The Week for Giving Thanks

Just as I like to make a big deal about birthdays, I really like to make a big to do about Thanksgiving. I think it is the perfect holiday. It's all about being thankful, enjoying people, and sharing good food and times with folks you care about. It's not about gifts or opening presents. This year we are celebrating in Asheville with a big potluck dinner Thursday evening. We expect to have 13 people including a few from the Triangle who took us up on our offer to visit for the holiday. In addition to the traditional turkey, we plan to have sweet potato casserole, dressing, mashed potatoes, salad, homemade bread, brussel sprouts, gravy, pumpkin pie, pecan pie, cranberry torte, fudge and maybe a few things I haven't thought of yet. Our buddy Jo has even decided to hang around and join in rather than make the drive to Columbia.

This past weekend, we attended the Holiday parade in downtown Asheville. They always hold the parade the Saturday before Thanksgiving-an odd time to have the Christmas parade but there you go. I caught the unicycle team and the llama golf caddy service on film. It's Asheville afterall. Why be normal???

I'll include some photos of the Thanksgiving Day food & fun once I have them. I'm salivating just thinking about all it now. I will miss seeing the rest of my family who are gathering in Charleston this year to eat at my Dad's. Bet they are having a real spread too.
Enjoy your Thanksgiving and don't forget to reflect on all the good things in your life.

Love at First Sight

Lately the skies around Asheville have been truly spectacular. The weather cools off overnight allowing a gentle fog to settle around town while the cooler, crisp air of the ridges remains higher up. The sunrise scatters through the fog about 6:50am with the most beautiful rosy glow near our house. Fortunately I woke up at the fist hint of light this weekend and ran out to our deck to get these photos. It is one of the best times of the day, as well as a really lovely time of year. One of my favorite things is to sit on the couch in our living room and watch the light change while I drink my coffee. With the leaves off the trees, the views of downtown, the skyline, and the ridges both east and west of town are gorgeous.

Ferdinand

We have been thinking lately that the market for new Priuses would get tight when the price of gasoline increases again. Holly's Prius, which we drive on all of our trips back and forth to Asheville as well as other long trips, now has 95,000 miles on it. Of course, it hasn't given us a lick of trouble. But we decided to go check out the new improved 2010 Prius, which is now rated at 51 mpg. So Saturday we bought a second one from the Toyota dealer in Asheville. We've named them Ferdinand (the new grey one) and Isabel (the old red one). Here's Holly beside her new toy.

Why It's Fun to Learn...and Teach

While Holly was toiling away Friday in the Asheville home office, I attended an educational conference held by my old residency program MAHEC. This one covered the latest greatest informational on the flu as well as other Infectious Disease topics. It was so current that one of the speakers said that her slides for the flu data were being updated daily as the number of cases continues to increase here in NC as well as the other parts of the country.

I wanted to attend this conference because MAHEC does such a good job with educational programs. Also, it being my old training program, I knew that I would see some folks from my time working in Asheville. I threw in my camera just in case I ran into the former director of my residency program. I have been thinking of him a lot recently. We have a few new providers in the Drew clinic, just hired straight from their residencies or Nurse Practitioner programs. As such, I have been doing more teaching than usual. It's been really fun to re-visit with them how to do a shoulder injection for rotator cuff syndrome or to help a young doc identify a mysterious rash. My residency director was an incredible teacher and mentor-funny, smart, patient, and extremely knowledgeable. So I had been thinking about all the things he taught me that I am now passing along to them. Luckily, he did attend the conference so I was able thank him directly and get this photo. In addition to being a great mentor and teacher, he is a terrific person. That's why I am so happy standing beside him.

This past w-e Holly and I ran in the Superhero 5K run held in downtown Asheville. Our pals turned up to volunteer as race marshalls and/or to photograph us and the crowd. This one was especially interesting since everyone was encouraged to dress up as their favorite Superhero. There were lots of costumes-Flash, Superman, Souperman, Batman, Robin, etc. We didn't have Superhero costumes so we went as ourselves with little bandannas wrapped around our necks. Ellen and Susan captured us trolling along enjoying the view of all the other Superheros in the race. This one was sponsored by our favorite pizza and beer place so we were treated to, yep you guessed it, pizza and beer after the run. It was a lot of fun.

I had planned to write November 8th to commemorate my last doses of chemo on that date last year. But we got busy having fun and I never took the time to sit and write. Wow what a difference a year makes! Out having fun instead of recovering from chemo. Anyway, I am 1 year out and it sure is terrific. Again, thanks to everyone who has been enormously supportive during all of this.

Yippee!

Thursday afternoon I was scheduled for my regular 3 mos recheck with Dr Long and Tanya in the bone marrow clinic. Usually I get my blood drawn, followed by a physical exam with Dr Long and/or Tanya, and finally a bone marrow biopsy. The aspirate and marrow they collect from my hip is sent off for special leukemia studies to look for any signs of recurrence. At my visit in late July, Dr Long decided that I could skip the bone marrow biopsy since my blood counts were so normal. But he told me that I'd have to get one at my next visit. So all week, I'd been dreading the visit. The biopsies are painful since the numbing medicine they use only dulls the pain at the skin and muscle overlying the biopsy site. The part where they drill into the hip bone and beyond into the marrow is quite painful. They drill a second hole to suck out liquid marrow for the aspirate sample and that produces an intense pain that radiates across the whole pelvis. That part isn't dumbed by the Lidocaine either.

My first bone marrow biopsy was actually at UNC where I was diagnosed with the leukemia in late May 2008 after my white blood cell counts started dropping followed by my red blood cells and then my platelets. That very first biopsy was angst ridden- what with the waiting for news of what this was. I knew that it was something bad because in addition to the low numbers of cells, the cells had begun to appear atypical, a sure sign of malignancy. But the actual biopsy procedure was not uncomfortable because they used what is called conscious sedation. They placed an IV in my arm, monitored my breathing and blood pressure, while they gave me IV morphine and ativan. It's kind of a "La La Land " where you know what is happening, but there is no pain or anxiety. I got spoiled a bit by that first biopsy because it was so easy. Well the actual procedure was easy anyway. My hip was sore and bruised and tender for the next several days, but Motrin handled that easily.

So the dread started seeping back in Monday, Tuesday, Wednesday this week as I thought about having another biopsy Thursday afternoon. My appointment was scheduled for 3pm at Duke, and Sallie, my boss, let me rearrange my hours to be there without missing work time. I worked the morning clinic and through lunch until 1:30pm. There is nothing like hearing 19 other peoples' health issues to take your mind off your own impending date with a big needle. And it worked to keep me busy and focused before I had to leave for my appointment. Then Dr Long decided that my blood counts looked great. Not only did I not need the biopsy, but he was cutting me loose to follow up whenever I wanted as long as my monthly blood test remains normal. All that worry and dread for nothing. I was so very relieved not to have the biopsy and even more relieved to get on to a more minimal follow up routine. Though it might not be needed, I did tell him that I want to be seen again in 6 mos. Call it post cancer wariness. I don't want to be too far removed from the clinic in case I need them.

We piled into the car as usual Thursday afternoon and headed for the mtns after my appointment. The mountain views are finally clear & sunny here. We are still seeing a little leaf foliage though it is definitely post peak. I love this time of year because the Asheville house starts to have a splendid view of downtown as well as the mountains both east and west of town. The sun comes up just over the east mountains, shining into our eyes with its low winter arc. We have to close the curtains for the first hour or two until it gets higher in the sky with less of a slanting path through the bedroom windows. If it's sunny, there is often a beautiful rosy glow to both the sunrise and the sunset. It's one of the reasons I like this house, though it is modest and boring in the way that raised ranches are. We keep feeding the birds, both in the front and the back of the house, and they keep coming for us. The woodpeckers are looking brilliant this time of year.

So Yippee for me!!!

People Who Share Their Bounty

Once in a while, I am truly astounded by the generosity of people. In addition to all of the intimate information that they share about themselves, I sometimes receive gifts from my patients. This week one of my patients brought me some canned goods from her garden. The jars included pear conserve, grape jam, homemade spaghetti sauce, heirloom tomatoes preserved with herbs and vinegar, and cooked wild pears. We had been talking about how nice it is to grow a bit of your own food, how it tastes better than anything you can buy at the store, when she announced that she was going to bring me some treats from her garden. I had forgotten about it for several days until she returned to the clinic toting a large basket full of goodies, some of which are shown here. Most of you know that I take care of many people without health insurance, and like this woman, they tend to work in low paying jobs. I was struck with gratitude at this woman's generosity and couldn't help but give her a big hug of thanks for all she'd done. How nice of her to take the trouble to do all of that and to drop by to give it all to me. And what a delicious surprise too; those heirloom tomatoes are swimming in the best garlic sauce I've ever tasted!

My other delight this morning was getting to meet Anna Elizabeth- all of 4 days old today. My work pal Sarah went into labor Thursday night and delivered her on Halloween eve about midday. Anna got to experience her first Halloween in Chapel Hill -from the inside of the UNC hospital, a much safer place than trolling down Franklin Street in costume. Mom and baby are doing great, and it was terrific to see them today before I had to leave for work. I had trouble tearing myself away from holding her to drive to the clinic. I can only imagine how it will feel for Sarah when she returns to work 3 mos from now.

Thanks to everyone who has shared a little piece of themselves with me this year. It doesn't go unnoticed or unappreciated.

How Does He Do It?

I looked outside my bedroom window Thursday morning as I was drinking coffee and thinking about the day ahead. I spied this guy in his usual corner of my garden showing off the last of his tomatoes. I don't know how he does it, but he manages to leapfrog me every year-if I put in 3 tomato plants, he has to plant 4. If mine stop producing in October, his go clear into November. Fortunately he is kind and shares them with me. Tee hee, as Susan says.

Well it is October no more, since I'm writing this on the evening of November 1st. We have set our clocks back, and I'm already missing the daylight. The weekend weather in Asheville was unseasonably warm and rainy. At one point, I was pretty sure I'd been transported to Seattle or some other Pacific Northwest clime. Today, finally, it was a respectable 45F with at least some patches of blue sky for a few minutes. That sunshine was a welcome sight. I used it to do a terrific 8 mile run around Beaver Lake (my first in over 7 weeks after my hamstring pull) and to clean up the garden a bit. I only had time to transplant a few perennials & trim some wild grapevines before heading back to Hillsborough. There is always next weekend to tackle the next two or three jobs that need to be done.

I'll be seeing my bone marrow doc and his PA later this week. I have an appointment with Dr Long and Tanya this Thursday afternoon, my usual 3 month follow up. Since they skipped the bone marrow biopsy when I saw them in July, I suspect that I won't be so lucky this time. I am hoping that all will be well with my blood counts, and maybe, just maybe, I can defer this biopsy too.

I have another big anniversary coming up this week. My last hospitalization for chemo last year was November 4-8th. I had 2 treatments each day on the 4th, 6th, and 8th. You can bet Holly and I will be celebrating how far we've come. As I always say, Yippee!!!