for the part of the building that runs like a regular doctor's office. You check in, they weigh you and take your blood pressure, and then you wait for the doctor and/or PA to see you in a regular exam room. It is a graduation of sorts from the other area which runs more like a day hospital (though the wait is at least as long since my doctor runs 1 to 1 and 1/2 hour behind schedule-ouch!).

Thursday was my first day of follow up in the return clinic. Tanya saw me first and gave me my lab results (Hemoglobin 9.8, platelets 116,000, white cell count 3.8 with a neutrophil count of 2200), and then Dr Long came in so that we could discuss the plan from here. I had several questions (1. Can I have a flu shot? yes, but we don't have them here. Get it from your own primary care doctor. 2. Can I return to work Jan 5th as we previously discussed? yes but don't overdo it. 3. When can I garden and handle mulch? now. 4. When can I get my catheter out? today, let's pull it.). All good news. They completed the paperwork to allow me back to work, and then pulled the catheter that I had in my chest for blood draws and transfusions. The line had been inserted back in June prior to my first hospitalization for chemo. It had a pigtail portion outside of my chest and was tunneled under my skin to my neck where it emptied into one of the big veins of my heart. It was sewed into my skin with a few stitches which they had to remove so that they could pull the line. I was a little anxious about them removing it because I thought it might hurt. The removal of my portacath, which was the line and reservoir used when I had my breast cancer treatment, required surgery. But these lines are more superficial and are half outside the body anyway. Tanya gave a big tug on the part outside my chest and bam, out it came despite it's 6 month home in my chest. It didn't hurt a bit-even less than when they use those soapy swab sticks to clean the area every week during my dressing change. What a joy and relief to have that out. Now I can shower without having to first cover the area with saran wrap, and I can soak in a bathtub. Nice. At the end of the visit, Dr Long shook my hand and congratulated me on the end of my treatment. He did that touching kind of handshake where you take your second hand and cup it over the patient's hand. It was very sweet.

After the clinic appointment, they sent me over to Duke South Radiology to have a chest X-ray. They still had me taking the ciprofloxin and posaconazole for the low cell counts and fungal pneumonia from JULY. They didn't want me to stop them until I had a chest film that was clear. So I moseyed over there and slid in before the clinic closed. Friday morning Tanya called to tell me that the film was clear, and I'm free to stop the anti-infectives. I have a lab check for my blood counts in another 2 weeks, and then I see them again January 12th for a follow up bone marrow biopsy. From here on, I'll be getting my blood counts checked every month with a bone marrow biopsy every 3 months (just long enugh to forget how painful THAT is).

Thursday night Holly and I went out to Tyler's taproom to celebrate the end of my treatment. It was great to commemorate the end of that ordeal. My brain is already re-writing the whole experience into something less arduous than it was. That's probably a good thing because, really, who wants to remember how hard it was, how scary that pneumonia was when they couldn't figure out what to treat it with, or how terrible that 7 continuous days of induction chemo felt when I couldn't eat for throwing up so much. I'm glad all of that is behind me, and I can just read about it here when I'm curious about the details that I've repressed.

I am very happy to be free to play in the dirt. Seven months without gardening is a long time for those perennials. I have a lot of cleaning up to do at both houses with many spent stalks to cull and cut back. I'll be busy in the garden here and next w-e in Asheville when we are there.

We just got back from Charleston for my MaMa's 94th birthday party. I'll write about that and the w-e tomorrow.
Photo: Hominy Grill in Chas. where I had an omelette with red rice and shrimp gravy. Holly had the Big Nasty biscuit filled with buttermilk fried chicken breast and topped with sausage gravy.

Sweet Smelling Cakes

I've been working hard to pull together all the treats I like to make for Christmas. Yesterday I made several loaves of Susan's pound cake recipe with marzipan added for good measure. Today it's harvest loaves with pumpkin and walnuts. I've already made one batch of granola to pass around. I made fudge previously, but we ate most of that at Thanksgiving. Since it doesn't keep very well, I'll make another batch closer to Christmas. It's nice to have that as a once a year treat; it's so, so decadent you wouldn't want to have that around all year. Right now the house smells really good as the pumpkin aroma mixes with the aroma of cinnamon and other spices. One of our friends doesn't eat butter so I wanted to find a cake that she would enjoy. Both my fruitcake and Susan's pound cake have quite a bit of butter in them. I hope she likes pumpkin loaf instead.

An update on the Vew-do toy that my neice and nephews put on their gift lists. My sister says it is some kind of balance board with wheels. Her husband the Army Ranger uses it to work on core strengthening. I can give you some really good exercise for that not requiring a board. Just do the Yoga tape I got Holly for her birthday. The strength and balance routine is all about core strengthening what with its boat pose and half boat pose. They are really toughies.

I finally managed to do a longer run here in Hillsborough. I made it all the way out to Ayrmount and around the wooded trail one time and back home without stopping to walk even once. That is about 6 miles. I guess I shouldn't be too impatient; I only started back running on November 15th. But still, it has been a long time coming-getting out to my usual long run spot and doing it w/o walking or stopping. I usually see a few woodpeckers when I am out there-none today though.

Photo: Billie, Holly and I tried out the new Tasting room at the Pisgah Microbrewery. They have the Solstice seasonal brew out now.

Nothing Like Music to Get You in the Christmas Spirit

Holly heard on the radio yesterday that the Duke Chorale would be doing a Christmas concert at the Duke Chapel last evening. In lieu of an admission price, they were asking the public to bring a non-perishable item for the needy. So we attended with about a thousand other people. I have been to that chapel many times over the years,and it never underwhelms. I used to attend church service there when I was an undergraduate and saw the Messiah performance a few times (though it's very long, it affords an excellent opportunity to write one's Christmas cards). The concert last night did not disappoint. They played the carillion bells starting at 6:30pm, and the concert began at 7pm. All of the lights were turned out to allow the chorale to parade into the dark chapel with small candles. Very stunning. The harmonies were terrific, especially as they filed into the dark vestry at the beginning of the service. They would sing a few songs and then included one for audience participation, done standing ( I am sure to relieve us from the hard church pews every so often). The music was terrific what with the powerful pipe organ and the acoustics in the chapel itself. I feel like I've had my Christmas eve service complete with carol singing. And we got to donate a little something for the Urban Ministries of Durham too. What a win-win.

To my great surprise, Holly came home at lunchtime yesterday, and we went for a hike in the Little River Regional Park by our house. Shelly, our housecleaner, told us about the park because they are holding a trail race there in January. I had hiked some of the trails with Billie the w-e she came to visit, but Holly had never been there. It was very nice-such a gem close to Hillsborough. On the way back, we stopped at Multiflora greenhouses (they had gobs and gobs of poinsettias) and bought a wreath for the house from a local Christmas tree farmer. Holly turned that into a welcoming addition to our front door with the help of a colorful red bow.

My supervisor and I are making arrangements for my return to work in January. Our clinic is starting to incorporate an electronic medical record, and my return will coincide with the start of that. Fortunately, I won't miss much of the training and I'll be back at work in time to join in with the other providers who will be using it during patient visits for the first time. I am nervous about returning to work-worried about finding my groove again after 7 months off. Per my doctor's recommendation, I am starting part-time to regain my stamina for seeing patients all day. You'd think I was starting a new job with the anxieties I've had about it, but I just want to do a good job after all of this time. I have to shake out the cobwebs and concentrate on how everything works again. I've been going over my spanish too since I haven't used that much in the last 6 months.
Also, I am desperately hoping that my anemia is better by then. Right now my hemoglobin is only 8. My usual level is 13. Though I have acclimated to the low levels especially with regards to my exercise, I still think I get more tired than I should. A few extra red blood cells would be really appreciated. Maybe I'll ask Santa for that.

Today's photo: Our Christmas tree at the Hillsborough house and one of the Multiflora greenhouses with their poinsettias (sorry for the poor light control-I still haven't taken that photo 101 class from Susan).

The Christmas Season

When we were in Asheville for the long w-e, we put up our Christmas tree and outdoor lights. Last night, we put up the tree here in the Hillsborough house. On my walk yesterday afternoon, I saw a couple at one of the big historic homes, putting up their wreaths, bows, and garland trimmings. The town put up the wreaths on our downtown street even before Thanksgiving. So everyone is getting in the holiday mood. I got an email from my sister with her children's Christmas want list. I have to admit that I've never even heard of 90% of the stuff. In fact, I couldn't even tell what category the things were. For example, what's a vew-do? Is it a toy, game, video game or what? It must be very popular because all 3 of the kids had it on their list (they are ages 6, 8 and 15). Anyway, it's nice to catapult from my favorite holiday into the Christmas season. Now that we have both of our trees up, it will feel like Christmas wherever we go. One year I didn't bother with a tree, and I felt like I missed the whole thing. It wasn't right.

I finished a great book last week that I had seen in the New York Times book review. It's called "Olive Kitteridge" by Elizabeth Strout. I got my copy from our library, showing yet again how on top of it our library staff is. They seem to order almost everything I read about in the NY Times. Anyway, the book is a nice collection of interconnected short stories set in Crosby Maine where Olive is the 7th grade science teacher. She is one of those curmudgeon types who doesn't mind telling anyone what she thinks. The author did a good job of showing how our lives change and our relationships mature as we get older. I really enjoyed the way she presented friendships through the aging characters. She has a great line at the end of the book about Olive getting together with another elderly man after her husband dies. She says they fit together like 2 pieces of swiss cheese, the holes being the parts nibbled away by life. That seems very true to me and accurately reflects the way older people love each other when they get together later in life. I love that they don't feel so old that they don't "bother" with that stuff.

I had a nice run this morning under the cold blue sky. My pal Donna W told me that I had inspired her to start doing push-ups. She's already up to 35 from only 4 at the beginning. Glad she likes them too. We got some great photos of her at Thanksgiving being Sister Mary Donna. You have to love someone who's not afraid to look silly and doesn't take herself too seriously.

Where's My Turkey Boost?

I went to the clinic this morning expecting my counts to be all glorious and high and everything. They aren't bad but the white cell count is the same as last Wed at 1.8, and the hemoglobin is 8.7 (it was 8.9 on Wed). My platelets are higher though at 110,000 (they were 71,000). I had expected all of the cell counts to be higher now that the chemo is out of my system and my bone marrow is returning to normal. My guess is that after multiple rounds of that high dose stuff, the bone marrow is tired (who knew?) I do have another appt later this week to see my doctor, and I'll ask him about it on Thursday. They will redraw the labs so I'll be able to see if the numbers have improved. Let's hope so; I'm ready to do some gardening.

We did have a great visit in Asheville. The hike and dinner were terrific. We also saw Billie and had dinner together. She is all busy with her Tree of Lights fundraising event that her hospice puts on each year. That happens this Friday so it will be data clean-up after that for her.

My pals Eliza and Shannon who worked with me at the health department were in town, and we able to meet up. We had brunch at Early Girl Cafe (Eliza) and coffee at Barnes&Nobles (Shannon). It was shoppers city over there at the Big Box stores and we were out of our minds to go there to meet up. You would never know from the crowd shopping, eating, and drinking lattes that we are in the middle of an economic meltdown. Maybe it's not as bad as they say.

There are numerous photos from Thankgiving that I'll be sharing over the next few days. These are from the hike up to Rattlesnake Lodge-Susan's compositions. Thanks for sharing them Susan.

We Gave Thanks

Well we had a small intimate group for the hike Thanksgiving day up to Rattlesnake lodge. This is the same hike we did last year, only the weather was very different. Last year we had a cold, raw rain, and Holly didn't even want to hike. This is a woman from Kansas, you know where they survive grueling heat in the summer and icy cold in the winter. Soft, I tell you, she's gone soft after all these years in NC. But yesterday we had really nice weather and she was happy to hike like the rest of us. It was in the fifties and clear, a beautiful day. Our hiking group consisted of Susan, Donna W, Ellen, Holly and me. Oh yeah and we took Riley, Donna Z's little dachshund too. We had all piled into the Prius and drove almost to the Parkway where the start of the trial is. There were so many other cars at the trailhead that we had no place to park initially, but by the time I got us turned around to park on the side of the road, someone had left. The hike was excellent; even Riley thought so. We did take some photos since one family was kind enough to take our picture with everyone's camera. I don't have my camera-computer cord with me so I'll have to upload the photos when I get back to Hillsborough.

Dinner was terrific. I took pictures of that too. I'll load those photos too next week. We ended up with quite a crew, the hikers above plus Patty, Ann, Maggi, Donna Z, Kathleen, and Karen H. Freddi couldn't attend since she went to Fla to be with her Dad who isn't doing well. We missed her. When Susan told me that we would be having 11 people for dinner instead of the 8 or so I had counted on, I decided that we would need a second pecan pie (this in addition to all of the regular food and the pecan pie, pumpkin pie, and fudge that we already had). So Thanksgiving morning I threw another one together quickly. I hate to be without enough and 11 people cannot possibly share one pecan pie. But we did actually, and I got to bring the 2nd pie home as well as the fudge and sweet potato casserole that was left over. (I'm currently baking fruitcake while I write. This is a good time to have lots of sweets around, especially to share with others). Before we ate, I told everyone how thankful I was to be there, literally and metaphorically, and Donna W said a nice prayer. Only the pilgrims could have been more thankful or grateful, and I'm sure they had less to eat than we did.

Holly and I ran together yesterday morning-hills, hills, and more hills. I had to walk most of those. But today I ran/walked the Beaver Lake route that is 6 miles long with 2 big hills, and I did some better. It's getting a bit easier each day.

Photo: View of downtown Asheville from our backyard. I may have included this one previously; I still like it.

Shoe Update

I'm in the clinic sitting in my Duke blue recliner on side A. Kristen, the twenty something yr old with aplastic anemia is to my left, wearing her best fancy shoes. Today is her last day in the clinic and for the occasion she is wearing a pair of grey pointy toed shoes with little bows on them. They have, oh about a 2 inch heel. She is also wearing her best Italian, chic jeans or some that approximate that anyway. My older guy Bob and his wife are seated to my right doing a crossword puzzle. He is waiting to see if his stem cell counts are up so that he can proceed with his transplant. She is waiting for her labs and then the provider is going to pull the Hickman catheter in her chest since she won't be needing blood or platelet transfusions after this. They have just given her a pain pill so that it won't be so uncomfortable when they finally do yank that thing out of her chest (I have this in my near future too). I'm waiting on my counts to learn if I need anything today. I don't expect to need any blood products since the bone marrow is producing now. I may need a magnesium or potassium pill since those get used up by all the bone marrow activity making new cells.

Later we will head west on I-40 to Asheville loaded down with pie and other sweets. I hope everyone reading this has a terrific plan for their Thanksgiving. And do give thanks because we all have a great deal to be grateful for. It's good to take at least one day to acknowledge that and share that spirit with others.

Holiday Exuberance Abounds

I was amazed at how upbeat everyone was at the clinic yesterday. The ladies at the front desk were extra cheerful. The nurses were extra cheerful and reminded me that we had a "Turkey breakfast" as they called it in the family support lounge. And the other patients were pretty cheerful too.

One was a guy with his wife who'd driven from Charlotte at 6 in the morning to make it to the clinic in time for his appt. He has a type of B cell lymphoma and needs a bone marrow transplant of his own cells. But they have had a hard time getting enough cells for the transplant procedure. I don't know all of the details, but he said that he'd had so much chemo that his bone marrow couldn't produce enough stem cells at one time for a transplant. They had already gotten some from his hip bone using the big biopsy needle, but they could only get 85% of what they needed. Now that his bone marrow is producing less, he is always anemic with a hemoglobin around 9.0 and has a decreased number of platelets. He bruises easily too because the platelet number is lower than it should be. But he said, after a year of chemo, his lymphoma is gone, and he is grateful every single day to wake up and be with his wife of 53 yrs. And I could tell he meant it. I hope he gets 100% of the bone marrow cells needed for the transplant so that he gets another 3 yrs or 13 yrs or 23 yrs with his wife.

I also sat close to the twenty something year old from a few weeks back; she was dressed, as usual, in her spiffy jeans and Italian pointy toed shoes. She was really cheerful too because Wed will be her last day in the clinic; she finishes up 43 days here including 6 days of chemo, her transplant, and many days coming to the clinic. Wednesday she gets to go back to Greenville NC where she is from. I did finally ask her about her diagnosis. She gave me the answer with a few "yes Mam's" thrown in. My immediate reaction every time I hear a twenty year old say that is "God I must seem old to them." But then I realize I do seem old to them, much the same way a middle aged woman with grey hair seemed old to me when I was 21 or 22. Anyway, she has aplastic anemia, a rare disorder in which the bone marrow stops producing. It leads to low cell counts and can be very dangerous since you need those cells for fighting infection, making platelets so that you don't bleed to death, and throwing out red blood cells to carry oxygen all around your body. In short, she needed someone else's bone marrow to replace this faulty version of hers that had stopped working. Fortunately her sister was a perfect match and now after 43 days here, she'll get to go home tomorrow. She was really, really happy the way that young people are when they get to go somewhere they really want (a kid at the circus comes to mind). I pointed out to her that now she would have any allergies of her sister. She said that she'd take a few sniffles in exchange for the gluten/wheat allergy she previously had. She said that she was looking forward to eating bread and pizza from now on. And it hadn't been all that bad, as she put it (I think she meant the chemo and the transplant and all the days in the clinic). Clearly, she's mastered the art of gratefulness. It will stand her in good stead.

Of course, I was extra cheerful yesterday too because my counts are coming up, and we get to go to Asheville for the long holiday w-e. And I got a great Thanksgiving card yesterday from my former colleague Suzanne who worked with me at the Health Dept in Asheville. She told me about reading the blog and thinking of me & Holly when she travels. It's so lovely when people take the time to write a note like she did, snail mail and all. Thanks Suzanne, it made my day even happier.

I've been on a cooking spree the last few days. Yesterday I made the sweet potato casserole with pecans for Thanksgiving and a new pasta sauce for dinner that my Dad turned me onto. Today I've made a big batch of granola to give to friends and a large pan of fudge with pecans. My Mom used to let me do her holiday cooking, but she always commented on the fact that I use so many nuts. Well yes, many of the things I like to cook call for nuts. This time of year it seems to be pecans. In fact, I keep stepping on them as I run through town in the mornings. We have a lot of pecan trees here in Hillsborough. This morning on my run, I saw a guy standing in his yard just eating them out of the shell from the tree in his yard. Maybe we need a pecan tree too. I'll have to get on that.

So tomorrow it's off to the clinic in the morning and then we head west and up for the long w-e holiday. What fun. Maybe we'll get some snow in Asheville for Thanksgiving.
Photo: See I do have some hair-short, grey, and curly.

I'm Keen on You

Today's visit to the clinic was another in and out, speedy gonzalez visit. I thought it might be short and sweet because my counts were just beginning to come up on Saturday when I went to the clinic. I thought they would be even higher today which means that I didn't need to have a blood transfusion or platelets. And sure enough, the platelets were 50,000 today up from 42,000 on Saturday; the hemoglobin was 9.2, the same as Saturday; and my white blood cell count was up to 1.0 from 0.4. Oh excellent news! I saw the Nurse Practitioner too, who said that I am free to go to Asheville for the Thanksgiving holiday. She wants to check my counts again on Wednesday just to make sure everything is alright, and then it's off until Monday. Yippee!

If I could split myself multiple ways, I'd celebrate by spending Thanksgiving not only with my crew in Asheville, but also the great group of friends here who are doing a turkey, and my sister's house in Columbus Georgia where my Mom, Brian, and both sisters will be, and with my Dad, Lynn, and Mama in Charleston. I'd love to give thanks and celebrate with everyone who has supported me so much during these last 6 months. I am truly grateful to you all. Think of me when you eat sweet potato casserole or dessert, my favorite parts of the meal.

They had a big thanksgiving breakfast for us in the clinic this morning. Despite being a healthcare clinic, there were lots of yummy but not so good for you breakfast items like donuts, croissants, coffee cake, pound cake, sausage biscuits, ham biscuits, egg casseroles with ham or sausage, bagels, bacon, well you get the idea. It was very sweet of the nurses and other staff to make us such a spread. They also put together a bake sale downstairs to benefit the Leukemia and Lymphoma society. I met Karen P down there to visit a bit, and we each got a carrot cake. It's for a good cause and besides who can't use an extra dessert with Thanksgiving coming up.

Today's photo: Gracie letting me know she loves my Keen boots

No Stopping

We woke up to a light dusting of snow here. Very pretty. I took a photo of our house with the snow, but much of it had already melted in the front yard. Nice to get snow before Thanksgiving; it gets me in the mood for the holidays.

We spent quite a while at the clinic yesterday since my counts were all low. My hemoglobin was 7.9 so they gave me 2 units of packed red blood cells. My platelets were back down to 15,000 so they gave me one bag of platelets as well. My white cell count was down to 0.3, but I just have to wait on the bone marrow to recover for that to come around. That tanking up really helped with my fatigue. I did get to visit with my friend Gail, who works at the DCRI in the same building as the clinic. It was good to catch up, and she made the visit go by much more quickly. That is always nice when I'm there for 5 hours like yesterday.

After the clinic appt, my Mom and I went to Costco to load up on ingredients for some holiday baking. Mostly I needed pecans, dried fruit, eggs, etc. They sure do have alot of stuff, and we only came home with a little bit of stuff each. Well I'm set now for all the pecan pie and sweet potato-pecan casserole that we have to make over the next week.

Mom made fried shrimp from Brian's local catch for dinner last night. It sure was yummy. That is always my birthday dinner at the beach so it felt like my birthday again last night.

Oh yeah, I titled today's entry No Stopping because I was able to run my entire 3 mile loop without having to walk. I even did the route that has the biggest hill (not an Asheville hill, mind you). Anyway, that's progress and most certainly helped along by all the blood I got yesterday.
Photo: Mom cleaning the shrimp

One Week Until Thanksgiving

I am hoping that we will be free of the clinic long enough to go to Asheville for Thanksgiving day. We have a long tradition of hiking with our group there and then eating a big potluck dinner together at someone's house. Susan and Donna are hosting this year. If we end up being seen at the clinic and have to remain in the Triangle, our friends here are having a similar deal and have graciously invited us. No offense to our truly terrific friends here, who we'd love to see, but we are hoping to get to the mtns. We haven't been to Asheville in 3 weeks due to my chemo and treatments here in the clinic, but it would be nice to do ONE THING this year that we usually do. Before I get too ahead of myself, I am quick to remember that it is not on my time, as Susan says. Regardless of where we end up eating dinner, I'm making a sweet potato-pecan casserole and pecan pie, and we will enjoy being with everyone.

I am sitting in my Duke blue recliner waiting to get my labs back. I feel tired, so I bet I need a transfusion of blood and platelets. If so, we'll be here a while waiting for all of that blood and platelets to be cross checked and arrive from the hospital.

Today's workout was a row and push-ups before I came to the clinic. I felt tired but did it anyway. I won't know what to do with myself once my counts come back for good and keep climbing to normal and beyond.

Chicken BBQ

I ate my last sandwich with chicken bbq that my Mom brought from Bessinger's in Charleston. It sure was good with all of that mustardy bbq sauce. I had been craving some chicken bbq which makes me think my body must need the protein to recover from all the chemo I've had. Well, I'm giving it what it wants I guess.

We just got back from the Farmer's Market in Raleigh. I had never been and Mom has wanted to go there everytime she has been up to stay with me. There was quite a range of fresh goods still available what with all the NC mtn apples (we both bought big bags of the Pink Lady variety), collards and other greens, turnips, and more kinds of sweet potatoes than I've ever seen. She bought a big box of those too. After reading the Barbara Kingsolver book "Animal, Vegetable, Miracle," about her family's experience with growing or buying only local food, I'm feeling all virtuous about getting NC grown stuff. Believe me, after you read that book, you want to go to every farmer's market and buy whatever they have just to reward the farmers for staying in business and bringing the food right to you instead of of some big agri-business deal with shipping contracts from here to Calif or worse yet, Chile or New Zealand. I'd have to quit my job to grow as much food as they did during their year of eating locally, but fortunately, we have not 1 but 2 Farmer's Markets here in Hillsborough not to mention all of the local stuff available at Weaver St Market.

I did a run this morning though it was quite cold. I need to get used to this cold weather and toughen up. It's been a little hard without hair, and the chemo does make one colder natured too. I'll just have to dress in more layers than usual and wear alot of wool. It really helps. I have a little beanie cap that someone knitted and donated to the Bone Marrow clinic. It was made with a lightweight cotton yarn, and I use it to cover my head indoors when I feel a draft. That helps alot too.

Photo: Quig doesn't care much for the cold either and has now take up residence in the bed, all wrapped in covers to stay warm.

Short and Sweet

My Mom is here to drive me while my counts are low and Holly is off at her conference in San Antonio. We were in and out of the clinic like lightning today. They drew my labs, got the counts back to us, and had us seen by the new Nurse Practitioner to make sure I am doing well, all within an hour. My numbers continue to drop as expected: Hemoglobin 8.4, platelets 30,000, white cell count 0.4. But I didn't not need a blood or platelet transfusion today. So I'm off the hook again until Thursday at 9am.

We did stop at Weaver St Market on the way home to have a yum-yum. Mom bought herself a coffee and a cinnamon roll, and I chose the pecan bar. They were really yummy, I have to say.

Photo: Billie cooking veggie pie in my kitchen this w-e

Walking Pieces

Over the w-e, I had the pleasure of visiting with my friend Billie who was with me Saturday and Sunday. Then just minutes after Billie left, my Mom pulled into town. Isn't it nice to be loved and cared for by friends and family? Both of them came bearing food too. Billie brought some yummy oatmeal raisin cookies her Mom had baked, and she cooked her special veggie pie with cabbage, carrot, onion, potato and cottage cheese. Fortunately, I was able to share the shrimp mole I had made with her, and she liked that. Mom unloaded a carfull with fresh shrimp caught by her husband Brian and Bessinger's bbq (pulled chicken that has been smoked and then cooked in SC bbq sauce which is mustard based. Don't knock it until you've tried it-none of this Lexington vs Eastern NC bbq style for me. It's SC mustard style that I appreciate most).

But I digress... Billie and I took a great hike along a new area for me-the Little River Regional Park which is North along Guess Rd, the Little River, and the Orange Co line. That place is a gem with really nice trails that criss cross and go along the banks of the river. There are also separate mtn biking trails, but we stuck to the hiking trails which are nicely marked with green numerical signs (the biking trails have blue markers). I'd like to take Holly out there and do some trail running. It seems perfect for that.

Sunday we went to the clinic and sure enough I needed platelets again with my count down to 12, 000. My red cell/hemoglobin level was 9.2 (no blood transfusion needed) with a white blood cell count of 0.4 (very low). So my bone marrow is at its low point now, and I have to be careful. Don't do anything wild and dangerous as my Mom says. Funny, with a white cell count of 0.4, wild and dangerous is eating food that could have bacteria or being around people who might make me sick. No worries, I'm careful.

Saturday was my first day of running since well, the last cycle of chemo. It wasn't pretty. I had to walk quite a bit after the first 1 1/2 miles. After I got tired and out of breath, the best I could do was to walk a bit and run a bit. It's pretty hard getting out of shape each cycle and having to start over again. I can see why all those co-workers and patients balk at exercising when I try to get them moving. If you're out of shape, exercise is hard. It doesn't feel exactly good. Of course, I have the advantage of getting back into shape easier and quicker than most people because I've been doing this for more than 30 yrs now. Today I did a "run" again, and it was much the same. Walking pieces and running pieces. Oh well, it will come along, and it will feel good again eventually. At least I can still do 50 push-ups if I do them in batches. Not everyone can say that.

Photo: Billie and me from this w-e at the clinic

Not Susan's Weekend for Canoeing the Pond

My friends Susan and Donna W had planned to head east from Asheville to do a trip canoeing on Merchants Mill Pond. These guys are hardy and have been known to canoe the Congaree Swamp over Thanksgiving when it is only 22 degrees. However, the rain over the state when they were supposed to leave, changed their minds. I got a voice mail message from Susan yesterday saying that she and Donna had conferred and decided that they didn't want to be wet and cold all w-e. Being a fair weather camper myself, I would have made the same decision. I was looking forward to Susan and Donna's trip because I haven't seen them in quite a while. Susan works at the hospital every 3rd w-e and had been to Folly Beach the last time we were in Asheville. So it's been a while since we've been able to connect in person. She sent me an email about how she had not even unpacked her stuff because she was disappointed about not being able to head out with her original plans. It got me thinking about her "found" w-e that now holds promise for whatever else she might want to do with the time. And it got me thinking about how the next few days were to be a little mini vacation for Holly and me in San Antonio while she has her veterinary pathology conference there. We had planned for me to go with her, taking advantage of her hotel suite right on the Riverwalk for 5 days. If you'd asked me a year ago what I'd be doing now, I'd have told you that we'd be at that conference together. Never in my wildest imagination would I have guessed that I'd be here getting treatment for leukemia while she heads to Texas. That's one of those zingers life throws you. I get to visit with my pal Billie as part of my "found" time, and I'll get to see my Mom again after a couple of months absence due to her overseas cruise. As Randy Pausch said in his last lecture (recorded on Youtube if you want to see it), you can't change the cards you are dealt, only the way you play them. I'd love to be in San Antonio with Holly for her conference, and I'd love for Susan to be canoeing Merchant Mills Pond. But we are both going to have some other fun instead.

I don't go back to the clinic until Sunday morning at 10am. Billie is coming tonight for the w-e and going to the clinic with me on Sunday morning. She is heavy into fundraising season at her Hospice job, getting ready for the Tree of Lights event. I'm glad I can provide some relief from all the overtime work she is doing right now.
Photo: In Susan's honor, another Pond photo from when we stopped there in October

Starting to Recoup Some Energy

Though I haven't rebounded in leaps and bounds yet, I am starting to emerge from the last chemo and its fatigue effect. I am not jumping up and down or zipping around yet, but I am starting to have a bit more energy. I am still sleeping 9 or 10 hours at night, but I haven't had a nap since Monday. And yesterday I was able to do a slightly longer walk in the afternoon in addition to my rowing workout. I didn't get the chance to workout before coming here to the clinic today because I overslept by 40 mins. Usually I have time to sip some tea while watching the birds and then to do a workout before heading to the clinic. I'll do my workout when I get home this morning. I don't expect my counts to fall so fast that I need anything today. It's usually the w-e before I need blood or platelets. But you just never know...

Still sitting in my Duke blue recliner waiting for my counts to come back. It was crazy in here Tuesday with people all over the place, and 6 folks getting hooked up to the stem cell machines. It is lots more sane in here today with many empty chairs. Calmer by far. I like that.

Staying Digital

One of the cool things about the blog is that it archives everything I've written since I started this in June. I had planned to make a keepsake book of my entries with the Blurb software that my friend Marty showed us. I thought it would make a nice record for Holly and me, sort of a "where we've been" look back at all we encountered together. I was noodling around on the Blurb website today, looking at the video on how to do this (they call it "slurping" which is the process of turning an online blog into a paper and print book; clever name, huh?). Anyway, due to changes in the Blogger software I use, Blurb cannot turn my archive into a book. They no longer support the Blogger software, although they apparently still support some other blog programs. I'm disappointed that I won't be able to turn this into a book easily. I do know several very tech savvy folks who may be able to help me pull it off (Angela, Marty and Alex come immediately to mind). I've already tried my usual trick which is to Google how to do it. But unfortunately, the word on the street is that Blogger made changes to their code that Blurb is not able or prepared to support. And that comment was posted only 2 days ago on Google. Darn. I'll be staying digital for now I guess.

Not a whole lot to report on the health front, which is good. I wanted to run this morning, but I felt a little weak and dizzy still from the last chemo. I did a row instead and took a longer walk than usual through town when Shelly, our housecleaner, came by. I like to stay out of her way while she cleans, and it's a good excuse to get out of the house for a while. She is a real sweetie and saves us from all that extra work.

I do head back to the clinic tomorrow though I don't expect to need anything nor to be there long. I don't usually need any blood or platelets until the w-e after my chemo ends. Billie is coming to visit this w-e so I hope we don't have to spend too long in the clinic waiting around. Then Sunday my Mom comes back to make sure I'm okay while Holly goes to San Antonio for a conference.
Photo: My hospital room from last week; ah it's good to be home!

Thank a Veteran

I had a short but sweet visit to the clinic this morning because my counts are fine, and I didn't need any blood or platelets. Of course, my numbers are on their way down. I thought I would need a blood transfusion because I am pretty tired from my chemo last week. I did a perfectly fine workout this morning, but I was really draggy yesterday. I took a nap in the afternoon while Gracie, our girlkitty, jumped up and down on me to try to get me to get up and feed her early. I usually wait until 4pm to feed the cats, though they try to get me to do it much earlier. It's our little game. I nap on the couch, and she jumps from the back of the couch onto me and then onto the floor. Subtle, real subtle.

Since it's Veteran's Day, I'm going to take a walk after lunch and see if the library is open. I have a few books I'd like to put on reserve if they aren't closed today. I'll celebrate being free too by walking around town and thinking about all of the people I know who've served in the Armed Forces. Thanks to them, I got to vote last week and help elect a historic candidate.

Oh, This Again

By now I am used to feeling pretty crappy after I finish my chemo round and leave the hospital. Today is no different although it feels good to know that I don't have to get better only to go back into the hospital to feel bad again. I never managed to get out for a walk or workout yesterday; I just felt too queasy and tired. I'm ashamed to admit that the only constructive things I accomplished yesterday were reading the NY Times, folding the laundry, and unloading the dishwasher. I had all good intentions of getting out for a short walk, at least, but my stomach just wasn't cooperating. I'm already ahead today as I've just finished my row and push-ups for the morning. I have a few errands to do at the Post Office, the library, and Weaver St Market, so I'll be going out soon to do those and amble through town. It looks nice out, and it has warmed up some from this morning.

It's going to be a low key day here. I'll probably finish the last of the books Marty and Deb loaned me. While I was in the hospital, I did finally read "The Last Lecture" by Randy Pausch, a professor at Carnegie Mellon who recently died of pancreatic cancer. After he was diagnosed with cancer, he gave a last lecture at the school about life lessons and turned it into a book for his 3 young children. The book is not depressing despite the fact that he talks about his cancer and how that has changed his life. It has plenty of good insight for us all, not just his kids. I checked it out of the library, of course, one of my favorite places.

Photo: a view of Beaver Lake in Asheville

The Day After the Last Chemo

Holly took pictures of the last bag of chemo, that infused from 8p-10p last night. Holly also took a few photos of me in my hospital room, while I was waiting for the last chemo to begin, waiting to walk out of the hospital into the cool night, and waiting to face the next phase of "after cancer." That will be close follow up first for my blood counts while they plummet from the drugs and then rebound as the bone marrow rejuvenates itself. My long term follow up will involve frequent blood tests to monitor my blood counts as well as bone marrow biopsies every 3 mos to check for rogue leukemia cells, if they try to come back. I know from the breast cancer treatment 2 years ago, that the mindset for this next part is different. You have to learn to live with uncertainty. You have to go on and live as if nothing has happened or else you just get bogged down in worry, dread, and fear. I found that I was pretty good at putting my diagnosis and treatment behind me; I don't expect this time to be any different. Going back to work & feeling healthy again help alot to normalize things and allow me to think about the future the same way everyone else does-you know with just enough denial to forget about the fact that we are all going to die someday. That's the thing about having a life threatening illness; you can't forget, you can't deny, you can't pretend-it's in your face pretty often. I didn't dwell on it much, and I certainly maintained and maintain lots of hope for the future. But really, none of us knows what is in store for us, how long we have to live. Having cancer is a big arrow pointing toward that even if you'd rather not go there.

I had some visitors to my room yesterday while I was waiting for my last chemo. Jennifer, the nurse who works with me at my clinic, and Brandy, her daughter came by. Brandy is in her early 20's and was diagnosed with Hodgkin's lymphoma about 7 months ago. She finished 6 mos of standard chemo treatment for her type of lymphoma but has failed the regimen. Her most recent PET scan showed a lung nodule which turned out to be more Hodgkin's cancer cells. She is now going to need a bone marrow transplant so that they can use even stronger chemo drugs to get her into remission. She seemed upbeat and rugged despite the news and being in the hospital herself for chemo. As hard as this is for me, I can only guess how difficult it must be for someone so young. Cancer never is fair, by the way. I know the docs in the bone marrow transplant unit will take great care of her, and she'll do well with her attitude. But you wouldn't wish that tough, tough course on anyone, especially after she's already done 6 months of chemo.

The other visitor was my old friend Susan from undergrad. She was at Duke to give a talk about the FDA's position on new biologic molecules that are being invented to treat cancer, MS, rheumatoid arthritis, etc. Most of these drugs are high tech designer antibodies, and currently there is no avenue for approval of generic versions of these medicines. Susan has a PhD in immunology, and her job at the FDA involves inspecting and approving these new types of drugs for human use. Big job, important job, tough job. But she is a tenacious, outspoken, and confident woman, always has been, and she is just the person I want going toe to toe with the drug companies to make a safe and effective medicine. She still has family here in Durham as her parents live in the Duke Forest neighborhood. I am sure it is a thrill for her parents to have her down to give a talk, not just because they are proud of her and her accomplishments, but also because she brought her 5 yo twin boys with her (she is also a twin by the way). I have to say it was like a time warp seeing her-she looks the same, barely any older, and seems much the same temperament wise. We hadn't seen each other since she lived here to do her MPH in toxicology at UNC, and I think that was the early 1990's.

My stomach today is a little icky as it always is after my chemo day. I am also a little dizzy if I stand up too fast, but they gave me blood before I left the hospital and that is helping me to feel a bit more energetic than I might otherwise. I plan to take a walk later while Holly goes off to bicycle with Amy and Sandy. I'll try to eat what I can, though I don't have much of an appetite with this queasiness. I don't head back to clinic until Tuesday morning to get my counts checked; I'm planning on an easy week.

The Last, Last Day

I am very excited that today is the last day of my 4th treatment and hence ends the whole shebang. I have had a rough time with my stomach this cycle with lots more queasiness and sometime nausea. I chalk it up to the accumulated effects of getting high dose chemo, twice a day, for so many cycles. If you count the original 7 days that I got the other chemo regimen, I have had 25 slugs of mean drug. Since I've been on the consolidation rounds 1-4 that are ending today, I've had 24 treatments barely separated by 3-4 weeks. That is precious little time for my stomach lining to heel much less everything else. But I wanted to push on as fast as they would let me go, so that my bone marrow could rebuild over the holidays and so that I can return to work in January.

Thanksgiving is my absolute favorite holiday, and I want to be as well as possible then. I love our tradition of joining friends for a hike in the day and having a big potluck dinner with Turkey & all the fixings in the early evening. It is my idea of the perfect holiday-a hike, hanging out with friends, good food, good pies, and fellowship. I do hope that we get to go to Asheville to celebrate it with our friends there. We haven't been able to see much of them since June when I was diagnosed with this leukemia. It would go a long way in making me feel like my life was normalizing again.

I never guessed that it would take this much time & effort to treat the leukemia, and I certainly didn't anticipate being out of work for 7 months. There are some days, looking back, when I was probably strong enough and clear headed enough to work at my clinic, but then a day or two later, I'd go back into the hospital for the next round of chemo. I have learned to be patient with all of that and just accept that I'd get back to a normal life in due time.

My hair has started to come in a bit thicker and a bit darker, but it is still more like fur than hair. It reminds me of baby bird hair. I still have lots of scalp visible, and the hair I do have is a curly mess. I'll give it some time after this last treatment to declare itself. If I don't like the odd mix of colors and lengths a month from now, I'll get it cut to even it out and start fresh without all of that chemo changing the hair follicles. I'd like to have my thick brown MaMa hair back. Then all will be recovering as expected.

I do have more work to do to get over this leukemia and especially to rebound from the low counts I will have for the next several weeks. But I do want to thank each and every person who has sent me good energy, or prayed for me, or drove me around, or stopped by with dinner, or brought me books to read in all of my downtime, or wrote fun & funny messages to me on the blog, or stayed with me when I needed company & help. I could not have done this without all of you. I owe you all a big debt of gratitude. I am so lucky to have many, many great friends, co-workers, and family members who stepped up to help me through this difficult period. I hope that I never have to do it again, but I know how terrific my support system is.

When I get out of the hospital this time, I'll set up some goals for myself before returning to work. I need to clear my mind and get rid of this chemo brain that is making my thinking fuzzy. I want to review my spanish which I haven't used much in the last 7 months. And I'd like to get my stamina back up to long runs that don't leave me on the couch recuperating all day. I have some medical knowledge I need to brush up on too before I start seeing patients again. And we want to take a trip to N. Calif to visit our pals Peggy and Naomi. Seven months is a long time not to be able to travel far from the hospital or clinic. We need to remedy that, to celebrate arriving at the end of this long journey.

Photo: more yellow leaves on my favorite ridge, Sunset Mtn (where I do my 10 miler race in May or June)

My hopes for the next 2 months are to get better, stronger, rebound my blood counts and immune system to the point of being able to work again. I look forward to getting rid of my chemo brain, the confusion or forgetfulness that comes with taking all of these high dose toxic medicines. And I can't wait to get rid of my chemo tummy, which is far worse this time than the last few cycles. I want to get my body and mind back up to speed so that I can handle a full day of work and working out.

Holly's Addendum:

I wanted to also extend my deepest gratitude to everyone who provided such wonderful support.

Thank you to all our family members for the many calls, the consolation, the visits, cards, meals, gifts, and sustaining love. (Quigley, Gracie and Henry also thank you for the generous helpings of pets, pet food and treats!). An added bonus for me has been to get to spend more time with Teresa's family; it's been a real treat for me. Thank you to all our friends and colleagues who've been there with well wishes, dinners, rides, visits, encouragement, and to listen. Thank you to all the wonderful health professionals at Duke, UNC, and Piedmont for their care and advice. The caregivers and staff at the Adult Bone Marrow Transplant Unit and 9th floor are truly the best, truly exceptional.

We have had the support of dear, wonderful people near--and farther than we could imagine! It's meant so much to have you in our lives and I've been touched by your support beyond words. I will walk out of Duke later tonight with Teresa into the balmy November evening knowing how blessed we've been, how very fortunate to have you all share this journey and to have had your help to get us through it. Love-Holly